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Exposure to sunlight, specifically ultraviolet B (UVB), is essential for cutaneous vitamin D synthesis. Despite significant daily sunlight availability in Africa and the Middle East, persons living in these regions are frequently vitamin D insufficient or deficient. Vitamin D insufficiency (25-hydroxyvitamin D (25(OH)D) between 15 and 20 ng/mL (37.5 - 50 nmol/L)) has been described in various population groups, ranging from 5% to 80%. Risk factors include traditional dress and avoidance of sunlight exposure, and multiple dietary factors as a result of specific cultural beliefs. Vitamin D resistance due to calcium deficiency mechanisms has been described in similar population groups, which may lead to hypovitaminosis D.Should the new diseases related to hypovitaminosis D prove to be truly associated, Africa and the Middle East will become an epicentre for many of these conditions. Urgent attention will need to be paid to cultural dress and dietary behaviours if hypovitaminosis D is to be taken seriously. Should such factors not be correctable, new strategies for supplementation or food fortification will have to be devised.

Exposure to sunlight, specifically ultraviolet B (UVB), is essential for cutaneous vitamin D synthesis. Despite significant daily sunlight availability in Africa and the Middle East, persons living in these regions are frequently vitamin D insufficient or deficient. Vitamin D insufficiency (25-hydroxyvitamin D (25(OH)D) between 15 and 20 ng/mL (37.5 - 50 nmol/L)) has been described in various population groups, ranging from 5% to 80%. Risk factors include traditional dress and avoidance of sunlight exposure, and multiple dietary factors as a result of specific cultural beliefs. Vitamin D resistance due to calcium deficiency mechanisms has been described in similar population groups, which may lead to hypovitaminosis D. Should the new diseases related to hypovitaminosis D prove to be truly associated, Africa and the Middle East will become an epicentre for many of these conditions. Urgent attention will need to be paid to cultural dress and dietary behaviours if hypovitaminosis D is to be taken seriously. Should such factors not be correctable, new strategies for supplementation or food fortification will have to be devised.

Information related to mastitis risk factors is useful for the design and implementation of clinical mastitis (CM) control programs. The first objective of our study was to model the risk of CM under Brazilian conditions, using cow-specific risk factors. Our second objective was to explore which risk factors were associated with the occurrence of the most common pathogens involved in Brazilian CM infections. The analyses were based on 65 months of data from 9,789 dairy cows and 12,464 CM cases. Cow-specific risk factors that could easily be measured in standard Brazilian dairy farms were used in the statistical analyses, which included logistic regression and multinomial logistic regression. The first month of lactation, high somatic cell count, rainy season and history of clinical mastitis cases were factors associated with CM for both primiparous and multiparous cows. In addition, parity and breed were also associated risk factors for multiparous cows. Of all CM cases, 54% showed positive bacteriological culturing results from which 57% were classified as environmental pathogens, with a large percentage of coliforms (35%). Coagulase-negative Staphylococcus (16%), Streptococcus uberis (9%), Streptococcus agalactiae (7%) and other Streptococci (9%) were also common pathogens. Among the pathogens analyzed, the association of cow-specific risk factors, such as Zebu breed (OR=5.84, 95%CI 3.77–10.77) and accumulated history of SCC (1.76, 95%CI 1.37–2.27), was different for CM caused by Coagulase-negative Staphylococcus and S. agalactiae in comparison to CM caused by coliforms. Our results suggest that CM control programs in Brazil should specially consider the recent history of clinical mastitis cases and the beginning of the lactations, mainly during the rainy season as important risk factor for mastitis.

Scix 2015, Sept. 27 - Oct. 2, 2015, Providence, RI, USA

Resume Objectif. — Cette etude met en relief l’interet du diagnostic precoce de l’hemorragie fœtomaternelle, afin de prevenir ses consequences graves sur le fœtus et le nouveau-ne. Patients et methodes. — Neuf nouveau-nes ont ete hospitalises pour anemie dans le service de medecine neonatale et de reanimation infantile du CHU de Grenoble entre octobre 1989 et septembre 1995. Le diagnostic d’hemorragie fœtomaternelle fut etabli par le test de Kleihauer suivant le sigma diagnostic fetal hemoglobin de notre laboratoire d’hematologie, et cela apres avoir elimine les autres causes d’anemies neonatales. Resultats. — Parmi les neuf observations d’hemorragie fœtomaternelle, sept nouveau-nes ont presente des signes evocateurs de souffrance fœtale aigue a type d’un rythme fœtal pathologique, d’un liquide amniotique meconial associe a un trace fœtal plat ou a une diminution des mouvements fœtaux. a la naissance, le tableau clinique etait variable en fonction du degre de l’hemorragie: un etat de mort apparente (deux cas), une detresse respiratoire (deux cas), un choc hypovolemique (un cas) ou bien une anemie isolee (quatre cas). l’hemorragie fœtomaternelle a entraine le deces d’un nouveau-ne par asphyxie severe et une encephalopathie anoxo-ischemique. Conclusion. — Ces donnees confirment l’interet du test de Kleihauer, rapide et peu couteux, qu’il faut pratiquer systematiquement devant toute suspicion d’hemorragie fœtomaternelle et une anemie neonatale inexpliquee.

Objective. To examine and compare health status and disease activity changes in patients with rheumatoid arthritis (RA) in a clinical trial of the biologic agent DAB 486 IL-2. Methods. Data on 45 patients with RA who were enrolled in a multicourse, double-blind trial, consisting of a first, placebo-controlled, course followed by open-label treatment with the active agent to a total of 3 active courses, were examined for evidence of improvement in health status (measured using the 5 components of the Arthritis Impact Measurement Scales 2 [AIMS2]) and disease activity (measured using standard clinical measures and erythrocyte sedimentation rate). Results. Over a single course of treatment, DAB 486 IL-2-treated patients showed significant improvement relative to placebo-treated patients on the symptom and social components of AIMS2 and in patient's assessment of disease activity. With subsequent open-label courses of treatment with DAB 486 IL-2, all 5 AIMS2 health status components and the disease activitymeasures of tender and swollen joint counts, grip strength, and the observer and patient assessments showed steady and generally parallel improvement. Conclusion. Short-term health status effects of this biologic agent were detected using the AIMS2.

Resumo: Algumas doenças infecciosas são potencialmente capazes de comprometer a viabilidade de uma produção de leite economi- camente sustentável. Este trabalho teve como objetivo avaliar a relação entre a soropositividade para diarreia viral bovina (BVD) nas taxas de descarte em 240 rebanhos leiteiros comerciais. Para quantificar os efeitos da infecção pelo vírus da BVDV nas taxas de descarte involuntário, as variáveis foram incluídas em modelos mistos de regressão linear múltipla generalizado. A soropositivi- dade diminuiu o número de animais descartados nos rebanhos positivos de acordo com os resultados encontrados neste trabalho. A presença de anticorpos em virtude da infecção natural teve um efeito protetor contra o descarte involuntário, demonstrando o efeito da imunidade de rebanho. Abstract: Some infectious diseases are potentially capable of compromising the viability of an economically sustainable milk production. The aim of this paper was to evaluate the relationship between the seropositivity status of bovine viral diarrhea (BVD) in 240 comercial herds and culling rates. To quantify the effects of BVD virus (BVDV) infection on culling rates, the variables were included on multiple generalizaded linear models. According to the results of this study, seropositivity decreased culling rates in positive herds. Presence of antibodies due to natural infection had a protector effect against involuntary culling rates showing the herd immunity effect. Made available in DSpace on 2011-11-14T18:48:28Z (GMT). No. of bitstreams: 1 2011AP04.pdf: 327337 bytes, checksum: 0a3a50d467c2641cea313fb8bc546d06 (MD5) Previous issue date: 2011-10-26

Background: CT scan measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT scan-assessed airway disease to objective measures of lung function and respiratory symptoms such as dyspnea in severe emphysema is less clear. Methods: Using data from 338 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study, densitometric measures of emphysema using a threshold of -950 Hounsfield units (%LAA-950) and airway wall phenotypes of the wall thickness (WT) and the square root of wall area (SRWA) of a 10-mm luminal perimeter airway were calculated for each subject. Linear regression analysis was performed for outcome variables FEV1and percent predicted value of FEV1with CT scan measures of emphysema and airway disease. Results: In univariate analysis, there were significant negative correlations between %LAA-950 and both the WT (r = -0.28, p = 0.0001) and SRWA (r = -0.19, p = 0.0008). Airway wall thickness was weakly but significantly correlated with postbronchodilator FEV1% predicted (R = -0.12, p = 0.02). Multivariate analysis showed significant associations between either WT or SRWA (β = -5.2, p = 0.009; β = -2.6, p = 0.008, respectively) and %LAA-950 (β = -10.6, p = 0.03) with the postbronchodilator FEV1% predicted. Male subjects exhibited significantly thicker airway wall phenotypes (p = 0.007 for WT and p = 0.0006 for SRWA). Conclusions: Airway disease and emphysema detected by CT scanning are inversely related in patients with severe COPD. Airway wall phenotypes were influenced by gender and associated with lung function in subjects with severe emphysema. © 2009 American College of Chest Physicians.

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Background Lupin seed flour has been reported as a causative agent of allergic reactions, especially in patients with allergy to peanut. Previous studies have demonstrated that autoclave treatment can considerably reduce the allergenicity of lupins. Aims The aim of this work was to evaluate the effect of instantaneous controlled pressure drop (détente instantanée contrôlée, DIC) treatment on lupin in vitro allergenicity. Methods Lupin cotyledons were subjected to instantaneous controlled pressure drop at several pressure and time conditions (3, 4.5 and 6 bar for 1, 2 and 3 min, respectively). Immunoreactivity to raw and DIC-treated extracts was evaluated by Western blot using a serum pool from 19 sensitized patients. Results Depending on the operating parameters used during DIC treatment, a reduction in protein solubility of lupin seed was observed. Moreover, drastic modifications in protein profiles were observed after DIC treatment by SDS-PAGE analysis. Western blot experiments showed that the decreases in IgE binding to lupin proteins were associated with the increases in steam pressure and time treatment, and binding was completely abolished by DIC at 6 bar for 3 min. Conclusions The results suggest that DIC treatment could produce a reduction in lupin allergenicity. Copyright © 2007 S. Karger AG.

Background The purpose of this study was to assess low molecular weight heparin auto-injection skills of self-supporting patients, taught by a nurse through a rapid demonstration in an emergency department. Methods The study was a prospective, multicentre study, carried out in emergency departments. It included all ambulatory attending patients over 18 years of age, who were given a lower limb cast in an emergency ward and provided with limited orthopaedic treatment. Eligible patients who accepted self-injection training were given a quick demonstration by the nurse in the emergency ward. A questionnaire about the perception of the patient was completed at the beginning of the treatment and at the end of the treatment. A surveillance chart for recording injections and side effects was also given to the patient, and platelet counts were performed twice weekly. Findings Two hundred and fourteen patients have been assessed. Forty-four patients (20.5%) were judged inappropriate for training (n=19) or refused it (n=25). Primary perception of the self-injection method showed absence of fear of injections among patients in 43.7% of cases. Training was successful in 88% of cases. Twenty-one patients out of 170 (12%) gave up after completing the training. Questionnaires given at the end of the treatment found a generally favourable opinion on self-injections among 73.26% of patients (n=86). Compliance was good – 95.5% of patients completed all their injections. Platelet counts were considered appropriate only in 52.5% of cases. Interpretation It seems possible to extend the practice of self-injection to other types of injections prescribed after discharge from the emergency department, such as preventive low molecular weight heparin for surgical or medical purposes and curative ambulatory low molecular weight heparin treatment for deep vein thrombosis.