Regional disparity of HIV incidence and prevalence among men who have sex with men.

BACKGROUND: HIV incidence can be estimated with cross-sectional studies using clinical, serological, and molecular data. Worldwide, HIV incidence data in only men who have sex with men (MSM) are scarce and principally focus on those with healthcare or under treatment. However, better estimates can be obtained through studies with national representativeness. The objective was to estimate the prevalence, incidence, and factors associated with acquiring HIV in a national sample of MSM who attend meeting places, considering geographical regions. METHODS: A nationally representative survey of MSM attending meeting places was performed in Mexico. Participants answered a questionnaire, and a dried blood spot (DBS) was collected. Samples were classified as recent infections using an algorithm with HIV status, antiretroviral therapy, and the result of BED-EIA assay. Parameters were analysed considering regions and demographic and sexual behaviour characteristics. RESULTS: The national HIV prevalence was 17.4% with regional differences; the highest prevalence (20.7%) was found in Mexico City, and the lowest prevalence was found in the West region (11.5%). The incidence was 9.4 per 100 p/y, with regional values from 6.2 to 13.2 for the Northeast and the Centre regions, respectively. Age, age at sexual debut, low wealth index, and rewarded sex were associated with HIV prevalence. Centre region, use of private clinics as health services, and having sex exclusively with men were associated with recent HIV infections. CONCLUSIONS: The incidence and prevalence showed regional differences, suggesting a difference in the dynamics of HIV transmission; some regions have a greater case accumulation, and others have a greater rate of new infections. Understanding this dynamic will allow developing health programs focused on HIV prevention or treating people already living with HIV.

Prevalence of active infection by herpes simplex virus type 2 in patients with high-risk human papillomavirus infection: A cross-sectional study.

The aim is to determine the prevalence of active infection by herpes simplex virus type 2 (HSV-2) among Mexican women with high-risk human papillomavirus (HR-HPV) cervical infection, recruited from public gynecology and colposcopy services. In a cross-sectional study, HSV-2 antibodies, HSV-2 DNA, and HR-HPV DNA were quantified. Significant differences in HSV-2 seroprevalence and HSV-2 active infection rates were found between negative and positive HR-HPV cases. HSV-2 seroprevalence was 28.15% and 16.1% (P = .0001), while HSV-2 active infection rates were 6.83% and 0.62% (P = .001) for positive and negative HR-HPV groups, respectively. The risk of HSV-2 seropositivity was 1.7 times greater for HR-HPV-positive cases (P = .02). Similarly, HR-HPV-positive cases were nine times more likely to have an HSV-2 active infection than HR-HPV-negative cases (P = .03). High HSV-2/h-HPV coinfection rates were observed among women recruited from public gynecology and colposcopy services. The main factors related to an HSV-2 active infection are a history of risky sexual behavior and HR-HPV infection. The prevalence of HSV-2 active infection among positive HR-HPV subjects indicate that these infections constitute an important group of STIs in Mexico.

[Proinflammatory state in obese children]. / Estado proinflamatorio en niños obesos.

INTRODUCTION: Obesity is a chronic disease that affects adults as well as children and is associated with insulin resistance, type 2 diabetes and cardiovascular disease. One of the reasons for the presence of low-grade inflammation in these patients could be that adipose tissue of the obese produces proin flammatory molecules that favor the development of atherosclerosis. OBJECTIVE: To determine serum levels of soluble CD40 ligand (sCD40L), monocyte chemoattractant protein 1 (MCP-1), interleukin 6 (IL-6), Tumor Necrosis Factor alpha (TNF-α) and high sensitivity CRP (hsCRP), in an obese chil dren population compared to a control group, also to analyze the correlation of these molecules with the anthropometric and metabolic variables. PATIENTS AND METHOD: A cross-sectional, observational study was carried out on 37 obese children, aged 8 to 12 years, and 20 children with normal weight. Serum levels of sCD40L, MCP-1, IL-6, TNF-α and hsCRP were determined. Data were expressed as the median and interquartil range and Spearman coefficient was used to investigate correlations between variables. RESULTS: Compared to the control group, obese children presented significantly higher values of sCD40L, MCP-1, IL-6, TNF-α, and hsCRP than control group. Body mass index and waist circumference correlated positively with sCD40L and MCP-1. CONCLUSION: Elevated levels of the studied molecules studied suggest the presence of low-grade inflammation associated with obesity in this population.

Deletion of 2.7 kb near HOXD3 in an Arabian horse with occipitoatlantoaxial malformation.

In the horse, the term occipitoatlantoaxial malformation (OAAM) is used to describe a developmental defect in which the first cervical vertebra (atlas) resembles the base of the skull (occiput) and the second cervical vertebra (axis) resembles the atlas. Affected individuals demonstrate an abnormal posture and varying degrees of ataxia. The homeobox (HOX) gene cluster is involved in the development of both the axial and appendicular skeleton. Hoxd3-null mice demonstrate a strikingly similar phenotype to Arabian foals with OAAM. Whole-genome sequencing was performed in an OAAM-affected horse (OAAM1) and seven unaffected Arabian horses. Visual inspection of the raw reads within the region of HOXD3 identified a 2.7-kb deletion located 4.4 kb downstream of the end of HOXD4 and 8.2 kb upstream of the start of HOXD3. A genotyping assay revealed that both parents of OAAM1 were heterozygous for the deletion. Additional genotyping identified two of 162 heterozygote Arabians, and the deletion was not present in 371 horses of other breeds. Comparative genomics studies have revealed that this region is highly conserved across species and that the entire genomic region between Hoxd4 and Hoxd3 is transcribed in mice. Two additional Arabian foals diagnosed with OAAM (OAAM 2 and 3) were genotyped and did not have the 2.7-kb deletion. Closer examination of the phenotype in these cases revealed notable variation. OAAM3 also had facial malformations and a patent ductus arteriosus, and the actual malformation at the craniocervical junction differed. Genetic heterogeneity may exist across the HOXD locus in Arabian foals with OAAM.

Variable functional recovery and minor cell loss in the ganglion cell layer of the lizard Gallotia galloti after optic nerve axotomy.

The lizard Gallotia galloti shows spontaneous and slow axon regrowth through a permissive glial scar after optic nerve axotomy. Although much of the expression pattern of glial, neuronal and extracellular matrix markers have been analyzed by our group, an estimation of the cell loss in the ganglion cell layer (GCL) and the degree of visual function recovery remained unresolved. Thus, we performed a series of tests indicative of effective visual function (pupillary light reflex, accommodation, visually elicited behavior) in 18 lizards at 3, 6, 9 and 12 months post-axotomy which were then processed for immunohistochemistry for the neuronal markers SMI-31 (neurofilaments), Tuj1 (beta-III tubulin) and SV2 (synaptic vesicles) at the last timepoint. Separately, cell loss in the GCL was estimated by comparative quantitation of DAPI(+) nuclei in control and 12 months experimental lizards. Additionally, 15 lizards were processed for electron microscopy to monitor relevant ultrastructural changes in the GCL, optic nerve and optic tract throughout regeneration. Hypertrophy of RGCs was persistent, morphology of the regenerated nerves varied from narrow to neuroma-like features and larger regenerated axons underwent remyelination by 9 months. The estimated cell loss in the GCL was 27% and two-third of the animals recovered the pupillary light reflex which involves the pretectum. Strikingly, visually elicited behavior involving the tectum was only restored in two specimens, presumably due to the higher complexity of this pathway. These preliminary results indicate that limited functional regeneration occurs spontaneously in the severely injured visual system of the lacertid G. galloti.

Brainstem auditory evoked responses and bone conduction assessment in alpacas.

Auditory loss has been reported in camelids using brainstem auditory evoked responses (BAER). Differentiation between conductive versus sensorineural dysfunction has not been investigated. Therefore, the objective of the study was to investigate auditory function using BAER and bone conduction (BC). Twenty-four alpacas: 15 females, 9 intact males (2-16 years of age) were included in a randomized clinical trial. BAER and BC were recorded using two derivations (vertex to mastoid and vertex to cranial aspect of second cervical vertebra). All alpacas underwent complete physical examinations and were sedated with xylazine hydrochloride at 0.6 mg/kg IM. Peaks, when present, were identified and latencies, amplitudes, and amplitude ratios were determined. Eleven alpacas had normal responses and 13 had auditory loss based on BAER. The latter consisted of complete absence of peaks bilaterally (n = 3), absence of peaks unilaterally (n = 1), delayed latencies bilaterally (n = 4), and delayed latencies unilaterally (n = 5). Distinct peaks on BC supported conductive auditory loss in 6 alpacas, difficult to interpret due to stimulus artifact and additional undefined peaks in 4, and absent peaks in 3 alpacas. The cause of auditory loss was presumed to be due to otitis in 6, aging in 4 (10-16 years old), and congenital sensorineural (absent peaks on BAER and BC) in 3 alpacas with unpigmented fiber and irises. BAER and BC are useful and non-invasive to perform techniques for the investigation of auditory loss in alpacas, and further characterization as conductive or sensorineural.

Incidence and risk factors for acute kidney injury: a prospective, randomized, single-blind clinical trial comparing total knee arthroplasty with and without tourniquet.

PURPOSE: Identify the incidence and risk factors for acute kidney injury (AKI) following total knee arthroplasty (TKA) with and without tourniquet. MATERIAL AND METHODS: 100 patients were randomized into two groups. Postoperative AKI was defined as the postoperative creatinine level 0.3 mg/dl compared with baseline. Potential variables associated with AKI were analyzed by multivariate logistic regression model to identify the AKI risk factors in TKA patients with and without tourniquet. RESULTS: AKI rate was 22%, tourniquet use (OR = 2.66, p = 0.014), blood loss > 500 cm3 (OR = 3.99, p = 0.001), postoperative Hb < 10 g/dl (OR = 2.68, p = 0.008), blood transfusions (OR = 2.86, p = 0.012) and diabetes (OR = 2.80, p = 0.006) were associated with increased risk of postoperative AKI. CONCLUSIONS: The use of tourniquet should be indicated with caution and should not be used routinely in patients with other risk factors for the development of acute kidney dysfunction, other measures to achieve trans-surgical hemostasis should be implemented in our environment to reduce the incidence of acute kidney dysfunction related to the use of the tourniquet.

PROPÓSITO: Identificar la incidencia y factores de riesgo para lesión renal aguda (LRA) después de la artroplastia total de rodilla (ATR) con y sin uso de torniquete. MATERIAL Y MÉTODOS: Se dividieron 100 pacientes en dos grupos. Se definió la LRA como una elevación postoperatoria de la creatinina 0.3 mg/dl comparada con el nivel basal preoperatorio. Las potenciales variables asociadas con la DRA fueron analizadas con un modelo de regresión logística multivariada para identificar los factores de riesgo de DRA en pacientes sometidos a ATR con y sin torniquete. RESULTADOS: La incidencia de LRA fue de 22%. El uso de torniquete (OR = 2.66, p = 0.014), pérdida sanguínea > 500 cm3 (OR = 3.99, p = 0.001), Hb postoperatoria < 10 g/dl (OR = 2.68, p = 0.008), transfusión sanguínea (OR = 2.86, p = 0.012) y la diabetes (OR = 2.80, p = 0.006) fueron asociados a un mayor riesgo postoperatorio de LRA. CONCLUSIONES: El uso de torniquete debe estar indicado con precaución y no debe utilizarse de forma rutinaria en pacientes con otros factores de riesgo para el desarrollo de disfunción renal aguda, otras medidas para lograr la hemostasia transquirúrgica deben implementarse en nuestro entorno para reducir la incidencia de disfunción renal aguda relacionada con el uso del torniquete.

Estimating Bordetella pertussis seroprevalence in adolescents and young adults in Mexico using the 2012 National Health and Nutrition Survey (ENSANUT).

BACKGROUND: Low vaccination rates and under-detection of pertussis infections in adolescents and young adults have an impact on the transmission of pertussis to infants. In this study, the proportion of adolescents and young adults with IgG antibodies against B. pertussis antigens, representing recent infection or vaccination, was estimated in a population-based probabilistic survey in Mexico. METHODS: Sera and data from 1,581 subjects, including 1,102 adolescents and 479 young adults (10-19 and 20-25 years old, respectively) randomly selected from Mexico's 2012 National Health and Nutrition Survey, were analyzed. IgG antibodies against pertussis toxin (PT) were measured with the CDC/FDA ELISA. A subset of 234 samples was additionally tested with Bp-IgG PT ELISA kit (EUROIMMUN AG, Lubeck, Germany). Threshold values from corresponding test kits were used to identify recent infection or vaccination. RESULTS: Overall anti-PT IgG seroprevalence was 3.9% (95% CI: 2.3-6.3); 3.1% (95% CI: 1.9-5.0) in adolescents, and 4.9% (95% CI: 2.2-11) in young adults. Seroprevalence did not significantly vary by sex, socioeconomic status, region or rural/urban location. Compared to the CDC/FDA ELISA, the EUROIMMUN test showed a 76% sensitivity and 88% specificity. The weighted estimates represent a considerable burden of recent infection in adolescents and young adults; however, most adolescents and adults were seronegative and, therefore, susceptible to pertussis infection. CONCLUSION: Since booster vaccination to B. pertussis after toddlerhood is not recommended in the Mexican national policy, anti-PT IgG seropositivity may be reasonably attributed to recent infection. Assessing pertussis seroprevalence requires careful consideration of the diagnostic test threshold interpretation and epidemiological model used.

CD3 expression distinguishes two gammadeltaT cell receptor subsets with different phenotype and effector function in tuberculous pleurisy.

Tuberculous pleurisy is a naturally occurring site of Mycobacterium tuberculosis (Mtb) infection. Herein, we describe the expression of activation, natural killer (NK) and cell migration markers, as well as effector functions from gammadeltaT cells in peripheral blood (PB) and pleural effusion (PE) from tuberculosis patients (TB). We observed a decreased percentage of circulating gammadeltaT from TB patients and differential expression of NK as well as of chemokine receptors on PB and PE. Two subsets of gammadeltaT cells were differentiated by the CD3/gammadeltaT cell receptor (gammadeltaTCR) complex. The gammadeltaTCR(low) subset had a higher CD3 to TCR ratio and was enriched in Vdelta2(+) cells, whereas most Vdelta1(+) cells belonged to the gammadeltaTCR(high) subset. In PB from TB, most gammadeltaTCR(high) were CD45RA(+)CCR7(-) and gammadeltaTCR(low) were CD45RA(+/-)CCR7(+)CXCR3(+). In the pleural space the proportion of CD45RA(-)CCR7(+)CXCR3(+) cells was higher. Neither spontaneous nor Mtb-induced interferon (IFN)-gamma production was observed in PB-gammadeltaT cells from TB; however, PE-gammadeltaT cells showed a strong response. Both PB- and PE-gammadelta T cells expressed surface CD107a upon stimulation with Mtb. Notably, PE-gammadeltaTCR(low) cells were the most potent effector cells. Thus, gammadeltaT cells from PB would acquire a further activated phenotype within the site of Mtb infection and exert full effector functions. As gammadeltaT cells produce IFN-gamma within the pleural space, they would be expected to play a beneficial role in tuberculous pleurisy by helping to maintain a T helper type 1 profile.

Effect of lipopolysaccharide infusion on gene expression of inflammatory cytokines in normal horses in vivo.

Horses are exquisitely sensitive to bacterial endotoxin and endotoxaemia is common in colic cases. In this study, gene expression of inflammatory cytokines was characterised in the blood of healthy horses following i.v. administration of lipopolysaccharide (LPS). Six horses received an LPS infusion and 6 controls received an equivalent volume of saline. Gene expression of genes encoding interleukin (IL)-1alpha, IL-1beta, IL-6, IL-8, and tumour necrosis factor-alpha (TNF-alpha) was quantified by real-time PCR. Gene expression of all inflammatory cytokines was upregulated following administration of LPS. Interleukin-1alpha, IL-1beta, IL-8 and TNF-alpha gene expression peaked at 60 min, while IL-6 expression peaked at 90 min post LPS infusion. Interleukin-1beta and IL-6 messenger RNA expression levels were above the baseline values 3 h post LPS infusion, whereas IL-1alpha, IL-8 and TNF-alpha expression levels returned to baseline values by 3 h after LPS infusion. It was concluded that LPS infusion upregulated gene expression of inflammatory cytokines in the blood of healthy horses.

A rapid detection method for the ryanodine receptor 1 (C7360G) mutation in Quarter Horses.

BACKGROUND: Anesthetic-induced malignant hyperthermia has been documented in Quarter Horses and is caused by a single-point mutation in the ryanodine receptor 1 gene at nucleotide C7360G generating a R2454G amino acid substitution. An accurate, faster molecular test that is less prone to contamination would facilitate screening for the mutation in horses intended for breeding, in those undergoing surgical procedures, and in those with clinical signs compatible with malignant hyperthermia. OBJECTIVE: To report a rapid and accurate method for the detection of the ryanodine receptor 1 C7360G mutation. ANIMALS: Eleven diseased, 10 healthy, and 225 randomly selected Quarter Horses. METHODS: This study included horses with the ryanodine receptor 1 C7360G mutation as detected by gene sequencing. Available genomic and complementary DNA extracted from whole blood, hair or skeletal muscle was used for genetic analysis. Real-time polymerase chain reaction (RT-PCR) melting curve analysis was performed by equine specific primers and 2 hybridization probes (sensor and anchor probes) that contain the site of the mutation. Results from this method were blinded and compared with nucleic acid sequencing for validation. RESULTS: A rapid genotyping assay with fluorescence resonance energy transfer probes and melting curve analysis was accurate (100% agreement, K= 1) for identification of affected horses. The prevalence of the mutation in a random population of Quarter Horses was 1.3%. CONCLUSIONS AND CLINICAL IMPORTANCE: Malignant hyperthermia in Quarter Horses can be rapidly and accurately detected by RT-PCR melting curve genotyping with hybridization probes.

Malignant hyperthermia associated with ryanodine receptor 1 (C7360G) mutation in Quarter Horses.

BACKGROUND: Anesthetic-induced malignant hyperthermia (MH) has been documented in Quarter Horses with a single point mutation in the ryanodine receptor 1 gene (RyR1) at nucleotide C7360G, generating a R2454G amino acid substitution. However, there have been no reports of nonanesthetic manifestations of MH in horses with the C7360G mutation. OBJECTIVE: To describe clinical manifestations of Quarter Horses with the C7360G mutation. ANIMALS: Eleven Quarter Horses with the RyR1 C7360G mutation. METHODS: This prospective study included horses with suspected MH, undetermined etiology of sudden death, death within hours of onset of rhabdomyolysis, muscle rigidity, stiffness, intermittent sweating, and persistent increases in serum muscle enzyme activities. Whole blood in EDTA and skeletal muscle were processed for genetic and histochemical analysis. Medical records and pedigrees were collected when available. RESULTS: Both anesthetic- and non-anesthetic-associated myopathic manifestations of MH occurred in halter Quarter Horses with mutation of RyR1. The disease is inherited as an autosomal dominant trait. Clinical and laboratory abnormalities were similar in both forms. Rhabdomyolysis was a common finding in both groups of horses. Skeletal muscle histochemical findings were nonspecific and compatible with a noninflammatory myopathic process. CONCLUSIONS AND CLINICAL IMPORTANCE: MH is a potentially fatal disease of Quarter Horses that could be triggered by halogenated anesthetics and other nonanesthetic factors that may include exercise, stress, breeding, illnesses, and concurrent myopathies.

Clinical presentation, diagnostic findings, and outcome of adult horses with equine coronavirus infection at a veterinary teaching hospital: 33 cases (2012-2018).

Equine coronavirus (ECoV) is a recently described enteric virus with worldwide outbreaks; however, there are little data available on clinical presentation, diagnosis, and outcome. The study objective was to document case management of ECoV in adult horses presented to a referral hospital and compare to a cohort of horses that tested negative for ECoV. A retrospective case series was performed based on positive real-time quantitative PCR results for ECoV on faeces from horses treated at the UC Davis Veterinary Medical Teaching Hospital from 1 March 2012 to 31 March 2018. Horses negative for ECoV were matched to the ECoV-positive group as controls. Data collected included signalment, history, exam findings, diagnostics, treatment, and follow-up. Thirty-three horses (median age, 11 years; range, 2-37 years) tested ECoV-positive, including three horses with co-infections. Presenting complaints for ECoV-infected horses included historic fevers (n = 25/30; 83%), anorexia (n = 14/30; 47%), and colic (n = 13/30; 43%). ECoV-positive horses had significantly lower white blood cell (median, 3.0 × 109/L; range, 0.68-16.2 × 109/L), neutrophil (median, 1.26 × 109/L; range, 0.15-14.4 × 109/L), and lymphocyte (median, 0.86 × 109/L; range, 0.42-3.47 × 109/L) counts than ECoV-negative horses. Electrolyte and metabolic derangements and scant faeces were common. Twenty-seven horses were hospitalised for a median of 5 days (range, 0.5-14 days), with 26/27 (96%) horses surviving to discharge. ECoV infection should be a differential diagnosis for adult horses with fever, colic, anorexia, and leukopenia. The disease has a low mortality rate, but horses may require intensive care to resolve severe leukopenia, systemic inflammation, and metabolic disturbances.

A review of equine muscle disorders.

Muscle disorders are a common cause of disability in horses. For many years, clinical manifestations such as muscle pain, exercise intolerance, weakness, and stiffness were believed to be caused by a single syndrome. However, in the past years a broad spectrum of muscle disorders have been recognized including glycogen and polysaccharide storage myopathies, malignant hyperthermia, mitochondrial myopathy, hyperkalemic periodic paralysis and others. For some, a specific mutation has been identified. Recognition of the myopathic clinical phenotype and thorough clinical, electrodiagnostic, and histological evaluations are essential to further our understanding of equine myopathies. Advances in understanding equine myopathies may potentially benefit other species including humans.

Brainstem auditory-evoked responses in horses with temporohyoid osteoarthropathy.

BACKGROUND: Facial and vestibulocochlear nerve dysfunction occurs commonly in horses with temporohyoid osteoarthropathy (THO); however, auditory dysfunction has not been thoroughly assessed. OBJECTIVE: To determine if auditory abnormalities occur in horses with THO. ANIMALS: Eleven diseased and 8 control horses. METHODS: This is a prospective study in which brainstem auditory-evoked responses (BAER) were recorded in 11 horses diagnosed with THO through neurologic, endoscopic, radiographic, or computed tomographic examinations. BAER findings were compared with those recorded from 8 adult control horses. RESULTS: All horses with THO were found to have BAER abnormalities that included complete unilateral BAER loss (82%, n=9/11), partial unilateral BAER loss (18%, n=2/11) on the most affected side, and contralateral partial BAER loss (46%, n=5/11). Nine horses had bilateral THO based on diagnostic imaging findings; of these, 5 (56%) horses also had bilateral BAER abnormalities. The complete absence of BAER in affected horses was most consistent with peripheral sensorineural hearing loss. There was a significant association between complete BAER loss and neurologic and diagnostic abnormalities. CONCLUSIONS AND CLINICAL IMPORTANCE: Auditory abnormalities such as complete or partial BAER loss are common in horses with THO. The BAER test is an objective diagnostic tool that can aid along with other diagnostic modalities in the assessment, management, and follow-up of horses with THO. Furthermore, BAER studies may help to elucidate the pathophysiology of THO in horses.

Qualitative and quantitative characteristics of the electroencephalogram in normal horses during spontaneous drowsiness and sleep.

BACKGROUND: The influence of sleep on the equine electroencephalogram (EEG) has not been well documented. HYPOTHESIS: The objectives were to develop a noninvasive method of electrode placement for recording the EEG in horses and to establish normal EEG parameters for the various states of vigilance. Findings are compared with previously published reports on equine sleep based on electrocorticography (ECoG). ANIMALS: Five neurologically normal horses. METHODS: Overnight EEGs were recorded digitally in association with simultaneous videotaping of the horses' behavior. Data were analyzed by visual inspection, states of vigilance were identified, and representative segments were quantitatively processed. Transient EEG events were examined. RESULTS: Slow wave sleep (SWS) was significantly different (P < .05) in frequency and power from drowsiness and rapid eye movement (REM) sleep. Second-degree heart block was associated with SWS as were transient events commonly recognized in EEGs of humans. Drowsiness and REM sleep were similar. In both, background activity was low-amplitude beta activity admixed with prominent activity of approximately 4 Hz. Standing REM sleep was associated with numerous partial collapses in 1 horse. CONCLUSIONS AND CLINICAL IMPORTANCE: Normative data for several states were described and probable benign variants identified. This information will serve as control data for sedative and anesthetic studies in this species. The sleep patterns observed during this study are those of horses removed from their usual surroundings, and thus may represent those encountered in a clinical environment.

Effects of feeding yeast and propionibacteria to dairy cows on milk yield and components, and reproduction*.

To determine the effect of supplemental feeding of Diamond V-XP yeast (XPY) alone or in combination with propionibacteria strain P169 on milk production, milk components, body weight, days to first and second ovulation, plasma insulin, and plasma and milk glucose, 31 primiparous and multiparous (MP) Holstein cows were fed one of three dietary treatments between 2 weeks prepartum to 30 weeks postpartum: (i) control (n = 10), fed a corn silage-based total mixed ration (TMR); (ii) XPY (n = 11), fed control TMR plus XPY (at 56 g/head/day); and (iii) P169+XPY (n = 10), received control TMR plus XPY plus P169 (at 6 x 10(11) cfu/head/day). After parturition, daily milk weights were recorded, and milk samples were collected twice weekly for milk component analyses. Daily uncorrected milk, solids-corrected milk, and 4% fat-corrected milk production for MP cows fed P169+XPY was 9-16% greater than control MP cows, but these increases were only evident during mid lactation (9-30 weeks). The percentage of milk fat was 8-18% greater in control than XPY and P169+XPY groups. Milk lactose percentage in MP cows fed P169+XPY was 3-5% greater than in control and XPY MP cows. Primiparous and MP cows fed P169+XPY had 28-32% greater milk glucose levels than control and XPY-fed cows. Diurnal plasma glucose concentration was not affected by diet in MP cows. Plasma insulin levels in MP cows fed P169+XPY were 30-34% greater than in other groups of MP cows. Milk glucose and plasma insulin responses to P169+XPY feeding suggest that P169+XPY might have enhanced gluconeogenesis and increased glucose uptake by the mammary gland in Holstein cows. Thus, a combined feed supplement of P169 and XPY may hold potential as a natural feed alternative to hormones and antibiotics to enhance lactational performance.

Presumed Neuroglycopenia Caused by Severe Hypoglycemia in Horses.

BACKGROUND: Neuroglycopenia refers to a shortage of glucose in the brain resulting in neuronal dysfunction and death if left untreated. Presumed neuroglycopenia has not been described in horses. OBJECTIVE: To report neurological signs in horses with presumed neuroglycopenia as the result of severe hypoglycemia. ANIMALS: Ninety horses (hours to 28 years of age) diagnosed with hypoglycemia (blood glucose concentration < 75 mg/dL [< 4.2 mmol/L]). METHODS: Retrospective study. Electronic medical records were searched. Signalment, history, complaint, clinical signs, laboratory findings including CSF analysis, electroencephalogram, clinical or definitive diagnosis, and outcome were recorded. Kruskal-Wallis analysis of variance and logistic regression were used to investigate association between blood glucose concentration and data extracted. Statistical significance was set at P < 0.05. RESULTS: Thirty-eight and 52 horses had mild (50-74 mg/dL [2.8-4.1 mmol/L]), and severe hypoglycemia (< 50 mg/dL [< 2.8 mmol/L]), respectively. Most common causes of hypoglycemia included liver and gastrointestinal (40%) disease, sepsis (33%), neoplasia (7%), and insulin-induced (4%). Most common neurologic deficits included obtundation (100%), seizures (42%), and disorientation (22%). CSF-glucose was severely low (mean 2.5 mg/dL [0.1 mmol/L], median 0 mg/dL). Paroxysmal discharges in support of seizures were identified in the occipital (visual) and parietal (closest to temporal-auditory) cortical regions upon EEG examination (8/8 horses). CONCLUSIONS AND CLINICAL IMPORTANCE: Neuroglycopenia is presumed to occur in horses as the result of severe hypoglycemia. Subclinical seizures, and intermittent blindness and deafness of cortical origin can occur. Severe altered state of consciousness and seizures can be observed at a blood glucose cut-off value of < 42 mg/dL (< 2.3 mmol/L).

Investigation of Known Genetic Mutations of Arabian Horses in Egyptian Arabian Foals with Juvenile Idiopathic Epilepsy.

BACKGROUND: The carrier status of lavender foal syndrome (LFS), cerebellar abiotrophy (CA), severe combined immunodeficiency (SCID), and occipitoatlantoaxial malformation (OAAM1) in foals with juvenile idiopathic epilepsy (JIE) is unknown. HYPOTHESIS/OBJECTIVES: To determine the carrier status of LFS, CA, SCID, and OAAM1 in foals with JIE. ANIMALS: Ten foals with JIE. MATERIALS AND METHODS: Archived DNA samples were tested for known genetic mutations causing LFS, CA, SCID, and OAAM1. The inclusion criteria consisted of having been diagnosed with JIE by ruling out other causes of seizures in foals and supported by electroencephalographic examination. RESULTS: Ten Egyptian Arabian horses (5 females and 5 males) were phenotyped as foals with JIE by electroencephalography (EEG). All foals were negative for the genetic mutations that cause LFS, CA, SCID, and OAAM1 except for 1 foal that was a carrier of CA. CONCLUSIONS AND CLINICAL IMPORTANCE: Juvenile idiopathic epilepsy of Egyptian Arabian foals and LFS appear to be phenotypically and genetically distinct disorders. There was no apparent association between JIE and LFS, CA, SCID, and OAAM1.

Outcomes after medical and surgical interventions in horses with temporohyoid osteoarthropathy.

BACKGROUND: Temporohyoid osteoarthropathy (THO) is a cause of neurological disease in horses that is characterised by facial and vestibulocochlear nerve deficits. Studies reporting and comparing survival following medical or surgical treatment of THO are lacking. OBJECTIVES: To compare survival and prognosis in horses with THO treated medically or surgically, and to report surgical complications. STUDY DESIGN: Retrospective study. METHODS: The medical records of horses diagnosed with THO were retrieved, and data on signalment, clinical signs and duration, corneal ulceration and bilateral occurrence were recorded. Neurological severity was graded according to clinical signs. Preoperative radiographic and endoscopic images were graded according to the severity of changes. Factors potentially affecting survival and treatment were compared using Cox proportional hazards regression. RESULTS: A total of 77 horses were identified as having THO during the period 1990-2014. Of these, 25 horses underwent ceratohyoid ostectomy (CHO) and eight underwent partial stylohyoid ostectomy (PSHO). Thirteen of 20, one of 25 and one of eight horses treated by medical therapy, CHO and PSHO, respectively, died or were subjected to euthanasia as a consequence of THO. Compared with CHO, medical therapy was significantly associated with nonsurvival, but there were no significant differences in survival between horses undergoing PSHO and medical therapy. The duration of clinical signs, and neurological, radiographic and endoscopic grades were not associated with survival of THO. However, the age of the horse was significantly associated with poorer survival. Survival time was significantly shorter in the medical therapy group compared with the two surgical groups combined, but did not differ significantly between the two surgical groups. No significant difference between groups was seen in the incidence of surgical complications (33.3% in the PSHO and 22.2% in the CHO group). MAIN LIMITATIONS: This was a nonrandomised study of treatment effects on survival and included a low number of cases. CONCLUSIONS: The survival prognosis in horses with THO is good to excellent in those submitted to surgical intervention, and fair in those treated with medical therapy alone.