EVALUATION OF PLASMA CARDIAC TROPONIN I IN ASIAN ELEPHANTS (ELEPHAS MAXIMUS) USING TWO CLINICAL ANALYZERS.

Cardiac troponin I (cTnI) is specific to myocardial tissue, highly conserved across taxa, and a reliable indicator of myocardial disease in human and veterinary medicine. Biomarkers, like cTnI, may be useful for cardiac evaluation of elephants because the application of other modalities is complicated by the size of the animal. The goal of this study was to establish observed ranges for plasma cTnI in Asian elephants (Elephas maximus) measured by two point-of-care analyzers. Blood was collected from captive juvenile (≤15 yr; n = 9), adult (16-50 yr; n = 42), and geriatric (>50 yr; n = 16) elephants. Following centrifugation, heparinized plasma was stored at 5°C prior to and in between analyses on iSTAT (Abbott Point of Care Inc, Princeton, NJ 08540, USA) and HUBI-QUANpro (Humiasis Co, Ltd, Anyang-si 14042, South Korea) analyzers. With the exception of two results, plasma concentrations of cTnI were below the limit of quantification (LOQ < 0.05 ng/ml) for the HUBI-QUANpro (n = 64), which prohibited comparison between the two analyzers. Observed ranges were determined for plasma cTnI concentrations reported by the iSTAT for the entire population sampled (n = 58; mean 0.011 ng/ml; SD ± 0.013 ng/ml; range 0.00-0.07 ng/ml; 95% CI 0.008-0.015 ng/ml; median 0.01 ng/ml) and with outliers excluded (n = 50; mean 0.007 ng/ml; SD ± 0.007 ng/ml; range 0.00-0.02 ng/ml; 95% CI 0.005-0.009 ng/ml; median 0.01 ng/ml). No significant differences were observed between age classes (P = 0.70) or sexes (P = 0.34). Higher cTnI concentrations were significantly correlated with increasing age (Pearson's r = 0.426; P = 0.002). Future studies are warranted to investigate the diagnostic potential of plasma cTnI in Asian elephants.

POINT-OF-CARE AND STANDARD LABORATORY REFERENCE INTERVALS FOR COAGULATION VALUES IN ASIAN ELEPHANTS (ELEPHAS MAXIMUS): VARIATION BY AGE CLASS, SEX, AND TIME TO CENTRIFUGATION.

In Asian elephants (Elephas maximus), elephant endotheliotropic herpesvirus causes significant calf mortality. Coagulation testing may aid veterinarians in early identification and management of hemostatic disorders. This study sought to establish reference intervals for select coagulation and platelet values. Blood was collected from clinically healthy Asian elephants (n = 63) in juvenile (≤15 yr old, n = 9), adult (>15 to ≤50 yr old, n = 41), and geriatric (>50 yr old, n = 13) age classes at seven institutions in Kanchanaburi Province, Thailand. Activated clotting time (ACT) was immediately assessed with a handheld analyzer, whereas remaining blood was stored at 5°C in sodium citrate and potassium EDTA collection tubes and transported to a central laboratory. Coagulation values were assessed on an automated blood coagulation analyzer, and platelet values were assessed on a hematology analyzer. Reference intervals were established for ACT, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, platelet count, mean platelet volume, platelet distribution width, and plateletcrit according to the American Society for Veterinary Clinical Pathology guidelines. No significant differences were observed for any value when comparing sex and time to centrifugation. Plasma fibrinogen (P = 0.002) and platelets (P = 0.003) varied significantly by age class, with adults displaying the highest fibrinogen concentrations and geriatric individuals displaying the lowest platelet counts. The ACT kaolin cartridges resulted in high success rates (84.3% feasibility) compared with celite cartridges (4.8% feasibility). Further studies are warranted to stratify reference intervals in accordance with age class trends.

A natural allele of Nxf1 suppresses retrovirus insertional mutations.

Endogenous retroviruses have shaped the evolution of mammalian genomes. Host genes that control the effects of retrovirus insertions are therefore of great interest. The modifier-of-vibrator-1 locus (Mvb1) controls levels of correctly processed mRNA from genes mutated by endogenous retrovirus insertions into introns, including the Pitpn(vb) tremor mutation and the Eya1(BOR) model of human branchiootorenal syndrome. Positional complementation cloning identifies Mvb1 as the nuclear export factor Nxf1, providing an unexpected link between the mRNA export receptor and pre-mRNA processing. Population structure of the suppressive allele in wild Mus musculus castaneus suggests selective advantage. A congenic Mvb1(CAST) allele is a useful tool for modifying gene expression from existing mutations and could be used to manipulate engineered mutations containing retroviral elements.

Into the large ears: otitis externa associated with nematodes, mites, and bacteria in Asian elephants (Elephas maximus).

BACKGROUND: The Asian elephant (Elephas maximus), which is an endangered species, harbors several parasites. Among the ectoparasites that it harbors, ear mites of the genus Loxanoetus have the potential to cause external otitis, an inflammation that may also be associated with the presence of other microorganisms. We assessed the relationships between ear mites, nematodes, yeast, bacterial rods, and cocci sampled from the ears of captive Asian elephants in Thailand. In addition, we discuss the possibility that dust-bathing behavior may be triggered by ear mite infestation, and that this in turn may lead to contamination of the ears with soil microorganisms. METHODS: Legally owned captive Asian elephants (n = 64) were sampled. Ear swabs were individually collected from both ears and microscopically examined for the presence of mites, nematodes, yeast, bacterial rods, cocci, and host cells. Mites and nematodes were identified to species level using morphological and molecular methods. RESULTS: Loxanoetus lenae mites were present in 43.8% (n = 28/64) of the animals (19 animals with mites in one ear and nine animals with mites in both ears). Nematodes of the genus Panagrolaimus were detected in 23.4% (n = 15/64) of the animals (10 with nematodes in one ear and five with nematodes in both ears). In adult elephants (Fisher's exact test, P = 0.0278) and female elephants (Fisher's exact test, P = 0.0107), the presence of nematodes in both ears was significantly associated with the presence of mites. In addition, higher categorical burdens of nematodes were also significantly associated with the presence of mites (Fisher's exact test, P = 0.0234) and epithelial cells (Fisher's exact test, P = 0.0108), and marginally significantly associated with bacterial cocci (Fisher's exact test, P = 0.0499). CONCLUSIONS: The presence of L. lenae mites in the ear canals of the Asian elephants was significantly associated with the occurrence of other microorganisms, such as soil nematodes, bacteria and yeasts. The presence of mites in their ears may increase the dust-bathing behavior of elephants which, if confirmed, represents a further paradigmatic example of a parasitic infestation affecting animal behavior.

Reconciliation and Disposal of Oral Medication: Creating a Safe Process for Clinical Research Personnel.

Clinical research nurses and non-licensed study coordinators observed variation in procedures for reconciliation and disposal of oral investigational medications across the institution. An academic medical center implemented a quality improvement project to standardize the process of reconciliation and disposal of oral investigational medications. An interprofessional collaborative workgroup was formed, which led to multiple interventions to standardize practice, including revision of three policies and procedures, redesign of specific work areas to establish drug-counting rooms, review of personal protective equipment requirements, revision of educational training, and regular cleaning of potentially contaminated workstations.

Using a campaign to promote safer medicines practice among healthcare professionals.

The Chesterfield Royal Hospital Foundation Trust has a work plan to improve the safe administration of medicines throughout the hospital. This includes measures to raise nurses' awareness of the risks associated with the administration of medicines, and initiatives to improve safety. Last year, two focus groups were held with qualified nurses from across the hospital to find out how they felt that practice could be made safer and more effective for patients. The nurses suggested that an educational campaign be organised to highlight best practice and to encourage nurses to think differently about medicines administration. This paper summarises the content and outcome of the campaign.

Previously unsuspected infantile hypertrophic pyloric stenosis diagnosed by endoscopy.

Infantile hypertrophic pyloric stenosis is a common cause of upper gastrointestinal obstruction in infants and presents as projectile, nonbilious emesis in the first few weeks of life. In general, patients with infantile hypertrophic pyloric stenosis are diagnosed after a complete history and physical have been performed augmented by serum electrolyte evaluation, abdominal ultrasound, or upper gastrointestinal barium series. However, some patients can have equivocal radiographic testing and normal serum electrolytes. Two patients are presented in which esophagastroduodenoscopy was used to diagnose previously unsuspected infantile hypertrophic pyloric stenosis.