Nematicidal Effect and Histological Modifications Induced by Hydrolysable Tannin Extract on the Third-Stage Infective Larvae of Haemonchus contortus.

Haemonchus contortus is the most frequent and most important nematode parasite in the ruminants production of tropical and subtropical regions. There are strains resistant to all families of available anthelmintics. Consequently, the conduction of research to find other resources that allow effective control of this parasitic disease, preferably focusing on green production, is necessary. The aim of this study was to evaluate the effect of hydrolysable tannin extract (HTE) on larvae 3 (L3) of H. contortus in vitro. L3 were exposed to different HTE concentrations and times. In addition, both light and scanning electron microscopy were used to explore physical damage on L3 subjected to HTE activity. After 72 h of incubation, the mean lethal concentration of HTE was 2 mg/mL; this concentration has been previously referred to as safe for consumption in cattle. Scanning electron microscopy revealed H. contortus L3 destruction, damage was evident by separation of the sheath mainly in the cervical and caudal regions of the larva and by rupture of the cuticle with larval evisceration. Our results suggest that hydrolysable tannin extract from chestnut could be considered as a green alternative for parasitic control in ruminants.

Asociación entre desenlaces clínicos y cumplimiento del protocolo de recuperación mejorada después de la cirugía (ERAS) en procedimientos colorrectales: estudio multicéntrico / Association between clinical outcomes and compliance with the Enhanced Recovery After Surgery (ERAS) protocol in colorectal procedures: A multicenter study

Introducción. Los protocolos de recuperación mejorada después de cirugía se han diseñado como una innovación en salud tras demostrarse que la mejora en los dispositivos médicos y la depuración de técnicas alcanzaron la meseta en disminución de complicaciones. Con estas estrategias de la medicina perioperatoria, en cirugía colorrectal se reducen la morbilidad y estancia hospitalaria. El objetivo del estudio fue evaluar si la tasa de adherencia al programa de recuperación mejorada después de la cirugía (ERAS) está asociada con los resultados quirúrgicos. Métodos. Estudio multicéntrico, observacional, retrospectivo de cohorte (2015-2019), en cinco hospitales latinoamericanos certificados por la sociedad ERAS. Se calculó la incidencia de complicaciones quirúrgicas durante el posquirúrgico inmediato (30 días) y la duración de la estancia hospitalaria. Se utilizaron análisis bivariado y regresión logística multivariada para evaluar los factores asociados con la tasa de complicaciones. Resultados. Fueron incluidos en el estudio 648 pacientes en cinco hospitales ERAS, con edad promedio de 61 años y mayor porcentaje de hombres (51 %). El cumplimiento global al protocolo ERAS fue de 75 % y la estancia promedio de 6,2 días (mediana: 4 días). Se tuvo un cumplimiento óptimo del protocolo ERAS (igual o mayor al 80 %) en 23,6 % de los pacientes. Se documentó fuga de la anastomosis en 4 %, complicaciones infecciosas en 8,4 %, íleo en 5,7 %, reingreso en 10,2 % y mortalidad de 1,1 %. El análisis multivariado mostró que los niveles de adherencia óptima al protocolo ERAS reducen significativamente la aparición de complicaciones como fuga de la anastomosis (OR 0,08; IC95% 0,01-0,48; p=0,005) y complicaciones infecciosas (OR 0,17; IC95%0,03-0,76; p=0,046).Discusión. Los resultados sugieren que un cumplimiento del programa ERAS mayor al 80 % se asocia a menor frecuencia de complicaciones en pacientes con cirugía electiva colorrectal

Introduction. Enhanced Recovery After Surgery (ERAS) protocol has been designed as an innovation in health after demonstrating that the improvement in medical devices and the refinement of techniques reached the plateau in reducing complications. With these strategies of perioperative medicine, in colorectal surgery morbidity and hospital stay are reduced. The aim of the study was to evaluate whether the rate of adherence to the ERAS protocol is associated with surgical outcomes.Methods. Multicenter, observational, retrospective cohort study (2015-2019), in five Latin American hospitals certified by the ERAS Society. The incidence of surgical complications during the immediate postoperative period (30 days) and length of hospital stay were calculated. Bivariate analyzes and multivariate logistic regression were used to assess factors associated with complication rates.Results. 648 patients were included in the study in five ERAS hospitals, with an average age of 61 years and a higher percentage of men (51%). Overall compliance with the ERAS protocol was 75% and the average stay was 6.2 days (median: 4 days). There was optimal compliance with the ERAS protocol (equal to or greater than 80%) in 23.6% of the patients. Anastomotic leak was documented in 4%, infectious complications in 8.4%, ileus in 5.7%, readmission in 10.2%, and mortality in 1.1%. Multivariate analysis showed that optimal adherence levels to the ERAS protocol significantly reduce the appearance of complications such as anastomotic leakage (OR 0.08; 95%CI 0.01-0.48; p=0.005) and infectious complications (OR 0.17; 95%CI 0.03-0.76; p=0.046).Discussion. The results suggest that compliance with the ERAS program greater than 80% is associated with a lower frequency of complications in patients with elective colorectal surgery

Anthelmintic effect and tissue alterations induced in vitro by hydrolysable tannins on the adult stage of the gastrointestinal nematode Haemonchus contortus.

Haemonchus contortus constitutes a severe problem for ruminant's production, it is the most frequent nematode parasite both in template and tropical regions, induces economical losses, and shows increasing resistance to currently available anthelmintics. Tannins are secondary metabolites that naturally fulfill defense functions in plants, representing a non-conventional, natural alternative in the treatment of gastrointestinal parasites in sheep. The objective of this work was to explore the in vitro anthelmintic activity of hydrolysable tannins on adult stage of Haemonchus contortus. Adults nematodes were obtained directly from the abomasum of ovines, and a dose response curve was performed with tannins extract at 0, 2, 4, 8, 25 and 50 mg/mL, and a time response curve at 0.5, 1, 2 and 24 h at 37 °C. Hydrolysable tannins decreased motility and induced mortality of H. contortus. We observed cuticle disruption around the mouth and reproductive organs, as well as evisceration. After 24 h of exposition, 8 mg/mL induced 83% of mortality and with 25 mg/kg 100% of mortality was achieved. The LD50 was 3.54 mg/mL, while LD90 was 10 mg/mL. We propose hydrolysable tannins as an alternative to contribute in the nematode control in ruminants.