Negatively controlled, randomized clinical trial comparing different antimicrobial interventions for treatment of clinical mastitis caused by gram-positive pathogens

The general objective of this study was to evaluate the effect of 3 intramammary antibiotic interventions using 2 commercially available antibiotics with narrow- or broad-spectrum activity on cure rates of clinical mastitis (CM) caused by gram-positive bacteria. We also compared the efficacy of treatment protocols, including a negative control, on outcomes at the cow and mammary quarter level. Before the onset of the study, 5,987 animals more than 12 mo old were randomly preassigned to 1 of 4 protocols in the event of gram-positive CM (except for Staphylococcus aureus and Trueperella pyogenes) during lactation: 3 infusions with 62.5 mg of amoxicillin performed 12 h apart (AMOX-L); 5 infusions once a day with 62.5 mg of amoxicillin (AMOX-EL); 5 infusions once a day with 125 mg of ceftiofur hydrochloride (CEFT-L); or negative control, no treatment performed until 5 d after diagnosis (NEG-CTR). Randomization was performed to preassign 90% of cows to one of the antibiotic protocols (30% in each group) and 10% to the negative control. A total of 696 quarter cases of CM met the inclusion criteria and were evaluated in the study. Quarter-level outcomes were assessed based on 5 milk samples collected up to 14 ± 3 d following enrollment (i.e., first day of treatment), whereas variables at the cow level [composite somatic cell count (SCC), milk production, and survival in the herd] were assessed up to 90 d after CM diagnosis. Streptococcus uberis, followed by Streptococcus dysgalactiae, were the main causes of gram-positive CM. Overall, clinical cure was higher for CEFT-L than for AMOX-EL, and no difference was observed between CEFT-L and AMOX-L. Likewise, no significant differences were detected on overall bacteriological cure, although some treatment effects were observed at the species level. Compared with antibiotic-treated groups, quarters assigned to NEG-CTR had higher counts of colony-forming units (cfu), 16S rRNA gene copy numbers, and Streptococcus relative abundance (RA) until d 5 after enrollment. Quarters treated with AMOX-L had higher cfu counts on d 5, 8, and 14 after enrollment compared with the other antibiotic protocols. In addition, the RA of Streptococcus spp. was higher on d 14 after enrollment for AMOX-treated quarters compared with the CEFT-L group. Linear score of SCC was higher for AMOX-treated cows than for CEFT-L in the first test day after CM. However, cows assigned to AMOX-L had higher milk production than those submitted to the AMOX-EL and CEFT-L protocols. In conclusion, the 2-d protocol with 3 intramammary infusions of amoxicillin (narrow-spectrum antimicrobial) had similar overall clinical and bacteriological cures as 5 administrations (once a day) with ceftiofur hydrochloride (wide spectrum). No significant difference was observed on CM recurrence and cow survival. However, quarters treated with 5-d protocols were more effective at reducing milk cfu counts than quarters in the AMOX-L protocol. In addition, lower Streptococcus spp. RA was observed in ceftiofur-treated quarters compared with the amoxicillin protocols at d 14 after CM diagnosis. Based on results of microbiome and bacterial load (quantitative PCR and cfu count) up to 5 d after CM diagnosis, antibiotic use remains an indispensable strategy for treatment of CM caused by gram-positive bacteria.

Sex differences in self-silencing

The construct of self-silencing was proposed to account for women's greater vulnerability to developing depression. This study of 1,117 students (795 women and 322 men) explored possible explanations for the empirical finding that men self-silence to the same or greater extent than women. Analysis showed that men reported more self-silencing than women. A factor analysis confirmed the subscale structure of the Silencing the Self Scale for women and men, with relatively few departures from the originally proposed subscales. Depression and self-silencing scores were correlated positively for both men and women. The results of two multiple regressions, performed separately for men and women, showed that depressive symptomatology accounted for a significant percentage of the variance in self-silencing but that social desirability did not account for a significant increment in the variance accounted for in silencing the self. The scores on the Care as Self-sacrifice and the Divided Self subscales were intercorrelated for women, but not for men, indicating that there may be a sex difference in perception of self-silencing behavior.

Feasibility of an obstetrician-based cord blood collection network for unrelated donor umbilical cord blood banking

The purpose of this study was to evaluate the feasibility of an obstetrician-based cord blood collection system for the purpose of banking cord blood for unrelated donor hematopoietic stem cell transplantation. Over 200 delivering physicians and 40 area obstetrical units were educated and became involved in the collection of cord blood during the third stage of labor. These products compared favorable with those obtained after placental delivery. Issues involved in the development of quality assurance for unrelated donor banking are discussed. An obstetrician-based cord blood collection network is feasible and advantageous in that cord blood can be collected from a wider variety of communities, thus enhancing the ethnic diversity of a bank.