Cutaneous and systemic poxviral disease in red (Tamiasciurus hudsonicus) and gray (Sciurus carolinensis) squirrels.

From September 2005 through October 2006, fibromatosis was diagnosed in 2 red squirrels (Tamiasciurus hudsonicus) and 1 gray squirrel (Sciurus carolinensis). All 3 squirrels had multifocal to coalescing, tan, firm alopecic cutaneous nodules. Two squirrels also had pulmonary nodules. Histologically, the cutaneous nodules had marked epidermal hyperplasia, with ballooning degeneration of keratinocytes, spongiosis, and eosinophilic cytoplasmic inclusions. The dermis was expanded by proliferation of atypical mesenchymal cells with cytoplasmic inclusions. Additional findings included pulmonary adenomatous hyperplasia with cytoplasmic inclusions, renal tubular epithelial hyperplasia with cytoplasmic inclusions, atypical mesenchymal proliferation in the liver, and atypical mesenchymal proliferation with cytoplasmic inclusions in the seminal vesicles. Ultrastructurally, poxviral particles were observed in skin scrapings and sections of cutaneous and pulmonary nodules. Polymerase chain reaction targeting the highly conserved Leporipoxvirus DNA polymerase gene was positive using DNA extracted from the cutaneous lesions of all 3 squirrels. Nucleotide sequence of the 390 base PCR amplicons was closely related to that of other members of the genus Leporipoxvirus. To the authors' knowledge, this is the first report of cutaneous and systemic poxviral disease in American red squirrels with molecular characterization of the squirrel fibroma virus.

Extensive lesions of monkeypox in a prairie dog (Cynomys sp).

Monkeypox with extensive lesions was diagnosed in a prairie dog that was involved in a recent human outbreak of monkeypox in the Midwestern United States. Gross lesions included oral ulcers, pulmonary consolidation, enlarged cervical and thoracic lymph nodes, and multifocal, small, white umbilicated plaques in the gastrointestinal wall. Microscopic lesions were extensive in the lungs and consisted of fibrinonecrotic bronchopneumonia with vasculitis and poorly defined eosinophilic intracytoplasmic inclusion bodies in cells thought to be alveolar epithelial cells, histiocytes, and fibroblasts. Multifocal necrotizing lesions, often accompanied by myxedema, were also present in most of the other examined organs. Aggregates of pox viral particles were observed within lesions by transmission electron microscopy. Monkeypox virus infection was confirmed by real-time polymerase chain reaction and virus culture at the Centers for Disease Control and Prevention. This report highlights the difficulties of rapid diagnosis of exotic or emerging diseases and further substantiates the prairie dog as an animal model of monkeypox.

Purification of turkey coronavirus by Sephacryl size-exclusion chromatography.

Sephacryl S-1000 size-exclusion chromatography was used to purify turkey coronavirus (TCoV) from infected turkey embryo. TCoV was propagated in the 22-day-old turkey embryos. Intestines and intestinal contents of infected embryos were harvested and homogenized. After low speed centrifugation, the supernatant was concentrated by ultracentrifugation through a cushion of 30 or 60% sucrose solution, or by ammonium sulfate precipitation. The purification methods included sucrose gradient and Sephacryl S-1000 size-exclusion chromatography. Ultracentrifugation through a cushion of 60% sucrose solution was better than the other two methods for concentration of TCoV from intestinal homogenate. The most effective method for purifying TCoV and removing extraneous materials was size-exclusion chromatography as analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. More spike-rich particles were observed in the sample purified by chromatography than those purified by sucrose gradient as examined by electron microscopy. Differentiation of turkey anti-TCoV antiserum from normal turkey serum was better achieved by ELISA plates coated with TCoV preparation purified by size-exclusion chromatography than that purified by sucrose density gradient. The results indicated that Sephacryl S-1000 chromatography was useful for purification of TCoV.

Prevention for the older woman. A practical guide to hormone replacement therapy and urogynecologic health.

Decisions to begin or continue hormone replacement therapy (HRT) are individualized, depending on a woman's anticipated benefits and risks from HRT. Estrogen, especially when begun early in menopause, has been shown to be beneficial in the prevention and treatment of osteoporosis. Potential risks of HRT include gallbladder disease, thromboembolism, and breast cancer. Systemic or topical estrogen can improve postmenopausal vaginal atrophy, vasomotor symptoms, and cervical cytologic changes. Treatment of other urogynecologic changes, such as vulval dystrophy and urinary incontinence, can relieve symptoms and improve the older woman's quality of life.

Humoral and cellular immune responses in turkey poults infected with turkey coronavirus.

The objective of the present study was to elucidate the kinetics of humoral and cellular immune responses of turkey poults infected with turkey coronavirus (TCV). Turkey poults were orally inoculated with TCV at 10 d of age, and the immune responses were analyzed at 1, 3, 7, 14, 21, 28, 42, and 63 d postinfection (PI) in three different experiments. Total Ig to TCV was initially detected at 7 and 14 d PI in Experiments 1 and 3. In addition, Ig gradually increased from 7 to 21 d PI and remained at 80 immunofluroescent antibody assay (IFA) titers or more thereafter. Lymphocyte proliferation responses of spleen cells to concanavalin A were higher in TCV-infected turkeys than in noninfected control turkeys with significant differences (P < 0.05) being noted at 14 and 63 d PI in Experiment 2 and at 3 and 28 d PI in Experiment 3. Strong IFA staining response to TCV antigen was observed in intestines of turkeys at 1, 3, and 7 d PI, and the response declined from 14 to 28 d PI in Experiment 3. In Experiment 3, the IgG isotype antibody response to TCV was markedly increased after 21 d PI and remained high until 63 d PI. The IgM isotype antibody response to TCV was 1.40 and 0.91 at 7 and 14 d PI, respectively. The IgA isotype antibody response to TCV was very low as detected at 7 (0.13), 14 (0.20), and 21 (0.17) d PI. Turkeys infected with TCV had significantly higher (P < 0.05) antibody response to sheep erythrocytes than noninfected controls at 7 d PI. Virus-specific lymphocyte proliferation response of spleen cells was significantly stimulated (P < 0.05) at 63 d PI in Experiment 3. The proportion of the CD4+ subpopulation of T lymphocytes was significantly increased (P < 0.05) at 1, 7, and 21 d PI in Experiment 3. The results indicate that humoral and cellular immunities to TCV are elicited in turkeys following infection with TCV.

Prevention for the older woman. A practical guide to assessing physical and cognitive function.

Life expectancy of women is greater than that of men at every age. Thus, an older woman is more likely than a man to be living without a spouse and living alone. It is important in caring for an older woman to establish how well she is functioning physically and cognitively and in what activities she may need assistance. Given the high prevalence of dementia with advanced age, screening for dementia should be considered in women over age 75. Although their risk of suicide is lower, older women are more likely to be depressed than older men, regardless of race, ethnic background, or economic status. Late-life depression is treatable, and screening should be considered in the presence of a major life change, recent stroke, or MI.

Coronary artery disease in women: different, often undertreated.

Cardiovascular disease is responsible for more deaths in women each year than all other causes combined. Women have different cardiac presentations than men and are more likely to be underdiagnosed and undertreated for coronary artery disease. This article addresses gender-specific issues in prevention, diagnosis, and treatment of coronary artery disease.

Differences in breast cancer screening rates: an issue of ethnicity or socioeconomics?

Previous reports suggest that use of preventive measures, such as screening mammography (SM), differs by ethnicity. It is unclear, however, if this is determined directly by ethnicity or indirectly by related socioeconomic factors. We studied self-reported data from 18,245 women aged 40-49 who participated in the Behavioral Risk Factor Surveillance System telephone survey in 1992 and 1993. Of these, 11,509 (63%) reported having obtained mammography within the preceding 2 years for screening purposes only. Using reports of other preventive healthcare behaviors, education level, socioeconomic status, and healthcare access problems as independent variables, bivariate associations were assessed, and a logistic regression model was developed. Models for each ethnic group were developed, with consistent results. Women who engaged in other preventive health measures, such as Pap smear (odds ratio [OR] 8.99, 95% confidence interval [CI] = 7.6-10.7), cholesterol measurement (OR 2.64, 95% CI = 2.3-3.0), and seatbelt use, were more likely to obtain SM. Women with healthcare access or insurance problems (OR 0. 59, 95% CI = 0.5-0.7) and current smokers (OR 0.71, CI = 0.6-0.8) had a lower likelihood of obtaining SM. Ethnicity, alcohol use, marital status, and education level were not significantly associated with women's reports of SM. Although ethnicity apparently does not influence a woman's likelihood of obtaining SM, access to healthcare and insurance and engaging in other healthy behaviors do. Health policy planners should consider the importance of these related factors when developing preventive health programs for women.

Detection of antibody to turkey coronavirus by antibody-capture enzyme-linked immunosorbent assay utilizing infectious bronchitis virus antigen.

An antibody-capture enzyme-linked immunosorbent assay (ELISA) for detection of antibody to turkey coronavirus (TCV) utilizing infectious bronchitis virus (IBV) antigen was developed. Anti-TCV hyperimmune turkey serum and normal turkey serum were used as positive or negative control serum for optimization of the ELISA system. Goat anti-turkey immunoglobulin G (light plus heavy chains) conjugated with horseradish peroxidase was used as detector antibody. The performance of the ELISA system was evaluated with 45 normal turkey sera and 325 turkey sera from the field and the cutoff point was determined. Serum samples of turkeys experimentally infected with TCV collected sequentially from 1 to 63 days postinfection were applied to the established antibody-capture ELISA using IBV antigens. The optimum conditions for differentiation between anti-TCV hyperimmune serum and normal turkey serum were serum dilution at 1:40 and conjugate dilution at 1:1600. Of the 325 sera from the field, 175 were positive for TCV by immunofluorescent antibody (IFA) assay. The sensitivity and specificity of the ELISA relative to IFA test were 93.1% and 96.7%, respectively, based on the results of serum samples from the field turkey flocks using the optimum cutoff point of 0.18 as determined by the logistic regression method. The ELISA values of all 45 normal turkey sera were completely separated from that of IFA-positive sera. The ELISA results of serum samples collected from turkeys experimentally infected with TCV were comparable to that of the IFA assay. Reactivity of anti-rotavirus, anti-reovirus, anti-adenovirus, or anti-enterovirus antibodies with the IBV antigens coated in the commercially available ELISA plates coated with IBV antigens could be utilized for detection of antibodies to TCV in antibody-capture ELISA.

Risk assessment of the menopausal patient.

Menopause is a physiologic event that gives a woman the opportunity to become involved in a preventive health program. Menopause is not a disease; however, it does cause symptoms in a significant percentage of women. Medical evaluation with an emphasis on health maintenance and lifestyle measures is important for menopausal women. Tailoring an individual program for women, which may include HRT and other therapeutic options, is guided by the menopausal risk assessment.

Medical aspects of pregnancy.

Women's health physicians should play a key role in preconception counseling and management of medical problems during pregnancy. Precautions recommended to reduce the risk of exposure to potential teratogens, medications, and medical interventions are discussed. The U.S. Food and Drug Administration categorization of medications given during pregnancy is reviewed, and medications commonly used in pregnancy are listed. The basics of preconception counseling and routine prenatal care are reviewed, and guidelines for optimum preconception control of common medical conditions are summarized. Serious medical problems in pregnancy include hypertension, diabetes mellitus, thromboembolic disorders, asthma, thyroid disease, seizure disorder, infections, systemic lupus erythematosus, hematologic disorders, cardiac disease, and gastrointestinal disorders. Therefore, both physician and patient need to emphasize a preventive medicine approach to ensure the best outcome for both mother and child.

Management of perimenopause: focus on alternative therapies.

A variety of herbs and other "natural alternative medicines" are marketed directly to consumers and sold over-the-counter as treatments for perimenopausal symptoms. Far from being innocuous placebos, many of these substances have real physiologic effects, including potential adverse effects and drug interactions. Yet they are largely untested and, by law, totally unregulated. This article reviews a few of the untested substances your patients may be taking, along with established treatments.

New drugs for reducing cardiovascular risk in women.

Atherosclerosis is largely preventable in women. Clinicians need to appreciate the gender-associated risks of cardiovascular disease and emphasize to their women patients that life-style changes can reduce cardiovascular risk. However, newer oral agents for diabetes and the statins for hyperlipidemia are important pharmacological adjuncts.

Effect of cytoxan-induced heteropenia on the response of specific-pathogen-free chickens to infectious bronchitis.

Epithelial damage in infectious bronchitis occurs early in the disease process. Heterophil infiltration into the tracheal mucosa is greatest at that time. To determine the contribution of heterophils to tracheal epithelial damage of infectious bronchitis, eight 3-wk-old specific-pathogen-free chickens were made heteropenic by four daily intramuscular injections of cyclophosphamide at 75 mg/kg body weight. Infection with Massachusetts 41 infectious bronchitis virus was timed to coordinate heteropenia with peak tracheal epithelial damage. Heteropenia was monitored by total leukocyte and differential cell counts of peripheral blood. Tissue damage and heterophil infiltrate were monitored by histopathology of tissues taken at termination of the study. Heteropenic birds had lower peripheral blood and tracheal heterophil numbers than nonheteropenic birds. No difference was found in epithelial damage of heteropenic and nonheteropenic birds. Epithelial damage in infectious bronchitis is most likely due to damage by the virus and not due to the infiltrated heterophils.

Menopause.

Most women live long enough to become postmenopausal. Menopause is not a disease, but it can be associated with discomfort, a decreased quality of life, and an increase in the disease risks of osteoporosis and coronary heart disease. The onset of menopause is an excellent time for a women's primary care physician to assess her overall health and the need for health maintenance measures, which may include hormone replacement therapy.

A sudden death syndrome induced in poults and chicks fed diets containing Fusarium fujikuroi with known concentrations of moniliformin.

A sudden death syndrome was induced in chicks and poults fed diets containing Fusarium fujikuroi, formulated to contain 0-330 mg/kg moniliformin (M) with or without the maximum recommended therapeutic concentration of monensin. Lesions of monensin toxicosis were not observed. Clinical signs were referable to cardiac dysfunction (sudden death, dyspnea, cyanosis, depression). Poults and chicks dying early in the study had no gross lesions or had lesions of right ventricular dilation. Treated poults and chicks dying late in the study or euthanatized at termination of the study had lesions of bilateral myocardial hypertrophy, usually concentric. Absolute heart weights and relative heart weights, expressed as a percentage of body weight, were significantly greater in treated birds than controls (P < 0.05), whereas body weights were significantly less (P < 0.05). Microscopically, lesions progressed from acute myocardial degeneration to necrosis, fibrosis, and hypertrophy. Ultrastructural findings were consistent with the gross and microscopic lesions. Serum pyruvate concentrations were a useful indicator of M-induced cardiotoxicosis. Concentrations of serum pyruvate increased with increased concentration of dietary M, but were not affected by addition of monensin to the diet. In chicks ingesting 40-300 mg/kg M, serum pyruvate concentrations were significantly greater (P > 0.05) than those in controls (controls, 0.28 +/- 0.08 mmol/liter; exposed 0.38 +/- 0.11-0.55 +/- 0.13 mmol/liter). Poults ingesting 80-330 mg/kg M had significantly greater serum pyruvate concentrations than controls (controls 0.33 +/- 0.09 mmol/liter; exposed 0.43 +/- 0.13-1.00 +/- 0.006 mmol/liter). The Vetronics System was used to evaluate electrocardiographic alterations in a limited number of chicks and poults surviving to the end of the feeding trial. Electrocardiographic alterations in poults and chicks fed diets containing > or = 40 mg/kg and > or = 160 mg/kg M, respectively, were consistent with ventricular hypertrophy, myocardial injury, and hypoxia. Electrocardiographic alterations were more striking in poults than in chicks. Altered myocardial metabolism due to M toxicosis, in conjunction with the unusual susceptibility of domestic poultry to altered cardiac metabolism, is believed to be the cause of the organ-specific lesions in these birds. These findings suggest that cardiac injury with subsequent alterations in cardiac electrical conductance may be a cause of the sudden deaths observed in poultry chronically intoxicated with dietary M.

Experimental infection of laying hens with Salmonella enteritidis strains that express different types of fimbriae.

A study was conducted to compare the pathogenicity of three Salmonella enteritidis phage type 8 strains (9, 21, and 30) in 30-wk-old laying hens. Strain 9 expressed two types of fimbriae of 14 and 21 kDa. Strain 30 expressed a single fimbrial type (21 kDa). Strain 21 did not express any fimbrial protein. Laying hens were divided into three groups of 35 each and each group was orally inoculated with a single S. enteritidis strain (1 x 10(8) cfu per bird). Significantly less intensive cecal colonization and fecal shedding of the organism were observed in hens that were inoculated with the strain that did not express fimbriae than in birds inoculated with other two strains (P < 0.05). Isolation of S. enteritidis from liver, spleen, reproductive organs, and egg contents did not differ between groups. Mean serum S. enteritidis lipopolysaccharide-specific antibody titers of birds inoculated with strain 21 were lower than titers of hens that were inoculated with the other two strains from the 5th wk through the end of the trial. Immunoblot of the bacterial outer membrane structures revealed the presence of serum antibodies against lipopolysaccharide, membrane-associated proteins, and purified 14 kDa fimbrial protein in birds inoculated with strain 9 as late as 9 wk postinoculation. Results of this study are consistent with a role for fimbrial proteins in the cecal colonization by S. enteritidis. In addition, cecal colonization mediated by fimbrial proteins may enhance the elicitation of humoral immune response against S. enteritidis.

Current issues in menopausal hormone replacement therapy.

For most menopausal women, the benefits of hormone replacement therapy outweigh the risks, despite the fears aroused by the unproven link to breast cancer. If the goal is solely to relieve menopausal symptoms, the treatment duration is generally 2 to 3 years and then gradually tapered off. If the goal is to provide cardiac protection and prevent osteoporosis, long-term, possibly lifetime, treatment is needed.