Evaluation of Megasphaera elsdenii supplementation on rumen fermentation, production performance, carcass traits and health of ruminants: A meta-analysis

Objective

This study was conducted to evaluate the use of Megasphaera elsdenii as a probiotic on rumen fermentation, production performance, carcass traits and health of ruminants by integrating data from various related studies using meta-analysis.

Methods

A total of 32 studies (consisted of 136 data points) were obtained and integrated into a database. The parameters integrated were fermentation products, rumen microbes, production performance, carcass quality, animal health, blood and urine metabolites. Statistical analysis of the compiled database used a mixed model methodology. Different studies were considered random effects, while M. elsdenii supplementation doses were considered fixed effects. P-values and the Akaike information criterion were employed as model statistics. The model was deemed significant at p < 0.05 or had a tendency to be significant when p-value between 0.05 < p < 0.10.

Results

Supplementation with M. elsdenii increased (p<0.05) some proportion of fermented rumen products such as propionate, butyrate, isobutyrate, and valerate, and significantly reduced (p<0.05) lactic acid concentration, acetate proportion, total bacterial population and methane emission. Furthermore, the probiotic supplementation enhanced (p<0.05) livestock production performance, especially in the average daily gain and body condition score. Regarding the carcass quality, hot carcass weight and carcass gain were elevated (p<0.05) due to the M. elsdenii supplementation. Animal health also showed improvement as indicated by the lower (p<0.05) diarrhoea and bloat incidences as well as the liver abscess. However, M. elsdenii supplementation had negligible effects on blood and urine metabolites of ruminants.

Conclusion

Supplementation of M. elsdenii is capable of decreasing ruminal lactic acid concentration, enhancing rumen health, elevating some favourable rumen fermentation products, and in turn, increasing production performance of ruminants.

Modification of dietary rumen degradable starch content by chemical processing of feed ingredients: A meta-analysis

The efficiency of starch utilization in ruminant feed can be enhanced by reducing the degradation of starch in the rumen. Chemical processing of feed ingredients may modify such ruminal starch degradation. This study aimed to evaluate the chemical processing of ruminant feed ingredients on rumen degradable starch (RDS) and starch degradation kinetics in the rumen. A database was constructed from a total of 34 articles, consisted of 100 observations. The articles were searched and identified from the Scopus platform. Data were analyzed by using the fixed effect model. The types of chemical processing in this study included sodium hydroxide, ammonia, potassium aluminum, urea, formaldehyde, and organic acid. Results indicated that chemical processing significantly reduced the RDS content (p < 0.001) and the immediately soluble fraction (p < 0.001) and increased the value of slowly degradable fraction (p < 0.001) and starch absorption in the small intestine (p < 0.01). Formaldehyde was particularly effective to decrease the RDS (p < 0.05). The RDS contents in corn and wheat were reduced by the chemical processing (p < 0.05), but not with that of barley. It can be concluded that chemical processing is effective in reducing starch degradation of ruminant feeds and may enhance its utilization by ruminants.

Interstitial lung disease in patients with hepatopulmonary syndrome: a case series and new observations

Hepatopulmonary syndrome (HPS) is characterized by impaired oxygenation due to pulmonary vascular dilatation in patients with end-stage liver disease. At our center, we identified 29 patients who were listed for liver transplantation (LT) with a model for end-stage liver disease exception for HPS between 2001 and 2012. Five of these patients were found to have concurrent interstitial lung disease (ILD). The chest high-resolution computed-tomography demonstrated ground-glass opacities and subpleural reticulation, most consistent with nonspecific interstitial pneumonia (NSIP). All four of our patients who underwent LT experienced prolonged hypoxemia postoperatively, with one surgery-related death. However, the three surviving patients had eventual resolution of their hypoxemia with no evidence of ILD progression. In conclusion, we report a high prevalence of ILD, most consistent with NSIP, among patients with HPS. Although there may be increased perioperative risks, the finding of ILD in patients with HPS should not be considered an absolute contraindication to LT.

Pulmonary artery systolic pressures estimated by echocardiogram vs cardiac catheterization in patients awaiting lung transplantation

BACKGROUND

At many lung transplant centers, right heart catheterization and transthoracic echocardiogram are part of the routine pre-transplant evaluation to measure pulmonary pressures. Because decisions regarding single vs bilateral lung transplant procedures and the need for cardiopulmonary bypass are often made based on pulmonary artery systolic pressures, we sought to examine the relationship between estimated and measured pulmonary artery systolic pressures using echocardiogram and catheterization, respectively.

METHODS

We retrospectively reviewed all patients in our program who had measured pulmonary hypertension (n = 57). Patients with both echocardiogram-estimated and catheterization-measured pulmonary artery systolic pressures performed within 2 weeks of each other were included (n = 19). We analyzed results for correlation and linear regression in the entire group and in the patients with primary pulmonary hypertension (n = 8) and pulmonary fibrosis (n = 8).

RESULTS

In patients with primary pulmonary hypertension, pulmonary artery systolic pressure was 94 +/- 27 and 95 +/- 15 mm Hg by echocardiogram and catheterization, respectively, with r(2) = 0.11; in patients with pulmonary fibrosis, 57 +/- 23 and 58 +/- 12 mm Hg with r(2) = 0.22; and in the whole group, 76 +/- 29 and 75 +/- 23 mm Hg with r(2) = 0.50. Thirty-two additional patients had mean pulmonary artery systolic pressure = 48 +/- 16 mm Hg by catheterization but either had no evidence of tricuspid regurgitation by echocardiogram (n = 22) or the pulmonary artery systolic pressure could not be measured (n = 10).

CONCLUSIONS

In patients with pulmonary hypertension awaiting transplant, pulmonary artery systolic pressures estimated by echocardiogram correspond but do not serve as an accurate predictive model of pulmonary artery systolic pressures measured by catheterization. Technical limitations of the echocardiogram in this patient population often preclude estimating pulmonary artery systolic pressure.

A low incidence of posttransplant lymphoproliferative disorder in 109 lung transplant recipients

STUDY OBJECTIVES

The incidence of posttransplant lymphoproliferative disorder (PTLD) has been reported to range from 6.4 to 20% in lung transplant (LT) recipients. Postulated contributing factors include Epstein-Barr virus (EBV) infection and the use of immunosuppression, particularly muromonab-CD3 (OKT3)(Orthoclone OKT-3; Ortho Biotech; Raritan, NJ). We sought to examine these PTLD risk factors in 109 LT recipients at our institution who survived > 1 month.

DESIGN

Retrospective review of EBV serology of all LT recipients at our institution. Our standard transplant protocol includes OKT3 for induction and refractory rejection, as well as lifelong acyclovir for herpes prophylaxis. We do not perform EBV donor-recipient matching.

SETTING

A university-based LT center.

RESULTS

We found that 5 of 109 patients were serologically negative for EBV prior to lung transplantation, and all of these patients converted following lung transplantation. The mean time to conversion was 151 days (range, 11 to 365 days). One fatal case of PTLD was documented in an EBV seroconverter (one of five patients) 12 weeks status posttransplantation for lymphangioleiomyomatosis. One nonfatal extrathoracic PTLD was documented in a seropositive patient (1 of 104 patients) 33 months posttransplantation.

CONCLUSIONS

We conclude the following: (1) PTLD in LT recipients may have a lower incidence (2 of 109 patients; 1.8%) than previously reported, despite an aggressive immunosuppressive regimen; and (2) the incidence of PTLD is higher in patients with primary EBV infection (20% vs 1%).

Percutaneous dilation of tracheal stenosis

A high-grade complex tracheal stenosis distal to a tracheostomy tube occurred in a patient with a chronic vegetative state. The stenosis was easily and rapidly dilated at bedside using commercially available percutaneous tracheostomy kit dilators. Following tracheal dilation, a larger tracheostomy tube was inserted, resulting in the splinting of the stenotic area. To my knowledge, this is the first report of such a bedside technique for the dilation of a tracheal stenosis through a tracheostomy. This technique may provide a temporary relief from tracheal obstruction as long as the stenosis is within the reach of the dilator.

Use of balloon-expandable metallic stents in the management of bronchial stenosis and bronchomalacia after lung transplantation

STUDY OBJECTIVES

Bronchial stenosis (BS) and bronchomalacia (BM) are often associated with lung allograft rejection or infection in lung transplant (LT) recipients. We reviewed our experience using balloon-expandable metallic (Palmaz) stents in the management of BS and BM in LT.

DESIGN

Retrospective review of cases.

PATIENTS

LT recipients with bronchoscopic and spirometric evidence of BS and BM.

INTERVENTIONS

Serial balloon dilation was performed for BS. Stent placement was done for refractory or recurrent BS, or persistent focal BM.

RESULTS

Twelve of 129 LT bronchial anastomoses at risk (9.3%) had complications, which included 11 BS and 5 BM. Four BS were accompanied by BM either concurrently or subsequently. The only isolated BM was associated with acute rejection and resolved after appropriate medical therapy. Balloon dilations alone were successful in relieving BS in three cases. Seven patients received a total of 11 stents. Stents were placed under conscious sedation using a flexible bronchoscope. Five of the seven patients had spirometric improvements after stent placements. One patient had no spirometric improvement, and another died before a follow-up study was done. There were no complications during stent placements. However, complications after stent placements included partial dehiscence of the stent from the bronchial wall, stent migration, partial obstruction of a segmental bronchial orifice by a stent in the main bronchus, and longitudinal stent collapse. One stent was successfully removed using a flexible bronchoscope in the endoscopy suite, and two others were removed by rigid bronchoscopy in the operating room.

CONCLUSIONS

Endobronchial placement of the Palmaz stent in LT recipients is relatively easy, and it can be removed if needed. However, because there are significant potential complications, the future use of this stent as an airway prosthesis in LT remains unclear.

Metallothionein, glutathione, and cystine transport in pulmonary artery endothelial cells and NIH/3T3 cells

Both glutathione (gamma-glutamylcysteinylglycine; GSH) and the metalloprotein metallothionein (MT) are composed of approximately one-third cysteine. Both have antioxidant activity and are induced by oxidant stresses and heavy metals. Intracellular cysteine levels may depend on uptake and reduction of extracellular cystine. GSH synthesis can be limited by the activity of the xc- cystine transport system, which is induced by oxidants and other stresses. MT is induced by treatments that also increase GSH levels and may compete with GSH for intracellular cysteine. We investigated the induction of MT and GSH and cystine transport in NIH/3T3 cells and bovine pulmonary artery endothelial cells exposed to cadmium (Cd) or arsenite. Cd and arsenite increased MT and GSH in both cells. Increases in MT and GSH were accompanied by increases in cystine uptake. Inhibition of cystine transport by glutamate decreased GSH levels and blocked Cd-induced GSH increases in both cell types. MT levels were not significantly affected, suggesting that MT synthesis is less sensitive to intracellular cysteine levels than GSH synthesis.

Acute lupus pneumonitis with normal chest radiograph

Patients with acute lupus pneumonitis (ALP) usually have hypoxemia, patchy infiltrates evidenced on a chest x-ray film, and an incomplete response to corticosteroids with high mortality. In contrast, lupus patients with a syndrome of acute reversible hypoxemia (SARH) have hypoxemia with normal chest x-ray films and a rapid response to corticosteroids. We present a case of biopsy-proven ALP with normal initial chest x-ray films, and a normal CT scan. We hypothesize that a continuum of vascular and parenchymal abnormalities may exist in the lungs of lupus patients. This case also illustrates the insensitivity of routine chest radiographs in demonstrating mild or early pneumonitis.

Mechanisms of use of extracellular glutathione by lung epithelial cells and pulmonary artery endothelial cells

Cells in most culture media use cystine as the primary source of the cysteine precursor needed for glutathione (GSH) synthesis. As a result, GSH levels in many cultured cells may be limited by the rate of uptake of cystine into cells. We have shown that incubation with extracellular GSH can result in the reaction of GSH with cystine to generate cysteine, and that bovine pulmonary artery endothelial cells and lung type II epithelial cells transported cysteine more efficiently than cysteine. Cysteine transport was not affected by the presence of GSH. In cells incubated with GSH in RPMI-1640 there was a cystine-dependent increase in intracellular GSH levels. The increases in GSH were not prevented by the presence of acivicin, an inhibitor of the gamma-glutamyl transpeptidase reaction. Incubation with oxidized glutathione (GSSG) did not result in significant increases in intracellular GSH levels. We conclude that a primary mechanism by which extracellular GSH may increase intracellular GSH levels in cultured cells is by reducing cystine to cysteine, which is then rapidly transported and used as a substrate for intracellular GSH synthesis.

Risk factors for severe measles

A retrospective study on measles was carried out in 522 children admitted to the Department of Pediatrics, Sumber Waras Hospital, Jakarta during the period of January 1982-December 1986. Most of the subjects (91.1%) came from lower socio-economic levels, living in unfavorable environmental conditions in crowded housing. The predominant age group was 2-5 years; complications were observed in 82.6% and mortality in 10.3%. The most common complications and cause of deaths were bronchopneumonia (94.4%), encephalopathy (88.9%) and diarrhea (25.9%) or combinations thereof. The outcome of measles infections is determined by the presence of malnutrition and complications which is influenced by the nutritional intake, exposure, susceptibility and constitution of the patients. The household characteristics (socio-economic, socio-cultural and health facilities available) influence the above mentioned interactions through intermediate variables of nutrition (feeding pattern, food supplements), constitution, age) and treatment. Research and intervention on measles can be designed and planned based on this model of interactions.