[Cushing syndrome because of herbal supplement]. / Syndroom van Cushing door kruidenpreparaat.

The use of exogenous glucocorticoids is a common cause of Cushing syndrome. We present a case of exogenous Cushing syndrome caused by Binahong: an over-the-counter 'herbal' supplement. A 54-year-old woman presented with weight gain, joint pain, hypertension and poorly regulated type 2 diabetes mellitus despite the start of semaglutide one year before presentation. Physical examination revealed signs of steroid excess with a moon face and abdominal obesity. Her serum cortisol level and ACTH level were suppressed. Synthetic glucocorticoid screening revealed a positive dexamethason level in the herbal supplement. After stopping the supplement her serum cortisol and dexamethason increased to normal levels. This case emphasizes the importance of awareness for the use of supplements containing hidden glucocorticoids causing Cushing syndrome.

The vertical transmission of antibiotic residues from parent hens to broilers.

Imprudent and superfluous use of antibiotics contributes to the selection of resistant bacteria, which is a large threat to human health. Therefore analytical procedures have been implemented in the poultry production sector to check if antibiotic treatments are registered, aiming to achieve more prudent use of antibiotics. These methods rely on the analysis of feathers, a matrix in which antibiotic residues persist. However, other routes besides direct administration, through which poultry feathers could contain antibiotic residues, should also be taken into account. In this research the vertical transmission from parent hen to broiler was investigated through a controlled animal study for the antibiotics enrofloxacin, doxycycline and sulfachlorpyridazine. Vertical transmission was observed for all antibiotics to both egg and egg shell. Also it is demonstrated that the transferred antibiotics from parent hen to chick are subsequently excreted via the chick's droppings. Through this route, the broilers' environment is contaminated. If eggs are hatched that were taken during treatment of the parent hen, this indirect route and/or the direct vertical transmission can eventually result in the detection of low concentrations of antibiotic residues in the broilers' feathers at greater age: <50 µg kg-1 for freely extractable residues and <10 µg kg-1 for non-freely extractable residues. No antibiotics were detected in the broilers' muscle or kidney from 4 weeks of age. This research provides relevant information regarding the possible amount of residues originating from vertical transmission when monitoring matrices such as feathers and broiler droppings in order to stimulate correct use and registration of antibiotics in the poultry sector.