Evaluation of 5 methods for diagnosing failure of passive transfer in 160 Holstein calves.

BACKGROUND: Inadequate absorption of colostral IgG1 is termed failure of transfer of passive immunity (FTPI). Dairy calves with FTPI have increased mortality and morbidity in their first 6 months of life. OBJECTIVES: This study compared the clinical performance of 5 methods for diagnosing FTPI in Holstein calves. METHODS: An observational study was performed using 160 Holstein heifer calves. Serum was harvested at 48 hours of age, and FTPI was assessed using a digital Brix refractometer for total solids measurements, and digital refractometry and the biuret method to measure serum total protein (STP) concentrations. Serum gamma-glutamyltransferase activity was measured with an automated analyzer, and serum IgG was measured with the zinc sulfate turbidity test and an enzyme-linked immunosorbent assay. Diagnostic test performance was compared with that of the reference method (FTPI defined as a serum total IgG concentration <10 g/L). Test performance was evaluated using the area under the receiver operating characteristic curve, the sensitivity, the specificity, and the positive likelihood ratio at the optimal test cut point, and by calculating the kappa coefficient. RESULTS: A serum digital Brix percentage of <7.8% and an STP concentration of <52 g/L measured using digital refractometry were the best methods to identify calves with FTPI. The STP concentration measured with digital refractometry was 0.1 g/L lower than that measured with the biuret method. CONCLUSIONS: The digital Brix refractometer and the digital refractometer provide accurate and clinically useful methods for identifying dairy calves with FTPI. In this study, the excellent performance of the Brix refractometer was likely due to the use of a fixed sample volume (200 µL) and a uniform sample temperature at the time of measurement.

Future Prospects of Biologic Therapies for Immunologic Diseases.

This article presents an overview of future uses for biologic therapies in the treatment of immunologic and allergic conditions. Discussion is centered on the use of existing therapies outside of their current indication or on new therapies that are close to approval. This information may help familiarize practicing allergists and immunologists with therapies they may soon encounter in their practice as well as help identify conditions and treatments that will require further study in the near future.

Fecal microbiota transplantation: a new old kid on the block for the management of gut microbiota-related disease.

Gut microbiota is deeply involved in the regulation of both health and disease within our body. The restoration of a healthy gut microbiota is, therefore, a main clinical target in the management of diseases associated with its disruption. Fecal microbiota transplantation (FMT) is an old therapy that has recently been rediscovered, having proved a clear efficacy against recurrent Clostridium difficile infection. By restoring the altered gut microbiota in a substantial and durable manner, FMT is considered a cutting-edge promising option for the treatment of disease that recognize the alteration of the gut microbiota as having a pathogenic role. FMT has shown interesting (even if uncertain) results in diseases such as metabolic syndrome and inflammatory bowel diseases. Moreover, the definition of a standard procedural protocol for each specific disease, as well as exhaustive studies about the relationship between donor's microbiota composition and clinical results, will certainly improve the therapeutic potential of FMT. Both the application of cutting-edge technologies for the assessment of gut microbiota composition (such as metagenomics) and the development of well-designed, large randomized trials are needed to put such perspectives into practice.

[Environmental-medical diagnosis and therapy. Hasty diagnosis of unspecified environmental syndromes should be avoided]. / Umweltmedizinische Diagnostik und Therapie. Vorschnelle Diagnose unspezifischer umweltmedizinischer Syndrome vermeiden.

In the past ten years environmental medicine has virtually exploded. Major instruments for the interdisciplinary environmental-medical diagnosis are history, on-site inspection, biomonitoring and ambient monitoring. Since the definitive diagnosis of an environment-related disease usually requires a joint evaluation of toxicological, somatic and psychosomatic findings, it is recommended that cooperation with an experienced center for environment medicine should be established early on. By doing so, an inappropriate diagnosis of unspecific environment-medical symptom complexes such as, e.g., multiple chemical sensitivity may be avoided. Such "diagnoses" may result in drastic, and for the patient and his family, often stressful, consequences.

Vitiligo, la faceta inmunológica / Vitiligo: the inmunological facet

El vitiligo es un cuadro dermatológico de acromía, que en la actualidad no ha podido ser definido claramente ya que existen muchas hipótesis no comprobadas sobre su posible causa. El proceso de la destruccióndel melanocito conlleva una serie de cambios en la actividad del sistema inmune de los afectados, que han hecho pensar en un proceso autoinmune al menos como parte de los mecvanismos etiológicos, en el participan tanto la inmunidad humoral como la celular. Se han identificado antígenos específicos en las membranas de los melanocitos e inmunoglobulinas G reactivas hacia ellos, modificaciones en la actividad celular con disminución de células de Langerhans y alteración de las proporciones de diferentes subpoblaciones de células T. Asímismo existen un aumento marcado en la expresión de ICAM-1 y anormal expresión de los MHC clase II por parte de los melanocitos en las fases activas de la enfermedad. Estos factores, y el incremento de la producción de linfocinas proinflamatorias (IL-6 e IL-8) indican la presencia de una citoxidad inmunológicamente mediada, pero la autoinmunidad podría ser solo un epifenómeno, o consecuencia de la exposición de antígenos nuevos mmmodificados por noxas desconocidas, quizás virales, a la luz de hallazgos que implican al virus de inclusión citomegálica en la patogénesis. En esta revisión, se trata de dar un panorama de los conocimientos acumulados en el campo inmunológico sobre el vitiligo en los últimos 40 años