A multifaceted risk model of brucellosis at the human–animal interface in Egypt

Brucellosis is a highly contagious zoonosis affecting humans and a wide range of domesticated and wild animal species. An important element for effective disease containment is to improve knowledge, attitudes and practices (KAP) of afflicted communities. This study aimed to assess the KAP related to brucellosis at the human–animal interface in an endemic area of Egypt and to identify the risk factors for human infection. A matched case–control study was conducted at the central fever hospitals located in six governorates in northern Egypt. Face‐to‐face interviews with cases and controls were conducted using a structured questionnaire. In total, 40.7% of the participants owned farm animals in their households. The overall mean practice score regarding animal husbandry, processing and consumption of milk and dairy products were significantly lower among cases compared with controls (−12.7 ± 18.1 vs. 0.68 ± 14.2, respectively; p < .001). Perceived barriers for notification of animal infection/abortion were predominate among cases and positively correlated with participants’ education. The predictors of having brucellosis infection were consumption of unpasteurized milk or raw dairy products and practicing animal husbandry. Applying protective measures against infection significantly reduced its risk. A model predicting risk factors for brucellosis among those who own animal showed that frequent abortions per animal increased the chance for brucellosis infection among human cases by 50‐fold (95% CI: 8.8–276.9), whereas the use of protective measures in animal care reduced the odds (OR = 0.11 [95% CI: 0.03–0.45]). In conclusion, consumption of unprocessed dairy products was equally important as contact with infected/aborted animals as major risk factors for Brucella spp. infection among humans in Egypt. There is poor knowledge, negative attitudes and risky behaviours among villagers which can perpetuate the risk of brucellosis transmission at the human–animal interface. This supports the need for integrating health education into the national brucellosis control programme.     

Seroprevalence of brucellosis in goats and sheep in Thailand: Results from the Thai National Brucellosis Surveillance System from 2013 to 2015

In Thailand, brucellosis re‐emerged in humans in 2003 and is considered a public health risk to goat farmers as the disease is endemic in small ruminants. The Thai Department of Livestock Development (DLD ) established a nationwide surveillance system for brucellosis in goats and sheep in 1997. Using data from this surveillance system, we describe the seroprevalence of brucellosis from 2013 to 2015 in small ruminants and the spatial distribution of the disease throughout Thailand. Surveillance data collected included the number of animals and herds tested, the province of the animal and herd and the laboratory results. Seroprevalence was estimated at both the animal and herd levels. During the 3‐year period, 443,561 goats and sheep were tested for brucellosis by the DLD throughout Thailand using the Rose Bengal Plate Test (RBPT ) and the enzyme‐linked immunosorbent assay test for Brucella . Among the 3 years, 2013 had the highest proportion of herds that tested positive for brucellosis at 13.80% (95% CI, 12.52, 15.16). Overall, this study found that brucellosis seroprevalence in small ruminants is decreasing throughout Thailand. However, there is variability in the spread of the disease with provinces in the eastern and western regions of Thailand having higher proportions of animals and herds testing positive. Overall provinces in the south had the lowest proportion of animals and herds testing positive for brucellosis. Periodic review of surveillance data documents the impact of the current brucellosis control programme and supports a targeted response in higher prevalence regions when there are limited financial resources for control measures.     

Seroprevalence of Rift valley fever in South African domestic and wild suids (1999–2016)

Rift valley fever (RVF) is a vector‐borne viral disease of domestic ruminants, camels and man, characterized by widespread abortions and neonatal deaths in animals, and flu‐like symptoms, which can progress to hepatitis and encephalitis in humans. The disease is endemic in Africa, Saudi Arabia and Yemen, and outbreaks occur after periods of high rainfall, or in environments supporting the proliferation of RVF virus (RVFV)‐infected mosquito vectors. The domestic and wild animal maintenance hosts of RVFV, which may serve as sources of virus during inter‐epidemic periods (IEPs) and contribute to occurrence of sporadic outbreaks, remain unknown, although reports indicate that the African buffalo (Syncerus caffer) may play a role. Due to the close proximity of the habitats of domestic pigs and warthogs to those of known domestic and wild ruminant RVFV maintenance hosts respectively, our study investigated their possible role in the epidemiology of RVF in South Africa by evaluating RVFV exposure and seroconversion in suids. A total of 107 warthog and 3,984 domestic pig sera from 2 and all 9 provinces of South Africa, respectively, were screened for presence of RVFV neutralizing antibodies using the virus neutralization test (VNT). Sero‐positivity rates of 1.87% (95% CI: 0.01%–6.9%) and 0.68% (95% CI: 0.49%–1.04%) were observed for warthogs and domestic pigs, respectively, but true prevalence rates, taking test sensitivity and specificity into account, were lower for both groups. There was a strong association between the results of the two groups (χ² = 0.75, p = .38), and differences in prevalence between the epidemic and IEPs were non‐significant for all suid samples tested (p > .05). This study, which provides the first evidence of probable exposure and infection of South African domestic pigs and warthogs to RVFV, indicates that further investigations are warranted, to fully clarify the role of suids in the epidemiology of RVF.     

Bovine Brucellosis in Argentina and Bordering Countries: Update

Bovine brucellosis is a zoonotic disease spread worldwide. The infection in cattle is predominantly caused by Brucella abortus and is usually detected in pregnant females through abortions. The disease is endemic in Argentina; however, infection in humans is underestimated and often not reported. The prevalence of bovine brucellosis in countries bordering Argentina is quite variable: 0.04% in Uruguay, 10.20% in the north and 0.06% in the south of Brazil, 0.2% in Chile, 3.15% in Paraguay and 2.27% in Bolivia. In 1999, the Argentine National Control and Eradication Program was implemented. Its strategies include identification of vaccinated animals, compulsory vaccination with B. abortus S19 of 100% of 3‐ to 8‐month‐old females, negative serological tests before animal movements and categorization of farms in terms of their brucellosis status. The epidemiological surveillance in milk is performed through the milk ring test and the indirect ELISA. The result of a national brucellosis survey performed in 2004 indicates that 12.4% (95% CI: 10.89–14.0) of Argentine beef farms are seropositive to Brucella and that the apparent prevalence in cattle is 2.10% (95% CI: 1.90–2.40). The official serological diagnostic tests are as follows: buffered plate antigen test, as screening, serum agglutination test, 2‐mercaptoethanol and fluorescence polarization assay, competitive ELISA, as confirmatory tests, and complement fixation test, as definitive test. Santa Fe and a district in Córdoba have ‘Outstanding Plans’. Tierra del Fuego is a ‘Zone free from bovine brucellosis’. One question arising when studying the Argentine situation is why the disease remains endemic if good regulations exist to control and eradicate it. In future, some different aspects might be evaluated to understand it, and further studies should be performed to prioritize, select and refine control strategies.     

Short Report: Identification of a Potential Marker of Anaplasma Phagocytophilum Associated with Cattle Abortion

Anaplasma phagocytophilum is a tick‐borne pathogen that causes tick‐borne fever in domestic ruminants. Tick‐borne fever is characterized by diverse symptoms and occasionally causes abortions in domestic ruminants, resulting in significant economic impact. However, in France, the potential frequency of A. phagocytophilum‐related abortions is unknown, and thus, it remains difficult to estimate the full extent of its economic impact. This gap in our knowledge is likely explained, at least in part, by the absence of suitable and specific tools capable of detecting A. phagocytophilum associated with abortion. Our objective was to identify a genetic marker able to differentiate A. phagocytophilum strains isolated from domestic ruminants that had aborted compared to those that had not. Thus, we typed a total of 123 A. phagocytophilum obtained from cattle, of which 25 originated from cows that had aborted, via multiple‐locus variable‐number tandem repeat (VNTR) analysis. These included 56 new A. phagocytophilum samples and 67 previously published A. phagocytophilum samples. A multivariate logistic model demonstrated that the triple‐repeat allele of the APV‐A VNTR was statistically more frequent in A. phagocytophilum from cattle that had aborted, compared to A. phagocytophilum from cattle that had not aborted (P = 0.03), while controlling for any regional effects (P < 0.0001). For four other VNTR, there were no statistical associations between specific alleles and abortion. The APV‐A triple‐repeat VNTR allele could thus act as a marker of A. phagocytophilum involved in abortions. If this hypothesis is confirmed in additional samples from other regions, this marker could then be utilized in the development of A. phagocytophilum abortive strain surveillance measures.     

Association between human papillomavirus infection and sperm quality: A systematic review and a meta-analysis

Human papillomavirus (HPV) has a high incidence rate in both males and females. HPV infection in women has been shown to affect fertility and lead to foetal death and pregnancy loss. However, research on HPV infection in men is limited. The aim of this study was to study the effect of HPV infection in semen on sperm quality and present the findings of previous studies through a meta-analysis. Databases including PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, WanFang data and China National Knowledge Infrastructure were searched for relevant studies. A systematic review and meta-analysis were performed, and 17 studies were included for analyses based on a set criterion. Meta-analyses indicated that HPV infection in semen significantly reduced sperm concentration (SMD = −0.12, 95% CI: −0.21 to −0.03, p = .009), sperm motility (SMD = −0.55, 95% CI: −0.780 to −0.33, p = .000), sperm viability (SMD = −0.55, 95% CI: −0.780 to −0.33, p = .000) and sperm morphology (SMD = −0.34, 95% CI: −0.61 to −0.07, p = .015). The high-risk HPV (HrHPV) infection could significantly reduce sperm count (SMD = −0.65, 95% CI: −1.11 to −0.18, p = .007) compared with high-risk HPV (LrHPV) infection. In conclusion, HPV infection in semen significantly reduced sperm quality, and the HrHPV infection could significantly reduce sperm count compared with LrHPV.     

Bluetongue Serotype 2 and 9 Modified Live Vaccine Viruses as Causative Agents of Abortion in Livestock: A Retrospective Analysis in Italy

The recent outbreak caused by Schmallenberg virus, which affected sheep, goats and cattle in Europe, highlighted the importance of having a robust surveillance plan capable of monitoring abortions and malformations in the livestock offspring. In this context, bluetongue viruses (BTVs) represented and represent one of the major threats to the European livestock industry. Aiming to improve the understanding on BTV cross placental transmission and serotype involvement, in this retrospective study foetal spleens and/or brains of 663 ovines, 429 bovines, 155 goats and 17 buffaloes were tested for the presence of BTV by virus isolation. BTV vaccine strains were isolated from 31 foetuses (2.4%; 95% CI: 1.7–3.4%): 24 (3.6%; 95% CI: 2.4–5.3%) from ovine foetal tissues; 6 (1.4%; 95% CI: 0.6–3.0%) from bovine foetal tissues and 1 (0.6%; 95% CI: 0.2–3.5%) from the spleen of a caprine foetus. All foetuses were from animals vaccinated with either BTV‐2 or BTV‐2, and BTV‐9 modified live vaccines (MLVs) produced by Onderstepoort Biological Products (OBP), South Africa. Among the 31 isolated vaccine strains, serotype 9 (n = 28) was more frequently isolated (P < 0.05) than serotype 2 (n = 3). In two cases infectious vaccine strains were found in the foetal tissues 2 months after the vaccine administration. Other pathogens known to be causative agents of abortion in ruminants were not detected nor isolated. This study demonstrates, for the first time, that BTV‐2 and BTV‐9 vaccine strains are able to cross the placental barrier of sheep, cattle and goats. BTV‐2 and BTV‐9 vaccine strains are able to infect foetuses and cause abortions or malformations depending on the period of pregnancy at the time of vaccination.     

Temporal Analysis and Costs of Ruminant Brucellosis Control Programme in Egypt Between 1999 and 2011

Data for the prevalence of brucellosis in ruminants in Egypt are scarce; recent studies suggest the disease is endemic, with a high prevalence. The aim of this study was to assess the financial costs and the impact of the current control programme on the pattern of brucellosis among ruminants between 1999 and 2011. A univariate binary logistic regression model was used to compare between seropositive proportions for different years for each species. The proportion of seropositive cattle was significantly increased from 2000 to 2004 then significantly decreased from 2005 to 2011. The proportion of seropositive buffalo fluctuated year to year; however, there was a significant increase in 2008 (OR 3.13, 95% CI 2.69–3.66, P < 0.001). There was a decrease in the proportion of seropositive sheep during the study period except in 2001 and 2009 in which there was a significant increase. The proportion of seropositive goats increased in 2000 and 2001, and then decreased from 2002 to 2007. In 2008, there was a significant increase in the seropositive proportion of goats (OR 2.53, 95% CI 2.21–2.90, P < 0.001). The average annual cost for the control programme including testing and compensation was more than US$3 million. The total cost for the control programme including testing and compensation for the period (13 years) between 1999 and 2011 was more than US$40 million, from which more than 56% for cattle. Further studies are required for the effectiveness of the current control strategies and alternative strategies should be considered. The socio‐economic impact of brucellosis and its control measures should be investigated.     

The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS)

Summary  In the first population-based study of vertebral fractures in Latin America, we found a 11.18 (95% CI 9.23–13.4) prevalence of radiographically ascertained vertebral fractures in a random sample of 1,922 women from cities within five different countries. These figures are similar to findings from studies in Beijing, China, some regions of Europe, and slightly lower than those found in the USA using the same standardized methodology. Introduction  We report the first study of radiographic vertebral fractures in Latin America. Methods  An age-stratified random sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico were included. In all cases a standardized questionnaire and lateral X-rays of the lumbar and thoracic spine were obtained after informed consent. Results  A standardized prevalence of 11.18 (95% CI 9.23–13.4) was found. The prevalence was similar in all five countries, increasing from 6.9% (95% CI 4.6–9.1) in women aged 50–59 years to 27.8% (95% CI 23.1–32.4) in those 80 years and older (p for trend < 0.001). Among different risk factors, self-reported height loss OR = 1.63 (95% CI: 1.18–2.25), and previous history of fracture OR = 1.52 (95% CI: 1.14–2.03) were significantly (p < 0.003 and p < 0.04 respectably) associated with the presence of radiographic vertebral fractures in the multivariate analysis. In the bivariate analyses HRT was associated with a 35% lower risk OR = 0.65 (95% CI: 0.46–0.93) and physical activity with a 27% lower risk of having a vertebral fracture OR = 0.73 (95% CI: 0.55–0.98), but were not statistically significant in multivariate analyses Conclusion  We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.     

Neutralizing antibodies against Rift Valley fever virus in wild antelope in far northern KwaZulu‐Natal,South Africa,indicate recent virus circulation

Rift Valley fever (RVF) is a zoonotic viral disease of domestic ruminants in Africa and the Arabian Peninsula caused by a mosquito‐borne Phlebovirus. Outbreaks in livestock and humans occur after heavy rains favour breeding of vectors, and the virus is thought to survive dry seasons in the eggs of floodwater‐breeding aedine mosquitoes. We recently found high seroconversion rates to RVF virus (RVFV) in cattle and goats, in the absence of outbreaks, in far northern KwaZulu‐Natal (KZN), South Africa. Here, we report the prevalence of, and factors associated with, neutralizing antibodies to RVFV in 326 sera collected opportunistically from nyala (Tragelaphus angasii) and impala (Aepyceros melampus) culled during 2016–2018 in two nature reserves in the same area. The overall seroprevalence of RVFV, determined using the serum neutralization test, was 35.0% (114/326; 95%CI: 29.8%–40.4%) and tended to be higher in Ndumo Game Reserve (11/20; 55.0%; 95%CI: 31.5%–76.9%) than in Tembe Elephant Park (103/306; 33.6%; 95%CI: 28.4%–39.3%) (p = .087). The presence of antibodies in juveniles (6/21; 28.6%; 95%CI: 11.3%–52.2%) and sub‐adults (13/65; 20.0%; 95%CI: 11.1%–37.8%) confirmed that infections had occurred at least until 2016, well after the 2008–2011 RVF outbreaks in South Africa. Odds of seropositivity was higher in adults than in sub‐adults (OR = 3.98; 95%CI: 1.83–8.67; p = .001), in males than in females (OR = 2.66; 95%CI: 1.51–4.68; p = .001) and in animals collected ≤2 km from a swamp or floodplain compared with those collected further away (OR = 3.30; 95%CI: 1.70–6.38; p < .001). Under similar ecological conditions, domestic and wild ruminants may play a similar role in maintenance of RVFV circulation and either or both may serve as the mammalian host in a vector–host reservoir system. The study confirms the recent circulation of RVFV in the tropical coastal plain of northern KZN, providing the basis for investigation of factors affecting virus circulation and the role of wildlife in RVF epidemiology.     

Does perceived risk predict breast cancer screening use? Findings from a prospective cohort study of female relatives from the Ontario site of the Breast Cancer Family Registry

While the relationship between perceived risk and breast cancer screening use has been studied extensively, most studies are cross-sectional. We prospectively examined this relationship among 913 women, aged 25–72 with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression. Overall, perceived risk did not predict subsequent use of mammography, CBE or genetic testing. Among women at moderate/high familial risk, those reporting a perceived risk greater than 50% were significantly less likely to have a CBE (odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.30–0.91, p = 0.04), and non-significantly less likely to have a mammogram (OR = 0.70, 95% CI: 0.40–1.20, p = 0.70) or genetic test (OR = 0.61, 95% CI: 0.34–1.10, p = 0.09) compared to women reporting a perceived risk of 50%. In contrast, among women at low familial risk, those reporting a perceived risk greater than 50% were non-significantly more likely to have a mammogram (OR = 1.13, 95% CI: 0.59–2.16, p = 0.78), CBE (OR = 1.11, 95% CI: 0.63–1.95, p = 0.74) or genetic test (OR = 1.29, 95% CI: 0.50–3.33, p = 0.35) compared to women reporting a perceived risk of 50%. Perceived risk did not significantly predict screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies for women with varying levels of familial breast cancer risk.     

The association between personal habits and bladder cancer in Turkey

Aims  In this study, we analyzed the effect of Turkish coffee and black tea consumption, alcohol intake and smoking on bladder cancer. Methods  A total of 164 patients with bladder tumors and 324 individuals without primary tumors were included in the study. The habits of coffee and tea consumption, alcohol intake and smoking were queried. Results  No association was found between bladder cancer and drinking coffee (p = 0.89) and tea (p = 0.37), but alcohol intake was found to be associated, with an odds ratio (OR) of 1.85 (95% CI 1.15–2.96; p = 0.009). While there was a relationship between bladder cancer and smoking and quitting smoking (OR: 4.84 [95% CI 2.93–8.00; p < 0.001] and OR: 4.10 [95% CI 2.41–6.97; p < 0.001] respectively), the associations between bladder cancer and smoking and quitting smoking were similar (OR: 1.18, 95% CI 0.74–1.86; p = 0.477). Smoking <10 cigarettes a day created an OR of 2.14 (95% CI 1.11–4.12; p < 0.001); 10–20 cigarettes an OR of 4.50 (95% CI 2.74–7.37; p < 0.001); >20 cigarettes an OR of 14.85 (95% CI 6.83–32.27; p < 0.001); smoking by inhaling the smoke an OR of 4.72 (95% CI 2.94–7.59; p < 0.001), and smoking by not inhaling the smoke an OR of 3.34 (95% CI 1.75–6.38; p < 0.001). The associations between bladder cancer and inhaling smoke and not inhaling smoke were similar (OR: 1.41, 95% CI 0.85–2.48; p = 0.228). Conclusion  We found that smoking and alcohol consumption are closely connected with bladder cancer. Our data showed that not inhaling the smoke was as much associated with bladder cancer as inhaling the smoke. The association between smoking and bladder cancer lasts after quitting smoking.     

Potential Adverse Effect of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) on Bisphosphonate Efficacy: An Exploratory Post Hoc Analysis From a Randomized Controlled Trial of Clodronate

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to have weak but beneficial effects on bone health, including fracture risk, but many epidemiological studies are likely confounded. We explored the relationship between NSAIDs and fracture risk in a post hoc analysis of a well-documented, randomized, placebo-controlled study of the bisphosphonate, clodronate, in which treatment reduced osteoporotic fracture risk by 23%. Concurrent medication use at baseline was used to identify those prescribed oral NSAIDs. Only verified, incident fractures were included in the analysis. A total of 1082 (20.8%) women reported use of NSAIDs at baseline. They were slightly, but significantly, younger (mean 79 versus 80 years, p = 0.004), heavier (mean 66.7 versus 64.7 kg, p < 0.001) than nonusers, with slightly higher femoral neck bone mineral density (FN-BMD, 0.66 versus 0.64 g/cm², p < 0.001). In an adjusted model, NSAID use was associated with a significant increase in osteoporotic fracture risk over the 3-year study period (hazard ratio [HR] 1.27; 95% confidence interval [CI], 1.01–1.62; p = 0.039). However, this increase in risk was not statistically significant in the placebo group (HR 1.11; 95% CI, 0.81–1.52). In women receiving clodronate, the effect of the bisphosphonate to reduce osteoporotic fracture risk was not observed in those receiving NSAIDs (HR 0.95; 95% CI, 0.65–1.41; p = 0.81) in contrast to those not using NSAIDs (HR 0.71; 95% CI, 0.58–0.89; p = 0.002). In a subset with hip BMD repeated at 3 years, BMD loss during clodronate therapy was greater in those women receiving NSAIDs than in nonusers (eg, total hip −2.75% versus −1.27%, p = 0.078; femoral neck −3.06% versus −1.12%, p = 0.028), and was not significantly different from that observed in women receiving placebo. The efficacy of the bisphosphonate, clodronate, to reduce fracture risk was largely negated in those receiving NSAIDs. Although the mechanism is unclear, this clinically significant observation requires exploration in studies of commonly used bisphosphonates. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).     

Hypertension might be a risk factor for erectile dysfunction: a meta‐analysis

The study aimed to evaluate whether hypertension was a risk factor for erectile dysfunction (ED). Databases including PubMed and Embase were retrieved to identify studies related to hypertension in ED patients. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect size. Subgroup analyses stratified by total number of enrolled subjects and research regions were performed. Sensitivity analysis was performed by removing a single study at one time. Egger's test was used to evaluate the publication bias. Totally, 40 studies including 121,641 subjects were included in the meta‐analysis. As a result, hypertension was closely related to ED (OR = 1.74, 95% CI, 0.63–0.80, p < .01). Subgroup analysis indicated hypertension was the risk factor for ED whatever the participants numbers. When stratified by different regions, hypertension was a risk factor for ED in Africa (OR = 3.35, 95% CI, 1.45–7.77, p < .01), Americas (OR = 1.97, 95% CI, 1.68–2.31, p < 0.01), Asia (OR = 1.46, 95% CI, 1.16–1.84, p < .01) and Europe (OR = 1.83, 95% CI, 1.34–2.49, p < .01), but not in Australia. Hypertension may be a potential risk factor for ED.     

Schmallenberg Virus in Belgium: Estimation of Impact in Cattle and Sheep Herds

Schmallenberg virus (SBV) emerged during summer 2011. SBV induced an unspecific syndrome in cattle and congenital signs (abortions, stillbirths and malformations) in domestic ruminants. To study the impact of SBV in Belgium, a phone survey was conducted upon September 2012. Hereto two groups of cattle farmers (A and B) and two groups of sheep farmers (C and D) were randomly selected. Farms from groups A (n = 53) and C (n = 42) received SBV‐positive result at RT‐PCR in the Belgian National Reference Laboratory (NRL). Farms from groups B (n = 29) and D (n = 44) never sent suspected samples to NRL for SBV analysis but were however presumed seropositive for SBV after the survey. Questionnaires related to reproduction parameters and clinical signs observed in newborn and adult animals were designed and addressed to farmers. As calculated on a basis of farmers’ observations, 4% of calves in group A and 0.5% in group B were reported aborted, stillborn or deformed due to SBV in 2011–2012. The impact as observed by sheep farmers was substantially higher with 19% of lambs in group C and 11% in group D that were reported aborted, stillborn or deformed due to SBV in 2011–2012. Interestingly, abortions or stillbirths were not clear consequences of SBV outbreak in cattle farms, and the birth of a deformed animal was an essential condition to suspect SBV presence in cattle and sheep farms. This study contributes to a better knowledge of the impact of the SBV epidemic. The results suggest that SBV impacted Belgian herds mostly by the birth of deformed calves, stillborn lambs and deformed lambs. This work also demonstrates that the birth of a deformed calf or lamb was a trigger for the farmer to suspect the presence of SBV and send samples to NRL for further analyses.     

Breast Reconstruction: Complication Rate and Tissue Expander Type

Background  Limited literature exists regarding complication rates among women undergoing breast reconstruction and the association of these rates with tissue expander types (anatomic, round and Becker). Methods  A historical cohort study investigated all breast reconstructions performed at Hadassah Medical Center for 140 consecutive women. Analyses were performed using both logistic and Poisson regression multivariate methods. Results  At least one major complication occurred in each of the following groups: anatomic (41%), round (20%), and Becker (11.7%) (p = 0.015). Women reconstructed with anatomic expanders were at increased risk for at least one complication (odds ratio [OR], 3.96; 95% confidence interval [CI], 1.18–13.3; p = 0.026) and an average increase of 331% (95% CI, 102–817%; p = 0.0002) in the number of major complications. Conclusion  The results of this study suggest that integrated-valve expanders are associated with more complications than the distant inflation port. The benefits of an anatomic shape may perhaps be better exploited using devices with a distant port.     

Prevalence,concordance and reproductive sequelae after Chlamydia trachomatis infection in Mexican infertile couples

There are few concordance studies on the Chlamydia trachomatis (infection among infertile couples. The objective of this research was to know the prevalence, concordance and reproductive sequelae that couples may develop when both partners show a C. trachomatis infection. A cross-sectional study among 688 infertile couples using the C. trachomatis detection by real-time PCR was performed. The infertility causes were obtained from their medical records. The prevalence of infection was 8.68%. The percentage of concordance was 22.4% (13 couples). A presence of tubal occlusion was only associated with infected-discordant women [RR = 3.46, 95% CI (1.54–7.74), p < .003]. Seminal values were not associated with discordant men. The concordant couples showed association with the infection and tubal occlusion [RR = 3.19, 95% CI (1.09–9.34), p < .05], and oligozoospermia [RR = 12.17, 95% CI (4.29–34.54), p < .001], hypospermia [RR = 14.13, 95% CI (4.78–41.84), p < .001]. An alteration in semen quality was shown particularly in men whose sexual partners show a tubal pathology. This could occur due to a C. trachomatis infection in the testis, which underlines the need to carry out effective and efficient strategies to identify and treat all sexual partners exposed to C. trachomatis.     

Loco‐regional Control After Neo‐adjuvant Chemotherapy and Conservative Treatment for Locally Advanced Breast Cancer Patients

Breast‐conserving treatment (BCT) has been validated for breast cancer patients receiving adjuvant chemotherapy. Our objective was to evaluate the difference in loco‐regional recurrence (LRR) rates between BCT and mastectomy in patients receiving radiation therapy after neo‐adjuvant chemotherapy (NCT). A retrospective data base was used to identify all patients with breast cancer undergoing NCT from 2002 to 2007. Patients with initial metastatic disease were excluded from this analysis. LRR was compared between those undergoing BCT and mastectomy. Individual variables associated with LRR were evaluated. Two hundred eighty‐four patients were included, 111 (39%) underwent BCT and 173 (61%) mastectomy. Almost all patients (99%) in both groups received postoperative radiation. Pathologic complete response was seen in 37 patients, of which 28 underwent BCT (p < 0.001). Patients receiving mastectomy had more invasive lobular carcinoma (p = 0.007) and a higher American Joint Committee on Cancer (AJCC) stage (p < 0.001) at diagnosis than those with BCT. At a median follow‐up of 6.3 years, the loco‐regional control rate was 91% (95% CI: 86–94%). The 10‐year LRR rate was similar in the BCT group (9.2% [95% CI: 4.9–16.7%]) and in the mastectomy group (10.7% [95% CI: 5.9–15.2%]; p = 0.8). Ten‐year overall survival (OS) rates (63% [95% CI: 46–79%] in the BCT group; 60% [95% CI: 47–73%] in the mastectomy group, p = 0.8) were not statistically different between the two patient populations. Multivariate analysis showed that AJCC stage ≥ III (HR: 2.6; 95% CI: 1.2–5.8; p = 0.02), negative PR (HR: 6; 95% CI: 1.2–30.6, p = 0.03), and number of positive lymph nodes ≥3 (HR: 2.5; 95% CI: 1.1–5.9; p = 0.03) were independent predictors of LRR. Ten‐year OS was similar in the BCT and in the mastectomy group (p = 0.1). The rate of LRR was low and did not significantly differ between the BCT and the mastectomy group after NCT. Randomized trials assessing whether mastectomy can be safely omitted in selected breast cancer patients (nonstage III tumors or those which do not require adjuvant hormone suppression) which respond to NCT are required.     

The association between androgen receptor splice variant 7 status and prognosis of metastatic castration-resistant prostate cancer: A systematic review and meta‑analysis

Recent studies have found that metastatic castrated-resistant prostate cancer (mCRPC) with positive androgen receptor splice variant 7 (AR-V7) may have poor prognosis during endocrine or chemotherapy treatment, but the specific mechanism was still unclear. We had finished literature search in March 2019 from PubMed, Web of Science database, and Embase. The final results were presented in this research. The pooled results showed that AR-V7 status predicted pooled PSA-PFS (HR = 4.31, 95% CI: 2.57–7.24, p < .001), rPFS (HR = 2.39, 95% CI: 1.28–4.48, p = .006) and OS (HR = 4.27, 95% CI: 3.22–5.66, p < .001) in mCRPC patients after endocrine or chemotherapy treatment. Subgroup analysis of different treatments revealed that mCRPC patients treated with chemotherapy had significant association between positive AR-V7 and OS (HR = 2.82, 95% CI: 1.72–4.62, p < .001), and also during endocrine therapy (HR = 4.78, 95% CI: 3.33–6.86, p < .001). Our study demonstrated that AR-V7-positive mCRPC patients may have worse prognosis. AR-V7 may be an independent prognostic factor for endocrine therapy or chemotherapy in patients with mCRPC.     

Is Patient-Specific Instrumentation Accurate and Necessary for Open-Wedge High Tibial Osteotomy? A Meta-Analysis

The purpose of this meta-analysis was to identify if patient-specific instrumentation (PSI) could increase the accuracy of the correction in high tibial osteotomy (HTO) and to explore the assessment indices and the necessity of using a PSI in HTO. A systematic search was carried out using online databases. A total of 466 patients were included in 11 papers that matched the inclusion criteria. To evaluate the accuracy of PSI-assisted HTO, the weight bearing line ratio (WBL%), hip-knee-ankle angle (HKA), mechanical medial proximal tibial angle (mMPTA), and posterior tibial slope angle (PTSA) were measured preoperatively and postoperatively and compared to the designed target values. Statistical analysis was performed after strict data extraction with Review Manager (version 5.4). Significant differences were detected in WBL% (MD = −36.41; 95% CI: −42.30 to −30.53; p < 0.00001), HKA (MD = −9.95; 95% CI: –11.65 to –8.25; p < 0.00001), and mMPTA (MD = –8.40; 95% CI:−10.27 to −6.53; p < 0.00001) but not in PTSA (MD = 0.34; 95% CI: −0.59 to 1.27; p = 0.47) between preoperative and postoperative measurements. There was no significant difference between the designed target values and the postoperative correction values of HKA (MD = 0.14; 95% CI: −0.19 to 0.47; p = 0.41) or mMPTA (MD = 0.11; 95% CI −0.34 to 0.55; p = 0.64). The data show that 3D-based planning of PSI for HTO is both accurate and safe. WBL%, HKA, and mMPTA were the optimal evaluation indicators of coronal plane correction. Sagittal correction is best evaluated by the PTSA. The present study reports that PSI is accurate but not necessary in typical HTO.