Effects of bovine necrotic vulvovaginitis on productivity in a dairy herd in Israel

Bovine necrotic vulvovaginitis (BNVV) is characterized by the development of a necrotic vulvovaginal lesion, almost exclusively in post-parturient first-lactation cows, associated with Porphyromonas levii. The scope of this survey was to evaluate the impact of BNVV on herd productivity as a means to rationally evaluate the resources that should be allocated in dealing with the syndrome. During an outbreak of BNVV in a dairy herd, following the introduction of a large number of cows from another farm, the impact of the animals' origin (local or transferred) and BNVV (positive or negative) upon involuntary culling rate, milk yield and days between pregnancies were assessed. The results indicated that the number of days between pregnancies was significantly higher in first-lactation cows with BNVV but was not influenced by the other independent variables. None of the other variables included in this survey had any effect on the involuntary culling rate and milk yield.

64. International child health (ICH) education in Canadian paediatric residency programss

A national survey was conducted of current ICH exposure and curriculum in pediatric residency programs. Our objectives were to quantify ICH teaching presently occurring, to identify how programs support trainees in undertaking ICH electives during their training, to determine attitudes towards ICH amongst paediatric program directors and chief residents across the country, and to identify barriers to ICH curriculum expansion within the post-graduate programs. A population census of all 44 chief residents and program directors from the 16 Canadian pediatric programs was undertaken. A self-administered survey was developed de novo for this study. Twenty-two qualitative and quantitative questions were developed under the following domains: demographics, program content, electives, attitudes and perceptions, barriers and future directions. Surveys were completed electronically. Descriptive statistics were used, and common themes were extracted from qualitative responses. The response rate was 65% (29 surveys), with 81% of the training programs represented. Seventy-three percent of the program directors, and 44% of the chief residents from across the country responded. Eighty-nine percent reported that their program did not have a formal curriculum in ICH. All respondents reported some ICH related educational sessions, however certain areas felt to be key were lacking. 80% agreed that electives should be encouraged as part of residency training, but 72% indicated lack of adequate funding for these electives. Overall, 86% agreed that ICH issues are important for paediatric trainees and 84% indicated that more emphasis should be placed on ICH in the paediatric resident curriculum. Eighty-six percent of respondents agreed that their program would be interested in new initiatives regarding ICH. The results of this survey demonstrate that although there are opportunities for ICH exposure in most paediatric training programs, formalized curriculum is lacking. The majority of programs indicated a willingness to support the integration of an ICH curriculum into their core educational components. The Association of Faculties of Medicine of Canada (AFMC). Towards a Medical Education Relevant to All : The Case for Global Health in Medical Education. A Report of the Global Health Resource Group. April 2006. Bateman C, et al. Bringing global issues to medical teaching. Lancet, 2001; 358:1539-42. Edwards R, et al. Understanding global health issues: are international health electives the answer? Medical Education, 2004; 38:688-690.

Sample-based assessment of the microbial etiology of bovine necrotic vulvovaginitis

A semiquantitative evaluation of potential bacterial pathogens was correlated to the severity of lesions during an outbreak of bovine necrotic vulvovaginitis (BNVV) on an Israeli dairy herd. Bacteriologic examination of 287 vaginal swabs from 104 post-calving heifers showed a highly significant correlation between Porphyromonas levii colony forming unit numbers and the clinical scores of the lesions, when assessed by an ordinal regression statistical model. No such correlation was found for the other bacteria included in the study. Nineteen samples taken for virological examinations resulted negative for bovine herpes viruses 1, 2, 4 and 5. Thus the results of this study substantiate the essential role of P. levii in the etiology of BNVV and indicate that BHV4 is not required as a predisposing factor to the syndrome.

The detection of an unidentified type of adenovirus in the stools of calves with weak calf syndrome by use of a commercial kit designed for the detection of human adenoviruses

An outbreak of polyarthritis in newborn calves in a large collective dairy herd was characterized by intra‐articular blood‐tinged synoviae, blood tainted faeces and massive subcorneal haemorrhages. Faecal samples from eight clinical newborn cases, 10 from unrelated dairy farms and 10 faecal samples from healthy calves were examined by the Rida^® Quick rotavirus/adenovirus‐combi test . A specific adenovirus antigen precipitin‐line was seen in the reaction in all the faecal samples from the diseased calves (n = 8), while all the others (n = 20) were negative. In addition, the same positive reaction was noted when one aqueous humor and two synovial samples were tested with this kit. Several other enteropathogens were found sporadically, but no conclusive significance could be attributed to their presence. Bovine viral diarrhoea and infectious bovine rhinothracheitis viruses as well as Chlamydia spp. and Mycoplasma spp. were not involved in this episode.

Application of diagnostic procedures to epidemiological situations with special reference to arboviral infections

The rationale behind the methodology employed to investigate a new disease that appears in an area hitherto unaffected is fundamentally different from that applied in an endemic disease situation. Special consideration must also be given to disease agents that appear and reappear at cyclical intervals. The authors present three separate approaches applicable in three different epidemiological situations. Each one may be used initially to determine the identity of the causal agent and the nature of the disease. These approaches, although described in a stepwise (flowchart) manner, are not meant to be applied rigidly, but rather should serve as a guideline for investigators. Special consideration is given to situations in which disease appears intermittently, using a sentinel model. Although this latter approach is expensive and time-consuming, it can yield excellent and reliable results when applied correctly.

Serological and clinical evidence of a teratogenic Simbu serogroup virus infection of cattle in Israel, 2001-2003

During the last 35 years, two major outbreaks of Akabane virus (AKAV) infection were recorded in cattle in Israel in 1969/1970 and 2002/2003. Congenital malformations of calves characterised by the appearance of an arthrogryposis and hydranencephaly syndrome first appeared in Israel in 1969. Based on epidemiological, clinical, pathological, histopathological and serological data, this syndrome was strongly correlated with seroreactivity to AKAV, a member of the Bunyaviridae, Simbu serogroup. In February 2002, the first cases of 'blind newborn calves' (BNC) were observed on farms located in the northern valleys of Israel. Microtitre serum neutralisation (SN) tests of serum from malformed calves and their dams were conducted using Akabane and Aino viruses (AINOV). The first SN test was performed at the reference laboratory of the Clinical Virology Section, Kyushu Research Station, National Institute of Animal Health, Kagoshima, Japan. The clear-cut findings of seroreactivity to AKAV by cattle located in the affected zone, in contrast to negative findings in cattle from unaffected farms (87% and 3.7%, respectively) was indicative of AKAV infection. In contrast, seroreactivity to Aino virus was relatively low in both affected and non-affected areas during the 2002 outbreak. In order to establish Israeli laboratory standards for Simbu serogroup diagnosis, 57 serum samples tested by the Japanese laboratory were retested by SN in Israel. An almost complete homology (96.5%) was found between the two SN panels of sera (kappa = 0.92). SN and ELISA kits enabled the surveillance of this arbovirus epidemic in the second consecutive year (2003). Moreover, AKAV was identified in trapped midges by hemi-nested PCR and real-time PCR. With these techniques, the geographical limits of the BNC epidemic that appeared in some areas of Israel was identified for the first time and was recorded in the Arava Rift Valley, 400 km south of the epicentre of the 2002 outbreak. The reintroduction of AKAV into this region, together with some evidence of AINOV activity and epidemics of bluetongue (BT) in the southern parts of Europe and the eastern Mediterranean, and renewed outbreaks of West Nile virus infection in Israel, Italy and southern France, are all evidence of the potential spread of arbovirus activity into southern Europe from the Mediterranean Basin.

Effect of bovine lactoferrin on a transmissible AIDS-like disease in mice

The effect of bovine lactoferrin (bLF) was examined on an AIDS-like disease (ALD) in mice. Induction of disease was achieved by inoculation with infected cell-free plasma from diseased mice to uninfected ones. The effect of treatment with bLF was investigated when administered simultaneously with the virus, 20 days prior to infection, or 20 days after infection. Animals underwent clinical surveillance and enumeration of white blood cells (WBC) and lymphocytes, as well as fluorescent staining of CD4 and CD8 bearing cells. Simultaneous administration of bLF and virus did not affect the pattern of ALD progress along the course of the experiment. Pretreatment with bLF prior to virus inoculation abolished on day 21 the detrimental effect of viral infection that lasted for two months. An opposite outcome was observed when bLF was administered 20 days after the virus. It seems that bLF had played a preventive role for a restricted period of time. However, an adverse response was elicited when bLF was administered 20 days after viral infection.

Reactions of peripheral blood mononuclear cells (PBMC) of camels with monoclonal antibodies against ruminant leukocytes

The particular immune system of the camel has been but little investigated. In this work circulating camel peripheral blood mononuclear cells (PBMC) were studied by flow cytometry. Monoclonal antibodies (mAbs) raised against ruminant leukocytes were used for the detection of cell surface antigens. Monoclonals to T-cell markers, CD4 (CACT138A) and CD8 (CACT80C), exhibited no reactivity towards camel PBMC in contrast to their reactivity to PBMC of other ruminant species and those of cattle in particular. A relatively high percentage (29.1+/-8.9%) of camel PBMC reacted with a non-immunoglobulin cell surface marker, B-B2, comparable to the reactivity of bovine PBMC. The B-B7 cell marker revealed 22.4+/-10.0% of reactive camel PBMC while the CD45 leukocyte common antigen was identified only on 19.4+/-3.1% of camel PBMC as compared to 74.7+/-4.9% for bovine PBMC. IgM (PIg45A) was detected on 9.1+/-1.4% of camel PBMC and on 46.6+/-19.5% of the bovine PBMC. Double fluorescent labeling with two B-cell markers and an anti-ruminant lambda light-chain mAb revealed 7-9% of cells bearing both B and lambda L-chain markers. Light chain reactivity was also assessed using an anti-goat F(ab')(2) antiserum. The values obtained, 14.3+/-5.8% for the camel and 47.8+/-2.7% for the cattle, are close to the values observed for surface IgM. These data suggest that camels, like other ruminants, possess L-chain bearing cells of the B-cell lineage. However, in the camel, Igs are different in that in addition to regular four chain Igs, about 65% of them possess two heavy chain Igs devoid of light chains. Because different sets of V(H) gene segments are used by four and two chain Igs, it is possible that there might be two lineages of B-cells each secreting a different form of antibodies.

An unusual outbreak of malignant catarrhal fever in a beef herd in Israel

Malignant catarrhal fever (MCF. corrizza contagiosa) is an invariably fatal communicable disease in cattle, whose causative agent is the ovine herpes virus-2, or the alcelaphine herpes virus-1. In one feed-lot family farm, 34 calves out of 100 became ill at the rate of one to four calves per week, and all of them subsequently died over a period of 4 months. Most of the initial cases were manifested clinically as the head and eye form, but most of the entire clinical spectrum of forms (the respiratory, intestinal and nervous forms) characteristic for MCF were observed as this epidemic progressed. Very few calves died without showing any specific signs of MCF. Pathological examinations revealed characteristic obliterative arteriovasculitis in the brain of calves with nervous signs, typical of MCF. Polymerase chain reaction (PCR) testing revealed 100% homology between the 238 bp hemi-nested PCR fragment and the ovine herpes virus-2 sequences. Based on the clinical signs, epidemiological data, pathological, and histopathological findings, and the PCR results, it was concluded that MCF occurred on the farm. The fact that sheep and goats were housed in close proximity on the same farm reinforced this diagnosis.

Influence of diet on the shedding of Candida glabrata by experimentally infected preweaned calves

The influence of three diets, comprising dam's milk (DM) from the same farm, commercial milk replacer with (CMRL) or without 3.2% lactose (CMR), on the duration and intensity of Candida glabrata shedding in the faeces of preweaned calves following experimental oral infection was examined. Shedding of other potential enteric pathogens was also monitored. The duration and intensity of C. glabrata shedding in DM-fed calves were reduced significantly compared with the calves fed the two diets based on milk replacers. Consequently, feeding calves with DM might disrupt the infective cycle, resulting in the yeast's elimination from a farm. In the CMR and CMRL groups, the periods of intensive shedding of C. glabrata and rotavirus overlapped but no diarrhoea was associated with the shedding of either microorganism. There was no evidence that lactose diminished colonization in vivo.

Endocardial and epicardial steroid lead pacing in the neonatal and paediatric age group

AIM

To compare the performance of steroid eluting epicardial and endocardial leads in infants and children requiring permanent pacing.

METHODS

Evaluation of pacing and sensing characteristics, impedances, and longevity of 159 steroid eluting leads implanted in 95 children. Group A consisted of 24 children weighing less than 15 kg with 15 endocardial leads (five atrial, 10 ventricular) and 19 epicardial leads (five atrial, 14 ventricular). Group B consisted of 71 children weighing more than 15 kg with 106 endocardial leads (56 atrial, 58 ventricular) and 19 epicardial leads (nine atrial, 10 ventricular).

RESULTS

Group A: Stimulation thresholds were lower for ventricular endocardial leads at implant (mean (SD) 0.84 (0.54) v 1.59 (0.64) V, p < 0.014) and at two year follow up (ventricular 0.64 (0.24) v 1.65 (0.69) V, p < 0.003). Impedance and sensing thresholds did not differ significantly at implant and follow up. Group B: Stimulation thresholds were lower for ventricular endocardial leads at implant (0.72 (0.48) v 1.48 (0.58) V, p < 0.001) and at follow up (0.88 (0.46) v 1.55 (0.96) V, p < 0.009). Impedance did not differ. Sensing thresholds were also better for ventricular endocardial leads at follow up (9.1 (5.2) v 14.2 (6.4) mV, p < 0.02). Complications requiring intervention occurred in both groups (n = 7 for endocardial v n = 18 for epicardial leads).

CONCLUSIONS

Endocardial and epicardial steroid eluting leads have comparable performance in the paediatric population.

CMF (cyclophosphamide, methotrexate, 5-fluorouracil) versus cnf (cyclophosphamide, mitoxantrone, 5-fluorouracil) as adjuvant chemotherapy for stage II lymph-node positive breast cancer: a phase III randomized multicenter study

A multicenter phase III randomized study compared the efficacies of two adjuvant polychemotherapeutic regimens in 145 patients with stage II node-positive breast cancer. The standard chemotherapy combination, CMF (cyclophosphamide, methotrexate, 5-fluorouracil), was administered to 77 women. The experimental protocol, CNF (cyclophosphamide, mitoxantrone, 5-FU), in which mitoxantrone (Novantrone) replaced methotrexate, was given to 68 patients. Follow-up of the 145 patients by six participating hospitals showed no statistically significant difference (p = 0.6) between the two treatment regimens during a median follow-up of 4.5 years in terms of overall survival. There was, however, a significant advantage (p = 0.04) in the disease-free survival for those receiving mitoxantrone (mean survival 4.4 years for CNF versus 2.7 years for CMF). Toxic side effects associated with CNF (particularly alopecia and myelotoxicity) were relatively more frequent but acceptable and did not lead to dose reduction. In light of its association with improved disease-free survival in this study, larger studies should be undertaken on the role of mitoxantrone as adjuvant treatment in stage II breast cancer.

Bcl-X(L)-caspase-9 interactions in the developing nervous system: evidence for multiple death pathways

Programmed cell death is critical for normal nervous system development and is regulated by Bcl-2 and Caspase family members. Targeted disruption of bcl-x(L), an antiapoptotic bcl-2 gene family member, causes massive death of immature neurons in the developing nervous system whereas disruption of caspase-9, a proapoptotic caspase gene family member, leads to decreased neuronal apoptosis and neurodevelopmental abnormalities. To determine whether Bcl-X(L) and Caspase-9 interact in an obligate pathway of neuronal apoptosis, bcl-x/caspase-9 double homozygous mutants were generated. The increased apoptosis of immature neurons observed in Bcl-X(L)-deficient embryos was completely prevented by concomitant Caspase-9 deficiency. In contrast, bcl-x(-/-)/caspase-9(-/-) embryonic mice exhibited an expanded ventricular zone and neuronal malformations identical to that observed in mice lacking only Caspase-9. These results indicate both epistatic and independent actions of Bcl-X(L) and Caspase-9 in neuronal programmed cell death. To examine Bcl-2 and Caspase family-dependent apoptotic pathways in telencephalic neurons, we compared the effects of cytosine arabinoside (AraC), a known neuronal apoptosis inducer, on wild-type, Bcl-X(L)-, Bax-, Caspase-9-, Caspase-3-, and p53-deficient telencephalic neurons in vitro. AraC caused extensive apoptosis of wild-type and Bcl-X(L)-deficient neurons. p53- and Bax-deficient neurons showed marked protection from AraC-induced death, whereas Caspase-9- and Caspase-3-deficient neurons showed minimal or no protection, respectively. These findings contrast with our previous investigation of AraC-induced apoptosis of telencephalic neural precursor cells in which death was completely blocked by p53 or Caspase-9 deficiency but not Bax deficiency. In total, these results indicate a transition from Caspase-9- to Bax- and Bcl-X(L)-mediated neuronal apoptosis.

Cellular immune response cytokine expression during the initial stage of bovine leukemia virus (BLV) infection determines the disease progression to persistent lymphocytosis

We have established experimental models of bovine leukemia virus (BLV) infection followed by progression to persistent lymphocytosis (PL) positive (BLV+PL+) or PL negative (BLV+PL-) stages of infection. Two out of six BLV infected animals developed PL+ 4 weeks after BLV infection. One other animal became PL+ late in the course of infection and three infected animals stayed PL-. These animals (PL-) exhibited transient lymphocytosis 3-4 weeks after infection and sustained PL- lymphocyte counts up to 24 weeks after infection. Competitive RT-PCR analysis of IFN-gamma mRNA expression revealed that peripheral blood mononuclear cells (PBMC) of animals with PL+ status developed by 4 weeks after infection had augmented IFN-gamma mRNA expression 3-4 weeks after BLV infection. However PBMC of animals that sustained a long-termed PL- lymphocyte count had elevated IFN-gamma mRNA expression 1-24 weeks after infection. Competitive RT-PCR analysis of IL-2 mRNA expression showed an increase in the levels of IL-2 mRNA in PL animals. Interleukin-10 (IL-10) mRNAs expression were elevated both in PL+ and PL- animals from 3 and 12 weeks after infection respectively. We suggest that early and extended expression of cellular response cytokines may delay the progression to PL+ in enzootic bovine leukemia.

Rheumatic manifestations of current pharmacopeia

Patient complaints arising as manifestations of medication side effects are commonly encountered in clinical practice. A rheumatologist must routinely consider side effects of drugs in the differential diagnosis of many symptoms. This review will remind the reader of certain well-described and some newly reported side effects commonly encountered in an internal medicine practice. Focal points incude arthralgias/arthritis, myopathy/myositis, ANA/drug-induced lupus, bone loss/osteoporosis, and tendon rupture.

Dinoflagellates from marine algal blooms produce neurotoxic compounds: effects on free calcium levels in neuronal cells and synaptosomes

In this report, evidence is presented that the marine unicellular eukaryotic dinoflagellates can cause neurotoxicity very likely by an increase in intracellular free calcium ions ([Ca(2+)](i)). Determinations of the effects of culture supernatants from different clones of the dinoflagellate Alexandrium sp. isolated from algal blooms on the viability of rat primary neuronal cells revealed that all clones tested were toxic for these cells. In addition, all Alexandrium clones tested, except for A. ostenfeldii BAH ME-141, were found to be toxic for rat pheochromocytoma PC12 cells. No toxicity was observed for culture supernatants from Gonyaulax and Coolia monotis. Calcium ions are important in the process of apoptotic cell death; our studies revealed that the dinoflagellate supernatants from A. lusitanicum K2, A. lusitanicum BAH ME-091, and A. tamarense 1M caused an increase in [Ca(2+)](i) levels in both PC12 cells and primary neuronal cells. These dinoflagellate supernatants, as well as the A. tamarense ccmp 115 supernatant, were found to cause also an increase in free calcium concentration in isolated synaptosomes. Our results suggest that the neurotoxic effects of certain dinoflagellate supernatants may be associated with disturbances in [Ca(2+)](i) levels.

Spontaneous closure and thrombosis of a ductal aneurysm in a neonate

The natural history of a ductal aneurysm detected prenatally is presented. Neurologic concerns in the neonate and absence of cardio-respiratory compromise permitted serial echo demonstration of constriction, thickening and subsequent closure with formation of thrombus in the aneurysm.

Experimental infection of calves with bovine leukemia virus (BLV): an applicable model of a retroviral infection

An experimental model of chronic infection with bovine leukemia virus (BLV) was established in young calves within a relatively short time. In the sera of all infected calves, precipitating antibodies were detected within 5 weeks after infection but upon disease progression pattern of cellular profiles varied. Three calves exhibited transient lymphocytosis 3-5 weeks after infection, two became persistent lymphocytotic (PL+) by that time and one stayed non-lymphocytotic (PL-) for 11 weeks and became PL+ after 4.5 months. Eventually all infected calves became PL+ by the end of the experiment, 6-12 months after infection. Increase of total counts of peripheral blood mononuclear cells (PBMC) related to polyclonal expansion of B-cells. The latter was assessed in all infected calves where the expansion of CD5-bearing cells (B+ CD5+) correlated with increase or decrease of total PBMC counts. Other cell populations such as CD4 and CD8 were also affected. Percentages decreased by 5 weeks after experimental infection to about half their original values though actual cell numbers stayed relatively stable. The experimental model we established compared well with field cases of naturally BLV-infected cattle and thus permitted the investigation of the disease at early stages of infection.

Short-termed expression of interleukin-12 during experimental BLV infection may direct disease progression to persistent lymphocytosis

In this study an attempt was made to elucidate cellular response cytokine expression upon experimental bovine leukemia virus (BLV) infection in cattle. Progression of infection was monitored by BLV gp51 mRNA expression or DNA amplification by RT-PCR or PCR, respectively, to detect provirus infected cells. Antibodies to BLV were detected by an agar gel immuno-diffusion (AGID) test in 5 weeks and persistent lymphocytosis (PL+) was established in all four BLV-infected animals in 24 weeks after infection. At the initial stage of infection a strong cellular immune response was induced mediated by IL-12p40 mRNA expression. Short-termed IL-12p40 expression was observed in peripheral blood mononuclear cells (PBMC) in two out of four infected animals following 1-3 weeks after infection, while viral mRNA expression was observed 2 weeks following infection. Expression of genes coding for the pro-inflammatory TNFalpha, IL-1beta and cellular response cytokines IFNgamma and IL-2 was detected beginning with the second and third week after infection in all BLV-infected animals. However, IFNgamma expression significantly decreased in 12 weeks after infection in three animals while IL-10 message initially detected 3 weeks after infection increased by 12 weeks and persisted. The observed immediate short-termed cell mediated immune response characterized by IL-12p40 and IFNgamma expression followed by an early shift to an IL-10 induced humoral response, may change the cytokine balance and direct disease progression to the PL+ stage.