Pegbovigrastim treatment resulted in an economic benefit in a large randomized clinical trial in grazing dairy cows.

This randomized controlled trial on 4 commercial grazing dairy farms investigated whether pegbovigrastim (PEG) treatment affected partial net return as calculated from milk revenues and costs for feed, medical treatments [clinical mastitis, uterine disease, and other diseases (i.e., any medical treatment that was not intended for clinical mastitis or uterine disease)], inseminations, and culling during a full lactation in grazing dairy cows. We also explored the effect of potential interactions of PEG treatment with parity, prepartum body condition score, and prepartum nonesterified fatty acids concentration on partial net return, milk revenues, and the costs mentioned above. Holstein cows were randomly assigned to 1 of the 2 following trial arms: a first PEG dose 9.4 ± 0.3 (mean ± standard error) days before the calving date and a second dose within 24 hours after calving (PEG: primiparous = 342; multiparous = 697) compared with untreated controls (control: primiparous = 391; multiparous = 723). The effect of PEG treatment on the outcomes of interest expressed per year was tested using general linear mixed models. Results are presented as least squares means ± standard error. Overall, PEG treatment increased the partial net return, resulting in an economic benefit per cow per year of $210 ± 100. The cost of treatment of clinical mastitis was lower for PEG treated cows compared with control cows ($9 ± 3). The largest nonsignificant difference was seen for the cost of culling; additionally, PEG treatment numerically reduced the cost of culling by $145 ± 77.

Effect of pegbovigrastim on fertility and culling in grazing dairy cows and its association with prepartum nonesterified fatty acids.

This randomized controlled trial on 4 commercial grazing dairy farms investigated whether treatment with pegbovigrastim (PEG) affected fertility and culling as measured during the full lactation. We also explored the effect of potential interactions of PEG treatment with parity, prepartum body condition score, prepartum nonesterified fatty acid concentration (pre-NEFA), and early-lactation clinical disease on these outcomes. Holstein cows were randomly assigned to 1 of 2 trial arms: a first PEG dose approximately 7 d before the expected calving date and a second dose within 24 h after calving (PEG: primiparous = 342; multiparous = 697) compared with untreated controls (control: primiparous = 391; multiparous = 723). Cox's proportional hazards regression models were used to analyze rate of first insemination, rate of pregnancy [within 150 and 305 d in milk (DIM)], and hazard of culling. Additional analyses were performed on data that were stratified by parity group and pre-NEFA class (low ≤0.3; high >0.3 mM). In high pre-NEFA cows, PEG treatment increased the rate of first insemination [hazard ratio (HR) = 1.15]. Early-lactation clinical mastitis (CM) and uterine disease (UD: retained placenta, metritis, or both) were associated with a reduced rate of pregnancy within 150 DIM (HR = 0.49 and 0.78, respectively). Pegbovigrastim treatment in high pre-NEFA cows with CM and UD increased the rate of pregnancy within 150 DIM (HR = 1.75 and 1.46, respectively). In high pre-NEFA cows, PEG treatment resulted in a lower hazard of culling (HR = 0.79). No treatment effect was detected in low pre-NEFA cows. This study shows that the effect of PEG treatment on fertility and culling interacts with pre-NEFA. In high pre-NEFA cows, PEG treatment increased the rate of first insemination, counteracted the negative association of early-lactation CM and UD with the rate of pregnancy, and decreased the hazard of culling.

Repercusiones de la pandemia por COVID-19 en una población de pacientes EPOC

Resumen: Introducción: En 2020 y 2021 la pandemia por COVID-19 tuvo repercusiones a nivel mundial. Los pacientes EPOC constituyen un grupo de riesgo para sufrir enfermedad grave por COVID-19. Las medidas sanitarias recomendadas por la OMS resultaron eficaces para disminuir tanto la propagación del SARS-CoV2 como la de otros virus respiratorios. Objetivo: Determinar las repercusiones de las medidas sanitarias tomadas para mitigar los efectos de la pandemia COVID-19 en una población de pacientes EPOC durante el año 2020. Metodología: Estudio observacional, analítico, longitudinal, retrospectivo de cohorte histórica. Incluyó a los 126 pacientes asistidos en la policlínica de EPOC entre el 13 de marzo de 2018 y el 12 de marzo de 2021. Se seleccionó una muestra por conveniencia que consideró a aquellos pacientes con diagnóstico espirométrico de EPOC, que se hubieran atendido al menos una vez en el período intra-pandemia (13/03/2020 - 12/03/2021) y que tuvieran al menos una consulta constatada en la historia clínica electrónica en el período pre-pandemia (13/03/2018 - 12/03/2020). Se obtuvieron datos mediante la revisión de historias clínicas y una encuesta telefónica. Resultados: 43 pacientes cumplieron los criterios de inclusión. La media de exacerbaciones por paciente pre-pandemia e intra-pandemia fue 2.14 y 1.53 respectivamente, existiendo una diferencia estadísticamente significativa (p=0.016). En ambos períodos predominó la causa infecciosa y las exacerbaciones leves. En el período intra-pandemia no hubo exacerbaciones severas. De los 36 pacientes encuestados, la gran mayoría cumplió con las medidas sanitarias recomendadas y se manifestó satisfecho con la atención telefónica recibida. Conclusiones: Las medidas sanitarias implementadas durante la pandemia por COVID-19 impresionan ser efectivas para disminuir las exacerbaciones de enfermedades crónicas como la EPOC debidas a la transmisión de patógenos respiratorios. La asistencia telefónica resulta una buena opción en términos de satisfacción asistencial.

Abstract: Introduction: In 2020 and 2021 the COVID-19 pandemic had worldwide consequences. COPD patients are at risk of suffering severe COVID-19 disease. The WHO´s public health recommended measures were successful in reducing the spread of both SARS-CoV2 and other respiratory viruses. Objective: To determine the consequences of the implementation of public health measures to mitigate the effects of the COVID-19 pandemic in a population of COPD patients assisted at Hospital Pasteur during 2020. Methodology: Observational, analytical, longitudinal, retrospective historic cohort study. It included the 126 patients assisted at Hospital Pasteur´s COPD clinic between March 13th 2018 and March 12th 2021. A sample was selected by convenience; it considered those patients with spirometric COPD diagnosis, assisted at least once in the intrapandemic period (13/03/2020 - 12/03/2021) and with at least one registered visit in the electronic medical record in the prepandemic period (13/03/2018 - 12/03/2020). Data was obtained by the revision of medical records and through a telephone survey. Results: 43 patients met the inclusion criteria. The mean of exacerbations per patient in the prepandemic and intrapandemic periods was 2.14 and 1.53 respectively, establishing a statistically significant difference (p=0.016). The infectious cause and mild exacerbations prevailed in both periods. In the intrapandemic period no severe exacerbations were registered. 36 patients answered the survey; the vast majority had complied with the public health recommended measures and were satisfied with the telephone assistance received. Conclusions: Public health measures implemented during the COVID-19 pandemic seem effective in reducing chronic diseases´ exacerbations produced by respiratory pathogens, like those due to COPD. Telephone assistance might be a good option where medical assistance satisfaction is concerned.

Resumo: Introdução: Em 2020 e 2021, a pandemia do COVID-19 teve repercussões globais. Os pacientes com DPOC constituem um grupo de risco para doença grave por COVID-19. As medidas de saúde recomendadas pela OMS foram eficazes na redução da propagação do SARS-CoV2 e de outros vírus respiratórios. Meta. Determinar as repercussões das medidas sanitárias adotadas para mitigar os efeitos da pandemia de COVID-19 em uma população de pacientes com DPOC durante o ano de 2020. Metodologia. Estudo observacional, analítico, longitudinal e retrospectivo de uma coorte histórica. incluiu todos os 126 pacientes atendidos na policlínica de DPOC entre 13 de março de 2018 e 12 de março de 2021. Foi selecionada uma amostra de conveniência que considerou aqueles pacientes com diagnóstico espirométrico de DPOC, que haviam sido atendidos pelo menos uma vez no período intra-pandemia (03/13 /2020 - 12/03/2021) e que teve pelo menos uma consulta verificada no prontuário eletrônico no período pré-pandemia (13/03/2018 - 12/03/2020). Os dados foram obtidos por meio de revisão de prontuários e inquérito telefônico. Resultados. 43 pacientes preencheram os critérios de inclusão. O número médio de exacerbações por paciente pré-pandêmico e intra-pandêmico foi de 2,14 e 1,53, respectivamente, com diferença estatisticamente significante (p=0,016). Em ambos os períodos, prevaleceu a causa infecciosa e as exacerbações leves. No período intrapandêmico não houve exacerbações graves. Dos 36 pacientes pesquisados, a grande maioria cumpriu as medidas de saúde preconizadas e manifestou satisfação com o atendimento telefônico recebido. Conclusões. As medidas de saúde implementadas durante a pandemia de COVID-19 parecem ser eficazes na redução das exacerbações de doenças crônicas, como a DPOC, devido à transmissão de patógenos respiratórios. O suporte telefônico é uma boa opção em termos de satisfação com o atendimento.

Effect of pegbovigrastim on clinical mastitis and uterine disease during a full lactation in grazing dairy cows.

In this randomized controlled trial on four commercial grazing dairy farms, we investigated whether pegbovigrastim (PEG) treatment affects clinical mastitis (CM) and uterine disease (i.e. retained placenta (RP), metritis and endometritis) occurrence during a full lactation. The association of prepartum body condition score and prepartum non-esterified fatty acid (NEFA) concentration with disease occurrence was also evaluated. Holstein cows were randomly assigned to one of two treatments: first PEG dose approximately 7 d before the expected calving date and a second dose within 24 h after calving (PEG) compared to untreated controls (Control). In total, 2,153 animals were included in the study: 733 primiparous cows (Control = 391, PEG = 342) and 1420 multiparous cows (Control = 723, PEG = 697). Treatment effects were evaluated with generalized linear mixed models and Cox's proportional hazard models. Treatment with PEG reduced the occurrence of a first case of CM during the first 30 days in milk (DIM) by 24.6% and reduced the hazard of a first case and the rate of total cases of CM during the full lactation. All PEG treatment effects were independent of parity. Prepartum body condition score interacted with PEG treatment: in over-conditioned cows, PEG reduced the occurrence of a first case of CM during the first 30 DIM by 49.5%. The hazard analysis of a first case of CM during the full lactation suggested that the preventive effect of PEG disappeared with increasing DIM. Treatment with PEG did not affect the occurrence of RP or metritis. Pegbovigrastim treated cows with metritis subsequently showed a reduced occurrence of endometritis compared to control cows with metritis. Pegbovigrastim reduces the occurrence of CM particularly in cows at risk of elevated lipid mobilization, and PEG ameliorates the uterine healing process in cows that experienced metritis.

Clinical disease incidence during early lactation, risk factors and association with fertility and culling in grazing dairy cows in Uruguay.

This paper aims to describe clinical disease incidence in early lactation and explore its association with fertility and culling in 13 commercial grazing dairy herds in Uruguay. Seven farms with less than 250 dairy cows considered small herds (SH) with a herd size average ± (SD) of 144 ± (56) cows and six farms with more than 500 cows considered large herds (LH) with a herd size average ± (SD) of 830 ± (239) cows were selected. Herd managers recorded health events during the first 90 days in milk in 5375 Holstein dairy cows [24.5% (n=1316) of them were primiparous cows, (PP)] during one year. Overall, 36.5% (n=1959) of the cows had at least one clinical health event between 1-90 days in milk. The cumulative incidences were 2.2% for twin birth and 4.9% for stillbirth. Cumulative incidence was 4.4% for retained placenta-metritis (RP-metritis), 27.6% for clinical mastitis and 5.0% for lameness. Our data showed that parity and herd size were risk factors for postpartum disease in grazing dairy herds. In PP cows, stillbirth incidence was higher than in multiparous (MP) cows (PP=6.9 ± 3.4, SD vs. MP=4.3 ± 2.6, SD), while in MP cows twin births (MP=2.7 ± 1.7, SD vs. PP=0.7 ± 2.7, SD), RP-metritis (MP=4.6 ± 3.9, SD vs. PP=3.8 ± 3.7, SD) and mastitis incidence (MP=30.9 ± 11.4, SD vs. PP=17.2 ± 13.9, SD) was higher. Clinical mastitis (LH=29.4 ± 9.6, SD vs. SH=19.1 ± 11.3, SD) and lameness incidence (LH=5.6 ± 1.9, SD vs. SH=2.3 ± 2.1, SD) was higher in large herds than in small herds. RP-metritis was increased by stillbirth (OR=4.4, 95 % CI=2.9-6.5) and twin birth (OR=2.8, 95 % CI=1.5-5.1). Diseases had a negative impact on time to first service and pregnancy rate and increased culling hazard rate. Disease incidence in early lactation was high and showed a wide variation among herds (10.4%-48.7%), which highlights the relevance of a herd health program prioritizing the early lactation disease control.

Increase in white blood cell counts by pegbovigrastim in primiparous and multiparous grazing dairy cows and the interaction with prepartum body condition score and non-esterified fatty acids concentration.

The objective of this study was to determine if parity affected the effect of pegbovigrastim (PEG) treatment on white blood cell (WBC) counts in grazing dairy cows. Additionally, the association of prepartum body condition score (BCS) and non-esterified fatty acid (Pre-NEFA) concentration with WBC counts was investigated. The effect of early-lactation disease was included in the statistical analysis. A randomized controlled trial on four commercial grazing dairy farms was performed. Holstein primiparous (Control = 87, PEG = 89) and multiparous (Control = 181, PEG = 184) cows were randomly assigned to one of two treatments: first PEG dose 8 ± 5 (mean ± SD) days before the expected calving date and a second dose within 24 h after calving (PEG) compared to untreated controls (Control). Treatment effects were evaluated with mixed linear regression models. Treatment with PEG increased WBC, neutrophil, lymphocyte and monocyte counts at 6 ± 1 (mean ± SD) days in milk. Parity, BCS and their interactions with treatment were not associated with WBC counts. In control cows, Pre-NEFA concentration was associated with reduced WBC, neutrophil and lymphocyte counts and tended to be associated with reduced monocyte counts. Pegbovigrastim treatment reversed the negative association of Pre-NEFA concentration with neutrophil and monocyte counts and tended to reverse the negative association of Pre-NEFA concentration with WBC counts. In the PEG treated group, cows diagnosed with retained placenta or metritis showed lower neutrophil counts when compared to PEG treated cows without these clinical diseases. These data confirm that PEG treatment increases WBC, neutrophil, lymphocyte and monocyte counts in grazing dairy cows and that this effect is independent of parity. Pegbovigrastim treatment reversed the negative association of Pre-NEFA concentration with neutrophil and monocyte counts, and tended to reverse the negative association of Pre-NEFA concentration with WBC counts.

Endocrine and reproductive parameters in sick and healthy primiparous and multiparous dairy cows.

To investigate the association of health status and parity with hormone profiles during the transition period and reproductive parameters in Holstein dairy cows, a prospective observational cohort study was carried out including only healthy primiparous (PP, n = 116) and multiparous (MP, n = 172) cows at the beginning of the study. A subset of 120 healthy and sick cows was randomly selected for insulin, IGF-I, leptin and adiponectin determination. Primiparous cows had greater IGF-I and adiponectin concentrations (P < 0.05) and tended (P=0.07) to have greater insulin concentrations than MP cows. While healthy and sick MP and sick PP cows presented a sharp decrease in IGF-I concentrations after calving, healthy PP cows maintained them. Postpartum adiponectin concentrations were lower in sick than in healthy MP cows. A greater percentage of healthy cows ovulated during the first 7 weeks after calving when compared to sick cows (67.9% vs 50%, P=0.002) and a similar trend was found for MP vs PP cows (64% vs 53%, P=0.01). More healthy cows were inseminated in comparison to sick cows (94% vs 76.5%, P < 0.01) and more PP than MP cows (90.4% vs 82.7%, P < 0.05). Similarly, healthy cows presented a greater proportion of pregnancy than sick cows (75% vs 54%, P < 0.01) and the proportion of pregnancy was higher in PP than in MP cows (74% vs 56%, P=0.04). Health status interacting with parity yielded different endocrine profiles, which may partially explain the differences in reproductive performance.