Effects of enriching IgG concentration in low- and medium-quality colostrum with colostrum replacer on IgG absorption in newborn Holstein calves.

Ingestion and absorption of greater quantities of IgG are required to increase serum IgG levels in newborn calves. This could be achieved by adding colostrum replacer (CR) to maternal colostrum (MC). The objective of this study was to investigate whether low and high-quality MC can be enriched with bovine dried CR to achieve adequate serum IgG levels. Male Holstein calves (n = 80; 16/treatment) with birth body weights (BW) of 40 to 52 kg were randomly enrolled to be fed 3.8 L of the following combinations: 30 g/L IgG MC (C1), 60 g/L IgG MC (C2), 90 g/L IgG MC (C3), C1 enriched with 551 g of CR (60 g/L; 30-60CR), or C2 enriched with 620 g of CR (90 g/L: 60-90CR). A subset of 40 calves (8/treatment) had a jugular catheter placed and were fed colostrum containing acetaminophen at a dose of 150 mg/kg of metabolic body weight, to estimate abomasal emptying rate per hour (kABh). Baseline blood samples were taken (0 h), followed by sequential samples at 1, 2, 3, 4, 5, 6, 8, 10, 12, 24, 36, and 48 h relative to initial colostrum feeding. Results for all measurements are presented in the following order, unless otherwise stated: C1, C2, C3, 30-60CR, and 60-90CR. Serum IgG levels at 24 h were different among calves fed C1, C2, C3, 30-60CR, and 60-90CR: 11.8, 24.3, 35.7, 19.9, and 26.9 mg/mL ± 1.02 (mean ± SEM), respectively. Serum IgG at 24 h increased when enriching C1 to 30-60CR, but not from C2 to 60-90CR. Similarly, apparent efficiency of absorption (AEA) values for calves fed C1, C2, C3, 30-60CR, and 60-90CR were different: 42.4, 45.1, 43.2, 36.3, and 33.4% ± 1.93, respectively. Enriching C2 to 60-90CR reduced AEA, and enriching C1 to 30-60CR tended to decrease AEA. The kABh values for C1, C2, C3, 30-60CR, and 60-90CR were also different: 0.16, 0.13, 0.11, 0.09, and 0.09 ± 0.005, respectively. Enriching C1 to 30-60CR or C2 to 60-90CR reduced kABh. However, 30-60CR and 60-90CR have similar kABh compared with a reference colostrum meal (90 g/L IgG, C3). Even though kABh was reduced for 30-60CR, results indicate that C1 has the potential to be enriched and achieve acceptable serum IgG levels at 24 h without affecting AEA.

Effect of palmitic acid-enriched supplements containing stearic or oleic acid on nutrient digestibility and milk production of low- and high-producing dairy cows.

We evaluated the effects of fatty acid (FA) supplement blends containing 60% palmitic acid (C16:0) and either 30% stearic acid (C18:0) or 30% oleic acid (cis-9 C18:1) on nutrient digestibility and milk production of low- and high-producing dairy cows. Twenty-four multiparous Holstein cows [118 ± 44 d in milk (DIM)] were divided into 2 blocks by milk production and then randomly assigned to treatment sequence in four 3 × 3 Latin squares within production level, balanced for carryover effects in three consecutive 21-d periods. Cows were blocked by milk yield and assigned to 1 of 2 groups (n = 12 per group): (a) low group (42.5 ± 3.54 kg/d; 147 ± 42 DIM) and (b) high group (55.8 ± 3.04 kg/d; 101 ± 34 DIM). Commercially available fat supplements were combined to provide treatments that consisted of the following: (1) control (CON; diet with no supplemental FA), (2) FA supplement blend containing 60% C16:0 and 30% C18:0 (PA+SA), and (3) FA supplement blend containing 60% C16:0 and 30% cis-9 C18:1 (PA+OA) The FA blends were fed at 1.5% of dry matter (DM) and replaced soyhulls from CON. Preplanned contrasts were (1) overall effect of FA treatments [CON vs. the average of the FA treatments (FAT); 1/2 (PA+SA + PA+OA)], and (2) effect of FA supplement (PA+SA vs. PA+OA). Regardless of production level, overall FAT reduced DMI compared with CON. Also, regardless of level of milk production, PA+OA increased total-tract FA digestibility compared with PA+SA. Treatment by production level interactions were observed for neutral detergent fiber (NDF) digestibility, total FA intake, and the yields of 3.5% fat-corrected milk (FCM), energy-corrected milk (ECM), and milk fat. In low-producing cows, FAT increased DM and NDF digestibility compared with CON. In high-producing cows PA+SA increased DM and NDF digestibility compared with PA+OA. In low-producing cows, PA+SA increased 3.5% FCM, ECM, and milk fat yield compared with PA+OA. However, in high-producing cows PA+OA tended to increase 3.5% FCM compared with PA+SA. In conclusion, low-producing cows responded better to a FA blend containing 60% C16:0 and 30% C18:0, whereas high-producing dairy cows responded more favorably to a FA blend containing 60% C16:0 and 30% cis-9 C18:1. However, further research is required to validate our observations that higher-yielding cows have improved production responses when supplemented with cis-9 C18:1 compared with C18:0.

Evaluation of serum protein-based arrival formula and serum protein supplement (Gammulin) on growth, morbidity, and mortality of stressed (transport and cold) male dairy calves.

Previous studies with calves and other species have provided evidence that blood serum-derived proteins and fructooligosaccharides (FOS) may benefit intestinal health. We assessed the effects of supplementing products containing serum proteins as a component of arrival fluid support or serum proteins plus FOS (in addition to additional solids, minerals, and vitamins) in an early life dietary supplement on performance, morbidity, and mortality of stressed (transport, cold) male calves. Male Holstein calves (n=93) <1 wk old were stratified by arrival body weight (BW) and plasma protein concentration, and then randomly assigned to 1 of 4 treatment groups in a 2×2 factorial arrangement of one-time administration of fluid support [either control electrolyte solution (E) or the serum protein-containing arrival formula (AF)] and 14d of either no supplementation (NG) or supplementation with Gammulin (G; APC Inc., Ankeny, IA), which contains serum proteins and FOS in addition to other solids, minerals, and vitamins. Upon arrival at the research facility, calves were orally administered either AF or E. At the next feeding, half of the calves from each fluid support treatment received either milk replacer (20% crude protein, 20% fat) or the same milk replacer supplemented with G (50g/d during the first 14d). Starter and water were freely available. Feed offered and refused was recorded daily. Calf health was assessed by daily assignment of fecal and respiratory scores. Stature measures and BW were determined weekly. Blood samples were obtained at d 0 (before treatments), 2, 7, 14, and 28. Calves were weaned at d 42 and remained in the experiment until d 56. After 2 wk of treatments, calves previously fed AF had greater body length (66.6 vs. 66.0cm), intakes of dry matter (38.7 vs. 23.5g/d) and crude protein (9.2 vs. 5.6g/d) from starter, and cortisol concentration in blood (17.0 vs. 13.9 ng/mL) than calves fed E. Supplementation with G resulted in greater BW gain during the first 2 wk, increased intakes of dry matter and CP, and decreased respiratory scores. For the 8-wk experiment, G supplementation resulted in lower mean fecal score (1.6 vs. 1.8) and fewer antibiotic treatments per calf (1.5 vs. 2.5) than NG. Survival was greater in G than in NG calves (98 vs. 84%). Despite the marked reduction in morbidity and mortality, blood indicators of acute-phase response, urea N, and total protein were not affected by AF or G in transported cold-stressed male calves.

Natural radioactivity in groundwater and estimates of committed effective dose due to water ingestion in the state of Chihuahua (Mexico).

The activity concentration of 222Rn, 226Ra and total uranium in groundwater samples collected from wells distributed throughout the state of Chihuahua has been measured. The values obtained of total uranium activity concentration in groundwater throughout the state run from <0.03 up to 1.34 Bq l-1. Generally, radium activity concentration was <0.16 Bq l-1, with some exceptions; in spring water of San Diego de Alcalá, in contrast, the value reached approximately 5.3 Bq l-1. Radon activity concentration obtained throughout the state was from 1.0 to 39.8 Bq l-1. A linear correlation between uranium and radon dissolved in groundwater of individual wells was observed near Chihuahua City. Committed effective dose estimates for reference individuals were performed, with results as high as 134 microSv for infants in Aldama city. In Aldama and Chihuahua cities the average and many individual wells showed activity concentration values of uranium exceeding the Mexican norm of drinking water quality.

Autologous transfusion and other approaches to reduce allogeneic blood exposure.

When used as the sole source of transfused blood, the principal advantage of autologous blood transfusion is the avoidance of transmission of infectious agents and the avoidance of the purported adverse immunomodulatory effects of allogeneic transfusion. In the 1990s, however, the risks of transfusion-transmitted diseases have been greatly reduced, and estimates of the cost-effectiveness of pre-operative autologous blood donations now vary between 2470 dollars and 3,400,000 dollars per quality-adjusted year of life saved, depending on assumptions about the existence and magnitude of any adverse immunomodulatory effects of allogeneic transfusion. There is a paucity of randomized controlled trials evaluating the clinical outcomes and the cost-effectiveness of autologous transfusion procedures, and this situation is unlikely to change in the near future because of the difficulties in conducting such trials. This chapter reviews the available evidence on the efficacy, safety and cost-effectiveness of the three common autologous transfusion procedures, that is, pre-operative autologous blood donation, acute normovolaemic haemodilution, and intra-operative and post-operative blood recovery.

Detection of monoclonal plasma cells in the peripheral blood stem cell harvests of patients with multiple myeloma.

We evaluated the harvest product from 47 patients undergoing peripheral blood (BP) stem cell collections for monoclonal plasma cells (PC) using a sensitive immunofluorescence technique. 60% (28/47) had documented tumour cells in the apheresis product. The 32 patients in plateau had a mean of 1.62 x 10(6) PC/l v 74.64 x 10(6) in 15 relapsed patients (P < 0.01). 32% (6/19) of patients without any tumour cells in the initial sample had them detected on a subsequent apheresis sample. In four cases (all treated with GM-CSF) small numbers of tumour cells were detected initially but became undetectable on a subsequent sample.

Minimal-exposure transfusion and the committed donor.

Autologous blood (collected preoperatively or salvaged intraoperatively) is the safest blood available for transfusion, but its use is not always feasible. It may be possible to decrease a patient's exposure to homologous donors. Pediatric cardiac surgery patients frequently are unable to donate autologous blood preoperatively. Since 1984, attempts have been made to provide parental apheresis platelets and intraoperative blood salvage to such patients to decrease their donor exposure. Further decreases in donor exposure have been the object of a program of collecting from one committed donor all the blood a patient is anticipated to need. This article reviews the experience with 50 pediatric cardiac surgery patients on such a program, in whom the mean decrease in homologous-donor exposure was 57 percent (range, 12-93%). Thirteen of these patients received only homologous blood products from one committed donor, for a mean decrease in homologous-donor exposure of 80 percent (range, 50-93%). A comparison of 12 of these 13 recipients with a matched control group showed no significant difference in red cell transfusion practice but a significant difference in the number of homologous-donor exposures per m2 of body surface area (BSA) (mean donor exposures/m2 of BSA: patients = 1.5, controls = 10.5). The use of one committed donor and autologous blood can provide a minimal-exposure transfusion.

Intraoperative blood salvage.

Interest in and use of IBS have increased recently. This form of haemotherapy involves the retrieval of blood shed perioperatively. IBS, together with other forms of ABT, has gained a prominent role in transfusion medicine, largely due to an increased awareness of the risks associated with transfusion of homologous blood. In addition to conserving erythrocytes, IBS prevents disease transmission, other adverse transfusion reactions, and alloimmunization to antigens in blood cells and plasma which may result from homologous blood use. An array of IBS devices is presently available, ranging from disposable canisters to complete processing systems. The devices are capable of recovering, filtering, washing and reinfusing shed erythrocytes. They can be divided into slow-flow and rapid-flow systems based on the rapidity of blood processing. Most systems use a dual channel aspiration cannula through which shed blood is aspirated and mixed with anticoagulant solution. The salvage procedure requires operator control at every step, even for the highly automated instruments. Various health care personnel have been trained to operate IBS equipment; a transfusion service nurse with blood bank expertise has proved to be a highly reliable operator in our practice. Extensive clinical observation has shown that salvaged erythrocytes function and survive normally. IBS has been applied in many surgical fields; it has two relative contraindications: its use in areas affected by infection or malignancy. Operative procedures characterized by large blood losses provide a cost-efficient application of IBS, including cardiac surgery, orthopaedic procedures, trauma, vascular surgery, and liver transplantation. New, highly efficient technology is emerging that is capable of recovering other blood components. Consequently, what presently amounts to erythrocyte recovery will be expanded shortly to include platelets and plasma, with its many constituents.

Intermittent leukapheresis: an adjunct to low-dose chemotherapy for Sézary syndrome.

Eleven patients with Sézary syndrome were treated with intermittent leukapheresis in addition to low-dose chlorambucil and prednisone. The results were as good as or better than those with chemotherapy alone. We believe the combined program with continuous leukapheresis to be optimal therapy but note that intermittent treatment offers some benefit for patients.

A blood bank consultation service: principles and practice.

In the blood bank setting, a close relationship with both clinicians and patients is essential for good medical practice. In July 1982, the Mayo Clinic Blood Bank and Transfusion Services formally organized a consultation service with daily visits to patients of mutual interest to blood bank consultants and clinicians for practice and education. Detailed diaries of this activity were maintained for 12 months, during which time 802 impatient visits were recorded. The most frequent reasons for consultations were clarification or amplification of the clinical history (34.0%), evaluation of transfusion reactions (27.2%), and assessment of serologic problems (18.2%). These consultations resulted in diagnostic, management, and therapeutic recommendations for a wide variety of medical problems. Of the 802 consultations, 23% were conducted at the direct request of clinicians. We believe that a blood bank consultation service is feasible, is enlightening for the blood bank and clinicians, and contributes to patient care.

Complications of dorsal column stimulation.

The complications associated with 92 dorsal column stimulator implants are reported. They were of two types, technical and functional. In all there were 58 significant complications. Most technical complications were correctable but complications difficult to correct occurred in 26 patients. Late failure in stimulation was observed in 32 implants that had given excellent pain control for periods ranging from months to years. Improvements in the results of this procedure may be achieved by future technical developments and by clarification of physiological mechanisms.

Autologous blood transfusion.

Autologous blood transfusion is a procedure in which blood is removed from a donor and returned to his circulation at some later time. Autologous transfusion can be performed in three ways: (1) preoperative blood collection, storage, and retransfusion during surgery; (2) immediate preoperative phlebotomy with subsequent artificial hemodilution and later return of the phlebotomized blood; and (3) intraoperative blood salvage and retransfusion. All three methods of autologous transfusion offer a potentially superior method of blood transfusion which eliminates many of the problems and complications associated with the banking and administration of homologous donor blood.

Blood transfusion for the patient who is difficult to transfuse.

There are two types of patients who are difficult to transfuse because of the presence of red cell antibodies, those patients who have an antibody reactive against an antigen of high incidence and those who have multiple antibodies. Possible sources of blood for the patient who has an antibody reactive against a high-incidence red cell antigen include the patient's family, rare donors lacking the high-incidence antigen, and self-donation. Possible sources of blood for those who have multiple antibodies are limited to rare donors lacking the appropriate combination of antigens or to self-donation.

Autologous blood transfusion.

Autologous blood transfusion is a procedure in which blood is removed from a donor and returned to his circulation at some later time. Autologous transfusion can be performed in three ways: (1) preoperative blood collection, storage, and retransfusion during surgery; (2) immediate preoperative phlebotomy with subsequent artificial hemodilution and later return of the phlebotomized blood; and (3) intraoperative blood salvage and retransfusion. All three methods of autologous transfusion offer a potentially superior method of blood transfusion which eliminates many of the problems and complications associated with the banking and administration of homologous donor blood.

Dorsal column stimulation and its prospects.

Results of a series of dorsal column stimulation implants in 76 patients are tabulated and correlated to implant location, type of electrodes used and pain causes; complications are also discussed.