Relationship between selected perinatal paratuberculosis management interventions and passive transfer of immunity in dairy calves.

The objective of this cohort study was to assess the relationship between perinatal calf management practices relevant to the control of paratuberculosis and passive transfer of immunoglobulin in calves born in an endemically infected Irish dairy herd. Data from 176 calves were used to assess the effect of time spent in the calving area, individual versus non-designated calving and colostrum pasteurisation on serum total protein, zinc sulphate turbidity, globulin and γ-glutamyltransferase. In addition, the effects of colostrum quality, volume of colostrum fed, method of colostrum administration and calving season on passive transfer were quantified. Serum samples were collected as part of routine herd health monitoring from calves aged between one and seven days. Multivariate linear and logistic regression models were used to assess the effect of each variable on the test result and failure of passive transfer as determined using a cut-off point for each diagnostic test. Colostrum pasteurisation and calving area were not significantly associated with passive transfer, whereas increased time spent in the calving pen was consistently associated with a detrimental effect. In addition, a strong seasonal effect was apparent, which appeared to be unrelated to colostrum quality and calf management. The authors are unaware of published studies documenting such a significant seasonal effect on passive transfer.

Optimisation of the zinc sulphate turbidity test for the determination of immune status.

Failure of passive transfer of maternal immunity occurs in calves that fail to absorb sufficient immunoglobulins from ingested colostrum. The zinc sulphate turbidity test has been developed to test bovine neonates for this failure. The specificity of this test has been shown to be less than ideal. The objective was to examine how parameters of the zinc sulphate turbidity test may be manipulated in order to improve its diagnostic accuracy. One hundred and five blood samples were taken from calves of dairy cows receiving various rates of colostrum feeding. The zinc sulphate turbidity test was carried out multiple times on each sample, varying the solution strength, time of reaction and wavelength of light used and the results compared with those of a radial immunodiffusion test, which is the reference method for measuring immunoglobulin concentration in serum. Reducing the time over which the reaction occurs, or increasing the wavelength of light used to read the turbidity, resulted in decreased specificity without improving sensitivity. Increasing the concentration of the zinc sulphate solution used in the test was shown to improve the specificity without decreasing sensitivity. Examination of the cut-off points suggested that a lower cut-off point would improve the performance.

Naltrexone plus group therapy for the treatment of opiate-abusing health-care professionals.

PURPOSE: The success rate of a treatment program tailored to opioid-abusing health-care professionals that included oral naltrexone and group therapy was studied. METHODS: 20 opioid-abusing health professionals were treated over a 5-year-period. Clients received an initial assessment, supervised administration of naltrexone, and weekly attendance at a psychotherapy group for health professionals. Naltrexone was administered for the first several months, then patients continued the program without naltrexone. RESULTS: 18 patients were referred to the program after being caught diverting medication. Two patients came spontaneously. Of the 18 referred patients, 12 had no relapses, and 5 had only one relapse, followed by long-term sobriety. Mean overall duration of naltrexone administration was 8 months, and the mean duration in the program was 1.9 years. 94% of referred clients had long term abstinence, and 66% were working in their profession during the program. CONCLUSIONS: Naltrexone in the setting of a structured program is helpful in the treatment and professional reinstatement of opioid abusing health professionals.

Molecular modeling parameters predict antioxidant efficacy of 3-indolyl compounds.

Many dietary constituents, such as indole-3-carbinol, are chemoprotective in toxicity and carcinogenicity bioassays. Indole-3-carbinol and related congeners appear to protect partly via radical and electrophile scavenging. To develop better chemoprotective indoles with lower intrinsic toxicity, we performed molecular graphic and quantum-mechanical analyses of model indolyl compounds to ascertain the determinant molecular features for antioxidant activity. We examined eight structurally related 3-indolyl compounds for relationships between antioxidation potential (using in vitro lipid peroxidation assays) and electronic, polar, and steric parameters, including bond dissociation energies, bond lengths, dipole moments, electronic charge densities, and molecular size parameters. Electronic features of the 3-methylene carbon and 1-nitrogen were not predictive of antioxidative potency due to extensive charge delocalization of the cation radical following electron abstraction from the nitrogen. Antioxidant efficacy of 3-indolyl compounds was most strongly predicted by molecular size parameters and by the energy of electron abstraction as calculated from the difference in heat of formation between the parent compound and its cation radical. A highly predictive multiple linear regression correlation model (r2 = 0.97) was obtained using the parameters of heat of formation, molecular weight, log P, and diplole moment.

Teenagers' perceptions of barriers to prenatal care.

A structured interview conducted during the postpartum hospitalization of 184 patients aged 17 years or younger was used to study teenagers' perceptions of barriers to prenatal care. The interview consisted of more than 100 questions on demographic characteristics, family and social support, desire for the pregnancy, perceptions of the importance of prenatal care, practical obstacles to access to health care (such as lack of transportation, day care, etc), financial problems related to care, problems finding time to obtain health care, knowledge of available prenatal care resources, and perceptions of ease or difficulty in the use of existing clinics. Multiple regression analysis using the Kessner index as the criterion variable showed that major factors related to the adequacy of prenatal care received by these teenagers were perceptions of cost barriers, the gestational age at which the teenager discovered she was pregnant, school enrollment status (those in school received poorer care than those who had dropped out), and the degree of social support experienced by the teenager. These findings suggest that specific changes in the health care system are needed to make prenatal care more accessible for pregnant teenagers. These changes would include enhancing community awareness that Medicaid pays for prenatal care, establishing links between prenatal clinics and school health systems, and scheduling prenatal clinics at times more convenient for teenagers.

The effect of multiple family therapy on addict family functioning: a pilot study.

Family therapy may help addicts remain drug abstinent by improving family functioning. In a outpatient pilot study eight addict families were evaluated before and after 16 weeks of multiple family therapy (MFT), while the addict was maintained on naltrexone, an opiate antagonist. The Beavers Timberlawn Family Assessment was used to rate videotapes on problem solving, family structure, individual autonomy, and affect. The 8 families showed significant improvement in global functioning, problem solving, structure, and autonomy, but not in affect. One addict relapsed during the 10 month follow up, and his was the only family that functioned worse at follow up. We concluded that MFT can help addict families progress from chaotic interactions to more stable family structures and from rigid to more flexible family functioning. This improvement in family functioning may be associated with ex-addicts remaining abstinent.

Clonidine in outpatient detoxification from methadone maintenance.

Inpatient narcotic detoxification with clonidine hydrochloride has been used since 1978. Outpatient withdrawal, potentially more useful, has not been adequately studied. This report describes a double-blind random assignment of 49 methadone hydrochloride-maintained patients whose dose had been lowered to 20 mg. Twenty-five were detoxified using methadone at 1-mg decrements, 24 by abrupt substitution with clonidine. Approximately 40% of both groups achieved successful detoxification, with one third maintaining abstinence over the subsequent six months. The groups were also largely equivalent on withdrawal symptoms, but the clonidine group experienced symptoms in the first half of the study and the methadone group in the second half. Clonidine appears to be a safe and efficacious outpatient treatment for opiate withdrawal, although the results were less favorable than those obtained in open or inpatient studies.

Family denial as a prognostic factor in opiate addict treatment outcome.

Opiate addicts living with family members generally have better treatment outcomes than addicts who live alone, but family support for the addict remaining drug-free depends on the family being aware of the addiction. We found that many addicts deny their drug abuse to their families and we hypothesized that these addicts would have poor treatment outcomes, even though they lived with nonaddict family members. To test this hypothesis, four groups of addicts in a naltrexone program were compared: 28 male addicts with their spouses, 27 addicts living with their parents, 23 addicts who denied their drug abuse to the family members with whom they lived, and 28 addicts who lived alone. The first two groups participated in family therapy, and these addicts remained drug-free longer than the other two addict groups (analysis of variance, p less than 0.001). The addicts who denied their drug abuse to their families remained drug-free for significantly less time than those who admitted their drug abuse to their families. Furthermore, addicts who admitted their drug abuse to their spouse, but denied it to their parents, remained drug-free for shorter times than married addicts who also told their parents. Thus, maximum family involvement in treatment including spouses and parents was associated with a better prognosis.

Multiple family therapy and naltrexone in the treatment of opiate dependence.

The effect of multiple family therapy on client compliance and retention in a high intervention, naltrexone treatment program was examined retrospectively. The population consisted of 65 opiate-dependent individuals consecutively treated with naltrexone and a standard program of counseling and supportive psychotherapy. Twenty-five of these individuals, in addition, received multiple family therapy. The data presented are suggestive of the efficacy of combining multiple family therapy and high intervention in patients being treated with naltrexone. Analysis of the data demonstrated that the group receiving multiple family therapy had a larger continuous time of naltrexone ingestion and remained in the treatment program longer than clients who did not receive multiple family therapy. These effects were independent of race and employment status. The implication of the results for treatment and avenues for future research are discussed.