The present study evaluated a probiotic and a competitive exclusion product injected in ovo on day 18 of incubation together with Marek's disease vaccine in eggs of 56-week-old broiler breeders. Three experiments were carried out. The first trial evaluated the effect of treatments on hatchability, cecal colonization of Salmonella Heidelberg (SH), and intestinal mucosa immunity (immunoglobulin A levels in the intestinal fluid). The second trial evaluated the viability of the microorganisms in the products inoculated in a solution containing diluent and Marek's disease vaccine. The third trial evaluated the colonization of the cecal microbiota in non-challenged chickens during first four days of life by culturing cecal samples under aerobic and anaerobic conditions. Hatchability was not affected by the treatments. SH cecal counts were reduced in three-day-old broilers inoculated in ovo with the competitive exclusion product. Liver and spleen pool SH counts were not different among treatments. Broilers inoculated in ovo presented higher intestinal IgA titers 24 hours after SH challenge compared with the controls. When birds were not challenged, lower cecal microbial counts in aerobic culture were determined in the control group than in the probiotic group on day 3, and in the competitive exclusion group on day 2 when cultured in anaerobiosis. The products inoculated and diluted in the vaccine solution were viable at all analyzed periods when cultured in anaerobiosis. The results of this study suggest in-ovo inoculation is an effective route for the administration of the evaluated products, which effectively enhanced the broilers' immune response to a SH challenge, as shown by the increase in IgA titers, and the reduction in cecal Salmonella Heidelberg colonization with the inovo inoculation with the competitive exclusion product.
alcohol. 1 With a total of ten cases reported in literature by now, we considered relevant to report another case we recently came across.A 55-year-old woman with 3-year history of cryptogenic cirrhosis was admitted to our Dermatology service because of the appearance of abdominal pruriginous lesions for the past 2 months. Clinical examination revealed yellowish confluent weals affecting her abdomen and flanks (Figs 1 and 2). Blood tests revealed hyperbilirubinemia. She was diagnosed with idiopathic yellow urticaria and was given antihistamines with clearance of the rash and symptoms, without scarring.The cause of yellow urticaria remains unknown, but it is suggested to be the result of increased blood vessels permeability due to capillary vasodilation, as described in common urticaria, and accumulation of excessive bilirubin into the surrounding dermis, responsible of the yellow colour of the skin. 2 The oedema fluid associated with urticaria in patients with jaundice may appear yellow because of hyperbilirubinemia. 3 Most reported cases were related to chronic hepatic dysfunction (endstage liver disease, metastatic disease of breast and colon, hepatic cirrhosis associated with alcohol, virus, haemochromatosis). 1,[3][4][5][6][7][8] Only one case was related to cholestasis in a patient with acute hepatic dysfunction due to haemorrhagic shock. 2 Liver dysfunction is characterized by a decrease in the capacity to conjugate bilirubin, with several other problems as dyscrasia. This impairs the normal process of excretion of bilirubin, with consequent bilirubin crystal deposition in tissues. 5 The jaundice may persist for several days, despite a normalized bilirubin, due to its affinity for elastin. 5 The diagnosis is clinical and does not require histopathological examination. Nevertheless, some of the reported cases demonstrated mild dermic oedema and perivascular inflammatory infiltrate composed of lymphocytes, neutrophils and eosinophils. 3,5 Dermic deposition of bilirubin crystals was demonstrated in one case. 3 Treatment is the same of acute urticaria and includes antihistamines and steroids. 1 Although yellow urticaria is an exceptional event, we can assert that it could be the only scenario in which aetiology of urticaria can be intuited on the basis of the clinical morphology.
Background Anti-TNF therapy represented a landmark in medical treatment of ulcerative colitis (UC). There is lack of data on the efficacy and safety of these agents in Brazilian patients, as public reimbursement is relatively recent. The present study aimed to analyze rates of clinical and endoscopic remission comparatively, between adalimumab (ADA) and infliximab (IFX), in Brazilian UC patients, and evaluate possible factors associated with remission after 1 year of treatment. Methods A national retrospective multicenter study (24 centers) was carried out including patients with moderate-to-severe UC treated with anti-TNF therapy. Disease activity was categorized using Mayo score at baseline, weeks 8, 26 and 52. Clinical remission was defined as a partial Mayo score ≤ 2. Endoscopic remission was defined as a Mayo endoscopic subscore ≤ 1. Patients were allocated in 2 groups (ADA and IFX) and a comparative efficacy study was performed. Statistical analysis: logistic regression model was used to study effects of predictor variables on categorical outcomes, such as presence or absence of remission at week 52. Statistical significance was assumed if p <0.05. Results Overall, 393 patients were included (111 ADA and 282 IFX). The mean age was 41.86 ± 13.60 y, 61.58% women, most patients had extensive colitis (62.40%) and 19.39% previous exposure to biological agent. Overall, clinical remission rate was 66.78%, 71.62% and 82.82% at weeks 8, 26 and 52, respectively. Remission rates were higher in the IFX group at weeks 26 (75.12% vs. 62.65 %, p <0.0001) and 52 (65.24% vs. 51.35%, p <0.0001) – figure 1. Overall, endoscopic remission was observed in 50% of patients at week 26 and in 65.98% at week 52, with no difference between the two groups (p = 0.114). Colectomy was performed in 23 patients (5.99%). The variables associated with clinical remission after 1 year of treatment were age, non-prior exposure to biological therapy, use of IFX, endoscopic remission at week 26 and no need for optimization (table 1). The variables associated with endoscopic remission after 1 year were non-prior exposure to biological therapy, clinical and endoscopic remission at week 26 and no need for optimization. Conclusion In this national multicentric study, overall efficacy of anti-TNF therapy was similar to real world data with IFX and ADA. IFX treatment was associated with higher rates of clinical remission after 1 year in comparison to ADA. Patients naive to biological therapy presented higher rates of clinical and endoscopic remission. This is the first real world national study analyzing efficacy of anti-TNF agents in UC in Brazil.
Cost Effectiveness Ratios (ICERs) was -48,469 USD per QALY gained. ConClusions: Study results showed that due to difference between Infliximab and Adalimumab medications` prices, Adalimumab is the dominant alternative in Islamic Republic of Iran, considering its threshold which is about 3,700 USD. Hence it is recommended that Adalimumab to be administered as the first choice of biologic therapy which is controversial to current approach of /most Iranian gastroenterologists.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.