Genotypic evaluation of antimicrobial resistance in Staphylococcus spp. isolated from bovine clinical mastitis / [Avaliação genotípica da resistência antimicrobiana em Staphylococcus spp. isolados de mastite clínica bovina]

Bovine clinical mastitis caused by Staphylococcus spp. is a serious and widespread disease in the world of dairy farming. Antimicrobial therapy is of fundamental importance in the prevention and treatment of infectious mastitis, but the indiscriminate use of antimicrobials acts as a determining factor for the spread of the disease. The present study evaluated the resistance profiles of 57 Staphylococcus spp. isolated from bovine clinical mastitis to beta-lactams and gentamicin, relating characteristics of phenotype (in vitro susceptibility tests) and genotype (detection and expression of genes encoding resistance - mecA, mecALGA251, blaZ, femA, femB, and aacA-aphD - using PCR and RT-PCR, respectively). One or more genes coding for resistance to different antimicrobials were detected in 50 Staphylococcus spp. isolates. The femA and femB genes were the most frequent (75.4% for both). The observed expression of the genes was as follows: blaZ (60%), femA (39.5%), aacA-aphD (50%), femB (32.6%), mecA (8.3%), and mecALGA251 (0%). Considering the relevance of the genus Staphylococcus to bovine mastitis, this study aimed to elucidate aspects regarding the genotypic and phenotypic profiles of these microorganisms so as to contribute to the development of effective strategies for mastitis control.(AU)

A mastite clínica bovina causada por Staphylococcus spp. é uma doença grave e generalizada no mundo da pecuária leiteira. A terapia antimicrobiana é de fundamental importância na prevenção e no tratamento da mastite infecciosa, mas o uso indiscriminado de antimicrobianos atua como fator determinante para a disseminação da doença. O presente estudo avaliou os perfis de resistência de 57 Staphylococcus spp. isolados de mastite clínica bovina em relação ao uso de betalactâmicos e gentamicina, relacionando características do fenótipo (testes de suscetibilidade in vitro) e genótipo (detecção e expressão de genes que codificam resistência - mecA, mecALGA251, blaZ, femA, femB, e aacA-aphD - usando PCR e RT-PCR, respectivamente). Um ou mais genes que codificam resistência a diferentes antimicrobianos foram detectados em 50 Staphylococcus spp. isolados. Os genes femA e femB foram os mais frequentes (75,4% para ambos). A expressão observada dos genes foi a seguinte: blaZ (60%), femA (39,5%), aacA-aphD (50%), femB (32,6%), mecA (8,3%) e mecALGA251 (0%). Considerando-se a relevância do gênero Staphylococcus para a mastite bovina, este estudo teve como objetivo elucidar aspectos referentes aos perfis genotípico e fenotípico desses microrganismos, a fim de contribuir para o desenvolvimento de estratégias eficazes para o controle da mastite.(AU)

Chlamydia felis: Lack of association between clinical signs and the presence of the cryptic plasmid.

Chlamydia felis is an obligate intracellular bacterial pathogen that infects cats, causing severe conjunctivitis associated with upper respiratory tract disease (URTD). In the present study, 186 cats from three non-commercial catteries in São Paulo, SP, Brazil were evaluated. The detection of Chlamydia felis was performed by PCR. The clinical severity was scored from 1 to 4, with a score of 4 as the most severe manifestation. The total occurrence of C. felis was of 18.82% (35/186) of cats overall, but notably, 58.06% (18/31) of infected cats originated from a single cattery. All animals harboring C. felis had URTD clinical signs and higher scores (3 and 4). In addition, C. felis occurrence was associated with the presence of cryptic plasmid. However, the virulence and clinical severity were not correlated.

Microbiological analysis and sensitivity profile of Staphylococcus spp. in subclinical mastitis of dairy goats / Análise microbiológica e perfil de sensibilidade do Staphylococcus spp. em mastite subclínica de caprinos leiteiros

Subclinical mastitis in goats causes economic losses and risks to public health. Given the need for research that shows the most isolated staphylococci species and sensibility tests comparing the resistance between coagulase-negative (CNS) and positive Staphylococcus (CPS) goats with subclinical mastitis, the aim of this study was to identify the microorganisms isolated from milk samples of goats with subclinical mastitis, as well as define the staphylococci species and determine the sensitivity profile of Staphylococcus spp. to antimicrobials. To collect samples, tests were performed for mug of black background and California mastitis test (CMT), collecting milk from CMT positive animals. A total of 226 samples from seven herds of dairy goats was collected and forwarded to the laboratory, where they were seeded for the isolation of the microorganism and implementing the antibiotic sensibility test. Of these, 122 samples had bacterial growth and the most isolated staphylococci species were: S. epidermidis (24.55%), S. lugdunensis (15.40%) and S. intermedius (13.64%). Samples showed increased resistance to antimicrobials: penicillin (81.8%), oxacillin (60.0%) and ampicillin (55.5%). Greater sensitivity to: enrofloxacin (99.1%), erythromycin (98.2%), gentamicin (98.2%) and vancomycin (98.2%) were observed. The S. epidermidis showed higher antimicrobial resistance to amoxicillin and penicillin than S. lugdunensis and S. intermedius. Similar resistance in vitro between CNS and CPS was observed to most antimicrobials. It is important to control the overuse of antibiotics to prevent the emergence of resistant strains.

A mastite subclínica em caprinos acarreta prejuízos econômicos e riscos à saúde pública. Tendo em vista a necessidade de pesquisas que demonstrem as espécies de estafilococos mais isoladas e os testes de sensibilidade que comparem a resistência entre Staphylococcus coagulase negativa (SCN) e positiva (SCP) de cabras com mastite subclínica, os objetivos do presente estudo foram identificar os microrganismos isolados de amostras de leite de cabras com mastite subclínica, bem como definir as espécies de estafilococos e determinar o perfil de sensibilidade de Staphylococcus spp. aos antimicrobianos. Para realizar a coleta das amostras, foram executados os testes da caneca de fundo preto e California mastitis test (CMT) com o leite dos animais reagentes ao CMT. Coletaram-se 226 amostras provenientes de sete rebanhos de caprinos leiteiros, as quais foram encaminhadas para o laboratório, onde foram semeadas para o isolamento do microrganismo e a realização do teste de antibiograma. Dessas amostras, 122 tiveram crescimento bacteriano e as espécies mais isoladas de estafilococos foram: S. epidermidis (24,55%), S. lugdunensis (15,40%) e S. intermedius (13,64%). As amostras apresentaram maior resistência aos antimicrobianos penicilina (81,8%), oxacilina (60,0%) e ampicilina (55,5%). Observou-se maior sensibilidade para enrofloxacina (99,1%), eritromicina (98,2%), gentamicina (98,2%) e vancomicina (98,2%). O S. epidermidis apresentou maior resistência antimicrobiana para a amoxicilina e a penicilina do que o S. lugdunensis e o S. intermedius. Foi verificada uma resistência in vitro semelhante entre os estafilococos coagulase negativa e positiva para a maioria dos antimicrobianos testados. É importante o controle do uso abusivo de antimicrobianos para evitar o surgimento de cepas resistentes.

Remotely-delivered cognitive remediation in multiple sclerosis (MS): protocol and results from a pilot study.

BACKGROUND: Cognitive impairment represents a critical unmet treatment need in multiple sclerosis (MS). Cognitive remediation is promising but traditionally requires multiple clinic visits to access treatment. Computer-based programs provide remote access to intensive and individually-adapted training. OBJECTIVE: Our goal was to develop a protocol for remotely-supervised cognitive remediation that enables individuals with MS to participate from home while maintaining the standards for clinical study. METHODS: MS participants (n = 20) were randomized to either an active cognitive remediation program (n = 11) or a control condition of ordinary computer games (n = 9). Participants were provided study laptops to complete training for five days per week over 12 weeks, targeting a total of 30 hours. Treatment effects were measured with composite change via scores of a repeated neuropsychological battery. RESULTS: Compliance was high with an average of 25.0 hours of program use (80% of the target) and did not differ between conditions (25.7 vs. 24.2 mean hours, p = 0.80). The active vs. control participants significantly improved in both the cognitive measures (mean composite z-score change of 0.46 ± 0.59 improvement vs. -0.14 ± 0.48 decline, p = 0.02) and motor tasks (mean composite z-score change of 0.40 ± 0.71improvement vs. -0.64 ± 0.73 decline, p = 0.005). CONCLUSIONS: Remotely-supervised cognitive remediation is feasible for clinical study with potential for meaningful benefit in MS.

Function of milk polymorphonuclear neutrophil leukocytes in bovine mammary glands infected with Corynebacterium bovis.

Corynebacterium bovis is one of the most commonly isolated bacteria from aseptically collected bovine milk samples. The objective of the current study was to characterize the bovine innate immune response by evaluating milk polymorphonuclear neutrophilic leukocytes (PMNL) in mammary glands infected with C. bovis. Twenty quarters infected with C. bovis and 28 culture-negative quarters (with milk somatic cell count <1×10(5) cells/mL) were used. The percentages of milk PMNL and the PMNL expression of L-selectin (CD62L), ß2-integrin (CD11b), and one of the endothelial-selectin ligands (CD44), as well as the levels of intracellular reactive oxygen species (ROS) and the phagocytosis of Staphylococcus aureus, were evaluated by flow cytometry. The apoptosis and necrosis rates of the PMNL were quantified using dual-color flow cytometry with fluorescein-labeled annexin and propidium iodide. The present study revealed a higher percentage of PMNL in the milk from C. bovis-infected quarters, although no significant differences were found in levels of CD44, CD62L, or CD11b expression among the PMNL. A lower percentage of apoptotic PMNL was observed in C. bovis-infected quarters, as well as higher percentages of viable PMNL and of PMNL that produced intracellular ROS. However, no alterations were observed in phagocytosis of Staph. aureus by the PMNL or in intensity of intracellular ROS production by PMNL. Thus, results from this investigation of the PMNL function support, at least in part, the fact that intramammary infections by C. bovis may offer protection against intramammary infections by other bacteria.

Management relevance of benthic biogeography at multiple scales in coastal waters of the northeast U.S.

Continuing pressures from human activities have harmed the health of ocean ecosystems, particularly those near the coast. Current management practices that operate on one sector at a time have not resulted in healthy oceans that can sustainably provide the ecosystem services humans want and need. Now, adoption of ecosystem-based management (EBM) and coastal and marine spatial planning (CMSP) as foundational principles for ocean management in the United States should result in a more holistic approach. Recent marine biogeographical studies and benthic habitat mapping using satellite imagery, large-scale monitoring programs, ocean observation systems, acoustic and video techniques, landscape ecology, geographic information systems, integrated databases, and ecological modeling provide information that can support EBM, make CMSP ecologically meaningful, and contribute to planning for marine biodiversity conservation. Examples from coastal waters along the northeast coast of the United States from Delaware Bay to Passamaquoddy Bay, Maine, illustrate how benthic biogeography and bottom seascape diversity information is a useful lens through which to view EBM and CMSP in nearshore waters. The focus is on benthic communities, which are widely used in monitoring programs and are sensitive to many stresses from human activities.

A theoretical model for the production of Ac-225 for cancer therapy by neutron capture transmutation of Ra-226.

Radium needles that were once implanted into tumours as a cancer treatment are now obsolete and constitute a radioactive waste problem, as their half-life is 1600 years. We are investigating the reduction of radium by transmutation by bombarding Ra-226 with high-energy neutrons from a neutron source to produce Ra-225 and hence Ac-225, which can be used as a generator to produce Bi-213 for use in 'Targeted Alpha Therapy' for cancer. This paper examines the possibility of producing Ac-225 by neutron capture using a theoretical model in which neutron energy is convoluted with the corresponding neutron cross sections of Ra-226. The total integrated yield can then be obtained. This study shows that an intense beam of high-energy neutrons could initiate neutron capture on Ra-226 to produce Ra-225 and hence practical amounts of Ac-225 and a useful reduction of Ra-226.

Bacillus cereus infection outbreak in captive psittacines.

This study reports an uncommon epizootic outbreak of Bacillus cereus that caused the sudden death of 12 psittacines belonging to the species Anodorhynchus hyacinthinus (1 individual), Diopsittaca nobilis (1 individual), Ara severa (1 individual) and Ara ararauna (9 individuals) in a Brazilian zoo. Post-mortem examination of the animals reveled extensive areas of lung hemorrhage, hepatic congestion, hemorrhagic enteritis and cardiac congestion. Histopathological examination of the organs showed the presence of multiple foci of vegetative cells of Gram-positive bacilli associated with discrete and moderate mononuclear inflammatory cell infiltrate. Seventeen B. cereus strains isolated from blood and sterile organs of nine A. ararauna were analyzed in order to investigate the genetic diversity (assessed by Rep-PCR) and toxigenic profiles (presence of hblA, hblC and hblD; nheA, nheB and nheC as well as cytK, ces and entFM genes) of such strains. Amplification of genomic DNA by Rep-PCR of B. cereus strains generated two closely related profiles (Rep-PCR types A and B) with three bands of difference. All strains were classified as belonging to the toxigenic profile I which contained HBL and NHE gene complexes, entFM and cytK genes. Altogether, microbiological and histopathological findings and the evidence provided by the success of the antibiotic prophylaxis, corroborate that B. cereus was the causative agent of the infection that killed the birds.

Lactation stage and udder health status of Santa Ines ewes / Estágio da lactação e saúde da glândula mamária em ovelhas da raça Santa Inês

Avaliou-se o risco de infecção em diferentes fases da lactação em 33 ovelhas da raça Santa Inês. Inicialmente a glândula foi submetida ao exame físico e à prova de fundo escuro. Posteriormente, amostras de leite foram coletadas assepticamente para a realização de exame bacteriológico - California Mastitis teste -, e contagens microscópica e automática de células somáticas. Nenhuma diferença foi observada entre as distintas fases de lactação. Observou-se alta persistência de infecções intramamárias, e tendência a maior contagem de células somáticas no último período de lactação, que pode ser oriunda da maior resistência a infecções neste período.

Multicenter randomized clinical trial of donepezil for memory impairment in multiple sclerosis.

OBJECTIVES: The goal of this study was to determine if memory would be improved by donepezil as compared to placebo in a multicenter, double-blind, randomized clinical trial (RCT). METHODS: Donepezil 10 mg daily was compared to placebo to treat memory impairment. Eligibility criteria included the following: age 18-59 years, clinically definite multiple sclerosis (MS), and performance ≤ ½ SD below published norms on the Rey Auditory Verbal Learning Test (RAVLT). Neuropsychological assessments were performed at baseline and 24 weeks. Primary outcomes were change on the Selective Reminding Test (SRT) of verbal memory and the participant's impression of memory change. Secondary outcomes included changes on other neuropsychological tests and the evaluating clinician's impression of memory change. RESULTS: A total of 120 participants were enrolled and randomized to either donepezil or placebo. No significant treatment effects were found between groups on either primary outcome of memory or any secondary cognitive outcomes. A trend was noted for the clinician's impression of memory change in favor of donepezil (37.7%) vs placebo (23.7%) (p = 0.097). No serious or unanticipated adverse events attributed to study medication developed. CONCLUSIONS: Donepezil did not improve memory as compared to placebo on either of the primary outcomes in this study. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence which does not support the hypothesis that 10 mg of donepezil daily for 24 weeks is superior to placebo in improving cognition as measured by the SRT in people with MS whose baseline RAVLT score was 0.5 SD or more below average.

Antimicrobial susceptibility of coagulase-negative staphylococci isolated from meat-producing ewes with mastitis / Susceptibilidade antimicrobiana de cepas de estafilococcos coagulase-negativa isolados de ovinos de corte com mastite

Avaliou-se a sensibilidade antimicrobiana in vitro de 121 cepas de estafilococos coagulase-negativa isolada de leite de ovelhas Santa Inês, aos fármacos: penicilina, amoxicilina, ampicilina, estreptomicina, oxaciclina, neomicina, cefalotina, gentamicina e sulfonamida. A resistência à sulfonamida foi a mais frequente (27,3 por cento), seguida pela estreptomicina (14,0 por cento) e pela oxaciclina (14,0 por cento), enquanto da gentamicina (1,6 por cento) foi a menos frequente. Todas as cepas foram sensíveis a pelo menos um antimicrobiano, e 20,3 por cento das cepas apresentaram resistência múltipla. Os resultados mostram a importância de Staphylococci coagulase-negativas como agentes causadores de mastite em ovinos, e o perfil de resistência múltipla indica a importância da determinação da resistência à oxaciclina como indicador da presença de ilhas de patogenicidade que contêm fatores de virulência e resistência a outros antimicrobianos que contribuem para a sobrevivência da bactéria ao tratamento.

Lipohypertrophy: does it matter in daily life? A study using a continuous glucose monitoring system.

AIMS: To use continuous glucose monitoring (CGMS) to compare glucose profiles in people with type 1 diabetes following injection of insulin into an area affected by lipohypertrophy vs. an area not affected by lipohypertrophy. METHODS: Eight patients with type 1 diabetes underwent 72 h of CGMS while following a standardized diet and injecting all insulin either into an area with or without lipohypertrophy. Patients underwent two testing periods in random order, separated by 4 days. On day 1 of each test subjects were admitted for measurement of insulin and plasma glucose levels immediately prior to, and hourly for 4 h following, a standardized lunch. RESULTS: Insulin area under the curve (AUC)(0-4 h) was similar for both test periods; 656; interquartile range (IQR): 518-1755 (normal tissue) vs. 602; IQR: 382-1436 (lipohypertrophic tissue), z = 1.7, p = 0.09. There was also no difference in the median time to maximal insulin concentration (Time(max) 2 h; IQR: 2-3 h; z = 0.6; p = 0.6). There was a 37.5% increase in mean plasma glucose levels following a standardized meal; however this was not significant between sites (AUC(0-4 h)t = -1.7; p = 0.1). Moreover, there was no difference in CGMS profiles (AUC(1-72 h)t = -0.9; p = 0.4) across the 72-h monitoring period. Overall the prevalence of hypoglycaemia (CGMS readings < 4 mmol/l) was similar between injection sites (11.6 vs. 10.6%, p = 0.1). CONCLUSION: The pharmacokinetic and pharmacodynamic effect of injecting into lipohypertrophic tissue is small in comparison to the usual clinical variation observed with insulin injections.

Universal health care--60 years of the British National Health Service 1948-2008.

The British National Health Service (NHS) is now 60 years old, affording an opportunity to examine its performance as a government-funded health plan covering all citizens. It opened in 1948 and by 1949 patients' demands on services far exceededestimates. Since then spendinghas increased yearly. There have been manyrecurringproblems particularly limitation of services due to underfunding and long waiting lists for treatments reaching a high of 1,263,000 patients awaiting hospital admission in 1998. In an attempt to solve its problems the NHS has been reorganized frequently. Major redesigns have occurredwith each newgovernment, accompaniedby increased costs andagrowingbureaucracy.Administrative and clerical staff grew from 29,021 in 1951 to 280,692 (+867%) in 2005. Significant problems continue. The NHS is an example of what can go wrong with a wholly government funded universal health care plan that is free at the point of delivery.

Donepezil improved memory in multiple sclerosis in a randomized clinical trial.

OBJECTIVE: To determine the effect of donepezil in treating memory and cognitive dysfunction in multiple sclerosis (MS). METHODS: This single-center double-blind placebo-controlled clinical trial evaluated 69 MS patients with cognitive impairment who were randomly assigned to receive a 24-week treatment course of either donepezil (10 mg daily) or placebo. Patients underwent neuropsychological assessment at baseline and after 24 weeks of treatment. The primary outcome was change in verbal learning and memory on the Selective Reminding Test (SRT). Secondary outcomes included other tests of cognitive function, patient-reported change in memory, and clinician-reported impression of cognitive change. RESULTS: Donepezil-treated patients showed significant improvement in memory performance on the SRT compared to placebo (p = 0.043). The benefit of donepezil remained significant after controlling for various covariates including age, Expanded Disability Status Scale, baseline SRT score, reading ability, MS subtype, and sex. Donepezil-treated patients did not show significant improvements on other cognitive tests, but were more than twice as likely to report memory improvement than those in the placebo group (p = 0.006). The clinician also reported cognitive improvement in almost twice as many donepezil vs placebo patients (p = 0.036). No serious adverse events related to study medication occurred, although more donepezil (34.3%) than placebo (8.8%) subjects reported unusual/abnormal dreams (p = 0.010). CONCLUSIONS: Donepezil improved memory in MS patients with initial cognitive impairment in a single center clinical trial. A larger multicenter investigation of donepezil in MS is warranted in order to more definitively assess the efficacy of this intervention.

Production and performance of multilayer-coated conical x-ray mirrors.

A method of fabricating replica figured x-ray optics with integral multilayer coatings is presented. With the intact electroforming multilayer process (IEMP) technique, we sputter multilayers onto a reusable superpolished mandrel, electroform nickel over the multilayers, and remove the multilayer-coated nickel shell intact from the mandrel. This approach offers advantages over more traditional, original, and segmented-replica fabrication techniques, including low cost; compatibility with a wide range of mirror designs, diameters, and focal lengths; simple integration with multilayer sputtering processes; and the ability to produce complete shells of revolution. The fabrication of W/Si multilayer-coated 10-cm-diameter conical x-ray mirrors is described, as are reflectivity measurements at 10 and 30 keV. The measured reflectivity of the IEMP multilayers at the 10-keV primary Bragg peak was 17%. Measurements of multiple points on the cone showed multilayer uniformity to within a few percent around the mirror.

Evaluation of the microbiological status of milk and various structures in mammary glands from naturally infected dairy cows.

A knowledge of the microbiological status of milk and of the different structures in the mammary glands has great importance in elucidating the pathogenesis of mammary gland infections. The objective of this study was to evaluate the microbiological status of various structures in the mammary glands from naturally infected dairy cows following slaughter. A total of 94 samples of milk, 184 samples of mammary parenchyma, 168 samples of gland cisterns, and 168 samples of teat cisterns were collected for microbiological examination. Microorganisms were detected in 59.9% of all samples, 67.0% of the milk samples, 70.1% of the mammary parenchymas, 55.9% of the gland cisterns and 48.8% of the teat cistern samples. When all samples were considered, coagulase-negative Staphylococcus were the most prevalent (35.7%) followed by coagulase-positive Staphylococcus (12.2%), Corynebacterium bovis (2.4%), Prototheca sp. (1.9%), and Streptococcus dysgalactiae (1.5%). There was a significantly higher occurrence of microorganisms in the milk and mammary parenchyma compared to the gland cisterns and teat cisterns.

Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients.

OBJECTIVE: To relate neuropsychological performance to measures of cerebral injury in persons with MS selected for cognitive impairment. METHODS: Participants were 37 individuals with relapsing-remitting (59.5%) and secondary progressive (40.5%) MS. They were tested at baseline as part of a clinical trial to enhance cognition with an acetylcholinesterase inhibitor. Eligibility criteria included at least mild cognitive impairment on a verbal learning and memory task. A modified Brief Repeatable Battery of Neuropsychological Tests formed the core of the behavioral protocol. Neuroimaging measures were central (ventricular) cerebral atrophy, lesion volume, and ratios of N-acetyl aspartate (NAA) to both creatine and choline. RESULTS: A clear, consistent relation was found between cognitive and MR measures. Among neuroimaging measures, central atrophy displayed the highest correlations with cognition, accounting for approximately half the variance in overall cognitive performance. NAA ratios in right hemisphere sites displayed larger correlations than those on the left. Multiple regression models combining the MR measures accounted for well over half the variance in overall cognitive performance. The Symbol Digit Modalities Test was the neuropsychological task most strongly associated with the neuroimaging variables. CONCLUSIONS: If a strong and stable association can be firmly established between cognitive and MR variables in appropriate subsets of MS patients, it might aid in the investigation of interventions to enhance cognition and modify the course of the disease.

Study and treatment of post Lyme disease (STOP-LD): a randomized double masked clinical trial.

OBJECTIVE: To determine whether post Lyme syndrome (PLS) is antibiotic responsive. METHODS: The authors conducted a single-center randomized double-masked placebo-controlled trial on 55 patients with Lyme disease with persistent severe fatigue at least 6 or more months after antibiotic therapy. Patients were randomly assigned to receive 28 days of IV ceftriaxone or placebo. The primary clinical outcomes were improvement in fatigue, defined by a change of 0.7 points or more on an 11-item fatigue questionnaire, and improvement in cognitive function (mental speed), defined by a change of 25% or more on a test of reaction time. The primary laboratory outcome was an experimental measure of CSF infection, outer surface protein A (OspA). Outcome data were collected at the 6-month visit. RESULTS: Patients assigned to ceftriaxone showed improvement in disabling fatigue compared to the placebo group (rate ratio, 3.5; 95% CI, 1.50 to 8.03; p = 0.001). No beneficial treatment effect was observed for cognitive function or the laboratory measure of persistent infection. Four patients, three of whom were on placebo, had adverse events associated with treatment, which required hospitalization. CONCLUSIONS: Ceftriaxone therapy in patients with PLS with severe fatigue was associated with an improvement in fatigue but not with cognitive function or an experimental laboratory measure of infection in this study. Because fatigue (a nonspecific symptom) was the only outcome that improved and because treatment was associated with adverse events, this study does not support the use of additional antibiotic therapy with parenteral ceftriaxone in post-treatment, persistently fatigued patients with PLS.

Aetiology and histopathology of bovine mastitis of espontaneous occurrence.

Infectious bovine mastitis is responsible for serious economic losses in dairy cattle breeding. Information about the damages caused by micro-organisms is of great interest and importance. The purpose of the present study was to report on the microbiological and histopathological aspects of the mammary parenchymas of slaughtered dairy cows. A total of 184 mammary glands were examined and samples of mammary parenchyma were collected for microbiological and histopathological examinations. Micro-organisms were isolated from 69.6% samples; 23 (12.5%) of the 184 samples did not show histological changes; inflammatory response was observed in 56 (30.4%) samples; inflammatory response and repair were present in 82 (44.6%) samples; repair process was verified in 23 (12.5%) of the mammary glands. Coagulase-negative Staphylococci were observed in 53.8% of the samples followed by coagulase-positive Staphylococci (7.6%), Prototheca sp. (2.2%) and Streptococcus dysgalactiae (1.6%). Coagulase-negative Staphylococci and coagulase-positive Staphylococci were associated mainly to chronic inflammatory response and chronic inflammatory response and repair. Samples from which no micro-organisms were isolated (n = 56) had no histological changes in 82.6% of the cases. These results were higher (P < 0.05) when compared to the samples with micro-organisms and without histological changes (17.4%).