Histopathological evaluation and risk factors related to the development of pouchitis in patients with ileal pouches for ulcerative colitis

OBJECTIVE: Many changes in mucosal morphology are observed following ileal pouch construction, including colonic metaplasia and dysplasia. Additionally, one rare but potential complication is the development of adenocarcinoma of the reservoir. The aim of this study was to evaluate the most frequently observed histopathological changes in ileal pouches and to correlate these changes with potential risk factors for complications. METHODS: A total of 41 patients were enrolled in the study and divided into the following three groups: a non-pouchitis group (group 1) (n = 20; 8 males; mean age: 47.5 years) demonstrating optimal outcome; a pouchitis without antibiotics group (group 2) (n = 14; 4 males; mean age: 47 years), containing individuals with pouchitis who did not receive treatment with antibiotics; and a pouchitis plus antibiotics group (group 3) (n = 7; 3 males; mean age: 41 years), containing those patients with pouchitis who were administered antibiotics. Ileal pouch endoscopy was performed, and tissue biopsy samples were collected for histopathological analysis. RESULTS: Colonic metaplasia was found in 15 (36.6%) of the 41 patients evaluated; of these, five (25%) were from group 1, eight (57.1%) were from group 2, and two (28.6%) were from group 3. However, no correlation was established between the presence of metaplasia and pouchitis (p = 0.17). and no differences in mucosal atrophy or the degree of chronic or acute inflammation were observed between groups 1, 2, and 3 (p > 0.45). Moreover, no dysplasia or neoplastic changes were detected. However, the degree of mucosal atrophy correlated well with the time of postoperative follow-up (p = 0.05). CONCLUSIONS: The degree of mucosal atrophy, the presence of colonic metaplasia, and the degree of acute or chronic inflammation do not appear to constitute risk factors for the development of pouchitis. Moreover, we observed that longer postoperative follow-up times were associated with greater degrees of mucosal atrophy.

Solanum americanum as a reservoir of natural enemies of the tomato red spider mite, Tetranychus evansi (Acari: Tetranychidae)

Brazilian populations of the pathogenic fungus Neozygites floridana (Weiser & Muma) Remaudiere & S. Keller (Entomophthoromycotina: Entomophthorales) and the predatory mite Phytoseiulus longipes Evans (Acari: Phytoseiidae) are potential candidates for introduction into Africa for classical biological control of the tomato red spider mite, Tetranychus evansi Baker & Pritchard (Acari: Tetranychidae). The efficiency of these natural enemies against T. evansi has been demonstrated under laboratory conditions, but little is known about their performance on native Solanaceae in the field. The American nightshade, Solanum americanum Mill., is native to the Americas and may serve as an alternative host plant for T. evansi and its natural enemies in the absence of tomato plants. In this work, we studied the population dynamics of T. evansi and its natural enemies on S. americanum in a screen house, semi-field and field plots in Recife, Pernambuco, Brazil, to evaluate the potential of natural enemies for controlling T. evansi. Of the four natural enemies found in association with T. evansi, only N. floridana and P. longipes were clearly associated with the reduction of the populations of T. evansi. Neozygites floridana was observed in a screen house, semi-field and field plots, but P. longipes was only detected in the semi-field plots. Increases in the population of T. evansi were always followed by increases in the density of one of these natural enemies, suggesting that they were important factors regulating T. evansi populations on S. americanum. The presence of this host plant near the release sites in Africa thus might increase the chances for the permanent establishment of these natural enemies.

Invasion of the dinoflagellate Ceratium furcoides (Levander) Langhans 1925 at tropical reservoir and its relation to environmental variables

Dinoflagellates of the genus Ceratium are chiefly marine but there are rare occurrences in freshwater. In this study we analyze the invasion and progressive establishment of Ceratium furcoides, an exotic species, in the Furnas Reservoir. Samples were taken at 36 points in the reservoir, during the months of March, June, September and December, 2007. Measurements of some physical and chemical variables were simultaneously performed at each site. The occurrence of C. furcoides was registered at 20 sites, with densities varying between 0.57 and 28,564,913.0 ind.m(-3). Blooms of this species were recorded in points which were classified as mesotrophic, coinciding with the places receiving high amounts of untreated domestic sewage. C. furcoides density was correlated with temperature, nutrients (nitrate and nitrite) and water electric conductivity. The highest density was recorded in June when temperature was low. The presence of Ceratium furcoides in the reservoir apparently has not yet affected the reservoir water quality or other plankton communities. However, if it becomes fully established it could perhaps become a problem in the reservoir or even to spread out to other reservoirs in Rio Grande basin.

Surgical Treatment of Type 2 Diabetes in Patients with BMI Below 35: Mid-term Outcomes of the Laparoscopic Ileal Interposition Associated with a Sleeve Gastrectomy in 202 Consecutive Cases

The objective of this study was to evaluate the mid-term outcomes of the laparoscopic ileal interposition into the jejunum (JII-SG) or into the duodenum (DII-SG) associated with sleeve gastrectomy for type 2 diabetes mellitus (T2DM) patients with BMI below 35. The procedures were performed on 202 consecutive patients. Mean age was 52.2 +/- 7.5. Mean duration of T2DM was 9.8 +/- 5.2 years. Insulin therapy was used by 41.1%. Dyslipidemia was observed in 78.2%, hypertension in 67.3%, nephropathy in 49.5%, retinopathy in 31.2%, coronary heart disease in 11.9%, and other cardiovascular events in 12.9%. Mean follow-up was 39.1 months (range, 25-61). Early and late mortality was 0.99% and 1.0%, respectively. Early reoperation was performed in 2.5%. Early and late major complications were 8.4% and 3.5%. Early most frequent complications were pneumonia and ileus. Intestinal obstruction was diagnosed in 1.5%. Mean BMI decreased from 29.7 to 23.5 kg/m(2), mean fasting glucose from 202.1 to 112.2 mg/dl, and mean postprandial glucose from 263.3 to 130 mg/dl. Triglycerides diminished from a mean of 273.4 to 110.3 mg/dl and cholesterol from a mean of 204.7 to 160.1 mg/dl. Hypertension was resolved in 87.5%. Mean hemoglobin A(1c) (HbA(1c)) decreased from 8.7 to 6.2% after the JII-SG and to 5.9% following the DII-SG. HbA(1c) below 7% was seen in 89.9% of the patients and below 6.5% in 78.3%. Overall, 86.4% of patients were off antidiabetic medications. Both JII-SG and DII-SG demonstrated to be safe, effective, and long-lasting alternatives for the treatment of T2DM patients with BMI < 35. Beyond glycemic control, other benefits were achieved.

Seasonal dynamics of cyanobacteria in a eutrophic reservoir (Arcoverde) in a semi-arid region of Brazil

Environmental conditions favor the predominance of dense populations of cyanobacteria in reservoirs in northeastern Brazil. The aim of this study was to understand cyanobacterial population dynamics in the rainy and dry seasons at two depths in the Arcoverde reservoir. Microalgae and cyanobacteria samples were collected during 24 hours with intervals of 4 hours (nycthemeral) at sub-surface and 10 m using a van Dorn bottle and a determined biomass. Physical and chemical variables were obtained and the data were analyzed using the principal component analysis (PCA). No nycthemeral variations in the taxonomic composition or distribution of the populations of cyanobacteria were found between the different times of day in either the rainy or dry season. In both seasons, the greatest biomass of the phytoplankton community was made up of cyanobacteria at two depths and all times of the day. Cylindrospermopsis raciborskii (Woloszynska) Seenayya et Subba Raju was dominant at all times of the day on both the surface and at the bottom. In the rainy season, the differences in cyanobacterial biomass between the surface and bottom were less significant than in the dry season. The differences in cyanobacterial biomass between surface and bottom were less pronounced than those found in the dry season. We concluded that a) physical variables better explain the alterations of species in the phytoplankton community in an environment dominated by cyanobacteria throughout the year; b) seasonal climatic factors associated to periods of stratification and de-stratification are important for alterations in the community and variations in biomass and, c) the turbidity caused by rainfall favored the emergence and establishment of other cyanobacteria, especially Planktothrix agardhii (Gomont) Anagnostidis & Komarek.

Calcium nitrate addition to control the internal load of phosphorus from sediments of a tropical eutrophic reservoir: Microcosm experiments

The main objective of this study was to perform laboratory experiments on calcium nitrate addition to sediments of a tropical eutrophic urban reservoir (Ibirite reservoir, SE Brazil) to immobilize the reactive soluble phosphorus (RSP) and to evaluate possible geochemical changes and toxic effects caused by this treatment. Reductions of 75 and 89% in the concentration of RSP were observed in the water column and interstitial water, respectively, after 145 days of nitrate addition. The nitrate application increased the rate of autotrophic denitrification, causing a consumption of 98% of the added nitrate and oxidation of 99% of the acid volatile sulfide. As a consequence, there were increases in the sulfate and iron (II) concentrations in the sediment interstitial water and water column, as well as changes in the copper speciation in the sediments. Toxicity tests initially indicated that the high concentrations of nitrate and nitrite in the sediment interstitial water (up to 2300 mg L-1 and 260 mg L-1, respectively) were the major cause of mortality of Ceriodaphnia silvestrii and Chironomus xanthus. However, at the end of the experiment, the sediment toxicity was completely removed and a reduction in the 48 h-EC50 of the water was also observed. Based on these results we can say that calcium nitrate treatment proved to be a valuable tool in remediation of eutrophic aquatic ecosystems leading to conditions that can support a great diversity of organisms after a restoration period. (C) 2012 Elsevier Ltd. All rights reserved.

Paleolimnologically inferred eutrophication of a shallow, tropical, urban reservoir in southeast Brazil

We studied the eutrophication history of a tropical shallow reservoir in the So Paulo metropolitan region, southeast Brazil. We analyzed grain size, geochemistry, diatom assemblages, and land-use records in a sediment core from the reservoir to infer its trophic state history during the last similar to 110 years (1894-2005). Eighty diatom species were observed in the core and shifts in the relative abundances of planktonic and benthic taxa indicate major limnological changes associated with complex interactions between hydrologic factors and eutrophication. Discostella stelligera was associated with deforestation and water physical changes whereas Aulacoseira granulata, a species abundant throughout the core, was mostly associated with high flux conditions and erosion events, regardless of trophic state. Eutrophication was triggered by construction of the city zoo (1958) and installation of the So Paulo State Department of Agriculture (1975) within the Gar double dagger as watershed, and increasing loads of untreated sewage from these institutions. The data suggest that deterioration in water quality began after similar to 1975 and markedly accelerated after similar to 1990. The reservoir has been hypereutrophic since 1999. Steady increases in geochemical proxies for trophic state, along with a decrease in C/N ratios, indicated higher nutrient concentrations and the prevalence of autochthonous production towards the core top. Appearance of Achnanthidium catenatum similar to 1993 highlighted the onset of a marked eutrophication phase. The subsequent dominance of Planothidium rostratum and Cyclotella meneghiniana suggested a sharp shift to a hypereutrophic state since 1999. Land-use history proved valuable for validating the chronology and interpreting anthropogenic impacts. Multi-proxy analysis of the sediment record provided an effective tool for tracking ecological shifts in the reservoir ecosystem. This study provides the first reconstruction of lake eutrophication history in Brazil and highlights the importance of hydrological/physical changes as drivers of diatom assemblage shifts in reservoirs, which may confound trophic state inferences based on shifts in the planktonic/benthic diatom ratio.

Invasion of the dinoflagellate Ceratium furcoides (Levander) Langhans 1925 at tropical reservoir and its relation to environmental variables

Dinoflagellates of the genus Ceratium are chiefly marine but there are rare occurrences in freshwater. In this study we analyze the invasion and progressive establishment of Ceratium furcoides, an exotic species, in the Furnas Reservoir. Samples were taken at 36 points in the reservoir, during the months of March, June, September and December, 2007. Measurements of some physical and chemical variables were simultaneously performed at each site. The occurrence of C. furcoides was registered at 20 sites, with densities varying between 0.57 and 28,564,913.0 ind.m-3. Blooms of this species were recorded in points which were classified as mesotrophic, coinciding with the places receiving high amounts of untreated domestic sewage. C. furcoides density was correlated with temperature, nutrients (nitrate and nitrite) and water electric conductivity. The highest density was recorded in June when temperature was low. The presence of Ceratium furcoides in the reservoir apparently has not yet affected the reservoir water quality or other plankton communities. However, if it becomes fully established it could perhaps become a problem in the reservoir or even to spread out to other reservoirs in Rio Grande basin.

Relationship between space distribution of the benthic macroinvertebrates community and trophic state in a Neotropical reservoir (Itupararanga, Brazil)

The purpose of this work was to verify the benthic macroinvertebrates community responses through environmental factors along a headwater tropical reservoir. Samplings were taken with a Van-Veen grab along the reservoir in littoral and profundal regions and in the headwater, next to the dam and the middle of the reservoir. Samples were taken during both wet and dry seasons. Dissolved oxygen concentrations, electric conductivity, temperature and pH near the sediment have been performed in situ, at every sampling station by using a multiprobe and Secchi disc. Total water phosphorus and chlorophyll a concentrations were analyzed to determine the trophic state index. Sediment's organic matter, total phosphorus, nitrogen concentrations and granulometric composition were measured. In order to verify which environmental variables would have more influence over the benthic macroinvertebrates community, a canonical correspondence analysis (CCA) was performed. The total number of recorded taxa was 28. Among them, the family Chironomidae (Diptera) was the richest group (19 taxa). It can be proposed that the benthic macroinvertebrates community may be influenced by environmental conditions such as nutrient and organic matter availability, as well as dissolved oxygen concentration. Macroinvertebrates are adequate bioindicators of water quality due to their sensibility to environmental changes mentioned before. Chironomus sp, Limnodrilus hoffmeisteri and Branchiura sowerbyi comprises a group that can be considered bio-indicators of eutrophic conditions. A second group can be considered as indicator of mesotrophic conditions. The presence of two or more members from that group which comprises Tanytarsini spp, Fissimentum sp, Pelomus sp and Goeldichironomus sp, like predominant taxa, may indicates mesotrophic conditions.

Proctocolectomy and ileal J-pouch anal anastomosis on the surgical treatment of familial adenomatous polyposis and ulcerative colitis: analysis of 49 cases

OBJECTIVE: To evaluate the results of ileal J-pouch anal anastomosis in ulcerative colitis and familial adenomatous polyposis. METHOD: Retrospective analysis of medical records of 49 patients submitted to ileal J-pouch anal anastomosis. RESULTS: Ulcerative colitis was diagnosed in 65% and familial adenomatous polyposis in 34%. Mean age was 39.5 years. 43% were male. Among familial adenomatous polyposis, 61% were diagnosed with colorectal cancer. Thirty-one percent of patients with ulcerative colitis was submitted to a previous surgical approach and 21% of these had toxic megacolon. Average hospital stay was 10 days. Post-operative complications occurred in 50% of patients with ulcerative colitis and 29.4% with familial adenomatous polyposis. Intestinal diversion was performed in 100% of ulcerative colitis and 88% of familial adenomatous polyposis. Pouchitis occurred in eight cases (seven ulcerative colitis and one FAP), requiring excision of the pouch in three ulcerative colitis. Mortality rate was 7.6%: two cases of carcinoma on the pouch and two post-operative complications. Late post-operative complications occurred in 22.4%: six familial adenomatous polyposis and five ulcerative colitis). Two patients had erectile dysfunction, and one retrograde ejaculation. One patient with severe perineal dermatitis was submitted to excision of the pouch. Incontinence occurred in four patients and two reported soil. Mean bowel movement was five times a day. CONCLUSION: Ileal J-pouch anal anastomosis is a safe surgery with acceptable morbidity and good functional results, if well indicated and performed in referral centers.

Ileal amino acid digestibility in canola meals from yellow- and black-seeded Brassica napus and Brassica juncea fed to growing pigs

Twelve ileal cannulated pigs (30.9 ± 2.7 kg) were used to determine the apparent (AID) and standardized (SID) ileal digestibility of protein and AA in canola meals (CM) derived from black- (BNB) and yellow-seeded (BNY) Brassica napus canola and yellow-seeded Brassica juncea (BJY). The meals were produced using either the conventional pre-press solvent extraction process (regular meal) or a new, vacuum-assisted cold process of meal de-solventization (white flakes) to provide 6 different meals. Six cornstarch-based diets containing 35% canola meal as the sole source of protein in a 3 (variety) × 2 (processing) factorial arrangement were randomly allotted to pigs in a 6 × 7 incomplete Latin square design to have 6 replicates per diet. A 5% casein diet was fed to estimate endogenous AA losses. Canola variety and processing method interacted for the AID of DM (P = 0.048), N (P = 0.010), and all AA (P < 0.05), except for Arg, Lys, Phe, Asp, Glu, and Pro. Canola variety affected or tended to affect the AID of most AA but had no effect on the AID of Lys, Met, Val, Cys, and Pro, whereas processing method had an effect on only Lys and Asp and tended to affect the AID of Thr, Gly and Ser. The effects of canola variety, processing method, and their interaction on the SID values for N and AA followed a similar pattern as for AID values. For the white flakes, SID of N in BJY (74.2%) was lower than in BNY and BNB, whose values averaged 78.5%; however, among the regular meals, BJY had a greater SID value for N than BNY and BNB (variety × processing, P = 0.015). For the white flakes, the SID of Ile (86.4%), Leu (87.6%), Lys (88.9%), Thr (87.6%) and Val (84.2%) in BNB were greater than BNY and BJY. Opposite results were observed for the regular processing, with SID of Lys (84.1%), Met (89.5%), Thr (84.1%), and Val (83.6%) being greater in BJY, followed by BNB and BNY(variety × processing, P < 0.057). The SID of Met was greatest for the white flakes (90.2%) but least for the regular processing (83.0%) in BNY (variety × processing, P < 0.057). It was concluded that the AID and SID of N and AA of the CM tested varied according to canola variety and the processing method used. Overall, the SID values for Ile, Leu, Lys, Met, Thr, and Val averaged across CM types and processing methods were 81.8, 82.6, 83.4, 85.9, 80.8, and 78.4%, respectively.

Effects of trophic levels (chlorophyll and phosphorous content) in three different water bodies (urban lake, reservoir and aquaculture facility) on gill morphology of Nile tilapia (Oreochromis niloticus)

Histological and ultrastructural analyses of gills were observed in Nile tilapia collected from three different waterbodies in southeast Brazil: an urban lake in a park in the city of São Paulo, a reservoir in a rural city, and a commercial aquaculture facility. These aterbodies were analyzed and classified as hypereutrophic, eutrophic, and supereutrophic, respectively, with 310.00, 94.00, 28.00 of phosphate (PO2_ 4 lg L _1) and 65.49, 24.95, 12.83 of chlorophyll (lg L _1). A significant difference in the histological alterations index (HAI) was observed only in fish from the urban lake, with the presence of cell hypertrophy, hyperplasia, aneurism, and other alterations. When compared to the other groups, a large quantity of rodlet cells was also observed in the urban group. These results demonstrate the correlation of eutrophic states of water with gill morphology. Also discussed is the premise that large amounts of organic material dissolved in water can alter the morphology of the fish gills