Probiotics: the scientific evidence in the context of inflammatory bowel disease

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of 5-hydroxytryptophan and m-hydroxybenzylhydrazine associated to Lactobacillus spp. on the humoral response of broilers challenged with Salmonella Enteritidis

This study investigates the effects of different doses of serotonin, its precursor 5-hydroxytry-ptophan (5HTP), and m-hydroxybenzylhydrazine inhibitor (NSD1015), administered via intraperitoneal for 5 consecutive days, on behavior and average body weight of broilers. We also measured the humoral immune response and quantification of Salmonella Enteritidis in broilers chickens that received the drugs evaluated and a Lactobacillus pool. The study was divided into 3 experiments: Experiment 1--administration of pharmaceuticals with choice of dosage; Experiment 2--administration of pharmaceuticals and a Lactobacillus pool in birds that were not challenged with S. Enteritidis, and Experiment 3--administration of pharmaceuticals and a Lactobacillus pool in birds challenged with S. Enteritidis. The ELISA was used to scan dosages of intestinal IgA and serum IgY. We used colony-forming units to quantify S. Enteritidis. The concentrations of IgA and IgY did not show significant differences (P>0.05) in Experiment 2. In Experiment 3, NSD1015 associated with Lactobacillus determined higher IgA concentrations, promoting greater stimulus to the immune system than 5HTP. Regarding quantification of S. Enteritidis in the cecal content of birds, 5HTP associated to Lactobacillus determined the smallest number of bacteria, showing possible interaction of 5-hydroxytryptophan and Lactobacillus spp. with the immune system of broiler chickens.

Uso do amido resistente na promoção da saúde intestinal de cães idosos: formação de produtos de fermentação e características histológicas da mucosa intestinal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Reflex postural control of patients with cerebral palsy for odontological assistance

Cerebral palsy (CP) describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.A child with cerebral palsy may have impairments in motor control, which contributes to loss of functional abilities in posture and mobility. The severity of the impairment on the neuromuscular system determines the variations of functional mobility in children with cerebral palsy. The control of the patient, during the dental treatment, is of fundamental importance because these patients present some pathological reflexes which interfere in the odontological assistance

Estresse oxidativo em equinos submetidos à obstrução intraluminal do cólon menor

Pós-graduação em Medicina Veterinária - FCAV

Sexualidade e doenças inflamatórias intestinais

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

A Pilot Study to Determine the Effectiveness of Probiotic Use in Elderly Patients with Antibiotic-Associated Diarrhea

Long-term care settings have the majority of their patients on multiple antibiotics, and outbreaks of antibiotic-associated diarrhea and Clostridium difficile are common. Probiotics have been used with these patients to reduce these side effects. Probiotics can re-establish the composition of intestinal microflora, enhance immune response, and clear pathogens from the host which may reduce the symptoms of antibiotic-associated diarrhea. Therefore, the goal of this study was to conduct a retrospective study of the effectiveness of using probiotic in elderly patients in a long-term care facility in a Midwestern city who suffered from antibiotic-associated diarrhea. The probiotic, CulturelleTM had been administered once a day to eight males and twelve female patients who were taking antibiotics and stool consistency and number were recorded. Out of the original group, seven of the patients receiving the probiotic appeared to have positive effects while two patients had negative effects on stools. Thirteen patients showed no change in stool consistency and number. It was difficult to determine the effects of the probiotic due to the use by the facility of a bowel movement protocol for preventing constipation and impaction, and the lack of dietary records. Published studies in patients in long-term facilities vary greatly in terms of trial design, type and dose of probiotic and duration of treatment, which may explain why probiotics work for some patients and not for others. Probiotic use is becoming more accepted with antibiotic-associated diarrhea but due to the lack of definitive evidence about efficacy and the safety of probiotic use, more studies need to be conducted. Advisors: Kaye Stanek Krogstrand and Julie Albrecht

Intestinal permeability parameters in obese patients are correlated with metabolic syndrome risk factors

Background & aims: Altered intestinal permeability has been shown to be associated with metabolic alterations in animal models of obesity, but not in humans. The aim of this study was to assess intestinal permeability in obese women and verify if there is any association with anthropometric measurements, body composition or biochemical variables. Methods: Twenty lean and twenty obese females participated in the study. Anthropometric measurements, body composition and blood pressure were assessed and biochemical analyses were performed. Administration of lactulose and mannitol followed by their quantification in urine was used to assess the intestinal permeability of volunteers. Results: The obese group showed lower HDL (p < 0.05), higher fasting glucose, insulin, HOMA index and lactulose excretion than the lean group (p < 0.05), suggesting increased paracellular permeability. Lactulose excretion showed positive correlation (p < 0.05) with waist and abdominal circumference. Blood insulin and the HOMA index also increased with the increase in mannitol and lactulose excretion and in the L/M ratio (p < 0.05). L/M ratio presented a negative correlation with HDL concentration (p < 0.05). Conclusions: We demonstrated that intestinal permeability parameters in obese women are positively correlated with anthropometric measurements and metabolic variables. Therapeutic interventions focused on intestine health and the modulation of intestinal permeability should be explored in the context of obesity. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Prevalence of excessive daytime sleepiness and associated factors in women aged 35-49 years from the "Pindamonhangaba Health Project" (PROSAPIN)

OBJETIVO: Estimar a prevalência da sonolência diurna excessiva (SDE) e identificar os fatores associados em mulheres de 35 a 49 anos de idade do "Projeto de Saúde de Pindamonhangaba" (PROSAPIN). MÉTODOS: O estudo foi observacional transversal com 372 mulheres com idade entre 35 e 49 anos selecionadas aleatoriamente da Estratégia Saúde da Família (ESF) do município de Pindamonhangaba, São Paulo, onde é desenvolvido o "Projeto de Saúde de Pindamonhangaba" (PROSAPIN). A SDE foi avaliada por entrevista utilizando a Escala de Sonolência de Epworth e os fatores associados por meio de questões que investigaram as características sócio-demográficas, a história ginecológica, a presença de comorbidades, o estilo de vida, a rotina de sono e o uso de medicamentos capazes de alterar o estado de alerta, além de mensuradas as variáveis antropométricas. Estimou-se a prevalência da SDE com intervalo de confiança de 95% (IC 95%) e foram identificados os fatores associados por meio de um modelo de regressão logística múltipla realizado no Programa Stata, versão 10.0. RESULTADOS: A prevalência da SDE foi de 18,5% (IC 95%: 14,7- 22,9) e os fatores associados foram: profissão relacionada a serviços domésticos (OR = 2,2; IC 95%: 1,1-4,3), nível de atividade física acima da média da população estudada (OR = 1,9; IC 95%: 1,1-3,4); e a presença de características sugestivas de ansiedade (OR = 1,9; IC 95%: 1,1-3,4). CONCLUSÃO: A prevalência da SDE em mulheres de 35 a 49 anos do PROSAPIN foi elevada e associada à característica sociodemográfica, à presença de comorbidades e ao estilo de vida.

Dyslipidemia: a prospective controlled randomized trial of intensive glycemic control in sepsis

Metabolic disturbances are quite common in critically ill patients. Glycemic control appears to be an important adjuvant therapy in such patients. In addition, disorders of lipid metabolism are associated with worse prognoses. The purpose of this study was to investigate the effects that two different glycemic control protocols have on lipid profile and metabolism. We evaluated 63 patients hospitalized for severe sepsis or septic shock, over the first 72 h of intensive care. Patients were randomly allocated to receive conservative glycemic control (target range 140-180 mg/dl) or intensive glycemic control (target range 80-110 mg/dl). Serum levels of low-density lipoprotein, high-density lipoprotein, triglycerides, total cholesterol, free fatty acids, and oxidized low-density lipoprotein were determined. In both groups, serum levels of low-density lipoprotein, high-density lipoprotein, and total cholesterol were below normal, whereas those of free fatty acids, triglycerides, and oxidized low-density lipoprotein were above normal. At 4 h after admission, free fatty acid levels were higher in the conservative group than in the intensive group, progressively decreasing in both groups until hour 48 and continuing to decrease until hour 72 only in the intensive group. Oxidized low-density lipoprotein levels were elevated in both groups throughout the study period. Free fatty acids respond to intensive glycemic control and, because of their high toxicity, can be a therapeutic target in patients with sepsis.

Production and carbon allocation in monocultures and mixed-species plantations of Eucalyptus grandis and Acacia mangium in Brazil

Introducing nitrogen-fixing tree species in fast-growing eucalypt plantations has the potential to improve soil nitrogen availability compared with eucalypt monocultures. Whether or not the changes in soil nutrient status and stand structure will lead to mixtures that out-yield monocultures depends on the balance between positive interactions and the negative effects of interspecific competition, and on their effect on carbon (C) uptake and partitioning. We used a C budget approach to quantify growth, C uptake and C partitioning in monocultures of Eucalyptus grandis (W. Hill ex Maiden) and Acacia mangium (Willd.) (treatments E100 and A100, respectively), and in a mixture at the same stocking density with the two species at a proportion of 1 : 1 (treatment MS). Allometric relationships established over the whole rotation, and measurements of soil CO2 efflux and aboveground litterfall for ages 4-6 years after planting were used to estimate aboveground net primary production (ANPP), total belowground carbon flux (TBCF) and gross primary production (GPP). We tested the hypotheses that (i) species differences for wood production between E. grandis and A. mangium monocultures were partly explained by different C partitioning strategies, and (ii) the observed lower wood production in the mixture compared with eucalypt monoculture was mostly explained by a lower partitioning aboveground. At the end of the rotation, total aboveground biomass was lowest in A100 (10.5 kg DM m(-2)), intermediate in MS (12.2 kg DM m(-2)) and highest in E100 (13.9 kg DM m(-2)). The results did not support our first hypothesis of contrasting C partitioning strategies between E. grandis and A. mangium monocultures: the 21% lower growth (delta B-w) in A100 compared with E100 was almost entirely explained by a 23% lower GPP, with little or no species difference in ratios such as TBCF/GPP, ANPP/TBCF, delta B-w/ANPP and delta B-w/GPP. In contrast, the 28% lower delta B-w in MS than in E100 was explained both by a 15% lower GPP and by a 15% lower fraction of GPP allocated to wood growth, thus partially supporting our second hypothesis: mixing the two species led to shifts in C allocations from above- to belowground, and from growth to litter production, for both species.

Obstructive acute abdomen due to intestinal intussusception in adolescent

Introduction: Intestinal intussusception is a rare disease out of childhood. It is represented by an invagination of a bowel into the lumen of the adjacent segment. Case Report: This article reports a case of 14 year-old patient presenting intestinal obstruction caused by an intussusception at the level of the terminal ileum. A surgical resection of the invaginated segment was done and the histopathological study disclosed no evidence of malignancy. Discussion: In children, it is usually idiopathic, but among adolescents and adults it is often related to anatomic lesions, some of them neoplastic with high risk of malignancy. Preoperative diagnosis of intestinal intussusception is difficult due to its nonspecific and subacute symptoms. Computed tomography and ultrassonography can confirm the intussusception through characteristic images. Conclusion: Intestinal intussusception in adolescents is a rare and often misdiagnosed disease, deserving special attention from surgeons and general doctors.

Identification of 2 Novel ANTXR2 Mutations in Patients With Hyaline Fibromatosis Syndrome and Proposal of a Modified Grading System

Juvenile hyaline fibromatosis (JHF) and infantile systemic hyalinosis (ISH) are rare, autosomal recessive disorders of the connective tissue caused by mutations in the gene encoding the anthrax toxin receptor 2 protein (ANTXR2) located on chromosome 4q21. Characteristically, these conditions present with overlapping clinical features, such as nodules and/or pearly papules, gingival hyperplasia, flexion contractures of the joints, and osteolytic bone defects. The present report describes a pair of sibs and three other JHF/ISH patients whose diagnoses were based on typical clinical manifestations and confirmed by histopathologic analyses and/or molecular analysis. A comparison of ISH and JHF, additional thoughts about new terminology (hyaline fibromatosis syndrome) and a modified grading system are also included. (C) 2012 Wiley Periodicals, Inc.

The peculiar isolated neutron star in the Carina Nebula Deep XMM-Newton and ESO-VLT observations of 2XMM J104608.7-594306

While fewer in number than the dominant rotation-powered radio pulsar population, peculiar classes of isolated neutron stars (INSs) which include magnetars, the ROSAT-discovered "Magnificent Seven" (M7), rotating radio transients (RRATs), and central compact objects in supernova remnants (CCOs) - represent a key element in understanding the neutron star phenomenology. We report the results of an observational campaign to study the properties of the source 2XMM J104608.7-594306, a newly discovered thermally emitting INS. The evolutionary state of the neutron star is investigated by means of deep dedicated observations obtained with the XMM-Newton Observatory, the ESO Very Large Telescope, as well as publicly available gamma-ray data from the Fermi Space Telescope and the AGILE Mission. The observations confirm previous expectations and reveal a unique type of object. The source, which is likely within the Carina Nebula (N-H = 2.6x10(21) cm(-2)), has a spectrum that is both thermal and soft, with kT(infinity) = 135 eV. Non-thermal (magnetospheric) emission is not detected down to 1% (3 sigma, 0.1-12 keV) of the source luminosity. Significant deviations (absorption features) from a simple blackbody model are identified in the spectrum of the source around energies 0.6 keV and 1.35 keV. While the former deviation is likely related to a local oxygen overabundance in the Carina Nebula, the latter can only be accounted for by an additional spectral component, which is modelled as a Gaussian line in absorption with EW = 91 eV and sigma = 0.14 keV (1 sigma). Furthermore, the optical counterpart is fainter than m(V) = 27 (2 sigma) and no gamma-ray emission is significantly detected by either the Fermi or AGILE missions. Very interestingly, while these characteristics are remarkably similar to those of the M7 or the only RRAT so far detected in X-rays, which all have spin periods of a few seconds, we found intriguing evidence of very rapid rotation, P = 18.6ms, at the 4 sigma confidence level. We interpret these new results in the light of the observed properties of the currently known neutron star population, in particular those of standard rotation-powered pulsars, recycled objects, and CCOs. We find that none of these scenarios can satisfactorily explain the collective properties of 2XMM J104608.7-594306, although it may be related to the still poorly known class of Galactic anti-magnetars. Future XMM-Newton data, granted for the next cycle of observations (AO11), will help us to improve our current observational interpretation of the source, enabling us to significantly constrain the rate of pulsar spin down.

Advice on the Management of Ambiguous Genitalia to a Young Endocrinologist from Experienced Clinicians

The birth of a child with ambiguous genitalia is a challenging and distressing event for the family and physician and one with life-long consequences. Most disorders of sexual differentiation (DSD) associated with ambiguous genitalia are the result either of inappropriate virilization of girls or incomplete virilization of boys. It is important to establish a diagnosis as soon as possible, for psychological, social, and medical reasons, particularly for recognizing accompanying life-threatening disorders such as the salt-losing form of congenital adrenal hyperplasia. In most instances, there is sufficient follow-up data so that making the diagnosis also establishes the appropriate gender assignment (infants with congenital adrenal hyperplasia, those with androgen resistance syndromes), but some causes of DSD such as steroid 5 alpha-reductase 2 deficiency and 17 beta-hydroxysteroid dehydrogenase deficiency are associated with frequent change in social sex later in life. In these instances, guidelines for sex assignment are less well established.