Getting insights on bovine mastitis treatment efficacy based on tissular indicators with an integrated udder health management file: Project LAECEA.

Mastitis is the most “antibiotic consuming” pathology in dairy medicine. Though antibiotics and antibiograms are known to vets since the early fifties, our practices did not evolved a lot from empiric antibiotic therapy. Indeed, the need for a treatment, the cost and the delay for an antibiogram are most of the time incoherent with a routine practice. Nevertheless, there is a surge for rational use of antibiotics. Our study was based on 1100 mastitis events from 30 Belgian farms collected between January 2011 and June 2012. We chose to compare tissular cure (TC) based on the threshold of 200.000 somatic cells/ml in milk at milk control at least 60 days after the clinical mastitis event. Regarding the mastitis event, severity (according 3 grades: alteration of milk as grade 1, alteration of quarter as grade 2 and alteration of general state as grade 3), quarter, treatments were recorded. We also assessed a chronicity status based on previous somatic cell count (SCC) of the cow. It was considered a new case a cow which at least 15 days before had an SCC <200.000 cells/ml, other were marked as chronic cases. In our distribution, we see a seasonal rise of incidence between January and May. This period would represent twice as many mastitis as the summer period. Overall TC reaches 46% of all mastitis events, which is quite poor. Rear quarters had significantly lower TC (p<0,05%). Grade 3 mastitis had lower TC, 42,6% (p<0.05%) versus 48,9 % for grade 2 and 44,2% for grade 1. Almost 49% of all mastitis was considered as chronic cases, which TC was 33% on average, whereas new cases reached 55,3% TC. Study of treatment was frustrating given the high number of different combinations of treatments. It was underlined that 4th generation cephalosporins (C4G) were the most used in our cohort, followed by aminopenicillin/methicillin association (PENA/PENM) and 1st generation cephalosporins/aminoglycosids (C1G/AG) association. Of these intramammary treatments, 20% of the cases were submitted to a second intramammary drug, mostly C1G or C1G/AG. One third of the cases were treated parenterally with antimicrobials, mostly macrolids, fluoroquinolones and penethacillin. Finally, 10% of mastitis was treated with anti-inflammatory drugs, mostly tolfenamic acid and flunixin-meglumin. Comparing mastitis without use of a secondary intramammary drug, only PENA and C1G/AG reached more than 60% TC. Considering new cases, then C1G/AG, PENA/PENM and Prednisolone containing specialties were above 60% TC. Use of a parenteral injections increased TC only on new cases (+12%), but not on chronic cases. Refining by severity, TC improved with a parenteral on new cases, mainly in grade 1 (+20%). Regarding associated factors, TC was negatively affected by chronicity, parity and lactation stage. Indeed, TC was lower on cases from more than 4 month in milk, third lactation (OR = 2.8 for no cure) compared with previous, and chronic cases (OR=2,6). Seemingly, chronicity was positively associated with parity and season. The 3rd parity cases had higher chances to be chronic ones (OR = 1,7), as well as cases from April to September (OR = 1,6). This evaluation of cure is rather simple and has a good variability which allows several questions about the real match between antimicrobial treatment for mastitis and the udder inflammation. Based on our epidemiological data, we can modify routine management of mastitis, as some cases might not worth the antimicrobial treatment.LAECE

A New Anti-Counterfeiting Feature Relying on Invisible Luminescent Full Color Images Printed with Lanthanide-Based Inks

Europium and terbium trisdipicolinate complexes are inkjet printed onto paper with commercially available desktop inkjet printers. Together with a commercial blue luminescent ink, the red-emitting luminescent ink containing europium and the green-emitting luminescent ink containing terbium are used to reproduce accurate full color images that are invisible under white light and appear under a 254 nm UV light. Such invisible luminescent images are attractive anti-counterfeiting security features. The luminescent prints have a color range (gamut) nearly as wide as the gamut of a standard sRGB display. The gamut of the luminescent prints is determined by relying on a simple model predicting the relative spectral radiant emittances of any printed luminescent color halftone. The model is also used to establish the correspondence between the surface coverages of the printed luminescent inks and the emitted color of these luminescent halftones. The accuracy of the spectral prediction model is very good and can be rationalized by the absence of quenching when the luminescent lanthanide complexes are printed in superposition with the other luminescent materials

MTF measurements of a type-II superlattice infrared focal plane array sealed in a cryocooler

International audienceIn operational electro-optical systems, infrared focal plane arrays (IR FPA) are integrated in cryocoolers which induce vibrations that may strongly affect their modulation transfer function (MTF). In this paper, we present the MTF measurement of an IR FPA sealed in its cryocooler. The method we use to measure the MTF decorrelates operational constraints and the technological limitations of the IR FPA. The bench is based on the diffraction properties of a continuously self imaging grating (CSIG). The 26 µm pixel size extracted from the MTF measurement is in good agreement with the expected value

Defining biological remission in Crohn's disease: interest, challenges and future directions.

peer reviewedIn Crohn's disease, the treat-to-target strategy has been highly encouraged and became a standard of care. In this context, defining the target (remission) constitutes a major stake which fuels the literature. Currently, clinical remission (symptoms control) is no longer the only objective of treatments since it does not allow to well control inflammation-induced tissue damage. The introduction of endoscopic remission as a therapeutic target was clearly a progress but this examination remains invasive, costly, not well accepted by patients and does not allow a tight control of disease activity. More fundamentally, morphological techniques (eg, endoscopy, histology, ultrasonography) are limited since they do not evaluate the biological activity of the disease but only its consequences. Besides, emerging evidence suggest that biological signs of disease activity could better guide treatment decisions than clinical parameters. In this context, we stress the necessity to define a novel treatment target: biological remission. Based on our previous work, we propose a conceptual definition of biological remission which goes beyond the classical normalisation of inflammatory markers (C-reactive protein and faecal calprotectin): absence of biological signs associated with the risk of short-term relapse and mid/long-term relapse. The risk of short-term relapse seems essentially characterised by a persistent inflammatory state while the risk of mid/long-term relapse implicates a more heterogeneous biology. We discuss the interest of our proposal (guiding treatment maintenance, escalation or de-escalation) but also the fact that its clinical implementation would require overcoming major challenges. Finally, future directions are proposed to better define biological remission

The Quality of Primary Care in a Country with Universal Health Care Coverage

BACKGROUND: Standard indicators of quality of care have been developed in the United States. Limited information exists about quality of care in countries with universal health care coverage. OBJECTIVE: To assess the quality of preventive care and care for cardiovascular risk factors in a country with universal health care coverage. DESIGN AND PARTICIPANTS: Retrospective cohort of a random sample of 1,002 patients aged 50-80years followed for 2years from all Swiss university primary care settings. MAIN MEASURES: We used indicators derived from RAND's Quality Assessment Tools. Each indicator was scored by dividing the number of episodes when recommended care was delivered by the number of times patients were eligible for indicators. Aggregate scores were calculated by taking into account the number of eligible patients for each indicator. KEY RESULTS: Overall, patients (44% women) received 69% of recommended preventive care, but rates differed by indicators. Indicators assessing annual blood pressure and weight measurements (both 95%) were more likely to be met than indicators assessing smoking cessation counseling (72%), breast (40%) and colon cancer screening (35%; all p 75% for hypertension, dyslipidemia and diabetes. However, foot examination was performed only in 50% of patients with diabetes. Prevention indicators were more likely to be met in men (72.2% vs 65.3% in women, p < 0.001) and patients <65years (70.1% vs 68.0% in those ≥65years, p = 0.047). CONCLUSIONS: Using standardized tools, these adults received 69% of recommended preventive care and 83% of care for cardiovascular risk factors in Switzerland, a country with universal coverage. Prevention indicator rates were lower for women and the elderly, and for cancer screening. Our study helps pave the way for targeted quality improvement initiatives and broader assessment of health care in Continental Europ

Analyse de l'efficience des traitements de mammites de 60 fermes de Wallonie dans la base LAECEA

Le traitement de la mammite bovine est un acte à part dans la routine d’une exploitation bovine. En effet, si les cas les plus graves sont vus presque systématiquement pas le vétérinaire traitant en France ou en Belgique, la plupart des cas peu sévères font l’objet d’une tacite délégation de diagnostic et de traitement, sur base d’une formation préalable et d’une prescription enregistrée. Aujourd’hui, cette pathologie représente le plus important poste de consommation d’antibiotiques en exploitation laitière. Concernant cette problématique, la profession vétérinaire doit disposer de nouveaux outils de diagnostic, de traitement, et surtout d’évaluation de la qualité du traitement. Or, depuis la fin des années 1940, la pratique de l’antibiothérapie est restée, comme en médecine humaine, basée essentiellement sur l’antibiothérapie empirique, plus ou moins régulée par des cultures bactériologiques et des antibiogrammes (Durel et al., 2012). La profession s’est dotée d’outils d’analyse épidémiologique et clinique au cours des décennies, mais les résultats sont mitigés : une diminution globale de la consommation d’antibiotiques, mais le recours accru à des classes de dernières générations. Aujourd’hui le grand enjeu de l’antibiothérapie se corse, avec l’identification de mécanisme de résistance suspects d’être communs avec la médecine humaine(Jaglic et al., 2010). Plusieurs classes de molécules communes avec la médecine humaine sont identifiées, et leur utilisation menace d’être régulée (Bagcigil et al., 2007). Face à ce constat, l’utilisation des antibiotiques destinés au traitement de la mamelle a été étudiée en Belgique, dans soixante fermes laitières wallonnes (Théron et al., 2011).Peer reviewe

Is it time to include older adults in inflammatory bowel disease trials? A call for action

peer reviewedThe therapeutic management of older patients with inflammatory bowel disease (IBD) is challenging, particularly because of the absence of evidence-based guidelines for these patients, who seem to frequently be excluded from clinical trials. In this systematic review we investigated the exclusion of older patients with IBD from phase 3 studies registered on PubMed and ClinicalTrials.gov, by assessing the upper limit of age exclusion criteria and the percentage of patients older than 65 years included in the trials. Exclusion criteria other than age were also recorded, and comorbidities were analysed separately. Our review of 222 phase 3 studies shows that older patients are frequently excluded from IBD clinical trials because of their age, which was used as an exclusion criterion in 129 (58%) of the 222 assessed trials. Of the 32 trials that detailed the percentage of included patients who were 65 years or older, only 763 (5·4%) patients of the 14 124 patients included were older than 65 years. In addition to age, patients were also excluded because of comorbidities (mainly renal, hepatic, and cardiovascular, and used as an exclusion criterion in 76% of trials), a history of dysplasia (45% of trials), and previous treatment for IBD (19% of trials). We propose a three-step process that should enable the inclusion of all older patients in IBD clinical trials, regardless of their age, comorbidities, and frailty

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