Global burden of COPD: systematic review and meta-analysis.

The aim of this study was to quantify the global prevalence of chronic obstructive pulmonary disease (COPD) by means of a systematic review and random effects meta-analysis. PubMed was searched for population-based prevalence estimates published during the period 1990-2004. Articles were included if they: 1) provided total population or sex-specific estimates for COPD, chronic bronchitis and/or emphysema; and 2) gave method details sufficiently clearly to establish the sampling strategy, approach to diagnosis and diagnostic criteria. Of 67 accepted articles, 62 unique entries yielded 101 overall prevalence estimates from 28 different counties. The pooled prevalence of COPD was 7.6% from 37 studies, of chronic bronchitis alone (38 studies) was 6.4% and of emphysema alone (eight studies) was 1.8%. The pooled prevalence from 26 spirometric estimates was 8.9%. The most common spirometric definitions used were those of the Global Initiative for Chronic Obstructive Lung Disease (13 estimates). There was significant heterogeneity, which was incompletely explained by subgroup analysis (e.g. age and smoking status). The prevalence of physiologically defined chronic obstructive pulmonary disease in adults aged > or =40 yrs is approximately 9-10%. There are important regional gaps, and methodological differences hinder interpretation of the available data. The efforts of the Global Initiative for Chronic Obstructive Lung Disease and similar groups should help to standardise chronic obstructive pulmonary disease prevalence measurement.

Comparison of probiotic and antibiotic intramammary therapy of cattle with elevated somatic cell counts.

The effects of treating subclinical mastitis with intramammary infusions of either a Lactobacillus or an antibiotic preparation on intramammary infection cure rate and on milk SCC were compared. Cows with two consecutive monthly DHIA composite SCC greater than 300,000 cells/ml (5.4771 log10/ml) were defined as high SCC cows. Twenty-six subclinical cows were randomly assigned to one of two treatments. Quarter foremilk samples were obtained from all quarters at d 0, 7, and 14 following infusion to determine the microbiological status and SCC. Composite milk SCC were determined monthly by DHIA and at d 0, 7, and 14 of the study. Coagulase-negative staphylococci were the predominantly isolated pathogens. Treatment of cows with Lactobacillus cured 21.7% of infected quarters, whereas 73.7% of infections treated with antibiotic were eliminated. Treatment of quarters with antibiotic did not reduce quarter SCC unless infected quarters were cured. Intramammary infusion of quarters with Lactobacillus increased quarter SCC, mainly because of an increase in SCC of initially uninfected, low SCC quarters. Monthly composite SCC were similar between treatments. The results indicate that administering Lactobacillus or antibiotic treatment to all quarters based on elevated composite SCC should not be adopted. Lactobacillus treatment increased SCC with no effect on infection rate.