XVI Congreso SEINAP. Fórmulas extensamente hidrolizadas / XVI Congreso SEINAP. Extensively hydrolized formulas

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Eating and rumination activity in 10 cows over 10 days.

Eating and rumination activities were evaluated in 10 Brown Swiss cows over 10 days, and the coefficients of variation (CV) were calculated for the investigated variables. A pressure sensor integrated into the noseband of a halter recorded jaw movements during chewing, which allowed the recording of eating and rumination times and the number of regurgitated boluses. The mean CVs ranged from 5.9 to 12.7% and were smaller for rumination (chewing cycles per bolus, 5.9%; daily number of cuds, 8.4%; rumination time, 9.1%) than for eating (eating time, 12.0%; chewing cycles related to eating, 12.7%). We concluded that of eating and rumination variables examined, the number of chewing cycles per regurgitated bolus is the most robust with little variation in individual cows.

Addition of transversus abdominis plane block to patient controlled analgesia for laparoscopic high anterior resection improves analgesia, reduces opioid requirement and expedites recovery of bowel function.

INTRODUCTION: Opioid sparing in postoperative pain management appears key in colorectal enhanced recovery. Transversus abdominis plane (TAP) blocks offer such an effect. This study aimed to quantify this effect on pain, opioid use and recovery of bowel function after laparoscopic high anterior resection. METHODS: This was a retrospective analysis of prospective data on 68 patients. Patients received an epidural (n=24), intravenous morphine patient controlled analgesia (PCA, n=22) or TAP blocks plus PCA (n=22) determined by anaesthetist preference. Outcome measures were numerical pain scores (0-3), cumulative intravenous morphine dose and time to recovery of bowel function (passage of flatus or stool). RESULTS: There were no differences in patient characteristics, complications or extraction site. The TAP block group had lower pain scores (0.7 vs 1.36, p<0.001) and morphine requirements (8 mg vs 15 mg, p=0.01) than the group receiving PCA alone at 12 hours and 24 hours. Earlier passage of flatus (2.0 vs 2.7 vs 3.4 days, p=0.002), stool (3.1 vs 4.1 vs 5.5 days, p=0.04) and earlier discharge (4 vs 5 vs 6 days, p=0.02) were also seen. CONCLUSIONS: Use of TAP blocks was found to reduce pain and morphine use compared with PCA, expedite recovery of bowel function compared with PCA and epidural, and expedite hospital discharge compared with epidural.

Adenylyl cyclases in the digestive system.

Adenylyl cyclases (ACs) are a group of widely distributed enzymes whose functions are very diverse. There are nine known transmembrane AC isoforms activated by Gαs. Each has its own pattern of expression in the digestive system and differential regulation of function by Ca(2+) and other intracellular signals. In addition to the transmembrane isoforms, one AC is soluble and exhibits distinct regulation. In this review, the basic structure, regulation and physiological roles of ACs in the digestive system are discussed.

[Proteolysis in digestive system regulation].

Signal enzymes with direct and indirect hormone releasing action are formed by means of proteolysis from exogenic and endogenic proteins. The proteolysis is the basis of hormone processing. The limited proteolysis forms hormones from pro-hormones, ligand proteolysis excludes or reduces their stimulated or inhibited effects. The existence of polipotent proteinaso-activated receptors with regulative and modulated role in norm and pathology was proved.

Food addiction: detox and abstinence reinterpreted?

The senior patient and/or the geriatrician are confronted with a confusing literature describing how patients interested in combating metabolic syndrome, diabesity (diabetes plus obesity) or simple obesity might best proceed. The present paper gives a brief outline of the basic disease processes that underlie metabolic pro-inflammation, including how one might go about devising the most potent and practical detoxification from such metabolic compromise. The role that dietary restriction plays in pro-inflammatory detoxification (detox), including how a modified fast (selective food abstinence) is incorporated into this process, is developed. The unique aspects of geriatric bariatric medicine are elucidated, including the concepts of sarcopenia and the obesity paradox. Important caveats involving the senior seeking weight loss are offered. By the end of the paper, the reader will have a greater appreciation for the challenges and opportunities that lie ahead for geriatric patients who wish to overcome food addiction and reverse pro-inflammatory states of ill-heath. This includes the toxic metabolic processes that create obesity complicated by type 2 diabetes mellitus (T2DM) which collectively we call diabesity. In that regard, diabesity is often the central pathology that leads to the evolution of the metabolic syndrome. The paper also affords the reader a solid review of the neurometabolic processes that effectuate anorexigenic versus orexigenic inputs to obesity that drive food addiction. We argue that these processes lead to either weight gain or weight loss by a tripartite system involving metabolic, addictive and relational levels of organismal functioning. Recalibrating the way we negotiate these three levels of daily functioning often determines success or failure in terms of overcoming metabolic syndrome and food addiction.

Lobster (Panulirus argus) hepatopancreatic trypsin isoforms and their digestion efficiency.

It is well known that crustaceans exhibit several isoforms of trypsin in their digestive system. Although the number of known crustacean trypsin isoforms continues increasing, especially those derived from cDNA sequences, the role of particular isoenzymes in digestion remains unknown. Among invertebrates, significant advances in the understanding of the role of multiple trypsins have been made only in insects. Since it has been demonstrated that trypsin isoenzyme patterns (phenotypes) in lobster differ in digestion efficiency, we used this crustacean as a model for assessing the biochemical basis of such differences. We demonstrated that the trypsin isoform known to be present in all individuals of Panulirus argus has a high catalytic efficiency (k(cat)/K(m) ) and is the most reactive toward native proteinaceous substrates, whereas one of the isoforms present in less efficient individuals has a lower k(cat) and a lower k(cat)/K(m), and it is less competent at digesting native proteins. A fundamental question in biology is how genetic differences produce different physiological performances. This work is the first to demonstrate that trypsin phenotypic variation in crustacean protein digestion relies on the biochemical properties of the different isoforms. Results are relevant for understanding trypsin polymorphism and protein digestion in lobster.

Repercusiones a largo plazo de la cirugía bariátrica / Long term effects of bariatric surgery

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From the tongue to the gut.

The physiology of human taste experienced an unprecedented expansion of knowledge brought forward by modern genetics and molecular biology. In the last 10 years, the cellular organization of taste receptors from taste buds distributed in the various papillae of the tongue and the soft palate was enlightened. This molecular revolution rapidly expanded over and above the tongue because several papers reporting the presence of taste receptors in nongustatory tissues (eg, gut, brain) appeared. Hence, the issue of perception of food molecules is no longer confined to the field of nutrition and food preferences, but is rapidly expanding to gastrointestinal (GI) function and, possibly, to gut dysfunction. In children, functional GI diseases are strictly correlated to food preference and food aversion and up to now, the tools to address these kinds of problems were basic nutritional requirements, familial good sense, and a lot of patience: blunt tools to face extremely common and disturbing complaints. The fact that taste receptors are expressed down the whole of the intestinal tract is of particular interest because of their possible role in digestive behavior and absorption of nutrients; therefore, recent and future discoveries in this field will make possible the fine-tuning of new, sharper tools to treat children with functional GI diseases.

Metal concentrations in digestive gland and mantle of Sepia officinalis from two coastal lagoons of Portugal.

Concentrations of both essential (Fe, Cu, Zn) and non essential (Cd, Hg and Pb) metals were measured in the digestive gland and mantle of female cephalopods Sepia officinalis captured in two distinct lagoons in Portugal: Aveiro Lagoon, with a history of anthropogenic and industrial pollution, and Formosa Lagoon receiving urban effluents. We provide evidence for the following: (1) the digestive gland is the main target organ for both essential and non essential metals, frequently containing concentrations few orders of magnitude higher as compared to mantle; the sole exception from this was the Hg that is equally distributed in the two tissues; (2) unexpectedly, the higher levels of metals were found in animals captured in the less polluted lagoon, except for Cd whose bioavailability in Aveiro lagoon might be related to industrial sources, while the influence of Cd speciation in local pray composition should not be ruled out (3) size influenced metal concentration in different way: smaller individuals accumulated significantly more Cu, while Hg concentrations showed the opposite trend; (4) Cd is positively correlated to Zn and Cu in digestive gland of specimens collected in spring in Aveiro Lagoon, and no relationship was found in Formosa Lagoon; (5) the molar ratios Cd:Zn and Cd:Cu in digestive gland increased with body weight in specimens from Aveiro area, both ratios becoming particularly higher in older individuals. Metal-specific accumulation patterns in both mantle and digestive gland at the two sites are discussed in the light of their toxicological implications.

Biomecânica ultra-sonográfica da deglutição: estudo preliminar / Sonographic evaluation of swallowing biomechanics: a preliminary study

OBJETIVO: Verificar, por meio da ultra-sonografia, os parâmetros espaciais do complexo hiolaríngeo na dinâmica da deglutição e a associação entre idade e efeitos. MATERIAIS E MÉTODOS: Neste estudo quantitativo e prospectivo foram incluídos 39 indivíduos sadios, de ambos os gêneros, na faixa etária de 20 a 70 anos (média, 45,56; desvio-padrão, 14,53). Avaliou-se a biomecânica da deglutição correspondente à medida da distância entre a porção superior do osso hióide e a borda superior da cartilagem tireóide, no momento de máxima elevação laríngea. As medidas foram realizadas com a ingestão de alimentos de consistências líquida e pastosa. RESULTADOS: A variação da distância da laringe ao hióide apresentou associação positiva com a idade, somente na deglutição de alimento pastoso, consistência na qual é solicitada maior atividade de propulsão lingual do que nos líquidos. CONCLUSÃO: É possível que o aumento da distância entre o hióide e a laringe, que representa menor elevação laríngea, na deglutição de pastosos, ocorra por efeito do envelhecimento, processo no qual se verifica diminuição de reservas funcionais, mesmo em indivíduos sadios. A ultra-sonografia pode detectar comportamentos relacionados a consistências alimentares, o que mostra sua possível potencialidade diagnóstica na avaliação da deglutição.

OBJECTIVE: To evaluate, by means of ultrasonography, the spatial parameters of the hyolaryngeal complex in the deglutition dynamics as well the correlation between age and effects. MATERIALS AND METHODS: The present prospective and quantitative study included 39 healthy men and women in the age range between 20 and 70 years (mean, 45.56; standard deviation, 14.53). The swallowing biomechanics corresponding to the measurement of the distance between the upper portion of the hyoid bone and the upper rim of the thyroid cartilage at the moment of maximum laryngeal elevation was evaluated. Measurements were performed with the ingestion of pasty or liquid food. RESULTS: The variation of the distance between the hyoid bone and the larynx presented a positive association with aging only in the swallowing of pasty food that requires a higher lingual propulsive activity than liquid food does. CONCLUSION: An increase in the distance between the hyoid bone and the larynx, corresponding to a poorer laryngeal elevation, may occur during the deglutition of pasty food as a result of aging, a process where a decrease in functional reserves is observed even in healthy individuals. Ultrasonography can detect the swallowing behavior related to foods consistency, demonstrating the diagnostic potentiality of this method in the evaluation of the deglutition.