Review: Chestnut and quebracho tannins in pig nutrition: the effects on performance and intestinal health.

Natural extracts are frequently adopted as a valuable alternative to antibiotics in intensive animal farming. Their diverse bioactive constituents such as phytosterols, glucosinolates, carotenoids and polyphenols have shown antioxidant, anti-inflammatory and antibacterial effects. Tannins are the largest class of polyphenol compounds of plant extracts, which can be classified into two hydrolysable or condensed subgroups. Poultry and swine nutrition are the most important sectors in which tannins have been used, firstly adopting tannin-rich feedstuffs and more recently, using tannin extracts from different plants. Several commercial products are available containing tannins extracted from the European chestnut tree (Castanea sativa Mill.) and the American quebracho (Schinopsis spp.). Tannins extracted from these plants have been applied on intensive swine farms due to their ability to improve animal performance and health. These positive and prominent effects are frequently associated with the antinutritional effects in reducing feed palatability, digestibility and protein utilization of feed. Some criticisms and contrasting results regarding pig performance and intestinal health have been reported. This paper provides an overview of the effects of chestnut and quebracho tannins on growth performance and intestinal health of pigs in order to clarify the appropriate dosage and response in the various physiological stages.

Effect of starch-based supplementation level combined with oil on intake, performance, and methane emissions of growing Nellore bulls on pasture.

Intake of tropical grass forages alone is generally insufficient to avoid nutrition imbalances and reduced animal performance; therefore, supplementation is often recommended. The hypothesis of the present study is that when combined with fat, soybean hulls (SH) could replace corn as a source of energy, reducing methane production without affecting animal performance. This study evaluated the effects of starch-based supplementation level combined with oil on intake, digestibility, performance, and methane emissions of growing Nellore bulls (P = 44; initial BW = 250.69 ± 27 kg) fed cv. Xaraés during the rainy season. There were no interactions between starch level and oil supplementation with regard to intake of DM (P = 0.67), forage DM (P = 0.55), supplement DM (P = 0.14), OM (P = 0.66), CP (P = 0.74), NDF (P = 0.50), ether extract (EE; = 0.47), and GE ( P= 0.68). The intake of EE was greater for animals supplemented with oil than those fed supplements without oil (P < 0.01). There were no interactions between starch level and oil supplementation on digestibility of DM (P= 0.18), OM (P = 0.11), NDF (P= 0.42), and EE (P = 0.14). Moreover, there was interaction between starch and oil supplementation on GE (P < 0.01). Independent of starch level used, the addition of oil decreased the digestibility of OM (P = 0.04) and NDF (P = 0.03). There were no main effects of starch level, oil, or interaction between starch and oil for initial BW (P = 0.10), final BW (P = 0.94), ADG (P = 0.40), feed efficiency (P= 0.37), and carcass gain (P = 0.38). There was no interaction between starch-based supplementation level and oil on methane emissions when expressed in grams per day (P = 0.77), kilograms per year (P = 0.77), grams per kilogram DMI (P = 0.53), and grams per kilogram carcass gain (P= 0.31). There was, however, an interaction (P = 0.04) between starch level and oil on methane emissions when corrected for NDF intake. Additionally, oil decreased enteric methane emission for intake of GE (P = 0.04) and EE (P < 0.01) of animals fed with starch level. Soybean hulls have an estimated feeding value similar to that of corn. The use of oil supplementation may be effective to reduce enteric methane emission of Nellore bulls raised on pasture.

Heat stress and dehydration in kendo.

AIM: This study aimed to analyze sweat rate, water percentage alteration, and temperature variation during kendo practice in order to relate the thermal stress induced by such sports and draw recommendations for its secure practice. METHODS: Participants were 12 male individuals. The studied variables were: age, weight, stature, body mass index, fat percentage, water loss percentage, tympanic temperature, and sweat rate. Measures were obtained in one day of 120 min practice (T: 24.1 ± 2.5 °C; RH: 73 ± 8.5%) using obligatory training equipment. RESULTS: The age of participants was on average 26 ± 6.2 years, stature 1.8 ± 0.03 m, weight 78 ± 13.7 kg, BMI 24.12 ± 4.03 kg/m² and fat percentage 15.7 ± 5.1%. Weight and temperature final values were significantly different from the initial ones (P<0.01). Estimated sweat rate was 0.35 L.h-1 (95% CI = [0.299; 0.400]) and estimated percentage of water loss was 0.946% (95% CI = [0.694; 1.174]). CONCLUSION: Kendo practice using obligatory equipment significantly increases temperature, even when sweat rate and water loss percentage are low. The almost complete obstruction of the evaporative surface leads to heat accumulation, which may result in risks comparable to those of American football players. Thus, preventive measures must be established to minimize the risks of the combination among environment (tropical climate), equipment (bogu) and the high physiological demand of this sport in order to prevent greater damages to the health of practitioners.

Long-term treatment with autologous red blood cells loaded with dexamethasone 21-phosphate in pediatric patients affected by steroid-dependent Crohn disease.

BACKGROUND: Inflammatory bowel disease (IBD) present in childhood in 15% to 25% of cases. The aim of therapy in children is not only to guarantee normal growth but also to prevent relapse and to maintain remission. Steroids are effective to induce remission; however, resistance, dependency, and irreversible side effects can develop. The aim of this study was to determine whether treatment with repeated infusions of autologous red blood cells (RBCs) loaded with dexamethasone 21-phosphate (Dex 21-P) is safe and allows maintenance of long-term remission in children with steroid-dependent Crohn disease (CD). PATIENTS AND METHODS: Eighteen consecutive pediatric patients who met the inclusion criteria were admitted to the study. Infusions of autologous RBCs loaded with Dex 21-P were performed every 4 weeks; the mean duration of treatment was 24 months. At the beginning of treatment and after 6, 12, and 24 months, we performed clinical evaluation according to the Pediatric Crohn Disease Activity Index (pCDAI). Assessment of body mass in dexamethasone and bone mineral density by means of computerized bone mineralometry-dual energy x-ray absorptiometry, endoscopic evaluation, and hematic morning cortisol determination were also performed. RESULTS: During treatment, the mean pCDAI significantly decreased (P < 0.05); 78% of patients discontinued steroids. Determination of morning cortisol showed suppression only on the first day after infusion, followed by normalization of values. Endoscopic findings showed remission in 44% of patients. None of the patients experienced serious side effects. CONCLUSIONS: These data suggest that repeated infusions of RBCs loaded with Dex 21-P can be safe and useful to maintain long-term remission in pediatric patients with moderately active CD.

The acceptability of isoflavones as a treatment of menopausal symptoms: a European survey among postmenopausal women.

OBJECTIVE: To investigate determinants of the acceptability of isoflavone products among postmenopausal women with regard to social and lifestyle factors, dietary habits, health concerns, food beliefs, menopausal symptoms and therapies, and to elucidate preferences for specific products. METHODS: A consumer survey was conducted among postmenopausal women in four European countries (Germany, Denmark, Italy and the UK), including a total of 465 respondents. RESULTS: The declared acceptability of isoflavones was highest in Germany (80%), followed by Italy (75%), the UK (59%) and Denmark (55%; p < 0.001). Among other factors, prior information about isoflavones (odds ratio (OR) 2.64, 95% confidence interval (CI) 1.54-4.51, p < 0.001) and belief that foods can be used to treat medical conditions (OR 2.18, 95% CI 1.17-4.05, p = 0.014) were the strongest predictors of potential acceptability. The preferred forms in which isoflavones might be taken differed markedly between countries. CONCLUSIONS: Information about the health effects of isoflavones and health-diet links should be considered the most important factors in attempts to influence the potential acceptability of isoflavone products. Foods enriched with isoflavones need to be developed with regard to specific cultural demands in order to assure consumer acceptance on the marketplace.

The role of fermented milk in complementary feeding of young children: lessons from transition countries.

Probiotic bacteria are used for production of fermented dairy products. The use of probiotic bacteria has the potential to replenish the natural intestinal flora of the body. These bacteria competitively inhibit the growth and colonization of pathogenic bacteria. Breastmilk is the best food for babies, also from a probiotic point of view. Human milk, in fact, contains many substances that stimulate the growth of bifidobacteria in vitro and in the small intestine of infants. Improvement of lactose digestion and avoidance of symptoms of intolerance in lactose malabsorbers are the most profoundly studied health-relevant effects of fermented milk. In fact fermented milks are nutritionally similar to unfermented milk, except that some of lactose is broken down to glucose and galactose. The role of fermented milk in complementary feeding and in particular for the prevention of anaemia is an innovative theme, recently focused. Iron deficiency in infants and young children is widespread and has serious consequences for child health. Prevention of iron deficiency should therefore be given high priority. The too-early introduction of unmodified cow's milk and milk products is an important nutritional risk factors for the development of iron-deficiency anaemia. Fermented milks represent an excellent source of nutrients such as calcium, protein, phosphorus and riboflavin. During the fermentation of milk, lactic acid and other organic acids are produced and these increase the absorption of iron. If fermented milk is consumed at mealtimes, these acids are likely to have a positive effect on the absorption of iron from other foods.

Impact after 1 year of compulsory iodisation on the iodine content of table salt at retailer level in South Africa.

The short-term effectiveness of introducing compulsory iodisation through revised health legislation, evaluated in terms of the iodine content of iodised table salt, was investigated in three of the nine provinces in South Africa. Shortly before the introduction of compulsory iodisation of table salt in December 1995, iodised at a higher level than before, 187 iodised salt samples were purchased at retailers in 48 magisterial districts situated in the three provinces of Western and Eastern Cape and Mpumalanga for analysis of the iodine content using the titration method. In a follow-up 1 year later 287 iodised salt samples were obtained from the same retailers for iodine determination. The mean iodine content of iodised salt increased significantly from 14 to 33 ppm. However, large variation in the iodine content of iodised table salt among and within salt brands existed at follow-up, and the mean iodine content was lower than the legal specification of 40 to 60 ppm. Only 24% of the samples were found within the range required by the law at follow-up compared to 42% before revising the salt legislation. Despite the introduction of compulsory salt iodisation, the mean retail price of iodised salt remained the same between 1995 and 1996 for a 500 g package of salt. Further refinement of the iodisation process is necessary to improve the accuracy of iodisation and decrease the variation in iodine content. This study nevertheless showed that the introduction of compulsory iodisation and elevating the legally specified iodine level of table salt resulted in a significantly elevated mean iodine level of iodised salt within 1 year, without any additional cost to the consumer.

Nifedipine GITS versus diltiazem in chronic stable angina: a randomised multicentre study.

In order to compare the efficacy of nifedipine gastrointestinal therapeutic system (GITS) with diltiazem, 99 patients with chronic stable angina were studied in a parallel-group randomised trial. According to the results of the two exercise tolerance tests (ETTs) performed during the placebo run-in, patients were divided into a fixed threshold group if the variability in time to 1 mm ST-segment depression was 20%, or a variable threshold group if it was higher. Efficacy was assessed by comparing the time to 1 mm ST-depression on a bicycle ETT after 4 weeks of treatment, adjusting for the baseline value. The adjusted means were 7.44 min for nifedipine GITS and 7.68 min for diltiazem; the difference was -0.24 min, with a lower 90% confidence limit of -0.90, which is within the stated interval for equivalence. The same result was confirmed by the 'intention-to-treat' analysis, and comparable results were obtained both in fixed and in variable threshold groups. The incidence of side effects was 12% with nifedipine GITS and 8.2% with diltiazem. Nifedipine GITS and diltiazem were found to be equally effective in increasing exercise tolerance in chronic stable angina patients.

[Sudden cardiac death in non-professional athletes]. / Morte improvvisa cardiaca in atleti non professionisti.

Sudden death during sports activities in non-professional athletes is a rare occurrence, however it is of great interest in clinical pathology and forensic medicine. We performed chemico-toxicologic and histopathologic investigations in three cases of sudden cardiac death in non-professional athletes, focusing in particular on the cardiac conduction system. Examination of conduction tissue was performed on sections seriated every 150 microns, stained alternately with hematoxylin-eosin and Heidenhain's trichrome (azan). In all three cases diagnostic evidence showed hyperacute myocardial infarction, due to spasm of coronaries with mild atherosclerosis, and myocardial lesions due to reperfusive necrosis. The pathogenesis of sudden death in young athletes is not related only to ischemic-coronary damage that is not exclusively mechanical, but also a dynamic event (spasm and reperfusion), but also to fatal arrhythmias related to abnormal findings in the conduction system. Such findings can therefore be considered the morphologic substrate of sudden cardiac death.

Selenium, zinc, and thyroid hormones in healthy subjects: low T3/T4 ratio in the elderly is related to impaired selenium status.

Iodothyronine 5' deiodinase, which is mainly responsible for peripheral T3 production, has recently been demonstrated to be a selenium (Se)-containing enzyme. The structure of nuclear thyroid hormone receptors contains Zinc (Zn) ions, crucial for the functional properties of the protein. In the elderly, reduced peripheral conversion of T4 to T3 with a lower T3/T4 ratio and overt hypothyroidism are frequently observed. We measured serum Se and RBC GSH-Px (as indices of Se status), circulating and RBC Zinc (as indices of Zn status), thyroid hormones and TSH in 109 healthy euthyroid subjects (52 women, 57 men), carefully selected to avoid abnormally low thyroid hormone levels induced by acute or chronic diseases or calorie restriction. The subjects were subdivided into three age groups. To avoid under- or malnutrition conditions, dietary records were obtained for a sample of 24 subjects, randomly selected and representative of the whole population for age and sex. Low T3/T4 ratios and reduced Se and RBC GSH-Px activity were observed only in the older group. A highly significant linear correlation between the T3/T4 ratio and indices of Se status was observed in the older group of subjects (r = 0.54; p < 0.002, for Se; r = 0.50; p < 0.002, for RBC GSH-Px). Indices of Zn status did not correlate with thyroid hormones, but RBC Zn was decreased in older as compared with younger subjects. We concluded that reduced peripheral T4 conversion is related to impaired Se status in the elderly.

Differential decrease of copper content and of copper binding to superoxide dismutase in liver, heart and brain of copper-deficient rats.

Dietary copper-deficiency in rats produced a organ-specific decrease of copper content. This was paralleled by a decrease of the activity of the copper-enzyme superoxide dismutase. In liver such a decrease is partially due to the existence of an apo-form of superoxide dismutase, which can be reactivated by addition of exogenous copper to tissue extracts. These results demonstrate in vivo that superoxide dismutase is post-translationally modulated by copper in higher vertebrates as previously found for yeast and mammalian cells in culture.

[Evaluation of the chronic antihypertensive effect of nitrendipine using ambulatory monitoring]. / Valutazione seriata con monitoraggio ambulatoriale dell'effetto antipertensivo cronico della nitrendipina.

Twenty patients (12 males, 8 females, mean age 51 +/- 10 years) with mild to moderate arterial hypertension were treated with nitrendipine (mean daily dose 17 mg) during a 6 month period. Patients were evaluated with blood measurement and with 24-hour ambulatory blood pressure monitoring. In 16 patients who completed the study, systolic and diastolic blood pressure decreased of 13-15% and 18-20% respectively after at least 1 month of therapy. Mean 24-hour blood pressure was reduced of 9.7% (p < 0.01) at the end of the third month and of 13.9% (p < 0.01) at the end of the sixth month. Both systolic and diastolic 24-hour blood pressure were significantly reduced. Nitrendipine was active on day time and night time pressure. Only 1 patient had edema of the legs. Heart rate was not increased by the drug. Total cholesterol and LDL cholesterol were reduced.

[Efficacy and tolerability of simvastatin and omega-3 fatty acid combination in patients with coronary disease, hypercholesterolemia and hypertriglyceridemia]. / Efficacia e tollerabilità dell'associazione di simvastatina con acidi grassi omega-3 in pazienti affetti da malattia coronarica, ipercolesterolemia ed ipertrigliceridemia.

Patients with ischemic heart disease are often affected by a mixed hyperlipoproteinemia, where a hypercholesterolemia of various severity is accompanied by slight or moderate hypertriglyceridemia (type IIb dyslipidemia). Current epidemiologic evidence suggests that hypertriglyceridemia has not to be disregarded, particularly in certain subgroups of patients. We evaluated the effect of the association of simvastatin 10 mg/day [an hydroxymethyl-glutaryl-CoA (HMG-CoA) reductase inhibitor] and omega-3 polyunsaturated fatty acids (n3-PUFA) in comparison with simvastatin 10 mg/day alone. The subjects undergoing the study were affected by coronary artery disease and showed hypercholesterolemia (LDL-cholesterol > 160 mg/dl) and moderate hypertriglyceridemia (serum triglycerides 200-400 mg/dl) after 2 months of moderate dietary therapy for hyperlipidemia (Step 1 of the National Cholesterol Education Program [NCEP]). Thirty-nine patients were randomized to have 1 of 2 scheduled treatments. At the same time the patients underwent severe dietary therapy for hyperlipidemia (Step 2 of the NCEP). After 3 months of treatment, total-cholesterol, LDL-cholesterol, and triglycerides were significantly lower than basal values in both groups (p < 0.05). Total-cholesterol, LDL-cholesterol, and triglycerides were lower in the group treated with n3-PUFA and simvastatin compared to simvastatin alone. However, only for triglycerides was the difference significant (-39.99% in patients treated with n3-PUFA and simvastatin versus -25.65% in patients treated with simvastatin alone, particularly in the first group of 35.85%; p < 0.05). With regard to HDL-cholesterol, the differences between the basal values and the 2 groups of treatments were non significant. Remarkable side effects were not observed in the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Red blood cells as an antigen-delivery system.

The use of adjuvants is usually required to induce strong immunological responses to protein antigens. However, in many cases these adjuvants cannot be extensively applied in human and veterinary vaccinations because of associated inflammatory reactions or granuloma formation. We show here that protein antigens (bovine serum albumin, hog liver uricase, and yeast hexokinase), coupled to autologous red blood cells by way of a biotin-avidin-biotin bridge, elicit an immunological response in mice similar to or higher than that obtained by the use of Freund's adjuvant. Quantities as low as 0.5 micrograms/mouse are high enough to generate these immunological responses. Furthermore, splenocytes of mice immunized by red blood cell-coupled antigens can be used to generate hybridomas secreting monoclonal antibodies. Thus, the delivery of antigens by autologous red blood cells is an effective way to avoid the use of adjuvants for producing anti-peptide antibodies and possibly to generate peptide vaccines.

[Hemosiderosis in thalassemia major. Quantitative study with magnetic resonance (MR)]. / L'emosiderosi nella talassemia major. Studio quantitativo con risonanza magnetica (RM).

Hemosiderosis, which results from transfusional therapy and from increased absorption of dietary iron, is a severe complication of thalassemia major. The complication is also very difficult to manage. An accurate determination of the total amount and of the distribution of body iron stores is essential for prognostic purposes and to evaluate the efficacy of chelation therapy. Therefore, a suitable tool for the noninvasive depiction of iron overload is to be hoped for. MR imaging has been usefully employed, of late, to this purpose. Sixteen thalassemic patients have been studied to evaluate iron depositions using a 1.5 T magnet. Signal intensities from liver, pancreas, spleen, bone marrow, and heart were considered. The signals were dramatically lower than the normal values obtained in a sex- and age-matched group; the differences were due to the iron. Iron distribution appeared inhomogeneous, with the highest overload in liver and bone marrow. Since cardiomyopathy represents the first cause of death in thalassemic patients, the relationship between cardiac function and iron overload in the heart has been thoroughly investigated. Finally, the authors conclude that MR will become a widely employed method for assessing iron overload and will contribute to improve the management of thalassemia major.

Angiographic morphology and response to therapy in unstable angina.

The coronary anatomy of 69 patients with unstable angina, subgrouped according to response to medical therapy, was investigated. All patients received oral treatment with nitrates, calcium antagonists, and beta-blocking agents. When combined oral treatment was not effective, an intravenous infusion of nitrates (10-100 micrograms/min) was subsequently administered. Coronary arteriography was performed within hours (14 +/- 9 h) from the last episode of chest pain in 28 patients refractory to medical treatment, while in 41 patients who became asymptomatic during medical therapy, angiography was performed after an observation period of several days (8 +/- 6 days). On angiography, the nonresponder group was characterized by a prevalence of eccentric and multiple lesions, and by a 46% incidence of thrombi (p less than 0.001). Recurrent symptoms requiring emergency bypass operation were common in this group. In patients responsive to medical treatment, a high percentage of concentric lesions (37%) and totally occluded (34%) coronary arteries was found (p less than 0.05). No infarcts and low rate of recurrent angina were noted in these patients during hospitalization. In conclusion, the finding of intracoronary thrombotic material and eccentric or multiple lesions can be an accurate markers of the active phase of the disease, while "silent" occlusion of the involved vessel may be accompanied by relief of symptoms during medical therapy.