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1.
Food Funct ; 11(3): 2218-2230, 2020 Mar 26.
Article in English | MEDLINE | ID: mdl-32100768

ABSTRACT

Ingested polyphenols from plant-based foods are in part carried to the large intestine and metabolised by resident microbiota. This work investigated the release and microbial transformation of polyphenols adsorbed individually or in combination to apple cell walls (ACW) and pure (bacterial) cellulose (BC). BC and ACW, representing poorly- and highly-fermentable fibre models respectively, were used to investigate influences of interactions with polyphenols (cyanidin-3-glucoside, (±)-catechin, ferulic acid), on the release and microbial metabolism of polyphenols during in vitro digestion and fermentation. Bound polyphenols were partially released (20-70%) during simulated digestion, depending on polyphenol molecular structure. All remaining bound polyphenols were completely released and metabolised after 6-9 h by porcine large intestine microbiota, with formation of a number of intermediates and end-products. The same pathways of polyphenol microbial metabolism were observed in the presence and absence of ACW/BC, suggesting that microbial metabolism of polyphenols and carbohydrate substrates seems likely independent. Some polyphenol metabolism products were produced faster in the presence of carbohydrate fermentation, particularly of ACW. Microbial metabolism pathways of model polyphenols by a porcine faecal inoculum are not affected by being associated with BC or ACW, but the rate of metabolism is modestly enhanced with concurrent carbohydrate fermentation.


Subject(s)
Dietary Fiber/metabolism , Digestion , Fermentation , Polyphenols/metabolism , Animals , Bacteria , Cell Wall , Cellulose , Gastrointestinal Microbiome , Malus , Models, Theoretical , Swine
2.
Animal ; 13(11): 2745-2754, 2019 11.
Article in English | MEDLINE | ID: mdl-31223098

ABSTRACT

Grains rich in starch constitute the primary source of energy for both pigs and humans, but there is incomplete understanding of physiological mechanisms that determine the extent of digestion of grain starch in monogastric animals including pigs and humans. Slow digestion of starch to produce glucose in the small intestine (SI) leads to undigested starch escaping to the large intestine where it is fermented to produce short-chain fatty acids. Glucose generated from starch provides more energy than short-chain fatty acids for normal metabolism and growth in monogastrics. While incomplete digestion of starch leads to underutilised feed in pigs and economic losses, it is desirable in human nutrition to maintain consistent body weight in adults. Undigested nutrients reaching the ileum may trigger the ileal brake, and fermentation of undigested nutrients or fibre in the large intestine triggers the colonic brake. These intestinal brakes reduce the passage rate in an attempt to maximise nutrient utilisation, and lead to increased satiety that may reduce feed intake. The three physiological mechanisms that control grain digestion and feed intake are: (1) gastric emptying rate; (2) interplay of grain digestion and passage rate in the SI controlling the activation of the ileal brake; and (3) fermentation of undigested nutrients or fibre in the large intestine activating the colonic brake. Fibre plays an important role in influencing these mechanisms and the extent of their effects. In this review, an account of the physiological mechanisms controlling the passage rate, feed intake and enzymatic digestion of grains is presented: (1) to evaluate the merits of recently developed methods of grain/starch digestion for application purposes; and (2) to identify opportunities for future research to advance our understanding of how the combination of controlled grain digestion and fibre content can be manipulated to physiologically influence satiety and food intake.


Subject(s)
Dietary Fiber/pharmacology , Eating , Energy Metabolism , Starch/metabolism , Swine/physiology , Animal Feed/analysis , Animals , Colon/metabolism , Diet/veterinary , Dietary Fiber/analysis , Dietary Fiber/metabolism , Digestion , Edible Grain , Fatty Acids, Volatile/metabolism , Fermentation , Ileum/metabolism , Satiety Response
3.
J Child Orthop ; 12(2): 123-128, 2018 Apr 01.
Article in English | MEDLINE | ID: mdl-29707050

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the management of paediatric torus fractures of the distal forearm in current practice in light of growing evidence supporting a 'minimalist' approach with splint immobilization and limited follow-up. We hypothesized that 'traditional' cast-based management has persisted despite alternative evidence. METHODS: A retrospective review was performed of a consecutive series of paediatric patients diagnosed with torus fractures of the distal forearm between 2011 and 2014. Records were reviewed to abstract the type of immobilization (splint versus cast) prescribed at each visit, number of radiographic exams, duration of immobilization, number of clinical visits and complications. The primary outcome was the proportion of patients exclusively managed in splints. Injuries were grouped based on treatment into a cast group (CG) and a splint group (SG) for statistical analyses. Additionally, injuries were grouped by epoch of time to determine if immobilization usage patterns evolved. RESULTS: A total of 240 forty injuries met criteria for inclusion. Of these, 16 (6.7%) were exclusively splinted (SG). Relative to the CG, the SG had fewer clinical visits (p < 0.001), fewer radiographic exams (p < 0.001) and a shorter total encounter time (p = 0.015). No change in immobilization use occurred over the study period. In all, 21 (9.4%) of the CG experienced complications. No clinically significant displacements occurred in either group. CONCLUSION: Cast utilization and frequent radiographic follow-up remain prevalent at our institution in the management of paediatric torus fractures. Splint-only management was associated with fewer clinical visits, fewer radiographic exams and a shorter total encounter time. LEVEL OF EVIDENCE LEVEL III: Therapeutic retrospective cohort study.

4.
Haemophilia ; 22(5): 700-5, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27385253

ABSTRACT

INTRODUCTION: Despite the availability of subcutaneous desmopressin (1-deamino-8-d-arginine vasopressin, SC-DDAVP) as a haemostatic agent for children with mild bleeding disorders, few publications specifically address the safety or efficacy of this mode of administration. AIM: Our aim was to assess whether a defined fluid restriction protocol was effective in preventing hyponatremia in children receiving perioperative SC-DDAVP, and to document adequate biological and clinical response in this setting. METHODS: We retrospectively analysed a cohort of children with mild bleeding disorders prescribed SC-DDAVP over a 5-year period following institution of a 'two-thirds maintenance' fluid restriction protocol. RESULTS: Sixty-nine patients received SC-DDAVP following this protocol, including 15 with mild haemophilia A, 49 with von Willebrand disease (VWD) and five with platelet storage pool disorder. In patients who underwent formal preoperative assessment a complete or partial response was observed in 28/29 with type 1 VWD and 14/15 with mild haemophilia A. Perioperative SC-DDAVP provided excellent haemostasis in all patients, with no requirement for factor concentrate or blood products. Mild asymptomatic hyponatremia was detected in seven children who received multiple doses of DDAVP (lowest sodium 129 mmol L(-1) ); however, adherence to the prescribed fluid restriction protocol was questionable in six of these cases. Symptomatic hyponatremia was not observed. CONCLUSION: Subcutaneous desmopressin was well-tolerated, with no serious side-effects observed, and good biological responses in preoperative trials. A two-thirds maintenance fluid regimen was effective at preventing symptomatic hyponatremia in our cohort, and is now the standard protocol for fluid restriction post-DDAVP administration in our centre.


Subject(s)
Blood Coagulation Disorders, Inherited/drug therapy , Deamino Arginine Vasopressin/therapeutic use , Hemostatics/therapeutic use , Adolescent , Blood Coagulation Disorders, Inherited/pathology , Child , Child, Preschool , Deamino Arginine Vasopressin/adverse effects , Hemophilia A/drug therapy , Hemophilia A/pathology , Hemostatics/adverse effects , Humans , Hyponatremia/etiology , Injections, Subcutaneous , Platelet Storage Pool Deficiency/drug therapy , Platelet Storage Pool Deficiency/pathology , Retrospective Studies , Severity of Illness Index , von Willebrand Diseases/drug therapy , von Willebrand Diseases/pathology
6.
Animal ; 10(8): 1296-302, 2016 Aug.
Article in English | MEDLINE | ID: mdl-26927308

ABSTRACT

Replacing dairy components from milk replacer (MR) with vegetable products has been previously associated with decreased protein and fat digestibility in milk-fed calves resulting in lower live weight gain. In this experiment, the major carbohydrate source in MR, lactose, was partly replaced with gelatinized corn starch (GCS) to determine the effect on protein and fat digestibility in milk-fed calves. In total, 16 male Holstein-Friesian calves received either MR with lactose as the carbohydrate source (control) or 18% GCS at the expense of lactose. In the adaptation period, calves were exposed to an increasing dose of GCS for 14 weeks. The indigestible marker cobalt ethylenediaminetetraacetic acid was incorporated into the MR for calculating apparent nutrient digestibility, whereas a pulse dose of chromium (Cr) chloride was fed with the last MR meal 4 h before slaughter as an indicator of passage rates. The calves were anesthetized and exsanguinated at 30 weeks of age. The small intestine was divided in three; small intestine 1 and 2 (SI1 and SI2, respectively) and the terminal ileum (last ~100 cm of small intestine) and samples of digesta were collected. Small intestinal digesta was analysed for α-amylase, lipase and trypsin activity. Digestibility of protein was determined for SI1, SI2, ileum and total tract, whereas digestibility of fat was determined for SI1, SI2 and total tract. Apparent protein digestibility in the small intestine did not differ between treatments but was higher in control calves at total tract level. Apparent crude fat digestibility tended to be increased in SI1 and SI2 for GCS calves, but no difference was found at total tract level. Activity of α-amylase in SI2 and lipase in both SI1 and SI2 was higher in GCS calves. Activity of trypsin tended to be higher in control calves and was higher in SI1 compared with SI2. A lower recovery of Cr in SI2 and a higher recovery of Cr in the large intestine suggest an increased rate of passage for GCS calves. Including 18% of GCS in a milk replacer at the expense of lactose increased passage rate and decreased apparent total tract protein digestibility. In the small intestine, protein digestion did not decrease when feeding GCS and fat digestion even tended to increase. Overall, effects on digestion might be levelled when partially replacing lactose with GCS, because starch digestion is lower than that of lactose but fat digestion may be slightly increased when feeding GCS.


Subject(s)
Animal Feed/analysis , Cattle/physiology , Dietary Fats/metabolism , Dietary Proteins/metabolism , Digestion , Lactose/analysis , Starch/analysis , Animal Nutritional Physiological Phenomena/drug effects , Animals , Diet/veterinary , Male
7.
Parasitology ; 143(8): 971-82, 2016 07.
Article in English | MEDLINE | ID: mdl-27001103

ABSTRACT

Almost half of all known microsporidian taxa infect aquatic animals. Of these, many cause disease in arthropods. Hepatospora, a recently erected genus, infects epithelial cells of the hepatopancreas of wild and farmed decapod crustaceans. We isolated Hepatospora spp. from three different crustacean hosts, inhabiting different habitats and niches; marine edible crab (Cancer pagurus), estuarine and freshwater Chinese mitten crab (Eriocheir sinensis) and the marine mussel symbiont pea crab (Pinnotheres pisum). Isolates were initially compared using histology and electron microscopy revealing variation in size, polar filament arrangement and nuclear development. However, sequence analysis of the partial SSU rDNA gene could not distinguish between the isolates (~99% similarity). In an attempt to resolve the relationship between Hepatospora isolated from E. sinensis and C. pagurus, six additional gene sequences were mined from on-going unpublished genome projects (RNA polymerase, arginyl tRNA synthetase, prolyl tRNA synthetase, chitin synthase, beta tubulin and heat shock protein 70). Primers were designed based on the above gene sequences to analyse Hepatospora isolated from pea crab. Despite application of gene sequences to concatenated phylogenies, we were unable to discriminate Hepatospora isolates obtained from these hosts and concluded that they likely represent a single species or, at least subspecies thereof. In this instance, concatenated phylogenetic analysis supported the SSU-based phylogeny, and further, demonstrated that microsporidian taxonomies based upon morphology alone are unreliable, even at the level of the species. Our data, together with description of H. eriocheir in Asian crab farms, reveal a preponderance for microvariants of this parasite to infect the gut of a wide array of decapods crustacean hosts and the potential for Hepatospora to exist as a cline across wide geographies and habitats.


Subject(s)
Brachyura/microbiology , Microsporidia/classification , Microsporidiosis/veterinary , Animals , DNA Primers/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Hepatopancreas/microbiology , Hepatopancreas/pathology , Microsporidia/genetics , Microsporidia/isolation & purification , Microsporidia/ultrastructure , Microsporidiosis/microbiology , Phylogeny , Sequence Analysis, DNA/veterinary
8.
Trends Parasitol ; 32(4): 336-348, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26796229

ABSTRACT

Intensification of food production has the potential to drive increased disease prevalence in food plants and animals. Microsporidia are diversely distributed, opportunistic, and density-dependent parasites infecting hosts from almost all known animal taxa. They are frequent in highly managed aquatic and terrestrial hosts, many of which are vulnerable to epizootics, and all of which are crucial for the stability of the animal-human food chain. Mass rearing and changes in global climate may exacerbate disease and more efficient transmission of parasites in stressed or immune-deficient hosts. Further, human microsporidiosis appears to be adventitious and primarily associated with an increasing community of immune-deficient individuals. Taken together, strong evidence exists for an increasing prevalence of microsporidiosis in animals and humans, and for sharing of pathogens across hosts and biomes.


Subject(s)
Communicable Diseases, Emerging/transmission , Food Chain , Food Parasitology/trends , Microsporidia/physiology , Microsporidiosis/transmission , Animals , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/parasitology , Humans , Microsporidiosis/epidemiology , Microsporidiosis/parasitology
9.
Acta Biomater ; 9(2): 5289-96, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23149253

ABSTRACT

During recent decades, research on biological systems such as abalone shell and fish armor has revealed that these biological systems employ carefully arranged hierarchical multilayered structures to achieve properties of high strength, high ductility and light weight. Knowledge of such structures may enable pathways to design bio-inspired materials for various applications. This study was conducted to investigate the spatial distribution of structure, chemical composition and mechanical properties in mineralized fish scales of the species Atractosteus spatula. Microindentation tests were conducted, and cracking patterns and damage sites in the scales were examined to investigate the underlying protective mechanisms of fish scales under impact and penetration loads. A difference in nanomechanical properties was observed, with a thinner, stiffer and harder outer layer (indentation modulus ∼69 GPa and hardness ∼3.3 GPa) on a more compliant and thicker inner layer (indentation modulus ∼14.3 GPa and hardness ∼0.5 GPa). High-resolution scanning electron microscopy imaging of a fracture surface revealed that the outer layer contained oriented nanorods embedded in a matrix, and that the nanostructure of the inner layer contained fiber-like structures organized in a complex layered pattern. Damage patterns formed during microindentation show complex deformation mechanisms. Images of cracks identify growth through the outer layer, then deflection along the interface before growing and arresting in the inner layer. High-magnification images of the crack tip in the inner layer show void-linking and fiber-bridging exhibiting inelastic behavior. The observed difference in mechanical properties and unique nanostructures of different layers may have contributed to the resistance of fish scales to failure by impact and penetration loading.


Subject(s)
Animal Structures/anatomy & histology , Animal Structures/physiology , Fishes/anatomy & histology , Animal Structures/diagnostic imaging , Animal Structures/ultrastructure , Animals , Biomechanical Phenomena/physiology , Elastic Modulus/physiology , Hardness , Nanotechnology , Spectrometry, X-Ray Emission , Spectroscopy, Fourier Transform Infrared , Stress, Mechanical , X-Ray Microtomography
11.
Acta Anaesthesiol Scand ; 53(10): 1268-74, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19594465

ABSTRACT

BACKGROUND: We evaluated the weekly progress of anesthesiology residents performing an interscalene block with ultrasound guidance (UG) for block success rates and for the specific time intervals: (i) time to image the brachial plexus and (ii) time from insertion of the block needle until motor stimulation occurred. Our primary objective was to characterize the influence of experience over the course of the regional anesthesia rotation on the performance of a UG interscalene block by anesthesiology residents. METHODS: Residents conducted an interscalene block with UG under the supervision of attending anesthesiologists experienced in this technique. Block efficacy, time intervals required to perform the block, and acute complications were recorded. We compared success rates over the course of the rotation, and analyzed process time data with respect to trainee level of experience, week of the trainee rotation, and patient body habitus. RESULTS: Twenty-one trainees conducted 222 blocks over a consecutive 7-month period. Block success rate was 97.3%, and did not change significantly over the course of the 4-week rotation. Total block time and imaging time significantly decreased over the 4-week rotation, while the needle insertion-to-stimulation time did not change. Slower imaging time was predicted by obesity. CONCLUSION: The success rates for a UG interscalene block provided by supervised residents were initially high, and remained so throughout the 4-week rotation. Trainees required less time to image the nerves and to perform the block over the course of the rotation.


Subject(s)
Anesthesiology/education , Clinical Competence , Internship and Residency , Nerve Block/instrumentation , Ultrasonography, Interventional , Brachial Plexus/diagnostic imaging , Fellowships and Scholarships , Humans , Middle Aged , Nerve Block/methods , Statistics, Nonparametric , Time Factors , Treatment Outcome
12.
Int J Lab Hematol ; 31(5): 567-71, 2009 Oct.
Article in English | MEDLINE | ID: mdl-18637806

ABSTRACT

The bone marrow immunofluorescenece test (BMIFT) demonstrates autoantibodies to granulocytes and their precursors on fresh-frozen bone marrow slides. It may be used to differentiate childhood autoimmune neutropenia (AIN) from other causes of childhood neutropenia, even when circulating neutrophil counts are low. We sought to characterize the diagnostic utility of the BMIFT in childhood AIN. All BMIFT requests for investigation of children with neutropenia between January 1998 and May 2007 were reviewed. Patients were classified as AIN or nonautoimmune causes. Baseline demographic data, results of BMIFT, granulocyte immunofluorescence testing and bone marrow findings were collected from clinical records and the institutional laboratory database. Seventy-six children had BMIFT performed for investigation of neutropenia. There were 45 patients diagnosed with AIN, 28 with nonimmune neutropenia and three failed tests. The median age of children with AIN was 1.2 years (range 0.3-15.3), compared with 3.6 years (range 0.1-15.7) in the nonautoimmune group. The median neutrophil count in AIN was 0.3 x 10(9)/l (0.9 x 10(9)/l in nonautoimmune). BMIFT was positive in 24 of 45 patients with AIN and 0 of 28 with nonautoimmune neutropenia (sensitivity 53%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value 57%). Ten patients had other autoimmune diatheses at diagnosis. The BMIFT is a simple, highly specific test with excellent PPV and thus is a clinically useful test to confirm AIN in children.


Subject(s)
Autoantibodies/immunology , Bone Marrow/immunology , Fluorescent Antibody Technique , Neutropenia/diagnosis , Adolescent , Child , Child, Preschool , Humans , Infant , Neutropenia/immunology , Neutrophils/immunology
13.
J Anim Sci ; 85(3): 673-83, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17121974

ABSTRACT

There is increasing evidence showing that dietary supplementation with prebiotics can be effective in the treatment of intestinal inflammation. Because weaning time is characterized by rapid intestinal inflammation, this study investigated the effect of a diet supplemented with a combination of 4 fermentable carbohydrates (lactulose, inulin, sugarbeet pulp, and wheat starch) on the mRNA content of proinflammatory cytokines in newly weaned piglets. Cytokines (IL-1beta, IL-6, IL-8, IL-12p40, IL-18, and tumor necrosis factor-alpha) were analyzed using a semiquantitative reverse-transcription PCR technique on d 1, 4, and 10 in the ileum and colon of piglets fed either a test diet (CHO) or a control diet. In addition to the diet, the effect of enforced fasting on cytokine mRNA content was also evaluated. No effect of fasting was observed on the pro-inflammatory cytokine mRNA content. Our results showed that the CHO diet induced an up-regulation of IL-6 mRNA content in the colon of piglets 4 d postweaning. This up-regulation was specific for the animals fed the CHO diet and was not observed in animals fed the control diet. An increase in IL-1beta mRNA content was also observed on d 4 postweaning in all of the piglets. Correlations between proinflammatory cytokines and the end-products of fermentation indicated that the regulation of cytokines may be linked with some of the fermentation end-products such as branched-chain fatty acids, which are in turn end-products of protein fermentation.


Subject(s)
Cytokines/genetics , Diet/veterinary , Dietary Carbohydrates/metabolism , Dietary Carbohydrates/pharmacology , Intestines/drug effects , Swine/genetics , Swine/metabolism , Animal Feed/analysis , Animal Nutritional Physiological Phenomena , Animals , Dietary Carbohydrates/analysis , Dietary Supplements , Female , Fermentation , Intestinal Mucosa/metabolism , Male , RNA, Messenger/metabolism , Weaning
14.
J Anim Sci ; 84(8): 2133-40, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16864874

ABSTRACT

An in vivo experiment was conducted to monitor the changes in fermentation end products in the feces of weaning piglets due to the inclusion of selected fermentable carbohydrates in the diet. The experiment involved 3 groups of 16 piglets each. Specially raised piglets (neither antibiotics nor creep feeding) were weaned abruptly at 4 wk of age. The piglets were offered 1 of 2 dietary treatments [a control diet (CON), or a fermentable carbohydrate-enriched diet (CHO)] and were subjected to 1 of the 2 fasting treatments (fasting for 2 d at the beginning of the experimental period or nonfasting). Fecal samples were collected per rectum every day during the experimental period. Piglets were slaughtered at the end of the 10-d experimental period, and digesta samples were collected from different parts of the gastrointestinal tract (GIT): the first half of the small intestine, the second half of the small intestine, the cecum, and colon. The DM, VFA profile, and ammonia concentrations were analyzed from the fecal and digesta samples. Daily feed intake was also recorded. There was no difference in concentrations of VFA in feces between the treatment groups. Ammonia concentration was lower (P < 0.05) in piglets fed the CHO diet compared with those fed the CON diet in both feces and digesta from different parts of GIT. Fasting had no effect on fermentation end products in feces. This study demonstrated that the inclusion of fermentable carbohydrates in weanling diets reduces protein fermentation along the GIT and also reduced the fecal concentration of ammonia.


Subject(s)
Dietary Carbohydrates/metabolism , Feces/chemistry , Fermentation/physiology , Swine/metabolism , Acetic Acid/analysis , Ammonia/analysis , Animal Feed/analysis , Animal Nutritional Physiological Phenomena , Animals , Butyric Acid/analysis , Diet/veterinary , Fatty Acids, Volatile/analysis , Female , Gastrointestinal Contents/chemistry , Male , Propionates/analysis , Weaning
15.
J Anim Sci ; 84(5): 1110-8, 2006 May.
Article in English | MEDLINE | ID: mdl-16612013

ABSTRACT

An experiment was conducted to examine changes in VFA and ammonia concentrations at different time points using 4 fermentable carbohydrate-rich feed ingredients as substrates and feces of unweaned piglets as inoculum. Fecal inoculum was collected, pooled, and mixed from 9 specially raised (no creep feed or antibiotics) crossbred piglets at 3 wk of age. Inulin, lactulose, molasses-free sugar beet pulp, and wheat starch were used as substrates and were fermented in vitro for 72 h (3 replicates per substrate). Cumulative gas production was measured as an indicator of the kinetics of fermentation. In addition, 3 bottles of substrate per time point with similar contents (amounts of substrate, inoculum, and media) were incubated but were allowed to release their gas throughout incubation. For these latter bottles, fermentation fluid was sampled at incubation time points including every hour between 1 and 24 h and at 48 h, and fermentation end products (VFA, lactate, and ammonia) and OM disappearance were measured. Dry matter and ash were analyzed from the postfermentative samples. The pH of the contents from these bottles was also recorded. The correlation in time between fermentation end products and cumulative gas produced was determined. The results showed that the prolongation of fermentation to 72 h, especially in the case of fast-fermenting inulin and lactulose, may lead to a different end product profile (P < 0.001) compared with the profile observed at the time at which most of the substrate has disappeared. Therefore, we concluded that the fermentation product profile at the end of in vitro fermentation at a specific time point cannot be used to compare fermentability of carbohydrate sources with different fermentation kinetics in terms of gas production.


Subject(s)
Ammonia/metabolism , Bioreactors , Fatty Acids, Volatile/metabolism , Fermentation/physiology , Swine , Animal Feed , Animals , Beta vulgaris , Feces , Gases , Inulin , Lactulose , Starch , Time Factors , Triticum
16.
Emerg Med J ; 23(3): 186-92, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16498154

ABSTRACT

BACKGROUND: Immediate risk stratification of patients with myocardial infarction in the emergency department (ED) at the time of initial presentation is important for their optimal emergency treatment. Current risk scores for predicting mortality following acute myocardial infarction (AMI) are potentially flawed, having been derived from clinical trials with highly selective patient enrollment and requiring data not readily available in the ED. These scores may not accurately represent the spectrum of patients in clinical practice and may lead to inappropriate decision making. METHODS: This study cohort included 1212 consecutive patients with AMI who were admitted to the Mayo Clinic coronary care unit between 1988 and 2000. A risk score model was developed for predicting 30 day mortality using parameters available at initial hospital presentation in the ED. The model was developed on patients from the first era (training set--before 1997) and validated on patients in the second era (validation set-during or after 1997). RESULTS: The risk score included age, sex, systolic blood pressure, admission serum creatinine, extent of ST segment depression, QRS duration, Killip class, and infarct location. The predictive ability of the model in the validation set was strong (c = 0.78). CONCLUSION: The Mayo risk score for 30 day mortality showed excellent predictive capacity in a population based cohort of patients with a wide range of risk profiles. The present results suggest that even amidst changing patient profiles, treatment, and disease definitions, the Mayo model is useful for 30 day risk assessment following AMI.


Subject(s)
Myocardial Infarction/mortality , Severity of Illness Index , Aged , Aged, 80 and over , Cohort Studies , Emergency Service, Hospital , Female , Humans , Male , Middle Aged , Myocardial Infarction/therapy , Prognosis , Risk Assessment , Risk Factors
17.
Lung Cancer ; 47(2): 165-72, 2005 Feb.
Article in English | MEDLINE | ID: mdl-15639715

ABSTRACT

BACKGROUND: Previous studies have attempted to investigate the impact of smoking cessation on lung cancer survival but have been limited by small numbers of former smokers and incomplete data. METHODS: Over a six-year period, 5229 patients with non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) were enrolled in a prospective cohort of whom 2052 were former smokers. Patient's characteristics were obtained from medical records and a baseline interview. Vital status was determined through multiple sources. Cox proportional hazards models were used to estimate the effect of smoking abstinence on post-diagnosis mortality. RESULTS: For all patients with NSCLC, the median survival among never, former, and current smokers was 1.4 years, 1.3 years, and 1.1 years, respectively (P < 0.01). Female NSCLC patients had a significantly lower risk of mortality with a longer duration of smoking abstinence (RR per 10 years of smoking abstinence = 0.85; 95% CI: 0.75, 0.97). No effect of smoking abstinence on mortality was observed for women with SCLC or for men with either histologic group. CONCLUSIONS: The identification of smoking history as a prognostic factor in lung cancer survival supports previous research suggesting a direct biologic effect of smoking on survival. However, this effect may vary by sex and type of lung cancer.


Subject(s)
Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Smoking Cessation , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Prognosis , Prospective Studies , Risk Factors , Sex Factors , Survival Analysis , Time Factors
18.
Br Poult Sci ; 45(5): 684-94, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15623224

ABSTRACT

(1) This in vivo trial was conducted to study the effects of polysaccharide extracts of two mushrooms, Lentinus edodes (LenE) and Tremella fuciformis (TreE), and a herb, Astragalus membranaceus (AstE) on growth performance, and the weights of organs and the gastrointestinal tract (GIT) of broiler chickens. (2) Three extracts (LenE, TreE and AstE) were supplemented at inclusion rates of 0.5, 1, 2, 3 and 4 g/kg from 7 to 14 d of age and compared with an antibiotic treatment group (20 mg/kg, virginiamycin (VRG) as well as a group of non-supplemented birds. (3) Body weight (BW) gain, feed intake and feed conversion ratio (FCR) of the extract-supplemented groups were not significantly different from those of the antibiotic group. Significant effects of type of extract and concentration on growth performance were found from 7 to 28 d of age. Generally, birds fed with LenE showed higher BW gain and lower FCR from 7 to 28 d of age than those fed with TreE and AstE and 2 g/kg LenE was considered the optimal inclusion rate for enhanced broiler growth. However, the extracts had no significant effect on the relative weights of organs and GIT compared with the antibiotic group. (4) The birds fed the extracts showed better growth performance than the non-supplemented birds, but were not significantly different from those fed VRG. Of the three extracts, LenE appeared to be a potential growth promoter. Future studies are needed to investigate whether the extracts can be used as alternatives for antibiotic growth promoters in challenged birds, and to elucidate the mechanisms for potentially enhanced growth performance in poultry.


Subject(s)
Astragalus propinquus/chemistry , Basidiomycota/chemistry , Chickens/growth & development , Polysaccharides/pharmacology , Shiitake Mushrooms/chemistry , Animal Nutritional Physiological Phenomena , Animals , Anti-Bacterial Agents/pharmacology , Diet , Dietary Supplements , Gastrointestinal Tract/anatomy & histology , Organ Size/drug effects , Virginiamycin/pharmacology , Weight Gain/drug effects
19.
Poult Sci ; 83(10): 1696-702, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15510555

ABSTRACT

This experiment was conducted to test whether dietary soybean meal oligosaccharides (SMO) and water-soluble polysaccharides (SMP) can assist broiler chickens in resisting Eimeria tenella, and to determine the survival of lactic acid bacteria in cecal contents postinfection. All birds received a soybean meal-free diet. The 6 experimental treatments were as follows: positive (COR) and negative (COW) control groups, 2 groups fed diets containing either 1% SMO or 0.5% SMP from 1 to 11 d of age; a vaccinated group (VAC), and an anticoccidial medicated group (ANT). Chickens of all treatments except COW were orally infected with 1000 sporulated oocysts of E. tenella on d 15. Fecal oocyst shedding was monitored per treatment group between d 5 and 13 postinfection. Lactic acid bacteria (LAB) in cecal contents were evaluated by a real-time PCR technique on d 7 postinfection. The results showed that the SMO and SMP groups had a lower number of oocysts per gram of feces during the monitoring period than the COR group. Threshold cycles were 22.21, 27.68, 13.99, 14.92, 12.97, and 14.85, for COW, COR, SMO, SMP, VAC, and ANT groups, respectively; specific PCR products were confirmed by the results of melting curve analysis and agarose gel electrophoresis. The results suggest that these LAB communities were promoted by SMO and SMP and have a competitive exclusion function when broiler chickens are infected with E. tenella.


Subject(s)
Cecum/microbiology , Chickens/microbiology , Coccidiosis/veterinary , Eimeria tenella/pathogenicity , Glycine max , Gram-Positive Bacteria/isolation & purification , Poultry Diseases/microbiology , Animal Feed , Animals , Chickens/parasitology , Coccidiosis/microbiology , Coccidiosis/parasitology , DNA, Bacterial/analysis , Feces/microbiology , Feces/parasitology , Gram-Positive Bacteria/genetics , Lactobacillus acidophilus/genetics , Lactobacillus acidophilus/isolation & purification , Leuconostoc/genetics , Leuconostoc/isolation & purification , Male , Oligosaccharides/administration & dosage , Pediococcus/genetics , Pediococcus/isolation & purification , Polymerase Chain Reaction , Polysaccharides/administration & dosage , Poultry Diseases/parasitology
20.
Poult Sci ; 83(7): 1124-32, 2004 Jul.
Article in English | MEDLINE | ID: mdl-15285503

ABSTRACT

We investigated the effects of polysaccharide extracts from 2 mushrooms, Lentinus edodes (LenE) and Tremella fuciformis (TreE), and an herb, Astragalus membranaceus (AstE), on cellular and humoral immune responses of Eimeria tenella-infected chickens. A total of 150 broiler chicks were assigned to 5 treatment groups: 3 groups were infected with E. tenella and fed with extracts (LenE, TreE, and AstE), and 2 control groups were infected with or without E. tenella. The 3 extracts were given at the level of 1 g/kg of the diet from 8 to 14 d of age. Specific systemic and cecum mucosal antibody production, proliferation of splenocytes, and peripheral T and B lymphocytes were measured during the 3 wk following Eimeria infection. A significantly higher production of specific IgA, IgM (at d 14 and 21 postinfection), and IgG (at d 21 postinfection) were detected in the Eimeria-infected groups fed with the extracts than in the infected group not fed with the extracts. Of the 3 extracts, TreE stimulated a slightly higher production of specific IgM (P = 0.052), and a significantly higher IgG production at 21 d postinfection. The cecal antibody production showed a similar trend to that of serum antibodies. The overall mean levels of cecal-specific IgA and IgG of the groups fed with extracts were significantly higher at 14 and 21 d postinfection compared with the group not fed with extracts. Of the 3 extracts, the AstE-fed group showed the highest IgG production at d 7 postinfection. Both TreE- and LenE-fed groups had significantly higher IgM and IgG levels compared with the AstE group at d 21 postinfection. The extract-fed groups also showed a significantly higher antigen-specific proliferation of splenocytes at 14 and 21 d postinfection compared with the group not fed with the extracts. The overall mean of erythrocyte rosette-forming cells (ERFC %) (at d 14 and 21) and erythrocyte-antibody-complement cells (EAC %) (at d 14) of the groups fed with the extracts was significantly higher compared with the group not fed the extracts. It is concluded from this study that supplementation with mushroom and herb extracts resulted in enhancement of both cellular and humoral immune responses in E. tenella-infected chickens.


Subject(s)
Chickens/immunology , Coccidiosis/veterinary , Eimeria tenella , Plant Extracts/administration & dosage , Polysaccharides/administration & dosage , Poultry Diseases/immunology , Animals , Antibody Formation/drug effects , Astragalus propinquus/chemistry , Basidiomycota/chemistry , Cecum/immunology , Cell Division , Coccidiosis/immunology , Female , Immunity, Cellular/drug effects , Immunoglobulin A/blood , Immunoglobulin G/blood , Immunoglobulin M/blood , Rosette Formation , Shiitake Mushrooms/chemistry , Spleen/cytology
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