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Background: The purpose of this study was to evaluate the effect of a prophylactic laparoscopic gastropexy on gastric motility in healthy large‐breed dogs. Methods: This was a prospective pilot study with nine healthy client‐owned dogs. Each dog was its own control. Gastric motility was evaluated before and after laparoscopic gastropexy. Dogs were fed a standard diet three weeks before and after surgery. Gastric motility was measured before and 3 weeks after surgery. A wireless motility capsule (WMC) was used to measure gastric pH, intragastric pressure, temperature, frequency of contractions, motility index (MI) and transit time. Non‐parametric statistical analysis was used to compare the paired data. Clients were contacted for follow‐up information 2 years postoperatively. Results: Median frequency of gastric contractions was 1.3 (range, 0.6–1.9 contractions/min) before gastropexy and 1.0 (range, 0.3–2.6 contractions/min) after gastropexy (P = 0.820). Median MI was 49.2 (range, 23.7–96.6) before gastropexy and 28.1 (range, 12.2–148.9) after gastropexy (P = 0.652). Median gastric emptying time was 1140 (range, 486–1230 min) before gastropexy and 1110 (range, 306–2610 min) after gastropexy (P = 0.570). During the hour before the WMC passed through the pylorus, median MI was 72.2 (range, 48.2–549.3) before gastropexy and 52.9 (range, 15.20–322.8) after gastropexy (P = 0.734), and frequency of contractions was 1.1 (range, 0.9–4.1 contractions/min) before gastropexy and 1.2 (range, 0.5–3.0 contractions/min) after gastropexy (P = 0.652). Conclusion: Motility in the stomach did not change in healthy dogs after prophylactic laparoscopic gastropexy. We conclude that preventive laparoscopic gastropexy does not induce gastroparesis. [ABSTRACT FROM AUTHOR]

Toll-like receptor-4 (TLR4) pathways are major contributors to pathological inflammatory responses induced by tissue damage. NI-0101 is the first monoclonal antibody (mAb) blocking TLR4 signaling. This activity is independent of the ligand type and concentration, therefore, potentially blocking any TLR4 ligands. A phase I single ascending dose study was conducted in 73 healthy volunteers to evaluate NI-0101 tolerability, preliminary safety, pharmacokinetics (PKs), and pharmacodynamics (PDs), in absence and in presence of a systemic challenge with lipopolysaccharide (LPS), a TLR4 ligand. NI-0101 was well tolerated without safety concern. The PK profile was characterized by a half-life of ∼10 days at high concentrations and by a rapid elimination at low concentrations due to expected target-mediated drug disposition. NI-0101 prevented cytokine release following ex vivo and in vivo LPS administration and prevented the C-reactive protein (CRP) increase and the occurrence of flu-like symptoms expected following the in vivo administration of LPS. [ABSTRACT FROM AUTHOR]

Context and objective: In France, national estimates of the incidence of cancers are based on mortality data by extrapolating the ratio between observed incidence and mortality in areas covered by cancer registries. The objective of this study is to determine the interest of using the discharge abstracts database gathered in hospitals to estimate breast cancer incidence in two French departments: Côte d'Or and Doubs. Methods: This study concerns the incident breast cancer cases identified in 2004 and 2005 through Côte d'Or and Doubs cancer registries and potential incident breast cancer cases selected through two algorithms in the Medical Information System Program (PMSI - Programme de Médicalisation des Systèmes d'Information) databases. The value of these algorithms was evaluated by probabilistic linkage between data from the anonymous registry and from the PMSI. Results: The first algorithm provides an estimated incidence close to those given by registries, and has a good sensitivity and positive predictive value; the second algorithm overestimates the incidence by about 100%, and has a poor positive predictive value. Conclusion: This study shows the usefulness of the PMSI databases and underlines the interest and difficulties of using these data to estimate cancer incidence. The PMSI database cannot be used as a unique source to estimate breast cancer incidence. [ABSTRACT FROM AUTHOR]

Background. The aim of the study was to assess the accuracy of the colorectal-cancer incidence estimated from administrative data. Methods. We selected potential incident colorectal-cancer cases in 2004-2005 French administrative data, using two alternative algorithms. The first was based only on diagnostic and procedure codes, whereas the second considered the past history of the patient. Results of both methods were assessed against two corresponding local cancer registries, acting as "gold standards." We then constructed a multivariable regression model to estimate the corrected total number of incident colorectal-cancer cases from the whole national administrative database. Results. The first algorithm provided an estimated local incidence very close to that given by the regional registries (646 versus 645 incident cases) and had good sensitivity and positive predictive values (about 75% for both). The second algorithm overestimated the incidence by about 50% and had a poor positive predictive value of about 60%. The estimation of national incidence obtained by the first algorithm differed from that observed in 14 registries by only 2.34%. Conclusion. This study shows the usefulness of administrative databases for countries with no national cancer registry and suggests a method for correcting the estimates provided by these data. [ABSTRACT FROM AUTHOR]

This population-based study aimed to assess the determinants of the outcome of chronic hepatitis C with analysis of the impact of antiviral therapy with or without sustained virological response (SVR) on cirrhosis decompensation, hepatocellular carcinoma, liver-related and non-liver-related mortality. A total of 1159 HCV-positive patients newly detected between 1994 and 2001 were included. For each outcome, the prognostic effect of patients' baseline characteristics was estimated by time-dependent Cox models using age as the time-scale and adjusting for treatment received during follow-up. The impact of antiviral therapy was assessed by using a propensity score in a sample including 184 patients treated in the first 24 months following diagnosis who were matched to 184 untreated patients. At the end of a 59-month median follow-up, 100 cases of compensated disease, 58 liver cancer and 163 deaths (55 liver related) were recorded. The 5-year rates of decompensated cirrhosis, hepatocellular carcinoma, liver-related and non-liver-related death were 4.4%, 2.7%, 5.0% and 8.9%, respectively. Multivariate analyses identified two variables with pejorative influence: alcohol consumption (RR = 4.29 for CD; RR = 5.76 for HCC; RR = 6.69 for liver-related death; P < 0.0001); HCV diagnosis unrelated to systematic screening (RR = 2.25 for CD; RR = 3.05 for HCC; RR = 4.31 for liver-related death, P < 0.03). In the matched subset, no significant benefit of antiviral therapy was observed. Nevertheless, among the 144 patients who achieved SVR, no death was observed. This population-based study showed substantial rates of decompensated cirrhosis, hepatocellular carcinoma and non-liver-related mortality. Alcohol consumption and absence of systematic screening were significant determinants of poor outcome, whereas treatment did not have significant influence. [ABSTRACT FROM AUTHOR]

Background, Low sunshine exposure might contribute to the pathogenesis of inflammatory bowel disease (IBD). Aim, To assess the geographic distribution of IBD incidence in relation to sunshine exposure in France to test the hypothesis that higher sun exposure is associated with lower IBD risk. Methods, Using the national health insurance database, incidence rates of Crohn's disease (CD) and ulcerative colitis (UC) were estimated for each of the 94 French administrative areas ('de'partements'), between 2000 and 2002. The surface UV radiation intensity was obtained by combining modelling and satellite data from Meteosat, the European meteorological satellite. Relationships between incidence rates and sun exposure were tested for significance by using a Poisson regression. We mapped smoothed relative risks (sRR) for CD and UC, using a Bayesian approach and adjusting for sun exposure, to search for geographical variations. Results, Areas with a smoothed RR of CD incidence significantly above 1 corresponded to areas with low sunshine exposure, whereas those with high or medium sunlight exposure had smoothed RRs either lower than 1 or not significantly different from 1. There was no association between sun exposure and UC incidence. Conclusions, This geographic study suggests that low sunlightexposure is associated with an increased incidence of Crohn's disease. Further studies are needed to determine if this association is causal. [ABSTRACT FROM AUTHOR]

Background A prevalence of 1.2% of coeliac disease (CD) in patients with chronic hepatitis C was recently reported, suggesting a possible epidemiological link between these two diseases. However, other studies have not found this relationship. Aim To conduct a French multicentre prospective study to assess the prevalence of CD in hepatitis C virus (HCV)-infected patients. Methods Between June 2003 and November 2005, 624 consecutive HCV-positive out-patients were tested for antiendomysial IgA antibodies (AEA), antigliadin IgA and IgG antibodies (AGA). Patients with positive AEA or IgA AGA and positive IgG AGA in a context of a high suspicion of CD were asked to undergo gastroscopy with duodenal biopsies. Results Isolated IgA AEA, IgA AGA and IgG AGA were 0.16%, 5.7% and 4.4%, respectively. Gastroscopy was required for 39 patients, 31 were performed (eight refusals), but only 25 duodenal biopsies were performed as six patients had cirrhosis. CD was never detected. Conclusions The prevalence of CD in HCV-positive patients was 0% (95% confidence interval: 0–0.59%), but there is a low prevalence of CD in the whole French population. [ABSTRACT FROM AUTHOR]

: In order for hepatitis C patients to receive antiviral treatment, they must reach medical care.: To assess the proportion of patients reaching medical care after hepatitis C diagnosis in a general population (1 006 171 inhabitants) in France.: Between 1994 and 1999, 1508 cases were diagnosed, of which 1251 were eligible for the study.: Two-hundred and two patients did not have any medical care; among them, 55.4% had normal alanine transferase, 58.4% had risk factors related to lifestyle and 22.8% were alcoholics. Amongst the 1049 other patients, 41.6% had a liver biopsy, 25.0% were treated. Treatment was more often carried out in males than in females (OR: 1.59;P = 0.001), and in patients under 65 than in older patients (OR: 2.22;P < 0.008). Among non-treatment reasons, alcoholism (P = 0.001), drug-addiction (P = 0.04) and escaping monitoring (P = 0.04) were more frequent in males than in females, whereas normal alanine transferase was more frequent in females than in males (P = 0.004). Amongst 278 patients with a Metavir score>A1F1, 71 (25.5%) did not undergo treatment.: In a general population, one patient in six did not receive on-going health care; a quarter of patients with a Metavir score>A1F1 did not receive any treatment. These results showed insufficient clinical management, which could compromise the effectiveness of treatment in general population. [ABSTRACT FROM AUTHOR]

The cumulative cardiotoxicity that occurs as a result of doxorubicin chemotherapy is irreversible and can affect both quality and quantity of life for the cancer patient. Cardiac troponin I (cTnI) is a sensitive and specific marker of cardiomyocyte death. The purpose of this retrospective study was to evaluate serum concentrations of cTnI in dogs with lymphoma or osteosarcoma given doxorubicin chemotherapy, and with known cardiac outcome, based on a minimum assessment by physical examination and thoracic radiography. Serum samples were also available for cTnI measurement from seven healthy dogs given intracoronary doxorubicin. Serial serum samples obtained before, during and after doxorubicin chemotherapy showed increased cTnI concentrations in some clinical patients following chemotherapy (P = 0.0083 compared to baseline), but this did not correlate with clinical signs of cardiomyopathy. In dogs that subsequently developed cardiomyopathy however, serum cTnI concentrations were elevated before clinical signs became evident (confirmed with echocardiography). [ABSTRACT FROM AUTHOR]

The efficacy and outcome of pulmonary metastatectomy in the management of hypertrophic osteopathy (HO) secondary to metastatic osteosarcoma was retrospectively evaluated in four dogs. Metastatectomy was performed by subpleural enucleation, partial lung lobectomy or complete lung lobectomy through either a median sternotomy or thoracoscopically. Perioperative morbidity was minimal. Clinical signs associated with HO resolved within 24 h of pulmonary metastatectomy in all dogs. Durable remission of symptomatic HO was achieved in all dogs (range, 50–294 days), although recurrence of HO was noted in one dog, 246 days postmetastatectomy due to metastasis to the lungs and chest wall. Pulmonary metastatectomy resulted in a rapid and prolonged resolution of HO, and the clinical benefits of metastatectomy potentially exceed the morbidity associated with the surgical procedure. [ABSTRACT FROM AUTHOR]

Aims: To compare respiratory status in dairy farmers with that of non-farming controls. Methods: Longitudinal study in the Doubs (France). From a cohort constituted in 1994 (T1), 215 (81.1%) dairy farmers and 110 (73.8%) controls were reevaluated in 1999 (T2). The protocol comprised a medical and occupational questionnaire, spirometric tests at both evaluations, allergological tests at T1, and a noninvasive measure of blood oxygen saturation (Spo[sub2]) at T2. Results: In 1999 analyses, the prevalence of chronic bronchitis was higher (p = 0.013), and FEV[sub1]/VC (p < 0.025) and Spo[sub2] (-0.7%, p < 0.01) lower in dairy farmers than in controls. In a multiple linear regression model, farming, age, and smoking were significantly and inversely correlated with Spo[sub2]. In the whole population, the mean annual decline in FEV[sub1] and FEV[sub1]/VC was -13.4 ml and -0.30%, respectively. Farming was associated with an accelerated decline in FEV[sub1]/VC (p < 0.025) after adjustment for covariates. No relation between allergy and respiratory function changes was observed, except for FEF[sub25-75]. Conclusions: This prospective study shows that dairy farming is associated with an excess of chronic bronchitis, with a moderate degree of bronchial obstruction and a mild decrease in Spo[sub2]. [ABSTRACT FROM AUTHOR]

Background – Ovariectomized sheep are a useful model of postmenopausal osteoporosis and other postmenopausal conditions. Estrogen may have a protective effect on the coronary arteries in postmenopausal women. The effects of raloxifene, a selective estrogen receptor modulator, on coronary arteries in aged ovariectomized ewes was investigated. Methods and Results – Forty eight aged ewes were randomly assigned to undergo sham surgery (Sham, n=7), ovariectomy (OVX, n=10), ovariectomy with estradiol supplementation (OVXE, n=8), ovariectomy with raloxifene supplementation, 0.02 mg/kg per day (RAL1, n=10), or ovariectomy with raloxifene supplementation, 0.10 mg/kg per day (RAL2, n=13). Contrast coronary angiography was performed 6 months after intervention. Diameters of the right main and left anterior descending coronary arteries in the RAL1, RAL2 and Sham groups were not different from each other, but were significantly greater than the OVX and OVXE groups. Intracoronary nitroglycerin did not affect the relationships of the diameters in any group. There were no differences in vascular remodeling between the groups. Conclusions – The results indicate that raloxifene in this sheep model allows greater dilation of coronary arteries than estrogen. Raloxifene may provide a significant protective functional effect on coronary arteries in postmenopausal heart disease. [ABSTRACT FROM AUTHOR]

Important differences have recently been highlighted between European countries in the survival of colorectal cancer patients. As data on stage at diagnosis were available for rectal cancers in three European population-based registries (Geneva Switzerland; Côte d'Or, France; Mallorca, Spain), we compared relative survival while assessing the effect of stage in a multiple regression model. We analysed 1005 rectal cancer cases diagnosed between 1982 and 1987 and followed up for at least 5 years. In the Mallorca registry, 16% of the patients were diagnosed in the TNM stage I (versus 21% in the Côte d'Or registry and 29% in the Geneva registry,P < 10[SUP-4]) and the 5-year relative survival rate was lower (35%) than in the other two registries (Côte d'Or 47%, Geneva 48%,P = 0.01). In the multivariate analysis, stage was the only independent prognostic factor, whereas the excess death risk did not vary significantly among registries (compared to Geneva, Côte d'Or relative risk was 1.0, Mallorca relative risk 1.11, 95% confidence interval 0.76-1.32 and 0.85-1.44 respectively). Survival differences between the registries were mainly due to stage at diagnosis. Thus, diagnostic conditions appear to be the main determinant of the survival inequalities found in those three European populations. [ABSTRACT FROM AUTHOR]

Background: A previous study showed there to be fewer microorganisms (especially thermophilic actinomycetes) on farms with artificial barn drying of fodder than on those using traditional storage methods. A cross sectional study was performed to see whether barn drying provides protection against respiratory problems in dairy farmers.Methods: The respiratory symptoms and function of a group of 123 farmers with daily exposure to cattle foddering from farms which had had a barn drying system for at least three years were compared with those of a representative sample of 274 farmers working in farms with traditional storage in five districts in the Doubs region of France.Results: Both groups were comparable for mean age, weight, height, smoking habits, alcohol consumption, past history of respiratory disease, history of allergy, geographical location of the farm, and length of exposure. Retrospectively estimated exposure to fodder was greater in the group using a barn drying system than in the group working with traditional storage. Acute symptoms at exposure (rhinitis, eye irritation, dry cough, asthma symptoms) and chronic symptoms all tended to be less frequent in the barn drying group, although not individually significantly so. Mean (SD) respiratory function parameters were higher in the barn drying group than in the traditional group: % vital capacity (VC) 104 (14) v 102 (15); % forced expiratory volume in one second (FEV1) 99 (14) v 94 (18); % FEV1/VC 96 (11) v 92 (16); % forced mid expiratory flow (FEF25-75) 87 (24) v 79 (25).Conclusion: The results of this cross sectional study suggest that barn drying of fodder may protect respiratory function in dairy farmers. [ABSTRACT FROM AUTHOR]

In a French region where farmer's lung (FL) is common, we determined the prevalence of FL precipitins in dairy farmers and analyzed the relation between the presence of FL precipitins and the clinical probability of the disease. All the exposed dairy farmers of both sexes (n = 2555) from five districts of the Doubs department were asked to respond to a medical and professional questionnaire. A total of 1763 (69%) farmers agreed to participate. Precipitins tests were conducted in 551 (31%) farmers who showed any respiratory symptom and in a random sample of 100 asymptomatic farmers. Serum for each farmer was analyzed by both double diffusion and immunoelectrophoresis again Micropolyspora faeni (MF) and extracts of moldy hay (HE) from Doubs. The 651 farmers were then divided into four groups (G 1-4) with a decreasing probability of FL (G1: typical FL symptoms; G4: asymptomatic farmers). The estimated prevalence of precipitins in the whole population was as follows: 1) by double diffusion, against HE: 83%, against MF: 27%;2) by immunoelectrophoresis, against HE: 26%, against MF: 19%. There was a close "linear" relation between the prevalence of precipitins detected by immunoelectrophoresis against HE and the symptoms: 51% in G1, 36% in G2, 29% in G3, and 13% in G4. Precipitins detected by immunoelectrophoresis were also related to exposure and geography (more immunization in tableland area than in plain or mountain area). Presence of precipitins detected by double diffusion was not related to exposure and geography (more immunization in tableland area than in plain or mountain area). Presence of precipitins detected by double diffusion was not related to symptoms, exposure, or geography. This study shows that the prevalence of precipitins is high in the exposed dairy farmers of Doubs, and suggests that immunoelectrophoresis (with the antigens used) is a more effective method for the diagnosis of FL than double diffusion. [ABSTRACT FROM AUTHOR]