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AIMS: To describe the incidence, aetiology, treatment, and outcomes of farmer-reported clinical mastitis on New Zealand dairy sheep farms. METHODS: A prospective cohort study was conducted on 20 spring-lambing New Zealand sheep milking farms over the 2022-2023 season. Clinical mastitis was defined as a change in the appearance of milk and/or signs of inflammation in the gland. Farmers were required to report all cases of clinical mastitis and collect information on affected ewes' demographics, clinical features, treatments (where applicable), and outcomes. Milk samples from mastitic glands were submitted for microbiological culture and identification by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF). RESULTS: Partial or complete clinical mastitis data were available for 236 cases from 221 ewes on 18/20 study farms. Clinical mastitis was diagnosed in 0-6% of ewes at the farm level, with an overall incidence of 1.8 (95% CI = 1.0-3.2)% using the study data, or 2.3 (95% CI = 1.6-3.3)% using the study data and farmer estimates that included unreported cases. Cases occurred mostly in early lactation, with 59% detected during the lambing period (August-October), at a median of 7 (IQR 3, 40) days in milk. The majority of cases featured clots in the milk (59%), swelling (55%), and unevenness (71%) of the glands. Pyrexia (rectal temperature ≥ 40.0°C) was diagnosed in 25% of cases and depression (lethargy, inappetence, or inability to stand) in 26% of cases. Treatment was given to 46% of cases, with tylosin being the most commonly used treatment (50% of treated cases). The most common outcome was immediate drying off to be culled without treatment (32%), followed by still milking and recovered but with lasting problems (25%). Nearly half of all the milk samples submitted were culture negative. Streptococcus uberis (14%), non-aureus staphylococci (12%), and Staphylococcus aureus (11%) were the most common isolates, found on 12, 8 and 8 of the 16 farms with microbiological data, respectively. CONCLUSIONS: Clinical mastitis affected up to 6% of ewes at the farm level. Systemic signs were observed in one quarter of affected ewes, suggesting a role for supportive treatment. Clinical mastitis can be severe and challenging to fully resolve in New Zealand dairy sheep. CLINICAL RELEVANCE: This is the first systematic study of clinical mastitis in New Zealand dairy ewes. It provides baseline information specific to New Zealand conditions for farmers, veterinarians, and other advisors to guide the management of mastitis for the relatively new dairy sheep industry in New Zealand.
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Industria Lechera , Mastitis , Enfermedades de las Ovejas , Animales , Ovinos , Nueva Zelanda/epidemiología , Femenino , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Ovejas/microbiología , Mastitis/veterinaria , Mastitis/epidemiología , Mastitis/microbiología , Estudios Prospectivos , Incidencia , Leche/microbiología , Agricultores , LactanciaRESUMEN
OBJECTIVE: To evaluate three birth-weight (BW) standards (Australian population-based, Fenton and INTERGROWTH-21st ) and three estimated-fetal-weight (EFW) standards (Hadlock, INTERGROWTH-21st and WHO) for classifying small-for-gestational age (SGA) and large-for-gestational age (LGA) and predicting adverse perinatal outcomes in preterm and term babies. METHODS: This was a nationwide population-based study conducted on a total of 2.4 million singleton births that occurred from 24 + 0 to 40 + 6 weeks' gestation between 2004 and 2013 in Australia. The performance of the growth charts was evaluated according to SGA and LGA classification, and relative risk (RR) and diagnostic accuracy based on the areas under the receiver-operating-characteristics curves (AUCs) for stillbirth, neonatal death, perinatal death, composite morbidity and a composite of perinatal death and morbidity outcomes. The analysis was stratified according to gestational age at delivery (< 37 + 0 vs ≥ 37 + 0 weeks). RESULTS: Following exclusions, 2 392 782 singleton births were analyzed. There were significant differences in the SGA and LGA classification and risk of adverse outcomes between the six BW and EFW standards evaluated. For the term group, compared with the other standards, the INTERGROWTH-21st BW and EFW standards classified half the number of SGA (< 10th centile) babies (3-4% vs 7-11%) and twice the number of LGA (> 90th centile) babies (24-25% vs 8-15%), resulting in a smaller cohort of term SGA at higher risk of adverse outcome and a larger LGA cohort at lower risk of adverse outcome. For term SGA (< 3rd centile) babies, the RR of perinatal death using the two INTERGROWTH-21st standards was up to 1.5-fold higher than those of the other standards (including the WHO-EFW and Hadlock-EFW), while the INTERGROWTH-21st -EFW standard indicated a 12-26% reduced risk of perinatal death for LGA cases across centile thresholds. Conversely, for the preterm group, the WHO-EFW and Hadlock-EFW standards identified a higher SGA classification rate than did the other standards (18-19% vs 10-11%) and a 20-65% increased risk of perinatal death in term LGA babies. All BW and EFW charts had similarly poor performance in predicting adverse outcomes, including the composite outcome (AUC range, 0.49-0.62) for both preterm (AUC range, 0.58-0.62) and term (AUC range, 0.49-0.50) cases and across centiles. Furthermore, specific centile thresholds for identifying adverse outcomes varied markedly by chart between BW and EFW standards. CONCLUSIONS: This study addresses the recurrent problem of identifying fetuses at risk of morbidity and perinatal mortality associated with growth disorders and provides new insights into the applicability of international growth standards. Our findings of marked variation in classification and the similarly poor performance of prescriptive international standards and the other commonly used standards raise questions about whether the prescriptive international standards that were constructed for universal adoption are indeed applicable to a multiethnic population such as that of Australia. Thus, caution is needed when adopting universal standards for clinical and epidemiological use. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Peso al Nacer , Retardo del Crecimiento Fetal/diagnóstico por imagen , Peso Fetal , Recién Nacido Pequeño para la Edad Gestacional , Ultrasonografía Prenatal , Australia , Femenino , Humanos , Valor Predictivo de las Pruebas , Embarazo , Valores de ReferenciaRESUMEN
Parity is a potential confounder of the association between medically assisted reproduction (MAR) and health outcomes. This concept paper describes a population-based record linkage study design for selecting MAR-unexposed women matched to the parity of MAR-exposed women, at the time of the first exposure to MAR. Women exposed to MAR were identified from claims for government subsidies for relevant procedures and prescription medicines, linked to perinatal records. Women unexposed to MAR were identified from linked perinatal and death records, matched to exposed women by age, rurality, age of first child (if any) and parity at the date of first MAR. The availability of a longitudinal, whole-of-population dataset ("population spine") based on enrolments in Australia's universal health insurance scheme was a critical design element. The example application examines cancer risk in women after exposure to MAR. Parity is a confounder in this setting because it is associated with MAR and hormone-sensitive cancers.
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The objective of this study was to explore the cost-effectiveness of using a progesterone-based synchrony program to manage phantom cows on seasonal-calving dairy farms. Phantom cows were defined as cows that had been artificially inseminated ≤14 d after mating start date (MSD), were not subsequently detected in estrus, and were diagnosed nonpregnant at a pregnancy diagnosis conducted approximately 49 d after MSD. Decision-tree analysis was applied to data from a previous randomized controlled trial in which phantom cows (n = 378) from spring-calving dairy farms were randomly allocated to an untreated control group or were immediately treated with a 10-d progesterone-based synchrony program with fixed-time artificial insemination. The net economic return of treating all cows presented by the farmer for pregnancy diagnosis that were diagnosed nonpregnant was compared with no intervention. The net return was calculated per cow present at MSD because the decision trees followed all cows present at MSD through to mating end date to account for farmers inadvertently presenting ineligible cows for pregnancy diagnosis and possible treatment. Probabilities, costs, and benefits of reproductive outcomes were based on published data and expert opinion. The effects of key variables on the economic return were tested by sensitivity analysis. Phantom cow intervention delivered a net return of NZ$4.451 (at the time of the study, NZ$1 = US$0.6629) per cow present at MSD. The sensitivity of pregnancy diagnosis, the proportion of ineligible cows presented by the farmer for pregnancy diagnosis, and the prevalence of phantom cows were highly influential on the net economic return from phantom cow intervention. These findings suggest that treatment of phantom cows in seasonal-calving dairy farms using a progesterone-based synchrony program is economically viable based on the current model assumptions. Accurate cow selection and pregnancy diagnosis are essential to success, and veterinarians and animal health advisors can improve the net economic return of intervention by selecting farms likely to have a higher prevalence of phantom cows based on the presence of observable risk factors.
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Bovinos/fisiología , Análisis Costo-Beneficio , Inseminación Artificial/veterinaria , Progesterona/farmacología , Progestinas/farmacología , Reproducción/efectos de los fármacos , Animales , Industria Lechera , Femenino , Inseminación Artificial/economía , EmbarazoRESUMEN
Aim: To determine the effect of a progesterone-based synchrony programme on the daily hazard of conception and the probability of being pregnant at the end of the seasonal mating period in cows not observed in oestrus within 35-49 days of insemination and that were diagnosed non-pregnant (phantom cows) on seasonally calving New Zealand dairy farms. Secondary aims were to determine the prevalence of phantom cows and estimate the proportion of phantom cows with a functional corpus luteum (CL) at enrolment. Methods: Phantom cows from 14 New Zealand commercial dairy farms were enrolled in a randomised, controlled trial. Cows that were artificially inseminated ≤14 days after mating start date and were not subsequently detected in oestrus, were presented for pregnancy diagnosis approximately 49 days after mating start date. Non-pregnant cows were diagnosed as phantom cows and randomly allocated to treatment and control groups. A milk sample was collected for progesterone assay to determine the presence of a functional CL. Treatment consisted of an injection of buserelin and insertion of an intravaginal device containing progesterone on Day 0, injections of dinoprost and equine chorionic gonadotrophin, and removal of the intravaginal device on Day 7, injection of buserelin on Day 9, and fixed time artificial insemination on Day 10. Treatment group cows were then mixed with bulls for the remainder of the seasonal mating period. Cows allocated to the control group were mated naturally by bulls. Statistical models were constructed to determine the effect of treatment on the daily hazard of conception and the probability of being pregnant at the end of the seasonal mating period. Results: A total of 378/4,214 (9.0%) cows presented for pregnancy diagnosis were diagnosed as phantom cows. A functional CL was diagnosed in 257/362 (71.0%) phantom cows. Median predicted enrolment to conception intervals were 33 (95% CI = 30-45) and 30 (95% CI = 28-33) days, for cows in the control and treatment groups, respectively. The odds of being pregnant at the end of mating were 1.70 (95% CI = 1.34-2.17) times greater for treated phantom cows than untreated phantom cows. Estimated marginal mean proportion pregnant at mating end date were 59.5 (95% CI = 47.9-70.1)% and 71.5 (95% CI = 62.6-79.0)% for control and treatment group cows, respectively. Conclusions: Treatment with a progesterone-based synchrony programme significantly increased the probability of phantom cows being pregnant at the end of the seasonal mating period.
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Fármacos para la Fertilidad Femenina/administración & dosificación , Fertilización/efectos de los fármacos , Infertilidad/veterinaria , Progesterona/administración & dosificación , Progestinas/administración & dosificación , Abortivos no Esteroideos/administración & dosificación , Administración Intravaginal , Animales , Buserelina/administración & dosificación , Bovinos , Gonadotropina Coriónica/administración & dosificación , Cuerpo Lúteo , Industria Lechera , Dinoprost/administración & dosificación , Femenino , Infertilidad/tratamiento farmacológico , Inseminación Artificial/veterinaria , Nueva Zelanda , Embarazo , Índice de Embarazo , Sustancias para el Control de la Reproducción/administración & dosificación , Resultado del TratamientoRESUMEN
OBJECTIVES: To assess the outcomes and major complications in cats that require oesophageal and gastric endoscopic foreign body removal. MATERIALS AND METHODS: The medical records of 52 cats with oesophageal and gastric foreign bodies that underwent endoscopic foreign body retrieval during a 13-year period (2006 to 2018) were retrospectively reviewed to characterise the clinical and radiographic signs, endoscopic findings, outcomes and major complications. RESULTS: Endoscopic foreign body retrieval was successful in 49 of the 52 cats (94.2%). Radiographs confirmed the foreign material in 24 of the 50 cats (48%). Major complications occurred in eight of the 52 cats (15.4%) and included pleural effusion (n=2), aspiration pneumonia (n=2), unsuccessful removal of foreign material with endoscopy (n=3), oesophageal stricture formation (n=3) and cardiopulmonary arrest (n=1). Cats with oesophageal foreign bodies were more likely to experience major complications than those with gastric foreign bodies. CLINICAL SIGNIFICANCE: Endoscopic foreign body removal in cats was associated with good overall outcomes and a low complication rate in this study sample. These results will help veterinarians better understand the outcomes of endoscopic foreign body removal in cats.
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Esófago , Cuerpos Extraños/veterinaria , Animales , Gatos , Endoscopía/veterinaria , Estudios Retrospectivos , EstómagoRESUMEN
BACKGROUND: Placental anomalies (placenta praevia, placental abruption, morbidly adherent placenta and cord insertion anomalies) are associated with maternal and fetal morbidity and mortality. It has been suggested these might be more prevalent in pregnancies after assisted reproduction technology (ART). OBJECTIVES: To determine whether ART singleton pregnancies are associated with an increased risk of placental anomalies compared with non-ART singleton pregnancies. SEARCH STRATEGY: MEDLINE, EMBASE, CENTRAL, Web of Science and Scopus (January 2018). SELECTION CRITERIA: Cohort studies reporting placental anomalies in ART and non-ART singleton pregnancies. DATA COLLECTION AND ANALYSIS: We report pooled odds ratios (OR) for the comparisons: (1) ART versus SC (spontaneously conceived), (2) ART versus non-ART (unspecified), (3) FET-ART (frozen-embryo transfer) versus SC, (4) ART versus non-ART (subfertile patients). Study quality was assessed using a modified Newcastle -Ottawa scale. MAIN RESULTS: 33 low/moderate quality studies evaluated 124 215 ART and 6 054 729 non-ART singleton pregnancies. Risk of placenta praevia, placental abruption and morbidly adherent placenta was higher in ART than SC pregnancies: odds ratio (OR) (OR 3.76, 95% CI 3.09-4.59); (OR 1.87, 95% CI 1.70-2.06) and (OR 2.27, 95% CI 1.79-2.87) respectively. Risk of placenta praevia and placental abruption was higher in ART than in non-ART (subfertile patients): (OR 2.51, 95% CI 2.12-2.98) and (OR 1.61, 95% CI 1.33-1.95) respectively. Results were similar when comparing ART with unspecified non-ART pregnancies. Risk of placenta praevia was higher, but not significantly so, in FET-ART than in SC pregnancies (OR 2.42, 95% CI 0.63-9.30). CONCLUSIONS: Singleton ART pregnancies are associated with an increased risk of placental anomalies compared with non-ART singleton pregnancies. TWEETABLE ABSTRACT: A review of over 6 million singleton pregnancies finds increased risk of placental anomalies after ART.
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Enfermedades Placentarias/etiología , Técnicas Reproductivas Asistidas/efectos adversos , Estudios de Cohortes , Femenino , Humanos , Estudios Observacionales como Asunto , Oportunidad Relativa , Enfermedades Placentarias/epidemiología , Embarazo , Medición de RiesgoRESUMEN
AIMS: To examine the association between the interval from internal teat sealant (ITS) administration to calving and the incidence of farmer-recorded clinical mastitis in the first 30 days of lactation in pasture-based dairy heifers. METHODS: Heifers that were administered an ITS by a single veterinary business in the South Island of New Zealand over the winter of 2014 were enrolled in a cross-sectional observational study. ITS was administered to all heifers on each participating farm on a single calendar day. The dates of calving and farmer-diagnosed clinical mastitis were recorded by farm staff. The interval from ITS administration to calving was categorised into four approximately evenly sized groups: <35, 35-48, 49-69 and >69 days. The quartile of the farm's calving period in which each heifer calved was also investigated as a potential confounding variable. A hierarchical logistic regression model was constructed to determine the association between the interval from ITS administration to calving with the odds of clinical mastitis in the first 30 days of lactation. RESULTS: Analysis was performed on 7,126 eligible heifers from 31 farms, with ITS administered between 9 May and 11 July 2014. The mean interval from ITS administration to calving was 52.9 (SD 24.4, min 1, max 137) days. Clinical mastitis was diagnosed in 420/7,126 (5.9 (95% CI=5.4-6.5)%) heifers between calving and day 30 of lactation. In the final multivariable model, which included calving period quartile, interval from ITS administration to calving was not associated with the odds of clinical mastitis (p=0.516). Compared to an interval from ITS administration to calving of <35 days, the adjusted OR of clinical mastitis for intervals of 35-48, 49-69 and >69 days were 0.83 (95% CI=0.59-1.17), 0.71 (95% CI=0.45-1.11) and 0.68 (95% CI=0.36-1.29), respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Within the range of intervals from ITS administration to calving observed in this study, there was no association with the odds of clinical mastitis in the first 30 days of lactation in dairy heifers. This study suggests that veterinary clinics may be able to extend their ITS administration service and treat dairy heifers earlier than the current recommendation of approximately 4 weeks before the planned start of calving.
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Bismuto/farmacología , Mastitis Bovina/prevención & control , Animales , Bismuto/administración & dosificación , Bovinos , Estudios Transversales , Femenino , Lactancia , Glándulas Mamarias Animales , Mastitis Bovina/epidemiología , Nueva Zelanda/epidemiología , Parto , Periodo Posparto , Embarazo , Factores de TiempoRESUMEN
A novel citrus viroid was discovered in a non-symptomatic Lisbon lemon (Citrus x limon L. Burm.f.) tree in New South Wales, Australia. Bioindexing, molecular detection and characterization involving sequencing combined with in silico analysis for the identification of the viroid-RNA hallmark properties of transmissibility and autonomous replication as well as specific sequence and structural motifs suggest that this viroid is a member of a new species in the genus Apscaviroid, family Pospiviroidae, which we have tentatively named "citrus viroid VII" (CVd-VII).
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Citrus/virología , Virus de Plantas/aislamiento & purificación , Viroides/aislamiento & purificación , Australia , Secuencia de Bases , ARN Viral/genética , Viroides/genéticaRESUMEN
AIMS: To examine associations between various cow-level factors and quality of first-milking colostrum (measured as Brix), and to evaluate herd-level associations between vaccination against calf diarrhoea and colostrum quality, in cows from dairy herds in the Waikato region of New Zealand. METHODS: A single colostrum sample was collected, by complete udder evacuation, from each of 20 cows from 29 dairy herds in the Waikato region of New Zealand during the 2016 spring calving period. Vaccination pre-partum with a calf diarrhoea vaccine was used in 15 herds. Each colostrum sample was tested using a digital Brix refractometer. The body condition score of each cow was recorded at the time of sample collection and farmers provided records of clinical mastitis and facial eczema from the previous 12 months, as well as the age and breed of cows. Associations between cow-level variables in non-vaccinated herds and Brix were examined using a multivariable linear mixed model and estimated marginal means obtained for different categories. RESULTS: Mean Brix of 281 samples from cows in non-vaccinated herds was 18.7 (SD 0.26)%; 63/281 (22.4%) samples had Brix ≥22% and 152/281 (54.1%) had Brix ≥18%. Mean Brix of colostrum samples from cows aged ≥6 years (20.2 (95% CI=19.1-21.2)%) was higher than for samples from 2-year-old cows (18.6 (95% CI=17.3-19.9)%) (p=0.005). Colostrum that was collected at the first milking on the day of calving had higher Brix (20.0 (95% CI=19.1-20.9)%) than colostrum collected from cows that calved the previous day (17.5 (95% CI=16.5-18.4)%) (p<0.001). Mean Brix of colostrum samples from cows which produced ≥8â L (18.2 (95% CI=17.1-19.2)%) tended to be lower than from cows which produced <8â L first-milking colostrum (19.1 (95% CI=18.3-20.0)%) (p=0.08). Among vaccinating herds, 9/15 (60%) had ≥60% colostrum samples with Brix ≥18% compared with 4/14 (29%) of non-vaccinating herds (p=0.04). CONCLUSIONS AND CLINICAL RELEVANCE: Colostrum quality, as measured by Brix, was associated with the total volume of first-milking colostrum, interval from calving to colostrum collection and cow age. Vaccination against calf diarrhoea was associated with a higher proportion of colostrum samples with adequate Brix. Careful selection of colostrum donor cows should ensure newborn calves are fed adequate quality colostrum which should be beneficial in preventing failure of passive transfer of IgG. Testing of colostrum from individual cows with a Brix refractometer is advocated for the selection of colostrum for feeding newborn calves.
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Diarrea Mucosa Bovina Viral/prevención & control , Bovinos/fisiología , Calostro/fisiología , Industria Lechera/métodos , Industria Lechera/normas , Vacunación/veterinaria , Animales , Calostro/metabolismo , Femenino , Modelos Lineales , Nueva Zelanda , Embarazo , Refractometría , Estaciones del AñoRESUMEN
Prisoner populations are characterized by high rates of hepatitis C (HCV), up to thirty times that of the general population in Australia. Within Australian prisons, less than 1% of eligible inmates access treatment. Public health strategies informed by social capital could be important in addressing this inequality in access to HCV treatment. Twenty-eight male inmates participated in qualitative interviews across three correctional centres in New South Wales, Australia. All participants had recently tested as HCV RNA positive or were receiving HCV treatment. Analysis was conducted with participants including men with experiences of HCV treatment (n=10) (including those currently accessing treatment and those with a history of treatment) and those who were treatment naïve (n=18). Social capital was a resourceful commodity for inmates considering and undergoing treatment while in custody. Inmates were a valuable resource for information regarding HCV treatment, including personal accounts and reassurance (bonding social capital), while nurses a resource for the provision of information and care (linking social capital). Although linking social capital between inmates and nurses appeared influential in HCV treatment access, there remained opportunities for increasing linking social capital within the prison setting (such as nurse-led engagement within the prisons). Bonding and linking social capital can be valuable resources in promoting HCV treatment awareness, uptake and adherence. Peer-based programmes are likely to be influential in promoting HCV outcomes in the prison setting. Engagement in prisons, outside of the clinics, would enhance opportunities for linking social capital to influence HCV treatment outcomes.
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Concienciación , Conocimientos, Actitudes y Práctica en Salud , Hepatitis C/tratamiento farmacológico , Aceptación de la Atención de Salud , Prisiones , Capital Social , Adolescente , Adulto , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Nueva Gales del Sur , Prisioneros , Adulto JovenRESUMEN
STUDY QUESTION: What were utilization, outcomes and practices in assisted reproductive technology (ART) globally in 2008, 2009 and 2010? SUMMARY ANSWER: Global utilization and effectiveness remained relatively constant despite marked variations among countries, while the rate of single and frozen embryo transfers (FETs) increased with a concomitant slight reduction in multiple birth rates. WHAT IS KNOWN ALREADY: ART is widely practised in all regions of the world. Monitoring utilization, an approximation of availability and access, as well as effectiveness and safety is an important component of universal access to reproductive health. STUDY DESIGN, SIZE, DURATION: This is a retrospective, cross-sectional survey on utilization, effectiveness and safety of ART procedures performed globally from 2008 to 2010. PARTICIPANTS, SETTING, METHODS: Between 58 and 61 countries submitted data from a total of nearly 2500 ART clinics each year. Aggregate country data were processed and analyzed based on forms and methods developed by the International Committee for Monitoring Assisted Reproductive Technologies (ICMART). Results are presented at country, regional and global level. MAIN RESULTS AND THE ROLE OF CHANCE: For the years 2008, 2009 and 2010, >4 461 309 ART cycles were initiated, resulting in an estimated 1 144 858 babies born. The number of aspirations increased by 6.4% between 2008 and 2010, while FET cycles increased by 27.6%. Globally, ART utilization remained relatively constant at 436 cycles/million in 2008 and 474 cycles/million population in 2010, but with a wide country range of 8-4775 cycles/million population. ICSI remained constant at around 66% of non-donor aspiration cycles. The IVF/ICSI combined delivery rate (DR) per fresh aspiration was 19.8% in 2008; 19.7% in 2009 and 20.0% in 2010, with corresponding DRs for FET of 18.8, 19.7 and 20.7%. In fresh non-donor cycles, single embryo transfer increased from 25.7% in 2008 to 30.0% in 2010, while the average number of embryos transferred fell from 2.1 to 1.9, again with wide regional variation. The rates of twin deliveries following fresh non-donor transfers were, in 2008, 2009 and 2010, 21.8, 20.5 and 20.4%, respectively, with a corresponding triplet rate of 1.3, 1.0 and 1.1%. Fresh IVF and ICSI carried a perinatal mortality rate per 1000 births of 22.8 (2008), 19.2 (2009) and 21.0 (2010), compared with 15.1, 12.8 and 14.6/1000 births following FET in the same periods of observation. The proportion of women aged 40 years or older undergoing non-donor ART increased from 20.8 to 23.2% from 2008 to 2010. LIMITATIONS, REASON FOR CAUTION: The data presented are reliant on the quality and completeness of data submitted by individual countries. This report covers approximately two-thirds of the world ART activity. WIDER IMPLICATIONS OF FINDINGS: The ICMART World Reports provide the most comprehensive global statistical census and review of ART utilization, effectiveness, safety and quality. While ART treatment continues to increase globally, the wide disparities in access to treatment and embryo transfer practices warrant attention by clinicians and policy makers. STUDY FUNDING/COMPETING INTERESTS: The authors declare no conflict of interest and no specific support from any organizations in relation to this manuscript. ICMART acknowledges financial support from the following organizations: American Society for Reproductive Medicine; European Society for Human Reproduction and Embryology; Fertility Society of Australia; Japan Society for Reproductive Medicine; Japan Society of Fertilization and Implantation; Red Latinoamericana de Reproduccion Asistida; Society for Assisted Reproductive Technology; Government of Canada (Research grant), Ferring Pharmaceuticals (Grant unrelated to World Reports). TRIAL REGISTRATION: not applicable.
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Técnicas Reproductivas Asistidas/tendencias , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Embarazo , Resultado del Embarazo , Técnicas Reproductivas Asistidas/efectos adversos , Técnicas Reproductivas Asistidas/estadística & datos numéricos , Informe de Investigación , Estudios RetrospectivosRESUMEN
A complete cytotoxic profile of exposure to silver (AgNP) nanoparticles investigating their biological effects on the innate immune response of circulating white blood cells is required to form a complete understanding of the risk posed. This was explored by measuring AgNP-stimulated gene expression of the pro-inflammatory cytokines interleukin-1 (IL-1), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) in THP-1 monocytes. A further study, on human monocytes extracted from a cohort of blood samples, was carried out to compare with the AgNP immune response in THP-1 cells along with the detection of pro-IL-1ß which is a key mediator of the inflammasome complex. The aims of the study were to clearly demonstrate that AgNP can significantly up-regulate pro-inflammatory cytokine gene expression of IL-1, IL-6 and TNF-α in both THP-1 cells and primary blood monocytes thus indicating a rapid response to AgNP in circulation. Furthermore, a role for the inflammasome in AgNP response was indicated by pro-IL-1ß cleavage and release. These results highlight the potential inflammatory effects of AgNP exposure and the responses evoked should be considered with respect to the potential harm that exposure may cause. Copyright © 2016 John Wiley & Sons, Ltd.
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Expresión Génica/efectos de los fármacos , Inflamasomas/metabolismo , Nanopartículas del Metal/toxicidad , Monocitos/efectos de los fármacos , Monocitos/inmunología , Plata/toxicidad , Línea Celular , Humanos , Inmunidad Innata/efectos de los fármacos , Inmunidad Innata/genética , Interleucina-1/genética , Interleucina-1/inmunología , Interleucina-6/genética , Interleucina-6/inmunología , Nanopartículas del Metal/química , Monocitos/metabolismo , Cultivo Primario de Células , Plata/química , Factor de Necrosis Tumoral alfa/genética , Factor de Necrosis Tumoral alfa/inmunología , Regulación hacia ArribaRESUMEN
AIM: To assess the effect of combining an internal teat sealant (ITS) and a long-acting cephalonium-based dry cow therapy (DCT) on the prevalence of cows with a somatic cell count (SCC) >150,000 cells/mL 60-80 days after calving, and the incidence of clinical mastitis diagnosed by farm staff in the first 100 days after calving. METHODS: Cows from a spring-calving, pasture-based, dairy farm in the South Canterbury region of New Zealand were randomly allocated to receive cephalonium DCT (n=289) or cephalonium and internal teat sealant (n=304) at the end of lactation. Cows were inspected twice daily by farm staff during the dry period and following calving for signs of mastitis. Individual SCC were determined from herd tests conducted in the previous lactation and following calving. Logistic regression models were used to determine relationships with the prevalence of cows with a SCC >150,000 cells/mL after calving, and survival analysis was used to model time to the first case of clinical mastitis following calving at the cow and quarter level. RESULTS: The OR for a cow with a SCC >150,000 cells/mL after calving, including age and individual SCC in the preceding lactation in the model, was 0.53 (95% CI=0.32-0.89) for cows treated with combination therapy compared to cows receiving cephalonium (p=0.017). At the cow level, including age and preceding SCC in the model, the hazard ratio for diagnosis of clinical mastitis by farm staff in the first 100 days of lactation was 0.60 (95% CI=0.39-0.98) for cows treated with combination therapy compared to cows receiving cephalonium (p=0.04). At the quarter level, the hazard ratio for diagnosis of clinical mastitis, with age included in the model, was 0.41 (95% CI=0.23-0.74) for the combination therapy compared to cephalonium alone (p<0.001). CONCLUSIONS: The combination of internal teat sealant and cephalonium DCT was more effective than cephalonium alone at reducing clinical mastitis diagnosed by farm staff in the 100 days after calving, and the prevalence of cows with a SCC >150,000 cells/mL 60-80 days after calving. CLINICAL RELEVANCE: This study adds to the evidence that the prevention of intra mammary infections throughout the dry period and up to calving by using combination therapy is important in reducing the incidence of farmer-diagnosed clinical mastitis and prevalence of cows with a SCC >150,000 cells/mL 60-80 days after calving.
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Antibacterianos/uso terapéutico , Cefalosporinas/uso terapéutico , Mastitis Bovina/prevención & control , Animales , Antibacterianos/administración & dosificación , Bovinos , Cefalosporinas/administración & dosificación , Femenino , Lactancia , Glándulas Mamarias Animales/microbiología , Glándulas Mamarias Animales/fisiología , Parto , Periodo Posparto , Embarazo , Estaciones del AñoRESUMEN
Linked administrative population data were used to estimate the burden of childhood respiratory syncytial virus (RSV) hospitalization in an Australian cohort aged <5 years. RSV-coded hospitalizations data were extracted for all children aged <5 years born in New South Wales (NSW), Australia between 2001 and 2010. Incidence was calculated as the total number of new episodes of RSV hospitalization divided by the child-years at risk. Mean cost per episode of RSV hospitalization was estimated using public hospital cost weights. The cohort comprised of 870 314 children. The population-based incidence/1000 child-years of RSV hospitalization for children aged <5 years was 4·9 with a rate of 25·6 in children aged <3 months. The incidence of RSV hospitalization (per 1000 child-years) was 11·0 for Indigenous children, 81·5 for children with bronchopulmonary dysplasia (BPD), 10·2 for preterm children with gestational age (GA) 32-36 weeks, 27·0 for children with GA 28-31 weeks, 39·0 for children with GA <28 weeks and 6·7 for term children with low birthweight. RSV hospitalization was associated with an average annual cost of more than AUD 9 million in NSW. RSV was associated with a substantial burden of childhood hospitalization specifically in children aged <3 months and in Indigenous children and children born preterm or with BPD.
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Hospitalización/economía , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/patología , Virus Sincitiales Respiratorios/aislamiento & purificación , Preescolar , Femenino , Costos de la Atención en Salud , Humanos , Incidencia , Lactante , Recién Nacido , Almacenamiento y Recuperación de la Información , Masculino , Nueva Gales del Sur/epidemiología , Estudios RetrospectivosRESUMEN
BACKGROUND: Located in the Pacific Ocean between Australia and New Zealand, the unique population isolate of Norfolk Island has been shown to exhibit increased prevalence of metabolic disorders (type-2 diabetes, cardiovascular disease) compared to mainland Australia. We investigated this well-established genetic isolate, utilising its unique genomic structure to increase the ability to detect related genetic markers. A pedigree-based genome-wide association study of 16 routinely collected blood-based clinical traits in 382 Norfolk Island individuals was performed. RESULTS: A striking association peak was located at chromosome 2q37.1 for both total bilirubin and direct bilirubin, with 29 SNPs reaching statistical significance (P < 1.84 × 10(-7)). Strong linkage disequilibrium was observed across a 200 kb region spanning the UDP-glucuronosyltransferase family, including UGT1A1, an enzyme known to metabolise bilirubin. Given the epidemiological literature suggesting negative association between CVD-risk and serum bilirubin we further explored potential associations using stepwise multivariate regression, revealing significant association between direct bilirubin concentration and type-2 diabetes risk. In the Norfolk Island cohort increased direct bilirubin was associated with a 28% reduction in type-2 diabetes risk (OR: 0.72, 95% CI: 0.57-0.91, P = 0.005). When adjusted for genotypic effects the overall model was validated, with the adjusted model predicting a 30% reduction in type-2 diabetes risk with increasing direct bilirubin concentrations (OR: 0.70, 95% CI: 0.53-0.89, P = 0.0001). CONCLUSIONS: In summary, a pedigree-based GWAS of blood-based clinical traits in the Norfolk Island population has identified variants within the UDPGT family directly associated with serum bilirubin levels, which is in turn implicated with reduced risk of developing type-2 diabetes within this population.
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Bilirrubina/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/genética , Predisposición Genética a la Enfermedad , Glucuronosiltransferasa/genética , Haplotipos/genética , Alelos , Secuencia de Bases , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/genética , Cromosomas Humanos Par 2/genética , Diabetes Mellitus Tipo 2/enzimología , Genes Recesivos , Estudio de Asociación del Genoma Completo , Humanos , Patrón de Herencia/genética , Desequilibrio de Ligamiento , Melanesia , Síndrome Metabólico/complicaciones , Síndrome Metabólico/genética , Anotación de Secuencia Molecular , Datos de Secuencia Molecular , Polimorfismo de Nucleótido Simple/genética , Factores de RiesgoRESUMEN
OBJECTIVES: The major aims of this study are to characterise and compile allelic data of human platelet antigen (HPA)-1 to -6 and -15 systems in five Malay sub-ethnic groups in Peninsular Malaysia. BACKGROUND: HPAs are polymorphic glycoproteins expressed on the surface of platelet membranes and are genetically differentiated across ethnogeographically unrelated populations. METHODS: Blood samples were obtained with informed consent from 192 volunteers: Banjar (n = 30), Bugis (n = 37), Champa (n = 51), Jawa (n = 39) and Kelantan (n = 35). Genotyping was done using polymerase chain reaction-sequence specific primer method. RESULTS: In general, frequencies of HPAs in the Malay sub-ethnic groups are more similar to those in Asian populations compared with other more distinct populations such as Indians, Australian Aborigines and Europeans. CONCLUSIONS: This study provides the first HPA datasets for the selected Malay sub-ethnic groups. Subsequent analyses including previously reported HPA data of Malays, Chinese and Indians revealed details of the genetic relationships and ancestry of various sub-populations in Peninsular Malaysia. Furthermore, the comprehensive HPA allele frequency information from Peninsular Malaysia provided in this report has potential applications for future study of diseases, estimating risks associated with HPA alloimmunization and for developing an efficient HPA-typed donor recruitment strategy.
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Alelos , Antígenos de Plaqueta Humana/genética , Frecuencia de los Genes , Genotipo , Pueblo Asiatico , Femenino , Técnicas de Genotipaje/métodos , Humanos , Malasia , MasculinoRESUMEN
Nanotechnology is a rapidly growing field with silver nanoparticles (AgNP) in particular utilized in a wide variety of consumer products. This has presented a number of concerns relating to exposure and the associated toxicity to humans and the environment. As inhalation is the most common exposure route, this study investigates the potential toxicity of AgNP to A549 alveolar epithelial carcinoma cells and the influence of a major component of lung surfactant dipalmitoylphosphatidylcholine (DPPC) on toxicity. It was illustrated that exposure to AgNP generated low levels of oxidative stress and a reduction in cell viability. While DPPC produced no significant effect on viability studies its presence resulted in increased reactive oxygen species formation. DPPC also significantly modified the inflammatory response generated by AgNP exposure. These findings suggest a possible interaction between AgNP and DPPC causing particles to become more reactive, thus increasing oxidative insult and inflammatory response within A549 cells.
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1,2-Dipalmitoilfosfatidilcolina/farmacología , Adenocarcinoma Bronquioloalveolar/patología , Neoplasias Pulmonares/patología , Nanopartículas del Metal/toxicidad , Plata/toxicidad , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Colorantes , Humanos , Inflamación/inducido químicamente , Inflamación/patología , Oxazinas , Especies Reactivas de Oxígeno/metabolismo , Sales de Tetrazolio , Tiazoles , Ensayo de Tumor de Célula Madre , XantenosRESUMEN
HYPOTHESIS: Metallic nanoparticles such as nano-silver have found many applications as alternative antimicrobials in recent years. However methods for determining their proposed antimicrobial activity have received little attention to date. The disk diffusion assay is commonly used as a demonstration of antimicrobial properties and is a regular feature in synthetic nanoparticle papers. The aim of this study was to assess its effectiveness in demonstrating the "nanoparticle specific" antimicrobial properties in the absence of ionic contributions from unreacted reducing agents and or impurities. EXPERIMENTS: The disk diffusion assay was carried out on a range of silver nanoparticles, both in-house synthesised and commercially available, using Escherichia coli ATCC 25922 as a model organism. RESULTS: Capped and purified nanoparticles show no antimicrobial activity despite claims to the contrary for this assay. Results will be discussed in terms of the need for researchers without a background in microbiology to understand the mechanism of antimicrobial action before choosing an assay. Also discussed is the importance understanding the physiochemical characteristics of when interpreting results. Finally the relevance of the results in terms establishing protocols for method development for 'nanoparticle specific' antimicrobial properties will also be considered.