Efficacy of Oral Metronidazole with Vaginal Clindamycin or Vaginal Probiotic for Bacterial Vaginosis: Randomised Placebo-Controlled Double-Blind Trial

BACKGROUND: To determine if oral metronidazole (MTZ-400 mg bid) with 2% vaginal clindamycin-cream (Clind) or a Lactobacillus acidophilus vaginal-probiotic containing oestriol (Prob) reduces 6-month bacterial vaginosis (BV) recurrence. METHODS: Double-blind placebo-controlled parallel-group single-site study with balanced randomization (1:1:1) conducted at Melbourne Sexual Health Centre, Australia. Participants with symptomatic BV [Nugent Score (NS) = 7-10 or ≥3 Amsel's criteria and NS = 4-10], were randomly allocated to MTZ-Clind, MTZ-Prob or MTZ-Placebo and assessed at 1,2,3 and 6 months. MTZ and Clind were administered for 7 days and Prob and Placebo for 12 days. Primary outcome was BV recurrence (NS of 7-10) on self-collected vaginal-swabs over 6-months. Cumulative BV recurrence rates were compared between groups by Chi-squared statistics. Kaplan-Meier, log rank and Cox regression analyses were used to compare time until and risk of BV recurrence between groups. RESULTS: 450 18-50 year old females were randomized and 408 (91%), equally distributed between groups, provided ≥1 NS post-randomization and were included in analyses; 42 (9%) participants with no post-randomization data were excluded. Six-month retention rates were 78% (n = 351). One-month BV recurrence (NS 7-10) rates were 3.6% (5/140), 6.8% (9/133) and 9.6% (13/135) in the MTZ-Clind, MTZ-Prob and MTZ-Placebo groups respectively, p = 0.13. Hazard ratios (HR) for BV recurrence at one-month, adjusted for adherence to vaginal therapy, were 0.43 (95%CI 0.15-1.22) and 0.75 (95% CI 0.32-1.76) in the MTZ-Clind and MTZ-Prob groups compared to MTZ-Plac respectively. Cumulative 6-month BV recurrence was 28.2%; (95%CI 24.0-32.7%) with no difference between groups, p = 0.82; HRs for 6-month BV recurrence for MTZ-Clind and MTZ-Prob compared to MTZ-Plac, adjusted for adherence to vaginal therapy were 1.09(95% CI = 0.70-1.70) and 1.03(95% CI = 0.65-1.63), respectively. No serious adverse events occurred. CONCLUSION: Combining the recommended first line therapies of oral metronidazole and vaginal clindamycin, or oral metronidazole with an extended-course of a commercially available vaginal-L.acidophilus probiotic, does not reduce BV recurrence. TRIAL REGISTRATION: ANZCTR.org.au ACTRN12607000350426

ELFE, a database to determine greenhouse gases and ammonia emissions factors from livestock

ELFE, a database to determine greenhouse gases and ammonia emissions factors from livestock. 20. Nitrogen Workshop. Coupling C-N-P-S cycle

Reference procedures for the measurement of gaseous emissions from livestock houses and stores of animal manure.

In the ten years before the EMILI 2012 symposium, gaseous losses from animal farms became increasingly important in the m edia. The paradox of this tendency was the great number of publications, scientific or not, even though the emissions of most animal farms had never been measured. Therefor e, the development of reference tools to measure greenhouse gas and ammonia emissio ns was important. Such tools allow recognition and remuneration of the best pract ices and equipment. Accordingly, ADEME funded an international project associating several research and development organizations involved with the animal production chain. The project proposed an initial set of 18 procedures to measure ammonia and greenho use gas emissions from animal houses and manure stores. These were adapted to the diversity of animal farms found throughout the world. Some methods were compared duri ng a ?building? and a ?liquid manure? experiment. Results showed a high difference among methods (ca. 80%), much higher than the estimated uncertainty. Associat ing independent emission measurements, together with a mass balance of the system, is necessary for the reliability of further results. However, previously published references lack uncertainty estimates of measurements that conform to GUM 2008. In the coming years, this is one of the major concerns for measuring emission factor s. Uncertainty estimates should depend on the measurand (temporal: hourly, per batch, yearly; spatial: animal, house, national) and include the uncertainties associated with system representativity and temporal interpolation.Edited by Mélynda Hassouna and Nadine Guingand

Young pregnant women's views on the acceptability of screening for chlamydia as part of routine antenatal care

<p>Abstract</p> <p>Background</p> <p>In pregnancy, untreated chlamydia infection has been associated with adverse outcomes for both mother and infant. Like most women, pregnant women infected with chlamydia do not report genital symptoms, and are therefore unlikely to be aware of their infection. The aim of this study was to determine the acceptability of screening pregnant women aged 16-25 years for chlamydia as part of routine antenatal care.</p> <p>Methods</p> <p>As part of a larger prospective, cross-sectional study of pregnant women aged 16-25 years attending antenatal services across Melbourne, Australia, 100 women were invited to participate in a face-to-face, semi structured interview on the acceptability of screening for chlamydia during pregnancy. Women infected with chlamydia were oversampled (n = 31).</p> <p>Results</p> <p>Women had low levels of awareness of chlamydia before the test, retained relatively little knowledge after the test and commonly had misconceptions around chlamydia transmission, testing and sequelae. Women indicated a high level of acceptance and support for chlamydia screening, expressing their willingness to undertake whatever care was necessary to ensure the health of their baby. There was a strong preference for urine testing over other methods of specimen collection. Women questioned why testing was not already conducted alongside other antenatal STI screening tests, particularly in view of the risks chlamydia poses to the baby. Women who tested positive for chlamydia had mixed reactions, however, most felt relief and gratitude at having had chlamydia detected and reported high levels of partner support.</p> <p>Conclusions</p> <p>Chlamydia screening as part of routine antenatal care was considered highly acceptable among young pregnant women who recognized the benefits of screening and strongly supported its implementation as part of routine antenatal care. The acceptability of screening is important to the uptake of chlamydia screening in future antenatal screening strategies.</p

Ammonia removal using biotrickling filters Part b Determination of the nitrogen accumulation in the scrubbing liquid at a livestock facility using electrical conductivity measurement

International audienceIt was demonstrated that the daily monitoring of electrical conductivity (EC) of scrubbing water can easily be used to determine the performance of biotrickling filters treating ammonia (NH3) emissions, generated by livestock facilities. Two different measurement campaigns were carried out on a pilot-scale biotrickling filter installed at a pig facility. Different phases of the operation were observed for each campaign, in accordance with EC values. For EC ranges of between 5 and 40 mS cm−1, performance was similar for both campaigns, indicating that the nitrogen accumulated in water (ϕ) was controlled by the operating conditions and biotrickling filter design (ϕ = 205 gN day−1 corresponding to 1.71 mS cm−1 day−1). Due to the correlation established in Part A of this study, the performance of the biotrickling filter can be directly expressed as gN h−1 m−3packing material without gas-phase monitoring. Thus, for an Empty Bed Residence Time of 1 s, the nitrogen accumulation capacity of the biotrickling filter was 24 gN h−1 m−3packing material. For higher EC values, the ammonia mass transfer slowed down and stopped with EC at around 50–60 mS cm−1 (campaign #1) and 70 mS cm−1 (campaign #2). It was evidenced that the mass transfer stopped due to ammonia mass transfer limitation controlled by the driving force, although biomass inhibition can occur at these levels of nitrogen concentration in the scrubbing liquid. EC monitoring can also be used to assess the ratio of nitrogen accumulated in water ϕ and amount of ammonia entering the system ϕmax . Thus ϕ/ϕmax ratios of 41% and 27% were recorded for campaign #1 and #2 respectively

Ammonia removal using biotrickling filters Part A Determination of the ionic nitrogen concentration of water using electrical conductivity measurement

International audienceIt is emphasized that a generalized relationship can be used to predict the ionic nitrogen concentration (i.e., sum of ammonium NH4+, nitrite NO2− and nitrate NO3−) of the scrubbing liquid in a biotrickling filter treating ammonia emissions by measuring the electrical conductivity (EC) of the water directly. From measurements carried out on different water samples from six biotrickling filters in operation in pig husbandries, the generalized relationship is Σ([NH4+ ]+[NO2− ]+[NO3− ])g N/L = 0.22 ECmS/cm. This equation is valid provided the fresh water feeding the biotrickling filter has a low electrical conductivity (andlt;1 mS cm−1). Moreover, since ammonium, nitrite and nitrate ions are the ultra-majority ions in the liquid phase, the balance between NH4+ and (NO2− + NO3−) was confirmed, and consequently the relationship NH4+ = 0.11 ECmS/cm can also be applied to determine the ammonium concentration from the EC. As a result, EC measurement could be applied extensively to monitor operating biotrickling filters worldwide and used to determine ammonia mass transfer in real time, keeping in mind that the accuracy of the generalized relationship is ±20%. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

La base de données ELFE : vers une meilleure connaissance des émissions gazeuses liées à l’élevage

National audienceThe increasing demand for animal products is a major challenge for the livestock sector that must reduce its environmental impacts and ensure its sustainability. This sector has been identified as an important contributor to polluting gas emissions. Improving the knowledge on the origin and the magnitude of air pollutants and greenhouse gases emissions from livestock sector is essential to address climate change and to contribute to improve air quality with the evolution of breeding practices (feeding strategy, manure management, etc.). A consortium involving research and extension services partners was created to build a database called ELFE (ELevages et Facteurs d’Emission) with international data from literature references focusing on emissions of ammonia, greenhouse gases, particles and odors on the different steps of manure management of cattle, pig and poultry productions systems and their associated key variables. Around 350 publications (among 1 000 publications collected) are integrated into the database and provide more than 5 200 emission values. The ELFE database allows calculating average of emission and their standard deviation taking into account the diversity of livestock systems. These data can be used to provide emission factor for national inventories for specific livestock systems and also, to evaluate practices on gas emissions mitigation. This database can also be used to analyze the influence of key variables on the emission factor variability using multicriteria assessment (climate, building type, etc.). Moreover, this database propose a classification of emission factor into three classes according to the degree on which information about their most influential key variables was complete (>50 % ; 30-50 % ; 50 % ; 30-50 % ; <30 % des métadonnées renseignées) afin d’évaluer son niveau de description

Les litières en élevage : identification, test et évaluation des techniques ou des pratiques consistant à mieux gérer les litières avec moins de matériaux

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