***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The efficacy of the combination of systemic enrofloxacin ( 5mg/kg twice with a 24-h interval , first dose i.v . , second dose s.c . ) and the nonsteroidal antiinflammatory agent ketoprofen ( 3mg/kg i.m . or 4 mg/kg per os daily for 1 to 3 d ) treatment was compared with antiinflammatory treatment only in dairy cows with naturally occurring acute clinical Escherichia coli mastitis . A total of 132 cows with acute clinical mastitis and with confirmed growth of E. coli in a pretreatment milk sample were r and omly allocated to 1 of 2 treatment groups . Response to treatment was evaluated clinical ly and by bacteriological culturing and determination of N-acetyl-beta-d-glucosaminidase ( NAGase ) activity on d 2 and 21 posttreatment . Enrofloxacin treatment did not increase bacteriological ( 90.5 % of treated vs. 86.8 % of nontreated cured ) or clinical cure ( 46.7 % of treated vs. 57.1 % of nontreated cured ) , cow survival ( 95.3 % of treated vs. 92.7 % of nontreated ) , or quarter milk production assessed 21 d posttreatment ( 21.8 vs. 29.3 % return to preinfection level for nontreated cows ) , nor did it decrease mammary gl and tissue damage estimated using determination of milk NAGase activity ( 24.0+/-0.3 vs. 18.3+/-1.3 pmol of 4-methylumbelliferone per min per microL for nontreated cows ) . Treatment did not influence the number of study cows remaining in the herd after 6 mo ( 71.9 % of treated vs. 80.6 % of nontreated ) . The only significant effects of enrofloxacin were enhancing the bacteriological cure ( odds ratio=3.32 for treated cows ) and decreasing the clinical cure ( odds ratio=0.05 for treated cows ) on d 2 posttreatment . Our results did not support the use of enrofloxacin to treat acute clinical E. coli mastitis Acute mastitis was induced in lactating cows by intramammary challenge with 10 μg of Escherichia coli lipopolysaccharide . The cows were monitored clinical ly prior to and for 96 hours after challenge . Milk production , complete blood counts , serum enzyme activities and milk indicators of inflammation were evaluated . Endotoxin challenge was in 7 groups of 3 cows each . Within the groups , cows were r and omly assigned to 3 intravenous treatments : saline controls , steroid ( one dose of dexamethasone at 0.44 mg/kg ) and non-steroidal agent ( two doses of flunixin meglumine at 1.1 mg/kg , 8 h apart).Anti-inflammatory therapy  reduced rectal and mammary gl and surface temperatures . Milk production was significantly reduced ( p<0.05 ) in cows treated with dexamethasone . Although dexamethasone treatment produced significant increases ( p<0.05 ) in blood leukocytes and segmented neutrophils , milk somatic cell concentrations were not significantly altered . Flunixin meglumine did not alter milk production or blood or milk leukocytes Recently , many changes have been implemented in Dutch dairy herds . Herd sizes have increased and antimicrobial use has been reduced . Certain types of antimicrobials can only be used in specific circumstances , and the preventive use of antimicrobials in dry cows is prohibited . The aim of this study was to quantify clinical mastitis ( CM ) , sub clinical mastitis ( SCM ) , and risk factors associated with CM in Dutch dairy herds in 2013 , in the context of these changes . For this study , 240 dairy herds were r and omly selected from farms that participated in test-day milk recording , used a conventional milking system , and agreed to participate in the study . Eventually , 233 Dutch dairy farmers had complete records of CM in their herds in 2013 and 224 of these farmers completed a question naire on management factors potentially associated with CM . All participating farmers gave consent to use their routinely collected herd data such as test-day records and cow identification and registration data . Clinical and sub clinical mastitis incidence rate ( CMI and SCMI , respectively ) per 100 cows per year , sub clinical mastitis prevalence , and average bulk tank milk somatic cell count were obtained for 2013 . The risk factor analysis was conducted using a generalized linear model with a log link function and a negative binomial distribution on herd level in Stata 13.1 . A median CMI of 28.6 per 100 cows at risk per year , SCMI of 70.1 per 100 cows at risk per year , SCM prevalence of 15.8 % , and bulk tank milk somatic cell count of 171 × 10(3 ) cells/mL were observed in 2013 . Factors that were significantly associated with a higher CMI were cleaning slatted floors only once per day compared with more than 4 times a day ( i.e. , mechanical ) , a higher percentage of Holstein Friesian cows present in the herd , treating less than 50 % of the cows with CM with antimicrobials , postmilking teat disinfection , and treatment of cows with elevated somatic cell count with antimicrobials . The results of this study indicated that udder health had not deteriorated compared with udder health in previous Dutch studies where herd sizes were somewhat smaller and before the restrictions in antimicrobial use . Several of the risk factors that were found can be influenced by the farmer and can prevent the occurrence of CMI . Still , when cases of CM occur , treatment with antimicrobials might be necessary to cure the CM case and is beneficial for the overall udder health in the herd The effect of bovine lactoferrin ( Lf ) was studied in experimental Escherichia coli mastitis , using enrofloxacin as a comparator . Mastitis was induced in six clinical ly healthy primiparous dairy cows by infusing 1500 colony-forming units of E. coli into a single udder quarter . The challenge was repeated into a contralateral quarter of the same cows 3 weeks later . At the first challenge , three cows were treated with 1.5 g of bovine lactoferrin intramammarily three times ( 12 , 20 and 36 h postchallenge , PC ) , and the other three cows received 5 mg/kg of enrofloxacin ( Baytril ) parenterally ( 12 , 36 and 60 h PC ) . Flunixin meglumine ( 2.2 mg/kg ) was administered to all cows twice at 24-h intervals . During the second challenge , the treatments for the two groups were reversed . Intramammary challenge with E. coli produced clinical mastitis in all cows , but the severity of the disease varied markedly . No statistically significant differences between treatment groups were observed in clinical signs such as rectal temperature , rumen motility and general attitude . Milk somatic cell count , daily milk yield and bacterial counts in cows treated with Lf and those receiving enrofloxacin also did not differ significantly . However , a trend for a more rapid elimination of bacteria was seen in the cows treated with enrofloxacin . Milk NAGase activity also decreased significantly faster in the group treated with enrofloxacin . The concentration of lipopolysaccharide in milk compared with the number of bacteria was significantly lower in Lf than in enrofloxacin-treated cows ( 20 h PC ) Question naires are frequently used instruments to collect data in epidemiological studies . In countries where more than one language is spoken , the development of a question naire in more than one language is needed . The objective of this study was to develop and test the repeatability and validity of English and French versions of a personal interview-format question naire design ed to capture udder health related management practice s used on dairy farms . A st and ardized protocol was used to develop and translate the research instrument . Equivalence of the English and French question naires was assessed using a cross-over study design with 24 bilingual dairy producers completing both versions on three different occasions in a r and omly assigned sequence . Repeatability of the question naire was evaluated using the test-retest method with the same questions being asked on two different occasions to 88 dairy producers participating in the National Cohort of Dairy Farms of the Canadian Bovine Mastitis Research Network .  Validity of the questions related to milking procedures and general housing was assessed using on-farm observations as a gold st and ard . Measures of agreement were calculated using kappa , quadratic-weighted Kappa and concordance correlation coefficients for categorical , ordinal and continuous variables , respectively . Sensitivity and specificity estimates were computed for the validity analysis . The overall equivalence of the English and French versions of the question naire was adequate ; agreement measures when administered twice in the same language were not significantly higher than when administered in each language . Similarly , question naire overall repeatability was good . When accounting for prevalence bias , Kappa and CCC estimates ranged from 0.40 to 0.92 for 27 of the 29 items evaluated in the question naire , with 18 items yielding agreement estimates greater than 0.60 . Finally , milking procedures and general housing questions validity was excellent with mean sensitivity and specificity of 86 % and 92 % , respectively . Although the overall evaluation of the instrument was satisfactory , specific doubtful items were identified . This illustrates the need to address question naire reliability as even rigorously design ed and pre-tested questions can have poor repeatability or validity . Our results indicate that the developed English and French question naires can be used simultaneously to accurately measure the udder health related management practice s used on Canadian dairy farms . This question naire is adaptable for use in other developed dairy industry population s. The question naire is freely available online at www.mastitisnetwork.org under the " Publications/others " section AIM : To compare clinical and bacteriological cure rates of clinical mastitis following treatment with either antimicrobials or homeopathic preparations . METHODS : Seven spring-calving herds from the Waikato region of New Zeal and were used to source cases of clinical mastitis ( n = 263 gl and s ) during the first 90 days following calving . Duplicate milk sample s were collected for bacteriology from each clinical ly infected gl and at diagnosis and 25 ( SD 5.3 ) days after initial treatment . Affected gl and s were treated with either an antimicrobial formulation or a homeopathic remedy . Generalised linear models with binomial error distribution and logit link were used to analyse the proportion of cows that were clinical treatment cures and the proportion of gl and s that were classified as bacteriological cures , based on initial and post-treatment milk sample s. RESULTS : Mean cumulative incidence of clinical mastitis was 7 % ( range 2–13 % across herds ) of cows . Streptococcus uberis was the most common pathogen isolated from culture-positive sample s from affected gl and s ( 140/209 ; 67 % ) . The clinical cure rate was higher for cows treated with antimicrobials ( 107/113 ; 95 % ) than for cows treated with homeopathic remedies ( 72/114 ; 63 % ) ( p < 0.001 ) based on the observance of clinical signs following initial treatment . Across all pathogen types bacteriological cure rate at gl and level was higher for those cows treated with antimicrobials ( 75/102 ; 74 % ) than for those treated with a homeopathic preparation ( 39/107 ; 36 % ) ( p < 0.001 ) . CONCLUSIONS AND CLINICAL RELEVANCE : Using herds located in the Waikato region of New Zeal and , homeopathic remedies had significantly lower clinical and bacteriological cure rates compared with antimicrobials when used to treat post-calving clinical mastitis where S. uberis was the most common pathogen . The proportion of cows that needed retreatment was significantly higher for the homeopathic treated cows . This , combined with lower bacteriological cure rates , has implication s for duration of infection , individual cow somatic cell count , costs associated with treatment and animal welfare Houttuynin sodium bisulphate ( HSB ) , alpha hydroxyl-capryl-ethyl-sodium-sulphonate , is a product formed by reacting sodium bisulphate with houttuynin , which is obtained from a medicinal herb Houttuynia cor data Thunb . From HBS an aqueous intramammary solution was made for the treatment of bovine clinical mastitis . A total of 104 acute and subacute mastitis cases were r and omly assigned into two groups with 52 cases in each group : 1 . an HSB group in which 80 mg HSB was infused into an affected gl and ; and 2 . a PS group in which intramammary administration of 800,000 i.u . penicillin G in combination with 1 g of streptomycin ( PS ) was conducted . The treatments were administered twice daily until the inflammatory signs were eliminated and mammary secretion became normal . In acute mastitis , 88.2 % ( 15 of 17 ) were clinical ly cured and 52.9 % ( nine of 17 ) microbiologically cured by HSB ; in the PS group , 90.0 % ( 18 
    Output:
    
We concluded that homeopathic treatments are not efficient for management of clinical mastitis