New types of fish feed based on processed animal proteins (PAPs), insect meal, yeast, and microbial biomasses have been used with success in gilthead sea bream. However, some drawback effects on feed ...conversion and inflammatory systemic markers were reported in different degrees with PAP- and non-PAP-based feed formulations. Here, we focused on the effects of control and two experimental diets on gut mucosal-adherent microbiota, and how it correlated with host transcriptomics at the local (intestine) and systemic (liver and head kidney) levels. The use of tissue-specific PCR-arrays of 93 genes in total rendered 13, 12, and 9 differentially expressed (DE) genes in the intestine, liver, and head kidney, respectively. Illumina sequencing of gut microbiota yielded a mean of 125,350 reads per sample, assigned to 1,281 operational taxonomic unit (OTUs). Bacterial richness and alpha diversity were lower in fish fed with the PAP diet, and discriminant analysis displayed 135 OTUs driving the separation between groups with 43 taxa correlating with 27 DE genes. The highest expression of intestinal
pcna
and
alpi
was achieved in PAP fish with intermediate values in non-PAP, being the pro-inflammatory action of
alpi
associated with the presence of
Psychrobacter piscatorii
. The intestinal
muc13
gene was down-regulated in non-PAP fish, with this gene being negatively correlated with anaerobic (Chloroflexi and
Anoxybacillus
) and metal-reducing (
Pelosinus
and
Psychrosinus
) bacteria. Other inflammatory markers (
igm, il8, tnf
α) were up-regulated in PAP fish, positively correlating the intestinal
igm
gene with the inflammasome activator
Escherichia/Shigella
, whereas the systemic expression of
il8
and
tnf
α was negatively correlated with the Bacilli class in PAP fish and positively correlated with
Paracoccus yeei
in non-PAP fish. Overall changes in the expression pattern of
il10
, galectins (
lgals1, lgals8
), and toll-like receptors (
tlr2, tlr5, tlr9
) reinforced the anti-inflammatory profile of fish fed with the non-PAP diet, with these gene markers being associated with a wide range of OTUs. A gut microbiota-liver axis was also established, linking the microbial generation of short chain fatty acids with the fueling of
scd1
- and
elovl6
-mediated lipogenesis. In summary, by correlating the microbiome with host gene expression, we offer new insights in the evaluation of fish diets promoting gut and metabolism homeostasis, and ultimately, the health of farmed fish.
Background & Aims: Myelosuppression in patients with Crohn's disease (CD) treated with azathioprine has been attributed to low activity of thiopurine
S-methyltransferase (TPMT). Allelic variants of ...the TPMT gene responsible for changes in the enzyme activity have been characterized. We investigated the distribution of mutant alleles associated with TPMT deficiency in patients with CD and myelosuppression during azathioprine/6-mercaptopurine therapy.
Methods: Forty-one patients with CD were included. They developed leukopenia or thrombocytopenia during azathioprine or 6-mercaptopurine treatment. Polymerase chain reaction–based methods were used to search for mutations associated with TPMT deficiency.
Results: Four patients (10%) had 2 mutant alleles associated with TPMT deficiency, 7 (17%) had 1 mutant allele, and 30 (73%) had no known TPMT mutation. The delay between administration of the drug and occurrence of bone marrow toxicity was less than 1.5 months in the 4 patients with 2 mutant alleles, and ranged from 1 to 18 months in patients with 1 mutant allele and from 0.5 to 87 months in patients with normal genotype.
Conclusions: Twenty-seven percent of patients with CD and myelosuppression during azathioprine therapy had mutant alleles of the TPMT gene associated with enzyme deficiency. Myelosuppression is more often caused by other factors. Continued monitoring of blood cell counts remains mandatory in patients treated with azathioprine.
GASTROENTEROLOGY 2000;118:1025-1030
Abstract
Introduction and objectives
Readmission rates at 30 days after heart failure (HF) hospitalizations are high. Disease management programs have shown to reduce them; however, the results of ...clinical trials are difficult to extrapolate to the entire population with HF. Our hospital has a multidisciplinary program for HF management (MHFP) led by the Cardiology Department, based on early post-discharge follow-up in a day hospital, for clinical-analytical assessment, optimization and titration of pharmacological treatment, structured education, promotion of self-care and intravenous treatment if appropriate. The objective of this study is to assess the impact of the MHFP on our patients all cause 30-day readmission rate (MHFP group), compared with the rest of our region (control group).
Methods
All discharges with HF as main diagnosis in our region were analysed through anonymized consultation of the Minimum Basic Data Set (an administrative public data base) in the period 2009–2015. The first admission of each patient in the period was identified as index admission. Patients who died in the index admission were excluded. Epidemiological characteristics, comorbidities and hospital stay were compared in the two groups. The outcome variable was the time to first readmission in the first 30 days after discharge. Quantitative variables were compared using Student's t and categorical variables with χ2. Cox method was used for multivariate analysis.
Results
We included 62,162 patients, 1,447 in the MHFP group and 60,715 in the control group. Epidemiological characteristics and main comorbidities were compared, and the results are shown in the table. Readmission rate was significantly lower in the MHFP group (13.5 vs 16%, HR 0.85, 95% CI 0.74–0.98 in multivariate analysis). The variables independently associated with an increase in readmissions at 30 days were age adjusted Charlson index, hospital length of stay in index admission and several comorbidities (obstructive pulmonary disease, myocardial infarction, and renal failure)
Conclusions
Over a period of 6 years, a MHFP significantly reduced 30-day readmissions after admission for HF, in its reference area. The generalization of these programs could have a relevant impact on costs reduction.
Funding Acknowledgement
Type of funding sources: None.
Direct consequences of biological invasions on biodiversity and the environment have been largely documented. Yet collateral indirect effects mediated by changes in agri-environmental policies aimed ...at combating invasions remain little explored. Here we assessed the effects of recent changes in water management in rice farming, which are aimed at buffering the impact of the invasive apple snail (
Lamarck) on greenhouse gas emissions and diversity of waterbird communities. We used observational data from a 2-year field monitoring (2015-2016) performed at the Ebro Delta regional scale. We found that drying rice fields reduced methane emission rates by 82% (2015) and 51% (2016), thereby reflecting the contribution of rice farming to climate change. However, there was a marked reduction (75% in 2015 and 57% in 2016) in waterbird diversity in dry fields compared with flooded fields, thus suggesting that post-invasion policies might hinder biodiversity conservation. Our results highlight the need for accounting for potential collateral effects during the policy decision-making process to design efficient agricultural management plans that lessen undesirable agri-environmental outcomes.
Numerous studies have shown the presence of pharmaceutically active compounds (PhACs) in different environmental compartments, for example, in surface water or wastewater ranging from nanograms per ...litre to micrograms per litre. Likewise, some recent studies have pointed to seasonal variability, thus indicating that PhAcs concentrations in the aquatic environment may depend on the time of year. This work intended to find out (1) whether Tagus fluvial and drinking water were polluted with different groups of PhACs and (2) if their concentrations differed between winter and summer seasons. From the 58 substances analysed, 41 were found belonging to the main therapeutic groups. Statistical differences were seen for antibacterials, antidepressants, anxiolytics, antiepileptics, and cardiovascular drugs, with higher concentrations being detected in winter than in summer. These results might indicate that the PhACs analysed in this study undergo lower environmental degradation in winter than in summer. In order to confirm these initial results, a continuous monitoring should be performed especially on those PhACs that either because of an elevated consumption or an intrinsic chemical persistence are poorly degraded during winter months due to low temperatures and solar irradiation. It is especially important to identify which of these specific PhACs are in order to recommend their substitution by equally effective and safe substances but also environmentally friendly.
Oral Diseases (2010) 16, 257–262
Objective: To analyse the influence of several prenatal and neonatal risk factors in the development of enamel defects in low birth weight children.
Subjects and ...methods: Children between 4 and 5 years of age (n = 102) were classified into: Group 1) 52 low birth weight (<2500 g); Group 2) 50 normal birth weight (≥2500 g). Medical history, prenatal and neonatal variables were collected. Enamel defects were evaluated with the modified Developmental Defects of Enamel Index.
Results: The prevalence of hypoplasia and average number of affected teeth were significantly higher in group 1 than in group 2 (59.6%vs 16% and 1.6 vs 0.3 respectively). Low gestational age was linked to a higher prevalence of hypoplastic (P = 0.027) and combined defects (P = 0.001). Children with neonatal risk factors (low Apgar scores, parenteral nutrition, orotracheal intubation, mechanical ventilation and acidosis) developed defects more frequently (P < 0.05). Defects were symmetrically distributed in children who were not intubated; in those who required intubation they concentrated on the left maxillary teeth (P < 0.05). Smoking during pregnancy, young maternal age and multiple birth were significantly associated to developmental defects.
Conclusions: The prevalence of enamel defects in primary dentition is significantly influenced by birth weight, gestational age and several systemic factors. Orotracheal intubation probably plays an important role as a result of laryngoscope trauma on the maxilla.
The purpose of this study was to compare the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) with spiral computed tomography (SCT) for the characterization of focal liver lesions (FLL) and ...to determine the degree of correlation between the two techniques. Seventy-seven FLL (45 hepatocellular carcinomas; 12 metastases; ten hemangiomas; two regenerating/dysplastic nodules; eight focal nodular hyperplasias) detected with ultrasound (US) were prospectively evaluated by CEUS using a second-generation contrast agent and SCT (with an interval of no more than one month between the two techniques). Independent observers made the most probable diagnosis and the results were compared with the final diagnoses (histology n = 59; MRI n = 18). Statistical analysis was performed by the Chi-square and Kappa tests. CEUS provided a correct, specific diagnosis in 69/77 (90%) of the FLL, while SCT did so in 67/77 (87%). The sensitivity, specificity, and diagnostic accuracy for malignancy were 91%, 90%, and 91%, respectively, for CEUS and 88%, 89%, and 88%, respectively, for SCT. No statistically significant difference was found between CEUS and SCT in the characterization of FLL (p > 0.05). In addition, agreement between the two imaging techniques was good (k = 0.75). We conclude that CEUS and SCT provide a similar diagnostic accuracy in the characterization of FLL, with a good degree of correlation between the two techniques.
To evaluate the ability of the American Joint Committee on Cancer (AJCC) 8th edition to predict local tumor control and globe salvage for children with retinoblastoma (RB).
International, ...multicenter, registry-based retrospective case series.
A total of 2854 eyes of 2097 patients from 18 ophthalmic oncology centers from 13 countries over 6 continents.
International, multicenter, registry-based data were pooled from patients enrolled between January 2001 and December 2013. All RB eyes with adequate records to allow tumor staging by the AJCC 8th edition criteria and follow-up to ascertain treatment outcomes were included.
Globe-salvage rates were estimated by AJCC clinical (cTNMH) categories and tumor laterality. Local treatment failure was defined as use of enucleation or external beam radiation therapy (EBRT), with or without plaque brachytherapy or intra-arterial chemotherapy (IAC).
Unilateral RB occurred in 1340 eyes (47%). Among the 2854 eyes, tumor categories were cT1 to cT4 in 696 eyes (24%), 1334 eyes (47%), 802 eyes (28%), and 22 eyes (1%), respectively. Of these, 1275 eyes (45%) were salvaged, and 1179 eyes (41%) and 400 eyes (14%) underwent primary and secondary enucleation, respectively. The 2- and 5-year Kaplan-Meier cumulative globe-salvage rates without the use of EBRT by cTNMH categories were 97% and 96% for category cT1a tumors, 94% and 88% for cT1b tumors, 68% and 60% for cT2a tumors, 66% and 57% for cT2b tumors, and 32% and 25% for cT3 tumors, respectively. Risk of local treatment failure increased with increasing cT category (P < 0.001). Cox proportional hazards regression analysis confirmed a higher risk of local treatment failure in categories cT1b (hazard ratio HR, 3.5; P = 0.004), cT2a (HR, 15.1; P < 0.001), cT2b (HR, 16.4; P < 0.001), and cT3 (HR, 45.0; P < 0.001) compared with category cT1a. Use of plaque brachytherapy and IAC improved local tumor control in categories cT1a (P = 0.031) and cT1b (P < 0.001).
Multicenter, international, internet-based data sharing validated the 8th edition AJCC RB staging to predict globe-salvage in a large, heterogeneous, real-world patient population with RB.
Hip dysplasia has been associated with risk factors such as breech presentation, female gender or family history. However, external factors, such as the use of baby carriers, seem to influence the ...development of the hip in the first months of life. The aim of this study is to evaluate the position of the hips of babies placed in different types of baby carriers by ultrasound image.
An ultrasound study of the hips of healthy babies between 1.5 and 3.5 months of age was carried out, when the children were carried in three different baby backpacks, which provide different degrees of support for the babies' thighs. All hips were typeI according to the Graf classification. Graf's alpha angle, acetabular coverage and distance to the pubis were assessed at baseline (examination table) and when the children were carried in the three different backpacks.
In all cases, the babies showed normal values in the three studied parameters, without statistically significant differences between any of the situations. There were also no differences in the ultrasound parameters related to the sex, age or weight of the baby.
The right hip of the babies shows normal ultrasound parameters when placed in any of the baby carriers studied.
Thermophilic Campylobacter spp. are recognized as a major cause of acute bacterial diarrhea in humans, with broiler meat being the most common source of human infection. Antibiotic therapy is usually ...necessary for severe or prolonged infections, especially in immunocompromised populations such as young or elderly individuals. However, different studies have demonstrated a close association between antibiotic use in animal production and antimicrobial resistance (AMR) in humans. In this sense, there is social pressure to reduce antibiotic administration and find adequate alternatives to control the presence of bacterial infections in farms. However, there is a lack of information related to Campylobacter AMR dynamics through the entire production system from breeders to their progeny. It is unknown if resistance genes are a result of adaptation through chromosomal mutation or through horizontal gene transfer, instead of vertical transmission of DNA from the parent to their progeny. Thus, the main objectives of this study were to assess the main AMR rates present in a poultry production system, to study the relationship between Campylobacter AMR profiles from breeders and their progeny, and to study the presence and distribution of antibiotic resistance genes in poultry production. Regarding AMR rates, ciprofloxacin was classified as extremely high, followed by nalidixic acid and tetracyclines that were classified as very high. Moreover, this study demonstrated a relationship between the AMR patterns and genes found from Campylobacter strains isolated in breeders and those present in their progeny.
PDF
