In vivo nematicidal potential of camel milk on Heligmosomoides polygyrus gastro-intestinal nematode of rodents

Following our previous fi ndings on the in vitro anthelmintic effect of camel milk on Haemonchus contortus, the current study aimed at investigating its in vivo effect. Investigations were carried out using mice infected with Heligmosomoides polygyrus which is a parasite commonly used to test the effi cacy of anthelmintics. Thirty six Swiss white mice of both sexes aged 5 – 6 weeks old, and weighing between 20 and 25 g were orally infected with 0.5 ml dose of 100, 1-week-old H. polygyrus infective larvae (L3 ). After the pre-patent period, infected animals were randomly divided into 6 groups of 6 animals each. The nematicidal effi cacy of camel milk was monitored through faecal egg count reduction (FECR) and total worm count reduction (TWCR). Four doses (8.25; 16.5; 33.0; 66.0 ml/kg body weight (bw)) for fresh camel milk and 22 mg/kg bw for albendazole were studied using a bioassay. Albendazole and 4 % dimethylsulfoxide were included in the protocol as reference drug and placebo, respectively. For all tested doses except 8.25 ml/kg bw, camel milk was effective in vivo against H. polygyrus reducing both faecal egg count and worm count (p < 0.05). The dose 66 ml/kg bw showed the highest nematicidal activity causing a 76.75 % FECR and a 69.62 % TWCR 7 day after initiating the treatment. These results support the possible use of camel milk in the control of gastro-intestinal helminthiasis

Cystic echinococcosis in slaughtered domestic ruminants from Tunisia

A total of 10,818 domestic ruminants (3913 cattle, 2722 sheep, 3779 goats, 404 dromedaries) slaughtered in various abattoirs in Tunisia between 2003 and 2010 were examined for the presence of Echinococcus granulosus hydatid cysts. The prevalence of cystic echinococcosis (CE) was 16.42% in sheep, 8.56% in cattle, 5.94% in dromedaries and 2.88% in goats. CE prevalence increased with age according to an asymptotic model and there was evidence of variation in infection pressure depending on the region of Tunisia where the animals were slaughtered. Cattle appeared to have the highest infection pressure of the species examined. The mean intensity of hepatic cysts was higher than that of pulmonary cysts in all species. The highest mean intensity of infection with E. granulosus larvae was observed in cattle (18.14) followed by sheep (9.58), goats (2.31) and dromedaries (2.12). The abundance of infection increased in a linear fashion with age in all animal species. Cyst abundance varied with species of animal and district of Tunisia. Cysts from dromedaries were more fertile (44.44%) than those from sheep (30.25%), goats (30.32%) and cattle (0.95%). The viability of the protoscoleces from fertile cysts from cattle (78.45%) was higher than those from sheep (70.71%) and camels (69.57%). The lowest protoscolex viability was recorded for hydatid cysts from goats (20.21%). This epidemiological study confirms the importance of CE in all domestic ruminant species, particularly in sheep, throughout Tunisia and emphasizes the need to interrupt parasite transmission by preventive integrated approaches in a CE control programm

Clinical features and outcomes of patients with tubercular uveitis treated with antitubercular therapy in the collaborative ocular tuberculosis study (COTS)-1

IMPORTANCE Eradication of systemic tuberculosis (TB) has been limited by neglected populations and the HIV pandemic. Whereas ocular TB often presents as uveitis without any prior evidence of systemic TB, the existing uncertainty in the diagnosis of TB uveitis may perpetuate missed opportunities to address systemic TB. OBJECTIVE To examine the clinical features of TB uveitis and the associations with response to antitubercular therapy (ATT). DESIGN, SETTING, AND PARTICIPANTS This retrospective multinational cohort study included patients from 25 ophthalmology referral centers diagnosed with TB uveitis and treated with ATT from January 1, 2004, through December 31, 2014, with a minimum follow-up of 1 year. MAIN OUTCOMES AND MEASURES Treatment failure, defined as a persistence or recurrence of inflammation within 6 months of completing ATT, inability to taper oral corticosteroids to less than 10mg/d or topical corticosteroid drops to less than 2 drops daily, and/or recalcitrant inflammation necessitating corticosteroid-sparing immunosuppressive therapy. RESULTS A total of 801 patients (1272 eyes) were studied (mean [SD] age, 40.5 [14.8] years; 413 [51.6%] male and 388 [48.4%] female; 577 [73.6%] Asian). Most patients had no known history (498 of 661 [75.3%]) of systemic TB. Most patients had bilateral involvement (471 of 801 [58.8%]). Common clinical signs reported include vitreous haze (523 of 1153 [45.4%]), retinal vasculitis (374 of 874 [42.8%]), and choroidal involvement (419 of 651 [64.4%]). Treatment failure developed in 102 of the 801 patients (12.7%). On univariate regression analysis, the hazard ratios (HRs) associated with intermediate uveitis (HR, 2.21; 95%CI, 1.07-4.55; P = .03), anterior uveitis (HR, 2.68; 95%CI, 1.32-2.35; P = .006), and panuveitis (HR, 3.28; 95%CI, 1.89-5.67; P < .001) were significantly higher compared with posterior distribution. The presence of vitreous haze had a statistically significant association (HR, 1.95; 95%CI, 1.26-3.02; P = .003) compared with absence of vitreous haze. Bilaterality had an associated HR of 1.50 (95%CI, 0.96-2.35) compared with unilaterality (HR, 1 [reference]), although this finding was not statistically significant (P = .07). On multivariate Cox proportional hazards regression analysis, the presence of vitreous haze had an adjusted HR of 2.98 (95%CI, 1.50-5.94; P = .002), presence of snow banking had an adjusted HR of 3.71 (95%CI, 1.18-11.62; P = .02), and presence of choroidal involvement had an adjusted HR of 2.88 (95%CI, 1.22-6.78; P = .02). CONCLUSIONS AND RELEVANCE A low treatment failure rate occurred in patients with TB uveitis treated with ATT. Phenotypes and test results are studied whereby patients with panuveitis having vitreous and choroidal involvement had a higher risk of treatment failure. These findings are limited by retrospectivemethods. A prospectively derived composite clinical risk score might address this diagnostic uncertainty through holistic and standardized assessment of the combinations of clinical features and investigation results that may warrant diagnosis of TB uveitis and treatment with ATT

Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic review of the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE, CINAHL, SCOPUS, BIOSIS, and Web of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review. A total of 44 globally representative group members met in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents

Long-term effect of a physical activity program (DIAfit) in an unselected population of patients with type 2 diabetes

Background and aim: The benefits of physical activity (PA) in improving glycemic control and physical fitness in patients with type 2 diabetes are well documented. However, data about effects of "real-life" PA programs in non-specialized centers and especially about their long-term effects are lacking and represent a relevant public health challenge. We aimed to evaluate the effect of a nation-wide PA program (DIAfit) on PA, well-being, body weight and metabolic parameters in patients with type 2 diabetes one year after the end of the program. We also asked about a feedback regarding the program and about barriers to perform PA more long-term. Methods: 185 Patients with type 2 diabetes participated in a newly approved national PA (DIAfit program) in 11 centers. All patients agreed to participate in the study and were randomly assigned to one or two PA groups (1-2 versus 3 weekly sessions; in total 36 sessions for both groups) including 6-8 interactive group workshop. A first evaluation was done at the end of the program. The current study focuses on the second evaluation one year after the end of the program. The first 123 patients who had finished the program one year before were contacted and invited to participate. They received a questionnaire and their physician was contacted to obtain further laboratory information. The primary outcome measure was self-reported PA using the short form of the International Physical Activity Questionnaire (IPAQ). Wellbeing using the WHO-Five Well-being Index (WHO-5) questionnaire, weight, the lipid profile and HbA1c were predefined secondary outcomes. Results: 71 of 123 the invited participants completed and returned the questionnaire (57.7%). Patients with follow-up data were slightly older, had a higher BMI, Patients with follow-up data had significantly lower levels of moderate PA and lower total well-being scores compared to patients with no follow-up data (all p≤0.03). Compared to baseline, moderate PA increased significantly and almost doubled (p=0036) walking and the total IPAQ score had a tendency to increase (both p=0.07) and vigorous PA did not change (p=0.350) one year after the end of the program. Well-being increased significantly by around 10% (p=0.032). Weight, lipid parameters and HbA1c did not change except for an increase in HDL-Cholesterol (p=0.01). The most important barriers for PA were health problems and a reduced physical condition (together 44%) and lack of motivation (19%). One year after the program, 90% of the patients gave the program a score of at least 8 out of 10. Conclusion A PA program in unselected patients with type 2 diabetes can improve PA and well-being one year after its end. There exist many barriers for PA in this population and PA group programs are well appreciated

Volatile compounds and oxidative stability of Pinus halepensis Mill. seed oil under heating conditions

Heating conditions of Pinus halepensis seed oil were monitored to evaluate the effect of thermo-oxidation processes on the bioactive compounds contained in the samples. The following parameters were monitored: ultra violet absorption at 232 and 270 nm, fatty acid composition, oxidative stability, antiradical activity and aromatic profiles. Under thermo-oxidation process, trans fatty acids (TFA) increased and conjugated linoleic acid isomers appeared. The antiradical activity significantly decreased from 73.3% to 52.5% after 120 min of heating. Oxidative stability decreased (r = 0.70). The volatile profile was heavily influenced by heating with the formation of new volatile compounds, such as the two isomers (E,Z)-2,4-decadienal and (E,E)-2,4-decadienal. a-pinene, and the main terpene compound was very vulnerable to heating conditions. Despite its peculiar pleasant aroma and nutritional value, the P. halepensis seed oil should not be used for cooking. Indeed, under frying conditions, its antioxidant properties and oxidative stability are lost and potential toxic compounds, such as TFA and unsaturated aldehydes, are forme

Multi-segmentation of sonar images using belief function theory

International audienc