RESUMEN
The safety and efficacy of an aroA-deleted live vaccine against avian colibacillosis (Poulvac(®) E. coli) was evaluated in broilers in a multicentre field trial. The trial sites consisted of 18 paired bird houses (randomly assigned to either the vaccination or the control treatment groups) located in 15 farms in three different regions of Morocco. A field dose of vaccine was administered on day of hatch by the spray route. Both clinical and performance parameters were compared between vaccinated and control groups, in which the experimental unit was defined as the individual bird house. No adverse reactions attributable to the vaccine were observed throughout the study. Non-inferiority of the vaccinated bird houses versus the control houses during a 2-week period post vaccination was statistically demonstrated for mortality and average daily weight gain. Vaccine efficacy was confirmed based on significant differences between vaccinated and unvaccinated groups measured for the full duration of the trial, including colibacillosis-like lesions observed at slaughter (1.7 versus 3.5%; P = 0.0054), total mortality (9.3 versus 10.3%; P = 0.0203), average daily weight gain (47.8 versus 46.2 g/day; P = 0.0006), average number of antibiotic treatment days (0.5 versus 2.0; P = 0.0008) and percentage of the birds that was marketed (90.0 versus 89.0%; P = 0.0309). In conclusion, the vaccine was demonstrated to be both safe and efficacious under field conditions.
Asunto(s)
Pollos/inmunología , Infecciones por Escherichia coli/veterinaria , Vacunas contra Escherichia coli/inmunología , Escherichia coli/inmunología , Enfermedades de las Aves de Corral/prevención & control , Vacunación/veterinaria , Animales , Pollos/microbiología , Escherichia coli/genética , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/prevención & control , Marruecos , Enfermedades de las Aves de Corral/microbiología , Eliminación de Secuencia , Vacunas Atenuadas/inmunologíaRESUMEN
BACKGROUND: The use of the artificial urinary sphincter (AUS) in women is limited. OBJECTIVE: To analyse long-term results and mechanical survival of the AUS (AMS 800; American Medical Systems, Minnetonka, MN, USA) in women with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD). DESIGN, SETTING, AND PARTICIPANTS: Women with SUI who were treated between January 1987 and March 2007 were included in this prospective study. Only women with low closure pressure at urethral profile and negative continence tests, indicators of severe ISD, were included. INTERVENTIONS: An AUS was implanted. The surgical technique was modified in 1999, involving opening the endopelvic fascia on both sides and dissection in contact with the vaginal wall. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Assessment of complications was made pre- and postoperatively and continence status was based on pad usage. Kaplan-Meier survival curves were used to calculate mechanical survival of the device. Student t test and the chi-square test were used to compare continence and complication rates. RESULTS AND LIMITATIONS: A total of 376 AUS were implanted in 344 patients, whose mean age was 57 yr. The mean follow-up, plus or minus standard deviation, was 9.6±4.0 yr. At last follow-up, postoperative continence rates, assessed as fully continent (no leakage), socially incontinent (some drops but no pad), or incontinent (one pad or more), were 85.6%, 8.8%, and 5.6%, respectively. The 3-, 5-, and 10-yr device survival rates were 92.0%, 88.6%, and 69.2%, respectively. The mean mechanical survival was 176 mo (14.7 yr). Three risk factors for AUS survival were the number of previous incontinence surgeries, the presence of neurogenic bladder, and simultaneous augmentation enterocystoplasty. Principal limitation of the study is the absence of validated incontinence questionnaire. CONCLUSIONS: The AUS provides excellent outcome in women with ISD, with low explantation rate and very good device survival.