Alta frecuencia de trombo endoluminal en pacientes con ictus isquémico tras la infección por coronavirus 2019 / High frequency of endoluminal thrombus in patients with ischaemic stroke following SARS-CoV-2 infection

Introducción El ictus isquémico puede ser una complicación grave en los pacientes con infección por SARS-CoV-2. Estudiar y caracterizar los diferentes subtipos etiológicos, las características clínicas y el pronóstico funcional podrá resultar útil en la selección de pacientes para un manejo y tratamiento óptimos. Métodos La recogida de variables se hizo de forma retrospectiva en pacientes consecutivos con infección por SARS-CoV-2 que desarrollaron un episodio de isquemia cerebral focal (entre el 1 de marzo del 2020 y el 19 de abril del 2020). Se llevó a cabo en un hospital universitario de tercer nivel en la Comunidad de Madrid (España). Resultados Durante el período de estudio 1.594 pacientes fueron diagnosticados de infección por SARS-CoV-2. Identificamos a 22 pacientes con ictus isquémico (1,38%); de estos, no cumplieron los criterios de inclusión 6. Un total de 16 pacientes con isquemia cerebral focal constituyeron la serie del estudio (15 con ictus isquémico y uno con accidente isquémico transitorio). En la valoración basal en el National Institutes of Health Stroke Scale la mediana fue de 9 (rango intercuartil: 16), la edad media ± desviación estándar fue de 73 ± 12,8 años; 12 pacientes fueron varones (75%). El tiempo desde los síntomas de COVID-19 hasta el ictus fue de 13 días. Se encontró oclusión de gran vaso en 12 pacientes (75%). El dímero-D estuvo elevado en el 87,5% y la proteína C reactiva en el 81,2% de los casos. La etiología más frecuente del ictus isquémico fue la aterotrombosis (9 pacientes, 56,3%) con un subtipo predominante que fue el trombo endoluminal sobre placa de ateroma (5 pacientes, 31,2%), 4 de ellos en la arteria carótida interna y uno de ellos en el arco aórtico. La mortalidad en nuestra serie fue del 44% (7 de 16 pacientes). Conclusiones En los pacientes con ictus y COVID-19 la etiología más frecuente fue la aterotrombótica, con una elevada frecuencia de trombo endoluminal sobre placa de ateroma... (AU)

Background Ischaemic stroke may be a major complication of SARS-CoV-2 infection. Studying and characterising the different aetiological subtypes, clinical characteristics, and functional outcomes may be valuable in guiding patient selection for optimal management and treatment. Methods Data were collected retrospectively on consecutive patients with SARS-CoV-2 infection who developed acute focal brain ischaemia (between 1 March and 19 April 2020) at a tertiary university hospital in Madrid (Spain). Results During the study period, 1594 patients were diagnosed with COVID-19. We found 22 patients with ischaemic stroke (1.38%), 6 of whom did not meet the inclusion criteria. The remaining 16 patients were included in the study (15 cases of ischaemic stroke and one case of transient ischaemic attack). Median baseline National Institutes of Health Stroke Scale score was 9 (interquartile range: 16), and mean (standard deviation) age was 73 years (12.8). Twelve patients (75%) were men. Mean time from COVID-19 symptom onset to stroke onset was 13 days. Large vessel occlusion was identified in 12 patients (75%). We detected elevated levels of D-dimer in 87.5% of patients and C-reactive protein in 81.2%. The main aetiology was atherothrombotic stroke (9 patients, 56.3%), with the predominant subtype being endoluminal thrombus (5 patients, 31.2%), involving the internal carotid artery in 4 cases and the aortic arch in one. The mortality rate in our series was 44% (7 of 16 patients). Conclusions In patients with COVID-19, the most frequent stroke aetiology was atherothrombosis, with a high proportion of endoluminal thrombus (31.2% of patients). Our clinical and laboratory data support COVID-19–associated coagulopathy as a relevant pathophysiological mechanism for ischaemic stroke in these patients. (AU)

Alta frecuencia de trombo endoluminal en pacientes con ictus isquémico tras la infección por coronavirus 2019 / High frequency of endoluminal thrombus in patients with ischaemic stroke following SARS-CoV-2 infection

Introducción El ictus isquémico puede ser una complicación grave en los pacientes con infección por SARS-CoV-2. Estudiar y caracterizar los diferentes subtipos etiológicos, las características clínicas y el pronóstico funcional podrá resultar útil en la selección de pacientes para un manejo y tratamiento óptimos. Métodos La recogida de variables se hizo de forma retrospectiva en pacientes consecutivos con infección por SARS-CoV-2 que desarrollaron un episodio de isquemia cerebral focal (entre el 1 de marzo del 2020 y el 19 de abril del 2020). Se llevó a cabo en un hospital universitario de tercer nivel en la Comunidad de Madrid (España). Resultados Durante el período de estudio 1.594 pacientes fueron diagnosticados de infección por SARS-CoV-2. Identificamos a 22 pacientes con ictus isquémico (1,38%); de estos, no cumplieron los criterios de inclusión 6. Un total de 16 pacientes con isquemia cerebral focal constituyeron la serie del estudio (15 con ictus isquémico y uno con accidente isquémico transitorio). En la valoración basal en el National Institutes of Health Stroke Scale la mediana fue de 9 (rango intercuartil: 16), la edad media ± desviación estándar fue de 73 ± 12,8 años; 12 pacientes fueron varones (75%). El tiempo desde los síntomas de COVID-19 hasta el ictus fue de 13 días. Se encontró oclusión de gran vaso en 12 pacientes (75%). El dímero-D estuvo elevado en el 87,5% y la proteína C reactiva en el 81,2% de los casos. La etiología más frecuente del ictus isquémico fue la aterotrombosis (9 pacientes, 56,3%) con un subtipo predominante que fue el trombo endoluminal sobre placa de ateroma (5 pacientes, 31,2%), 4 de ellos en la arteria carótida interna y uno de ellos en el arco aórtico. La mortalidad en nuestra serie fue del 44% (7 de 16 pacientes). Conclusiones En los pacientes con ictus y COVID-19 la etiología más frecuente fue la aterotrombótica, con una elevada frecuencia de trombo endoluminal sobre placa de ateroma... (AU)

Background Ischaemic stroke may be a major complication of SARS-CoV-2 infection. Studying and characterising the different aetiological subtypes, clinical characteristics, and functional outcomes may be valuable in guiding patient selection for optimal management and treatment. Methods Data were collected retrospectively on consecutive patients with SARS-CoV-2 infection who developed acute focal brain ischaemia (between 1 March and 19 April 2020) at a tertiary university hospital in Madrid (Spain). Results During the study period, 1594 patients were diagnosed with COVID-19. We found 22 patients with ischaemic stroke (1.38%), 6 of whom did not meet the inclusion criteria. The remaining 16 patients were included in the study (15 cases of ischaemic stroke and one case of transient ischaemic attack). Median baseline National Institutes of Health Stroke Scale score was 9 (interquartile range: 16), and mean (standard deviation) age was 73 years (12.8). Twelve patients (75%) were men. Mean time from COVID-19 symptom onset to stroke onset was 13 days. Large vessel occlusion was identified in 12 patients (75%). We detected elevated levels of D-dimer in 87.5% of patients and C-reactive protein in 81.2%. The main aetiology was atherothrombotic stroke (9 patients, 56.3%), with the predominant subtype being endoluminal thrombus (5 patients, 31.2%), involving the internal carotid artery in 4 cases and the aortic arch in one. The mortality rate in our series was 44% (7 of 16 patients). Conclusions In patients with COVID-19, the most frequent stroke aetiology was atherothrombosis, with a high proportion of endoluminal thrombus (31.2% of patients). Our clinical and laboratory data support COVID-19–associated coagulopathy as a relevant pathophysiological mechanism for ischaemic stroke in these patients. (AU)

High frequency of endoluminal thrombus in patients with ischaemic stroke following AARS-CoV-2 infection.

BACKGROUND: Ischaemic stroke may be a major complication of SARS-CoV-2 infection. Studying and characterising the different aetiological subtypes, clinical characteristics, and functional outcomes may be valuable in guiding patient selection for optimal management and treatment. METHODS: Data were collected retrospectively on consecutive patients with COVID-19 who developed acute focal brain ischaemia (between 1 March and 19 April 2020) at a tertiary university hospital in Madrid (Spain). RESULTS: During the study period, 1594 patients were diagnosed with COVID-19. We found 22 patients with ischaemic stroke (1.38%), 6 of whom did not meet the inclusion criteria. The remaining 16 patients were included in the study (15 cases of ischaemic stroke and one case of transient ischaemic attack). Median baseline National Institutes of Health Stroke Scale score was 9 (interquartile range: 16), and mean (standard deviation) age was 73 years (12.8). Twelve patients (75%) were men. Mean time from COVID-19 symptom onset to stroke onset was 13 days. Large vessel occlusion was identified in 12 patients (75%). We detected elevated levels of D-dimer in 87.5% of patients and C-reactive protein in 81.2%. The main aetiology was atherothrombotic stroke (9 patients, 56.3%), with the predominant subtype being endoluminal thrombus (5 patients, 31.2%), involving the internal carotid artery in 4 cases and the aortic arch in one. The mortality rate in our series was 44% (7 of 16 patients). CONCLUSIONS: In patients with COVID-19, the most frequent stroke aetiology was atherothrombosis, with a high proportion of endoluminal thrombus (31.2% of patients). Our clinical and laboratory data support COVID-19-associated coagulopathy as a relevant pathophysiological mechanism for ischaemic stroke in these patients.

High frequency of endoluminal thrombus in patients with ischaemic stroke following SARS-CoV-2 infection. / Alta frecuencia de trombo endoluminal en pacientes con ictus isquémico tras la infección por coronavirus 2019.

BACKGROUND: Ischaemic stroke may be a major complication of SARS-CoV-2 infection. Studying and characterising the different aetiological subtypes, clinical characteristics, and functional outcomes may be valuable in guiding patient selection for optimal management and treatment. METHODS: Data were collected retrospectively on consecutive patients with SARS-CoV-2 infection who developed acute focal brain ischaemia (between 1 March and 19 April 2020) at a tertiary university hospital in Madrid (Spain). RESULTS: During the study period, 1594 patients were diagnosed with COVID-19. We found 22 patients with ischaemic stroke (1.38%), 6 of whom did not meet the inclusion criteria. The remaining 16 patients were included in the study (15 cases of ischaemic stroke and one case of transient ischaemic attack). Median baseline National Institutes of Health Stroke Scale score was 9 (interquartile range: 16), and mean (standard deviation) age was 73 years (12.8). Twelve patients (75%) were men. Mean time from COVID-19 symptom onset to stroke onset was 13 days. Large vessel occlusion was identified in 12 patients (75%). We detected elevated levels of D-dimer in 87.5% of patients and C-reactive protein in 81.2%. The main aetiology was atherothrombotic stroke (9 patients, 56.3%), with the predominant subtype being endoluminal thrombus (5 patients, 31.2%), involving the internal carotid artery in 4 cases and the aortic arch in one. The mortality rate in our series was 44% (7 of 16 patients). CONCLUSIONS: In patients with COVID-19, the most frequent stroke aetiology was atherothrombosis, with a high proportion of endoluminal thrombus (31.2% of patients). Our clinical and laboratory data support COVID-19-associated coagulopathy as a relevant pathophysiological mechanism for ischaemic stroke in these patients.

Update on the major imported helminth infections in travelers and migrants.

Helminth infections cause considerable morbidity worldwide and may be frequently underdiagnosed especially in areas of lower endemicity. Patients may harbor latent infections that may become symptomatic years or decades after the initial exposure and timely diagnosis may be critical to prevent complications and improve outcomes. In this context, disease in special populations, such as immunosuppressed patients, may be of particular concern. Heightened awareness and recent diagnostic developments may contribute to the correct management of helminth infections in nonendemic regions. A review of the main helminth infections in travelers and migrants (strongyloidiasis, taeniasis-neurocysticercosis and schistosomiasis) is presented, focusing on epidemiology, developments in diagnosis, treatment and prevention.

Addition of fermented and unfermented grape skin in broilers' diets: effect on digestion, growth performance, intestinal microbiota and oxidative stability of meat.

Grape skin is a source of polyphenols with antioxidant and antimicrobial properties. Little information is available regarding its application in animal feeding. The present study investigated the effect of inclusion of fermented (FS) and unfermented (UFS) grape skin at two different doses (30 g/kg, FS30 and UFS30, and 60 g/kg, FS60 and UFS60) and 200 mg/kg vitamin E (α-tocopheryl acetate) in a corn-soybean diet on growth performance, ileal protein digestibility, ileal and excreta total extractable polyphenols content and digestibility, intestinal microbiota and thigh meat oxidation in broiler chickens. Growth performance was depressed in chickens fed UFS and FS diets. A reduction in ileal protein digestibility was also observed in birds fed UFS, being this effect more pronounced in those fed 60 g/kg. The dietary inclusion of grape skin increased both ileal and excreta polyphenols contents, being higher in birds fed UFS than in those fed FS. Excreta moisture content increased in birds fed UFS and FS diets. No effect of dietary inclusion of grape skin was observed on ileal counts of lactic-acid bacteria and Clostridium, but UFS inclusion in the diet reduced ileal count of Escherichia coli as compared with FS dietary inclusion. After 7 days of refrigerated storage, values of thiobarbituric acid reactive substances (TBARS) were lower in chicken meat when grape skin was added in the diet at 60 g/kg instead of 30 g/kg, and meat from birds fed 60 g/kg of grape skin reached TBARS values similar to those of birds supplemented with vitamin E. In conclusion, high doses of grape skin polyphenols depressed growth performance and protein digestibility, and increased excreta moisture content. Unfermented grape skin contained more polyphenols than FS, and its inclusion in the diet led to higher ileal and excreta polyphenols contents and to a lower ileal count of E. coli. Furthermore, the antioxidant potential of the polyphenols present in grape skin was observed after 7 days of meat storage, with the dose of 60 g/kg of grape skin being as effective as vitamin E supplementation in maintaining oxidative stability of meat.

Addition of exogenous enzymes to diets containing grape pomace: Effects on intestinal utilization of catechins and antioxidant status of chickens.

Grape pomace (GP) is a rich source of polyphenols with antioxidant capacity. An experiment was conducted to study the effect of GP phenolic compounds included at 5 and 10%, and the addition (individually or combined) of hydrolyzing enzymes (carbohydrase enzyme complex and tannase at 500ppm) on intestinal utilization of catechins and antioxidant status in broiler chickens. A diet supplemented with 200ppm of α-tocopheryl acetate was also used. Our findings demonstrate the capacity of chickens to digest the monomeric (catechin, epicatechin, gallic acid, and epicatechin-O-gallate) and dimeric (procyanidin B1 and procyanidin B2) catechins present in grape pomace. The addition of enzymes (mainly tannase) hydrolyzed the polymeric structures into smaller catechins, but also promoted a lower digestibility of the monomeric and dimeric catechins suggesting that polymeric structures might favour the intestinal utilization of these catechins. The intestinal accumulation of phenolic compounds generated with tannase and with 10% GP reversed the antimicrobial effect against Clostridium perfringens observed with 5% of GP. Grape pomace improved the antioxidant status of the bird, increasing the α-tocopherol and reducing the iron content on plasma, not affecting the plasma gluthatione. Enzymes modified the intestinal utilization of catechins but not additional protective effect was detected on any of the parameters analyzed to evaluate the antioxidant status.

CNS myelin induces regulatory functions of DC-SIGN-expressing, antigen-presenting cells via cognate interaction with MOG.

Myelin oligodendrocyte glycoprotein (MOG), a constituent of central nervous system myelin, is an important autoantigen in the neuroinflammatory disease multiple sclerosis (MS). However, its function remains unknown. Here, we show that, in healthy human myelin, MOG is decorated with fucosylated N-glycans that support recognition by the C-type lectin receptor (CLR) DC-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN) on microglia and DCs. The interaction of MOG with DC-SIGN in the context of simultaneous TLR4 activation resulted in enhanced IL-10 secretion and decreased T cell proliferation in a DC-SIGN-, glycosylation-, and Raf1-dependent manner. Exposure of oligodendrocytes to proinflammatory factors resulted in the down-regulation of fucosyltransferase expression, reflected by altered glycosylation at the MS lesion site. Indeed, removal of fucose on myelin reduced DC-SIGN-dependent homeostatic control, and resulted in inflammasome activation, increased T cell proliferation, and differentiation toward a Th17-prone phenotype. These data demonstrate a new role for myelin glycosylation in the control of immune homeostasis in the healthy human brain through the MOG-DC-SIGN homeostatic regulatory axis, which is comprised by inflammatory insults that affect glycosylation. This phenomenon should be considered as a basis to restore immune tolerance in MS.

Effects of dietary grape seed extract on growth performance, amino acid digestibility and plasma lipids and mineral content in broiler chicks.

Polyphenols are chemically and biologically active compounds. Grape seed extracts (GSEs) have been widely used as a human food supplement for health promotion and disease prevention. However, there is little information regarding its application in animal feeds. An experiment was conducted to investigate the effect of inclusion of GSE at 0.025, 0.25, 2.5 and 5.0 g/kg in a wheat soya bean control diet on growth performance, protein and amino acid (AA) digestibility and plasma lipid and mineral concentrations in broiler chickens at 21 days of age. Performance was not affected by dietary treatment except in the case of birds fed the diet with the highest GSE concentration, which showed a worsening of weight gain and feed conversion. Apparent ileal digestibility (AID) of protein was significantly reduced in the birds fed the highest concentration of GSE, which also had a reduction on the AID of arginine, histidine, phenylalanine, cystine, glutamic acid and proline compared with those fed control diet. The inclusion of graded concentration of GSE in the chicken diets caused a significant linear decrease in the concentrations of plasma copper, iron and zinc. Plasma cholesterol, triglycerides and lipoproteins (high-density lipoprotein, low-density lipoprotein and very-low-density lipoprotein) concentrations were not affected by dietary GSE. In conclusion, this study demonstrated that incorporation of GSE in chicken diets up to 2.5 g/kg had no adverse effect on growth performance or protein and AA digestibility. Feed conversion was reduced and growth rate was retarded, when chickens were fed 5 g/kg of GSE. This study also indicated that grape polyphenols reduce the free plasma minerals.

Chemical characterization of organic microcontaminant sources and biological effects in riverine sediments impacted by urban sewage and pulp mill discharges.

The Biobío River basin is highly impacted by a variety of anthropogenic activities such as pulp mills and urban wastewaters subjected to different treatment processes. This work assesses for the first time, the contamination source and biological effects (estrogenic and dioxin-like activities) in the river basin by the determination of 45 organic microcontaminants in seven sediment samples. Pressurized solvent extraction combined with two-dimensional comprehensive gas chromatography coupled to time of flight mass spectrometry was employed for this purpose. The organic microcontaminants identified comprise monoterpenes, sesquiterpenes, diterpenes, ionones, lineal alkyl benzenes, polycyclic aromatic hydrocarbons, musk fragrances, sterols and phathalate esters. The presence of pine and eucalyptus pulp mill effluents increased the abundance of resin-derived neutral compounds and monoterpenes respectively. A principal component analysis showed that the Biobío River basin was impacted by domestic wastewater treatment plants (WWTPs), pine or eucalyptus Kraft pulp mills and pyrolytic and pyrogenic processes. Finally, the recombinant yeast assays showed that the presence of estrogenic and dioxin-like activity was mostly located in sediments impacted by domestic WWTP effluents.

[Percutaneous gastrostomy complicated with abdominal wall hematoma; severe anemia secondary to percutaneous endoscopic gastrostomy]. / Gastrostomía percutánea complicada con hematoma de pared abdominal; anemización severa secundaria a gastrostomía endoscópica percutánea.

Endoscopic percutaneous gastrostomy (PEG) is a safe and effective procedure that offers clear advantages over nasogastric tube feeding to ensure adequate nutrition in patients with swallowing problems who have an intact digestive tract. With proper placement and monitoring methodology there are few complications in both the peritrack procedure as in the long run. However, despite being considered a safe technique it is not devoided of serious complications. We report a patient with dysphagia, requiring percutaneous endoscopic gastrostomy placement developing a severe anemia with severe subcutaneous hematoma, given the exceptional case and literature review.

Gastrostomía percutánea complicada con hematoma de pared abdominal; anemización severa secundaria a gastrostomía endoscópica percutánea / Percutaneous gastrostomy complicated with abdominal wall hematoma; severe anemia secondary to percutaneous endoscopic gastrostomy

Introducción: La Gastrostomía Percutánea Endoscópica (PEG), es un método seguro y efectivo que ofrece claras ventajas respecto a la alimentación por sonda naso-gástrica para conseguir una nutrición adecuada en pacientes con problemas de deglución, pero que mantienen intacto el sistema digestivo. Sin embargo, a pesar de ser considerada una técnica segura no está exenta de complicaciones graves. Presentamos una paciente con disfagia que tras la práctica de la gastrostomía endoscópica percutánea desarrolla una anemización severa con gran hematoma subcutáneo, dado lo excepcional del caso y revisamos la literatura (AU)

Endoscopic percutaneous gastrostomy (PEG) is a safe and effective procedure that offers clear advantages over nasogastric tube feeding to ensure adequate nutrition in patients with swallowing problems who have an intact digestive tract. With proper placement and monitoring methodology there are few complications in both the peritrack procedure as in the long run. However, despite being considered a safe technique it is not devoided of serious complications. We report a patient with dysphagia, requiring percutaneous endoscopic gastrostomy placement developing a severe anemia with severe subcutaneous hematoma, given the exceptional case and literature review (AU)

Changes in polyphenol and polysaccharide content of grape seed extract and grape pomace after enzymatic treatment.

Grape seed extract and grape pomace are rich sources of polyphenols. The aim of this study was to evaluate the release of polyphenols, the solubilisation of carbohydrate, and the antioxidant capacity of these grape by-products after enzymatic reaction with carbohydrases (cellulolytic and pectinolytic activities) and tannase for 24h. The use of tannase in these by-products, and pectinase in grape pomace changed the galloylated form of catechin to its free form, releasing gallic acid and increasing the antioxidant activity. In grape pomace, cellulase treatment was not efficient for phenolic release and antioxidant activity improvement. The addition of carbohydrases to grape pomace, either alone or in combination, degraded the cell wall polysaccharides, increasing the content of monosaccharides. These results provide relevant data about the potential of pectinase, tannase and combinations of enzymes on the release of polyphenols and monosaccharides from grape by-products, improving the antioxidant capacity and the nutritional value.

Chronic effects of Pinus radiata and Eucalyptus globulus kraft mill effluents and phytosterols on Daphnia magna.

Two kraft pulp mill effluents were compared in terms of their chronic toxicity to Daphnia magna. One resulted from pulping Pinus radiata and the other came from a parallel processing of Pinus radiata and Eucalyptus globulus (mixed kraft pulp mill effluent). The concentration of phytosterols found in the mixed kraft pulp mill effluent was higher than in the effluent from Pinus radiata, with values of 0.1082 and 0.02 µg/L, respectively. The phytosterols per se are responsible for 12.9% and 8.1% of the deviation from the natural shape, while the kraft pulp mill effluents account for 25.6%-27.8% of shape deviation. The role of ß-sitosterol and stigmasterol is discussed in relation to endocrine disruption.

Effects of dietary polyphenol-rich grape products on intestinal microflora and gut morphology in broiler chicks.

Grapes have high amounts of phenolic compounds, which can modulate the gut activity as well as modify the structure and function of the gastrointestinal tract. The microbiological activity of avoparcin, grape pomace concentrate, and grape seed extract was evaluated in an in vitro study. An in vivo experiment was also conducted to study the effect of the inclusion of grape pomace concentrate and grape seed extract in the diet of broiler chicks on performance, intestinal microflora (by cultured and terminal restriction fragment length polymorphism methodology), and gut morphology at 21 d of age. Dietary treatments included an antibiotic-free diet (CON), a positive control (AVP; 50 mg/kg of avoparcin), and antibiotic-free diets containing grape pomace concentrate (GPC; 60 g/kg) or grape seed extract (GSE; 7.2 g/kg). Performance was not affected by dietary treatment except in the case of birds fed the GSE diet, which showed decreased weight gain. In the ileal content, birds fed CON and GSE diets had the highest populations of Lactobacillus. Compared with the CON diet, the AVP, GPC, and GSE diets increased the populations of Enterococcus and decreased the counts of Clostridium in the ileal content. In the cecal digesta, birds fed GPC and GSE diets had higher populations of Escherichia coli, Lactobacillus, Enterococcus, and Clostridium than birds in any other treatment group. Animals fed GPC and GSE diets showed a higher biodiversity degree than those fed control diets. The frequency of detection of several potential phenol-degrading bacteria as well as unidentified and uncultured organisms was increased in animals fed GPC and GSE diets. Birds fed the CON diet had longer villi and deeper crypt depth than birds in any other treatment group. The highest villi height:crypt depth ratio corresponded to birds fed GPC and AVP diets and the lowest to those fed CON and GSE diets. In conclusion, dietary polyphenol-rich grape products modify the gut morphology and intestinal microflora and increase the biodiversity degree of intestinal bacteria in broiler chicks.

Monitoring endocrine activity in kraft mill effluent treated by aerobic moving bed bioreactor system.

A Moving Bed Bioreactor (MBBR) was operated at three different hydraulic retention times for a period of 414 days. The fate of the extractive compounds and the estrogenic activity of the Pinus radiata kraft mill effluents were evaluated using Yeast Estrogen Screen (YES) and gas chromatography - mass spectrometry (GC-MS) detection. Results show that the MBBR reactor is able to remove between 80-83% of estrogenic activity present in the kraft mill Pinus radiata influent, where the values of the effluent's estrogenic activity ranged between 0.123-0.411 ng L(-1), expressed as estrogenic equivalent (EEqs) of 17-a-ethynylestradiol (EE2 eq.). Additionally, the biomass of the MBBR reactor accumulated estrogenic activity ranging between 0.29-0.37 ng EEqs EE2 during the different Hydraulic Retention Time (HRT) operations. The main groups present in pulp mills effluents, corresponding to fatty acids, hydrocarbons, phenols, sterols and triterpenes, were detected by solid phase extraction (SPE) and gas chromatography - mass spectrometry (GC-MS). The results suggest that the sterols produce the estrogenic activity in the evaluated effluent.

Detection of estrogenic activity from kraft mill effluents by the yeast estrogen screen.

Estrogenic activity of kraft pulp mill effluents (P. radiata, E. globulus and mixed -50% E. globulus and 50% P. radiata) was evaluated by the yeast estrogen screen assay. The estrogenic activity values were relatively low, ranking between 1.475 and 0.383 ng/L of EE2 eq. (Estrogenic equivalent of 17 alpha-ethynylestradiol), where the highest value corresponds to the E. globulus effluent and the lowest value to the P. radiata effluent. Analysis by solid phase extraction (SPE) and gas chromatography-mass spectrometry (GC-MS) of chemical compounds present in all three effluents detected at least five major groups of organic compounds, corresponding to fatty acids, hydrocarbons, phenols, sterols and triterpenes. Comparison of analytical and biological data suggests that sterols could be the cause of the estrogenic activity in the evaluated effluent.

Effect of dietary supplementation with glutamine and a combination of glutamine-arginine on intestinal health in twenty-five-day-old weaned rabbits.

The effect of dietary supplementation with 1% l-glutamine and a combination of 1% l-glutamine and 0.5% l-arginine on intestinal health was examined in weaned rabbits. A basal diet was formulated to meet nutrient recommendations. Another 2 diets were formulated by adding 1% (as-fed basis) Gln or a mixture of 1% (as-fed basis) Gln + 0.5% (as-fed basis) Arg (Gln-Arg) to the basal diet. In Exp. 1, a total of 357 rabbits were blocked by litter and assigned at random to the experimental diet to determine mortality (119 per diet) and growth performance (35 per diet; from weaning at 25 to 56 d of age). Rabbits were fed the experimental diets for a 2-wk period and thereafter received a commercial diet. Rabbits weaned at 25 d (blocked by litter and assigned at random to diets) were slaughtered at 35 d and used to determine apparent ileal digestibility of DM, CP, and AA (Exp. 2, a total of 60 rabbits), intestinal morphology, N-aminopeptidase and myeloperoxidase intestinal activity, the expression of PPARgamma at the ileum and kidney, serum immunoglobulin in healthy and sick rabbits (Exp. 3, a total of 24 rabbits), and ileal and cecal microbial composition by PCR-RFLP (Exp. 4, a total of 45 rabbits). Dietary treatment did not affect ADG, ADFI, or G:F, during the entire fattening period. Supplementation with Gln reduced mortality during the first 2 wk and the whole fattening period from 18.5 to 8.4% (P = 0.023) and from 31.9 to 20.2% (P = 0.039), respectively, whereas no effect was detected for Arg supplementation. Among all the variables studied, the reduction on mortality due to Gln was related to a reduced intestinal colonization (Eimeria lesions) and changes on microbial ecosystem in the ileum and cecum, reducing the frequency of detection of Clostridium spp. (from 86.7 to 33.3%, P = 0.003) at the ileum, and Helicobacter spp. at the ileum (from 86.7 to 46.7%, P = 0.003) and at the cecum (from 86.7 to 46.7, P = 0.028), whereas no effect was detected for Arg supplementation. In conclusion, 1% l-Gln supplementation to postweaned rabbit diets decreased fattening mortality and modified the intestinal microbiota (although no consistent effects were observed on mucosal histology or inflammatory and systemic immune response). Diets containing a combination of 1% Gln and 0.5% Arg were of little additional benefit.

[Massive tricuspid valve insufficiency after blunt chest trauma: report of one case]. / Rotura de válvula tricúspide con insuficiencia masiva secundaria a traumatismo torácico cerrado: Caso clínico.

Cardiac valve lesions after a blunt chest trauma are rare and less than 1% of cardiac lesions because of chest trauma affect the tricuspid valve. We report a 70 year-old female that suffered a severe chest trauma in a car accident. During the repair of the multiple skeletal lesions, the patient had a severe hemodynamic decompensation. A myocardial trauma with pericardial effusion and massive tricuspid insufficiency, due to anterior leaflet prolapse, was diagnosed on echocardiography. After discharge the patient remained in functional class II, with hepatomegaly, jugular ingurgitation and lower limb edema. A control echocardiogram, performed six months after the accident, showed dilatation of right heart chambers and massive tricuspid insufficiency. The patient was operated, and a tricuspid valve repair was performed suturing the ruptured papillary muscle to the ventricular wall and performing a tricuspid annuloplasty with a prosthetic ring. After 15 months of follow up, the patient remains asymptomatic.

[Fighting the coronary artery disease epidemic in Chile: caveats in the control of cardiovascular risk factors]. / Combatiendo la epidemia de enfermedad coronaria en Chile: Potencialidades y problemas en el control de los factores de riesgo.

In this issue of the journal Lanas et al report an estimation of population attributable risk (PAR) for myocardial infarction (MI) derived from different risk factors in Chile. Cigarette smoking, dyslipidemia and hypertension accounted for 71% of total PAR. Mortality from MI has decreased in Chile, but epidemiologic surveys carried out in different hospitals across the country, strongly support that most of this effect comes from better treatment of MI. Recent changes in public health policies, favoring the treatment of hypertension and diabetes may help control cardiovascular morbidity and mortality. However, a really significant impact will be obtained when the development of the disease may be halted. To evaluate this possibility, newer methods to diagnose atherosclerosis non invasively may come to our rescue. On the other hand, pharmacologic treatment of dyslipidemia and hypertension continue to offer the most powerful way to decrease levels of cardiovascular risk factors. According to current knowledge, wise balance of non pharmacologic and pharmacologic means of primary prevention, with due respect for ethic aspects, is the most effective way to curve the epidemic of coronary artery disease in Chile.