Retocolectomia total e anastomose íleo-anal com reservatório ileal: experiência de 16 anos

O reservatório ileal pélvico tem sido a melhor opção cirúrgica para a retocolite ulcerativa (RCU) e polipose adenomatosa familiar (PAF). Desde 1983 esta técnica vem sendo empregada, e o objetivo deste trabalho é apresentar revisão desta casuística, analisando seus resultados e seus pontos controversos. Setenta e três pacientes, com média de idade de 34,6 (13-63) anos e com predomínio do sexo feminino (42 pacientes, 56,7%) se submeteram ao procedimento para tratamento de RCU (46 pacientes - 63,0%) e PAF(27 - 37,0%). Foram utilizadas as seguintes variantes técnicas: em S, de grande tamanho e ramo eferente longo (oito); em S pequeno e ramo eferente reduzido (22); em "dupla câmara" (20); em J (23). Todos os procedimentos foram seguidos da construção de ileostomia de proteção. De 1993 em diante, todos os pacientes tiveram a arcada do colo direito preservada. Setenta pacientes têm pelo menos um ano de pós-operatório e 61 têm dois anos ou mais com média de 7,01 (1-16) anos. Foram consideradas complicações precoces aquelas que ocorreram até o 30º dia de pós- operatório e tardias, após esse tempo. Resultados funcionais foram analisados após um ano do fechamento da ileostomia. Ocorreram 35 complicações precoces em 22 pacientes e 39 complicações tardias em 35 pacientes. Vinte e cinco pacientes não apresentaram complicações. As principais complicações foram: obstrução intestinal (19,1 %), fistulizações cutâneas, com vagina ou trato urinário (10,9%), isquemia de reservatório (parcial ou total), (9,5%), e ileíte do reservatório (pouchitis) (6,8%). Nove pacientes (12,3%) têm ileostomia funcionante, sendo que sete pacientes têm ainda o reservatório mantido no lugar e dois tiveram-no ressecado. A mortalidade diretamente relacionada ao procedimento foi em dois pacientes, mas outros quatro pacientes evoluíram tardiamente ao óbito, por causas como desnutrição crônica e tumor de cerebelo. Em conclusão, apesar da morbidade e da existência ainda de questões controversas, as perspectivas tardias têm sido animadoras e têm estimulado a indicação deste tipo de procedimento.

Reservação da arcada vascular do cólon direito para o alongamento mesenterial na cirurgia do reservatório ileal

OBJETIVO: Avaliar a eficácia da preservação da arcada vascular do cólon direito (AVCD) na manutenção da perfusão sangüínea do reservatório após manobras de alongamento do mesentério ileal. MÉTODOS: O estudo incluiu 46 pacientes (janeiro/1990 a julho/2000, para o tratamento de retocolite ulcerativa (RCU) e polipose adenomatosa familiar (PAF), que foram divididos em dois grupos: grupo com preservação da arcada (CPA), 27 pacientes, média de idade - 34,0 (19-53) anos, 15 (55,6%) eram do sexo feminino e 24 (88,9%) eram brancos; e grupo sem preservação da arcada (SPA), 19 pacientes, média de idade 41,5 (13 - 62) anos, oito (42,1%) eram do sexo feminino e 18 (94,8%) eram brancos. Trinta pacientes (65,2%) apresentavam RCU e 16 (34,7%) PAF. Foram comparadas a ocorrência de complicações atribuídas à má perfusão sangüínea ou tensão na anastomose ileoanal, assim como as indicações de reoperações. RESULTADOS: No grupo CPA, em quatro pacientes (18,5%), as complicações estavam relacionadas ao comprometimento da viabilidade intestinal ou à tensão ao nível da anastomose. No grupo SPA, estas complicações ocorreram em sete pacientes (36,9%). Foram reoperados três pacientes (11,1%) do grupo CPA, por causas relacionadas ou à má perfusão sangüínea ou à tensão excessiva no nível da anastomose e no grupo SPA cinco (26,3%), pela mesma causa. CONCLUSÕES: Apesar das limitações metodológicas, observou-se tendência para menor ocorrência de complicações isquêmicas no grupo com preservação da AVCD. Quando o abaixamento do reservatório ileal tem que ser ao nível da linha pectínea, torna-se importante a perfusão sangüínea via AVCD como auxiliar na preservação de sua viabilidade.

Cistectomia radical laparoscópica com reservatório ileal

Worldwide experience with laparoscopic radical cystectomy is increasing in the last few years. We describe a 29-year-old female who underwent a laparoscopic radical cystectomy with ileal reservoir for a bladder sarcoma. Operative time was 405 minutes and estimated blood loss was 500 mL. She had an uneventful postoperative course and was discharged in the fifth postoperative day. Key-words: bladder, cystectomy, laparoscopy, urinary diversion, bladder neoplasms.

Thermal Processing of Smoked Yellowfin Tuna (Thunnus albacares) in Flexible Pouches

This study is the first of its kind in India, where in smoked and thermal processed products have been developed using locally available wood as the source of wood smoke and flavoring and a shelf life of one year has been achieved. Retortable pouches of three layers, both imported and indigenous were found suitable to store thermal processed products. Heat penetration rate is quicker in retort pouches due to their thin profile in comparison to cans and hence the total process time is lesser. The nutritional and sensory attributes of the pouch products are better retained during processing. Hence these products are more acceptable than canned products. lndian vegetarian food products and fish curry products are available in the ready to eat form in the markets. Smoked and thermal processed products have not gained an entry to the market and hence this study will pave an opening for such products. Currently trade in tuna products from India is meager compared to the global trade. ln India proper utilization of tuna resources is yet to be achieved due to the lack of infrastructure for handling and knowledge of value addition. The raw material cost is also less due to the poor quality of the fish when landed. Hence, the availability of such products will help in the trade of tuna products, improving the quality of raw material landing and ultimately realizing a better value to the fishermen and processors.

Standardised ileal digestibility of crude protein and amino acids of UK-grown peas and faba beans by broilers

In view of the increasing interest in home-grown legumes as components of diets for non-ruminant livestock and in an attempt to reduce the reliance on imported soya bean meal (SBM), two experiments were conducted to evaluate samples of peas and faba beans for their standardised ileal digestibility (SID) of amino acids determined with young broiler chicks. Experiment 1 evaluated six faba bean and seven pea cultivars and Experiment 2 evaluated two faba bean and three pea cultivars as well as a sample of soya bean meal provided as a reference material. Peas and beans were added at 750g/kg as the only source of protein/amino acids in a semi-synthetic diet containing the inert marker titanium dioxide; SBM was added, in a control diet, at 500g/kg. Each diet was fed to six replicates of a cage containing two Ross-type broilers for 96h at which point birds were culled allowing removal of ileal digesta. Chemical analyses allowed the calculation of the coefficient of SID of amino acids. There were no differences between samples of the same pulse species (P>0.05) but peas had higher values (P<0.05), similar to SBM, than beans. Trypsin inhibitor content (expressed as g trypsin inhibitor units/mg sample) of all pea samples was low and in the range 0.83–1.77mg/kg. There was relatively little variation in bean tannin content and composition amongst the coloured-flowered varieties; however, the white-flowered cultivar had no tannins. There was no correlation between tannin content and coefficient of SID. The content of SID of amino acids (g/kg legume) was higher in SBM when compared with peas and beans by virtue of having higher total concentrations.

Adhesion of Salmonella enterica var Enteritidis strains lacking fimbriae and flagella to rat ileal explants cultured at the air interface or submerged in tissue culture medium

Rat ileal air interface and submerged explant models were developed and used to compare the adhesion of Salmonella enterica var Enteritidis wild-type strains with that of their isogenic single and multiple deletion mutants. The modified strains studied were defective for fimbriae, flagella, motility or chemotaxis and binding was assessed on tissues with and without an intact mucus layer. A multiple afimbriate/aflagellate (fim(-)/fla(-)) strain, a fimbriate but aflagellate (fla(-)) strain and a fimbriate/flagellate but non-motile (mot(-)) strain bound significantly less extensively to the explants than the corresponding wild-type strains. With the submerged explant model this difference was evident in tissues with or without a mucus layer, whereas in the air interface model it was observed only in tissues,vith an intact mucus layer. A smooth swimming chemotaxis-defective (che(-)) strain and single or multiple afimbriate strains bound to explants as well as their corresponding wild-type strain. This suggests that under the present experimental conditions fimbriae were not essential for attachment of S. enterica var Enteritidis to rat ileal explants, However; the possession of active flagella did appear to be an important factor. in enabling salmonellae to penetrate the gastrointestinal mucus layer and attach specifically to epithelial cells.

Tracking (poly)phenol components from raspberries in ileal fluid

The (poly)phenols in ileal fluid after ingestion of raspberries were analysed by targeted and non-targeted LC-MSn approaches. Targeted approaches identified major anthocyanin and ellagitannin components at varying recoveries and with considerable inter-individual variation. Non-targeted LC-MSn analysis using an Orbitrap mass spectrometer gave exact mass MS data which was sifted using a software program to select peaks that changed significantly after supplementation. This method confirmed the recovery of the targeted components but also identified novel raspberry-specific metabolites. Some components (including ellagitannin and previously unidentified proanthocyanidin derivatives) may have arisen from raspberry seeds that survived intact in ileal samples. Other components include potential breakdown products of anthocyanins, unidentified components and phenolic metabolites formed in either the gut epithelia or after absorption into the circulatory system and efflux back into the gut lumen. The possible physiological roles of the ileal metabolites in the large bowel are discussed.

Enzimas exógenas no desempenho e na digestibilidade ileal de nutrientes em frangos de corte

O objetivo deste trabalho foi avaliar o efeito da combinação de fitase e do complexo amilase, protease e xilanase, em dietas de milho e soja, formuladas com redução e sem redução dos níveis de energia, cálcio e fósforo sobre o desempenho e a digestibilidade ileal de nutrientes, em frangos de corte. Foi utilizado o delineamento inteiramente casualizado, com esquema fatorial 2x2, com duas dietas-controle: com redução e sem redução dos nutrientes, e duas suplementações das enzimas (sem adição e com adição de fitase e complexo enzimático), com dez repetições de 40 aves. A digesta ileal foi coletada aos 43 dias de idade, para determinação da energia digestível e dos coeficientes de digestibilidade da proteína bruta, matéria seca, cálcio e fósforo. O desempenho apresentou interação em todos os parâmetros analisados. As aves do tratamento com redução dos nutrientes mostraram pior desempenho em relação às aves da dieta sem redução dos nutrientes. Não houve efeito da matéria seca na digestibilidade e na retenção de cálcio. A adição da combinação enzimática melhorou a digestibilidade da proteína e a retenção de fósforo. Houve interação quanto à energia digestível, com efeito apenas nas dietas sem redução dos nutrientes, com maiores valores nas dietas suplementadas.

Molecular Identification and Characterization of Ileal and Cecal Fungus Communities in Broilers Given Probiotics, Specific Essential Oil Blends, and Under Mixed Eimeria Infection

Broiler digestive tract fungal communities have gained far less scrutiny than that given corresponding bacterial communities. Attention given poultry-associated fungi have focused primarily on feed-associated toxin-producers, yeast, and yeast products. The current project focused on the use of pyrosequencing and denaturing gradient gel electrophoresis (DGGE) to identify and monitor broiler digestive fungal communities. Eight different treatments were included. Four controls were an Uninfected-Unmedicated Control, an Unmedicated-Infected Control, the antibiotic bacitracin methylene disalicylate plus the ionophore monensin as Positive Control, and the ionophore monensin alone as a Negative Control. Four treatments were two probiotics (BC-30 and Calsporin) and two specific essential oil blends (Crina Poultry Plus and Crina Poultry AF). All chickens except the Unmedicated-Uninfected Control were given, at 15 days of age, a standard oral Eimeria inoculum of sporulated oocysts. Ileal and cecal digesta were collected at pre-Eimeria infection at 14 days of age and at 7 days post-Eimeria infection at 22 days of age. Extracted cecal DNA was analyzed by pyrosequencing to examine the impact of diet supplements and Eimeria infection on individual constituents in the fungal community, while DGGE was used to compare more qualitative changes in ileal and cecal communities. Pyrosequencing identified three phyla, seven classes, eight orders, 13 families, 17 genera, and 23 fungal species. Ileal and cecal DGGE patterns showed fungal communities were clustered mainly into pre- and post-infection patterns. Post-infection Unmedicated-Uninfected patterns were clustered with pre-infection groups demonstrating a strong effect of Eimeria infection on digestive fungal populations. These combined techniques offered added versatility towards unraveling the effects of enteropathogen infection and performance enhancing feed additives on broiler digestive microflora.

Ileal mucosal mast cell, eosinophil, and goblet cell populations during Hymenolepis diminuta infection of the rat

The population dynamics in the enteric connective tissues of eosinophils, mucosal mast cells (MMC), and in the mucosal epithelium of goblet cells were examined morphometrically in fixed ileal tissue of outbred Sprague Dawley rats during the first 32 days of infection with the tapeworm Hymenolepis diminuta. MMC and eosinophils were present in the lamina propria and submucosa; however, only eosinophils were also present in the muscularis externa. Eosinophilic infiltrate was first observed in the lamina propria at 15 days postinfection (dpi) and the numbers of eosinophils remained elevated through 32 dpi. Initial mucosal mastocytosis was detected on 6 dpi and MC numbers continued to rise over the study period without reaching a plateau. Goblet cell hyperplasia occurred only at 32 dpi. In contrast to some intestinal nematode infections where these same 3 cell types are associated with the host's expulsion responses, H. diminuta is not lost by a rapid host response in the outbred Sprague Dawley rat strain used in these experiments. We suggest that either the induction of hyperplasia of these host effector cells in ileum tissue during H. diminuta infection is not capable of triggering parasite rejection mechanisms, or the function of the induced hyperplasia is necessary for some as yet unassociated physiological or tissue architecture change in the host's intestine.

Effect of free-choice feeding on the performance and ileal digestibility of nutrients in broilers

An experiment was conducted to study ileal digestibility of nutrients and to verify the ability of broilers to select feed in order to meet their requirements for protein and energy. The treatments consisted of six diets: R+S: free-choice feeding with rice bran (energy) and soybean meal (protein); C+G: free-choice feeding with corn (energy) and corn gluten meal (protein); R+G: free-choice feeding with rice bran (energy) and corn gluten meal (protein); C+S: free-choice feeding with corn (energy) and soybean meal (protein); R+C+G+S: free-choice feeding with rice bran and corn (energy) and corn gluten meal and soybean meal (protein); and BD: basal diet represented by a complete diet composed of 63% corn and 33% soybean meal. The results indicated that the adjustment to nutritional requirements does not depend only on the ability of birds to select feed. It might also depend on intake and ingredient quality, since some ingredients did not provide a balanced amount of nutrients. The birds were able to fulfill their requirements for maintenance, that is, they consumed the minimum amount of amino acids (g per day) for maximum growth. The free-choice group with corn gluten meal as the protein source had the worst performance, which indicated that this feed is not recommended as a primary source of amino acids for broilers. The C+G diet presented the highest digestibility coefficient of dry matter and crude protein, whereas the C+S diet resulted in the highest digestibility coefficient of ether extract and nitrogen-free extract, indicating that diet digestibility was affected by the type of feed used as energy and protein sources. In general, the high digestibility values indicate that broilers are able to efficiently digest and absorb the supplied feed.

Effect of broiler chicken age on ileal digestibility of corn germ meal

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Meta-análise da digestibilidade ileal de aminoácidos e minerais em suínos alimentados com dietas contendo enzimas

O objetivo deste trabalho foi avaliar, por meio da meta-análise, o efeito da fitase e da xilanase sobre a digestibilidade ileal aparente (DIa) de aminoácidos, cálcio e fósforo, em suínos em fase de crescimento. A base de dados consistiu de 21 artigos publicados entre 1998 e 2009, no total de 82 tratamentos e 644 suínos. A meta-análise foi realizada por análise gráfica, de correlação, de variância-covariância. As concentrações de fósforo fítico e as frações fibra em detergente neutro, fibra em detergente ácido e lignina em detergente ácido, nas dietas, apresentaram correlações baixas e negativas com a DIa do cálcio, fósforo e aminoácidos. A adição de fitase às dietas aumentou em 2% a DIa da arginina, em 14% a do cálcio e em 34% a do fósforo. A DIa da arginina, fenilalanina, isoleucina e lisina foi 3,3% superior em suínos alimentados com dietas com xilanase, em relação às dietas sem a enzima. O fósforo fítico e as fibras, nas dietas, reduzem a DIa do cálcio, do fósforo e dos aminoácidos essenciais. O uso de fitase e xilanase, nas dietas, melhora o aproveitamento de cálcio, fósforo e alguns aminoácidos. No entanto, o excesso de cálcio e fósforo nas dietas reduz a ação da fitase sobre a digestibilidade ileal dos nutrientes.

Uso de indicadores para estimar fluxos de matéria seca ileal em eqüinos fistulados

This experiment was carried out with six half-bred Bretao-Campolinacolts with ileum fistulated to evaluate the difference in the ileum dry matter flow estimated by chromic oxide, cellulose, NDF, lignin and fecal lignin through the collection of ileum samples digesta at 28 h intervals, totalizing six samples per animal, starting at 10:00 a.m. The animals were fed ad libitum with the following diets: R1: clephantgrass, R2: elephantgrass plus ground corn, and R3: elephantgrass plus ground corn plus soybean meal. The data was statistically described, based on the coefficient of variation. The values of dry matter prececal digestion coefficients were, respectively, for diets 1, 2 and 3, at six schedules, for cellulose (-16.4; 21.4 and 6.6%), NDF(-34.7; 28.8 and -12.8%), to lignin (-51.5; -5.1 and -25.7%), in two schedules for cellulose (-13.4; 25.6 and 21.5%), fecal lignin (-37.1, 16.6 and -6.4%) and chromic oxide (-219.3, 36.4 and 9.5%). The coefficients of variation were, respectively, for the diets i, 2 and 3, at six schedules, for cellulose (148.3; 107.5 and 522.7%), NDF (95.4; 80.9 and 314.3%), lignin (210.2; 752.3 and 209.6%), at two schedules for cellulose(148.5; 80.7 and 70.0%), fecal lignin, (262.4; 177.9 and 723.5%) and chromic oxide (141.1; 158.9 and 473.4%). In diet i, the ileum dry matter now were over estimated for all markers, showing that chosen collection lime to estimate the flows were not adequate. Based on the coefficient of variation of the diets 2 and 3, the cellulose at two schedules was the most marker indicator to determine the ileum dry matter flow.