Associations between Johne's disease and fertility in UK dairy herds

The objective of this observational study was to quantify associations between Mycobacterium avium subspecies paratuberculosis (MAP) antibody status and a variety of fertility outcomes, in UK dairy cattle. Longitudinal milk recording, fertility and MAP antibody enzyme-linked immunosorbent assay (ELISA) milk test data were collated retrospectively from 121,762 lactations in 78 herds. Datasets were structured into appropriate units to suit outcomes and enable temporal association between current and future MAP status, and fertility measures. Current MAP status was categorised according to most recent status within 180 days, with time-related future MAP status assigned based on MAP antibody ELISA milk test data for each cow. Multilevel multivariable logistic regression models were used to evaluate associations between MAP status and 21-day pregnancy and submission rate and conception risk. Posterior predictions and cross-validation techniques were used to assess model fit and check model building assumptions. A negative association was found between risk of insemination (Odds Ratio [OR], 0.78; 95% Credible Interval [CI], 0.66-0.92) and conception occurring (OR, 0.65; CI, 0.5-0.84) and transition from negative to non-negative MAP test status in the next 30-90 days. A positive association was observed between risk of insemination (OR, 1.34; CI, 1.16-1.52) and conception occurring (OR, 1.26; CI, 1.11-1.43) and transition from negative to non-negative MAP test status in the next 90-180 days. Current positive MAP test status was negatively and positively associated with insemination (OR, 0.59; CI, 0.49-0.70) and conception risk (OR, 1.12; CI, 0.96-1.30), respectively. Herd managers will have had access to test results, declaring cows with past recent or multiple positive MAP antibody ELISA results not to be bred, negatively influencing insemination risk. Overall, these results demonstrate the temporal association between a positive MAP antibody ELISA result and dairy cow fertility outcomes, with particular variability prior to a positive MAP antibody ELISA result.

Randomized controlled field trial comparing quarter and cow level selective dry cow treatment using the California Mastitis Test

Selective use of antibiotic dry cow treatment can be implemented at the cow or quarter level, with the latter having the potential to further reduce antibiotic use. Our objective was to compare these 2 approaches in 6 herds in the United Kingdom in which environmental mastitis predominated. Eight hundred seven cows were enrolled and categorized as having a high cell count (n = 401) or low cell count (n = 406) in the last 3 mo of lactation and clinical mastitis history. All quarters of all enrolled cows received an internal teat sealant. Within each category, cows were randomly allocated to 1 of 3 groups; in one group antibiotic treatment was allocated at cow level (i.e., all 4 quarters received antibiotic), whereas in the 2 remaining groups antibiotic treatment was allocated at quarter level, based on California Mastitis Test (CMT) findings. Two different thresholds, score 1 and 2, were used to determine likely infection status. Quarter milk samples were collected at dry off and postcalving for bacteriological culture and somatic cell count (SCC). Cows were monitored for clinical mastitis from dry off until 100 d in milk. Cow level SCC and milk yield data were collated from farm records. Within each category, the 2 quarter level treatment groups were compared with cow level treatment at dry off. Leaving quarters untreated with intramammary antibiotic in cows in the high cell count group, with a CMT <2 or <1, reduced antibiotic use by 55% and 31%, respectively, and resulted in no difference in the odds of being infected with any pathogen postcalving, but was associated with a higher SCC at the first test day. Intramammary antibiotic treatment of quarters with a CMT ≥1 in cows in the low cell count category at dry off was not associated with any reduction in the odds of being infected with a major pathogen postcalving but was associated with a decrease in the odds of being infected with a minor mastitis pathogen postcalving. The use of antibiotics in quarters of cows categorized as low cell count at dry off, increased the proportion of quarters treated with antibiotic from 0% at cow level to 31% (CMT ≥ 1) and 12% (CMT ≥ 2) at quarter level, only resulting in a reduction in SCC of around 20,000 cells/mL at the first test day, if all quarters with CMT score ≥1 were treated with antibiotic. No differences in clinical mastitis incidence and milk yield in the first 100 d in milk were detected between any of the treatment groups. These study findings support selective quarter level dry off treatment only in cows with cow level SCC >200,000 cells/mL at dry off.

Routes to diagnosis and missed opportunities in the detection of renal cancer

AIM

To determine the proportion of renal cancers for which incidental detection was the route to diagnosis, the characteristics of tumours identified in this way, and the frequency with which opportunities to make this diagnosis were missed.

MATERIALS AND METHODS

Consecutive patients with renal cancers treated at Royal Cornwall Hospitals NHS Trust (April 2011 and July 2018 inclusive) were identified from the Trust's cancer registry database, and a retrospective review of the imaging and electronic case notes was undertaken. Mann-Whitney U-tests for comparison of patient age and tumour size at diagnosis, and chi-squared tests for comparing cell type distribution and grade were performed. Logistic regression was then used to identify the characteristics of patients in whom a renal tumour was missed initially.

RESULTS

Of 327 patients, 194 (63%) presented incidentally, and 133 (37%) symptomatically. Incidentally detected cancers were found in younger patients, (median of 65 years versus 69 p=0.01) and were smaller at presentation (median of 5.5 versus 7.2 cm, p<0.00001). Thirty-six different reporters missed opportunities to diagnose renal cancer in 50 (16%) patients on 78 occasions, 28 lesions (35%) being missed more than once. Thirty were imaged incompletely; four were visible only on a single image and three on a scout view at magnetic resonance imaging.

CONCLUSION

The commonest route to diagnosis of renal cancer is by incidental detection of a mass. In 16% of patients in whom renal cancer is diagnosed, there is at least one prior examination on which the lesion is visible at an earlier date. The clinical impact of these missed diagnostic opportunities remains uncertain.

The association between sleep and cognitive abnormalities in bipolar disorder

BACKGROUND

Bipolar disorder (BD) is associated with attentional and processing abnormalities. Such abnormalities are also seen in healthy subjects with sleep disruption. We hypothesised cognitive abnormalities in BD patients would be worse in those with objectively verified sleep abnormalities.

METHODS

Forty-six BD patients and 42 controls had comprehensive sleep/circadian rhythm assessment over 21 days alongside mood questionnaires. Cognitive function was assessed with a range of tasks including Psychomotor Vigilance Test (PVT), Attention Network Task (ANT) and Digit Symbol Substitution Test (DSST). BD participants with normal and abnormal sleep were compared with age- and sex-matched controls.

RESULTS

BD patients had longer response times and made more lapses (responses >500 ms) than controls on the PVT (both p < 0.001). However, patients with normal sleep patterns did not differ from controls while those with sleep abnormalities did (p < 0.001). An identical pattern of effects were seen with the ANT response times, with the abnormality in bipolar abnormal sleepers related to the executive attentional network. Similarly, patients made fewer correct responses on the DSST compared with the controls (p < 0.001). Bipolar normal sleepers did not differ while those with abnormal sleep did (p < 0.001). All these differences were seen in bipolar abnormal sleepers who were euthymic (p < 0.01) and across the main abnormal sleep phenotypes.

CONCLUSIONS

We confirm impairment in attention and processing speed in BD. Rather than sleep abnormalities exacerbating such dysfunction, the impairments were confined to bipolar abnormal sleepers, consistent with sleep disturbance being the main driver of cognitive dysfunction.

Factors affecting the cost-effectiveness of on-farm culture prior to the treatment of clinical mastitis in dairy cows

The objective of this study was to use probabilistic sensitivity analysis to evaluate the cost-effectiveness of using an on-farm culture (OFC) approach to the treatment of clinical mastitis in dairy cows and compare this to a ‘standard’ treatment approach. A specific aim was to identify the herd circumstances under which an OFC approach would be most likely to be cost-effective. A stochastic Monte Carlo model was developed to simulate 5000 cases of clinical mastitis at the cow level and to calculate the associated costs simultaneously when treated according to 2 different treatment protocols; i) a 'conventional' approach (3 tubes of intramammary antibiotic) and ii) an OFC programme, whereby cows are treated according to the results of OFC. Model parameters were taken from recent peer reviewed literature on the use of OFC prior to treatment of clinical mastitis. Spearman rank correlation coefficients were used to evaluate the relationships between model input values and the estimated difference in cost between the standard and OFC treatment protocols. The simulation analyses revealed that both the difference in the bacteriological cure rate due to a delay in treatment when using OFC and the proportion of Gram-positive cases that occur on a dairy unit would have a fundamental impact on whether OFC would be cost-effective. The results of this study illustrated that an OFC approach for the treatment of clinical mastitis would probably not be cost-effective in many circumstances, in particular, not those in which Gram-positive pathogens were responsible for more than 20% of all clinical cases. The results highlight an ethical dilemma surrounding reduced use of antimicrobials for clinical mastitis since it may be associated with financial losses and poorer cow welfare in many instances.

Sleep and circadian rhythm disturbance in bipolar disorder

BACKGROUND

Subjective reports of insomnia and hypersomnia are common in bipolar disorder (BD). It is unclear to what extent these relate to underlying circadian rhythm disturbance (CRD). In this study we aimed to objectively assess sleep and circadian rhythm in a cohort of patients with BD compared to matched controls.

METHOD

Forty-six patients with BD and 42 controls had comprehensive sleep/circadian rhythm assessment with respiratory sleep studies, prolonged accelerometry over 3 weeks, sleep questionnaires and diaries, melatonin levels, alongside mood, psychosocial functioning and quality of life (QoL) questionnaires.

RESULTS

Twenty-three (50%) patients with BD had abnormal sleep, of whom 12 (52%) had CRD and 29% had obstructive sleep apnoea. Patients with abnormal sleep had lower 24-h melatonin secretion compared to controls and patients with normal sleep. Abnormal sleep/CRD in BD was associated with impaired functioning and worse QoL.

CONCLUSIONS

BD is associated with high rates of abnormal sleep and CRD. The association between these disorders, mood and functioning, and the direction of causality, warrants further investigation.

A Bayesian micro-simulation to evaluate the cost-effectiveness of interventions for mastitis control during the dry period in UK dairy herds

Importance of the dry period with respect to mastitis control is now well established although the precise interventions that reduce the risk of acquiring intramammary infections during this time are not clearly understood. There are very few intervention studies that have measured the clinical efficacy of specific mastitis interventions within a cost-effectiveness framework so there remains a large degree of uncertainty about the impact of a specific intervention and its costeffectiveness. The aim of this study was to use a Bayesian framework to investigate the cost-effectiveness of mastitis controls during the dry period. Data were assimilated from 77 UK dairy farms that participated in a British national mastitis control programme during 2009-2012 in which the majority of intramammary infections were acquired during the dry period. The data consisted of clinical mastitis (CM) and somatic cell count (SCC) records, herd management practices and details of interventions that were implemented by the farmer as part of the control plan. The outcomes used to measure the effectiveness of the interventions were i) changes in the incidence rate of clinical mastitis during the first 30days after calving and ii) the rate at which cows gained new infections during the dry period (measured by SCC changes across the dry period from <200,000cells/ml to >200,000cells/ml). A Bayesian one-step microsimulation model was constructed such that posterior predictions from the model incorporated uncertainty in all parameters. The incremental net benefit was calculated across 10,000 Markov chain Monte Carlo iterations, to estimate the cost-benefit (and associated uncertainty) of each mastitis intervention. Interventions identified as being cost-effective in most circumstances included selecting dry-cow therapy at the cow level, dry-cow rations formulated by a qualified nutritionist, use of individual calving pens, first milking cows within 24h of calving and spreading bedding evenly in dry-cow yards. The results of this study highlighted the efficacy of specific mastitis interventions in UK conditions which, when incorporated into a costeffectiveness framework, can be used to optimize decision making in mastitis control. This intervention study provides an example of how an intuitive and clinically useful Bayesian approach can be used to form the basis of an on-farm decision support tool.

Invited review: Opportunities for genetic improvement of metabolic diseases

Metabolic disorders are disturbances to one or more of the metabolic processes in dairy cattle. Dysfunction of any of these processes is associated with the manifestation of metabolic diseases or disorders. In this review, data recording, incidences, genetic parameters, predictors, and status of genetic evaluations were examined for (1) ketosis, (2) displaced abomasum, (3) milk fever, and (4) tetany, as these are the most prevalent metabolic diseases where published genetic parameters are available. The reported incidences of clinical cases of metabolic disorders are generally low (less than 10% of cows are recorded as having a metabolic disease per herd per year or parity/lactation). Heritability estimates are also low and are typically less than 5%. Genetic correlations between metabolic traits are mainly positive, indicating that selection to improve one of these diseases is likely to have a positive effect on the others. Furthermore, there may also be opportunities to select for general disease resistance in terms of metabolic stability. Although there is inconsistency in published genetic correlation estimates between milk yield and metabolic traits, selection for milk yield may be expected to lead to a deterioration in metabolic disorders. Under-recording and difficulty in diagnosing subclinical cases are among the reasons why interest is growing in using easily measurable predictors of metabolic diseases, either recorded on-farm by using sensors and milk tests or off-farm using data collected from routine milk recording. Some countries have already initiated genetic evaluations of metabolic disease traits and currently most of these use clinical observations of disease. However, there are opportunities to use clinical diseases in addition to predictor traits and genomic information to strengthen genetic evaluations for metabolic health in the future.

Current management practices and interventions prioritised as part of a nationwide mastitis control plan

The objectives of this study were to report performance and management data taken from a sample of UK dairy farms that have participated in the Agriculture and Horticulture Development Board Dairy Mastitis Control Plan (DMCP) and to identify important mastitis prevention practices that are not currently widely implemented. A total of 234 UK dairy herds were included in the study from which farm management and udder health data were collected. Herds were grouped according to their mastitis epidemiology and could be classed as (i) environmental dry period (EDP) (i.e. environmental pathogen with majority of infections being acquired during the dry period), (ii) environmental lactation (EL), (iii) contagious dry period (CDP) or (iv) contagious lactation (CL). The results of this study showed that many mastitis-related management practices that are generally considered to be important were not widely performed. A better understanding of those practices not widely adopted by UK dairy farmers at present may aid practitioners in identifying and overcoming potential barriers to improved mastitis control.

Accuracy of preoperative CT T staging of renal cell carcinoma: which features predict advanced stage?

AIMS

To characterise CT findings in renal cell carcinoma (RCC), and establish which features are associated with higher clinical T stage disease, and to evaluate patterns of discrepancy between radiological and pathological staging of RCC.

MATERIALS AND METHODS

Preoperative CT studies of 92 patients with 94 pathologically proven RCCs were retrospectively reviewed. CT stage was compared with pathological stage using the American Joint Committee on Cancer (AJCC), 7(th) edition (2010). The presence or absence of tumour necrosis, perinephric fat standing, thickening of Gerota's fascia, collateral vessels were noted, and correlated with pT stage. The sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) for predicting pT stage ≥pT3a were derived separately for different predictors using cross-tabulations.

RESULTS

Twenty-four lesions were pathological stage T1a, 21 were T1b, seven were T2a, 25 were T3a, 11 were T3b, four were T3c, and two were T4. There were no stage T2b. Sixty-three (67%) patients had necrosis, 27 (29%) thickening of Gerota's fascia (1 T1a), 25 had collateral vessels (0 T1a), 28 (30%) had fat stranding of <2 mm, 20 (21%) of 2-5mm and one (1%) of >5 mm. For pT stage ≥pT3a, the presence of perinephric fat stranding had a sensitivity, specificity, PPV and NPV of 74%, 65%, 63%, and 76%, respectively. Presence of tumour necrosis had a sensitivity, specificity, PPV, and NPV of 81%, 44%, 54%, and 72%, respectively. Thickening of Gerota's fascia had a sensitivity, specificity, PPV, and NPV of 52%, 90%, 81% and 70%, respectively; and enlarged collateral vessels had a sensitivity, specificity, PPV, and NPV value of 52%, 94%, 88%, and 71% respectively.

CONCLUSION

The presence of perinephric stranding and tumour necrosis were not reliable signs for pT stage >T3a. Thickening of Gerota's fascia and the presence of collateral vessels in the peri- or paranephric fat had 90% and 94% specificity, with 82% and 88% PPV, respectively, for the presence of tumour stage for pT stage >T3a. These are considered reliable signs of locally advanced renal cancer.

The influence of reproductive hormones on the torpor patterns of the marsupial Sminthopsis macroura: bet-hedging in an unpredictable environment

Seasonal cycles of reproduction are common in many mammals and these are combined with the necessary energy budgeting for thermoregulatory challenges. Many mammals meet the challenge of changing environmental temperatures in winter by using torpor, a controlled reduction in body temperature and metabolic rate. We aimed to determine the effects of photoperiod and reproductive hormones on the seasonal cycles of reproduction and torpor use in a marsupial that commences reproduction in winter, the stripe-faced dunnart, Sminthopsis macroura. Males and females were placed under LD 14:10 and natural reproductive hormones blocked by either flutamide (males) or mifepristone (females) or tamoxifen (females). Reproductive parameters, metabolic rate and torpor variables were determined. The same animals were then placed under LD 10:14 and given testosterone (males) or progesterone (females) or oestrogen (females). Reproductive parameters, metabolic rate and torpor variables were measured. Body mass and tail widths (fattening indicator) in males were significantly affected by testosterone, and the effects were reversed by hormone blockers. Reproductive parameters were unaffected. Resting metabolic rate and ability to use torpor were not affected by treatment in males, however torpor characteristics, especially torpor bout duration, were affected by presence of testosterone in males. In females, body mass was unaffected by hormone presence, although tail widths were affected. Disruption of reproductive cycles occurred with hormone blockers in females, however, resting metabolic rate was not affected, and only presence of progesterone affected torpor characteristics in females. Our results differ from those found for rodents, where presence of testosterone abolishes the use of torpor in males, and oestrogen inhibits torpor use in females. Our study suggests that, in this mammal, metabolic responses to the presence or absence of reproductive hormones differs between males and females, and there is no absolute endocrinologically-driven reproductive season demarcated from the torpor season.

Non-elective percutaneous nephrostomy (PCN) service in a tertiary uroradiology centre: can radiologists and urologists agree on timing?

AIM

To assess agreement between uroradiologists and urologists with regards to the timing of non-elective percutaneous nephrostomy (PCN) catheter insertion, and whether any delay produced unacceptable complications.

MATERIALS AND METHODS

Standardized data collection forms detailing patient demographics, indications for PCN catheter insertion, blood results, procedural details, and immediate complications were completed by uroradiologists. At the time of referral, patients were stratified by both radiologists and urologists into three groups as follows: group 1 = PCN within 6 h; group 2 = PCN between 6 and 24 h; and group 3 = PCN between 24 and 48 h.

RESULTS

One hundred and eighteen non-elective PCN catheter insertions were performed over 2 years. Radiologists stratified 12 patients (10.2%) into group 1, 65 (55.1%) patients into group 2, and 41 (34.7%) patients into group 3. Urologists stratified 14 (11.9%) patients into group 1, 68 (57.6%) patients into group 2, and 36 (30.5%) patients into group 3. There was good agreement between radiologist and urologists (κ = 0.865) on stratification in all but nine (7.6%) cases. Ninety-four point one percent of PCN catheters were inserted within the timeframe stratified by radiologists and urologists, or sooner. Sepsis was associated with a shortened timeframe. Elevated international normalized ratio (INR; >1.5) resulted in an increased timeframe. A major complication rate of 3% is within recommended limits. Fourteen percent of PCN catheter insertions were inserted outside normal working hours. Urgency stratification has decreased the number of cases performed out of hours.

CONCLUSION

Radiologists and urologists had good agreement on stratification with an acceptable major complication rate of 3%.

A comparison of broad-spectrum and narrow-spectrum dry cow therapy used alone and in combination with a teat sealant

The dry period is a critical time in the lactation cycle, offering the optimum time for cure of existing intramammary infection (IMI), while also encompassing the periods of highest susceptibility to new intramammary infection. Until recent years, intramammary infection in the dry period has been controlled with the use of antibiotic dry cow therapy. The aim of this study was to investigate 3 different dry cow therapy regimens, in low-somatic cell count (SCC; bulk milk SCC<250,000 cells/mL) herds in southwest England. A total of 489 cows was recruited to the study and randomly allocated to receive either the broad-spectrum antibiotic cefquinome, a combination treatment comprising the narrow-spectrum antibiotic cloxacillin and an internal teat sealant, or the narrow-spectrum antibiotic cloxacillin alone. All quarters were sampled for bacteriology at drying off and again in the week immediately postcalving; 2 quarters were also sampled 2 wk before the estimated calving date to allow an assessment of infection dynamics during the dry period. Quarters were subsequently monitored for clinical mastitis for the first 100 d of lactation. Conventional multilevel (random effects) models were constructed to assess the efficacy of products in preventing IMI. Survival analysis was used to examine factors that influenced the risk of clinical mastitis using conventional Cox proportional hazards models. No differences were identified between the treatment groups in terms of cure of IMI caused by the major pathogens. Quarters in both the combination and cefquinome-treated groups were more likely to be free of a major pathogen or enterobacterial pathogen postcalving. With respect to clinical mastitis, the cefquinome-treated group was less likely to develop clinical mastitis than was the cloxacillin treated group.

Comparison of metabolic and prolactin variables from a six-month randomised trial of olanzapine and quetiapine in schizophrenia

Schizophrenia patients have a potential increased risk of metabolic dysregulation during antipsychotic treatments. Our objective was to compare changes in prolactin and metabolic variables (glucose, lipids and weight) as a post-hoc analysis from a six-month, randomised, controlled study of olanzapine (OLZ, n = 171; 10-20 mg/day) or quetiapine (QUE, n = 175; 300-700 mg/day). No statistically significant treatment group differences for baseline to endpoint mean changes in body mass index (P = 0.209) or weight (P = 0.250) were observed. There was a greater incidence of clinically significant weight gain (defined as > or =7% increase from baseline) in OLZ (19.2%) compared to QUE (13.2%)-treated patients (P = 0.181). No statistically significant treatment group differences for lipids and glucose variables, either as mean change from baseline to endpoint or treatment-emergent (TE) categorical changes were found (P > or = 0.05). Incidence rates for TE diabetes were similar between treatment groups 2.5% (n = 4) in the OLZ-treatment group and 1.3% (n = 2) in the QUE-treatment group (P = 0.685). Hyperprolactinaemia was present at baseline in many patients (OLZ 32.9%; QUE 31.4%), but after 2 weeks of treatment prolactin values had reverted to normal for nearly all patients (OLZ 100%; QUE 99.4%). There were no significant treatment differences in any variable between cohorts.

Invited review: The role of contagious disease in udder health

Contagious diseases are a threat to animal health and productivity, both nationally and at the farm level. This makes implementation of biosecurity measures to prevent their introduction and spread within countries and farms a necessity. Mastitis is the most common and costly contagious disease affecting dairy farms in the western world. The major mastitis pathogens are endemic in most countries, and biosecurity measures to prevent introduction and transmission must therefore be implemented at farm level. The 40-yr-old mastitis control plan remains a solid foundation to prevent the spread of contagious intramammary infections. Contagious diseases that do not affect the mammary gland directly may have an indirect effect on mastitis. This is true for list A diseases such as foot and mouth disease, for which biosecurity measures may need to be taken at national level, and for other infections with nonmastitis pathogens such as bovine viral diarrhea virus and Mycobacterium avium ssp. paratuberculosis. Maintaining a closed herd decreases the risk of introduction of pathogens that affect udder health directly or indirectly. If animals are purchased, their udder health history should be evaluated and they should be examined and tested for contagious diseases. Transmission of infections by and to humans and nonbovine animals may occur. Contact with visitors and nonbovine animals should therefore be minimized. Because of globalization and heightened consumer awareness, the importance of biosecurity now supersedes individual farms, and increased pressure to control transmission of contagious diseases can be expected at industry or government levels in western countries and elsewhere.

Changes in weight and metabolic parameters during treatment with antipsychotics and metformin: do the data inform as to potential guideline development? A systematic review of clinical studies

BACKGROUND

Changes in weight and metabolic parameters have been commonly reported in patients with schizophrenia. Metformin has been evaluated in clinical studies to prevent or reduce weight gain and changes in metabolic parameters in non-diabetic subjects. We undertook a systematic review of the efficacy and safety of metformin in reducing weight gain and metabolic abnormalities in non-diabetic subjects with schizophrenia or bipolar disorder taking antipsychotic medication to establish if these data could potentially drive guideline development.

METHODS

Medical databases were searched using terms including 'antipsychotic', 'atypical antipsychotic agent', 'antipsychotic agents', 'antipsychotic-drug' and 'metformin' and 'weight'. Studies reporting weight and/or metabolic outcomes in non-diabetic subjects with schizophrenia and bipolar disorder were included regardless of methodological type and subject age.

RESULTS

Nine randomised double-blind studies and two open cohort studies evaluating metformin and changes in weight in trials up to 16 weeks were identified. In all, 495 participants received antipsychotics (mostly olanzapine), and three studies were in subjects aged < 18 years. The adult studies predominantly utilised non-Caucasian subjects with chronic schizophrenia. Weight and lifestyle intervention programmes were provided to all cohorts in eight studies, which confounded interpretation of the data. In ten studies, the addition of metformin to antipsychotic treatment was associated with either significantly attenuated weight gain or weight loss compared with control groups. Nine studies measured various glucose parameters. In four studies, subjects prescribed metformin had significantly improved glucose parameters relative to controls. The two studies of metformin in patients with first-episode schizophrenia demonstrated the largest improvement in weight and glucose parameters.

CONCLUSIONS

Metformin may have some value in reducing or preventing weight gain and changes in metabolic parameters during treatment with antipsychotic medication particularly in first-episode psychosis; however, it has been predominantly studied short-term and in non-Caucasian populations. A number of new trials are due to report data 2009-2013 to aid definitive interpretation of the role of metformin. Further longer-term studies are warranted before definitive guidelines can be established.

Bayesian analysis of a mastitis control plan to investigate the influence of veterinary prior beliefs on clinical interpretation

The fundamental objective for health research is to determine whether changes should be made to clinical decisions. Decisions made by veterinary surgeons in the light of new research evidence are known to be influenced by their prior beliefs, especially their initial opinions about the plausibility of possible results. In this paper, clinical trial results for a bovine mastitis control plan were evaluated within a Bayesian context, to incorporate a community of prior distributions that represented a spectrum of clinical prior beliefs. The aim was to quantify the effect of veterinary surgeons’ initial viewpoints on the interpretation of the trial results.

A Bayesian analysis was conducted using Markov chain Monte Carlo procedures. Stochastic models included a financial cost attributed to a change in clinical mastitis following implementation of the control plan. Prior distributions were incorporated that covered a realistic range of possible clinical viewpoints, including scepticism, enthusiasm and uncertainty. Posterior distributions revealed important differences in the financial gain that clinicians with different starting viewpoints would anticipate from the mastitis control plan, given the actual research results. For example, a severe sceptic would ascribe a probability of 0.50 for a return of <£5 per cow in an average herd that implemented the plan, whereas an enthusiast would ascribe this probability for a return of >£20 per cow. Simulations using increased trial sizes indicated that if the original study was four times as large, an initial sceptic would be more convinced about the efficacy of the control plan but would still anticipate less financial return than an initial enthusiast would anticipate after the original study. In conclusion, it is possible to estimate how clinicians’ prior beliefs influence their interpretation of research evidence. Further research on the extent to which different interpretations of evidence result in changes to clinical practice would be worthwhile.

Quarter and cow risk factors associated with a somatic cell count greater than 199,000 cells per milliliter in United Kingdom dairy cows

Quarter and cow risk factors associated with a somatic cell count (SCC) >199,000 cells/mL at the next milk recording during lactation were investigated during a 12-mo longitudinal study on 8 commercial Holstein-Friesian dairy herds in Southwest England, United Kingdom. The individual risk factors studied on 1,677 cows included assessments of udder and leg hygiene, teat-end callosity and hyperkeratosis, body condition score (BCS), and measurements of monthly milk quality and yield. The outcome variable used for statistical analysis was the next recorded individual cow SCC >199,000 cells/mL. Statistical analysis included use of generalized linear mixed models. Significant covariates associated with an increased risk of SCC >199,000 cells/mL were increasing parity, increasing month of lactation, previous SCC (SCC 200,000 cells/mL and greater, odds ratio = 7.12), and cows with a BCS <1.5 (odds ratio = 2.09) or BCS >3.5 (odds ratio = 2.20). Significant covariates associated with a reduced risk of SCC >199,000 cells/mL were cows with contamination of the skin of the udder and quarters with mild (odds ratio = 0.65) and moderate (odds ratio = 0.62) hyperkeratosis of the teat-end. These results suggest that individual quarter and cow-level factors are important in the acquisition of intramammary infections as measured by SCC during lactation. Cow energy status, as measured by BCS, may influence the risk of intramammary infection during lactation.

Quarter and cow risk factors associated with the occurrence of clinical mastitis in dairy cows in the United Kingdom

Quarter and cow risk factors associated with the development of clinical mastitis (CM) during lactation were investigated during a 12-mo longitudinal study on 8 commercial Holstein-Friesian dairy farms in the southwest of England. The individual risk factors studied on 1,677 cows included assessments of udder and leg hygiene, teat-end callosity, and hyperkeratosis; body condition score; and measurements of monthly milk quality and yield. Several outcome variables for CM were used for statistical analysis, which included use of generalized linear mixed models. Significant covariates associated with an increased risk of CM were increasing parity, decreasing month of lactation, cows with very dirty udders, and quarters with only very severe hyperkeratosis of the teat-end. Thin and moderate smooth teat-end callosity scores were not associated with an increased risk for CM. Cows that recorded a somatic cell count >199,000 cells/mL and a milk protein percentage <3.2 at the first milk recording after calving were significantly more likely to develop CM after the first 30 d of lactation. There was no association between cow body condition score and incidence of CM. Of the cases of CM available for culture, 171 (26.7%) were confirmed as being caused by Escherichia coli and 121 (18.9%) confirmed as being caused by Streptococcus uberis. Quarters with moderate and very severe hyperkeratosis of the teat-end were at significantly increased risk of clinical E. coli mastitis before the next visit. Quarters with very severe hyperkeratosis of the teat-end were significantly more likely to develop clinical Strep. uberis mastitis before the next visit. There were strong trends within the data to suggest an association between very dirty udders (an increased risk of clinical E. coli mastitis) and teat-ends with no callosity ring present (an increased risk of clinical Strep. uberis mastitis). These results highlight the importance of individual quarter- and cow-level risk factors in determining the risk of CM associated with environmental pathogens during lactation.

Factors affecting cure when treating bovine clinical mastitis with cephalosporin-based intramammary preparations

Data were collated for an independent scientific analysis from 2 international, multicenter studies that had compared the efficacy of 3 different cephalosporin-containing intramammary preparations in the treatment of clinical mastitis in dairy cattle [cefalexin (first generation) in combination with kanamycin; cefquinome (fourth generation); and cefoperazone (third generation)]. Quarters were assessed using standard bacteriological techniques before treatment and at 16 and 25 d posttreatment. Additional data were also available on individual cows and study farms, including parity, breed, and cow somatic cell count histories, herd bulk milk somatic cell counts, and farm management regimens. Sufficient data for analysis were available from a total of 491 cases on 192 farms in 3 countries (United Kingdom, France, and Germany) with up to 16 cases being recruited from any one farm. Clinical cases were of diverse etiology, representing both contagious and environmental pathogens. Univariable analysis demonstrated that quarters in the cefalexin + kanamycin and cefquinome treatment groups were not significantly different from each other, but were both significantly more likely to be pathogen free posttreatment than quarters in the cefoperazone group. Multivariable analysis was undertaken using conventional random effects models. Two models were built, with the first incorporating only information available to the practitioner at the time of treatment and the second including all information collected during the study. These models indicated that country, pretreatment rectal temperature (above-normal temperature associated with an increased chance of being pathogen free posttreatment), individual cow somatic cell count (increased somatic cell count associated with a decreased chance of being pathogen free posttreatment), and pathogen (Staphylococcus aureus isolation associated with a decreased chance of being pathogen free posttreatment) were useful predictors of pathogen free status; parity, yield, bulk milk somatic cell counts, and other farm management factors were not. The importance of country in the analysis demonstrates the need to generate local data when assessing treatment regimens. In addition, these results suggest that the factors important in predicting the outcome of treatment of clinical mastitis cases may be dissimilar to those reported to affect the likelihood of cure when treating subclinical intramammary infections.

Cow, farm, and herd management factors in the dry period associated with raised somatic cell counts in early lactation

This study investigated cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on somatic cell counts (SCC) in early lactation. Data from 52 commercial dairy farms throughout England and Wales were collected over a 2-yr period. For the purpose of analysis, cows were separated into those housed for the dry period (6,419 cow-dry periods) and those at pasture (7,425 cow-dry periods). Bayesian multilevel models were specified with 2 response variables: ln SCC (continuous) and SCC >199,000 cells/mL (binary), both within 30 d of calving. Cow factors associated with an increased SCC after calving were parity, an SCC >199,000 cells/mL in the 60 d before drying off, increasing milk yield 0 to 30 d before drying off, and reduced DIM after calving at the time of SCC estimation. Herd management factors associated with an increased SCC after calving included procedures at drying off, aspects of bedding management, stocking density, and method of pasture grazing. Posterior predictions were used for model assessment, and these indicated that model fit was generally good. The research demonstrated that specific dry-period management strategies have an important influence on SCC in early lactation.

Comparison of the efficacy of cloxacillin alone and cloxacillin combined with an internal teat sealant for dry-cow therapy

All the quarters in the cows with high somatic cell counts in 10 herds were treated at drying off with either 600 mg cloxacillin or 600 mg cloxacillin and 4 g of an internal teat sealant containing 65 per cent bismuth subnitrate. The quarters were sampled daily for bacteriological tests for the three days before drying off and twice after calving to establish whether they were infected. Clinical mastitis cases were monitored from drying off until 100 days after calving. The odds of a quarter being bacteriologically negative after calving or developing clinical mastitis in the first 100 days after calving were investigated by multilevel logistic regression. The quarters treated with the internal sealant and cloxacillin were significantly more likely to be bacteriologically negative in the immediate period after calving and were significantly less likely to suffer clinical mastitis during the first 100 days after calving than the quarters treated with cloxacillin alone. There was more variation between cows than between herds in the underlying risk of an infection after calving, but there was more variation between herds than between cows in the underlying risk of clinical mastitis during the 100 days after calving.

Cow, farm, and management factors during the dry period that determine the rate of clinical mastitis after calving

The purpose of the research was to investigate cow characteristics, farm facilities, and herd management strategies during the dry period to examine their joint influence on the rate of clinical mastitis after calving. Data were collected over a 2-yr period from 52 commercial dairy farms throughout England and Wales. Cows were separated for analysis into those housed for the dry period (8,710 cow-dry periods) and those at pasture (9,964 cow-dry periods). Multilevel models were used within a Bayesian framework with 2 response variables, the occurrence of a first case of clinical mastitis within the first 30 d of lactation and time to the first case of clinical mastitis during lactation. A variety of cow and herd management factors were identified as being associated with an increased rate of clinical mastitis and these were found to occur throughout the dry period. Significant cow factors were increased parity and at least one somatic cell count > or = 200,000 cells/mL in the 90 d before drying off. A number of management factors related to hygiene were significantly associated with an increased rate of clinical mastitis. These included measures linked to the administration of dry-cow treatments and management of the early and late dry-period accommodation and calving areas. Other farm factors associated with a reduced rate of clinical mastitis were vaccination with a leptospirosis vaccine, selection of dry-cow treatments for individual cows within a herd rather than for the herd as a whole, routine body condition scoring of cows at drying off, and a pasture rotation policy of grazing dry cows for a maximum of 2 wk before allowing the pasture to remain nongrazed for a period of 4 wk. Models demonstrated a good ability to predict the farm incidence rate of clinical mastitis in a given year, with model predictions explaining over 85% of the variability in the observed data. The research indicates that specific dry-period management strategies have an important influence on the rate of clinical mastitis during the next lactation.

National intervention study of mastitis control in dairy herds in England and Wales

An intervention study was carried out on 52 dairy farms in England and Wales to determine whether the implementation of a well-specified mastitis control plan in herds with an incidence of clinical mastitis of more than 35 cases per 100 cows per year would reduce the incidence of clinical mastitis, and also reduce the incidence of increases in the somatic cell counts of individual cows. A clearly defined plan for the diagnosis and control of mastitis was developed by two veterinary specialists from the research literature. The herds were randomly allocated to receive the plan either at the start of the study (intervention herds) or after one year (control herds). Data on mastitis management and the farm environment were collected during farm visits. After one year there was a significant 22 per cent reduction in the proportion of cows affected with clinical mastitis on the intervention farms compared with the control farms. There were also significant reductions of approximately 20 per cent in the incidence of clinical mastitis and in the occurrence of increases in the somatic cell counts of individual cows from below, to above 200,000 cells/ml.

Survey of the incidence and aetiology of mastitis on dairy farms in England and Wales

A survey of clinical and subclinical mastitis was carried out on 97 dairy farms in England and Wales, selected at random from members of a national milk recording scheme. The farmers were asked to collect aseptic milk samples from five consecutive cases of clinical mastitis and from five quarters with high somatic cell counts using a defined protocol, and they completed a questionnaire that included information on the cows sampled, the herd and the history of mastitis in the herd. The samples were collected throughout the year. The mean incidence of clinical mastitis was 47 cases per 100 cows per year (estimated from historic farm records) and 71 cases per 100 cows per year (estimated from the samples collected). Streptococcus uberis and Escherichia coli were isolated in pure culture from 23.5 per cent and 19.8 per cent, respectively, of the clinical samples; 26.5 per cent of the clinical samples produced no growth. The most common isolates from the samples with high cell counts were coagulase-negative staphylococci (15 per cent), S uberis (14 per cent) and Corynebacterium species (10 per cent). Staphylococcus aureus and coagulase-positive staphylococci together accounted for 10 per cent of the samples with high somatic cell counts; 39 per cent produced no bacterial growth.

Plasma steroids and steroid-binding capacity in male semelparous dasyurid marsupials (Phascogale tapoatafa) that survive beyond the breeding season in captivity

The semelparous dasyurids display a unique life history, in that all males die within a few weeks of the completion of the breeding season. Studies of several semelparous species have revealed that the male die-off is stress-related, and accompanied by increased plasma androgen and cortisol levels and decreased corticosteroid binding capacity, resulting in suppression of immune and inflammatory responses. This study examines the endocrine profile of male brush-tailed phascogales (Phascogale tapoatafa) that survive beyond the breeding season in captivity. Plasma cortisol, corticosteroid binding globulin and albumin levels were monitored in both males and females and steroid partitioning calculated. Captive males surviving beyond the breeding season did not show the elevation in plasma cortisol and decrease in corticosteroid binding capacity reported in wild males. Plasma albumin concentrations also remained constant during the sampling period. These data indicate that captive males do not undergo the same stress response described in wild populations.

Identification and properties of steroid-binding proteins in nesting Chelonia mydas plasma

We report for the first time the presence of a sex steroid-binding protein in the plasma of green sea turtles Chelonia mydas, which provides an insight into reproductive status. A high affinity, low capacity sex hormone steroid-binding protein was identified in nesting C. mydas and its thermal profile was established. In nesting C. mydas testosterone and oestradiol bind at 4 degrees C with high affinity (K (a) = 1.49 +/- 0.09 x 10(9) M(-1); 0.17 +/- 0.02 x 10(7) M(-1)) and low binding capacity (B (max) = 3.24 +/- 0.84 x 10(-5) M; 0.33 +/- 0.06 x 10(-4) M). The binding affinity and capacity of testosterone at 23 and 36 degrees C, respectively were similar to those determined at 4 degrees C. However, oestradiol showed no binding activity at 36 degrees C. With competition studies we showed that oestradiol and oestrone do not compete for binding sites. Furthermore, in nesting C. mydas plasma no high-affinity binding was observed for adrenocortical steroids (cortisol and corticosterone) and progesterone. Our results indicate that in nesting C. mydas plasma temperature has a minimal effect on the high-affinity binding of testosterone to sex steroid-binding protein, however, the high affinity binding of oestradiol to sex steroid-binding protein is abolished at a hypothetically high (36 degrees C) sea/ambient/body temperature. This suggests that at high core body temperatures most of the oestradiol becomes biologically available to the tissues rather than remaining bound to a high-affinity carrier.

Seasonal variation of bulk milk somatic cell counts in UK dairy herds: investigations of the summer rise

Individual cow somatic cell count (SCC) patterns were explored over a one year period in 33 dairy herds to investigate the reason for a summer rise in bulk milk somatic cell counts (BMSCC). Cow test day somatic cell counts were categorised according to the magnitude of change since the previous test day reading, to examine which categories were responsible for the summer increase. Multilevel models using Markov chain Monte Carlo methods were specified to estimate the number of somatic cells/ml produced by different cell count categories. Stage of lactation and parity were accounted for in the models. There was an increase in the proportion of cows that remained above 200,000 cells/ml for two consecutive recordings in summer and this group of cows were responsible for 70.8% of the increase in somatic cells/ml produced from May to September compared with October to March. There was no evidence that a greater new infection rate (somatic cell counts moving from below 100,000 cells/ml to over 200,000 cells/ml) contributed to the increased summer bulk milk somatic cell counts. There was no indication that a general small increase in all somatic cell counts played an important role in the increased summer somatic cell counts. Markov chain Monte Carlo methods provided a valuable and flexible platform for parameter estimation in reasonably complex multilevel models.

Comparison of growth and development of the red-tailed phascogale (Phascogale calura) in three captive colonies

The red-tailed phascogale (Phascogale calura) is an endangered dasyurid species that has recently been brought into captivity in an effort to increase numbers before release back into the wild. As part of investigations into the reproductive biology of the species, information on the growth and development of young was collected throughout lactation from litters raised in three separate colonies. Growth curves for aging young throughout lactation and a timetable of developmental changes were constructed. While two colonies, with fourth- and fifth-generation captive animals, showed no significant difference in growth, animals from a third colony that had been wild caught before breeding displayed a slower rate of growth from 34 days of age. The pattern of development resembled that of other dasyurids, with young left in the nest from 44 days of age, fully furred by 78 days and weaned between 90 and 110 days. Captive phascogales invest heavily in their young, with litters weighing 380 ± 67% of maternal bodyweight at weaning.

Patterns, incidence and predictive factors for pain after interventional radiology

AIM

To evaluate prospectively the pattern, severity and predictive factors of pain after interventional radiological procedures.

MATERIALS AND METHODS

All patients undergoing non-arterial radiological interventional procedures were assessed using a visual-analogue scale (VAS) for pain before and at regular intervals for 24 h after their procedure.

RESULTS

One hundred and fifty patients (87 men, mean age 62 years, range 18-92 years) were entered into the study. Significant increases in VAS score occurred 8 h after percutaneous biliary procedures (+47.7 mm, SD 14.9 mm; p=0.001), 6 h after central venous access and gastrostomy insertion (+23.7 mm, SD 19.5 mm; p=0.001 and +28.4 mm, SD 9.7 mm; p=0.007, respectively) and 4h after oesophageal stenting (+27.8 mm, SD 20.2 mm, p=0.001). Non-significant increases in VAS pain score were observed after duodenal and colonic stenting (duodenal: +5.13 mm, SD 7.47 mm; p=0.055, colonic: +23.3 mm, SD 13.10 mm, p=0.250) at a mean of 5h (range 4-6h). Patients reported a significant reduction in pain score for nephrostomy insertion (-28.4mm, SD 7.11 mm, p=0.001). Post-procedural analgesia was required in 99 patients (69.2%), 40 (28.0%) requiring opiates. Maximum post-procedural VAS pain score was significantly higher in patients who had no pre-procedural analgesia (p=0.003).

CONCLUSION

Post-procedural pain is common and the pattern and severity of pain between procedures is variable. Pain control after interventional procedures is often inadequate, and improvements in pain management are required.

Multilocus sequence typing of intercontinental bovine Staphylococcus aureus isolates

A total of 258 bovine-associated Staphylococcus aureus isolates from the United States, Chile, and the United Kingdom, plus the reference isolate S. aureus Newbould 305 (NCIMB 702892), were analyzed by multilocus sequence typing (MLST). A collection of previously characterized United Kingdom isolates were also included in the analysis. The results demonstrated that MLST is suitable for the differentiation of bovine S. aureus isolates from various sites (milk, teat skin, milking machine unit liners, hands, and bedding) and countries. The theory of the host specificity of S. aureus is supported by the detection of a previously undescribed clonal complex that comprised 87.4% of the isolates studied, with representatives from all geographic locations investigated. This suggests that a single clonal group has achieved a widespread distribution and is responsible for the majority of infections. Some sequence types (STs; ST25, ST115, ST124, and ST126) demonstrated site specificity, as they were significantly (P < 0.05) associated with milk or teat skin.

Accuracy of reporting of intravenous urograms: a comparison of radiographers with radiology specialist registrars

AIM

To evaluate whether uroradiographers trained to do so can interpret intravenous urograms as accurately as radiology specialist registrars (SpRs).

METHODS

A total of 150 consecutive IVU examinations were prospectively assessed. The preliminary reporter (a uroradiographer, or an SpR in years 1 to 4) wrote a provisional report on each, and all the IVUs were subsequently assessed by an experienced uroradiologist blinded to the provisional report. The uroradiologist's report was taken as the standard. Comparisons between the provisional reports and the standard were made by Pearson chi-squared test (chi(2)).

RESULTS

Data were available for 149 IVUs. In comparison with the standard report, 1st year SpRs interpreted the IVU series with an accuracy of 76%; the combined group of 2nd, 3rd and 4th year SpRs achieved an accuracy of 88%, whereas the uroradiographers demonstrated an accuracy of 92%. Overall, the difference was to be statistically significant (p=0.021), with a linear trend for increased accuracy with increased experience being highly significant (p=0.006).

CONCLUSION

The uroradiographers significantly outperformed all the SpRs from years 1 to 4, achieving 92% accuracy in interpretation compared with an experienced consultant uroradiologist.

Prevalence and associations between bacterial isolates from dry mammary glands of dairy cows

To assess the prevalence and patterns of bacterial isolates, cultures were made from the dry mammary glands of dairy cows in six commercial dairy herds in the UK. Milk samples were taken from all four quarters of 480 cows at drying off and at weekly intervals from 14 days before to seven days after calving. A major mastitis pathogen was isolated from at least one quarter of 220 (45.8 per cent) of the cows and from more than one quarter of 90 (18.8 per cent) of them. During the late dry to calving period, of the 957 quarters with three culture results, a major mastitis pathogen was cultured from 236 (24.7 per cent) quarters of 186 (38.8 [corrected] per cent) cows. The most commonly isolated major pathogen was Escherichia coli, followed by Streptococcus uberis and coagulase-positive staphylococci. There were significant differences between the patterns of isolates from different farms and in different calving months, suggesting that the rate of infection was partially dependent on external conditions. The isolation of E. coli, S. uberis or coagulase-positive staphylococci from a cow during the late dry/periparturient period was associated with an increased risk of that cow being culled in the next lactation. Bayesian general linear mixed models were used to assess the associations between the different bacterial species. The probability of isolating either E. coli or S. uberis was significantly greater when the other organism was cultured in a milk sample; this was also true of coagulase-positive staphylococci and S. uberis. When Corynebacterium species were isolated from a milk sample, the probability of isolating coagulase-positive staphylococci or S. uberis decreased significantly, and when coagulase-negative staphylococci were isolated the probability of isolating coagulase-positive staphylococci was reduced.

The use of Markov chain Monte Carlo for analysis of correlated binary data: patterns of somatic cells in milk and the risk of clinical mastitis in dairy cows

Two analytical approaches were used to investigate the relationship between somatic cell concentrations in monthly quarter milk samples and subsequent, naturally occurring clinical mastitis in three dairy herds. Firstly, cows with clinical mastitis were selected and a conventional matched analysis was used to compare affected and unaffected quarters of the same cow. The second analysis included all cows, and in order to overcome potential bias associated with the correlation structure, a hierarchical Bayesian generalised linear mixed model was specified. A Markov chain Monte Carlo (MCMC) approach, that is Gibbs sampling, was used to estimate parameters. The results of both the matched analysis and the hierarchical modelling suggested that quarters with a somatic cell count (SCC) in the range 41,000-100,000 cells/ml had a lower risk of clinical mastitis during the next month than quarters <41,000 cell/ml. Quarters with an SCC >200,000 cells/ml were at the greatest risk of clinical mastitis in the next month. There was a reduced risk of clinical mastitis between 1 and 2 months later in quarters with an SCC of 81,000-150,000 cells/ml compared with quarters below this level. The hierarchical modelling analysis identified a further reduced risk of clinical mastitis between 2 and 3 months later in quarters with an SCC 61,000-150,000 cells/ml, compared to other quarters. We conclude that low concentrations of somatic cells in milk are associated with increased risk of clinical mastitis, and that high concentrations are indicative of pre-existing immunological mobilisation against infection. The variation in risk between quarters of affected cows suggests that local quarter immunological events, rather than solely whole cow factors, have an important influence on the risk of clinical mastitis. MCMC proved a useful tool for estimating parameters in a hierarchical Bernoulli model. Model construction and an approach to assessing goodness of model fit are described.

Somatic cell count distributions during lactation predict clinical mastitis

This research investigated somatic cell count (SCC) records during lactation, with the purpose of identifying distribution characteristics (mean and measures of variation) that were most closely associated with clinical mastitis. Three separate data sets were used, one containing quarter SCC (n = 1444) and two containing cow SCC (n = 933 and 11,825). Clinical mastitis was defined as a binary outcome, present or absent, for each lactation, and SCC were log (base 10) transformed. A generalized linear mixed model within a Bayesian framework was used for analysis. Parameters were estimated using Markov Chain Monte Carlo with Gibbs sampling. Results from the 3 data sets were similar. Increased maximum and standard deviation log SCC during lactation, rather than increased geometric mean, were the best overall indicators of clinical mastitis. Distributions of SCC were also investigated separately for different mastitis pathogens. Increased maximum log SCC was associated with clinical mastitis caused by all pathogen types. Increased standard deviation log SCC was associated with Staphylococcus aureus, and Streptococcus uberis clinical mastitis and increased coefficient of variation log SCC (standard deviation divided by mean) was associated with Escherichia coli clinical mastitis. Increased geometric mean lactation SCC was associated with an increased risk of Staph. aureus clinical mastitis but a reduced risk of E. coli clinical mastitis. Our results suggest that using measures of variation and maximum cow SCC would enhance the accuracy of predicting clinical mastitis, compared with geometric mean SCC, and therefore improve genetic programs that aim to select for clinical mastitis resistance. The results are also consistent with low SCC increasing susceptibility to some mastitis pathogens.

Identification of Corynebacterium bovis by Endonuclease Restriction Analysis of the 16S rRNA Gene Sequence

Despite its high prevalence within the bovine mammary gland, Corynebacterium bovis is considered a minor pathogen and of limited clinical significance. It has been suggested that intramammary infection with C. bovis may protect quarters against subsequent infection with other pathogens. The literature has produced much conflicting data on the subject. A possible explanation for some of the divergence of opinion on the subject is incorrect identification of isolates in previous studies. This paper describes a novel method for differentiating C. bovis from other lipophilic Corynebacterium species based on endonuclease restriction analysis. The 16S rRNA gene sequences for all known lipophilic Corynebacterium species were obtained from published data and analyzed. It was predicted that endonuclease restriction with HindIII and SmaI could be used to differentiate C. bovis from all other known lipophilic Corynebacterium species. The method was successfully employed to identify 741 of 762 (97.2%) lipophilic Corynebacterium species as C. bovis. Twenty one (2.8%) were identified as species other than C. bovis. Using this technique, it was demonstrated that it is not safe to assume that all lipophilic coryneform organisms isolated from bovine milk samples are C. bovis. This method is an alternative to more traditional methods of identification in large scale studies until methods such as 16S rRNA gene sequencing become more widely available.