Impact on beef cattle productivity of infection with anthelmintic-resistant nematodes

ABSTRACTAims: The main goal of the current study was to evaluate, on a commercial beef cattle farm, the impact of infection with gastrointestinal nematodes resistant to both ivermectin (IVM) and moxidectin (MXD) on the productivity of calves.Methods: Male Aberdeen Angus calves, aged 9-11 months, with faecal nematode egg counts (FEC) ≥200 epg and body weight ≥190 kg, were allocated to two herds. Herd A (n = 90) grazed a maize-winter forage crop rotation and Herd B (n = 90) grazed a 2-year-old Agropyrum pasture. On Day 0 in each herd, calves were randomly allocated into five groups (n = 18), which were treated with 0.2 mg/kg IVM; 0.2 mg/kg MXD; 3.75 mg/kg ricobendazole (RBZ), both IVM and RBZ, or remained untreated. Faecal samples collected on Days -1 and 19 were used to determine the percentage reduction in FEC, and genera of the nematodes were determined by the identification of the third-stage larvae recovered from faecal cultures. Total weight gain was determined from body weights recorded on Days -1 and 91.Results: Overall mean reduction in FEC was 42% for IVM, 67% for MXD, 97% for RBZ and 99% for IVM + RBZ. The reduction in FEC for Cooperia spp. was ≤78% for IVM and MXD, and for Haemonchus spp. was 0 and 36% for IVM and MXD, respectively, confirming the presence of parasites resistant to both anthelmintics. Only IVM + RBZ treatment resulted in 100% efficacy against Haemonchus spp. The overall estimated mean total weight gain for calves treated with IVM was 15.7 (95% CI = 11.9-19.7) kg and for calves treated with IVM + RBZ was 28.8 (95% CI = 25-32.5) kg (p < 0.001). Mean total weight gain for calves treated with MXD was 23.5 (95% CI = 19.7-27.2) kg.Conclusions and clinical relevance: In calves naturally infected with resistant nematodes, under the production system assessed here, weight gains were lower in calves treated with anthelmintics that were moderately or highly ineffective compared to those treated with highly effective anthelmintics. These results demonstrate to farmers and veterinarians the importance of a sustainable and effective nematode control under field conditions.

Pharmacokinetic-pharmacodynamic assessment of the ivermectin and abamectin nematodicidal interaction in cattle

In a context of nematodicidal resistance, anthelmintic combinations have emerged as a reliable pharmacological strategy to control gastrointestinal nematodes in grazing systems of livestock production. The current work evaluated the potential drug-drug interactions following the coadministration of two macrocyclic lactones (ML) ivermectin (IVM) and abamectin (ABM) to parasitized cattle using a pharmacokinetic/pharmacodynamic (PK/PD) approach. The kinetic behavior of both compounds administered either separately or coadministered was assessed and the therapeutic response of the combination was evaluated under different resistance scenarios. In the pharmacological trial, calves received a single subcutaneous (s.c.) injection of IVM (100 μg/Kg); a single s.c. injection of ABM (100 μg/Kg) or IVM + ABM (50 μg/Kg each) administered in different injection sites to reach a final ML dose of 100 μg/Kg (Farm 1). Plasma samples were taken from those animals up to 20 days post-treatment. IVM and ABM plasma concentrations were quantified by HPLC. A parasitological trial was carried out in three farms with different status of nematodes resistance to IVM. Experimental animals received IVM (200 μg/Kg), ABM (200 μg/Kg) or IVM + ABM (100 μg/Kg each) in Farm 2, and IVM + ABM (200 μg/Kg each) in Farms 3 and 4. The anthelmintic efficacy was determined by fecal egg count reduction test (FECRT). PK analysis showed similar trends for IVM kinetic behavior after coadministration with ABM. Conversely, the ABM elimination half-life was prolonged and the systemic exposure during the elimination phase was increased in the presence of IVM. Although IVM alone failed to control Cooperia spp., the combination IVM + ABM was the only treatment that achieved an efficacy higher than 95% against resistant Cooperia spp. in all farms. In fact, when Cooperia spp. was the main genus within the nematode population and Haemonchus spp. was susceptible or slightly resistant to ML (Farms 2 and 4), the total FECR for the combination IVM + ABM was higher than 90%. Instead, when the predominant nematode genus was a highly resistant Haemonchus spp. (Farm 3), the total FECR after the combined treatment was as low as the single treatments. Therefore, the rational use of these pharmacological tools should be mainly based on the knowledge of the epidemiology and the nematode susceptibility status in each cattle farm.

Understanding the main route of drug entry in adult Fasciola hepatica: Further insights into closantel pharmacological activity

Closantel (CLS) is highly effective against adult liver flukes after its oral or subcutaneous (sc) administration in ruminants. Trans-tegumental diffusion and oral ingestion are the two potential routes available for the entry of drugs into Fasciola hepatica. The work reported here contributes to improve the understanding of CLS pharmacology. The main goals of were: I) to determine the pattern of in vivo CLS accumulation into adult F. hepatica and relevant tissues in CLS-treated sheep; II) to investigate the influence of the physicochemical composition of the incubation medium on the CLS diffusion process into adult F. hepatica; III) to assess the ovicidal activity of CLS against F. hepatica eggs; and IV) to investigate the in vivo effect of CLS treatment on glutathione S-transferases activity in adult liver flukes exposed to CLS. Fourteen healthy sheep were each orally infected with 75 F. hepatica metacercariae. Sixteen (16) weeks after infection, animals were treated with CLS by oral (n = 6, 10 mg/kg) or sub-cutaneous (sc) (n = 6, 5 mg/kg) route. At 12, 24 and 36 h post-treatment, animals were sacrificed (n = 2) and samples of blood, bile and adult F. hepatica were collected. In addition, flukes recovered from non-treated sheep (n = 2) were ex vivo incubated (60 min) in the presence of CLS in either RPMI or bile as incubation medium. CLS concentration was measured by HPLC. The ovicidal activity of CLS was investigated using eggs obtained from the bile of untreated sheep. Finally, glutathione S-transferase activity in F. hepatica recovered from untreated and CLS-treated sheep was assessed. In the in vivo studies, the highest CLS concentrations were measured in plasma and adult liver flukes. A positive correlation was observed between CLS concentration in plasma and in F. hepatica. Results obtained in the current work indicate that the in vivo accumulation of CLS into adult liver flukes occurs mainly by the oral route. After ex vivo incubation, the uptake of CLS by the parasite was markedly diminished in the presence of bile compared with that observed in the presence of RPMI as incubation medium. CLS lacks ovicidal activity at therapeutically relevant concentrations. Lastly, CLS significantly increased glutathione S-transferase activity in flukes recovered at 12 h (oral treatment) and 24 h (sc treatment), compared to the control liver flukes.

A pharmacology-based comparison of the activity of albendazole and flubendazole against Echinococcus granulosus metacestode in sheep

Cyst echinococcosis (CE) is a zoonotic disease caused by the larval stage of the Echinococcus granulosus helminth parasite. The work reported here aimed to compare the efficacy of albendazole (ABZ) and flubendazole (FLBZ) against CE in naturally infected sheep. Additionally, their comparative pharmacokinetic behaviour and the assessment of serum liver enzymes activities were studied. Twelve (12) naturally infected sheep were allocated to the following experimental groups: unmedicated control group, FLBZ-treated and ABZ-treated. Treatments were orally performed every 48 h, over 55 days at dose rate of 10 (FLBZ) and 8.5 (ABZ) mg/kg (equimolar dose rates). The efficacy of the drug treatments was based on protoscoleces' vitality/viability. The kinetic disposition assessment included the Initial and Final Kinetic Studies which implicated the collection of blood samples after both the first and the last drug administration. Blood samples were processed to measure drug concentrations by HPLC. The protoscoleces' vitality observed in the untreated control group (98%) was significantly reduced in the presence of both ABZ and FLBZ. 90% of mice inoculated with protoscoleces in the control group developed hydatid cysts in their peritoneal cavity (viability study). However, only 25% (FLBZ) and 33% (ABZ) of mice inoculated with protoscoleces recovered from treated sheep, developed hydatid cysts in their abdominal cavity. Reduced FLBZ (R-FLBZ) was the main metabolite recovered in the bloodstream after oral administration of FLBZ to sheep. Low plasma concentrations of FLBZ parent drug were measured up to 48 h post-administration. ABZ was not detected in plasma at any time post-treatment, being its metabolites ABZ sulphoxide (ABZSO) and ABZ sulphone (ABZSO₂) recovered in plasma. Hepatotoxicity due to the continued treatment with either ABZ or FLBZ was not observed. A 3-fold increase ethoxyresorufin O-deethylase activity, a cytochrome P450 1A (CYP1A)-dependent enzyme reaction, was observed in liver microsomes obtained from sheep receiving ABZ, compared to those of the unmedicated and FLBZ-treated animals. In conclusion, FLBZ is an available anthelmintic which may be developed into an effective and safe drug for the human CE treatment. Despite the low plasma concentrations measured by FLBZ/R-FLBZ, an important reduction in protoscoleces' vitality was observed in cysts located in sheep liver. Modern pharmaceutical technology may help to greatly improve FLBZ systemic exposure improving its efficacy against CE.

Increased epinephrine and skeletal muscle responses to hypoglycemia in non-insulin-dependent diabetes mellitus

We evaluated skeletal muscle counterregulation during hypoglycemia in nine subjects with non-insulin-dependent diabetes mellitus (NIDDM) (HbA1c 9.4 +/- 0.5%, nl < 6.2%) compared with six normal controls, matched for age (51 +/- 3 and 49 +/- 5 yr, respectively) and body mass index (27.3 +/- 1.2 and 27.0 +/- 2.1 kg/m2). After 60 min of euglycemia (plasma insulin approximately 140 microU/ml), plasma glucose was lowered to 62 +/- 2 mg/dl by 120 min. Hypoglycemia induced a 2.2-fold greater increase in plasma epinephrine in NIDDM (P < 0.001), while the plasma glucagon response was blunted (P < 0.01). Hepatic glucose output ([3H-3]glucose) suppressed similarly during euglycemia, but during hypoglycemia was greater in NIDDM (P < 0.005). Conversely, glucose uptake during euglycemia was 150% greater in controls (P < 0.01) and remained persistently higher than in NIDDM during hypoglycemia. In NIDDM, plasma FFA concentrations were approximately fivefold greater (P < 0.001), and plasma lactate levels were approximately 40% higher than in controls during hypoglycemia (P < 0.01); the rates of glycolysis from plasma glucose were similar in the two groups despite a 49% lower rate of glucose uptake in NIDDM (3.4 +/- 0.9 vs. 6.9 +/- 1.3 mg/kg per minute, P < 0.001). Muscle glycogen synthase activity fell by 42% with hypoglycemia (P < 0.01) in NIDDM but not in controls. In addition, glycogen phosphorylase was activated by 56% during hypoglycemia in NIDDM only (P < 0.01). Muscle glucose-6-phosphate concentrations rose during hypoglycemia by a twofold greater increment in NIDDM (P < 0.01). Thus, skeletal muscle participates in hypoglycemia counterregulation in NIDDM, directly by decreased removal of plasma glucose and, indirectly, by providing lactate for hepatic gluconeogenesis. Consequently, in addition to inherent insulin resistance in NIDDM, the enhanced plasma epinephrine response during hypoglycemia may partially offset impaired glucagon secretion and counteract the effects of hyperinsulinemia on liver, fat, and skeletal muscle.

[Major hepatic resections for carcinoma of the biliary tract]

The Authors report their experience regarding two primitive tumours of the confluent and one tumour of the gall bladder involving the biliary confluent, all treated by major hepatic demolitions--one left hemihepatectomy and two extended right hemihepatectomies--with removal of the biliary tree en bloc and appropriate reconstruction. These highly demolitionary operations were performed with the aim of achieving greater radicality. The indications for such type of operation, dictated by notions of tumoral biology and reasons of surgical technique, are discussed. The Authors make a comparison of their experience with the data obtained from literature, which up to now reports only twenty-two; no statistical judgment on the effectiveness of the method is therefore possible, even if the results obtained and the theoretical presuppositions would seem to confirm its validity.

[Cavitary carcinomas of the lung with a pseudocystic aspect. Description of 2 clinical cases]

In this paper the Authors describe two cases of carcinoma of the lung with cavitary aspects that came under their observation. There are various hypotheses on the formation of such cavities: it is possible that the neoplastic cells may have a growth trend in a centrifugal direction, or that the cavity is due to a necroic-colliquaive process of the mass itself or to extensive phenomena of autophagism. In other cases the neoplastic cells carpet already existing air cysts, giving the appearance of thin wall cavitation. It is precisely this type of cavitation that poses problems of differential diagnosis. In fact, when other instrumental investigations such as bronchoscopy or needle biopsy, always combined with cytology of the sputum, are not decisive, a relatively certain diagnosis can be obtained only by observing the evolution of the picture for some time, as was the case in the patients referred to above.

[Exocrine pancreas cancers: our experience (author's transl)]

The AA. report 136 cases of exocrine pancreas carcinomata that they have observed in 8 years in Surgical Hospital in Verona and they tackle diagnostic problems and surgical therapy. They confirmed the utility for the diagnosis of echotomography (ECO), computerizing axial tomography (T.A.C.), retrograde-endoscopic-cholangio-pancreatography (PTC). Considering the survival, at a distance of the cases that had an operation and life quality, the AA. incline, if possible, for a destroying surgical operation.

[A case of choleretroperitoneum (clinical study)]

The AA. report one case of "choleretroperitoneum". They discuss the techniques of diagnosis that they have used, outlining the importance of A.C.T. (Axial Computerizing Tomography) and of Transduodenoscopic Cliolangiography, that have permitted a preoperative diagnosis and an exact surgical treatment of this case.

[Lipoid pulmonary granuloma in Parkinson's disease. Presentation of clinical case]

The authors describe one case of lipoid granuloma of the lung in a patient with PARKINSON'S disease. The cause of this pulmonary sequel is probably to be found in the alteration of the mechanism of deglutition, typical of PARKINSON'S disease, with aspiration bronchopneumonia and subsequent evolution to granuloma formation. In the case presented (a man of 64) the X-ray picture resembled the irregular mass opacities and bronchial amputations characteristically associated with cancer of the lung. As the actual anatomical extent of the process exceeded the limits indicated by radiological examination, the whole left lung was removed at surgery; histological studies, however, revealed the essentially benign nature of the lesion. The patient was discharged in due course of time as surgically cured. There was no major deterioration of his neurological status either at discharge time or at later rechecks.

[Bronchogenic cyst of the lung and pulmonary tuberculosis. Presentation of a case]

The paper considers a clinical case of multiple bronchogenic cysts associated with a pneumonitic process of TB character, operated successfully by means of an upper right and middle bilobectomy. No similar case was found in literature. The malformations were of congenital origin, characterised histologically by a cavity, the walls of which contain elements proper to the bronchus: cartilage and ciliate columnar epithelium. The squamous metaplasia is rare, and the neoplastic transformation very rare. From the clinical point of view a distinction is made between asymptomatic cysts, in which the clinical picture is dominated by compressive phenomena affecting the surrounding structures, or sometimes by infection due to supervening bacterial, mycotic or--as in our case--tubercular contamination. The therapeutic indication is exclusively surgical, with methods of exeresis varying according to the extent and location of the morbid process.

[Recent aspects of pulmonary tuberculosis in thoracic surgery]

Pulmonary tuberculosis--although appreciable reduced as regards number of cases--is still far from being wiped out and even today constitutes a real problem in the field of thoracico-pulmonary surgical pathology. Infection with Koch's bacillus can from this point of view arise basically according to two procedures: a) as superimposed element--unexpected guest--on a pulmonary disease of surgical interest, sometimes being mistaken for it (e.g. a tubercular inflammation of slow evolution mistaken for a cancer of the lung) or b) taking the form of pulmonary relics of an earlier and apparently extinguished Kochian infection, the starting point of an always possible revival of the infection during the postoperative period. In the former case the so-called attack therapy must be adopted without delay in accordance with well tested doses and schedules; in the latter case by means of a chemoprophylaxis, carried out in with rifampicin (600/1200 mg/day) in the cases reported and also continued in the postoperative period.