Feline spongiform encephalopathy in a cat in Norway.
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Biomedical subjects
Publications and source records attributed to K Ueland.
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A naturally occurring feline immunodeficiency virus (FIV) infection in a closed breeding colony of cats, was studied for a period of 9 months. The colony consisted of 25 adult cats, of which six proved to be infected with FIV as judged by serological examination and virus isolation. In all, 48 kittens were monitored for levels of antibodies against FIV during their first 6 months of life. All the kittens (n = 30) born of FIV-infected queens showed maternal antibodies against FIV, although these declined to undetectable levels by the age of 5 months. Antibodies against FIV were not shown in any of 18 kittens born of FIV-negative queens. An attempt to isolate the virus from 12 kittens between 2 and 6 weeks of age did not succeed. None of the cats in the colony seroconverted during the observation period. In conclusion, neither vertical nor horizontal transmission of FIV infection were demonstrated in the colony during the 9-month investigation period.
A specific and sensitive polymerase chain reaction (PCR) procedure for the detection of feline immunodeficiency virus (FIV) in peripheral blood mononuclear cells (PBMC) was developed. PBMC from both blood samples and cultures were digested by proteinase K in a lysis buffer, and after heat inactivation of the proteinase, the resultant material was used in a two step amplification protocol using nested sets of primers. Two independent amplifications, from the gag and pol genes respectively, were performed in each tube. The PCR was positive for six of 14 samples from FIV seropositive adult cats, while all 36 samples from seronegative cats were negative. In comparison with an antigen-capturing ELISA procedure, the PCR detected FIV infection in PBMC cultures on average two days earlier.
Serum samples from 224 Norwegian cats were analyzed for the presence of feline leukemia virus (FeLV) p27 common core antigen, and for antibodies to feline immunodeficiency virus (FIV). Ninety specimens originated from the serum bank at the central referral clinic at the Norwegian College of Veterinary Medicine, which had been collected during the years 1983-1989; 67 sera were submitted from veterinarian practitioners; while 67 sera originated from cats presented for euthanasia. The cats were classified into one "healthy" and one "sick" group. Only 2.2% of sick cats and 1.2% of healthy cats showed FeLV antigenemia, a finding which is lower than which has been reported from many other countries. The prevalence of FIV antibodies was 10.1% in sick cats and 5.9% in healthy cats. Antibodies to FIV was most prevalent in male cats (14.7%) than in female cats (2.1%), and more prevalent among domestic cats (12.0%) compared to pedigree cats (2.4%). Antibodies to FIV in the cats demonstrated increasing prevalence with increasing age. It may be concluded that FeLV causes minor problems in Norwegian cats, while FIV is present in a similar prevalence to what is reported from other countries.
During the autumn of 1988 an outbreak of canine infectious tracheobronchitis, which seemed to be more infectious than usual, occurred throughout Scandinavia. Paired serum samples and bacterial swabs were collected from 52 dogs with clinical signs of infectious tracheobronchitis in three districts of Norway. The results revealed a fourfold or greater rise in the titre of antibodies against canine parainfluenza virus in 79 per cent of the cases, strongly suggesting that the virus was of aetiological importance in the outbreak. Bordetella bronchiseptica was not isolated from the diseased dogs, and they showed no rise in the titres of antibodies against influenza virus, reovirus or adenovirus.
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Labor characteristics and quantitation of uterine activity resulting from oxytocin induction of labor after intracervical prostaglandin E2 (PGE2) gel priming have not been previously reported. Forty-seven women with modified Bishop scores of 5 or less received preinduction priming with 0.5 mg of intracervical PGE2 gel. Oxytocin was used to induce labor after priming, and uterine activity was quantitated. A matched group of control patients was managed identically but did not receive PGE2 gel. In the gel group, modified Bishop scores improved significantly and in two patients (4%), priming alone induced labor. No uterine hyperstimulation or fetal heart rate abnormalities occurred during priming. Cesarean sections for all indications and those for failed induction were less common in the gel group. The length of the active phase and the second stage of labor were significantly shorter in the gel group. Uterine activity was similar in both groups. The data suggest a primary cervical action of the gel.
A 34-week male fetus experienced intrauterine death due to an umbilical cord hematoma. Rupture of the hematoma occurred at the time of delivery, but compression of the cord vessels and fetal blood loss into the hematoma, rather than the rupture itself, were the cause of death. Membranes had been ruptured for several days prior to the fetal demise, and both chorioamnionitis and funisitis were present. Inflammation of the umbilical cord, as well as a defect in the elastin and smooth muscle components of the vein, may have predisposed the cord to development of the hematoma.
The recently developed technology of Doppler echocardiography was used to evaluate a pregnancy complicated by aortic stenosis. Given the lack of established norms for this test during pregnancy and the known cardiovascular changes during pregnancy, it is difficult to interpret this test. However, in the case presented, this test suggested the need for more conservative management, a plan that was justified postpartum.
Total parenteral nutrition was provided to ten patients during pregnancy. No obstetrical or fetal complications attributable to the nutrition therapy occurred. All infants were at or above the tenth percentile in weight for gestational age. Total parenteral nutrition appears to be safe for the mother and fetus when given after the first trimester; the safety of total parenteral nutrition in the first trimester requires further study.
In order to study how physicians choose to use electronic fetal monitoring and interpret tracings, we administered a questionnaire to which 107 practicing obstetricians and 11 experts in electronic fetal monitoring responded. Sixty-one (57%) of the respondents monitored more than half of their deliveries (high users). In comparison to the less frequent users of electronic fetal monitoring (low users), they showed more positive attitudes toward electronic fetal monitoring and were nearly always more likely to perform cesarean sections on hypothetical patients described in the questionnaire. These differences appeared to be due to the high users' higher estimate of danger to the fetus. We also found that most physicians were generally more likely to perform a cesarean section on a high-risk mother than a low-risk mother with the same tracing. The majority of high and low users and nearly all of the experts, however, felt that antepartum risk factors are not of value in deciding what to do about an abnormal tracing. We conclude that there is wide variation in the way in which obstetricians use, interpret, and act on electronic fetal monitoring tracings. Some of these differences may be due to differing attitudes toward electronic fetal monitoring, differences in interpretation of electronic fetal monitoring tracings, and differences in the way obstetricians incorporate maternal risk factors into their decision-making.
Many nursing women returning to a full-time job and desiring to continue to breast feed are using oxytocin nasal sprays to facilitate breast emptying during the work day. Very few complications have been reported from its use, and the preparation has been assumed to be innocuous. However, we encountered a nursing mother whose life appears to have been jeopardized by the excessive and unmonitored application of such a spray. The patient was hospitalized for a viral illness and given a large quantity of intravenous fluid. In association with excessive self-administration of an oxytocin nasal spray, she developed severe water intoxication, with hyponatremic encephalopathy and convulsions. During the same hospitalization the patient subsequently developed a Guillain-Barré type of peripheral polyneuritis. The syndrome of inappropriate secretion of antidiuretic hormone has been reported to accompany the neurologic manifestations of the Guillain-Barré syndrome and may have been the cause of the convulsions. However, the temporal associations in this case strongly favor the unmonitored use of the oxytocin nasal spray as etiologic.
A unique case of Marfan's syndrome is presented in which the diagnosis was first established during early labor when the patient presented with chest pain, hypotension, and fetal distress as the earliest symptoms and signs. Prompt diagnosis in combination with correct medical and surgical therapy resulted in the survival of both the mother and infant.
The potential for beta-adrenergic drugs to increase total bilirubin formation via cyclic adenosine monophosphate-mediated stimulation of hepatic microsomal heme oxygenase in the human neonate was evaluated. The pulmonary excretion rate of endogenously produced carbon monoxide (VeCO), an index of total bilirubin formation (TBF), was measured in 18 preterm neonates whose mothers received beta-adrenergic drugs for tocolysis and in 18 preterm neonates whose mothers were untreated. The mean VeCO of the neonates in the former group (17.2 +/- 7.3 microL/kg/hr) was the same as that in the latter group (17.4 +/- 6.2 microL/kg/hr); both values were elevated when compared with the mean VeCO of 20 term newborns (13.9 +/- 3.5 microL/kg/hr). Our findings indicate that TBF is not significantly increased in neonates whose mothers received beta-adrenergic drugs before delivery.
The cervix must remain closed during pregnancy to maintain the pregnancy yet open during parturition. It must perform at the right time and in the right sequence. The process that coordinates these activities is labor and it is an equal mixture of uterine contractions and cervical effacement/dilatation. Neither of these factors can be ignored if one is to understand parturition. Dilatation of the cervix depends upon the biochemical and physical processes that produce effacement. A better understanding of this active, ongoing process will enable one to manipulate them with new drugs that could produce effacement without uterine contractions. Conversely, the capacity to "stiffen" the cervix to ward off premature birth is another potential therapeutic approach that may be utilized. Research into the genesis and physical expression of the incompetent cervix is needed, as are studies of the cervix after forceable dilatation following a D and C. All of these possibilities and future advances are dependent upon our ability to quantitate the physical state of cervical tissue, both in situ and in vitro.
Oral prostaglandin E2 appears to play a dual role in human parturition. It induces normal uterine contractions and softens the cervix, thereby decreasing the resistance of the cervix to dilatation. Labor and delivery with oral PGE2 is achieved with less total uterine work when compared with spontaneous nonstimulated labor. This contention is supported by the fact that the rate of cervical dilatation in the active phase of labor is faster (2.73 cm/hr) than that reported by Hendricks et al. for ideal labor (2.12 cm/hour), yet uterine contractility is not increased. Analysis of the composite data of Friedman and Sachtleman in 1974 also shows a more rapid active phase dilatation in the PGE2-stimulated labors (3.3 cm/hour) as compared with spontaneous labor (2.98 cm/hour). Oral PGE2 offers a safe and efficacious alternative to oxytocin for the induction of labor in women. It appears to have a major advantage over oxytocin. The softening effect of PGE2 on the cervix would make this drug an ideal agent for use in patients with low Bishop scores who have medical indications for induction of labor. Regardless of route of administration, prostaglandin E2 is a potent uterine stimulant and must be used with the same precautions and safeguards as intravenous oxytocin.