High intermittent colonization by diverse clones of ß-lactam-resistant Gram-negative bacilli suggests an excessive antibiotic use and different sources of transmission in haemodialysis patients.

BACKGROUND: The spread of ß-lactam-resistant Gram-negative bacilli (GNB) is a topic of worldwide concern; however, knowledge about colonization by these bacteria in haemodialysis patients is limited. AIM: To analyse the dynamics and factors associated with colonization by ß-lactam-resistant GNB in a dialysis centre. METHODS: A longitudinal study was conducted. Stool samples were collected for each patient to evaluate extended-spectrum ß-lactamase (ESBL)- and carbapenemase-producing Gram-negative bacilli. Colonization screens were performed at three time-points and then classified as absent, intermittent, or persistent. Molecular typing included enterobacterial repetitive intergenic consensus (ERIC)-polymerase chain reaction, pulsed-field gel electrophoresis (PFGE), and multi-locus sequence typing (MLST). Clinical information was obtained from medical records and personal interview. A generalized estimating equations model was performed to determinate factors associated with the colonization. FINDINGS: A total of 210 patients were included. ESBL-producing and carbapenem-resistant GNB colonization reached 41.2% and 11.5%, respectively. Most patients were intermittent carriers with frequencies of 73.9% and 92.95% for each bacteria group. The most frequent ESBL was CTX-M-G1, while the most common carbapenemase was KPC. ERIC-PCR and PFGE revealed high genetic diversity among strains and the Escherichia coli clone ST131 was the most important by MLST. Fluoroquinolone use (odds ratio: 3.13; 95% confidence interval: 1.03-9.44; P [cap] = 0.043) and chronic obstructive lung disease (odds ratio: 3.53; 1.42-8.74; P = 0.006) were associated with ESBL-producing GNB colonization. CONCLUSION: Our findings indicate a high intermittent colonization by diverse clones of ß-lactam-resistant GNB in haemodialysis patients. It suggests excessive antibiotic pressure that favours the acquisition of bacteria with diverse genetic profiles and different transmission sources.

Parásitos gastrointestinales en mamíferos silvestres cautivos en el Centro de Fauna de San Emigdio, Palmira (Colombia) / Gastrointestinal parasites in captive wild mammals at the fauna center from San Emigdio, Palmira (Colombia)

RESUMEN La parasitosis intestinal en mamíferos silvestres es una de las principales complicaciones debido a las condiciones exógenas del cautiverio; predisponen al animal a complicaciones fisiológicas o infecciones secundarias que impiden su rehabilitación y reintroducción. El objetivo de esta investigación fue determinar la presencia de parásitos gastrointestinales en mamíferos silvestres del Centro de Atención y Valoración de Fauna silvestre del Centro de Educación Ambiental San Emigdio, San Emigdio, Palmira (Colombia). Se tomaron muestras fecales de 25 animales cautivos en el Centro de Atención y Valoración y fueron analizadas mediante dos técnicas: a) montaje con solución salina al 0,85 % y solución de lugol al 1% y b) técnica de flotación por solución saturada (Sheather) con densidad de 1.28g/ml, encontrando un 36% de positividad. Se encontró Enterobius vermicularis, Fasciola sp., Entamoeba sp. y Ancylostoma sp. El grupo de primates no humanos presentó cargas parasitarias más altas con respecto a felinos, caninos y demás mamíferos del estudio. Los microorganismos identificados son reconocidos como parásitos causantes de complicaciones en animales cautivos y en libertad; al igual, son catalogados como posibles riesgos zoonóticos.

ABSTRACT Intestinal parasitosis in wild mammals is one of the main complications due to the exogenous conditions of captivity. They predispose the animal to physiological complications or secondary infections that prevent its rehabilitation and reintroduction. The objective is to determine the presence of gastrointestinal parasites in wild mammals from the Wildlife Care and Valuation Center of the San Emigdio Environmental Education Center, San Emigdio, Palmira (Colombia). Fecal samples were taken from 25 captive animals in Care and Valuation Center being analyzed using two techniques: a) assembly with 0.85% saline solution and 1% lugol solution and b) saturated solution flotation technique (Sheather) with a density of 1.28g/ml, with a 36% of positivity. Enterobius vermicularis, Fasciola sp., Entamoeba sp. and Ancylostoma sp. were found. The group of non-human primates had higher parasitic intensity compared to felines, canines and other mammals in the study. The identified microorganisms are recognized as parasites causing complications in captive animals and in free life; likewise, they are classified as possible zoonotic risks.

Computed tomography of tympanic bullae in pre-weaned dairy calves diagnosed with clinical respiratory disease.

Clinical disease from otitis media in calves is a significant problem in the dairy industry and evaluation of disease severity, chronicity, and imaging remains a challenge. Our objectives were to compare imaging findings in calves with an early diagnosis of respiratory disease to calves with treatment failure. This was a prospective study of 30 Jersey heifer calves, 26-95 days of age, with elevated clinical respiratory scores. Ten clinically healthy calves served as controls for clinical scoring. Three groups of calves were selected based on elevated scores using the McGuirk respiratory scoring system and treatment history. Group A included new cases, group B included primary treatment failures, and group C included multiple treatment failures. Calves underwent a skull CT, four view radiography, post-mortem photography of the tympanic bulla and bacteriological diagnostics. Imaging and post-mortem results were evaluated using normalized scoring schemes. Computed tomography imaging of the tympanic bulla differentiated calves early in the course of disease (group A) from calves that had not responded to treatment (groups B and C). Radiographs differentiated only group C from groups A and B. Use of a 35 degree angle dorsal-right or dorsal-left ventral oblique projection for radiography allowed effective evaluation of the tympanic bulla. Clinical respiratory scores were similar among all three groups. Computed tomography imaging can differentiate early from advanced otitis media. Radiographs, which can be performed in the field, also have utility to identify advanced otitis media to aid management decisions.

Calf care personnel on dairy farms and their educational opportunities.

As dairy herd sizes become larger and the organization of the business more complex, targeting communication and education to enhance animal care becomes more difficult. The purpose of this study was to describe selected demographics of calf care employees on large (>500 animals) and small (<501 animals) dairy farms that raise their own calves. Two to 8 individuals per farm involved with calf care, including owners, veterinarians, and calf managers, feeders, and treaters, were interviewed in either English or Spanish. Interviews were conducted in person on 53 dairy farms located in Arizona, Idaho, New York, Oregon, and Washington State. The number of preweaned calves on the farm ranged from 9 to 1,500 (median = 93). A total of 224 individuals were interviewed across 8 job titles. As farm size increased, personnel structure became more complex. Farms with >100 preweaned calves were 15 times more likely to have a calf manager title compared with farms with ≤100 preweaned calves. Eight farms designated the same person as calf manager, treater, and feeder, all with ≤100 preweaned calves. Thirty-two (60%) of the farms had at least 1 full-time calf feeder. Almost 30% of owners and over 40% of veterinarians interviewed were over 50 yr of age, whereas over 40% of the calf managers, feeders, and treaters were under 30 yr of age. Seventy-three percent of feeders and 72% of treaters spoke Spanish at home. For languages in which interviewees were comfortable speaking, more than 30% of owners and 33% of veterinarians were comfortable communicating in Spanish. For calf care employees, 60% of calf managers, 42% of feeders, and 38% of treaters were bilingual (English and Spanish), but most (72%) preferred to be interviewed in Spanish. The level of education varied by job title for those interviewed, but most of the calf care team had high school or less education. However, some diversity was observed in educational background within job title with almost 38% of the calf managers having at least some college education. The majority of feeders (88%) and treaters (83%) reported being trained by another employee and 66 and 58%, respectively, had not received any continuing education in the previous year. With the amount of diversity seen on these farms, understanding employees' educational backgrounds, language, and generational differences may be valuable when developing training for new procedures for animal health or other aspects of animal care.

Semen parameters on the day of oocyte retrieval predict low fertilization during conventional insemination IVF cycles.

PURPOSE: Poor fertilization during conventional IVF is difficult to predict in the absence of abnormal semen parameters; large-scale studies are lacking. The purpose of this study is to evaluate factors associated with low fertilization rates in conventional insemination IVF cycles. METHODS: A retrospective cohort study evaluating demographic, reproductive evaluation, and IVF cycle characteristics to identify predictors of low fertilization (defined as 2PN/MII ≤ 30% per cycle). Participants were included if they were undergoing their first IVF cycle utilizing fresh autologous oocytes and conventional insemination with male partner's sperm (with normal pretreatment semen analysis). They were randomly divided into a training set and a validation set; validation modeling with logistic regression and binary distribution was utilized to identify covariates associated with low fertilization. RESULTS: Postprocessing sperm concentration of less than 40 million/ml and postprocessing sperm motility < 50% on the day of retrieval were the strongest predictors of low fertilization in the training dataset. Next, in the validation set, cycles with either low postprocessing concentration (≤ 40 million/ml) or low postprocessing progressive motility (≤ 50%) were 2.9-times (95% CI 1.4, 6.2) more likely to have low fertilization than cycles without either risk factor. Furthermore, cycles with low postprocessing concentration and progressive motility were 13.4 times (95% CI 4.01, 45.06) more likely to have low fertilization than cycles without either risk factor. CONCLUSIONS: Postprocessing concentration and progressive motility on the day of oocyte retrieval are predictive of low fertilization in conventional IVF cycles with normal pretreatment diagnostic semen analysis parameters.

Efectividad de las intervenciones digitales basadas en teléfonos móviles para la prevención de infecciones de transmisión sexual: protocolo de revisión sistemática / Effectiveness of digital interventions based on mobile phones for the prevention of sexually transmitted infections: A systematic review protocol

INTRODUCCIÓN Las infecciones de transmisión sexual, incluida el VIH, son un importante problema de salud pública. Cada día más de un millón de personas contraen una infección de transmisión sexual. Los sistemas de salud están buscando soluciones para mejorar la educación y lograr cambios en el comportamiento de las personas para prevenir infecciones de transmisión sexual. Las intervenciones digitales basadas en tecnologías móviles en salud (M-health), en especial las basadas en teléfonos móviles, podrían ser una importante herramienta en salud pública para la prevención de infecciones de transmisión sexual/VIH. Esta revisión sistemática resume la evidencia sobre la efectividad de las intervenciones basadas en teléfonos móviles para la prevención de infecciones de transmisión sexual/VIH. MÉTODOS Y ANÁLISIS El protocolo fue diseñado y será reportado en concordancia con la directriz "Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P)". Se incluirán ensayos controlados aleatorizados que evalúen el efecto de las intervenciones basadas en teléfonos móviles para la prevención de infecciones de transmisión sexual/VIH. Las intervenciones de interés serán aquellas dirigidas a usuarios de teléfonos móviles, basada en cualquier función o aplicación que pueda usarse o enviarse y que hayan sido diseñadas para educar, promocionar o modificar conductas para reducir comportamiento sexual de riesgo y prevención de infecciones de transmisión sexual incluyendo VIH. La búsqueda electrónica para identificar los estudios se realizará en el Registro Cochrane Central de ensayos controlados (CENTRAL), en EMBASE y MEDLINE/PubMed. Se evaluará el riesgo de sesgo utilizando la herramienta recomendada por la colaboración Cochrane. Se realizará metanálisis y se presentarán los datos mediante el método GRADE.

INTRODUCTION Sexually transmitted infections, including HIV, are an important public health problem. Every day, over one million persons become infected with a sexually transmitted infection (STI). Health systems are searching for solutions to improve sex education and change the sexual behavior of people in order to prevent them. In public health, digital interventions based on mobile health technologies (M-health), especially those based on mobile phones, might be a crucial tool for the prevention of STIs and HIV. This systematic will review and summarize the evidence on the effectiveness of mobile phone-based interventions for the prevention of STIs and HIV. METHODS AND ANALYSIS The protocol was designed and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The protocol will include randomized controlled trials that assess the effect of interventions based on mobile phones for the prevention of STIs/HIV. The interventions of interest will be those targeting mobile phone users and should consist of providing information by mobile phone through any function or application that can be used or sent to, and that has been designed to educate, promote or modify sexual behaviors and prevent STIs, including HIV. The data sources to identify these studies will be the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and MEDLINE. The risk of bias will be assessed using the tool recommended by Cochrane. Finally, a meta-analysis will be done and data will be presented following the GRADE method.

Metabotypes with elevated protein and lipid catabolism and inflammation precede clinical mastitis in prepartal transition dairy cows.

Clinical mastitis (CM), the most prevalent and costly disease in dairy cows, is diagnosed most commonly shortly after calving. Current indicators do not satisfactorily predict CM. This study aimed to develop a robust and comprehensive mass spectrometry-based metabolomic and lipidomic workflow using untargeted ultra-performance liquid chromatography high-resolution mass spectrometry for predictive biomarker detection. Using a nested case-control design, we measured weekly during the prepartal transition period differences in serum metabolites, lipids, inflammation markers, and minerals between clinically healthy Holstein dairy cows diagnosed with mastitis postcalving (CMP; n = 8; CM diagnosis d 1 = 3 cows, d 2 = 2 cows, d 4 = 1 cow; d 25 = 1 cow, and d 43 = 1 cow that had subclinical mastitis since d 3) or not (control; n = 9). The largest fold differences between CMP and control cows during the prepartal transition period were observed for 3'-sialyllactose in serum. Seven metabolites (N-methylethanolamine phosphate, choline, phosphorylcholine, free carnitine, trimethyl lysine, tyrosine, and proline) and 3 metabolite groups (carnitines, AA metabolites, and water-soluble phospholipid metabolites) could correctly classify cows for their future CM status at both 21 and 14 d before calving. Biochemical analysis using lipid and metabolite-specific commercial diagnostic kits supported our mass spectrometry-based omics results and additionally showed elevated inflammatory markers (serum amyloid A and visfatin) in CMP cows. In conclusion, metabolic phenotypes (i.e., metabotype) with elevated protein and lipid metabolism and inflammation may precede CM in prepartal transition dairy cows. The discovered serum metabolites and lipids may assist in predictive diagnostics, prevention strategies, and early treatment intervention against CM, and thereby improve cow health and welfare.

Influence of protein fermentation and carbohydrate source on in vitro methane production.

Incubations were carried out with batch cultures of ruminal micro-organisms from sheep to analyse the influence of the N source on in vitro CH4 production. The two substrates were mixtures of maize starch and cellulose in proportions of 75:25 and 25:75 (STAR and CEL substrates, respectively), and the three nitrogen (N) sources were ammonia (NH4 Cl), casein (CA) and isolated soya bean protein (SP). Five isonitrogenous treatments were made by replacing non-protein-N (NPN) with CA or SP at levels of 0 (NPN), 50 (CA50 and SP50, respectively) and 100% (CA100 and SP100) of total N. All N treatments were applied at a rate of 35 mg of N/g of substrate organic matter and incubations lasted 16.5 h. With both proteins, N source × substrate interactions (p = 0.065 to 0.002) were detected for CH4 production and CH4 /total VFA ratio. The increases in CH4 production observed by replacing the NPN with protein-N were higher (p < 0.05) for STAR than for CEL substrate, but the opposite was observed for the increases in volatile fatty acid (VFA) production. As a consequence, replacing the NPN by increased levels of CA or SP led to linear increases (p < 0.05) in CH4 /total VFA ratio with STAR, whereas CH4 /total VFA ratio tended (p < 0.10) to be decreased with CEL substrate. Increasing the amount of both proteins decreased linearly (p < 0.05) ammonia-N concentrations, which may indicate an incorporation of amino acids and peptides into microbial protein without being first deaminated into ammonia-N. In incubations with the tested N sources as the only substrate, the fermentation of 1 mg of CA or SP produced 1.24 and 0.60 µmol of CH4 respectively. The results indicate the generation of CH4 from protein fermentation, and that the response of CH4 production to protein-N supply may differ with the basal substrate.

Dental pathology in conventionally fed and pasture managed dairy cattle.

Healthy teeth are important in the first stages of digestion for dairy cattle, yet little is known about bovine dental disease. This study aimed to investigate dental pathology of dairy cattle in two parts. First dairy cattle cadaver heads (n=11) were examined at the time of culling. Second, the authors performed oral exams in cattle fed a total mixed ration (TMR) (n=200) and pasture-based (n=71) grazing cattle. Cadaver heads were imaged using radiography and computed tomography before gross dissection to study dental anatomy and pathology. The most prevalent dental abnormalities were excessive transverse ridging of the occlusal surface, the presence of diastemas and third molar dental overgrowths (M3DO) in cadaver heads. Average thickness of subocclusal dentine ranged from 3.5 mm to 5.8 mm in cheek teeth but was >10 mm in maxillary teeth with M3DO. Radiographic findings were compared with oral examinations in live cattle. Prevalence of M3DO upon oral examination was 19 per cent and 28 per cent in herds of cattle fed a TMR diet and 0 per cent in a herd of grazing cattle. Dental abnormalities are prevalent in dairy cattle but due to thin subocclusal dentine in the cheek teeth, established equine dental treatment methodology is not appropriate for bovine cheek teeth with the exception of those that have developed M3DO.

Male soy food intake was not associated with in vitro fertilization outcomes among couples attending a fertility center.

Male factor etiology may be a contributing factor in up to 60% of infertility cases. Dietary intake of phytoestrogens has been related to abnormal semen quality and hormone levels. However, its effect on couple fecundity is still unclear. Intake of soy products was assessed in 184 men from couples undergoing infertility treatment with in vitro fertilization. Couples were recruited between February 2007 and May 2014 and prospectively followed to document treatment outcomes including fertilization, implantation, clinical pregnancy and live birth. Multivariate generalized linear mixed models with random intercepts, binomial distribution and logit link function were used to examine this relation while accounting for repeated treatment cycles and adjusting for potential confounders. Male partner's intake of soy foods and soy isoflavones was unrelated to fertilization rates, the proportions of poor quality embryos, accelerated or slow embryo cleavage rate, and implantation, clinical pregnancy and live birth. The adjusted live birth rates per initiated cycle (95% CI) for partners of men in increasing categories of soy food intake were 0.36 (0.28-0.45), 0.42 (0.29-0.56), 0.36 (0.24-0.51), and 0.37 (0.24-0.52), respectively. Soy food intake in men was not related to clinical outcomes among couples presenting at an infertility clinic. Data on the relation between phytoestrogens and male reproductive potential remain scarce and additional research is required to clarify its role in human reproduction.

Glycosylflavonoids from Cecropia pachystachya Trécul are quorum sensing inhibitors.

The Cecropia genus is widely distributed in Latin America including at least 60 species, and some of them are commonly used in traditional medicine for the treatment of several diseases. We used Cecropia pachystachya Trécul to search for quorum sensing (QS) inhibitors compounds and found that the aqueous extract of C. pachystachya leaves is a promising source of substances with this activity. Using as biosensor Chromobacterium violaceum ATCC 31532 and Escherichia coli pSB403, the compounds chlorogenic acid (2), isoorientin (3), orientin (4), isovitexin (6), vitexin (7), and rutin (9) were identified as QS inhibitors. None of these compounds inhibited the growth of neither the used biosensors nor the microorganisms Staphylococcus aureus ATCC 23591, Escherichia coli ATCC 25922 and Saccharomyces cerevisiae, used here as growth inhibition controls. Along with the rutin, here we presented for the first time the QS-inhibition potential of the C-glycosyl flavonoids. The prospective of this evidence lead to the use of these compounds as antipathogenic drugs or antifoulants.

Association of abnormal hind-limb postures and back arch with gait abnormality in dairy cattle.

Detection of lameness in individual cows is important for the prompt treatment of this painful and production-limiting disease. Current methods for lameness detection involve watching cows walk for several strides. If clinical signs predictive of lameness could be observed more conveniently, as cows are undergoing regularly scheduled examinations while standing, detection levels could increase. The objective of this study was to assess the association between postures observed while cows are standing in stanchions and clinical lameness evaluated by locomotion scoring, and to evaluate the observation of these postures as a test for lameness. The study included 1,243 cows from 4 farms. Cows were observed while standing in stanchions for regularly scheduled management procedures and the presence of arched back and cow-hocked, wide-stance, and favored-limb postures were recorded. The same cows were locomotion-scored as they exited the milking parlor. The proportion of cows observed with arched back and cow-hocked and favored-limb postures increased with increasing severity of lameness (higher locomotion score) but did not increase for the wide-stance posture. For the presence of these postures as a test for lameness (locomotion score ≥3), sensitivity and specificity were 0.63 and 0.64 for back arch, 0.54 and 0.57 for cow hocks, and 0.05 and 0.98 for favored limb. Back-arched, cow-hocked, and favored limb postures were associated with lameness but were not highly sensitive or specific as diagnostic tests. However, observation of back arch may be useful to identify cows needing further examination.

Comparison of modeled sampling strategies for estimation of dairy herd lameness prevalence and cow-level variables associated with lameness.

Monitoring herd lameness prevalence has utility for dairy producers and veterinarians in their efforts to reduce lameness, for animal welfare assessment programs, and for researchers. Locomotion scoring is a method used to quantify lameness and calculate prevalence. Because of the time necessary to locomotion score each cow in large dairy herds, a sampling strategy to determine herd lameness prevalence that allows scoring of fewer cows would be useful. Such a sampling strategy must be validated for accuracy compared with the lameness prevalence when all cows in a herd are locomotion scored. The purpose of this study was to assess 3 previously suggested methods of estimating lameness prevalence by strategic sampling of dairy herds. Sampling strategies tested included (1) sampling a calculated number of cows in the middle third of the milking parlor exit order for each pen, (2) sampling a calculated number of cows weighted across pens and distributed evenly within each pen, and (3) sampling all cows in the high production, low production, and hospital pens. Lactating cows on 5 dairy farms in Washington and Oregon (n=4,422) were locomotion scored using a 5-point scale to determine herd-level lameness prevalence (percentage with locomotion score ≥3). Milking parlor exit order, order in headlocks at the feed bunk within each pen, and breed were recorded for each cow. The number of days in lactation, milk production, and parity were collected from farm computer records. Pen grouping strategy for each farm was obtained by interview with farm management. Sampling strategies were modeled using the locomotion score data set for each herd. Estimates of lameness prevalence obtained from the milking parlor exit order sample and the sample distributed across pens were within 5 percentage points of the whole herd prevalence. The third strategy estimated the lameness prevalence within 5 percentage points on 4 farms, but overestimated prevalence on 1 farm. Pen-level prevalence obtained by locomotion score of all cows in the pen was variable and not reliably predictive of herd-level prevalence. Cows of Holstein breed, parity >1, and exiting the milking parlor in the last 20% of the pen had greater odds of lameness compared with other breeds, parities, and milking parlor exit order groups in a multivariate analysis. This study indicates that the sampling strategies using the middle of milking parlor exit order and a calculated sample distributed across the herd may be used to obtain an estimate of herd lameness prevalence.

Progressive increase of glucose transporter-3 (GLUT-3) expression in estrogen-induced breast carcinogenesis.

INTRODUCTION: Increased glucose uptake and glycolysis are main metabolic characteristics of malignant cells. A family of glucose transporters (GLUTs) facilitates glucose movement across the plasma membranes in a tumor-specific manner. Glucose transporter-1 (GLUT-1), GLUT-3 and recently GLUT-12, have been previously shown in breast cancer cells and are found to be associated with poor prognosis. In addition, it has been shown that estrogen plays critical roles in GLUT regulation, however, the stage-specific GLUT regulation of mammary carcinogenesis is unclear. METHODS: GLUT expression patterns were investigated in an in vitro-in vivo progressive, estrogen-induced, mammary carcinogenesis model which consisted of four cell lines, with same genetic background. In this model, different stages of tumor initiation and progression are represented, MCF-10F being the normal stage, E2 cells the transformed stage by estrogen, C5 cells, the invasive stage, and T4 cells the tumorigenic stage. In addition, loss of ductulogenesis and solid mass formation in collagen matrix and invasiveness of the cells were counted. RESULTS: Real time PCR showed that GLUT1 expression was downregulated in MCF10F after treatment with 17ß-estradiol (E2), and in the invasive cell type (C5), but not in the tumor cells (T4), which had no changes compared to MCF10F. C5 and T4 cells showed the highest rate of GLUT-3 expression. These cells were also found to be associated with loss of ductulogenesis, solid mass formation and higher invasive capacity, whereas, GLUT-12 was downregulated in C5 and T4 cells. CONCLUSION: Estrogen-induced malignant transformation is associated with remarkable and progressive GLUT-3 expression, GLUT-1 re-expression at further stages, as well as GLUT-12 downregulation.

Induction therapies in kidney transplantation: the experience of Hospital Pablo Tobon Uribe, Medellín, Colombia 2005-2010.

BACKGROUND: Induction therapies in kidney transplantation have led to prescriptions of lower doses of maintenance immunosuppression and fewer acute rejection episodes. We sought to assess the use of an affordable monoclonal antibody in terms of the incidences of rejection episodes as well as graft and patient survivals and cytomegalovirus (CMV) and opportunistic infections among our kidney transplant recipients between August 2005 and December 2010. Data were obtained for patients who had more than 20 months' follow-up. MATERIALS AND METHODS: We retrospectively analyzed data from kidney recipients between August 2005 and December 2010, using descriptive statistics and Kaplan-Meier survival analysis. We performed a multivariate analysis with logistic regression for the dependent variables of rejection episodes and death. RESULTS: Among 425 transplant patients graft survival was 89.2% and patient survival was 94.1% after 76.2% of patients received alemtuzumab, 10.7% daclizumab, 3.6% basiliximab, 2.4% thymoglobulin, and 7%, no induction therapy. Rejection incidence in general in the first year was 10.8% and CMV incidence 10%. There was an increased risk of rejection among subjects without any us with alemtuzumab induction therapy. CONCLUSION: Induction therapies show an important reduction in kidney transplant rejection incidence during the first year, allowing low doses of maintenance immunosuppressants, thereby diminishing long-term adverse effects. Alemtuzumab seemed to be a safe alternative with similar results to those obtained with standard immunosuppression.

Nefropatía membranosa como causa de hematuria microscópica aislada / Membranous nephropathy presenting as microscopic hematuria

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Effect of rubber flooring on claw health in lactating dairy cows housed in free-stall barns.

Multiparous dairy cows between 10 to 30 d in milk (DIM) were enrolled in a clinical trial to evaluate the effects of rubber flooring on the development of claw lesions, locomotion scores, clinical lameness, and rates of hoof growth and wear. Two groups of cows were housed in identical free-stall facilities, except that 1 pen (rubber, n = 84) had rubber alley mats covering the entire concrete floor of the pen, whereas cows in the second pen were exposed to concrete flooring (concrete, n = 82) without rubber alley mats. All cows were evaluated 3 times between 10 and 30, 74 and 94, and 110 and 130 DIM for 1) the presence of claw lesions on their rear feet, 2) the occurrence of clinical lameness based on a locomotion score, and 3) rates of claw growth and wear as observed on the dorsal wall of the right lateral claw. No differences between flooring groups at the time of enrollment were detected for lactation number, mean DIM at first examination, body condition score, and proportion of cows with claw lesions at the first examination. Odds of developing claw lesions between examinations were not different for cows exposed to the rubber surface compared with those exposed to concrete. Cows on concrete, however, had greater odds of developing or exacerbating existing heel erosion than cows on rubber flooring. Regardless of the flooring surface, the lateral claw was more likely to develop lesions than the medial claw. Odds of becoming lame by the third examination and the proportion of cows requiring therapeutic hoof trimming because of lameness were greater for concrete-exposed cows than those on rubber. Cows on rubber flooring had decreased claw growth and wear between the first and last examination compared with cows on concrete. Regardless of flooring surface, second-lactation cows had greater wear rates than those in third or greater parities. Results of our study suggest that a soft flooring surface, such as interlocking rubber, is beneficial for hoof health.

Effects of an injectable trace mineral supplement on first-service conception rate of dairy cows.

A total of 825 dairy cows from a commercial dairy farm in central California were used to evaluate effects of one or 2 doses of an injectable trace mineral supplement containing 20 mg/mL of zinc, 20 mg/mL of manganese, 5 mg/mL of selenium, and 10 mg/mL of copper on first-service conception rate. Cows were randomly allocated into treatment or control group to either a single dose (experiment 1) or a double dose (experiment 2) of injected supplement. Allocation was based on days in lactation for experiment 1 and the length of gestation periods for experiment 2. In experiment 1, cows 38 to 45 d in lactation (n = 190) received a single dose of 5 mL of injected supplement. Similar cows were used as controls (n = 227). In experiment 2, cows and pregnant heifers received an initial injection of 5 mL of the mineral supplement from 2 to 3 wk precalving (n = 186). An equal dose was repeated 38 to 45 d in lactation. A similar group of cows and pregnant heifers served as controls for experiment 2 (n = 222). Health and reproductive events postcalving were recorded. In experiment 1, the odds of first-service conception were not significantly different for cows receiving a one-dose regimen of minerals compared with untreated control cows; conception rates were 26.8 and 27.5% for experiment 1 treatment and control groups, respectively. In experiment 1, the odds of first-service conception were significantly lower (odds ratio = 0.66) for cows and heifers given the 2-dose regimen of minerals compared with untreated controls; overall conception rates were 21.5 and 31.5% for experiment 2 treatment and control groups, respectively. In this intensively managed dairy herd, a single dose of injected trace minerals before breeding had no beneficial effects on first-service conception rate. However, dairy cows receiving a dose of trace minerals before calving and another dose before breeding had lower conception at first service.