Carboxymethylcellulose and psyllium effects in sand output of horses with asymptomatic sand accumulation / [Efeitos da carboximetilcelulose e do psyllium sobre a eliminação de areia de cavalos com sablose assintomática]

The aim of this study was to evaluate the effects of Psyllium (PSY) and Carboxymethylcellulose (CMC) administration on fecal elimination of sand in horses with asymptomatic sand accumulations. Eight horses were selected from sandy areas and randomly divided into 2 groups of four animals. The subjects were treated either with CMC or PSY. The presence of intestinal sand was confirmed through radiography and glove sedimentation test. The study was performed in two phases, with a 7-day interval. In phase I, all the animals received 8 liters of warm water; in phase II, the CMC group received 8 liters of water + 1g/kg of CMC, whereas the PSY group received 8 liters of water + 1g/kg of PSY. All administrations were performed through nasogastric intubation and fractionated in 2 equal volume administrations with an interval of two hours. General and specific physical examination of the digestive system were performed in conjunction with abdominal ultrasonography before the administrations and after 6, 12, 24, 36 and 48 hours, aiming to evaluate intestinal motility and presence of sand. All the feces eliminated by the animals within the 72 hours following the administrations were quantified, diluted and sedimented in order to calculate the sand output (g/kg of feces). All the animals were also subjected to radiographic examination to quantify sand accumulation prior to phase I and after 72 hours of phases I and II. No adverse effects were observed after the treatments. It was possible to notice higher sand elimination in both groups during the phase I, whereas no difference was observed in sand elimination rates between the groups in phase II. The radiographic scores presented differences between the initial timepoint and 72h in phases I and II for both groups. Based on the sand elimination rates and radiographic score, this study demonstrated that sand output was greater after administration of water alone, compared to CMC and Psyllium, leading to the inference that removal of the sandy environment and prevention of sand re-ingestion are effective measures for the elimination of sand from the colon of horses with asymptomatic sand accumulations.(AU)

O objetivo deste estudo foi avaliar os efeitos da administração do psyllium (PSY) e da carboximetilcelulose (CMC) sobre a eliminação fecal de areia em equinos com sablose assintomática. Oito equinos com confirmação radiográfica de sablose assintomática foram divididos em dois grupos (grupo CMC e grupo PSY). O estudo foi realizado em duas fases, com intervalo de sete dias. Na fase 1, todos os animais receberam 8L de água; na fase 2, o grupo CMC recebeu 8L de água + 1g/kg de CMC e o grupo PSY recebeu 8L de água + 1g/kg de PSY. Antes da administração de cada solução e após seis, 12, 24, 36 e 48 horas, foram realizados exame físico e ultrassonografia abdominal. Todas as fezes eliminadas em 72 horas foram avaliadas para quantificar a eliminação de areia (g/kg de fezes). Antes da fase 1 e após 72 horas das fases 1 e 2, o exame radiográfico foi realizado para quantificar o escore de acúmulo de areia. Houve maior eliminação de areia após a administração de água em comparação com a administração de CMC, e não se observou diferença entre a CMC e o PSY. Uma redução significativa nos escores radiográficos de acúmulo de areia foi observada após a administração de água, bem como a manutenção dos escores após a administração da CMC e do PSY. Com base na produção de areia e no escore radiográfico, este estudo sugere que a remoção do ambiente arenoso, impedindo a reingestão de areia, é uma medida eficaz para a eliminação da areia do cólon de cavalos com acúmulos de areia assintomáticos.(AU)

Comparação das artérias carótidas comuns de equinos e muares por ultrassonografia modo-B e Doppler espectral e a relação com a massa corpórea / Comparison of the common carotid arteries of horses and mules by B-mode and Doppler spectral ultrasonography and the relation with body mass

A ultrassonografia convencional e o Doppler espectral nas artérias carótidas comuns em equinos e muares são considerados escassos, diferentemente do que ocorre na medicina humana. Este trabalho propôs comparar as artérias carótidas comuns de equinos e muares por ultrassonografia modo-B e Doppler espectral, além de verificar as diferenças dessas variáveis entre os gêneros desses animais e a relação com a massa corpórea. Foram avaliados os seguintes parâmetros: massa corpórea, diâmetros das artérias, espessura da camada íntima-média (EIM), índice de resistividade (IR), índice de pulsatilidade (IP), velocidade sistólica (VS), velocidade diastólica (VD) e velocidade média (VM). Salvo a massa corpórea, esses parâmetros foram obtidos de três regiões (cranial, médio e caudal) e submetidos à análise conjuntamente. Os diâmetros das artérias carótidas comuns são diferentes entre equinos e muares, com valores menores nos equinos. O IR, o IP, a VS e a VM diferiram entre equinos e muares, sendo maiores nos equinos, e a VD superior nos muares. Não foi observada diferença das variáveis do modo-B e Doppler entre gêneros nos equinos, diferentemente dos muares, cujos machos apresentaram valores maiores do diâmetro, do IR e do IP, mas menores da VS e da VM. A massa corpórea não influenciou as variáveis do modo-B, independentemente do gênero, mas apresenta correlação significativa nas variáveis do modo Doppler. As artérias carótidas comuns de equinos e muares são diferentes pelos exames ultrassonográficos modo-B e Doppler espectral. O gênero não influencia no modo-B e no Doppler nos equinos, porém influencia parcialmente nos muares. A massa corpórea de equinos e de muares, independentemente do gênero, não tem associação com as variáveis do modo-B, apenas com o Doppler.(AU)

Conventional ultrasound and spectral Doppler in the common carotid arteries in horses and mules are considered scarce, different from human medicine. The aim of this study was to compare the common carotid arteries of horses and mules by B-mode ultrasonography and spectral Doppler ultrasonography, as well as to verify the differences of these variables between their genders and the relation with body mass. The following parameters were evaluated: body mass, artery diameter, intima-media thickness (EIM), resistivity index (IR), pulsatility index (IP), systolic velocity (VS), diastolic velocity (VD) and average velocity (VM). Besides the body mass, the other variables were obtained from three regions (cranial, medium and caudal) and analyzed together. The diameters of the common carotid arteries are different between horses and mules, being smaller in horses. The IR, IP, VS and VM differed between horses and mules, being higher in the horses, but the VD was higher in mules. No difference in the variables in B-mode and Doppler between gender were observed in horses, different from mules, in which the diameters, IR and IP values were higher in males and the VS and VM was higher in females. Body mass did not influence B-Mode, both for horses and mules. A significant correlation was observed for Doppler. The common carotid arteries of horses and mules are different by ultrasound scans B-mode and spectral Doppler. Gender does not influence the B-Mode and Doppler variables in horses, but can in mules. The body mass of horses and mules, regardless of gender, is not associated with B-mode variables, but with Doppler variables.(AU)

Implementation of immobilization accessories for positioning of small animals for radiation therapy / Implementação de acessórios de imobilização para o posicionamento de pequenos animais para a radioterapia

Radiation therapy is a modality that is presenting great advances in veterinary medicine worldwide. In Brazil, this therapeutic option is underachieved. The success of this method depends on several factors, including the use of appropriate accessories for protection and immobilization of patients. For the immobilization of small animals during treatment, in addition to sedation and anesthesia, immobilizing accessories, similar to those used in human radiotherapy, are used. This study aimed to present proposals for immobilizing accessories adapted to the positioning of small animals in order to be used in radiotherapy planning. In order to achieve results, accessories were made and tested in a living animal simulating a radiotherapy planning, which proved to be favorable to use in positioning small animals undergoing radiotherapy and for implementation processes.(AU)

A radioterapia é uma modalidade que tem apresentando grandes avanços dentro da medicina veterinária pelo mundo. No Brasil, essa opção terapêutica é pouco realizada. O sucesso dessa modalidade depende de vários fatores, entre eles, o uso de acessórios adequados para a proteção e imobilização dos pacientes. Para a imobilização dos pequenos animais durante o tratamento, além da sedação e da anestesia, são utilizados acessórios imobilizadores semelhantes aos usados na radioterapia humana. Devido a isso, este trabalho teve como objetivo de apresentar propostas de acessórios de imobilização adaptados ao posicionamento de pequenos animais para o uso nos planejamentos radioterápicos. Para a sua realização, foram confeccionados acessórios e testados em um animal vivo simulando um planejamento radioterápico, os quais mostraram ser favoráveis ao uso nos posicionamento de pequenos animais submetidos à radioterapia e para sua implementação.(AU)

Shiga toxin-producing Escherichia coli and atypical enteropathogenic Escherichia coli strains isolated from healthy sheep of different populations in São Paulo, Brazil.

AIMS: Sheep are important carriers of Shiga toxin-producing Escherichia coli (STEC) in several countries. However, there are a few reports about ovine STEC in American continent. METHODS AND RESULTS: About 86 E. coli strains previously isolated from 172 healthy sheep from different farms were studied. PCR was used for detection of stx(1), stx(2), eae, ehxA and saa genes and for the identification of intimin subtypes. Restriction fragment length polymorphism (RFLP)-PCR was performed to investigate the variants of stx(1) and stx(2), and the flagellar antigen (fliC) genes in nonmotile isolates. Five isolates were eae(+) and stx(-), and belonged to serotypes O128:H2/beta-intimin (2), O145:H2/gamma, O153:H7/beta and O178:H7/epsilon. Eighty-one STEC isolates were recovered, and the stx genotypes identified were stx(1c)stx(2d-O118) (46.9%), stx(1c) (27.2%), stx(2d-O118) (23.4%), and stx(1c)stx(2dOX3a) (2.5%). Pulsed-field gel electrophoresis (PFGE) revealed 27 profiles among 53 STEC and atypical enteropathogenic Escherichia coli (EPEC) isolates. CONCLUSIONS: This study demonstrated that healthy sheep in São Paulo, Brazil, can be carriers of potential human pathogenic STEC and atypical EPEC. SIGNIFICANCE AND IMPACT OF THE STUDY: As some of the STEC serotypes presently found have been involved with haemolytic uraemic syndrome (HUS) in other countries, the important role of sheep as sources of STEC infection in our settings should not be disregarded.

Risk factors for non-adherence to medication in inflammatory bowel disease patients.

BACKGROUND: Inflammatory bowel diseases are chronic conditions requiring medication throughout life to treat the disease and control the risk of relapse and colorectal cancer. Adherence to prescribed drugs is therefore crucial to their management. AIM: To identify determinants and potential risk factors of non-adherence in inflammatory bowel disease patients. METHODS: An anonymous 24-item questionnaire (available online as Supplementary material) was administered to 485 out-patients attending a tertiary referral centre. RESULTS: Sixty-one per cent of the patients reportedly adhered to their treatment. No differences emerged between inflammatory bowel disease and socio-demographic characteristics other than age, non-adherence being significantly associated with cases under 40 years (43% vs. 34%, P = 0.041). The most common reasons for non-adherence vs. adherence were forgetfulness (61% vs. 44%, P = 0.000), disease remission (25% vs. 10%, P = 0.000), recent diagnosis (24% vs. 15%, P = 0.000) and full-time employment (55% vs. 26%, P = 0.000). Oral therapy was associated with a significantly better adherence than rectal therapy (60% vs. 32%, P = 0.001). Communication affects patient adherence: a significant interaction was found for adherence and patients <40 years who had a good relationship with their doctors. CONCLUSIONS: Risk factors for non-adherence are younger age, busy working life, recent diagnosis and disease remission. Good communication with the doctor might improve adherence.

Esophageal involvement in juvenile localized scleroderma: a pilot study.

OBJECTIVES: To evaluate the esophageal involvement in patients with juvenile localized scleroderma (JLS). METHODS: A cohort of patients with JLS underwent esophageal stationary manometry to evaluate esophageal motility and lower esophageal sphincter (LES) function, distal esophagus 24-hour pH-monitoring to detect gastroesophageal reflux (GER) and upper gastrointestinal (GI) endoscopy to evaluate the presence of esophagitis. RESULTS: Fourteen patients (10 female, mean age 13.3 yrs, mean disease duration 4.7 yrs), took part in the study. Ten had linear scleroderma, three deep morphea, and one generalized morphea. Esophageal abnormalities were found in 8/14 patients (57%): pathological acid exposure on 24-hour pH-monitoring was found in 7; non-specific esophageal motor abnormalities in 5 and endoscopy-proved esophagitis in 5 symptomatic patients. Interestingly, 5 out of 8 patients with esophageal abnormalities were found to be ANA positive, and 2 were also RF positive. CONCLUSION: Esophageal involvement is not unusual in patients with juvenile localized scleroderma, even in the absence of specific symptoms. These preliminary findings, if confirmed in a larger cohort of patients, may support the indication for an extensive GI evaluation especially in presence of positive autoantibodies or specific GI symptoms.

Use of alternative and complementary therapies by inflammatory bowel disease patients in an Italian tertiary referral centre.

BACKGROUND: Alternative and complementary therapies are increasingly used by patients with inflammatory bowel disease, but no data are available on their use in Italy. AIM: To ascertain the prevalence and pattern of the use of alternative and complementary therapies, and demographic and clinical factors associated with their use in a large sample of Italian inflammatory bowel disease patients. METHODS: A structured questionnaire was administered to a cohort of outpatients at a tertiary referral centre. RESULTS: Five hundred and fifty-two patients completed the questionnaire; 156 (28%) reported using alternative and complementary therapies, which mainly involved homeopathy (43.6%), followed by controlled diets or dietary supplements (35.5%), herbs (28.2%), exercise (25.6%) and prayer (14.7%). Alternative and complementary therapies were used to ameliorate intestinal symptoms (52.5%), in the hope of being cured (41%) and to reduce the intake of drugs (39.7%). An improvement in well-being (45.5%) and inflammatory bowel disease symptoms (40.3%) were the most commonly reported benefits. A higher education (p=0.027), a more frequently relapsing disease (p=0.001) and dissatisfaction with the doctor's communication (p=0.001) correlated with alternative and complementary therapy use. Non-compliance with conventional drugs, disease severity and curiosity regarding novel therapies were predictors of alternative and complementary therapy use. CONCLUSIONS: Alternative and complementary therapies are frequently used by Italian inflammatory bowel disease patients. Doctors should improve their empathy and their understanding about possible benefits of alternative and complementary therapies.

Interaction between rifaximin and dietary fibre in patients with diverticular disease.

BACKGROUND: Cyclic administration of rifaximin in association with dietary fibre achieves symptomatic relief in uncomplicated diverticular disease (DD) by means of a still undefined mechanism. AIM: To investigate the effects of a combination of rifaximin and fibre on both hydrogen production by intestinal microflora and oro-anal transit time. METHODS: In a controlled, double-blind crossover trial, 64 patients with uncomplicated DD were given bran (20 g/day) and randomly treated with rifaximin (1200 mg/day) or a placebo for 14 days. Evaluation was based on clinical status, breath test, oro-anal transit time and faecal weight. RESULTS: The global symptomatic score was significantly reduced after rifaximin (7.1 +/- 4.1 to 4.1 +/- 3.3; P < 0.005) but not after placebo (6.8 +/- 3.8 to 6.1 +/- 3.5). Hydrogen production significantly increased after placebo from 198 +/- 134 to 267 +/- 161 ppm/min, while Rifaximin reduced it from 222 +/- 187 to 166 +/- 131 ppm/min (P = 0.05). The total oro-anal transit time decreased from 56.1 +/- 28.2 to 51.3 +/- 28.0 h in placebo and from 54.4 +/- 31.9 to 45.1 +/- 32.4 h (P < 0.05) in rifaximin-treated patients. CONCLUSIONS: The administration of rifamixin improves the benefits of dietary fibre in uncomplicated DD by preventing its bacterial degradation.

Increased intestinal permeability and NOD2 variants in familial and sporadic Crohn's disease.

BACKGROUND: Abnormal barrier function may be genetically determined in Crohn's disease. AIM: To examine the role of abnormal intestinal permeability in genetic predisposition in multiplex vs. sporadic Crohn's disease families. METHODS: Intestinal permeability was measured in patients, relatives and partners by means of lactulose/mannitol test. Healthy subjects from the hospital staff served as controls. CARD15 mutations were investigated in sporadic and familial Crohn's disease patients and in a group of blood donors. RESULTS: The median lactulose/mannitol ratio was increased significantly in Crohn's disease patients vs. their relatives [0.03 (0.01-0.24) vs. 0.01 (0.003-0.19), P=0.005]. The percentage of abnormal tests was significantly higher in familial vs. sporadic first-degree relatives of Crohn's disease patients (29% vs. 11%, P=0.0281). Abnormal permeability occurred significantly more frequent in patients with familial Crohn's disease carrying the frameshift mutation. The frameshift mutation 3020 insC was associated with increased permeability in 75% in the multiplex and in 61% of the sporadic CD patients. One partner had abnormal lactulose/mannitol ratio. Conclusion Intestinal permeability is raised in Crohn's disease patients and relatives, with higher rates in familial vs. sporadic healthy relatives. CARD15 mutations are associated with abnormal permeability in ileal Crohn's disease.

Frequency of Shiga toxin-producing Escherichia coli (STEC) isolates among diarrheic and non-diarrheic calves in Brazil.

The occurrence of Shiga toxin (Stx) gene sequences was examined in 344 fecal samples from diarrheic (n=139) and non-diarrheic (n=205) calves from 12 beef farms in São Paulo State, Brazil to study the prevalence of Shiga toxin-producing Escherichia coli (STEC) strains. Forty-four (12.7%) animals were found to be positive for stx. The frequency of carriage of stx was higher in diarrheic calves (28/139, 20%) than in non-diarrheic animals (16/205, 7.8%) (P<0.001). Among the 24 STEC strains recovered from the animals, 12 isolates carried stx1, four stx2, and 8 carried both stx1 and stx2 genes. The eae and the enterohaemolysin (Ehly) gene sequences occurred at high frequencies in these STEC strains (41.6 and 50.0%, respectively). A total of 16 serotypes were identified. The serotypes O111:NM (four isolates), O111:H8 (two) and O118:H16 (one), currently described as enterohaemorrhagic E. coli (EHEC), were isolated from cattle in Brazil for the first time. These findings reinforce the importance of cattle as a reservoir of EHEC strains in Brazil.

Properties of Shiga toxin-producing Escherichia coli (STEC) isolates from sheep in the State of São Paulo, Brazil.

Fecal samples from 48 sheep from two farms in São Paulo, SP, Brazil, were examined to determine the prevalence of Shiga toxin-producing Escherichia coli (STEC). Forty-two STEC strains were isolated from 25 (52.1%) of 48 sheep feces, and were examined for the presence of genes encoding STEC-related virulence factors. Twenty-one (50.0%) of the 42 STEC isolates were positive for stx(1) and stx(2), 16 isolates (38.1%) were stx(1), and five (11.9%) were stx(2). Expression of Shiga toxins was demonstrated by the Vero cell toxicity test for all the strains carrying stx. Fourteen of the STEC strains (33.3%) carried the enterohemolysin gene (ehly) and presented the enterohemolytic phenotype, and five (11.9%) were positive for the plasmid encoded katP gene. The eae gene was not present in any of the isolates. STEC strains presenting stx(1), stx(2) and ehly were most commonly (23.8%) recovered from these sheep. The predominant STEC serotype found was ONT:H8, and others included O5:H-, O16:H-, O75:H-, O75:H8, O87:H16, O91:H-, O146:H21, O172:H-, OR:H-, ONT:H- and ONT:H16. This is the first report on ovine STEC in South America, and identifies a number of ovine non-O157 STEC that belong to serotypes implicated in human disease.