Use of commercial somatic cell counters to quantify somatic cells in non-lactating bovine mammary gland secretions.

Measurement of the somatic cell count (SCC) in milk is commonly used to detect mastitis in lactating dairy cows. Many techniques and tools have been developed and adapted to quantify milk SCC, but few tools have been evaluated in their ability to enumerate somatic cells in non-lactating bovine mammary secretions. This limits the tools available for detecting mastitis in non-lactating animals. The objective of these studies was to evaluate methods of somatic cell quantification, originally developed for milk, in their ability to quantify the SCC in non-lactating bovine mammary secretions when compared to the gold standard microscopic quantification method. Two experiments were conducted. In a first experiment, 222 mammary secretions were collected and diluted 1:10 with PBS. Cells in these suspensions were quantified microscopically and with a DeLaval Cell Counter. Microscopic SCC (MSCC) ranged from 1.9 × 106 to 259.5 × 106 cells/mL while DeLaval Cell Counter SCC (DSCC) ranged from 1.8 × 106 to 27.0 × 106 cells/mL; a measurement of agreement between the 2 measures, based on the Lin's Concordance Correlation Coefficient (CCC) suggested moderate agreement between measures (CCC = 0.60). In a second experiment 72 mammary secretions were collected and diluted 1:50 in PBS. Somatic cells in these suspensions were quantified microscopically, with a DeLaval Cell Counter, and by a DHIA laboratory using a Fossomatic™ FC. MSCC ranged from 1.6 to 47.5 × 106 cells/mL, DSCC ranged from 1.0 to 35.7 × 106 cells/mL, and Fossomatic SCC (FMSCC) ranged from 1.6 to 46.7 × 106 cells/mL. CCCs of 0.81 and 0.88 resulted when DSCC and FMSCC were paired with the MSCC, respectively. The results of this work indicate that a significantly greater concentration of somatic cells exist in non-lactating mammary secretions and dilution of these mammary secretions influences accuracy of SCC estimates. Future studies seeking to quantify somatic cells in mammary secretions from non-lactating cows should identify the most appropriate dilution factors specific to each method of measure, given that these two factors will influence the accuracy of SCC estimates. Development of a standardized approach for quantifying somatic cells in non-lactating dairy animals such as heifers and cows, via a rapid automated counter, can allow for the detection of mastitis in non-lactating dairy animals.

Adverse respiratory effects following overhaul in firefighters.

Overhaul is the stage in which firefighters search for and extinguish possible sources of reignition. It is common practice not to wear respiratory protection during overhaul. Fifty-one firefighters in two groups, 25 without respiratory protection and 26 wearing cartridge respirators, were monitored for exposure to products of combustion and changes in spirometric measurements and lung permeability following overhaul of a structural fire. Testing at baseline and 1 hour after overhaul included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), serum Clara cell protein (CC16), and serum surfactant-associated protein A (SP-A). Overhaul increased CC16 in both groups, indicating increased alveolarcapillary membrane permeability. Contrary to expectations, SP-A increased and FVC and FEV1 decreased in the firefighters wearing cartridge respirators. Changes in FEV1, CC16, and SP-A were associated with concentrations of specific products of combustion or carboxyhemoglobin levels. Firefighter exposures during overhaul have the potential to cause changes in spirometric measurements and lung permeability, and self-contained breathing apparatus should be worn during overhaul to prevent lung injury.

Characterization of firefighter exposures during fire overhaul.

Previous studies have characterized firefighter exposures during fire suppression. However, minimal information is available regarding firefighter exposures during overhaul, when firefighters look for hidden fire inside attics, ceilings, and walls, often without respiratory protection. A comprehensive air monitoring study was conducted to characterize City of Phoenix firefighter exposures during the overhaul phase of 25 structure fires. Personal samples were collected for aldehydes; benzene; toluene; ethyl benzene; xylene; hydrochloric acid; polynuclear aromatic hydrocarbons (PNA); respirable dust; and hydrogen cyanide (HCN). Gas analyzers were employed to continuously monitor carbon monoxide (CO), HCN, nitrogen dioxide (NO2), and sulfur dioxide (SO2). Area samples were collected for asbestos, metals (Cd, Cr, Pb), and total dust. During overhaul the following exceeded published ceiling values: acrolein (American Conference of Governmental Industrial Hygienists [ACGIH] 0.1 ppm) at 1 fire; CO (National Institute for Occupational Safety and Health [NIOSH] 200 ppm) at 5 fires; formaldehyde (NIOSH 0.1 ppm) at 22 fires; and glutaraldehyde (ACGIH 0.05 ppm) at 5 fires. In addition, the following exceeded published short-term exposure limit values: benzene (NIOSH 1 ppm) at two fires, NO2 (NIOSH 1 ppm) at two fires, and SO2 (ACGIH 5 ppm) at five fires. On an additive effects basis, PNA concentrations exceeded the NIOSH recommended exposure limits (0.1 mg/M3) for coal tar pitch volatiles at two fires. Maximum concentrations of other sampled substances were below their respective permissible exposure limits. Initial 10-min average CO concentrations did not predict concentrations of other products of combustion. The results indicate that firefighters should use respiratory protection during overhaul. In addition, these findings suggest that CO should not be used as an indicator gas for other contaminants found in this atmosphere.

Myeloma-associated systemic amyloidosis presenting as chronic paronychia and palmodigital erythematous swelling and induration of the hands.

Mucocutaneous involvement occurs predominantly in primary systemic amyloidosis as well as in myeloma-associated systemic amyloidosis. It is rarely observed in other types of amyloidoses. Signs of such involvement may aid in the early diagnosis of the disease process. Herein, we describe a 64-year-old white male patient with myeloma-associated systemic amyloidosis in whom the disease presented with unique cutaneous lesions consisting of chronic paronychia and palmodigital erythematous swelling and induration of the hands. Following weekly regimens with prednisone (20 mg/day) and melphalan (2 mg/day) administered every 16 weeks, almost complete resolution of the cutaneous lesions was observed after 1 year of therapy. Also, in response to chemotherapy, modest regression of the myelomatous bone lesions and complete resolution of the underlying gammopathy occurred.

Crystal deodorant dermatitis: irritant dermatitis to alum-containing deodorant.

Two patients developed an irritant dermatitis of the axillae shortly after using an over-the-counter "natural deodorant crystal" product containing alum. We discuss this previously unreported, untoward reaction to alum, an ancient agent with newfound popularity as an alternative health product.

Report of an association between discoid lupus erythematosus and smoking.

Smoking has been shown to be associated with many medical disorders, including many involving the skin. While preliminary studies suggest a modest association between smoking and systemic lupus erythematosus, epidemiologic data on discoid lupus erythematosus (DLE) and smoking are lacking. To study this relationship, we examined current smoking habits in two unique patient populations with DLE. One group was compared with matched dermatology patients while the second group was compared with the corresponding statewide population. For both groups, the current smoking prevalence was much higher than that of the comparison population. For the control-matched group of DLE patients, smoking prevalence was found to be significantly greater than that of controls (odds ratio 12.2; p = 0.001). We therefore propose that smoking is a risk factor for development of DLE.

Effect of test exercises and mask donning on measured respirator fit.

Quantitative respirator fit test protocols are typically defined by a series of fit test exercises. A rationale for the protocols that have been developed is generally not available. There also is little information available that describes the effect or effectiveness of the fit test exercises currently specified in respiratory protection standards. This study was designed to assess the relative impact of fit test exercises and mask donning on respirator fit as measured by a controlled negative pressure and an ambient aerosol fit test system. Multiple donnings of two different sizes of identical respirator models by each of 14 test subjects showed that donning affects respirator fit to a greater degree than fit test exercises. Currently specified fit test protocols emphasize test exercises, and the determination of fit is based on a single mask donning. A rationale for a modified fit test protocol based on fewer, more targeted test exercises and multiple mask donnings is presented. The modified protocol identified inadequately fitting respirators as effectively as the currently specified Occupational Safety and Health Administration (OSHA) quantitative fit test protocol. The controlled negative pressure system measured significantly (p < 0.0001) more respirator leakage than the ambient aerosol fit test system. The bend over fit test exercise was found to be predictive of poor respirator fit by both fit test systems. For the better fitting respirators, only the talking exercise generated aerosol fit factors that were significantly lower (p < 0.0001) than corresponding donning fit factors.

Report of a nipple nevus and an overview of accessory mammary tissue.

Supernumerary nipples, also known as accessory nipples, are the most frequently encountered congenital anomaly of the breast. Once associated with fertility or divine powers, they are now widely held to be of cosmetic significance only. During the past 20 years, however, there has been a steady number of articles reporting the suspected association of supernumerary nipples with numerous benign and malignant medical conditions. We describe a previously unreported accessory nipple variant occurring as a nevoid nodule surmounting an otherwise normal primary nipple. The patient was otherwise healthy. The embryogenesis of this anomaly is hypothesized to result from in utero nipple dichotomy, rather than a failure of regression along the embryonic milk line.

The causes and treatment of pseudofolliculitis barbae.

Pseudofolliculitis barbae, commonly referred to as "razor bumps" or "ingrown hairs," is a papular and pustular, foreign body inflammatory reaction that can affect any individual who has curly hair and who shaves. This condition is a particular nuisance to African-Americans. This report will discuss the causes of pseudofolliculitis barbae and present a systematic approach to treatment.

Toward a new paradigm in substance abuse and other problem behavior prevention for youth: youth development and empowerment approach.

The purpose of this article is to 1) address a paradigm shift taking place in the field of substance abuse prevention directed for youth and 2) to introduce an innovative approach to substance abuse and other problem behavior prevention that reflects this shift in prevention paradigm. The new path introduced is youth development and empowerment (YD&E) approach. In order to establish a conceptual foundation for this approach, this article 3) reviews the theoretical advances made in the field of substance abuse prevention during the last three decades. This is followed by a conceptualization of the processes of implementing the YD&E program by 4) specifying the mechanism used for the empowering processes and by 5) identifying the structural components of the youth empowerment model that serve the empowering processes. It is hoped that this article serves as a conduit for an improved approach to adolescent substance abuse prevention and youth development that goes beyond, rather than against, the traditional risk-factor approach. In this new approach, youths are viewed as assets and resources to our community rather than social problems or community liabilities. The organizing concept of this new paradigm is: social, economic, and public opportunity denied to youth is equal to social problems imposed on youth by adults.

Localized crusted scabies of the scalp and feet.

An atypical case of crusted scabies in a patient with acquired immunodeficiency syndrome is presented in which lesions at the time of evaluation were confined to the scalp and feet. Because of the unusual presentation, the scalp involvement (which clinically mimicked seborrheic dermatitis) was initially missed. Although both the crusted variant of scabies and scabietic involvement of the scalp are well documented to occur in immunocompromised patients, to our knowledge scabies confined to the scalp and feet has not been previously reported.

Practical method for collecting nail plate specimens.

The use of a biopsy bag allows for the efficient collection of nail plate specimens. The bag functions as both a shield and net for the control and capture of nail clipping projectiles.

Hair casts: a case of pseudonits.

Hair casts are often misdiagnosed because of their close resemblance to nits from an infestation with pediculosis capitis. In their clinical presentation both of these disorders may appear to have white keratinous material adherent to hair shafts and can look very similar. Microscopic examination provides the definitive and correct diagnosis. We report a case of hair casts, also referred to as pseudonits.

An update on molluscum contagiosum.

Molluscum contagiosum is a common viral infection of the skin, and occasionally the mucous membranes, manifesting as benign tumors. The characteristic appearance is of pearly, umbilicated papules. The disease is self-limited in immunocompetent hosts, but may be protracted in those who are immunocompromised. Multiple local therapeutic options are available; the use of systemic agents has been reported in recalcitrant cases or in patients in whom topical therapy is difficult to apply.

Effect of leak location on measured respirator fit.

A significant difference in leak detection as a function of leak location was observed during a study assessing how well current models of quantitative fit-test systems detect leakage. Known sources of leakage (matched hypodermic needles) were introduced at three fixed locations into factory-probed half-mask and full-face respirators mounted on a headform-breathing machine system. The leak locations were the bridge of the nose, the cheek, and the chin. Baseline leakage into each respirator was determined by conducting a fit-test with all fixed leak sources capped. Fit tests were repeated with each individual source uncapped. Study objectives included determining (1) how well each system measured the leakage, and (2) whether leak location had any effect on leak measurement. An ambient aerosol fit-test system (Portacount Plus) and a controlled negative pressure (CNP) fit-test system (FitTester 3000) were used. The ambient aerosol system detected an overall average of 37.2% of the known leakage, with a coefficient of variation of 44.7%. An analysis of variance showed significant differences in aerosol system measurements of leakage as a function of leak location and mask type (p < 0.001). A different pattern of aerosol leak detection as a function of leak location was observed between half-mask and full-face respirators, which appears to be related to differences in in-mask airflow dynamics. The CNP system detected an overall average of 97.9% of the known leakage through the same hypodermic needles, with a coefficient of variation of 4.3%. CNP system results were not affected by leak location (p > 0.43) or mask type (p > 0.32).