Influence of applying different units of measurement on reporting antimicrobial consumption data for pig farms

Background: Antimicrobial use in livestock is one of the factors contributing to selection and spread of resistant microorganisms in the environment. National ve

Monitoring of Farm-Level Antimicrobial Use to Guide Stewardship: Overview of Existing Systems and Analysis of Key Components and Processes

peer-reviewedThe acknowledgment of antimicrobial resistance (AMR) as a major health challenge in humans, animals and plants, has led to increased efforts to reduce antimicrobial use (AMU). To better understand factors influencing AMR and implement and evaluate stewardship measures for reducing AMU, it is important to have sufficiently detailed information on the quantity of AMU, preferably at the level of the user (farmer, veterinarian) and/or prescriber or provider (veterinarian, feed mill). Recently, several countries have established or are developing systems for monitoring AMU in animals. The aim of this publication is to provide an overview of known systems for monitoring AMU at farm-level, with a descriptive analysis of their key components and processes. As of March 2020, 38 active farm-level AMU monitoring systems from 16 countries were identified. These systems differ in many ways, including which data are collected, the type of analyses conducted and their respective output. At the same time, they share key components (data collection, analysis, benchmarking, and reporting), resulting in similar challenges to be faced with similar decisions to be made. Suggestions are provided with respect to the different components and important aspects of various data types and methods are discussed. This overview should provide support for establishing or working with such a system and could lead to a better implementation of stewardship actions and a more uniform communication about and understanding of AMU data at farm-level. Harmonization of methods and processes could lead to an improved comparability of outcomes and less confusion when interpreting results across systems. However, it is important to note that the development of systems also depends on specific local needs, resources and aims

Melatonin in sleepless children : everything has a rhythm?

Every living organism has an biological clock regulating endogenous melatonin production, synchronized by exogenous impulses like daylight, temperature and feeding. Inappropriately applied bright light disturbs this melatonin rhythm. Some large swine producers apply artificial light three times a day for three hours; we compared the 24 hour melatonin rhythm of pigs in a large swine production unit with pigs in a farm with natural light schemes (chapter two). No significant differences were found comparing mean melatonin levels of both farms of different light and feeding phases. We measured salivary melatonin concentrations after a single dose melatonin at 11 a.m. in three patients with worsening sleep quality after initial good response to melatonin treatment (chapter three). These levels remained above 50 pg/mL, in contrast to levels found in three controls with sustained response to melatonin. After resuming melatonin treatment with a considerably lower dose sleep problems disappeared, suggestive of slow melatonin hepatic CYP1A2 metabolisation. In patients with loss of response to melatonin, a melatonin clearance test and a considerably dose reduction is advised. In chapter four the meta-analysis of the efficacy and safety of exogenous melatonin in advancing sleep-wake rhythm in patients with delayed sleep phase disorder is described. Five trials including 91 adults and four trials including 226 children showed that melatonin treatment advanced mean DLMO by 1.18 hours and clock hour of sleep onset (SOT) by 0.67 hours. Melatonin decreased sleep-onset latency (SOL) by 23.27 minutes. In conclusion, melatonin is effective in advancing sleep-wake rhythm and DLMO in delayed sleep phase disorder. In chapter five a post-hoc analysis of two previously published trials in children with CSOI assessing onset and stability of the therapeutic effect of 4-weeks melatonin treatment is described. One week and four weeks of melatonin treatment showed a phase-advance of SOT from 22:05 to 20:45 hrs. respectively 21:09 hrs. and SOL decreased from 53 min to 18 respectively 25 min. The onset of melatonin treatment effect can be expected within a few days after commencement and remains stable after that. The Meldos study (chapter six) aimed to establish a dose–response relationship for melatonin 0.05, 0.1, 0.15 mg/kg or placebo in advancing DLMO, SOT, and reducing SOL in 72 children aged 6-12 yrs with CSOI in a 1-week randomized, double-blind trial. Treatment with melatonin significantly advanced SOT and DLMO by 1 hour and decreased SOL by 35 min. This effect of melatonin was not dose related but increased with an earlier circadian time of administration. Melatonin 0.05 mg/kg given at least 1-2 hrs before DLMO and before desired bedtime is effective for treatment of CSOI in children. After mean 3.1 yrs, we evaluated pubertal development, sleep quality and mental health development of 51 former Meldos participants with questionnaires (chapter seven). Mean questionnaire scores did not differ significantly from published scores of the general Dutch population of the same age and sex, indicating that melatonin treatment (mean dose 2.69 mg) in children may be sustained over a long period of time without deviation of sleep, puberty and mental health

New treatment options for Feline Infectious Peritonitis

Feline infectieuze peritonitis (FIP) wordt veroorzaakt door het Feline Corona Virus (FCoV), een veelvoorkomend virus bij katten met een prevalentie van 10 tot 80 procent, afhankelijk van de leefomstandigheden van de kat. FCoV veroorzaakt zelf meestal geen verschijnselen. Ongeveer 1 tot 12 procent van de katten die geïnfecteerd is met FCoV, ontwikkelt FIP, door één of meerdere mutaties in het coronavirus. Of een FcoV-infectie muteert tot FIP, is onder andere afhankelijk van het virus, de infectiedruk en de immuunrespons van de kat

The Use of Exogenous Melatonin in Delayed Sleep Phase Disorder: a Meta-analysis

Study Objectives: To perform a meta-analysis of the efficacy and safety of exogenous melatonin in advancing sleep-wake rhythm in patients with delayed sleep phase disorder. Design: Meta analysis of papers indexed for PubMed, Embase, and the abstracts of sleep and chronobiologic societies (1990–2009). Patients: Individuals with delayed sleep phase disorder. Interventions: Administration of melatonin. Measurements and Results: A meta-analysis of data of randomized controlled trials involving individuals with delayed sleep phase disorder that were published in English, compared melatonin with placebo, and reported 1 or more of the following: endogenous melatonin onset, clock hour of sleep onset, wake-up time, sleep-onset latency, and total sleep time. The 5 trials including 91 adults and 4 trials including 226 children showed that melatonin treatment advanced mean endogenous melatonin onset by 1.18 hours (95% confidence interval [CI]: 0.89–1.48 h) and clock hour of sleep onset by 0.67 hours (95% CI: 0.45–0.89 h). Melatonin decreased sleep-onset latency by 23.27 minutes (95% CI: 4.83 –41.72 min). The wake-up time and total sleep time did not change significantly. Conclusions: Melatonin is effective in advancing sleep-wake rhythm and endogenous melatonin rhythm in delayed sleep phase disorder

Keuzemogelijkheden in de farmacotherapie : Stappenplan leidt dierenarts tot alternatief

Het is soms moeilijk de juiste diergeneesmiddelen te vinden voor kat of hond, papegaai, duif of parkiet. Via de cascade kunnen dierenartsen toch ver komen, bijvoorbeeld door gebruik van humane geneesmiddelen