Assessment of daily activity patterns and biomarkers of pain, inflammation, and stress in lactating dairy cows diagnosed with clinical metritis.

The objectives of the present case-control study were to assess (1) daily activity patterns (lying time, number of steps, number of lying bouts, and lying bout duration), and (2) circulating concentrations of biomarkers of pain (substance P), inflammation (haptoglobin), and stress (cortisol) in lactating dairy cows diagnosed with clinical metritis. Lactating dairy cows (n = 200) from 2 commercial dairy herds were enrolled in the present study. Cows diagnosed with clinical metritis (n = 100) at 7 ± 3 d in milk were matched according to lactation and days in milk to cows without clinical metritis (NO-CM; n = 100). On study d 1, clinical metritis was diagnosed (using a Metricheck device, Simcro Tech Ltd., Hamilton, New Zealand) by the presence of watery, reddish, or brownish foul-smelling vaginal discharge, and blood samples were collected for assessment of circulating concentration of substance P, haptoglobin, cortisol, total calcium, ß-hydroxybutyrate, and blood cells. In addition, on study d 1 body condition of cows was visually assessed, and activity monitors were placed on the hind leg of a subset of cows (CM, n = 56; CON, n = 56) and were kept until study d 7. Cows showing any other signs of other diseases were not included in the study. Cows with clinical metritis tended to spend more time lying (CM = 628.92 min/d; NO-CM = 591.23 min/d) compared with NO-CM cows. Activity analysis by parity revealed that primiparous cows with clinical metritis spent more time lying compared with primiparous cows without clinical metritis. However, no differences in daily lying time were observed between multiparous cows with and without clinical metritis. Furthermore, cows in the CM group had a higher circulating concentration of substance P (CM = 47.15 pg/mL; NO-CM = 37.73 pg/mL) and haptoglobin (CM = 233.00 µg/mL; NO-CM = 99.98 µg/mL) when compared with NO-CM cows. Cows with clinical metritis had lower body condition score, and a greater proportion of cows in this group had hypocalcemia when compared with cows without clinical metritis. The circulating concentration of leukocytes and erythrocytes were decreased in cows with clinical metritis compared with cows without clinical metritis. Results from this study showed that concentrations of markers of inflammation, stress, pain, and activity were affected in cows diagnosed with clinical metritis; thus, strategies aimed to minimize the negative effects associated with clinical metritis may be required to improve the welfare of dairy cows.

Canadian National Breast Screening Study: assessment of technical quality by external review.

Mammograms from the Canadian National Breast Screening Study (NBSS) were reviewed by three external experts to provide an objective evaluation of their technical quality, to establish a model for auditing mammograms in a screening program, and to assess whether NBSS mammograms improved over time. The sample reviewed included 10 randomly chosen mammograms from each of 15 screening centers for each calendar year of their operation between 1980 and 1987. All 830 mammograms were reviewed on two consecutive days in randomized sequence by each reader, and rated 0-3 for each of four criteria including positioning and image quality, with a total possible score of 0-12. Although the mammograms were not in temporal sequence when reviewed, the scores assigned by each reader were significantly higher for mammograms dating from later years. Subjects' ages at entry (40-49 vs 50-59 years) did not affect the score. The largest increase in scores was associated with a 1985 protocol change in which mediolateral oblique positioning replaced straight mediolateral positioning. This study reinforces the importance of monitoring technical quality in screening programs and establishes that the NBSS benefited from technical improvements during its operation. A retrospective review of NBSS mammography by three external reviewers confirmed that technical quality improved from 1980 to 1987. This improvement was associated with improved technology (film, processing, and units) and with the quality assurance programs operating during the NBSS, which identified problems and offered remedies.

Pulmonary infection with nontuberculous mycobacteria.

Nontuberculous mycobacterial infections (NTM) are being increasingly recognized as a cause of chronic pulmonary disease. We recently reviewed the clinical, radiologic, and bacteriologic presentation of 89 adult patients ill enough to have been hospitalized between 1981 and 1985 with the diagnosis of NTM. Preexisting lung disease was present in 82% and alcohol abuse in 40%. Although M. avium complex was identified in 51% of the patients, M. xenopi, which is usually reported to occur infrequently, accounted for 38% of our cases and M. kansasii for only 9%. Treatment was limited by a high incidence of associated disease, in vitro drug resistance, drug toxicity, and a mortality rate of 32% within 18 months of admission. Nevertheless, bacteriologic conversion occurred in 29% of those treated. M. xenopi appears to be an important pathogen in southern Ontario. It differs from the other NTM by having a different pattern of in vitro drug resistance but not by its clinical or radiologic presentation.

Cytologic diagnosis of bronchioloalveolar carcinoma by fine-needle aspiration biopsy.

From 1970 to June 1984, 275 patients with bronchioloalveolar carcinoma were admitted to the Toronto General Hospital. Of these, 181 (190 aspiration biopsies, including nine repeat samples) had this diagnosis made following the use of transthoracic fine-needle aspiration biopsy. Based on the cytomorphologic features observed in the aspiration preparations, the tumor was subclassified into three types: nonsecretory, secretory, and poorly differentiated. The cytologic features of these three types of bronchioloalveolar carcinoma are presented and illustrated. Cytomorphologically, the three types of this tumor are distinctly different and their features are sufficiently distinctive from those of bronchogenic adenocarcinoma and metastatic adenocarcinomas to be of diagnostic value. Transthoracic fine-needle aspiration biopsy appears to be a definitive minimally invasive means of establishing the diagnosis of bronchioloalveolar carcinoma preoperatively and especially to be of value for those small peripheral cancers which are relatively inaccessible to direct method of study and are potentially surgically curable.

Field management of neonatal diarrhea.

This article deals with the management and health factors involved in raising healthy calves. Practical considerations are given for veterinarians to implement a disease control program. Various management techniques concerning the feeding, housing, and ventilation of the neonate are also discussed.

Progressive paresis in sheep due to delayed neurotoxicity of triaryl phosphates.

This report describes the history, signs, histopathology, and diagnosis of a delayed neurotoxicity in Suffolk sheep caused by transmission oil. The signs of toxicity included hyperexcitability, a stiff gait, tetraparesis and inability to maintain sternal recumbency. The circumstances involved in exposure to the transmission oil were determined. Histopathology revealed widespread degeneration of axons in the spinal cord, especially their more distal portions.

Cytopathology of thymoma.

From 1967 to 1981, 37 cases were diagnosed as thymoma by transthoracic fine needle aspiration biopsy. All were verified histologically, with no false-positive results. The various cytomorphologic patterns of thymoma are presented. All aspirates from the thymomas were reviewed and found to be composed of epithelial elements, with an admixture of lymphocytes in various proportions. There were 13 cases of lymphocytic predominance, 11 of epithelial-cell predominance, 4 of spindle-cell predominance, and 9 of mixed cell types. In the cytologic preparations the epithelial elements from different tumors exhibited different cytologic appearances and were tentatively subclassified into five types: small, intermediate, large, large pleomorphic and spindle shaped. The cytologic features of thymoma observed in aspiration biopsies are sufficiently distinctive from those of other anterior mediastinal tumors to be diagnostic. It appears feasible to investigate an anterior mediastinal mass with percutaneous fine needle aspiration for the purpose of establishing the diagnosis of thymoma prior to median sternotomy or thoracotomy.

Use of selenium in problem cattle herds.

A 150-cow beef herd had problems with diarrhea in all neonatal calves, with 50% mortality. Necropsy revealed changes consistent with colibacillosis. Vaccination of cows in late pregnancy with E coli and BVD vaccines reduced morbidity but did not eliminate the problem. Assays revealed low serum Se levels. Limited supplementation of Se in premix at 90 mg/lb premix, with 17 lb premix/ton feed, resolved the problem. A 70-cow dairy herd had long-term problems with increased numbers of cystic ovaries and retained placentas, and low conception rates. Serum Se levels were low; results of various other diagnostic tests were inconclusive. Dietary supplementation of Se greatly improved reproductive efficiency. Gross and microscopic lesions may not be inconclusive for a diagnosis of Se deficiency. Dietary supplementation of Se is recommended over injection.

Aspiration needle biopsy of thoracic lesions.

We reviewed our experience with 2,114 percutaneous aspiration needle biopsies of intrathoracic lesions. Aspiration was performed for cytological diagnosis employing biplane fluoroscopy and a 20 gauge needle, 0.9 mm in outside diameter. A satisfactory specimen was obtained in 88% of biopsies, and the chance of obtaining a correct diagnosis of a malignant lesion was 81.5%. The false positive rate was 2.3%, and the cytologists could always distinguish between primary and secondary neoplasms. A false negative rare of 13.6% (36 patients) resulted in only three delayed thoracotomies and two instances of interval metastases discovered at mediastinoscopy. Cellular specificity in primary tumors was not sufficiently accurate to affect therapy. Pneumothoraces occurred frequently (31.9% of patients) but wee generally small; 10.4% of patients required chest drainage. There were no recorded instances of tumor implantation in needle tracts. We conclude that a rapid and accurate diagnosis of intrathoracic pathology can be obtained by this technique. It is associated with an acceptable morbidity and may greatly expedite both patient care and investigation.

Developmental bronchopulmonary disease in adults: practical clinical considerations.

Developmental abnormalities of the tracheobronchial tree and its vascular components may be seen in both pediatric and adult patients. These abnormalities occur as pure bronchial anomalies (in which the vascular organization is normal), as pure vascular anomalies (in which the bronchial arborization has proceeded normally) or as combined bronchial and vascular anomalies. The clinical syndromes associated with these anomalies may usefully be considered together as different aspects of potential failure of bronchovascular development. In the adult the bronchogenic cyst is the most commonly encountered pure bronchial abnormality, arteriovenous malformation the commonest pure vascular anomaly and sequestration the most frequent mixed defect. Between 1958 and 1978, 32 bronchogenic cysts, 14 sequestrations and 18 parenchymal aneurysms were treated at the Toronto General Hospital. Diagnostic and therapeutic considerations suggest that surgical intervention is warranted in most cases.