Objectives-To describe a large series of patients with vertebral osteomyelitis (VO), and to compare the clinical, biological, radiological, and prognostic features of pyogenic (PVO), tuberculous (TVO), and brucellar vertebral osteomyelitis (BVO). Methods-A retrospective multicentre study, which included 219 adult patients with VO with confirmed aetiology, who were diagnosed between 1983 and 1995 in two tertiary care centres. Of these patients, 105 (48%) had BVO, 72 (33%) PVO, and 42 (19%) TVO. Results-One hundred and forty eight (67.6%) patients were male and 71 (32.4%) female. The mean (SD) age was 50.4 (16.4) years (range 14-84) and the mean (SD) duration of symptoms before the diagnosis was 14 (16.8) weeks. In 127 patients (57.9%) the vertebral level involved was lumbar, in 70 (31.9%) thoracic, and in 16 (7.3%) cervical. One hundred and nineteen patients (54.4%) received only medical treatment and 100 (45.6%) required both medical and surgical treatment. The presence of diabetes mellitus, intravenous drug abuse, underlying chronic debilitating diseases or immunosuppression, previous infections, preceeding bacteraemia, recent vertebral surgery, leucocytosis, neutrophilia, and increased erythrocyte sedimentation rate (ESR) were significantly associated to PVO. A prolonged clinical course, thoracic segment involvement, absence of fever, presence of spinal deformity, neurological deficit, and paravertebral or epidural masses, were significantly more frequent in the group of TVO. The need for surgical treatment and the presence of severe functional sequelae were more frequent in the groups of PVO and TVO. Conclusion-There are significant clinical, biological, radiological, and prognostic diVerences between BVO, PVO, and TVO. These diVerences can point to the causal agent and orient the initial empirical medical treatment while awaiting a final microbiological diagnosis. (Ann Rheum Dis 1997;56:709-715) In 1975 Ross and Fleming rightly pointed out "neither common enough to be readily recognizable, nor rare enough to be a medical curiosity, vertebral osteomyelitis (VO) represents a diagnostic challenge to the physician". 1The clinical picture of VO is rather nonspecific. It commonly starts insidiously and follows an indolent course making early diagnosis diYcult.2-4 Consequently, patients often develop highly destructive lesions or neurological complications related to compression of the spinal cord or its roots.

We recorded conception rates and estimated pregnancy rates following second and later timed artificial inseminations (TAIs) after hormonal resynchronization on commercial dairy farms, using the so-called G6G protocol (PGF day-0; GnRH 2, 8 days; PGF 15, 16 days, GnRH 17 days; TAI 18 days), and the 5-day Ovsynch protocol or 5DO (GnRH day 0; PGF 5, 6 days; GnRH 7 days; TAI 8 days). In four farms, both protocols were implemented in parallel, and these 1,368 s and later TAIs were used for the protocols' comparison based on logistic regression (544 TAIs in primiparous; 824 in multiparous cows; 1,024 TAIs after G6G [600 TAIs in multiparous and 424 in primiparous]; 344 TAIs after 5DO [224 TAIs in multiparous and 120 in primiparous]; 280 TAIs during the hot season; 1,088 during the cool season). Conception rate (CR) was 31.7% ± 12.0% among all cows, 35.1% ± 10.7% among cows resynchronized with the G6G protocol and 21.8% ± 9.7% among cows resynchronized with the 5DO protocol (p < 0.0001). CR among all cows was lower during the hot season (19.3% ± 8.4%) than during the cool season (34.9% ± 10.6%; p < 0.0001), and similar seasonal results were observed with G6G protocols. Logistic regression showed significant effects on CR in second and later TAIs by protocol (OR = 0.514; 95% CI 0.385-0.686; p < 0.0001) and season (OR = 0.486; 95% CI 0.350-0.676; p < 0.0001). Parity did not influence CR after second and later TAIs (p > 0.1), and no interaction with season or resynchronization protocol was found. Estimated pregnancy rates based on these CR data from both hormonal protocols suggest that G6G can be effectively used for second and later TAIs and highlight the importance of considering protocol and season when designing strategies for second and later timed AIs on dairy farms.

Bovine viral diarrhoea (BVD), one of the most important infectious diseases affecting bovine production systems, is thought to show a subclinical course in most cases, especially in regions that have suffered high BVD prevalence for a long time. However, few studies have assessed this rigorously under non-epidemic conditions. Here we assessed how often active BVD infection in a herd, defined as at least one antigen-positive animal, is associated with clinical signs. Surveying and sampling methods were used to detect BVD infection based on clinical picture. Analysis of 1203 samples of individual animals from 167 herds clinically suspected of BVD infection showed that 33.7% of dairy farms, 30.6% of beef cow-calf farms and 40% of feedlots contained at least one animal positive for BVD viral antigen. Prevalence of BVD infection was 7.7% at the animal level, much higher than the prevalence of 1–3% reported in the literature. This suggests that clinical picture can be useful for detecting active BVD infection, and that infections show a variable clinical course. On dairy farms, the presence of at least one antigen-positive animal was associated with a tendency towards lower fertility and higher rates of stillbirths and calf health problems (P < 0.1). On feedlots, such presence was associated with a tendency to a higher of calf health problems. In beef cow-calf systems, however, the presence of an antigen-positive animal was not associated with any particular sign. These results suggest a higher association of active BVD infections spreading in a herd and clinical pictures at the herd level, particularly in dairy herds.

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