Gastrointestinal nematode parasites of sheep: a dynamic model for their effect on liveweight gain.

This paper presents an individual-based model for gastrointestinal nematode parasites of sheep and includes the effect of these parasites on the liveweight performance of young sheep. Parasitism is known to affect the host animal in at least two ways. The first induces a loss of appetite in the host, which reduces pasture consumption compared with the parasite-free animal. This effect is examined in the first part of the study. The second major effect of parasitism is a reduction in the metabolic efficiency of the host which decreases nutrients available for maintenance and growth. The latter part of the paper examines the consequences of incorporating this effect on the liveweight changes in individuals in a group of sheep. Previous models addressing this issue have only given mean liveweight and worm burden changes.

Assessment of bronchial beta blockade after oral bevantolol.

We have applied a new method for quantitative measurement of bronchial beta adrenoceptor blockade to a new beta adrenoceptor antagonist, bevantolol. Dose-response curves to a beta agonist, albuterol, were obtained in six normal subjects by measuring specific airway conductance (sGaw) after increasing doses of inhaled albuterol. These were repeated on three separate occasions 2 hr after subjects had taken oral placebo or bevantolol (75 or 150 mg), double-blind in random order. The dose-response curves after bevantolol 75 mg were displaced in the right of placebo in four subjects and after 150 mg were displaced to the right of placebo in all subjects. The mean dose ratios for bevantolol 75 or 150 mg were 1.02 and 2.77, much the same as those obtained in the same subjects after practolol 100 and 200 mg and considerably less than that after propranolol 40 mg. The mean reductions in exercise heart rate were 25% and 29% after bevantolol 75 and 150 mg. Our data show that bronchial beta blockade after a beta blocking drug can be assessed quantitatively in many by a double-blind technique.

Controlling internal parasites in grazing ruminants without recourse to anthelmintics: approaches, experiences and prospects.

Interest in ways of raising stock without using anthelmintics has been stimulated by the desire for intensive grazing systems to adopt more sustainable methods of internal parasite control and by potential premiums for "organic" produce. This requires grazing management systems which are practicable and achieve levels of parasite control sufficient to meet realistic production objectives. This paper will summarise 3 years experience of lamb and cattle production without a recourse to anthelmintics on 2 production systems: a mixed cropping, lamb finishing, and cattle rearing unit and an all grass, mixed-stock, hill country unit in which all non-replacement lambs are sold at weaning. On both units parasite control was almost entirely dependent on integrated grazing management of sheep and cattle and strict systems of grazing management had to be rigidly applied. Acceptable productivity could be more readily achieved in sheep than cattle. Rams selected for resistance to nematodes were also used in both sheep flocks. Their influence on lamb production was equivocal. There is a need for more information on factors influencing parasite epidemiology and for consideration of strategies other than alternate grazing. The impact of pasture species on parasite epidemiology needs to be clarified. Current research indicates substantial differences between grasses in terms of parasite burdens acquired and production losses suffered by lambs grazing them. Grazing management may need to vary with pasture species. Also, specialty forage crops, particularly those containing condensed tannins (i.e. Hedysarum coronarium, Lotus pedunculatus and Lotus corniculatus) hold special promise as a means of countering parasite-induced production losses and dagginess. Using biological control of free-living larval stages and vaccination, may in the long term, also prove useful. Developing effective and acceptable systems for raising stock without using anthelmintics presents a considerable challenge, to parasitologists, as well as to plant breeders, agronomists, and farming systems researchers.

Haemophilus aphrophilus endocarditis in pregnancy.

The clinical and microbiological features of a case of Haemophilus aphrophilus endocarditis in pregnancy are described. The complicating effect of pregnancy on treatment and the difficulties in identifying the organism in the laboratory are discussed.

Do normal plasma neurotensin concentrations increase ileal output?

Infusions of neurotensin increase ileal secretion in experimental animals, and the volume of ileal effluent in patients with ileostomies. The aim of the present study was to determine whether normal postprandial plasma concentrations of neurotensin increase the volume of fluid leaving the ileum. Basal and peak postprandial plasma neurotensin concentrations were 23 (17-36) and 39 (25-43) pmol/l (median and range) respectively in five subjects with ileostomies and 15 (3-27) and 32 (15-82) pmol/l respectively in nine normal subjects. Infusion of neurotensin for 30 min at a rate of 6.3 pmol/kg/min into six patients with ileostomies increased ileostomy output about 10-fold, and produced a significant decrease in the concentration of solid material, but plasma neurotensin concentrations rose to 237 (82-422) pmol/l during infusion at this rate. Infusion of neurotensin at 2.3 pmol/kg/min, producing plasma levels of 60 (16-108), had no significant effect the amount or nature of ileostomy effluent. We conclude that normal postprandial plasma concentrations of neurotensin are unlikely to influence the volume of fluid leaving the ileum.

Theophylline analysis at the chest clinic--comparison of a portable versus conventional system.

The running cost and clinical application of a new, portable, direct-injection, high-performance, liquid chromatograph for the measurement of theophylline was compared with conventional laboratory-based analysis by studying the two methods in two parallel chest clinics. Thirty-six patients were managed with the portable method and 33 by the conventional system. They were already receiving theophylline preparations for treatment of their asthma or chronic airflow limitation. Over the 12-week period of study, the percentage of patients with levels in the therapeutic range rose from 33% to approximately 87% in both clinics, but this change was achieved in only 6 weeks using the portable system. Patients whose theophylline levels were increased into the therapeutic range had improved symptom scores as measured by visual analogue scales but we were unable to demonstrate any significant change in spirometry. The cost of the portable system compared favourably with laboratory analysis, and had the additional benefit of quicker detection of non-compliance and facility for discussion with the patients at the time of consultation.

A solitary cardiac metastasis involving the tricuspid valve ring.

An unique case of solitary metastasis to the region of the tricuspid valve is described. The mechanisms of formation and symptomatology of cardiac neoplasms are discussed. Tumour spread in this case was probably embolic.

Effect of topographical aspect and farm system on the population dynamics of Trichostrongylus larvae on a hill pasture.

The population dynamics of Trichostrongylus colubriformis larvae were compared over two years on contrasting topographical aspects north (warm and dry) and south-facing (cool and moist) hill slopes) on paddocks which form part of the 'non-chemical' and conventional' farm systems at the AgResearch Ballantrae Hill Country Station located in a summer-moist region of New Zealand. Sheep faeces containing 50,000 Trichostrongylus eggs were incubated for 4 days at 25 degrees C and then deposited on each of 36 sub-plots in each of 8 plots in a 2 x 2 factorial design in the summer (summer trial) and again in autumn (autumn trial). Pasture was removed to ground level and larvae extracted from six sub-plots from each plot 2, 4, 6, 8, 11 and 14 weeks after contamination in all trials. Larvae were recovered from two strata, 0-5 cm above the soil surface and > 5 cm above the soil surface. Fewer (p < 0.001) larvae were recovered from herbage (47 vs. 118) and residual faeces (28 vs. 246) from the autumn than from the summer trials. This coincided with more rapid (p < 0.001) faecal disappearance in the autumn trials. In the summer trials, fewer (p < 0.003) larvae were recovered from the herbage (101 vs. 182) and residual faeces (140 vs. 352) from plots on the south than the north facing aspect. In the autumn trials there was a rapid (p < 0.0001) faecal disappearance from the south-facing aspect. In the autumn trials there was a non-significant (p < 0.10) trend for fewer larvae to be recovered from the south-facing aspect (2 vs. 54). This also coincided with more rapid faecal disappearance from the south-facing aspect. There was no effect of farm system on the number of larvae recovered. Despite greater (p < 0.0001) numbers of larvae recovered from the bottom stratum of herbage, the density of larvae (L3/kg DM) tended (p < 0.12) to be higher in the top stratum of herbage. It was concluded that season and aspect have a marked effect on the number of larvae recovered from herbage and that this was inversely related to the rate of faecal disappearance.

A case of feline primary hypoadrenocorticism.

A 2-year-old entire female British Shorthair cat was referred to the University of Bristol for investigation of lethargy, weakness, constipation and hypothermia. Clinical examination revealed a profoundly weak, hypovolaemic and hypothermic cat. Serum biochemistry revealed hyponatraemia, hyperkalaemia and hyperphosphataemia and the urine was isosthenuric. Lack of response to exogenous adrenocorticotrophic hormone confirmed a diagnosis of hypoadrenocorticism. Treatment consisted initially of intravenous fluid therapy and subsequently a combination of fludrocortisone and prednisolone per os. At follow-up, 20 months after the initial diagnosis the cat remained stable and free of clinical signs.

A study of the efficacy of topical and systemic therapy for the treatment of feline Microsporum canis infection.

Microsporum canis infection was induced in 21 healthy SPF-derived cats. Once infection was established (4 weeks after inoculation) the cats were divided into three equal groups housed in separate rooms and monitored for 16 weeks. During this time, group A cats received oral griseofulvin at approximately 50 mg/kg daily and were shampooed twice weekly with a product containing chlorhexidine and miconazole. Group B cats were treated with griseofulvin alone, and group C cats served as untreated controls. The cats were examined on a weekly basis and the severity of lesions was scored semi-quantitatively. In addition, hair samples were collected from each cat on a weekly basis by the MacKenzie brush technique and by the sticky-tape method. A semi-quantitative scoring system was also used for the assessment of fungal (M canis) growth. Generally, significant differences in clinical scores were not seen between the groups although at weeks 3, 4 and 11 there was a significant difference (P< or =0.015) with cats in group A having significantly lower median scores than those in group C. Median times to clinical resolution (return of clinical scores to zero) in groups A, B and C were at treatment weeks 2, 9 and 12, respectively (P>0.05). Median times for mycological resolution (persistently negative culture results) for groups A, B and C were at treatment weeks 2, 9 and 12, respectively, for the MacKenzie brush technique and at weeks 4, 8 and 12 for the sticky-tape technique. For both these results, the groups differed significantly (P< or =0.001) and in both instances group A had significantly more rapid resolution than groups B or C. Median culture scores were significantly different between the three groups using one or both of the sampling techniques at week 2 through to week 12 of treatment with median scores for either group A alone, or groups A and B being significantly lower than group C (P< or =0.026). These results showed a benefit from the addition of twice-weekly chlorhexidine-miconazole shampooing to systemic griseofulvin therapy alone in the treatment of M canis infected cats.

Prevalence of polycystic kidney disease in Persian cats in the United Kingdom.

The prevalence of polycystic kidney disease was assessed in 132 Persian cats, 46 of them referred for the investigation and treatment of medical or surgical conditions, and 86 apparently healthy cats referred specifically to be screened for the disease. Cats referred for the investigation of renomegaly or renal failure were excluded, and cats under 10 months old were only included if they had been examined postmortem. One hundred and twenty-six of the cats were examined ultrasonographically with a 7.5 MHz sector scanner, and the other six cats were examined postmortem. Forty-nine of the 86 cats referred specifically for screening (57.0 per cent) and 16 of the 46 cats referred for other clinical reasons (34.8 per cent) were affected by the disease, giving an overall prevalence of 49.2 per cent.

Myocarditis associated with Mycoplasma pneumoniae infection.

A 48-year-old patient presented with pneumonia and pleural effusion due to Mycoplasma pneumoniae, and subsequently developed pharyngitis and electrocardiographic evidence of myocarditis. The sparse literature on mycoplasma myocarditis is reviewed. The clinical features, electrocardiographic changes and prognosis are discussed.

Amoxycillin versus ampicillin in treatment of exacerbations of chronic bronchitis.

To compare the efficacy and unwanted effects of amoxycillin and ampicillin in the treatment of acute exacerbations of chronic bronchitis, 199 patients were recruited from 28 centres into a double-blind between-patient comparison of four regimens: ampicillin 250 mg or 500 mg, amoxycillin 250 mg or 500 mg, each given orally three times daily for seven days. In these doses, amoxycillin and ampicillin were equally effective and there was no apparent advantage in using the higher dose of either drug in preference to the lower dose. Unwanted effects were few. Only in five patients did diarrhoea lead to withdrawal of therapy and there was no significant difference between the two drugs in this respect. Rashes occurred in four patients, all on ampicillin.

The problems of tuberculosis in the elderly.

A prospective study of tuberculosis notifications from 1976 to 1980 in the North Staffordshire Health District (NSHD), an area with only a small immigrant population, has been carried out. The notification rate for all new cases of tuberculosis in white patients over 55 years of age in the NSHD was twice that reported for England and Wales by the Medical Research Council (1980). Of 433 cases in all ethnic groups 52 (12 per cent) were diagnosed only at necropsy. In addition 48 (11 per cent) died before treatment was completed. Tuberculosis was the only cause of death in 39 of these 100 cases and contributed to death in a further 19 cases, the site of disease being thoracic in 86. Of those who died before completion of treatment, tuberculosis was the cause of death or contributory in 23 and 16 of the 23 (70 per cent) had been on treatment for less than 13 weeks. Death occurred more commonly before or during treatment with increasing age. In a retrospective study of treatment during 1979 and 1980, major unwanted drug-induced effects occurred in 40 per cent of all treated cases in the over-65 age group, mostly related to rifampicin. The survey highlighted the problems of tuberculosis in the elderly white population. They present with advanced disease, are diagnosed late and their course is complicated by other disease and a poor tolerance of therapy.

How important is the sequence of administration of inhaled beclomethasone dipropionate and salbutamol in asthma.

Sixty patients with fairly stable asthma of mild or moderate severity entered a multicentre, double-blind cross-over trial, comparing the efficacy of inhaled beclomethasone dipropionate preceded 10 minutes earlier by inhalation of salbutamol with that of beclomethasone followed 10 minutes later by salbutamol during two consecutive three-month periods. Patients received beclomethasone 100 microgram and salbutamol 200 microgram four times daily. Analysis of occurrence of exacerbations, usage of additional inhaled salbutamol, peak expiratory flow rate and symptom scores showed no evidence that regular beclomethasone was more effective when preceded by salbutamol rather than when followed by it.

Regional conference in Birmingham.

This report is based on the regional conference held at the Queen Elizabeth Postgraduate Medical Centre in September 1993. The conference attracted about 140 participants and was a great success. The programme had been specifically designed to update physicians in areas of medicine where there had been significant management changes. Topics discussed ranged across a broad spectrum of specialties and were presented by a mixture of experts both local and national.