[Terminology for classifying the porcine reproductive and respiratory syndrome virus (PRRSV) status of swine herds]. / Terminologie zur Klassifizierung des PRRSV-Status von Schweineherden.

Standardized terminology for the porcine reproductive and respiratory syndrome virus (PRRSV) status of swine herds is necessary to facilitate communication between veterinarians, swine producers, genetic companies, and other industry participants. It is also required for implementation of regional and national efforts towards PRRSV control and elimination. The purpose of this paper is to provide a herd classification system for describing the PRRSV status of herds, based upon a set of definitions reflecting the biology and ecology of PRRSV. The herd classification system was developed by a definitions committee formed jointly by the American Association of Swine Veterinarians (AASV) and the United States Department of Agriculture PRRS-Coordinated Agricultural Project, and was approved by the AASV Board of Directors on March 9, 2010. The committee included veterinarians from private practice and industry, researchers, and representatives from AASV and the National Pork Board. Breeding herds, with or without growing pigs on the same premises, are categorized as Positive Unstable (Category I), Positive Stable (Category II), Provisional Negative (Category III), or Negative (Category IV) on the basis of herd shedding and exposure status. Growing-pig herds are categorized as Positive or Negative. Recommended testing procedures and decision rules for herd classification are detailed.

Ogilvie's syndrome: a case report.

OBJECTIVE: Ogilvies syndrome (OS) is a rare condition in obstetrics but occurs most commonly after caesarean section. Mortality rates from OS can be as high as 36-50% when bowel perforation or ischemia develops which highlights the early recognition of this condition. Early diagnosis is therefore essential to prevent serious morbidity and mortality. CONCLUSION: We, therefore report a case of OS after caesarean section in which early detection by senior clinicians resulted in successful management of the condition and an excellent outcome.

Striae gravidarum in primiparae.

BACKGROUND: Striae distensae are widely known to occur in pregnancy and aesthetically they can be a cause of great concern for many women. Various factors have been reported to be associated with the development of striae but the results are conflicting. OBJECTIVES: To observe the prevalence of striae gravidarum in primiparae and identify independent associated risk factors. METHODS: An observational analysis of 324 primiparae was conducted within 48 h of delivery. Data was collected in the form of a questionnaire and physical examination. Seventy-two primiparae participated in a pilot study in 1999 and the remaining were assessed over a 4-month period in 2000. Seventeen variables were recorded, and striae graded according to quantity and severity. Fifteen primiparae were excluded prior to analysis. RESULTS: Fifty-two per cent (161 of 309) of primiparous white women had striae of which 12% (20 of 161) were classified as severe. The most significant risk factor was low maternal age (P < 0.0001). Twenty per cent (14 of 71) of teenagers had severe striae, a finding not seen in women over 30 years of age. Other significant risk factors included maternal body mass index greater than 26 (P = 0.0003), maternal weight gain of more than 15 kg (P = 0.0121) and high neonatal birth weight (P = 0.0135). CONCLUSIONS: Logistic regression analysis demonstrated that maternal age, body mass index, weight gain and neonatal birth weight were independently associated with the occurrence of striae. It appears that the group at highest risk of developing severe striae are teenagers. This finding is important and may provide impetus to explore the pathomechanisms of striae.

Toward a standard of care for child ADHD: implications for marriage and family therapists.

In this article, we briefly review the etiology of Attention Deficit Hyperactivity Disorder (ADHD) and describe the most current scientifically supported theory about the nature of this disorder. Based on the research literature, several organizations have established standards of care for its diagnosis and treatment, which involves a multimodal strategy for treatment at the biological, individual, family, school, and community levels. Assessment and treatment guidelines are provided for Marriage and Family Therapists (MFTs), and specific areas of competency are proposed for MFTs who are working with children who have ADHD.

Detection of U.S., Lelystad, and European-like porcine reproductive and respiratory syndrome viruses and relative quantitation in boar semen and serum samples by real-time PCR.

Transmission of porcine reproductive and respiratory syndrome virus (PRRSV) via boar semen has been documented. Since semen is widely disseminated for artificial insemination and the virus can cause significant health and economic consequences, it is essential to have well-validated, rapid diagnostic techniques to detect and quantitate the virus for diagnostic and research purposes. Previously, boar semen was tested by a nested PCR (nPCR) assay which was compared to the "gold standard" swine bioassay. A correlation of 94% was observed, indicating that, most of the time, PCR detected infectious virus. Subsequently, a real-time PCR targeting the 3' untranslated region of the PRRSV genome was compared with nPCR by testing 413 serum and semen samples from PRRSV-inoculated and control boars. There was 95% agreement between the results of the two tests, with the majority of samples with discordant results containing virus at the lower range of detection by the assays. The virus in all samples was quantitated by using a standard curve obtained by serial dilution of an in vitro transcript. By using the in vitro transcript, the lower limit of sensitivity was observed to be approximately 33 copies/ml. Reactivity with a panel of more than 100 PRRSV isolates from various geographical regions in the United States was also documented. No reactivity with nine nonrelated swine viruses was noted. A real-time PCR was also developed for the detection of the European Lelystad virus and the European-like PRRSV now found in the United States. In six of six PRRSV-inoculated boars, peak levels of viremia occurred at 5 days postinoculation (DPI) and were most consistently detectable throughout 22 DPI. In five of six boars, PRRSV was shed in semen for 0 to 2 days during the first 10 DPI; however, one of six boars shed the virus in semen through 32 DPI. Therefore, in general, the concentration and duration of PRRSV shedding in semen did not correlate with the quantity or duration of virus in serum. These differences warrant further studies into the factors that prevent viral replication in the reproductive tract.

Reproductive dysfunction in women with epilepsy: recommendations for evaluation and management.

BACKGROUND: Epilepsy is commonly associated with reproductive endocrine disorders. These include polycystic ovary syndrome (PCOS), isolated components of this syndrome such as polycystic ovaries, hyperandrogenaemia, hypothalamic amenorrhoea, and functional hyperprolactinaemia. OBJECTIVE: To summarise the currently known relations between epilepsy and reproductive endocrine disorders. METHODS: A review of clinical experience and published reports. RESULTS: The most likely explanations for endocrine disorders related to epilepsy or antiepileptic drugs are: (1) a direct influence of the epileptogenic lesion, epilepsy, or antiepileptic drugs on the endocrine control centres in the brain; (2) the effects of antiepileptic drugs on peripheral endocrine glands; (3) the effects of antiepileptic drugs on the metabolism of hormones and binding proteins; and (4) secondary endocrine complications of antiepileptic drug related weight changes or changes of insulin sensitivity. Regular monitoring of reproductive function at visits is recommended, including questioning about menstrual disorders, fertility, weight, hirsutism, and galactorrhoea. Particular attention should be paid to patients on valproate and obese patients or those experiencing significant weight gain. Single abnormal laboratory or imaging findings without symptoms may not constitute a clinically relevant endocrine disorder. However, patients with these kinds of abnormalities should be monitored to detect the possible development of a symptomatic disorder associated with, for example, menstrual disorders or fertility problems. CONCLUSIONS: If a reproductive endocrine disorder is found, antiepileptic drug treatment should be reviewed to ensure that it is correct for the particular seizure type and that it is not contributing to the endocrine problem. The possible benefits of a change in treatment must be balanced against seizure control and the cumulative side effect of alternative agents.

Selection-based versus topography-based responding: An important distinction for stimulus equivalence?

English-speaking subjects were taught 16 English-French word pairs. Within any given trial, one word from each pair was presented; for eight items, subjects were to select its counterpart from an array of words in the other language (selection-based training), and for the other eight items there was no array and subjects were to type its counterpart (topography-based training). In Experiment 1, all items were trained from French to English, and later, interspersed no-feedback probe trials tested for the emergence of the reversed relations. Half of the eight selection-trained items were tested in the selection-based mode and half were tested in the topography-based mode; similarly, half of the eight topography-trained items were tested in the selection-based mode and half were tested in the topography-based mode. On the first reversal test trial, all 7 subjects scored 100% correct for the selection-tested items; in contrast, 5 of the 7 subjects scored 0% or near 0% correct for the topography-tested items, which improved to varying degrees with repeated testing. The training response mode affected neither acquisition rate nor reversal test trial performance. In Experiment 2, all items were tested in the topography-based mode only, and subjects were exposed to nine consecutive reversal test trials prior to interspersed probe testing. Improved accuracy across reversal test trials was not observed until the conditions of probe testing were instated, an indication that reexposure to the trained relations was a crucial component of delayed emergence. In Experiment 3, all items were trained from English to French, resulting in subjects typing a familiar rather than an unfamiliar word on reversal test trials. Accuracy on reversal test trials was considerably better than in the previous two experiments. We discuss the implications of our findings for stimulus equivalence research.

Porcine reproductive and respiratory syndrome virus infection in neonatal pigs characterised by marked neurovirulence.

Neonatal pigs from three herds of pigs were somnolent and inappetent and had microscopic lesions characterised by severe meningoencephalitis, necrotic interstitial pneumonia and gastric muscular inflammation. Porcine reproductive and respiratory syndrome virus (PRRSV) infection was diagnosed and confirmed by virus isolation, fluorescent antibody examination of frozen lung sections, serology, immunohistochemistry and in situ hybridisation. Each herd had a history of PRRSV infection and was using or had used a modified-live vaccine. The isolates from the affected pigs were genetically distinct from the modified-live vaccine strain of the virus when compared by restriction enzyme analysis and nucleotide sequencing of PRRSV open reading frames 5 and 6. The virus was identified in macrophages or microglia of brain lesions by immunohistochemical staining of brain sections with an anti-PRRSV monoclonal antibody and an anti-macrophage antibody. The replication of the virus in the brain was verified by in situ hybridisation. The meningoencephalitis induced by the virus in pigs from each of the herds was unusually severe and the brain lesions were atypical when compared with other descriptions of encephalitis induced by the virus, which should therefore be considered as a possible diagnosis for neonatal pigs with severe meningoencephalitis. In addition, field isolates of the virus which are capable of causing disease can emerge and coexist with modified-live vaccine virus in some pig herds.

Fibrillin microfibrils are reduced in skin exhibiting striae distensae.

Striae distensae (striae: stretch marks) are a common disfiguring condition associated with continuous and progressive stretching of the skin--as occurs during pregnancy. The pathogenesis of striae is unknown but probably relates to changes in those structures that provide skin with its tensile strength and elasticity. Such structures are components of the extracellular matrix, including fibrillin, elastin and collagens. Using a variety of histological techniques, we assessed the distribution of these extracellular matrix components in skin affected by striae. Pregnant women were assessed for the presence of striae, and punch biopsies were obtained from lesional striae and adjacent normal skin. Biopsies were processed for electron microscopy, light microscopy and immunohistochemistry. For histological examination, 7 microns frozen sections were stained so as to identify the elastic fibre network and glycosaminoglycans. Biopsies were also examined with a panel of polyclonal antibodies against collagens I and III, and fibrillin and elastin. Ultrastructural analysis revealed alterations in the appearance of skin affected by striae compared with that of normal skin in that the dermal matrix of striae was looser and more floccular. Light microscopy revealed an increase in glycosaminoglycan content in striae. Furthermore, the number of vertical fibrillin fibres subjacent to the dermal-epidermal junction (DEJ) and elastin fibres in the papillary dermis was significantly reduced in striae compared with normal skin. The orientation of elastin and fibrillin fibres in the deep dermis showed realignment in that the fibres ran parallel to the DEJ. However, no significant alterations were observed in any other extracellular matrix components. This study identifies a reorganization and diminution of the elastic fibre network of skin affected by striae. Continuous strain on the dermal extracellular matrix, as occurs during pregnancy, may remodel the elastic fibre network in susceptible individuals and manifest clinically as striae distensae.

Evaluation of the effects of nursery depopulation of the profitability of 34 pig farms.

The financial impact of nursery depopulation was assessed on 34 pig farms by constructing a partial budget model to measure the profitability of the nursery production. The model measured margin over variable cost and used production data generated from a previous study; it assumed that fixed costs remained constant throughout the study and that feed cost, weaned pig cost and market price per nursery pig also remained fixed. The mean margin over variable cost per sow on the 34 farm after nursery depopulation was Pounds 116. Thirty-two of the farms showed reductions in this cost, ranging from Pounds 20 to Pounds 408 per sow, in the 12 months after nursery depopulation compared with the previous 12 months. Of the two farms which did not show an increase in profitability, one showed no change and the other showed a net loss of Pounds 8 per sow. The sows' serostatus for porcine reproductive and respiratory syndrome virus infection was monitored but there was no significant difference between the margin over variable cost per sow of the seropositive (Pounds 130) and seronegative (Pounds 170) herds.

Evaluation of the effects of nursery depopulation on the persistence of porcine reproductive and respiratory syndrome virus and the productivity of 34 farms.

Nursery depopulation has been described as an effective strategy for improving the performance of weaned pigs. In order to assess whether the strategy was effective under a wide range of conditions, a study was carried out on 34 farms in the USA. Four groups with different depopulation protocols were designed on the basis of the location of the depopulated facility (on site vs off site) and the period for which the nursery remained empty (seven days vs 14 days). The changes in average daily liveweight gain, percentage mortality, feed efficiency and treatment cost per pig produced were assessed 12 months before and after nursery depopulation. The ability to eliminate porcine reproductive and respiratory syndrome (PRRS) virus was examined by indirect fluorescent antibody testing of the nursery pigs. Significant improvements (P < 0.0001) were detected in both average daily gain and percentage mortality after depopulation when the differences within an individual group were analysed, but no significant differences (P > 0.14) were observed between the study groups. Serological testing indicated that antibodies to PRRS virus were still present in 14 of the 34 farms after depopulation.

Are follicle stimulating hormone measurements predictive of ovarian response to hyperstimulation with human menopausal gonadotrophin?

Previous studies have suggested that elevated serum follicle stimulating hormone (FSH) concentrations are associated with a poor ovarian response to hyperstimulation with human menopausal gonadotrophin (HMG) in in vitro fertilisation (IVF) programmes. We have used the day 2 serum FSH concentration to determine the dose of HMG administered in women under 40 years. If the FSH concentration was below 9 IU/l, a constant dose of 150 IU HMG were administered; if above 9 IU/l a constant dose of 300 IU HMG was used. Women over the age of 40 years were given 300 IU HMG regardless of their serum FSH concentration. This retrospective study was undertaken to assess whether this approach was beneficial for the younger women and also whether the FSH concentration was predictive of outcome in older women. The study included all women < 40 years (n = 143) and > 40 years (n = 32) having their first IVF treatment cycle during 1994. In the younger women, there was no difference in the number of cancelled treatment cycles (9.7% vs. 7.5%); the number of follicles present (9.6 vs. 8.2); serum oestradiol concentration (6971 pmol/l vs. 6686 pmol/l); number of eggs collected (7.9 vs. 5.7); number of embryos created (3.7 vs. 3.6); and pregnancy rate (13.5% vs. 15%) between women with normal (n = 103) or elevated (n =40) FSH concentrations. By using the serum FSH concentration to select women in whom a poor response was expected, and administering a higher dose of HMG, a similar ovarian response was produced and the pregnancy rate was similar to those in women with normal FSH concentrations. Women over 40 years with elevated serum FSH concentrations (n = 17) had a significantly (P < 0.05) higher cancellation rate (17.6% vs. 0%) and fewer number of eggs collected (6.9 vs. 2.5) than the group with normal FSH concentrations (n = 15). One woman conceived in each group. These findings confirmed previous studies showing that the serum FSH is predictive of ovarian response. This study confirmed the value of measuring the day 2 serum FSH concentration as a predictor of response; and it provides a scientific approach to determine the dose of HMG administered for IVF stimulation. A satisfactory response to induction of ovulation will be achieved using 150 IU HMG in women with FSH < 9 IU/l but if the FSH is raised i.e. above 9 IU/l, 300 IU is required to achieve a similar response.

Intraverbal stimulus-response reversibility: Fluency, familiarity effects, and implications for stimulus equivalence.

English-speaking subjects with little knowledge of the French language used a computerized flashcard program, Think Fast, to learn 16 English-French word pairs (intraverbals) by typing one word of the pair when presented with the other word as a textual stimulus. In Phase 1, half of the intraverbals were taught from French to English (FE-1) and half from English to French (EF-1). Then, in Phase 2, training continued with the stimulus and response items of each intraverbal reversed, i.e., cards previously in the FE-1 condition were trained from English to French (EF-2) and cards previously in the EF-1 condition were trained from French to English (FE-2). Feedback was provided throughout the experiment. Reversing the stimulus and response items in Phase 2 significantly reduced rate correct and accuracy scores for eight of the nine subjects. In Experiments 1 and 2, this effect was more pronounced for cards in the EF-2 condition; in Experiment 3, when the criterion for a "correct" response was more lenient, there was no consistent difference between cards in the EF-2 and FE-2 conditions. Symmetry, as indicated by accuracy scores on the first trial in Phase 2, was generally poor: eight of the nine subjects averaged only 29% correct when asked to respond to the reversed relations for the first time. We relate our paradigm and results to recent developments in fluency, verbal behavior, and stimulus equivalence, and provide directions for future research.

Direct PCR analysis for toxigenic Pasteurella multocida.

A more rapid, accurate method to detect toxigenic Pasteurella multocida is needed for improved clinical diagnosis, farm biosecurity, and epidemiological studies. Toxigenic and nontoxigenic P. multocida isolates cannot be differentiated by morphology or standard biochemical reactions. The feasibility of using PCR for accurate, rapid detection of toxigenic P. multocida from swabs was investigated. A PCR protocol which results in amplification of an 846-nucleotide segment of the toxA gene was developed. The PCR amplification protocol is specific for toxigenic P. multocida and can detect fewer than 100 bacteria. There was concordance of PCR results with (i) detection of toxA gene with colony blot hybridization, (ii) detection of ToxA protein with colony immunoblot analysis, and (iii) lethal toxicity of sonicate in mice in a test set of 40 swine diagnostic isolates. Results of an enzyme-linked immunosorbent assay for ToxA agreed with the other assays except for a negative reaction in one of the 19 isolates that the other assays identified as toxigenic. In addition to accuracy, as required for a rapid direct specimen assay, toxigenic P. multocida was recovered efficiently from inoculated swabs without inhibition of the PCR. The results show that PCR detection of toxigenic P. multocida directly from clinical swab specimens should be feasible.