Population prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in the Netherlands. should asymptomatic persons be tested during Population-based chlamydia Screening also for gonorrhoea or only if chlamydial infection is found?

BACKGROUND: Screening and active case finding for Chlamydia trachomatis (CT) is recommended to prevent reproductive morbidity. However insight in community prevalence of gonococcal infections and co-infections with Neisseria gonorrhoea (NG) is lacking. METHODS: Nested study within a large population-based Chlamydia Screening Pilot among 21.000 persons 15–29 year. All CT-positive (166) and a random sample of 605 CT-negative specimens were as well tested for gonococcal infection. RESULTS: Overall Chlamydia prevalence in the Pilot was 2.0% (95% CI: 1.7–2.3), highest in very urban settings (3.2%; 95% CI: 2.4–4.0) and dependent of several risk factors. Four gonococcal infections were found among 166 participants with CT infection (4/166 = 2.4%; 95% CI: 0.1%–4.7%). All four had several risk factors and reported symptoms. Among 605 CT-negative persons, no infection with NG could be confirmed. CONCLUSION: A low rate of co-infections and a very low community prevalence of gonococcal infections were found in this population based screening programme among young adults in the Netherlands. Population screening for asymptomatic gonococcal infections is not indicated in the Netherlands. Although co-infection with gonorrhoea among CT-positives is dependent on symptoms and well-known algorithms for elevated risks, we advise to test all CT-positives also for NG, whether symptomatic or asymptomatic

Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for practice

Chlamydia trachomatis infection of the genital tract is the most common sexually transmitted infection and has a world-wide distribution. The consequences of infection have an adverse effect on the reproductive health of women and are a common cause of infertility. Recent evidence also suggests an adverse effect on male reproduction. There is a need to standardise the approach in managing the impact of C. trachomatis infection on reproductive health. We have surveyed current UK practice towards screening and management of Chlamydia infections in the fertility setting. We found that at least 90% of clinicians surveyed offered screening. The literature on this topic was examined and revealed a paucity of solid evidence for estimating the risks of long-term reproductive sequelae following lower genital tract infection with C. trachomatis. The mechanism for the damage that occurs after Chlamydial infections is uncertain. However, instrumentation of the uterus in women with C. trachomatis infection is associated with a high risk of pelvic inflammatory disease, which can be prevented by appropriate antibiotic treatment and may prevent infected women from being at increased risk of the adverse sequelae, such as ectopic pregnancy and tubal factor infertility. Recommendations for practice have been proposed and the need for further studies is identified

Spray-dried porcine plasma and yeast derived protein meal influence the adaption to weaning of primiparous and multiparous sow progeny in different ways

Pigs from 154 litters (n = 1132, 19 +/- 3 days of age, 4.9 +/- 1.1 kg of bodyweight) were used in a 3 x 2 factorial design to evaluate two raw materials with nutraceutical properties being used in feeds, spray-dried porcine plasma (SDPP) and a yeast protein meal, and their effects on growth performance, immune parameters and gastrointestinal adaption of piglets to weaning. Factors included dietary treatments being (1) 5% SDPP (PLA), (2) 3.5% yeast protein meal (NUP) and (3) medicated control (TMC) and parity (primiparous versus multiparous). The treatment groups were imposed from Day 19 through to weaning at Day 27. Selected pigs (n = 720, 28 +/- 3 days of age, 7.4 +/- 1.0 kg of bodyweight) were weaned and remained on their respective diets from Day 28 to Day 34. From Day 35 to Day 48 all group-housed pigs were offered a commercial weaner 1 diet, and from Day 49 to Day 68 pigs were offered a commercial weaner 2 diet. Growth performance, survival, and serum immunoglobulinGwere monitored throughout the nursery phase (Day 28 to Day 68). Adaptation of the gastrointestinal tract in the acute post-weaning phase (Day 28 to Day 34) was assessed in 36 individually housed male weaners, with the effects of feed on structural, digestive, microbial and immune parameters along the gastrointestinal tract determined atDay 34. Pre-weaning feed disappearance was greater (P< 0.01) in multiparous litters independent of diet. In the commercial nursery, total removals (mortality and morbidity) were highest (P<0.01) in primiparous sow progeny, with pigs offered NUP having greater (P <= 0.05) total removals. Pigs offered PLA had superior average daily gain, average daily feed intake and feed conversion ratio from Day 28 to Day 34 (P<0.05). Pigs offered NUP tended to (P=0.07) have superior average daily gain from Day 35 to Day 49. Pigs offered NUP had higher (P<0.05) serum immunoglobulinGconcentrations at Day 68 compared with pigs offered TMC, with the effect most pronounced in primiparous sow progeny. Individually housed weaners offered PLA consumed more (P<0.05) feed on Day 30 to Day 31, had shorter relative intestine length (P<0.05), greater villous height in the medial jejunum (P<0.10) and lower immuno-pathology scores along the intestine. Pigs offered PLA also tended (P<0.10) to have increased pancreatic-specific lipase and amylase activity compared with pigs offered NUP. Pigs offered NUP had a higher ratio of E. coli : coliforms in the colon (P<0.01) and more counts of beta-haemolytic bacteria in the medial jejunum (P<0.05) and colon (P<0.10). Diets containing either SDPP or NUP offered pigs benefits beyond nutrition relative to the medicated control diet. The benefits of SDPPwere highly effective but transient, while the yeast derived protein had a successive or accumulative effect which was more pronounced in primiparous sow progeny. Received 3 May 2012, accepted 17 October 2012, published online 29 November 201

Real exposure to pig pancreatic juice and bile inhibit exocrine pancreatic secretion in pigs

The mechanisms involved in the down regulation of the exocrine pancreas are still not fully elucidated. The purpose of the present study was to examine the effect of duodenal and ileal exposure to pancreatic enzymes and bile on pancreatic secretion. Experiments were performed with pigs fitted with pancreatic duct, ileal and jugular vein catheters, and duodenal T-shaped cannula. A negative feedback regulation of pancreatic secretion was found for both duodenal and ileal delivery of pancreatic juice. Pancreatic secretion was unaffected by duodenal delivery of bile and bile salts, while ileal delivery of bile and bile salts lowered it. On the other hand, pancreatic secretion was increased by duodenal loading of commercial non- or activated pancreatic enzyme preparations, thus probably recognised as dietary protein. Plasma cholecystokinin (CCK) level was lowered only by duodenal delivery of pancreatic juice. In conclusion, the results prove the existence of negative feedback mechanism regulating pancreatic secretion dependent on the presence of pure pancreatic juice or bile at the ileal level. The mechanism at the duodenal level is exclusively sensitive to pure pancreatic juice. (c) 2007 Elsevier B.V All rights reserved

Authors' response to: Re: 'Prophylactic antibiotics for preventing genital tract infection in women undergoing surgical procedures for incomplete abortion: a systematic review and meta-analysis of randomised controlled trials'.

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