Effects of dietary lipid composition bioavailability and inulin-type fructans on mineral in growing rats

Objective: This study reports the effects of feeding with a combination of inulin-type fructans (ITF) and fish oil (FO) on mineral absorption and bioavailability as part of a semipurified diet offered to rats. Methods: Male Wistar rats (n = 24) were fed a 15% lipid diet (soybean oil [SO] or a 1:0.3 fish:soybean oil mixture [FSO]) and diets containing the same sources of lipids supplemented with 10% ITF (Raftilose Synergy 1) ad libitum for 15 d. Feces and urine were collected for mineral analyses during the last 5 d of the test period. Fatty acid composition was determined in liver and cecal mucosa homogenates. Liver and bone mineral analyses were performed by atomic absorption spectrophotometry. Bone biomechanical analyses were evaluated by a 3-point bending test. Results: Compared with the controls, ITF-fed rats had enlarged ceca and a significant decrease in cecal content pH (P < 0.001). The apparent mineral absorption was improved in these rats, and this effect was enhanced by dietary combination with FO for all minerals except for magnesium. Addition of ITF to the diet resulted in higher bone mineral content (calcium and zinc) and bone strength, but increased bone mineral content was only statistically significant in FO-fed animals. A decrease in liver iron stores (P = 0.015) was observed in rats fed FO, considering that ITF consumption returned to levels comparable to the SO control group. Conclusion: These findings confirm the positive influence of ITF on mineral bioavailability, which was potentiated by addition of FO to the diet. (C) 2009 Published by Elsevier Inc.

Toxicokinetics and toxicological effects of single oral dose of fumonisin B1 containing Fusarium verticillioides culture material in weaned piglets

Toxicokinetics and the toxicological effects of culture material containing fumonisin B(1) (FB(1)) were studied in male weaned piglets by clinical, pathological, biochemical and sphingolipid analyses. The animals received a single oral dose of 5 mg FB(1)/kg of body weight. obtained from Fusarium verticillioides culture material. FB(1) was detected by H PLC in plasma collected at 1-h intervals up to 6 h and at 12-h intervals up to 96 h. FB(1) eliminated in feces and urine was quantified over a 96-h period and in liver samples collected 96 h post-intoxication. Blood samples were obtained at the beginning and end of the experiment to determine serum enzyme activity, total bilirubin, cholesterol, sphinganine (Sa), sphingosine (So) and the Sa/So ratio. FB(1) was detected in plasma between 30 min and 36 h after administration. The highest concentration of FB(1) was observed after 2 h, with a mean concentration of 282 mu g/ml. Only 0.93% of the total FB(1) was detected in urine between 75 min and 41 h after administration, the highest mean concentration (561 mu g/ml) was observed during the interval after 8 at 24 h. Approximately 76.5% of FB(1) was detected in feces eliminated between 8 and 84 h after administration, with the highest levels observed between 8 and 24 h. Considering the biochemical parameters, a significant increase only occurred in cholesterol, alkaline phosphatase and aspartate aminotransferase activities. In plasma and urine, the highest Sa and Sa/So ratios were obtained at 12 and 48 h, respectively. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Domestic Cats Constitute a Natural Reservoir of Human Enteropathogenic Escherichia coli Types

Feces of 70 diarrhoeic and 230 non-diarrhoeic domestic cats from Sao Paulo, Brazil were investigated for enteropathogenic (EPEC), enterohaemorrhagic (EHEC) and enterotoxigenic (ETEC) Escherichia coli types. While ETEC and EHEC strains were not found, 15 EPEC strains were isolated from 14 cats, of which 13 were non-diarrhoeic, and one diarrhoeic. None of 15 EPEC strains carried the bfpA gene or the EPEC adherence factor plasmid, indicating atypical EPEC types. The EPEC strains were heterogeneous with regard to intimin types, such as eae-theta (three strains), eae-kappa (n = 3), eae-alpha 1 (n = 2), eae-iota (n = 2), one eae-alpha 2, eae-beta 1 and eae-eta each, and two were not typeable. The majority of the EPEC isolates adhered to HEp-2 cells in a localized adherence-like pattern and were positive for fluorescence actin staining. The EPEC strains belonged to 12 different serotypes, including O111:H25 and O125:H6, which are known to be pathogens in humans. Multi locus sequence typing revealed a close genetic similarity between the O111:H25 and O125:H6 strains from cats, dogs and humans. Our results show that domestic cats are colonized by EPEC, including serotypes previously described as human pathogens. As these EPEC strains are also isolated from humans, a cycle of mutual infection by EPEC between cats and its households cannot be ruled out, though the transmission dynamics among the reservoirs are not yet understood clearly.

Acute toxicity of a single gavage dose of fumonisin B(1) in rabbits

The aim of this study was to determine the clinical, pathological and mycotoxicological effects of oral administration of fumonisin B, (FBI) in rabbits. Eighteen rabbits were randomly assigned to two experimental groups: control group, 0 mg FB(1): fumonisin group. 31.5 mg FB(1)/kg body weight, corresponding to about 630 mg FB(1)/kg diet. Fumonisin administered as a single oral dose to rabbits resulted in acute toxicity, significantly interfering with body and liver weight. Serum biochemical analysis revealed a significant increase of total protein, alkaline phosphatase (AP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), urea and creatinine in the group receiving FBI compared to control animals, a finding characterizing hepatic and renal injury in this group. Urinary protein concentrations were markedly elevated at 12,24,48 and 72 h after dosing, although visible pathological abnormalities were not observed, probably because of rapid repair of the damage. FBI was detected in feces, with a maximum concentration at 24h after administration, indicating that the enterohepatic circulation is important in rabbits. FBI concentrations found in urine were low, with peak elimination at 12 h after intoxication. The highest FBI concentrations were observed in feces compared to urine and liver, demonstrating that feces are the main routes of excretion. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

Capillariaisis (Trichurida, Trichinellidae, Capillaria hepatica) in the Brazilian Amazon: low pathogenicity, low infectivity and a novel mode of transmission

Background: Human capillariasis caused by Capillaria hepatica (syn. Calodium hepaticum) is a rare disease with no more than 40 cases registered around the world. Classically, the disease has severe symptoms that mimic acute hepatitis. Natural reservoirs of C. hepatica are urban rodents (Mus musculus and Rattus novergicus) that harbor their eggs in the liver. After examining the feces of 6 riverine inhabitants (Rio Preto area, 8 degrees 03`S and 62 degrees 53`W to 8 degrees 14`S and 62 degrees 52`W) of the State of Rondonia, Brazil, and identifying C. hepatica eggs in their feces, the authors decided to investigate the real dimension of these findings by looking for two positive signals. Methods: Between June 1(st) and 15(th), 2008, 246 out of 304 individuals were clinically examined. Blood samples were collected, kept under -20 degrees C, and test by the indirect immunofluorescence technique. Results: The first positive signal was the presence of specific antibodies at 1: 150 dilution, which indicates that the person is likely to have been exposed to eggs, most likely non-infective eggs, passing through the food chain or via contaminated food (total prevalence of 34.1%). A second more specific signal was the presence of antibodies at higher titers, thus indicating true infection. Conclusions: The authors concluded that only two subjects were really infected (prevalence of 0.81%); the rest was false-positives that were sensitized after consuming non-embryonated eggs. The present study is the first one carried out in a native Amazonian population and indicates the presence of antibodies against C. hepatica in this population. The results further suggest that the transmission of the parasite occurs by the ingestion of embryonated eggs from human feces and/or carcasses of wild animals. The authors propose a novel mode of transmission, describing the disease as a low pathogenic one, and showing low infectivity.

Structure, processing and midgut secretion of putative peritrophic membrane ancillary protein (PMAP) from Tenebrio molitor larvae

A cDNA coding for a Tenebrio molitor midgut protein named peritrophic membrane ancillary protein (PMAP) was cloned and sequenced. The complete cDNA codes for a protein of 595 amino acids with six insect-allergen-related-repeats that may be grouped in A (predicted globular)- and B (predicted nonglobular)-types forming an ABABAB structure. The PMAP-cDNA was expressed in Pichia pastoris and the recombinant protein (64 kDa) was purified to homogeneity and used to raise antibodies in rabbits. The specific antibody detected PMAP peptides (22 kDa) in the anterior and middle midgut tissue, luminal contents, peritrophic membrane and feces. These peptides derive from PMAP, as supported by mass spectrometry, and resemble those formed by the in vitro action of trypsin on recombinant PMAP. Both in vitro and in vivo PMAP processing seem to occur by attack of trypsin to susceptible bonds in the coils predicted to link AB pairs, thus releasing the putative functional AB structures. The AB-domain structure of PMAP is found in homologous proteins from several insect orders, except lepidopterans that have the apparently derived protein known as nitrile-specifier protein. Immunocytolocalization shows that PMAP is secreted by exocytosis and becomes entrapped in the glycocalyx, before being released into midgut contents. Circumstantial evidence suggests that PMAP-like proteins have a role in peritrophic membrane type 2 formation. (C) 2007 Elsevier Ltd. All rights reserved.

Urininkontinens hos kvinnor : Livskvalitet och hjälpsökande

Syftet med denna studie var att undersöka hur kvinnors livskvalitet påverkas vid urininkontinens, om åldern påverkar livskvaliteten samt om kvinnorna sökt hjälp för sina symtom. Metoden var en systematisk litteraturstudie, där vetenskapliga artiklar söktes i flera databaser. Sökordet ”urinary incontinence” ingick i alla sökningar i olika kombinationer med andra sökord. Endast kvantitativa artiklar hittades vid sökningen. Efter att de granskats enligt den mall som författaren sammanställt bedömdes artiklarna vara av god kvalitet. Femton artiklar ingick i resultatredovisningen. Det övergripande resultatet som denna studie kom fram till är att livskvaliteten hos kvinnor påverkas vid urininkontinens. Graden av urininkontinens påverkar upplevelsen av inkontinensen, ju större besvär, desto större negativ påverkan på livskvaliteten beskrevs hos de drabbade. Ju äldre man blir, desto större negativ påverkan på livskvaliteten påvisades. Som mest var det knappt hälften av de kvinnor som deltog i studien som sökt hjälp för sina symtom, det varierade från sex till 42 %. Genom att söka hjälp skulle möjligheten att förbättra livskvaliteten öka för dessa kvinnor.

Individuell utprovning av inkontinenshjälpmedel i kommunala särskilda boenden

The purpose of this study was to examine the extent to which incontinence aids, used in local authority/municipal nursing homes, were adapted to the resident’s urine-leakage volume and to find out how nurses perceived the current situation concerning individual testing of incontinence aids in municipal nursing homes. The study method was a quantitative empirical study and was carried out in two phases. The first phase was a weighing test, carried out in three nursing homes, whereby the incontinence aids used by 25 residents during a 48 hour period were weighed. The second phase was the completion of a questionnaire by the municipal nurses working in the same local authority. The questionnaire covered: the division of responsibilities; routines for testing incontinence aids, and the level of knowledge concerning individual incontinence aid testing. Only 22 % of the pads used during the observation were properly adapted to the patients’ urinary leakage volume, while 76 % of incontinence aids were larger than necessary in relation to the real volume of urinary leakage. The municipal nurses, who have a key role and formal responsibility for individual incontinence aid testing, considered that there was insufficient knowledge within the organisation concerning individual incontinence aid testing, and that the division of responsibilities in this area was unclear. There were great variations relating to the extent of the nurses’ involvement in individual incontinence aid testing, and the nurses stated that increased involvement in individual incontinence aid testing was dependent on more time being made available for this task. Only a minority of the nurses thought that the requisitioning of incontinence aids was preceded by individual testing of the incontinence pads within the organisation. The majority of nurses considered that this was not the case or were unsure of the situation.

Urininkontinens bland kvinnor : ett dolt hälsoproblem

Syftet med denna studie var att undersöka förekomst och svårighetsgrad av urininkontinens hos kvinnor och hur det påverkade deras dagliga liv. Syftet var vidare att studera om kvinnorna sökt hjälp för sin urininkontinens och om de var nöjda med den hjälp de erbjudits. Studien utgjordes av en tvärsnittsstudie med kvantitativ ansats. Populationen i studien omfattade alla de kvinnor över 18 år som under en dag besökte en framlottad vårdcentral i Dalarna. Totalt delades 416 enkäter ut, varav 397 besvarades och 368 inkluderades i studien. Ett validerat mätinstrument ICIQ-UI SF (The International Consultation on Incontinence Modular Questionnaire-Urine Incontinence Short Form) på svenska användes och två tilläggsfrågor konstruerades. Resultatet visar att 54% av kvinnorna besvärades av urininkontinens där ansträngningsinkontinens var den vanligaste typen. Kvinnorna hade urinläckage av mindre omfattning, liten mängd, och påverkan på dagliga livet var låg, dock var de kvinnor med blandinkontinens mera påverkade. En stor andel sökte inte hjälp för sin urininkontinens då de ansåg att besvären inte var så stora. De få kvinnor som sökt hjälp var nöjda med den hjälp de fått. Svårighetsgraden av urininkontinens enligt ICIQ-UI SF visade att övervägande delen av kvinnorna hade obetydliga till måttliga besvär. Resultatet tyder på att urininkontinens är ett dolt hälsoproblem.

Granskning av riktlinjer vid Sveriges förlossningskliniker gällande sfinkterskada i samband med förlossning : Innehållsanalys med en kombination av en deduktiv och induktiv ansats

Background: Sphincter injury is serious complication in connection to vaginal childbirth. Desire to avoid vaginal birth again is seen in women who previously suffered from a sphincter injury. Objective: To identify and evaluate obstetric guidelines in Sweden regarding sphincter injury in relation to childbirth Method: Content analysis with a combination of a deductive and inductive approach. Results: The most frequently occurring risk factors and prevention with help of perineal protection were described in the guidelines. The physician made diagnosis and repaired the sphincter injury at the theatre.  Complications such as coital pain and anal incontinence were described in the guidelines. Paracetamol and diclofenac was most common analgesic regimen given for pain. Prophylaxis such as antibiotic treatment and laxative were common. Information given to women was described. Follow-up by physician, midwife and physiotherapist was recommended after four weeks to six months. For future birth a cesarean section was recommended. Conclusion: The guidelines were constructed in the same way and had to a large extent similar content. The authors of the present work recommend a national guideline.

Improving continence services for older people from the service-providers’ perspective : a qualitative interview study

Objective: To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design: Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting: 3 acute and 13 primary care National Health Service Trusts in England. Participants: 16 continence service leads in England actively treating and managing older people with UI. Results: In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and highquality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions: Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

Does successful treatment of constipation or faecal impaction resolve lower urinary tract symptoms? A structured review of the literature

Consensus guidelines advocate the treatment of constipation and faecal impaction in order to improve symptoms of urinary frequency, urgency and urinary incontinence and to promote bladder emptying in the absence of urinary tract obstruction. This structured review of the literature was undertaken to search for and appraise evidence to support or negate the hypothesis of this relationship. The search strategy was comprehensive and identified six relevant studies. Two of these had been conducted on an adult population and four studies involved children with constipation. These studies were appraised for methodological quality. It was found that sample sizes were small and evidence was inconsistent. Variable methods of reporting meant that data were not able to be pooled for meta-analysis.
Based on the limited and conflicting evidence, it is recommended that further research be undertaken to identify any correlation between bowel and bladder function.

Development, implementation, and evaluation of a continence education package in acute and subacute care settings

OBJECTIVE: The objective of the study was to trial and evaluate the effect that a discharge Continence Education Package (CEP) had on patients' continence awareness and management preferences.
DESIGN: An exploratory descriptive design was used.
SETTINGS AND SUBJECTS: A total of 631 participants were included in the study: 352 females (55.8%) and 279 males (44.2%) from 4 rural and regional settings in Victoria, Australia.
INSTRUMENTS AND METHODS: A specifically designed questionnaire was used to assess participants' knowledge of incontinence and its management and also to investigate their treatment preferences and intentions if they experienced this type of problem. Data were collected at 2 time periods. Specifically, patients were interviewed before discharge from acute and subacute settings identified as Time 1 (T1). Then the participants were given the CEP and asked to complete a similar questionnaire.
RESULTS: The findings revealed that fewer than 25% of participants had received information on continence before the study being conducted, yet the majority had indicated that they had experienced continence symptoms. The majority of participants found the CEP easy to understand (98.2%) and helpful (95.3%). Most participants said it provided them with information about types of actions to take and/or treatment options for incontinence problems. It also raised their awareness of the signs and symptoms associated with incontinence and provided them with a useful self-administered gauge with which to assess their continence status.
CONCLUSIONS: These findings suggest that the CEP may be a useful educational tool for use in the general population.

The challenge of managing continence care in residential aged care settings : recommendations for research and practice

Incontinence-related problems are a major reason for placement in residential aged care facilities. Data from the Residential Classification Scale indicates that 86% of people in residential aged care facilities in Australia are dependent on others for bladder management, 77% require some support with bowel management and 78% require some support with toileting. In this paper, we present an overview of the literature on the issues that need to be considered for the management of incontinence in residential aged care settings. Based on this literature, we make recommendations for research and practice. Although residential care facilities are mandated to provide continence care, there is little research evidence on which to base care or to evaluate the effectiveness of current practices. Further research is required to address this gap in information to ensure delivery of residential aged care that meets the requirements of the Aged Care Act 1997.

Does a continence educational brochure promote health-seeking behavior?

OBJECTIVE: This study reviewed whether participants who were given a continence education package, which included a Continence Educational Brochure (CEB), and who indicated that they were bothered by incontinence symptoms changed health-seeking behaviors about their incontinence problem because of being given the brochure.
METHOD: This study used a descriptive and exploratory design. Participants were given the CEB and asked to read the information. They were also asked to complete a continence questionnaire and mail this back to the research team. Participants who indicated that they were bothered by a continence problem and consented to being interviewed were telephoned 2 to 3 months later. They were asked questions to determine their actions and progress in relation to managing their continence problem and whether the CEB had influenced their behavior.
SETTING AND SUBJECT: A total of 631 participants (352 females, 55.8%; 279 males, 44.2%) from 4 rural and regional settings in Victoria, Australia, participated. Of this sample, 111 participants (78 females, 70.3%; 33 males, 29.7%) who reported that they were bothered by a continence problem were interviewed 3 months after being given the CEB.
RESULTS: Two thirds of the total sample of participants (n = 111) sought help for their continence problem. Approximately 70.3% (n = 78) continued to have a continence problem. Of this group, 84.6% were still bothered by the continence problem and 65.4% had taken action to treat their incontinence. Forty-nine participants (44.1%) indicated that they had discussed the issue of bladder or bowel problems with someone directly because of this study or the information contained in the brochure. More than 94% of participants who remembered the CEB indicated that they believed the brochure would be helpful if given to other people.
CONCLUSIONS: These findings suggest that the CEB prompted individuals to discuss their continence problem and in fewer cases to seek professional help. Given these findings, distribution of a continence education package is advocated as a continence health promotion strategy.