Environmental factors in familial Crohn's disease in Belgium

BACKGROUND: Environmental factors are believed to trigger the onset of Crohn's disease (CD) in genetically susceptible individuals. The aim of this study was to assess environmental and familial factors that might be etiologically related to CD. METHODS: Twenty-one families with 3 or more affected first-degree relatives were studied, together with 10 matched control families. There were 74 patients with CD, 84 unaffected family members, and 59 controls. Family members were interviewed together at the parental home. A 176-item questionnaire delved into first symptoms, childhood vaccinations and diseases, food items, potable water supplies, social activities, travel, pets, and home and surrounding environment. Questions were directed specifically for 2 time-frames, childhood until age 20 and a 10-year epoch before the onset of first symptoms within a family. The possible factors linked to disease were evaluated using univariate and multivariate logistic regression. RESULTS: There were significantly more smokers in the patients and their relatives than in controls. Patients had more appendicitis during adolescence, ate less oats, rye, and bran than controls, and consumed more unpasteurized cheese. Patients drank significantly less tap water and more well water than controls. Clustering of cases in time occurred in 13 of the 21 affected families. CONCLUSIONS: The less frequent consumption of oats, rye, and bran and the more frequent eating of unpasteurized cheeses imitate potential dietary influences on gastrointestinal flora. More importantly, our data suggest that the drinking of well water represents an important risk factor for CD

Achados clínico patológicos durante um surto de disenteria de inverno em bovinos no Rio Grande do Sul Clinic pathological features during a winter dysentery outbreak in cattle in Rio Grande do Sul

Descreve-se um surto de disenteria de inverno que afetou 10 vacas leiteiras de uma propriedade localizada em Viamão, Rio Grande do Sul. O quadro clínico caracterizou-se por uma diarréia inicialmente líquida esverdeada com estrias de sangue e muco, evoluindo, em alguns animais, para uma diarréia de coloração marrom escura à sanguinolenta, que persistiu, em média, cinco dias. Drástica diminuição na produção de leite e no consumo de alimentos, além de graus variados de depressão também foram observados. Apenas um dos 10 animais afetados morreu. Durante a necropsia, observaram-se mucosas pálidas, conteúdo sanguinolento com presença de grande quantidade de coágulos, principalmente no cólon espiral e petéquias na mucosa do cólon. Os principais achados histológicos foram encontradas no cólon espiral, onde havia criptas dilatadas, sem epitélio de revestimento ou revestidas por epitélio pavimentoso e/ou cuboidal, por vezes com núcleos grandes e nucléolos proeminentes. Algumas criptas eram preenchidas por debris necróticos e polimorfonucleares. Na imuno-histoquímica com anticorpo monoclonal para coronavírus bovino (8F2) em cortes do cólon espiral, havia marcações positivas no citoplasma de enterócitos das criptas, nos debris necróticos destas e em macrófagos na lâmina própria.<br>The report describes a winter dysentery outbreak that affected 10 dairy cows from a ranch located in the county of Viamão, Rio Grande do Sul. The most significant clinical sign was profuse and watery diarrhea, which ranged from a greenish to a brownish coloration and from occasional blood streaks with mucus to a bloody diarrhea. Most cases persisted for 5 days and also included depression, drastic decrease in milk production and in food consumption. Only one of the affected animals died. The necropsy revealed pale mucosa and sanguineous content with high quantity of blood clots, particularly within the spiral colon, and petechiae on the colonic mucosa. Histopathological lesions were predominant in the spiral colon, and consisted of a high number of dilated crypts without epithelium or with the replacement of a pavement epithelium with occasional immature cuboidal cells, which sometimes showed enlarged nucleus and proeminent nucleolus. Some crypts were filled with epithelial desquamation and polymorphnuclear cells. Bovine coronavirus (8F2) monoclonal antibody was used for immunohistochemistry on sections of the spiral colon that showed positive reactions in the cytoplasm of the infected crypt epithelium, sloughed necrotic cells, and within macrophages in the lamina propria of both