[Cereal related complaints in children]. / Granengerelateerde klachten bij kinderen.

There's a lot of attention for gluten-free diets on social media. Doctors get many questions about gluten sensitivity or possible wheat allergy. With some basic knowledge, it's easier to give answers to these questions and to prevent unnecessary and sometimes harmful diets. This article gives basic information about cereals, gluten, grasses and their crossreactivity. We give an overview about the differences between celiac disease, gluten sensitivity and IgE-mediated wheat allergy. We also describe diagnostics, treatment and natural history of coeliakie, gluten sensitivity and wheat or cereal allergy.

Impact of early-life feeding on local intestinal microbiota and digestive system development in piglets.

Early-life gut microbial colonisation is known to influence host physiology and development, shaping its phenotype. The developing gastro-intestinal tract of neonatal piglets provides a "window of opportunity" for programming their intestinal microbiota composition and corresponding intestinal development. Here, we investigated the impact of early feeding on jejunum and colon microbiota composition, and intestinal maturation in suckling piglets. From two days of age, early-fed (EF; n = 6 litters) piglets had access to solid feed containing a mixture of fibres till weaning (day29) in addition to sow's milk, whereas the control (CON; n = 6 litters) piglets exclusively fed on sow's milk. Early feeding elicited a significant impact on the colon microbiota, whereas no such effect was seen in the jejunal and ileal microbiota. Quantified eating behavioural scores could significantly explain the variation in microbiota composition of EF piglets and support their classification into good, moderate, and bad eaters. Members of the Lachnospiraceae family, and the genera Eubacterium, Prevotella, and Ruminococcus were quantitatively associated with eating scores. EF piglets were found to have a decreased pH in caecum and colon, which coincided with increased short-chain fatty acid (SCFA) concentrations. Moreover, they also had increased weights and lengths of several intestinal tract segments, as well as a decreased villus-crypt ratio in jejunal mucosa and an increased abundance of proliferative cells in colon mucosa. The approaches in this study indicate that early feeding of a mixed-fibre (pre-weaning) diet changes the microbiota composition, pH, and fermentation products in the distal gut of piglets, while it also alters both macroscopic and microscopic intestinal measurements. These results exemplify the potential of early feeding to modulate intestinal development in young piglets.

[Respiratory insufficiency caused by acute disseminated encephalomyelitis in a child]. / Respiratoire insufficiëntie bij een kind door acute disseminerende encefalomyelitis.

A 1.5-year-old boy presented with progressive ataxia and meningeal irritation after a period of general malaise and fever. He was eventually admitted to a paediatric intensive care unit for respiratory insufficiency. A diagnosis of acute disseminated encephalomyelitis (ADEM) with pontine involvement was made. The patient was mechanically ventilated and treated with immunoglobulins and corticosteroids, after which he recovered almost completely. ADEM is characterised by rapidly progressive demyelination of the central nervous system. The exact incidence and aetiology are unknown. The disorder is considered to be an autoimmune reaction, and current treatment is aimed at the suppression of this reaction. Despite the dramatic clinical and radiological presentation of ADEM, the prognosis is favourable in most cases.

[A girl with breath-holding spells and anaemia, treated with iron supplementation]. / Een meisje met 'breath-holding spells' en anemie, behandeld door ijzersuppletie.

A girl aged 1.5 years was presented because of frequent breath-holding spells. Anaemia was also diagnosed. Iron supplementation reduced the frequency and severity of the spells until they fully disappeared. The pathophysiological relationship between breath-holding spells and anaemia has not been clarified, but iron supplementation appears to be effective in many patients.

[Conservative treatment of open incomplete radial fracture in an adult horse]. / Conservatieve behandeling van een open onvolledige radiusfractuur bij een volwassen paard.

A non-displaced radialfracture of a horse was,diagnosed. The horse had an open fracture resulting from external trauma. A diagnosis was made on radiographs taken 48h after trauma. The horse was treated conservatively by box rest and Robert-Jones bandages. After 7 days the wound was opened to let the wound drainage necrotic material and small sequesters and was washed every other day. After 7 weeks, radiographs showed complete consolidation. Four months after the injury the horse was back to work at his former level and is still working two years after the incident.

[Acute generalised exanthematous pustolosis in a 2-year-old girl following treatment with amoxicillin]. / Acute gegeneraliseerde exanthemateuze pustulosis bij een 2-jarig meisje na amoxicillinegebruik.

A two-year-old girl had had fever for one week, and since the previous day general malaise, cutaneous pustolosis with swollen hands and feet. The skin condition had developed three days after the start of amoxicillin therapy. Laboratory tests at the time of admission indicated an infection. The diagnosis was 'acute generalised exanthematous pustulosis' (AGEP). During treatment with a soothing lotion, lasting one week, the patient improved and the skin condition disappeared. AGEP is characterised by acute onset of a pustular eruption in association with fever. It is usually seen after the use of drugs. This is an uncommon disease in children.

[Toxic shock syndrome in 3 children]. / Toxischeshocksyndroom bij 3 kinderen.

A 16-year-old and a 10-year-old girl were admitted with general signs of illness, and respectively a green vaginal discharge and a panaritium. They recovered following antibiotic treatment and surgical relief of the panaritium. A 2-year-old boy became ill the morning after eating tainted cold meat; he died in the course of the following night. In all 3 patients Staphylococcus aureus was incubated with the toxic-shock-toxin-1-gene and/or the enterotoxin-A-gene. These 3 cases occurred within one year in a general hospital. TSS probably occurs more frequently than is generally assumed. Given that it is a life-threatening disease, rapid diagnosis is of major importance.

Studies of the transmission routes of Ornithobacterium rhinotracheale and immunoprophylaxis to prevent infection in young meat turkeys.

The importance and prevention of the horizontal as well as the vertical transmission of Ornithobacterium rhinotracheale were investigated. In our first experiment we observed that specific-pathogen-free broiler chickens that were placed in hatching incubators at a commercial turkey hatchery during hatch showed respiratory tract lesions at postmortem examination that were positive for O. rhinotracheale by bacteriology and immunohistology. It appeared that vertical transmission occurred and that horizontal transmission of O. rhinotracheale is possible. In a second experiment, the turkeys derived from vaccinated parents showed significantly fewer respiratory tract lesions at postmortem examination at 16 days of age than the birds derived from nonvaccinated parents. In a third experiment, all vaccinated young birds, regardless of the vaccination state of their parents, showed significantly fewer respiratory tract lesions at 6 wk of age. We concluded that vaccination of the breeders reduces vertical transmission and that vaccination of the progeny is needed to resist challenge at 6 wk of age.

[Bladder infection with Capillaria plica in a male dog]. / Blaasinfectie met Capillaria plica bij een sheltie reu.

In a male dog with symptoms of haematuria an infection with C. plica was established. During the first urine examination large numbers of erythrocytes and leucocytes were seen. The dog was treated with antibiotics. After 10 days a second urine examination revealed several eggs of C. plica, accompanied by leucocytes and erythrocytes. The infection was eliminated with fenbendazole treatment (50 mg/kg/day, for 10 days).

In vitro antibiotic sensitivity of strains of Ornithobacterium rhinotracheale isolated in The Netherlands between 1996 and 1999.

All the strains of Ornithobacterium rhinotracheale isolated in the Netherlands between 1996 and 1999 were tested in the agar gel diffusion test for their sensitivity to amoxycillin, tetracycline, enrofloxacin and trimethoprim/sulphonamide (TMP/S). The percentages of strains sensitive to amoxycillin and tetracycline decreased in successive years from approximately 62 per cent to 14 per cent, and four strains were resistant to enrofloxacin or TMP/S. Twelve multiresistant strains were tested against seven alternative antibiotics; they were resistant to all of them except clavulanic acid-potentiated amoxycillin.

[Sterility and hygiene pays the price: latex allergy]. / Steriliteit en hygiëne eisen tol: latexallergie.

Latex allergy is an increasing problem among veterinarians and doctors. Within the veterinary profession this subject is seldom discussed. This article describes a case history of latex allergy and provides additional information about this disorder.

[Ornithobacterium rhinotracheale infections in poultry: a review]. / Ornithobacterium rhinotracheale infecties bij pluimvee: een overzicht.

O. rhinotracheale is a relatively new bacterium. It is found in commercial fowl and wild birds throughout the world. O. rhinotracheale causes respiratory disease, presenting as pneumonia and air sacculitis. It is transmitted horizontally as well as vertically. O. rhinotracheale is difficult to isolate. Serologically, twelve serotypes can be distinguished, of which serotype A is the most prevalent. Treatment can be difficult, because acquired resistance against the regular antibiotics is common in O. rhinotracheale isolates. An inactivated vaccine for broiler breeders has been developed and for turkeys an inactivated autovaccine can be made.