Efficacy of VERYL® in the treatment of cattle naturally infected with gastro-intestinal nematodes in Kenya.

Co-infections caused by trypanosomes and gastro-intestinal nematodes (GINs) compromise cattle productivity and their control requires a holistic approach. The effectiveness of trypanocides and anthelmintics is compromised by increasing resistance. Use of combined chemotherapeutic products for synergy, mainly practiced in human medicine, is gaining importance in livestock. A trial to evaluate efficacy of VERYL®, containing diminazene diaceturate (3.5 mg/kg body weight) and levamisole chloride (5 mg/kg body weight) for the control of GINs in cattle, was conducted at KALRO-VSRI Muguga, Kenya, between June and August 2016. Thirty-eight cattle aged between 6 and 12 months, naturally infected with GINs, were randomly allocated into two groups; a treatment group received VERYL® intra-muscularly at 10 mL/100 kg bwt and a control group which received Veriben® (Diminazene aceturate) at 3.5 mg/kg bwt. Faecal egg counts (FECs), coproculture, packed cell volume (PCV) and local tolerance at the injection site were measured during the study. FECs were comparable between the treatment and control groups at day 0. However, treatment of cattle with VERYL significantly (p < 0.001) reduced FECs by day 7 and sustained to day 21 post-treatment. Coproculture results for the treatment and control groups revealed presence of Haemonchus, Cooperia, Ostertagia, Trichostrongylus and Oesophagostomum species. Cattle treated with VERYL® had a significant (p < 0.05) reduction in larval recoveries compared to the control group. VERYL® had minimal adverse effects which cleared after a short while and is thus recommended for controlling GINs in cattle.

The WHOQOL-BREF questionnaire: French adult population norms for the physical health, psychological health and social relationship dimensions.

BACKGROUND: Medical and scientific committees need validated instruments to assess quality of life, but the lack of general population norms limits their full use in research and clinical practice. This study aimed to determine norms for the French general population for the physical and psychological health and social relationship dimensions of the abbreviated version of WHOQOL-BREF questionnaire in a large representative community sample. METHODS: A sample of 16,450 randomly selected subjects 18-75 years old, in two steps: households and individuals, was drawn from the National Health Barometer 2005, a periodic study by the French National Institute for Preventive and Health Education. Quality of life and other characteristics were collected using a computer-assisted telephone interview by use of a booklet. RESULTS: Internal consistency was good. Normative data for the French population are analyzed by age, sex and self-reported chronic disease. CONCLUSIONS: Our data provide normative scores for the general French population for three of four dimensions of the WHOQOL-BREF that can be useful to researchers using this measure of health-related quality-of-life assessment and to clinical practitioners.

[Evaluation of an immunological test for detecting occult fecal blood for case-finding in colorectal tumors]. / Evaluation d'un test immunologique de recherche de sang dans les selles pour le dépistage des tumeurs colorectales.

Screening for colorectal tumours (cancers and polyps) by searching for blood in stools using the gaiac test is a well-known method. We evaluated a new gaiac test, the originality of which from its coupling with an enzyme immuno-assay specifically measuring human hemoglobin (Fecatest). The objectives of this new test were to decrease false positives and thus to improve the positive predictive value of screening. Subjects over 45 years of age attending health examinations at a Center of Preventive Medicine were studied. Of the 5,185 subjects who received the test, 4,376 (84 p. 100) performed it correctly, demonstrating good compliance in this population. For 664 (15 p. 100), the results of the gaiac test were positive. This positivity rate was higher for men than for women (20 p. 100 vs. 10 p. 100) but was not influenced by age. After positive results, 471 (70 p. 100) patients completed investigations decreasing the overall compliance to 80 p. 100. Fifteen cases of cancer and 78 cases of adenomas were found. The positive predictive value of the test was 20 p. 100 for tumours. A benign cause was found in 44 p. 100 of 471 patients, and investigations were negative in 36 p. 100. When the gaiac test was positive, the immunoenzymatic method significantly improved the positive predictive value for cancer (6 p. 100 vs. 3 p. 100) but not for polyps (20 p. 100 vs. 17 p. 100). Three of the 15 cancers and half of the 78 adenomas would not have been discovered with the immunoenzymatic method.(ABSTRACT TRUNCATED AT 250 WORDS)

[Field epidemiology: possible beginning of community health. An example: epidemic caused by water]. / L'épidémiologie de terrain: ouverture possible vers la Santé communautaire. Un exemple: une épidémie d'origine hydrique.

The authors illustrate one facet of field epidemiology. They describe an example: a waterborne disease outbreak. The investigations were undertaken in a town in Moselle (F), on the general population with health professionals, school teachers, counselors and water service workers. They estimate that one thousand people had suffered from gastroenteritis (attack rate greater than 60%). Water was polluted and people became ill at the same time and in the same place. There is a strong statistical association between drinkers of polluted water and gastroenteric illness (relative risk: 10). This study has provided population information and resulted in motivation of the responsible people. In the conclusion of the epidemiological investigation they have carried out coherent measures for the protection of the water distribution system.

[Longitudinal study of the risks related to the consumption of water not conforming to bacteriological norms]. / Etude longitudinale des risques liés à la consommation d'eaux non conformes aux normes bactériologiques.

A prospective follow-up study lasting 18 months in 1983-1984 was conducted in 50 villages in order to assess the risk related to the consumption of drinking water which did not meet the bacteriology standards. 119 physicians, 52 pharmacists and 118 primary-school teachers enumerated the cases of acute gastro-intestinal diseases observed among a population of 29,272 inhabitants. A weekly water sample was analysed in each village as to the presence of four indicator germs of fecal contamination: total plate count, total coliforms, fecal coliforms (thermotolerant) and fecal streptococci. 1,950 cases of acute gastro-intestinal diseases were registered by the physicians and pharmacists during a population experience of 1,873,303 persons-weeks, i.e. an incidence density of 1.06 X 10(-3) cases per person-week. The risk notified by the school teachers among children aged 7 to 11 was higher: 16.3 X 10(-3) cases per child-week. The villages were classified in 3 groups, according to the proportion of substandard samples: "good", "intermediate", and "bad" categories. The relative risk contrasting the "bad" and "good" villages was 3.5 for the cases notified by the physicians and the pharmacists among the general population (95% confidence interval = 2.5-4.8); it was 1.7 for the cases reported by the teachers among the children (95% confidence interval = 1.5-1.9). This concordant difference was very significant but not constant across the 18 months of the survey. The authors conclude that the bacteriology standards are a relevant indicator of a health hazard.

[Treatment of recurrent or neglected clubfoot by Ilizarov's appliance]. / Traitement du pied bot varus équin récidivé ou négligé par appareil d'Ilizarov.

Nine cases of severe, multioperated clubfeet in children and adolescent have been corrected with Ilizarov apparatus. The two first patients have been treated by midtarsal osteotomy plus progressive correction. One poliomyelitic foot have had a slide lengthening of Achilles tendon and a plantar release. Six did not have any open procedure. One ring and two half circles were linked by five threated rods, in order to allow multi axial correction. Seven wires were introduced in the bones; the correction was obtained in a mean time of two months, the device was maintained one more month, then replaced by a walking cast during one month. The results have been seven times satisfactory, with an average follow up of nineteen months after the end of treatment. We did not note any early complication. One more procedure have been performed for flexum of the toes. The ankle range of motion have always been the same as the preoperative one.

[Aid tool for the assessment of health measures performance: the example of the program for alcoholism prevention in Lorraine]. / Outil d'aide à l'évaluation de performance des actions de santé: l'exemple du programme de prévention de l'alcoolisme en Lorraine.

From "alcohol primary prevention program in Lorraine", the authors developed a tool for an evaluation of performance: a card index to assess each action of the program. This tool can be applied to various programs, in particular health regional ones. Before presenting the tool, the authors specify conceptual frameworks to which they refer and present the evaluation of performance step which is declined in "evaluation of the results" and "evaluation of the processes". This assessment combine an understanding and a data based approaches. They show how those two kinds of assessment meet different and complementary aims. The tool presented includes 9 cards. The first 8 cards joined together in a booklet make possible a description and evaluation of each contributive action to the program. A ninth card gives a synthesis view to follow and assess the entire program in comparison with the starting reference frame. The publication of this perfectible tool is a call to practices exchanges between professionals in load of health programs.

[The external carotid vein. Historical review of Paul Launay's work]. / La veine carotide externe. Rappel historique des travaux de Paul Launay.

The authors, one century later, review the anatomical studies conducted by Launay, a student of Farabeuf, concerning the venous drainage of the face and neck. These studies were based on the analogy between the arterial system and the venous drainage of the external carotid territory. After describing the external carotid vein, the didactic and practical aspects of this study are emphasized.

Effectiveness of spa therapy in chronic low back pain: a randomized clinical trial.

OBJECTIVE: To assess the overall effectiveness of spa therapy compared with usual routine drug therapy in chronic low back pain (LBP). METHODS: One hundred and twenty-one patients were randomly allocated to treatment (n = 59) and control (n = 62) groups. In the treatment group, patients underwent routine drug therapy and spa therapy 6 days/week for 3 consecutive weeks in Saint-Nectaire, France. In the control group, patients received routine drug therapy. Effectiveness was assessed based on clinical measures, duration and intensity of pain, Roland and Morris' disability questionnaire, the patient's overall evaluation of back health, and drug consumption (analgesic and antiinflammatory). Groups were compared using analysis of covariance with repeated measures. RESULTS: At 3 weeks, patients in the treatment group had significant improvement in all outcome variables (p < 0.0001) except for the Schober index and analgesic and antiinflammatory drug consumption. At 6 months, improvement was still significant for the same outcome variables (p < 0.0001), plus a significant reduction in analgesic consumption. CONCLUSION: This study suggests both immediate and 6 month effectiveness of spa therapy in chronic LBP. Spa therapy may be beneficial in the management of chronic LBP.

Short and long-term effect of spa therapy in chronic low back pain.

The effect of spa therapy on chronic low back pain (LBP) was assessed in a randomized trial comparing patients undergoing a 3-week therapy programme in a spa resort in France (n = 50) with patients receiving ambulatory care (n = 52). After 3 weeks, patients in the spa group had significant improvement in their spine mobility and functional score (Waddell index) and a reduction in their daily duration of pain, pain intensity and drug consumption. The long-term effect was assessed after 9 months and showed continued reduction in pain and drug consumption, and improvement in spine mobility but no longer in functional score which returned to baseline level. It is concluded that spa therapy has a positive short-term and a moderate long-term effectiveness on chronic LBP.

Use of spa therapy to improve the quality of life of chronic low back pain patients.

OBJECTIVES: This study assessed the effectiveness of adding spa therapy to usual drug treatment in chronic low back pain patients. METHODS: A total of 224 patients were assigned randomly to either a treatment (n=128) or a control (n=96) group. Subjects in both groups received usual drug therapy. Those in the treatment group also underwent spa therapy in Vittel, France, for 6 days a week for 3 consecutive weeks. Effectiveness was assessed using a quality-of-life scale (the Duke Health Profile), clinical measures, and the Roland and Morris disability questionnaire. Groups were compared using an analysis of variance with repeated measures. RESULTS: At both 3 weeks and 3 months, patients in the treatment group exhibited significant improvement in measures of: physical and mental dimensions of quality of life, anxiety, depression, pain duration, pain intensity, and functional disability. CONCLUSION: This study suggests that spa therapy is an effective treatment for chronic low back pain patients.

Measurement methods of drug consumption as a secondary judgment criterion for clinical trials in chronic rheumatic diseases.

Drug consumption is sometimes used as a secondary judgment criterion for clinical trials. Many measurement methods are available to quantify drug consumption. Several methods were applied in a rheumatic disease trial involving 121 patients with chronic low back pain who lived around Saint-Nectaire, France, and who participated in the trial from April to November 1993 to determine an easily used and practical measurement method to detect a significant drug consumption change over time. Analgesic and nonsteroidal antiinflammatory drugs (NSAIDs) were classified according to the anatomical therapeutic chemical classification. Consumption was quantified on a weekly basis in number of tablets (method 1), unit of defined daily dose (method 2), milligrams of active principle (method 3), and NSAID equivalence score (method 4). These methods were applied in a randomized clinical trial of spa therapy on sufferers of chronic low back pain. An analysis of variance with repeated measures showed a significant difference in drug consumption between treatment and control groups detected by all methods, except for the NSAID consumption measured with method 3. The comparison of each method by the relative efficiency index indicated that method 1 had a greater sensitivity for detecting changes of drug consumption. Tablet count appears to be a more sensitive and more practical method for detecting a drug consumption change in clinical trials.

[Use of reverse blood flow vascular island nasolabial pedicle flap in the repair of the columella]. / Utilisation d'un lambeau naso-génien en îlot vasculaire à pédicule rétrograde dans la réparation columellaire. A propos d'un cas.

The authors report the use of a vascular island nasolabial flap with facial arterial pedicle and reverse blood flow inspired by the flap described by C. Le Quang in an unpublished indication. This case concerns a 64-year-old patient with a large botryomycoma of the columella. The size of the defect following excision and the length of the columella authorized reconstruction using a split thickness nasolabial reverse flap. At one year post-operatively the result was aesthetic and defatting was unnecessary. This flap is used to repair defects of the nasal lateral wall and ala. In some conditions, it can be used to repair the collumela, providing a safe vascular support in one stage.

[Iliac transosseous transposition of rectus abdominis muscle flap to cover a sacral pressure sore]. / Transposition d'un lambeau de grand droit de l'abdomen par un trajet trans-osseux iliaque pour la couverture d'une escarre sacrée.

The use of an inferiorly based rectus abdominis myocutaneous flap to cover a pelvic pressure sore offers a solution when the possibilities of other local flaps have been exhausted. For sacral pressure sores, the iliac bone is an obstacle for the transposition of this flap. In this case report, we describe how this obstacle can be overcome by creating a trans-osseous tunnel in the ala of the iliac bone through which the flap takes the most direct route to the recepient site.

A follow-up study of gastro-intestinal diseases related to bacteriologically substandard drinking water.

In a prospective follow-up study conducted in 52 French alpine villages, one weekly water sample was taken in each village provided with untreated ground water and analyzed as to the presence of four indicator bacteria: total plate count, total coliforms, thermotolerant (fecal) coliforms, and fecal streptococci. Cases of acute gastro-intestinal disease (AGID) occurring among 29,272 inhabitants were reported through physicians, pharmacists, and primary school teachers. A loglinear model identified fecal streptococcus (FS) as the best predictor; the presence of fecal coliforms enhanced the effect of FS. The total bacteria count and the total coliforms had no independent contributions. A threshold analysis suggested that any level of indicator bacteria above zero was associated with an excess of AGID.

Comparison of bacterial indicators and sampling programs for drinking water systems.

A total of 48 French villages were selected for a survey of water quality from February 1983 to June 1984 as part of an epidemiological study conducted in the rural area of the Rhône-Alpes region. Water samples were collected and analyzed on a weekly basis in each village. Bacteriological analysis of each water sample included enumeration of standard plate count bacteria, total and thermotolerant coliforms, and fecal streptococci. The water quality regulations are examined as to the analysis frequency, the volume of samples, and the relationship between the various bacterial indicators. Analyzing 300-ml, instead of 100-ml, samples tends to generate better information on single water samples. However, if many samples are analyzed over time from the same community, the value of using large volumes of water samples is diminished. The comparisons between bacterial indicators showed that the information obtained from the various indicators was very similar. However, fecal streptococci had a better predictive value of a negative test than coliforms with respect to the French standards.