Bioaugmentation of pilot-scale slow sand filters can achieve compliant levels for the micropollutant metaldehyde in a real water matrix.

Metaldehyde is a polar, mobile, low molecular weight pesticide that is challenging to remove from drinking water with current adsorption-based micropollutant treatment technologies. Alternative strategies to remove this and compounds with similar properties are necessary to ensure an adequate supply of safe and regulation-compliant drinking water. Biological removal of metaldehyde below the 0.1 µg•L-1 regulatory concentration was attained in pilot-scale slow sand filters (SSFs) subject to bioaugmentation with metaldehyde-degrading bacteria. To achieve this, a library of degraders was first screened in bench-scale assays for removal at micropollutant concentrations in progressively more challenging conditions, including a mixed microbial community with multiple carbon sources. The best performing strains, A. calcoaceticus E1 and Sphingobium CMET-H, showed removal rates of 0.0012 µg•h-1•107 cells-1 and 0.019 µg•h-1•107 cells-1 at this scale. These candidates were then used as inocula for bioaugmentation of pilot-scale SSFs. Here, removal of metaldehyde by A. calcoaceticus E1, was insufficient to achieve compliant water regardless testing increasing cell concentrations. Quantification of metaldehyde-degrading genes indicated that aggregation and inadequate distribution of the inoculum in the filters were the likely causes of this outcome. Conversely, bioaugmentation with Sphingobium CMET-H enabled sufficient metaldehyde removal to achieve compliance, with undetectable levels in treated water for at least 14 d (volumetric removal: 0.57 µg•L-1•h-1). Bioaugmentation did not affect the background SSF microbial community, and filter function was maintained throughout the trial. Here it has been shown for the first time that bioaugmentation is an efficient strategy to remove the adsorption-resistant pesticide metaldehyde from a real water matrix in upscaled systems. Swift contaminant removal after inoculum addition and persistent activity are two remarkable attributes of this approach that would allow it to effectively manage peaks in metaldehyde concentrations (due to precipitation or increased application) in incoming raw water by matching them with high enough degrading populations. This study provides an example of how stepwise screening of a diverse collection of degraders can lead to successful bioaugmentation and can be used as a template for other problematic adsorption-resistant compounds in drinking water purification.

Prevention of venous thromboembolism in hematologic neoplasms: an expert consensus from SEHH-SETH.

Venous thromboembolism (VTE) is a serious complication in hematologic neoplasms, so finding adequate prevention strategies is an urgent requirement. However, prospective studies with large enough cohorts are scarce, limiting the development of evidence-based thromboprophylaxis guidelines. The present position paper is addressed to all hematologists treating patients affected by hematologic neoplasms with the aim to provide clinicians with a useful tool for the prevention of VTE.

Ultrasonido como complemento en el manejo de la vía aérea / Ultrasound as a complement in the management of the airway

OBJECTIVE: To analyze the usefulness of ultrasound (US) as a complement to airway management. An overview of how to obtain a real-time airway ultrasound at the bedside is reviewed and the support for its use is checked against the evidence. MATERIALS AND METHODS: The search was carried out in Pubmed and Medline, yielding 722 articles of interest with different levels of evidence. The literature search was limited to studies conducted in humans, published in English and Spanish between August 2011 and August 2021.35 articles were included in this review. DISCUSSION: The usefulness of ultrasound in the evaluation and management of the airway is analyzed: predictors of difficult airway; cervical airway access; confirmation of tracheal intubation; calculation of endotracheal tube (ETT) size and depth. CONCLUSIONS: Airway ultrasound could be a useful tool for anesthesiologists, emergency physicians and intensivists, which could help improve patient care and safety. However, more research is needed to validate its use.

OBJETIVO: Analizar la utilidad del ultrasonido (US) como complemento al manejo de la vía aérea. Se revisa una descripción general de cómo obtener una ecografía de la vía aérea en tiempo real a la cabecera del paciente y se coteja el respaldo de su utilización con la evidencia. MATERIALES Y MÉTODOS: La búsqueda se realizó en Pubmed y Medline, arrojando 722 artículos de interés con distinto nivel de evidencia. La búsqueda bibliográfica se limitó a estudios realizados en humanos, publicados en inglés y español entre agosto de 2011 y agosto de 2021. Se incluyeron 35 artículos en esta revisión. DISCUSIÓN: Se analiza la utilidad del ultrasonido en la evaluación y manejo de la vía aérea: predictores de vía aérea difícil (VAD); acceso cervical de la vía aérea; confirmación de intubación traqueal; cálculo de tamaño de tubo endotraqueal (TET) y profundidad de éste. CONCLUSIONES: El ultrasonido en la vía aérea podría ser una herramienta útil para anestesiólogos, emergenciólogos e intensivistas, que podrían ayudar a mejorar la atención y la seguridad del paciente. Sin embargo, se necesitan más investigaciones para validar su uso.

Diphtheritic angina in the tongue and floor of the mouth: unusual presentation.

Diphtheria is an infectious disease caused by Corynebacterium diphtheriae, and is generally characterised by proliferation of the bacteria in the upper respiratory tract, formation of a pseudomembrane, and systemic diffusion of the diphtheria toxin throughout the body. We present the case of a young man with pseudomembranous plaques on the tongue and floor of the mouth, who received systemic and locoregional medical treatment, with a satisfactory outcome after 14 days.

Colonic adenosquamous carcinoma and mucinous adenocarcinoma with microsatellite instability.

A 43-year-old man presented with two-month history of fatigue, weakness, paleness, rectal bleeding, sweating, and weight loss of 10 kg in the past one month. A complete blood count revealed anaemia. The patient underwent a right hemicolectomy. The microscopic examination revealed an adenosquamous carcinoma associated with a mucinous adenocarcinoma in a patient with microsatellite instability due to loss of MLH1 and PMS2 expression and retention of MSH2 and MSH6 expression in both the squamous and glandular components. We also observed an atypical immunohistochemical phenotype in the adenocarcinoma component showing CK7 expression and reduced CK20 and CDX2 expression.

Concordancia diagnóstica entre atención primaria y psiquiatra en derivaciones a Centro Comunitario de Salud Mental en Talca / Diagnostic Concordance between Primary Care and psychiatrist in Communitary Mental Health Center in Talca

Psychiatric diseases have a high presence in Chilean population. Most of the cases are treated in the primary care. Despite this, and because of their complexity, some cases need specialist care. Is important the appropriate referral to secondary care which can be measured by the diagnostic concordance. The purpose of this study is to analyze the diagnostic concordance between primary care and the evaluation of Psychiatrists in secondary level at Communitary Mental Health Center (COSAM) in Talca. METHODOLOGY: Cross-sectional descriptive study. All medical files of the patients older than 15 years old treated at COSAM were examined from August 2012 to November 2013. Moreover, the diagnostics of both primary care derivation and Psychiatrists of COSAM were compared with Kappa Index. RESULTS: The general concordance between the diagnostics of primary care level and COSAM was moderated (kappa index: 0.54). Higher in men than in women. The results showed a high concordance in the diagnostic of eating disorders and Dementia, a moderated concordance in the diagnostic of Bipolar Disorder and Panic Disorder. Finally, a low concordance in the diagnostic of General Anxiety Disorder (GAD), Personality Disorder and Major Depressive Disorder.Although the concordance in the derivations to COSAM is moderated, higher than international studies, the concern is in the failure in the diagnostic of the Bipolar Disorder, an inappropriate treatment can be prescribed if there is not a correct diagnostic.

Diagnostic value of serum fibrinogen as a predictive factor for complicated appendicitis (perforated). A cross-sectional study.

BACKGROUND: Acute appendicitis (AA) has a prevalence of 8% in the general population with a rate of complicated (perforated) appendicitis (CA) up to 40%. Serum fibrinogen may serve as an indicator for CA. PATIENTS AND METHODS: 115 patients were included from January 2012 to December 2012 using a positive pathology report for AA as a gold standard diagnostic method. We divided the patients into two groups accordingly to the pathology report: Complicated Appendicitis and Uncomplicated Appendicitis (UA). Our primary endpoint was to compare the levels of serum fibrinogen between the two groups and find if there is a relationship between fibrinogen level and CA. RESULTS: 68 patients were diagnosed with UA and 47 with CA. Using a fibrinogen value of 885 mg/dl we found to be the best cut-off for predicting complicated appendicitis with a sensitivity of 86.77% (76.87-93.71 IC 95%), a specificity of 91.49 (83.51-99.46 IC 95%), a positive predictive value of 93.65 (95% CI 86.81-99.64) and, a negative predictive value of 82.69 (95% CI 65.73-87.84). CONCLUSION: In the setting of a patient with a clinical diagnosis of AA, this study demonstrates fibrinogen as a good predictor factor for appendiceal perforation.

RUNX3 gene polymorphisms and haplotypes in Mexican patients with colorectal cancer.

We analyzed a possible association between RUNX3 gene polymorphisms and haplotypes in Mexican patients with colorectal cancer (CRC). Genomic DNA samples were obtained from the peripheral blood of 176 Mexican patients with CRC at diagnosis and from 195 individuals that formed the control group. The polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism. Association was estimated by odds ratio (OR). The haplotypes and linkage disequilibrium were established using the Arlequin v3.5 software. We found that the RUNX3 polymorphisms analyzed were in Hardy-Weinberg equilibrium. The RUNX3 rs2236852 AA genotype and A allele showed association with CRC (OR = 0.39, 95%CI = 0.21-0.73, P < 0.01; OR = 0.65, 95%CI = 0.49-0.87, P < 0.01, respectively), while the rs6672420, rs11249206, and rs760805 polymorphisms did not show significant association with CRC. The TA haplotype (SNPs rs760805 and rs2236852) showed an increased risk for CRC (OR = 2.52, 95%CI = 1.47-4.30, P < 0.001). In conclusion, we found that the AA genotype and A allele of rs2236852 polymorphism confer a decreased CRC risk, while the TA haplotype appears to increase the risk of CRC development in Mexican patients.

Serological evidence of Hepatitis E Virus infection in Antioquia, Colombia slaughtered pigs / Evidencia serológica de infección por el Virus de Hepatitis E en cerdos faenados en Antioquia, Colombia

Objective. To detect the presence of specific antibodies against Hepatitis E virus (HEV) in pigs slaughtered in Antioquia, the department where the greatest amount of pork is produced and consumed in Colombia. Materials and methods. Between September 2011 and May 2012, blood samples from pigs were obtained in five slaughterhouses of Antioquia, four of them located in the Aburrá Valley subregion and other located in northern subregión. Serum were evaluated with a commercial ELISA kit for diagnosing HEV in humans but adapted to detect IgG and IgM antibodies in pigs. Results. A 100.0% seropositivity for IgG antibodies was found in 1000 samples evaluated, and 82.06% for IgM antibodies were found in 740 samples. Conclusions. These results indicate that pigs in slaughter age in Antioquia, and possibly in Colombia, have been exposed to HEV at some point in their production process and a high percentage of them can arrive to slaughterhouses with recent infection.

Objetivo. Detectar la presencia de anticuerpos específicos contra el virus de la Hepatitis E (HEV) en cerdos faenados en Antioquia, departamento donde se produce y consume la mayor cantidad de carne de cerdo en Colombia. Materiales y métodos. Entre septiembre de 2011 y mayo de 2012, se obtuvieron muestras de sangre de cerdos en cinco plantas de faenado, cuatro de ellas ubicadas en el Valle de Aburrá y una en la subregión Norte del departamento de Antioquia, las cuales fueron evaluadas mediante un kit de ELISA comercial para diagnóstico de HEV en humanos pero adaptado para la detección de anticuerpos tipo IgG e IgM en cerdos. Resultados. Se encontró una seropositividad de 100.0% para anticuerpos tipo IgG en 1000 muestras evaluadas y de 82.06% para anticuerpos tipo IgM en 740 muestras. Una muestra de heces positiva para la detección del genoma HEV es similar al genotipo 3 encontrada en Estados Unidos. Conclusiones. Estos resultados indican que los cerdos en edad de faenado en Antioquia y posiblemente en Colombia, han tenido exposición a HEV del, un virus zoonótico emergente a nivel mundial, en algún momento de su proceso productivo.

Effect of ZNF217 gene polymorphisms on colorectal cancer development in a Mexican population.

The ZNF217 gene, a potential oncogene amplified and overexpressed in several cancers including colorectal cancer (CRC), acts as a transcription factor that activates or represses target genes. The polymorphisms rs16998248 (T>A) and rs35720349 (C>T) in coronary artery disease have been associated with reduced expression of ZNF217. In this study, we analyzed the 2 polymorphisms in Mexican patients with CRC. Genotyping of rs16998248 and rs35720349 sites was performed by polymerase chain reaction-restriction fragment length polymorphism in 203 Mexican Mestizos, 101 CRC patients, and 102 healthy blood donors. Although no statistical differences regarding genotype and allele frequencies of ZNF217 polymorphisms were observed (P > 0.05), linkage disequilibrium was significant in CRC patients (r(2) = 0.39, P < 0.0001), as a result of reduced AC haplotype frequency. Thus, the AC haplotype may protect against CRC.

Population structure of Squatina guggenheim (Squatiniformes, Squatinidae) from the south-western Atlantic Ocean.

Population genetic analyses based on both mitochondrial cytochrome b and the internal transcribed spacer 2 of recombinant (r)DNA genes were implemented to examine hypotheses of population differentiation in the angular angel shark Squatina guggenheim, one of the four most-widespread endemic species inhabiting coastal ecosystems in the south-western Atlantic Ocean. A total of 82 individuals of S. guggenheim from 10 sampling sites throughout the Río de la Plata mouth, its maritime front, the outer shelf at the subtropical confluence and the coastal areas of the south-west Atlantic Ocean, were included. The analysis of molecular variance (AMOVA) based on the second internal transcribed spacer (its-2) region supports that the samples from the outer shelf represent an isolated group from other sites. Historical gene flow in a coalescent-based approach revealed significant immigration and emigration asymmetry between sampling sites. Based on the low level of genetic diversity, the existence of a long-term population decline or a past recent population expansion following a population bottleneck could be proposed in S. guggenheim. This demographic differentiation suggests a degree of vulnerability to overexploitation in this endemic and endangered south-west Atlantic Ocean shark, given its longevity and low reproductive potential.

Association of MMP7-181A/G and MMP13-77A/G polymorphisms with colorectal cancer in a Mexican population.

Colorectal cancer (CRC) is characterized by enhanced expression and activity of several metalloproteinases (MMPs), including MMP13 and MMP7, which play an important role in tumor invasion and metastasis. The objective of this study was to analyze the association of functional MMP7-181A/G and MMP13-77A/G promoter polymorphisms with susceptibility to CRC in a Mexican population. Genomic DNA samples were obtained from peripheral blood of 102 CRC patients and 125 blood donors who were included as the control group. Identification of polymorphisms was based on polymerase chain reaction-restriction fragment length polymorphism methodology. The association was estimated by the odds ratio (OR) test. The results showed that MMP7-181A/G and MMP13-77A/G variants were associated with CRC. For MMP7-181A/G, the AA (P=0.02, OR=3.38, 95% confidence interval (CI)=1.16-9.84) and AG (P=0.01, OR=3.4, 95%CI=1.17-9.83) genotypes were associated with an increased risk of CRC. For MMP13-77A/G, the AA and AG genotypes were associated with CRC (AA genotype: P=0.04, OR=3.2, 95%CI=1.004-10.2; AG genotype: P=0.01, OR=4.08, 95%CI=1.3-13.07). In conclusion, AA and AG genotype carriers for both polymorphisms are at a higher risk of developing CRC in this Mexican population.

Causas de fiebre en pacientes hospitalizados en la unidad de cuidados intensivos del hospital naval almirante nef / Causes of fever In patients hospitalized in the ICU of hospital naval almirante nef

La fiebre es una anormalidad común en los pacientes hospitalizados en la unidad de cuidados intensivos. Encontrar la etiología del cuadro significa una alta demanda de recursos materiales y humanos que podrían afectar el pronóstico del paciente. Los objetivos de este trabajo fueron identificar las causas actuales de fiebre desarrollada en pacientes durante su hospitalización en la Unidad de Cuidados Intensivos Generales (UCIGEN) y describirlas según su prevalencia; categorizarlas en etiología infecciosa y no infecciosa; determinar el pronóstico según su etiología y buscar la existencia de elementos clínicos y de laboratorio que orienten a una causa infecciosa o no infecciosa. Se realizó un estudio de cohorte retrospectiva que consideró a todos los pacientes hospitalizados por7 o más días en la UCIGEN del Hospital Naval Almirante Nef y que egresaron de ella entre julio del año 2007 y julio del año 2012. De un total de 386 pacientes, 82 presentaron fiebre (21,24 por ciento) y en 10 de ellos (12,20 por ciento) no se logró determinar la causa. En los 72 pacientes (87,80 por ciento) que tuvieron una causa conocida, 67 casos fueron de etiología infecciosa y 5 de etiología no infecciosa. La principal causa de fiebre fue la neumonía asociada a ventilación mecánica (31,76 por ciento), seguida de la infección con uno o más microorganismos diferentes en más de un foco infeccioso (12,20 por ciento). No hubo relación estadísticamente significativa entre la etiología de la fiebre y elementos clínicos ni de laboratorio, como tampoco entre el pronóstico y la etiología (OR =0,684; IC 95 por ciento = 0,073 - 8.816). En conclusión, la fiebre desarrollada en los pacientes de la UCIGEN es predominantemente de origen infeccioso cuya causa más frecuente es la neumonía asociada a ventilación mecánica. Se recomienda orientar la búsqueda hacia una etiología infecciosa,...

Fever is a common abnormality in the ICU patients. Finding the fever etiology means a high demand of material and human resources that could affect the patient prognosis. The objectives of this investigation were to identify the actual causes of fever developed in patients during their hospitalization in the ICU and describe them according to their prevalence; categorize them according in infectious and noninfectious etiology; determinate their prognosis according to their etiology and find the existence of clinical and laboratory elements to guide a cause infectious or noninfectious. A retrospective cohort study was realized that considered 386 patients hospitalized for 7 or more days at the Hospital Naval Almirante Nef ICU and were discharged from it in July of 2007 and July of 2012. From a total of 386 patients, 82 did fever (21.24 percent) and in 10 of them (12.20 percent) were not able to determine the cause, of the 72 patients (87.80 percent) who had a known cause, 67 cases were due to infection and only 5 cases due to a non-infectious cause. Of all patients who developed fever, the leading cause was mechanical ventilation-associated pneumonia (31.76 percent), followed by infection with one or more isolated microrganism (12.20 percent). There was no statistically significant relationship between the etiology of fever and clinical or laboratory items, nor there was between the prognosis and etiology (OR = 0.684, 95 percent CI = 0.073-8.816). In conclusion the currently fever developed in ICU patients is predominantly due to an infectious cause and is most often caused by mechanical ventilation-associated pneumonia. It is recommended to guide the search for an infectious etiology,...

Percepción y cumplimiento del consentimiento informado anestesiológico para cirugías electivas en un hospital del norte del Perú / Perception and compliance with anesthesiological informed consent for elective surgeries in a hospital in northern Peru

Introducción: El consentimiento informado es uno de los pilares fundamentales de la relación médico-paciente, por ello este estudio busca determinar el grado del cumplimiento y el grado de percepción del Consentimiento Informado Anestesiológico (CIA) brindado a los pacientes sometidos a cirugía electiva en el Hospital III José Cayetano Heredia-EsSalud (HJCH) durante Febrero del 2013. Material y métodos: Se llevó a cabo un estudio descriptivo, prospectivo, transversal y observacional en el HJCH-(Piura), en Febrero del 2013. Se elaboró y validó una encuesta para evaluar la percepción del CIA en cuatro dimensiones: información, entendimiento, autonomía y valores. Se aplicó dicha encuesta a los pacientes programados a cirugías electivas en el periodo de estudio. De estos mismos se revisó las historias clínicas para evaluar el cumplimiento de la documentación del CIA, a través de una lista de chequeo. Resultados: 131 pacientes fueron encuestados, la edad promedio fue de 49,98 años, el 67,2% eran mujeres. El 29,8% tenían nivel de estudios secundario, y el 67,2% presentaron cirugías previas. El grado de percepción total del CIA fue malo, según 52,7% de los encuestados. La percepción de la información, el entendimiento y la autonomía fue mala en un 67,9%, 54,2% y 70,2% respectivamente; mientras que los valores fueron percibidos como regulares en un 58,8%. El cumplimiento de la documentación del CIA se calificó como malo en un 49,6% de las historias clínicas revisadas. Conclusión: La percepción de los pacientes acerca del CIA y el grado de cumplimiento de la documentación del CIA es mala. (AU)

Introduction: The consent is part of the medical act that arises from the doctor-patient relationship; because this study aims to determine the degree of compliance and the degree of perception of anesthesiologist informed consent (AIC) given to hospitalized patients for elective surgery in Jose Cayetano Heredia-Essalud III-Hospital in February the 2013. Material and methods: a study descriptive, prospective, and observational and cross was performed at Jose Cayetano Heredia Hospital III-EsSalud, in Piura, during February in 2013 for which was developed and validated a questionnaire to evaluate AIC in four dimensions: information, understanding, autonomy and values. This questionnaire was applied to hospitalized patients for elective surgery during study period. Also the medical records of these patients were reviewed to know the degree of compliance of the documentation of process of AIC, for this was elaborated a check list. Results:131 patients were surveyed, the average age was 49,98 years, 67,2% were female. The 29.8% had secondary level of education, and 67,2% of the total had previous surgeries. The degree of global perception CIA was wrong, by 52,7% of respondents. The perception of information, understanding and autonomy was wrong in 67,9%, 54,2% and 70,2% respectively, while the values were perceived as fair by 58,8%. The degree of compliance the CIA documentation was scored as wrong in 49,6% of medical records reviewed. Conclusion:The perception of patients about of CIA and the degree of compliance with the documentation of the CIA is bad. (AU)

Lesiones en órganos de cerdos posdestete, inducidas por el lipopolisacárido de E. coli / Injuries in post-weaning pig organs, induced by the E. coli lipopolysaccharide

Objetivo. Evaluar el efecto de la ingestión de varios niveles de Lipopolisacárido (LPS) de E. coli sobre las manifestaciones clínicas y lesiones en órganos de cerdos recién destetados. Materiales y métodos. El trabajo de campo se realizó en el Centro San Pablo, perteneciente a la Universidad Nacional de Colombia. El estudio se realizó con 52 cerdos destetados (6.5±0.5 kg) a los 21 días de edad. Los animales fueron alimentados durante 10 días con una dieta basal compuesta de leche y algunos de sus derivados, adicionada con cuatro niveles de LPS (0, 0.3, 0.5 y 1.0 μg/ml de alimento). Los cerdos se sacrificaron escalonadamente los días 1, 5, 7 y 10 posdestete y se tomaron muestras de intestino delgado, estómago, hígado, páncreas, corazón, pulmón, riñón y bazo. El monitoreo clínico y paraclínico se realizó diariamente durante la investigación. Para determinar la ganancia de peso, los animales fueron pesados el día del destete y el día del sacrificio. Resultados. Hubo diferencia (p<0.01) en las variables peso de los órganos y ganancia de peso, donde los animales que consumieron el mayor nivel de LPS presentaron los menores valores, llegando a su mínimo nivel el día 10 posdestete. Las variables presentación de: lesiones macroscópicas, diarreas, y temperatura rectal, aumentaron con el nivel de inclusión de LPS en la dieta, llegando a su máximo nivel el día 10 posdestete (p<0.01). Conclusiones. El LPS de E. coli provoca la inhibición del crecimiento corporal y de los órganos en estudio y una alta incidencia de diarreas.

Objective: To evaluate the effects of the intake of several levels of lipopolysaccharides (LPS) from E. coli on clinical manifestations and injuries in organs of newly weaned pigs. Materials and methods. The experiment was conducted at the San Pablo Production Center of the Universidad Nacional de Colombia. 52 weaned pigs at 21 days of age were used. The animals were fed a basal diet composed of milk and some of its derivatives, and an addition of four LPS levels (0, 0.3, 0.5 and 1.0 μg / mg of feed) during 10 days. The pigs were sequentially sacrificed on days 1, 5, 7, and 10 after weaning, and samples of the small intestine, stomach, liver, pancreas, heart, lungs, kidney and spleen were extracted. Clinical and laboratory monitoring was performed daily during the investigation. To determine weight gain, the animals were weighed on weaning day, and on slaughter day. Results: There were statistical differences (p<0.01) in organ weights and weight gain, where animals that consumed the highest levels of LPS showed the lowest values, reaching the lowest level on day 10 post-weaning. The variables: macroscopic lesions, diarrhea, and rectal temperature increased with the increase in LPS levels in the diet, reaching their peaks on day 10 post-weaning (p<0.01). Conclusions: E. coli LPS causes inhibition of the studied body and organ growth parameters, and a high incidence of post-weaning diarrhea.