Search

Objective: To investigate diagnostic methods, surgical methods and indications, early complications and short term outcome of cervical spine surgery for rheumatoid arthritis (RA).Methods: A nation-wide registration of rheumatoid cervical spine surgery carried out in Sweden during 1993.Results: Eighty-six (74 primary) procedures in 83 patients were reported from 11 hospitals. Pain was a more common indication for surgery than was neurologic impairment. C1-C2 instability or subluxation was present in 66/82, subaxial subluxations in 27/82 and atlantoaxial impaction in 10/82 procedures (data partly missing in one case). Indications for surgery and preoperative investigations were found to be reasonably uniform, but surgical methods and post-operative care varied between hospitals. Posterior fusion was performed in 76 patients. C1-C2 wiring with bone grafting was the most common procedure followed by occipito-cervical fusion with wires and bone cement. Subaxial cervical decompression without fusion, posterior fusion with onlay graft only, and carbon fiber grafts were used in a small number of patients. Total mortality was 5/83. The early complication rate was low, but 17 patients showed recurrent subluxation at follow-up at median 7 (1-17) months. Seven of them required reoperation in the same segment.Conclusion: The variation in treatment policy and number of operated patients in the different hospitals speak in favor for centralization of cervical spine surgery in RA. New methods for C1-C2-fusion need to be evaluated. [ABSTRACT FROM AUTHOR]

Abstract Background The fox tapeworm Echinococcus multilocularis has foxes and other canids as definitive host and rodents as intermediate hosts. However, most mammals can be accidental intermediate hosts and the larval stage may cause serious disease in humans. The parasite has never been detected in Sweden, Finland and mainland Norway. All three countries require currently an anthelminthic treatment for dogs and cats prior to entry in order to prevent introduction of the parasite. Documentation of freedom from E. multilocularis is necessary for justification of the present import requirements. Methods The probability that Sweden, Finland and mainland Norway were free from E. multilocularis and the sensitivity of the surveillance systems were estimated using scenario trees. Surveillance data from five animal species were included in the study: red fox (Vulpes vulpes), raccoon dog (Nyctereutes procyonoides), domestic pig, wild boar (Sus scrofa) and voles and lemmings (Arvicolinae). Results The cumulative probability of freedom from EM in December 2009 was high in all three countries, 0.98 (95% CI 0.96-0.99) in Finland and 0.99 (0.97-0.995) in Sweden and 0.98 (0.95-0.99) in Norway. Conclusions Results from the model confirm that there is a high probability that in 2009 the countries were free from E. multilocularis. The sensitivity analyses showed that the choice of the design prevalences in different infected populations was influential. Therefore more knowledge on expected prevalences for E. multilocularis in infected populations of different species is desirable to reduce residual uncertainty of the results.

Abstract Background The incidence of bovine babesiosis, caused by Babesia divergens (Apicomplexa: Piroplasmida) has decreased markedly since the 1930 s, but may re-emerge as a consequence of climate change and changes in legislation and pasturing practices. This is a potentially serious disease, with both economical and animal welfare consequences. Therefore, there is a need to survey the distribution of B. divergens. Methods We tested sera from 306 healthy pastured cows from 24 farms along the southern Norwegian coast by using an indirect immunofluorescence IgG antibody test (IFAT). Fractions of seropositive cows were compared by calculating 95% CI. Results The results of this test showed that 27% of the sera were positive for B. divergens antibodies. The fraction of antibody-positive sera that we detected showed a two-humped distribution, with a high fraction of positives being found in municipalities in the western and eastern parts of the study area, while the municipalities between these areas had few or no positive serum samples. Conclusions Neither the farmers' observations nor the Norwegian Dairy Herd Recording System give an adequate picture of the distribution of bovine babesiosis. Serological testing of cows by using IFAT is a convenient way of screening for the presence of B. divergens in an area.

Abstract Background In the last few years stud farms have experienced increasing problems with Parascaris equorum infections in foals despite intensive deworming programs. This has led to the question as to whether the anthelmintic drugs used against this parasite are failing. This study aimed to investigate the efficacy of ivermectin, fenbendazole and pyrantel on the faecal output of ascarid eggs of foals. Methods A Faecal Egg Count Reduction Test (FECRT) was performed on nine large studs in Sweden. Anthelmintic drugs were given orally and faecal samples were examined for ascarid eggs on the day of deworming and 14 days later. Faecal Egg Count Reductions (FECRs) were calculated on arithmetic means of transformed individual FECRs and on arithmetic means of individual FECRs. Results Seventy-nine (48%) out of a total of 165 foals sampled were positive for P. equorum eggs before deworming and 66 of these met the criteria for being used in the efficacy assessment. It was shown that there was no, or very low activity of ivermectin on the output of ascarid eggs in the majority of the foals, whereas for fenbendazole and pyrantel it was >90%. Conclusion Ivermectin resistance was shown in 5 out of 6 farms. Therefore, ivermectin should not be the drug of choice in the control of P. equorum infections in foals. According to the results of this study, fenbendazole or pyrantel are still effective and should be used against this parasite.

Bovine eimeriosis is a common, globally distributed infection in housed calves aged from 3 to 12weeks. To date, no national prevalence study revealing the occurrence and distribution of Eimeria species under Swedish environmental and farming conditions has been performed. This study revealed the excretion of Eimeria bovis or Eimeria zuernii (alone or together) in 23% of all sampled calves (N=541) and 61% of all herds (N=99). The number of tested calves was critical for whether positive calves were detected or not. Nine other Eimeria species were identified, the most frequently reported being Eimeria ellipsoidalis (9% and 35% of positive calves and herds, respectively) and Eimeria auburnensis (4% and 19% of positive calves and herds, respectively). Not all calves shedding oocysts had diarrhoea and not all diarrhoeic calves shedded oocysts. Based on these present findings, Swedish cattle practitioners should include bovine eimeriosis as a relevant differential diagnosis to other common gastrointestinal pathogens in 3 to 12weeks old calves with diarrhoea or unthrifty calves without diarrhoea. When testing a herd for bovine eimeriosis, a sufficient number of faecal samples, i.e. 10 or more samples, should be examined to obtain a reliable picture of the infection status in a given farm., (Copyright © 2016 Elsevier Inc. All rights reserved.)

To investigate if the Swedish entry rules for pets to prevent the introduction of Echinococcus multilocularis (EM) are proportional (i.e. that their costs do not exceed the value of their benefits), a dichotomous-choice contingent valuation study was conducted. The study was performed before the first case of EM was detected in Sweden in February 2011. About 5000, randomly selected, Swedish citizens were invited to participate and 2192 of them (44%) accepted to do so. Missing information on whether or not one would accept to pay for keeping the rules for 143 respondents resulted in 2049 observations (41%) available for the estimation of willingness to pay (WTP), and missing information on personal characteristics for another 274 respondents reduced the number of observations available for sensitivity analysis to 1775 (36%). Annual expected WTP for keeping the rules ranged between € 54.3 and € 99.0 depending on assumptions about compensations demanded by respondents not willing to pay. The estimates are conservative since only answers from respondents that were absolutely certain they would pay the suggested bid were regarded as yes-responses. That WTP is positive implies that Swedish citizens perceived the benefits of the rules to be larger than their costs., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: The fox tapeworm Echinococcus multilocularis has foxes and other canids as definitive host and rodents as intermediate hosts. However, most mammals can be accidental intermediate hosts and the larval stage may cause serious disease in humans. The parasite has never been detected in Sweden, Finland and mainland Norway. All three countries require currently an anthelminthic treatment for dogs and cats prior to entry in order to prevent introduction of the parasite. Documentation of freedom from E. multilocularis is necessary for justification of the present import requirements., Methods: The probability that Sweden, Finland and mainland Norway were free from E. multilocularis and the sensitivity of the surveillance systems were estimated using scenario trees. Surveillance data from five animal species were included in the study: red fox (Vulpes vulpes), raccoon dog (Nyctereutes procyonoides), domestic pig, wild boar (Sus scrofa) and voles and lemmings (Arvicolinae)., Results: The cumulative probability of freedom from EM in December 2009 was high in all three countries, 0.98 (95% CI 0.96-0.99) in Finland and 0.99 (0.97-0.995) in Sweden and 0.98 (0.95-0.99) in Norway., Conclusions: Results from the model confirm that there is a high probability that in 2009 the countries were free from E. multilocularis. The sensitivity analyses showed that the choice of the design prevalences in different infected populations was influential. Therefore more knowledge on expected prevalences for E. multilocularis in infected populations of different species is desirable to reduce residual uncertainty of the results.

The present study was undertaken to investigate the prevalence of ascarid infections in Swedish commercial laying hens in 2004 and 2008 following a recent nationwide change to alternative housing systems but before anthelmintics became available. Also, the influence on prevalence of farm and flock characteristics and management was studied in 2004. The results showed that the overall prevalence was significantly higher in 2008 (38%; n = 64/169) compared with 2004 (24%; n = 44/186) (P = 0.001). Ascarid infections were rare in caged flocks, including furnished (enriched) cages, both years (2.4 to 4.3%), and were significantly more common in non-cage systems in both years (16.7 to 48.6% in 2004, and 28.6 to 77.1% in 2008 depending on the housing system). There was no significant difference in prevalence between hens kept on litter indoors and free-range/organic hens. The absence of a hygiene barrier at the entrance of the house or unit increased the risk of infection (P < 0.001), which suggests that parasite eggs were introduced horizontally to the farms. The risk of infection also increased with the age of equipment used in the barn; for example, the risk increased with an odds ratio of 7.5 (95% confidence interval = 2.3 to 25) when comparing equipment 1 year old with equipment ≥7 years old. The results of this study show that ascarid infections may re-emerge following a change to alternative housing. With the impending ban on conventional battery cages in the member states of the European Union, ascarid infections are likely to increase in importance and efficient control options such as hygiene barriers should be implemented on all farms.

Background: The incidence of bovine babesiosis, caused by Babesia divergens (Apicomplexa: Piroplasmida) has decreased markedly since the 1930 s, but may re-emerge as a consequence of climate change and changes in legislation and pasturing practices. This is a potentially serious disease, with both economical and animal welfare consequences. Therefore, there is a need to survey the distribution of B. divergens., Methods: We tested sera from 306 healthy pastured cows from 24 farms along the southern Norwegian coast by using an indirect immunofluorescence IgG antibody test (IFAT). Fractions of seropositive cows were compared by calculating 95% CI., Results: The results of this test showed that 27% of the sera were positive for B. divergens antibodies. The fraction of antibody-positive sera that we detected showed a two-humped distribution, with a high fraction of positives being found in municipalities in the western and eastern parts of the study area, while the municipalities between these areas had few or no positive serum samples., Conclusions: Neither the farmers' observations nor the Norwegian Dairy Herd Recording System give an adequate picture of the distribution of bovine babesiosis. Serological testing of cows by using IFAT is a convenient way of screening for the presence of B. divergens in an area.

Background: In the last few years stud farms have experienced increasing problems with Parascaris equorum infections in foals despite intensive deworming programs. This has led to the question as to whether the anthelmintic drugs used against this parasite are failing. This study aimed to investigate the efficacy of ivermectin, fenbendazole and pyrantel on the faecal output of ascarid eggs of foals., Methods: A Faecal Egg Count Reduction Test (FECRT) was performed on nine large studs in Sweden. Anthelmintic drugs were given orally and faecal samples were examined for ascarid eggs on the day of deworming and 14 days later. Faecal Egg Count Reductions (FECRs) were calculated on arithmetic means of transformed individual FECRs and on arithmetic means of individual FECRs., Results: Seventy-nine (48%) out of a total of 165 foals sampled were positive for P. equorum eggs before deworming and 66 of these met the criteria for being used in the efficacy assessment. It was shown that there was no, or very low activity of ivermectin on the output of ascarid eggs in the majority of the foals, whereas for fenbendazole and pyrantel it was >90%., Conclusion: Ivermectin resistance was shown in 5 out of 6 farms. Therefore, ivermectin should not be the drug of choice in the control of P. equorum infections in foals. According to the results of this study, fenbendazole or pyrantel are still effective and should be used against this parasite.

A clinical study was performed in 21 dogs to evaluate the efficacy of selamectin for the treatment of naturally acquired infection of sucking lice (Linognathus setosus [L.setosus]) in dogs. Each dog was randomly assigned to one of two treatment groups. One group was treated with selamectin applied topically at a mean dosage of 7.9 mg/kg. The other group was treated with permethrin applied topically at a mean dosage of 85.7 mg/kg. At day 42 posttreatment, all animals remaining in the study (10 treated with selamectin and six with permethrin) were clear of lice. In both groups, the reduction in lice counts from pretreatment values to day 42 was statistically significant at P< or =0.0001. Selamectin applied topically appeared to be effective against L. setosus infection in dogs.

In a laboratory study to evaluate the efficacy of selamectin for treatment of canine nasal mite infection, 12 purpose-bred beagles were experimentally infected with Pneumonyssoides caninum (P. caninum). Six of the dogs were treated with selamectin applied to the skin of the back at dosages of 6 to 24 mg/kg for three times at 2-week intervals. The remaining six dogs were an untreated control group. At necropsy 39 to 46 days after inoculation, no P. caninum mites were found in any of the treated dogs. In contrast, nasal mites were found in five of the untreated dogs. This difference was statistically significant at P=0.015.

Libyostrongylus douglassii, a pathogenic trichostrongylid nematode of the ostrich, was recently identified as a potentially important parasite in ostriches on Swedish farms. This parasite is well adapted to the hot and dry climates of sub-Saharan Africa, the natural habitat of the ostrich. The influence of low temperatures in colder climates, such as in Sweden, on free-living stages of L. douglassii is however insufficiently known. In this study, parasite free ostrich faeces were mixed with infective L(3)-stage larvae of L. douglassii, which had been cultured from eggs obtained from two Swedish farms. Samples of the mixture were placed on a grass surface, and analyses for L(3)-stage larvae were performed at regular intervals. The results of the study showed that L(3)-stage larvae may remain alive during a period of at least 97 days on pasture during the winter season in Sweden, even when the temperature within the samples was repeatedly below -0.1 degrees C, and the air temperature varied between -19.6 and +14.9 degrees C. It was concluded that L(3)-stage larvae of L. douglassii probably have the ability to remain viable on pastures during winter in Sweden.

A prospective study of 474 dogs, 145 cats, and 66 wild red foxes submitted for necropsy to the Departments of Pathology at the National Veterinary Institute and the Swedish University of Agricultural Sciences, Uppsala, Sweden, was conducted to examine for the presence of Pneumonyssoides caninum, the canine nasal mite. Pneumonyssoides caninum (P. caninum) was found in 95 (20%) of the dogs but in none of the cats or foxes. The median number of P. caninum mites per infected dog was 13 (range, 1 to 250). Dogs older than 3 years of age were more often infected with P. caninum than younger dogs, and large-breed dogs were more often infected than small-breed dogs. No sex predisposition was found.

Object: The authors performed a prospective study to determine whether cervical laminectomy without simultaneous fusion results in spinal instability., Methods: Because of clinical and radiographic signs of cord compression, 15 patients with rheumatoid arthritis (including one with Bechterew's disease) and severe involvement of the cervical spine underwent decompressive laminectomy without fusion performed on one or more levels. Preoperative flexion-extension radiographs demonstrated dislocation but no signs of instability at the level of cord compression. Clinical and radiological reexamination were performed twice at a median of 15 months (6-24 months) and 43 months (28-72 months) postoperatively. One patient developed severe vertical translocation 28 months after undergoing a C-1 laminectomy, which led to sudden tetraplegia. She required reoperation in which posterior fusion was performed. No signs of additional instability at the operated levels were found in the remaining 14 patients. In three patients increased but stable dislocation was demonstrated. The results of clinical examination were favorable in most patients, with improvement of neurological symptoms and less pain., Conclusions: The authors conclude that decompressive laminectomy in which the facet joints are preserved can be performed in the rheumatoid arthritis-affected cervical spine in selected patients in whom signs of cord compression are demonstrated, but in whom radiographic and preoperative signs of instability are not. Performing a simultaneous fusion procedure does not always appear necessary. Vertical translocation must be detected early, and if present, a C-1 laminectomy should be followed by occipitocervical fusion.

A multicentric clinical trial was done to evaluate the clinical efficacy of milbemycin oxime in the treatment of nasal mite (Pneumonyssoides caninum) infection in dogs. Milbemycin oxime was given to 70 dogs of different breeds, genders, and ages, with clinical signs associated with nasal mite infection. Twenty-five dogs had a verified infection, and 45 dogs had signs suggestive of nasal mite infection. Milbemycin oxime was given at the dosage of 0.5 to 1.0 mg/kg body weight orally once a week for three consecutive weeks. One month after initiation of treatment, 68 of the dogs had no more clinical signs associated with nasal mite infection.

Nine Norwegian Red cattle, aged 7-14 months, persistently infected with bovine virus diarrhoea virus (BVDV) were inoculated with a Swedish strain of Babesia divergens. Six persistently infected cattle of the same age and breed were kept as controls. Blood and serum samples were collected regularly during the observation period. Rectal temperatures were recorded every morning for 25 days post infection, and the animals were examined clinically on a daily basis. Sera were examined for antibodies to B. divergens by indirect immunofluorescence antibody test (IFAT). Eight of the infected animals developed fever of 2-5 days duration. Babesia divergens organisms appeared in the erythrocytes of all infected animals on the day after inoculation. The parasitaemia lasted for 4-11 days. One animal had a transient haemoglobinuria. Compared with the control group, there was a 20% decrease in the haematocrit. There was a transient lymphopenia and thrombocytopenia during the period of fever. There were no differences in mean numbers of neutrophils between the two persistently infected groups. Compared with cattle free of BVDV, the persistently infected cattle had consistently lower total leucocyte count that was mainly due to decreased mean numbers of neutrophils and monocytes. All infected animals develop antibodies > or = 1:1280 between day 7 and 10 post infection. The magnitude of the antibody response was considerably lower than that of BVDV-free animals inoculated with the same strain and dosage of B.divergens.

Nine Norwegian Red Cattle, 9-12 months old, were inoculated simultaneously with Ehrlichia (Cytoecetes) phagocytophila and Babesia divergens. Ten cattle of the same breed and age were kept as controls. Clinical evaluation was done on a daily basis and rectal temperatures were recorded every morning for 4 weeks post inoculation. Blood and serum samples were collected regularly during the observation period. Sera were examined for the presence of antibodies to E. phagocytophila and B. divergens by an indirect immunofluorescence antibody test. All infected animals showed two periods of fever that corresponded to the proliferation of B. divergens and E. phagocytophila in the peripheral blood. The simultaneous infection did not induce more severe clinical symptoms than infection with either organism alone. Compared with the control group, there was a 25% decrease in the mean haematocrit. The leukogram showed a biphasic pattern and corresponded to the changes seen in infection with either organism alone. The simultaneous infection did not suppress antibody formation towards E. phagocytophila or B. divergens.

A 34-year-old splenectomized man presented with fever, myalgia and dysuria. His condition rapidly deteriorated, he became anuric and developed severe haemolytic anaemia, thrombocytopenia and fibrinolysis. Peripheral blood smears revealed intra-erythrocytic parasites consistent with Babesia divergens in 40% of the erythrocytes. The diagnosis was confirmed by gerbil inoculation and by a significant rise in antibody titer. Blood exchange transfusion reduced the number of babesia infected erythrocytes to 1%. Parenteral therapy with a combination of quinine and clindamycin eradicated parasitaemia after 10 days of treatment and the patient rapidly improved. Renal failure necessitated haemodialysis for one month, whereafter the patient made a full recovery. Human babesiosis is a rare disease, but with a potential fatal outcome and should be considered as a diagnostic alternative in splenectomized and otherwise immunocompromised individuals with severe febrile illnesses.