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The purpose of the present study was based upon the first diagnosed bovine cutaneous leishmaniasis in a cow in Switzerland in April 2009. We continued descriptively the search for other bovine cases in Switzerland. We carried out similar investigations in the original farm where the case had occurred, and in parallel also in the neighboring farm. Additionally, veterinary practitioners sent us an overall of 12 suspected cases of bovine leishmaniasis. Following diagnostic investigations, all cases were negative for Leishmania. The occurrence of this infection appears therefore to be a very rare event. Finally some differential diagnoses are discussed.

Abdominal pain is a frequent symptom and in the majority of cases the underlying disease is not life threatening. The general practitioner's first task is to differentiate between inflammatory and other diseases. The patient's history, the clinical examination and laboratory tests form the basis for the differential diagnosis. A sonography is the first additional examination in the vast majority of the cases. Accidentally found gallstones usually do not require surgical intervention. Surgery in asymptomatic patients should be limited to gallbladder polyps and patients with calcifications in their gallbladder wall.

Approximately 20-30% of patients with cardiac chest pain have a normal coronary angiogram. In about 5% of these patients, a myocardial bridge can be identified. The characteristic feature is systolic compression of an epicardial vessel, usually the left anterior descending artery (LAD), with the angiographic "milking effect". Using modern imaging techniques, such as intravascular ultrasound (IVUS), intracoronary Doppler ultrasound (ICD) and intracoronary pressure wires, the pathophysiological consequence of myocardial bridging could be established. While previously considered a clinically insignificant variant, ICD recordings demonstrated an increased flow velocity in the tunneled segment. Frame-by-frame IVUS analysis revealed a delayed relaxation after systolic compression, which may extend significantly into diastole. This explains both the impaired coronary flow reserve and ischemia. In IVUS, a circular or eccentric rhythmic compression of the vessel is visible, which may be partial or complete. Latest computed tomography technology can also be used to visualize myocardial bridging noninvasively. Provocation tests, such as application of nitroglycerin, orciprenaline, dobutamine or atrial stimulation, may augment systolic compression and explain symptoms and the beneficial effect of beta-blockers. In severe cases (i.e. limiting symptoms with ischemia despite medication), surgical myotomy may be performed after careful appraisal of the benefit-risk ratio. A high restenosis and complication rate associated with coronary stenting precludes a general recommendation of this interventional approach. Whether drug-eluting stents help to overcome this limitation remains to be shown. Long-term prognosis is good, although previous investigations have been performed in a limited number of cases only.

The clinical, echocardiographical and pathomorphological findings of cows with either cardiomyopathy, endocarditis valvularis thromboticans and pericarditis traumatica are described. Based on these examples the use of echocardiography for improved diagnosis is presented.

The goal of this study was to determine via echocardiography the size of the left and right cardiac ventricles and the width of the interventricular septum and the left free ventricular wall in 51 healthy cows. The heart regions were examined in standing cows using a 3.0 Mhz sector transducer in 2-D-Mode. The dimensions of the heart were measured in the caudal long and short axes on the right side and in the caudal and cranial long axes on the left. The diameter of the ventricles was determined in a plane immediately beneath the mitral or tricuspid valves and that of the aorta and pulmonary artery in a plane immediately above the aortic and pulmonary valves, respectively. At the end of the study, all of the cows were slaughtered, the hearts were removed and the same parameters were determined using a tape measure. Results of in vivo and in vitro measurements were compared. In the right caudal long axis, the diameters of the left ventricle during both diastole (x +/- s = 7.0 +/- 0.73 cm) and systole (4.5 +/- 0.69 cm) were larger than those of the right ventricle during diastole (4.1 +/- 1.02 cm) and systole (3.6 +/- 0.98 cm). The diameter of the ventricles during diastole was larger than that during systole. Analogous results were obtained in both other axes. The diameter of the right ventricle during systole was larger when measured in the right caudal long axis (3.6 +/- 0.98 cm) than in the right caudal short axis (3.2 +/- 1.15 cm). This was also true for measurements obtained during diastole. The interventricular septum and the left ventricular wall were thicker during systole than during diastole. The diameter of the pulmonary artery was larger during diastole (5.6 +/- 0.82 cm) than systole (5.2 +/- 0.84 cm). The diameter of the aorta was smaller than that of the pulmonary artery and did not change significantly during diastole (4.9 +/- 0.92 cm) and systole (4.8 +/- 0.80 cm). The diameters of both ventricles measured at post mortem were smaller than those measured in vivo during diastole and larger than those measured during systole. There were no significant differences between the measurements performed twice, three days apart, in 11 of the cows.

This study involved 182 calves, heifers and cows that were the first generation progeny of cows with bovine spongiform encephalopathy (BSE). All animals underwent clinical and neurological examinations. Blood, milk, urine, ruminal fluid and cerebrospinal fluid samples were examined. Each cow underwent a specific examination for BSE which included assessment of behaviour, sensitivity and locomotion. This examination was performed twice, and there was very good agreement between the results. The most common symptom was nervousness (14 animals). In the first examination, 68 animals were mildly to moderately sensitive to touching of the head, 44 animals were hypersensitive to a halogen light and 35 animals were hypersensitive to a camera flash. Twenty-four animals reacted by kicking when the hindlimbs were touched with a broom. None of the animals had disturbances in locomotion. Based on the interpretation of all findings and the comparison of the results of the first and second examinations, 173 animals were diagnosed as free of BSE. In 9 animals, the disease could not be ruled out; however, it could not be confirmed in any of them. Histological and immunohistochemical examinations of the brain of all animals were negative for BSE (see Part 2 of the study for details). The results of this study indicate that abnormal clinical findings may occur in clinically healthy cattle. However, none of the progeny of cows with BSE exhibited clinical signs typical of BSE, such as disturbances in behaviour; sensitivity and locomotion.

Caring for an alcoholic is not an easy task for the physician. Firstly, he is confronted with a patient, who is not or only marginally aware of his medical, psychological and social problems. This is not surprising, as alcoholism is--in most cases--much more than a bad habit. It is the (failed) attempt of coping with life. Secondly, our attitude towards alcoholism is very ambivalent, and doctors are often ill at ease concerning this problem.