Use of blend based on an emulsifier, monolaurin, and glycerides of butyric acid in the diet of broilers: impacts on intestinal health, performance, and meat

The objective of this study was to evaluate whether the addition of a blend based on α-monolaurin mono-, di- and triglycerides of butyric acid, and lysolecithin on the performance even on diets containing reduced inclusion of oil in the diet and without the use of growth-promoting antibiotics of broilers considering the effect on health, performance, and meat. Three treatments were defined: positive control (TP: with enramycin), negative control (TN: no enramycin), and blend (T-FRA: with monolaurin and glycerides of acid butyric minus 0.8% soybean oil). At 21 days, broilers treated with TP and T-FRA obtained the lower feed conversion ratio (FC); at 35 days, T-FRA broilers obtained lower FC than TN broilers. Cholesterol levels were higher in the blood of T-FRA broilers. On day 42, levels of ROS and TBARS were lower in the intestine, muscles, and liver of T-FRA broilers. Moreover, glutathione S-transferase and total non-enzymatic antioxidants were greater at the intestinal and muscular levels. The T-FRA broilers had a lower percentage of lipids in the meat. The MIC indicated that 111mg of the blend/mL inhibited the growth of E. coli; however, the counts of total coliforms and E. coli in the feces and the broilers' litter did not differ between treatments. In conclusion, the addition of the blend T-FRA in broiler diets was able to improve the feed conversion and maintain the other performance parameters even considering a reduction of 0.8% in the inclusion of oil.

[Large Pneumothorax in a Sleep Apnea Patient with CPAP without Previously Known Lung and Thoracic Diseases - a Case Report]

CPAP is the most common treatment for obstructive sleep apnea.Serious complications from this treatment are very rare. Pneumothorax following lung barotrauma under CPAP therapy has been described in case reports only in patients with pre-existing lung and thoracic diseases.A 68-year-old sleep apnea patient without pre-existing lung or thoracic diseases and with established CPAP therapy since many years was admitted to the hospital after a severe thoracic pain event with persistent shortness of breath. Chest radiograph and computed tomography showed an extensive right-sided pneumothorax with basal bullous emphysema. After surgical treatment of the secondary spontaneous pneumothorax, on the third postoperative day CPAP with reduced pressure was re-introduced with satisfactory sleep apnea findings and without pneumothorax recurrence.As possible cause of pneumothorax in the patient, alveolar inflammatory changes due to over-distention and increased pressure in the alveoli was assumed, which can occur after years of CPAP treatment with gradual pressure increase.In summary, in sleep apnea patients treated with CPAP for years, after sudden onset of thoracic pain and shortness of breath possible spontaneous pneumothorax should be considered.

Biomarkers of exposure to metal dust in exhaled breath condensate: methodology optimization

In occupational assessments where workers are exposed to metal dust, the liquid condensate of exhaled breath (EBC) may provide unique indication of pulmonary exposure. The main goal of this study was to demonstrate the quality of EBC to biological monitoring of human exposure. A pilot study was performed in a group of metal dust-exposed workers and a group of nonexposed individuals working in offices. Only metal dust-exposed workers were followed along the working week to determine the best time of collection. Metal analyses were performed with inductively coupled plasma mass spectrometry (ICP-MS). Analytical methodology was tested using an EBC sample pool for several occupationally exposed metals: potassium, chromium, manganese, copper, zinc, strontium, cadmium, antimony, and lead. Metal contents in EBC of exposed workers were higher than controls at the beginning of the shift and remained augmented throughout the working week. The results obtained support the establishment of EBC as an indicator of pulmonary exposure to metals.

Elevated serum C-reactive protein as a predictive factor for anastomotic leakage in colorectal surgery

BACKGROUND

C-reactive protein (CRP) has been used as an indicator of postoperative complications in abdominal surgery. Its short half-life makes it a reliable marker of the systemic inflammatory response secondary to a surgical procedure or to the appearance of complications, rapidly returning to normal values with the recovery of the patient.

AIM

To demonstrate the value of sequential serum determinations of postoperative C-reactive protein (CRP) and white blood cell counts (WBC) in the identification of increased risk of anastomotic leakage after colorectal surgery.

METHODS

We reviewed the daily postoperative serum CRP and white blood cell counts in 173 patients who underwent surgery for colorectal disease with anastomosis, between January 2008 and October 2009. Patients with anastomotic leakage (Group A, n = 24) were compared to patients without leakage (Group B, n = 149). Patients with ongoing infections before surgery or with acquired postoperative infections other than leakage were excluded. Mean pre- and postoperative values of CRP and WBC were compared.

RESULTS

The diagnosis of anastomotic leakage was made between the 4th and 11th postoperative day (POD; mean 7th POD). The daily average values of serum CRP were significantly higher in group A starting at the 2nd POD and remained significantly elevated until the diagnosis of leakage (p = 0.003). The cut-off value of 140 mg/L on the 3rd POD maximized the sensitivity (78%) and specificity (86%) of serum CRP in assessing the risk of leakage. Comparison of postoperative serum WBC values did not show any significant differences between the two groups until the 6th POD.

CONCLUSION

According to these results, an early and persistent elevation of CRP after colorectal surgery with anastomosis, is a marker of anastomotic leakage. A cut-off value > 140 mg/L on POD3 maximizes sensitivity and specificity.

Gastroprotective effect of aparisthman, a diterpene isolated from Aparisthmium cordatum, on experimental gastric ulcer models in rats and mice

Aparisthmium cordatum (Juss.) Bail. (Euphorbiaceae), known in the State of Pará, Brazil as "ariquena queimosa", is a medium-sized tree which is native to the North Brazilian coastal region. Previous phytochemical studies of the bark of A. cordatum yielded a furan diterpenoid with a clerodane skeleton, called aparisthman. Recently, we reported the antiulcerogenic activity of trans-dehydrocrotonin (DHC), a furan diterpene isolated from Croton cajucara bark, in different ulcerogenic models in mice and rats. The aim of the present study was to assess the possible antiulcerogenic activity of aparisthman. When previously administered (p.o.) at the dose of 100 mg/kg(-1), aparisthman reduced significantly (p < 0.01) gastric injury induced by the indomethacin/bethanechol (71%), ethanol (71%), pylorus ligature, (59%) and hypothermic restraint-stress models (50%), in mice and rats. In the HCl/ethanol-induced gastric ulcer model in mice, at oral doses of 100 and 250 mg/kg(-1), aparisthman from A. cordatum reduced significantly (p < 0.001) the formation of gastric lesions by 59% and 66%, respectively, as compared with control. In the pylorus-ligature model, aparisthman (p.o.) decreased the volume of gastric juice as compared with control (p < 0.001). When aparisthman (100 mg/kg(-1)) was administered intraduodenally to mice, significant modifications were found, such as a decrease in gastric acidity as compared with control. In the animals pre-treated with aparisthman, free mucus production increased by 19% in the gastric mucosa (p < 0.05). The results suggest that aparisthman from A. cordatum presents a significant anti-ulcer effect when assessed in these induced ulcer models. Although the mechanism underlying this antiulcerogenic effect remains unknown, it seems to be related to an increase of the defensive mechanisms of the stomach such as prostaglandin synthesis and mucus production. The good yield of aparisthman obtained from A. cordatum, as well as its antiulcerogenic activity, suggest that this compound should be submitted to pharmacological research as a potential new antiulcerogenic drug.

Hepatic enzymes' level during chronic use of anticonvulsant drugs

We studied retrospectively 894 adult epileptic patients treated during the period from 1983 to 1992. Hepatic enzymes abnormal values were seen in 49% (n = 438). In 22.3% (n = 200), at least 2 enzyme levels in different moments were altered. They were divided in three groups: GI with alterations at transaminases (3%, n = 6), GII with alterations at GGT and AP enzymes (72%, n = 144) and GIII with alterations in both groups (25%, n = 50). No patient developed clinical symptoms of liver disease. The increase of gamma-glutamil-transferase (GGT) and alkaline phosphatase (AP) levels is frequent and not necessarily pathological. Slight increase of transaminases can occur with no clinical correlation. The routine screening of hepatic enzymes level during the chronic use of anticonvulsivant drugs in adults has a questionable value.