Wasting and mortality in beef cattle parasitized by Eurytrema coelomaticum in the State of Paraná, southern Brazil.

A sporadic wasting syndrome affecting beef cattle herds parasitized by Eurytrema coelomaticum is described in the State of Paraná, southern Brazil. The disease was characterized by progressive weight loss, poor body condition despite plenty of good quality forage available, and death. Annual losses ranged from 1 to 3%. The clinical course of the disease varied from 2 to 10 months after the onset of the first clinical signs. At necropsy, one of the three distinct following patterns of lesions were observed: the pancreas was of normal size and color; small, shrunken, white and markedly and diffusely firm (fibrosis); or slightly enlarged and dark with a shriveled capsular surface. Myriads of leaf-shaped trematodes of the genus Eurytrema were packed inside multiple dilated ducts with thickened, whitish fibrous walls, or the flukes were embedded in the remaining pancreatic parenchyma. Microscopic findings included extensive loss of the pancreatic parenchyma with replacement fibrosis, intralesional flukes and eggs, and ductal hyperplasia. Inflammatory reaction varied from absent to severe with the presence of a granulomatous reaction around the trematode eggs. One affected animal had high plasma amylase concentration (1580U/L) suggesting exocrine pancreatic insufficiency. Glucose blood levels were not significantly increased. We suggest that diffuse and marked fibrosis of the pancreas induced by the presence of large amounts of pancreatic flukes is the cause of the sporadic cases of chronic wasting and death of cattle in this geographic area.

Papillary adenocarcinoma of the extrahepatic bile duct in a Holstein cow.

A 15-year-old female Holstein cow was presented with a history of anorexia and weight loss. Abnormal physical examination findings included poor body condition, dehydration, icterus, and photodermatitis on nonpigmented areas of the skin of the dorsum. At necropsy, the common bile duct was greatly enlarged, with thickened walls, and tightly adhered to the hepatic capsular surface and serosa of adjacent loops of the small intestine. Two sessile, yellowish, friable, well-circumscribed, cauliflower-like, bulging masses (14 and 8 cm in diameter) were attached to the inner surface of the common bile duct blocking its lumen. Microscopically, the tumor was composed of well-differentiated, columnar epithelial cells with oval or round, vesicular, basal nuclei arranged in papillary projections. Periodic acid-Schiff-positive material accumulated in the apical cytoplasm of the neoplastic cells. Immunostaining of the tumor cells was positive for cytokeratin (CK) of wide-spectrum screening and for CK 7. The diagnosis of papillary adenocarcinoma of the extrahepatic bile duct was based on the morphologic features of the neoplasm and evidence of local invasion. To the best of our knowledge, extrahepatic bile duct carcinomas have not been described in cattle.

Lead poisoning in cattle in southern Brazil

Em setembro de 2000, três novilhas, provenientes de um pequeno rebanho de bovinos de corte, apresentaram severa depressão, tremores musculares, ato de pressionar a cabeça contra objetos e de ranger de dentes, intensa salivação, cegueira e morte. Envenenamento por chumbo foi diagnosticado com base nos sinais clínicos e em função da presença de grandes concentrações de chumbo nos rins e no fígado de um dos animais afetados. Latas de tinta velhas, presentes no potreiro onde estavam os animais e cujo conteúdo extravasava através de fendas provocadas pela ferrugem, foram identificadas como a fonte de chumbo que causou a toxicose nos animais.

Clinical and pathological study of feline mammary fibroadenomatous change associated with depot medroxyprogesterone acetate therapy

Descrevem-se seis casos de alteração fibroadenomatosa mamária felina (AFAMF) associada à administração de uma única injeção de acetato de medroxiprogesterona (AMP) na dose recomendada pelos fabricantes. A doença foi observada em gatas jovens não-castradas atendidas em dois hospitais veterinários de 1999 a 2001. O diagnóstico de AFAMF foi feito com base no histórico, sinais clínicos e achados macroscópicos e confirmado histologicamente em quatro dos seis casos. Sugere-se que a ocorrência da AFAMF esteja associada ao efeito prolongado de uma única injeção de AMP de depósito administrada em situações nas quais o emprego dessa terapia não é recomendado.

Lysosomal storage disease in Sida carpinifolia toxicosis: an induced mannosidosis in horses.

REASONS FOR PERFORMING STUDY: This study reports a neurological disease unrecognised until now in ponies in southern Brazil. HYPOTHESIS: Epidemiological data strongly suggests that the ingestion of Sida carpinifolia is involved in the aetiology. We tested the hypothesis that it is an acquired lyosomal storage disease. METHODS: Following the death of 3 ponies, all ponies from the premises were closely monitored; epidemiological data and clinical findings carefully recorded. Fragments of several organs, including CNS, were fixed in neutral formalin and embedded in paraffin-wax. Sections were stained with haematoxylin and eosin. Representative sections of the cerebellum and trigeminal ganglia were submitted to lectin histochemical procedures. RESULTS: The neurological disorder, characterised by stiff gait, muscle tremors, abdominal pain and death, was observed on a farm with 3 hectares of pasture. Three of 11 ponies died 15-20 days after they had been introduced into a new paddock heavily infested by the plant Sida carpinifolia. No significant gross lesions were observed. The main histological findings included multiple cytoplasmatic vacuoles in swollen neurones in the brain, cerebellum, spinal cord, autonomic ganglia (trigeminal and celiac ganglia), and submucosal and myenteric plexus of the intestines. In the kidneys, there was marked vacuolation of the proximal convoluted tubular cells. Sections of cerebellum and trigeminal ganglion were submitted to lectin histochemistry. The vacuoles in different cerebellar and ganglion cells reacted strongly to the following lectins: Concanavalia ensiformis, Triticum vulgaris and succinylated-Triticum vulgaris. CONCLUSIONS: The pattern of staining coincides with that of both swainsonine toxicosis and inherited mannosidosis reports. The histopathological changes were similar to those described in S. carpinifolia spontaneous and experimental poisoning in goats. This disease seems to be similar to Swainsona, Oxytropis and Astragalus toxicosis. POTENTIAL RELEVANCE: S. carpinifolia should be evaluated as a possible cause in the diagnosis of equine neuropathies.

Relevant in times of turmoil: WHO and public health in unstable situations.

For millions of people world-wide, surviving the pressure of extreme events is the predominant objective in daily existence. The distinction between natural and human-induced disasters is becoming more and more blurred. Some countries have known only armed conflict for the last 25 years, and their number is increasing. Recently, humanitarian sources reported 24 ongoing emergencies, each of them involving at least 300,000 people "requiring international assistance to avoid malnutrition or death". All together, including the countries still only at risk and those emerging from armed conflicts, 73 countries, i.e., almost 1.8 trillion people, were undergoing differing degrees of instability. Instability must be envisioned as a spectrum extending between "Utopia" and "Chaos". As emergencies bring forward extreme challenges to human life, medical and public health ethics make it imperative for the World Health Organisation (WHO) to be involved. As such, WHO must enhance its presence and effectiveness in its capacity as a universally accepted advocate for public health. Furthermore, as crises become more enmeshed with the legitimacy of the State, and armed conflicts become more directed against countries' social capital, they impinge more on WHO's work, and WHO must reconcile its unique responsibility in the health sector, the humanitarian imperative and the mandate to assist its primary constituents. Health can be viewed as a bridge to peace. The Organization specifically has recognised that disasters can and do affect the achievement of health and health system objectives. Within WHO, the Department of Emergency and Humanitarian Action (EHA) is the instrument for intervention in such situations. The scope of EHA is defined in terms of humanitarian action, emergency preparedness, national capacity building, and advocacy for humanitarian principles. The WHO's role is changing from ensuring a two-way flow of information on new scientific developments in public health in the ideal all-stable, all-equitable, well-resourced state, to dealing with sheer survival when the state is shattered or is part of the problem. The WHO poses itself the explicit goals to reduce avoidable loss of life, burden of disease and disability in emergencies and post-crisis transitions, and to ensure that the Humanitarian Health Assistance is in-line with international standards and local priorities and does not compromise future health development. A planning tree is presented. The World Health Organization must improve its own performance. This requires three key pre-conditions: 1) presence; 2) surge capacity; and 3) institutional support, knowledge, and competencies. Thus, in order to be effective, WHO's presence and surge capacity in emergencies must integrate the institutional knowledge, the competencies, and the managerial set-up of the Organization.

Internally displaced persons.

There were estimated to be over 20 million internally displaced persons (IDPs) at the end of 1999, a number that surpasses global estimates of refugees. Displacement exposes IDPs to new hazards and accrued vulnerability. These dynamics result in greater risk for the development of illness and death. Often, access of IDPs to health care and humanitarian assistance is excluded deliberately by conflicting parties. Furthermore, the arrival of IDPs into another community or region strains local health systems, and the host population ends up sharing the sufferings of the internally displaced. Health outcomes are dismaying. From a health perspective, the best option is to avoid human displacement. WHO contributes to the prevention of displacement by working for sustainable development. Placing health high on the political agenda helps maintain stability, and thereby, reduce the likelihood for displacement. Primary responsibility for assisting IDPs, irrespective of the cause, rests with the national government. However, where the government is unwilling or unable to provide the necessary aid, the international humanitarian community must step in, with WHO playing a major role in the health sector. There is consensus among the partners of the World Health Organization (WHO) that, in emergencies, the WHO must: 1) take the lead in rapid health assessment, epidemiological and nutritional surveillance, epidemic preparedness, essential drugs management, control of communicable diseases, and physical and psychosocial rehabilitation; and 2) provide guidelines and advice on nutritional requirements and rehabilitation, immunisation, medical relief items, and reproductive health. If the vital health needs of IDPs--security, food, water, shelter, sanitation and household items--are not satisfied, the provision of health services alone cannot save lives. Community participation is essential, and community participation implies bolstering the assets and capacities of the beneficiaries.

Baccharis megapotamica var Weirii poisoning in Brazilian cattle.

Three Holstein heifers died after consumption of Baccharis megapotamica var weirii in southern Brazil. Main histologic lesions included degeneration and necrosis of the epithelium from the forestomachs and of the lymphoid tissue of the spleen and lymph nodes.

Monensin poisoning in Brazilian horses.

Three outbreaks of monensin poisoning caused 12 deaths in 16 horses. The illnesses were associated with the ingestion of the same batch of a commercial ration labeled for feeder calves which contained 180 +/- 20 ppm sodium monensin. The morbidity rate was 100% and lethality was 60%, 75%, and 100%. Clinical signs were tachycardia and cardiac arrythmia, groaning, incoordination, sudoresis, recumbency, and paddling movements with the limbs before death. Two horses had dark discolored urine (myoglobinuria). Serum levels of creatine phosphokinase activity were increased. Main necropsy findings were in the skeletal muscles and myocardium.

Phytolacca decandra poisoning in sheep in southern Brazil.

A clinical case of sheep deaths due to Phytolacca decandra occurred in Southern Brazil and was experimentally duplicated by force-feeding the plant. General neurologic signs and diarrhea with rumen and reticulum hyperemia and coagulation necrosis of the mucosa were seen.

Armed conflicts, health and health services in Africa. An epidemiological framework of reference.

Because of war, between the 1980s and early '90s Africa suffered about 5 million excess deaths and economic losses estimated at US $13 billion per year. In 1995, war was directly or indirectly affecting 550 million people in 35 countries. Besides violent deaths, injuries and disabilities, displacements of population increase the risk for acute respiratory infections, diarrhoeas, epidemics and parasitic disease. The risk for malnutrition and deficiencies is made worse by the loss of means of production, of food stocks, of commerce and by banditism. Military operations target water plants and health facilities as means of deliberately hurting civilians. Economic crisis curtails the budgets of the social sectors and, together with social distress, undermines national capacities. The delivery of health care is hampered right when hazards and vulnerabilities increase, with general greater risk of illness and death. With the cessation of hostilities, the need for curative and preventative health activities increases and is a matter of emergency, as equitable access to services is important for peace. Repatriation of refugees, demobilization of soldiers and demining require special health activities. War leaves behind new hazards and vulnerabilities such as landmines, wide availability of weapons, artificial concentrations of population, loss of national capacities and psychological disorders. All this interacts tragically with Africa's wider epidemiological realities of poverty, food insecurity, proneness to natural disasters and endemic diseases.

Disasters in Africa: old and new hazards and growing vulnerability.

Disasters occur when hazards and vulnerability meet. Out of 100 disasters reported worldwide, only 20 occur in Africa, but Africa suffers 60% of all disaster-related deaths. This is probably due to the type of hazards that affect this continent, to under-reporting, and to the fact that under the circumstances prevailing in Africa, it is easy for any disaster to escalate and multiply its impact. Africa's natural hazards are mainly epidemics, endemic diseases, drought, floods, agricultural pests and bush fires, but some areas are also susceptible to earthquakes, cyclones and volcanic eruptions. The natural hazards interact with manmade ones, such as armed conflicts, air, road and railway incidents, other industrial hazards such as mining accidents, chemical spills, etc., and with widespread vulnerability. The context is one of rapid population growth, forced movements of population, environmental degradation, precarious urbanization, food insecurity, poverty, fragile economies, infrastructures and institutions, and cultural and political instability. The 53 countries of the continent are highly susceptible and vulnerable and their 761,390,000 people are exposed to both natural and manmade hazards. Through complex causal chains, disasters affect people directly and indirectly. In the first 6 months of 1996, meningitis had already killed 5,000 people. Throughout Africa, there are 500,000 measles-associated deaths each year; the direct and indirect costs of malaria are estimated at US$ 1.7 billion per year. In June 1996 food emergencies were looming in 14 African countries with 22 million people facing direct food shortages. Since 1980, conflicts have caused at least 3.7 million excess deaths and cost the Region about US$ 13 billion per year. Wars have destroyed 70% of the health network of some countries, and have left behind 30-40 million landmines, making Africa the most mine-infested continent in the world.

Leprosy control: the rationale of integration.

After considering the situation and the perspectives of integration and the drawbacks that a vertical approach can represent for leprosy control, the author proposes the framework of control programmes as a systemic model for comprehensive health care. The structure that health services in developing countries are adopting in order to implement PHC allows for an horizontal integration of specific activities; conversely, activities which have already proved their value for leprosy control can easily enlarge their scope and include other prevalent conditions. Integration leads to an improvement in patients' and health workers' attitudes; provided that the necessary supervision is guaranteed, integration is feasible and warrants more effective patients' care and a better exploitation of resources in order to reduce the specific risk in the community.

Five years of hanseniasis control activities in the Cape Verde Islands based on the OMSLEP system.

After some general information about the use of the OMSLEP System in the National Hanseniasis Control Program of the Republic of Cape Verde the author presents some operational and epidemiological indices produced by the System, adding a short evaluation of the Program and of the use of the System.