bluuebunny/crossref_metadata_2025 huggingface dataset:
Rhesus Alloimmunisation: Forgotten but not Gone
Authors: Rowlands Shelley
Published: September 2010

The prophylactic use of rhesus immunoglobulin has led to a significant reduction in the incidence of haemolytic disease of the newborn secondary to rhesus alloimmunisation, which now only occurs in 1 in 1000 live births. Despite prophylaxis, antibodies to the D antigen are still the commonest cause of rhesus isoimmunisation. Although now a rare pregnancy disorder rhesus isoimmunisation continues to be a challenging obstetric complication and while the face of this disease has undergone many changes over recent years, the principles of management remain unchanged. Pregnancies at risk of the disease are identified by past obstetric history and the antenatal detection of red cell antibodies with serial measurement of antibody levels. In cases of heterozygous paternity the real risk of fetal disease can be determined using new DNA techniques to determine the fetal blood cell type with tissue obtained from amniocentesis, and now by molecular analysis of circulating fetal DNA in the maternal plasma and serum. Sensitised pregnancies are monitored for the development of fetal anaemia. Since its introduction into clinical practise by Liley over 40 years ago, spectral analysis of amniotic fluid bilirubin as an indirect measure of fetal haemolysis has been the primary method of screening for fetal anaemia. Noninvasive evaluation is now possible with the use of doppler ultrasound to detect changes to fetal blood flow secondary to fetal anaemia, most commonly using the middle cerebral artery, and ultrasound evaluation of fetal haemopoetic organs and for the diagnosis of hydrops. Ultrasound guided intrauterine transfusion of red blood cells remains the treatment for the severely affected fetus. Perinatal survival rates in the non hydropic fetus are reported at over 90% and long term studies have revealed normal neurological outcomes for more than 90% cases.
Life Blood – Nurses at the Front Line of Transfusion Practice
Authors: Aranda Sanchia
Published: September 2010

In 2002 the Victoria Government, through a Blood Matters Collaborative, supported the introduction of Transfusion Nurse roles in participating Victorian Hospitals. The TN role, based on haemovigilance roles internationally, was key to the introduction of change initiatives undertaken as part of the collaborative project. TNs required a broad knowledge of transfusion practice along with training in organisational change and implementation of change concepts. Training for the TNs was provided through a Graduate Certificate in Transfusion Practice developed specifically for the project. This program has now been developed for online delivery. This paper will outline the role development and role vision developed for TNs throughout the Blood Matters Collaborative and considers the issues that have arisen since completion of the project in terms of role sustainability. Important issues include the place of TNs within organisational structures, development of sustainable systems of role integration and the ongoing integrity and sustainability of programs developed for role preparation.
Ruth Sanger Oration ‘Life, Death and Oxygen: A Story of Science, Dogma, and Serendipity’
Authors: Isbister James
Published: September 2010

As a cosmic element Oxygen is the third most abundant element in the universe. Its presence in the atmosphere and solubility in water makes life on Earth possible. As a human element Oxygen makes up approximately 60% of our body weight and access to too little or too much is fatal. Medically, Oxygen is an essential therapeutic element and its technical delivery has led to the development of blood transfusion, ventilators and intensive care units. The discovery and evolution of our understanding of Oxygen as ‘The Molecule that made the World’ is a story of genius, serendipity and politics. To the haematologist and transfusionist Oxygen’s relationship to the red cell and the haemoglobin molecule is a constant source of amazement and fascination. The red cell, the only cell in the body that is not dependent on Oxygen for energy production, has, in conjunction with the cardiovascular and respiratory systems, the awesome responsibility of delivery adequate amounts of Oxygen to every cell in the body 24 hours a day 7 days a week. Haemoglobin, probably the most studied molecular in biology, has been pivotal in the broader understanding of molecular structure and function and continues to reveal it’s secrets. Oxygen, as an economic element is essential to industry and as an environmental element is closely linked to conservation of planet Earth. Many sports have a close and frequently dubious interest in enhancing delivery of oxygen to the muscles. On the basis of doubtful people who feel the need are increasingly being enticed to ‘Flood their bodies with Oxygen as therapy against our polluted World’. It is the presenter’s aim that this lecture will illustrate the paramount role of Oxygen to our existence and it’s central importance in the history of medicine, and blood transfusion in particular.
Varying Specificities of Several anti‐Mi(a) Antibodies Purified by Affinity Chromatography on Peptides Representing the Mi(a) Antigen are not the same as an anti‐Mi(a) Monoclonal Antibody
Authors: Flower Robert , Lin Marie
Published: September 2010

Aim  Anti‐Mi(a) has been used as a generic term to describe a number of antibodies to variant MNS (vMNS) antigens. The aim of this study was to compare the specificty reported for an anti‐Mia) monoclonal antibody with monospecific polyclonal antibodies recovered from human sera by affinity chromatography. The hypothesised pattern was equal reactions with QNTDK28HKRDT and QNTDM28HKRD peptides. Sepharose columns one with each form of the peptide (K28 or M28) were prepared. A 10 ml pool of sera that reacted with the M28‐peptide AND strongly agglutinated Vw cells, was subjected to affinity chromatography on the M28‐peptide column.

Result  A concentrated eluate reacted only with the M28‐peptide by ELISA and agglutinated all Vw, HUT, MiIII and Mi VI cells tested. This was an anti‐Mi(a) but with different pattern of ELISA reactivity to that reported for the monoclonal antibody. In a sequential second affinity chromatography, the fraction that did NOT bind to the M28‐peptide was applied to the K28‐peptide column: The concentrate reacted with K‐containing peptide and agglutinated all Vw, HUT, MiIII and Mi IV cells – an anti‐Mi(a) with a different (lysine‐specific) pattern of reactivity. In one case an antibody that also reacted with cells with an Sta phenotype was isolated from the K28‐peptide column.

Conclusion  In human antisera to Mi(a) there are several patterns of reaction for antisera that agglutinate Vw and Mi(a) cells. None of these resembled the MAb (hypothesis refuted). Complex reactivities predicted by early serolgists in the field can now be studied using specific antisera.
Strict Specimen Labelling Criteria – A Safety Initiative Experience from a Hospital
Authors: Borosak Marija , Curcic Slav , Schneider Hans , Street Alison , Cole‐Sinclair Merrole
Published: September 2010

Aim  Correct patient and specimen identification and labelling are critical to ensuring that the correct results are issued for the right patient, and that medical decisions and treatments given on the basis of these test results are appropriate. This is particularly critical in pre‐transfusion testing with the risk of ABO mismatch transfusion and potential fatality a real possibility. Background: Over 11 months, data relating to mislabelled specimens demonstrated a basal rate of 2 ‘wrong‐blood‐in‐tube’(WBIT) incidents per month and 8 of 23 were for pre‐transfusion testing. These incidents were detected only where inconsistencies either in clinical information or previous test results were apparent. Intervention Our pathology service developed a set of strict minimum identification criteria for ALL pathology specimens and a policy of rejection of specimens that do not comply. These criteria align with ANZSBT guidelines for pre‐transfusion samples. An 8 week education and notification phase followed by strict application of the criteria in February 2004 and a subsequent follow‐up phase was conducted.

Result  Smooth implementation of a major network‐wide initiative has occurred over the last 5 months, as evidenced by the low specimen incident rate of 1%. Early indicators of success include an increased awareness of WBIT episodes with three self‐reported episodes of WBIT since implementation. Unlabelled specimens have reduced by at least 50% compared to the same period prior to intervention.

Conclusion  Our experience may be of interest to other institutions considering similar initiatives. A reduction in WBIT events is the most preferred outcome, however it may be many months before this can be appreciated due to low detection levels.
The Transfusion Medicine Team – A Hospital Perspective
Authors: Borosak Marija , Curcic Slav , Magrin Geoff , Street Alison , Cole‐Sinclair Merrole
Published: September 2010

Background and aim  Three serious transfusion‐related incidents over a 9 month period highlighted the clinical risk in transfusion during 2001–2002. This lead to the development of a strategy to comprehensively review and implement transfusion safety initiatives across the Bayside health network of which the Alfred is a major hospital. Intervention The initiative commenced in January 2003 with the assembly of a multi‐disciplinary team that consisted of medical, nursing, scientific as well as hospital executive representation. This was possible with the appointment of a Transfusion Nurse as part of the Victorian Department of Human Services Blood Matters Collaborative and a Transfusion Medicine Registrar, co‐appointed by the hospital and Australian Red Cross Blood Service. The activities consisted initially of process mapping blood transfusion practice. Key areas were then selected for targeting process improvement, namely; – Patient and product identification, – Sample labelling, – Blood component administration.

Result  Initiatives implemented were; – Widespread medical and nursing education on transfusion issues. – Increase transfusion information availability. – Network‐wide implementation of strict criteria for specimen labelling (all specimens) in line with ANZSBT pre‐transfusion testing guidelines. – Development of a pre‐transfusion testing and blood request form. – Development of a blood administration form to reconcile all transfusion related documentation in the medical record. ‐ Policy and guideline development.

Conclusion  Sustained improvement requires ongoing dedicated personnel to maintain gains, continue to audit practice, analyse incident data both actual adverse incidents as well as near‐miss events and to respond to these challenges within an ongoing and operational quality improvement framework.
Hospital Transfusion Education – A Global Perspective
Authors: Verrall Trudi , Phythian Meradith , Saxon Ben , Robinson Kathryn
Published: September 2010

Aim  The Adelaide Women’s & Children’s Hospital WCH) in South Australia has been actively involved in the BloodSafe program since 2002. BloodSafe has identified an inadequate safety culture in hospitals in relation to blood management practices. Paediatric transfusion practice covers diverse patient groups & is often performed infrequently leading to a loss of staff confidence. These factors, along with the lack of paediatric guidelines prompted the WCH BloodSafe nurse to build links with other paediatric centres both in Australia & overseas with the aim of identifying successful transfusion education strategies for hospital staff.

Method  A South Australian Premier’s Nursing scholarship was granted to review paediatric transfusion practices and explore the role of Transfusion Nurses in Canada & the United Kingdom (UK). Hospitals throughout Ontario, England & Scotland were visited in May 2004.

Result  Ontario hospitals have Transfusion Safety Officers that educate staff using orientation & professional development education sessions. In the UK a key intervention of the National Blood Conservation Strategy is a directive that all staff involved in the transfusion process require transfusion education. Clinical competency packages for all staff groups including porters & specimen collectors have been developed. The Effective Use of Blood Group in Scotland has developed an interactive web based transfusion learning package enabling staff to learn at their own pace.

Conclusion  While these diverse education packages can help to shape the delivery of transfusion education in Australian Hospitals, materials that reflect current Australian practice & products need to be developed.
TRALI a Review
Authors: Couvara Anastasia
Published: September 2010

TRALI is a life‐threatening complication from the transfusion of a blood product. It is characterised by a clinical constellation of signs and symptoms including dyspnoea, cyanosis, hypotension, tachycardia, fever, chills and bilateral non‐cardiogenic pulmonary oedema. We will discuss its diagnosis, differential diagnosis, treatment and causative factors. TRALI has been described as a leading cause of transfusion related death. However the incidence of non lethal forms of TRALI is unknown and we will discuss the reasons for this, as well as future directions for the prevention and treatment of this complication.
Blood Banking, Immunohaematology, Transfusion Science: what’s next?
Authors: Green Ralph E B
Published: September 2010

During their education all Medical Scientists will be exposed at some stage to the intricacies of blood grouping, crossmatching and the investigation of adverse responses to the transfusion of blood and blood products. For some, this exposure engenders fear and trepidation and they cannot wait to get into a discipline that is less demanding and stressful. For others the discipline is a challenge that allows them to use their problem solving skills and to experience the adrenal rush of responding to urgent requests for blood from theater or casualty to help save a bleeding patient.

As in all disciplines of Laboratory Medicine, technology, especially information communication technology (ICT), is having a significant impact upon how blood transfusion science is being practiced. However unlike all other disciplines, blood transfusion is also subject to the regulations of the Therapeutic Goods Authority which impose a broad range of safety requirements on the products that Medical Scientist work with and release for patients. Whilst some testing technology such as column agglutination and ICT is seemingly simplifying the preparation and release of products for patients, developments in other areas are opening up new challenges.

The creation of Cell Therapies laboratories in a number of the major hospitals in Australia is the latest development in transfusion practice. Could the next stage in our progression be the incorpor ation of the hospital blood bank into the Cell and Tissue Therapies Laboratory, where the testing and processing of all cell and tissue products is undertaken under the one coordinating body.

This presentation will review the education and training of Medical Scientists at RMIT University for the discipline of Transfusion Science and present a perspective on where future directions in our educational programs might go.
Tackling the Problem of Bacterial Contamination
Authors: AuBuchon James P
Published: September 2010

Focus on the risks of viral transmission via transfusion has pushed recognition of other transfusion risks to the background over the last several decades. With reduction in the risks of HCV and HIV to very low levels (well less than 1/million units), productive attention can now be directed toward other risks. Bacterial contamination of platelets represents the largest morbidity and mortality risk faced by a platelet recipient, and the risk of dieing due to a contaminated unit is at least 10‐ if not 100‐times greater than the chance of HIV transmission. Approximately 1 in every 1–4,000 units of platelets can be shown to contain bacteria, and the frequency of fatality due to port‐transfusion sepsis is 14/million units transfused. Bacterial contamination is often not recognized clinically, however, because of the situation of the patient. A variety of techniques to limit and detect bacterial contamination are available for implementation. Culturing is used most widely. Checking pH, glucose concentration or preservation of swirling are simple and inexpensive techniques but suffer from lack of sensitivity. The development of immunologic techniques that can be accomplished rapidly may shift the testing to immediately before issuance for transfusion, a time at which any contamination would be easier to detect because of growth during the storage period. Not only will detection techniques improve transfusion recipient safety, but they can lead to cost‐savings through extension of the platelet storage period as has already been implemented in several European countries.
The Role of the National Blood Authority
Authors: DeGraaff Peter
Published: September 2010

Since its establishment on 1 July 2003, the National Blood Authority (NBA) has been making steady progress towards fulfilling its vision of ‘Saving and improving Australian lives through a world‐class blood supply’. While the NBA’s early focus has been on developing organisational infrastructure and meeting compliance requirements as a new Commonwealth agency, it has already begun to bring about improvements to the management of the blood sector in line with the recommendations of the 2001 Stephen Review. As the centralised procurement agency for blood and blood products, the NBA is responsible for managing existing supply contracts with the Australian Red Cross Blood Service, CSL Limited and a number of pharmaceutical companies, and is currently negotiating new contracts with two major suppliers. The NBA has also been working with the signatories to the National Blood Agreement, all nine Australian Government Jurisdictions, to coordinate national demand and supply planning. It is introducing an agreed single national pricing schedule and has developed improved forecasting models and reporting mechanisms to ensure that jurisdictional requirements for blood and blood products are more closely matched to supply. With time, the NBA hopes to play a greater facilitation role in encouraging the better clinical use of blood and blood products as this will not only result in better patient outcomes, but will also contribute to ensuring the adequacy of the blood supply. This presentation discusses why the NBA was established, its roles and responsibilities, and how it is working to bring about reforms in the sector in terms of increased value for money, transparency and accountability.
Design and Delivery of a ‘Donor‐centric’ Blood Collection Facility
Authors: Savvas Ross , Voller Matt , Moek Peter , McGinn Simon , McDonald Lisa , Doherty Kathleen
Published: September 2010

Aim  ARCBS collection sites are located in capital city centres, regional and metropolitan static sites and mobile units. The project aimed to establish a ‘donor‐centric’ collection facility that met evolving donor needs.

Methods & Result  Due to Adelaide’s high level of urbanisation combined with; (a) the eastern based skew of the existing Pirie Street operation and (b) the demographic profiles of donor and non‐donor cohorts, potential sites for further investigation were identified. This process was further enhanced by surveying donors (stakeholder buy in and input) who indicated a preference for a mid‐CBD site. This selection was supported by retailing and traffic analysis that reinforced the Currie St. location – a major street frontage with a transport hub to the western suburbs. ‘Guiding Principles’ for the design and operation of the centre were developed and stated that the site must; – have a WOW factor – make donation easy for donors – have a modern and professional outlook – have its own personality – be creative and bold – not compete with the existing city site – cater for a different market segment to existing sites. The Guiding Principles and recommendations from donor focus groups, were used by the architects to develop concept drawings. These were reviewed by the Donor Advisory Committee, and specifications finalised. Furniture, fittings, refreshments and marketing strategies also focussed on the target donor groups and Guiding Principles.

Conclusion  A donor focus in the planning, design and development of this centre has produced a facility that currently exceeds collection targets and has been nominated for building industry awards.
RhD Prophylaxis in Australia: 1966 and Beyond
Authors: Thomson Amanda
Published: September 2010

In the late 1960s clinical trials showed that the incidence of Rh D immunisation of Rh negative women could be dramatically reduced by the administration of Rh D immunoglobulin (Ig) after delivery. In 1968 Australia became the first country to be self sufficient in Rh D Ig with the introduction of the Rh programme. Despite appropriate use of Rh D Ig 1–2% of Rh negative women still became immunised. Studies subsequently showed that immunisation rates could be further reduced by prophylactic administration of Rh D Ig during pregnancy. Routine antenatal prophylaxis has been practiced in Canada and USA for more than 20 years. The first NHMRC Clinical Practice Guidelines on the use of Rh D Ig were issued in 1999. These acknowledged that routine antenatal prophylaxis was best practice, however could not be recommended due to supply constraints. Subsequent initiatives included the licensing of the 250 IU dose of Rh D Ig, expansion of plasma collection and importation of product. Staged introduction of routine antenatal prophylaxis began in late 2002 with introduction of prophylaxis for primigravidae. Stage 2, which provides antenatal prophylaxis for all Rh D negative women, is to be implemented by 1 January 2005. Stage 3 will see cessation of the need for use of imported product. A Joint Consultative Committee of involved specialties is helping to ensure consultation and communication for the implementation process. The possibility of developing a laboratory Rh D Ig which could be produced in unlimited quantities, in a standardised formulation with no reliance on human derived sources has been entertained for many years. Results of trials of possible options have been intermittently published. However, it is likely that the ‘liquid gold’ anti D plasma donated by our amazing volunteers will be needed for many years to come.
Genetic risk factors associated with Creutzfeld‐Jakob disease in Slovenians and a rapid typing forPRNPcodon 129 single nucleotide polymorphism
Authors: Galvani V. , Rupreht R. R. , Šerbec V. Č. , Vidan‐Jeras B.
Published: September 2010

summary. PRNPhas been the most informative marker for the predisposition to variant Creutzfeld‐Jakob disease (vCJD). All victims of the vCJD carried methionine (M) at the position 129 of the PrP. Prions could travel through the immune system to get from the gut to the brain, and human leucocyte antigens (HLAs) could be involved in this carriage, with HLA‐DQ7 being less efficient. Contradictory reports have raised the question of the influence of sampling in population studies. We developed a fast and reliable real‐time polymerase chain reaction for codon 129 single nucleotide polymorphism (SNP) using TaqMan technology, which overcomes the main drawbacks of other methods and analysed Slovenian population (n = 97). The comparison with other populations served for the estimation of the genetic risk for the development of vCJD in Slovenians. The frequencies at the codon 129 SNP in the Slovenian population were 43·3% M, 45·4% M/V 11·3% V. Considerable differences between the DQ7 frequencies in diverse samples from the same population can be seen, especially when compared to Slovenian population. This could be because of the diverse criteria for including subjects into the study and the sampling of geographically distinct subpopulations. Analysing the adequacy of HLA‐DQ7 as a possible predictive factor for developing Creutzfeld‐Jakob disease (CJD) by case – control studies could be improved with exact and equal sampling of groups of patients and controls. CJD genetic risk factors in the Slovenians were not found significantly different than those in British.
Why don’t women volunteer to give blood? A study of knowledge, attitude and practice of women about blood donation, Yazd, Iran, 2005
Authors: Javadzadeh Shahshahani H
Published: September 2010

summary The most important aim of all blood transfusion centres is to recruit blood donors from low‐risk groups of society to donate blood voluntarily and regularly. In the city of Yazd, Iran, only 5% of blood donors are women. The aim of this study was to assess barriers of donation of blood by women and the level of knowledge, attitude and practice regarding blood donation. In this cross‐sectional study, 1602 women were selected by cluster sampling method and asked to fill a specially formatted questionnaire. Data were analysed by ANOVA and the t‐test. Levels of knowledge were different between the various groups. Illiterate women and housewives had the least levels of knowledge. Fifteen per cent of the women had donated blood at least once in the past. The most important motivational factor was sense of moral duty with a spiritual reward and the most important barriers for donating blood were anaemia, fear, lack of time and difficulty in access to donation sites. A significant percentage of women had false beliefs about blood donation. Increase in the level of knowledge of women and correction of false beliefs should be the topmost priority. Further studies are needed to determine whether addressing anaemia and women’s health can tend to increase the number of female blood donors.
A placebo‐controlled trial of cetirizine in seasonal allergic rhino‐conjunctivitis in children aged 6 to 12 years
Authors: Masi M. , Candiani R. , van de Venne H.
Published: September 2010

A total of 124 children of both sexes aged between 6 and 12 years with pollen‐associated rhino‐conjunctivitis were included in a multicentre double‐blind study of parallel group design to compare the effects of cetirizine 10 mg daily, given as 5 mg morning and evening for 2 weeks, with those of placebo of identical appearance. Rhinorrhea, sneezing, nasal obstruction and nasal and ocular pruritus were evaluated using symptom scores by patients on daily self‐evaluation cards and by investigators who, in addition, made a global evaluation at the end of treatment. Appropriate wash‐out periods for previous medicines were observed. Unchanged treatment of asthma was allowed and inhaled corticosteroids were continued in 3 placebo patients. Compliance was checked and found to be less than 80% of the prescribed dosage in 2 cetirizine patients. The mean percentage of study days when symptoms were absent or at the most mild (i.e. present but not disturbing), as reported daily by the patients, was significantly greater with cetirizine (56.2%) than placebo (29.7%). This 26.5% difference was considered clinically significant. The value of this method of expressing treatment effects in allergic rhinitis is discussed. Improvement in maximum symptom scores (severest symptoms) assessed by investigators was better for cetirizine than placebo after treatment for 1 week and 2 weeks. Improvement in individual daily symptoms was greater for cetirizine than placebo after a few days. Global evaluations of response by investigators at the end of the study showed improvement in both groups that was significantly greater with cetirizine, providing a response that was considered excellent or good in 79% of patients on cetirizine compared with 50% of patients on placebo. Tolerance was good. Somnolence that was generally mild and transient was reported in 6 patients of the cetirizine group and in 2 patients of the placebo group.
Discrepant clinical responses and blood chemokine profiles between two non‐steroidal anti‐inflammatory medications for children with mild persistent asthma
Authors: Hung Chih‐Hsing , Li Chi‐Yuan , Lai Yuan‐Sheng , Hsu Ping‐Ching , Hua Yi‐Ming , Yang Kuender D.
Published: September 2010

In a randomized study, two oral medications, ketotifen and montelukast, were compared for children with mild persistent asthma. Montelukast revealed faster clinical responses than ketotifen, showing improved exhaled nitric oxide, peak expiratory flow, and asthma scores in 1 wk. After 8‐wk of medication, both ketotifen and montelukast revealed improved clinical responses. However, 8 wk of ketotifen, but not montelukast, decreased plasma serum thymus and activation‐regulated chemokine (317.854 ± 207.906 vs. 181.348 ± 167.109, p < 0.05), macrophage‐derived chemokine (355.11 ± 174.30 vs. 169.19 ± 62.42, p < 0.05) levels. In conclusion, different oral non‐steroidal anti‐inflammatory drugs revealed faster or slower treatment responses due to different mechanisms.
Proposal for a standardized interpretation of the atopy patch test in children with atopic dermatitis and suspected food allergy
Authors: Heine Ralf G. , Verstege Andrea , Mehl Anne , Staden Ute , Rolinck‐Werninghaus Claudia , Niggemann Bodo
Published: September 2010

The interpretation of the atopy patch test (APT) to foods is not standardized. This study aimed to validate the reading of the APT in terms of the diagnostic accuracy of individual skin signs. Eighty‐seven children (mean age 2.4 ± 2.5 yr, range 0.5–13.5; 57 male) with atopic dermatitis (AD) and suspected food allergies underwent APT to cow's milk, hen's egg, wheat and soy. Twelve‐millimetre Finn chambers were applied for 48 h, and results were read after 48 and 72 h. Skin changes were graded for erythema, induration, papule formation and ‘crescendo’ phenomenon (increase of skin sign severity from 48 to 72 h). Food allergy was assessed by double blind, placebo‐controlled food challenges (DBPCFC). Sensitivity, specificity and predictive values were calculated for each skin signs in relation to challenge outcome. Of 165 DBPCFC children, 75 (45%) were positive. The combination of any skin induration plus papules (seven or more), or of moderate erythema plus any induration plus seven or more papules had a positive predictive value (PPV) and specificity for the challenge outcome of 100%; however, the sensitivity was low (8% and 15%). The best diagnostic accuracy for single signs was found for induration beyond the Finn chamber margin (PPV 88%, specificity 99%, sensitivity 9%) and presence of at least seven papules (PPV 80%, specificity 96% sensitivity 21%). Presence of both induration and of at least seven papules at 72 h were the APT skin signs with the greatest diagnostic accuracy for food allergy in children with AD.
Atopic wheezing and early life antibiotic exposure: a nested case–control study
Authors: Thomas Mike , Custovic Adnan , Woodcock Ashley , Morris Julie , Simpson Angela , Murray Clare S.
Published: September 2010

Several factors including early‐life antibiotic usage have been implicated in the rising prevalence of allergic sensitization and asthma. A nested case–control study comparing antibiotic exposure of 37 sensitized children with recurrent wheeze (age 3–5 yr) and 37 non‐sensitized children who had never wheezed was carried out within a population‐based birth cohort (matching for age, sex, parental atopy, allergen exposure, and pet ownership). We collected data on antibiotic prescriptions during first 3 yr of life (timing, type, indication) from the primary care medical records. Significantly, more cases than controls received one or more antibiotic courses during the first year of life (92% vs. 70%, p = 0.04). The median time to first antibiotic course was shorter for the cases than the controls (6 vs. 8 months, p = 0.03). The total number of antibiotic receipts was greater amongst cases in each of the first 3 yr of life, but this reached significance only when the whole three‐year period was considered (249 vs. 182 courses, p = 0.05). The increased ratio of antibiotic receipt in cases over controls was highest in the first year of life (1.32, 95% CI 0.99–1.78). Significantly more cases than controls were prescribed antibiotics for lower respiratory tract infection during the first 3 yr (p = 0.007), but not during the first year of life (p = 0.52). Antibiotics use by class was similar in the two groups. Our data support the hypothesis that early life exposure to broad‐spectrum antibiotics may have a causative role in sensitisation and the expression of wheeze.
Effects of feeding probiotics during weaning on infections and antibody responses to diphtheria, tetanus and Hib vaccines
Authors: West Christina E. , Gothefors Leif , Granström Marta , Käyhty Helena , Hammarström Marie‐Louise K.C. , Hernell Olle
Published: September 2010

Microbial exposure is necessary for the development of normal immune function, which has driven the idea of using probiotics for treatment and prevention of immune‐mediated diseases in infancy and childhood. Mounting evidence indicates that probiotics have immunomodulatory effects. However, the mechanisms are still poorly understood. Specific antibody response is a valuable proxy for immune system maturation status in infancy. We aimed at determining the impact of Lactobacillus F19 (LF19) during weaning on infections and IgG antibody responses to routine vaccines. In a double‐blind, placebo‐controlled randomized intervention trial, infants were fed cereals with (n = 89) or without LF19 (n = 90) from 4 to 13 months of age. Infants were immunized with DTaP (diphtheria and tetanus toxoid and acellular pertussis), polio and Hib‐conjugate vaccines at (3), 5 and 12 months of age. We assessed the number of days with infections, antibiotic prescriptions and antibody concentrations to Hib capsular polysaccharide (HibPS), diphtheria toxin (D) and tetanus toxoid (T) before and after the second and third doses. Days with infectious symptoms did not differ between the groups. Days with antibiotic prescriptions were fewer in the LF19 group (p = 0.044). LF19 enhanced anti‐D concentrations when adjusting for breastfeeding duration and colonization with LF19 (p = 0.024). There was an interaction of the intervention and colonization with LF19 on anti‐T concentrations during the course of vaccination (p = 0.035). The anti‐HibPS concentrations were higher after the first and second dose of Hib vaccine in infants breastfed <6 months compared with those breastfed ≥6 months (p < 0.05), with no effect by LF19. In conclusion, feeding LF19 did not prevent infections, but increased the capacity to raise immune responses to protein antigens, with more pronounced effects in infants breastfed <6 months.
A Serological Survey on Erysipelas in Chickens by Growth Agglutination Test
Authors: Takahashi T. , Takagi M. , Yamamoto K. , Nakamura M.
Published: September 2010

From March to April 1992, 200 culled chickens sent to an abattoir in Tokyo, Japan were examined for the presence of growth agglutinating antibody in the serum. In the serological survey, 11 (5.5 %) of 200 chicken sera had high growth agglutination titres againstErysipelothrix rhusiopathiae, ranging from 1 : 16 to 1 : 128. These findings indicate a high rate of erysipelas infection among chickens in the field.
Prevalence ofeaeand Shiga Toxin Genes amongEscherichia coliStrains Isolated from Healthy Calves
Authors: Osek J. , Winiarczyk S.
Published: September 2010

Strains ofEscherichia coli(n = 390) isolated from 132 healthy, 4–8‐week‐old calves, were tested by polymerase chain reaction (PCR) for theeae(intimin) gene and shiga toxin genes (stx1andstx2). All strains were also analysed for F5, F17 and F41 fimbriae and for the heat‐labile (LT) and heat‐stable (STI and STII) genetic markers. Overall, theeaegene was detected in 84 (21.5 %) of the strains tested. Only 21 (5.4 %) isolates were positive forstx1(18 strains) orstx2(three strains); nine of thestx1‐positive isolates also possessed theeaegene. A high percentage (29.2 %) of the isolates tested expressed F17 but no enterotoxin genes were detected. None of theeae‐ orstx‐positive strains belonged to the O157 serogroup.
A New Product with Formic Acid for Varroa jacobsoni Oud. Control in Argentina. I. Efficacy
Authors: Eguaras M. , Del Hoyo M. , Palacio M. A. , Ruffinengo S. , Bedascarrasbure E. L.
Published: September 2010

An organic product based on formic acid in a gel matrix was evaluated for use in Varroa control under autumnal climatic conditions in Argentina. Twenty colonies each received two gel packets with formic acid in two applications and numbers of falling mites were registered. After this treatment colonies received two other acaricides in order to compare efficacy. Average final efficacy in colonies treated with the organic product was 92% with a low variability. The gel matrix kept an adequate formic acid concentration inside the colonies with only two applications. This product is, therefore, a good alternative for Varroa control because it is organic, easy to use and presents a low variability in final efficacy between colonies. No queen, brood, or adult honeybee mortality was registered.
Variations among Unbred Heifers in the Activities of Polymorphonuclear Leucocytes from the Mammary Gland and Blood
Authors: Ryšánek D. , Babák V. , Sládek Z. , Toman M.
Published: September 2010

The phenotypic characteristics are described for the activity of polymorphonuclear leucocytes (PMN) obtained by either lavage of the cavity system of juvenile mammary glands stimulated with a synthetic muramyl dipeptide analogue or isolation from the peripheral blood. Attention was paid to the variability of characteristics and its sources, and to correlations among them. The following characteristics were investigated in 27 clinically healthy, unbred Bohemian Red Pied × Holstein heifers: migration activityin situ, number of phagocytosing PMN, phagocytotic index, bactericidal activity of PMN and unstimulated and zymosan‐stimulated luminol‐dependent chemiluminescence. Considerable individual variation was found in the characteristics. Significant differences between blood PMN and PMN from lavages after influx induction were found for bactericidal activity (P < 0.05) and chemiluminescence (P < 0.01). A significant correlation between blood PMN and mammary gland PMN was found only for the number of phagocytosing cells (r=0.329;P < 0.01). Highly significant positive correlations (P < 0.01) were demonstrated between the number of phagocytosing PMN [a], phagocytotic index [b], and bactericidal activity [c] in both blood PMN (rab=0.602; rac=0.565; rbc=0.529) and mammary gland PMN (rab=0.730, rac=0.618, rbc=0.589). No significant correlation was demonstrated for non‐stimulated (NS), zymosan‐stimulated (ZS), or opsonized zymosan‐stimulated (OZS) chemiluminescence with any of the other characteristics of phagocytotic activity, in either blood PMN or mammary gland PMN (P > 0.05). The animal was a highly significant source of variability for all the phagocytotic activity characteristics (P < 0.01). Udder quarter was a non‐significant source of variability for all the characteristics of phagocytotic activity except for NS chemiluminescence (P < 0.05) and ZS or OZS chemiluminescence (P < 0.01). However, udder quarter was a non‐significant source of variability of chemiluminescence indices ZS/NS and OZS/NS (P > 0.05). It has been demonstrated thatin situmigration activity, the number of phagocytosing PMN, phagocytotic index, bactericidal activity of PMN and chemiluminescence indices of PMN collected from juvenile mammary glands of unbred heifers after influx induction can be regarded as candidate early markers of resistance to mammary infections.
The Effect ofPasteurella haemolyticaA2 Infection on Phagocytosis Efficiency of Caprine Broncho‐Alveolar Macrophages
Authors: Zamri‐Saad M. , Mera H. R.
Published: September 2010

An experiment was designed to study thein vivoeffect ofPasteurella haemolyticaA2 infection on the phagocytosis activity of caprine broncho‐alveolar macrophages and the extent of pneumonic lesions. Twelve healthy local Kacang goats, about 7 months of age, were divided into two groups of six. Goats in group 1 were inoculated intratracheally with 4 ml inoculum containing 2.8 × 109colony‐forming units (CFU)/ml ofStaphylococcus aureus. Goats in group 2 were inoculated intratracheally with 4 ml of inoculum containing 9.5 × 108 CFU/ml ofPasteurella haemolyticaA2 isolated earlier from pneumonic lungs of goat. At intervals of 3 and 7 days post‐challenge five goats from each group were killed and the lungs were washed with sterile phosphate‐buffered saline. Smears were prepared from the lung washing fluid and the number of macrophages with phagocytic activity was determined. At day 3 post‐infection, goats of both groups showed a similar pattern of pneumonic lesion. The lung washing fluid of goats in group 2 was found to contain numerous neutrophils and macrophages. Goats in group 2 showed significantly (P < 0.05) higher extent of lung lesions than group 1. Similarly, the average extent of lung lesions was significantly (P < 0.05) more severe in group 2 at day 7 post‐infection. The lung washing fluid contained mostly macrophages. The phagocytic activity followingS. aureusinfection was more efficient and significantly (P < 0.01) higher compared with infection byP. haemolyticaA2. There were weak correlations between the extent of pneumonic lesion and the phagocytic activity. Thus, goats with poor phagocytic activity were likely to develop more extensive lung lesions.
Antimicrobial Susceptibility of Pasteurella multocida Isolated From Cattle and Pigs
Authors: Yoshimura H. , Ishimaru M. , Endoh Y. S. , Kojima A.
Published: September 2010

Minimum inhibitory concentrations (MICs) of 10 antimicrobial agents were determined for Pasteurella multocida from cattle and pigs (72 and 68 isolates, respectively). Higher MICs were observed with oxytetracycline, doxycycline, tilmicosin and thiamphenicol for porcine isolates than for bovine isolates. Enrofloxacin was the most active, with an MIC for 90 % of the isolates (MIC90) of 0.05 μg/ml for both bovine and porcine isolates. Aspoxicillin exhibited the same excellent activity against penicillin‐susceptible isolates as ceftiofur, with MICs ranging from ≤ 0.025 to 0.1 μg/ml. Aminoglycosides were less active, with an MIC90 of > 100 μg/ml for both bovine and porcine isolates.
Sows Intramammarily Inoculated withEscherichia coli: Influence of Time of Infection, Hormone Concentrations and Leucocyte Numbers on Development of Disease
Authors: Magnusson U. , Mörner A. Pedersen , Persson A. , Karlstam E. , Sternberg S. , Kindahl H.
Published: September 2010

The aim of this study was to identify factors that influence the development of disease in sows inoculated withEscherichia coliin the mammary gland. Ten cross‐bred primiparous sows were intramammarily inoculated with livingE. colibacteria at different time points before parturition: seven sows within 48 h before parturition and three sows approximately 96 h before parturition. Before and after inoculation, blood samples and mammary gland biopsy specimens were collected and clinical observations were made. All seven sows inoculated close to parturition developed a rectal temperature of >39.5°C during the first 48 h post‐partum and two of them also showed other signs of clinical disease. In the sows inoculated 4 days before parturition, the rectal temperature never exceeded 39.5°C during the first 48 h post‐partum and none of them showed any other sign of clinical disease. There was a tendency (P < 0.1) that histological signs of mastitis were more frequent in the sows inoculated close to parturition. There were no overall differences between the two groups of sows in plasma concentrations of cortisol, oestradiol‐17β and 15‐ketodihydro‐PGF2αbefore inoculation. Before inoculation, the number of neutrophils in the blood was overall higher (P < 0.05) in the group of sows that were inoculated close to parturition. In comparison, the number of lymphocytes before inoculation had a tendency (P < 0.1) to be lower in that group. The data suggest that the time of infection of the mammary gland relative to parturition and the number of circulating neutrophils at the time of infection influence the development of clinical coliform mastitis in the sow.
Effect of Subcutaneous Injection of Ginseng on Cows with SubclinicalStaphylococcus aureusMastitis
Authors: Hu S. , Concha C. , Johannisson A. , Meglia G. , Waller K. P.
Published: September 2010

Cows with subclinical mastitis caused byStaphylococcus aureuswere subjected to subcutaneous injections with either an extract from the root ofPanax ginsengCA Meyer at a dose of 8 mg/kg body weight per day for 6 days, or with saline as a control. The injection areas were checked for adverse reactions. The daily milk production was measured before and after treatment. Blood was collected for total and differential leucocyte counts, identification of lymphocyte subpopulations using flow cytometry, lymphocyte proliferation test, and neutrophil phagocytosis and oxidative burst assay. Quarter milk samples were collected for bacteriological analysis and somatic cell counts (SCC). After the end of treatment, the numbers ofS. aureus‐infected quarters and milk SCC tended to decrease in ginseng‐treated cows. Phagocytosis and oxidative burst activity of blood neutrophils were significantly increased 1 week after ginseng treatment, but the proliferative response of blood lymphocytes did not change significantly. The number of monocytes in ginseng‐injected cows was significantly higher 1 week post‐treatment than pre‐treatment, and the number of lymphocytes was significantly higher than pre‐infusion at 2 and 3 weeks after ginseng treatment. Similar changes were not observed in the control group. The present findings indicate that ginseng treatment can activate the innate immunity of cows and may contribute to the cow’s recovery from mastitis. It is therefore suggested that ginseng has a potential as a stimulator of the immune system of dairy cows.
Why is Anti‐Microbial Resistance a Veterinary Problem As Well?
Authors: Mateu E. , Martin M.
Published: September 2010

Resistance to anti‐microbial agents has become one of the main issues in public health strategies world‐wide. Much attention has been paid to the emergence of pathogenic micro‐organisms such as enterococci orSalmonellathat have developed resistance mechanisms that render them almost untreatable with current antibiotics. One of the alleged reasons for such an emergence is the non‐medical use of antibiotics, especially in animals. However, only recently have veterinary forums and journals begun to discuss this topic. On the other hand, anti‐microbial resistance has also become a problem in veterinary medicine and the number of reports indicating high rates of resistance among animal‐originated micro‐organisms is considerable. The present review deals with the mechanisms of resistance known for antibiotics in common veterinary use, the problem of anti‐microbial resistance in veterinary medicine and the links between the use of antibiotics in animals and the emergence of anti‐microbial resistance in humans.