Euphoric Presentation in Creutzfeldt-Jakob Disease and Its Diagnostic Implications: A Case Report.

Creutzfeldt-Jakob disease (CJD) constitutes an aggressively advancing, terminal neurodegenerative condition classified within the spectrum of transmissible spongiform encephalopathies. The difficulty in establishing a diagnosis before death arises from the condition's rarity and the resulting limited level of suspicion attributed to it. The polymorphic nature of CJD symptoms contributes to the challenge of early diagnostic recognition. Emotional and behavioral changes have been well documented, but the initial presentation of euphoria has not been documented. Here, we present the case of a female patient who was experiencing an unusual state of euphoria followed by intermittently altered mental status. She was ultimately diagnosed with sporadic CJD, discharged home on hospice, and died within six months of discharge.

Non-tamponade Indications for Pericardial Drainage: A Case Report of Acute Streptococcus pneumoniae Purulent Pericarditis.

Pericardial drainage is a procedure completed to evacuate fluid from the pericardial space. This can be completed by pericardiocentesis or pericardial window. These procedures are most often done in the setting of cardiac tamponade, typically to correct low blood pressure due to low stroke volume from extrinsic compression of the heart chambers by the pericardial fluid. Elective pericardiocentesis can be done in cases where fluid accumulation is secondary to pathological processes, including hemopericardium secondary to complications of trauma to the chest, toxins, myocardial infarction, cardiac surgery, serosanguinous pericardial effusion due to malignancy, right heart failure, acute pericarditis, chemotherapeutic agents, metabolic derangements like uremia, and autoimmune disorders. Here, we report a case of a 66-year-old immunocompetent male with acute bacterial pericarditis resulting in fibrinous pericardial effusion without echocardiographic cardiac tamponade physiology in whom pericardial drainage proved beneficial.

Effect of veterinary feed directive rule changes on tetracycline-resistant and erythromycin-resistant bacteria (Salmonella, Escherichia, and Campylobacter) in retail meats in the United States.

BACKGROUND: Antimicrobial-resistant bacteria are a growing public health threat. In 2017 the U.S. Food and Drug Administration implemented Veterinary Feed Directive (VFD) rules changes to limit medically important antimicrobial use in food-producing animals, combating antimicrobial-resistant bacteria. The effect of the VFD rule changes on the occurrence of bacteria resistant to medically-important antimicrobials in retail meats is yet to be investigated in the U.S. This study investigates whether the VFD rule changes affected the occurrence of tetracycline-resistant and erythromycin-resistant bacteria (Salmonella, Escherichia, and Campylobacter) in retail meats in the U.S. METHODS: Multivariable mixed effect logistic regression models were used to analyze 2002-2019 retail meats surveillance data from the National Antimicrobial Resistance Monitoring System (NARMS) in the U.S. Variables included VFD rule changes, meat type, quarter of year, and raising claims. A potential association between these variables and the occurrence of tetracycline-resistant and erythromycin-resistant bacteria (Salmonella, Escherichia, and Campylobacter) in retail meats was estimated. RESULTS: Analysis included data regarding tetracycline-resistant Salmonella (n = 8,501), Escherichia (n = 20, 283), Campylobacter (n = 9,682), and erythromycin-resistant Campylobacter (n = 10,446) in retail meats. The odds of detecting tetracycline-resistant Escherichia (OR = 0.60), Campylobacter (OR = 0.89), and erythromycin-resistant Campylobacter (OR = 0.43) in chicken breast significantly decreased after the VFD rule changes, compared to the pre-VFD rule change period. The odds of detecting tetracycline-resistant Salmonella (0.66), Escherichia (OR = 0.56), and Campylobacter (OR = 0.33) in ground turkey also significantly decreased. However, the odds of detecting tetracycline-resistant Salmonella (OR = 1.49) in chicken breast and erythromycin-resistant Campylobacter (OR = 4.63) in ground turkey significantly increased. There was no significant change in the odds of detecting tetracycline-resistant Salmonella and Escherichia in ground beef or pork chops. CONCLUSIONS: The implementation of VFD rule changes had a beneficial effect by reducing the occurrence of tetracycline-resistant and erythromycin-resistant bacteria in chicken and ground turkey. Ongoing surveillance of antimicrobial resistance and antimicrobial use could complement the implementation of stewardship such as VFD rule in food-producing animals in the U.S.

Tetracycline, Sulfonamide, and Erythromycin Residues in Beef, Eggs, and Honey Sold as "Antibiotic-Free" Products in East Tennessee (USA) Farmers' Markets.

Foods that contain antibiotic residues have potential adverse health effects on consumers and provide selective pressure for the threat of antimicrobial resistance (AMR). This study's objective was to measure tetracycline, sulfonamide, and erythromycin residues in beef, eggs, and honey sold as "antibiotic-free" at farmers' markets in East Tennessee (East TN) in the United States (U.S.). Between July and September 2020, 36 "antibiotic-free" food products (9 beef, 18 egg, and 9 honey products) were purchased from East TN farmers' markets and tested for tetracycline, sulfonamide, and erythromycin residues using competitive enzyme-linked immunosorbent assays (cELISA). All beef, egg, and honey products had tetracycline residue; the median concentrations were 51.75, 30.25, and 77.86 µg/kg, respectively. Sulfonamide residue was present in every sample of beef. Of 18 eggs, 11 eggs had detectable sulfonamide residue; the median concentrations were 3.50 and 1.22 µg/kg in beef and eggs, respectively. Each sample of beef and honey contained erythromycin residue; the median concentrations were 3.67 and 0.68 µg/kg, respectively. Overall, the median concentrations of tetracycline, sulfonamide, and erythromycin residues were below the maximum residue levels (MRLs) set in the U.S. for beef and eggs. Thus, the beef and eggs sold as "antibiotic-free" in East TN farmers' markets can be considered safe for consumption. Safety determination for honey could not be made because MRLs have not been set for honey in the U.S. Because these residues should not be expected in "antibiotic-free" food products, it is important to further investigate the potential sources of these residues in these products.

Prevalence of Cardiac Lesions in Cases of Bovine Blackleg in Tennessee (USA), 2004-2018.

Blackleg is a common cause of death in cattle, mostly caused by the bacterium Clostridium chauvoei. Cardiac lesions were traditionally considered uncommon in cases of blackleg in cattle until a 2018 study reported otherwise. This study was aimed at determining the prevalence of cardiac disease among cattle that died of blackleg in Tennessee, USA. The outcome of this study would reinforce the importance of assessing cardiac lesions in suspected cases of blackleg in cattle. The University of Tennessee Veterinary Medical Center database searched for cattle with a confirmed diagnosis of blackleg necropsied between 2004 and 2018. Of the 120 necropsy reports, 37 had a diagnosis of blackleg. Histology slides of skeletal muscle (26/37) and the heart (26/37) were reviewed to confirm the presence of supportive lesions. Of the 37 cases of blackleg identified, 26 animals (70.3%) had cardiac lesions, including 4 (10.8%) that had only cardiac involvement without skeletal muscle lesions. Specifically, (5.4%; 2/37) had only necrotizing myocarditis; (13.5%; 5/37) had only fibrinous or fibrinosuppurative pericarditis, epicarditis, or endocarditis; (51.4%; 19/26) had a combination of myocarditis and pericarditis, epicarditis, or endocarditis; and (29.7%; 11/37) had no lesions. Furthermore, of the 26 cases with cardiac lesions, 24 cases had gross lesions, while 2 cases were identified only by microscopic examination. This indicates that gross examination alone is insufficient to identify cardiac involvement in blackleg cases in cattle. Contrary to traditional perceptions, cardiac lesions in cases of bovine blackleg could be as high as 70% and are most often associated with skeletal muscle lesions. The prevalence of cardiac lesions in cases of blackleg in cattle may be higher when the heart is examined microscopically than if it is only evaluated grossly. Pathologists should specifically evaluate the heart for lesions in suspected cases of blackleg in cattle and utilize microscopic examination when gross lesions are absent.

Hemorrhagic Stroke Due to Varicella Zoster Virus Vasculopathy.

Varicella-zoster virus (VZV) vasculopathy is a granulomatous vasculitis that has a wide variety of clinical presentations. It is most common in patients with HIV not on anti-retroviral therapy (ART) with low cluster of differentiation (CD)4 cell counts. This disease affects the central nervous system and can cause small intracranial bleeds. Our patient presented with stroke-like symptoms in the setting of recent VZV reactivation in the ophthalmic distribution with HIV on ART. Her MRI scan showed a small punctate bleed and the CSF workup was consistent with VZV vasculitis. She was treated with 14 days of acyclovir and five days of high-dose steroids with clinical improvement to baseline.

Associations between meniscal tears and various degrees of osteoarthritis among dogs undergoing TPLO for cranial cruciate ligament rupture.

OBJECTIVE: The aim of this study was to evaluate the association between meniscal lesions and severity of osteoarthritis (OA) among dogs that underwent Tibial Plateau Leveling Osteotomy (TPLO) for stabilization of cranial cruciate ligament rupture (CrCLR) at the University of Tennessee in 2011-2017. RESULTS: There were a total of 252 meniscal tears. Factors associated with diagnosis of medial meniscal tears (MMT) in dogs were severe OA in comparison to no OA (3.8 OR, 2.0-8.0 95% CI, 0.001 p-value), sporting and mixed breed group compared to other breed (3.6 OR, 1.7-7.6 95% CI, 0.004 p-value; 3.2 OR, 1.6-6.6 95% CI, 0.019 p-value, respectively), increasing age (1.1 OR, 1.0-1.2 95% CI, 0.018 p-value), complete CrCLR compared to partial (3.3 OR, 2.1-5.0 95% CI, < 0.001 p-value), and arthrotomy compared to arthroscopy (2.2 OR, 1.4-3.1 95% CI, 0.002 p-value). The factors that did not have significance in predicting MMT were weight, sex, lameness period, and side affected.

The effect of changing COVID-19 restrictions on the transmission rate in a veterinary clinic.

With the declaration of the COVID-19 pandemic by the World Health Organization on March 11, 2020, the University of Tennessee College of Veterinary Medicine (UTCVM), like other institutions, restructured their services to reduce the potential spread of the COVID-19 virus while simultaneously providing critical and essential veterinary services. A mathematical model was developed to predict the change in the level of possible COVID-19 infections due to the increased number of potential contacts within the UTCVM hospital. A system of ordinary differential equations with different compartments for UTCVM individuals and the Knox county population was formulated to show the dynamics of transmission and the number of confirmed cases. Key transmission rates in the model were estimated using COVID-19 case data from the surrounding county and UTCVM personnel. Simulations from this model show the increasing number of COVID-19 cases among UTCVM personnel as the number of daily clients and the number of veterinary staff in the clinic are increased. We also investigate how changes within the Knox county community impact the UTCVM hospital. These scenarios show the importance of understanding the effects of re-opening scenarios in veterinary teaching hospitals.

Effect of Changes in Veterinary Feed Directive Regulations on Violative Antibiotic Residues in the Tissue of Food Animals from the Inspector-Generated Sampling in the United States.

The presence of antibiotic residues in the tissue of food animals is a growing concern due to the adverse health effects that they can cause in humans, such as antibiotic resistance bacteria. An inspector-generated sampling (IGS) dataset from the United States National Residue Surveillance Program, collected between 2014 and 2019, was analyzed to investigate the association of changes in the veterinary feed directive (VFD) regulations on the detection of violative penicillin, tetracycline, sulfonamide, desfuroylceftiofur, tilmicosin, and florfenicol, residues in the tissue of food animals. Multivariable logistic regression models were used for analysis. While the animal production class was significantly associated with residue violations for tetracycline, having a sample collection date after the implementation of change in VFD regulations was not. However, the odds of detecting violative sulfonamide and penicillin residues in the tissue of food animals following the implementation of the change in VFD regulations were 36% and 24% lower than those collected before the implementation of the change in VFD regulations period, respectively, irrespective of animal production class. Violative desfuroylceftiofur, tilmicosin, and florfenicol residues in the tissue of food animals were not significantly associated with the implementation of changes in the VFD regulations. Further investigation of the factors that influence the presence of violative antibiotic residues in the tissue of food animals following the change in VFD regulations would lend clarity to this critical issue.

Emotive Themes from Tennessee Cattle Producers Regarding Responsible Antibiotic Use.

To improve judicious antimicrobial use (AMU) in food animals in the United States, all feed additives that were medically important antimicrobials were moved from over the counter to Veterinary Feed Directive in 2017. This action required a change in behavior of producers' AMU practices. Because emotions are important aspects of behavior, several behavioral interventions have targeted people's emotions as means of effecting change. Hence, understanding and incorporating the emotional experiences of producers towards current AMU practices can be a starting point to making future behavioral changes that could reduce the emergence of antimicrobial resistance challenge. Between June 2017 and March 2018, seven focus group meetings of Tennessee (TN) beef and dairy cattle producers were conducted to evaluate producers' emotional views regarding responsible AMU in TN cattle. Sixty-two TN cattle producers participated and emotively expressed the following: (1) deep connections to animals in ways that improve animal and public health; (2) pride in their quality of products; (3) distress that consumers misconceive their AMU practices as indiscriminate; and (4) recommended that producers be more transparent about their AMU practices and the public improve their awareness for detecting marketers' deceptive product labels that take advantage of public ignorance. Knowledge of these producers' emotions would help educators target more successful behavioral change campaigns, improving stewardship in AMU practices among producers.

Improving Sleep Among Adult Patients With Insomnia Disorder: A Quality Improvement Project.

Background: The Centers for Disease Control and Prevention (CDC) reported that between 28.5% and 44.1% of adults in the US sleep less than seven hours nightly. Aims: The aim of this quality improvement project was to improve sleep quality and duration among patients aged 40 and older with insomnia disorder in an outpatient mental health clinic. Methods: Patients diagnosed with insomnia disorder who were sleeping less than seven hours at least three nights weekly participated in the project (n = 20). Sleep hygiene education was provided and participants kept a sleep diary. The duration and quality of sleep was evaluated by comparing the information recorded in the diaries with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition description of insomnia disorder. Results: All participants achieved improvement to 6-8 hours of restful sleep nightly.

Prevalence of Antimicrobial Resistant and Extended-Spectrum Beta-Lactamase-producing Escherichia coli in Dairy Cattle Farms in East Tennessee.

Antimicrobials have been widely used in dairy farms to prevent and control dairy cattle diseases since 1960s. This led to the emergence of antimicrobial resistant bacteria (ARB) that, along with their antimicrobial resistance genes (ARGs), can spread from dairy farms to humans. Therefore, regular antimicrobial resistance (AMR) monitoring is important to implement proper mitigation measures. The objective of this study was to determine the prevalence of AMR and extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli in dairy cattle. A cross-sectional study was conducted in four dairy cattle farms (A-D) in East Tennessee. A total of 80 samples consisting of 20 samples each of bulk tank milk, feces, dairy cattle manure-amended soil, and prairie soil adjacent to the farms were collected and cultured for the isolation of E. coli. Tetracycline (TETr)-, third-generation cephalosporin (TGCr)- and nalidixic acid (NALr)-resistant E. coli (n = 88) were isolated and identified on agar media supplemented with TET, cefotaxime, and NAL, respectively. TGCr E. coli were tested for ESBLs and other coselected ARGs. TETr (74%, n = 88) was the most common, followed by TGCr (20%) and NALr (8%). Farms had significant (p < 0.001) differences: the highest prevalence of TGCr (55%) and TETr (100%) were observed in farm D, while all NALr isolates were from farm C. Over 83% of TGCr isolates (n = 18) harbored ESBL gene blaCTX-M. Majority (78%) of the E. coli isolates were multidrug-resistant (MDR), being positive for beta-lactams (blaCTX-M), TETs tet(A), tet(B), tet(M)), sulfonamides (sul2), aminoglycosides (strA), and phenicols (floR). This study indicated the widespread occurrence of MDR ESBLs-E. coli in dairy cattle farms. AMR surveillance of more dairy farms and identification of farm-level risk factors are important to mitigate the occurrence and spread of ARB of significant public health importance, such as ESBLs-E. coli.

Hematological and immunological responses to naturally occurring bovine respiratory disease in newly received beef calves in a commercial stocker farm.

The objective was to determine temporal changes in hematological and immune parameters in response to naturally occurring bovine respiratory disease (BRD) in commercially managed stocker calves. Forty newly weaned beef steers purchased from auction markets were housed at a commercial stocker operation in Crossville, TN. Blood samples, rectal temperature, and thoracic ultrasonography (TUS; 1: normal to 3: severe) were collected on days 0, 7, 14, and 21. Castration status (FC: freshly castrated; PC: previously castrated) was determined on arrival based on presence of a fresh castration site at the scrotum. Calves received antibiotics for BRD based on clinical severity scoring (CSS; 0: moribund, 4: moribund) and rectal temperature. Complete blood counts (CBC) were performed. Calves were categorized based on the number of treatments (NumTrt) received (0x, 1x, and 2x). Temporal variations in CBC and immune parameters were analyzed using mixed model repeated measure ANOVA (Proc GLIMMIX; SAS 9.4). Variation of CBCs and immune parameters based on TUS was determined using mixed model ANOVA. There was a NumTrt by day interaction effect on the responses of white blood cells (WBC) (P = 0.04) and haptoglobin (HPT) (P = 0.04). On day 21, WBC were greater in the 2x NumTrt group than other groups, but there were no differences in WBC between NumTrt levels on other days. Haptoglobin was greater in the 2x group on days 14 and 21 than 0x or 1x. Red blood cells (RBC) (P = 0.02) and WBC (P = 0.04) differed between FC and PC groups, and lower RBC and WBC were observed in the FC group. A castration status × day effect for mean corpuscular volume (MCV; P = 0.04) was observed where FC group had higher MCV at days 14 and 21 than the PC group. Tumor necrosis factor-α differed based on NumTrt (P = 0.03) and higher concentrations were found in 2x group. We observed a day effect for IL-1ß (P = 0.009) and TNF-α (P = 0.001). Significant effect of TUS on HPT at day 14 (P = 0.0004) and day 21 (P = 0.002) was observed. Combining HPT and platelet explained 15% of the variability in treatment status on a given day, whereas HPT and hemoglobin explained 10% of the variability in lung consolidation status. Although hematological and immunological parameters varied largely in our study, the potential of combining HPT with hematological variables should be studied further. Results from this study would help in understanding temporal changes in CBC and immune parameters in newly received stocker cattle.

Blood and immune parameters are altered during bovine respiratory disease (BRD) progression and can be used for predicting disease status. We aimed looking at the dynamics of hematology and immunology in newly received stocker cattle in naturally occurring BRD. Forty newly received stocker cattle were managed by a local producer and monitored for BRD occurrence for 21 d after receiving during the high-risk period. Newly weaned calves were monitored as they experience several stress factors and become prone to BRD. Additionally, there are limited data related to immunological changes that occur in high-risk stocker cattle. Since there is no perfect diagnostic test for BRD, the diagnosis of BRD is likely missed when only visual signs are used. We observed that haptoglobin (HPT) was the most important parameter to differentiate BRD severity. The combination of HPT with blood parameters (hemoglobin and platelets) was useful to predict treatment and lung infection status. Therefore, measuring hematological and immunological parameters might be helpful to determine BRD status and facilitate treatment decisions in newly received stocker cattle.

Control of Salmonella Dublin in a bovine dairy herd.

Salmonella enterica serovar Dublin (S. Dublin) was diagnosed in a dairy herd after signs of acute gastroenteritis and sepsis. Two hundred eighty-three Holstein cattle were sampled resulting in 700 observations, and serology for S. Dublin was performed. Holstein cattle sampled were divided by origin and arrival date to determine on-farm exposure. Prevalence estimates were calculated and compared with control measures implemented on the dairy during the outbreak. One group of cows, presumed to be the original carrier animals, had the highest overall seroprevalence (76.5%). Seroprevalence decreased throughout the study, coinciding with testing and management changes. This report documents biosecurity measures that identified S. Dublin after the purchase of subclinical carrier cattle and the steps taken to successfully control herd transmission.

Species misidentification in local markets: Discrepancies between reporting and molecular identification of bushmeat species in northern Uganda.

Bushmeat hunting and consumption, although widely utilized as necessary supplement to household income and nutrition in many regions, presents threats to public health and wildlife conservation efforts. In northern Uganda, consumption of bats and primates, two wildlife groups often implicated in zoonotic disease emergence, is not widely culturally accepted; however, these species are reported by hunters to often be hunted and sold as culturally desirable species, like antelope and warthog. To investigate the prevalence of market bushmeat misidentifiction, we collected 229 bushmeat samples from 23 communities adjacent to Murchison Falls National Park. Reported species was recorded on acquisition for each sample. PCR targeting mammalian cyt b and 12 s rRNA genes and sequencing were performed to identify samples to the lowest taxonomic unit using NCBI BLAST. Overall, 27.9% (61/219) of samples had disparate results between species reported and BLAST analysis. Thirty-four species were identified, with the most frequent wildlife being waterbuck (31.5%), warthog (13.7%), and black rat (5.9%). These data reveal a public health risk for bushmeat consumers in northern Uganda as they cannot assess species-related risk when purchasing bushmeat and take appropriate precautions against zoonotic pathogen exposure. These data also provide insight into regional hunter prey preference and market preference of local community members which may inform conservation strategy in the region.

Delay in Hip Fracture Repair in the Elderly: A Missed Opportunity Towards Achieving Better Outcomes.

BACKGROUND: Hip fractures are a major cause of morbidity and mortality in the elderly. The American Academy of Orthopedic Surgeons (AAOS) recommends surgical repair within 48 hours of admission, as this is associated with lower postoperative mortality and complications. This study demonstrates the association between patient demographics, level of care, and hospital region to delay in hip fracture repair in the elderly. METHODS: The National Trauma Data Bank (NTDB) was queried for elderly patients (age >65 years) who underwent proximal femoral fracture repair. Identified patients were subcategorized into two groups: hip fracture repair in <48 hours, and hip fracture repair > 48 hours after admission. Patient and hospital characteristics were collected. Outcome variables were timed from the day of admission to surgery and inpatient mortality. RESULTS: Out of 69,532 patients, 28,031 were included after inclusion criteria were applied. 23,470 (83.7%) patients underwent surgical repair within 48 hours. The overall median time to procedure was 21 (interquartile range [IQR] 7-38) hours. Females were less likely to undergo a delay in hip fracture repair (odds ratio [OR; 95% confidence interval {CI}]: 0.82 [0.76-0.88], P< 0.05), and patients with higher Injury Severity Score (ISS ≥25) had higher odds of delay in surgical repair (OR; 95% CI: 1.56 [1.07-2.29], P< 0.05). Patients treated at hospitals in the Western regions of the United States had lower odds of delay, and those treated in the Northeast and the South had higher odds of delay compared to the hospitals in the Midwest (taken as standard). There was no association between trauma level designation and odds of undergoing delay in hip fracture repair. CONCLUSION: Variables related to patient demographic and hospital characteristics are associated with delay in hip fracture repair in the elderly. This study delineates key determinants of delay in hip fracture repair in the elderly patients.

Peripheral Intravenous Catheter Complications in Hospitalized Cats: An Observational Pilot Study.

OBJECTIVES: There is little information about complications associated with peripheral catheter use in cats. The primary objective of this study was to determine the main reason for catheter removal in cats hospitalized in the Intensive Care Unit at a university teaching hospital. The secondary objective was to describe catheter-associated complications in cats hospitalized. METHODS: All feline patients with peripheral intravenous catheters admitted to the Intensive Care Unit between June and August 2017 were prospectively enrolled in this study. All catheters were evaluated at least 3 times a day per institutional Intensive Care Unit protocol. The catheters were monitored throughout the cat's hospitalization period for development of complications, including occlusion, phlebitis and extravasation. Data collected included patient signalment, reason for hospitalization, catheter size and location, number of hours the catheter remained in place, reason for removal and if the catheter was replaced once removed. RESULTS: Thirty-four cats were enrolled in the study, and a total of 42 catheters were placed in those cats. Median peripheral IV catheter duration was 23.8 hours (interquartile range [IQR] 13.8-41.3 hours). The most frequent reason for catheter removal was patient discharge from the hospital (24/42, 57.1%). Overall catheter complication rate was 21.4% (9/42). Complications observed included phlebitis, extravasation, patient removal, occlusion, and edema formation. CLINICAL SIGNIFICANCE: The results of this study conclude that the majority of peripheral IV catheters in cats are removed due to discharge from hospitalization. More studies with a larger population of cats are needed to see if there is a relationship between length of indwelling catheterization and risk of catheter-associated complications.

Factors associated with seroprevalence of bovine anaplasmosis in Mississippi, USA.

Anecdotally, Veterinary Feed Directive prescriptions in the southeastern United States (U.S.) are written most often for treatment and prevention of bovine anaplasmosis (BA) but seroprevalence estimates and factors associated with this disease are currently unavailable in Mississippi (MS). Bovine anaplasmosis, a tick-borne disease of cattle caused by Anaplasma marginale, remains an economically important disease in U.S. The lack of recent seroprevalence of BA throughout the U.S. makes accurate assessment of production losses incurred by the cattle industry in the U.S. difficult, if not impossible to estimate. This study was aimed at determining the seroprevalence of and factors associated with BA in MS. Data were obtained from an active survey of 207 beef cows slaughtered between May 2013 and December, 2014 as well as from reviewing 5182 Veterinary Diagnostic Laboratories (VDLs) records of specimens from MS submitted for BA testing between 2002 and 2018. From the active surveillance, the overall observed apparent seroprevalence of BA in MS with cELISA was 28.99% (95% CI: 23.23 - 35.50%) while the estimated true seroprevalence was 29.02% (22.74 - 36.07%). However, from the laboratory records, the overall apparent period seroprevalence of BA in MS between 2002 and 2018 irrespective of diagnostic assay used was 16.72% (15.73 - 17.76%) and yearly increase in the diagnosis of BA followed a significant trend (P < 0.0001). With cELISA, the apparent seroprevalence of BA was 22.11% (20.78 - 23.49%) and the estimated true seroprevalence was 21.62% (20.18 - 23.11%). However, with CFT, the apparent seroprevalence of BA was 13.50% (10.75 - 16.81%) and the estimated true seroprevalence was 47.90% (36.30 - 61.87%). Factors associated with positive BA results were age, cattle type, and quarter of the year the specimens were submitted. The odds of the outcome were 22 as high in adults, 27 times as high in beef cattle, and 2 times as high between October to December in comparisons to juveniles, dairy cattle, and between April to June, respectively. Cattle population in the counties was not associated with positive BA results. Current records from the VDLs appear to accurately estimate the seroprevalence of BA in MS and thus serves as a reliable surveillance tool BA in the state. Because the burden of BA appears to be distributed throughout the state, future prevention and control measures for BA should focus on the identified putative risk factors and be intensified throughout MS.

A survey of antimicrobial use practices of Tennessee beef producers.

BACKGROUND: Inappropriate antimicrobial use (AMU) is a key modifiable factor that leads to the development of antimicrobial resistance (AMR). The objectives of this study were to determine the following among Tennessee beef cattle producers: (1) the opinions on factors driving AMU (2) opinions on alternatives to antimicrobials, (3) the knowledge and perceptions regarding AMU and AMR, and (4) the preferred avenues for receiving information on prudent AMU. A survey questionnaire was made available to participants both in print and online from January 26, 2018 through May 11, 2018. The questions targeted the producers' demographics and their AMU practices; factors driving producer's choice of antimicrobials; perceptions, opinions and concerns about AMU and AMR in cattle production. Ordinal logistic regression was used to test for associations between the captured demographic information and producers' degree of concern about AMR. RESULTS: Overall, 231 beef producers responded to all or some of the survey questions. More than 60% of the participants mentioned that they kept up-to-date written records on antimicrobial purchases and AMU. Regarding extra-label use, 169 (84.1%) of the 201 respondents did not practice extra-label AMU. Profitability of the beef operation was a key factor influencing the decisions of many producers to use antimicrobials for disease management and prevention on their farms. Of the 228 producers who completed the question on the rating of their degree of concern about AMR, 50 (21.9%) reported that they were very concerned about AMR, 133 (58.3%) were moderately concerned, and 36 (15.8%) reported that they were not concerned about AMR. Nine producers (4%) did not rate their degree of concern about AMR because they were not familiar with what antimicrobial resistance meant. The inferential analyses suggested that younger beef producers were significantly less concerned about AMR when compared to the older ones (P = 0.019). Regarding avenues for receiving information on prudent AMU, no single medium was most preferred by all the respondents. CONCLUSIONS: There is a need to promote the use of written antimicrobial treatment protocols among beef producers in Tennessee. Continued training for beef producers on infection prevention and control and prudent AMU is needed.

Assessment of hydromorphone and dexmedetomidine for emesis induction in cats.

OBJECTIVE: To compare the efficacy of hydromorphone and dexmedetomidine at inducing emesis in cats. DESIGN: Prospective, blinded, randomized crossover study. SETTING: Veterinary university teaching hospital. ANIMALS: 12 healthy purpose-bred cats. INTERVENTIONS: Cats were randomly assigned to receive hydromorphone (0.1 mg/kg, subcutaneously) or dexmedetomidine (7 µg/kg, IM). Following administration, the incidences of emesis, number of emetic events, signs of nausea (hypersalivation, lip licking), temperature, heart rate, respiratory rate, and sedation score were recorded for 6 hours. MEASUREMENTS AND MAIN RESULTS: Emesis was successful in 9 of 12 (75%) cats when treated with hydromorphone and in 7 of 12 (58%) cats when treated with dexmedetomidine (P = 0.67). Dexmedetomidine was more likely to cause sedation than hydromorphone (P < 0.001). Heart rate in cats was significantly decreased at 1 and 2 hours post-hydromorphone (P = 0.003, 0.014, respectively) and at 1, 2, 3, 5, 6 hours post-dexmedetomidine (P = 0.001, 0.003, 0.038, 0.013, 0.001, respectively). Cats were more likely to develop an increase in body temperature with hydromorphone administration although this was not clinically significant. CONCLUSIONS: Results of the present study indicate that hydromorphone is an effective alternative to dexmedetomidine for the induction of emesis in cats. Hydromorphone appears to cause less sedation and less decrease in heart rate. Further investigation into the most adequate dose of hydromorphone for optimizing emesis is warranted.