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Abdominal bloating (AB) is a common symptom among patients with gastroesophageal reflux disease (GERD); however, in clinical practice, its prevalence is likely underestimated due to the lack of objective tools to measure its frequency and severity. It is associated with dissatisfaction and worse quality of life, but data on its prevalence before and after mechanical control of GERD (i.e. fundoplication, magnetic sphincter augmentation, and antireflux mucosectomy) are lacking. To assess and determine the pre- and postoperative prevalence and severity of AB among patients with GERD, we conducted a structured literature search using MeSH and free-text terms in MEDLINE (via Pubmed), EMBASE, and Taylor & Francis Online between January 1977 and October 2022. Fifteen articles reporting the prevalence or severity of AB using quality-of-life questionnaires before or after antireflux surgery (ARS) were included. Overall, a high prevalence of AB before ARS was found. A decline in the prevalence and severity of AB was documented postoperatively in most cases independent of the surgical approach. Among surgical approaches, a complete fundoplication had the highest reported postoperative AB. Overall, patients reported less severe and less frequent AB after ARS than before. The traditional belief that postoperative bloating is a sequela of ARS should be reevaluated.
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Refluxo Gastroesofágico , Laparoscopia , Humanos , Qualidade de Vida , Prevalência , Resultado do Tratamento , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/epidemiologia , Fundoplicatura/efeitos adversosRESUMO
The current study was conducted to investigate the feasibility of high concentration diet (HCD) supplementation with Dimethyl Silicone Oil (DSO) to prevent frothy rumen bloat in goats. The treatments were control group (group C, feeding HCD) and test group (group T, feeding HCD supplemented with 0.1%DSO). The results showed that compared with the group C, the ruminal pH value, Microbial Crude Protein content of group T was extremely significantly higher (p < 0.01), the levels of acetic acid and propionic acid were significantly (p < 0.05) and extremely significantly (p < 0.01) lower in group T, respectively. The foam production and foam strength of the rumen fluid in the group T was extremely significantly lower (p < 0.01), the viscosity was extremely significantly (p < 0.01) higher than those of group C. The total gastrointestinal apparent digestibility of various nutrients, the rumen microbial relative abundance at the phylum level and genus level were not significantly different (p > 0.05). The results indicated that the supplementation of 0.1% DSO in HCD can significantly eliminate foam of the rumen fluid, and didn't disturb the ruminal microorganisms, no negatively affect on digestibility of nutrients in goats, thereby has the application prospect of preventing frothy rumen bloat.
The gas produced by rumen fermentation is wrapped in foam and cannot be discharged is the root cause of frothy bloat induced by a high concentration diet. In the present study, the feasibility of dietary supplementation with Dimethyl Silicone Oil (DSO) to prevent frothy bloat was preliminarily evaluated. The results indicated that DSO can significantly eliminate foam of the rumen fluid, and has not negatively effect on the ruminal microorganisms and the digestibility of nutrients in goats, thereby has the application prospect of preventing frothy bloat.
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Rúmen , Óleos de Silicone , Animais , Óleos de Silicone/metabolismo , Rúmen/metabolismo , Cabras/metabolismo , Estudos de Viabilidade , Dieta/veterinária , Suplementos Nutricionais , Ração Animal/análiseRESUMO
Introduction. The high incidence of lactose intolerance leads us to consider that many of our patients could suffer from this alteration. Therefore, as its main sign (even when asymptomatic) is increased intestinal gas, patients recovering from a Nissen fundoplication have a significant probability of suffering from gas bloat syndrome. Materials and Methods. This prospective study was conducted from November 2012 to January 2017, we included all the patients who had been treated by the Nissen technique for gastroesophageal reflux disease with gas bloat syndrome detected during follow-up and tested positive for lactose intolerance. The study participants were then prescribed a lactose-poor diet to be followed for 3 months. The patients were asked to complete quality of life and symptomatology questionnaires before and after diet. The pre- and post-diet results were then compared. Results. The pre- and post-diet results showed statistically significant improvements in both questionnaires. Conclusion. Lactose intolerance may account for the symptoms presented by a significant number of patients with gas bloat syndrome following antireflux surgery; these patients could benefit from consuming a lactose-free diet, which we expect to alleviate or, in some cases, eliminate the above symptoms.
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Fundoplicatura/efeitos adversos , Refluxo Gastroesofágico/cirurgia , Intolerância à Lactose/complicações , Complicações Pós-Operatórias/etiologia , Dieta , Humanos , Estudos Prospectivos , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Although around 30% of patients with gastroesophageal reflux disease (GERD) are insufficiently treated with medical therapy, only 1% opt for surgical therapy. One of the reasons behind this multifactorial phenomenon is the described adverse effect of long-term dysphagia or gastric bloating syndrome after surgical treatment. Aim of this study was to evaluate the most common side effects associated with anti-reflux surgery, as well as long-term outcomes in a large cohort of highly surgically standardized patients after laparoscopic Nissen fundoplication (LNF). METHODS: Out of a prospective patients' database including all patients that underwent anti-reflux surgery between 01/2003 and 01/2017 at our institution, 350 consecutive patients after highly standardized LNF were included in this study. A standardized interview was performed by one physician assessing postoperative gastrointestinal symptoms, proton pump inhibitor intake (PPI), GERD-Health-Related-Quality-of-Life (GERD-HRQL), Alimentary Satisfaction (AS), and patients' overall satisfaction. RESULTS: After a median follow-up of 4 years, persistent dysphagia (PD) after LNF was observed in 8 (2%) patients, while postoperative gas-bloat syndrome in 45 (12.7%) cases. Endoscopic dilatation was needed in 7 (2%) patients due to dysphagia, and 19 (5%) patients underwent revision surgery due to recurrence of GERD. The postoperative GERD-HRQL total score was significantly reduced (2 (IQR 0-4.3) vs. 19 (IQR 17-32); p < 0.000) and the median AS was 9/10. Heartburn relief was achieved in 83% of patients. Eighty-three percent of patients were free of PPI intake after follow-up, whereas 13% and 4% of the patients reported daily and irregular PPI use, respectively. CONCLUSION: LNF is a safe and effective surgical procedure with low postoperative morbidity rates and efficient GERD-related symptom relief. PD does not represent a relevant clinical issue when LNF is performed in a surgical standardized way. These results should be the benchmark to which long-term outcomes of new surgical anti-reflux procedures are compared.
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Transtornos de Deglutição/etiologia , Fundoplicatura/efeitos adversos , Refluxo Gastroesofágico/cirurgia , Laparoscopia/efeitos adversos , Adulto , Feminino , Fundoplicatura/métodos , Refluxo Gastroesofágico/tratamento farmacológico , Azia/etiologia , Azia/cirurgia , Humanos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Inibidores da Bomba de Prótons/uso terapêutico , Qualidade de Vida , Recidiva , Reoperação , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Esophageal groove dysfunction is one of the major causes of ruminal bloat. This condition is fatal in new born calves if it is not treated early. In healthy, suckling calves, milk should bypass the forestomach (rumen and reticulum) and enter into the abomasum where enzymatic digestion of milk proteins takes place. However, failure of the esophageal groove allows milk to enter into the forestomach, which results in the production of excess gases by microbial fermentation. Consequently, this increase in abdominal distention particularly on the left side in ruminants is an imminent manifestation of excess gases in the foresomach. CASE PRESENTATION: A 10-day-old crossbred male calf presented with a distended left abdomen and manifesting dyspnea at a dairy farm. The calf was weak, reluctant to move, and had visibly congested mucus membranes. Regarding the calf's feeding, milk was the only thing ingested and the calf had not started on dry feeds (hay, concentrates, and roughages). According to the herdsman of the farm, the calf had a mild-to-moderate form of bloat and 3-5 h after milk feeding the bloat would disappear spontaneously. During bloat, an increase in pulse rate, respiratory rate (tachypnea), and shallow breathing was noted. Physical examination revealed severe distention of the left side of the abdomen, and on percussion, accumulation of gases mixed with fluid in the left abdomen was detected. An attempt was made to release gases from forestomach by introducing a stomach tube with oral antibiotics; however, the case was not resolved. The calf suffered from frequent recurrence of bloat after every milk feed, and in response to the refractory outcome to conventional treatment, a rumenostomy was indicated and a better treatment response was achieved. In addition, IV fluid and other supportive therapy were provided while milk was withheld. However, considering the fact that milk is a natural feed that should not be taken away from every calf at this age, we had to encourage calf to consume milk as it would not result in bloat as far as rumen fistula is being created. Furthermore, encouraging calves to consume starter feed (fresh grasses and hay) earlier than usual recommended period whilst decreasing milk intake would hasten the rumen function. CONCLUSIONS: Cases like this are successfully managed by a rumenostomy when conventional options fail.
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Doenças dos Bovinos/fisiopatologia , Rúmen/patologia , Gastropatias/veterinária , Animais , Animais Recém-Nascidos , Bovinos , Dieta/veterinária , Esôfago/fisiopatologia , Masculino , Leite , Rúmen/cirurgiaRESUMO
Creating the ideal nutrition program for calves is a demanding task that has undergone tremendous change in recent years. Products and technologies including novel milk replacers and automated calf feeding systems have been developed to facilitate the ability of dairy producers to feed for higher growth rates before weaning. The creation of new feeding programs and milk replacers has to be looked at carefully, not only from a nutrition point of view but also from the perspective of a potential effect on physiologic digestion and calf health. Abomasal emptying is a critical factor that may link nutrition and disease. The purpose of this article is to review both intrinsic and extrinsic factors that are responsible for abomasal emptying. Predominant extrinsic factors controlling abomasal emptying include meal volume, energy density, and osmolality along with the content and source of protein. This article also reviews experimental methods used to measure abomasal emptying in the calf including those that would be appropriate for use under field conditions. Among these methods, the use of ultrasonography and different absorption tests (d-xylose, acetaminophen) as tools to measure abomasal emptying are discussed. The relationship between abomasal emptying and disease is explored, particularly as it relates to abomasal bloat. Abomasal bloat is a complex syndrome that seems to be increasing in frequency and whose etiology likely at least partially involves slowing of abomasal emptying. Suggestions for minimizing the effect of feeding programs on abomasal emptying are explored as well as needs for future research.
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Abomaso/fisiologia , Doenças dos Bovinos/fisiopatologia , Esvaziamento Gástrico , Gastroenteropatias/fisiopatologia , Gastroenteropatias/veterinária , Absorção Fisiológica , Acetaminofen/metabolismo , Animais , Bovinos , Doenças dos Bovinos/etiologia , Feminino , Gastroenteropatias/etiologia , Ultrassonografia/métodos , Ultrassonografia/veterinária , Xilose/metabolismoRESUMO
Acute gastric dilation resulting in death was identified in two adult black-footed ferrets (Mustela nigripes) housed at the Smithsonian Conservation Biology Institute in Front Royal, Virginia. Both individuals were adult males (3 and 5 yr) and previously clinically healthy prior to the event. The etiology of gastric dilation in both cases could not be definitively determined, and necropsy revealed severe cardiovascular compromise secondary to bloat. Limited literature is available regarding a syndrome of this type in adult black-footed ferrets. Differential diagnoses considered included gastric dilatation volvulus (GDV), severe gastric distention of unknown origin, and gastric outflow obstruction. Given the severity of this syndrome and the findings in these two cases, acute gastric dilation should be considered in black-footed ferrets presenting with acute abdominal distention, respiratory distress, and cardiovascular compromise.
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Furões , Dilatação Gástrica/veterinária , Animais , Evolução Fatal , Dilatação Gástrica/patologia , MasculinoRESUMO
Feeding high concentrate diets is highly prone to rumen bloat in ruminants, which is very common in production. This study explored the factors responsible for the occurrence of foamy rumen bloat. The experiment was conducted using goats as test animals, fed high concentrate diets and scored for rumen distension into high, medium and low bloat score groups. Rumen fluid was collected from 6 goats in each group separately. The foaming production, foam persistence, pH value, viscosity and the content of protein, total saccharide and mineral elements in rumen original fluid (ROL) were measured, and the protein and total saccharide content in rumen foam liquid (RFL) and rumen residual liquid (RRL) were determined. The results showed that the protein content in rumen original fluid and rumen foam liquid was significantly higher than that in rumen residual liquid (p < 0.05), and the protein content in rumen foam liquid was 10.81% higher than that in rumen original fluid. The higher the rumen bloat score, the higher the foam production, foam persistence, viscosity, protein, Ni, Mg, Ca, and K concentrations of the rumen original fluid, and the lower the PH and Na concentrations of the rumen original fluid; correlation analysis showed that the viscosity of the rumen original fluid was significantly and positively correlated with the foam production and foam persistence (p < 0.05). Foaming production and foam persistence of rumen original fluid were significantly and positively correlated with the contents of protein, total saccharide, K, Ca, Mg and Ni (p < 0.05). and negatively correlated with the content of Na (p < 0.05); after controlling other components those were significantly related to the foaming performance of rumen original fluid only protein still was significantly positively correlated with the foam persistence of rumen original fluid (P<0.05). In summary, the contents of protein, total saccharide and mineral elements in the rumen fluid had a significant effect on the foaming performance of rumen in ruminants, with protein playing a decisive role and the other components playing a supporting role. Reducing the content of protein in the diet in production is beneficial to reduce the occurrence of rumen bloat in ruminants.
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Frothy bloat, associated predominantly with grazing legume-based pastures, is considered the second most costly disease in beef cattle in southern Australia, costing $84.4 M annually. It frequently results in the sudden death of cattle. In response to concerns from cattle producers, an online survey was conducted in southern Australia in late 2020 to determine the impact of bloat, identify risk factors and determine the efficacy of current preventive measures. For 217 responses, over two-thirds (70%) of producers reported bloat occurring in the previous 12 months, with estimated morbidity and mortality rates of 3.7% and 5.0% respectively. Bloat was associated with clover or clover-dominant paddocks (79%) and was not associated with grass or grass-dominant pastures or low clover pastures (92%) nor grazing crops (27%). For bloat that occurred in the past 12 months, cattle were very commonly grazing on clover or clover-dominant paddocks (90%) and occasionally lucerne-dominated paddocks (7%). Two-thirds of producers reported having preventive measures in place when losses occurred. Bayesian Network analysis confirmed that grazing clover-based pastures for more than 7 days, yearling cattle and the months of July-September were the main risk factors for bloat occurrence, with pasture type (clover) being the most important. Conversely, no clear relationship between weather conditions and bloat occurrence was evident. This survey highlights the known risk of clover-based pastures for causing bloat in cattle, and that losses occur in many cases despite preventive measures being used. This suggests that current methods for preventing bloat in cattle are suboptimal.
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Medicago sativa , Poaceae , Animais , Bovinos , Teorema de Bayes , Austrália , Austrália do Sul , Ração Animal/análiseRESUMO
Rumen bloat is the most common digestive disorder in fattening ruminants, which is responsible for around 2-3 % of deaths in the ruminants industry and is therefore considered to be a serious threat to ruminant farming. The root cause of rumen bloat caused by feeding high concentrate dies would be attributed to the production of a large amount of stable foam during the fattening period. The exact mechanism of rumen foam formation has yet to be investigated. Proteins, polysaccharides and carboxylates derived from feed, and synthesized by microbes during the rumen fermentation may act as foaming agents or stabilizers in the formation progress of rumen foam. Supplementation of condensed tannins and other additives can be an effective way to prevent feedlot bloat induced by feeding high concentrate diets.
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Gastric dilatation and volvulus (GDV) is an acute, life-threatening syndrome of dogs, particularly large and giant breeds with a deep chest conformation. Rapid diagnosis is important for prompt initiation of stabilization therapy and surgical correction. Negative prognostic factors include hyperlactatemia not responding to fluid therapy, gastric perforation, or need for splenectomy or gastric resection. Gastropexy is essential for all dogs affected by GDV, following correct gastric repositioning. Prophylactic gastropexy for at-risk breeds can be performed via minimally invasive laparoscopic surgery.
Assuntos
Doenças do Cão , Dilatação Gástrica , Gastropexia , Volvo Intestinal , Volvo Gástrico , Animais , Doenças do Cão/prevenção & controle , Doenças do Cão/cirurgia , Cães , Dilatação Gástrica/prevenção & controle , Dilatação Gástrica/cirurgia , Dilatação Gástrica/veterinária , Gastropexia/veterinária , Volvo Intestinal/cirurgia , Volvo Intestinal/veterinária , Volvo Gástrico/prevenção & controle , Volvo Gástrico/cirurgia , Volvo Gástrico/veterináriaRESUMO
Grazing ruminants contribute to global climate change through enteric methane and nitrous oxide emissions. However, animal consumption of the plant polyphenolics, proanthocyanidins, or condensed tannins (CTs) can decrease both methane emissions and urine nitrogen levels, leading to reduced nitrous oxide emissions, and concomitantly increase animal health and production. CTs are largely absent in the foliage of important temperate pasture legumes, such as white clover (Trifolium repens), but found in flowers and seed coats. Attempts at enhancing levels of CT expression in white clover leaves by mutagenesis and breeding have not been successful. However, the transformation of white clover with the TaMYB14-1 transcription factor from Trifolium arvense has resulted in the production of CTs in leaves up to 1.2% of dry matter (DM). In this study, two generations of breeding elevated foliar CTs to >2% of DM. The CTs consisted predominantly of prodelphinidins (PD, 75-93%) and procyanidins (PC, 17-25%) and had a mean degree of polymerization (mDP) of approximately 10 flavan-3-ol subunits. In vitro studies showed that foliar CTs were bound to bovine serum albumin and white clover proteins at pH 6.5 and were released at pH 2.-2.5. Using rumen in vitro assays, white clover leaves containing soluble CTs of 1.6-2.4% of DM significantly reduced methane production by 19% (p ≤0.01) and ammonia production by 60% (p ≤ 0.01) relative to non-transformed wild type (WT) controls after 6 h of incubation. These results provide valuable information for further studies using CT expressing white clover leaves for bloat prevention and reduced greenhouse gas emissions in vivo.
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Canine gastric dilatation-volvulus (GDV) is a common life-threatening condition occurring primarily in large and giant breeds with a 3.9% to 36.7% lifetime risk. The genetic correlates of GDV have not previously been systematically explored. We undertook an inter-breed genome-wide association analysis (GWAS) of 253 dogs from ten breeds including 106 healthy dogs and 147 dogs with at least one GDV episode. SNP array genotyping followed by imputation was conducted on 241 samples to identify GDV-associated single-nucleotide polymorphisms (SNPs) and copy number variations (CNVs). A subset of 33 dogs (15 healthy dogs and 18 GDV patients from the three most represented breeds) was characterized by whole genome sequencing (WGS). After genome-wide Bonferroni correction, we identified a significant putatively protective intergenic SNP (rs851737064) across all breeds. The signal was most significant in Collies, German Shorthaired Pointers, and Great Danes. Subsequent focused analysis across these three breeds identified 12 significant additional putatively protective or deleterious SNPs. Notable significant SNPs included those occurring in genes involved in gastric tone and motility including VHL, NALCN, and PRKCZ. These data provide important new clues to canine GDV risk factors and facilitate generation of hypotheses regarding the genetic and molecular underpinnings this syndrome.
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Dilatação Gástrica/genética , Volvo Gástrico/genética , Fatores Etários , Animais , Cruzamento , Variações do Número de Cópias de DNA/genética , Doenças do Cão/genética , Cães , Feminino , Dilatação Gástrica/complicações , Dilatação Gástrica/fisiopatologia , Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla/métodos , Masculino , Polimorfismo de Nucleotídeo Único/genética , Fatores de Risco , Volvo Gástrico/complicações , Volvo Gástrico/metabolismoRESUMO
Frothy bloat is major digestive disorder of cattle grazing alfalfa pastures. Among the many factors identified to contribute to the development of frothy bloat, the disruption of rumen microbiota appears to be of central importance. Anaerobic rumen fungi (ARF) play an important role in sequential breakdown and fermentation of plant polysaccharides and promote the physical disruption of plant cell walls. In the present study, we investigated the dynamics of ARF during the development of alfalfa-induced frothy bloat and in response to bloat preventive treatments. By sequencing the internal transcribed spacer ï¼ITS1ï¼region of metagenomic DNA from the solid fraction of rumen contents, we were able to identify eight distinct genera of ARF, including Neocallimastix, Caecomyces, Orpinomyces, Piromyces, Cyllamyces, Anaeromyces, Buwchfawromyces, and unclassified Neocallimastigaceae. Overall, transition of steers from a baseline hay diet to alfalfa pastures was associated with drastic changes in the composition of the fungal community, but the overall composition of ARF did not differ (p > 0.05) among bloated and non-bloated steers. A correlation network analysis of the proportion of ARF and ruminal bacterial communities identified hub fungal species that were negatively correlated with several bacterial species, suggesting the presence of inter-kingdom competition among these rumen microorganisms. Interestingly, the number of negative correlations among ARF and bacteria decreased with frothy bloat, indicating a potential disruption of normal microbial profiles within a bloated rumen ecosystem. A better understanding of fungal-bacterial interactions that differ among bloated and non-bloated rumen ecosystem could advance our understanding of the etiology of frothy bloat.
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BACKGROUND: Abomasitis is a syndrome affecting young milk-fed calves. The current veterinary literature describes mainly its necropsy findings. OBJECTIVES: To describe the clinical presentation, complementary tests, treatments, and case-fatality rate of calves with a clinical diagnosis of abomasitis and to identify potential factors associated with outcome. METHODS: Observational retrospective cohort study (2006-2016). Review of the medical records of calves <3 months of age presented with abdominal and abomasal distension for <7 days that were clinically diagnosed with abomasitis at the Faculty of Veterinary Medicine of the Université de Montréal. A follow-up examination was conducted by telephone interview. ANIMALS: Twenty-three calves clinically diagnosed with abomasitis. RESULTS: Median age of presentation was 3 days (range, 0-62 days). The typical duration of the clinical course was <24 hours (15/23). On admission, the 2 most common clinical signs were anorexia (13/14) and positive succussion (13/14). Hyper-l-lactatemia (15/16) and increased γ-glutamyl-transferase activity (13/14) were the most common laboratory abnormalities. Hypoproteinemia (19/22) and a left shift (15/18) of the neutrophils also were observed. The short-term case-fatality rate was 52% (12/23). The clinical diagnosis was confirmed on all necropsied calves. Clostridium spp. and Escherichia coli were the most frequently isolated bacteria. Based on univariate statistical analysis, the surviving calves were significantly (P < .05) less hypothermic, less acidemic, less hyper-l-lactatemic, and had lower serum creatinine concentrations on admission than did the deceased calves. CONCLUSIONS AND CLINICAL IMPORTANCE: In our study, abomasitis was associated with a guarded prognosis.
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Abomaso , Doenças dos Bovinos/diagnóstico , Gastrite/veterinária , Animais , Animais Recém-Nascidos , Bovinos , Doenças dos Bovinos/microbiologia , Clostridium/isolamento & purificação , Estudos de Coortes , Escherichia coli/isolamento & purificação , Feminino , Gastrite/diagnóstico , Masculino , Registros/veterinária , Estudos RetrospectivosRESUMO
This experiment compared incidence of frothy bloat, as well as ruminal, physiological, and performance responses of beef heifers receiving a bloat-provoking diet and supplemented with Yucca schidigera extract. Sixteen ruminally cannulated Angus-influenced heifers were ranked by body weight (BW) and assigned to 4 groups of 4 heifers each. Groups were enrolled in a replicated 4 × 4 Latin square design containing 4 periods of 28 d, and a 21-d washout interval between periods. Groups were assigned to receive no Y. schidigera extract (CON), or Y. schidigera extract at (as-fed basis) 1 g/heifer daily (YS1), 2 g/heifer daily (YS2), or 4 g/heifer daily (YS4). During each period, heifers (n = 16/treatment) were housed in individual pens, and fed a sorghum (Sorghum bicolor L.)-based bloat-provocative diet at 2% of their BW. Diet and treatments were individually fed to heifers, twice daily in equal proportions (0700 and 1600 hours). Heifers were assessed for bloat score (0 to 5 scale, increasing according to bloat severity) 3 hr after the morning feeding. Blood samples were collected on days 0, 7, 14, 21, and 28 prior to (0 hr) and at 3, 6, and 9 hr relative to the morning feeding. Rumen fluid samples were collected at the same time points on days 0 and 28. Orthogonal contrasts were tested to determine whether inclusion of Y. schidigera extract (0, 1, 2, or 4 g/heifer daily) yielded linear or quadratic effects, and explore an overall effect of Y. schidigera extract supplementation (CON vs. YS1 + YS2 + YS4). Rumen fluid viscosity was impacted quadratically by Y. schidigera extract inclusion (P = 0.02), being greatest in YS1, followed by YS2, and equivalent between CON and YS4 heifers. Heifers receiving Y. schidigera extract had greater (P ≤ 0.05) rumen propionate, iso-valerate, and valerate concentrations, as well as less (P < 0.01) acetate : propionate ratio compared with CON heifers. Inclusion of Y. schidigera extract linearly increased (P ≤ 0.04) average daily gain and feed efficiency. No other treatment effects were noted (P ≥ 0.19) including bloat score (1.07 ± 0.03 across treatments), ruminal protozoa count, plasma concentrations of cortisol, haptoglobin, urea N, total protein, and rumen concentration of total volatile fatty acids. Supplementing Y. schidigera extract up to 4 g/d favored rumen propionate concentrations and linearly increased growth and feed efficiency but failed to mitigate incidence of frothy bloat in beef heifers consuming a grain-based bloat-provocative diet.
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Yucca , Ração Animal/análise , Animais , Bovinos , Dieta/veterinária , Feminino , Fermentação , Extratos Vegetais/metabolismo , Extratos Vegetais/farmacologia , Rúmen/metabolismoRESUMO
Euthanasia of companion animals in veterinary emergency medicine is a common cause of death. Euthanasia is economic when it is the consequence of the pet owner's inability to afford essential treatment while a viable medical alternative to euthanasia exists. Gastric dilatation-volvulus (GDV) is an acute life-threatening emergency condition of dogs; if left untreated, rapid death is highly likely. Surgical treatment leads to survival of around 80-90% of dogs; however, such treatment is costly. Therefore, pre-surgical euthanasia may be largely economically motivated. Having pet insurance, a financial instrument to reduce the burden of unforeseen veterinary medical costs on pet owners, would be expected to abolish the risk for pre-surgical economic euthanasia. We therefore aimed to determine whether pet insurance attenuates the risk of pre-surgical economic euthanasia in dogs with GDV. Non-referred dogs (n = 260) with GDV and known insurance status seen at 24 emergency clinics over a 2-year period were included. Relevant data (e.g., insurance status, age, comorbidities, outcome) were retrospectively extracted from a pet insurer's claim records (insured animals) or from electronic medical records of participating hospitals (non-insured animals). Forty-one percent of dogs (106 of 260 dogs) did not survive to hospital discharge; 82 (77%) of non-survivors died before surgery, all through euthanasia. The pre-surgical euthanasia rate was 10% in insured and 37% in non-insured dogs (p < 0.001). When adjusted for the effect of age, deposit size, comorbidities, and blood lactate concentration, the absence of insurance increased the odds of pre-surgical euthanasia by a factor of 7.4 (95% CI 2.0 to 37; p = 0.002). Of dogs undergoing surgery, 86% survived to hospital discharge. Overall, 80% of insured animals and 53% of non-insured animals survived to hospital discharge (p < 0.001). Thus, insurance was associated with a marked decrease in risk of pre-surgical euthanasia indicating that the cause of pre-surgical euthanasia of dogs with GDV is predominantly economic in nature. The rate of pre-surgical euthanasia in dogs with GDV may emerge as a suitable marker to quantify economic decision making of pet owners and to measure the impact of financial interventions aimed at mitigating economic duress associated with cost of veterinary emergency care.
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Condensed tannins (CT) are highly desirable in forage as they sequester dietary protein and reduce bloat and methane emissions in ruminants. However, the widely used forage legume white clover (Trifolium repens) only produces CTs in flowers and trichomes and at levels too low to achieve therapeutic effects. Genetic transformation with transcription factor Ta-MYB14-1 from Trifolium arvense was effective in inducing CTs to 0.6% of leaf dry matter. CT synthesis has been elevated further by crossing the primary white clover transgenic line with wild type genotypes producing the related phenylpropanoids, anthocyanins. CT levels in leaves were highest under the anthocyanin leaf marks associated with the "red midrib" trait; however, there was no evidence for CT accumulation in leaf sections with the "red V" anthocyanin marking. Ta-MYB14-1 was stably inherited in two generations of crosses, and T2 progeny produced up to 3.6-fold higher CTs than the T0 parent. The profile of small CT oligomers such as dimers and trimers was consistent in T0, T1, T2, and BC2 progeny and consisted predominantly of prodelphinidins (PD), with lesser amounts of procyanidins (PC) and mixed PC:PD oligomers.
Assuntos
Proteínas de Plantas/genética , Proantocianidinas/análise , Fatores de Transcrição/genética , Trifolium/química , Melhoramento Vegetal , Folhas de Planta/química , Folhas de Planta/genética , Folhas de Planta/metabolismo , Proteínas de Plantas/metabolismo , Proantocianidinas/metabolismo , Fatores de Transcrição/metabolismo , Trifolium/genética , Trifolium/metabolismoRESUMO
Introduction Medical students have been documenting notes in the electronic health records (EHR) for many years but often wrote separate notes from housestaff and faculty because licensed providers (LPs) could not bill the Centers for Medicare and Medicaid Services (CMS) for Evaluation and Management (E/M) services. However, in 2018, CMS updated its policy to allow LPs to simply verify any component of an E/M service under appropriate supervision, allowing LPs to bill a full medical student note. Methods At Virginia Commonwealth University Health Systems (VCUHS), a task force was formed to develop and pilot the One Note System (ONS), a system that incorporates the new CMS guidelines for certain note types. In June 2019, or 10 months after implementation of the ONS, the authors developed and distributed a survey that explored perceptions regarding the ONS among medical students, housestaff (residents and fellows), and faculty. Results The results showed that most participants were aware of the ONS and preferred email as the form of training. Overall, the ONS had a positive impact on faculty and housestaff workflow, improved self-reported faculty wellbeing, and increased meaning in student work. Only a minority reported barriers to implementing the ONS. Conclusions The One Note System was successfully implemented at VCUHS and positively received. Other outcomes to measure include impact of the ONS on student and trainee education, compliance and billing, quality and quantity of documentation, and faculty and housestaff burnout rates.
RESUMO
Starting from the discussion on the original set of criteria advanced by Clark and Chalmers (1998) meant to avoid the overextension of the mind, or the so-called cognitive bloat, we will sketch our solution to the problem of criteria evaluation, by connecting it to the search for a mark of the mental. Our proposal is to argue for a "weak conscientialist" mark of the mental based on transparent access, which vindicates the role of consciousness in defining what is mental without, however, identifying the mental with the conscious. This renovated link between mind and consciousness, spelled out through the concept of transparency, further develops some of our previous work on the topic (Di Francesco, 2007; Di Francesco and Piredda, 2012) and is partially inspired by Horgan and Kriegel (2008).