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1.
Epidemiol Infect ; 146(8): 985-990, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29690946

RESUMO

Antimicrobial resistance is a limiting factor for the success of the treatment of infectious diseases and is associated with increased morbidity and cost. The present study aims to evaluate prescribing patterns of antimicrobials and quantify progress in relation to targets for quality improvement in the prescription of antimicrobials in Northern Ireland's secondary care sector using three repetitive point prevalence surveys (PPS) over a 6-year period: the European Surveillance of Antimicrobial Consumption (ESAC-PPS) in 2009 and 2011 and the Global-PPS on Antimicrobial Consumption and Resistance in 2015. Out of 3605 patients surveyed over the three time points, 1239 (34.4%) were treated with an antibiotic, the most frequently prescribed antibiotic groups were a combination of penicillins, including ß-lactamase inhibitors. Compliance with hospital antibiotic policies in 2009, 2011 and 2015 were 54.5%, 71.5% and 79.9%, respectively. Likewise, an indication for treatment was recorded in patient notes 88.5%, 87.7% and 90.6% in 2009, 2011 and 2015, respectively, and surgical prophylactic antibiotic prescriptions for >24 h was 3.9%, 3.2% and 0.7% in 2009, 2011 and 2015, respectively. Treatment based on biomarker data was used in 61.5% of cases. In conclusion, a general trend in the improvement of key antimicrobial-related quality indicators was noted. The PPS tool provided a convenient, inexpensive surveillance system of antimicrobial consumption and should be considered an essential component to establish and maintain informed antibiotic stewardship in hospitals.


Assuntos
Antibacterianos/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Melhoria de Qualidade/estatística & dados numéricos , Centros de Cuidados de Saúde Secundários/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Irlanda do Norte
2.
J Neurol Neurosurg Psychiatry ; 82(7): 810-3, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21257981

RESUMO

OBJECTIVES: To determine the disability, distress and employment status of new neurology outpatients with physical symptoms unexplained by organic disease and to compare them with patients with symptoms explained by organic disease. METHODS: As part of a cohort study (the Scottish Neurological Symptoms Study) neurologists rated the extent to which each new patient's symptoms were explained by organic disease. Patients whose symptoms were rated as 'not at all' or only 'somewhat' explained by disease were considered cases, and those whose symptoms were 'largely' or 'completely' explained by disease were considered controls. All patients completed self-ratings of disability, health status (Medical Outcomes Study Short Form 12-Item Scale (SF-12)) and emotional distress (Hospital Anxiety and Depression Scale) and also reported their employment and state financial benefit status. RESULTS: 3781 patients were recruited: 1144 (30%) cases and 2637 (70%) controls. Cases had worse physical health status (SF-12 score 42 vs 44; difference in means 1.7 (95% CI -2.5 to 0.9)) and worse mental health status (SF-12 score 43 vs 47; difference in means -3.5 (95% CI -4.3 to to 2.7)). Unemployment was similar in cases and controls (50% vs 50%) but cases were more likely not to be working for health reasons (54% vs 37% of the 50% not working; OR 2.0 (95% CI 1.6 to 2.4)) and also more likely to be receiving disability-related state financial benefits (27% vs 22%; (OR 1.3, 95% CI 1.1 to 1.6)). CONCLUSIONS: New neurology patients with symptoms unexplained by organic disease have more disability-, distress- and disability-related state financial benefits than patients with symptoms explained by disease.


Assuntos
Doenças do Sistema Nervoso/psicologia , Desemprego/estatística & dados numéricos , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Estudos de Coortes , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Avaliação da Deficiência , Pessoas com Deficiência , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Pacientes Ambulatoriais , Estudos Prospectivos , Escócia/epidemiologia , Seguridade Social , Estresse Psicológico/psicologia , Resultado do Tratamento
3.
Clin Neurol Neurosurg ; 112(9): 747-51, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20646830

RESUMO

OBJECTIVE: Information on the nature and relative frequency of diagnoses made in referrals to neurology outpatient clinics is an important guide to priorities in services, teaching and research. Previous studies of this topic have been limited by being of only single centres or lacking in detail. We aimed to describe the neurological diagnoses made in a large series of referrals to neurology outpatient clinics. METHOD: Newly referred outpatients attending neurology clinics in all the NHS neurological centres in Scotland, UK were recruited over a period of 15 months. The assessing neurologists recorded the initial diagnosis they made. An additional rating of the degree to which the neurologist considered the patient's symptoms to be explained by disease was used to categorise those diagnoses that simply described a symptom such as 'fatigue'. RESULTS: Three thousand seven hundred and eighty-one patients participated (91% of those eligible). The commonest categories of diagnosis made were: headache (19%), functional and psychological symptoms (16%), epilepsy (14%), peripheral nerve disorders (11%), miscellaneous neurological disorders (10%), demyelination (7%), spinal disorders (6%), Parkinson's disease/movement disorders (6%), and syncope (4%). Detailed breakdowns of each category are provided. CONCLUSIONS: Headache, functional/psychological disorders and epilepsy are the most common diagnoses in new patient referral to neurological services. This information should be used to shape priorities for services, teaching and research.


Assuntos
Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/terapia , Neurologia , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Epilepsia/diagnóstico , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Feminino , Geografia , Transtornos da Cefaleia/diagnóstico , Transtornos da Cefaleia/epidemiologia , Transtornos da Cefaleia/terapia , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/diagnóstico , Exame Neurológico , Seleção de Pacientes , Estudos Prospectivos , Escócia/epidemiologia , Fatores Sexuais , Medicina Estatal/estatística & dados numéricos
4.
Psychol Med ; 40(4): 689-98, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19627646

RESUMO

BACKGROUND: Patients whose symptoms are 'unexplained by disease' often have a poor symptomatic outcome after specialist consultation, but we know little about which patient factors predict this. We therefore aimed to determine predictors of poor subjective outcome for new neurology out-patients with symptoms unexplained by disease 1 year after the initial consultation. METHOD: The Scottish Neurological Symptom Study was a 1-year prospective cohort study of patients referred to secondary care National Health Service neurology clinics in Scotland (UK). Patients were included if the neurologist rated their symptoms as 'not at all' or only 'somewhat explained' by organic disease. Patient-rated change in health was rated on a five-point Clinical Global Improvement (CGI) scale ('much better' to 'much worse') 1 year later. RESULTS: The 12-month outcome data were available on 716 of 1144 patients (63%). Poor outcome on the CGI ('unchanged', 'worse' or 'much worse') was reported by 482 (67%) out of 716 patients. The only strong independent baseline predictors were patients' beliefs [expectation of non-recovery (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.40-2.96), non-attribution of symptoms to psychological factors (OR 2.22, 95% CI 1.51-3.26)] and the receipt of illness-related financial benefits (OR 2.30, 95% CI 1.37-3.86). Together, these factors predicted 13% of the variance in outcome. CONCLUSIONS: Of the patients, two-thirds had a poor outcome at 1 year. Illness beliefs and financial benefits are more useful in predicting poor outcome than the number of symptoms, disability and distress.


Assuntos
Atitude Frente a Saúde , Doenças do Sistema Nervoso Central/diagnóstico , Doenças do Sistema Nervoso Central/terapia , Cultura , Adulto , Doenças do Sistema Nervoso Central/epidemiologia , Estudos de Coortes , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
5.
Brain ; 132(Pt 10): 2878-88, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19737842

RESUMO

It has been previously reported that a substantial proportion of newly referred neurology out-patients have symptoms that are considered by the assessing neurologist as unexplained by 'organic disease'. There has however been much controversy about how often such patients subsequently develop a disease diagnosis that, with hindsight, would have explained the symptoms. We aimed to determine in a large sample of new neurology out-patients: (i) what proportion are assessed as having symptoms unexplained by disease and the diagnoses given to them; and (ii) how often a neurological disorder emerged which, with hindsight, explained the original symptoms. We carried out a prospective cohort study of patients referred from primary care to National Health Service neurology clinics in Scotland, UK. Measures were: (i) the proportion of patients with symptoms rated by the assessing neurologist as 'not at all' or only 'somewhat explained' by 'organic disease' and the neurological diagnoses recorded at initial assessment; and (ii) the frequency of unexpected new diagnoses made over the following 18 months (according to the primary-care physician). One thousand four hundred and forty-four patients (30% of all new patients) were rated as having symptoms 'not at all' or only 'somewhat explained' by 'organic disease'. The most common categories of diagnosis were: (i) organic neurological disease but with symptoms unexplained by it (26%); (ii) headache disorders (26%); and (iii) conversion symptoms (motor, sensory or non-epileptic attacks) (18%). At follow-up only 4 out of 1030 patients (0.4%) had acquired an organic disease diagnosis that was unexpected at initial assessment and plausibly the cause of the patients' original symptoms. Eight patients had died at follow-up; five of whom had initial diagnoses of non-epileptic attacks. Seven other types of diagnostic change with very different implications to a 'missed diagnosis' were found and a new classification of diagnostic revision is presented. One-third of new neurology out-patients are assessed as having symptoms 'unexplained by organic disease'. A new diagnosis, which with hindsight explained the original symptoms, rarely became apparent to the patient's primary care doctor in the 18 months following the initial hospital consultation.


Assuntos
Doenças do Sistema Nervoso/diagnóstico , Adulto , Transtorno Conversivo/diagnóstico , Transtorno Conversivo/fisiopatologia , Erros de Diagnóstico , Feminino , Seguimentos , Cefaleia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/etiologia , Exame Neurológico , Pacientes Ambulatoriais , Seleção de Pacientes , Prognóstico , Resultado do Tratamento
6.
Ann Oncol ; 18(11): 1861-9, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17804467

RESUMO

BACKGROUND: Fatigue is associated with cancer and its treatment but we know little about how many and which patients suffer fatigue of clinical severity. We aimed to determine the prevalence of clinically relevant fatigue (CRF) and its associations in outpatients with various cancer diagnoses. PATIENTS AND METHODS: A survey of outpatients with colorectal, breast, gynaecological, genitourinary, sarcoma, melanoma and miscellaneous tumours at a regional cancer centre. Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) fatigue subscale and the Hospital Anxiety and Depression Scale (HADS). These self-report data were linked to demographic and clinical variables. Data were available on 2867 outpatients. RESULTS: The prevalence of CRF (EORTC fatigue subscale > or =40) was 32% (95% confidence interval 31-34%). The variables independently associated with CRF were primary cancer site, having disease present, type of cancer treatment and emotional distress (total HADS score > or =15). Emotional distress had the strongest association with fatigue but half the cases of CRF were not distressed. CONCLUSION: CRF is common in cancer outpatients and is associated with type of disease and treatment, as well as with emotional distress. The association between CRF and emotional distress is strong but they are not equivalent conditions.


Assuntos
Fadiga/epidemiologia , Neoplasias/epidemiologia , Qualidade de Vida , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial , Ansiedade/epidemiologia , Ansiedade/fisiopatologia , Institutos de Câncer , Causalidade , Comorbidade , Estudos Transversais , Fadiga/fisiopatologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias/diagnóstico , Neoplasias/terapia , Pacientes Ambulatoriais/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Prevalência , Fatores de Risco , Distribuição por Sexo , Papel do Doente , Perfil de Impacto da Doença , Estresse Psicológico , Inquéritos e Questionários , Reino Unido/epidemiologia
7.
Br J Cancer ; 96(6): 868-74, 2007 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-17311020

RESUMO

To: (1) estimate the prevalence of clinically significant emotional distress in patients attending a cancer outpatient department and (2) determine the associations between distress and demographic and clinical variables, we conducted a survey of outpatients attending selected clinics of a regional cancer centre in Edinburgh, UK. Patients completed the Hospital Anxiety and Depression Scale (HADS) on touch-screen computers and the scores were linked to clinical variables on the hospital database. Nearly one quarter of the cancer outpatients 674 out of 3071 (22%; 95% confidence interval (CI) 20-23%) met our criterion for clinically significant emotional distress (total HADS score 15 or more). Univariate analysis identified the following statistically significant associations: age<65, female gender, cancer type and extent of disease. Multivariate analysis indicated that age<65 (odds ratio 1.41; 95% CI 1.18-1.69), female gender (odds ratio 1.58; 95% CI 1.31-1.92) and active disease (odds ratio 1.72; 95% CI 1.43-2.05) but not cancer diagnosis, were the independent predictors of clinically significant emotional distress. Services to treat distress in cancer patients should be organised to target patients by characteristics other than their cancer diagnosis.


Assuntos
Neoplasias/psicologia , Estresse Psicológico/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Pacientes Ambulatoriais , Prevalência , Estresse Psicológico/epidemiologia , Reino Unido/epidemiologia
8.
Neurosci Lett ; 306(3): 161-4, 2001 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-11406320

RESUMO

Chronic treatment with antidepressant drugs (2 weeks or longer) increases corticosteroid receptor mRNA expression in the hippocampus and reduces hypothalamic-pituitary-adrenal axis activity in parallel with improving mood and neuroendocrine function. Earlier effects are less well documented. We examined the effects of short term (9 days) treatment with fluoxetine (10 mg/kg) and venlafaxine (10 mg/kg) on hippocampal mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) mRNA expression and spatial memory in adult rats. In situ hybridization histochemistry showed that the antidepressants decreased MR mRNA expression in all hippocampal subregions (e.g. 45% decrease in CA1 with venlafaxine, P<0.001), while GR mRNA expression was selectively reduced in the CA3 subregion. There was a trend for decreased plasma corticosterone levels following fluoxetine (50% fall, P=0.07) and venlafaxine (30% fall, P=0.18) but neither antidepressants affected spatial memory in the watermaze. Thus antidepressants can have complex and opposing actions on hippocampal corticosteroid receptor expression depending on the duration of treatment.


Assuntos
Antidepressivos de Segunda Geração/farmacologia , Cicloexanóis/farmacologia , Fluoxetina/farmacologia , Hipocampo/fisiologia , Receptores de Glucocorticoides/genética , Receptores de Mineralocorticoides/genética , Animais , Corticosterona/sangue , Expressão Gênica/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , RNA Mensageiro/metabolismo , Ratos , Ratos Endogâmicos , Cloridrato de Venlafaxina
9.
Proc Natl Acad Sci U S A ; 98(8): 4716-21, 2001 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-11274359

RESUMO

11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD-1) intracellularly regenerates active corticosterone from circulating inert 11-dehydrocorticosterone (11-DHC) in specific tissues. The hippocampus is a brain structure particularly vulnerable to glucocorticoid neurotoxicity with aging. In intact hippocampal cells in culture, 11beta-HSD-1 acts as a functional 11beta-reductase reactivating inert 11-DHC to corticosterone, thereby potentiating kainate neurotoxicity. We examined the functional significance of 11beta-HSD-1 in the central nervous system by using knockout mice. Aged wild-type mice developed elevated plasma corticosterone levels that correlated with learning deficits in the watermaze. In contrast, despite elevated plasma corticosterone levels throughout life, this glucocorticoid-associated learning deficit was ameliorated in aged 11beta-HSD-1 knockout mice, implicating lower intraneuronal corticosterone levels through lack of 11-DHC reactivation. Indeed, aged knockout mice showed significantly lower hippocampal tissue corticosterone levels than wild-type controls. These findings demonstrate that tissue corticosterone levels do not merely reflect plasma levels and appear to play a more important role in hippocampal functions than circulating blood levels. The data emphasize the crucial importance of local enzymes in determining intracellular glucocorticoid activity. Selective 11beta-HSD-1 inhibitors may protect against hippocampal function decline with age.


Assuntos
Envelhecimento/metabolismo , Corticosterona/sangue , Hidroxiesteroide Desidrogenases/metabolismo , /prevenção & controle , 11-beta-Hidroxiesteroide Desidrogenases , Envelhecimento/fisiologia , Animais , Glicemia/metabolismo , Hipocampo/metabolismo , Hipocampo/fisiologia , Masculino , Camundongos , Camundongos Knockout , Transcortina/metabolismo
10.
Neurosci Lett ; 288(1): 66-70, 2000 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-10869817

RESUMO

Adult neurones remain dependent on neurotrophic factors such as insulin-like growth factor 1 (IGF-1) to sustain neuronal viability by maintaining cell phenotype, supporting synaptic plasticity and providing neuroprotective and neuroregenerative mechanisms. A decline in the cellular expression of neurotrophic factors has been speculated to contribute to the age-related changes that occur in the brain, where the hippocampus appears particularly susceptible. Using in situ hybridisation, we have made a detailed comparison of the expression of IGF-1 mRNA in the hippocampal formation between young (6 months) and aged (23 months) rats. IGF-1 mRNA expression was measured from cell populations containing only high density radioactive labelling (>20 grains/cell) to avoid ambiguity of signal. The amount of IGF-1 mRNA signal was significantly lower in cells of the alveus (P<0.05) and stratum lacunosum moleculare (P<0.01) of aged compared to young rats. These findings challenge reports that IGF-1 mRNA is unaltered in the ageing hippocampus and provide further evidence that changes in the IGF-1 system is a significant factor in the progressive age-related deterioration of normal neuronal function.


Assuntos
Envelhecimento/fisiologia , Hipocampo/fisiologia , Fator de Crescimento Insulin-Like I/genética , Animais , Expressão Gênica/fisiologia , Hipocampo/citologia , Hibridização In Situ , Masculino , Neurônios/química , Neurônios/fisiologia , RNA Mensageiro/metabolismo , Ratos , Ratos Endogâmicos
11.
J Anat ; 197 Pt 4: 553-62, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11197528

RESUMO

Approximately 30 % of human and mammalian populations develop cognitive impairments with ageing. Many of these impairments have been linked to dysfunction of the hippocampus, a well studied area of the medial-temporal lobe, which is involved in episodic memory and control of the hypothalamo-pituitary-adrenal stress axis and, thus, of glucocorticoid secretion. This paper reviews the growing body of studies which explore a possible relationship between lifetime exposure to glucocorticoids and hippocampal impairment. There is now strong evidence which associates hypercortisolemia in aged men with later cognitive dysfunction and this complements a wealth of rodent and other human data. We conclude with a discussion of possible pharmacological and behavioural interventions.


Assuntos
Envelhecimento/fisiologia , Glucocorticoides/fisiologia , Hipocampo/metabolismo , Mamíferos/fisiologia , Idoso , Animais , Antidepressivos/uso terapêutico , Cálcio/metabolismo , Cerebelo/fisiologia , Corticosterona/fisiologia , Terapia de Reposição de Estrogênios , Radicais Livres/metabolismo , Humanos , Hidrocortisona/fisiologia , Transtornos da Memória/metabolismo , Transtornos da Memória/prevenção & controle , Camundongos , Ratos , Receptores de Glucocorticoides/metabolismo , Receptores de Mineralocorticoides/metabolismo
12.
J Anim Sci ; 71(6): 1648-56, 1993 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8325822

RESUMO

The effects of sorghum type on amino acid digestion were determined by feeding heifers (230 kg) equipped with ruminal, duodenal, and ileal cannulas bird-resistant (BR) or non-BR grains that had a normal or waxy endosperm (NORMAL-BR, WAXY-BR, NORMAL, WAXY). Dry-rolled grain diets were fed at 2% of BW in a 4 x 4 Latin square design. Total (TAA), essential (EAA), and nonessential (NAA) amino acid intake (grams/day) tended to be greater for BR than for non-BR grains. Feed (plus endogenous) amino acids reaching the duodenum were calculated by subtracting amino acids of microbial protein from total flow. Flow (grams/day) of total and feed TAA, EAA, NAA, and proline-rich-protein (sum of aspartate, glutamate, glycine, and proline) to the duodenum was greater (P < .05) for BR than for non-BR grains. The ratio between feed proline-rich-protein and NAA reaching the duodenum was similar to that noted with feed intake. Amino acid disappearance (grams/day) from the small intestine was unchanged (P > .10) by sorghum type, although the digestibility (percentage of duodenal flow) of TAA, EAA, NAA, and most individual amino acids was decreased (P < .05) for BR varieties. Amino acid flow to the cecum (grams/day) was generally greater for NORMAL-BR than for WAXY-BR (P < .10) or for NORMAL (P < .01) and greater (P < .10) for WAXY-BR than for WAXY.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Aminoácidos/metabolismo , Ração Animal , Bovinos/fisiologia , Digestão , Grão Comestível , Aminoácidos/administração & dosagem , Animais , Aves , Proteínas na Dieta/administração & dosagem , Proteínas na Dieta/metabolismo , Ingestão de Alimentos , Feminino , Trânsito Gastrointestinal , Intestino Delgado/fisiologia , Ligação Proteica , Taninos/metabolismo
13.
J Anim Sci ; 69(6): 2571-84, 1991 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1885372

RESUMO

To compare the effects of sorghum grain hybrids on site and extent of digestion, two yellow (Y1 and Y2), two cream (C1 and C2), and two hetero-yellow (HY1 and HY2) sorghum grains were fed (1.85% BW, DM basis) in an 81% dry-rolled grain diet to steers (342 kg BW) equipped with ruminal, duodenal, and ileal cannulas within a 6 X 6 Latin square. Yellow (YEL) hybrids had a homozygous yellow endosperm and a yellow seed coat; cream (CREAM) and hetero-yellow (HET-YEL) hybrids had a heterozygous (partial) yellow endosperm, with white or red seed coats, respectively. Total tract starch digestibility (percentage) was greater (P less than .10) for CREAM and HET-YEL (82.3) than for YEL (78.9), primarily because of greater (P less than .05) starch digestion in the large intestine. Ruminal starch digestibility (percentage) was greater (P less than .10) for HET-YEL (73.2) than for CREAM (66.3) and was a larger proportion of total tract digestion for HET-YEL (90.6) than for CREAM (80.1). Ruminal starch digestion was correlated negatively (r = -.46; P less than .08) with ruminal escape of feed N. Prececal starch digestibility (average 76.2%) was more strongly correlated with ruminal digestibility (r = .69; P less than .01) than with digestion in the small intestine (r = .41; P = .12). Total tract nonammonia N (NAN) digestibility (percentage) was greater (P less than .10) for CREAM than for HET-YEL, greater for Y1 (P less than .10) than for Y2, greater for C2 (P less than .05) than for C1, and greater for HY2 (P less than .05) than for HY1. Flow of NAN to the duodenum was correlated negatively (r = -.55; P less than .05) with prececal starch digestion. Small intestinal NAN disappearance (g/d) was greater (P less than .01) for HY1 (76.0) than for HY2 (52.2). Microbial N flow (r = .88; P less than .01), but not feed N flow (r = .17; P = .52), to the duodenum was correlated with partial NAN digestibility in the small intestine. Hybrids differed in site and extent of digestion. Differences were generally larger for N than for starch.


Assuntos
Ração Animal , Bovinos/fisiologia , Digestão , Grão Comestível , Animais , Concentração de Íons de Hidrogênio , Intestino Grosso/metabolismo , Intestino Delgado/metabolismo , Masculino , Nitrogênio/metabolismo , Rúmen/metabolismo , Amido/metabolismo
14.
J Anim Sci ; 69(6): 2601-7, 1991 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1885373

RESUMO

A double L-shaped intestinal cannula was developed in an attempt to overcome problems observed previously with simple T-type cannulas. The cannula was constructed from cyclopolyvinyl chloride water pipe fittings. Construction materials were fairly rigid, but by connecting the split cannula pieces with elastic castration bands the cannula had some flexibility. Placing a short cone over the exposed cannula barrel reduced mechanical damage to the intestine. The double L cannula required a much smaller incision in the intestine during surgical insertion than a T-type cannula; it also simplified replacement. Construction is described; use and performance of the cannula has been satisfactory.


Assuntos
Cateterismo/veterinária , Bovinos/cirurgia , Digestão , Intestinos/cirurgia , Animais , Bovinos/fisiologia , Duodeno/fisiologia , Duodeno/cirurgia , Ingestão de Alimentos , Feminino , Íleo/fisiologia , Íleo/cirurgia , Intestinos/fisiologia , Masculino , Manejo de Espécimes/veterinária , Ganho de Peso
15.
Urol Res ; 19(3): 181-8, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1909472

RESUMO

The effects of physiological concentrations of chondroitin sulphate, human serum albumin and Tamm-Horsfall mucoprotein on the crystallization of calcium oxalate in undiluted, ultrafiltered human urine were investigated using particle size analysis and scanning electron microscopy. Neither the amount of oxalate required to induce detectable calcium oxalate crystal nucleation nor crystal morphology was affected by the presence of any of these macromolecules. Chondroitin sulphate had no effect on the amount of crystalline material deposited or on the size of the particles precipitated in response to a standard oxalate load. Human serum albumin slightly reduced the size of the crystal aggregates and caused a small increase in the amount of crystal matter precipitated. By contrast, Tamm-Horsfall mucoprotein significantly inhibited crystal aggregation and markedly increased the volume of matter deposited, although this could not be attributed to a promotion of solute precipitation. It was concluded that chondroitin sulphate, human serum albumin and Tamm-Horsfall mucoprotein cannot account for the inhibitory effects of macromolecules with a relative mass greater than 10 kDa in spun and filtered urine. Nonetheless, Tamm-Horsfall mucoprotein is likely to inhibit crystal aggregation in whole urine in vivo and may therefore be instrumental in preventing calcium oxalate stone formation.


Assuntos
Oxalato de Cálcio/urina , Sulfatos de Condroitina/farmacologia , Mucoproteínas/farmacologia , Albumina Sérica/farmacologia , Adulto , Oxalato de Cálcio/química , Cristalização , Humanos , Masculino , Microscopia Eletrônica de Varredura , Tamanho da Partícula , Proteínas da Gravidez/farmacologia , Uromodulina
16.
J Anim Sci ; 68(12): 4319-25, 1990 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2286571

RESUMO

Twelve Hereford cows and four mature, ruminally cannulated Hereford x Angus heifers were fed supplements providing either 0 (control), 1, 2, or 3 kg/d of soybean hulls and including 440 g of protein/d (cottonseed meal was used to equalize protein intake) to determine the effects of supplementation on intake and utilization of low-quality native grass hay. Cattle were housed in individual pens and fed coarsely chopped (5-cm screen) native grass hay harvested in mid-November (4.1% CP, 76.9% NDF). Hay OM intake peaked (quadratic, P = .04) at 10.1 kg/d with 1 kg of soybean hulls and decreased when 2 kg (9.8 kg/d) or 3 kg (9.1 kg/d) of soybean hulls were fed. Although hay intake decreased when soybean hulls replaced cottonseed meal, feeding 3 kg soybean hulls decreased hay OM intake by only .64 kg. Total OM digestibility increased linearly (P = .009) with added increments of soybean hulls (45.8%, 46.2%, 46.6% and 48.6% for 0 through 3 kg soybean hulls/d, respectively), indicating that hulls were more digestible than the hay. Digestibility of NDF was not affected (P = .14) by level of soybean hull supplementation, although ADF digestibility increased (linear, P = .03). Increases in OM intake and digestibility with soybean hulls combined to increase digestible OM intake (linear, P = .0001). Soybean hull supplementation increased ruminal VFA concentrations (linear, P = .04) and the molar proportion of propionate (linear, P = .006).(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Ração Animal , Bovinos/metabolismo , Digestão , Ingestão de Alimentos , Rúmen/metabolismo , Animais , Bovinos/crescimento & desenvolvimento , Proteínas na Dieta/metabolismo , Feminino , Fermentação , Poaceae , Soja
17.
J Anim Sci ; 68(10): 3429-40, 1990 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-2254213

RESUMO

Four diverse sorghum hybrids (yellow, cream, hetero-yellow and red) and corn grain were dry-rolled and fed in an 85% grain diet to Angus-Hereford steers (241 kg) equipped with ruminal and double L-type duodenal and ileal cannulas to compare the effects of grain source on site and extent of digestion. Yellow (yel) has a homozygous yellow endosperm, with a yellow seed coat, whereas cream and hetero-yellow (het-yel) have a heterozygous yellow endosperm with white and red seed coats, respectively. Red has a homozygous white endosperm with a red seed coat. Diets were fed at 2% of initial BW (DM basis) in a 5 x 5 Latin square. Total digestive tract starch digestibility (%) was greater (P less than .05) for corn (92.5) than for red (84.3), yel (84.3) and het-yel (82.9) but not greater (P greater than .10) than for cream (87.9). Ruminal starch digestibility (%) was greater (P less than .10) for corn (85.8) than for sorghum hybrids (69.1). Pre-cecal starch digestibility (%) was greater (P less than .05) for corn (90.6) than for het-yel (76.2), red (74.8) and yel (74.1). Ruminal escape (%) of grain N was greater (P less than .10) for red (79.9) than for het-yel (69.2), cream (66.5) and yel (66.1), with corn (53.6) being less (P less than .10) than sorghum hybrids. Pre-cecal and total tract non-NH3 N digestibilities (%) were not altered (P greater than .10) by grain source. Hybrid of sorghum altered site and extent of starch digestion and ruminal escape of grain N; hybrids had estimated gain:feed ratios that were 81 to 93% of those of rolled corn grain.


Assuntos
Ração Animal , Bovinos/metabolismo , Digestão , Sistema Digestório/metabolismo , Ração Animal/análise , Animais , Carboidratos da Dieta/análise , Carboidratos da Dieta/metabolismo , Grão Comestível , Mucosa Intestinal/metabolismo , Masculino , Rúmen/metabolismo , Amido/análise , Amido/metabolismo , Zea mays
18.
J Anim Sci ; 67(6): 1623-33, 1989 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2768120

RESUMO

To determine the effects of blends of high-moisture harvested sorghum grain (HMS) and dry-rolled corn (DRC) on site and extent of digestion, high-grain diets were fed to Angus-Hereford heifers (315 kg) in a 5 x 5 latin square. The grain portion consisted of ratios (HMS:DRC) of 0:100, 25:75, 50:50, 75:25 and 100:0. Heifers were equipped with ruminal, duodenal and ileal T-type cannulas. Digestibilities of OM (P less than .05) and non-ammonia nitrogen (NAN; P less than .01) in the total tract declined linearly as HMS replaced DRC. Chyme flow (liters/d) through the duodenum increased linearly (P less than .01), and true ruminal OM disappearance tended to decline linearly (P less than .10) as HMS replaced DRC. A quadratic response (P less than .05) in extent of starch disappearance (g/d) in the rumen was noted; blends were lower than either individual grain. Ruminal escape of feed N tended to be quadratic (P less than .10); values for individual grain types were greater than blends. Microbial efficiency increased linearly (P less than .05) as HMS replaced DRC. Extent of starch digestion in the rumen averaged 82.7% compared to only 2.9% in the small intestine and 5.7% in the large intestine. Altering the ratio of HMS to DRC appeared to have more effect on ruminal fermentation than on digestion in the small intestine; most starch and nitrogen responses were quadratic. Increases in ruminal pH and chyme flow, potentially caused by increased salivary flow, may cause non-linear changes in the solubility of proteins in HMS and DRC, when fed as blends, altering the digestibility of protein and starch from values predicted from the individual grains.


Assuntos
Ração Animal/análise , Bovinos/metabolismo , Digestão , Grão Comestível , Animais , Duodeno/metabolismo , Feminino , Concentração de Íons de Hidrogênio , Intestino Grosso/metabolismo , Nitrogênio/metabolismo , Rúmen/metabolismo , Zea mays
19.
Br J Urol ; 60(6): 480-8, 1987 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-3427328

RESUMO

The daily excretion of calcium, oxalate, uric acid and glycosaminoglycans, the 24-h urinary pH and volume, and the inhibitory effects of the urines on calcium oxalate crystal growth and aggregation, were measured in 44 normal women, 41 normal men, 32 female stone formers and 63 male stone formers. No significant differences could be found between the normal men and women, the male and female stone formers, or between the patients and their normal controls with regard to the excretion of oxalate and glycosaminoglycans, and the urinary pH. The normal women exhibited significantly lower urinary volumes and excreted less calcium per day than did the other subject groups. The excretion of calcium by the female stone formers was indistinguishable from that of both groups of men. The male and female stone formers did not differ from their corresponding control groups with regard to the excretion of urate, but both groups of male subjects had significantly higher daily urate excretions than did either female category. This was attributed to the greater body weights of the men. There were no discernible differences between any of the subject groups with regard to the inhibitory effects of their urines on calcium oxalate crystal growth, but urines from both groups of female subjects demonstrated a significantly greater inhibitory influence on crystal aggregation than did those of the men. It would appear that the relatively low incidence of uninfected calcium oxalate urolithiasis in women compared with men may be attributable to (a) a lower daily calcium excretion and (b) a higher inhibitory activity of their urines towards crystal aggregation.


Assuntos
Cálcio/urina , Oxalatos/urina , Cálculos Urinários/etiologia , Adulto , Fatores Etários , Peso Corporal , Feminino , Glicosaminoglicanos/urina , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Ácido Úrico/urina , Cálculos Urinários/urina
20.
Clin Chim Acta ; 167(3): 329-38, 1987 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-3621616

RESUMO

Removal of macromolecules with Mr greater than 10,000 had no discernible effect on the detectable nucleation of calcium oxalate crystals from undiluted human urine, but promoted the deposition of crystalline material and markedly increased the degree of aggregation of the precipitated crystals. Calcium oxalate crystals and crystal aggregates precipitated from ultrafiltered urine were, on average, 68% larger than those deposited from whole urine. These findings suggest that urinary macromolecules play a key role in preventing calcium oxalate kidney stone disease by inhibiting the formation of large crystal aggregates and thereby reducing the probability of particle retention in the kidney tubules.


Assuntos
Oxalato de Cálcio/urina , Precipitação Química , Cristalização , Humanos , Cálculos Renais/urina , Substâncias Macromoleculares
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