Association of abnormal uterine discharge with new intramammary infection in the early postpartum period in multiparous dairy cows

The association of abnormal uterine discharge with the development of intramammary infection (IMI) was studied in 62 multiparous Holstein cows during the nonlactating period and from lactation days 3 through 30. Duplicate milk samples were obtained from each mammary gland at approximately day 30 of the nonlactating period. Milk samples for bacteriologic culture also were obtained from each gland from all cows at the end of the previous lactation, at parturition, and on a minimum of 7 additional dates during the first 30 days of lactation. Beginning after parturition and continuing once weekly for 4 weeks, each cow was examined, using a vaginal speculum to visually estimate the quantity of abnormal uterine discharge in the vagina. Additionally, uterine swab specimens were obtained for aerobic bacteriologic culture. Cows were allotted to groups on the basis of the maximal amount of abnormal uterine discharge observed at any 1 of the 4 examinations. Cows in group 1 had normal discharge or < 30 ml of abnormal discharge; in group 2, > or = to 30 ml of abnormal discharge, observed only on examination by vaginal speculum; and in group 3, > or = to 30 ml of abnormal discharge visible externally. A difference was not detected in the development of new IMI in the nonlactating period between cows that subsequently developed uterine discharge and those that did not. Although significant differences were not found, a tendency for lactating cows with abnormal uterine discharge to be at increased risk for developing new IMI was observed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Activity of pirlimycin against pathogens from cows with mastitis and recommendations for disk diffusion tests

Pirlimycin is an analog of clindamycin that will be recommended for therapy of bovine mastitis. It has good activity against staphylococci and streptococci, the major pathogens for bovine mastitis. Five hundred and thirty bacterial isolates recovered from cows with mastitis were studied to confirm the spectrum of activity and to develop recommendations for susceptibility testing. Pirlimycin is not active against isolates of Enterobacteriaceae, it varies in its activity against enterococci, and it is active against veterinary isolates of streptococci (MIC for 50% of strains tested, < or = 0.03 to 0.06 microgram/ml) and staphylococci (MIC for 50% of strains tested, 0.25 to 1.0 microgram/ml). On the basis of levels of drug attained in the milk with recommended dosing schedules, we chose MIC breakpoints of < or = 2 micrograms/ml for susceptibility and > or = 4 micrograms/ml for resistance. We also recommended a disk diffusion test using a disk containing 2 micrograms/ml and breakpoints of < or = 12 mm for resistance and > or = 13 mm for susceptibility.     

A semi-automated method for the determination of oestrogens in early morning urine specimens from normal and infertile women

The effects of caffeine (3.125, 6.25, 12.5, 25, 50, and 100 mg/kg) on lever pressing, schedule induced licking and water consumption induced by a fixed interval 1 min schedule were studied. Changes in these dependent variables were assessed when animals were reduced to 80% of their initial body weight by partial food deprivation and when body weights recovered after the animals were returned to conditions of ad lib feeding. Results indicate differential effects of the drug between animals at 80% body weight and when they are permitted to recover. Tolerance was examined for a single large dose only for the same dependent variables in animals at 80% body weight.     

Studies on early enteral nutrition for patients with gastric cancer from the view of immunity

The enteral nutrition after operation for gastric cancer patients with special reference to its immunological improving effect was examined. The subjects were 25 patients who underwent an operation and they were classified into 2 groups by the postoperative nutritional control method. E group: patients who received enteral nutrition after operation (n = 12) and T group those who reviewed TPN postoperatively (n = 13). In the 25 subjects the serum proteins, nitrogen balance and 3-methylhistidine (3-Mehis) were measured before and after the operation. The total lymphocyte counts were measured before and after operation. The total lymphocyte subsets and NK cell activity were determined with monoclonal antibodies. Nutritionally, there was no significant difference in the serum proteins and nitrogen balance and 3-Mehis/Cr ratio also showed no significant difference. Immunologically, an improving effect was observed in E group postoperatively with CD4+CD45R-Leu8- (helper T) cell subpopulation, CD8+CD11b- (cytotoxic T) cell subpopulation and CD3-CD16+CD56+ (NK-LAK) cell subpopulation.     

A longitudinal study of hospitalization rates for patients with chronic disease: results from the Medical Outcomes Study

OBJECTIVE: To prospectively compare inpatient and outpatient utilization rates between prepaid (PPD) and fee-for-service (FFS) insurance coverage for patients with chronic disease. DATA SOURCE/STUDY SETTING: Data from the Medical Outcomes Study, a longitudinal observational study of chronic disease patients conducted in Boston, Chicago, and Los Angeles. STUDY DESIGN: A four-year prospective study of resource utilization among 1,681 patients under treatment for hypertension, diabetes, myocardial infarction, or congestive heart failure in the practices of 367 clinicians. DATA COLLECTION/EXTRACTION METHODS: Insurance payment system (PPD or FFS), hospitalizations, and office visits were obtained from patient reports. Disease and severity indicators, sociodemographics, and self-reported functional status were used to adjust for patient mix and to compute expected utilization rates. PRINCIPAL FINDINGS: Compared to FFS, PPD patients had 31 percent fewer observed hospitalizations before adjustment for patient differences (p = .005) and 15 percent fewer hospitalizations than expected after adjustment (p = .078). The observed rate of FFS hospitalizations exceeded the expected rate by 9 percent. These results are not explained by system differences in patient mix or trends in hospital use over four years. Half of the PPD/FFS difference in hospitalization rate is due to intrinsic characteristics of the payment system itself. CONCLUSIONS: PPD patients with chronic medical conditions followed prospectively over four years, after extensive patient-mix adjustment, had 15 percent fewer hospitalizations than their FFS counterparts owing to differences intrinsic to the insurance reimbursement system.     

Comparison of PCR and pp65 antigenemia assay with quantitative shell vial culture for detection of cytomegalovirus in blood leukocytes from solid-organ transplant recipients

This study compared PCR and an assay for cytomegalovirus (CMV) pp65 antigenemia (CMV-vue; INCSTAR Corp.) with a quantitative shell vial culture (QSVC) technique for the detection of CMV in serial blood specimens from 46 solid-organ transplant recipients. In a comparison based on 535 specimens tested by PCR and QSVC, CMV was detected by PCR in 41 and by QSVC in 37 of 43 recipients at risk of CMV infection. The mean number of days after transplantation of initial detection of CMV was 29.9 for PCR and 34.0 for QSVC (P = 0.01). The antigenemia assay was performed on 395 specimens, including 304 of those also tested by PCR. In these specimens, CMV was detected by the antigenemia assay, QSVC, and PCR in 30, 32, and 35 (respectively) of 38 patients at risk, with no statistically significant difference in the time to detection. Each of the assays detected CMV in similar proportions of patients with and without clinically significant CMV infection. PCR stayed positive longer after transplantation than the other assays but frequently returned to negative when more than 6 months had elapsed after transplantation. The antigenemia assay and PCR stayed positive longer after institution of antiviral therapy than QSVC. PCR can provide highly sensitive detection of CMV viremia, but a PCR assay for CMV is not yet available in kit form. The pp65 antigenemia assay and shell vial culture are quantifiable and comparable in sensitivity. Either is recommended for rapid detection of CMV in blood specimens from solid-organ transplant recipients.     

The course of patients with suspected myocardial infarction. The identification of low-risk patients for early transfer from intensive care

The hospital course of all patients admitted to a medical intensive-care unit (ICU) with suspected myocardial infarction was reviewed to test the feasibility of identifying patients suitable for earlier transfer from the ICU. Three hundred sixty patients admitted after presentation with uncomplicated chest pain could be stratified into three risk groups within 24 hours of admission to the ICU. One hundred sixty-eight patients (47 per cent), who were without major complications, elevation of total serum creatine phosphokinase, or electrocardiographic evidence of transmural infarction during the first day, could be designated "low-risk" patients. Three per cent of the low-risk patients subsequently met clinical criteria for infarction, 2 percent had late complications in the ICU, and none died. Rates of infarction, late complications in the ICU, and mortality in the hospital were significantly higher for patients at intermediate and high risk. Identification of low-risk patients for whom early transfer may be routinely indicated is feasible and could reduce by 55 per cent the total number of days that such patients spend in the ICU.     

A polymerase chain reaction assay for detecting snails infected with bilharzia parasites (Schistosoma mansoni) from very early prepatency

In the present study, we adapted a polymerase chain reaction (PCR) assay, previously shown by us to be very sensitive for detecting cercariae in water, for the sensitive detection of Schistosoma mansoni DNA in infected snails from early prepatency. Polymerase chain reaction primers were designed based on the 121-basepair highly repeated sequence we previously identified in the genome of S. mansoni. The DNA was prepared from the snails by a simple alkaline extraction procedure, and the PCR assay enabled a clear differentiation between infected and normal snails. Infected snails were detected as early as one day after penetration of a single miracidium. The high sensitivity of the test enabled identification of a single infected snail even when its DNA was pooled with material from up to 99 uninfected snails, thus demonstrating the possibility of mass diagnosis in pools of snails. The assay has the potential for large-scale determination of prepatent infection prevalence in snails, thus offering new possibilities for the evaluation of schistosomiasis transmission and for schistosomiasis control, as discussed.     

An examination of predictive bias for second grade reading outcomes from measures of early literacy skills in kindergarten with respect to English-language learners and ethnic subgroups.

The assessment of early literacy skills during the kindergarten year can provide useful information about student performance in prereading skills, which are predictors of later reading achievement. This study examined the use of fluency-based prompts of student phonemic awareness, alphabetic principle, and oral reading at the end of kindergarten for predicting later reading achievement at the end of second grade. Predictive validity and bias studies were undertaken with respect to English-language learners (ELLs) and four selected ethnic subgroups: European American (EA), African American (AA), Asian American (AsA), and Hispanic American (HA). Results indicated that the predictive validity of the early literacy measures was strong, and no evidence of predictive bias for ELL and non-ELL groups was found. However, evidence of a small amount of predictive bias was found between the EA and HA students with respect to intercept differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Augmented Berlin-Frankfurt-Munster therapy abrogates the adverse prognostic significance of slow early response to induction chemotherapy for children and adolescents with acute lymphoblastic leukemia and unfavorable presenting features: a report from the Children's Cancer Group

PURPOSE: Compared with previous Children's Cancer Group (CCG) acute lymphoblastic leukemia (ALL) trials, therapy based on the Berlin-Frankfurt-Munster (BFM) 76 trial has effected an improvement in event-free survival (EFS). In an attempt to improve EFS further, CCG investigators formulated an augmented BFM (A-BFM) regimen that provides prolonged, intensified postinduction chemotherapy relative to the CCG-modified BFM regimen. PATIENTS AND METHODS: We tested A-BFM in 101 patients with ALL and unfavorable presenting features that showed slow early response (SER) to induction therapy who attained remission on day 28. Their outcome was compared with that of 251 concurrent patients with unfavorable presenting features, a rapid early response to therapy (RER), and remission by day 28, treated with CCG-BFM with or without cranial radiation (CRT). RESULTS: The 4-year EFS rate from the end of induction for SER patients treated with A-BFM was 70.8% +/- 4.6%. Seventeen patients remain in continuous remission beyond 5 years. Vincristine (VCR) neurotoxicity developed in 50% of patients, but was rarely debilitating. Allergies to Escherichia coli L-asparaginase (L-ASP) occurred in 35% of patients. Avascular necrosis of bone (AVN) developed in 9% of patients. In comparison, a concurrent RER group treated with standard BFM +/- CRT had a 4-year EFS rate of 73.1% +/- 4.6%. CONCLUSION: The toxicity of A-BFM is significant, but acceptable. Compared with historical control SER patients treated with CCG-modified BFM, A-BFM therapy appears to produce a significant improvement in EFS. This is the first study to show that intensive chemotherapy, as given in the A-BFM regimen, can abrogate the adverse prognostic significance of SER.