The Preconception Period analysis of Risks and Exposures Influencing health and Development (PrePARED) consortium

BACKGROUND

Preconception health may have intergenerational influences. We have formed the PrePARED (Preconception Period Analysis of Risks and Exposures influencing health and Development) research consortium to address methodological, conceptual, and generalisability gaps in the literature.

OBJECTIVES

The consortium will investigate the effects of preconception exposures on four sets of outcomes: (1) fertility and miscarriage; (2) pregnancy-related conditions; (3) perinatal and child health; and (4) adult health outcomes.

POPULATION

A study is eligible if it has data measured for at least one preconception time point, has a minimum of selected core data, and is open to collaboration and data harmonisation.

DESIGN

The included studies are a mix of studies following women or couples intending to conceive, general-health cohorts that cover the reproductive years, and pregnancy/child cohort studies that have been linked with preconception data. The majority of the participating studies are prospective cohorts, but a few are clinical trials or record linkages.

METHODS

Data analysis will begin with harmonisation of data collected across cohorts. Initial areas of interest include nutrition and obesity; tobacco, marijuana, and other substance use; and cardiovascular risk factors.

PRELIMINARY RESULTS

Twenty-three cohorts with data on almost 200 000 women have combined to form this consortium, begun in 2018. Twelve studies are of women or couples actively planning pregnancy, and six are general-population cohorts that cover the reproductive years; the remainder have some other design. The primary focus for four was cardiovascular health, eight was fertility, one was environmental exposures, three was child health, and the remainder general women's health. Among other cohorts assessed for inclusion, the most common reason for ineligibility was lack of prospectively collected preconception data.

CONCLUSIONS

The consortium will serve as a resource for research in many subject areas related to preconception health, with implications for science, practice, and policy.

Early Infection Dynamics of Dichelobacter nodosus During an Ovine Experimental Footrot In Contact Infection

INTRODUCTION

Ovine footrot caused by Dichelobacter nodosus is a highly contagious and painful disease representing an economic as well as an animal welfare problem. In order to get more information on the infection dynamics, 26 lambs and 4 ewes enrolled in an in-contact infection trial were monitored over two weeks for the presence of D. nodosus-specific DNA. Two D. nodosus-positive ewes were housed together with 13 confirmed negative lambs. The control group consisted of another 13 lamb siblings and two confirmed D. nodosus-negative ewes. Every foot of all sheep was sampled seven times over the two weeks experiment period and subsequently analyzed for the presence of D. nodosus by quantitative real-time PCR. The control group was negative at the beginning and the end of the experiment and showed no clinical symptoms of footrot. The two positive ewes showed a high, but hundred fold differing level of virulent D. nodosus that remained constant over time with one of the ewes being also weakly positive for benign D. nodosus. All lambs of the infection group were positive for virulent D. nodosus at 14 days post infection (dpi). The first positive animals were observed on 3 dpi. The D. nodosus load remained at a low level and only increased in a few lambs at the end of the trial. Five of the contact lambs showed suspicious clincal signs (score 1-2) at 14 dpi corroborating the PCR results and indicating that the disease starts as early as two weeks after contact with positive sheep.

[Objective assessment of udder filling degree in diary cattle during shows]

INTRODUCTION

Overbagged udders are commonly seen at dairy cow shows in Switzerland and abroad due to prolonged milking intervals. In recent years various studies documented the negative effects of prolonged milking intervals and examined the objectivity of an ultrasound-based assessment scheme for determining udder filling. In addition, risk factors were calculated which lead to udder edema outside the puerperal phase. For example, the effects of a sudden increased 24-hour milking interval were altered behavior (reduced feeding time, increased rumination time) and a significantly increased cell count in experimental cows. Edema formation was observed sonographically in the subcutaneous udder tissue at the sites of predilection known from previous studies. No evidence of edema was observed in cows milked at 12 hour intervals. Based on these results, a new scoring system was defined using ultrasound images of show cows (grade 0 = no edema, grade 1 = slight, grade 2 = moderate, grade 3 = severe edema). Results documented that experienced clinicians were able to score ultrasound images reliable (interobserver reliability κ = 0.815, three different clinicians; intraobserver reliability κ = 0.90 and κ = 0.85, two clinicians) and little variability existed between the clinicians. A prolonged milking interval was identified as the main risk factor. Modified Swiss Dairy Show Regulations were implemented by January 1st, 2018 and ultrasonographic examinations proofed to be reliable in practice. Since January 1st, 2019 visual scoring of the udder filling is evaluated as part of a pre-show inspection. The sonographic evaluation can be used as a reliable diagnostic addition.

[Footbath as treatment of footrot in sheep. Current -situation on Swiss sheep farms]

INTRODUCTION

Footrot in sheep should be eradicated in Switzerland in the future. Based on scientific findings, this can be achieved with disinfectant footbaths. It is unknown how many sheep farmers are already using this means and how it is used. The current study evaluated the farm operation, the design of the footbath, the use of disinfectants and footbath with a written survey of a representative sample of all sheep farmers. The sample population was selected randomly, however stratified by language region and herdsize to control for differences between these groups. 45.3% (n=1134) of the distributed questionnaires were received for evaluation. On average 32.8% of the respondents used a footbath. Even on large farms (> 50 animals), which were more frequently affected by footrot, a footbath was available only in 52.6% of the farms in the French-speaking part and 67.7% in the German/Italian speaking part of Switzerland. The footbaths were correctly applied in most respects (e.g., pre-claw cleaning, liquid level and concentration of disinfectants, time in the footbath, post-bath drying phase) in the current study. Most commonly mobile plastic baths were in use. The disinfectants used were mainly formalin, copper and zinc sulfate. The incorrect disposal of the heavy-metal containing copper and zinc sulfate solutions was identified as an important problem: In 59% of the sheep farms the remaining footbath solutions were disposed in the slurry pit or manure storage. In summary the current study recommends (i) to motivate sheep farmers to use a footbath for the treatment and prevention of footrot, and (ii) to replace the currently used disinfectants with substances that are non-toxic to humans, animals and the environment.

Evaluation of arterial digital blood flow in dairy cows with claw horn disruption lesions using Doppler ultrasonography

Vascular changes play an important role in the pathogenesis of claw horn disruption lesions in cattle. The aim of the study was to measure arterial blood flow in the hind limbs of German Holstein cows with claw horn disruption lesions. A 10-MHz linear transducer was used to assess blood flow in the interdigital artery in the dorsal pastern region in the hind limbs of 11 non-lame and 33 lame German Holstein cows in which lameness was scored clinically. Qualitative and quantitative blood flow parameters were compared in affected limbs and unaffected contralateral hind limbs in lame cows and in the hind limbs of lame cows and non-lame cows. A pulsed-wave Doppler signal suitable for analysis was obtained in 78 of 88 limbs (33 affected and contralateral limbs, 22 limbs of control cows). Blood flow curve types 1 and 2 were predominant in the hind limbs of lame cows. Vessel diameter, end-diastolic velocity, and blood flow rate were significantly greater in lame cows than in non-lame cows and were numerically greater in moderately lame cows than in mildly lame cows. The differences in the qualitative and quantitative parameters between lame and non-lame cows were most likely caused by inflammation of the pododerm. The role of weight distribution between the paired hind limbs and the existence of claw horn disruption appeared to have an effect on the differences in local circulation in the affected and unaffected contralateral hind limbs in lame cows.

Evaluation of arterial digital blood flow in dairy cows with claw horn disruption lesions using Doppler ultrasonography

Vascular changes play an important role in the pathogenesis of claw horn disruption lesions in cattle. The aim of the study was to measure arterial blood flow in the hind limbs of German Holstein cows with claw horn disruption lesions. A 10-MHz linear transducer was used to assess blood flow in the interdigital artery in the dorsal pastern region in the hind limbs of 11 non-lame and 33 lame German Holstein cows in which lameness was scored clinically. Qualitative and quantitative blood flow parameters were compared in affected limbs and unaffected contralateral hind limbs in lame cows and in the hind limbs of lame cows and non-lame cows. A pulsed-wave Doppler signal suitable for analysis was obtained in 78 of 88 limbs (33 affected and contralateral limbs, 22 limbs of control cows). Blood flow curve types 1 and 2 were predominant in the hind limbs of lame cows. Vessel diameter, end-diastolic velocity, and blood flow rate were significantly greater in lame cows than in non-lame cows and were numerically greater in moderately lame cows than in mildly lame cows. The differences in the qualitative and quantitative parameters between lame and non-lame cows were most likely caused by inflammation of the pododerm. The role of weight distribution between the paired hind limbs and the existence of claw horn disruption appeared to have an effect on the differences in local circulation in the affected and unaffected contralateral hind limbs in lame cows.

Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population

OBJECTIVE

To determine whether men with unexplained infertility and low total T (TT) have abnormal spermatogenesis and lower fecundity.

DESIGN

Secondary analysis of the prospective, randomized, multicenter clinical trial, Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS).

SETTING

Infertility clinics.

PATIENT(S)

Nine hundred couples with unexplained infertility enrolled in AMIGOS. Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. For inclusion in this secondary analysis, a fasting TT was required.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Logistic regression, adjusted for age and body mass index, assessed the association between low TT (defined as <264 ng/dL), semen parameters, and pregnancy outcome.

RESULT(S)

Seven hundred eighty-one men (mean age, 34.2 ± 5.7 years) with a median (interquartile range) TT of 411 (318-520) ng/dL were included. Men with TT <264 ng/dL were less likely to have normal (≥4% strict Kruger) morphology (unadjusted odds ratio [OR], 0.56; 95% confidence interval [CI], 0.34, 0.92; adjusted OR, 0.59; 95% CI, 0.35, 0.99). There was no association between low TT and semen volume < 1.5 mL, sperm concentration < 15 × 10⁶/mL, or motility < 40%. Among couples whose male partner had low TT, 21 (18.8%) had a live birth, compared with 184 (27.5%) live births in couples with a male partner having TT > 264 ng/dL. The odds of live birth decreased by 40% in couples whose male partner had low TT (unadjusted OR, 0.60; 95% CI, 0.36, 1.00; adjusted OR, 0.65; 95% CI, 0.38, 1.12).

CONCLUSION(S)

In couples with unexplained infertility, low TT in the male partner was associated with abnormal sperm morphology and lower live birth rates.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01044862.

Detection of specific Treponema species and Dichelobacter nodosus from digital dermatitis (Mortellaro's disease) lesions in Swiss cattle

INTRODUCTION

The aim of this study was to determine the prevalence of the three Treponema species as well as D. nodosus in Digital dermatitis (DD) and slurry of Swiss cattle using PCR. A total of 86 specimens from 24 farms were enrolled in the study. Slurry samples from 21 DD-affected and one unaffected farm were collected to assess the potential of environmental transmission. Nested and real-time PCR were performed from the specimens to detect Treponema species and D. nodosus, respectively. The DD-stages were positive for at least one or more of the DD-associated Treponema species in 50 of 61 cases (82.0%) and in 9 of 25 cases (36.0%) in unaffected animals. Infected animals with small focal active lesions showed a significantly lower prevalence (14.8%) compared to the other DD stages (67.2%; P=0.011). Most prevalent was T. phagedenis (65.1%). D. nodosus was detected in 51.8% of clinical DD lesions and 24.1% in unaffected cases, but its presence was not significantly associated with the various DD-stages. All samples positive for D. nodosus contained the acid protease gene aprB2 but were negative for aprV2, the latter associated with virulence in sheep foot rot. Control farms were negative for all DD-associated Treponema species while positive for aprB2 and negative for aprV2. The presence of aprB2 suggests it is ubiquitous in the animal environment. With respect to the slurry samples, three out of 21 specimens (14.3%) were positive for one or more of the DD-associated Treponema species and eleven out of 21 specimens (52.4%) were positive for aprB2 and negative for aprV2 of D. nodosus. In conclusion, an association was found between the presence of clinical DD and specific Treponema species, while for D. nodosus no such link with DD lesions could be observed.

Anti-Müllerian hormone as a predictor of reproductive potential

PURPOSE OF REVIEW

Anti-Müllerian hormone (AMH), a marker of ovarian reserve, declines over a woman's reproductive lifespan. AMH is highly correlated with a woman's age and number of primordial ovarian follicles, and has been shown to predict time to menopause in women in their 40s. For these reasons, it was assumed that AMH levels could predict a woman's reproductive potential or serve as a 'fertility test'. Recently, studies have sought to determine the association between AMH and fertility.

RECENT FINDINGS

Although a small, prospective, time-to-pregnancy study of 98 women suggested that an AMH level less than 0.7 ng/ml was associated with lower day-specific probabilities of conception, the follow-up, larger cohort did not identify an association with AMH and fecundability. Women with AMH values less than 0.7 ng/ml had similar pregnancy rates after 12 cycles of attempting to conceive as women with normal AMH values after adjusting for age. Four additional studies, including a secondary analysis of the NICHD EAGER trial including over 1200 women confirmed these findings.

SUMMARY

Although AMH is a marker of ovarian reserve, existing literature does not support the use of AMH as a marker of reproductive potential in the general population.

Short communication: Risk factors for sonographically detectable udder edema in overbagged cows at dairy shows

At dairy cow shows, the appearance of the udder is very important. To show cows at their best, udders are often presented in an overbagged state by extending milking intervals before the show. This practice represents an animal welfare issue because it is associated with behavior changes (e.g., excessive abduction and decreased eating time) and may affect the health of the animal. The aim of the current study was to determine the association between various parameters (e.g., milk yield, days in milk, milking procedures, or administration of nonsteroidal anti-inflammatory drugs, steroids, or diuretics) and the sonographically detectable udder edema score. Data were collected from the show catalogs, by interviewing the exhibitors, by analyzing official veterinary treatment protocols and official milking data, via laboratory analysis of blood samples, and by sonographic examinations of the udders at the show. For sonographically detectable udder edema scoring, 3 scans were taken, 1 on each fore quarter and 1 incorporating both rear quarters at the level of the median suspensory ligament. For grading the scans, a scoring system of 4 grades (score 0 = no edema, 1 = slight edema, 2 = moderate edema, 3 = severe edema) was used. Data from 321 cows of different breeds were collected at 4 highly competitive Swiss dairy shows (shows A-D) between January and September 2017. To determine risk factors for sonographically detectable udder edema, data were analyzed with 2 different logistic regression models. In model 1, the odds ratios were 3.33 (milking intervals of ≥16 h vs. <14 h), 3.84 (show A vs. show C), and 7.39 (dairy breeds vs. dual-purpose breeds). Milking intervals of dairy breeds were significantly higher than those of dual-purpose breeds. In model 2, milking interval was the only significant risk factor with an odds ratio of 9.00 for milking intervals of ≥16 h. Only the milking intervals represented a relevant risk factor in both models; therefore, we concluded that the previously described sonographic udder edema scoring is a useful technique for detecting overbagged udders at dairy shows. Its routine implementation may improve cow welfare at dairy shows.

Tail walking in a bottlenose dolphin community: the rise and fall of an arbitrary cultural 'fad'

Social learning of adaptive behaviour is widespread in animal populations, but the spread of arbitrary behaviours is less common. In this paper, we describe the rise and fall of a behaviour called tail walking, where a dolphin forces the majority of its body vertically out of the water and maintains the position by vigourously pumping its tail, in a community of Indo-Pacific bottlenose dolphins (Tursiops aduncus). The behaviour was introduced into the wild following the rehabilitation of a wild female individual, Billie, who was temporarily co-housed with trained dolphins in a dolphinarium. This individual was sighted performing the behaviour seven years after her 1988 release, as was one other female dolphin named Wave. Initial production of the behaviour was rare, but following Billie's death two decades after her release, Wave began producing the behaviour at much higher rates, and several other dolphins in the community were subsequently sighted performing the behaviour. Social learning is the most likely mechanism for the introduction and spread of this unusual behaviour, which has no known adaptive function. These observations demonstrate the potential strength of the capacity for spontaneous imitation in bottlenose dolphins, and help explain the origin and spread of foraging specializations observed in multiple populations of this genus.

[The significance of cryptosporidiosis for the health of calves in Switzerland]

INTRODUCTION

Diarrhea in calves is one of the most important cattle diseases in Switzerland. The diagnosis and treatment of calf diarrhea represent a major challenge. Single-celled Cryptosporidium parasites are the most prevalent causative agents of calf diarrhea besides rotavirus in the first weeks of life, and are responsible for about 50% of diarrheal cases. Cryptosporidium parvum has been described as a cause of diarrhea in one to three weeks old calves since the 1970s. Oral ingestion of persistent environmental oocysts results in severe diarrhea lasting four to six days and shedding of large numbers of infectious oocysts. A tiny amount of 10 oocysts is already sufficient to cause disease. Detailed knowledge about the epidemiology and virulence of the different C. parvum strains is still lacking. In addition, current diagnostic tests cannot reliably distinguish between non-pathogenic (e.g. C. bovis) and pathogenic Cryptosporidium species. Until now, no effective therapeutic drug or vaccine against calf cryptosporidiosis has been found. Water-borne epidemics and the zoonotic potential of Cryptosporidium in immunodeficient patients are of great medical importance. The increasing number of cryptosporidiosis cases associated with high infant mortality in less industrialized and impoverished regions (including South-East Asia and sub-Saharan Africa) has intensified the research in recent years. The recent discoveries of new therapeutics against C. parvum may benefit calf medicine in the near future. This review article reports on these new developments, highlights calf cryptosporidiosis in Switzerland and draws attention to a new research project.

[AntibioticScout.ch: Decision support for the prudent use of antimicrobials: Application in cattle]

INTRODUCTION

The administration of antibiotics in livestock has been criticized for many years, in particular because of an inappropriate use and the appearance of antibiotic residues in the environment, which can promote the emergence and spread of resistant bacteria. However, antibiotics are essential for the successful and sustainable control of bacterial pathogens. With the aim of optimizing the use of antibiotics in food animals and minimizing the prevalence of resistant bacteria, AntibioticScout. ch provides a decision aid for the prudent use of antimicrobial drugs. This approach emphasizes the importance of supportive therapy and the hallmarks of preventive concepts. Procedures to improve animal health and animal welfare in accordance with the principles of good veterinary practice are primary and effective tools to reduce the use of antimicrobial drugs. The necessary reduction in the use of antibiotics must, therefore, be accompanied by appropriate management strategies in animal husbandry. In particular, hygiene, animal welfare and biosecurity measures are crucial to ensure an optimal health status in farm animals.

Modeling of live-birth rates and cost-effectiveness of oocyte cryopreservation for cancer patients prior to high- and low-risk gonadotoxic chemotherapy

STUDY QUESTION

What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis?

SUMMARY ANSWER

Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC).

WHAT IS KNOWN ALREADY

The decision to undergo FP prior to treatment is multifactorial and can be costly and delay treatment. Not all treatments carry the same gonadotoxicity and patients may choose to undergo FP-OC based on the probability of premature ovarian insufficiency, predicted outcomes and cost. A comprehensive model that incorporates age at diagnosis and toxicity of treatment to help guide patients in the decision to undergo FP-OC does not yet exist.

STUDY DESIGN, SIZE DURATION

This study used a Decision Analysis Model to estimate effectiveness and cost of FP for cancer patients.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Age-based estimates of LBR and cost per live birth were calculated for ages 25-40 years based on gonadotoxicity of treatment. A decision analysis model was constructed using Treeage Pro 2015 with case base probabilities derived from national registries, practice guidelines and medical records from a national network of infertility practices (IntegraMed).

MAIN RESULTS AND THE ROLE OF CHANCE

Compared to no FP-OC, FP-OC improved LBRs for women of all ages undergoing either low-risk chemotherapy (LRC) or HRC; however, it was most cost effective for women undergoing LRC at older ages or HRC at younger ages. Although FP-OC results in higher LBRs, it was always more costly. Using donor oocyte IVF can be a successful alternative to autologous FP-OC.

LIMITATIONS REASONS FOR CAUTION

Decision tree results reflect probabilities of certain events and are compiled from multiple reputable sources but are not directly derived from a recruited cohort of patients. Outcomes are based on United States estimates and should be interpreted in the broader context of individual patient diagnoses, treatment care plans and country of origin.

WIDER IMPLICATIONS OF THE FINDINGS

The development of this analytic model will help guide practitioners in their counseling of women from age 25 to 40 years, who are considering FP-OC at the time of cancer diagnosis. It provides a realistic pathway from diagnosis to LB and accounts for the majority of costs and outcome possibilities.

STUDY FUNDING/COMPETING INTEREST(s)

This study was partially funded by a grant from National Institute of Health (NIH)/National Institute of Child Health and Human Development (NICHD) (R01 HD67683) to A.Z.S. There are no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Wairakite, the calcium analogue of analcime, a new zeolite mineral

During the study of hydrothermal alteration of cores recovered Dfrom holes drilled at Wairakei during the exploration for geothermal steam, an unusual zeolite mineral was found. Optical, chemical, and X-ray data indicate that this zeolite is a new mineral, the calcium analogue of analcime. The name wairakite is given to the new mineral after the locality Wairakei in New Zealand. Wairakei is situated in the central part of the North Island, approximately 4 miles north-north-east from Lake Taupo, in an active volcanic region. The material was submitted to Dr. D. S. Coombs, Department of Geology, University of Otago, Dunedin, for an investigation of its X-ray crystallography.

Performance of a composite flow moulded carbon fibre reinforced osteosynthesis plate

Non-metallic implants have the advantage over metallic implants of reduction in artefact with CT and MR diagnostic imaging. In-vivo performance of a carbon fibre reinforced polyetheretherketone radiolucent plate (Snake Plate [SP]) with high stiffness, and fixed angle converging screws was compared with a seven-hole titanium Locking Compression Plate (LCP), using a sheep tibial osteotomy model (gap 0.6 mm). The sheep were divided into two groups, and the osteotomies were stabilized with a SP (n=6) or a LCP (n=6). The callus dimensions were measured radiographically at zero, two, four, six and eight weeks. The animals were euthanatized after eight weeks. Osteotomised and contralateral tibiae were tested in pairs torsion, to determine strength and stiffness. In the radii of six separate sheep, initial vascular disturbance after plate implantation was evaluated. All of the sheep of the SP and LCP groups showed maximal callus areas at six weeks. The differences between the groups, in callus dimension, were not significant at any time point. The median values for relative reduction (100 x [operated – contralateral] / contralateral) in strength of osteotomized tibiae was ™13.93% for the SP group and ™7.49% for the LCP group (p = 0.5228), and for stiffness it was ™24.44 % for the SP group and ™27.08% for the LCP group (p = 0.6481). Neither the SP nor LCP caused any notable disturbance in periosteal circulation. The SP appears to represent a valuable alternative to metallic implants for shaft fracture repair. The main advantages of the SP are radiolucency, high deformation resistance, internal fixator concept and converging screw configuration for optimal loading conditions in the bone-implant construct.

Collateral Ligament Prosthesis for Stabilization of Transverse Subchondral Fracture of Metatarsus III/IV in a Calf

The successful use of a collateral ligament prosthesis for stabilization of a transverse subchondral fracture of metatarsus III/IV in a newborn calf is reported. The proximal metaphysis of the right metatarsus III/IV was displaced medially with the medial collateral ligaments ruptured. On the medial side the periosteum was intact, whereas it was detached on the lateral side. The fracture was reduced and the collateral ligaments and the periosteum were reattached on the lateral side of the proximal metatarsus III/IV using titanium alloy staples. On the medial side a braided polypropylene yarn prosthesis, including the ruptured collateral ligaments was attached to the os tarsale II/III and the proximal metatarsus III/IV, using titanium alloy staples. The minimal internal stabilization was reinforced by a full limb fibreglass cast.

Seven months after the operation clinical and radiographic follow-up examination revealed complete healing of the fracture without signs of ankylosis of the tarsometatarsal joint. The calf did not show any signs of lameness and axial alignment of the fractured bone in the frontal and sagittal plane was excellent.

Subchondral fractures in calves have rarely been described. The case reported here deals with treatment of a subchondral fracture of metatarsus III/IV in a newborn calf. Open fracture reduction was followed by minimal internal stabilization, using a collateral ligament prosthesis, which was reinforced by external coaptation. Follow-up examination revealed complete healing of the fracture in good alignment.

Treatment of Delayed Union and Septic Osteomyelitis of Metacarpus III/IV in a Calf Using Gentamicin-impregnated Collagen Sponges and Minimal External Coaptation

A newborn calf was admitted for evaluation of a primarily closed comminuted metaphyseal fracture of metacarpus III/IV. Closed reduction and application of transfixation pins and a fibreglass cast were performed. Ten days after pin removal, radiographs revealed that the initially healed fracture had collapsed, and osteomyelitis was diagnosed. Bacteriological culture from the deep draining tract yielded Actinomyces pyogenes and Staphylococcus aureus. Standard treatment of delayed union or nonunion caused by septic osteomyelitis consists of surgical debridement, rigid fixation, and long-time administration of antibiotics. In this case, we used surgical debridement, administration of a new long-acting local antibiotic (gentamicin- impregnated collagen sponges), and minimal external stabilization. At day 27 after initiation of this treatment, the skin defect had healed, and the fracture was stable on manual palpation.

Standard treatment of delayed union or nonunion caused by septic osteomyelitis consists of surgical debridement, rigid fixation and prolonged administration of antibiotics. In the case described, we used surgical debridement, administration of a long-acting local antibiotic (gentamicin-impregnated collagen sponges), and minimal external stabilization. The promising outcome of this case and the good results in human surgery warrant further investigation in the use of gentamicin-impregnated collagen sponges in veterinary orthopaedics.

Shaft Fractures of the Metacarpus and Metatarsus in Cattle

This study describes the history, signalment, fracture configuration, methods of treatment and outcome of 58 cattle suffering from a shaft fracture of the metacarpus or metatarsus. For the purpose of describing the accuracy of fracture reduction and progress of healing, as defined by radiographs, a grading system was developed and is described.

Of the 58 animals, 17 (29.3%) were treated by means of a full-limb cast, seven (12.1%) by a walking-cast, 13 (22.4%) by a modified walking-cast, and 11 (19.0%) by open reduction and internal fixation (ORIF). Ten animals (17.2%) were slaughtered, because of economic reasons, immediately after the diagnosis had been confirmed. The (modified) walking-cast techniques were more frequently used for treatment of complex fractures; full-limb cast and ORIF were more frequently used for the other fracture types. Radiographic long-term followup data revealed that ORIF provided significantly better long-term results than external coaptation. An angular limb deformity in the saggital plane (plantar bowing) occurred in three of four metatarsal, but not in metacarpal fractures treated by external coaptation. A significant correlation existed between the quality of fracture reduction and the long-term result. However, a correlation was not found between the age and body weight of the animals and the outcome, and between the time from trauma to treatment and the outcome.

Fifty-eight shaft fractures of the metacarpus and metatarsus in cattle were evaluated retrospectively using a new radiographic scoring system. Open reduction and internal fixation provided significantly better long-term results than external coaptation. A significant correlation was found between the quality of the fracture reduction and the long-term result; a correlation was not found between age and body weight of the animal and the outcome, nor between the time that elapsed from trauma to treatment and the outcome.