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Patterns of milking unit kick-off as a proxy for habituation to milking in primiparous cows. JDS COMMUNICATIONS 2023; 4:385-389. [PMID: 37727250 PMCID: PMC10505780 DOI: 10.3168/jdsc.2023-0384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/11/2023] [Indexed: 09/21/2023]
Abstract
The onset of lactation and the subsequent habituation to the milking routine is a stressful period, particularly for primiparous (PRI) cows. The objective of this study was to describe the dynamics of milking unit kick-off (KO) behavior in PRI cows during the first 3 mo of lactation, considering multiparous (MUL) cows as a reference for comparison. In addition, the potential associations between KO and milk yield and mastitis presentation were investigated. A total of 869 cows (PRI = 199; MUL = 670) on a dairy farm in northern CO were included in the analysis. Cows calving between August and November 2020 were enrolled from 3 DIM until 90 DIM. Participants were milked 3×/day in a 60-unit rotary parlor and data from each milking session were downloaded from parlor management software. Milking unit kick-off was used as a proxy for habituation to the milking procedure. Kick-off events were reported by the milking system and defined as an abrupt interruption in the milk flow during the milking process. Cow KO events were recorded for each milking session. Subsequently, occurrence of KO was analyzed by grouping the 3 consecutive milking sessions in each day and categorized as yes or no, indicating whether or not an individual kicked at least once in a given day. Data were analyzed by repeated measures ANOVA and logistic regression, including parity category, calving season, occurrence of dystocia, and their potential interactions in the models. Least squares means for daily proportions of KO were calculated considering the number of cows with KO events per day in the PRI and MUL categories. Subsequently, odds ratios for the occurrence of KO in PRI versus MUL were calculated at multiple periods of time. When KO was analyzed by DIM, proportions of KO were greater in PRI than in MUL during the whole monitoring period. In PRI, proportions of KO increased from 0.10/d to 0.20/d between 3 DIM and 15 DIM, to start decreasing around 30 DIM and remaining above MUL up to 90 DIM. On the contrary, in MUL cows, proportions of KO remained close to 0.05/d during the 90-d period. Overall, the odds of KO were greater for PRI versus MUL cows (odds ratio [95% confidence interval] = 2.07 [1.58-2.73]). No differences in milk yield were established among KO categories, while the percentage of cows affected with mastitis was greater in cows grouped in the quartile with more frequent KO events. We concluded that the relationship between days in milk and the proportion of PRI cows displaying KO was not linear, but rather KO increased during the first 2 wk postpartum before decreasing after the first month of lactation. First-parity cows had greater levels of KO than MUL cows, which is most likely associated with the process of habituation to milking during their first lactation.
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Consensus recommendations on calf- and herd-level passive immunity in dairy calves in the United States. J Dairy Sci 2020; 103:7611-7624. [PMID: 32448583 DOI: 10.3168/jds.2019-17955] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/16/2020] [Indexed: 01/29/2023]
Abstract
Passive immunity in calves is evaluated or quantified by measuring serum or plasma IgG or serum total protein within the first 7 d of age. While these measurements inform about circulating concentrations of this important protein, they are also a proxy for evaluating all of the additional benefits of colostral ingestion. The current individual calf standard for categorizing dairy calves with successful passive transfer or failure of passive transfer of immunity are based on serum IgG concentrations of ≥10 and <10 g/L, respectively. This cutoff was based on higher mortality rates in calves with serum IgG <10 g/L. Mortality rates have decreased since 1991, but the percentage of calves with morbidity events has not changed over the same time period. Almost 90% of calves sampled in the USDA National Animal Health Monitoring System's Dairy 2014 study had successful passive immunity based on the dichotomous standard. Based on these observations, a group of calf experts were assembled to evaluate current data and determine if changes to the passive immunity standards were necessary to reduce morbidity and possibly mortality. In addition to the USDA National Animal Health Monitoring System's Dairy 2014 study, other peer-reviewed publications and personal experience were used to identify and evaluate potential standards. Four options were evaluated based on the observed statistical differences between categories. The proposed standard includes 4 serum IgG categories: excellent, good, fair, and poor with serum IgG levels of ≥25.0, 18.0-24.9, 10.0-17.9, and <10 g/L, respectively. At the herd level, we propose an achievable standard of >40, 30, 20, and <10% of calves in the excellent, good, fair, and poor categories, respectively. Because serum IgG concentrations are not practical for on-farm implementation, we provide corresponding serum total protein and %Brix values for use on farm. With one-third of heifer calves in 2014 already meeting the goal of ≥25 g/L serum IgG at 24 h of life, this achievable standard will require more refinement of colostrum management programs on many dairy farms. Implementation of the proposed standard should further reduce the risk of both mortality and morbidity in preweaned dairy calves, improving overall calf health and welfare.
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PSI-10 Pathway analyses revealed up-regulation of calcium-dependent genes in the cardiac right ventricle of Angus steers fed at high altitude. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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L’activité des psychiatres libéraux en 2013 : une description à partir des bases médico-administratives. Eur Psychiatry 2014. [DOI: 10.1016/j.eurpsy.2014.09.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IntroductionDans le cadre de travaux sur la prise en charge de la dépression et des troubles anxieux, la CNAMTS s’est intéressée à l’activité des psychiatres libéraux.MéthodeÀ partir des bases médico-administratives nationales de l’assurance maladie (SNIIRAM), l’activité et la patientèle des psychiatres ont été analysées en 2013.RésultatsQuatorze mille trois cent psychiatres exerçaient en France en 2013, dont 8000 salariés et 6300 libéraux. Ces derniers étaient en majorité des hommes (60 %) à la moyenne d’âge élevée (57 ans), les 2/3 exerçant en secteur 1. Les disparités de répartition sur le territoire sont relativement importantes avec des densités élevées dans les grands centres urbains et dans le sud de la France. Ces déséquilibres ne sont pas sans conséquence sur l’activité des psychiatres. En 2013, les psychiatres libéraux ont assuré 14,5 millions de consultations pour 1,8 millions de patients (tous régimes, France entière). Parmi ces consultations libérales, on dénombrait un nombre important d’« honoraires de surveillance » réalisés en clinique (2,6 millions), mais peu de « consultations d’urgence » (12 300) réalisées à la demande du médecin généraliste par les psychiatres libéraux. La moitié des psychiatres libéraux ont réalisé 23 % de l’ensemble des consultations, alors que les 20 % les plus actifs en réalisaient 48 %. Peu de patients (4 %) ont nécessité plus de 40 consultations dans l’année, mais ces consultations fréquentes représentaient 27 % de l’activité des psychiatres libéraux. Les consultations ponctuelles (une ou deux consultations par patient) visant probablement à poser un diagnostic ou faire le bilan de prise en charge représentaient un tiers de la patientèle mais 4 % de l’activité.DiscussionLa disponibilité en psychiatres libéraux est très variable sur le territoire. Un effectif modéré de psychiatres assure une part importante de l’activité libérale. Un effectif très modéré de patients bénéficie très fréquemment de cette activité libérale.
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Abstract
To respond to meat safety and quality issues in dairy market cattle, a collaborative project team for 7 western states was established to develop educational resources providing a consistent meat safety and quality message to dairy producers, farm advisors, and veterinarians. The team produced an educational website and CD-ROM course that included videos, narrated slide sets, and on-farm tools. The objectives of this course were: 1) to help producers and their advisors understand market cattle food safety and quality issues, 2) help maintain markets for these cows, and 3) help producers identify ways to improve the quality of dairy cattle going to slaughter. DairyBeef. Maximizing Quality & Profits consists of 6 sections, including 4 core segments. Successful completion of quizzes following each core segment is required for participants to receive a certificate of completion. A formative evaluation of the program revealed the necessity for minor content and technological changes with the web-based course. All evaluators considered the materials relevant to dairy producers. After editing, course availability was enabled in February, 2003. Between February and May, 2003, 21 individuals received certificates of completion.
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Cannulation technique for the late gestation bovine fetus. Theriogenology 1998. [DOI: 10.1016/s0093-691x(98)90690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Clinical evaluation of the llama patient incorporates procedures and measurements similar to those used in the diagnosis of disease in other animals. These commonly include clinical laboratory measurements. This article reports on the improvements in our knowledge of clinical laboratory variables in llamas.
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Abstract
Recognition of the risk factors that predispose the neonate to disease should prompt early diagnosis of potential disease problems and lead to a higher rate of neonatal survival. Understanding the normal physiologic changes of this adaptive period provides insight into the problems that may develop and a basis for rational therapeutic treatment.
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Abstract
The problem of "ill thrift" or "failure to thrive" in juvenile llamas is widespread and relatively common in the continental United States. Juvenile llama immunodeficiency syndrome (JLIDS) is one of several causes of the problem and is the most common cause of ill thrift in juvenile llamas evaluated at Colorado State University's Veterinary Teaching Hospital. This article will review current knowledge of JLIDS and will briefly discuss other causes of ill thrift in juvenile llamas.
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Characterization of erythrocytic indices and serum iron values in healthy llamas. Am J Vet Res 1992; 53:1776-9. [PMID: 1456519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
An electronic particle counter with attached particle-size analyzer was configured to directly determine concentration, mean cell volume, and volume distribution of erythrocytes in llama blood. Blood from 38 healthy llamas was used to characterize erythrocytic measurements and serum iron values for this species. Volume distribution curves for llama erythrocytes were similar in shape to those of other species. These curves had a unimodal, symmetric shape with a tail skewed to the right. Reference ranges for directly measured mean cell volume, erythrocyte concentration, hemoglobin concentration, and mean cell hemoglobin concentration were 21 to 28 fl, 11.3 x to 17.5 x 10(6) cells/microliters, 12.8 to 17.6 g/dl, and 43.2 to 46.6 g/dl, respectively. Reference ranges for serum iron concentration, total iron-binding capacity, and transferrin saturation were determined to be 70 to 148 micrograms/dl, 230 to 370 micrograms/dl, and 22 to 50%, respectively.
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Reference hematologic values and morphologic features of blood cells in healthy adult llamas. Am J Vet Res 1992; 53:1773-5. [PMID: 1456518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hematologic values and cellular morphologic features were evaluated for 38 healthy adult llamas. Reference ranges were determined for PCV, reticulocyte concentration, leukocyte concentration, and leukocyte differential counts. The approach used in this study was to focus on hematologic values that may be determined by use of techniques readily available to the practicing veterinarian and nonveterinary laboratory. Unique cellular morphologic features commonly observed and interpreted as normal included large granular lymphocytes, hyposegmented eosinophil nuclei, folded erythrocytes, and hemoglobin crystals.
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The clinicopathologic, light, and scanning electron microscopic features of eperythrozoonosis in four naturally infected llamas. Vet Pathol 1990; 27:426-31. [PMID: 2278130 DOI: 10.1177/030098589902700607] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The hematologic, biochemical, and light and scanning electron microscopic features of eperythrozoonosis in four llamas are described. One female and three male yearling llamas were presented for evaluation of chronic weight loss. Three of four llamas had historical evidence of chronic inflammatory conditions. On examination, multiple clinical problems were apparent, including poorly to non-regenerative anemia, inflammatory disease, and hypoproteinemia. Coccoid- and ring-shaped basophilic organisms were present on the erythrocytes of all the llamas. On scanning electron microscopy, individual, pairs, and clusters of coccoid-shaped organisms were present on the erythrocytes. The organisms measured 0.4 to 0.6 micron in diameter and caused no marked deformation of the erythrocyte membrane. A rare organism could be found that produced a slight indentation into the erythrocyte membrane. The light and scanning electron microscopic morphologic features suggested that the organism was an Eperythrozoon. Serial evaluation of serum iron concentrations of the llamas showed a decrease serum iron in all animals, with a concurrent decrease in the total iron binding capacity and percent transferrin saturation in two of the llamas. Common abnormalities seen on serum electrophoresis included a decrease in albumin and beta serum fraction in all llamas and a decrease in the gamma globulin fraction of two individuals.
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Endometrial biopsy technique and uterine pathologic findings in llamas. J Am Vet Med Assoc 1990; 197:1157-62. [PMID: 2254142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Uterine tissue specimens from 90 llamas with history of infertility were examined and graded microscopically; 83 specimens were obtained by endometrial biopsy and 7 specimens were obtained at necropsy. Fifteen llamas (16.7%) had a normal uterus, which was graded 1A. Twenty-three llamas (25.6%) had minor uterine abnormalities that were graded 1B. Forty-five llamas (50.0%) had appreciable endometritis that was graded 2A. Three llamas (3.3%) had endometritis with gland fibrosis that was graded 2B. Two llamas (2.2%) had notable uterine gland fibrosis that was graded 3A. Two llamas (2.2%) had uterine neoplasia that was graded 3B. Thirty-six llamas had follow-up evaluation; 22 became pregnant, most after some form of treatment. Uterine biopsy in llamas was readily performed without complications and was valuable in identifying a wide range of uterine diseases, most of which were amenable to treatment.
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Renal excretion of creatinine, electrolytes, protein, and enzymes in healthy sheep. Am J Vet Res 1990; 51:414-9. [PMID: 1969253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Urinary indices of renal function and damage were measured in 6 healthy, mature ewes over a 48-hour period. Endogenous creatinine clearance, total and fractional electrolyte excretion rates, protein excretion, urine volume, and urine gamma-glutamyltransferase and beta-glucuronidase activities were measured. Significant variations in the excretion rates of creatinine, electrolytes, and protein were not found between intervals within the 48-hour urine collection period. Total urinary electrolyte excretion rates were significantly (P less than 0.001) correlated with fractional electrolyte excretion rates normalized for creatinine concentration; however, coefficient of determination was low.
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Urinary indices of renal function in sheep with induced aminoglycoside nephrotoxicosis. Am J Vet Res 1990; 51:420-7. [PMID: 2316920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Aminoglycoside nephrotoxicosis (AGNT) was induced in ewes by daily SC administration of gentamicin. Changes in urinary indices of renal function during the development of AGNT are reported. Measurements from timed, volume-measured urine samples were made on days 0, 7, and 8 and included creatinine clearance, total excretion (TE) rates of electrolytes (Na, K, Cl, P) and urine volume. Measurements from free-catch urine samples (without volume measurement) were made daily and included fractional excretion (FE) rate of electrolytes, urine osmolality, and urine-to-serum osmolality and urine-to-serum creatinine ratios. With the onset of AGNT, FE rates of Na, K, Cl, and P- increased many fold above baseline values (200x, 4 to 5x, 6 to 9x, and 70 to 95x, respectively, on days 7 and 8), indicating decreased tubular reabsorption or increased tubular secretion. The increased FE rates were not representative of increases in total electrolyte excretion rates. The total excretion of Na (TENa) was mildly increased, TEK was decreased, TECl was unchanged, and TEP was significantly increased on days 7 and 8. Abnormal urinalysis results, glucosuria, and increased FEP preceded appreciable increase in serum creatinine concentration. Other abnormal urinary indices of renal function coincided with or followed the increase in serum creatinine concentration. Urinary indices may help characterize renal function associated with the disease state, but did not provide early indication of AGNT.
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Enzymuria as an index of renal damage in sheep with induced aminoglycoside nephrotoxicosis. Am J Vet Res 1990; 51:428-32. [PMID: 1969254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Acute nephrotoxicosis was induced in ewes by daily SC administration of gentamicin. Activity of 3 urine enzymes, gamma-glutamyltransferase (GGT), beta-N-acetylglucosaminidase (AGS), and beta-glucuronidase (GRS), were measured during the development of aminoglycoside nephrotoxicosis. Measurements from timed, volume-measured urine samples were performed on days 0, 7, and 8. Measurements from urine samples obtained without volume measurement (spot samples) were performed daily. Urine GGT and AGS activities were high 3 days prior to detection of high serum creatinine concentration and 1.5 days before the appearance of casts in the urine sediment; values consistently remained in the abnormal range until termination of the study. High urine GRS activity was inconsistent and transient; serum GGT activity did not change during the course of the study. Urine GGT and AGS activities expressed as total excretion per unit time and body weight, enzyme activity per unit volume, and as ratio of urine enzyme activity to urine creatinine concentration were strongly correlated. Urine GGT and AGS, but not GRS activities, are suitable indicators of renal tubular cell damage in sheep with aminoglycoside nephrotoxicosis. Urine GGT and AGS activities indicate cellular changes occurring several days prior to the first indications of renal functional change.
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Abstract
Examination of the diseased llama often relies on clinical laboratory information to supplement that from the physical examination and history. Because of the llama's only recent importance as a companion animal, little information is available on the analysis and interpretation of clinical laboratory parameters in this species. Llamas possess red blood cells with a unique shape, small size, and high hemoglobin content. The hemoglobin has a high oxygen affinity, which helps the animal adapt to high altitudes and presents with an oxyhemoglobin dissociation curve shifted to the left. The llama maintains high resting blood glucose, creatinine, and urea nitrogen levels. It is very efficient at recycling urea nitrogen via nonrenal pathways. Most of the clinical pathologic parameters can be utilized and interpreted as in other species, but with a different baseline of normal values.
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Abstract
Ultrastructural examination of a mechanobullous disease of probable hereditary nature in Belgian foals, confirmed light microscopic findings that separation of the dermo-epidermal junction occurred through the lamina lucida of the basement membrane, leaving the intact lamina densa adherent to the dermis and the plasmalemma of the basal epithelial cells intact. The location of the cleft and the presence of small hemidesmosomes in adjacent intact skin are additional characteristics which make this condition similar to junctional epidermolysis bullosa of man.
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Abstract
Physical and clinicopathologic findings from six cows with proximal duodenal obstruction (PDO) and 58 cows with abomasal volvulus (AV) were compared retrospectively. Many of the physical signs were similar in cows with PDO and cows with AV, but the two conditions differed in the type of abdominal distention, and in the findings from rectal examination and abdominal auscultation. Cows with PDO had significantly lower mean values for serum sodium (Na+) and chloride ion (Cl-), and higher mean values for plasma bicarbonate [HCO3-], base excess, carbon dioxide pressure (pCO2), serum phosphate, urea nitrogen, and total protein than AV affected cattle. Cows with PDO showed hyperglycemia (range, 263-990 mg/dl; mean, 618 mg/dl) of unexplained etiology that was significantly higher than blood-glucose concentrations in AV cows (mean, 178 mg/dl). Although all AV cows with anion gap values greater than 32 mEq/l died;PDO cows with equally elevated anion gap survived. The anion gap elevations in PDO and AV cows resulted from accumulation of different anions. Although the site of obstruction of aborad flow of ingesta is similar in both disease conditions, the differences in physical and clinicopathologic findings appear to reflect differences in the degree of reticulo-omasal orifice obstruction and the degree of abomasal vascular compromise.
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Effect of an interfering substance on determination of potassium by ion-specific potentiometry in animal urine. Am J Vet Res 1988; 49:710-4. [PMID: 3395016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Analytical characteristics of photometry and ion-specific potentiometry for urine from sheep, horses, cows, dogs, and cats were determined, using solutions of sodium and potassium chloride. The performance of both methods were acceptable, but the ion-specific potentiometer (in the mode for urine analysis) was superior in terms of linearity of response and correlation between actual vs measured concentrations. Coefficients of variation of either method for repeated analyses of various concentrations of sodium and potassium were always less than 2.5%. The measurement of sodium concentration in urine samples correlated well between both methods for samples from sheep, horses, cows, dogs, and cats. In contrast, measurement of potassium concentrations in urine samples from sheep, horses, cows, and cats was underestimated consistently by ion-specific potentiometry. The magnitude of the apparent error was variable between species and was often increased with greater urine potassium concentrations. These phenomena were not seen in urine samples from dogs. Sequential dilution of urine samples from sheep before analysis reduced the magnitude of the error observed by ion-specific potentiometry. Seemingly, an equilibrium process existed in which potassium was bound by an anionic or zwitterionic chemical and was sequestered from interaction with the ion-specific electrode. Ultrafiltration experiments indicated the putative potassium chelator was a low molecular weight compound.
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Parelaphostrongylosis in llamas. J Am Vet Med Assoc 1985; 187:1243-5. [PMID: 4077654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Multiple nodular mineralized masses in the nuchal ligament, adjacent muscle, and epidurally in the atlanto-occipital space. J Am Vet Med Assoc 1985; 187:641-2. [PMID: 4086377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Effects of temperature on in vitro penetration of human sperm into bovine cervical mucus. THE JOURNAL OF REPRODUCTIVE MEDICINE 1984; 29:833-6. [PMID: 6520822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A standardized bovine cervical mucus preparation was used to test the hypothesis that the penetration of human sperm into cervical mucus is a temperature-dependent process. Cervical mucus penetration (CMP) was tested in vitro at several incubation temperatures around "room" temperature. Semen specimens were also exposed to cold (0 C) for various periods of time and then tested for CMP at 37 C incubation. We found that incubation at 37 C produced optimal sperm-mucus penetration. Minor fluctuations in ambient laboratory temperature, such as may occur during a workday or between seasons, produced significant variations in CMP results and precluded the comparison of test results longitudinally over time. Prior exposure of normal semen specimens to 0 C for as long as 45 minutes, such as might occur in transport, did not reduce CMP significantly if incubation was performed at 37 C. We conclude that 37 C is the optimal incubation temperature for CMP testing and that if temperature is controlled, CMP is sufficiently simple and reproducible for routine use in physicians' offices and clinical laboratories.
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