Factors determining milk quality and implications for production structure under somatic cell count standard modification.

Consumer and processor demand for high-quality milk has placed increasing pressure on US milk producers to achieve higher product standards. International standards for somatic cell count (SCC) are becoming more stringent, but in May 2011, the United States National Conference on Interstate Milk Shipments chose to retain the 750,000 cells/mL standard. Using ordinary least squares and quantile regressions on US Department of Agriculture Agricultural Resource Management Survey Dairy Costs and Returns Report data for 2005, we model producer and farm-level characteristics associated with SCC. Quantile regression analysis allows for a more parsed inquiry into statistical associations. Dairy Costs and Returns Report data provide cross-sectional information on the physical structure, input expenses, demographics, and outputs for farms in selected states. Location outside the Southeast, lower herd age, full-time farming status, use of biosecurity guidelines, good milking facilities and operations management, and application of related quality tests are all associated with lower SCC levels. Size of operation had little effect on SCC levels after controlling for other factors. Many of the operations that did not attain a more demanding SCC standard of 400,000 cells/mL had older operators, operators who expressed intention to exit within 10 yr, smaller size, and location in the Southeast when compared with those meeting the tighter standard. The results suggest that the stricter scheme favors larger farms that are more committed to production and are less likely to be sole or family proprietorships.

Better psychological functioning and higher social status may largely explain the apparent health benefits of wine: a study of wine and beer drinking in young Danish adults.

BACKGROUND: Findings from a recent series of Danish studies suggest that moderate wine drinkers are healthier than those who drink other alcoholic beverages or those who abstain. OBJECTIVE: To identify possible explanatory factors associated with the health benefits of wine consumption through the examination of a wide spectrum of social, cognitive, and personality characteristics related to both beverage choice and health in young Danish adults. SUBJECTS AND METHODS: Descriptive cross-sectional study of characteristics associated with beverage choice in a sample of 363 men and 330 women between the ages of 29 and 34 years, selected from the Copenhagen Perinatal Cohort on the basis of perinatal records. MAIN OUTCOME MEASURES: Socioeconomic status, education, IQ, personality, psychiatric symptoms, and health-related behaviors, including alcohol consumption, were analyzed. The outcome variables were subjected to linear and logistic regression analyses with 2 factors (beer and wine), each with 2 levels (drinking or not drinking a certain beverage type). RESULTS: Wine drinking was significantly associated with higher IQ, higher parental educational level, and higher socioeconomic status. Beer drinking was significantly associated with lower scores on the same variables. On scales concerning personality, psychiatric symptoms, and health-related behaviors, wine drinking was associated with optimal functioning and beer drinking with suboptimal functioning. CONCLUSIONS: Our data demonstrate that wine drinking is a general indicator of optimal social, cognitive, and personality development in Denmark. Similar social, cognitive, and personality factors have also been associated with better health in many populations. Consequently, the association between drinking habits and social and psychological characteristics, in large part, may explain the apparent health benefits of wine.

Phosphorylation of the Fas associated factor FAF1 by protein kinase CK2 and identification of serines 289 and 291 as the in vitro phosphorylation sites.

We previously identified the human Fas associated factor (FAF1) as one of the interacting partners of protein kinase CK2 beta subunit. Since FAF1 is a phosphoprotein we investigated whether it is a substrate for CK2. Here, we report the full length human FAF1 cDNA sequence, expression of FAF1 in Escherichia coli and purification and characterization of FAF1 as a substrate for CK2. FAF1 as well as an N-terminal 40 kDa degradation product serve as substrates for both the recombinant CK2 holoenzyme (km 100 microM) and the isolated catalytic alpha subunit (km 200 microM). Despite the high k(m) values, we obtained evidence that CK2 is the major cellular kinase responsible for FAF1 phosphorylation, using tissue extracts as kinase sources. By MALDI-MS we identified the two serine residues at positions 289 and 291 as the major in vitro CK2 phosphorylation sites. These data may help us elucidate the functions of FAF1 and the involvement of CK2 mediated phosphorylation in processes such as apoptotic signaling, ubiquitination, nuclear translocation and embryonic development.

Conditioned emotional responding under diazepam: a psychophysiological study of state dependent learning.

An experimental study on 34 healthy male volunteers demonstrated that a therapeutic dose of diazepam (15 mg PO) influenced the reproduction of a conditioned emotional response (skin conductance activity) on subsequent test days. This effect depended upon the pharmacological state present at acquisition, and was in accordance with a drug-dissociation interpretation of diazepam's amnesic effect. The results are interpreted as an example of diazepam state-dependency effects upon development of behavioral tolerance to stress. The clinical consequence of the results indicates that patients under diazepam medication will to a certain degree be deprived of the ability to develop appropriate coping strategies. It is concluded that combining psychotherapy with diazepam treatment may have the opposite effects to those intended.

Logistics of referral, diagnostic assessment and treatment of patients with breast symptoms and signs.

BACKGROUND AND AIMS: The logistics of diagnosis and treatment in a hospital with slightly above 400 new cases of breast cancer per year is analysed. MATERIALS AND METHODS: The patient flow from referral, through the diagnostic procedures and through surgical treatment is described. RESULTS AND CONCLUSIONS: The basic principle of the diagnostic assessment is the triple diagnostic procedure including mammography supplemented by ultrasonography, fine needle aspiration cytology and clinical examination. The radiologist and pathologist are working together in the breast diagnostic centre and are thus able to give a "single visit diagnosis" in most cases. The surgeon sees the patient either the same day or the next. A "consensus meeting" held each week with representatives for all specialities present has an important function in quality assurance and education. If one or more of the triple diagnostic components reach conclusion level "suspicious lesion", surgery is indicated. In hospital management is based on day surgery for all biopsies, wide excisions with or without sentinel node and some ablatio simplex mammae. For wide excision and ablation with complete axillary node clearance, the patients are transferred from the day surgery unit to a patient hotel after 3-4 hours of observation and stay till the drain can be removed. Only in rare case of high cardiopulmonary risk, beds in ordinary wards are used. This is a highly cost efficient logistic saving the hospital approximately 400,000 EUR a year compared to ordinary in hospital treatment.

Comparison of psychomotor performance after intravenous and rectal diazepam.

Twenty-four healthy subjects participated in a triple crossover study in which some of the widely used psychomotor tests were applied as indicators of psychomotor ability. Diazepam was administered in doses of 10 mg intravenously, 10 mg rectally, and 35 mg rectally. Plasma levels of diazepam and performance decrement in the Trieger dot test (DOT), the perceptual speed test (PST), the digit symbol substitution test (DSST), and continuous reaction time were measured up to 12 hr after administration. The psychomotor effects were quite similar after administration of 10 mg diazepam intravenously and rectally. When the 35-mg rectal administration was compared to the 10-mg administrations, performance was still affected at 12 hr.

[Prophylactic use of prostaglandin synthesis inhibitors in connection with IUD insertion]. / Profylaktisk brug af prostaglandinsyntesehaemmere ved oplaegning af spiral.

In a double-blind, randomized, placebo-controlled study conducted at a contraception clinic, 55 women (three nulliparous) were given either ibuprofen 600 mg or placebo 1-4 hours prior to insertion of IUD, 4-6 hours after insertion of IUD and the following morning. Pain was assessed by ten point Numerical Rating Scales during insertion, in the first 4-6 hours and in the following three days. No benefit of ibuprofen was demonstrated at insertion or at any other time during the first three days. The patients were further randomized to type of IUD: TCu-380A and Nova T (R.). No difference in pain scores was evaluated between these.

PIP: In a double-blind, randomized, placebo-controlled study conducted at a family planning clinic in Herlev, County of Copenhagen, during the period of May 1994 to May 1995, a total of 55 women were randomized in the following 4 groups according to treatment: 1) ibuprofen and the Gyne T 380 IUD, 2) ibuprofen and Nova T IUD, 3) placebo and Gyne T 380 IUD, and 4) placebo and Nova T IUD. All women were given either ibuprofen 600 mg or placebo 1-4 hours prior to insertion of an IUD, 4-6 hours after insertion, and the morning after insertion. Pain was assessed by a 10-point Numerical Rating Scale during insertion, in the first 4-6 hours, and over the following 3 days. The median values of pain intensity for Nova T and Gyne T were 3.0/2.9 at insertion, 1.6/1.9 during the first 4-6 hours, 1.3/1.5 during the first day, 1.1/1.3 the next day, and 1.1/1.1 on the third day after insertion. The median values of pain intensity for the ibuprofen/placebo groups were 3.3/2.5 at insertion, 1.7/1.8 during the first 4-6 hours, 1.4/1.3 during the first day, 1.3/1.1 the next day, and 1.1/1.1 on the third day after insertion. Among the women who had just given birth only 6% had intensity of pain over point 3 after 4-6 hours and none of them had it beyond the first day. 38% had significantly more pain (3) at insertion; this problem could be prevented by local anesthesia. No benefit of ibuprofen was demonstrated at insertion or at any other time during the first three days. The patients were further randomized according to the type of IUD: TCu-380A and Nova T. No difference in pain scores was ascertained between these groups.

[Atypical endometrial hyperplasia. Prognosis and course]. / Atypisk hyperplasi i endometriet. Prognose og forløb.

The treatment of patients with the diagnosis atypical endometrial hyperplasia has been disputed during the last decades. The aim of the study was to evaluate the treatment of these patients and analyse the progression rate to invasive carcinoma of the endometrium. Fifty-seven patients with atypical hyperplasia were examined and treated from 1976 through 1991. The medical records were examined retrospectively and the pathology slides were revised by one pathologist in accordance with the 1975 WHO recommendations. Thirty-one (54%) patients were on oestrogen treatment as monotherapy at the time of diagnosis. Forty-two patients had a hysterectomy performed within five months, and five patients had a hysterectomy performed 10 to 61 months after diagnosis. A total of 18 out of 57 patients (31.6%) had or developed endometrial carcinoma all with myometrial invasion: 14 stage I with < or = 50% myometrial invasion, three stage I with > 50% myometrial invasion, and one stage IV. There was no significant difference in age, body mass index, parity or hormone replacement treatment between the group with endometrial carcinoma and the group without endometrial carcinoma. We conclude that unopposed oestrogen treatment and nulliparity are the main risk factors for atypical hyperplasia and that hysterectomy is the appropriate treatment for patients with atypical hyperplasia of the endometrium.

[Long-term effect of 131I therapy of multinodular non-toxic goiter]. / Langtidseffekten af 131I-behandling ved multinodøs atoksisk struma.

The aim of this study was to investigate the long term effect of 131I treatment on thyroid function and size in patients with non-toxic multinodular goitre. The subjects were 69 consecutive patients with multinodular non-toxic goitre selected for 131I treatment and followed for a minimum of 12 months. Outcome measures were standard thyroid function variables and ultrasonically determined thyroid volume before and after treatment. Fifty-nine patients were treated with a single dose of 131I, 12 with two doses, and one with four doses. In 45 patients treated with one dose who remained euthyroid the median thyroid volume was reduced from 73 (interquartile range 50-106) ml to 29 (interquartile range 23-48) ml at 24 months. The median reduction was 40 (22-48) ml, half of which occurred within three months. Patients treated with two doses as well as those developing hypo- or hyper-thyroidism also had a significant reduction in thyroid volume. Eleven patients developed hypothyroidism (cumulative five year risk 22%). Side effects were few. In conclusion we find that 131I treatment of multinodular non-toxic goitre is an attractive alternative to surgery.

[Treatment of isolated systolic hypertension in the elderly by general practitioners]. / Praktiserende laegers behandling af isoleret systolisk hypertension hos aeldre.

By means of a questionnaire investigation, 150 general practitioners selected at random were asked about how they defined isolated systolic hypertension in elderly individuals, whether they employed medicinal treatment of this patients group and what their reasons for this were. The mean values for the highest systolic blood pressure which were considered to be normal were 175, 185 and 200 mmHg for the age groups 60-69 years, 70-79 years and > or = 80 years. Only approximately one fourth of Danish general practitioners consider medicinal treatment of isolated systolic hypertension and only at a much higher systolic blood pressure level than shown by a corresponding investigation among American doctors where 89% employ treatment for isolated systolic hypertension. On the basis of the present strategy in Denmark and the recent results from the first prospective placebo-controlled investigation of the treatment of isolated systolic hypertension, the future therapeutic strategy is discussed.

Analgesic and antiemetic effect of ketorolac vs. betamethasone or dexamethasone after ambulatory surgery.

BACKGROUND: Glucocorticoids are known to provide slower onset and more prolonged duration of analgesic effect than ketorolac. In the present study, we wanted to evaluate the effect over time from a single dose of either intravenous (i.v.) dexamethasone or an intramuscular (i.m.) depot formulation of betamethasone compared with i.v. ketorolac. MATERIALS AND METHODS: One hundred and seventy-nine patients admitted for mixed ambulatory surgery were included in the study. After induction of general i.v. anaesthesia, the patients were randomized to receive double-blindly either dexamethasone 4 mg i.v. (Group D) or betamethasone depot formulation 12 mg i.m. (Group B) or ketorolac 30 mg i.v. (Group K). Fentanyl was used for rescue analgesic medication in the post-operative care unit (PACU) and codeine with paracetamol after discharge, for a study period of 3 days. RESULTS: There was significantly less post-operative pain in the ketorolac group during the stay in the unit (88% with minor or less pain in Group K vs. 74% and 67% in Groups D and B, respectively, P < 0.05), significantly less need for rescue medication (P < 0.05) and significantly less nausea or vomiting (12% in Group K vs. 30% in the other groups pooled, P < 0.05). The ketorolac patients were significantly faster for ready discharge, median 165 min vs. 192 min and 203 min in Groups D and B, respectively (P < 0.01). There were no differences between the groups in perceived pain, nausea, vomiting or rescue analgesic consumption in the 4- to 72-h period. CONCLUSION: Dexamethasone 4 mg or bethamethasone 12 mg did not provide prolonged post-operative analgesic effect compared with ketorolac 30 mg, which was superior for analgesia and antiemesis in the PACU.

Potential misclassification of causes of death from COPD.

Little is known about causes of death in chronic obstructive pulmonary disease (COPD) and the validity of mortality statistics in COPD. The present authors examined causes of death using data from the Copenhagen City Heart Study. Of the 12,979 subjects with sufficient data from the baseline examination during 1976-1978, 6,709 died before 2001. Of these, 242 died with COPD as cause of death. Among subjects with at least severe COPD at baseline, only 24.9% had COPD as cause of death and, in almost half of the cases where COPD was listed as cause of death, the subject had a normal forced expiratory volume in one second /forced vital capacity ratio at baseline. In COPD patients, having COPD on the death certificate was associated with chronic mucus hypersecretion (CMH) at baseline, an odds ratio (OR) of 3.6 (95% confidence interval 1.7-7.7), and being female (OR 2.7 (1.3-5.6)). In subjects without COPD, CMH and smoking were predictors of COPD as underlying cause of death, ORs 2.3 (1.5-3.7) and 2.2 (1.4-3.6), respectively. It was concluded that chronic obstructive pulmonary disease is underreported on death certificates, that biases in the use of chronic obstructive pulmonary disease as cause of death can be assessed, and that possible "over-diagnosis" of chronic obstructive pulmonary disease on death certificates in subjects unlikely to have significant disease should initiate caution when using causes of mortality in chronic obstructive pulmonary disease epidemiology.

National character does not reflect mean personality trait levels in 49 cultures.

Most people hold beliefs about personality characteristics typical of members of their own and others' cultures. These perceptions of national character may be generalizations from personal experience, stereotypes with a "kernel of truth," or inaccurate stereotypes. We obtained national character ratings of 3989 people from 49 cultures and compared them with the average personality scores of culture members assessed by observer ratings and self-reports. National character ratings were reliable but did not converge with assessed traits. Perceptions of national character thus appear to be unfounded stereotypes that may serve the function of maintaining a national identity.

Electrodermal activity in anxiety disorders.

Forty anxiety patients diagnosed according to DSM-III-R criteria were included: panic disorder (n = 12), agoraphobia (n = 11), generalized anxiety disorder (n = 9), anxiety disorder not otherwise specified (n = 8) and compared with 12 controls. Millon Clinical Multiaxial Inventory and Symptom Checklist-90R symptom and personality scales did not separate the diagnostic groups. Electrodermal activity showed delayed habituation and high spontaneous skin resistance fluctuations in the panic and agoraphobia groups compared with the non-panic groups. The generalized anxiety disorder patients could not be separated from the controls, and the anxiety disorder not otherwise specified patients showed less electrodermal activity than the controls on most variables. In contrast to self-report instruments, electrodermal activity discriminated between diagnostic groups of patients with DSM-III-R anxiety disorders, more specifically between patients with and without panic attacks.

Electrodermal lability in anxiety disorders.

Twenty-eight anxiety patients, aged below 50 years, were diagnosed according to DSM-III-R criteria (panic disorder with and without agoraphobia, generalised anxiety disorder, and anxiety disorder not otherwise specified). The patients were characterised by high levels of state and trait anxiety and neuroticism, compared with the controls. However, there were no differences between patients and controls in electrodermal habituation rate, non-specific activity, or skin resistance level. When the patients were divided into electrodermally labile and stable subjects, significant differences were found between patients and controls in both electrodermal activity and Eysenck's personality dimensions. The labile patients were more introverted and attained higher psychoticism scores than either the stable patients or controls. Duration of anxiety symptoms removed the difference found in extroversion, but not in any other variable. The results are discussed in relation to the utility of electrodermal measurements in validation of diagnostic entities. It is concluded, that from the psychophysiological point of view, anxiety disorders may be examined within a dimensional framework.

Development of collagenous colitis in sequential biopsy specimens.

The present report describes the morphologic findings in sequential colorectal biopsy specimens obtained from 2 patients who within 1.5-2.5 yr developed collagenous colitis. The initial biopsy specimens revealed an acute nonspecific inflammatory reaction in the colorectal mucosa. An intermediate stage, characterized by edema and slight fibrosis in the subepithelial region of the colorectal mucosa, preceded the final development of collagenous colitis. We suggest that the mechanism that leads to the formation of a thick, bandlike subepithelial collagenous deposit in the colorectal mucosa may be triggered off by some inflammatory or toxic stimulus.

Temporal changes in cardiac function and cerebral blood flow during sequential postmenopausal hormone replacement.

OBJECTIVE: The purpose was to assess the temporal changes in cardiac function and cerebral blood flow during postmenopausal administration of estrogen with and without progestogen. STUDY DESIGN: Sixteen postmenopausal volunteers were assessed during estradiol plus sequential norethindrone acetate and placebo in two 12-week periods. Temporal changes were measured by magnetic resonance flow mapping 8 times. RESULTS: Systemic vascular resistance was reduced during estradiol (-6.9%; P <.05), declined further during the addition of norethindrone acetate, and was accompanied by an increase in stroke volume (maximum increase, 5.2%; P <.05) without fluid retention. Both systolic (-5 mm Hg; P =.03) and diastolic (-3 mm Hg; P =.03) blood pressure were reduced during estradiol. Cerebral blood flow was reduced after 9 weeks of hormone replacement therapy (-37 mL/min; P =.01) but increased to baseline after the addition of norethindrone acetate. CONCLUSIONS: Sequential hormone replacement therapy is associated with changes in cardiac function, which are of therapeutic potential in cardiovascular disorders. Sequential hormone replacement therapy exhibits an overall neutral effect on cerebral blood flow.