Effectiveness of intrauterine treatment with cephapirin in dairy cows with purulent vaginal discharge.

The objective of this study was to assess the efficacy of cephapirin intrauterine treatment preceding a timed artificial insemination protocol in lactating dairy cows with purulent vaginal discharges (PVDs). Holstein dairy cows (n = 1247) from 18 herds were enrolled in a controlled randomized clinical trial. At 34 days in milk (DIM; ±7 days), cows had a genital examination (transrectal palpation, vaginoscopy, and uterine bacteriology). They were randomly assigned to either the control group (CONT, no treatment) or the treatment group (CEPH) consisting of 1 intrauterine infusion of 500-mg cephapirin benzathine (RCL) (Metricure, Merck Animal Health, Montreal, Canada) regardless of the uterine health status. All cows were systematically enrolled in a presynch-ovsynch protocol for the first insemination. A second genital examination was made 2 weeks later. Cows that received any systemic or local antibiotics 10 days prior sampling to the end of the synchronization protocol were excluded from the study. Reproductive data of cows were collected for at least 300 DIM, entered in a databank, and validated (health record management software, DSAHR). Pregnancy diagnosis was done by transrectal palpation at the routinely scheduled veterinarian visits. On the basis of the highest sum of sensibility and specificity for pregnancy status at 120 DIM, the optimal cutoff for vaginal discharge score was determined as the presence of cloudy discharge with or without purulent material (PVD+, score 2). With a prevalence of 21.6% at 34 DIM, PVD+ was detrimental to the first-service conception rate (FSCR; PVD+: 26 ± 5%; PVD-: 40 ± 3%; P = 0.02). The negative effect of PVD+ was indicated by a hazard ratio of 0.72 (chi-square = 8.58; P < 0.01; 95% confidence interval = 0.56-0.91). Treatment with cephapirin was associated with a significant improvement of the FSCR in PVD+ cows (PVD+ CEPH: 36 ± 5%, PVD+ CONT: 23 ± 5%; P < 0.05), although it did not produce a considerable clinical cure based on the second examination. Thus, a longer period of time following treatment may be needed to properly assess the efficacy of intrauterine treatment in PVD+ cows. In conclusion, cephapirin intrauterine treatment in PVD+ cows at 34 DIM considerably improves reproductive performance compared with untreated PVD+ cows.

Prediction of bulk tank somatic cell count violations based on monthly individual cow somatic cell count data.

The regulatory limit in Canada for bulk tank somatic cell count (BTSCC) was recently lowered from 500,000 to 400,000 cells/mL. Herd indices based on changes in cow somatic cell count over 2 consecutive months (e.g., proportion of healthy or chronically infected cows, cows cured, and new intramammary infection rate) could be used as predictors for BTSCC violations. The objective of this study was to develop a predictive model for exceeding the limit of 400,000 cells/mL in the next month using these herd indices. Dairy Herd Improvement (DHI) data were used from 924 dairy herds in Québec, Canada. Test-day BTSCC was estimated by dividing the sum of all cows' DHI test-day somatic cell count times DHI test-day milk production by the total volume of milk produced by the herd on that test-day. In total, 986 of 8,681 (11.4%) estimated BTSCC exceeded 400,000 cells/mL. The final predictive model included 6 variables: mean herd somatic cell score at the current test-month, proportion of cows >500,000 cells/mL at the current test-month, proportion of healthy cows during lactation at the current test-month, proportion of chronically infected cows at the current test-month, average days in milk at the current test-month, and annual mean daily milk production. The optimized sensitivity and specificity of the model were 76 and 74%, respectively. The positive predictive value and negative predictive value were 25 and 95%, respectively. This low positive predictive value and high negative predictive value demonstrated that the model was less accurate at predicting herds that would violate the estimated BTSCC threshold but very accurate at identifying herds that would not. In addition, the area under the curve for the receiver operating characteristic curve was 0.82, suggesting that the model had excellent discrimination between test-months that did and did not exceed 400,000 cells/mL. An internal validation was completed using a bootstrapped resampling-based estimation method and confirmed that the final model provided a validated estimate of predictive accuracy. This model could be used to monitor and advise clients on impending risks of exceeding the BTSCC limit.

Effect of nonclinical Staphylococcus aureus or coagulase-negative staphylococci intramammary infection during the first month of lactation on somatic cell count and milk yield in heifers.

Coagulase-negative staphylococci (CNS) are the most prevalent cause of intramammary infections in heifers around calving, but Staphylococcus aureus should not be ignored because it is also prevalent, contagious, and more likely to persist into lactation. The objective of this study was to determine the effect of a subclinical infection caused by S. aureus or CNS diagnosed during the first month of lactation in heifers on SCC, milk production, and culling risk during the entire first lactation. Data were obtained from a cohort of 50 farms following a mastitis monitoring and control program and subscribing to the animal health record system (DS@HR) through the ambulatory clinic of the Faculté de médecine vétérinaire of the Université de Montréal (St-Hyacinthe, Québec, Canada). This program included routinely collecting a composite milk sample at each farm visit from all recently freshened heifers. A total of 2,273 Holstein heifers were examined. Among the 1,691 heifers meeting the full selection criteria, 90 (5%) were diagnosed with S. aureus, 168 (10%) were diagnosed with CNS, and 153 (9%) were negative (no pathogen isolated). Test-day natural logarithm somatic cell count (lnSCC) was modeled in a repeated measures linear regression model with herd as random effect. The model-adjusted mean lnSCC in S. aureus and CNS groups were significantly higher than in the culture-negative group from 40 to 300 d in milk. At the test-day level, lnSCC in S. aureus and CNS groups were on average 1.2 and 0.6 higher, respectively, than the culture-negative group. A similar model for milk yield showed that mean milk yield was not statistically different between culture groups from 40 to 300 d in milk. The presence of a S. aureus or CNS intramammary infections in the first month of lactation in heifers correlates with future increased SCC over the entire first lactation.

[Psychological and health sequelae of childhood sexual, physical and psychological abuse]. / Les conséquences à long terme de la violence sexuelle, physique et psychologique vécue pendant l'enfance.

BACKGROUND: The co-occurrence of child victimization experiences is not a rare phenomenon. However, few studies have explored the long-term consequences of such experiences. Empirical studies present important methodological limitations, namely the fact that few studies have documented more than two forms of victimization, that they rely on non representative samples and have not used multivariate analyses. The present study aims to evaluate the specific contribution of each form of child victimization (sexual, physical and psychological) on the outcomes in adulthood. Moreover, the study explores the role of co-occurrence on these symptoms. METHODS: A phone survey was conducted with a representative sample of 804 adults from the province of Quebec. Households were randomly selected among those having a telephone. Sociodemographic variables, child victimization experiences (sexual, physical and psychological) and partner violence were evaluated to explore their links with psychological distress, post-traumatic stress symptoms and physical health of participants. RESULTS: Higher psychological distress in men is associated with younger age, lower education level and having experienced sexual and physical violence in childhood. For women, psychological distress is linked to younger age, having experienced partner violence, childhood physical and psychological violence. Only experiencing partner violence and childhood sexual and psychological victimization are linked to greater post-traumatic stress symptoms in men and women. Finally, lower education level and childhood sexual and physical victimization increase physical health problems for men, while for women, only lower education level contributes to the prediction. CONCLUSION: The results of this study show that experiencing more than one form of childhood victimization increases the negative outcomes in adulthood, underlying the relevance of considering the phenomenon of co-occurring victimization in the elaboration and dissemination of intervention programs.

Identification of a human chromosome-specific interstitial telomere-like sequence (ITS) at 22q11.2 using double-strand PRINS.

Interstitial telomeric sequences (ITSs), telomere-like repeats at intrachromosomal sites, are common in mammals and consist of tandem repeats of the canonical telomeric repeat, TTAGGG, or a repeat similar to this. We report that the ITS in human chromosome region 22q11.2 is, in the sequenced genome database, 101 tandem repeats of the sequence TTAGGGAGG. Using the primed in situ labeling (PRINS) technique and primers against the canonical telomeric repeat (TTAGGG), we illuminated telomeric sites for all chromosomes and an ITS locus at 22q11.2. Using the TTAGGGAGG sequence, we designed PRINS primers that efficiently and specifically illuminate the 22q11.2 ITS locus without illuminating telomeric and other ITS loci. The 22q11.2 locus has more repeat units than other ITSs loci enabling an unprecedented high detection frequency for this interstitial telomere locus. The 22q11.2 is associated with hot spots for disease-related chromosome breaks for multiple disorders, such as DiGeorge syndrome and chronic myeloid leukemia. We describe our findings that the ITS at 22q11.2 is in the same area of, and proximal to the common rearrangement region of multiple disorders. We suggest that the ITS might be involved in DNA repair processes in this area to protect the chromosome from more serious damage.

Prepartum monensin for the reduction of energy associated disease in postpartum dairy cows.

A total of 1317 Holstein cows from 45 farms in the Canadian provinces of Quebec, Prince Edward Island (PEI) and Ontario were enrolled in a randomized trial during 1998 and 1999 to further confirm the efficacy of a monensin controlled release capsule in preventing periparturient disease in lactating dairy cows. Cows were randomized on the farms to receive either a monensin controlled release capsule (CRC) 2 to 4 wk before expected calving or to serve as negative controls. Health data were collected for 90 d postcalving and were analyzed with logistic regression accounting for the intraherd correlation with generalized estimating equations. Monensin CRC significantly reduced the incidence of both clinical ketosis and abomasal displacement post-calving. There was a numerical but nonsignificant decrease in the incidence of retained placenta in cows receiving a monensin CRC. A pooled analysis of two separate but similar studies (conducted in 1995 and 1998) demonstrated a strengthened association between monensin CRC administration precalving and reduced periparturient disease. A 40% reduction in both abomasal displacement and clinical ketosis was observed with precalving administration of a monensin CRC. In addition, the larger dataset highlighted a trend for a 25% reduction in the incidence of retained placenta in monensin-treated cows. Improved energy metabolism as a result of monensin treatment is likely the mechanism for the reduction in incidence of all three of these diseases. Thus the term "energy associated disease" was created to assess the combined impact of the precalving monensin treatment on the incidence of retained placenta, displaced abomasum, and clinical ketosis. The monensin controlled release capsule reduced the incidence of energy associated disease by 30%.

A questionnaire on the health, management, and performance of cow-calf herds in Québec.

Questionnaires were mailed to 520 cow-calf producers in Québec in order to compare management practices and herd performance according to herd size (small: < 40 females, or large: > or = 40 females) and in 4 geographic areas for the 1995 calving season. Owners of large herds adopted management practice and preventive measures more often than did owners of small herds. Average calving and weaning rates were 95% and 87% respectively. Average perinatal and preweaning mortality rates were between 4.9% and 5.6%. A greater percentage of owners with large herds than owners of small herds reported diarrhea and pneumonia problems. Among large herds, the number of herds experiencing pneumonia and calf mortality associated with diarrhea tended to be higher in areas of the northwest. Calf mortality due to pneumonia was higher in the northeast. No regional variation was found among small herds. Further research is needed to identify diseases risk factors.

Cow level sampling factors affecting analysis and interpretation of milk urea concentrations in 2 dairy herds.

The goals of this study were to determine the influence of the variations among udder quarters, the somatic cell count, the time of sampling during the day, sample conservation, and centrifugation on milk urea (UREA) concentrations, and to propose a sample collection procedure for herds that are not on a Dairy Herd Improvement (DHI) program. Forty cows from 2 herds with different feeding practices were randomly selected. The quarter sampled and the somatic cell count did not significantly influence UREA concentrations. Milk urea concentrations were highest in the morning. The diurnal pattern was not influenced by intrinsic factors like parity, days postpartum, or daily milk yield. The UREA concentrations were significantly higher after refrigeration for one week (mean UREA change = +0.41 +/- 0.24 mmol/L, P = 0.0001) and freezing for one month (mean UREA change = +1.52 +/- 1.25 mmol/L, P = 0.0001). Urea concentrations were slightly higher in lactoserum than in whole milk (mean UREA difference = +0.17 +/- 0.24 mmol/L, P = 0.0001). Although this study included only 2 herds and does not allow extrapolation, differences were found in the diurnal pattern of UREA in these 2 herds, which possibly reflect differences in feeding strategy. With consideration of these results, a 6-point sampling procedure for herds that are not on a DHI program is proposed.

Factors affecting milk urea nitrogen and protein concentrations in Quebec dairy cows.

Milk urea nitrogen (MUN), together with percentage milk protein (PROT), are increasingly used as indicators of the protein-energy balance and for monitoring nutrition and diagnosing feeding disorders. The goal of this study was to analyze the effects of parity, milk yield, days in lactation, somatic-cell count, and herd and feeding factors on MUN and PROT. In 10 dairy herds, one milk sample was taken from each of 418 cows, within +/- 2 days of the routine milk-test visit. We used a four-step multiple linear-regression model with backward elimination, including interactions between herd and the different factors. For both dependent variables, there were significant interactions with herd. Herd-specific models were markedly different; however, the daily amount of protein concentrates fed remained (and had a positive coefficient) in seven of 10 herd models for MUN. This factor is easy to record under field conditions and has to be considered in the evaluation of the ration by means of MUN and PROT. Overfeeding of rumen soluble protein can be easily diagnosed and corrected using MUN analyses. The relationships between MUN and PROT in respect of the factors parity, daily milk yield, and days postpartum also vary considerably among herds.

Effect of cow-specific factors and feeding frequency of concentrate on diurnal variations of blood metabolites in dairy cows.

OBJECTIVE: To determine the effect of feeding frequency and cow-specific factors on diurnal variations of blood metabolites concentrations. ANIMALS: 40 dairy cows from 2 herds. PROCEDURE: Each herd was fed concentrate at a specific feeding frequency (automatic vs twice daily). Blood samples were collected 4 times daily. Plasma concentrations of glucose, nonesterified fatty acids (NEFA), and beta-hydroxybutyrate (BHBA) were analyzed, and concentrations of urea, cholesterol, and total protein (TP) were determined in serum samples. A multivariate repeated-measures ANOVA was used to test the effect of time, feeding frequency, production group, parity, days after parturition, and daily milk yield on diurnal variations of metabolites. RESULTS: Concentrations of glucose, BHBA, and urea remained relatively constant in the herd that was fed by use of automatic distribution of concentrate; however, significant diurnal patterns were detected in the herd fed only twice daily. Only slight differences in glucose and urea concentrations were detected between high- and low-producing cows, but concentration of BHBA was significantly influenced by number of days in lactation. In contrast, diurnal variations in NEFA and cholesterol concentrations were similar between the 2 herds but differed with regard to production group. Concentrations of TP did not have relevant diurnal patterns and did not differ between production groups. CONCLUSIONS AND CLINICAL RELEVANCE: Diurnal variations and feeding frequency affect glucose, BHBA, and urea concentrations in cows. In contrast, concentrations of NEFA, cholesterol, and TP appear to be less sensitive to time of sample collection. Feeding frequency, composition of feed, or both, have a major impact on blood metabolites concentrations.

Assessment and management of antipsychotic-induced adverse events.

OBJECTIVE: To review and discuss the spectrum of adverse events caused by antipsychotic agents that can directly influence the outcome of treatment by interfering with patient acceptance of and adherence to therapy. METHOD: The adverse effects of traditional and second-generation antipsychotic medications were discussed during a series of clinical workshops attended by psychiatrists from across Canada. The various adverse effects of antipsychotic drugs as well as their assessment and management are reviewed. RESULTS: Simple techniques for assessing adverse effects such as extrapyrimidal symptoms (EPS) are described. In some cases, adverse effects can be managed by dosage reduction and/or the use of adjunctive therapies such as antiparkinsonian agents and benzodiazepines. However, in some patients dose reduction carries the risk of symptom reemergence, while the commonly used adjunctive medications are associated with adverse effects of their own. CONCLUSIONS: Treatment-related side effects often require a reduction in dosage or a change in medication. Proper management can help encourage patient compliance and improve the outcome of antipsychotic treatment. The availability of the newer atypical antipsychotics offers another alternative, because they are associated with a much lower incidence of antipsychotic-induced side effects.

Expanding roles for radiology administrators.

In a fast-moving trend, radiology administrators are being asked to assume responsibility for other hospital departments. Pressure to reduce costs is the primary force behind restructuring that results in expanded roles for managers. The changes mean fewer management positions and increased responsibilities for those who retain their jobs. To maximize their opportunities for success, radiology administrators should actively seek expanded duties; cultivate the support of medical leadership; use mentors, professional literature and organizations such as the AHRA to gear up for new responsibilities; and recognize negotiation and presentation skills as extremely valuable assets.

Getting ready for reform.

Most hospitals and radiology departments are feeling the pressure of increased competition and consumerism. Mr. Bouchard discusses trends and possible solutions, and provides lists of practical strategies administrators can use to cope with financial repositioning.

[Cesarians on dairy cows: 159 cases]. / Césarienne chez la vache laitière: 159 cas.

A retrospective study on 159 cesareans on dairy cows referred between 1985 and 1989 to the veterinary teaching hospital is reported. The objective of the study was to evaluate the probability and the factors associated with survival and subsequent calving. The risk of dying for the cows was 24% following surgery. The risk of dying differed if the cow had an emphysematous, dead, or live calf; it was 63%, 21%, and 14%, respectively. Of all the cows returned to the farm and for which there was a breeding recorded, 64% calved again. But only 28% of all the cows returned home and, therefore, only 17% of all the referred cases calved again. We used multivariate analysis to obtain a predictive model on prognosis following surgery. The prognosis was only influenced by the calf condition at admission.