Deoxynivalenol and pigs: review of harmful effect of Mycotoxin on swine health

Abstract Mycotoxins are compounds produced by certain types of fungi, and the mycotoxin one of the most most frequently found in the tested cereal samples is deoxynivalenol (DON), naturally-occurring mycotoxin produced by Fusarium spp. An animal sensitive to the effects of this mycotoxin is the pig due to the diet containing primarily cereals and the structure of a digestive system, which causes DON to be quickly absorbed unchanged into the bloodstream and partially metabolized in the liver. An important aspect when considering the toxicity of DON is the occurrence of its modified forms, which can be transformed into DON in the digestive system. The toxic effect of DON can also be caused by other mycotoxins which co-occur in cereals. The toxic effect of DON on the body of pigs was observed mainly in the digestive, immune, and reproductive systems. The noticeable of DON’s toxic effects depends on the exposure time, route of administration and mycotoxin concentration. The changes are mainly caused by impaired gene expression, inhibiting protein synthesis or the effect of DON on pathways in pigs’ bodies. The negative impact of DON on the health of pigs may lead to reduced weight gain, poor health, and increased susceptibility to infections and reproductive disorders. There have also been many methods of DON elimination from cereals, but their efficiency is insufficient

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit