An in-depth investigation of the microbiota and its virulence factors associated with severe udder cleft dermatitis lesions.

Udder cleft dermatitis (UCD) is a skin condition affecting the anterior parts of the udder in dairy cattle. In the present study, we aimed to shed light on the microbiota in severe UCD lesions versus healthy udder skin by putting forward a taxonomic and functional profile based on a virulence factor analysis. Through shotgun metagenomic sequencing, we found a high proportion of bacteria in addition to a low abundance of archaea. A distinct clustering of healthy udder skin versus UCD lesion samples was shown by applying principal component analysis and (sparse) partial least squares analysis on the metagenomic data. Proteobacteria, Bacillota, and Actinomycetota were among the most abundant phyla in healthy udder skin samples. In UCD samples, Bacteroidota was the most abundant phylum. At genus level, Bifidobacterium spp. had the highest relative abundance in healthy skin samples, whereas Porphyromonas spp. and Corynebacterium spp. had the highest relative abundance in UCD samples. In the differential abundance analysis, Porphyromonas spp. and Bacteroides spp. were significantly differentially abundant in UCD samples, whereas Bifidobacterium spp., Staphylococcus sp. AntiMn-1, and Staphylococcus equorum were more commonly found in healthy samples. Moreover, the abundance of several treponeme phylotypes was significantly higher in lesion samples. The streptococcal cysteine protease speB was among the most abundant virulence factors present in severe UCD lesions, while a plethora of virulence factors such as the antitoxin relB were downregulated, possibly contributing to creating the ideal wound climate for the dysbiotic community. Network analysis showed healthy lesion samples had a large network ofpositive, correlations between the abundances of beneficial species such as Aerococcus urinaeequi and Bifidobacterium angulatum, indicating that the healthy skin microbiome forms an active protective bacterial network, which is disrupted in case of UCD. In UCD samples, a smaller microbial network mainly consisting of positive correlations between the abundances of Bacteroides fragilis and anaerobic Bacteroidota was exposed. Moreover, a high correlation between the taxonomic data and virulence factors was revealed, concurrently with 2 separate networks of microbes and virulence factors. One network, matching with the taxonomic findings in the healthy udder skin samples, showcased a community of harmless or beneficial bacteria, such as Bifidobacterium spp. and Butyrivibrio proteoclasticus, associated with hcnB, hcnC, relB, glyoxalase, and cupin 2. The other network, corresponding to UCD samples, consisted of pathogenic or facultative pathogenic and mainly anaerobic bacteria such as Treponema spp., Mycoplasmopsis spp., and bovine gammaherpesvirus 4, that correlated with virulence factors SpvB, fhaB, and haemagglutination activity domain-associated factor. Our results point toward a dysbiotic community with a notable decrease in diversity and evenness, with a loss of normal skin inhabitants and innocuous or useful species making way for predominantly anaerobic, facultative pathogens. The shift in the abundance of virulence factors such as fhaB and SpvB could play a role in the manifestation of a local micro-environment favorable to the microbiome associated with udder skin lesions. Lastly, the presence of specific networks between microbial species, and between microbes and virulence factors was shown.

Severe udder cleft dermatitis lesion transcriptomics points to an impaired skin barrier, defective wound repair and a dysregulated inflammatory response as key elements in the pathogenesis.

This study is the first to investigate the transcriptomic changes occurring in severe udder cleft dermatitis lesions (UCD) in Holstein-Friesian cows. An examination of the gene expression levels in natural UCD lesions and healthy udder skin through RNA Seq-Technology provided a deeper insight into the inflammatory pathways associated with this disease. A clear distinction between the gene expression patterns of UCD lesions and healthy skin was shown in the principal component analysis. Genes coding for inflammatory molecules were upregulated such as the chemokines C-X-C motif ligand 2 (CXCL2), 5 (CXCL5) and 8 (CXCL8), and C-C motif ligand 11 (CCL11). Moreover, the genes coding for the multifunctional molecules ADAM12 and SLPI were amongst the highest upregulated ones, whereas the most downregulated genes included the ones coding for keratins and keratin-associated molecules. Predominantly inflammatory pathways such as the chemokine signaling, cytokine receptor interaction and IL-17 signaling pathway were significantly upregulated in the pathway analysis. These results point towards a fulminant, dysregulated inflammatory response concomitant with a disruption of the skin barrier integrity and a hampered wound repair mechanism in severe UCD lesions.

Unaffected semen quality parameters in Neospora caninum seropositive Belgian Blue bulls.

Neospora caninum is a protozoan parasite that causes abortion, perinatal mortality, and subfertility in cattle worldwide. Despite the presence of the DNA of the parasite in semen of infected bulls, the effect on semen quality has not been extensively studied. This study aimed to investigate the effect of a natural Neospora caninum infection on fresh and frozen semen quality parameters in Belgian Blue bulls. Two hundred and fourteen bulls were serologically screened with an indirect ELISA-test specific for anti-Neospora caninum antibodies, every two months during one year. In addition to serological screening, semen was collected twice weekly using an artificial vagina. The following semen quality parameters were assessed: ejaculate volume, concentration, total motility of fresh semen samples, as well as morphology, total and progressive motility for frozen/thawed semen samples. Bulls were semen sampled throughout the whole year, but only semen samples of bulls that had six consecutive positive or negative ELISA-test results were included in our dataset (n = 98). Generalized linear and binomial mixed models were used for statistical analysis of each outcome variable. In these models the explanatory variables were defined as: age, barn location, mean Temperature Humidity Index (THI) during sperm production (14-42 days before sampling), maximum daily THI at collection, season of sperm production, season at collection and the Neospora caninum antibody test results. Initially, individual explanatory variables were tested in univariable models for each outcome variable. Akaike information criterion (AIC) values were used to select explanatory variables to build a multivariable model, where the Neospora caninum test result was forced in all models. The present study reveals an overall apparent seroprevalence of Neospora caninum of 9,2% in the study population. No significant associations were detected between natural neosporosis, substantiated by ELISA-antibody levels, and any of our tested outcome variables on fresh and frozen/thawed semen samples. Based on the results of the present study, we conclude that Neospora caninum seropositive bulls do not have lower semen quality parameters compared with seronegative bulls.

Decision tree analysis for pathogen identification based on circumstantial factors in outbreaks of bovine respiratory disease in calves.

Respiratory tract infections continue to be a leading cause of economic loss, hampered animal welfare and intensive antimicrobial use in cattle operations, worldwide. To better target antimicrobial therapy, control and prevention towards the involved pathogens, there is a growing interest in microbiological tests on respiratory samples. However, these tests are time consuming, cost money and sampling might compromise animal welfare. Therefore, the objective of the present study was to develop immediately applicable decision trees for pathogen identification in outbreaks of bovine respiratory disease based on circumstantial factors. Data from a cross sectional study, involving 201 outbreaks of bovine respiratory disease in dairy and beef farms between 2016 and 2019 was used. Pathogens were identified by a semi-quantitative PCR (polymerase chain reaction) on a pooled non-endoscopic broncho-alveolar lavage sample from clinically affected animals. Potential risk factors of involved animals, environment, management and housing were obtained by enquiry. Classification and regression tree analysis was used for decision tree development with cross-validation. Different trees were constructed, involving a general 3-group classification tree (viruses, Mycoplasma bovis or Pasteurellaceae family) and a tree for each single pathogen. The general 3- group classification tree was 52.7 % accurate and had a sensitivity of 81.5 % and a specificity 52.2 % for viruses, respectively 51.7 % and 84.4 % for M. bovis and 28.9 % and 93.6 % for Pasteurellaceae. The single-pathogen trees were more specific than sensitive: Histophilus somni (Se = 25.8 %; Sp = 94.5 %), Mannheimia haemolytica (Se = 69.2 %; Sp = 70.6 %), bovine coronavirus (Se = 42.2 %; Sp = 89.6 %) and bovine respiratory syncytial virus (Se = 34.0 %; Sp = 96.6 %). For Pasteurella multocida, M. bovis and parainfluenzavirus type 3 no meaningful tree was obtained. The concept and trees are promising, but currently lack sensitivity and specificity in order to be a reliable tool for practice. For now, the obtained trees can already be informative for decision making to some extend depending on the end node in which an outbreak falls.

Pathogen-specific risk factors in acute outbreaks of respiratory disease in calves.

Respiratory tract infections (bovine respiratory disease) are a major concern in calf rearing. The objective of this study was to identify pathogen-specific risk factors associated with epidemic respiratory disease in calves. A cross-sectional study was conducted, involving 128 outbreaks (29 dairy, 58 dairy-mixed, and 41 beef) in Belgium (2016-2018). A semiquantitative PCR for 7 respiratory pathogens was done on a pooled nonendoscopic bronchoalveolar lavage sample for each herd. Potential risk factors were collected by questionnaire and derived from the national cattle registration databank. Most outbreaks occurred between October and March, and single and multiple viral infections were detected in 58.6% (75/128) and 13.3% (17/128), respectively. Bovine coronavirus (BCV) was the most frequently isolated virus (38.4%), followed by bovine respiratory syncytial virus (bRSV; 29.4%) and parainfluenzavirus type 3 (PI-3; 8.1%). Mycoplasma bovis, Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni were detected in 33.3, 41.2, 89.1, and 36.4% of the herds, respectively. Specific risk factors for BCV detection were detection of M. haemolytica [odds ratio (OR) = 2.8 (95% confidence interval = 1.1-7.5)], increasing herd size [OR = 1.3 (1.0-1.8) for each increase with 100 animals] and detection of BCV by antigen ELISA on feces in calves in the last year [OR = 3.6 (1.2-11.1)]. A seasonal effect was shown for bRSV only {more in winter compared with autumn [OR = 10.3 (2.8-37.5)]}. Other factors associated with bRSV were PI-3 detection [OR = 13.4 (2.1-86.0)], prevalence of calves with respiratory disease [OR = 1.02 (1.00-1.04) per 1% increase], and number of days with respiratory signs before sampling [OR = 0.99 (0.98-0.99) per day increase]. Next to its association with BCV, M. haemolytica was more frequently detected in herds with 5 to 10 animals per pen [OR = 8.0 (1.4-46.9)] compared with <5 animals, and in herds with sawdust as bedding [OR = 18.3 (1.8-191.6)]. Also, for H. somni, housing on sawdust was a risk factor [OR = 5.2 (1.2-23.0)]. Purchase of cattle [OR = 2.9 (1.0-8.0)] and housing of recently purchased animals in the same airspace [OR = 5.0 (1.5-16.5)] were risk factors for M. bovis. This study identified pathogen-specific risk factors that might be useful for the development of customized control and prevention and for the design of decision support tools to justify antimicrobial use by predicting the most likely pathogen before sampling results are available.

Use of a breeding bull and absence of a calving pen as risk factors for the presence of Mycoplasma bovis in dairy herds.

Mycoplasma bovis is an important cause of pneumonia and mastitis in cattle throughout the world, often reported as emerging. In absence of an effective vaccine for M. bovis, current prevention and control strategies rely on the identification of risk factors for within- and between-herd spread. The objective of this study was to determine the prevalence of M. bovis in Belgian dairy herds and to identify risk factors associated with a positive PCR or antibody ELISA bulk tank milk (BTM) test. A cross-sectional study was performed in 2016 on 100 dairy farms, analyzing BTM using PCR and antibody ELISA. Information on herd-level risk factors focusing on biosecurity and management were collected through a questionnaire and sourced from the national herd identification system (SANITRACE, Animal Health Service Flanders). Multivariable logistic regression was used to identify herd-level risk factors for the presence of M. bovis DNA and antibodies in BTM. The apparent prevalence on BTM was 7 and 17% for PCR and antibody ELISA, respectively. The true prevalence was 7.1% [95% confidence interval (CI) = 2.1-11.5%] and 24.8% (95% CI = 16.4-33.2%). There was no overlap between ELISA- and PCR-positive farms, resulting in a combined true prevalence of 31.8% of the Belgian farms being in recent contact with M. bovis. Risk factor analysis showed that herds with a breeding bull [M. bovis-positive results for 45.5 and 13.6% of herds with and without a bull, respectively, odds ratio = 4.7 (95% CI = 1.1-19.8)] and without a calving pen [M. bovis-positive result in 52.4 and 20.6% of the herds without and with a calving pen, respectively, odds ratio = 3.7 (95% CI = 1.06-12.5)] had higher odds to harbor M. bovis antigen or antibodies in BTM. In conclusion, the present study points to a several fold increase in the prevalence of M. bovis in Belgian dairy herds. The importance of the breeding bull and calving pen in the between- and within-herd spread of M. bovis might have been underestimated in the past. Focusing on these factors might contribute to more effective control programs in the future.

Meckel's enterolith : a rare cause of mechanical small bowel subobstruction.

Meckel's diverticulum is the most common congenital gastrointestinal malformation and may present with bleeding, obstruction and diverticulitis. Symptomatic Meckel's diverticulum is associated with age <50 years, male gender, diverticular length > 2 cm and ectopic mucosa. Formation of enteroliths is a rare complication of Meckel's diverticulum and the majority of stones will remain in the diverticulum. Factors promoting enterolith formation through precipitation of calcium in the small intestinal alkaline environment include stasis as well as diverticular anatomy and histology. Mechanical obstruction due to liberation of enteroliths is even more rare and other mechanisms include intussusception, adhesions, volvulus and neoplasms. Visualization of enteroliths on plain abdominal films is challenging because not all stones are radiopaque. Surgical diverticulectomy or segmental bowel resection with anastomosis is preferred in case of complications. We present a case of mechanical small bowel sub-obstruction resulting from an expelled Meckel's enterolith.

Factors associated with high 24-month persistence with denosumab: results of a real-world, non-interventional study of women with postmenopausal osteoporosis in Germany, Austria, Greece, and Belgium.

Persistence with osteoporosis therapy is vital for fracture prevention. This non-interventional study of postmenopausal women receiving denosumab in Germany, Austria, Greece, and Belgium found that persistence with denosumab remains consistently high after 24 months in patients at high risk of fracture. PURPOSE: Continued persistence with osteoporosis therapy is vital for fracture prevention. This non-interventional study of clinical practice evaluated medication-taking behavior of postmenopausal women receiving denosumab in Germany, Austria, Greece, and Belgium and factors influencing persistence. METHODS: Subcutaneous denosumab (60 mg every 6 months) was assigned according to prescribing information and local guidelines before and independently of enrollment; outcomes were recorded during routine practice for up to 24 months. Persistence was defined as receiving the subsequent injection within 6 months + 8 weeks of the previous injection and adherence as administration of subsequent injections within 6 months ± 4 weeks of the previous injection. Medication coverage ratio (MCR) was calculated as the proportion of time a patient was covered by denosumab. Associations between pre-specified baseline covariates and 24-month persistence were assessed using multivariable logistic regression. RESULTS: The 24-month analyses included 1479 women (mean age 66.3-72.5 years) from 140 sites; persistence with denosumab was 75.1-86.0%, adherence 62.9-70.1%, and mean MCR 87.4-92.4%. No covariate had a significant effect on persistence across all four countries. For three countries, a recent fall decreased persistence; patients were generally older with chronic medical conditions. In some countries, other covariates (e.g., older age, comorbidity, immobility, and prescribing reasons) decreased persistence. Adverse drug reactions were reported in 2.3-6.9% patients. CONCLUSIONS: Twenty-four-month persistence with denosumab is consistently high among postmenopausal women in Europe and may be influenced by patient characteristics. Further studies are needed to identify determinants of low persistence.

Epidemiology of basal and squamous cell carcinoma in Belgium: the need for a uniform and compulsory registration.

BACKGROUND: Non-melanoma skin cancer (NMSC) is the most common type of cancer among Caucasians, however, few data exist on its incidence. Because of a sheer volume of these tumours, NMSC is often not systematically registered. OBJECTIVE: To describe and analyse the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in Belgium. METHODS: Incidence data of BCC and SCC, including multiple primary skin tumours in the same patient, were extracted from the Belgian Cancer Registry from 2004 to 2012 (predominantly coming from pathology notifications). Belgian legislation makes cancer registration compulsory for oncological care programmes and for all pathological anatomy laboratories. RESULTS: Between 2004 and 2012, 113 254 BCC and 33 153 SCC cases were reported in Belgium. A total of 130 339 patients had 146 407 tumours. Approximately, 10% of the patients (12 759 patients) had multiple tumours. The world age-standardised incidence rate (WSR) for BCC increased from 36.9 in 2004 to 98.4 per 100 000 person years in 2012 for males and from 34.2 in 2004 to 102.0 in 2012 for females. For SCC, the WSR increased from 14.9 in 2004 to 24.7 in 2012 for males and from 6.8 in 2004 to 13.5 in 2012 for females. CONCLUSIONS: From 2004 to 2012, the incidence of BCC and SCC markedly rose in Belgium, as also seen worldwide. Known causes are increased sun exposure caused by changed sunlight-related behaviour (increased outdoor activities and holidays, use of tanning beds and changes in clothing style), ageing and improved registration. Because of their high and increasing incidence, these cancers will have major implications on healthcare planning and preventive measures. Therefore, we recommend compulsory registration, whenever is possible, of BCC and SCC, although it is an ambitious objective, especially in countries with a high burden of these tumours and in countries where registration is currently unavailable.

N2O and NO emissions during autotrophic nitrogen removal in a granular sludge reactor--a simulation study.

This contribution deals with NO and N2O emissions during autotrophic nitrogen removal in a granular sludge reactor. Two possible model scenarios describing this emission by ammonium- oxidizing biomass have been compared in a simulation study of a granular sludge reactor for one-stage partial nitritation--Anammox. No significant difference between these two scenarios was noticed. The influence of the bulk oxygen concentration, granule size, reactor temperature and ammonium load on the NO and N2O emissions has been assessed. The simulation results indicate that emission maxima of NO and N2O coincide with the region for optimal Anammox conversion. Also, most of the NO and N2O are present in the off-gas, owing to the limited solubility of both gases. The size of granules needs to be large enough not to limit optimal Anammox activity, but not too large as this implies an elevated production of N2O. Temperature has a significant influence on N2O emission, as a higher temperature results in a better N-removal efficiency and a lowered N2O production. Statistical analysis of the results showed that there is a strong correlation between nitrite accumulation and N2O production. Further, three regions of operation can be distinguished: a region with high N2O, NO and nitrite concentration; a region with high N2 concentrations and, as such, high removal percentages; and a region with high oxygen and nitrate concentrations. There is some overlap between the first two regions, which is in line with the fact that maximum emission of NO and N2O coincides with the region for optimal Anammox conversion.

Prevalence of respiratory pathogens in diseased, non-vaccinated, routinely medicated veal calves.

The prevalence of respiratory pathogens in diseased veal calves was determined in 24 respiratory disease outbreaks in 15 herds in Belgium. Bacteria were cultured from nasopharyngeal swabs and seroconversion against viruses and Mycoplasma bovis was determined on paired sera. At the individual calf level, Mycoplasma species, Mannheimia haemolytica and Pasteurella multocida, were isolated from 70.5 per cent, 21.5 per cent and 26.0 per cent of swabs, respectively. At the herd level, the presence of M bovis could be confirmed in 84.6 per cent of the herds examined. Seroconversion against bovine viral diarrhoea virus (BVDV) was present in 71.4 per cent of herds, parainfluenzavirus type 3 in 53.3 per cent, bovine respiratory syncytial virus in 40.0 per cent, bovine adenovirus type 3 in 46.7 per cent, bovine coronavirus in 30.0 per cent, and bovine herpesvirus type 1 in 26.7 per cent. At postmortem examination, Mycoplasma species could be cultured from 61.9 per cent of pneumonic lungs (n=21). Sixty per cent of calves tested were positive for BVDV (n=20), and 20.0 per cent were positive for bovine respiratory syncytial virus (n=16).

The presence of bluetongue virus serotype 8 RNA in Belgian cattle since 2008.

After a short winter break, bluetongue virus serotype 8 was responsible in 2007 for a large-scale epidemic among ruminant populations in Western Europe. Little is known about the mechanisms allowing the virus to survive winter conditions. A yearly mass vaccination of cattle and sheep started in spring 2008, which was recognized as successful in terms of clinical protection, but occult circulation of the bluetongue virus has not been adequately addressed. We studied the carriage of bluetongue RNA in the spleen of cattle in the vector-free period and the circulation of bluetongue virus in cattle populations in Belgium since the introduction of vaccination programmes. Overall, the results presented here show evidence for the long-term carriage of bluetongue virus RNA in the spleen of cattle and demonstrated a low but significant circulation and transplacental transmission of bluetongue virus in Belgian cattle in 2009, with apparent disappearance in 2010.

Haemorrhagic diathesis in neonatal calves: an emerging syndrome in Europe.

In 2008 and 2009 a large number of cases of haemorrhagic diathesis (HD) in neonatal calves were reported in different European countries. In Flanders, 84 cases of neonatal HD in 30 herds were reported in this period. The disease typically affects calves younger than 1 month old from different breed and gender. Prominent clinical signs are cutaneous bleeding, petechiae on all mucosae, melena and often high fever. Early in the disease, the mental state of the animals is uncompromised. The typical haematological finding is pancytopenia, with severe to complete thrombocytopenia being the cause of the increased susceptibility to bleeding. In seven of the affected herds blood samples of calves of the same age group as the clinical case were collected and on six of those farms at least one subclinical case could be identified. Necropsy findings were generalized petechiae, ecchymoses or haemorrhages and variable lymphadenopathy. Histopathology of haemorrhagic lesions revealed multifocal extravasation of red blood cells (haemorrhage) with preservation of tissue architecture and absence of other abnormalities. Total bone marrow aplasia and depletion of all lymphoid tissue was the most prominent finding on histology. Activated macrophages and haemophagocytosis were seen on bone marrow cytology from two live calves. Polymerase chain reaction for bovine viral diarrhoea virus, bluetongue and epizootic haemorrhagic disease virus was negative. Several attempts to isolate a viral agent were unsuccessful.

Excess costs related to non-steroidal anti-inflammatory drug utilization in general practice.

Data concerning the reasons for consultation and the use of NSAIDs were collected in 4643 patients, seen by 126 GPs over 2 days' consultation. In all, 11.6 per cent took NSAIDs. They were older (49 vs. 46 years, p = 0.02), took more drugs (3 vs. 2.5, p < 0.01), and more had ADRs (8 vs 2 per cent) than non-users, even after correction for age, sex and number of drugs taken. Some 33 per cent of NSAID users also took adjuvant medication for the prevention of gastric injury (including with COX-2 inhibitors meloxicam, nimesulide). Estimated excess costs associated with NSAID use were high, related to excess consultations (GP or specialist, for ADRs, approx. 5-8 million Euros per year in France) and to use of preventive medication (100 million Euros per year at least).

[Reduction of traumatic dislocation of the shoulder. For a gentler approach....]. / La réduction des luxations traumatiques de l'épaule. Pour une plus grande douceur....

Early traumatic anterior dislocation of the shoulder may be reduced very easily using a method combining gentle traction along the axis of the arm, slow external rotation and outwards pressure on the humeral head with the patient seated. This gentle method does not require sedation or analgesia.

[Dermo-hypodermic lymphoid pseudotumors with follicular hyperplasia. Apropos of a case]. / Pseudo-tumeurs lymphoïdes dermohypodermiques avec hyperplasie folliculaire. A propos d'une observation.

We report the case of a female patient with ubiquitously distributed cutaneous and subcutaneous nodules measuring 2 to 6 cm along their long axis. These nodules first developed at the age of 63 years and subsequently appeared in crops separated by spontaneous remissions. Studies of removed nodules demonstrated diffuse lymphoid follicular hyperplasia suggesting a tumor and raising difficult nosologic problems, especially regarding relationships with the extranodal multicentric Castleman syndrome. In march 1987, biopsy of a large scapular nodule spreading into the striated muscle suggested possible transformation into a low grade malignant lymphoma of the lymphoplasmocytoid type.

[Unexpected effect of repetition of imaged behavior]. / Effect inattendu de la répétition de comportement imaginée.

In order to examine the efficiency of covert behavior rehearsal, 33 subjects, randomly assigned to three groups, were submitted to a task in a social condition. To reduce the stress-induced anxiety, the participants of the first group had been prepare by covert behavior rehearsal in a relaxed condition. Those of the second group received only relaxation and the third group had no preparation at all. The behavior rehearsal had no positive effect on the efficacy of the task execution. Moreover, a negative influence appeared. The results are discussed.