Droplets generated from toilets during urination as a possible vehicle of carbapenem-resistant Klebsiella pneumoniae.

BACKGROUND: In the health care setting, infection control actions are fundamental for containing the dissemination of multidrug-resistant bacteria (MDR). Carbapenemase-producing Enterobacterales (CPE), especially Klebsiella pneumoniae (CR-KP), can spread among patients, although the dynamics of transmission are not fully known. Since CR-KP is present in wastewater and microorganisms are not completely removed from the toilet bowl by flushing, the risk of transmission in settings where toilets are shared should be addressed. We investigated whether urinating generates droplets that can be a vehicle for bacteria and explored the use of an innovative foam to control and eliminate this phenomenon. METHODS: To study droplet formation during urination, we set up an experiment in which different geometrical configurations of toilets could be reproduced and customized. To demonstrate that droplets can mobilize bacteria from the toilet bowl, a standard ceramic toilet was contaminated with a KPC-producing Klebsiella pneumoniae ST101 isolate. Then, we reproduced urination and attached culture dishes to the bottom of the toilet lid for bacterial colony recovery with and without foam. RESULTS: Rebound droplets invariably formed, irrespective of the geometrical configuration of the toilet. In microbiological experiments, we demonstrated that bacteria are always mobilized from the toilet bowl (mean value: 0.11 ± 0.05 CFU/cm2) and showed that a specific foam layer can completely suppress mobilization. CONCLUSIONS: Our study demonstrated that droplets generated from toilets during urination can be a hidden source of CR-KP transmission in settings where toilets are shared among colonized and noncolonized patients.

Lack of almagate interference in breath test results for Helicobacter pylori diagnosis (Almatest study). / Ausencia de interferencia de almagato en los resultados de la prueba de aliento para el diagnóstico de Helicobacter pylori (estudio Almatest).

OBJECTIVE: The 13C-urea breath test (UBT) is the most widely used non-invasive diagnostic test for Helicobacter pylori. Debate continues to surround the possible interference of antacid intake on its result. This study aims to confirm the non-interference of almagate in the determination of H. pylori by UBT. PATIENTS AND METHODS: Observational, multicentre study in adult patients treated with almagate in whom a UBT (TAUKIT®) was indicated. When the UBT result was negative, use of almagate was stopped for 30 days and the UBT was repeated. When the result was positive, no further determinations were made. The primary endpoint was the percentage of patients who, having had a negative result in the first breath test, were positive in the second after having stopped taking almagate (UBT false negatives, possibly attributable to almagate). RESULTS: Of the 167 evaluable patients, 59% were female, average age was 49 and 97% had gastrointestinal symptoms. The result of the first UBT was negative in 71% of cases. Of these, in the second UBT test after stopping the almagate, the negative result was confirmed in 97.5%. Out of the total number of cases evaluated, the rate of false negatives was 1.8%. CONCLUSIONS: Taking almagate has minimal or no interference in the result of UBT for the diagnosis of H. pylori infection. It can therefore be used in the weeks prior to a UBT.

Effects of feeding increasing levels of iron from iron sulfate or iron carbonate on nursery pig growth performance and hematological criteria.

A total of 140 weanling pigs (241 × 600, DNA, Columbus, NE; initially 5.5 ± 0.79 kg body weight) were used in a 32-d study evaluating the effects of increasing dietary Fe from either iron sulfate (FeSO4) or iron carbonate (FeCO3) on nursery pig growth performance and blood Fe status. The pigs used for this trial did not receive an Fe injection after birth in order to increase the sensitivity to added dietary Fe after weaning. Pigs were weaned at approximately 21 d and allotted to pens based on the initial weight in a completely randomized block design with five pigs in each pen and four pens per treatment. Experimental treatments were arranged as a 2 × 3 + 1 factorial with main effects of dietary Fe source (FeSO4 vs. FeCO3) and level (10, 30, or 50 mg/kg of added Fe) plus a negative control with no additional dietary Fe. The basal diet contained 40 mg/kg total dietary Fe based on ingredient contributions and was formulated with an Fe-free trace mineral premix. Experimental diets were formulated below the pigs recommended Fe requirement based on NRC (2012) estimates. Experimental diets were fed in pellet form in a single phase for the duration of the trial. From day 0 to 32, there was no evidence for source × level interactions for growth performance, hemoglobin (Hb), or hematocrit (Hct) values. There was no evidence for a difference (P > 0.10) in dietary Fe source. Providing increasing Fe levels in the diet from either FeSO4 or FeCO3 improved (P < 0.05) average daily gain, average daily feed intake, gain-to-feed ratio, and increased (P < 0.05) Hb and Hct values. A day effect (P = 0.001) was observed for both Hb and Hct with values increasing throughout the study. Increasing dietary Fe levels in the diet from either FeSO4 or FeCO3 increased (linear; P < 0.05) Hb and Hct values on days 14, 21, and 32. In summary, these data suggest that the micronized form of FeCO3 is a source of Fe that can be added to nursery diets to yield similar responses to those observed from FeSO4 supplementation. Similar to previous research, increasing dietary Fe improved the growth performance and increased Hb and Hct values when pigs have low Fe status at weaning.

Effect of threonine and potassium carbonate on broiler chicken performance, immunity, carcass traits, and small intestine morphology.

This study aimed to investigate the interactive effect of dietary threonine (i.e., 100, 110, and 120%) and low and high dietary potassium (i.e., 0.85 and 0.94% of diet) on the performance, immune response, blood metabolites, carcass traits, and jejunum morphology of broiler chickens in Iran. In a completely randomized design, 300 1-day-old broiler chicks (Ross 308) were assigned to one of six dietary treatments with a 3 × 2 factorial arrangement. Broiler chicken growth performance, blood metabolite concentration, jejunum morphology, and antibody titter against Newcastle disease and influenza viruses were not affected by dietary treatments (P > 0.05). High level of dietary potassium led to lower toe web thickness index at 4 h post injection while compared to control group, threonine supplementation significantly decreased toe web thickness of broiler chickens at 24 and 48 h post injection (P < 0.05). Dietary treatments had no significant effects on carcass, abdominal fat, and breast and thigh percentages while higher dietary potassium increased serum glucose concentration (P < 0.05). Broilers fed diet supplemented with 20% supplemented threonine and higher potassium level had lower breast meat fat percentage while those fed diet supplemented with 20% threonine and low potassium had higher thigh meat protein percentage (P < 0.05). It can be concluded that although threonine supplementation improved toe web thickness index as cell-mediated immune response and lowered breast meat fat percentage in broiler chickens, there was no interaction between potassium with threonine in broiler chicken nutrition.

Potassium phosphate and potassium carbonate administration by feed or drinking water improved broiler performance, bone strength, digestive phosphatase activity and phosphorus digestibility under induced heat stress conditions.

Potassium phosphate (K2HPO4) and potassium carbonate (K2CO3) administration by feed or water were evaluated on broiler performance, bone strength, alkaline phosphatase activity (ALP), and phosphorus digestibility under heat stress and high chloride condition. Experimental groups include control; 15 cc/kg K2HPO4; 30 cc/kg K2HPO4; 15 cc/l K2HPO4; and 3.7 g/kg K2CO3. Body weight (BW), feed and water consumption, plasma potassium, phosphorus, and calcium concentration along with plasma and digestive ALP and intestinal digesta pH were measured during the trial. Tibia ash, calcium and phosphorus content, and breaking strength were measured on days 21 and 42 and phosphorus digestibility on day 36 of age. As a result of this, study feed and water consumption was increased by supplementation of the feed or water with K2HPO4 (P ≤ 0.001). K2HPO4 increased body weight at 42 days of age (P ≤ 0.001). Tibia ash and phosphorus content was increased by K2HPO4 supplementation (P ≤ 0.004; P ≤ 0.003). K2CO3 did increased tibia ash but not changed tibia phosphorus content significantly. Tibia shear force, shear energy, extension, and length were improved by K2HPO4 administration at 42 days of age (P ≤ 0.001). Administration of either feed or water with K2HPO4 increased plasma potassium, phosphorus, and calcium concentration at 21 days of age, whereas K2CO3 reduced plasma potassium at 21 days of age (P ≤ 0.05). Plasma ALP reduced by addition of 15 cc K2HPO4 and K2CO3 to diets at 42 days of age, whereas digestive ALP was increased by inclusion of K2HPO4 and not by K2CO3. Supplementation of either feed or water with K2HPO4 increased phosphorus digestibility, whereas K2CO3 reduced phosphorus digestibility (P ≤ 0.003). Jejunum and ileum pH was reduced by K2HPO4 or by K2CO3 at 21 and 42 days of age (P ≤ 0.006; (P ≤ 0.05). Over all, results of current study revealed that K2HPO4 can be a suitable potassium salt choice instead of KCL in hot weather conditions especially when the water or diet contains high levels of chloride.

Carbon monoxide releasing molecule-A1 improves nonalcoholic steatohepatitis via Nrf2 activation mediated improvement in oxidative stress and mitochondrial function.

Nuclear factor-erythroid 2 related factor 2 (Nrf2)-mediated signaling plays a central role in maintaining cellular redox homeostasis of hepatic cells. Carbon monoxide releasing molecule-A1 (CORM-A1) has been reported to stimulate up-regulation and nuclear translocation of Nrf2 in hepatocytes. However, the role of CORM-A1 in improving lipid metabolism, antioxidant signaling and mitochondrial functions in nonalcoholic steatohepatitis (NASH) is unknown. In this study, we report that CORM-A1 prevents hepatic steatosis in high fat high fructose (HFHF) diet fed C57BL/6J mice, used as model of NASH. The beneficial effects of CORM-A1 in HFHF fed mice was associated with improved lipid homeostasis, Nrf2 activation, upregulation of antioxidant responsive (ARE) genes and increased ATP production. As, mitochondria are intracellular source of reactive oxygen species (ROS) and important sites of lipid metabolism, we further investigated the mechanisms of action of CORM-A1-mediated improvement in mitochondrial function in palmitic acid (PA) treated HepG2 cells. Cellular oxidative stress and cell viability were found to be improved in PA + CORM-A1 treated cells via Nrf2 translocation and activation of cytoprotective genes. Furthermore, in PA treated cells, CORM-A1 improved mitochondrial oxidative stress, membrane potential and rescued mitochondrial biogenesis thru upregulation of Drp1, TFAM, PGC-1α and NRF-1 genes. CORM-A1 treatment improved cellular status by lowering glycolytic respiration and maximizing OCR. Improvement in mitochondrial respiration and increment in ATP production in PA + CORM-A1 treated cells further corroborate our findings. In summary, our data demonstrate for the first time that CORM-A1 ameliorates tissue damage in steatotic liver via Nrf2 activation and improved mitochondrial function, thus, suggesting the anti-NASH potential of CORM-A1.

The influence of alkalosis on repeated high-intensity exercise performance and acid-base balance recovery in acute moderate hypoxic conditions.

PURPOSE: Exacerbated hydrogen cation (H+) production is suggested to be a key determinant of fatigue in acute hypoxic conditions. This study, therefore, investigated the effects of NaHCO3 ingestion on repeated 4 km TT cycling performance and post-exercise acid-base balance recovery in acute moderate hypoxic conditions. METHODS: Ten male trained cyclists completed four repeats of 2 × 4 km cycling time trials (TT1 and TT2) with 40 min passive recovery, each on different days. Each TT series was preceded by supplementation of one of the 0.2 g kg-1 BM NaHCO3 (SBC2), 0.3 g kg-1 BM NaHCO3 (SBC3), or a taste-matched placebo (0.07 g kg-1 BM sodium chloride; PLA), administered in a randomized order. Supplements were administered at a pre-determined individual time to peak capillary blood bicarbonate concentration ([HCO3-]). Each TT series was also completed in a normobaric hypoxic chamber set at 14.5% FiO2 (~ 3000 m). RESULTS: Performance was improved following SBC3 in both TT1 (400.2 ± 24.1 vs. 405.9 ± 26.0 s; p = 0.03) and TT2 (407.2 ± 29.2 vs. 413.2 ± 30.8 s; p = 0.01) compared to PLA, displaying a very likely benefit in each bout. Compared to SBC2, a likely and possible benefit was also observed following SBC3 in TT1 (402.3 ± 26.5 s; p = 0.15) and TT2 (410.3 ± 30.8 s; p = 0.44), respectively. One participant displayed an ergolytic effect following SBC3, likely because of severe gastrointestinal discomfort, as SBC2 still provided ergogenic effects. CONCLUSION: NaHCO3 ingestion improves repeated exercise performance in acute hypoxic conditions, although the optimal dose is likely to be 0.3 g kg-1 BM.

Comparison of the effect of dietary copper nanoparticles and one copper (II) salt on the metabolic and immune status in a rat model.

The aim of the study was to evaluate the effects of a diet containing different levels of Cu in two different chemical forms (carbonate and nanoparticles) on metabolic, immune and antioxidant status in a rat model. Five experimental treatments (8 rats in each) were used to test different dosages of Cu added to the diet (standard -6.5 mg/kg, half the standard dosage -3.25 mg/kg, and no added Cu as a negative control) and two sources of added copper (standard -CuCO3 and copper nanoparticles -CuNPs). Blood and urine samples were collected from all the animals after four weeks of treatment. Metabolic and immune parameters were determined in blood and urine samples. The study has shown that a dietary Cu deficiency (negative control) decreases rat's plasma levels of Cu, Fe, CREAT, BIL and IL-6, whereas reducing the level of Cu from the recommended 6.5 mg/kg to 3.25 mg/kg decreases only the plasma concentration of TG, IgE and IL-6. Replacing CuCO3 with CuNPs in rat diets affects their metabolism, as indicated by decreased Ca, CREAT, BIL, ALB and IL-6 plasma levels. To sum up, CuNP added to a diet of rats have a more beneficial effect on metabolic indices (indicative of kidney and liver function) and inhibit inflammatory processes more effectively than CuCO3.

Fragmented particles containing octreotide acetate prepared by spray drying technique for dry powder inhalation.

Dry powder inhalers (DPIs) have been proposed as an alternative administration route for protein and peptide drugs. However, DPI particles are easy to aggregate due to the strong interactions between the particles, leading to poor aerosolization performance. In this study, fragmented particles containing octreotide acetate (OA) were prepared by spray drying technique for dry powder inhalation, which were expected to decrease the particle-particle interaction by reducing the contact sites. Mannitol and ammonium carbonate were used as protein stabilizer and fragment-forming agent, respectively. The obtained fragmented particles presented larger particle size, lower density, better dispersibility, and well in vitro aerodynamic behavior (emitted dose > 97%, fine particle fraction ≈ 40%). The circular dichroism spectrum results indicated that OA maintained the stability throughout the spray drying process. The relative bioavailability of dry powder inhalation (DPI) compared with subcutaneous injection of commercial product was up to 88.0%, demonstrating the feasibility of DPI for OA delivery. These results confirmed that the proposed fragmented particles had great potential for pulmonary delivery of protein and peptide drugs in a painless, rapid, and convenient manner.

Carbonate esters turn camptothecin-unsaturated fatty acid prodrugs into nanomedicines for cancer therapy.

We report that carbonate esters could turn hydrophobic camptothecin (CPT)-unsaturated fatty acid prodrugs into nanoaggregates in aqueous solution. The active CPT could be rapidly released once triggered by a reductive stimulus when a carbonate ester was combined with a disulfide bond, resulting in a potent in vivo antitumor activity.

Lanthanum Carbonate - A New Phosphate Binding Drug in Advanced Renal Failure.

BACKGROUND: Lanthanum (La) is considered to be a non-essential element. La has been used for several decades in China to improve yield in plant production and has also been shown to have significant performance enhancing effects in feeding trials on animal husbandry. The estimated dietary intake of La in humans is below 150 µg, which is lower than 10% of the estimated limit of safe and acceptable daily intake. METHODS: The present review is based on literature search in available databases. RESULTS: Upon ingestion of La as carbonate, the lanthanum ion (La3+) is released in the stomach and traps dietary phosphate as insoluble lanthanum phosphate complexes in the gut, thereby inhibiting phosphate absorption. Lanthanum carbonate as a drug to lower serum phosphate in endstage kidney failure was approved for human use by the US FDA in 2004 and by the EU in 2006. When used to treat patients with advanced renal insufficiency, lanthanum carbonate is administered orally at a dose of maximally 3000 mg per day. The uptake of lanthanum ions from the gut to the circulation is negligible. And few systemic side effects have been recorded upon the use of lanthanum carbonate as a phosphate binding drug, although gastrointestinal discomfort with pain, vomiting and diarrhea may occur. Lanthanum carbonate has the potential to chelate to drugs with anionic groups and therapeutic co-administration with lanthanum carbonate may reduce the bioavailibility of drugs like tetracyclines, quinolones and levothyroxine. CONCLUSION: The findings in this review confirm that lanthanum carbonate is a clinically useful phosphate binding drug with few side effects in advanced renal failure.

Involvement of the Nrf2/HO-1/CO axis and therapeutic intervention with the CO-releasing molecule CORM-A1, in a murine model of autoimmune hepatitis.

Concanavalin A (ConA)-induced hepatitis is an experimental model of human autoimmune hepatitis induced in rodents by i.v. injection of Con A. The disease is characterized by increase in serum levels of transaminases and massive immune infiltration of the livers. Type 1, type 2, and type 17 cytokines play a pathogenic role in the development of ConA-induced hepatitis. To understand further the immunoregulatory mechanisms operating in the development and regulation of ConA-induced hepatitis, we have evaluated the role of the anti-inflammatory pathway Nrf2/HO-1/CO (Nuclear Factor E2-related Factor 2/Heme Oxygenase-1/Carbon Monoxide) in this condition and determined whether the in vivo administration of CO via the CO-releasing molecule (CORM) CORM-A1, influences serological and histological development of Con-A-induced hepatitis. We have firstly evaluated in silico the genes belonging to the Nrf2/HO-1/CO pathway that are involved in the pathogenesis of autoimmune hepatitis (AIH). The data obtained from the in silico study demonstrate that a significant number of genes modulated in the liver of ConA-challenged mice belong to the Nrf2 pathway; on the other hand, the administration of CORM-A1 determines an improvement in several sero-immunological and histological parameters, and it is able to modulate genes identified by the in silico analysis. Collectively, our data indicate that the Nrf2/HO-1/CO pathway is fundamental for the regulation of the immune responses, and that therapeutic intervention aimed at its modulation by CORM-A1 may represent a valuable strategy to be considered for the treatment of autoimmune hepatitis in humans.

[Magnetic therapy for complex treatment of chronic periodontal disease]. / Opyt primeneniya magnitoterapii v kompleksnom lechenii bol'nykh khronicheskim generalizovannym parodontitom.

The aim of the study was to elaborate the methodology of magnetic therapy for complex treatment of chronic periodontal disease (CPD). The study included 60 patients aged 35 to 65 years with moderate CPD divided in 2 groups. Patients in group 1 (controls) received impulse carbonate irrigation for 12 min №10, group 2 additionally received magnetic therapy for 5 min №10 in maxillary and mandibular areas. CLINICAL RESULTS: periodontal and rheological indices proved magnetic therapy to be useful tool for eradication of inflammation, periodontal tissue functional recovery and stabilization.

Comparison of the use of sodium carbonate (washing soda crystals) and apomorphine for inducing emesis in dogs.

OBJECTIVE: To describe the use of sodium carbonate and apomorphine in a historical cohort of dogs, compare the occurrence of emesis and report any adverse effects recorded. METHODS: This historical, observational study included information from medical records of dogs that received an emetic agent. The occurrence of emesis with apomorphine or sodium carbonate was calculated and the association between emesis and agent was explored, with the odds ratio and 95% confidence interval (CI) reported. A non-inferiority analysis of the occurrence of emesis for sodium carbonate was performed against an equivalence range of ±7% of the estimated occurrence of emesis with apomorphine. Owners were emailed a short survey about their dog's health after their visit to the hospital for induced emesis. RESULTS: Records for 787 dogs seen from January 2007 to December 2013 were included. For apomorphine, 382/392 dogs showed emesis (97%, 95% CI 95-100%). For sodium carbonate, 320/395 dogs showed emesis (81%, 95% CI 77-85%), which fell below the equivalence range for apomorphine (97 ± 7%, 90-100%) and was considered inferior. The odds ratio of emesis with apomorphine to sodium carbonate was 9.0 (95% CI 4.6-17.6). Of 18 responses to the survey, 5 reported abnormalities after emesis (3 with sodium carbonate, 2 with apomorphine). CONCLUSION: The occurrence of emesis with sodium carbonate was high but inferior to apomorphine. However, the advantages of sodium carbonate, including less expense and ease of accession compared with apomorphine, make it a viable choice in emergency medicine.

Histological evaluation of sodium percarbonate exposure on the gills of rainbow trout.

Ichthyophthirius multifiliis is a recurring problem in Australian rainbow trout Oncorhynchus mykiss farms and requires strategically timed, repeat treatments for effective management. Sodium percarbonate (SPC) is permitted for use in Australia, with host safety margins based on the toxicity of acute exposures to hydrogen peroxide (HP), the active product released when SPC is added to water. The effects of exposure to HP released by SPC, of repeated doses and of doses exceeding 100 mg l-1 on rainbow trout are unknown. We exposed juvenile rainbow trout (mean weight: 30.5 ± 9 g) to repeated doses of 50, 150 and 250 mg l-1 SPC for 1 h on Days 1, 2, 7 and 8 of a treatment regime. The effect of SPC was assessed by histological evaluation of structural changes in gill tissue. Survival was 100% in all groups, but some fish exposed to 250 mg l-1 SPC displayed impaired swimming performance, and on Day 9 after the final treatment, oedema was present in 9.8% of lamella, which was significantly higher than the mean occurrence of 1.7, 4.2 and 1.3% in fish treated with 0, 50 and 150 mg l-1 SPC, respectively. These changes resolved within 24 h of the cessation of treatment. We conclude that SPC is safe to use on rainbow trout in doses of ≤150 mg l-1 at 17°C, however caution is advised at doses approaching 250 mg l-1. Water temperature, fish age, fish size and maturity, intensity of parasite infection and stocking density could alter the sensitivity of rainbow trout to SPC treatments.

Anti-diabetic actions of carbon monoxide-releasing molecule (CORM)-A1: Immunomodulation and regeneration of islet beta cells.

We have recently shown that carbon monoxide releasing molecule (CORM)-A1 prevents type 1 diabetes induced in C57BL/6 mice with multiple low doses of streptozotocin (MLDS) by shifting the Th1/Th17/M1 balance towards a Th2/M2 response. In the present work we tested the hypothesis that CORM-A1 might influence regulatory arm of the immune response, as well as beta cell regeneration. CORM-A1 (2 mg/kg/day) was administered for 10 days to mice induced with MLDS and/or depleted of low dose cyclophosphamide (CY)-sensitive FoxP3+ T regulatory (Treg) cells. Besides monitoring hyperglycaemia, ex vivo analysis of spleen, pancreatic lymph nodes (PLN) and pancreas was performed at the end of treatment. In CORM-A1-treated MLDS-induced mice the improvement of hyperglycaemia was observed only without depletion of CY-sensitive FoxP3+ Treg cells. This was accompanied by decreased levels of interleukin (IL)-12, IL-2 and early activation marker CD25 in the spleen and PLN and increased transforming growth factor (TGF)-ß, resulting in reduced lymphocyte proliferation in both organs. In parallel, decreased transcript levels of IL-2, but increased mRNA expression of TGF-ß, accompanied with up-regulation of Ki-67 protein expression was observed within pancreas. Together, the data suggested that besides the immunomodulatory potential, CORM-A1 probably induces beta cell regeneration.

Effect of variable water intake as mediated by dietary potassium carbonate supplementation on rumen dynamics in lactating dairy cows.

Water is a critical nutrient for dairy cows, with intake varying with environment, production, and diet. However, little work has evaluated the effects of water intake on rumen parameters. Using dietary potassium carbonate (K2CO3) as a K supplement to increase water intake, the objective of this study was to evaluate the effect of K2CO3 supplementation on water intake and on rumen parameters of lactating dairy cows. Nine ruminally cannulated, late-lactation Holstein cows (207±12d in milk) were randomly assigned to 1 of 3 treatments in a replicated 3×3 Latin square design with 18-d periods. Dietary treatments (on a dry matter basis) were no added K2CO3 (baseline dietary K levels of 1.67% dietary K), 0.75% added dietary K, and 1.5% added dietary K. Cows were offered treatment diets for a 14-d adaption period followed by a 4-d collection period. Ruminal total, liquid, and dry matter digesta weights were determined by total rumen evacuations conducted 2h after feeding on d 4 of the collection period. Rumen fluid samples were collected to determine pH, volatile fatty acids, and NH3 concentrations, and Co-EDTA was used to determine fractional liquid passage rate. Milk samples were collected twice daily during the collection period. Milk, milk fat, and protein yields showed quadratic responses with greatest yields for the 0.75% added dietary K treatment. Dry matter intake showed a quadratic response with 21.8kg/d for the 0.75% added dietary K treatment and 20.4 and 20.5kg/d for control and the 1.5% added dietary K treatment, respectively. Water intake increased linearly with increasing K2CO3 supplementation (102.4, 118.4, and 129.3L/d) as did ruminal fractional liquid passage rate in the earlier hours after feeding (0.118, 0.135, and 0.141 per hour). Total and wet weights of rumen contents declined linearly and dry weight tended to decline linearly as dietary K2CO3 increased, suggesting that the increasing water intake and fractional liquid passage rate with increasing K2CO3 increased the overall ruminal turnover rate. Ruminal ammonia concentrations declined linearly and pH increased linearly as K supplementation increased. As a molar percentage of total volatile fatty acids, acetate increased linearly as dietary K increased, though propionate declined. Increasing dietary K2CO3 and total K in the diets of lactating dairy cows increased water consumption and modified ruminal measures in ways suggesting that both liquid and total ruminal turnover were increased as both water and K intake increased.

The effect of dietary cation-anion difference concentration and cation source on milk production and feed efficiency in lactating dairy cows.

Feed costs currently account for 55% or more of the total cost of milk production in US dairy herds, and dairy producers are looking for strategies to improve feed efficiency [FE; 3.5% fat-corrected milk (FCM) per dry matter (DM) intake]. Increasing dietary cation-anion difference [DCAD; Na+K-Cl (mEq/kg of DM)] has been shown to increase milk production, FCM, and FE. However, the optimal DCAD concentration for maximal FE has yet to be determined. The objectives of this research were to test the effects of DCAD concentration and cation source on dairy FE. Sixty Holstein dairy cows (20 cows per experiment) were used in three 4×4 Latin square design experiments with 3-wk experimental periods. In experiments 1 and 2, we tested the effect of DCAD concentration: cows were fed a basal diet containing ~250 mEq/kg of DM DCAD that was supplemented with potassium carbonate at 0, 50, 100, and 150 mEq/kg of DM or 0, 125, 250, and 375 mEq/kg of DM in experiments 1 and 2, respectively. In experiment 3, we tested the effect of cation source: sodium sesquicarbonate replaced 0, 33, 67, and 100% of the supplemental potassium carbonate (150 mEq/kg of DM DCAD). The DCAD concentration had no effect on milk production, milk protein concentration, or milk protein yield in experiments 1 and 2. Dry matter intake was not affected by DCAD concentration in experiment 1 or by cation source in experiment 3. However, DMI increased linearly with increasing DCAD in experiment 2. We detected a linear increase in milk fat concentration and yield with increasing DCAD in experiments 1 and 2 and by substituting sodium sesquicarbonate for potassium carbonate in experiment 3. Increased milk fat concentration with increasing DCAD led to increases in 3.5% FCM in experiments 1 and 2. Maximal dairy FE was achieved at a DCAD concentration of 426 mEq/kg of DM in experiments 1 and 2 and by substituting Na for K in experiment 3. The results of these experiments suggest that both DCAD concentration and the cation source used to alter DCAD concentration have effects on milk fat content and yield and dairy FE.

Substitution effects of a carbonated hydroxyapatite biomaterial against intoxication chloride nickel-exposed rats.

AIMS: This study aimed to investigate the potential effects of a synthetic apatite (carbonated hydroxyapatite) on the detoxification of a group of male "Wistar" rats exposed to nickel chloride. METHODS: Toxicity was evaluated by rats' bioassay of nickel chloride. Wistar rats received this metal daily by gavage for seven days (4 mg/ml nickel chloride/200 g body weight, BW). To detoxify this organism, a subcutaneous implantation of the apatite is made. RESULTS: The results revealed that exposure to nickel induced oxidative stress, disorders in the balances of ferric phosphocalcic, renal failures, liver toxicity and significant increase in nickel rates in the bones of intoxicated rats. The application of the carbonated hydroxyapatite presented in this study restored those disorders back to normal. The synthetic apatite protected the rats against the toxic effects of nickel by lowering the levels of lipid peroxidation markers and improving the activities of defense enzymes. It also amended ferric and phosphocalcic equilibriums, protected liver and kidney functions and reduced the nickel rate in the bones of the rats. Overall, the results provided strong support for the protective role of carbonated hydroxyapatite in the detoxification of rats exposed to nickel. Those beneficial effects were further confirmed by physico-chemical characterization (X-ray diffraction and infrared spectroscopy), which revealed its property of anionic and cationic substitution, thus supporting its promising candidacy for future biomedical application. CONCLUSION: The hydroxyapatite is an effective biomaterial to solve health problems, particularly detoxification against metals (nickel).

[A woman in her forties with cancer, syncope and spasms]. / En kvinne i 40-årene med kreft, synkope og kramper.

A female in her forties with advanced incurable rectal cancer presented to our emergency department after loss of consciousness followed by brief myoclonic jerks in her legs. A cerebral MRI was normal. Her electrocardiogram showed a prolonged QTc interval of 596 milliseconds and hypokalemia was present. She had no family history of congenital long QT syndrome or of cardiovascular disease. She was not on any medication apart from having ingested 100 g caesium carbonate over the previous 11 days as an alternative cancer treatment. Caesium chloride is postulated to increase pH and thereby induce apoptosis in cancer cells. In treatment doses caesium competes with potassium for membrane transport proteins in the cardiac cell membrane and in the reabsorption tubuli of the kidneys. A result is hypokalemia shortly after depolarization during the cardiomyocytes' repolarisation phase or delayed post-depolarisation. Torsade de pointes ventricular arrhythmias, ventricular tachycardia, pump failure and death can follow. A few case reports of adverse effects from caesium ingestion have been published, as well as reports on how caesium is used in animal models to induce ventricular tachycardia, but the hazards of caesium ingestion and its long half-life are not well known in the medical care profession or among patients. As this patient's QTc interval normalised slowly to 413 milliseconds 60 days after stopping caesium ingestion, we consider caesium intoxication and convulsive syncope from a self-terminating ventricular tachycardia as the most probable aetiology. The main message from this case is that alternative medicine can have life-threatening side effects.