Dairy producer perceptions of the Farmers Assuring Responsible Management (FARM) Animal Care Program

Dairy farms producing 98% of the US milk supply participate in the Farmers Assuring Responsible Management (FARM) Animal Care Program. Producers who sell milk to cooperatives or processors participating in FARM must follow program standards. The objectives of this study were to assess producer perceptions about the knowledge, experience, and value of FARM and to determine whether perceptions differ based on demographics. A concurrent triangulation design was implemented through collecting quantitative and qualitative data using a 30-question survey instrument. Quantitative questions aimed to address project objectives, and qualitative data were provided through 1 open-ended survey question that asked participants what they thought the main goal of the FARM program was. Participants offered additional feedback through providing text in comment boxes, writing on the back of the survey, or writing a separate letter and returning it with their survey. Quantitative data were analyzed using principal components analysis and modeling, and qualitative data were analyzed through thematic analysis. Dairy producers from cooperatives or processors that participate in the FARM program were recruited via electronic and postal mail. A total of 487 respondents from 40 states completed the survey. Of the survey participants, 414 (85.0%) answered the open-ended question and 190 (39.0%) provided additional qualitative feedback. Thematic analysis revealed 5 main themes: distrust of program, producers on the defense, anger, efficiency, and nostalgia. Of respondents, 73.6% reported being knowledgeable about the FARM Animal Care Program. Greater level of formal education and larger herd size were associated with greater producer knowledge. More dairy producer input in the revisions of FARM was identified as a need by 83.3% of respondents. Although 89.3% of respondents reported positive experiences with evaluations and relationships with evaluators, 45.6% did not think that the program had value overall. Respondent age was positively associated with perceived value of FARM. Respondent age was also significant in determining the reasons why FARM was considered to be important. Results indicate that to increase buy-in and positive perceptions from producers, future versions of FARM should solicit producer input during the development of program standards, target specific producer demographics for program promotion, and address perceived communication deficits and program inequalities. Findings from this study can be used to inform future versions of the program.

Residual feed intake, body composition, and fertility in yearling beef heifers

One hundred thirty-seven spring-born yearling beef heifers of British breed types were used to determine the relationships between residual feed intake (RFI) and growth rate, body composition, mature size, and fertility. Heifers were housed in a dry lot facility during the experimental period, and data were collected over a 2-yr period (yr 1, n = 67; yr 2, n = 70). Individual feed intake, BW, BCS, hip height, and ultrasonic measurements [subcutaneous rib fat (UBF), rump fat (URF), LM area (LMA), and intramuscular fat (IMF)] of body composition were recorded. Individual feed intakes (kg of TDN consumed/d) were used to calculate RFI combining both years of data. Heifers averaged 387.0 ± 19.4 d of age and 337.1 ± 29.9 kg of BW at initiation of the experiment. Mean ADG was 1.14 ± 0.21 kg/d during the trial. Based on RFI, with year of test and farm of origin included in the model as covariates, heifers were classified into groups: positive (POS; 0.74 kg of TDN/d) or negative (NEG; -0.73 kg TDN/d) for first analysis and high (HI), medium (MED), or low (LO; mean RFI = 1.06, -0.01, and -1.13 kg of TDN/d, respectively) subsequently. An initial phenotypic relationship (P < 0.05) between RFI and both UBF and URF (r = 0.19 and 0.17, respectively) was sustained (P < 0.01) with UBF (r = 0.27) and URF (r = 0.24) to trial conclusion. No other correlations with RFI were significant. Heifers classified as POS reached puberty earlier than those classified as NEG (414 ± 3.83 vs. 427 ± 4.67 d of age, P = 0.03), and possessed greater LMA per 100 kg of BW (LMACWT) at conclusion of the trial (P < 0.01). Medium heifers exhibited less URF (P < 0.05) compared with either HI or LO heifers at trial initiation. Low heifers possessed less LM area (cm(2)) per 100 kg of BW (P < 0.05) than HI but did not differ (P > 0.10) from MED heifers at either the beginning or the end of test. Additionally, a negative linear relationship was observed between RFI and age at puberty (P < 0.05). Each 1-unit increase in RFI corresponded to a decrease of 7.5 d in age at puberty, but did not affect pregnancy or conception rates (P > 0.10). Differences in body fat and rate of metabolism associated with RFI could delay reproductive maturity.

Reliable lymphatic drainage to axillary sentinel lymph nodes regardless of tumor location within the breast

BACKGROUND

This analysis was performed in order to determine whether primary tumor location in breast cancer affects the axillary sentinel lymph node (SLN) identification (ID) rate, the false negative (FN) rate, incidence of axillary nodal metastases, or the number of SLN identified.

METHODS

In this prospective multi-institutional study, SLN biopsy was performed on clinical stage T1-2, N0 breast cancer patients using blue dye alone or in combination with radioactive colloid, followed by completion axillary LN dissection.

RESULTS

Central tumor location was associated with an improved FN rate, which may be related to reliable drainage from the subareolar lymphatic plexus. Tumor location did not significantly affect the SLN ID rate or the mean number of SLN identified. Medial tumor location was associated with a decreased rate of axillary nodal metastasis.

CONCLUSIONS

Breast cancers drain reliably to the axillary lymph nodes regardless of tumor location within the breast.

Is surgical excision necessary for atypical ductal hyperplasia of the breast diagnosed by Mammotome?

BACKGROUND

Core biopsy findings of atypical ductal hyperplasia (ADH) underestimates the diagnosis of malignancy by 18% to 88%. Using the Mammotome biopsy technique, more accurate assessment of the lesion is possible, making selective excision of these lesions a consideration.

METHODS

The records of 62 patients who were found to have ADH at Mammotome biopsy and subsequently underwent excision of the lesion were reviewed. Patient data were statistically analyzed for predictors of malignancy at the time of surgical excision.

RESULTS

Of the 62 patients, 9 (15%) had malignancy at excision. Variables predicting for malignancy included markedly atypical hyperplasia and incomplete removal of calcifications at Mammotome biopsy, a previous contralateral breast cancer, and a family history of breast cancer, with a combined sensitivity of 100% and specificity of 80%.

CONCLUSIONS

Mild ADH found on Mammotome, not associated with a personal or family history of breast cancer, may not need excision if all calcifications have been removed.

Neutralization profiles of sera from human immunodeficiency virus (HIV)-infected individuals: relationship to HIV viral load and CD4 cell count

The relationship of the neutralizing activity (NA) profile of sera from human immunodeficiency virus (HIV)-infected individuals to the HIV viral load and the absolute CD4 count was examined. The NA of 24 serum samples against autologous isolates (AI) and HIV type 1 strain MN was examined. Three NA patterns were recognized. Nine sera neutralized both AI and MN (+/+), six sera neutralized MN but not AI (-/+), and nine sera failed to neutralize both AI and MN (-/-). The identification of the three neutralization patterns (+/+, -/+, and -/-) indicated that resistance to neutralization was progressive. A reciprocal relationship between the viral burden of the patients and the NA profiles was observed. The nine subjects with a -/- NA profile had a plasma viral load of > or =5 x 10(4) copies/ml and a cellular viral burden of > or =1,122 infectious units per million viable cells, which were significantly different from those of the other groups (P < 0.02). These patterns were independent of the phenotypic characteristics of the virus. Longitudinally, subjects with a -/- profile at baseline gained their HIV-specific NA by 24 weeks of antiretroviral therapy when this was associated with a >/=1-log(10) decline in the plasma HIV viral load. The sera from week 24 from some patients were able to neutralize both the 24-week and the baseline dominant virus isolates. A change in CD4 cell count of 50 or more in either direction predicted a -/- or +/+ profile. The verification of the autologous NA profile might be important in selecting patients who may benefit from immune-based therapies involving neutralizing monoclonal antibodies.

Tumorigenic conversion of a rat urothelial cell line by human polymorphonuclear leukocytes activated by lipopolysaccharide

Chronic inflammation is a significant risk factor for the development of urinary bladder cancer. We have shown that inflammation induced by killed Escherichia coli and also by its lipopolysaccharide (LPS) strikingly enhances N-methyl-N-nitrosourea (MNU)-initiated rat bladder carcinogenesis. Aspirates from the bladder lumen contained a large quantity of hydrogen peroxide (H2O2) and several cytokines. In this study, we tested the hypothesis that reactive oxygen intermediates (ROI) released from activated polymorphonuclear leukocytes (PMN) are involved in inflammation-associated bladder carcinogenesis. Using an immortalized nontumorigenic rat urothelial cell line, MYP3, we examined the effect of LPS-activated PMN on malignant transformation. MYP3 cells pretreated with or without MNU were exposed daily to LPS-activated PMN for one week and were then tested for growth in soft agar. In contrast to no colony formation by the parental cells, a varying number of colonies developed from cells treated with LPS-activated PMN. Although combined treatment with MNU and PMN was most effective (P<0.01), cells treated with LPS-activated PMN alone also formed a small number of colonies. Addition of catalase, which decomposes H2O2, and/or an antioxidant, alpha-tocopherol, reduced the number of colonies induced by LPS-activated PMN (P<0.05). Cells derived from colonies were tumorigenic in athymic nude mice. However, tumorigenicity in mice was greater with cells treated with both MNU and PMN than with cells treated with PMN alone. Our results suggest that ROI released from LPS-activated PMN may be one of the mechanisms involved in the carcinogenesis associated with active urinary tract infection.

Pharmacokinetics of primaquine in healthy volunteers

The pharmacokinetics of primaquine were investigated in 8 healthy subjects (4 males and 4 females). The volunteers received 15 mg base of primaquine daily for 14 days. The results showed that the concentration-time profiles in whole blood and in plasma were similar. The mean values (+/- SD) of area under the curve (AUC) of the last dose were significantly decreased when compared to the values of the first dose both in whole blood and in plasma (909.96 +/- 603.07, 1,147.05 +/- 684.8 ng.hr/ml respectively in whole blood with p = 0.007 and 1,255.11 +/- 531.59, 1,603.66 +/- 505.45 ng.hr/ml respectively in plasma with p = 0.023). The decrease in the concentration-time profile of the last dose was due to enhancement of drug elimination with significant increase in clearance after the last dose (4.871 +/- 1.741 and 6.443 +/- 2.514 ml/min/kg respectively in whole blood with p = 0.007, 3.199 +/- 1.197 and 4.422 +/- 2.068 ml/min/kg respectively in plasma with p = 0.016).

Augmentation of the lymphokine-activated killer cell response in head and neck cancer patients by combination interleukin-2 and interferon-alpha

The majority of patients with head and neck cancer present with advanced disease (stage III and IV), for which current chemotherapeutic regimens offer dismal results. Although known to have defects in their cell-mediated immunity, their poor performance status makes them unlikely candidates for aggressive immunotherapeutic protocols because of associated severe toxicities. This study evaluates the effect of subthreshold recombinant interferon-alpha (rIFN-alpha) and interleukin-2 (rIL-2) on the generation of lymphokine-activated killer (LAK) cells from the peripheral blood of patients with head and neck cancers. In vitro treatment of patients' lymphocytes consisted of incubation in 1,000 U/mL rIL-2, 100 U/mL rIL-2, 100 U/mL rIFN-alpha, and 100 U/mL rIFN-alpha plus 100 U/mL rIL-2 for 4 to 5 days. Cytotoxicity was measured using a standard 4-hour chromium-51 (51Cr)-release assay with Raji (B lymphoblastoid) tumor target cells. LAK activity was arbitrarily defined as greater than 20% cytolysis of Raji target cells. LAK activity was generated in a smaller percentage of the head and neck cancer patients by 1,000 U/mL rIL-2 compared with normal adult donors: 54% versus 100%, p less than 0.05; IFN-alpha (100 U/mL) induced LAK activity in approximately 50% of the cancer patients. The addition of rIFN-alpha (100 U/mL) to rIL-2 (100 U/mL) resulted in LAK generation in a higher percentage of patients (83% versus 54%), as well as increased levels of cytotoxicity, p = 0.05. This combination also resulted in cytotoxicity levels equivalent to high-dose (1,000 rIL-2 U/mL). These in vitro data support a clinical trial to assess the therapeutic efficacy of combined low-dose rIL-2 and rIFN-alpha in vivo in head and neck cancer patients.

Widespread in vitro resistance to chloroquine of Plasmodium falciparum in the Congo, 1987

The drug sensitivity of 184 Plasmodium falciparum isolates was studied in vitro in three areas of the Congo in January 1987. Results show that parasites resistant to chloroquine but not to quinine or mefloquine were prevalent in the three investigated regions, but the drug response pattern varied widely. In Brazzaville, after the outburst of chloroquine resistance in 1985, prevalence of chloroquine resistant isolates seemed to have stabilized around 60%. The phenomenon more recently reached the North where about 30% isolates could be considered as drug resistant. As in Cameroon, wide variations in the prevalence and the level of resistance were observed within a very limited area emphasizing the role of drug pressure in market places where chloroquine is easily available.

Effect of hypocapnia on local cerebral glucose utilization in rats

The effect of hypocapnia on regional cerebral glucose utilization (L-CMRg) was studied in 14 Sprague Dawley rats. After cannulation of femoral vessels, halothane was discontinued and anesthesia was maintained with 70% N2O in oxygen. The animals' lungs were mechanically ventilated to achieve normocapnia (PaCO2 = 40 +/- 2 mmHg) in group A or hypocapnia (PaCO2 = 25 +/- 2 mmHg) in group B. L-CMRg was measured by the 14C-2-deoxyglucose autoradiographic method. Twenty-six anatomically discrete structures representing cortical, subcortical, limbic, and brainstem areas were studied. In hypocapnic animals, mean values for L-CMRg were higher in 25 out of 26 structures studied. The increase in L-CMRg was heterogenous. The structures that had higher L-CMRg during normocapnia showed the greatest increase in L-CMRg. When the two groups were compared using a profile analysis, in six regions (lateral and ventral thalamus, inferior colliculus, lateral habenulla, medial geniculate body, and auditory cortex), a value of P less than 0.05 was obtained.

Low prevalence of P. falciparum in-vivo resistance to chloroquine in northern Cameroon in 1986

The response to chloroquine of 49 Plasmodium falciparum isolates from the Northern dry areas of Cameroon was assessed by 7 day in-vivo assays. Twenty seven patients were treated with the standard 25 mg/kg dose, and 22 received a reduced, but frequently used, 10 mg/kg dose. The results of these in vivo assays are in agreement with in-vitro data showing a low prevalence and a low degree of chloroquine resistance. In contrast with P. falciparum isolates from Southern Cameroon, no case of RII or RIII resistance was detected in the North. Clearance of parasite was delayed in 4 of the 22 patients treated with 10 mg/kg, and for one of them parasites remained up to day 7 despite subnormal but appropriate chloroquine blood concentrations.

A radioimmunoassay for the antimalarial drug chloroquine

We describe a 3H-based RIA for the antimalarial drug chloroquine (CLQ), the most commonly used antimalarial drug. In the assay a monoclonal antibody is used that is directed against 4-amino-7-chloroquinoline conjugated to keyhole limpet hemocyanin by the glutaraldehyde method. Besides CLQ, this antibody also recognizes with good affinity the 4-aminoquinoline homologs, hydroxychloroquine and amodiaquine. No extraction step or sample preparation is required, and the method can detect as little as 10 micrograms/L, the lower concentration in plasma of humans who are taking CLQ as a preventive measure. The between-assay CV is less than or equal to 10%, the within-assay CV less than or equal to 3%. Results correlate with those by liquid chromatography (r2 = 0.96). The speed and simplicity of the RIA method make it useful in evaluating the CLQ concentrations in acutely toxic patients.

A radioimmunoassay for the antimalarial drug chloroquine

We describe a 3H-based RIA for the antimalarial drug chloroquine (CLQ), the most commonly used antimalarial drug. In the assay a monoclonal antibody is used that is directed against 4-amino-7-chloroquinoline conjugated to keyhole limpet hemocyanin by the glutaraldehyde method. Besides CLQ, this antibody also recognizes with good affinity the 4-aminoquinoline homologs, hydroxychloroquine and amodiaquine. No extraction step or sample preparation is required, and the method can detect as little as 10 micrograms/L, the lower concentration in plasma of humans who are taking CLQ as a preventive measure. The between-assay CV is less than or equal to 10%, the within-assay CV less than or equal to 3%. Results correlate with those by liquid chromatography (r2 = 0.96). The speed and simplicity of the RIA method make it useful in evaluating the CLQ concentrations in acutely toxic patients.

Decreased sensitivity to chloroquine and quinine of some Plasmodium falciparum strains from Senegal in September 1984

The in vitro sensitivity of 135 Plasmodium falciparum isolates collected in the areas of Thies and Kaolack, Senegal, were studied in September 1984, by means of the 48 hr microtest with 3H-hypoxanthine incorporation. Results are available in 110 of 135 cases studied (81%). The isolates collected around Kaolack were found on average less sensitive to chloroquine than those from Thies (mean EC50 28 and 17 nmol/l of medium, respectively, P less than 0.05) and in 1 isolate a high degree of resistance was found (EC50 178 nmol/l). Some of those isolates also were studied using the WHO standard microtest and similar results were recorded. With both assays probit regression lines show EC99 in Kaolack greater than 114 nmol/l. These data suggest that in 1984 chloroquine resistance was possibly emerging in the extreme west of Africa. Sensitivity to quinine could be evaluated in 15 of 24 isolates tested. One of them, originating from Thies, was highly resistant to this drug (EC50 760 nmol/l) and 2 additional isolates with EC50s of 370 and 274 nmol have decreased sensitivity. These results suggest that quinine, as well as chloroquine, sensitivity should be monitored in the African region.

Transfusion requirements of adolescents with severe haemophilia A

The transfusion requirements of 75 adolescents with severe haemophilia A were studied during the five-year period 1973-77. The annual incidence of the 4935 episodes studied increased by a factor of 2.2 while the number of transfusions rose by a factor of 2.5 and the amount of therapeutic material used during the five years of the survey increased by a factor of 2.6. A further 166 bleeds occurred during periods of prophylaxis in 1976 and 1977, which generated a 25% increase in factor VIII used during those years. The increased usage of factor VIII in the years 1976 and 1977 was thus due mainly to increased numbers of transfusions given per bleed and to the use of prophylaxis but also to a slight increase in the units of factor VIII given in each dose. Twice weekly prophylaxis reduced the bleeding frequency by 30% and resulted in an increase of about 12% in usage of factor VIII. Prophylaxis given three times weekly reduced the bleeding frequency by about 60% at the cost of an increase of 77% in therapeutic materials. Iliopsoas, retroperitoneal, and abdominal wall bleeds were the commonest bleeds needing retransfusion within 24 hours, while bleeds into the extremities of the upper and lower limbs needed least retransfusions within 24 hours. Retroperitoneal bleeds needed the most transfusions per episode followed by iliopsoas, buttock, abdominal wall, and hip joint bleeds. The transfusion requirements of bleeds below the diaphragm tended to diminish steadily the more peripheral they became. This relationship did not hold for upper limb bleeds.

Effect of Age and Site on Transfusion Requirements of Adolescents With Severe Haemophilia A

4935 bleeding episodes in 75 adolescents with severe haemophilia A and without inhibitors to Factor VIII were studied during 5 years 1973-1977 6726 Factor VIII transfusions were given. 1.22 transfusions per bleed given in 1973 rose to 1.39 transfusions per bleed in 1977. 1.20 transfusions per bleed were given to 10 year olds which rose to 1.47 at 15 years. 745 bleeding episodes needed retransfusion within 24 hours. Iliopsoas (61% of bleeds) and retroperitoneal (58% of bleeds) were the sites needing most retransfusions wichin 24 hours. Total transfusions per bleed were most frequent in retroperitoneal (3.6) and iliopsoas (2.5) bleeds. On 181 occasions bleeds occurred into more than one site simultaneously and required 221 transfusions for complete resolution. Multiple bleeds involving the thigh (1.4) and upper arm (1.4) required most transfusions per bleeding episode.

Conclusions are that adolescent transfusion requirements peak at 15 years. Bleeds into the psoas and retroperitoneum may benefit from higher initial doses of Factor VIII and multiple bleeds require no more initial therapy than single bleeds.

Twice weekly prophylactic therapy in haemophilia A

Factor VIII-containing materials were administered to four severely affected haemophiliacs twice weekly in doses calculated to raise the factor VIII level to either 15% or 30% of average normal. The pooled results from those patients with statistically similar baseline bleeding frequencies showed a significant reduction in bleeding frequency on both doses in the first 48 hours. The 30% dose produced a more significant reduction than the 15% dose in the first 24 hours, but there was no significant difference between the two doses in the second 24 hours. It appears that to reduce the bleeding frequency of severely affected haemophiliacs by 60% would require a two-and-a-half-fold increase in therapeutic materials. A 90% reduction would need nine times the amount of material currently in use.

Prophylaxis in haemophilia: a double-blind controlled trial

A double-blind controlled trial of prophylactic factor VIII therapy has been carried out on nine severe haemophiliacs at the Lord Mayor Treloar College. Infusions were given once weekly and calculated to give a post-infusion plasma concentration of at least 0.25 I.U./ml of factor VIII. This regime reduced the overall bleeding frequency by 15%. The bleeding frequency in the first 3 days post-infusion was reduced by 66%. A moderate overall reduction in morbidity was also achieved. It is calculated that to reduce the incidence of bleeding in severe haemophiliacs by 15% would require a 73% increased usage of therapeutic materials. More than twice this amount of material is likely to be needed to reduce the bleeding frequency of the same group by 66%.