Effects of immunization against luteinizing hormone-releasing hormone and treatment with trenbolone acetate on reproductive function of beef bulls and steers.

The objectives of this study were 1) to evaluate the ability of trenbolone acetate (TBA) administered in tandem with LHRH immunization to suppress reproductive function in bulls and 2) to examine the effects of LHRH and androgen (TBA) signaling on pituitary gland function. Forty-four Angus × Hereford crossbred calves (BW=225 ± 2 kg; age=187 ± 6 d) received castration, LHRH immunization, or TBA administration in a 2 × 2 × 2 factorial design. Treatment groups receiving LHRH immunization contained 6 animals, whereas other treatment groups contained 5 animals. Animals immunized against LHRH received a primary injection and 2 booster injections of ovalbumin-LHRH-7 fusion protein on d 0, 42, and 196, respectively. Animals treated with TBA were implanted on d 224. Serum LHRH antibodies increased (P<0.05) after each booster for immunized animals, but were negligible in nonimmunized animals throughout the experiment. Serum testosterone concentration (P<0.001) and scrotal circumference (P<0.05) were depressed in LHRH-immunized bulls compared with nonimmunized bulls by d 84 and 168 of the experiment, respectively. Treatment with TBA tended (P=0.08) to decrease serum testosterone concentrations of nonimmunized bulls. Weights of testes at slaughter were decreased (P<0.001) for LHRH-immunized (232 ± 41 g) compared with nonimmunized (752 ± 45 g) bulls, but did not differ (P=0.80) between TBA-implanted (500 ± 49 g) and nonimplanted bulls (484 ± 36 g). Both LHRH immunization and castration decreased pituitary gland stores of LH and FSH (P<0. 001). There was no effect (P>0.10) of TBA on pituitary gland FSH content and only a tendency (P=0.09) to increase pituitary gland LH content. Immunization against LHRH decreased expression of LH ß-subunit and common α-subunit genes (P<0.001). Castration increased expression of LH ß-subunit and common α-subunit genes (P=0.02). Treatment with TBA further suppressed (P=0.04) α-subunit mRNA expression in LHRH-immunized steers. In summary, LHRH immunization decreased synthesis and storage of LH and decreased storage, but not synthesis of FSH in bulls. The increased synthesis of LH and FSH in nonimmunized, but not LHRH-immunized steers suggests that castration removes the negative feedback on gonadotropin synthesis but that LHRH is still needed for release of these hormones. Androgen replacement with TBA did not restore the negative feedback control of gonadotropin synthesis.

Factors affecting preovulatory follicle diameter and ovulation rate after gonadotropin-releasing hormone in postpartum beef cows. Part I: Cycling cows.

Cows induced to ovulate small dominant follicles were reported to have reduced pregnancy rates compared with cows that ovulated large follicles. The reason for the presence of small dominant follicles at the time of GnRH-induced ovulation in timed AI protocols is unknown. The objectives of this experiment were to examine the role of day of the estrous cycle at initiation of treatment on ovulation after the first GnRH injection (GnRH1) and associated effects on growth rate and final size of the ovulatory follicle at the second GnRH injection (GnRH2), serum concentrations of estradiol at GnRH2, and subsequent luteal concentrations of progesterone in suckled beef cows. Estrous cycles of cows were manipulated to be at 1 of 5 specific days of the cycle (d 2, 5, 9, 13, and 18, d 0 = estrus; n = 12 per treatment group) at the beginning of the CO-Synch protocol (GnRH1 on d -9, PGF(2alpha) on d -2, and GnRH2 on d 0). Day of the estrous cycle at GnRH1 did not affect the size of the preovulatory follicle or the proportion of cows ovulating at GnRH2 (P = 0.65 and 0.21, respectively). When all cows were included in the analysis, cows that ovulated after GnRH1 had similar follicle size at GnRH2 compared with cows that did not ovulate after GnRH1 (11.4 and 10.4 mm, respectively; P = 0.23). When only cows that could ovulate after GnRH1 (excluding cows treated on d 2) were included in the analysis, cows that ovulated to GnRH1 had a larger follicle at GnRH2 than cows that did not ovulate after GnRH1 (11.4 and 9.5 mm, respectively; P = 0.04). Follicle growth from d -5 to 0 was similar between cows that ovulated after GnRH1 and cows that did not (1.01 vs. 0.89 mm/d, respectively; P = 0.75). There was a tendency for faster follicle growth rate in cows that ovulated a large follicle (>11 mm) compared with cows that ovulated a small follicle (< or = 11 mm; 1.01 vs. 0.86 mm/d, respectively; P = 0.07). Serum concentrations of estradiol at GnRH2 and progesterone after ovulation were reduced in cows that ovulated small follicles compared with cows that ovulated large follicles (P = 0.006 and 0.005, respectively). In summary, day of the estrous cycle at initiation of synchronization did not affect ovulatory follicle size, but follicle growth rates affected the size of the follicle at GnRH2. Cows that ovulated a small follicle had reduced serum concentrations of estradiol at GnRH2 and progesterone after ovulation.

Factors affecting preovulatory follicle diameter and ovulation rate after gonadotropin-releasing hormone in postpartum beef cows. Part II: Anestrous cows.

There is large variation in dominant follicle diameter at the time of GnRH-induced ovulation in the CO-Synch protocol [a first GnRH injection on d -9 (GnRH1), followed by PGF(2alpha) on d -2, and a second GnRH injection (GnRH2) with timed AI on d 0], and the reason for the presence of small dominant follicles at GnRH2 is not known. Our hypothesis was that ovulatory response to GnRH1 and progesterone exposure [controlled intravaginal drug-releasing insert (CIDR; EAZI-Breed, Pfizer Animal Health, New York, NY)] would affect ovulatory follicle size at GnRH2 in anestrous cows. This study used a 2 x 2 factorial arrangement of treatments in which anestrous suckled beef cows (n = 55) either ovulated (Ov1+) or failed to ovulate (Ov1-) after GnRH1 and either received (CIDR+) or did not receive (CIDR-) a 7-d CIDR treatment (from GnRH1 to PGF(2alpha)), resulting in the following treatment groups: Ov1+CIDR+, Ov1-CIDR+, Ov1+CIDR-, and Ov1-CIDR- (n = 9, 17, 11, and 18, respectively). The Ov1+ cows had larger follicles at GnRH2 (12.3 vs. 11.0 mm; P = 0.04), a decreased proportion of small follicles within cows that ovulated to GnRH2 (2/16 vs. 14/23; P = 0.003), and a similar growth rate of the ovulatory follicle from d -5 to 0 (d 0 = GnRH2; 1.1 +/- 0.06 vs. 1.1 +/- 0.07 mm/d; P = 0.99) compared with Ov1- cows. Administration of a CIDR had no effect on follicle diameter at GnRH2 (11.8 vs. 11.2 mm; P = 0.3), proportion of small ovulatory follicles at GnRH2 (7/19 vs. 9/20; P = 0.6), and follicular growth rate from d -5 to 0 (d 0 = GnRH2; 1.2 +/- 0.07 vs. 1.1 +/- 0.07 mm/d; P = 0.76). Administration of a CIDR, but not ovulation to GnRH1, increased follicle growth from d -2 to 0 (d 0 = GnRH2; P = 0.03 and 0.9, respectively). Large follicles (>11 mm) had a similar growth rate from d -5 to 0 (d 0 = GnRH2; P = 0.44) compared with small follicles (1.1 +/- 0.07 vs. 1.2 +/- 0.07 mm/d), but the large ovulatory follicles were larger at d -5 compared with small ovulatory follicles (P < 0.001). Follicle diameter was positively correlated with serum concentrations of estradiol at GnRH2 (r = 0.622; P < 0.0001). In summary, ovulation to GnRH1, but not CIDR administration, resulted in increased dominant follicle diameter at GnRH2 in anestrous suckled beef cows. Large follicles were already larger 5 d before GnRH2 but grew at a rate similar to small follicles; follicle size was positively correlated with serum concentrations of estradiol at the time of GnRH-induced ovulation.

Qualitative study of clinic staff members' experiences using an immunization registry.

OBJECTIVES: To examine individual clinic staff members' experiences with using an immunization registry and to compare staff members' perceptions of immunization registries across different provider sites. DESIGN: Cross-sectional survey using in-depth interviews and direct observation. SETTINGS: The pediatric department of an urban community health center and 2 urban hospital-based pediatric primary care clinics. PARTICIPANTS: Twenty-five subjects were recruited using maximum variation sampling at each site. The subjects included clerks, clinic assistants, licensed practical nurses, a nurse practitioner, and registered nurses. MAIN OUTCOME MEASURES: Clinic staff members' perceptions of an immunization registry and frequency of registry use. RESULTS: Differences were observed in subjects' perceptions of an immunization registry across provider sites. Although most subjects had positive attitudes toward the registry, they did not necessarily believe that the registry decreased their workload. The ability to access immunization registry data and actual use of the registry seem to be related to training of clinic personnel, location of the registry terminal, and helpfulness and availability of registry staff. CONCLUSION: Obtaining the opinions of immunization registry users is an important strategy to evaluate the usefulness of a registry in a site and target possible areas for improvement.

The cost to providers of participating in an immunization registry.

INTRODUCTION: The medical and public health communities advocate immunization registries as one tool to achieve national immunization goals. Although substantial resources have been expended to establish registries across the nation, minimal research has been conducted to evaluate provider participation costs. METHODS: The objective of this study was to identify the direct costs to participate in an immunization registry. To estimate labor and equipment costs, we conducted interviews and direct observation at four sites that were participating in one of two immunization registries. We calculated mean data-entry times from direct observation of clinic personnel. RESULTS: The annual cost of participating in a registry varied extremely, ranging from $6083 to $24,246, with the annual cost per patient ranging from $0.65 to $7. 74. Annual per-patient costs were lowest in the site that used an automated data-entry interface. Of the sites requiring a separate data-entry step, costs were lowest for the site participating in the registry that provided more intensive training and had a higher proportion of the target population entered into the registry. CONCLUSIONS: Ease of registry interface, data-entry times, and target population coverage affect provider participation costs. Designing the registry to accept electronic transfers of records and to avoid duplicative data-entry tasks may decrease provider costs.

Measuring immunization registry costs: promises and pitfalls.

INTRODUCTION: The medical and public health communities advocate the use of immunization registries as one tool to achieve national goals for immunization. Despite the considerable investment of resources into registry development, little information is available about the costs of developing or maintaining a registry. METHODS: The objective of this study was to measure the direct costs of maintaining one immunization registry. Cost and resource-use data were collected by interviewing registry personnel and staff at participating pediatric practices, collecting available financial records, and direct observation. RESULTS: The estimated direct cost for maintaining the registry during the 3 calendar years 1995 through 1997 was $439,232. In 1997, this represented an annual cost of $5.26 per child immunized whose record was entered into the registry. In all years, personnel expenses represented at least three fourths of the total costs, with the majority of administrative effort donated. Yearly costs increased over time largely because of growing administrative personnel requirements as the registry became fully operational. CONCLUSION: Considerable resources are required to establish and maintain immunization registries. Because personnel costs, particularly nontechnical personnel, represent a large portion of total registry costs, it is important to accurately account for donated effort. Recommendations for future registry cost studies include prospective data collection and focusing upon the costs of providing specific outreach or surveillance functions rather than overall registry costs. In addition, registry effectiveness evaluations are needed to translate registry costs into cost-effectiveness ratios.