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Eastern North Carolina is a major contributor to both turkey and swine production in the United States. In this region, turkeys and swine are frequently grown in close proximity and by common growers. To further characterize colonization of turkeys and swine with Campylobacter in such a setting, we investigated the prevalence of thermophilic campylobacters in eight paired operations involving turkey farms in close proximity to finishing swine farms. All 15 surveyed flocks and 15 herds were Campylobacter positive at one or more sampling times. Campylobacter was isolated from 1,310 (87%) of the 1,512 turkey samples and 1,116 (77%) of the 1,448 swine samples. Most (>99%) campylobacters from swine samples were Campylobacter coli, found in 59 to 97% of the samples from the different herds. Both Campylobacter jejuni and C. coli were recovered from the turkey flocks (overall prevalences of 52 and 35%, respectively). Prevalence among flocks ranged from 31 to 86% for C. jejuni and 0 to 67% for C. coli, and both species were recovered from most flocks. Relative prevalence of C. coli was higher in young birds (brooders), whereas C. jejuni predominated in grow-out birds (P < 0.0001). The prevalence of C. coli in a swine herd was generally not a good predictor for prevalence of this species in the corresponding turkey flock. These findings indicate that even though turkeys and swine grown in proximity to each other were commonly colonized with thermophilic campylobacters, the relative prevalences of C. jejuni and C. coli appear to be host associated. [ABSTRACT FROM AUTHOR]

A prospective ecologic study, using routinely collected data from commercial turkey companies, was done of 312 turkey flocks placed over a 1-yr period. The objective was to identify hatchery- and transportation-associated risk factors for poult mortality in the first 14 d after placement using statistical models. Logistic regression was used to determine the effects of hatchery-and transportation-related factors on odds of mortality for hen and tom flocks separately. Hatchery and transportation-related risk factors for hen flock mortality included truck, truck temperature, and number of poults dead on arrival at the farm. Hatchery and transportation-related risk factors for tom flock mortality included desnooding, truck, truck temperature, shipping time, and weather conditions at placement.

Poult enteritis mortality syndrome (PEMS) is an economically devastating disease. To date, many questions about the syndrome remain unanswered, including its cause, transmission of causative agent(s), and control methods. Turkey coronavirus (TCV) infection has been associated with some outbreaks of PEMS, with areas having a higher prevalence of TCV infection also experiencing an increased incidence of PEMS. This study was designed to establish mortality patterns for flocks experiencing excess mortality and TCV infection in PEMS-affected regions and to delineate the possible role of TCV in PEMS-affected flocks. Fifty-four commercial turkey flocks on farms in areas with and without a history of TCV infection were monitored for weekly mortality and for antibodies to TCV. Flocks were chosen on the basis of placement dates and were monitored from day of placement until processing. All flocks were tested for TCV by an indirect fluorescent antibody assay. PEMS status was determined with the use of the clinical definition of mortality greater than 2% during any 3-wk period from 2 wk of age through the end of brooding due to unknown cause. Of the 54 flocks, 24 remained healthy, 23 experienced PEMS, and 7 tested positive for TCV but did not experience PEMS. Ten flocks experienced PEMS and tested positive for TCV, whereas 13 flocks experienced PEMS and did not test positive for TCV. Four health status groups were evident: healthy, PEMS positive, TCV positive, and PEMS + TCV positive. Distinct mortality patterns were seen for each of the four health status groups. Whereas TCV was associated with PEMS in 43% of PEMS cases, 13 cases (57%) of PEMS did not involve TCV. Additionally, 7 out of 17 cases of TCV (41%) did not experience excess mortality (PEMS) at any time during brooding of the flock. The results of this study indicate that TCV can be associated with PEMS but is neither necessary nor sufficient to cause PEMS.

Simon nitinol vena caval filters were placed percutaneously in 20 patients. Follow-up (average, 14 months) data were available for 16 patients, and four patients were lost to follow-up. There were no proved or suspected cases of pulmonary embolism after filter insertion. Complications encountered included caval penetration (n = 5, one acute and four at follow-up), caval thrombus (n = 4, two determined radiologically and two clinically), postplacement deep venous thrombosis (n = 2, one radiologic and one clinical), filter migration (n = 1), and delayed fracture of a filter leg (n = 2). Although no deaths or significant morbidity resulted from any complication, the relatively high complication rate, especially of significant caval penetration (documented in 25% of filter insertions), merits continued short- and long-term assessment of patient status after filter placement.

The authors describe a case in which a leaflet from a mitral valve prosthesis embolized to the right external iliac artery. Intravascular ultrasound proved useful in locating the valve fragment prior to and during surgery, allowing for its removal.

One hundred one LG-Medical (LGM) vena cava filters were placed in 97 patients at four institutions. Placement was a complete technical success in 90% (91 of 101). In 6% of attempts, LGM filter insertion was complicated by incomplete opening of the filter. Pulmonary embolism after filter placement was not definitely demonstrated in any patient. The probability of inferior vena cava patency was 92% at 6 months after filter insertion. Thrombosis at the insertion site was seen in eight of 35 patients (23%) evaluated with duplex ultrasound or venography. Thrombus was observed in 37% of filters at follow-up examination, with cephalic extension of thrombus above the filter in 20% of all patients examined. Filter migration (greater than 1 cm) was seen in 12%; significant angulation was observed in only one patient (2%). In vitro experimentation demonstrated that incomplete opening of the LGM filter during placement can be avoided, in part, by brisk retraction of the insertion cannula. The low-profile introducer system of the LGM filter allows increased alternatives in selecting the site for filter insertion. The low-profile system also makes outpatient filter placement a possibility. No significant difference in the prevalence of thrombosis at the insertion site following LGM filter insertion was noted compared with previous results reported for percutaneous transfemoral placement of the Greenfield filter. The nonopaque sheath does not permit careful localization prior to filter deposition. Modification of the LGM filter to include a radiopaque sheath is suggested.

Flock records from a commercial turkey company were analyzed to determine if poult source affected flock performance. Comparisons were made between flocks supplied by two hatcheries (X and Y) reared on the same farms and among flocks reared on different farms. Flocks from hatchery X had significantly better livability and feed-conversion ratios than flocks from hatchery Y. Although not statistically significant, flocks from hatchery X tended to grade better at processing (percent grade A) and have lower condemnations than flocks from hatchery Y. Season significantly affected livability and feed conversion of all flocks regardless of hatchery source.

Amplatz vena caval filters were inserted percutaneously in 30 patients. Radiologic and clinical follow-up was available in 24 patients (cavogram, CT, or sonography in 20 patients, plain abdominal radiographs in two, and lower extremity venograms in two). Clinical follow-up only was available in four patients, and autopsy reports were available in two patients without radiologic follow-up. The filter was inserted without difficulty in 29 (97%) of the patients. Complications after insertion included recurrent pulmonary embolism in two (7%) of 30, caval thrombosis in seven (23%) of 30, ipsilateral lower extremity deep venous thrombosis after placement of the filter in one (3%) of 30, caval penetration in two (10%) of 20, and caval stenosis in one (5%) of 20. No migration of the filter was noted. Our experience suggests that the Amplatz vena caval filter is easy to insert and adequately prevents recurrent pulmonary embolism but is associated with a relatively high rate of caval thrombosis.