Oesophageal sarcocystosis observed at slaughter provides a reliable and efficient proximate measure of Toxoplasma gondii seroprevalence in sheep

OBJECTIVE

Successful disease management requires effective surveillance. Slaughterhouse inspections provide opportunities to efficiently collect regular disease data from many animals across large areas. Toxoplasma is a cat-borne parasite that causes reproduction failure in sheep, although it is not visually detectable at slaughterhouses. Macroscopic sarcocystosis is a disease of sheep that is visually detectable at slaughter and is caused by parasites that share a similar biology with Toxoplasma. We investigated if sarcocystosis could act as a proximate measure for Toxoplasma exposure in sheep to facilitate its efficient surveillance at large scales.

DESIGN/METHODS

We compared the presence of macroscopic sarcocystosis to Toxoplasma serostatus at the animal and farm levels.

RESULTS

At the animal level, we found a weak association between Toxoplasma seropositivity and sarcocysts in the oesophagus (OR = 1.76 [95% CI: 1.17, 2.65; _McFadden's R² = 0.01]) but no association between Toxoplasma seropositivity and sarcocysts in skeletal muscles. At the farm level, the seroprevalence of Toxoplasma was strongly associated with oesophageal sarcocystosis prevalence (OR = 28.59 [95% CI: 13.07, 62.57; _McFadden's R² = 0.34]) but less strongly associated with sarcocystosis prevalence in skeletal muscles (OR = 7.91 [95% CI: 1.24, 50.39; _McFadden's R² = 0.02]).

CONCLUSIONS

For Toxoplasma surveillance in sheep at the farm level, routine slaughter inspection and recording of macroscopic oesophageal sarcocystosis could be are liable and efficient proximate measure. The monitoring of oesophageal sarcocystosis may be a useful passive Toxoplasma surveillance tool for guiding the timing and location of other Toxoplasma detection methods to facilitate the management of Toxoplasma impacts within the sheep industry.

Older Adults' Sedentary Behavior and Physical Activity After Hip Fracture: Results From an Outpatient Rehabilitation Randomized Controlled Trial

BACKGROUND AND PURPOSE

Prolonged sedentary time and limited physical activity can result in deleterious effects on health and mobility, especially for older adults with fall-related hip fracture. Therefore, the purpose of this study was to examine the effect of a multidisciplinary clinic on sedentary behavior and physical activity (prespecified secondary outcomes) and provide descriptions of activity patterns over 1 year for men and women.

METHODS

We conducted a parallel-group, single-blinded randomized controlled trial comparing a multidisciplinary clinic and usual care (intervention) with usual care (control). We recruited 53 community-dwelling older adults aged 65+ years who were 3 to 12 months postfracture and collected data at baseline, 6, and 12 months; study staff were blinded to group allocation. The clinic included a geriatric assessment by the geriatrician, physiotherapist, and occupational therapist. Referrals were made to other professionals, when indicated. We collected the accelerometer-measured sedentary behavior and physical activity at 3 time points. We used linear mixed-effects models to compare groups at 6 and 12 months and mixed models to compare outcomes between men and women.

RESULTS

Participants were sedentary for more than 10 hours of a 13-hour day, and there were no significant differences between the study groups at 6 months (2.4 [95% confidence interval: -22.4 to 27.2] minutes) or 12 months (-3.7 [95% confidence interval: -33.6 to 26.1] minutes). Compared with women, men spent 47.2 min/d more in sedentary time (P = .052) and 43.8 min/d less in light physical activity (P = .047).

DISCUSSION

Older adults after hip fracture spend prolonged periods of waking hours sedentary with very little activity.

No Evidence of Toxoplasma Gondii Exposure in South Australian Koalas (Phascolarctos cinereus)

Infection with the cat-borne parasite Toxoplasma gondii has been detected in numerous Australian marsupials and can lead to severe disease (toxoplasmosis) in some cases. The seroprevalence of Toxoplasma on Kangaroo Island, South Australia has been reported to be higher than the South Australian mainland in macropods, cats, and sheep, suggesting an increased risk of infection on this island. However, Toxoplasma seroprevalence in small- and medium-sized terrestrial mammals was almost zero on the island and did not differ from that on the mainland. We surveyed Toxoplasma seroprevalence in koala (Phascolarctos cinereus) populations on the island and on the mainland and assessed their risk of infection and their role in the life cycle of Toxoplasma. All screened koalas from the island (n = 94) and the mainland (n = 63) were seronegative. This represents the largest Toxoplasma seroprevalence survey in this species and provided sufficient evidence to confidently demonstrate freedom from parasite exposure in both island and mainland populations at the time of the survey. Because koalas are extensively arboreal and predominately consume tree foliage, they appear to be at negligible risk of Toxoplasma infection. Furthermore, as koalas are rarely consumed by cats, we suggest that they have a minor role in the parasite's life cycle.

DNA methylation signatures in peripheral blood mononuclear cells from a lifestyle intervention for women at midlife: a pilot randomized controlled trial

Physical activity confers many health benefits, but the underlying mechanisms require further exploration. In this pilot randomized controlled trial we tested the association between longitudinal measures of DNA methylation and changes in objective measures, including physical activity, weight loss, and C-reactive protein levels in community-dwelling women aged 55 to 70 years. We assessed DNA methylation from 20 healthy postmenopausal women, who did not have a mobility disability and allocated them to a group-based intervention, Everyday Activity Supports You, or a control group (monthly group-based health-related education sessions). The original randomized controlled trial was 6 months in duration and consisted of nine 2-h sessions that focused on reducing sedentary behaviour for the intervention group, or six 1-h sessions that focused on other topics for the control group. We collected peripheral blood mononuclear cells, both at baseline and 6 months later. Samples were processed using the Illumina 450k Methylation array to quantify DNA methylation at >485 000 CpG sites in the genome. There were no significant associations between DNA methylation and physical activity, but we did observe alterations at epigenetic modifications that correlated with change in percent body weight over a 6-month period at 12 genomic loci, 2 of which were located near the previously reported weight-associated genes RUNX3 and NAMPT. We also generated a potential epigenetic predictor of weight loss using baseline DNA methylation at 5 CpG sites. These exploratory findings suggest a potential biological link between body weight changes and epigenetic processes.

Incontinence and Nocturia in Older Adults After Hip Fracture: Analysis of a Secondary Outcome for a Parallel Group, Randomized Controlled Trial

Objective: To test the effect of a follow-up clinic on urinary incontinence (UI) and nocturia among older adults with hip fracture. Method: Fifty-three older adults (≥65 years) 3 to 12 months following hip fracture were enrolled and randomized to receive usual care plus the intervention (B4), or usual care (UC) only. The B4 group received management by health professionals, with need-based referrals. UI, nocturia, and quality of life were measured with questionnaires at baseline, 6 months, and 12 months. Results: There were 48 participants included in this analysis, and at baseline, 44% of study participants self-reported UI. At final assessment, six out of 24 B4 participants and 12 out of 24 UC participants reported UI. Four out of five study participants reported nocturia at baseline; this did not decrease during the study. Discussion: Following hip fracture, many older adults report UI and most report nocturia. Health professionals should be aware of the high occurrence of urinary symptoms among older adults post hip fracture.

Are we missing the sitting? Agreement between accelerometer non-wear time validation methods used with older adults' data

We used Bland Altman plots to compare agreement between a self-report diary and five different non-wear time algorithms [an algorithm that uses ≥60 min of consecutive zeroes (Troiano) and four variations of an algorithm that uses ≥90 min of consecutive zeroes to define a non-wear period] for estimating community-dwelling older adults’ (n = 106) sedentary behaviour and wear time (min/day) as measured by accelerometry. We found that the Troiano algorithm may overestimate sedentary behaviour and wear time by ≥30 min/day. Algorithms that use ≥90 min of continuous zeroes more closely approximate participants’ sedentary behaviour and wear time. Across the self-report diary vs. ≥90 min algorithm comparisons, mean differences ranged between −4.4 to 8.1 min/day for estimates of sedentary behaviour and between −10.8 to 1.0 min/day for estimates of wear time; all 95% confidence intervals for mean differences crossed zero. We also found that 95% limits of agreement were wide for all comparisons, highlighting the large variation in estimates of sedentary behaviour and wear time. Given the importance of reducing sedentary behaviour and encouraging physical activity for older adult health, we conclude that it is critical to establish accurate approaches for measurement.

Reflections on Hip Fracture Recovery From Older Adults Enrolled in a Clinical Trial

This study describes patients' perspectives on recovery during participation in a randomized controlled trial that tested a postoperative hip fracture management program (B4 Clinic), compared with usual care, on mobility. Semistructured qualitative interviews were conducted with 50 older adults with hip fracture (from both groups) twice over 12 months. A total of 32 women (64%) and 18 men (36%) participated in the study with a mean age at baseline of 82 (range = 65-98) years. A total of 40 participants reported recovery goals at some point during their recovery from hip fracture but only 18 participants realized their goals within 12 months. Recovering mobility, returning to prefracture activities, and obtaining stable health were the most commonly reported goals. Participants described good social support, access to physiotherapy, and positive perspective as most important to recovery. These factors were influenced by participants' knowledge, resources, and monthly contact with study staff (perceived as a form of social support). The most frequently reported barriers to participants' recovery were the onset of complications, pain, and limited access to physiotherapy. Potential implications of these findings include design and modification of new or preexisting fracture programs, prioritizing patient engagement and enhanced knowledge for future clinical research in hip fracture recovery.

Abomasal Emptying Defect of Sheep may be an Acquired Form of Dysautonomia

Abomasal emptying defect (AED) is a disease syndrome that primarily affects Suffolk sheep and is characterized by distension and impaction of the abomasum. No histologic lesion has been consistently associated with this condition. There is no known etiology. In this study, nine cases of AED were identified by necropsy, including three rams and six ewes between 2 and 6 years of age. Four of the cases occurred sporadically, and five ewes were submitted on the same day from a single flock. Histologic examination of celiacomesenteric ganglia from six of the affected sheep revealed scattered chromatolytic or necrotic neurons, without inflammation. Chromatolytic neurons were observed more frequently in AED-affected sheep than in seven healthy Suffolk sheep ( P < 0.08, weak statistical support). Neuronal necrosis was not observed in any of the healthy sheep. Lineage records of the flock that suffered an outbreak were incompatible with the possibility of a simple inheritance pattern for this disease; furthermore, the very occurrence of AED in outbreak form is inconsistent with transmission solely by inheritance. Only one of the six tested sheep showed concurrent immunohistochemical evidence of scrapie. The lesion pattern in celiacomesenteric ganglia is suggestive of a neurotoxicosis. Neuronal lesions of AED resemble dysautonomic diseases of humans and other animals.

Gait Speed and Variability for Usual Pace and Pedestrian Crossing Conditions in Older Adults Using the GAITRite Walkway

Objectives: To determine gait characteristics of community-dwelling older adults at different speeds and during a crosswalk simulation. Methods: Twenty-two older adults completed walking trials at self-selected slow, usual, and fast paces, and at a crosswalk simulation, using the GAITRite walkway. These objective measures were complemented by self-report health and mobility questionnaires. Results: Gait speeds at self-selected slow, usual, and fast paces were 98.7 (18.1) cm/s, 140.9 (20.4) cm/s, and 174.0 (20.6) cm/s, respectively, and at simulated crosswalk conditions was 144.2 (22.3) cm/s. For usual pace, right step length variability was 2.0 (1.4) cm and step time variability was 13.6 (7.2) ms, compared with 2.4 (1.3) cm and 17.3 (9.7) ms, respectively, for crosswalk conditions. Discussion: Our sample of healthy older adults walked at a speed exceeding standards for crossing urban streets; however, in response to a crosswalk signal, participants adopted a significantly faster and more variable gait.

A Comparison of Antiserum and Protein A as Secondary Reagents to Assess Toxoplasma gondii Antibody Titers in Cats and Spotted Hyenas

Toxoplasma gondii is a protozoal parasite with worldwide distribution that is able to infect a wide variety of mammals and birds. Our main goal was to screen for T. gondii antibody titers in a previously untested species, the spotted hyena ( Crocuta crocuta); however, this goal first required us to investigate serological procedures that could be suitable for hyenas. Cats are the closest domestic relations of hyenas, so T. gondii antibody titers were first compared in 26 feral cats with specific or nonspecific fluorophore-labeled secondary reagents, i.e., anti-cat IgG or protein A. Substitution of anti-cat IgG with protein A caused a statistically significant drop in titer measurements in cats (P = 0.01) with a reduction of the geometric mean titer equivalent to 1 doubling-dilution. The same procedures were then applied to captive spotted hyenas. Titers measured in 9 of 10 hyenas were identical whether anti-cat IgG or protein A was used as the secondary reagent: 5 had titers <1:16, 2 had titers of 1:16, and 2 had titers of 1:32. One hyena had maximum titers of 1:64 or 1:32 when anti-cat IgG or protein A was used, respectively. The use of protein A as the secondary reagent in serologic assays can be applied to a range of mammalian species and seems unlikely to affect test specificity; however, the use of protein A may reduce test sensitivity, as suggested in the present study using cats. Despite a control program, some exposure to T. gondii had occurred in the Zoo's spotted hyenas.

"Not just another walking program": Everyday Activity Supports You (EASY) model-a randomized pilot study for a parallel randomized controlled trial

BACKGROUND

Maintaining physical activity is an important goal with positive health benefits, yet many people spend most of their day sitting. Our Everyday Activity Supports You (EASY) model aims to encourage movement through daily activities and utilitarian walking. The primary objective of this phase was to test study feasibility (recruitment and retention rates) for the EASY model.

METHODS

This 6-month study took place in Vancouver, Canada, from May to December 2013, with data analyses in February 2014. Participants were healthy, inactive, community-dwelling women aged 55-70 years. We recruited through advertisements in local community newspapers and randomized participants using a remote web service. The model included the following: group-based education and social support, individualized physical activity prescription (called Activity 4-1-1), and use of a Fitbit activity monitor. The control group received health-related information only. The main outcome measures were descriptions of study feasibility (recruitment and retention rates). We also collected information on activity patterns (ActiGraph GT3X+ accelerometers) and health-related outcomes such as body composition (height and weight using standard techniques), blood pressure (automatic blood pressure monitor), and psychosocial variables (questionnaires).

RESULTS

We advertised in local community newspapers to recruit participants. Over 3 weeks, 82 participants telephoned; following screening, 68% (56/82) met the inclusion criteria and 45% (25/56) were randomized by remote web-based allocation. This included 13 participants in the intervention group and 12 participants in the control group (education). At 6 months, 12/13 (92%) intervention and 8/12 (67%) control participants completed the final assessment. Controlling for baseline values, the intervention group had an average of 2,080 [95% confidence intervals (CIs) 704, 4,918] more steps/day at 6 months compared with the control group. There was an average between group difference in weight loss of -4.3 [95% CI -6.22, -2.40] kg and reduction in diastolic blood pressure of -8.54 [95% CI -16.89, -0.198] mmHg, in favor of EASY.

CONCLUSIONS

The EASY pilot study was feasible to deliver; there was an increase in physical activity and reduction in weight and blood pressure for intervention participants at 6 months.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT01842061.

Neospora caninum in cattle: experimental infection with oocysts can result in exogenous transplacental infection, but not endogenous transplacental infection in the subsequent pregnancy

Whilst it is presumed that infection of pregnant cattle with Neospora caninum oocysts can provoke abortion and is the likely cause of epidemic abortion outbreaks, only two previous experiments have involved inoculation of pregnant cows with oocysts (and only one abortion was provoked in 22 pregnancies). Here, we describe the oral oocyst challenge of 18 cows synchronously bred and inoculated precisely at 70 (n=6), 120 (n=6) and 210 (n=6) days in pregnancy with a nominal dose of 40,000 oocysts. Only one abortion occurred (at the 120 days challenge) which could be definitively ascribed to N. caninum and no transplacental infection (TPI) was detected in any of the other 11 calves born in the 70 and 120 day challenge groups. In contrast, 4/5 live calves born to cattle challenged at 210 days were transplacentally infected. When cows which had transplacentally infected their calves in the first pregnancy were rebred, no TPI occurred. The results show that the timing of challenge influences clinical and parasitological outcomes and that cattle in late pregnancy are exquisitely sensitive to oocyst challenge leading to exogenous TPI and congenitally infected calves. However, cattle which were indisputably systemically infected in their first pregnancy did not induce endogenous TPI in their subsequent pregnancy. This confirms previous results with experimental tachyzoite challenge and suggests that post-natal infection does not lead to persisting infections which can recrudesce in pregnancy.

Neospora caninum infection in a free-ranging raccoon (Procyon lotor) with concurrent canine distemper virus infection

During a canine distemper virus (CDV) outbreak in raccoons (Procyon lotor) from Cook County, Illinois, a juvenile female suffering from seizures was killed and necropsied. Gross and histologic findings of necrotizing encephalitis and proliferative bronchopneumonia were attributed to CDV infection and considered the cause of clinical signs. A section of cerebellum stained immunohistochemically for Neospora caninum revealed an approximately 40 microm diameter, round to oval cyst with a 2- to 3-microm-thick wall and filled with 1-2 microm diameter, round to oval bradyzoites. Polymerase chain reaction (PCR) results were positive for N. caninum using DNA extracted from the brain. Specific PCR for the closely related organisms Toxoplasma gondii and Hammondia heydorni yielded negative results. This case report provides histologic, immunohistochemical, and molecular evidence that raccoons are a naturally occurring intermediate host of N. caninum.

Effects of host maturity and prior exposure history on the production of Neospora caninum oocysts by dogs

To investigate whether dogs shed Neospora caninum oocysts more than once, five dogs with a previous history of shedding oocysts were fed infected bovine tissues. Two of three dogs shed oocysts when they were re-exposed 18-20 months after the first challenge; two other dogs re-exposed earlier, only 8 months after the primary exposure, did not produce oocysts. These results suggest that dogs may become refractory to shedding N. caninum oocysts for a period approximately between 8 and 18 months after a primary infection; however, this possibility requires statistical validation by testing of more dogs. The development of a high antibody titer did not ensure that a dog would completely resist shedding oocysts after consuming an infected meal. Oocyst production was also compared between puppies and adult dogs with primary infections. Twelve puppies (three from the present study and nine from a previous study) shed significantly more oocysts (mean: 166,400) compared with five adult dogs following primary exposure (mean: 2900), indicating that a dog's age can influence N. caninum oocyst production (P=0.02).

Transmission of Neospora caninum between wild and domestic animals

To determine whether deer can transmit Neospora caninum, brains of naturally infected white-tailed deer (Odocoileus virginianus) were fed to 4 dogs; 2 of these dogs shed oocysts. Oocysts from 1 of the dogs were tested by polymerase chain reaction and found to be positive for N. caninum and negative for Hammondia heydorni. The internal transcribed spacer 1 sequence of the new strain (designated NC-deer1) was identical to N. caninum from domestic animals, indicating that N. caninum is transmitted between wild and domestic animals, often enough to prevent divergent evolution of isolated populations of the parasite. NC-deerl oocysts were administered to a calf that developed a high antibody titer, providing evidence that N. caninum from wildlife can infect cattle. In addition, N. caninum antibody seroprevalence was detected in 64/164 (39%) free-ranging gray wolves (Canis lupus), 12/113 (11%) coyotes (Canis latrans), 50/193 (26%) white-tailed deer, and 8/61 (13%) moose (Alces alces). These data are consistent with a sylvatic transmission cycle of N. caninum between cervids and canids. We speculate that hunting by humans favors the transmission of N. caninum from deer to canids, because deer carcasses are usually eviscerated in the field. Infection of canids in turn increases the risk of transmitting the parasite to domestic livestock.

Transplacental transmission and abortion in cows administered Neospora caninum oocysts

Neospora caninum infection is a common cause of bovine abortion. One method by which cattle can acquire infection is through ingestion of oocysts; however, this has not yet been proved to cause transplacental infection or abortion. In this study, 19 cows, pregnant between 70 and 176 days, were administered 1500 to 115,000 oocysts through an esophageal tube. Seventeen of the cows became seropositive, indicating acquisition of infection, whereas 8 negative control cows remained seronegative (P < 0.001). Offspring were examined using serology, histology, immunohistochemistry, parasite isolation, and polymerase chain reaction (PCR). Six offspring were infected and 1 of them was aborted. The aborted fetus had typical lesions and positive immunohistochemistry and PCR for N. caninum. All 6 cows with infected offspring had continuously rising antibody titers, whereas 10 of 11 infected cows with uninfected offspring had falling titers after an early apex. The risk of transplacental transmission was increased by later exposure times during gestation and by the dose of oocysts (P < 0.01 for the 2 combined variables). The lowest dose of oocysts, when administered after the 160th day of gestation, caused transplacental infection in 1 of 2 animals. This study demonstrates that infection with N. caninum oocysts can cause transplacental transmission and abortion in cattle.

IgG avidity pattern in cattle after ingestion of Neospora caninum oocysts

The avidity (functional affinity) of specific antibodies are being used to estimate duration of bovine Neospora caninum infection. Here, we report for the first time the avidity pattern in cattle orally inoculated with N. caninum oocysts. In all, 16 pregnant cows and 7 calves were administered N. caninum oocysts. In the cows, the avidity increased during the early course of infection. In all but one, the avidity was < or = 35 during the first 6 weeks after infection and no cow had an avidity value >50 until week 9. The calves were sampled either week 6 (n = 3) or week 9 (n = 9) after infection, and by then had avidities between 2 and 17. The results are in agreement with results from previous investigations of naturally infected cattle, and calves that were experimentally infected with tachyzoites. They further validate the ability of the N. caninum iscom avidity ELISA to accurately assess the duration of infection.

Neospora caninum in vitro: evidence that the destiny of a parasitophorous vacuole depends on the phenotype of the progenitor zoite

We previously reported that Neospora caninum can be induced to express BAGI, a bradyzoite antigen, within 3 days of culture under stress conditions. The main goals of the present experiment were to increase the expression of BAGI in vitro (in part by extending cultures for 9 days), to observe parasitophorous vacuoles at various points of stage differentiation, and to test the ability of organisms produced in vitro to function like mature bradyzoites. Expression of BAG1 and of a tachyzoite antigen (NcSAGI) was monitored using a double-label immunofluorescence assay. For the purpose of this study, organisms expressing NcSAG1 were designated as tachyzoites, those expressing BAG1 were designated as bradyzoites, and those expressing both antigens were designated as intermediate zoites. The greatest percentage of intermediate zoites and bradyzoites (14%) occurred in bovine monocytes maintained for 9 days. These bradyzoites did not appear to be functionally mature; they did not induce patent infections in dogs. in contrast to bradyzoites that were produced in chronically infected mice. In vitro, large parasitophorous vacuoles contained either a pure population of tachyzoites or a mixture of tachyzoites and intermediate zoites, which is indicative of asynchronous stage conversion of organisms within a vacuole. Bradyzoites were first observed within small vacuoles on day 6. and bradyzoites never shared vacuoles with tachyzoites. This finding suggests that vacuoles containing bradyzoites may develop only if the cell is invaded by a zoite that has already begun bradyzoite differentiation. An alternative possibility is that cysts may develop if the establishing tachyzoite undergoes bradyzoite differentiation before multiplying. Cysts do not appear to arise from transformation of tachyzoites within large parasitophorous vacuoles.

Improved production of Neospora caninum oocysts, cyclical oral transmission between dogs and cattle, and in vitro isolation from oocysts

Scarce information is available about Neospora caninum oocysts and sporozoites, in part because only small numbers of oocysts have typically been produced by experimentally infected dogs. We hypothesized that I reason for low experimental production of oocysts is that dogs have been fed tissues from experimentally infected mice instead of tissues from cattle (which are natural intermediate hosts of N. caninum). In this study, 9 dogs were fed tissues from N. caninum-infected calves, and oocyst production was compared with 6 dogs that were fed infected mouse carcasses. The number of oocysts produced by dogs that ingested infected calf tissues (mean = 160,700) was significantly greater (P = 0.03) than the number of oocysts shed by dogs that ingested infected mice (mean = 5,400). The second goal of our experiment was to demonstrate cyclical oral transmission of N. caninum between dogs and cattle. As few as 300 oocysts were used to successfully infect calves, and tissues from these calves induced patent infections in 2 of 3 dogs; oocysts from I of these dogs were administered to another calf, and tissues from this calf subsequently induced a third dog to shed oocysts. Oocysts were confirmed to be N. caninum using a species-specific polymerase chain reaction technique. In addition, sporulated oocysts were used to recover N. caninum in vitro after digestion in an acid-pepsin solution and inoculation of cell monolayers.

Neospora caninum: oocyst challenge of pregnant cows

Three pregnant cows were each orally challenged at 10 weeks of gestation with 600 sporulated oocysts of Neospora caninum. The number of oocysts was limited by those available. In concurrent bioassays, one oocyst per os infected each of two gerbils. Challenged cattle developed Neospora-specific antibody, cell proliferation and gamma-interferon responses. N. caninum specific PCR demonstrated persisting infection in the brains of cows 4 months after calving. Abortion was not induced and there was no evidence of transplacental infection in the healthy calves born at full-term. This experiment suggests that the dose threshold for induction of abortion exceeds 600 oocysts.

Redescription of Neospora caninum and its differentiation from related coccidia

Neospora caninum is a protozoan parasite of animals, which before 1984 was misidentified as Toxoplasma gondii. Infection by this parasite is a major cause of abortion in cattle and causes paralysis in dogs. Since the original description of N. caninum in 1988, considerable progress has been made in the understanding of its life cycle, biology, genetics and diagnosis. In this article, the authors redescribe the parasite, distinguish it from related coccidia, and provide accession numbers to its type specimens deposited in museums.

Isolation of Neospora caninum from the brain of a naturally infected dog, and production of encysted bradyzoites in gerbils

Neospora caninum was isolated from the brain of an adult dog in Brazil. Cerebral tissue from the dog was inoculated into Mongolian gerbils. Gerbils were euthanized 3-4 months later and bradyzoite-containing tissue cysts were observed in their brains. N. caninum (designated NC-Bahia) was isolated in cell culture after inoculation with tissue cysts from the gerbils. The identity of the parasite was confirmed by immunohistochemical examination and polymerase chain reaction (PCR). Gerbils may be a useful alternative to immunosuppressed mice for isolation of N. caninum and for production of encysted bradyzoites.

In harm's way: a postmodern narrative inquiry

Deliberate self-harm is a traumatic experience which has serious consequences at individual and social levels. Differing motivations for self-harm and different modes of injury require that therapeutic responses vary. Yet, according to the literature and personal observation, nursing responses tend to be uniform and inflexible. Not only are such responses inadequate for effectively dealing with individuals who self-harm, they also have unintended, hidden deleterious consequences for nurses and nursing. In this paper, a story about self-harm is analysed using a postmodern perspective that helps to illuminate multiple dimensions to this complex issue. The approach enriches understanding, opening up possibilities to improve the quality of the nurse--patient relationship.

Hepatic failure and hemochromatosis of Salers and Salers-cross cattle

Hemochromatosis is rare in domestic mammals. Five clinical cases and one preclinical case of hemochromatosis were diagnosed in Salers and Salers-cross cattle. Clinical disease developed between 9 and 22 months of age. Animals were healthy until weaning but then lost weight, developed rough hair coats, and lost incisor teeth. In two animals, hemochromatosis was identified by liver biopsy, biochemical evidence of hepatic injury, and/or elevated transferrin saturation values. At necropsy, carcasses were thin, with firm dark brown livers and lymph nodes, soft bones, and brown-colored small bowel. The principal histologic changes were hepatocellular siderosis and periportal, bridging, and perivenular fibrosis. Siderocalcinosis involved collagen, elastin, reticulin, and basement membrane components in liver, lymph nodes, spleen, duodenum, and kidney. Hepatic iron concentrations in clinically affected cattle were 1,500-10,500 microg/g wet weight (reference range for cattle = <300 microg/ g). Ultrastructurally, the heaviest intrahepatic deposition was in hepatocytes, which contained large intracytoplasmic siderosomes. Iron deposition in bone was associated with osteopenia. Genetic analysis indicated a common ancestral bull in the pedigrees of five of six affected cattle; no pedigree was available for the remaining animal. Four dams of five affected animals were phenotypically normal and had histologically normal livers. Test mating of four cows to the ancestral bull resulted in a female calf that developed clinicopathologic and histologic evidence of preclinical hemochromatosis by 40 days of age. It was not possible to establish the pattern of inheritance because of the small number of pedigrees from affected cattle.

Neospora caninum: its oocysts and its identity: an opinion

A recently published opinion that Hammondia heydorni, Neospora caninum, and N. hughesi are a single species is not supported by genetic comparisons. Furthermore, the suggestion that oocysts shed by dogs after experimental infection with N. caninum might have been of another organism is not consistent with the finding that these oocysts induced N. caninum infections in mice.

Evidence of point-source exposure to Neospora caninum and protective immunity in a herd of beef cows

OBJECTIVE

To determine whether cows with evidence of previous infection with Neospora caninum were less likely to abort or give birth prematurely during an outbreak of neosporosis, compared with herdmates with evidence of primary infection.

DESIGN

Cohort study.

ANIMALS

208 pregnant beef cows.

PROCEDURES

Aborted fetuses and calves born prematurely were examined during an outbreak of neosporosis in a herd of beef cows. Sera were collected from all cows during the outbreak and again 71 days later. Cows were classified into groups on the basis of normal and abnormal reproductive outcomes. Sera were examined, using an avidity ELISA procedure for N caninum, and results were compared between groups and among time points.

RESULTS

Antibody concentrations decreased significantly and IgG avidity values increased significantly over time. During the outbreak, cows with normal reproductive outcomes were significantly more likely to have high IgG avidity values than cows with abnormal reproductive outcomes.

CONCLUSIONS AND CLINICAL RELEVANCE

The herd had numerous abortions and premature births with evidence of recent point-source exposure to N caninum. Therefore, to reduce risk of transmission of N caninum to cattle, attempts should be made to prevent canine feces from contaminating feed, especially feedstuffs used to prepare mixed rations for cattle. Cows with evidence of previous exposure to N caninum were less likely to abort or give birth prematurely during the outbreak than cows with primary infections with N caninum; this finding suggests development of protective immunity in previously infected cows.

Dissociative identity disorder: a literature review

This paper presents a review of the literature into dissociative identity disorder. This disorder, previously known as multiple personality disorder, is increasingly diagnosed, in part because of more focused diagnostic tools, but also because people are accessing services to assist with the longterm problems of early child abuse and neglect. Dissociative identity disorder is examined in the literature according to a variety of discourses, each of which suggest different ways of conceptualizing problems and therapeutic approaches. These discourses reviewed include: psychiatry, psychology, corporeality, feminism, social constructivism, anthropology, and postmodernism. The paper concludes with an examination of the nursing literature and suggests opportunities for nursing research into this complex mental health problem.

The in vitro development of Neospora caninum bradyzoites

Neospora caninum is a recently identified apicomplexan protozoan parasite that is closely related to Toxoplasma gondii. Neospora caninum is of significant economic importance as it causes neurological disease and abortion in numerous animals. Antibodies to BAG1/hsp30 (also known as BAG5), a T. gondii bradyzoite-specific protein, have been demonstrated to react with N. caninum tissue cysts in vivo. Bradyzoite differentiation of N. caninum in vitro was investigated using culture conditions previously utilised for T. gondii in vitro bradyzoite development. Utilising the NC-Liverpool isolate of N. caninum, cyst-like structures developed within 3-4 days of culture of this parasite in human fibroblasts. In addition, an antigen reacting with mAb 74.1.8 (anti-BAG1) and rabbit anti-recombinant BAGI was demonstrable by immunofluorescence, fluorescence-activated cell sorter, and immunoblot analyses. Expression of this antigen was increased by stress conditions, similar to that which has been described for T. gondii bradyzoite induction. Cyst-wall formation in vitro, as assayed by lectin binding, did not occur as readily for N. caninum as it does for T. gondii.

Comparative ultrastructure of tachyzoites, bradyzoites, and tissue cysts of Neospora caninum and Toxoplasma gondii

The ultrastructure of tachyzoites, bradyzoites and tissue cysts of the NC-1, NC-5 and NC-Liverpool strains of Neospora caninum are reviewed and compared with those of the VEG and ME-49 strains of Toxoplasma gondii. While each stage of N. caninum and T. gondii shared many ultrastructural characteristics, each parasite stage also had certain features or organelles that could be used to distinguish the two parasites. Some of the most prominent ultrastructural differences occurred in the number, appearance and location of rhoptries, looped-back rhoptries, micronemes, dense granules, small dense granules and micropores. The tissue cysts of both parasites were also basically similar, being surrounded by a cyst wall and not compartmentalised by septa. The cyst wall of N. caninum was irregular and substantially thicker, 0.5-4 microm, than those of T. gondii which were smooth and 0.5 microm thick.

Serological evidence of human infection with the protozoan Neospora caninum

Neospora caninum is a protozoan parasite that is closely related to Toxoplasma gondii. Dogs are a definitive host. Prior to its discovery in 1988, N. caninum infection in animals was often mistakenly diagnosed as toxoplasmosis. Neosporosis in animals is characterized by encephalitis, abortion, and other conditions that clinically and pathologically resemble toxoplasmosis. The potential of N. caninum to infect humans is unknown. Therefore, evidence of human exposure to this parasite was sought by screening for antibodies in blood donors by indirect fluorescent antibody (IFA) tests and immunoblotting. Of 1,029 samples screened, 69 (6.7%) had titers of 1:100 by IFA testing. Fifty of the 69 (72%) sera that were positive for N. caninum were also negative for a closely related protozoan pathogen of humans, T. gondii. Immunoblot analysis confirmed the specificity of the positive sera for N. caninum antigens, with several sera recognizing multiple Neospora antigens with molecular masses similar to those of antigens recognized by monkey anti-N. caninum serum. An immunodominant antigen of approximately 35 kDa was observed with 12 sera. These data provide evidence of human exposure to N. caninum, although the antibody titers in healthy donors were low. The significance of human exposure to, and possible infection with, this parasite is unknown and warrants further study.

Repetitive abortion in Neospora-infected ewes

Pregnant ewes inoculated with cultured Neospora caninum tachyzoites in 1995, 1996, or 1995 and 1996 aborted or delivered weak or clinically normal lambs in 1996. Nine of 11 ewes in the study had previously produced infected lambs or fetuses after being experimentally infected in 1995. Fetuses and lambs produced in 1996 showed histologic lesions and zoites indicative of Neospora. Serologic responses and production of infected fetuses/lambs indicated systemic neosporosis in the ewes during gestation, although tachyzoites could not be cultured from maternal tissues. The repetitive infection of fetuses, and resulting clinical and histopathologic findings in the present study are similar to those reported in naturally infected cattle, adding to the already established similarities of neosporosis between sheep and cattle.

Dogs are definitive hosts of Neospora caninum

Dogs were investigated to determine if they are definitive hosts of Neospora caninum. Four dogs were fed N. caninum tissue cysts in infected mouse tissue, and two negative control dogs were fed uninfected mouse tissue. Dog faeces were examined daily for 30 days using a sucrose flotation technique. Three challenged dogs shed spherical to subspherical unsporulated oocysts, measuring 10 to 11 microns in diameter. Oocysts sporulated within 3 days and contained two sporocysts, each with four sporozoites. Outbred, inbred, and gamma-interferon knockout mice were inoculated with canine faecal extracts and monitored for evidence of neosporosis using a variety of morphologic, immunohistologic, serologic, and genetic analyses. Mice that received faeces from each dog observed to shed oocysts were demonstrated to have neosporosis by two or more techniques. One mouse was demonstrated to be infected with N. caninum by immunohistochemistry, ultrastructural analysis, and a species-specific PCR test. No evidence of neosporosis was observed in control animals. Based on this study, dogs are a definitive host of Neospora caninum.

Oral inoculation of cats with tissue cysts of Neospora caninum

OBJECTIVE

To test the hypothesis that cats are definitive hosts of Neospora caninum.

ANIMALS

6 weaned male kittens obtained from 2 sources, and several dozen outbred mice.

PROCEDURE

Cats were fed large numbers of 3 strains of N caninum: tissue cysts in buffered saline solution, mouse brain homogenates, and whole carcass homogenates from seropositive mice. Fecal specimens were examined for 4 weeks by use of flotation tests, and bioassays were performed in mice. One cat was inoculated parenterally with tachyzoites, to determine whether cats could respond serologically to N caninum. Tissue cysts from portions of oral inocula were cultured to verify viability. Indirect fluorescent antibody serologic testing, histologic and immunohistologic examinations, cell culture, and polymerase chain reaction procedures were performed 4 to 8 weeks after oral exposure, to seek evidence of infection of cats and mice.

RESULTS

None of the cats or mice seroconverted to N caninum, with the exception of the single cat inoculated parenterally. Fecal shedding of oocysts was not observed, except for Isospora felis oocysts that were shed by 2 cats beginning prior to oral challenge exposure. Evidence of infection was not detected in tissues of cats or mice, with the exception of the parenterally inoculated cat.

CONCLUSIONS

The hypothesis that cats are definitive hosts of N caninum is not supported.

CLINICAL RELEVANCE

Extermination of cats in efforts to control bovine neosporosis is not warranted.

Antibody responses of cows during an outbreak of neosporosis evaluated by indirect fluorescent antibody test and different enzyme-linked immunosorbent assays

Serum samples from 70 (33 aborting and 37 non-aborting) dairy cows from a herd in California were analyzed for Neospora caninum antibodies in different laboratories by various serologic assays including enzyme-linked immunosorbent assay (ELISA) with recombinant antigens (Nc4.1 and Nc14.1), kinetic ELISA, whole tachyzoite lysate ELISA, immunostimulating complex (iscom) ELISA, antigen capture competitive inhibition ELISA, and by the indirect fluorescent antibody test. Eighteen percent of pregnant cows in this herd had aborted within 2 mo of the index case. All 70 cows had antibodies to N. caninum by at least 1 of the tests. Antibody levels to N. caninum in aborting cows as a group were higher than in nonaborting cows. However, it was concluded that no serological test could be used to establish definitively that N. caninum caused the abortion in an individual cow.

Evaluation of ruminal sulfide concentrations and seasonal outbreaks of polioencephalomalacia in beef cattle in a feedlot

OBJECTIVES

To measure concentrations of thiamine in blood and sulfide in ruminal fluid in cattle with polioencephalomalacia (PEM) and to evaluate temporal associations between PEM and risk factors.

DESIGN

Epidemiologic analysis.

SAMPLE POPULATION

14 steers with acute signs of PEM, 26 clinically normal steers and records of all cattle in a feedlot for the past 6 years.

PROCEDURES

Concentrations of thiamine in blood and sulfide in ruminal fluid were measured. Values were compared between healthy steers that had been in the feedlot for 3 weeks or 2 months. Records were used to estimate the incidence of PEM and the time when cattle were at greatest risk of developing PEM.

RESULTS

Thiamine concentrations in steers with PEM were within reference ranges. Healthy steers had significantly greater sulfide concentrations 3 weeks after entering the feedlot, when the incidence of PEM was greatest, than 2 months after entering the feedlot, when risk of developing PEM was low. Thiamine concentrations were within reference ranges at these times. Annually recurrent outbreaks of PEM during the summer began after initiating use of a water well containing a high content of sulfate.

CLINICAL IMPLICATIONS

Excessive ruminal sulfide production is an important factor in the pathogenesis of PEM, without concurrent thiamine deficiency. Most cases of PEM developed between 15 and 30 days after introduction to a high-sulfur diet. When water is an important source of dietary sulfur, risk of PEM may increase during hot weather.

A protocol for the production of Neospora caninum tissue cysts in mice

Identification of a definitive host for Neospora caninum has been inhibited by lack of an efficient method for producing bradyzoites, needed for oral infectivity trials. An improved protocol for producing bradyzoite-containing tissue cysts in mouse brains is described. Six variables, including mouse strain (Balb/C, CBA/Ca, and ICR), sex, N. caninum isolate (NC-2 and NC-Liverpool), tachyzoite inoculum dose, immunosuppression with methylprednisolone acetate (MPA), and sulfadiazine treatment were tested. Tissue cyst numbers were estimated using an immunohistologic staining procedure specific for bradyzoites. Male ICR mice (> or = 30 g) that were immunosuppressed with 2 mg MPA 7 days prior to and 2.5 mg MPA at the time of subcutaneous inoculation with 400,000 N. caninum tachyzoites produced the highest numbers of tissue cysts. Significant numbers were produced by methods using the NC-2 strain of N. caninum; however, protocols using NC-Liverpool produced greater numbers of tissue cysts. Sulfadiazine treatment did not appear to contribute to tissue cyst production. The procedure described is superior to previously described methods with regard to numbers of tissue cysts produced, protocol reproducibility, and survival of mice until tissue cyst formation.

Separation and cryopreservation of Neospora caninum tissue cysts from murine brain

A protocol was developed for the separation, concentration enumeration, and cryopreservation of Neospora caninum tissue cysts from mouse brains. Brains from chronically infected mice were homogenized and tissue cysts counted in 10-microliters aliquots. Tissue cysts were separated from brain homogenates by centrifugation at 4,400 g on 35% (v/v) Percoll/phosphate-buffered saline (PBS) continuous-density gradients. After removal of the brain layer, the separated tissue cysts were concentrated by diluting the remaining solution with PBS and centrifuging at 500 g. The pellet was resuspended in PBS and tissue cysts were enumerated. Fifty percent of tissue cysts were recovered from brains centrifuged once and 64% from brains centrifuged twice. Tissue cysts were preserved with 7.5% dimethyl sulfoxide in horse serum at -60 C. After thawing, bradyzoites were digested in an acid/pepsin solution and placed onto Vero cell cultures. Neospora caninum tachyzoites were recovered from cell cultures, indicating that bradyzoites retained viability after concentration and cryopreservation. Separated tissue cysts ranged in diameter from 107 microns to 15 microns (average = 31 microns), and the average bradyzoite dimensions were 2 x 7.5 microns. These methods make it possible to store viable N. caninum tissue cysts for oral-infectivity trials and other studies.

Experimental neosporosis in pregnant ewes and their offspring

Six groups of six pregnant ewes each were inoculated with 170,000 or 1,700,000 tachyzoites of Neospora caninum on gestation day 65, 90, or 120. All ewes seroconverted, and none showed signs of illness other than abortion. Regardless of the inoculum dose, all ewes inoculated on gestation day 65 aborted; ewes inoculated on gestation day 90 aborted, gave birth to weak lambs, or gave birth to clinically normal lambs; and all ewes inoculated on gestation day 120 gave birth to clinically normal lambs. Using an immunohistological procedure that stains bradyzoites, we observed protozoal cysts in brains of 11 of 29 (38%) aborted fetuses, in one of four (25%) weak lambs, and in seven of 18 (39%) clinically normal lambs. Cysts were not observed in extraneural tissues from two clinically normal lambs that had cysts in the brain. No evidence of infection was observed in tissues of five ewes examined using an immunohistological procedure that stains N. caninum tachyzoites and bradyzoites. Multifocal nonsuppurative encephalitis was observed in 46 of 51 (90%) aborted, weak, or clinically normal lambs. Cerebral necrosis, dystrophic mineralization, and meningitis were also commonly identified in live and aborted lambs (even when severely autolyzed). Nonsuppurative, necrotizing placentitis was observed in 15 of 17 (88%) placentas. Nonsuppurative myositis was common in fetuses but not in live lambs. Inflammation occurred less frequently in liver and lung. Clinical and pathological features of neosporosis in sheep closely resemble those of bovine neosporosis and ovine toxoplasmosis. Although abortion caused by naturally occurring neosporosis in sheep has not been reported, diagnosticians should carefully distinguish between neosporosis and toxoplasmosis in cases of ovine protozoal abortion unless future investigations exclude the likelihood of naturally acquired neosporosis in sheep.

Evidence suggesting a point source exposure in an outbreak of bovine abortion due to neosporosis

A Holstein dairy farm suffered an abortion outbreak due to neosporosis. Abortion losses were > 18%. Cows with the highest Neospora antibody titers were at the greatest risk of aborting. Mummified fetuses were found after the 43rd day of the outbreak. The epidemic curve was suggestive of a point source exposure, which is consistent with the hypothesis that Neospora can be spread by a definitive host.

An immunohistochemical method for detecting bradyzoite antigen (BAG5) in Toxoplasma gondii-infected tissues cross-reacts with a Neospora caninum bradyzoite antigen

The previously cloned gene of a bradyzoite-specific antigen (BAG5) of Toxoplasma gondii was used to express a fusion protein for subsequent antiserum production in rabbits. The BAG5 antiserum was used in an immunohistochemical procedure to look for reactive epitopes in bradyzoites and tachyzoites of T. gondii within animal tissues. Encysted bradyzoites in brain were stained deeply and diffusely. Although most unencysted organisms in brain were not stained, occasional free organisms had mild to deep staining. There was no staining of tachyzoites in liver where cysts were not observed. Neospora caninum organisms within animal tissues were also examined using the BAG5 immunohistochemical procedure. The BAG5 antiserum cross-reacted with N. caninum bradyzoites but had no affinity for tachyzoites.

Myositis, lameness, and paraparesis associated with use of an oil-adjuvant bacterin in beef cows

Right hind limb lameness, progressing to bilateral paraparesis, was observed in 56 of 610 (9%) beef cows. Lameness began 6 days to 4 weeks after vaccination in the right longissimus lumborum (loin) muscle with an Escherichia coli/Campylobacter bacterin in an oil adjuvant. Postmortem examination of 5 affected cows revealed a large inflammatory mass at the site of vaccination. In each cow, the mass spread through adjacent intervertebral foramina into the vertebral canal and compressed the lumbar portion of the spinal cord. Microbiologic procedures did not reveal a microbial agent in affected tissues or in an unopened bottle of bacterin from the same lot used in the herd. Histologic examination revealed pyogranulomatous inflammation of the vaccination site and adjacent epidural tissue, with inflammatory nodules centered around large clear spaces that probably represented remnant emulsion from the oil adjuvant in the bacterin. As evident in these cows, IM injection of irritating products may cause severe myositis. Vaccination into paravertebral muscles is risky because of possible extension of inflammation through intervertebral foramina.

Iatrogenic compressive lumbar myelopathy and radiculopathy in adult cattle following injection of an adjuvanted bacterin into loin muscle: histopathology and ultrastructure

Compressive lumbar myelopathy is a recognized iatrogenic complication of injecting water-in-oil vaccines into paravertebral sites of laboratory animals and chickens. Herein, we report the histologic and ultrastructural features of a similar complication in a herd of cattle. Iatrogenic posterior paresis developed over 34 days in 56 of 610 cows (9.2%) following injection of a commercial bacterin 11-34 days earlier into M. longissimus lumborum. The bacterin was composed of inactivated Escherichia coli and Campylobacter fetus ssp. venerealis in a proprietary adjuvant. Tissues were collected for histopathology from 9 affected cattle that died or were euthanized after clinical signs lasting 6-38 days. A range of tissues, including the injection site lesion and lumbar spinal nerve roots, was obtained for ultrastructural examination from a cow with paresis of 31 days duration. There was locally extensive pyogranulomatous myositis with fibrosis and necrosis in right M. longissimus lumborum. Extension of the lesion into the vertebral canal via spinal nerve foramina resulted in focal pyogranulomatous inflammation in epidural fat and in adjacent dura mater. There was axonal degeneration in dorsal, lateral, and ventral columns and chromatolysis of spinal motor neurons in lumbar spinal cord, secondary to compression. A distinctive histologic and ultrastructural feature of pyogranulomata was the presence of osmiophilic material at the center of inflammatory foci, surrounded by macrophages and giant cells that contained intracytoplasmic lipid droplets. Ultrastructural examination of entrapped spinal nerves revealed axonal degeneration and loss of myelinated and unmyelinated fibers, segmental demyelination with remyelination, axonal spheroid formation, and early axonal regeneration.(ABSTRACT TRUNCATED AT 250 WORDS)

Sulphide-induced polioencephalomalacia in lambs

Polioencephalomalacia (PEM) was induced in four of 10 lambs by the administration of a sulphide solution into the oesophagus at 20 min intervals for a period of 40 to 120 min. Signs of neurological dysfunction occurred in all 10 lambs during that time and included stupor, visual impairment and seizures. Gross autofluorescent and microscopic lesions in cerebrocortical grey matter were present as soon as 20 h after sulphide administration and were indistinguishable from lesions in naturally occurring disease. These findings, when considered together with an earlier study that revealed an association between high ruminal concentrations of sulphide and PEM, indicate that this disease can result from sulphide toxicosis, independent of the metabolic status of thiamine.

High sulfide concentrations in rumen fluid associated with nutritionally induced polioencephalomalacia in calves

Nine 115- to 180-kg, hay-adapted, Holstein steers were fed an experimental diet with added sodium sulfate that induces polioencephalomalacia (PEM). Five calves developed the disease. Thiamine concentrations in blood, CSF, brain, and liver were not indicative of thiamine deficiency. The odor of hydrogen sulfide in eructated rumen gas was associated with the onset of PEM. Sulfide concentrations in rumen fluid were measured 1 or 2 times a week by 2 techniques. Sulfide concentrations progressively increased in all 9 calves after the feeding of the PEM-inducing diet commenced. The highest concentrations coincided with the onset of clinical signs of PEM and were significantly higher in the calves that developed PEM than in those that did not. This suggests that PEM can result from sulfide toxicosis following excess production of sulfide in the rumen.