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Rozzano, Italy

Rinaldi F.,University of Pavia | De Silvestri A.,Biometry Unit | Tamarozzi F.,University of Pavia | Cattaneo F.,University of Pavia | And 2 more authors.
BMC Infectious Diseases | Year: 2014

Background: Available treatments for uncomplicated hepatic cystic echinococcosis (CE) include surgery, medical therapy with albendazole (ABZ), percutaneous interventions and the watch-and-wait (WW) approach. Current guidelines indicate that patients with hepatic CE should be assigned to each option based on cyst stage and size, and patient characteristics. However, treatment indications for transitional CE3b cysts are still uncertain. These cysts are the least responsive to non-surgical treatment and often present as indolent, asymptomatic lesions that may not warrant surgery unless complicated. Evidence supporting indications for treatment of this stage is lacking. In the attempt to fill this gap before the implementation of randomized clinical trials, we compared the clinical behavior of single hepatic CE3b cysts in 60 patients followed at the WHO Collaborating Centre for Cystic Echinococcosis of the University of Pavia.Methods: We analyzed retrospectively data of 60 patients with hepatic CE3b cysts seen at our clinic over 27 years, who either received ABZ or were monitored with WW. Univariate and multivariate analysis were performed to investigate the effect on outcome (inactivation or relapse) of variables such as age, sex, origin, treatment, cyst size and presence of other echinococcal hepatic cysts using a multiple failure Cox proportional hazard model.Results: ABZ treatment was positively associated with inactivation (p < 0.001), but this was not permanent, and no association was found between therapeutic approach and relapse (p = 0.091). No difference was found in the rate of complications between groups.Conclusions: In conclusion, our study shows that ABZ treatment induces temporary inactivation of CE3b cysts, while during WW cysts remain stable over time. As the rate of adverse events during periods of ABZ treatment and WW did not differ significantly in the follow-up period considered in this study (median 43 months, IQR 10.7-141.5), expectant management might represent a valuable option for asymptomatic CE3b cysts when strict indication for surgery is absent and patients comply with regular long-term follow-up. © 2014 Rinaldi et al.; licensee BioMed Central Ltd.

Strydom P.E.,Animal Production Institute | Frylinck L.,Animal Production Institute | Smith M.F.,Biometry Unit
Animal | Year: 2011

Cattle breeds indigenous to Africa (Sanga) compare favourably to Bos indicus breeds with regard to adaptation to harsh environments. This study compared the meat quality of three Sanga breeds (Nguni, Tuli and Drakensberger), a Sanga-related breed (Bonsmara) and a B. indicus breed (Brahman) and supported these results with biochemical and histological measurements on the M. longissimus lumborum. Twelve young grain-fed steers of each breed were slaughtered and carcasses were electrically stimulated. All Sanga (and related) breeds, with the exception of the Tuli, had lower Warner-Bratzler shear force (SF) values at 2 and 21 days post mortem compared with the BR (P < 0.05). Measurements related to the calcium-dependent protease system and myofibrillar fragmentation explained the bulk of the variation among breeds, whereas variation in fibre type, sarcomere length and connective tissue properties gave less convincing support. With the exception of the Tuli, Sanga and Sanga-related breeds produced more tender (according to SF) meat than BR, mainly due to favourable calpain-to-calpastatin ratios. Small differences in colour, drip loss and cooking properties were found among breeds (P < 0.05). © The Animal Consortium 2011.

Thiart C.,University of Cape Town | Ngwenya M.Z.,Biometry Unit | Haines L.M.,University of Cape Town
Journal of the Southern African Institute of Mining and Metallurgy | Year: 2014

Kriging is an interpolation technique for predicting unobserved responses at target locations from observed responses at specified locations. Kriging predictors are best linear unbiased predictors (BLUPs) and the precision of the BLUP is assessed by the mean square prediction error (MSPE), commonly known as the kriging variance. Both the BLUP and the MSPE depend on the covariance function describing the spatial correlation between locations and on specific parameters. The parameters are usually treated as known, whereas in practice they invariably have to be estimated and the empirical BLUP (that is, the EBLUP) so obtained. The empirical or estimated mean square prediction error (EMSPE), or the so called 'plug-in' kriging variance estimator, underestimates the true kriging variance of the EBLUP, at least in general. In this paper five estimators for the kriging variance of the EBLUP are considered and compared by means of a simulation study in which a Gaussian distribution for the responses, an exponential structure for the covariance function, and three levels of spatial correlation - weak, moderate, and strong - are adopted. The Prasad-Rao estimator obtained using restricted or residual maximum likelihood (REML) is recommended for moderate and strong spatial correlation and the Kacker-Harville estimator for weak correlation in the random fields. © The Southern African Institute of Mining and Metallurgy, 2014.

Krecek R.C.,Ross University School of Medicine | Krecek R.C.,University of Johannesburg | Mohammed H.,University of Trinidad and Tobago | Michael L.M.,Bayer Pty Ltd | And 5 more authors.
PLoS ONE | Year: 2012

There is a high prevalence of Taenia solium taeniosis/cysticercosis in humans and pigs in the Eastern Cape Province (ECP) of South Africa. The objective of this study was to identify risk factors of porcine cysticercosis in select districts of the ECP. Data were collected in 2003 by interviewing 217 pig producers from the area. Blood samples were collected from 261 of their pigs, which were tested using two enzyme-linked immunosorbent assays (ELISA) for the presence of antibodies to cysticercosis. Frequencies of both owner- and pig-level characteristics were determined. For pig-level analysis, all bivariable and multivariable associations were determined using the surveylogistic procedure of the SAS/STAT® software to accommodate for the intraclass correlation that exists for clusters of pigs within one owner and for clusters of owners within a district. All tests for significance were performed at the α = 0.05 level, and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were determined. Among the respondents, 48% of their households lacked a latrine, 98% slaughtered pigs at home, and 99% indicated that meat inspection services were not available. On bivariable analysis, there was a significant association between porcine infection and district (p = 0.003), breed (p = 0.041) and the absence of a latrine (p = 0.006). On multivariable analysis, the absence of a latrine was the only variable significantly associated with porcine infection (aOR = 1.89; 95% CI = 1.07, 3.35) (p = 0.028). The increased odds of porcine infection with households lacking a latrine contributes to our understanding of the transmission of this parasite in the ECP. Determining and addressing the risk factors for T. solium infection can potentially lower the very high prevalence in humans and pigs in this endemic area. © 2012 Krecek et al.

Levi Setti P.E.,University of Milan | Levi Setti P.E.,Yale University | Albani E.,University of Milan | Matteo M.,University of Foggia | And 5 more authors.
Human Reproduction | Year: 2013

Study Question Was the delivery rate of ART cycles negatively affected by the enactment of the Law 40/2004 by the Italian Parliament which imposed a long list of restrictions for ART procedures? Summary Answer This large and extensive comparative analysis of ART outcomes prior to and after the introduction of the Law 40 revealed a significant reduction in pregnancy and delivery rates per cycle, independent of age or other clinical variables, once the law went into effect. What is Known AlreadySeveral studies have been published on the effect of Law 40/2004 on ART outcomes, some authors demonstrating a negative impact of the Law in relation to specific etiologies of infertility, other authors showing opposite Conclusions . Study Design , Size, DurationRetrospective clinical study of 3808 patients treated prior to the enactment of the Law, September 1996-March 2004 (Group I) and 6898 treated during the Law, March 2004-May 2009 (Group II). Participants/Materials, Setting , Method SA total of 10 706 ART cycles were analysed, 3808 performed before and 6898 after the application of the Law. An intention-to-treat statistical analysis was performed to detect pregnancy and delivery rates (pregnancies ≥24 weeks) per started cycle. A P value of <0.05 was considered statistically significant. We analysed different outcomes: differences in fertilization, pregnancy and delivery rate, multiple pregnancies and miscarriage rates between the two time periods. Main Results and the Role of Chance The delivery rate for started cycle was 20% before and 16.0% after the introduction of the Law representing a 25% reduction (P < 0.001). The multivariate analysis, corrected by female age of >38 years, duration of infertility, basal FSH level and number of retrieved oocytes, showed a 16% lower delivery rate (odds ratio: 0.84; confidence interval: 0.75-0.94). This statistical approach removed the risk that the observed effects were due to chance and confirmed unequivocally that the Law was an independent factor responsible for the reduced likelihood of a successful outcome. Limitations , Reasons for Caution This is a retrospective study. A prospective randomized study, with patients treated in the same time period and randomized to restrictions or not, would have minimized potential Limitations due to differences in years of treatments. Wider Implications of the FindingsOur findings based on the analysis of such a large number of cycles proved clearly and unequivocally that imposing restrictions on the practice of ART penalized patients. These data represent a relevant clinical contribution for countries still debating the enactment of restrictive Limitations of ART. Study Funding/Competing Interest This investigation has been supported by a finalized grant from Lombardy County, Italy (DGR 7255, 3 July 2008). © 2012 The Author.

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