RESUMO
The use of echocardiography by physicians who are not echocardiographers has become common throughout the world across highly diverse settings where the care of acutely ill patients is provided. Echocardiographic evaluation performed in a point-of-care manner can provide relevant information regarding the mechanism of causes of shock, for example, increasing the rates of correct diagnosis and allowing for faster informed decision-making than through evaluation methods. Considering that the accurate diagnosis of life-threatening situations is essential for professionals working with acutely ill patients, several international associations recommend that physicians responsible for critically ill patients acquire and develop the ability to perform bedside ultrasound examinations, including echocardiographic examinations. However, there is no consensus in the literature regarding which specific applications should be included in the list of skills for nonechocardiographer physicians. Taking into account the multiplicity of applications of echocardiography in different scenarios related to acutely ill patients; the differences in the published protocols, with regard to both the teaching methodology and competence verification; and the heterogeneity of training among highly diverse specialties responsible for their care at different levels, this consensus document aimed to reflect the position of representatives of related Brazilian medical societies on the subject and may thus serve as a starting point both for standardization among different specialties and for the transmission of knowledge and verification of the corresponding competencies.
Assuntos
Estado Terminal , Humanos , Brasil , Clostridiales , Estado Terminal/terapia , EcocardiografiaRESUMO
Introduction: Early-life events are associated with the risk of obesity and comorbidities later in life. The gut microbiota-whose composition is influenced by genetics and environmental factors-could be involved. Since the microbiota affects metabolism and fat storage, early-life insults could contribute to the occurrence of obesity driven, in part, by microbiota composition. We examined associations of gut bacteria with early-life events, nutritional status, and body composition in the Nutritionist's Health Study (NutriHS). Methods: A cross-sectional study of 114 female participants examining early-life data, body composition, and biological samples was conducted. Fecal microbiota structure was determined targeting the V4 region of the 16S rRNA gene. Principal coordinates analysis (PCoA) and permutational multivariate analysis of variance (PERMANOVA) were used to test the impact of variables on microbial diversity. Profiles were identified using the Jensen-Shannon divergence matrix and Calinski-Harabasz index. Differential abundance between the categories of exclusive breastfeeding duration and nutritional status was tested using DESeq2. Results: In the sample [median age 28 years and body mass index (BMI) 24.5 kg/m2], 2 microbiota profiles driven by the Blautia or Prevotella genus were identified. An estimated 9.1% of the variation was explained by the profiles (p < 0.001), 2.1% by nutritional status (p = 0.004), and 1.8% by exclusive breastfeeding (p = 0.012). The proportion of participants with BMI <25 kg/m2 and who were breastfed for at least 6 months was higher in the Blautia profile (p < 0.05). Conclusion: Findings in a Blautia-driven profile of healthy women reinforce that early-life events play a role in defining gut microbiota composition, confirming the importance of exclusive breastfeeding for infant gut colonization in establishing a protective profile against adiposity-related outcomes in adulthood.
Assuntos
Clostridiales , Obesidade , Adulto , Clostridiales/genética , Estudos Transversais , Feminino , Humanos , Obesidade/genética , Fenótipo , RNA Ribossômico 16S/genéticaRESUMO
Horses are non-ruminant, herbivorous mammals, been used through history for various purposes, with a gut microbiota from cecum to the colon, possessing remarkable fermentative capacity. We studied the fecal microbiota of Azteca, Criollo, Frisian, Iberian, Pinto, Quarter and Spanish horse breeds living in Mexico by next-generation DNA sequencing of 16S rRNA gene libraries. Dominant phyla Firmicutes, Bacteroidetes, Proteobacteria, Spirochaetes, Fibrobacteres, Actinobacteria and Verrucomicrobia have different relative abundances among breeds, with contrasted alpha and beta diversities as well. Heatmap analysis revealed that Ruminococcaceae, Lachnospiraceae, Mogibacteriaceae families, and order Clostridiales are more abundant in Spanish, Azteca, Quarter and Criollo breeds. The LEfSe analysis displayed higher abundance of order Bacteroidales, family BS11, and genera Faecalibacterium, Comamonas, Collinsella, Acetobacter, and Treponema in Criollo, Azteca, Iberian, Spanish, Frisian, Pinto, and Quarter horse breeds. The conclusion is that dominant bacterial taxa, found in fecal samples of horse breeds living in Mexico, have different relative abundances.
Assuntos
Actinobacteria , Bacteroidetes , Actinobacteria/genética , Animais , Bacteroidetes/genética , Clostridiales/genética , Fezes/microbiologia , Sequenciamento de Nucleotídeos em Larga Escala , Cavalos , Mamíferos/genética , México , RNA Ribossômico 16S/genética , Verrucomicrobia/genéticaRESUMO
Tyzzer disease (TD) is caused by Clostridium piliforme, a gram-negative and obligate intracellular bacterium. The disease occurs in multiple species. A triad of lesions, namely colitis, hepatitis, and myocarditis, is described in cases of TD in some species, such as rats and mice. We carried out a retrospective analysis of 25 equine cases with a diagnosis of TD; 24 of 25 cases occurred in foals <45 d old; the remaining foal was 90 d old. There were 12 males and 12 females; no sex information was available for one foal. The affected breeds were Quarter Horse, Thoroughbred, Arabian, Paint, and Hanoverian. Most of the cases (19 of 25) occurred in the spring. There were 9 cases of sudden death; the remaining animals had diarrhea, fever, distended abdomen, depression, weakness, non-responsiveness, and/or recumbency. Gross findings included icterus, hepatomegaly with acinar pattern, serosal hemorrhages, pulmonary edema, and/or fluid content in small and large intestine. Microscopically, all foals had severe, multifocal, necrotizing hepatitis. Necrotizing lymphohistiocytic colitis was observed in 10 of 25 foals, and multifocal necrotizing myocarditis was found in 8 of 25. Gram-negative, Steiner-positive, intracytoplasmic filamentous bacteria were observed in hepatocytes, enterocytes, and myocardiocytes, respectively. PCR detected C. piliforme DNA in the liver (24 of 24), colon (20 of 24), and heart (5 of 25). Our results indicate that necrotic hepatitis is the hallmark of TD in horses; the so-called triad of lesions is not a consistent characteristic of the disease in this species.
Assuntos
Infecções por Clostridium , Colite , Doenças dos Cavalos , Miocardite , Doenças dos Roedores , Animais , Clostridiales , Clostridium/genética , Infecções por Clostridium/microbiologia , Infecções por Clostridium/veterinária , Colite/veterinária , Feminino , Doenças dos Cavalos/diagnóstico , Cavalos , Masculino , Camundongos , Miocardite/veterinária , Ratos , Estudos RetrospectivosRESUMO
Clinical History: A 25-year-old female emu (Dromaius novaehollandiae) presented with a 1-week history of lethargy, hyporexia, and recumbency. The bird had lived its entire life at the Winnie Carter Wildlife Center in Texas and had an unremarkable medical history, apart from bilateral congenital blindness. Necropsy Findings: Within the coelomic cavity, the serosal surface of the intestines was coated with a moderate amount of tan to green, mucoid, opaque, foul-smelling fluid (fibrinoheterophilic coelomitis) (Fig. 1). The large intestine was diffusely dilated and filled with dark red fluid and strands of yellow, friable material (fibrin). The mucosa of the small intestine, and most severely the colon, was diffusely roughened, thickened, dull, and covered by a thick yellow to green, opaque, friable diphtheritic membrane (Fig. 2). The distal colon was diffusely, markedly distended and focally contained a 50x7x5 cm, semi-firm accumulation of feces coated by a 4-5 mm diameter layer of tan, friable material (fibrin) located 21 cm from the opening of the cloaca. Gross evaluation of the eyes revealed bilateral aphakia. Follow-up questions: Morphologic diagnosis Ancillary tests to determine the etiology (AU)
Assuntos
Animais , Aves , Dromaiidae/microbiologia , Enterocolite/fisiopatologia , Triacetonamina-N-Oxil , ClostridialesRESUMO
One of the bottlenecks of the hydrogen production by dark fermentation is the low yields obtained because of the homoacetogenesis persistence, a metabolic pathway where H2 and CO2 are consumed to produce acetate. The central reactions of H2 production and homoacetogenesis are catalyzed by enzyme hydrogenase and the formyltetrahydrofolate synthetase, respectively. In this work, genes encoding for the formyltetrahydrofolate synthetase (fthfs) and hydrogenase (hydA) were used to investigate the diversity of homoacetogens as well as their phylogenetic relationships through quantitative PCR (qPCR) and next-generation amplicon sequencing. A total of 70 samples from 19 different H2-producing bioreactors with different configurations and operating conditions were analyzed. Quantification through qPCR showed that the abundance of fthfs and hydA was strongly associated with the type of substrate, organic loading rate, and H2 production performance. In particular, fthfs sequencing revealed that homoacetogens diversity was low with one or two dominant homoacetogens in each sample. Clostridium carboxivorans was detected in the reactors fed with agave hydrolisates; Acetobacterium woodii dominated in systems fed with glucose; Blautia coccoides and unclassified Sporoanaerobacter species were present in reactors fed with cheese whey; finally, Eubacterium limosum and Selenomonas sp. were co-dominant in reactors fed with glycerol. Altogether, quantification and sequencing analysis revealed that the occurrence of homoacetogenesis could take place due to (1) metabolic changes of H2-producing bacteria towards homoacetogenesis or (2) the displacement of H2-producing bacteria by homoacetogens. Overall, it was demonstrated that the fthfs gene was a suitable marker to investigate homoacetogens in H2-producing reactors. KEY POINTS: ⢠qPCR and sequencing analysis revealed two homoacetogenesis phenomena. ⢠fthfs gene was a suitable marker to investigate homoacetogens in H2 reactors.
Assuntos
Hidrogênio , Acetobacterium , Clostridiales , Eubacterium , FilogeniaRESUMO
This study evaluated the effects of flours from four different sweet potato root (SPR) varieties, being two with white peel and two with purple peel, on the composition and metabolic activity of human colonic microbiota in vitro. The capability of these SPR flours (20 g/L) to cause alterations in relative abundance of different bacterial groups found as part of human colonic microbiota, as well as in lactic acid and short-chain fatty acid production was evaluated during 48 hr of an in vitro colonic fermentation. The SPR flours were submitted to a simulated gastrointestinal digestion prior to use in experiments. The four SPR flours increased the relative abundance of Lactobacillus/Enterococcus (range: 0.49-4.48%) and Bifidobacterium (range: 0.32-3.27%) and decreased the relative abundance of Bacteroides/Prevotella (range: 0.29-7.49%), Clostridium histolyticum (range: 0.15-2.08%), and Eubacterium rectale/Clostridium coccoides (range: 0.28-3.86%) during the 48 hr of colonic fermentation. The four SPRF flours had positive prebiotic indexes (> 0.38) after 24 and 48 hr of colonic fermentation, reinforcing the occurrence of selective stimulatory effects on colonic microbiota. An increased metabolic activity of human colonic microbiota was caused by tested SPR flours, which was evidenced by decreased pH (range: 3.20-3.83) and increased lactic acid and short chain fatty acid production during the 48 hr of colonic fermentation. The four examined SPR flours were capable of causing positive alterations in composition and driving the metabolic activity of human colonic microbiota during in vitro colonic fermentation, which should be linked to their prebiotic properties. PRACTICAL APPLICATION: The four examined sweet potato root flours (SPRF) caused beneficial alterations in composition besides of driving the metabolic activity of human colonic microbiota in vitro. These results characterize the examined SPRF as candidates for use as prebiotic ingredients by food industry for formulation of value-added functional foods or dietary supplements.
Assuntos
Ipomoea batatas , Microbiota , Clostridiales , Fezes/química , Fermentação , Farinha , Humanos , Prebióticos/análiseRESUMO
Cashew apple by-product (CAB) is an important agro-industrial waste still underutilized, although it has been characterized as source of a variety of nutrients and bioactive compounds. This study evaluated the capability of freeze-dried CAB (FCAB) submitted to a simulated gastrointestinal digestion of inducing changes in relative abundance of distinct microbial groups found as part of human colonic microbiota, as well as in pH and short-chain fatty acid production during a 24-h in vitro fermentation using a pooled human fecal inocula. FCAB increased the relative abundance of Bifidobacterium and Lactobacillus/Enterococcus during colonic fermentation, besides to decrease the relative abundance of Bacteroides/Prevotella, Eubacterium rectale/Clostridium coccoides, and Clostridium histolyticum. FCAB increased the counts of lactic acid bacteria and decreased the counts of Enterobacteriaceae during colonic fermentation. Furthermore, FCAB decreased pH and increased the production of short-chain fatty acids in colonic fermentation media. These effects could be linked to contents of dietary fibers and the presence of fructans and different phenolic compounds found in FCAB. These results showed that FCAB induced positive alterations in composition and metabolic activity of human colonic microbiota in vitro, which indicate prebiotic properties.
Assuntos
Anacardium , Microbiota , Clostridiales , Fezes/química , Fermentação , Humanos , Prebióticos/análiseRESUMO
BACKGROUND: Despite widespread use, the impact of minocycline hydrochloride microspheres on the shifts of oral bacterial species resistant to minocycline remains unknown. This study aimed at examining the percentage and taxonomy of minocycline-resistant isolates in saliva and subgingival plaque samples before and after minocycline microspheres application in periodontitis patients during maintenance. METHODS: Patients received supra- and sub-gingival debridement with (test) or without (control) minocycline microspheres application to sites with probing depth >4 mm and were clinically monitored at baseline, 1, 3, and 6 months. Samples were collected at baseline, 1 and 6 months and analyzed via cultivation with or without 4 µg/mL minocycline. Percentage of resistant strains was determined by colony counting and taxonomy by checkerboard DNA-DNA hybridization. Significant clinical changes were sought with the Mann-Whitney test and differences in percentage of resistant isolates with the Friedman and Mann-Whitney tests. RESULTS: Groups showed similar clinical improvements. Mean percentage of resistant isolates rose at 1 month and decreased at 6 months in saliva and plaque samples in test group (P <0.05) but remained unchanged in control group. Percentage of resistant isolates of Gemella morbillorum and Eubacterium saburreum increased significantly at 6 months in both groups. Antibiotic resistance by Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Porphyromonas gingivalis was either absent or infrequent. CONCLUSION: Minocycline microspheres result in transient selection of minocycline resistant species in saliva and subgingival plaque samples.
Assuntos
Antibacterianos , Farmacorresistência Bacteriana , Minociclina , Periodontite/terapia , Aggregatibacter actinomycetemcomitans , Antibacterianos/uso terapêutico , Clostridiales , Gemella , Humanos , Microesferas , Minociclina/uso terapêutico , Porphyromonas gingivalisRESUMO
This study investigated the effects of consumption of wheat-durum pasta added of Bifidobacterium animalis inactivated by gamma-irradiation (paraprobiotic) on health and gut microbiota of rats. Twenty-one male rats were divided into three groups as follow: control (Control) receiving standard diet; pasta control (PC) receiving diet containing pasta, and paraprobiotic pasta Bifidobacterium-irradiated (PPBI), receiving paraprobiotic pasta. The serum levels of glucose and total cholesterol were reduced (p < 0.05) in PPBI when compared to the Control (p < 0.05). PPBI showed high abundance (p Ë 0.05) of Firmicutes and Actinobacteria and a lower abundance of Bacteriodes compared to Control and PC. Besides, the PPBI showed high abundance (p Ë 0.05) of Clostridiales, Lactobacillales; Bifidobacteriales, Bacillales, and Coriobacteriales in comparison to Control. Specific genera such as Bifibacterium, Lactobacillus, Ruminococcus, Allobaculum, and Blautia were more related to PPBI. Findings reveal wheat-durum pasta as a potential vehicle for delivering paraprobiotics B. animalis.