Analysis of the culturable gut yeast microbiota of dogs with digestive disorders.

Despite the increasing interest in studying the gut mycobiota of dogs, the association between fungal colonization and the development of digestive disorders in this species remains largely understudied. On the other hand, the high prevalence of antifungal-resistant yeasts detected in previous studies in samples from animals represents a major threat to public health. We analyzed the presence of culturable yeasts in 112 rectal swab samples obtained from dogs with digestive disorders attended in a veterinary teaching hospital. Our results revealed that Malassezia pachydermatis was frequently isolated from the studied dog population (33.9% of samples), and that the isolation of this yeast was significantly associated to the age of animals, but not to their sex, disease group, or the presence of vomits and/or diarrhea. In contrast, other yeast species were less prevalent (17.9% of samples in total), and their isolation was not significantly associated to any variable included in the analysis. Additionally, we observed that 97.5% of the studied M. pachydermatis isolates (n = 158, 1-6 per positive episode) displayed a minimum inhibitory concentration (MIC) value >4 µg/ml to nystatin, 31.6% had a MIC ≥32 µg/ml to fluconazole, and 27.2% had a MIC >4 µg/ml to amphotericin B. The antifungal susceptibility profiles of non-Malassezia (n = 43, 1-7 per episode) were more variable and included elevated MIC values for some antifungal-species combinations. These results confirm that the intestine of dogs is a reservoir of opportunistic pathogenic yeasts and suggest that the prevalence of M. pachydermatis colonization depends more on the age of animals than on any specific digestive disorder.

An Update on Herbal Products for the Management of Inflammatory Bowel Disease.

Inflammatory Bowel Disease (IBD), including Ulcerative Colitis (UC) and Crohn's Disease (CD), is a continuously increasing healthcare problem mainly characterized by chronic relapsing intestinal inflammation. The common symptoms of UC and CD include inflammation, diarrhea, abdominal pain, bleeding, and weight loss. IBD is generally caused by an interaction between genetic and environmental or microbial factors that influence the body's immune response and is responsible for digestive disorders and inflammation of the intestinal tract. However, a complete understanding of the pathophysiology and work-up of IBD is necessary to ensure appropriate treatment for the management of this complex disease. This review enlightens herbal therapeutics and drug delivery systems for the management of IBD, and thus provides new insights into this field and facilitates access to new treatments.

Prevalencia de alteraciones digestivas asociadas a Chagas importado (estudio PADChI): un estudio observacional / Prevalence of digestive disorders associated with imported Chagas disease (PADChI study): an observational study

Background Chagas disease (CD) is a parasitic disease caused by Trypanosoma cruzi, in which up to 10–20% of those affected may suffer digestive disorders. Multiple studies have been carried out on CD in non-endemic countries, mainly related to cardiological involvement. However, digestive disorders have not been analyzed in such depth. The objective of the study was to determine the prevalence of digestive disorders in imported CD at the time of first care. Methods An observational cross-sectional descriptive analysis of imported CD was performed. Chagasic structural damage and infectious digestive comorbidity were evaluated. The association between Chagasic structural damage and heart disease in Chagas patients was also investigated. Results After reviewing a total of 1,216 medical records, those of 464 patients were selected for analysis. Globally, the prevalence of digestive disorders in imported Chagas was 57.76%, 95% CI (53.25–62.27). The prevalence of comorbidity of infectious diseases was 40.73% CI 95% (36.25–45.22). Colonic abnormalities were found in 84 of 378 barium enema patients. CD-related esophageal abnormalities were present in 63 of 380 patients studied with esophagogram. Conclusions The prevalence of digestive disorders associated with CD is high, so the presence of infectious diseases (mainly parasitic and H. pylori infection) should be ruled out. It is important to exclude structural involvement in all symptomatic patients, and asymptomatic patients should also be considered and offered (AU)

Antecedentes La enfermedad de Chagas (EC) es una enfermedad parasitaria causada por Trypanosoma cruzi, en la que hasta un 10–20% de los afectados pueden sufrir trastornos digestivos. Se han realizado múltiples estudios sobre la EC en países no endémicos, principalmente relacionados con el compromiso cardiológico. Sin embargo, los trastornos digestivos no se han analizado con tanta profundidad. El objetivo del estudio fue determinar la prevalencia de los trastornos digestivos en la EC importada en el momento de la primera atención. Métodos Se realizó un análisis descriptivo transversal observacional de la EC importada. Se evaluó el daño estructural chagásico y la comorbilidad digestiva infecciosa. También se investigó la asociación entre el daño estructural chagásico y la enfermedad cardíaca en pacientes con Chagas. Resultado Tras la revisión de un total de 1.216 historias clínicas, se seleccionaron para el análisis las de 464 pacientes. A nivel global, la prevalencia de trastornos digestivos en Chagas importado fue del 57,76% IC95% (53,25–62,27). La prevalencia de comorbilidad de enfermedades infecciosas fue de 40,73% IC95% (36,25–45,22). Se encontraron anomalías colónicas en 84 de 378 pacientes con enema de bario. Las anomalías esofágicas relacionadas con la EC estuvieron presentes en 63 de 380 pacientes estudiados con esofagograma. Conclusiones La prevalencia de trastornos digestivos asociados a EC es alta, por lo que conviene descartar la presencia de enfermedades infecciosas (principalmente parasitarias e infección por H. pylori). Es importante excluir afectación estructural en todos los pacientes sintomáticos, y también se debería considerar y ofrecer a pacientes asintomáticos (AU)

Prevalence of digestive disorders associated with imported Chagas disease (PADChI study): an observational study.

BACKGROUND: Chagas disease (CD) is a parasitic disease caused by Trypanosoma cruzi, in which up to 10-20% of those affected may suffer digestive disorders. Multiple studies have been carried out on CD in non-endemic countries, mainly related to cardiological involvement. However, digestive disorders have not been analyzed in such depth. The objective of the study was to determine the prevalence of digestive disorders in imported CD at the time of first care. METHODS: An observational cross-sectional descriptive analysis of imported CD was performed. Chagasic structural damage and infectious digestive comorbidity were evaluated. The association between Chagasic structural damage and heart disease in Chagas patients was also investigated. RESULTS: After reviewing a total of 1,216 medical records, those of 464 patients were selected for analysis. Globally, the prevalence of digestive disorders in imported Chagas was 57.76%, 95% CI (53.25-62.27). The prevalence of comorbidity of infectious diseases was 40.73% CI 95% (36.25-45.22). Colonic abnormalities were found in 84 of 378 barium enema patients. CD-related esophageal abnormalities were present in 63 of 380 patients studied with esophagogram. CONCLUSIONS: The prevalence of digestive disorders associated with CD is high, so the presence of infectious diseases (mainly parasitic and H. pylori infection) should be ruled out. It is important to exclude structural involvement in all symptomatic patients, and asymptomatic patients should also be considered and offered.

Digestive disorders associated with the consumption of palm fiber (Elaeis guineensis) in feedlot cattle / Distúrbios digestivos associados ao consumo de fibra de dendê (Elaeis guineensis) em bovinos criados em regime de confinamento

Digestive disorders in cattle are associated with the breeding system and feed provided to the animals. Abomasal compaction is primarily related to the ingestion of forage with elevated levels of lignin, low quality, and difficult digestibility. In addition, the excess of fibrous food in the diet can lead to phytobezoars that may be responsible for intestinal obstruction disorders. This study aimed to describe pathological and clinical aspects of an outbreak of digestive disorders associated with the consumption of palm fiber (Elaeis guineensis). The outbreak struck a herd of 499 animals raised in a feedlot system after a change in diet that included an increase in the amount of palm fiber. Forty (8.01%) animals showed clinical signs such as fattening and regurgitation during rumination, and 21 (4.2%) animals died later. The cattle affected presented with apathy, emaciation, dehydration, distended abdomen, incomplete or absent ruminal movements, and congestive mucosa. Three animals were submitted to necropsy, and distended rumen and reticulum has a large amount of brownish liquid, long and tangled vegetable fibers with sand and stones. In two animals, the omasum had many rounded structures measuring approximately 5cm in diameter, made of vegetable fiber (phytobezoars). Abomasum of animals had similar material to the rumen, and one animal had compressed content. In two animals, dilatation was observed in the small intestine, and in the opening, the total obstruction of the lumen by phytobezoar was observed. During the follow-up of the slaughter of 76 cattle, 15 (19.7%) had phytobezoars of different sizes in the omasum and abomasum. The increased amount of oil palm fiber in animal feeding favored the occurrence of compression abomasum and intestinal obstruction phytobezoa, causing significant economic losses.(AU)

Alguns distúrbios digestivos em bovinos podem estar associados ao sistema de criação e alimentação dos animais. Entre estes estão à compactação de abomaso e a obstrução intestinal por fitobezoários, ambas relacionadas principalmente com a ingestão de alimentos com altos níveis de lignina e, consequentemente, de difícil digestibilidade. Neste trabalho são descritos os aspectos clínicos e patológicos de um surto de distúrbios digestivos em bovinos associados ao consumo de fibra de dendê (Elaeis guineensis). O surto acometeu um rebanho de 499 bovinos, criados em sistema de confinamento, após uma mudança na dieta que incluiu o aumento na quantidade de fibra de dendê. Após a mudança 40 animais (8,01%) apresentaram diarreia, distensão abdominal e regurgitação durante a ruminação e 21 animais (4,2%) morreram. Os bovinos examinados clinicamente apresentavam sinais de apatia, emagrecimento, desidratação, abdômen distendido, movimentos ruminais incompletos e ausentes, além de mucosas congestas. Três animais foram submetidos à necropsia e observou-se rúmen e reticulo distendidos e com grande quantidade de líquido acastanhado, fibras vegetais longas e emaranhadas e presença de areia e pedras. Em dois animais o omaso continha grande número de estruturas arredondadas medindo aproximadamente 5cm de diâmetro, constituídas de fibras vegetais (fitobezoários). No abomaso dos animais havia material semelhante ao do rúmen, sendo que um animal apresentou conteúdo compactado e um deles também tinha fitobezoários. Em dois animais foram observadas dilatação e obstrução total do lúmen do intestino delgado por fitobezoários. Durante o acompanhamento do abate de 76 bovinos, 15 (19,7%) apresentavam fitobezoários de diferentes tamanhos no abomaso e omaso. O aumento da quantidade de fibra de dendê na alimentação dos animais favoreceu a ocorrência de casos de compactação de abomaso e obstrução intestinal por fitobezoários, ocasionando perdas econômicas significativas.(AU)

Íleo paralítico em três bovinos: Relato de caso / Paralytic ileus in three cattle: case report

O íleo paralítico é uma obstrução do tipo funcional, na qual o lúmen intestinal está patente, comprometendo a passagem da ingesta no intestino. Este relato objetiva descrever três casos em vacas com aptidão leiteira, atendidos na rotina hospitalar e diagnosticados com íleo paralítico. Em seus históricos, os proprietários queixavam-se que os animais apresentavam redução do apetite, timpania ruminal, diminuição da produção de leite e eliminação das fezes. Ao exame físico, alguns sinais clínicos apresentaram destaque, como apatia, desidratação, redução da motilidade ruminal e intestinal, fezes em pequena quantidade e com muco, distensão do abdômen e ao balotamento constatou-se a presença de líquido. Na análise do fluido ruminal todos os animais apresentaram o teor de cloreto elevado (>30 mEq/L), caracterizando, dessa forma, um processo obstrutivo. Diante dos achados, suspeitou-se inicialmente de um quadro de obstrução intestinal. Nos casos, a conduta adotada foi realizar uma laparotomia exploratória através do flanco direito, porém constatou-se, que não existia qualquer segmento com obstrução de natureza mecânica, que justificasse as alterações físicas e laboratoriais encontradas. Diante destes resultados, configurou-se um quadro clínico indicativo de íleo paralítico. As vacas foram submetidas a um protocolo terapêutico pós-cirúrgico composto por antibioticoterapia, anti-inflam

Paralytic ileus is an obstruction of the functional type, in which the intestinal lumen is patent, compromising the passage of the intake in the intestine. The objective of this study was to describe three cases in dairy cows treated in the hospital routine diagnosed with paralytic ileus. In their histories, the owners complained that the animals presented reduced appetite, ruminal tympany, decreased milk yield and elimination of faeces. At the physical examination, some clinical signs were prominent in both, such as apathy, dehydration, reduction of ruminal and intestinal motility, faeces were present in small quantity and with mucus present, abdominal enlargement and the succession produced sloshing sounds. In the analysis of the ruminal fluid, the chloride content in both was high (>30 mEq/L), characterizing an obstructive process. In the face of the findings, a diagnosis of intestinal obstruction was initially suspected. In animals, the adopted approach was to perform an exploratory laparotomy through the right flank, but it was verified that there was no segment with mechanical obstruction that justified the physical and laboratorial alterations found. In view of these results, a clinical diagnosis indicative of paralytic ileus was established. The three animals were submitted to a post-surgical therapeutic protocol consisting of antibiotic therapy, anti-inflammatory, calcium, pro-kinetic and supportive treatment. The animals showed a favourable response to therapeutic treatment, with restoration of gastrointestinal function and other physiological parameters, and was discharged after a clinical evolution ranging from ten to twelve days.

Íleo paralítico em três bovinos: relato de caso / Paralytic ileus in three cattle: case report

O íleo paralítico é uma obstrução do tipo funcional, na qual o lúmen intestinal está patente, comprometendo a passagem da ingesta no intestino. Este relato objetiva descrever três casos em vacas com aptidão leiteira, atendidos na rotina hospitalar e diagnosticados com íleo paralítico. Em seus históricos, os proprietários queixavam-se que os animais apresentavam redução do apetite, timpania ruminal, diminuição da produção de leite e eliminação das fezes. Ao exame físico, alguns sinais clínicos apresentaram destaque, como apatia, desidratação, redução da motilidade ruminal e intestinal, fezes em pequena quantidade e com muco, distensão do abdômen e ao balotamento constatou-se a presença de líquido. Na análise do fluido ruminal todos os animais apresentaram o teor de cloreto elevado (>30 mEq/L), caracterizando, dessa forma, um processo obstrutivo. Diante dos achados, suspeitou-se inicialmente de um quadro de obstrução intestinal. Nos casos, a conduta adotada foi realizar uma laparotomia exploratória através do flanco direito, porém constatou-se, que não existia qualquer segmento com obstrução de natureza mecânica, que justificasse as alterações físicas e laboratoriais encontradas. Diante destes resultados, configurou-se um quadro clínico indicativo de íleo paralítico. As vacasforam submetidas a um protocolo terapêutico pós-cirúrgico composto por antibioticoterapia, anti-inflamatório, cálcio, procinético e tratamento de suporte. Os animais manifestaram uma resposta favorável a conduta terapêutica, com restabelecimento da função gastrointestinal e dos demais parâmetros fisiológicos, recebendo alta após uma evolução clínica variando entre dez a doze dias.

Paralytic ileus is an obstruction of the functional type, in which the intestinal lumen is patent, compromising the passage of the intake in the intestine. The objective of this study was to describe three cases in dairy cows treated in the hospital routine diagnosed with paralytic ileus. In their histories, the owners complained that the animals presented reduced appetite, ruminal tympany, decreased milk yield and elimination of faeces. At the physical examination, some clinical signs were prominent in both, such as apathy, dehydration, reduction of ruminal and intestinal motility, faeces were present in small quantity and with mucus present, abdominal enlargement and the succession produced sloshing sounds. In the analysis of the ruminal fluid, the chloride content in both was high (>30 mEq/L), characterizing an obstructive process. In the face of the findings, a diagnosis of intestinal obstruction was initially suspected. In animals, the adopted approach was to perform an exploratory laparotomy through the right flank, but it was verified that there was no segment with mechanical obstruction that justified the physical and laboratorial alterations found. In view of these results, a clinical diagnosis indicative of paralytic ileus was established. The three animals were submitted to a post-surgical therapeutic protocol consisting of antibiotic therapy, anti-inflammatory, calcium, pro-kinetic and supportive treatment. The animals showed a favourable response to therapeutic treatment, with restoration of gastrointestinal function and other physiological parameters, and was discharged after a clinical evolution ranging from ten to twelve days.

Impacts of surgical interventions on the long-term outcomes in individuals with trisomy 18.

OBJECTIVE: We aim to clarify whether surgical interventions can contribute to improve the long-term outcomes among individuals with trisomy 18. METHODS: We retrospectively studied 69 individuals with trisomy 18 admitted to 4 tertiary neonatal centers between 2003 and 2017. A cohort was divided into two groups: subjects with surgical interventions and conservative treatments. We compared the rates of survival and achieving homecare between the groups. RESULTS: Gestational age and birth weight were 37 (27-43) weeks and 1,700 (822-2,546) g, respectively. There were 68 patients with congenital heart disease and 20 patients with digestive disease. Surgical interventions including cardiac and digestive surgery were provided in 41% of individuals. There was no difference in gestational age (p=0.30), birth weight (p=0.07), gender (p=0.30), and fetal diagnosis (p=0.87) between the groups. During the median follow up duration of 51 (2-178) months, overall survival rates in 6, 12 and 60 months were 57%, 43% and 12%, respectively. Survival to hospital discharge occurred in 23 patients, and the rates of achieving homecare in 1, 6, and 12 months are 1%, 18% and 30%, respectively. There was no significant difference in survival rate (p=0.26) but in the rate of achieving home care (p=0.02) between the groups. Cox hazard analysis revealed that prenatal diagnosis (hazard ratio 0.30, 95%CI: 0.13-0.75), cardiac surgery (hazard ratio 2.40, 95%CI:,1.03-5.55), and digestive surgery (hazard ratio 1.20, 95%CI: 1.25-3.90) were related to the rate of achieving homecare. CONCLUSION: Aggressive surgical interventions contribute not to the long-term survival but to achieve homecare among individuals with trisomy 18. EVIDENCE LEVEL: Level 3 (Prognostic study, Case-Control study).

Higher intake of medications for digestive disorders in children prenatally exposed to drugs with atropinic properties.

Childhood digestive disorders are a common occurrence and are sometimes unexplained. Maternal medication during the development of the foetus' digestive system may contribute to the increase in childhood digestive disorders, especially with drugs acting on the cholinergic system. This study investigated the association between prenatal exposure to drugs with atropinic properties and the use of digestive disorder medications in childhood (0-3 years). Children from POMME (PrescriptiOn Médicaments Mères Enfants), a French database of reimbursed drugs for pregnant women and their children, were included (N = 8 372). Each drug prescribed during antenatal life was assigned an atropinic score (0 = null, 1 = low, 3 = strong). The prenatal atropinic burden was calculated as the sum of atropinic scores of drugs prescribed. More than 30% (N = 2 652) of the children were prenatally exposed to atropinic drugs. They used significantly more digestive disorder medications than unexposed children (RRa = 1.11 [1.06; 1.16]). The strength of the association increased with the prenatal atropinic burden. Our results suggest long-term digestive effects after prenatal exposure to atropinic drugs.

The Dietary Intervention of Transgenic Low-Gliadin Wheat Bread in Patients with Non-Celiac Gluten Sensitivity (NCGS) Showed No Differences with Gluten Free Diet (GFD) but Provides Better Gut Microbiota Profile.

The study evaluated the symptoms, acceptance, and digestibility of bread made from transgenic low-gliadin wheat, in comparison with gluten free bread, in Non-coeliac gluten sensitivity (NCGS) patients, considering clinical/sensory parameters and gut microbiota composition. This study was performed in two phases of seven days each, comprising a basal phase with gluten free bread and an E82 phase with low-gliadin bread. Gastrointestinal clinical symptoms were evaluated using the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire, and stool samples were collected for gluten immunogenic peptides (GIP) determination and the extraction of gut microbial DNA. For the basal and E82 phases, seven and five patients, respectively, showed undetectable GIPs content. The bacterial 16S rRNA gene V1-V2 hypervariable regions were sequenced using the Illumina MiSeq platform and downstream analysis was done using a Quantitative Insights into Microbial Ecology (QIIME) pipeline. No significant differences in the GSRS questionnaires were observed between the two phases. However, we observed a significantly lower abundance of some gut genera Oscillospira, Dorea, Blautia, Bacteroides, Coprococcus, and Collinsella, and a significantly higher abundance of Roseburia and Faecalibacterium genera during the E82 phase compared with the basal phase. The consumption of low-gliadin bread E82 by NCGS subjects induced potentially positive changes in the gut microbiota composition, increasing the butyrate-producing bacteria and favoring a microbial profile that is suggested to have a key role in the maintenance or improvement of gut permeability.

"Dry mouth" and "Flammer" syndromes-neglected risks in adolescents and new concepts by predictive, preventive and personalised approach.

BACKGROUND: "Dry mouth" syndrome (chronic hyposalivation) can be caused by a number of pathophysiological conditions such as acute and chronic stress exposure, abnormal body weight (both too high and too low ones), eating disorders (such as anorexia nervosa), metabolic syndrome(s), Sjögren's and Sicca syndromes, drugs and head/neck radiotherapy application. In turn, the chronic hyposalivation as a suboptimal health condition significantly reduces quality of life, may indicate a systemic dehydration, provokes and contributes to a number of pathologies such as a strongly compromised protection of the oral cavity, chronic infections and inflammatory processes, periodontitis, voice and digestive disorders. Consequently, "dry mouth" syndrome might be extremely useful as an indicator for an in-depth diagnostics of both-co-existing and snowballing health-threating conditions. However, predictive diagnostics, targeted prevention and personalisation of treatments are evidently underdeveloped for individuals at high risk suffering from the "dry mouth" syndrome. WORKING HYPOTHESIS AND METHODOLOGY: In the current study, we have hypothesised that individuals demonstrating "Flammer syndrome" (FS) phenotype may suffer from the "dry mouth" syndrome more frequently, due to disturbed microcirculation, psychological factors (obsessional personality/perfectionism), and diminished feeling of thirst with consequently insufficient daily liquid intake potentially resulting in the systemic dehydration with individually pronounced level of severity. If confirmed, FS phenotyping linked to the chronic hyposalivation might be predictive for individuals at risk identified by innovative screening programmes. To verify the working hypothesis, healthy individuals (negative control group) versus individuals with evident hyposalivation as well as patients diagnosed with periodontitis (positive control group) observed and treated at the dental clinic were investigated. The degree to which an individual is affected by hyposalivation was determined by the Bother xerostomia Index utilising a questionnaire of 10 issue-specific items and monitoring of a typically matt roof of the mouth in dental practice. An extent to which individuals included in the study are the carriers of the FS phenotype was estimated by the specialised 15-item questionnaire. RESULTS AND CONCLUSIONS: For both-the target group (hyposalivation) and positive control group (periodontitis)-FS phenotype was demonstrated to be more specific compared to the disease-free (negative control) group. Moreover, self-reports provided by interviewed adolescents of the target group frequently recorded remarkable discomfort related to "dry mouth" syndrome, acute and chronic otorhinolaryngological infections and even delayed wound healing. Further, interviewed adolescents do worry about the symptoms which might be indicative for potential diseases; they are also amazed that too little attention is currently paid to the issue by caregivers. In conclusion, FS questionnaire linked to the "dry mouth" syndrome is strongly recommended for application in primary healthcare. Consequently, targeted preventive measures can be triggered early in life. For example, traditional, complementary and alternative medicine demonstrates positive therapeutic effects in individuals suffering from xerostomia. For in-depth diagnostics, epi/genetic regulations involved into pathophysiologic mechanisms of hyposalivation in FS-affected individuals should be thoroughly investigated at molecular level. Identified biomarker panels might be of great clinical utility for predictive diagnostics and patient stratification that, further, would sufficiently improve personalised care to the patient.

Burden of NCDs in SNNP region, Ethiopia: a retrospective study.

BACKGROUND: Non-communicable diseases (NCDs) are medical conditions or diseases that are non-transmissible. As NCDs are becoming one of major public health problem, providing local description of diseases and injuries is key to health decision- making and planning processes. So, this study aimed to describe caseload of NCDs in Southern Nations Nationalities and People's Region, Ethiopia. METHODS: A facility based retrospective study was conducted in February 2015 in SNNPR, Ethiopia. A total of 22,320 records of three years retrieved from 23 health facilities using systematic sampling. Data were entered in to Epi-Info 3.5.3 and descriptive analysis was carried out using SPSS version 20. RESULTS: From 22,320 records reviewed, 6633 (29.7%) clients visited health facilities due to Non-Communicable Diseases (NCDs). Majority (37.2%) of NCD cases were in productive age groups (20-35 year). Near to half (43%) of NCD cases were from rural and 45.8% were females. Digestive disorder (26.7%), cardiovascular diseases (18.8%) and Diabetes Mellitus (13.1%) were the most prevalent types of NCDs. CONCLUSION: Health facilities are burdened with significant proportion of clients with NCDs. Young population accounts large share and NCDs are becoming public health problem of urban and rural area within a health care system that focus on communicable diseases. There is a need to strengthen the health system to work towards NCDs, and investigate risk factors associated with NCDs at individual level.

Molecular cloning, polymorphism, and expression analysis of the LKB1/STK11 gene and its association with non-specific digestive disorder in rabbits.

Liver kinase B1 (LKB1, also called STK11) encodes a serine/threonine kinase mutated in Peutz-Jeghers cancer syndrome characterized by gastrointestinal polyposis. Although LKB1 plays an important role in regulating energy homeostasis, cell growth, and metabolism via activation of adenosine monophosphate (AMP)-activated protein kinase (AMPK), nothing is known about its molecular characteristics and possible involvement in non-specific digestive disorder (NSDD) of rabbits. In the present study, we first cloned the coding sequence (CDS) of rabbit LKB1, which consisted of 1317 bp encoding 438 amino acids (AAs) and contained a highly conserved S_TKc kinase domain. Its deduced AA sequence showed 87.93-91.10% similarities with that of other species. In order to determine its involvement in NSDD, a NSDD rabbit model was built by a dietary fiber deficiency. The polymorphic site of LKB1 was then investigated in both healthy and NSDD groups using directing sequencing. Our results suggested that a synonymous variant site (840 c. G > C, CCC→CCG) existed in its S_TKc domain, which was associated with susceptibility to NSDD. Furthermore, qPCR was utilized to examine the mRNA levels of LKB1 and its downstream targets (i.e., PRKAA2, mTOR and NF-kß) in several intestinal-related tissues from both healthy and NSDD groups. Significant changes in their expression levels between two groups indicated that impaired LKB1 signaling contributed to the intestinal abnormality in NSDD rabbits. Taken together, it could be concluded that LKB1 might be a potential candidate gene affecting the occurrence of rabbit NSDD. This information may serve as a basis for further investigations on rabbit digestive diseases.

Use of rumination and activity monitoring for the identification of dairy cows with health disorders: Part I. Metabolic and digestive disorders.

The objectives of this study were to evaluate (1) the performance of an automated health-monitoring system (AHMS) to identify cows with metabolic and digestive disorders-including displaced abomasum, ketosis, and indigestion-based on an alert system (health index score, HIS) that combines rumination time and physical activity; (2) the number of days between the first HIS alert and clinical diagnosis (CD) of the disorders by farm personnel; and (3) the daily rumination time, physical activity, and HIS patterns around CD. Holstein cattle (n=1,121; 451 nulliparous and 670 multiparous) were fitted with a neck-mounted electronic rumination and activity monitoring tag (HR Tags, SCR Dairy, Netanya, Israel) from at least -21 to 80 d in milk (DIM). Raw data collected in 2-h periods were summarized per 24 h as daily rumination and activity. A HIS (0 to 100 arbitrary units) was calculated daily for individual cows with an algorithm that used rumination and activity. A positive HIS outcome was defined as a HIS of <86 during at least 1 d from -5 to 2 d after CD. Blood concentrations of nonesterified fatty acids, ß-hydroxybutyrate, total calcium, and haptoglobin were determined in a subgroup of cows (n=459) at -11±3, -4±3, 0, 3±1, 7±1, 14±1, and 28±1 DIM. The sensitivity of the HIS was 98% [95% confidence interval (CI): 93, 100] for displaced abomasum (n=41); 91% (95% CI: 83, 99) for ketosis (n=54); 89% (95% CI: 68, 100) for indigestion (n=9); and 93% (95% CI: 89, 98) for all metabolic and digestive disorders combined (n=104). Days (mean and 95% CI) from the first positive HIS <86 and CD were -3 (-3.7, -2.3), -1.6 (-2.3, -1.0), -0.5 (-1.5, 0.5), and -2.1 (-2.5, -1.6) for displaced abomasum, ketosis, indigestion, and all metabolic and digestive disorders, respectively. The patterns of rumination, activity, and HIS for cows flagged by the AHMS were characterized by lower levels than for cows without a health disorder and cows not flagged by the AHMS from -5 to 5 d after CD, depending on the disorder and parameter. Differences between cows without health disorders and those flagged by the AHMS for blood markers of metabolic and health status confirmed the observations of the CD and AHMS alerts. The overall sensitivity and timing of the AHMS alerts for cows with metabolic and digestive disorders indicated that AHMS that combine rumination and activity could be a useful tool for identifying cows with metabolic and digestive disorders.

Dilatação do ceco em bezerros: relato de casos / Cecal dilatation in calves: case reports

A dilatação do ceco (DC) é um transtorno digestivo de natureza fermentativa com maior ocorrência em vacas de leite, sendopoucos os relatos sobre a sua ocorrência em bezerros. Portanto, este trabalho teve como objetivo relatar as manifestações clínicocirúrgicas,laboratoriais e anatomopatológicas da DC diagnosticada em quatro bezerros, atendidos na Clínica de Bovinos, CampusGaranhuns da Universidade Federal Rural de Pernambuco (UFRPE). Ao exame clínico dos animais constatou-se um quadro deapatia, desidratação, alteração no apetite, motilidade do rúmen, abomaso e intestinos diminuída e ainda, fezes escassas e diarreicas.Observou-se um aumento na região da fossa paralombar direita e na auscultação, com auxílio da percussão, verificou-se umaressonância timpânica (“tilintar”). O hemograma revelou uma leucocitose por neutrofilia com desvio para esquerda regenerativo,linfocitose e monocitose, e ainda, uma hiperfibrinogenemia. Na análise do fluido ruminal verificou-se uma elevação do teor decloretos (>30mEq/L). Foi indicada uma laparotomia exploratória na região do flanco direito, em dois dos bezerros, sendo possívelconfirmar a DC. Em função da gravidade da lesão e condição clínica precária todos os animais vieram a óbito. Na necropsia,além da DC, foram evidenciadas alterações secundárias a esta enfermidade. Ratifica-se neste trabalho que a DC em bezerrosé uma enfermidade de baixa ocorrência, podendo afirmar que o prognóstico é ruim na maioria dos casos, quando diagnosticadatardiamente.

Cecal dilatation is a fermentative disorder of the digestive tract that has a greater occurrence in dairy cows and few reports incalves. Therefore, this study aimed to report the clinical, surgical, laboratorial findings and pathological lesions of the cecal distentionin four calves that were diagnosticated and treated at the Clínica de Bovinos, Campus Garanhuns, Universidade Federal Ruralde Pernambuco (UFRPE). The clinical findings were apathy, dehydration, lack of appetite, decrease in ruminal, abomasal andintestinal motility and diarrheal and scarce feces. The abdomen was distended on the right side (paralumbar fossa) and there wasa tympanic resonance in the same area. The blood assays have shown leukocytosis with neutrophilia with a regenerative left shift,lymphocytosis and monocytosis, and also hyperfibrinogenemia. The ruminal fluid analysis showed a high content of chlorides(>30mEq/L). Exploratory laparotomy on the right flank was performed on two calves that confirmed cecal distention. The severityof the injury and poor clinical condition lead animals to death. At necropsy, in addition to DC, minor changes were observed inthis disease. Is ratified this study that DC is a disease in calves of low occurrence and can say that the prognosis is poor in mostcases, when diagnosed late.

Single Nucleotide Polymorphisms of NLRP12 Gene and Association with Non-specific Digestive Disorder in Rabbit.

The NLRP12 (NLR family, pyrin domain containing 12) serves as a suppressor factor in the inflammatory response and protects the host against inflammation-induced damage. In the present study, we aimed to study the polymorphisms of NLRP12 gene and its association with susceptibility to non-specific digestive disorder (NSDD) in rabbits. We re-sequenced the entire coding region of the rabbit NLRP12 gene and detected a total of 19 SNPs containing 14 synonymous and five non-synonymous variations. Among them, the coding SNP (c.1682A>G), which would carry a potential functional implication, was subsequently subjected to genotyping for case-control association study (272 cases and 267 controls). The results revealed that allele A was significantly protective against NSDD with an odds ratio value of 0.884 (95% confidence interval, 0.788 to 0.993; p = 0.038). We also experimentally induced NSDD in growing rabbits by feeding a fibre-deficient diet and subsequently investigated NLRP12 mRNA expression. The mRNA expression of NLRP12 in healthy status was significantly higher than that in severe NSDD (p = 0.0016). The highest expression was observed in individuals carrying the protective genotype AA (p = 0.0108). These results suggested that NLRP12 was significantly associated with the NSDD in rabbits. However, the precise molecular mechanism of NLRP12 involving in the development of rabbit NSDD requires further research.

Características clínicas del síndrome de intestino irritable en pacientes de dos centros asistenciales / Clinical characteristics of the irritable bowel syndrome in patients from two medical centers

Objetivo. Evaluar la eficacia y la seguridad de la esplenectomía en el corto y largo plazos en pacientes con púrpura trombocitopénica inmunológica crónica (PTIC) y determinar los predictores de respuesta a esta intervención. Material y métodos. Se realizó un estudio descriptivo y retrospectivo de 89 pacientes con PTIC (49 esplenectomizados y 40 no esplenectomizados) en el Hospital Nacional Arzobispo Loayza de Lima. Resultados. La respuesta inicial al tratamiento con corticoides fue completa en el 35 por ciento de los pacientes no esplenectomizados y en ninguno de los esplenectomizados, y hubo respuesta parcial en el 60,0 por ciento y 71,55 por ciento, respectivamente. El tiempo promedio entre el diagnóstico y la esplenectomía fue 24,01 mas o menos 31,52 meses. Las complicaciones presentadas durante la cirugía (12 por ciento) y el postoperatorio (23 por ciento) se resolvieron totalmente en todos los casos. Ningún paciente falleció como consecuencia de la esplenectomía. La respuesta inicial a la esplenectomía fue completa en el 73,47 por ciento y parcial en el 18,37 por ciento. Al primer, segundo y tercer años de seguimiento, las respuestas completas y parciales fueron 72,91 por ciento y 18,75 por ciento, 69,44 por ciento y 19,44 por ciento y 67,74 por ciento y 16,13 por ciento, respectivamente. Elpromedio de plaquetas antes y después de la esplenectomía (p menor que 0,0000) y la cuenta de plaquetas al final del seguimiento en los esplenectomizados y los no esplenectomizados (p = 0,013) tuvieron diferencia significativa. Solo el promedio de plaquetas preoperatorio fue predictor de buena respuesta a la esplenectomía (p menor que 0,014). Conclusiones. La esplenectomía es un tratamiento eficaz y seguro para los pacientes adultos con PTIC.

Objectives. To evaluate the efficacy and safety of the splenectomy in patients with chronic immune thrombocytopenic purpura (CITP) during the short term and the long term follow up and to determine predictors of response after surgery. Material and Methods. A descriptive and retrospective study was carried out with the data of 89 CITP patients in Hospital Nacional Arzobispo Loayza of Lima (49 with splenectomy and 40 without splenectomy). Results. Complete initial response to steroid therapy occurred in 35 per cent in the non splenectomy group and none in the splenectomy group. And, partial response to steroid therapy was 60 per cent and 71,55 per cent, respectively. The mean time between CITP diagnosis and splenectomy was 24,01 more or less 31,52 months. Surgical complications in the splenectomy group were observed during the surgery period in 12 per cent and during the post surgery period in 23 per cent. No one patient diaed a s a consequence of the splenectomy. Initial response to splenectomy was complete in 73,47 per cent and partial in 18,37 per cent. During the first, second and third year o follow up, complete and partial responses to splenectomy were 72,91 per cent and 18,75 per cent; 69,44 per cent and 19,44 per cent; 67,74 per cent; and, 16,13 per cent, respectively. A significant increase in the mean platelet count was observed following splenectomy (p minor that 0,0000) and there was a significant difference too in the platelet count between patients with and without splenectomy at the end of the study (p = 0,013). The mean platelet count before surgery was the only predictor of good response to splenectomy, (p minor that 0,014). Conclusions: The results have shown that splenectomy is a safe and effective procedure for the adult patients with CITP.