The serological detection of Bovine papillomavirus's E5 oncoprotein antibodies in horses.

Equine sarcoids (ES) are known globally as the most frequent skin tumour affecting horses. These tumours affect the horse's monetary value, they can affect the horse's welfare and can be difficult and expensive to treat. Bovine papillomavirus (BPV) is considered to be the aetiological agent of this tumour, as BPV 1, 2 and 13 have been detected in ES. This is the only known natural cross species infection by a papillomavirus. The BPV genome can be divided into two coding regions: The early region E which encodes the transforming proteins E5, E6 and E7 as well as the replication and transcription regulatory proteins E1 and E2 and the late region encoding the structural proteins of the virus L1 and L2. The E5 oncoprotein is believed to downregulate MHC 1 and as a result, escapes an immune reaction with affecting the cells cycle and eventually allows the viral affected cells to proliferate into ES. We have constructed an ELISA test by utilising the C terminal peptide of the E5 oncoprotein and explored the possibility of IgG antibodies existence in horses to the E5 oncoprotein. For this study we have examined 136 horses, some showing ES lesions (80 horses) and some without ES lesions (56 horses). By using our ELISA test, we have shown that antibodies to the E5 oncoprotein are in fact present and that from a certain level seem to be found only in ES positive horses. Therefore, proving that an immune response to this protein can be expected.

[Red lines or staffing definition in nursing]. / Untergrenzen oder Personalbemessung in der Pflege.

The lower limits for nursing staff-as red lines to demarcate a dangerous nursing practice-are not suitable for initiating the urgently needed trend reversal to improve staffing in nursing. The German Nursing Staff Strengthening Act sets the right framework conditions for overcoming the shortage of skilled workers by returning to full coverage of nursing staff costs, but this can only be successful if-as required by the Concerted Action on Nursing-the build-up of nursing staff is presented by a procedure for a needs-based nursing staff definition. With the nursing staff regulation PPR 2.0, the German Hospital Association, the worker's union ver.di, and the German Nursing Council have presented a pragmatic but above all immediately usable solution that has been extensively pretested. This interim solution must now be introduced immediately and bindingly in the political process and the path for further scientific development must be initiated. Health care-not only in the current COVID-19 pandemic situation-depends to a large extent on an adequate supply of nursing staff. To also ensure this in the future is the order of the day and binding nurse staffing to a needs-based staff definition are key.

Detection of IgM-rheumatoid factor and anti-citrullinated protein antibodies in healthy horses and their comparison.

Rheumatoid factor (RF) is used in human and veterinary medicine in the form of IgM RF traditionally to support the diagnosis of rheumatoid arthritis (RA). In the latest diagnostic criteria, presence of anti - citrullinated protein antibodies (ACPA) was added to the grading system for the diagnosis of RA in humans. A change which is not integrated or routinely used in veterinary medicine. The criteria changed partly because of RF's diagnostic shortcomings, which include its increased titer detection in humans with non-rheumatoid diseases, inability to predict the disease and increased titers over the limit in the older population. Clinical signs similar to human RA were reported in horses in a condition known as idiopathic polysynovitis. Similarities in the clinical presentation to RA raised a question to the usability of RF and ACPA in horses. In our study, sixty clinically healthy horses, ranging from 3 days to 30 years of age, were evaluated for their serum levels of IgM RF. 55 of these horses were tested for ACPA, using methods of ELISA measuring Anti - CFG (Anti citrullinated fibrinogen antibody). The results of the study demonstrated the existence of an age-dependent increase in the level of IgM RF up to the age of about 9 years and ACPA's independence of the horse's age as well as both markers independence of the horse sex.

Interdisciplinary care programme to improve self-management for cancer patients undergoing stem cell transplantation: a prospective non-randomised intervention study.

The purpose of this single-centre prospective non-randomised study was to evaluate the effectiveness of an interdisciplinary care programme to enhance self-management in patients with haematopoietic stem cell transplantation (HSCT). Patients undergoing HSCT, aged >14 years with informed consent were recruited (n = 79). Patients in the intervention group (IG) received standard care plus the SCION-HSCT intervention to counteract three problems after HSCT: muscle weakness, oral mucositis and malnutrition. Control group patients received standard care. Primary endpoint was global health-related quality of life (HRQoL) at discharge (EORTC QLQ C30 v. 3.0). Baseline characteristics were balanced between both groups, except physical performance (ECOG) being significantly lower for patients of the IG. At discharge, no group differences could be seen regarding HRQoL. Non-confirmatory post hoc analyses showed for patients of the IG a shorter duration of hospitalisation (MD -10.90; 95% CI -18.05 to -3.75) and increased activity during hospitalisation (MD 2.44; 95% CI 1.27-3.61). In conclusion, clinical effectiveness of the intervention could not be proven with respect to the aspired improvement of HRQoL. However, the nurse-led interdisciplinary caring programme could be carried out in every day ward routine. Further research should focus on working mechanisms of complex interventions aiming to improve HRQoL of patients undergoing HSCT.

Equine atypical myopathy: A metabolic study.

Atypical myopathy (AM) is a potentially fatal disease of grazing horses. It is reportedly caused by the ingestion of sycamore seeds containing toxic hypoglycin A. In order to study metabolic changes, serum and urine samples from nine horses with atypical myopathy and 12 control samples from clinically healthy horses were collected and then analysed using a high-performance liquid chromatography coupled with tandem mass spectrometry; serum metabolic profiles as the disease progressed were also studied. Metabolic data were evaluated using unsupervised and supervised multivariate analyses. Significant differences were demonstrated in the concentrations of various glycine conjugates and acylcarnitines (C2-C26). Moreover, the concentrations of purine and pyrimidine metabolites, vitamins and their degradation products (riboflavin, trigonelline, pyridoxate, pantothenate), and selected organic and amino acids (aspartate, leucine, 2-oxoglutarate, etc.) were altered in horses with AM. These results represent a global view of altered metabolism in horses with atypical myopathy.

Multiple hypersensitivities including recurrent airway obstruction, insect bite hypersensitivity, and urticaria in 2 warmblood horse populations.

BACKGROUND: Multiple hypersensitivities (MHS) have been described in humans, cats, and dogs, but not horses. HYPOTHESES: Horses suffering from recurrent airway obstruction (RAO), insect bite hypersensitivity (IBH), or urticaria (URT) will have an increased risk of also being affected by another one of these hypersensitivities. This predisposition for MHS also will be associated with decreased shedding of strongylid eggs in feces and with a single nucleotide polymorphism (SNP BIEC2-224511), previously shown to be associated with RAO. ANIMALS: The first population (P1) included 119 randomly sampled horses representative of the Swiss sporthorse population; the replication population (P2) included 210 RAO-affected Warmblood horses and 264 RAO-unaffected controls. All horses were Warmbloods, 14 years or older. METHODS: Associations between disease phenotypes (RAO, IBH, URT, MHS) fecal egg counts, the SNP BIEC2-224511 as well as management and environmental factors were investigated. RESULTS: In P1, RAO-affected horses had a 13.1 times higher odds ratio (OR) of also suffering from IBH (P = .004). In P2, the respective OR was 7.4 (P = .002) and IBH-affected horses also showed a 7.1 times increased OR of concomitantly suffering from URT (P < .001). IBH, URT, and MHS phenotypes were significantly associated with the absence of nematode eggs in the feces. CONCLUSIONS AND CLINICAL IMPORTANCE: This is the first report of MHS in horses. Specifically, an increased risk for IBH should be expected in RAO-affected horses.

Guttural pouch mycosis in horses: a retrospective study of 28 cases.

The medical records of 28 horses with guttural pouch mycosis were reviewed. The most commonly observed clinical signs were nasal discharge, epistaxis, dysphagia and/or cough. All 28 horses had the disease unilaterally, however, in five of them, it had spread into the contralateral pouch via the mesial septum. Three horses were treated medically, 11 horses underwent surgery and seven horses were treated both medically and surgically. Fifty percent of horses (14/28) were euthanased or died, fifty percent of horses (14/28) survived. There was no significant correlation between treatment method (medical, surgical, combination) and survival rate. The most common reason for euthanasia was dysphagia due to pharyngeal dysfunction. There was a highly significant correlation between the presence of dysphagia and non-survival (p=0.008).

[Neonatal enterovirus meningitis: transmission via parents during rooming-in and current epidemiology in Germany]. / Neonatale Enterovirus-Meningitis: Transmission durch die Eltern beim familiären Rooming-in und derzeitige Epidemiologie der Erkrankung in Deutschland.

INTRODUCTION: Non-polio-enterovirus infections are common in children and adults and usually lead to a mild, self-limiting disease. Perinatally acquired enterovirus infections, however, may lead to a severe disease including meningitis, encephalitis, hepatitis, coagulopathy or myocarditis. The mode of transmission may be not obvious. METHODS: 2 cases of neonatal enterovirus meningitis are presented. The disease was probably transmitted by the parents after birth during rooming-in within the hospital. The frequency of neonatal enterovirus infections in Germany was determined by analysing data of the enterovirus surveillance system of the national commission for polio eradication. RESULTS: In both cases, the parents suffered from a febrile infection. In case 1, transmission by the febrile mother was suspected. In case 2, transmission of Coxsackie B5-virus by the father was confirmed by viral culture. Both neonates exhibited fever, one patient had the typical clinical signs of meningitis. Levels of inflammatory indicators in blood (CRP, IL-6) were remarkably low. From 2006 to 2009, 322 neonates were included within the voluntary, passive enterovirus surveillance system. In 81 patients (25%) an enterovirus was detected via RT-PCR. The yearly frequency of infections was between 8 and 21. In 58 of 322 specimens (18%) serotyping was possible. CONCLUSION: Infections with enterovirus are both clinically and epidemiologically relevant during the neonatal period. Predominantly in the typical season, from June to October, enteroviral infections may be an important differential diagnosis to neonatal sepsis. The infection may be transmitted via infected parents during rooming-in within the hospital.

The NK-1 receptor-antagonist aprepitant in high-dose chemotherapy (high-dose melphalan and high-dose T-ICE: paclitaxel, ifosfamide, carboplatin, etoposide): efficacy and safety of a triple antiemetic combination.

Complete protection from nausea/vomiting is currently achieved in a minority of patients receiving high-dose chemotherapy (HDC). Currently the use of 5-HT3-antagonists and dexamethasone (DEX) represents the standard of care. The role of the NK-1-antagonist aprepitant in HDC remains to be better defined. A total of 64 patients undergoing multiple days of HDC received granisetron, DEX plus aprepitant during chemotherapy. After the end of chemotherapy aprepitant plus DEX was given for a further 2 days. Primary end point was CR defined as no vomiting and no use of rescue medication in the overall phase (day 1 until 5 days after end of chemotherapy). Acute/delayed and overall CR were achieved in 83%/70% and 63%, respectively. Acute and delayed nausea were observed in 20 and 38% of the patients. The tolerability of the aprepitant regimen over 4-5 days was comparable with the 3-day antiemetic regimen. In our study, aprepitant demonstrated good tolerability. Taking into account the methodological constraints of comparing our results with those from the available literature, the addition of aprepitant to the antiemetic treatment regimen may provide improved prevention of chemotherapy-induced nausea and vomiting during HDC.

Equine granulocytic anaplasmosis in the Czech Republic.

Twelve confirmed cases of equine granulocytic anaplasmosis (EGA) and five additional suspected cases, showing a compatible clinical history and specific IgG titres of 1280 or above, were recorded in the Czech Republic during the period 2002 to 2008. The diagnosis was based on clinical signs, the detection of Anaplasma phagocytophilum morulae in neutrophils in blood smears, serology and molecular methods. Pyrexia (39.8 to 41.3 degrees C), depression, partial or total anorexia, limb oedema and icterus were the most frequently observed clinical abnormalities. Haematological examination revealed thrombocytopenia in all the horses, and mild anaemia and leucopenia in five of them. Several horses showed high titres of specific antibodies immediately after onset of the disease, suggesting that they had previously been exposed to A phagocytophilum. Genotyping of the A phagocytophilum strains distinguished two genetic variants, with divergence in the sequence of the ank gene of the bacterium, circulating in the Czech Republic.

Types of indwelling urinary catheters for long-term bladder drainage in adults.

BACKGROUND: Prolonged urinary catheterisation is common amongst people in long-term care settings and this carries a high risk of developing a catheter-related urinary tract infection and associated complications. A variety of different kinds of urethral catheters are available. Some have been developed specifically to lower the risk of catheter-associated infection, for example antiseptic or antibiotic impregnated catheters. Ease of use, comfort and handling for the caregivers and patients, and cost-effectiveness are also important factors influencing choice. OBJECTIVES: The primary objective was to determine which type of in-dwelling urinary catheter is best to use for long-term bladder drainage in adults. SEARCH STRATEGY: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 15 December 2004), MEDLINE (January 1950 to February 2005) and CINAHL (January 1982 to February 2005). We also handsearched 28 relevant journals and conference proceedings. We examined the bibliographies of relevant articles and contacted catheter manufacturers, scientific societies and experts for trials. SELECTION CRITERIA: All randomised trials comparing types of indwelling urinary catheters for long-term catheterisation in adults. Long-term catheterisation was defined as more than 30 days. DATA COLLECTION AND ANALYSIS: Data extraction has been undertaken by two review authors independently and simultaneously. Any disagreement has been resolved by a third review author. The included trial data were handled according to the description of the Cochrane Collaboration Reviewers' Handbook. MAIN RESULTS: Three trials were included involving 102 adults in various settings. Two trials had a parallel group design and one was a randomised cross-over trial. Only two of the six targeted comparisons were assessed by these trials: antiseptic impregnated catheters versus standard catheters (one trial) and one type of standard catheter versus another standard catheter (two trials). The single small cross-over trial was inadequate to assess the value of silver alloy (antiseptic) impregnated catheters. In the two trials comparing different types of standard catheters, estimates of differences were all imprecise because the trials also had small sample sizes: confidence intervals were too wide to rule out clinically important differences. One trial did suggest, however, that the use of a hydrogel coated latex catheter rather than a silicone catheter may be better tolerated (RR for need for early removal 0.41, 95% CI 0.22 to 0.77). AUTHORS' CONCLUSIONS: Very few trials have compared types of catheter for long-term bladder drainage. All were small and showed methodically weaknesses. Therefore, the evidence was not sufficient as a reliable basis for practical conclusions. Further, better quality trials are needed to address the current lack of evidence in this clinically important area.

Pathomorphological study on gastroduodenal ulceration in horses: localisation of lesions.

Gastroduodenal ulceration is a prevalent disease in foals and adult horses. Decreased performance as well as fatal complications relate to this syndrome. The objective of our study was to determine the prevalence of gastric ulceration in a mixed population of horses by postmortem examination and to evaluate a possible association between equine gastric ulcer syndrome (EGUS) and sex or age of the examined horses, to evaluate the localisation of lesions in the proximal part of the gastrointestinal tract and to determine the occurrence of gastric parasites. Postmortem examinations were performed on 71 horses over a period of 24 months. Gastric ulcers were found in 52 horses (73.2%). There was no significant association between age or sex and occurrence of gastric ulcers. In all horses the squamous mucosa lesions were localised near the margo plicatus (100% of the cases), whereas in 23 horses the lesions were near the margo plicatus and lesser curvature and in 7 horses at the greater curvature. In 18 horses the mucosa was affected in the whole extent of the margo plicatus and in 1 horse diffuse lesions of the squamous mucosa were noted. Lesions of the glandular mucosa were localised in 11 horses at the fundic area, in 1 horse they occurred in the pylorus, and in 10 horses diffuse lesions of the glandular mucosa were recorded. A low prevalence of Gasterophilus intestinalis infection was detected (1 horse, 1.4%). We have confirmed that gastric ulcers are a common problem in horses and duodenal or oesophageal ulceration is rare (not a single case of the latter was found in this study). Lesions in the glandular mucosa of the stomach are more frequent in suckling foals than in older animals. Lesions of the glandular mucosa are also common in adult horses, and a complete gastroscopic examination including examination of the pylorus is advisable to evaluate this syndrome.

Comparison of the prevalence of APC-resistance in vascular patients and in a normal population cohort in Western Germany.

OBJECTIVE: To compare the prevalence of APC-resistance (APC-R) in patients with peripheral vascular disease and the general population. DESIGN: Prospective cohort examination. MATERIALS AND METHODS: Three hundred and eleven patients (group A) suffering from arterial occlusive disease or an abdominal aortic aneurysm were prospectively screened for APC-R. There were 228 men and 83 women with a mean age of 65 years (20-88 years). Two hundred and sixty patients underwent an open surgical or interventional procedure. A total of 306 patients were followed clinically for an average of 8 months (1-31 months). Two hundred and seven healthy volunteers (group B) served as a control group. RESULTS: The prevalence of a functional APC-R was 11% (33/311) and 8% in groups A and B, respectively, (p = 0.272). APC-R did not occur more frequently among patients who were treated primarily for a bypass occlusion (3/21 vs 30/290) (p = 0.476). None of five patients who had a postinterventional graft or vessel occlusion (1.9%) had an APC-R. Sixteen patients (5%) experienced an arterial occlusion during follow-up of which two had APC-R. CONCLUSIONS: Previously published increased prevalence rates of APC-R in patients with arterial disorders could not be confirmed in this study. A firm association between the presence of APC-R and previous bypass occlusion or postoperative failure of the vascular reconstruction could not be demonstrated.

Isolation and partial characterization of equine herpesvirus type 1 in Czechia.

Equine herpesvirus type 1 was determined as the etiological cause of an abortion storm in Czechia in 2003 after the virus strain was isolated from aborted fetus and identified by serological means and by PCR technique. Cloning and sequencing of the glycoprotein D confirmed the identity of the isolates and showed molecular relationships to known EHV-1 strains. Comparison of glycoprotein D sequences with corresponding sequence of EHV-1 reference strains (Kentucky-A and Ab1) revealed high nucleotide homology. The Czech isolate of EHV-1 virus does not differ significantly from the Ab1 strain regarding the glycoprotein D gene and does not bear the frameshift in the 3' terminus which occurs in the Kentucky-A strain.

Fibrinogen adsorption in the diabetic foot syndrome and peripheral arterial occlusive disease: first clinical experience.

The elimination of fibrinogen from plasma improves plasma viscosity and whole-blood viscosity. For extracorporeal adsorption of fibrinogen, the pentapeptide gly-pro-arg-pro-lys was coupled to sepharose CL-4B3. Adsorbers containing 135 ml of coupled sepharose CL-4B were used to eliminate fibrinogen from the plasma of 7 men and 3 women (48-75 years old). Nine patients suffered from diabetes mellitus, 1 patient from peripheral arterial occlusive disease, and 5 patients were on regular hemodialysis. Treatments were scheduled on Days 1, 2, 4, 6, 8, 10, 13, 16, 19, 22, 25, and 28. One hundred forty-four treatments with fibrinogen adsorption were performed. No clinical side effects due to the fibrinogen adsorption procedure were observed. In these 10 patients, fibrinogen concentration before the first treatment was 473.7 +/- 183.7 mg/dl. In the first treatment session, fibrinogen concentration was lowered to 241.4 +/- 125.8 mg/dl by treating 4,270 +/- 1,180 ml of plasma. In the following 134 treatments, the pretreatment concentration of fibrinogen was 262.6 +/- 83.4 mg/dl, and the posttreatment concentration was 120.6 +/- 37.2 mg/dl. The mean amount of plasma treated was 3,737 +/- 1,643 ml, and the mean duration of a treatment session (except first treatment) was 143.7 +/- 63.1 min. In 7 patients, a mean posttreatment fibrinogen concentration of < or = 123 mg/dl was obtained; in the other patients, concentrations of 133, 177, and 184 mg/dl were obtained. Yet, the decrease of fibrinogen concentration was also pronounced in these 3 patients: -82%, -67%, and -73%, respectively. During the treatment period of 28 days, wound healing was observed in 9 of the 10 patients. In conclusion, affinity chromatography using the pentapeptide gly-pro-arg-pro-lys is an effective, selective, and safe procedure to lower fibrinogen concentration in plasma. It could be a therapeutic option in severe blood vessel disease in which drug therapy is not sufficient and invasive procedures such as bypass or angioplasty cannot be applied. Yet, more information is needed, for example, about the fibrinogen concentration that has to be reached to get the maximal improvement of micro- and/or macrocirculation.

Complications associated with the use of indwelling epidural catheters in dogs: 81 cases (1996-1999).

OBJECTIVE: To evaluate complications associated with use of indwelling epidural catheters in dogs in a clinical setting. DESIGN: Retrospective clinical study. ANIMALS: 81 client-owned dogs. PROCEDURE: Medical records were reviewed for dogs in which a 19-gauge epidural catheter was placed percutaneously at L7-S1 and advanced to the point of maximum efficacy for pain control (between L7 and T4, depending on the procedure). Catheters were used to provide perioperative epidural analgesia during surgeries that included perineal (n = 6), hind limb (33), abdominal (43), thoracic (5), forelimb (2), and cervical (1) procedures. RESULTS: Catheters were maintained in situ from 1 to 7 days (mean, 2.3 days; median, 2.0 days). Sixty-four dogs did not have complications; 17 dogs had minor complications. Catheter dislodgement was the most common complication (13/80 [16%] dogs). Catheter site contamination without inflammation developed in 2 (2.4%) dogs; inflammation at the catheter site developed in 2 (2.4%) dogs but was not related to duration of time the catheter was in place. Complications were not serious and did not require treatment other than catheter removal. Dogs that dislodged their catheters were significantly younger (mean, 2.9 years; median, 2.0 years) than other dogs (mean, 6.2 years; median, 6.0 years). Dogs that received femoral fracture repair dislodged their catheters more often (62.5%) than dogs undergoing other procedures (10.9%). CONCLUSIONS AND CLINICAL RELEVANCE: The complication rate associated with temporary epidural catheterization of dogs appears to be low, and complications generally are not serious.

The major facilitator superfamily.

In 1998 we updated earlier descriptions of the largest family of secondary transport carriers found in living organisms, the major facilitator superfamily (MFS). Seventeen families of transport proteins were shown to comprise this superfamily. We here report expansion of the MFS to include 29 established families as well as five probable families. Structural, functional, and mechanistic features of the constituent permeases are described, and each newly identified family is shown to exhibit specificity for a single class of substrates. Phylogenetic analyses define the evolutionary relationships of the members of each family to each other, and multiple alignments allow definition of family-specific signature sequences as well as all well-conserved sequence motifs. The work described serves to update previous publications and allows extrapolation of structural, functional and mechanistic information obtained with any one member of the superfamily to other members with limitations determined by the degrees of sequence divergence.

Bilateral xanthine nephrolithiasis in a dog.

Xanthinuria is an uncommon metabolic disorder clinically manifested as urolithiasis. There are two forms of the disease, congenital and iatrogenic. The former was diagnosed in a four-year-old dachshund bitch. The patient was presented with signs of terminal chronic renal failure. Urine was bacteriologically sterile with massive amorphous crystalluria. Bilateral nephrolithiasis was diagnosed at necropsy. The kidneys were shrunken with marked atrophy of the renal cortex and medulla. Infrared spectrometry revealed that the stones comprised 100 per cent xanthine. Later, two of the patient's siblings were examined for urine xanthine content; both showed higher concentrations of xanthine than a control dog. The described case is compared with seven known published cases of congenital xanthinuria.