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1.
Inflammatory reactions in the teat and udder of the dry cow   总被引:1,自引:0,他引:1  
The inflammatory reactions in the teat and udder of the dry cow were studied by total and differential somatic cell counts (SCC) and by measuring bovine serum albumin, N-acetyl-beta-D-glucosaminidase (NAGase), plasminogen and plasmin. The teat and udder cisterns were surgically separated from each other in two udder quarters of each cow. Salmonella endotoxin was infused in one teat cistern and one udder quarter, and saline was infused in one teat cistern and one udder quarter. The inflammatory response was followed by several samplings post infusion. The reactions in the dry udder quarters were mainly in line with the results of similar studies in lactating glands. The differential SCC and the NAGase results were, however, somewhat different. The teats were capable of a strong inflammatory response. Reactions different from those seen in the glands were observed with regard to permeability changes and NAGase. The experimental model used showed promising results and is suitable for further studies of the inflammatory process.  相似文献   

2.
Infections were induced at the end of lactation in all udder quarters of 19 cows by the infusion of 0.2 mL of a 10-4 dilution in milk of a six hour milk culture of Staphylococcus aureus, strain 305 (A.T.C.C No. 29740). Two right or two left udder quarters were infected at 15 days and the opposite two five days before the last milking of lactation. Following the last milking all four udder quarters of eight cows were treated with 400 mg novobiocin in 10 mL of 2% aluminum monosterate in peanut oil, gelled. All udder quarters of eight other cows were treated with 50 mg novobiocin in the same vehicle and the udder quarters of three cows were treated with the vehicle only.

At calving, eight of 32 quarters treated with 400 mg novobiocin were still infected, as were 18 of 32 treated with 50 mg of novobiocin and all those quarters treated with vehicle only. Results were identical from udder quarters infected 15 and five days before drying off.

No significant differences were found between quarters in milk yield on the last day of lactation, nor the length of the dry period. An increasing number of udder quarters were infected at calving with increase in lactation age of the cow, although the small number of cows would not allow a firm conclusion. A significant difference in results was found between front and hind udder quarters, only five of 32 front quarters were infected at calving as compared to 21 to 32 hind quarters.

The method proposed was found to give essentially the same results as those from a large field trial using the same antibiotic. It should therefore be useful in evaluation trials of new antibiotic products for dry cow treatment.

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3.
Improvement of udder health through a process of genetic selection is related to heritability and the role of the specific trait in the probability of an individual cow developing an infection. It was suggested that different patterns of leucocyte population of the healthy gland are a significant factor in mastitis. Thus, in order to analyse the heritability of a trait and its correlation with udder health, the present study examined the leucocyte populations of uninfected mammary glands, their variability among quarters in a particular cow, and the changes that occur during lactation. Each one of the 20 cows examined was tested on average 3.06 times during lactation. The somatic cell count (SCC)/ml ranged from 12,000 to 151,000, the coefficients of determination (R2) were higher than 0.5 for SCC. No significant differences were found in the dependent variables between the sampled times (test) nor any interaction between the slopes calculated for the cows over time. No significant differences were found among quarters within a cow for any of the dependent variables including SCC. The effect of the cow trait was found to be significant for polymorphonuclear (PMN), macrophage (MO), and T-lymphocyte-bearing CD4+. The number of lymphocytes labelled with the anti-B monoclonal antibodies was negligible. In conclusion the patterns of leucocyte populations in milk together with the variance among cows should enable an analysis of the heritability of this trait and its correlation with udder health in a future study.  相似文献   

4.
The objective of the present study was to determine the distribution of subclincial mastitis and intramammary infection (IMI) across udder quarters and to quantify, if any, the level of interdependence between quarters. Subclinical mastitis was defined as an udder quarter somatic cell count of > or =250,000. Intramammary infection was defined as the presence of pathogens in an udder quarter. The data used in the analyses consisted 6577 test-day records from 2034 lactations with observations on subclinical mastitis and 8428 test-day records from 2575 lactations with observations on IMI; each test-day record consisted data on all four udder quarters. Records were from animals on three research herds in southern Ireland. Observed distributions of IMI were compared to expected distributions, estimated using a binomial probability distribution, assuming independence among quarters. Generally, the observed frequencies deviated significantly from the expected frequencies, indicating some level of interdependence between quarters. Intraclass correlations were estimated from a mixed model including cow and test-day record nested within cow as random effects; fixed effects in the model included herd, year of calving, month of calving, parity, days in milk at sampling and interactions. Intraclass correlations within test-day record ranged from 0.14 to 0.50 for subclinical mastitis and from 0.02 to 0.40 for IMI. Thus, substantial interdependence between quarters exists which should be accounted for when analysing data from experiments across udder quarters. Failure to do so may result in incorrect inferences from statistical tests.  相似文献   

5.
SUMMARY The effects of three selection strategies for dry cow therapy on prevention of new infections and rate of antibiotic usage were compared. Quarter infection status of 1044 cows in 12 herds was determined by bacteriological methods at drying off, calving and three to five months into the following lactation. Cows that were uninfected at drying off were randomly allocated to treatment (whole udder, dry cow therapy) and non-treatment groups. Infected cows were randomly allocated to whole udder or infected quarter only treatments. The strategies compared were blanket treatment (treat all quarters of all cows), selective cow treatment (treat all quarters of any cow infected in one or more quarters) and selective quarter treatment (treat infected quarters only). Selective cow treatment was identified as the preferred strategy. Blanket treatment resulted in increased antibiotic usage (15.5 vs 6.4 tubes per infection eliminated) with no additional benefit, and selective quarter treatment resulted in a higher new infection rate (6.4%vs 3.9% quarters) in the dry period. The prevalence of infection within a herd at drying off had no influence on new infection rates in the dry period or early lactation. The cure rate after dry cow treatment (mean of 66%) decreased significantly with increasing age (P < 0.001). Cows infected in the previous lactation contributed over 76% of infections at calving and nearly 70% at mid-lactation. To lower the incidence of mastitis in a herd, a greater emphasis on culling of older infected cows and prevention of new infections during lactation is needed.  相似文献   

6.
The role of Staphylococcus aureus and coagulase-negative staphylococcal exosecretions in bovine udder infection was tested by monitoring the cows' response to in vivo inoculation of bacterial exosecretions into udder quarters. Twenty Israeli-Holstein dairy cows were included in the study; two or three of the udder quarters of each cow were intracisternally inoculated with 0.04-0.05 mg/quarter (total proteins) of the various sterile bacterial exosecretions in a sterile pyrogen-free saline. Each udder was inoculated with two or three different bacterial exosecretions or placebo (Columbia Broth). Cows were monitored for 96 h post-inoculation for rectal temperature, heart and respiratory rates, alimentary tract activity (rumen contraction), udder temperature, pain, oedema and udder size. Milk samples were examined bacteriologically and for somatic cell count, N-acetyl-D-glucosaminidase (NAGase) activity and somatic cell differentiation. No enterotoxins (beta-G) or toxic shock syndrome toxin-1 were detected in response to any of the bacteria tested. Control quarters or those inoculated with Columbia Broth, showed similar NAGase and somatic cell count values throughout the experiment. Twelve of the 18 strains tested, induced inflammation in the inoculated quarters while six did not. Of the 12 strains causing local inflammation, only six were found significantly different from the control and were considered as high response (group 1). The other six that caused a local inflammation did not differ significantly from the control, and were considered to be moderate response (group 2). The six S. aureus isolates that did not cause an inflammatory response were considered to have low response (group 3). In all quarters inoculated with S. aureus bacterial exosecretions belonging to groups 1 and 2, the polymorphonuclear cells and macrophages were proportionally increased while CD4+ and CD8+ T-lymphocyte populations decreased. One-dimensional NuPAGE (7%) Tris-acetate gel electrophoresisof the bacterial exosecretions revealed four different bands appearing between 36 and 31 kDa, marked from top to bottom as A, B, C and D. An association was found between the combinations of expressed bands and the cow responses: the majority of the cases could be linked to the expression of bands B and C.  相似文献   

7.

Background

Studies outside the Nordic countries have indicated that subclinical mastitis (measured by milk somatic cell count or the California Mastitis Test), intramammary infections (IMI), or blind quarters in beef cows may have negative effects on beef calf growth. Knowledge on prevalence of such udder health problems in Swedish beef cows is scarce. Therefore, the main aim of this study was to investigate subclinical mastitis, IMI and udder conformation in a number of beef cow herds. Production of β-lactamase in staphylococci was also investigated. Associations between certain cow factors and subclinical mastitis and IMI, and associations between cow and calf factors and 200 day calf weaning weight were also studied. The herds were visited once within a month after calving and once at weaning. Udder examination and quarter milk sampling, for somatic cell count and bacteriology, were performed in 8 to 12 cows per herd and occasion.

Results

Approximately 50%, 40% and 10% of the cows had subclinical mastitis, IMI, and at least one blind quarter, respectively, but the prevalence varied markedly between herds. Intramammary infections (mainly due to staphylococci) were identified in 13-16% of the milk samples. Less than 5% of the staphylococcal isolates produced β-lactamase. Approximately 11% of the cows sampled twice had the same IMI (mostly Staphylococcus aureus) at both samplings. Cow factors of importance for subclinical mastitis and/or IMI were teat and udder shape, breed, parity, presence of blind quarters, and cow hygiene. No significant associations were found between udder health parameters studied and calf weaning weights.

Conclusions

Subclinical mastitis and IMI, but not blind quarters, were common in beef cows, but the prevalence varied markedly between herds. Most IMI were caused by staphylococci and more than 95% of those were sensitive to penicillin. Cows with large funnel-shaped teats or pendulous udder after calving, and cows with blind quarters were at risk of having subclinical mastitis and/or IMI. Poor hygiene was also a risk factor for udder health problems. No significant associations were found between udder health and calf weaning weight. More studies on risk factors are warranted to improve advisory services on awareness and prevention of mastitis in beef cows.  相似文献   

8.
Factors affecting bacteriological cure rates (BCR) and new intramammary infections (IMI) during the dry period as well as clinical mastitis (CM) during early lactation were investigated in 414 German Holstein dairy cows receiving dry cow therapy. Cows were treated with either benethamine benzylpenicillin (300,000 IU), penethamate hydriodide (100,000 IU), and framycetin sulphate (100 mg, n = 136), or cefquinome (150 mg, n = 135), or benzathine cloxacillin (1,280 mg, n = 143). Overall BCR, IMI, and CM at parturition were 86.4%, 20.7%, and 4.3%, respectively. The three antibiotic treatments differed only in BCR, with cloxacillin yielding better results than the others. Udder quarters from cows with > 4 lactations had a higher risk of IMI and CM at calving. Chronic changes in udder tissues were linked to a lower BCR and were associated with a higher risk of CM during early lactation. The risk of CM at calving was higher in udder quarters with unspecific or subclinical mastitis before drying off. In conclusion, with antibiotic dry cow therapy, age and health status of the udder appear to be major determinants of IMI and CM during the dry period and early lactation, while BCR was associated with the antibiotic type and udder tissue status.  相似文献   

9.
The minimal inhibitory concentrations (MIC) of carbenicillin, ticarcillin and BL-P 1654 for gram-negative udder pathogens were determined using the agar plate dilution method. The MIC of the drugs for 50% and 90% of the isolates examined ranged for Escherichia coli and Aerobacter spp. from 1.56 to 25 micrograms/ml, and for Klebsiella spp. and Pseudomonas spp. from 3.12 to 50 micrograms/ml. The Serratia spp. were relatively non-susceptible for the drugs studied (MIC greater than 50 micrograms/ml). Each drug was administered intravenously at 5 g and 15 g per cow to different groups of cows with normal and inflamed quarters of the udder. Distribution and elimination kinetic parameters calculated from serum drug level data were very similar to those of other beta-lactam antibiotics. Although drug concentrations in milk from inflamed quarters were higher than in milk from normal quarters, they were considerably below the MIC for the majority of gram-negative udder pathogens. The data suggest that parenteral treatment of gram-negative udder infections with carbenicillin, carfecillin, ticarcillin and BL-P 1654 at the dose levels used in the present study is unlikely to result in a bacteriological cure and would probably be clinically ineffective.  相似文献   

10.
Staphylococcus aureus (S. aureus) often causes long-lasting chronic sub-clinical udder infections in dairy cows. To investigate if this can be due to a negative impact of S. aureus on lymphocytes important for the immune defence, alterations in proportions and expression intensity of CD4+, CD8+, WC1+, B and IL-2R+ lymphocytes was studied in blood and milk, as S. aureus mastitis developed from acute clinical to chronic sub-clinical form. Six healthy dairy cows were inoculated with S. aureus in one udder quarter per cow, and one quarter per cow acted as an uninfected control. Blood samples, and milk samples from infected and non-infected quarters were collected before infection and for five weeks after infection. All infected quarters developed acute clinical mastitis, of which five turned into chronic sub-clinical mastitis. In infected quarters, the proportions of all lymphocyte sub-sets, except WC1+ cells, differed in acute phase compared to pre-infection, while the dominant finding in the chronic phase was increased expression intensities per cell. An impact on blood lymphocytes and milk lymphocytes in non-infected quarters also occurred, mainly during the chronic phase. The most prominent finding was the increased proportion and expression of B-lymphocytes in blood, infected and non-infected quarters during chronic sub-clinical mastitis. As S. aureus can invade and survive intracellularly, a preferential stimulation of B-cells, suggesting development of a humoral response, may not be sufficient to eliminate intracellular bacteria, which could explain the persistence of the infection.  相似文献   

11.
选择安徽淮南乳品公司为试验试点,随机抽取荷斯坦奶牛472头(1~≥6胎)进行隐性乳房炎与乳房性状相关性分析,测定的乳房性状主要包括前房附着、后房高度、后房宽度、悬韧带、乳房深度、乳头位置和乳头长度。结果表明:淮南地区荷斯坦奶牛隐性乳房炎的乳区阳性率和奶牛阳性率分别为25.79%和53.18%;乳房性状前房附着、后房高度、后房宽度、悬韧带、乳房深度、乳头位置、乳头长度的线性评分分别为31.92分、47.02分、29.00分、37.64分、20.02分、39.74分、20.88分。隐性乳房炎的乳区阳性率与前房附着、后房高度、后房宽度、悬韧带、乳房深度、乳头位置、乳头长度的表型相关系数分别是-0.0731、0.0211、0.1003、-0.0369、0.0996、-0.0323及-0.0151,其中与后房宽度、乳房深度为显著(P<0.05)的正相关,其余均未达到显著水平(P>0.05);奶牛阳性率与前房附着、后房高度、后房宽度、悬韧带、乳房深度、乳头位置、乳头长度的表型相关系数分别为-0.0427、0.0680、0.0347-、0.0060、0.1071、-0.0119和0.0223,除与乳房深度为显著(P<0.05)的正相关外其余均不显著(P>0.05)。  相似文献   

12.
The germ levels of 2,182 milk samples obtained from udder quarters with subclinical mastitis were compared to milk sampled from 2,061 udder quarters with physiological cell counts or conductivity values. Three cattle herds were involved in the test programme. No germ growth was established from 9.5 per cent of all samples taken from udder quarters with increased cell counts and conductivities and from 4.1 per cent of those samples taken from intact udder quarters. Samples taken from udder quarters with subclinical mastitis exhibited the following rises in bacteria, as compared to samples from intact quarters: staphylococci by 3.1 per cent, staphylocci in germ mixtures by 3.0 per cent, CAMP-positive streptococci by 2.2 per cent, alpha-haemolytic CAMP-negative streptococci by 0.8 per cent, anhaemolytic streptococci in germ mixtures by 0.4 per cent, beta-haemolytic streptococci by 0.5 per cent, and Pseudomonas aeruginosa by 1.4 per cent. Other germ species and mixtures exhibited declining trends along with growing subclinical affection of udder quarters. All findings so far obtained in the presence of subclinical mastitis are likely to suggest that 11.4 per cent of detected bacteria were of pathogenicity to udders. However, attempts to localise those 11.4 per cent were unsuccessful, since no significant difference could be calculated by comparison of intact with affected udder quarters. Reference is made in the discussion to primary and secondary germ levels of milk samples and their relevance to the problem and its elucidation.  相似文献   

13.
Tamethicillin (TAM) is a basic ester pro-drug of methicillin (MET) which is converted in the body by non-specific esterases to MET. Equal doses of MET and TAM were administered intramuscularly in a crossover trial involving four dairy cows. Acute mastitis was induced in each cow by infusing two quarters of the udder with Escherichia coli endotoxin 3 h before antibiotic administration.  相似文献   

14.
The importance was studied of cowshed strains of K. pneumoniae as causative agents of bovine mastitis. An experiment was conducted with a healthy lactating dairy cow at the age of five years. The microbial inoculum was introduced by a teat tubule, at a dose of 2 ml broth culture 24 hours old. At first, Bac. subtilis was instilled in one udder quarter, to find out the local reaction to nutrient medium, and/or to an uninjurious saprophyte . After five days, a trial was performed on the other udder quarters using three strains of K. pneumoniae, isolated from the rectal contents and the skin of healthy cattle. Finally reinfection followed to study potential allergization of mammary gland. The conclusions as follows may be drawn from the results: 1) Bac. subtilis did not cause any alteration of the main clinic signs, but the inoculated quarter became swollen and its watery secretion contained pus corpuscles. No elimination of bacilli was observed and the morbid condition recovered in five to seven days. 2) After instillation of K. pneumoniae cultures bodily temperature rose by 1.9 degrees C in the course of six hours, all three udder quarters became swollen, showed symptoms of hyperthermia and pain , their secretion also exhibited pathological changes. The NK test revealed highly increased gelling of secretion and pH shift to alkalinity, the number of somatic cells increased 12 to 17 times. The main clinic signs, as well as appearance and consistence of the udder became normal in three days, but the other parameters like NK test and the number of somatic cells in milk normalized in about ten days. 3) Klebsiellae were eliminated from the quarters for one to eleven days, the elimination lasted longer and the counts were significantly higher in capsular strains.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

15.
The study was aimed at summarising the literature that compares the incidence levels of spontaneously occurring intramammary infections (IMI) during the dry period, without versus with antibiotic dry cow treatment (DCT). A meta-analytic relative risk (RR) calculation was implemented when a priori relevant. Two main categories of comparison were used in the 36 selected papers. In the first category, the udder quarters were randomly allocated (at quarter or cow level) to an untreated or a treated group. Quarter incidence averaged 12.8% (weighted mean) in untreated quarters, and depending on the DCT used, from 6.6 to 8.0% in treated quarters. The meta-analytic RR of new IMI for untreated versus treated quarters varied from 1.54 to 1.94, depending on the DCT used. DCT was mainly found effective against IMI due to streptococci and coagulase-positive staphylococci. Based on only a few papers, the application of an internal teat sealer was associated to a quite similar (or possibly better) protection against IMI than DCT, but only in a subpopulation of particular (selected) cows. In the second category of studies, a selective dry cow or quarter antibiotic-treatment (selective DCT or DQT), according to cow or quarter selection criteria, was compared to blanket DCT. The meta-analytic RR of new IMI was 1.71 for selective DCT versus blanket DCT. Selective DQT seemed to be more at risk than selective DCT, but consisted of treating a much lower proportion of quarters. The summary-results provided by our meta-analysis should only be used with caution, due to possibly low external validity. More research seems to be relevant on the risk factors of new IMI during the dry period to make the outcomes of omission of DCT in selected cows more predictable under field conditions.  相似文献   

16.
The prophylactic use of a dry-cow antibiotic for reducing the incidence of mastitis due to Streptococcus uberis was studied in four seasonally calving dairy herds involving 378 cows. The treatment was a long-acting dry-cow antibiotic preparation administered immediately after the last milking of lactation. New intramammary infections were identified by comparing the bacteriological status of quarters at drying off with that after calving, or through manual udder palpation during the dry period. The administration of dry-cow antibiotic to uninfected quarters at drying off reduced the overall incidence of new infections with Streptococcus uberis from 12.3% for untreated quarters to 1.2% of quarters (p<0.01). The reduction was significant (p<0.01) for both dry-period and post-calving infections. The susceptibility of uninfected quarters to new infection by Streptococcus uberis appeared to be unrelated to the infection status of a cow at drying off. Clinical infections during the dry period were most prevalent (97%) in quarters identified as having open teat canals. Fewer open teat canals (p<0.05) were observed among antibiotic treated quarters over the first 4 weeks of the dry period. Treated quarters had a lower (p<0.05) incidence of new clinical infection during the ensuing lactation and lower somatic cell counts. This did not affect production levels of milk, milk fat or protein. The results clearly indicated a prophylactic benefit for the dry cow antibiotic treatment against new Streptococcus uberis infections during the dry period.  相似文献   

17.
Infection of the mammary gland (mastitis) was produced by infusing ten quarters 2/cow x 5 cows) with Staphylococcus aureus strain 305. Mastitic and normal quarters were then infused with a preparation containing two levels of penicillin G (100,000 and 200,000 IU) in 10 mL of 3% aluminum monostearate and peanut oil. Milk penicillin levels were determined prior to treatment and twice daily for eight milkings after treatment. Normal and mastitic quarters infused with 200,000 IU had higher peak levels than those infused with 100,000 IU. Milk penicillin levels were similar in mastitic and normal quarters for the first three milkings after treatment. However, residues persisted for a longer time in milk from mastitic quarters. Penicillin was not detected in milk from the untreated control quarters nor in serum samples assayed during the experiment. The in vitro penicillin G sensitivity of the udder pathogen (MIC=0.039 and MBC=0.078 IU) was well below the milk penicillin levels for the first five milkings in all cases. However, infection recurred in two of the ten quarters (one receiving 100,000 IU and one receiving 200,000 IU).  相似文献   

18.
Infection of the Bovine Udder with Bovine Herpesvirus   总被引:3,自引:3,他引:0       下载免费PDF全文
Infectious bovine rhinotracheitis — infectious pustular vulvovaginitis (bovine herpesvirus) grown in tissue culture was used as inoculum in trials to infect the lactating bovine udder. Six experiments were undertaken in which one or more quarters were infused with 1 ml. of tissue culture fluids containing 106 to 107 tissue culture infectious doses (TCID) of virus. In four of the experiments the inoculated quarters showed marked evidence of infection in the form of acute inflammation, swelling, reduced milk secretion and profound changes in the physical appearance of the milk. In each case virus was recovered in high titres in the milk from about the second until the tenth to fifteenth days following exposure. Uninfected quarters remained normal in appearance and virus could not be recovered from the milk.

In three of the experiments it was shown that serum and milk antibodies appeared shortly after the disappearance of virus from the milk. One experiment involving two animals showed that about 1000 TCID of virus were required to produce infection. In one experiment a cow having a pre-inoculation serum titre for bovine herpesvirus proved resistant to infection.

The experiments indicate that the bovine udder is readily susceptible to bovine herpesvirus in non-immune animals, and that the virus produces an acute, limited infection leading to a temporary disfunction of the gland. It appears that natural invasion of the udder through the teat canal is not readily accomplished by the virus.

  相似文献   

19.
The prophylactic use of a dry-cow antibiotic for reducing the incidence of mastitis due to Streptococcus uberis was studied in four seasonally calving dairy herds involving 378 cows. The treatment was a long-acting dry-cow antibiotic preparation administered immediately after the last milking of lactation. New intramammary infections were identified by comparing the bacteriological status of quarters at drying off with that after calving, or through manual udder palpation during the dry period. The administration of dry-cow antibiotic to uninfected quarters at drying off reduced the overall incidence of new infections with Streptococcus uberis from 12.3% for untreated quarters to 1.2% of quarters (p<0.01). The reduction was significant (p<0.01) for both dry-period and post-calving infections. The susceptibility of uninfected quarters to new infection by Streptococcus uberis appeared to be unrelated to the infection status of a cow at drying off. Clinical infections during the dry period were most prevalent (97%) in quarters identified as having open teat canals. Fewer open teat canals (p<0.05) were observed among antibiotic treated quarters over the first 4 weeks of the dry period. Treated quarters had a lower (p<0.05) incidence of new clinical infection during the ensuing lactation and lower somatic cell counts. This did not affect production levels of milk, milk fat or protein. The results clearly indicated a prophylactic benefit for the dry cow antibiotic treatment against new Streptococcus uberis infections during the dry period.  相似文献   

20.
We tested an equation, which had been developed previously using discriminant analysis, for predicting whether a cow has coliform mastitis. Variables indicating a high probability of coliform infection included history of previous mastitis in the affected quarter, weakness, clear or white color of milk, water consistency of the milk, swelling of the udder, lack of previous mastitis in other quarters, lack of palpable udder abscesses, and a high body temperature. Application of this predictive equation to 114 cows with mastitis to determine if they would have coliform organisms cultured from the affected quarters resulted in an accuracy of 71% (sensitivity = 0.42, specificity = 0.85), compared to an accuracy of 62% (sensitivity = .64, specificity = .61) for cowside prediction by the attending clinicians. Changing the cutoff score of the discriminant rule so that the sensitivity of the discriminant prediction was similar to that of the clinicians yielded an accuracy of 64% (sensitivity = .64, specificity = .64).  相似文献   

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