Effectiveness of Three Sampling Approaches for Optimizing Mapping and Preventive Chemotherapy against Schistosoma mansoni in the Western Part of Côte d'Ivoire.

The elimination of schistosomiasis as a public health problem by 2030 is one of the main goals put forth in the World Health Organization's roadmap for neglected tropical diseases. This study aimed to compare different sampling approaches to guide mapping and preventive chemotherapy. A cross-sectional parasitological survey was conducted from August to September 2022 in the health districts of Biankouma, Ouaninou, and Touba in the western part of Côte d'Ivoire. The prevalence and intensity of Schistosoma mansoni infection were assessed in children aged 5-14 years using three sampling approaches. The first approach involved a random selection of 50% of the villages in the health districts. The second approach involved a random selection of half of the villages selected in approach 1, thus constituting 25% of the villages in the health district. The third approach consisted of randomly selecting 15 villages from villages selected by approach 2 in each health district. The overall prevalence of S. mansoni was 23.5% (95% confidence interval (CI): 19.9-27.6%), 21.6% (95% CI: 17.1-26.8%), and 18.3% (95% CI: 11.9-27.1%) with the first, second, and third approach, respectively. The respective geometric mean S. mansoni infection intensity was 117.9 eggs per gram of stool (EPG) (95% CI: 109.3-127.3 EPG), 104.6 EPG (95% CI: 93.8-116.6 EPG), and 94.6 EPG (95% CI 79.5-112.7 EPG). We conclude that, although randomly sampling up to 50% of villages in a health district provides more precise population-based prevalence and intensity measures of S. mansoni, randomly selecting only 15 villages in a district characterized by low heterogeneity provides reasonable estimates and is less costly.

Potential associations between Schistosoma mansoni infection and physico-chemical characteristics and water-related human activities in Côte d'Ivoire: a cross-sectional study.

BACKGROUND: Schistosomiasis remains a public health problem, particularly in sub-Saharan Africa. The disease is intimately connected to poverty and environmental factors. Our research was readily embedded into a multi-country schistosomiasis oversampling study. The aim of the study presented here was to determine the prevalence of Schistosoma mansoni and to investigate the role of water body characteristics and water-related human activities in disease transmission. METHODS: In August and September 2022, a cross-sectional study was conducted in the western part of Côte d'Ivoire. Stool and urine samples were collected from 1602 and 1729 children aged 5-14 years, respectively, in 65 villages in the health districts of Biankouma, Ouaninou and Touba. Additionally, data were collected from direct observation of water-related activities at water bodies and interviews conducted with community leaders and health workers. The prevalence and risk factors for Schistosoma infection were assessed using generalised estimating equation models. RESULTS: The prevalence ofS. mansoni and S. haematobium were 27.4% (95% confidence interval [CI] 21.5-34.3%) and 0.1% (95% CI 0.03-0.5%), respectively. Low prevalence of soil-transmitted helminths was observed with 2.4%, 0.4% and 0.2% for hookworm, Trichuris trichiura and Ascaris lumbricoides, respectively. At the health district level, we found S. mansoni prevalence of 34.4% (95% CI 25.0-45.3%), 34.3% (95% CI 24.0-46.2%) and 16.3% (95% CI 9.5-26.6%) for Biankouma, Ouaninou and Touba, respectively. Female and male participants were at a similar risk of infection (29.0% vs. 26.0%, odds ratio [OR]: 1.18, 95% CI 0.92-1.50). Children aged 9-14 years showed a higher prevalence than their younger counterparts aged 5-8 years (34.5% vs. 22.7%, OR: 1.80, 95% CI 1.42-2.27). High infection prevalence was observed in villages where children were washing clothes and dishes at open surface water sites and pursued recreational activities (e.g. swimming and playing in the water). The temperature, total dissolved solids and pH of water samples showed no significant association with S. mansoni infection at the village unit. CONCLUSIONS: Human water-related activities such as washing clothes and playing in the water are risk factors for S. mansoni transmission. Hence, preventive chemotherapy should be combined with information, education and communication to avoid or reduce the frequency of water exposure in children as part of a comprehensive package of interventions towards elimination of schistosomiasis as a public health problem.

Prevalence and risk factors of schistosomiasis and hookworm infection in seasonal transmission settings in northern Côte d'Ivoire: A cross-sectional study.

BACKGROUND: Schistosomiasis and hookworm infection remain public health problems in large parts of sub-Saharan Africa. The epidemiology of schistosomiasis and hookworm was studied in seasonal transmission settings in the northern part of Côte d'Ivoire. METHODOLOGY: In August 2018, a cross-sectional study was conducted. Urine and stool samples were collected from 742 individuals aged 6-96 years in 16 localities from four departments in northern Côte d'Ivoire. Urine samples were examined by a filtration method for quantification of Schistosoma haematobium eggs. Stool samples were subjected to duplicate Kato-Katz thick smears and eggs of Schistosoma mansoni and soil-transmitted helminths (STHs) were counted. Additionally, a questionnaire was administered to determine demographic characteristics and to identify risk factors of schistosomiasis and STHs. Malacologic surveys were carried out at water points that are contacted by humans and animals. PRINCIPAL FINDINGS: The prevalence of schistosomiasis was very low. Only two cases of S. mansoni were found (0.3%, 95% confidence interval [CI]: 0.1-1.0%). The distribution of S. haematobium was focal, with cases found only in two departments; Ferkessédougou (5.4%, 95% CI: 2.5-9.9%) and Ouangolodougou (2.7%, 95% CI: 0.9-6.3%). Hookworm was the only STH species observed with a prevalence of 1.5% (95% CI: 0.8-2.8%). A higher risk of S. haematobium infection was observed in males compared to females, but the difference was not statistically significant (2.3% versus 1.3%, odds ratio [OR]: 1.5, 95% CI: 0.8-2.7). Participants aged 16-20 years showed the highest prevalence of S. haematobium. A total of 111 human- and animal-water contact points were identified at 47 water sources. Three potential intermediate host snails of schistosomes were collected; namely, Bulinus forskalii (n = 761), Bulinus truncatus (n = 205), and Biomphalaria pfeifferi (n = 1). Yet, only one specimen of Bu. truncatus was found to be shedding schistosome cercariae. CONCLUSIONS/SIGNIFICANCE: This study confirms very low transmission of schistosomiasis and hookworm in northern Côte d'Ivoire. The establishment and rigorous implementation of integrated surveillance-response systems could lead to the elimination of schistosomiasis and hookworm in this part of Côte d'Ivoire.

Antimicrobial disposition in pulmonary epithelial lining fluid of horses, part III. cefquinome.

Cefquinome concentrations, following intravenous and aerosol administration to horses, in pulmonary epithelial lining fluid (PELF) were examined and compared to plasma concentrations. Single dose of cefquinome sulphate (1 mg/kg) was administered intravenously to six horses followed by a single aerosol administration (225 mg) with a wash-out period of 14 days between treatments. After each drug administration, cefquinome concentrations in plasma and PELF, obtained by intrabronchial cotton swabs, were determined. After intravenous administration, cefquinome concentrations in plasma declined fast and were not detectable after 12 h. After aerosol administration, plasma concentrations were low or below limit of quantification (LOQ) during the entire sampling period. The degree of penetration of cefquinome into PELF after intravenous administration as described by the AUC(PELF) /AUC(plasma) ratio was 0.33. Following aerosol administration, cefquinome concentrations in PELF were high, but only detectable for 4 h. Based on AUC values, total cefquinome concentrations in PELF were one-third of total plasma concentrations after intravenous administration together with shorter time above Minimum Inhibitory Concentrations (T > MIC) in PELF, thus twice daily dosing may be required when treating lower airway infections in horses. Lower doses of cefquinome can be administered as aerosols providing high local drug concentrations in lung, but additional optimization of formulation is needed to improve distribution and persistence in lung.

Antimicrobial disposition in pulmonary epithelial lining fluid of horses. Part I. Sulfadiazine and trimethoprim.

Sulfadiazine (SDZ) and trimethoprim (TMP) concentrations were examined in plasma and pulmonary epithelial lining fluid (PELF), following intravenous and oral administration and compared to minimum inhibitory concentrations (MICs) of common bacterial isolates from equine lower airway infections. SDZ/TMP (25/5 mg/kg) was administered intravenously, intragastric or per os to fed horses, and blood samples were collected before and 11 times, over 24 h, after administration. PELF samples were collected via a tampon device four times after drug administration and analysed for drug concentrations. Additionally, MICs of SDZ and TMP alone and in combination were determined in a selection of clinical respiratory isolates. Bioavailability was 74% for SDZ and 46% for TMP after paste administration in fed horses. The degree of penetration of SDZ and TMP into PELF, as described by AUC(PELF) /AUC(plasma) ratios, was 0.68 and 0.72, respectively, after intravenous administration. After oral administration, the degree of penetration for SDZ and TMP was 0.92 and 0.46, respectively. MIC measurements using SDZ/TMP ratios of 5:1 and 10:1 did not affect the interpretation of the results. The results indicate that clinically relevant drug concentrations of mainly TMP are difficult to maintain in PELF, especially after oral administration of SDZ/TMP.

Antimicrobial disposition in pulmonary epithelial lining fluid of horses, part II. Doxycycline.

Doxycycline concentrations, following two types of oral administration to horses, in pulmonary epithelial lining fluid (PELF) were examined and compared to plasma concentrations. The oral bioavailability was estimated from plasma concentrations achieved after an intravenous study in two horses. Doxycycline (10 mg/kg) was administered either intragastric or as topdressing to nonfasted horses. Blood samples were collected for drug analysis, before and 11 times after administration during 24 h. PELF samples were collected by a tampon device four times after drug administration and analysed for doxycycline concentrations. Another two horses received doxycycline intravenously at a dose of 3 mg/kg and plasma was taken 14 times during a 24- h period. The oral bioavailability of doxycycline was calculated to 17% after intragastric administration and 6% after topdressing administration in nonfasted horses. The degree of penetration of doxycycline into PELF, as described by AUC(PELF) /AUC(plasma) ratios, was 0.87 after intragastric administration. The results indicate that clinically relevant doxycycline concentrations are possible to maintain in PELF after intragastric administration. Furthermore, if bioavailability could be enhanced for per os administration, doxycycline might be a valuable drug for the treatment of lower airway infections in horses.

Physiology and treatment of retained fetal membranes in cattle.

Retained fetal membranes (RFM) in cattle have adverse effects on fertility and production. Understanding the pathophysiology and causes of RFM is important for managing this disease. The hormonal processes that lead to normal placental separation are multifactorial and begin before parturition. A variety of risk factors, including early or induced parturition, dystocia, hormonal imbalances, and immunosuppression, can interrupt these normal processes and result in retention of the placenta. Current research does not support the efficacy of many commonly practiced treatments for RFM. Systemic administration of antibiotics can be beneficial for treating metritis after RFM, but antibiotic administration has not been shown to significantly improve future reproduction in cows with RFM. Collagenase injected into the umbilical arteries of retained placentas specifically targets the lack of placentome proteolysis and might enhance placental release. However, such therapy is costly and its benefits in terms of improving subsequent reproductive function have not been evaluated.

Proposed design and optimization of a higher harmonic cavity for ALS-U.

Higher harmonic cavities (HHCs), also known as Landau cavities, have been proposed to increase the beam lifetime and Landau damping by lengthening the bunch and increasing the synchrotron tune spread. Here, we present an optimized 1.5 GHz normal conducting HHC design for the Advanced Light Source Upgrade project at Lawrence Berkeley National Lab with a superconducting-like geometry for lower R/Q. The optimization goal is to reach the required shunt impedance while maintaining a relatively high Q value of the cavities. A multi-objective genetic algorithm (MOGA)-based optimization process is applied to optimize the radio frequency (RF) design. This study serves as an example of how a genetic algorithm can be used to optimize RF cavities. Detailed exploration and characterization of the MOGA-based RF cavity optimization have been demonstrated from the aspects of minimizing the coupled bunch instabilities and analyzing the higher-order modes and the corresponding impedance of the HHC.

Effect of a feed/fast protocol on pH in the proximal equine stomach.

REASONS FOR PERFORMING STUDY: Risk factors for the development of gastric squamous ulcers include various management procedures, such as intermittent feed deprivation that can occur during weight management regimens or stall and dry lot confinement. OBJECTIVES: To investigate the effect of intermittent feed deprivation relative to continuous feed intake on proximal intragastric pH, specifically in the region of the squamous mucosa of the lesser curvature. METHODS: In 6 horses, pH electrodes were placed just inside of the oesophageal sphincter in the stomach for each of two 72 h protocols (A and B) in a randomised, cross-over design. Protocol A consisted of 12 h fed, 12 h fasted, 24 h fed and 24 h fasted, in sequence. Protocol B consisted of 72 h fed. During the fed periods of each protocol, horses had ad libitum access to coastal Bermuda hay and were fed sweet feed (1 kg, b.i.d.). Horses had ad libitum access to water at all times. RESULTS: Proximal intragastric pH was significantly lower during protocol A, than during protocol B. However, hourly mean pH was significantly different only during the day and evening hours between protocols. During protocol B, mean proximal pH decreased significantly from 03.00 to 09.00 compared to 19.00 to 23.00 h. A moderate positive correlation of hay intake vs. proximal gastric pH could be established. CONCLUSIONS: Intermittent feed deprivation decreased proximal gastric pH in horses relative to those horses for which feed was not restricted. However, the effect was only significant when fasting occurred during the day and evening hours, as a nocturnal decrease in pH occurred simultaneously in the fed horses. POTENTIAL RELEVANCE: Episodes of daytime feed deprivation should be avoided if possible, as proximal gastric acid exposure rapidly increases during such events.

Characterisation of the inflammatory reaction in equine idiopathic focal eosinophilic enteritis and diffuse eosinophilic enteritis.

REASONS FOR PERFORMING STUDY: Idiopathic focal eosinophilic enteritis (IFEE) and diffuse eosinophilic enteritis (DEE) are primary eosinophilic intestinal conditions without a known cause that are associated with an increasing number of surgical colic cases. Histology may be helpful in defining disease aetiology and pathogenesis. OBJECTIVES: To characterise further the inflammatory infiltrate in equine IFEE and to compare the condition with DEE. METHODS: Twenty-three IFEE cases and 5 DEE cases were examined by light microscopy including immunohistology to identify infiltrating leucocytes. Inflammatory infiltrates in mucosa and submucosa were characterised in IFEE lesions (Group 1), the intestine distant from the lesions in IFEE (Group 2) and DEE (Group 3). RESULTS AND CONCLUSIONS: IFEE lesions represented an accumulation of leucocytes in submucosa and muscularis, with dominance of eosinophils and macrophages and smaller numbers of lymphocytes, plasma cells and neutrophils. T cells represented the dominant lymphocytes. The mucosa overlying the lesion and both mucosa and submucosa in IFEE nonlesion sites and in DEE exhibited a similar composition, with different prevalence of various cell types. Macrophages were significantly more prevalent in the mucosal and submucosal infiltrates in IFEE nonlesion sites than in DEE, and lymphocytes significantly more prevalent in the mucosa in DEE than in IFEE nonlesion sites. The findings confirm IFEE as a primary eosinophilic intestinal disorder and indicate that IFEE represents a focally exacerbated inflammatory reaction in horses with DEE, possibly due to functional changes in the macrophage and T cell components, with subsequent excessive recruitment of both eosinophils and macrophages.

Effect of paddock vs. stall housing on 24 hour gastric pH within the proximal and ventral equine stomach.

REASONS FOR PERFORMING STUDY: Stall housing has been suggested as a risk factor for ulcer development in the equine stomach; however, the exact pathogenesis for this has not been established. OBJECTIVES: To investigate the effect of 3 environmental situations (grass paddock, stall alone or stall with adjacent companion) on pH in the proximal and the ventral stomach. METHODS: Six horses with permanently implanted gastric cannulae were used in a randomised, cross-over, block design. Each horse rotated through each of three 24 h environmental situations. Horses remained on their normal diet (grass hay ad libitum and grain b.i.d.) throughout the study. Intragastric pH was measured continuously for 72 h just inside the lower oesophageal sphincter (proximal stomach) and via a pH probe in the gastric cannula (ventral stomach). RESULTS: Neither proximal nor ventral 24 h gastric pH changed significantly between the 3 environmental situations. Mean hourly proximal gastric pH decreased significantly in the interval from 01.00-09.00 h compared to the interval from 13.00-20.00 h, regardless of environmental situation. Median hourly proximal pH only differed in the interval from 06.00-07.00 h compared to the interval 14.00-19.00 h. Neither mean nor median hourly ventral gastric pH varied significantly with the time of day. CONCLUSIONS: The change in housing status used in the current study did not affect acid exposure within either region of the equine stomach. The pH in the ventral stomach was uniformly stable throughout the study, while the proximal pH demonstrated a 24 h circadian pattern.

Age-related dynamics of constitutive cytokine transcription levels of feline monocytes.

Monocytes/macrophages are central mediators of inflammation and immunity and therefore of major interest in the study of immunosenescence. In healthy adult cats, monocytes have been shown to constitutively transcribe pro- and anti-inflammatory cytokines. However, in order to characterize the effect of age, feline monocyte functions were examined for changes in cytokine transcription levels in early stages of immunosenescence. For this purpose, isolated, short-term cultured monocytes from barrier-maintained adult cats of different ages (15 mo to 10 yr) were examined for transcription of IL-1 beta, IL-6, IL-10, IL-12 p40 and TNF-alpha by real-time PCR. Transcription levels of cytokines varied and were generally highest for IL-1 beta. For IL-1 beta, IL-6 and IL-12 p40, both young and old cats exhibited highest levels. The age association was significant. TNF-alpha appeared to be transcribed at similar levels over the examination period, whereas IL-10 tended to decline with age but without any statistical significant differences. The observed age association of the constitutive transcription of some cytokines indicates a drop in monocyte activities from youth to middle age, which is then followed by a (progressive) increase with increasing age. This provides evidence that monocytes are in part responsible for the pro-inflammatory status observed with ageing.

A review of the equine age-related changes in the immune system: comparisons between human and equine aging, with focus on lung-specific immune-aging.

The equine aging process involves many changes to the immune system that may be related to genetics, the level of nutrition, the environment and/or an underlying subclinical disease. Geriatric horses defined as horses above the age of 20, exhibit a decline in body condition, muscle tone and general well-being. It is not known whether these changes contribute to decreased immune function or are the result of declining immune function. Geriatric years are characterized by increased susceptibility to infections and a reduced antibody response to vaccination as a result of changes in the immune system. Humans and horses share many of these age-related changes, with only a few differences. Thus, inflamm-aging and immunosenescence are well-described phenomena in both human and equine research, particularly in relation to the peripheral blood and especially the T-cell compartment. However, the lung is faced with unique challenges because of its constant interaction with the external environment and thus may not share similarities to peripheral blood when considering age-related changes in immune function. Indeed, recent studies have shown discrepancies in cytokine mRNA and protein expression between the peripheral blood and bronchoalveolar lavage immune cells. These results provide important evidence that age-related immune changes or 'dys-functions' are organ-specific.

Can intubation harm the brain in critical care situations? A new simple technique may provide a method for controlling brain temperature.

Many animal species are able to keep the brain temperature some degrees centigrade lower than the deep body temperature when exposed to environmental heat stress. The lower temperature is based on cooling of the nasal venous blood through the respiratory airflow and local counter-current transfer of heat between venous and arterial blood in the cavernous sinus-carotid artery complex. Anaesthetized, intubated animals do not have any air flow through the nasal cavities. However, when the nasal cavities were flushed with oxygen, the deep brain temperature dropped within minutes and returned to previous values when the oxygen flushing was stopped. Cooling was found in animals with a rete mirabile (pigs), and in animals without a rete (rats). If a similar cooling mechanism is present in man (no rete) under intensive care, a simple flushing of the nasal cavities with gas will protect the brain against hyperthermal damage.

Lipid analysis of lavage samples from the equine guttural pouch (auditory tube diverticulum).

The guttural pouch is a large, air-filled diverticulum of the auditory tube, present in the horse and other species. Lipid analysis of saline lavage from the equine guttural pouch has demonstrated the presence of phospholipids and neutral lipids in amounts that are variable but consistently greater than in any other species described. A stain specific for choline-containing phospholipids has demonstrated the presence of phospholipid-containing vesicles only within the cells of subepithelial, seromucoidlike glands, suggesting that these cells incorporate phospholipids in their secretions. The functional significance of surface-active agents in the guttural pouch may be different from that proposed for other species because of the unique anatomical design and the different proposed functions of the guttural pouch.

Functional anatomy observations of the pharyngeal orifice of the equine guttural pouch (auditory tube diverticulum).

The pharyngeal orifice of the equine auditory tube has not been adequately described. Its larger size and position, further rostral within the nasopharynx compared with other species, cannot be easily explained, but could be important for the proposed brain-cooling function of the guttural pouches; however, unlike other species, it may not be the sole regulator of auditory tube aeration. A 'second orifice' (representing the final entrance to the auditory tube diverticulum) deserves recognition in performing a role in air exchange between the auditory tube, diverticulum and middle ear. The results of this investigation suggest that regular guttural pouch ventilation during resting respiration does not occur. Previous reports may reflect, at least in part, a misinterpretation of air pressure measurements within the guttural pouches and nasopharynx. Small decreases in simulated inspiratory pressure consistently caused the passive opening of both the pharyngeal orifice and pouch ostium in horse cadavers suggesting that an active counter process may exist in the live horse to maintain closure of the guttural pouch openings during rest and light exercise. Intrinsic tone of the stylopharyngeus and pterygopharyngeus muscles may be part of this active process. The investigation offers theoretical evidence that opening of the equine auditory tubes to ventilate the guttural pouch occurs in two different ways, active and passive. The active process has two stages: (1) opening of the pharyngeal orifices by simultaneous contractions of the levator and tensor veli palatini and pterygopharyngeus muscles; then (2) opening of the pouch ostia by contractions of dorsal portions of the palatopharyngeus muscles. The alternative passive route involves reduction in tone of the stylopharyngeus and pterygopharyngeus muscles accompanied by increased inspiratory pressure.

A preliminary study on the role of the equine guttural pouches in selective brain cooling.

The equine guttural pouch is a large, air-filled diverticulum of the auditory tube whose function is not clear. Since the horse does not possess a known, well-developed brain-cooling mechanism that could satisfy cerebral thermoregulatory demands, an hypothesis is proposed that respiratory air enters the guttural pouches, when needed, to ventilate and cool the internal carotid arteries (ICA). Experiments were initially carried out on nine cadavers, where blood flow was mimicked with warmed saline propelled by peristaltic pumps. Subsequent experiments were conducted on an anaesthetized horse where the guttural pouch was ventilated and ICA temperatures were measured. Results showed that whenever the guttural pouch was ventilated with cooled or warmed environmental air, or warmed 100% humidified air, temperatures within the ICA dropped significantly in cadavers (0.4-5 degrees C) and in the anaesthetized horse (1-3 degrees C), depending on conditions. Simulated respiration trials also resulted in ICA temperature drops of 0.9-2.3 degrees C in two of five cadavers tested, indicating that the wide 3-5 cm pharyngeal orifices of the guttural pouches have the capacity to allow enough respiratory air to ventilate the pouch. Despite the fact that a single, unbranching 13 cm portion of the ICA is exposed on the wall of each guttural pouch, the results of this investigation suggest that during heavy exercise, horses could utilize their guttural pouches to cool ICA blood destined for the brain.

Anatomic, radiographic and physiologic comparisons of the internal carotid and maxillary artery in the horse.

The anatomy of the internal carotid and maxillary arteries was examined using angiography, subtraction angiography and arterial cast preparations in three horses. Subtraction angiography was superior to angiography in demonstrating the anatomy of the occipital, external ophthalmic, ethmoidal and palatine arteries. In three horses manipulation of the internal carotid and occipital arteries during angiography resulted in vasospasm which prevented filling of these vessels with contrast. Direct arterial blood pressure measurements of the maxillary artery impinging on the guttural pouches was measured in four anaesthetized and standing horses. Arterial pressure recordings from the maxillary artery indicate there is retrograde blood flow from contralateral vessels into the occluded arterial segment. Vasospasm prevented measurement of arterial pressure in the internal carotid artery.

Actinobacillus lignieresii infection in two horses.

A 10-year-old pregnant Norwegian Fjord horse was examined for gross swelling of the muzzle of 2 years' duration. Examination of biopsy specimens revealed diffuse dermal fibrosis, micropustule formation, and vascular thrombosis; large numbers of Actinobacillus lignieresii were isolated in pure culture. Prolonged treatment with i.v. administration of sodium iodide and oral administration of trimethoprim-sulfamethoxazole caused regression of the swelling and did not induce abortion. A 5-month-old American Paint filly was examined for swelling in the udder region. Bacteriologic culture of purulent material obtained from the left teat revealed A lignieresii. Treatment with oral administration of rifampin and trimethoprim-sulfamethoxazole resulted in complete resolution of clinical signs. To the authors' knowledge, these findings represent the first report of mastitis and chronic nasal cellulitis caused by A lignieresii infection in horses.

Hypernatremia in neonatal elk calves: 30 cases (1988-1998).

OBJECTIVE: To characterize hypernatremia in neonatal elk calves, including clinical signs, incidence, physical examination findings, and possible causes. DESIGN: Retrospective case series. ANIMALS: 26 neonatal elk calves were examined; 4 calves were evaluated twice, for a total of 30 examinations. PROCEDURE: Medical records were reviewed for signalment, history, physical examination findings, results of diagnostic tests, and response to treatment. Hypernatremia was defined as serum sodium concentration > 153 mEq/L. RESULTS: Hypernatremia was diagnosed in 14 calves and was significantly associated with diarrhea, high WBC count, high anion gap, and high serum concentrations of albumin, chloride, creatinine, and urea. Hypernatremia was not significantly associated with survival, but high serum albumin concentration and rectal temperature were significantly associated with survival of calves. Animals given antibiotics and electrolyte solutions orally prior to evaluation were significantly more likely to die than those untreated. Dehydration was a common reason for evaluation but was not significantly associated with survival. CONCLUSIONS AND CLINICAL RELEVANCE: Hypernatremia was significantly associated with diarrhea. Treatment of diarrheic elk calves is often the same as that used in bovine calves with diarrhea; however, bovine calves are commonly hypo- or normonatremic. Our experience suggests that treatment protocols used in bovine calves are unsatisfactory for elk calves. The rate at which serum sodium concentration is reduced should be < 1.7 mEq Na/L/h to avoid development of neurologic signs associated with iatrogenically induced cerebral edema.