Abstract P5-18-18: Lapatinib versus trastuzumab, or both, added to preoperative chemotherapy for breast cancer: A meta-analysis of randomized evidence

Purpose: We compared the efficacy and safety of the addition of lapatinib versus trastuzumab, or the combination, to neoadjuvant chemotherapy in HER2-positive breast cancer.

Methods: Potentially eligible trials were identified through PubMed and Cochrane Library searches and abstracts of major international conferences. The endpoints that we assessed were pathologic complete response (pCR) rate and toxicity. Pooled relative risks (RR) were estimated for each endpoint with fixed or random effects models, depending on between-studies heterogeneity.

Results: Six trials were identified with 1494 eligible patients. The probability to achieve pCR was higher for the trastuzumab plus chemotherapy arm than lapatinib plus chemotherapy (RR 1.25, 95% Confidence Interval (CI): 1.08–1.43; p-value = 0.003) (6 trials; 1494 patients). Furthermore, the probability for pCR was significantly higher in the group given both lapatinib and trastuzumab than in the group given trastuzumab alone (RR 1.39, 95% CI: 1.20–1.63; p-value < 0.001) (4 trials; 779 patients). Diarrhea and dermatologic toxicities were statistically more frequent in patients receiving lapatinib than trastuzumab. The combination was associated with a higher rate of diarrhea than trastuzumab alone. No differences were observed regarding cardiac adverse events among patients receiving trastuzumab, lapatinib, or the combination.

Conclusion: These data support the superiority of a dual-HER2 inhibition for the treatment of HER2-positive breast cancer in the neoadjuvant setting. The direct comparison of trastuzumab and lapatinib demonstrated that lapatinib is inferior in terms of pCR and toxicity.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-18-18.

P3-07-34: Occult Metastasis in Sentinel Node: Should This Affect the Clinical Decision Making? A Systematic Review and Meta-Analysis

Background: The role of occult metastases (micrometastasis or isolated tumor cells [ITC]) in sentinel lymph nodes (SLN) remains a field of debate and speculation. The purpose of this systematic review and meta-analysis was to investigate the prognostic relevance of occult metastases in SLN.

Methods: We searched PubMed, without year or language restriction through June 2011, for studies on patients with invasive breast cancer with micrometastasis or ITC in the SLN and presented Hazard Ratios (HR) on Overall Survival (OS) / Disease-Free Survival (DFS) or enough data for HR-calculation. We used fixed- or random-effects meta-analyses, as appropriate, to calculate pooled estimates of HR. Results: Fifteen studies were considered eligible. Of those, 3 studies were excluded due to the lack of data for HR-calculation. Both the presence of ITC (5 studies; 1264 patients with ITC) and micrometastasis (10 studies; 1093 patients with micrometastasis) were associated with worse DFS (pooled HR 1.29, 95% Confidence Interval [CI]: 1.09−1.52, P-value = 0.002 for ITC, pooled HR 1.45, 95% CI: 1.28−1.64, P-value < 0.001 for micrometastasis). No significant differences were observed regarding OS neither for the presence of ITC (5 studies; 877 patients with ITC; pooled HR 1.20, 95% CI 0.98−1.46) nor for micrometastasis (8 studies; 1094 patients with micrometastasis; pooled HR 1.36, 95% CI: 0.98−1.88).

Conclusion: Based on the current evidence, it seems that the presence of occult metastasis in SLN is of prognostic significance in regard to DFS. However, the clinical significance of this difference is questioned since it cannot be translated into differences in OS. In anticipation of randomized trials aimed to evaluating the optimal management of each category of tumor burden within SLN, current evidence suggest a limited clinical significance of occult metastases in SLN.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-07-34.

Localization of disease-related PrP in Danish patients with different subtypes of prion disease

OBJECTIVE

The transmissible spongiform encephalopathies are characterized by vacuolization, neuronal loss, gliosis and deposition of a misfolded and Proteinase K resistant isoform of the prion protein (PrP(Sc)) in the central nervous system. METHODS MATERIALS AND PATIENTS: Paraffin-embedded tissue blot (PET-blot), immunohistochemistry (IHC) and Western blotting (WB) were combined to study the morphology and localization of disease related PrP in Danish patients with different subtypes of sporadic Creutzfeldt-Jakob disease, familiar Creutzfeldt-Jakob disease and Gerstmann-Sträussler-Scheinker disease.

RESULTS AND CONCLUSION

There was a good morphological and anatomical concordance between what was found with PET-blot and IHC in all patients. In some specific cases, the PET-blot was superior to IHC in sensitivity. To our knowledge, this is the first report where PET-blot analysis is applied to hereditary forms of human transmissible spongiform encephalopathies and compared with sporadic cases of Creutzfeldt-Jakob disease.

Posttherapeutic (131)I SPECT-CT offers high diagnostic accuracy when the findings on conventional planar imaging are inconclusive and allows a tailored patient treatment regimen

PURPOSE

The purpose of this prospective study was to determine the diagnostic impact and influence on patient treatment of posttherapeutic (131)I SPECT-CT when the findings on planar posttherapeutic whole-body scintigraphy (ptWBS) were inconclusive.

MATERIALS AND METHODS

A total of 53 SPECT-CT scans were performed in 41 patients with thyroid cancer after high-dose (131)I therapy (2.944 to 7.526 GBq (131)I) because of diagnostic uncertainty on ptWBS. Physiological uptake in the salivary glands, gastric mucosa, gut, nasal mucosa, urinary tract and liver were considered to be normal. Any other foci of increased (131)I uptake, except iodine uptake clearly located in the thyroid bed, were considered to be abnormal. The data were evaluated on a lesion and a patient basis.

RESULTS

Regarding neck lesions, SPECT-CT provided a diagnostic impact in 26/90 lesions (28.9%) and confirmed the diagnosis in 64/90 lesions (71.1%). On a patient basis, SPECT-CT changed N status in 12/33 patients (36.4%), provided a diagnostic impact in 21/33 patients (63.6%) and led to a treatment change in 8/33 patients (24.2%). Regarding lesions distant from the neck, SPECT-CT confirmed the diagnosis in 62/71 lesions (87.3%) and had a diagnostic impact in 9/71 lesions (12.7%). On a patient basis, SPECT-CT changed M status in 4/19 patients (21.1%), had a diagnostic impact in 14/19 patients (73.7%) and led to a treatment change in 2/19 patients (10.5%). Considering all patients, SPECT-CT led to a treatment change in 10/41 patients (24.4%).

CONCLUSION

Integrated SPECT-CT is a useful tool, especially in cases of diagnostic uncertainty and helps to individualize patient management.

Guidelines for radioiodine therapy of differentiated thyroid cancer

INTRODUCTION

The purpose of the present guidelines on the radioiodine therapy (RAIT) of differentiated thyroid cancer (DTC) formulated by the European Association of Nuclear Medicine (EANM) Therapy Committee is to provide advice to nuclear medicine clinicians and other members of the DTC-treating community on how to ablate thyroid remnant or treat inoperable advanced DTC or both employing large 131-iodine ((131)I) activities.

DISCUSSION

For this purpose, recommendations have been formulated based on recent literature and expert opinion regarding the rationale, indications and contraindications for these procedures, as well as the radioiodine activities and the administration and patient preparation techniques to be used. Recommendations also are provided on pre-RAIT history and examinations, patient counselling and precautions that should be associated with (131)I iodine ablation and treatment. Furthermore, potential side effects of radioiodine therapy and alternate or additional treatments to this modality are reviewed. Appendices furnish information on dosimetry and post-therapy scintigraphy.

Is there a role for scintigraphic imaging of bone manifestations in Gaucher disease? A review of the literature

Gaucher disease is the most prevalent inherited, lysosomal storage disease and is caused by deficient activity of the enzyme beta-glucocerebrosidase. Bone and bone marrow alterations are frequent in the most prevalent non-neuronopathic form of Gaucher disease. Imaging of bone manifestations in Gaucher disease is performed by a variety of imaging methods, conventional X-ray and MRI as the most frequently and most important ones. However, different modalities of scintigraphic imaging have also been used. This article gives an overview on scintigraphic imaging with respect to bone manifestations in Gaucher disease discussing the advantages and limitations of scintigraphic imaging in comparison to other imaging methods.

Sentinel node SPECT-CT in breast cancer. Can we expect any additional and clinically relevant information?

The AIM of this study was to determine the additional value of SPECT/CT in sentinel node scintigraphy in breast cancer. Furthermore, it was our question to determine, whether the low-dose computed tomography component (LD-CT) can be used for axillary lymph node staging of clinically negative patients.

PATIENTS, METHODS

51 patients with invasive breast cancer <3 cm in diameter were included in our prospective investigation. SPECT/CT was performed on a dedicated scanner 30 minutes after subareolar injection of (99m)Tc-Nanocoll. Axillary staging with CT(LD) was performed using standard CT-criteria. SLN were allocated to an axillary level using SPECT alone and SPECT/CT. Additionally, the number of SLN on CT(LD) corresponding to the scintigraphic hot node was notified for each patient and compared to the number of SLN found with the gamma probe.

RESULTS

In 45/51 evaluable patients SLN could be localised in level I in 43 patients and in level II in two patients (all positive) using SPECT-CT, whereas a clear allocation could not be obtained by SPECT alone. The number of SLN was discrepant between SPECT and CT(LD) in 13/45 patients. The number of SLN detected with the gamma probe (n = 68) not significantly differed from the number of SLN detected by CT(LD) (n = 65) but was significantly higher than with SPECT (n = 51). CT(LD) yielded a sensitivity of 35.7%, a specificity of 83.9%, a positive predictive value (PPT) of 50%, a negative predictive value (NPV) of 74.3% and a diagnostic accuracy of 68.9% for axillary staging with CT(LD).

CONCLUSION

The additional information of SPECT/CT allows a more accurate characterization of the SN concerning size, depth and anatomical location. CT(LD) when performed during (99m)Tc-Nanocoll sentinel-SPECT/CT is not suitable for axillary staging in breast cancer patients with clinical negative axilla due to its low sensitivity and moderate specificity. Therefore, it does not influence the decision for SNB or ALND. The limited resolution of SPECT leads to an underestimation of the number of SLN compared to CT(LD) and the gamma probe.

Use of IgG avidity ELISA to differentiate acute from persistent infection with Salmonella Dublin in cattle

AIMS

To investigate whether an immunoglobulin (Ig)G avidity ELISA can be used to differentiate between acute and persistent infection with Salmonella (S.) Dublin in cattle. To determine whether the IgG isotype, IgG(1) and IgG(2) responses in acute and persistent infections differ.

METHODS AND RESULTS

Animals were selected from two herds with long-term infection (years) and two herds recently infected (<3 months). Forty-seven animals were categorized into groups based on the persistence of their antibody level in milk. Based on titre from two serial dilutions the avidity index (AI) was calculated for IgG (IgG-AI), IgG(1) (IgG(1)-AI) and IgG(2) (IgG(2)-AI). The mean IgG-AI for suspected carrier animals with either persistently high (group 1) or persistently high to medium high (group 2) antibody levels was significantly (P = 0.003) higher (32.1% and 38.4%) than for acutely infected animals (21.7% and 22.3%). The probability of being a suspect carrier was associated with IgG-AI, antibody level in the sample and age. However, the effect of age could be the result of a biased sample selection. Specificities and sensitivities were calculated at a range of cut-off values for IgG-AI and IgG(1)-AI. Overall, IgG(2)-AI was high compared with IgG(1)-AI, and there was no difference in IgG(2)-AI between infection groups. There was no difference in the ratio IgG(2):IgG(1) for acute and persistent infection groups.

CONCLUSIONS

Assuming that a persistently high antibody response is indicative of persistent infection with S. Dublin in cattle, it can be concluded that the IgG-AI can aid in differentiating between acute and long-term infection on herd level. However, for the test to be useful as an alternative tool to repeated sampling over time for detection of persistently infected carriers during control strategies in cattle herds, the test needs to be optimized and studied further in a larger sample of well-characterized infections in cattle. The affinity of IgG(2) is higher than IgG(1) early in the S. Dublin infection. There appears to be no difference in the IgG(2)-AI between the acute and chronic infection stages.

SIGNIFICANCE AND IMPACT OF THE STUDY

For decades the strategies for detection of persistently infected cattle in S. Dublin infected herds have involved repeated bacteriological culture of faecal samples or repeated antibody measurements over several months. Both methods are time consuming and costly, leaving a new method for detection of carrier animals based on a single sampling highly desirable. This study illustrates a tool, IgG-AI, which may prove useful, although more validation of the method is required before it is used in practice.

Receptor activator of nuclear factor kappaB ligand and osteoprotegerin in men with thyroid cancer

BACKGROUND

Suppressive thyroid hormone therapy is generally a lifelong treatment for patients with differentiated thyroid cancer (DTC). However, long-standing thyrotropin (TSH) suppression is a risk factor for osteoporosis. Osteoprotegerin (OPG) and receptor activator of nuclear factor kappaB ligand (RANKL) are central regulators of bone turnover. The aim was to analyze the effects of a suppressive thyroid hormone therapy in males with DTC on the OPG/RANKL system and on bone metabolism.

PATIENTS AND METHODS

The OPG and soluble RANKL (sRANKL) were determined in 40 men (mean age, 53.2 years) with DTC on suppressive thyroid hormone therapy (TSH; 0.053 +/- 0.037 mU L(-1), duration 5.7 +/- 4.4 years) and 120 healthy controls matched for age. The markers of bone metabolism were C-terminal telopeptide of type I collagen in serum (sCTx) and osteocalcin (OC).

RESULTS

The control group had OPG values (mean +/- SD) of 1.9 +/- 1.0 pmol L(-1) and sRANKL values of 0.40 +/- 0.62 pmol L(-1). In patients with DTC, results for OPG were 3.03 +/- 1.04 pmol L(-1) (P < 0.05) and for sRANKL were 0.13 +/- 0.16 pmol L(-1) (P < 0.05). The control group presented values for sCTx of 2669 +/- 1132 pmol L(-1) and for OC of 17.89 +/- 6.5 ng mL(-1). Patients with DTC on suppressive thyroid hormone therapy had increased sCTx values of 3810 +/- 2020 pmol L(-1) (P = 0.03) but comparable OC values of 19.21 +/- 7.67 ng mL(-1) (NS).

CONCLUSIONS

Suppressive thyroid hormone therapy in men with DTC increased bone degradation and induced significant changes in the OPG/RANKL system. These changes include, besides the risk of osteoporosis, possible negative effects on the vascular function and an increased risk of cardiovascular disease.

Seroprevalence of Toxoplasma gondii infection in goats and sheep in Zimbabwe

Seroprevalence rates of Toxoplasma gondii anti-antibodies in adult goats and sheep from different parts of Zimbabwe were determined. A total of 225 (67.9%) of the 335 serum samples tested were positive for anti-T. gondii IgG antibodies with the indirect fluorescent antibody test. There were differences in antibody seroprevalences among communal land goats from the different agro-ecological zones (Natural regions llb and III: 80 and 96.7%, respectively; Natural region IV: 65.9%; Natural region V: 45%; and Natural region III had a significantly higher seroprevalence than IV and V. The highest seroprevalences found in Natural regions II b and Ill are likely to be linked to the existence of more households and hence the possibility of a higher concentration of domestic cats that increases the chances of environmental contamination with their faeces harbouring T. gondii oocysts. The seroprevalence rate in sheep from a large commercial farm (10%) was significantly lower than that of sheep reared under the communal grazing system (80%). Overall, significantly higher proportions of seropositive animals had antibody titres of 1:50 (34.2% of 225) and 1:100 (44% of 225) as compared to the 9.8% and 12% with antibody titres of 1:200 and > or =1:400, respectively.

Cancer chemotherapy administered via hemodialysis fistulas

End-stage renal failure (ESRF) patients can develop cancer before or after kidney disease occurs. Cancer chemotherapy often needs to be administered via the sort of central venous catheter that is normally avoided in ESRF care. Three cases are presented in which ESRF patients received chemotherapy for cancer via existing hemodialysis fistulas, and the consequences of central venous access in a fourth patient are discussed.

Short-term Study of the Uptake of PrPSc by the Peyer's Patches in Hamsters after Oral Exposure to Scrapie

The disease-associated prion protein (PrP(Sc)) has been detected in the ileal Peyer's patches of lambs as early as one week after oral exposure to scrapie. In hamsters, the earliest reported time of PrP(Sc) detection in the Peyer's patches after oral exposure to scrapie is 69 days post-infection. To evaluate the acute uptake of inoculum and to investigate whether the Peyer's patches constitute the primary site of entry for scrapie after oral exposure, hamsters were each exposed orally to 1 ml of a 10% brain homogenate from hamsters in the terminal stage of infection with the 263 K strain of the scrapie agent. PrP(Sc) was demonstrated in the Peyer's patches only a few days after exposure, i.e., much earlier than previously reported. This study supports the view that the Peyer's patches constitute at least one of the primary entry sites of PrP(Sc) after oral exposure to scrapie.

Seroprevalence of Toxoplasma gondii infection in domestic pigs reared under different management systems in Zimbabwe

Serum samples from 474 domestic pigs (Sus scrofa) from Zimbabwe were tested for anti-Toxoplasma gondii IgG antibodies using the indirect fluorescent antibody test. The results showed that T. gondii infection is widespread in Zimbabwean pigs. Seroprevalence was lowest in fattening pigs from large and small-scale commercial farms that practise good hygiene (19.75% of 238) and highest in backyard scavenging pigs (35.71% of 70). Only 11.7% (11) of the 127 positive samples had titres of > or = 1:400 and nine (81.82%) of these 11 originated from pigs reared under poor hygienic conditions. A prevalence of 3.51% was found in the same group of fattening pigs using an indirect IgG enzyme-linked immunosorbent assay at the single serum dilution of 1:400. The serosurvey shows the importance of modern intensive husbandry systems in reducing the prevalences of T. gondii infection in domestic pigs.

Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis

CONTEXT

Plasma fibrinogen levels may be associated with the risk of coronary heart disease (CHD) and stroke.

OBJECTIVE

To assess the relationships of fibrinogen levels with risk of major vascular and with risk of nonvascular outcomes based on individual participant data.

DATA SOURCES

Relevant studies were identified by computer-assisted searches, hand searches of reference lists, and personal communication with relevant investigators.

STUDY SELECTION

All identified prospective studies were included with information available on baseline fibrinogen levels and details of subsequent major vascular morbidity and/or cause-specific mortality during at least 1 year of follow-up. Studies were excluded if they recruited participants on the basis of having had a previous history of cardiovascular disease; participants with known preexisting CHD or stroke were excluded.

DATA EXTRACTION

Individual records were provided on each of 154,211 participants in 31 prospective studies. During 1.38 million person-years of follow-up, there were 6944 first nonfatal myocardial infarctions or stroke events and 13,210 deaths. Cause-specific mortality was generally available. Analyses involved proportional hazards modeling with adjustment for confounding by known cardiovascular risk factors and for regression dilution bias.

DATA SYNTHESIS

Within each age group considered (40-59, 60-69, and > or =70 years), there was an approximately log-linear association with usual fibrinogen level for the risk of any CHD, any stroke, other vascular (eg, non-CHD, nonstroke) mortality, and nonvascular mortality. There was no evidence of a threshold within the range of usual fibrinogen level studied at any age. The age- and sex- adjusted hazard ratio per 1-g/L increase in usual fibrinogen level for CHD was 2.42 (95% confidence interval [CI], 2.24-2.60); stroke, 2.06 (95% CI, 1.83-2.33); other vascular mortality, 2.76 (95% CI, 2.28-3.35); and nonvascular mortality, 2.03 (95% CI, 1.90-2.18). The hazard ratios for CHD and stroke were reduced to about 1.8 after further adjustment for measured values of several established vascular risk factors. In a subset of 7011 participants with available C-reactive protein values, the findings for CHD were essentially unchanged following additional adjustment for C-reactive protein. The associations of fibrinogen level with CHD or stroke did not differ substantially according to sex, smoking, blood pressure, blood lipid levels, or several features of study design.

CONCLUSIONS

In this large individual participant meta-analysis, moderately strong associations were found between usual plasma fibrinogen level and the risks of CHD, stroke, other vascular mortality, and nonvascular mortality in a wide range of circumstances in healthy middle-aged adults. Assessment of any causal relevance of elevated fibrinogen levels to disease requires additional research.

Seroprevalence of Toxoplasma gondii infection in goats and sheep in Zimbabwe

Seroprevalence rates of Toxoplasma gondii anti-antibodies in adult goats and sheep from different parts of Zimbabwe were determined. A total of 225 (67.9 %) of the 335 serum samples tested were positive for anti-T. gondii IgG antibodies with the indirect fluorescent antibody test. There were differences in antibody seroprevalences among communal land goats from the different agro-ecological zones (Natural regions IIb and III: 80 and 96.7 %, respectively; Natural region IV: 65.9 %; Natural region V: 45 %; and Natural region III had a significantly higher seroprevalence than IV and V. The highest seroprevalences found in Natural regions II b and III are likely to be linked to the existence of more households and hence the possibility of a higher concentration of domestic cats that increases the chances of environmental contamination with their faeces harbouring T. gondii oocysts. The seroprevalence rate in sheep from a large commercial farm (10 %) was significantly lower than that of sheep reared under the communal grazing system (80 %). Overall, significantly higher proportions of seropositive animals had antibody titres of 1:50 (34.2 % of 225) and 1:100 (44 % of 225) as compared to the 9.8 % and 12 % with antibody titres of 1:200 and > 1:400, respectively.

Preliminary characterisation of Toxoplasma gondii isolates from Zimbabwe, with stage-specific monoclonal antibodies

Cell-culture-derived clones of eight Toxoplasma gondii isolates from Zimbabwe were characterised in IFAT with a panel of five monoclonal antibodies (mAb). Each clone had been established from a single murine brain cyst. The antibodies were bradyzoite-specific (4.3), tachyzoite-specific (4.25, 5.1 and anti-P(30)), or tachyzoite- and bradyzoite-specific (5.15). Their strong reactivity with the bradyzoite-specific mAb 4.3 and their weaker reactivity with the tachyzoite-specific 4.25, 5.1 and anti-P(30) indicated that all the isolates are probably of genetic type II. Each of the isolates reacted in the IFAT in a similar way to the Danish reference strain of T. gondii, SSI-119.

Longitudinal study of interferon-gamma, serum antibody and milk antibody responses in cattle infected with Mycobacterium avium subsp. paratuberculosis

During a 2-year study period, 252 animals from dairy herds infected with Mycobacterium avium subsp. paratuberculosis, and 119 animals from non-infected herds were subjected to repeated blood and faecal sampling. Animals were retrospectively grouped by infection status as infected, exposed (culture negative animals from infected herds), or non-infected animals, and by age, 12-23 months (1+ year), 24-35 months (2+ years), or 36 months and older (3+ years). Samples were collected for culture of faeces, assessment of interferon-gamma (IFN-gamma) secreted by M. paratuberculosis antigen stimulated whole-blood lymphocytes (IFN-gamma test), and measurement of antibody responses against M. paratuberculosis in serum and milk by an in-house absorbed ELISA. The IFN-gamma test diagnosed higher proportions of infected and exposed animals than the antibody ELISAs. The highest sensitivity of IFN-gamma test was in infected cattle of 2+ years of age. Receiver-operating characteristic (ROC) analyses supported the assumption that the IFN-gamma test had a better performance than antibody tests of animals of 1+ and 2+ years of age. However, for animals of 3+ years all tests performed equally well. Application of single sampling compared with repeated samplings showed better performance of the IFN-gamma test by repeated samplings, and the milk antibody ELISA in animals of 3+ years of age performed significantly better with repeated sampling compared with single sampling. In conclusion, the IFN-gamma test may be applied for screening of cattle of 1 and 2 years of age for exposure to M. paratuberculosis and the antibody ELISAs from 3 years of age.

Clinical Experience with a Commercially Available Negative Oral Contrast Medium in PET/CT

PURPOSE

To evaluate a commercially available negative oral contrast material for PET/CT.

MATERIAL AND METHODS

In a prospective series of 49 patients, Mukofalk, which is a vegetarian-based substance, was used as a negative oral contrast medium in whole body PET/CT studies. Mukofalk was administered during a time period of 1.5 hours before the examination. Quality of small bowl distension and eventual pathological tracer uptake in the intestine were evaluated.

RESULTS

Distension of the small bowel was excellent or good in 41 (85 %) and poor in 8 (15 %) patients. Mild tracer uptake in the small bowel was observed in 5 patients (10.2 %) and moderate uptake in another 2 patients (4 %). In none of these patients did the F-18 FDG uptake interfere with image interpretation.

CONCLUSION

Mukofalk can be used as a negative oral contrast medium in PET/CT studies.

Cross-sectional survey in pig breeding farms in Hesse, Germany: seroprevalence and risk factors of infections with Toxoplasma gondii, Sarcocystis spp. and Neospora caninum in sows

A cross-sectional survey was performed to estimate the prevalences of antibodies to Toxoplasma gondii (ELISA, IFAT), Sarcocystis spp. (ELISA, using S. miescheriana as antigen) and Neospora caninum (ELISA, immunoblotting) in sows from breeding farms in southern Hesse, Germany. A total of 2041 plasma samples of sows from 94 randomly selected farms was examined. Data on farm profiles, husbandry management and sows were collected by a questionnaire and exploratively analysed. For T. gondii the ELISA results agreed well with the results obtained by IFAT (kappa=0.71). Antibodies to T. gondii were detected by ELISA in 19% of the sows. Sixty-nine percent of the farms had at least one seropositive sow, and a within-farm seroprevalence of >or=50% was observed in 14% of all farms. The prevalence of anti-T. gondii antibodies was positively correlated with the age of sows. The within-herd seroprevalence was significantly higher in farms with reproductive disorders than in those without such problems. On the farm level, the farm type 'piglet production' (versus 'pedigree breeding' or 'farrow-to-finish') was the only risk factor associated with the presence of T. gondii-seropositive sows. Antibodies to Sarcocystis spp. were found in 29% of the sows. Seventy-two percent of the farms harboured at least one seropositive sow, and a within-farm seroprevalence of >or=50% was detected in 23% of all farms. The seroprevalence increased significantly with the age of sows. On the farm level, only the farm type 'piglet production' (versus 'pedigree breeding') and the replacement of sows by purchasing (versus raising on the own farm) were identified as risk factors for seropositivity. Antibodies to N. caninum were detected in one sow using both the screening ELISA and the confirmatory immunoblotting technique. This may indicate the first natural N. caninum infection in pigs.

The effect of colostrum on pigs pre-natally or post-natally exposed toSchistosoma japonicum

Pre-natal infection ofSchistosoma japonicumin pigs may prove to be a useful model in shedding light on human pre-natal schistosomiasis. This study describes the effects of immune colostrum on worm burdens, tissue egg counts, liver pathology and crude worm or egg antigen-specific IgG and IgA responses, in groups of pigs pre-natally, pre-natally+post-natally or post-natally exposed toS. japonicum. Results suggest that pre-natal exposure and immune colostrum did not affect the establishment of a post-natal challenge infection. However, immune colostrum seemed to increase the levels of septal fibrosis in pre-natally exposed pigs. These findings indicate that further investigations will prove valuable, elucidating the influence of the parasitological and immunological status of the sow, on pre-natally exposed pigs, and on the ability of these pigs to develop resistance againstS. japonicumlater in life.