Effect of protein C and activated protein C on alveolar fibrin deposition and turnover in a piglet model of septic shock.
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Biomedical subjects
Publications and source records attributed to A Veldman.
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For application in broiler production, we developed a multispecies (MSPB) and a chicken-specific (CSPB) probiotic preparation in fluid form. The MSPB contained different probiotic species of human origin, whereas the CSPB consisted of 7 Lactobacillus species isolated from the digestive tract of chickens. In a field trial with broilers, MSPB treatment resulted in a slight increase (by 1.84%) in broiler productivity based on an index taking into account daily weight gain, feed efficiency, and mortality. The CSPB treatment reduced mortality in 2 subsequent field trials and raised productivity by 2.94 and 8.70%. In a controlled trial with broilers showing a high index of productivity, probiotic treatment further raised productivity by 3.72%. Based on the present 4 studies in combination with 9 studies published earlier, it is suggested that with higher productivity rates of the broilers the effect of probiotics becomes smaller.
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The response of intestinal epithelial cells to short-chain fatty acids, which are increasingly used as food additives, was investigated. Human small intestinal epithelial cell model Caco-2 cells were exposed to formate, propionate and butyrate to assess their effect on cellular growth, metabolism, differentiation and protection against bacteria. The Caco-2 cells were entirely grown in the different short-chain fatty acids and respective growth patterns were determined. Differentiated cells were exposed to 0-20 mM short-chain fatty acids for 48 h and changes in DNA, RNA, (glyco)protein syntheses, sucrase isomaltase activity, transepithelial electrical resistance and protection against Salmonella enteritidis were measured. The short-chain fatty acids, altered linearly and differentially the growth pattern ranging from stimulation by formate to inhibition by butyrate. Formate inhibited cellular metabolism. Low concentrations of up to 5 mM propionate and 2 mM butyrate stimulated metabolism, while higher doses were inhibitory. Formate had no effect on sucrase isomaltase enzyme activity and transepithelial electrical resistance, whereas propionate and butyrate increased these markers of differentiation. Infection with S. enteritidis did not benefit from the short-chain fatty acid-induced transepithelial electrical resistance. It is concluded that formate, propionate and butyrate selectively and differentially modulate growth characteristics, cellular metabolism, sucrase isomaltase activity and transepithelial electrical resistance in a concentration- and carbon atom-related fashion. The short-chain fatty acid-induced transepithelial electrical resistance does not confer protection against S. enteritidis.
BACKGROUND: Whether twins are more prone to increased neonatal morbidity than singletons remains controversial. It was the aim of this study to define the special risks of preterm twins with an emphasis on cerebral morbidity. METHODS: A retrospective chart review was carried out of all consecutively born twins (n = 230) and the corresponding sets of singletons of a single level-III neonatal intensive care unit. The subjects had a gestational age between 24 and 37 weeks, and were born in 1990-98. RESULTS: Twin pregnancies were more often complicated by preterm contractions (odds ratio (OR) 4.03 (95% confidence interval (CI) 2.39, 6.78)) whereas gestosis was significantly less (OR 0.14 (95% CI 0.05, 0.41)). Grades III and IV intracranial bleeding occurred significantly more often in twins compared to singletons (OR 3.75 (95% CI 1.65, 8.97)), with infants of less than 32 weeks' gestational age being predominantly affected (OR 3.31 (95% CI 1.33, 8.29)). Infants of less than 32 weeks' gestational age developed respiratory distress syndrome more often than the corresponding singletons (OR 1.93 (95% CI 1.15, 3.25)). There were no differences in all observed items between the first- and second-born twins. CONCLUSION: Twins of less than 37 weeks' gestational age were significantly more often affected by high-grade intraventricular hemorrhage irrespective of birth order. Periventricular leukomalacia occurred twice as often as in singletons. There were no differences with respect to mortality and further morbidity except for respiratory distress syndrome in preterm twins of less than 32 weeks' gestational age.
Dietary starch is the major energy source for broiler chickens, and knowledge about its digestive behavior can be important. In a digestibility trial with 720 broiler chickens, site, rate and extent of starch digestion were measured for 12 feedstuffs. Starch digestion was determined using the slaughter technique, which involves removal of the small intestine from the recently killed chicken, with manual collection of the contents. Starch digestion coefficients were calculated from remaining starch in three segments of the small intestine and in excreta. Mean retention time in four segments of the small intestine was measured. This enabled calculations for starch digestion rate (k(d)). Ileal starch digestibility varied from 33% (potato starch) to 99% (tapioca). Retention time for digesta in the postduodenal small intestine varied from 136 min (barley diet) to 182 min (potato diet). On the basis of starch digestion rates, a distinction was made between slowly digestible starch (k(d) < 1 h(-1)), gradually digestible starch (k(d):1-2 h(-1)) and rapidly digestible starch (k(d) > 2 h(-1)). Starch from common beans was digested most slowly (k(d): 0.5 h(-1)), and starch from tapioca was digested most rapidly (k(d): 4.3 h(-1)). Starch digestion rates of potato starch and legume seeds were lower than those of cereal grains and tapioca. Degradation of starch entering the hind gut of the birds did not occur. Milling of corn affected rate, but not the extent of starch digestion. We concluded that site of starch digestion within the small intestine is not an accurate indicator for starch digestion rate.
Current feed evaluation systems for poultry are based on digested components (fat, protein and nitrogen-free extracts). Digestible starch is the most important energy source in broiler chicken feeds and is part of the nitrogen-free extract fraction. Digestible starch may be predicted using an in vitro method that mimics digestive processes in the gastrointestinal tract of broiler chickens. An experiment was designed to use this method for predicting site, rate and extent of starch digestion in broiler chickens. In vitro starch digestion was studied in 12 experimental diets differing in starch sources. These diets were also used in a digestibility trial with broiler chickens. Correlations between in vitro and in vivo starch digestion were calculated. Starch digestion after 2 h incubation correlated well with in vivo starch digestion in the first half of the small intestine (r = 0.94). A 4-h incubation period resulted in a good correlation between in vitro starch digestion and ileal starch digestion (r = 0.96). In vitro starch digestion rate (h(-1)) correlated well with in vivo starch digestion rate (r = 0.87). In vitro starch digestion of individual starch sources was additive. It appeared that legume seeds and waxy corn contained two starch fractions, which were digested at different rates. We conclude that starch digestion rate in broiler chickens is well predicted by the in vitro method.
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BACKGROUND AND OBJECTIVE: International long-distance travel increasingly takes elderly and sometimes already ill persons to foreign countries. In case of illness it is usually best, for both medical and social reasons, that the person return home. This study was undertaken to assess possibilities and limits of bringing such patients home by scheduled airline. PATIENT AND METHODS: The transportation reports and case notes of 95 patients who had been repatriated to Germany in 1995 and 1996 for medical reasons were analysed retrospectively. The mean age was 56 (16-94) years. 50% of the patients had medical, 23% surgical, 19% neurological and 8% psychiatric illnesses. RESULTS: None of the patients died during transport. The NACA score (National Advisory Committee for Aeronautics, USA) for determining the degree of severity of an illness (point scale 1-7) in this group of patients was between 1 and 4, median of 3. Five patients with a score of 5 or higher were judged not to be fit for transport. Two were repatriated by ambulance plane, in three transport was postponed by a few days. No invasive procedures, other than providing intravenous access, were necessary. CONCLUSIONS: Patients who fall ill abroad can be safely and carefully brought home by scheduled airliner over great distances without additional risk caused by the transport. Ambulance planes are needed only in illnesses with an NACA score of 4 or higher.
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OBJECTIVES: To compare high-frequency oscillatory ventilation (HFOV) and intermittent positive pressure ventilation (IPPV) as a primary ventilation mode in preterm infants with respiratory distress syndrome. Primary end points were survival and maintenance of the randomized ventilation mode. STUDY DESIGN: Prospective, multicenter, randomized clinical trial. SETTING: Level III neonatal intensive care units at three university children's hospitals. PATIENTS: Ninety-six premature infants (gestational age < 32 weeks) randomly assigned to HFOV or IPPV within the first 2 hours of life. All patients received a natural surfactant. No differences were found between the study groups with respect to the demographic data or the severity of respiratory distress syndrome. Infants were stratified at randomization, by birth weight, into two groups: 750 to 1000 gm (n = 32) and 1001 to 1500 gm (n = 64). The centers involved complied with a study protocol that planned a reduction in respiratory pressures when the infant's oxygen requirement had reached a fractional concentration of inspired oxygen of 0.6. RESULTS: Five patients in the HFOV group died, and eight patients did not respond to the randomized ventilation mode; whereas four patients in the IPPV group died, and nine were switched to HFOV. No differences were found in gas exchange or ventilator support over the first 72 hours. Premature infants with a birth weight < 1000 gm had a significantly shorter course to reach fractional concentration of inspired oxygen of 0.21 while receiving IPPV than those receiving HFOV (9.3+/-4.5 days vs 27.5+/-10.2 days, p = 0.01). No differences were found between the groups in extraalveolar air (HFOV seven; IPPV, seven) and intracranial bleeding (HFOV, nine; IPPV, eight). CONCLUSION: After surfactant treatment, HFOV, as a primary ventilation mode in premature infants with respiratory distress syndrome, is as safe and efficacious as conventional ventilation.
Two diets, with or without a nonfermentable carboxymethylcellulose (CMC) with high viscosity, were fed to broiler chickens beginning at 2 wk of age to study whether the anti-nutritive effect of gelling fibers on lipid digestibility may be associated with reduced intestinal bile salt concentration. Moreover, the microflora were examined to study whether possible changes in bile salt concentration coincide with alterations in microbial numbers. Carboxymethylcellulose depressed apparent lipid digestibility (P = 0.021). Feed intake and weight gain were not significantly affected. Water intake was increased in birds fed the CMC diet (P = 0.039). Bile acid concentration in small intestinal digesta was decreased (P = 0.047) in birds fed the CMC diet, which may have been caused by the increased water content of digesta (P < 0.001). The concentration of bile acids per gram dry matter or per milligram chromium was not reduced in small intestinal contents. Broiler chickens fed the CMC diet excreted more bile acids in the excreta (P < 0.001). Total aerobic and anaerobic microbial counts in the intestinal digesta were significantly increased in the duodenum plus jejunum (P = 0.038) but not in the ileum. Significant increases were found in the numbers of Clostridia (P = 0.017), Lactobacillus (P = 0.009), Bacteroides (P = 0.022), and yeasts and molds (P = 0.012). The present study supports the hypothesis that a nonfermentable gelling fiber (CMC) decreases apparent lipid digestibility by reducing the concentration of bile acids in the chyme in broiler chickens. Moreover, the ingestion of gelling fibers may increase the bacterial activity in the small intestine, which may further contribute to malabsorption of lipids.
The question addressed was whether the viscosity per se of dietary non-starch polysaccharides influences macronutrient digestion in broiler chickens. Water-soluble carboxymethylcellulose preparations of low (LCMC) or high viscosity (HCMC) were fed to broiler chickens (n = 10/group) from 21 to 35 d of age. The HCMC preparations reduced weight gain and raised water intake compared with LCMC. After the HCMC diet was fed, viscosity of the supernatant of small intestinal contents was significantly raised. The HCMC preparations raised the group mean ATP concentration in the digesta of duodenum plus jejunum, indicating that bacterial activity was increased. Consumption of HCMC depressed apparent fecal digestibility of lipids and nitrogen and also apparent ileal digestibility of starch. The dietary HCMC tended (P = 0.077) to reduce plasma triglyceride concentrations. After HCMC consumption, the weights of the small intestine and colon, without or with contents, were elevated. The data indicate that high viscosity of digesta in broiler chickens is associated with a reduced macronutrient digestion and impaired growth performance. Because the carboxymethylcellulose preparations were nonfermentable by fresh feces, we suggest that HCMC reduces macronutrient digestion by raising the viscosity of small intestinal contents, which is associated with enhanced bacterial fermentation due to accumulation of undigested material.
Two experiments were conducted to determine apparent ileal DM and crude-protein (CP) digestibilities in rations fed to pigs. An evaluation was made of Cr2O3 and HCl-insoluble ash as digestive markers. In addition, the effects of body weight (BW) on apparent ileal DM and CP (N x 6.25) digestibilities were studied. In Expt 1, thirteen barrows averaging 35 kg BW were fitted with post-valve T-caecum (PVTC) cannulas to determine the apparent ileal DM and CP digestibilities of a wheat gluten-bran ration (B2) and a soyabean-meal ration (E1). Immediately after morning feeding ileal digesta samples were collected on an hourly basis for a total of 12 h. Subsequently. N and marker contents were determined in the samples. The postprandial patterns of N and Cr passage were more similar than those of N and HCl-insoluble ash. Therefore Cr2O3 is more suitable as a marker than HCl-insoluble ash. The apparent ileal CP digestibility coefficient of ration B2 derived using Cr2O3 as a marker was significantly (P < 0.05) higher by 0.018 compared with the value obtained using HCl-insoluble ash. The corresponding values for ration E2 obtained using Cr2O3 and HCl-insoluble ash were both 0.825. In Expt 2, apparent ileal DM and CP digestibilities were determined in eighteen rations using twelve barrows also fitted with PVTC cannulas (BW from 40 to 100 kg). The protein sources for these rations were from different groups of feedstuffs. In four and three of the rations apparent ileal DM and CP digestibilities respectively were significantly different (P < 0.05) when assessed using the two markers. The digestibility coefficients were not systematically higher or lower for either marker. Absolute differences were < 0.049 on average. Significant effects of live weight on apparent ileal CP digestibilities were found.
In three experiments broiler chickens were inoculated with sporulated Eimeria acervulina oocysts at 18 d of age. Feed intake, body-weight gain, brush-border enzyme activities, fat digestion, protein digestion and protein retention were measured. Body-weight gain was reduced during the acute phase of the infection and increased during the recovery phase of the infection. Feed intake was decreased on day 4 and day 5 postinfection (PI) and increased from day 7 to day 11 PI. Maltase (EC 3.2.1.20) and sucrase (EC 3.2.1.48) activities were decreased on day 5 PI in all intestinal segments. In Expts 2 and 3, however, maltase activity was increased in the ileum. Fat digestion was decreased from day 2 to day 11 PI. N digestion and retention were decreased from day 2 to day 11 PI.
Previously an experimental infection model was developed in which broiler chickens were inoculated with sporulated Eimeria acervulina oocysts at an age of 18 d. The infection resulted in adverse performance results and reduced nutrient digestion. In two new experiments with the infection model effects of diet adjustments on fat digestion were investigated. In the first experiment addition of 0.4 g cholic acid/kg to a diet rich in animal fat resulted in increased fat digestion during the infection. In the second experiment replacing animal fat by coconut oil resulted in improved fat digestion during the coccidiosis infection. However, replacement of animal fat by soybean oil did not improve fat digestion.
Between July 1990 and April 1991 the rate of contamination with Salmonella species of poultry feeds and feed components used by the Dutch feed industry was surveyed. Ten per cent of 360, 10 g samples of poultry feeds were found to be contaminated. Mash feeds, mostly used for layer-breeders, were far more frequently (21 per cent) contaminated than pelleted feeds (1.4 per cent). The rate of contamination of 130 samples of fish meal was 31 per cent, of 83 samples of meat and bone meal 4 per cent, 58 samples of tapioca 2 per cent and of 15 samples of maize grits 27 per cent. Twenty-eight serotypes of salmonellae were isolated, but no Salmonella enteritidis was found, despite the occurrence of an epidemic in poultry caused by this serotype since 1987. The serotypes isolated most frequently were not the same as those encountered in poultry flocks. The Enterobacteriaceae isolated from the feedstuffs were predominantly thermotrophic. They were shown to be useful markers of the rate of contamination with salmonellae and of the efficiency of decontamination of the feedstuffs by pelletisation.