Low Levels of Hive Stress Are Associated with Decreased Honey Activity and Changes to the Gut Microbiome of Resident Honey Bees

Honey bees (Apis mellifera) face increasing threats to their health, particularly from the degradation of floral resources and chronic pesticide exposure. The properties of honey and the bee gut microbiome are known to both affect and be affected by bee health. Using samples from healthy hives and hives showing signs of stress from a single apiary with access to the same floral resources, we profiled the antimicrobial activity and chemical properties of honey and determined the bacterial and fungal microbiome of the bee gut and the hive environment. We found honey from healthy hives was significantly more active than honey from stressed hives, with increased phenolics and antioxidant content linked to higher antimicrobial activity. The bacterial microbiome was more diverse in stressed hives, suggesting they may have less capacity to exclude potential pathogens. Finally, bees from healthy and stressed hives had significant differences in core and opportunistically pathogenic taxa in gut samples. Our results emphasize the need for understanding and proactively managing bee health. IMPORTANCE Honey bees serve as pollinators for many plants and crops worldwide and produce valuable hive products such as honey and wax. Various sources of stress can disrupt honey bee colonies, affecting their health and productivity. Growing evidence suggests that honey is vitally important to hive functioning and overall health. In this study, we determined the antimicrobial activity and chemical properties of honey from healthy hives and hives showing signs of stress, finding that honey from healthy hives was significantly more antimicrobial, with increased phenolics and antioxidant content. We next profiled the bacterial and fungal microbiome of the bee gut and the hive environment, finding significant differences between healthy and stressed hives. Our results underscore the need for greater understanding in this area, as we found even apparently minor stress can have implications for overall hive fitness as well as the economic potential of hive products.

The role of honey in the ecology of the hive: Nutrition, detoxification, longevity, and protection against hive pathogens

Honey is the source of energy for the European honey bee, Apis mellifera. Beyond simple nutrition and a hedge against the seasonal, geographic, and chemical unpredictability of nectar, honey has properties that protect the hive against various stresses. Enzyme-mediated detoxification during honey ripening neutralizes potentially toxic phytochemicals, and bees that consume honey have enhanced tolerance to other ingested toxins. Catalase and antioxidant phenolics protect honey bees from oxidative damage caused by reactive oxygen species, promoting their longevity. Phytochemical components of honey and microRNAs have the potential to influence developmental pathways, with diet playing a large role in honey bee caste determination. Components of honey mediate stress response and promote cold tolerance during overwintering. Honey has a suite of antimicrobial mechanisms including osmotic pressure, low water activity, low pH, hydrogen peroxide, and plant-, honey bee-, and microbiota-derived compounds such as phytochemicals and antimicrobial peptides. Certain types of honey, particularly polyfloral honeys, have been shown to inhibit important honey bee pathogens including the bacteria responsible for American and European Foulbrood, the microsporidian Nosema ceranae, and the fungi responsible for Stonebrood. Understanding the diverse functional properties of honey has far-ranging implications for honey bee and hive health and management by beekeepers.

The thermogenic responses to overfeeding and cold are differentially regulated

OBJECTIVE

Brown adipose tissue (BAT) is a highly metabolic tissue that generates heat and is negatively associated with obesity. BAT has been proposed to mediate both cold-induced thermogenesis (CIT) and diet-induced thermogenesis (DIT). Therefore, it was investigated whether there is a relationship between CIT and DIT in humans.

METHODS

Nine healthy men (23 ± 3 years old, 23.0 ± 1.8 kg m(-2) ) completed 20 min of cold exposure (4°C) 5 days per week for 4 weeks. Before and after the intervention, CIT (the increase in resting metabolic rate at 16°C relative to 22°C) was measured by a ventilated hood indirect calorimeter, whereas DIT was measured as the 24-h thermic response to 1 day of 50% overfeeding (TEF150% ) in a respiratory chamber.

RESULTS

After the cold intervention, CIT more than doubled from 5.2% ± 14.2% at baseline to 12.0% ± 11.1% (P = 0.05), in parallel with increased sympathetic nervous system activity. However, 24-h energy expenditure (2,166 ± 206 vs. 2,118 ± 188 kcal day(-1) ; P = 0.15) and TEF150% (7.4% ± 2.7% vs. 7.7% ± 1.6%; P = 0.78) were unchanged. Moreover, there was no association between CIT and TEF150% at baseline or post-intervention, nor in their changes (P ≥ 0.47).

CONCLUSIONS

Cold acclimation resulted in increased CIT but not TEF150% . Therefore, it is likely that CIT and DIT are mediated by distinct regulatory mechanisms.

The technology boom: a new era in obesity management

As technology continues to develop rapidly, the incidence of obesity also continues to climb at an alarming rate. The increase in available technology is thought to be a contributor in the obesogenic environment, yet at the same time technology can also be used to intervene and improve health and health behaviors. This article reviews the components of effective weight management programs and the novel role that technology, such as SMS, websites, and smartphone apps, is playing to improve the success of such programs. Use of these modern technologies can now allow for individualized treatment recommendations to be delivered to individuals remotely, increased self-monitoring/tracking of health-related data, broader and more rapid dissemination of health information/recommendations, and increased patient-dietician/physician contact. The use of technology in weight management programs results in improved long-term weight management, and in most cases improved cost-effectiveness. Rather than blaming increased food intake and sedentary lifestyle on technology, rapidly developing and innovative technologies should be used to our advantage and deployed to combat the obesity epidemic.

Interaction between dietary fat and exercise on excess postexercise oxygen consumption

The objective of this study was to determine the effect of increased physical activity on subsequent sleeping energy expenditure (SEE) measured in a whole room calorimeter under differing levels of dietary fat. We hypothesized that increased physical activity would increase SEE. Six healthy young men participated in a randomized, single-blind, crossover study. Subjects repeated an 8-day protocol under four conditions separated by at least 7 days. During each condition, subjects consumed an isoenergetic diet consisting of 37% fat, 15% protein, and 48% carbohydrate for the first 4 days, and for the following 4 days SEE and energy balance were measured in a respiration chamber. The first chamber day served as a baseline measurement, and for the remaining 3 days diet and activity were randomly assigned as high-fat/exercise, high-fat/sedentary, low-fat/exercise, or low-fat/sedentary. Energy balance was not different between conditions. When the dietary fat was increased to 50%, SEE increased by 7.4% during exercise (P < 0.05) relative to being sedentary (baseline day), but SEE did not increase with exercise when fat was lowered to 20%. SEE did not change when dietary fat was manipulated under sedentary conditions. Physical activity causes an increase in SEE when dietary fat is high (50%) but not when dietary fat is low (20%). Dietary fat content influences the impact of postexercise-induced increases in SEE. This finding may help explain the conflicting data regarding the effect of exercise on energy expenditure.

No effect of caloric restriction on salivary cortisol levels in overweight men and women

OBJECTIVE

The effect of weight loss by diet or diet and exercise on salivary cortisol levels, a measure of hypothalamic pituitary adrenal activity, in overweight individuals is not known. The objective was to test the hypothesis that 24 weeks of moderate caloric restriction (CR) (25%) by diet or diet and aerobic exercise would alter morning and diurnal salivary cortisol levels.

DESIGN AND SETTING

Randomized control trial in an institutional research center.

PARTICIPANTS

Thirty-five overweight (BMI: 27.8±0.7 kg/m(2)) but otherwise healthy participants (16 M/19 F).

INTERVENTION

Participants were randomized to either calorie restriction (CR: 25% reduction in energy intake, n=12), calorie restriction+exercise (CR+EX: 12.5% reduction in energy intake+12.5% increase in exercise energy expenditure, n=12) or control (healthy weight-maintenance diet, n=11) for 6 months.

MAIN OUTCOME MEASURE

Salivary cortisol measured at 8:00, 8:30, 11:00, 11:30, 12:30, 13:00, 16:00 and 16:30. Morning cortisol was defined as the mean cortisol concentration at 08:00 and 08:30. Diurnal cortisol was calculated as the mean of the 8 cortisol measures across the day.

RESULTS

In the whole cohort, higher morning and diurnal cortisol levels were associated with impaired insulin sensitivity (morning: P=0.004, r(2)=0.24; diurnal: P=0.02, r(2)=0.15). Using mixed model analysis, there was no significant effect of group, time or sex on morning or diurnal cortisol levels.

CONCLUSION

A 10% weight loss with a 25% CR diet alone or with exercise did not impact morning or diurnal salivary cortisol levels.

The patient on low dose aspirin: a concern for the anesthesiologist?

Low dose aspirin administration has been generally accepted as prophylactic therapy for myocardial infarction and cerebrovascular disease. It is also used generally to prevent embolic phenomenon, as for example in pregnant patients. Thus, anesthesiologists are often confronted with patients receiving aspirin for whom neuraxial anesthesia may be the preferred technique. Much controversy has arisen in the literature as to whether the possible complications of anticoagulation outweigh the benefits of regional techniques. The anesthesiologist must be able to provide patients with a rational and current approach to the selection of an appropriate anesthetic technique.

Perioperative considerations for the patient on herbal medicines

Herbal medicines have enormous presence in the United States health care system. There is an increasing trend towards reimbursement of herbal medicines by insurance companies, which further encourage their utilization. Herbs are listed under the "supplement" category by the Food and Drug Administration. The Dietary Supplement and Health Education Act signed into law in October 1994, requires no proof of efficacy, no demonstration of safety, and sets no standards for quality control for the products labeled as "supplements" thereby increasing the risk of adverse effects of these herbs. The United States has experienced an epidemic of over-the-counter "natural" products over the last two decades; but there is little motivation for the manufactures to conduct randomized, placebo-controlled, double-blinded clinical trials to unequivocally prove the safety and efficacy of these drugs. Physicians, irrespective of their specialty, should not underestimate the potential risks associated with the use of herbs as reports indicate that within the last two decades, more than 100 herbogenic deaths have occurred, many serious complications have been reported, patients have required renal dialysis, renal transplantation and hepatic transplantation after taking botanicals. Internists must inquire about the patient's use of herbal products. In addition, the education of each patient regarding the serious, potential drug-herb interactions should be a routine component of preoperative assessment. The American Society of Anesthesiologists (ASA) recommends that all herbal medications should be discontinued 2-3 weeks prior to an elective surgical procedure. If the patient is not sure of the content of the herbal medicine, he/she should be urged to bring the container so that an attempt can be made to review the contents of the preparation. While such an action holds some promise in the elective setting, emergency care should be based on a thorough drug-intake history from the patient or a relative, if possible. Medical research and medical literature in general has not addressed this new group of health supplements, despite the fact that many of these herbs have the potential to cause serious health problems and drug interations. There is a need to conduct scientific clinical trials to study the anesthetic drug responses to commonly used neutraceutical agents.

Perioperative considerations for the patient taking herbal medicines

There has been a significant increase in the proliferation and use of dietary supplements known as neutraceuticals. Since 1994, herbal products have been regulated by the Dietary Supplement Health and Education Act (DSHEA), which does not require burden of proof to demonstrate premarketing safety and efficacy studies. Scientific literature and government policies have not adequately addressed this fast-emerging group of more than 20,000 health supplements. Lack of purity and standardization of these agents, combined with minimal education in traditional homeopathic medical education, has led to serious health-related problems including arrhythmias, cardiovascular compromise, strokes, and deaths. Even though 30% of our traditional medicines are derived from botanicals, most physicians are either unfamiliar or unwilling to develop any level of expertise with neutraceuticals. A review emphasizing perioperative considerations is provided of the history of herbal medicines, governmental policies, and specific herbal agent-drug interactions.

Effects of garlic extract (Allium sativum) on neutrophil migration at the cellular level

Studies of the effects of garlic extract on oxidative and lipoprotein levels have yielded widely different findings. Leukocytes play an important role during many processes, including inflammation. They migrate from intravascular spaces into tissues and attack microorganisms. In a recent study, the inhibitory effects of the nonsteroidal antiinflammatory drug, ibuprofen, on leukocyte transmigration were demonstrated using an in vitro assay. Little is known about the cellular effects of garlic extracts (Allium sativum). The aim of the current study was to investigate the influence of garlic extract on leukocyte migration through endothelial cell monolayers and thereby evaluate a possible role in inflammatory processes. Human umbilical endothelial cells were cultured on microporous membranes to make an endothelial cell monolayer (ECM). Freshly isolated neutrophils were used in a recently described migration assay. The amount of untreated neutrophils migrating through the untreated ECM was used as control and set at 100%. Neutrophils and/or ECM were pretreated with garlic extract using moderate, higher, and lower concentrations. Moderate plasma concentrations of garlic extract inhibited neutrophil migration through ECM significantly (64 +/- 5.8% standard deviation [SD]; P < 0.05) when both cell types were treated, (a situation that may have clinical relevance). Treating either neutrophils or ECM alone showed significant reductions in migratory rate (neutrophils treated alone: 81 +/- 7.7% SD, P < 0.05; ECM alone: 70 +/- 6.7%, P < 0.05). Thus, garlic extract is identified as a potent inhibitor of leukocyte migration through endothelial cell monolayers. Treatment of both cell types has an additive effect. Endothelial cells seem to be more affected than neutrophils. Further investigations are necessary to understand the potential clinical consequences.

Garlic extract (allium sativum) reduces migration of neutrophils through endothelial cell monolayers

Leukocytes play an important role during inflammation. They migrate from intravascular spaces into tissues and attack micro-organisms. In a recent study, the inhibitory effects of the non-steroidal anti-inflammatory drug, ibuprofen, on leukocyte transmigration were demonstrated using an in vitro assay. Little is know about the cellular effects of garlic extracts (allium sativum). The aim of the current study was to investigate the influence of garlic extract on leukocyte migration through endothelial cell monolayers and thereby evaluate a possible role in inflammatory processes. Human umbilical endothelial cells were cultured on microporous membranes to make an endothelial cell monolayer (ECM). Freshly isolated neutrophils were used in a recently described migration assay. The amount of untreated neutrophils migrating through the untreated ECM was used as control and set at 100%. Neutrophils and/or ECM were pre-treated with garlic extract using moderate, as well as higher and lower concentrations. Moderate plasma concentrations garlic extract inhibited neutrophil migration through ECM significantly (64 +/- 5.8% SD; P < 0.05), when both cell types were treated, (a situation that may have clinical relevance). Treating either neutrophils or ECM alone showed significant reductions in migratory rate (neutrophils treated alone: 81 +/- 7.7% SD, p < 0.05; ECM alone: 70 +/- 6.7%, p < 0.05). Thus, garlic extract is identified as a potent inhibitor of leukocyte migration through endothelial cell monolayers. Treatment of both cell types has an additive effect. Endothelial cells seem to be more affected than neutrophils. Further investigations are necessary to understand the potential clinical consequences. During inflammation, neutrophils play an important role. They migrate rapidly from the vascular space into tissues to destroy invading micro-organisms. During migration through endothelial cell monolayers (ECM), neutrophils undergo morphologic changes from rounded, relatively smooth cells to elongated, ruffled cells with pseudopodia. Recently, the influence of the non-steroidal anti-inflammatory drug, ibuprofen, on leukocyte function was investigated using an in vitro double chamber migration assay that includes ECM. Garlic extract (allium sativum) is a widely used "over the counter" herbal preparation. The effect of garlic on lipid metabolism is well documented. Previous studies have examined the influence of the extract on leukocyte function, e.g. respiratory burst. The effect of garlic on thrombocyte aggregation has also been recently described as has an anti-fungal effect. To our knowledge, nothing is known about the effect of garlic leukocyte transmigration. Therefore, we aimed to examine the effects of garlic extract on leukocyte transmigration through ECM in an in-vitro cell co-culture system.

Assessment of right ventricular function by right ventricular systolic time intervals in acute respiratory failure

OBJECTIVE

Whether right ventricular systolic time intervals accurately reflect right ventricular function in patients with acute respiratory failure was determined by assessing the correlation between right ventricular systolic time intervals and the right ventricular end-systolic pressure-volume relationship.

DESIGN

A prospective study.

SETTING

A surgical intensive care unit in a university hospital.

PATIENTS

Twenty patients with acute respiratory failure.

MEASUREMENTS AND MAIN RESULTS

Right ventricular systolic time intervals were determined by the simultaneous graphic display of the electrocardiogram, the phonocardiogram, and the pulmonary artery pressure curve and were expressed as a ratio of the pre-ejection period/right ventricular ejection time. The total electromechanical systole was measured from the onset of the electrocardiographic wave complex to the pulmonic component of the second heart sound. Right ventricular ejection time was measured from the rapid upstroke of the pulmonary artery pressure curve to the dicrotic notch. Right ventricular ejection fraction, from which right ventricular end-systolic volume was derived, was measured by the thermodilution technique. Pulmonary artery dicrotic notch pressure was used as an estimate of right ventricular end-systolic pressure. Data were collected at the baseline and after one or two alterations in preload, to define the right ventricular end-systolic pressure-volume relationship line. There was an inverse correlation between the pre-ejection period/right ventricular ejection time ratio and the slope of the right ventricular end-systolic pressure-volume relationship line (r2 = .67; p < .0001). When patients were divided into two groups, based on the pre-ejection period/right ventricular ejection time ratio, the slope of the right ventricular end-systolic pressure-volume relationship line was lower in the group with a high pre-ejection period/right ventricular ejection time ratio (p < .0001). No difference in other hemodynamic data, between the two groups, was noted.

CONCLUSIONS

These data suggest that right ventricular systolic time intervals reflect right ventricular performance accurately in patients with acute respiratory failure.

Cardiac surgery in patients with protamine allergy

Intravenous administration of protamine is associated with risk of severe anaphylactic and anaphylactoid reactions. In this review the incidence, pathophysiology, clinical management, and strategies for prevention of protamine reactions are addressed.

Anaesthesia for the patient with acquired immune deficiency syndrome--a review

Acquired immunodeficiency syndrome affects over 10 million persons worldwide. The disease represents an enormous cost to society in health care resources and in loss from the workforce. Although initially reported in 1980 as a disease affecting mainly homosexuals and intravenous drug abusers with a predominance in males, the male to female ratio was close to parity by 1992. The disease attacks all systems in the body. Preanaesthetic evaluation focuses on assessment of lung function and presence of infection, evaluation of endocarditis and treatment of congestive failure, rehydration and correction of electrolyte imbalances, transfusion and documentation of central nervous system manifestations. The Center for Disease Control and Prevention has produced guidelines to protect health care workers from transmission of the virus. Although the risk of infection is extremely low, these precautions should be routinely adopted.

Perioperative management of the head trauma patient

Realizing that miracle drugs that can reverse severe brain damage have not yet been identified, studies in recent years have focused on identifying risk factors for head trauma and resuscitative events that might impede or improve outcome. Risk factors for poor outcome include advanced age, alcoholism, delay in transfer and operation, management errors and technical mistakes. Quality assurance programmes, now established in all United States hospitals, may be flawed in that assessments of preventable trauma deaths are often based on unsubstantiated subjective case review methods. Studies of the cerebral effects of anaesthetic agents have reconfirmed the detrimental effects of nitrous oxide in the trauma victim. Ketamine, a N-methyl D-aspartate receptor antagonist, has shown surprising cerebral protective effects in animal models. Appropriate fluid therapy after head injury requires avoidance of sugar-containing solutions, maintenance of normovolaemia and consideration of use of hypertonic solutions to maintain vascular volume. Although hypothermia continues to be an appealing means of affording brain protection after head injury, the degree and duration have still not been established. Establishment of the airway in the neck injured patient should be by careful endotracheal tube placement which causes less cervical movement than mask ventilation and less risk of infection or trauma than the nasotracheal route.

Extracorporeal shock wave lithotripsy of gall stones: an in vitro comparison between an electrohydraulic and a piezoceramic device

A comparative study of the effectiveness of two types of lithotripter in fragmenting gall bladder stones is reported. The machines used were a Piezolith 2300, which generates shock waves by the piezoceramic principle, and a Dornier MPL 9000, which produces the shock waves by underwater spark discharge. With each machine, corresponding stones of 45 pairs of weight and volume matched calculi (median volume 0.5 cm3, median diameter 10.5 mm) obtained at cholecystectomy were treated. All stones were successfully disintegrated (fragments smaller than 2 mm) with up to 5400 (median 628) shocks with the Piezolith and 3450 (median 428) shocks with the MPL 9000 lithotripters. With the Piezolith, operating at the highest power setting, a 1.65 fold median higher number of shocks was required for stone fragmentation than with the MPL 9000 at a medium power setting. Stone volume seemed to be the only determinant which affected ease of fragmentation; composition and density of the stones as assessed by computed tomography did not seem to be governing factors.

The lessons from in vitro lithotripsy for the clinical treatment of gallstones

Fifty-eight gallbladder stones were treated in vitro, using a Wolf Piezolith 2300 lithotripter, to discover whether complete fragmentation (i.e., no particles greater than 2 mm diameter) could be achieved by lithotripsy alone. In 16 stones this was accomplished with up to 6000 shocks being administered. The degree of fragmentation was judged first by eye during the experiment and then by both microscopy and sieving of the debris. Eye judgement proved to be an unreliable indicator with 23 of the 42 stones in the failed lithotripsy group receiving 6000 shocks or less. Cholesterol analysis and high resolution radiography revealed no significant differences between the successfully and unsuccessfully fragmented stones, but X-ray diffractometry did show a higher incidence of inorganic calcium salts in the latter group. This study shows that lithotripsy can successfully fragment gallbladder stones, but that a minimum of 6000 shocks, using the Piezolith 2300, should be given to ensure adequate treatment. Additionally, the presence of radiopaque stones does not necessarily preclude successful treatment by this method.

Moyamoya disease: pathophysiology and anesthetic management

Moyamoya disease, an ischemic cerebrovascular disease, is characterized by a slowly increasing bilateral occlusion of the internal carotid circulation. Although collateral pathways are formed, therapy is aimed at further increasing blood flow by surgical anastomosis before ischemic events and fixed neurologic defects occur. This disease remains one of the few indications for performance of the operation of superficial temporal artery to middle cerebral artery anastomosis. Anesthetic considerations involve increasing substrate supply and decreasing demand for its use. Two cases of moyamoya disease are described, noteworthy not only because of the rarity of the disease but because of its occurrence in the Hispanic race rather than the traditional appearance in those only of Japanese descent. The anesthetic management is outlined and the literature reviewed.

Effect of suxamethonium on the ICP of cats with and without thiopentone pretreatment

Twelve cats were assigned equally to two groups, one with normal, and the other with artificially-increased intracranial pressure. When suxamethonium was administered to these animals, the intracranial pressure increased in both groups, irrespective of their baseline intracranial pressure. When the same dose of suxamethonium was administered after pretreatment with thiopentone in both groups of animals, the intracranial pressure again increased from the control values.

Some inquiries in neuroanesthesia and neurological supportive care

Complications of performing neurosurgery in the sitting position have been well defined, and include cardiac and respiratory effects, air embolism, and pneumocephalus. Prophylactic measures and early diagnosis allow prompt therapy with minimal residual sequelae. All anesthetic agents and techniques alter the intracranial dynamics. A clear understanding of drug effects and the pathology involved allow a rational choice of anesthetic management to maximize the potential for a good outcome. Patients with cerebrovascular disorders frequently have multisystem disease, and careful preanesthetic assessment and preparation ensure a more stable intraoperative and postoperative course. Many chemical and mechanical reactions follow an ischemic hypoxic insult, but appropriate therapeutic intervention and early establishment of cardiorespiratory support measures have shown promise in improving the neurological outcome in these patients.

Anaesthetic considerations in patients with mitral valve prolapse

Mitral valve prolapse (MVP), reported as occurring in up to 17% of healthy individuals, is considered to be the commonest cardiac valvular abnormality. Although the anaesthetic course may be uneventful, complications may arise for the first time in the peri-operative period and include life threatening dysrhythmias, mitral regurgitation and infective endocarditis. Anaesthetic management of three of the seven patients with MVP treated at our institution over a 12-month period is discussed and the literature reviewed.