Factors associated with changes of state of foot conformation and lameness in a flock of sheep

The aim of this research was to investigate transitions between foot conformation, lameness and footrot in sheep. Data came from one lowland flock of approximately 700 ewes studied for 18 months. Multilevel multistate analyses of transitions between good and poor foot conformation states in ewes, and lame and non-lame states in ewes and lambs were conducted. Key results were that the longer sheep had feet in good conformation, the more likely they were to stay in this state; similarly, the longer a ewe was not lame the more likely she was not to become lame. Ewes with poor foot conformation were more likely to become lame (OR: 1.83 (1.24-2.67)) and to be > 4 years (OR: 1.50(1.09-2.05)). Ewes with footrot were less likely to move to good foot conformation (OR: 0.48 (0.31-0.75)) and were more likely to become lame (OR: 3.81(2.60-5.59)). Ewes lame for > 4 days and not treated with parenteral antibacterials had a higher risk of developing (OR: 2.00 (1.08-3.61)), or remaining in (OR: 0.49 (0.29-0.95)) poor foot conformation compared with ewes never lame. Treatment of ewes lame with footrot with parenteral antibacterials increased the probability of transition from a lame to a non-lame state (OR: 1.46 (1.05-2.02)) and these ewes, even if lame for > 4 days, were not more likely to develop poor foot conformation. The risk of a ewe becoming lame increased when at least one of her offspring was lame (OR: 2.03 (1.42-2.92)) and when the prevalence of lameness in the group was ≥ 5% (OR: 1.42 (1.06-1.92)). Lambs were at increased risk of becoming lame when they were male (OR: 1.42 (1.01-2.01)), single (OR: 1.86 (1.34-2.59)) or had a lame dam or sibling (OR: 3.10 (1.81-5.32)). There were no explanatory variables associated with lambs recovering from lameness. We conclude that poor foot conformation in ewes increases the susceptibility of ewes to become lame and that this can arise from untreated footrot. Treatment of ewes lame with footrot with parenteral antibacterials leads to recovery from lameness and prevents or resolves poor foot conformation which then reduces the susceptibility to further lameness with footrot

Non-Hodgkin’s Lymphoma of the Uterine Cervix

Non Hodgkin’s Lymphoma (NHL) causes many deaths worldwide and its incidence is increasing. They occur commonly in middle aged and elderly people and are disseminated at diagnosis. We present an interesting case of NHL in a 52 years old female, who presented with past a history of postmenopausal bleeding. A 3 x 5 cms endocervical polyp was noticed in the cervix. Biopsy of the polyp revealed it to be a CD20-positive diffuse large B-cell (DLBCL)-type NHL. She was diagnosed as stage IE after staging work-up. She attained a complete response, and has been in remission for 1 year 8 months

Footrot and interdigital dermatitis in sheep: Farmer satisfaction with current management, their ideal management and sources used to adopt new strategies

The aims of this research were to identify management practices that sheep farmers currently use to treat and prevent footrot in sheep and whether they consider that these are successful management tools and to find out how sheep farmers would ideally like to manage footrot in their flock. Over 90% of lameness in sheep in the UK is caused by Dichelobacter nodosus, which presents clinically as interdigital dermatitis (ID) alone or with separation of hoof horn (FR). A questionnaire was sent to 265 farmers to investigate their current management and their satisfaction with current management of the spectrum of clinical presentations of footrot. Farmers were also asked their ideal management of footrot and their interest in, and sources of information for, change. Approximately 160 farmers responded. Farmers satisfied with current management reported a prevalence of lameness ≤5%. These farmers caught and treated lame sheep within 3 days of first seeing them lame, and treated sheep with FR and ID with parenteral antibacterials. Farmers dissatisfied with their management reported a prevalence of lameness >5%. These farmers practised routine foot trimming, footbathing and vaccination against footrot. Whilst 89% of farmers said they were satisfied with their management of FR over 34% were interested in changing management. Farmers identified veterinarians as the most influential source for new information. Farmers reported that ideally they would control FR by culling/isolating lame sheep, sourcing replacements from non-lame parents, trimming feet less, using antibacterial treatments less and using vaccination more. Footbathing was a commonly used management that was linked with dissatisfaction and that also was listed highly as an ideal management. Consequently, some of the ideal managements are in agreement with our understanding of disease control (culling and isolation, sourcing healthy replacements) but others are in contrast with our current knowledge of management and farmers self-reporting of satisfaction of management of footrot (less use of antibacterial treatment, more footbathing and vaccination). One explanation for this is the theory of cognitive dissonance where belief follows behaviour, i.e. farmers report that they believe an ideal which is what they are currently doing, even if the management is sub-optimal

Naming and recognition of six foot lesions of sheep using written and pictorial information: a study of 809 English sheep farmers

In 2005, 3000 questionnaires were sent to a random sample of English sheep farmers from a list kept by the English Beef and Lamb Executive (EBLEX) to investigate whether farmers could correctly name six common foot lesions in sheep from a characteristic picture and a written description. The lesions were interdigital dermatitis (ID), footrot (FR), contagious ovine digital dermatitis (CODD), shelly hoof, foot abscess and toe granuloma. In addition, farmers were asked to report the total percent of lame sheep in their flock in 2004 and the percent of this lameness attributable to each of the six lesions listed above. The overall response percentage was 44 with a useable response of 32%. Fifty-nine farmers out of 262 (23%) who answered all six questions named all six lesions correctly. This was greater than expected by chance. The same questionnaire of six lesions was presented at a meeting of specialist sheep advisors, primarily veterinarians, 37/47 (79%) responders named all six lesions correctly. From the six lesions listed above, the percent correctly named by farmers was approximately 83%, 85%, 36%, 28%, 65% and 43% and the percent incorrectly attributed to another lesion was 5%, 47%, 10%, 13%, 35% and 7%, respectively. The most commonly used incorrect name was FR, with farmers tending to name any hoof horn lesion as FR. A comparison of the distribution of sheep lame by a lesion correctly named compared with the same lesion incorrectly named as FR suggested that farmers recognised lesions but did not name them correctly; the distribution of lameness fitted the pattern for the correctly named lesion rather than the pattern of lameness attributed to FR. The results were validated with farm visits and a repeatability study of the questionnaire. The mean farmer-estimated prevalence for all lameness was 10.4%; with 6.9%, 3.7%, 2.4%, 1.9%, 0.9% and 0.8% of the sheep lame with ID, FR, CODD, shelly hoof, foot abscess and toe granuloma respectively from respondents who correctly named these lesions. Whilst ID and FR were the most prevalent causes of lameness in most flocks it is possible that in up to 17% flocks the primary cause of lameness was a different lesion

Farmers' practices and factors associated with the prevalence of all lameness and lameness attributed to interdigital dermatitis and footrot in sheep flocks in England in 2004

The aim of this study was to investigate whether the risk factors associated with all causes of lameness in sheep differed from those associated with the lesion specific causes of lameness, interdigital dermatitis (ID) and footrot (FR). A total of 809 randomly selected English sheep farmers participated in a postal survey in 2005. Data were requested on their management of lameness in 2004 and whether this had changed from 2003 and the prevalence of all lameness, and lameness caused by ID and FR. The farmer ability to recognise ID and FR was assessed from their responses to a written and pictorial description. On 443 farms where both ID and FR were correctly named by the farmer, the mean prevalence of all lameness, and lameness caused by ID and FR were 10.0% (95% CI: 8.9, 10.8), 6.5% (95% CI: 5.8, 7.3) and 3.1% (95% CI: 2.8, 3.6), respectively. The mean prevalence of all lameness on all 809 farms was not significantly different at 10.2% (95% CI: 9.2, 11.0). The data were analysed using negative binomial regression models with the three outcomes farmer estimated prevalence of all lameness and lameness caused by ID or FR in 2004. Farmers who changed management of sheep between 2003 and 2004 were excluded from the analysis, thus all fixed effects were the farmers’ managements in 2003 and 2004 to ensure that the management was in place for at least one year before the prevalence estimates. Routine foot trimming ≥once/year compared with no routine foot trimming was significantly associated with an increased prevalence of all lameness (prevalence ratio (PR) = 1.34), ID (PR = 1.50) and FR (PR = 1.35). Footbathing was also significantly associated with increased prevalence of all lameness (PR = 1.67), ID (PR = 1.68) and FR (PR = 1.76). A stocking density of >8 ewes/ha was associated with a significantly increased prevalence of all lameness (PR = 1.26) and ID (PR = 1.39). There was a significantly lower prevalence of FR (PR = 0.73; PR = 0.70, respectively) on farms in the North East and South East of England. Separating lame sheep at pasture was associated with a decreased prevalence of all lameness and ID (PR = 0.75; PR = 0.73) and location of the farm in South East England was associated with a lower prevalence of all lameness and ID (PR = 0.75; PR = 0.71, respectively). We conclude that management factors associated with all lameness, and lameness attributed to ID and FR are similar

Recognition of lameness and decisions to catch for inspection among sheep farmers and specialists in GB

Background: Epidemiological studies have used farmer estimates of the prevalence of lameness in their flocks. This assumes that farmers can identify lame sheep. Eight movie clips of sheep with locomotion from sound to moderately lame were used to investigate the ability of farmers and sheep specialists to recognise lame sheep. Each participant was asked to complete a form and indicate, for each movie clip, whether they thought the sheep was lame and whether they would catch it if it was the only lame sheep or if 2 – 5, 6 – 10 or > 10 sheep were equally lame. The farmers' responses were compared with their estimates of flock lameness prevalence and the interval between observing a lame sheep and catching it. Results: 178 farmers and 54 sheep specialists participated. Participants could identify even mildly lame sheep but made a separate decision on whether to catch them. This decision was dependent on the severity of lameness and the number of sheep lame in a group. Those who said they would catch the first lame sheep in a group were significantly more likely to catch mildly lame sheep (farmer-reported median prevalence of lameness 5% (IQR: 2%–6%)). In contrast, farmers who waited for several sheep to be lame indicated that they would only catch more severely lame sheep (farmer reported median flock lameness 11% (IQR: 9%–15%)). Approximately 15% of farmers did not catch individual lame sheep (farmer reported median flock lameness 15% (IQR: 10%–15%)). The flock prevalence of lameness increased as time to treatment increased and time to treatment was positively correlated with only catching more severely lame sheep. Conclusion: If movie-clips are similar to the flock situation, farmers and specialists can recognise even mildly lame sheep but vary in their management from prompt treatment of the first lame sheep in a group to no individual sheep treatments. The former practices would be appropriate to minimise transmission of footrot, a common, infectious cause of lameness and so reduce its incidence. The analysis also suggests that farmers estimate lameness prevalence relatively accurately because farmers who treated the first mildly lame sheep in a group also reported the lowest prevalence of lameness in their flock

Extramedullary Plasmacytoma of Soft Tissues and Gingiva

Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm of soft tissue without bone marrow involvement or other systemic characteristics of multiple myeloma. It accounts for 3% of all plasma cell tumors. Multiple extramedullary plasmacytoma is defined when there is more than one extramedullary tumor of clonal plasma cells and such presentation has not been described earlier. We report such rare case of multiple extramedullary plasmacytoma involving multiple soft tissues in chest, abdomen, mandible, maxilla, and gingiva

Asking God about the date you will die: HIV testing as a zone of uncertainty in rural Malawi

Testing for HIV is becoming more available in Africa. Global advocates of testing see it as key to AIDS prevention. However, testing is not always perceived as a good thing by people at risk. Here, we consider testing from the perspective of people in a high-prevalence community. Using qualitative data from rural Malawi, we show that the decision to test is not as straightforward as suggested in the testing advocacy literature, but is marked by uncertainty and ambivalence. Reluctance to test is connected to the perception that testing inevitably leads to a positive diagnosis, and subsequent deterioration and death. This fear is in turn linked to overestimation of the transmissibility of HIV. We recommend that testing advocates address this concern that being tested means having a death sentence pronounced, and emphasize the benefits of testing for the majority who are HIV-negative, as well as the minority who are HIV-positive.ambivalence, HIV testing, Malawi