Multistate outbreak of listeriosis caused by imported cheese and evidence of cross-contamination of other cheeses, USA, 2012.

Listeria monocytogenes is a foodborne pathogen that can cause bacteraemia, meningitis, and complications during pregnancy. In July 2012, molecular subtyping identified indistinguishable L. monocytogenes isolates from six patients and two samples of different cut and repackaged cheeses. A multistate outbreak investigation was initiated. Initial analyses identified an association between eating soft cheese and outbreak-related illness (odds ratio 17·3, 95% confidence interval 2·0-825·7) but no common brand. Cheese inventory data from locations where patients bought cheese and an additional location where repackaged cheese yielded the outbreak strain were compared to identify cheeses for microbiological sampling. Intact packages of imported ricotta salata yielded the outbreak strain. Fourteen jurisdictions reported 22 cases from March-October 2012, including four deaths and a fetal loss. Six patients ultimately reported eating ricotta salata; another reported eating cheese likely cut with equipment also used for contaminated ricotta salata, and nine more reported eating other cheeses that might also have been cross-contaminated. An FDA import alert and US and international recalls followed. Epidemiology-directed microbiological testing of suspect cheeses helped identify the outbreak source. Cross-contamination of cheese highlights the importance of using validated disinfectant protocols and routine cleaning and sanitizing after cutting each block or wheel.

Multistate outbreak of Escherichia coli O157:H7 infections associated with in-store sampling of an aged raw-milk Gouda cheese, 2010.

In 2010, 41 patients ill with Escherichia coli O157:H7 isolates determined to be indistinguishable by pulsed-field gel electrophoresis were identified among residents of five Southwestern U.S. states. A majority of patients reported consuming complimentary samples of aged raw-milk Gouda cheese at national warehouse chain store locations; sampling Gouda cheese was significantly associated with illness (odds ratio, 9.0; 95 % confidence interval, 1.7 to 47). Several Gouda samples yielded the O157:H7 outbreak strain, confirming the food vehicle and source of infections. Implicated retail food-sampling operations were inconsistently regulated among affected states, and sanitation deficiencies were common among sampling venues. Inspection of the cheese manufacturer indicated deficient sanitation practices and insufficient cheese curing times. Policymakers should continue to reexamine the adequacy and enforcement of existing rules intended to ensure the safety of raw-milk cheeses and retail food sampling. Additional research is necessary to clarify the food safety hazards posed to patrons who consume free food samples while shopping.

Combined-type osteosarcoma in a rhesus macaque.

A femoral mass from a 15-year-old rhesus macaque was evaluated. Grossly, the mass consisted of a large, osteolytic focus in the distal femur, a gelatinous core of neoplastic tissue in the medullary cavity, and an invasive mass-obliterating musculature of the thigh. On histopathologic evaluation, three neoplastic mesenchymal cell populations, osteoblasts, fibroblasts, and primitive mesenchymal cells were identified. The mass was diagnosed as a combined type osteosarcoma. To our knowledge, this is the first osteosarcoma in a rhesus macaque with this subclassification.

An immunohistochemical study of cyclooxygenase-2 expression in various feline neoplasms.

Cyclooxygenase (COX) enzymes catalyze the synthesis of prostaglandins and exist as two isoforms, COX-1 and COX-2. COX-2 is a potent inducible mediator of inflammation. COX-2 is also upregulated in several human tumors and in canine squamous cell, renal cell, and transitional cell carcinomas, prostatic adenocarcinoma, and intestinal neoplasia. The purpose of this study was to determine whether COX-2 is expressed in various feline tumors. Results of this study may help determine whether COX-2 is a potential target for therapeutic and preventive strategies in cats. Immunohistochemical studies were performed on paraffin-embedded tissues using the amplified streptavidin-biotin-horseradish peroxidase system. COX-2 was found in 7 of 19 (37%) feline transitional cell carcinomas and in 2 of 21 (9%) feline oral squamous cell carcinomas. No COX-2 immunoreactivity was detected in cutaneous squamous cell carcinomas (6), adenocarcinomas (nine mammary, eight pulmonary, seven intestinal), lymphomas (six nasal, six intestinal), or 10 vaccine-associated sarcomas. The widespread absence of COX-2 expression in most feline neoplasms might suggest that COX-2 inhibitors would have a low potential as anticancer agents.

Retrospective analysis of mortalities associated with medication errors.

The types, causes, contributing factors, and patient demographics of fatal medication errors were reviewed. Case reports of medication errors from hospitals, ambulatory care settings, and patients' homes that were entered in FDA's Adverse Event Reporting System during 1993-98 were the source of information on fatal medication errors. Each report was classified using predefined criteria and a taxonomy developed by the National Coordinating Council for Medication Error Reporting and Prevention. The types, causes, contributing factors, and patient demographics were identified, and the causality of each case was assessed to prevent future fatalities. The data indicated 5,366 medication error reports. Fifty-nine reports were excluded and classified as duplicate reports or intentional overdoses. Of the remaining medication error reports, 68.2% resulted in serious patient outcomes and 9.8% were fatal. Of the 469 fatal medication error reports, 48.6% occurred in patients over 60 years. The most common types of errors resulting in patient death involved administering an improper dose (40.9%), administering the wrong drug (16%), and using the wrong route of administration (9.5%). The most common causes of errors were performance and knowledge deficits (44%) and communication errors (15.8%). Fatal medication errors accounted for approximately 10% of medication errors reported to FDA and were most frequently the result of improper dosing of the intended drug and administration of an incorrect drug. A review of case reports of medication errors from 1993 to 1998 yielded information on the most frequent causes of and contributing factors involved in fatal medication errors.

Low- or high-intensity strength training partially restores impaired quadriceps force accuracy and steadiness in aged adults.

Because many daily tasks are executed at only a fraction of maximal strength, an understanding of submaximal force control may be important for improving function in aged adults. We compared the effects of low- and high-intensity (LI and HI, respectively) strength training on maximal and explosive strength and on the accuracy (force error) and steadiness (variability) of submaximal quadriceps force in elderly humans. Older subjects (age, 72 years; n = 27) had 57% lower maximal strength in comparison with young subjects (age, 21 years; n = 10). Older subjects had 190% (19 N), 50% (1 N), and 80% (4 N) more force error in matching 25 N of quadriceps force during eccentric, isometric, and concentric contractions, and had 157%, 0%, and 60% more variability in these forces compared with young subjects. Force error and force variability were correlated with each other but not with maximal strength. Thirty sessions of LI (n = 9 participants) or HI (n = 9 participants) training of equal total work increased maximal strength in the older subjects by 29%. Training also significantly reduced force error and variability--by 31% and 30%, respectively--of eccentric and concentric contractions. A control group of older subjects (n = 9) showed no significant changes in any variables. LI or HI strength training was equally effective in partially restoring elderly adults' maximal strength and control of submaximal force.

Effects of energy balance on follicular development and first ovulation in postpartum dairy cows.

As milk production has increased during the past four decades, conception rates in lactating cows have declined. Although reduced reproductive performance has been associated with high milk yields, measures of postpartum ovarian activity have been more closely related to energy balance. The relationship between daily energy balance and postpartum reproductive activity is confirmed by longer intervals to first ovulation in cows with greater body condition loss. Patterns in daily energy balance, such as improvement from nadir, have been correlated with enhanced follicular function and a shorter interval to first ovulation. Such observations are consistent with increased LH pulse frequency following the energy balance nadir in lactating dairy cows. Evidence indicates a primarily hypothalamic locus for the modulation of LH secretion during negative energy balance. Formation of follicular waves after parturition begins synchronously in response to increased FSH in the first week postpartum, and is typically not a limiting factor in reproductive recrudescence. Altered follicular responsiveness to gonadotrophic support through changes in metabolic hormones such as insulin-like growth factor I (IGF-I) and insulin may contribute to impaired function of dominant follicles early postpartum. Positive relationships between changes in energy balance, peripheral IGF-I and function of dominant follicles support the identification of IGF-I and the day of the energy balance nadir as metabolic modulators of postpartum ovarian activity in dairy cows.

A retrospective-cohort study on the development of cataracts in dogs with diabetes mellitus: 200 cases.

The objective of the study was to determine the incidence and estimated median time to cataract formation in dogs with diabetes mellitus. The animals studied were 200 dogs with diabetes mellitus which were referred to a university teaching hospital between 1985 and 1995. Medical records from dogs with a diagnosis of diabetes mellitus were reviewed and, where necessary, further follow-up information was gathered from the referring veterinarian. Incidence rate and median time to diabetic cataract formation was calculated using survival-analysis techniques in a retrospective cohort study design. Among the 200 dogs in the study population, 23 had cataracts at the time of diabetes diagnosis that were presumed to be related to other disease processes. Of the remaining 177 dogs, 132 had documented cataract development with features suggestive as being secondary to diabetes. Twenty-three dogs did not have obvious cataracts at the time of their last examination while 22 dogs did not have cataracts at the time they were lost to follow-up. These 55 cases contributed to the statistical models as noncases of cataracts until the last date for which an examination was available. Half of the population had developed cataracts by the 170th day postdiagnosis of diabetes mellitus, while 75% and 80% of the population developed cataracts by 370 days and 470 days, respectively. The results of this study suggest that the majority of dogs with diabetes will develop cataracts within 5-6 months from the time of diagnosis of the disease, and that approximately 80% of dogs will develop cataracts within 16 months of diagnosis.

Energy balance, metabolic hormones, and early postpartum follicular development in dairy cows fed prilled lipid.

The objectives of this study were to relate energy balance and metabolic hormones during the early postpartum period in dairy cows with dominant follicle development before first ovulation and to evaluate the effects of prilled lipid on follicular development during the first follicular wave after parturition and the postpartum anovulatory interval. At parturition, 42 cows received a control diet (4.8% fat) or a diet supplemented with prilled fatty acids (7.0% fat). Energy balance was determined daily. Ovarian follicular development was monitored by ultrasonography, and blood plasma or serum was analyzed for estradiol, progesterone, and metabolic hormones. Dry matter intake was lower in cows supplemented with dietary lipids during the first 4 wk of lactation, but energy intake, energy balance, and the postpartum anovulatory interval were similar between diets. A wave of follicular development occurred in all cows during the 2nd wk postpartum, and 50% of all cows ovulated their first dominant follicle. Numbers of follicles that were 3 to 5 mm, 6 to 9 mm, and 10 to 15 mm on d 8 postpartum were similar between diets and unrelated to energy balance or metabolic hormones. Diameter of the dominant follicle during d 8 to 14 postpartum and maximum diameter of the first-wave ovulatory follicle did not differ between diets. Cows with nonovulatory first-wave dominant follicles had lower mean plasma concentrations of estradiol during d 8 to 14 postpartum, a longer interval to the day of the energy balance nadir, lower serum concentrations of IGF-I, and higher 4% FCM yield than did cows with ovulatory first-wave dominant follicles. Serum IGF-I during d 1 to 13 was positively correlated with plasma estradiol during d 8 to 14 postpartum. Possibly because of reductions in dry matter intake, the consumption of prilled lipid by dairy cows during early lactation may be ineffective in altering energy balance, follicular development, and the postpartum anovulatory interval. Ovulation failure of dominant follicles early in the postpartum period is associated with greater production of 4% fat-corrected milk, a delayed energy balance nadir, and reduced concentrations of peripheral IGF-I.

Energy balance and ovarian follicle development prior to the first ovulation postpartum in dairy cows receiving three levels of dietary fat.

The objectives of this study were to characterize early postpartum (PP) follicular development in dairy cows and to evaluate the influence of energy balance (EB) and the level of dietary fat on dominant follicle development and function. Forty-five multiparous Holstein cows were fed either low (LF, 3.3%), moderate (MF, 5.2%), or high (HF, 7.1%) total dietary fat beginning at parturition, and daily EB was determined for all cows. Follicular development was monitored by ultrasonography, and blood plasma was analyzed for metabolites, metabolic hormones, progesterone, estradiol, and FSH. After an increase (p < 0.01) in mean plasma FSH during Days 1-5, all cows experienced a wave of follicular development during the second week PP regardless of diet or EB. Feeding the MF (p < 0.05) or HF (p < 0.06) diet resulted in a greater number of class IV (> 15 mm) follicles on Day 14 PP as compared to the LF diet. Cows fed the MF diet had higher (p < 0.05) peak plasma estradiol during the first follicular wave and a shorter (p < 0.05) interval to first ovulation than both LF and HF cows. Follicular development prior to first ovulation was characterized by either ovulation of the first dominant follicle (OV, n = 19), one or more waves of nonovulatory dominant follicles (NOV, n = 18), or the formation of a follicular cyst (CYST, n = 8). Ovulation failure during the first follicular wave PP was accompanied by lower (p < 0.001) peak plasma estradiol (0.96 +/- 0.36 vs. 5.0 +/- 0.35 pg/ml), a smaller (p < 0.01) maximum follicle diameter (16.0 +/- 0.9 vs. 20.0 +/- 1.0 mm), lower (p < 0.09) levels of plasma insulin-like growth factor-I (IGF-I; 73.5 +/- 10.1 vs. 102.9 +/- 9.9 ng/ml), and a longer (p < 0.02) interval to the EB nadir (14.6 +/- 1.9 vs. 6.4 +/- 1.9 days). The number of days to first ovulation was positively correlated with days to the EB nadir (r = 0.55), with dominant follicles that emerged after the EB nadir exhibiting enhanced (p < 0.01) production of estradiol and greater (p < 0.01) ovulatory success. The development of large (> 10 mm) dominant follicles was not a limiting factor in PP reproductive recovery, and moderate dietary fat shortened the interval to first ovulation. Follicular competence early PP was associated with higher plasma IGF-I and a shorter interval to the EB nadir.

Plasma and milk urea nitrogen in relation to pregnancy rate in lactating dairy cattle.

The objectives of this study were to relate concentrations of plasma (PUN) and milk (MUN) urea nitrogen to pregnancy rate in dairy cows and compare various methods of analysis and preparation of milk for measuring MUN. In two experiments, blood or milk samples were collected on the day of AI from Holstein cows (n = 160 and n = 155, respectively). Three methods of MUN analysis were compared. Two laboratory chemical procedures yielded similar results, whereas a quick dipstick method overestimated chemical analyses. Before and after milking strip samples had MUN concentrations equivalent to those in composite milk. Concentrations of PUN or MUN greater than 19 mg/dL were associated with decreased (P < .02) pregnancy rates (18 and 21 percentage point reduction in the two experiments). In two subset groups of cows (n = 51 and n = 23, respectively), plasma progesterone or MUN concentrations were monitored during the 5-d period after AI. Plasma progesterone concentrations increased similarly during the period for cows divided into low vs high PUN but were greater in pregnant than in nonpregnant cows on d 4 and 5 (P < .04). The MUN concentrations showed low within-cow variation (CV = 8%) but were lower in pregnant cows and had a decreasing trend over time compared with nonpregnant cows (P < .05). Based on this study, plasma and milk will yield similar results for monitoring urea nitrogen in dairy cows; PUN and MUN concentrations > 19 mg/dL were associated with approximately a 20 percentage point decrease in pregnancy rate after AI in lactating dairy cattle.

Time of daily supplementation for steers grazing dormant intermediate wheatgrass pasture.

To compare the effects of time of daily protein supplementation on grazing behavior, forage intake, digesta kinetics, ruminal fermentation, and serum hormones and metabolites, 12 ruminally cannulated Holstein steers (449 and 378 kg average initial and final BW, respectively) were allotted to three groups. Treatments consisted of CON = no supplement, AM = cottonseed meal (.25% of BW) at 0600, and PM = cottonseed meal (.25% of BW) at 1200. Steers grazed a dormant (1.1% N) intermediate wheatgrass (Thinopyrum intermedium Host) pasture. Sampling trials occurred in December, January, and February. Supplementation altered (P = .01) time spent grazing; CON steers grazed approximately 1.5 h longer than supplemented steers. Supplemented steers lost less (P = .02) BW (-40 kg) than CON steers (-75 kg) did. Supplementation did not alter (P greater than .15) forage OM intake; however, total OM intake was greater (P = .01) for supplemented steers (22.3 g/kg of BW) than for CON (18.4 g/kg of BW) steers. Supplementation did not affect (P greater than .15) digesta kinetics. Extent of in situ NDF (96 h) and rate (%/h) of disappearance for supplemented steers was greater (P = .01) than for CON steers. Across all periods, ruminal NH3 N and total VFA concentrations were lower (P = .01) for CON steers than for supplemented steers. Serum insulin (ng/mL) concentration was lower (P = .03) and concentration of serum growth hormone (ng/mL) was higher (P = .02) for CON steers than for supplemented steers. Cottonseed meal supplementation enhanced utilization of intermediate wheatgrass; however, supplementation time had minimal effects on the variables measured.

Mapping bovine herpesvirus type 1 latency-related RNA in trigeminal ganglia of latently infected rabbits.

Here we have used the bovine herpesvirus type 1 (BHV-1) rabbit model together with in situ nucleic acid hybridization to identify and map viral RNA present in latently infected neurons. Radioactively labeled cloned HindIII fragments representing most of the BHV-1 genome (Cooper strain) were individually hybridized to sections of trigeminal ganglia taken from rabbits during acute and latent stages of infection. Whereas all viral genomic fragments hybridized to lytically infected tissue culture cells and to acutely infected ganglia, only HindIII fragment D (map units 0.734 to 0.842) hybridized to latently infected ganglionic neurons. Additional in situ hybridization experiments using subcloned fragments of HindIII-D further mapped the latency-related viral RNA to a 1.9-kilobase region (map units 0.734 to 0.748) of the viral genome. These results indicate that BHV-1 gene transcription is restricted during the latent phase of infection; further, they suggest that specific viral transcription may be involved in establishment or maintenance of latent BHV-1 infection.

Communication deviations in alcoholics; a pilot study.

Impairments in speech, language, voice and hearing were observed in 14 of 15 alcoholics in treatment.