Elucidating the Varying Impact of Necrotic Enteritis Using Performance and Health Indicators in Broiler Infection Models.

Necrotic enteritis (NE) continues to be a significant burden to the poultry industry, compounded by pressure to reduce antibiotic use. Researchers use NE-challenge models to study the infection biology of NE and as screening tools to develop potential novel interventions. Currently, data are limited comparing such models between research establishments, and few indicate which quantitative metrics provide the most accurate measure for determining the efficacy of interventions. We compared data from 10 independent NE-challenge trials incorporating six challenge models employed in four geographical regions to determine the extent of variability in bird responses and to determine, using principal component analysis (PCA), which variables discriminated most effectively between nonchallenged control (NC) and challenged control (CC) groups. Response variables related to growth performance (weight gain, feed intake, feed conversion), health (mortality, lesion scores, NE induction rate), and, in three trials only, gut integrity (tight junction protein claudin-1, claudin-2, and zonula occludens-1 expression, coccidia counts, and intestinal permeability [assessed by FITC-dextran assay]). Treatments included a CC, which varied between trials (for example, in Eimeria predisposition, Clostridium perfringens strain, and days of inoculation), and a NC. The degree of response to challenge in CC birds varied significantly among models and trials. In all trials, lesion scores 1 to 4 days postchallenge were increased in CC vs. NC birds and varied both within and among models (by 0.29-1.17 points and 0.05-2.50 points, respectively). In addition, NE-related mortality at day 28 was increased in CC vs. NC, both within and among models (by 1.79%-4.72% and 0.02%-16.70%, respectively), and final (day 35 or 42) body weight was reduced by 3.9%-14.4% and overall FCR increased by up to 27% across trials (P , 0.05). A PCA on the combined dataset including only performance indicators failed to adequately differentiate NC and CC groups. However, the combination of performance and gut integrity variables and standardization of data by trial and phase achieved greater resolution between groups. This indicated that the inclusion of both types of variables in future NE-challenge studies would enable the generation of more robust predictions about intervention efficacy from different types of infection models. A final PCA based on a subset of key indicator variables, including body weight, feed intake, feed conversion ratio, mortality, and lesion score, achieved a good level of separation between NC and CC status of birds and could, with further research, be a useful supplement to existing approaches for assessing and predicting the NE status of birds in the field.

Determinación del impacto variable de la enteritis necrótica mediante indicadores de rendimiento y salud en modelos de infección de pollos de engorde. La enteritis necrótica (EN) sigue siendo un problema importante para la industria avícola, que se ha agudizado por la presión para reducir el uso de antibióticos. Los investigadores utilizan modelos de desafío de enteritis necrótica para estudiar la biología de la infección de este problema y como herramientas de detección para desarrollar posibles intervenciones novedosas. Actualmente, los datos que comparan dichos modelos entre grupos de investigación son limitados y pocos indican qué métricas cuantitativas proporcionan la medida más precisa para determinar la eficacia de las intervenciones. Comparamos datos de 10 ensayos independientes de desafío para enteritis necrótica que incorporan seis modelos de desafío empleados en cuatro regiones geográficas para determinar el grado de variabilidad en las respuestas de las aves y determinar, utilizando el análisis de componentes principales (PCA), qué variables discriminaron más efectivamente entre el control no desafiado (NC) y grupos de control desafiados (CC). Variables de respuesta relacionadas con el rendimiento del crecimiento (aumento de peso, consumo de alimento, conversión alimenticia), salud (mortalidad, puntuaciones de lesiones, tasa de inducción de enteritis necrótica) y, en sólo tres ensayos, la integridad intestinal (proteína de unión estrecha claudina-1, claudina-2, y expresión de zonula occludens-1, recuentos de coccidias y permeabilidad intestinal [evaluada mediante ensayo FITC-dextrano]). Los tratamientos incluyeron un control desafiado, que fue variable entre los ensayos (por ejemplo, en la predisposición a Eimeria, la cepa de Clostridium perfringens y los días de inoculación) y un control no desafiado. El grado de respuesta al desafío en aves del grupo control desafiado varió significativamente entre modelos y ensayos. En todos los ensayos, las puntuaciones de lesiones de 1 a 4 días después del desafío aumentaron en las aves del grupo control desafiado en comparación con el control no desafiado y variaron tanto dentro como entre los modelos (entre 0.29 y 1.17 puntos y entre 0.05 y 2.50 puntos, respectivamente). Además, la mortalidad relacionada con enteritis necrótica en el día 28 aumentó en el control desafiado en comparación con el control no desafiado, tanto dentro como entre modelos (entre un 1.79% y un 4.72% y entre un 0.02% y un 16.70%, respectivamente), y el peso corporal final (día 35 o 42). se redujo entre un 3.9% y un 14.4% y la conversión alimenticia en general aumentó hasta un 27% en todos los ensayos (P ,0.05). El análisis de componentes principales sobre el conjunto de datos combinado que incluye solo indicadores de desempeño no logró diferenciar adecuadamente los grupos control no desafiado y desafiado. Sin embargo, la combinación de variables de rendimiento e integridad intestinal y la estandarización de los datos por ensayo y fase lograron una mayor resolución entre los grupos. Esto indicó que la inclusión de ambos tipos de variables en futuros estudios de desafío para enteritis necrótica permitiría la generación de predicciones más sólidas sobre la eficacia de la intervención a partir de diferentes tipos de modelos de infección. Un análisis de componentes principales final basado en un subconjunto de variables indicadoras clave, incluido el peso corporal, el consumo de alimento, el índice de conversión alimenticia, la mortalidad y la puntuación de las lesiones, logró un buen nivel de separación entre el estado de las aves no desafiadas y desafiadas y podría, con más investigación, ser un complemento útil a los enfoques existentes para evaluar y predecir el estado de enteritis necrótica de las aves en el campo.

[Functional intestinal disorders: assessment and perception by physicians of their patients perception. Results of two national studies]. / Troubles fonctionnels intestinaux: évaluation de la perception par les praticiens du vécu de leurs patients. Résultats de deux enquêtes nationales.

OBJECTIVE: In 1999, a first national survey on functional intestinal disorders (FID) revealed the patients' good perception of the medical corps and treatments proposed. The aim of the present study was to assess the physicians' perception of their patients, their symptoms and their degree of satisfaction. METHODS: The survey was conducted among the physicians who had recruited the patients of the initial study. Eight hundred and eighty five replies were analysed (general practitioners--GPs: 88%; gastro-enterologists--GE: 11%). RESULTS: The mean number of patients with FID seen in one week was of 11.40 (GP: 10.80; GE: 16.29). Thirty percent of patients were seen for the first time by a GP and 65 percent by a GE. The mean yearly number of consultations for these patients was of 7.16 for the GPs and 3.81 pour les GEs. A coloscopy was prescribed by 49% of GPs and 66% of GEs. The pain and transit disorders mentioned in 98 and 78.7% of cases had evolved over a mean of 56.57 months. COMMENTS: Although aware of the repercussion of FID in daily life, the practitioners evaluated a psychological component of 69% in the expression of the disorder. They considered the pain intense in 6% of cases versus the 41% expressed by the patient. The scores out of 10 for 8 items showed a mean result of 6.86 in their evaluation of the degree of the patients' understanding of their disease and its treatment, and of 6.13 for the quality of the medical act. These same criteria, assessed one year earlier by the patients themselves, showed better scores.

[Gastrointestinal functional disorders. National evaluation survey of patient symptoms and management]. / Troubles fonctionnels intestinaux. Enquête nationale d'évaluation par les patients des symptômes et leur prise en charge.

OBJECTIVE: An anonymous self-administered questionnaire was completed by patients with gastrointestinal functional disorders to determine symptoms and management strategies employed. METHODS: The questionnaire was filled out by 1266 patients who complained of abdominal pain in 8 out of 10 cases as well as disturbed bowel movements and abdominal distension. RESULTS: Half of the patients had started self medication, generally before consulting their general practitioner. The patients were generally satisfied with their medical care. Superior efficacy was observed for antispasmodics in combination or not with anxiolytic agents (75%, 71% and 69% efficacy respectively). The digestive disorders led to an interruption of occupational activities in 21% of the patients. DISCUSSION: Optimal management of patients with this benign chronic disorder that nevertheless has a major impact on their quality of life requires sufficient knowledge of the opinions of both the patients and their physicians. A second survey on this question has been initiated.

Demodex folliculorum and topical treatment: acaricidal action evaluated by standardized skin surface biopsy.

A standardized skin surface biopsy was performed in 34 patients suffering from skin diseases with high Demodex folliculorum density (Dd) > 5D/cm2 before, during and after topical treatment. The patients were randomized into six comparable groups to study six topical treatments: metronidazole 2%, permethrin 1%, sublimed sulphur 10%, lindane 1%, crotamiton 10% and benzyl benzoate (BB) 10%. Their acaricidal activity was measured according to three criteria: (i) for each treatment, decrease of Dd to under the normal threshold (< or = 5 D/cm2); (ii) for each treatment, a significant decrease in Dd; and (iii) comparison of the relative difference in Dd between treatments. These three criteria converged to establish the acaricidal activity of BB on D. folliculorum; the efficacy of crotamiton was demonstrated by the second criterion. An important irritating effect was observed with BB and sulphur.

Cetirizine and pseudoephedrine retard alone and in combination in the treatment of perennial allergic rhinitis: a double-blind multicentre study.

We compared the efficacy and safety of 5 mg cetirizine (CTZ), 120 mg pseudoephedrine retard (PER) and their combination (COM), given twice daily for three weeks, for the treatment of perennial allergic rhinitis. Two hundred and ten evaluable patients (97 males and 113 females) were included in the study and randomly allocated to one of three treatment groups, each of 70 patients. Nasal obstruction, sneezing, rhinorrhoea, nasal and ocular pruritus were scored each day throughout the study by patients using a symptom scale ranging from 0 (no symptom) to 3 (severe). The mean proportion of days without symptoms was higher in the COM group (11.8%) than in the CTZ (6.8%) and PER (5.1%) groups, but the differences were not statistically significant. The mean percentage of days when symptoms were absent or at most mild was significantly higher in the COM group (64.8%) than in either CTZ (45.5%; p = 0.003) or PER groups (40.6%; p = 0.0001). In addition, evaluation of symptoms by investigators and their global evaluation at the end of treatment showed statistically significant differences in favour of COM compared, to both CTZ and PER. The most frequent adverse events were somnolence in the CTZ and COM groups (8.6% and 12.9%, respectively) while insomnia was most frequent in the PER group. No clinically significant abnormalities were found in haematological or biochemical tests. These results indicate that the combined treatment was more effective than and as well tolerated as treatment with each individual agent.

[Nephronophthisis, tapeto-retinal degeneration, encephalopathy and vermian agenesis: a new association. Apropos of 3 familial cases]. / Néphronophtise, dégénérescence tapéto-rétinienne, encéphalopathie et agénésie vermienne: une nouvelle association. A propos de trois cas familiaux.

We observed a combination of nephronophthisis, tapetoretinal degeneration, vermian agenesis and encephalopathy in three first cousins. Juvenile nephronophthisis, the main inherited renal disease of childhood, is occasionally associated with a genetically linked disease involving the eyes and/or bone and/or liver and/or nervous system. We have assembled approximately one hundred cases of complex nephronophthisis. We discuss the various associations, among which the Senior syndrome (nephronophthisis + tapetoretinal degeneration) is the most frequent. The familial combination seen in our patients has apparently not been previously reported and seems to represent a new expression of the disease.