The objectives of this study were to compare the effectiveness of different indicators of mammary inflammation in buffalo and to evaluate the association of the indicators with buffalo milk yield, composition, and rennet coagulation properties. This study was carried out at four buffalo farms in central Italy using a total of 50 lactating buffalo. Milk from each buffalo was tested at the beginning, middle, and end of lactation. To evaluate the relationship between mastitis markers and milk components, three classes were defined for each of the following markers: total somatic cell count (TSCC), differential somatic cell count (DSCC), and bacteriological results The regression coefficient for the reference method and the alternative method of determining TSCC was 0.81, indicating that the method routinely used to analyze buffalo milk consistently underestimated actual TSCC. The milk samples positive for udder-specific bacteria also had higher TSCC values than the samples that were negative for bacteria (872×10 3 /ml vs. 191×10 3 /ml). In samples that were positive for udder-specific bacteria, polymorphonuclear leukocytes (PMN) made up greater than 50% of the cells. Moreover, only 1% of the samples in the lowest TSCC class were positive for bacteria. The correlation between TSCC and PMN was stronger (0.70), and PMN values in buffalo milk increased significantly when the TSCC class changed from low (38%) to medium and high (56% and 64%). Milk yield was negatively related to TSCC. Significant changes in lactose (4.87%, 4.80% and 4.64%) and chloride content (0.650 mg/ml, 0.862 mg/ml and 0.882 mg/ml) were also observed with increasing TSCC values. Higher TSCC was associated with impaired rennet coagulation properties: the clotting time increased, while the curd firming time (p≤0.05) and firmness decreased. We concluded that in buffalo as in dairy cows, TSCC is a valid indicator of udder inflammation; we also confirmed that a value of 200×10 3 cells/ml should be used as the threshold value for early identification of an animal affected by subclinical mastitis. In addition to its association with significantly decreased milk yield, a TSCC value above this threshold value was associated with changes in milk composition and coagulating properties.

ImportancePoint-of-care ultrasonography (POCUS) allows to obtain real-time images to correlate with the patient’s presenting signs and symptoms. It can be used by various specialties and may be broadly divided into diagnostic and procedural applications.ObjectiveWe aimed at reviewing current knowledge on the use of POCUS in Pediatric Emergency Departments (PEDs).FindingsUS diagnostic capacity in paediatric patients with suspected pneumonia has been studied and debated whereas literature regarding the usefulness of point-of-care echocardiography in the pediatric setting is still limited. Similarly, Focused Assessment with Sonography for Trauma (FAST) has become a standard procedure in adult emergency medicine but it is still not well codified in the pediatric practice. Concerning procedural applications of POCUS we identified 4 main groups: peripheral vascular access, bladder catheterizations, identification and drainage of abnormal fluid collections and foreign body identification.Conclusions and relevanceBedside emergency ultrasound is routinely used by adult emergency physicians and in the last 10 years its application is recognized and applied in PED. Pediatric emergency physicians are encouraged to familiarize with POCUS as it is a safe technology and can be extremely helpful in performing diagnosis, managing critical situations and guiding procedures, which results in globally improving pediatric patients care.

High somatic cell count (SCC) affects milk quality and cheesemaking, resulting in a reduction in cheese yield and quality. In dairy cows, quarter milk samples with > 200,000 cells/ml are considered to have subclinical mastitis, while there is much uncertainty on the corresponding levels of SCC in buffalo milk. In this study 30 lactating water buffaloes were selected and SCC, differential somatic cell counts and several whey components were tested in quarter milk samples to assess the relationship between inflammation markers and milk quality. Overall 236 quarter milk samples were considered. To evaluate the relationship between cellular markers (SCC, polymorphonuclear leucocytes, PMN, and N-Acetyl-beta-glucosaminidase, NAGase) and other milk components, three classes were defined (low, medium and high). Analysis of milk yield showed a significant reduction in the high class of each of the three markers chosen. Overall, the highest class was characterized by significant changes in milk composition and a lower milk quality. The presence of an inflammatory status of the udder was frequent after the first trimester of lactation and in buffaloes with two or more parturitions. This study showed that significant changes in milk components can be observed when SCC are > 400,000 cells/ml, PMN are > 50% and NAGase is > 100 units. These thresholds could be suggested as levels to define udder health status in buffalo cows.

With some analytical parameters, certified reference materials are lacking and the reference method shows limited performance. Somatic cell counting in milk is a clear example. It is one of the most frequently performed measurements, estimated at over 500 000 000 tests/year world wide. It serves as an indicator for the udder health status of lactating animals, is relevant in food legislation, in payment of raw milk, and also has a considerable impact for farm management and animal-breeding programs. The analytical performance of nowadays fluoro-opto-electronic routine methods in terms of precision is superior to the reference method based on microscopy. Laboratories have therefore adopted various solutions for anchoring their counting level. It is there that a reference system approach can serve to optimally safeguard comparability of routine testing results in laboratories world wide. A reference system is characterized as a systematically developed anchoring system that is fed by different types of information from various sources, that is, measurements on reference materials, reference method analysis, and routine method results. A joint Project Group of the International Dairy Federation and the International Committee on Animal Recording has been given the task to design a workable global reference system for somatic cell counting in milk. This paper describes the structure and the functioning of such a reference system, a plan for the implementation and the responsibilities of the involved stakeholders in safeguarding its functioning. After approval in IDF and ICAR, the resulting proposal is to be offered for adoption by concerned governmental and nongovernmental bodies worldwide.