Follow-up of patients with systemic immunological diseases undergoing fatty-degenerative osteolysis of the jawbone surgery and treated with RANTES 27CH.

Regulated-on-activation, normal T cell expressed and secreted (also called RANTES, CCL5 or R/C) is a chemotactic cytokine that plays a key role in recruiting immune cells to inflammatory sites. R/C is involved in the pathogenesis of many systemic immune-mediated diseases (SIDs) and is upregulated in fatty-degenerative osteolysis jawbone (FDOJ) cavitations. Surgical cleaning of degenerative areas reduces the source of chronic R/C but might not be sufficient to re-establish the altered immunological patterns. The aim of the present study was to collect clinical data from patients suffering from sids who underwent dental surgery of FDOJ areas (n=46), by measuring R/C serum levels at the first visit (V0) prior to surgery, and at the second visit (V1). The majority of patients (n=41) were treated one month with ultra-low dose RANTES (27CH), a medicine used in micro-immunotherapy, while five patients were not. Mean and standard deviation of R/C serum levels at V0 in treated and untreated patients were respectively 48.5±25.8ng/ml and 42.48±22.22ng/ ml. Untreated patients had a tendency towards higher R/C levels at V1 (68.36±30.7ng/ml; p=0.062), while an opposite tendency was observed in treated patients (40.9±20.3ng/ml; p=0.129). Investigators observed that a cut-off set at 40ng/ml at V0 seemed to be predictive of the efficacy of the dental surgery/treatment (p=0.0013, n=26) and that gender could influence R/C levels and patient's responsiveness. The Authors, being aware that this is a preliminary follow-up, wanted to lay the basis for forthcoming studies, in which a larger cohort of patients and well-defined inclusion/exclusion criteria will be established.

[Ceco-cecal intussusception in a Simmental heifer]. / Caeco-caecale Invagination bei einem Simmentaler Rind.

This report describes the clinical, laboratory and ultrasonographic findings in a Simmental heifer with a ceco-cecal intussusception. The general condition of the heifer was moderately reduced and it showed mild colic signs. Physical examination revealed a firm longish mass visible and palpable in the right flank. Findings upon rectal examination, fecal output und defecation were normal. Ultrasound examination of the mass revealed features typical for an intussusception. Based on the slow development of symptoms, normal fecal output and ultrasonography findings, a ceco-cecal intussusception was diagnosed. Right flank laparatomy was performed under general anaesthesia, and an end-to-side anastomosis between the jejunum and the spiral colon was made after resection of the intussuscepted intestines. Recovery was uneventful.

The history of Belgian assisted reproduction technology cycle registration and control: a case study in reducing the incidence of multiple pregnancy.

STUDY QUESTION: What is the effect of a legal limitation of the number of embryos that can be transferred in an assisted reproductive technology (ART) cycle on the multiple delivery rate? SUMMARY ANSWER: The Belgian national register shows that the introduction of reimbursement of ART laboratory costs in July 2003, and the imposition of a legal limitation of the number of embryos transferred in the same year, were associated with a >50% reduction of the multiple pregnancy rate from 27 to 11% between 2003 and the last assessment in 2010, without any reduction of the pregnancy rate per cycle. WHAT IS KNOWN ALREADY: Individual Belgian IVF centres have published their results since the implementation of the law, and these show a decrease in the multiple pregnancy rate on a centre by centre basis. However, the overall national picture remains unpublished. STUDY DESIGN, SIZE, DURATION: Cohort study from 1990 to 2010 of all ART cycles in Belgium (2685 cycles in 1990 evolving to 19 110 cycles in 2010), with a retrospective analysis from 1990 to 2000 and prospective online data collection since 2001. PARTICIPANTS/MATERIALS, SETTING, METHODS: Registration evolved from paper written reports per centre to a compulsory online registration of all ART cycles. From 2001 up to mid-2009, data were collected from Excel spread sheets or MS Access files into an MS Access database. Since mid-2009, data collection is done via a remote and secured web-based system (www.belrap.be) where centres can upload their data and get immediate feedback about missing data, errors and inconsistencies. MAIN RESULTS AND THE ROLE OF CHANCE: National Belgian registration data show that reimbursement of IVF laboratory costs in July 2003, coupled to a legal limitation in the number of embryos transferred in utero, were associated with a 50% reduction of the multiple pregnancy rate from 27 to 11% without reduction of the pregnancy rate per cycle, and with an increase in the number of fresh and frozen ART cycles due to improved access to treatment. LIMITATIONS, REASONS FOR CAUTION: There is potential underreporting of complications of ART treatment, pregnancy outcome and neonatal health. WIDER IMPLICATIONS OF THE FINDINGS: Over the 20 years of registration, the pregnancy rate has remained constant, despite the reduction in the number of embryos transferred, optimization of laboratory procedures and stimulation protocols, introduction of quality systems and implementation of the EU Tissue Directive over the period 2004-2010. STUDY FUNDING/COMPETING INTEREST(S): No external funding was sought for this study. None of the authors has any conflict of interest to declare.

Gammaglobulin and selenium status in healthy neonatal dairy calves in Switzerland.

Serum samples from 142 calves and their dams were analyzed for gammaglobulins (gammaG, calves) and selenium concentrations (Se, calves and dams). A questionnaire provided information about birth and colostrum management. The calves and their dams were distributed into two groups according the calves' gammaG concentration (< 10 and >= 10 g/L), Se concentrations were compared between groups. The correlation between gammaG and Se concentrations in the calves and their dams was analyzed. Risk factors for failure of passive transfer and Se deficiency were assessed based on the questionnaire. The gammaG concentration of 42.9 % of the calves was < 10 g/L (median: 10.9). Calves showed significantly higher gammaG values after optimized colostrum administration than calves with suboptimal colostrum administration (p < 0.004). The median Se concentration was 26.8 and 36.5 µg/L for the calves and dams, respectively. A high correlation was observed between the Se concentration of the dam and her calf (r = 0.72, p < 0.001). The calves' Se and gammaG concentrations were not significantly correlated. These results demonstrate that further efforts toward better information of farmers regarding colostrum management and Se supply are warranted.

Intestinal atresia and ectopia in a bovine fetus.

A 2-year-old Red Holstein cow was presented with uterine torsion at 235 days of pregnancy. The fetus extracted by cesarean section had weak vital signs and marked abdominal distention. An edematous pouch that contained tubular structures with peristaltic activity was associated with the umbilical cord. Because of poor prognosis, both dam and fetus were euthanized. At necropsy, the fetus had severe distention of the forestomachs, abomasum, and proximal small intestine; absence of distal small intestine, cecum, and proximal colon; atresia of the 2 blind ends of the intestine; and atrophy of distal colon and rectum. The tubular structures associated with the umbilical cord were identified as the segments of intestine that were absent in the fetus. Intestinal atresia combined with ectopia may be caused by local ischemia during temporary herniation and rotation of the fetal gut into the extraembryonic coelom. The close connection between ectopic intestine and amniotic sheath of the umbilical cord in this case may have facilitated vascularization and allowed development and viability of the ectopic intestine.

[Epidemiology of healthcare-associated infections due to MRSA in Brest University Hospital from 2004 to 2007. Impact of hydroalcoholic gel and antibiotics consumptions]. / Épidémiologie des infections nosocomiales à SARM au CHU de Brest du 1(er) janvier 2004 au 31 décembre 2007. Impact des consommations de produits hydroalcooliques et d'antibiotiques.

UNLABELLED: The fight against healthcare-associated infections is based on preventive measures of multidrug resistant bacteria diffusion. Hand hygiene is the simplest and the most effective preventive measure to reduce cross-transmission of infectious agents. Hydroalcoholic solutions for hand hygiene was recently introduced in the University Hospital of Brest (France). The aims of the study were: to describe the epidemiology of healthcare-associated infections due to methicillin-resistant Staphylococcus aureus (MRSA); to determine the annual consumptions of antistaphylococcal antibiotics; and to discuss the relation between consumption of antiseptic products or antibiotics and the epidemiology of MRSA. METHODS: A retrospective epidemiological and pharmaco-epidemiological study was realized from January 2004 to December 2007 in the University Hospital of Brest (France). It allowed to bring to light the cases of healthcare-associated infections due to MRSA and to quantify the consumptions of hang hygiene products and antistaphylococcal antibiotics. RESULTS: this retrospective study showed a decrease of healthcare-associated infections due to MRSA and an increase of the consumption of hydroalcoholic solutions. Antistaphylococcal resistance rates also decreased in a context of fall of the global antibiotics consumption in the hospital.

[Microbiological investigation of endoscopes at Brest Hospital over a period from 2007 to 2009]. / Contrôles microbiologiques des endoscopes au centre hospitalier régional de Brest du 1(er) janvier 2007 au 31 décembre 2009.

OBJECTIVES: The aim of this study is to evaluate the quality of disinfection of endoscopes at Brest hospital over a period from 2007 to 2009. PATIENTS AND METHODS: Retrospective study of microbiological investigations of endoscopes done at Brest hospital from 2007 to 2009. The interpretation of the microbiological investigations is based on the recommendations of the Comité technique national des infections nosocomiales et infections liées aux soins (CTINILS) of 2007. RESULTS: Most of the controls realized over the period deal with gastroenterological endoscopes (63.4 %) and bronchial endoscopes (21.8 %). Most of the controls (66.8 %) are conformed to the target level. Only 26.7 % of the controls get the level of action. Globally, the rate of level of action significantly increases (p=0.004) from 2007 (21.2 %) to 2009 (35.6 %). This increase is relatively important in gastroenterology endoscopy (46.8 % in 2009 versus 24.1 % in 2007) whereas the rate decreases in bronchial endoscopy (14.8 % in 2009 versus 25.9 % in 2007). In gastroenterological endoscopy, rates vary with the type of endoscopes and the context of controls, but there is no significant difference between manual disinfection and automated disinfection. The most frequent germ found in gastroenterological and bronchial endoscopies is Pseudomonas aeruginosa. CONCLUSION: Our results show that it is very difficult to insure a perfect disinfection of endoscopes. Difficulties met are certainly related with the complexity of the endoscopes and of the techniques of disinfection. Infections of patients are very infrequent in endoscopy, which takes the question of the pertinence of the threshold used for microbiological investigations.

Cross-border reproductive care in Belgium.

BACKGROUND: Cross-border reproductive care indicates the cross-border movements made by patients to obtain infertility treatment they cannot obtain at home. The problem at present is that empirical data on the extent of the phenomenon are lacking. This article presents the data on infertility patients going to Belgium for treatment. METHODS: A survey was conducted among the centres for reproductive medicine that are allowed to handle oocytes and create embryos (B-centres). Data were collected on the nationality of patients and the type of treatment for which they attended during the period 2000-2007. RESULTS: Sixteen of 18 centres responded to the questionnaire. The flow of foreign patients has stabilized since 2006 at approximately 2100 patients per year. The majority of foreign nationals seeking treatment in Belgium were French women for sperm donation. The next highest group was patients entering the country to obtain ICSI with ejaculated sperm. CONCLUSIONS: There are clear indications that numerous movements are motivated by the wish to evade legal restrictions in one's home country, either because the technology is prohibited or because the patients have characteristics, which exclude them from treatment in their own countries.

[Ultrasonographic findings in 22 cattle with pericarditis traumatica]. / Sonographische Befunde bei 22 Rindern mit Pericarditis traumatica.

The goal of the present study was to describe the ultrasonographic findings in 22 cattle with traumatic pericarditis. A 5.0 MHz linear transducer or a 5.0 MHz convex transducer was used to examine the thorax, reticulum and liver. There was severe pleural effusion in 17 heifers and severe pericardial effusion in 13 animals. Echogenic deposits and strands of fibrin were seen on the epicardium of 7 animals. Eighteen cattle had signs of traumatic reticuloperitonitis, and 11 had ascites. Because of cardiac insufficiency, 14 cattle had a markedly enlarged liver due to congestion and 15 had dilatation of the caudal vena cava. Ultrasonography is a useful diagnostic aid for visualisation and characterisation of thoracic and abdominal lesions in cattle with traumatic pericarditis.

Ultrasonic transit-time measurement of blood flow in the umbilical arteries and veins in the bovine fetus during stage II of labor.

The vitality of the bovine fetus during parturition depends on an intact umbilical circulation to supply adequate amounts of oxygen and nutrients to the fetus. The goal of the present study was to measure the blood flow in the umbilical vessels during stage II of labor and to determine when blood flow ceases in the umbilical cord. In 20 cows, ultrasonographic transducers were placed on one umbilical vein and one umbilical artery after rupture of the allantochorionic sac, and the blood flow volume per unit time was measured. At the same time, a pressure transducer was placed into the uterus to measure uterine pressure. Parturition was spontaneous in all 20 cows. In 20 live calves born, pH, base excess and lactate concentration were measured in the blood immediately after birth. During the last 90 min before birth the mean total umbilical blood flow (artery and vein combined) was 1.186+/-0.028 L/min. Calves with a blood pH> or =7.2 (n=13) had a higher mean total blood flow than calves with a pH<7.2 (n=7; 1.243+/-0.038 versus 1.095+/-0.038 L/min). In calves with a blood pH<7.2, the mean total blood flow decreased from 1.178+/-0.134 at 20 min before birth to 0.959+/-0.126 L/min at the end of stage II of labor. During this time period, the arterial blood flow did not differ between calves with a blood pH> or =7.2 and<7.2, but venous blood flow decreased significantly in calves with a blood pH<7.2. During uterine contractions, the total umbilical blood flow decreased significantly by 0.22 L/min. The blood flow in the umbilical artery and vein ceased before the calves were completely born.

Blood gas and acid-base analysis of arterial blood in 57 newborn calves.

The pH, partial pressure of oxygen (pO(2)), partial pressure of carbon dioxide (pCO(2)), concentration of bicarbonate (HCO(3)(-)), base excess and oxygen saturation (SO(2)) were measured in venous and arterial blood from 57 newborn calves from 55 dams. Blood samples were collected immediately after birth and 30 minutes, four, 12 and 24 hours later from a jugular vein and a caudal auricular artery. The mean (sd) pO(2) and SO(2) of arterial blood increased from 45.31 (16.02) mmHg and 64.16 (20.82) per cent at birth to a maximum of 71.89 (8.32) mmHg and 92.81 (2.32) per cent 12 hours after birth, respectively. During the same period, the arterial pCO(2) decreased from 57.31 (4.98) mmHg to 43.74 (4.75) mmHg. The correlation coefficients for arterial and venous blood were r=0.86 for pH, r=0.85 for base excess and r=0.76 for HCO(3)(-). The calves with a venous blood pH of less than 7.2 immediately after birth had significantly lower base excess and HCO(3)(-) concentrations for 30 minutes after birth than the calves with a venous blood pH of 7.2 or higher. In contrast, the arterial pO(2) was higher in the calves with a blood pH of less than 7.2 than in those with a higher pH for 30 minutes after birth.

Ultrasonography of the omasum in cows with various gastrointestinal diseases.

The omasums of 30 healthy cows and 55 cows with various gastrointestinal disorders (10 with left displacement and eight with right displacement of the abomasum, 10 with abomasal volvulus, 10 with traumatic reticuloperitonitis, nine with ileus of the small intestines and eight with reticulo-omasal stenosis) were examined ultrasonographically on the right side of the body with a 3.5 MHz linear transducer. The dorsal and ventral margins of the omasum and its size in the fifth to 11th intercostal spaces were determined. Generally, the ultrasonographic appearance of the omasum did not differ between the healthy and abnormal cows. The omasum appeared as a semicircle, and the omasal wall closest to the transducer was visible as a thick echogenic line. In a few of the abnormal cows, the omasal laminae were visible and the omasum appeared to have motility. In the cows with left and right displacement of the abomasum and abomasal volvulus, the dorsal margin of the omasum was significantly further from the dorsal midline in some intercostal spaces than in the healthy cows. In the cows with left displacement of the abomasum, the ventral margin of the omasum was significantly further from the dorsal midline in the 7th intercostal space than in the healthy cows. In the cows with reticulo-omasal stenosis, traumatic reticuloperitonitis and ileus of the small intestine, the ventral margin of the omasum was significantly closer to the dorsal midline in some intercostal spaces than in the healthy cows. The mean (sd) size of the omasum in the healthy cows varied from 16.3 (1.5) cm to 56.9 (10.0) cm, depending on the intercostal space, and the omasum was significantly smaller in some intercostal spaces in the cows with reticulo-omasal stenosis, right displacement of the omasum, abomasal volvulus and ileus of the small intestine.

Clinical findings in 28 cattle with traumatic pericarditis.

Traumatic pericarditis was confirmed postmortem in 28 cattle that had shown signs of a heart rate of more than 100 bpm, distended jugular veins and muffled heart sounds or abnormal pericardial sounds. The heart rate was higher than normal in 24 of them, and in 18 of these it ranged from 100 to 130 bpm. Twenty of the cattle had muffled heart sounds and 10 had pericardial sounds, such as splashing, rubbing or squeaking sounds. Both jugular veins were distended in 24 of the cattle, and 15 had oedema of the throat region, brisket and ventral abdomen. The most important laboratory findings were a reduced clotting time in the glutaraldehyde test in 26 animals, leucocytosis in 22 and a higher than normal concentration of fibrinogen in 19. There was an increase in the activity of gamma-glutamyl transferase in 20, and of aspartate aminotransferase in 15, and in the concentration of bilirubin in 11 of the cattle, indicative of hepatic congestion. A definitive diagnosis of traumatic pericarditis was made on the basis of the clinical findings in 15 of the 28 animals, all of which had typical signs of the disease. In another eight animals, traumatic pericarditis was suspected, although one of the characteristic signs was absent. A tentative but incorrect diagnosis of valvular endocarditis was made in three animals, and a similarly incorrect diagnosis of traumatic reticuloperitonitis was made in the other two.

[Results of a survey system for neurosurgical site infections, October 1998-January 2003]. / Résultats d'une surveillance des infections du site opératoire en neurochirurgie, octobre 1998-janvier 2003.

BACKGROUND AND PURPOSE: In the neurosurgery setting, incidence of surgical site infections (SSI) are considered as low to moderately low (1 to 10%). These infections are nevertheless a major problem because of the associated morbidity and mortality. A SSI survey system has been initiated in our neurosurgical unit. We report the incidence of SSI and identified SSI risk factors. METHODS: Data collected included demographic and medical information recorded with the operating room computer system. Any SSI occurring during the patient's postsurgical hospital stay or observed at postoperative visits was notified using a standardized questionnaire. SSIs were registered using Centers for Disease Control criteria. A multiple logistic regression model was used to determine SSI incidence and evaluate risk factors for SSI. Results were reported to the neurosurgical team every three months. RESULTS: From October 1998 to January 2003, 7399 operative procedures were collected. One hundred and twenty-two SSIs were notified with a mean incidence per patient of 1.65% (95% CI [1.37-1.95]). Among the SSIs 42% were superficial, 58% were deep or organ-space. Risk factors significantly associated with SSI were operation site (higher risk with CSF shunt), operation modality (higher risk with postponed operation) and operation duration greater than 75th percentile. CONCLUSION: SSI are an important problem in neurosurgery. This SSI survey gave us fundamental information about SSI and risk factors. Complementary studies are now necessary about postponed operative procedures. Propositions are made to improve the system.

Availability of Mental Health Services for Individuals Who Are Deaf or Deaf-Blind.

A survey of state mental health agencies found that a majority have no specific policy or procedure regarding how to provide mental health services to persons who are deaf or who are deaf-blind. Agency representatives report that staff lack knowledge of how to provide mental health services to persons who are deaf-blind and the agencies lack qualified interpreters. They recommend training for social workers and counselors to address best practices in working with people who are deaf-blind concerning communication methods and strategies, physical interaction, cultural issues, everyday life, sensory deprivation, ethics, use of an interpreter, and other general issues.

Ileal impaction in 22 cows.

The clinical signs, diagnosis, treatment and outcome of 22 cows with ileal impaction were investigated using the medical records of bovine patients referred to the Department of Farm Animals, Vetsuisse Faculty, University of Zurich from 1993 to 2003. Only 15 of the cows had signs of colic, which were subtle but slowly increased in severity in some patients. The results of haematological and biochemical analyses were mildly abnormal in only few animals. There was no correlation between the duration of the disorder before admission, the severity of symptoms and the results of the haematological and biochemical analyses. Dilated loops of small intestine in the right dorsal quadrant of the abdomen could be palpated transrectally and imaged via ultrasonography. A definitive diagnosis of ileal impaction was made during exploratory laparotomy by finding the impaction and ruling out other abnormalities. In 19 cows, the obstructing food mass was easily massaged into the caecum, and in three animals an enterotomy was carried out. All cows had an uneventful recovery with no recurrence of the disorder. It is concluded that the cause of the impaction was most likely due to seasonal influences and winter-feeding with a hay based ration. The short and long-term prognosis after surgical intervention was good.

[Cryopreservation of human embryos by vitrification]. / Cryopréservation des embryons humains par vitrification.

Vitrification is a cryopreservation strategy where cells are converted into a glass-like amorphous solid which is free of any crystalline structure. Such process is achieved by a combination of high concentration of cryoprotectant and an extremely high cooling rate. In the last years, survival rates of up to 80% after thawing and pregnancy rates of almost 30% could be achieved after transfer of vitrified embryos at the zygote, cleavage, morula and blastocyst stages. Also deliveries of healthy babies have been reported numerous times. To this day, a limited interest in this technique can be noted. The explanation may lye in the apprehension of many ART units regarding exposure of embryos to high concentrations of cryoprotectants and storage in non sterile conditions. The aim of the first part of this article, is to analyse if such fears are justified on the basis that vitrification mimics conditions already in use for many years in slow-cooling procedures where cells are plunged into liquid nitrogen at around -30 degrees C and secondly since storage of embryos are now possible in high aseptic conditions. In the second part, results on survival after thawing, pregnancy rates and baby take home rates of vitrified embryos will be presented and the problems associated with vitrification of blastocysts will be discussed.

Speech discrimination and intelligibility: outcome of deaf children fitted with hearing aids or cochlear implants.

We retrospectively studied outcome of a sample of 36 congenitally deaf children who were fitted with either a conventional hearing aid (HA, N = 14) or a cochlear implant (CI, N = 22), and who received many years of audio-phonatory training by our multi-disciplinary team. In order to rate speech discrimination perception, we developed a new metric of speech discrimination performance based on several existing discrimination tests for the French language. Speech perception skills were measured with and without lip-reading cues. We also studied the evolution of auditory capacity in real-life situations, and the evolution of the intelligibility of spoken language during a five year period. To rate auditory capacity and speech intelligibility, we used commonly used metrics: CAP and SIR. During the five successive years of observation, CAP and SIR scores improve for both the HA and CI children. Improvement, however, is more pronounced for the CI children. At the end of the 5-years period, CAP and SIR scores of CI children are significantly higher than those of HA children. Our study is one of few that evaluates outcome of HA and CI fitting with age matched congenitally deaf children anno 2000.

Marchantia polymorpha mitochondrial orf identifies transcribed sequence in angiosperm mitochondrial genome.

Heterologous hybridizations performed using nine Marchantia polymorpha mitochondrial orfs and the sdh4 gene against angiosperm mtDNA suggested that three of them and the sdh4 gene have been conserved in the mitochondrial genome of different angiosperm species. Solanum tuberosum mtDNA fragments, which hybridized to M. polymorpha orf207 and sdh4 gene, were cloned, sequenced, and their expressions evaluated by Northern and RT-PCR. Hybridizing fragments to sdh4 gene and orf207 from potato mtDNA were shown to be transcribed, but only in the case of sdh4 gene was there homology between the protein encoded by the DNA sequence from M. polymorpha and the potato mitochondrial genome. M. polymorpha orf207 showed little similarity to an open reading frame from potato mtDNA, named here orf78. The putative proteins encoded by both orf207 and orf78 were not related, indicating that these orfs do not constitute homologous sequences.