Occurrence of Isospora suis in Germany, Switzerland and Austria.

Nationwide surveys for the occurrence of Isospora suis were carried out in Germany, Austria and Switzerland including a questionnaire regarding herd size, health status and management practices and a coccidiosis sampling kit for pooled faecal samples from litters of suckling piglets. A total of 184 veterinary practices participated in the survey and returned 1745 samples (331 kits) from 324 farms in the north (n = 98), south (n = 84), centre/east (n = 42) and west (n = 10) of Germany, Austria (n = 61) and Switzerland (n = 29) with larger farms in north and centre/east (average number of sows: 270 and 500) and smaller ones in the south (95), Austria (60) and Switzerland (43). Larger farms tended to have better hygienic standards (slatted floors, disinfection of the farrowing units). The majority of the participating farms (93.5%) reported problems with diarrhoea in piglets at 2-3 weeks of age, significantly associated (P < 0.001) with uneven weaning weights (94.9%). Toltrazuril (5%; Baycox) was used only rarely; however, in these farms unevenness of weaning weights was less frequently observed (P = 0.011). A 76.2% of the farms were positive for I. suis (samples contained mostly low or moderate oocyst numbers), especially in the south (P < 0.001). Oocysts were more frequently found in samples from farms with reported diarrhoea (P = 0.011), uneven weight gain (P = 0.019) or in herds of small size (P < 0.001). Disinfection, floor type or treatment with toltrazuril did not affect the frequency of observation of oocysts.

[Thoracic outlet syndrome]. / Le syndrome du défilé cervico-thoracique.

Thoracic outlet syndrome (TOS) is due to compression/irritation of brachial plexus elements ("neurogenic TOS") and/or subclavian vessels ("vascular TOS") in their passage from the cervical area toward the axilla. The usual site of entrapment is the interscalenic triangle. TOS is a highly controversial subject in regard to its incidence, diagnostic criteria and optimal treatment. Constitutional factors--osseous or more often fibromuscular--and external factors such as trauma predispose to the development of TOS. Various clinical pictures include pain in the cervical region and arm, paresthesias, aggravated by overhead positions of the arms, hand intrinsic muscle deficit/atrophy, easy fatiguability, paleness, coldness of hand. The clinical examination may be entirely normal or show cervical and scapular muscle spasm, tenderness of supraclavicular area, radial pulse attenuation upon positional maneuvers, sensory and/or motor deficit, usually of C8/T1 distribution. The diagnosis is based on clinical evaluation and absence of other relevant pathology. Sometimes TOS can enhance symptoms consecutive to cervical or supraclavicular lesions. Cervical spine and distal peripheral nerves are investigated by radiological and electrophysiological studies. Unless there is significant motor deficit or subclavian artery compression, the treatment should be kept conservative as long as possible, by adapted physical therapy. In case of neurological deficit or symptoms unresponsive to medical treatment, the patients will--like in other nerve entrapment syndromes--be helped by decompressive surgery, nowadays preferably performed via an anterior supraclavicular approach.