Comparison of Methods for Detection of Blastocystis Infection in Routinely Submitted Stool Samples, and also in IBS/IBD Patients in Ankara, Turkey

BACKGROUND: This study compared diagnostic methods for identifying Blastocystis in stool samples, and evaluated the frequency of detection of Blastocystis in patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). RESULTS AND DISCUSSION: From a set of 105 stool specimens submitted for routine parasitological analysis, 30 were identified as positive for Blastocystis by the culture method. From that group of 30 positives, Lugol's stain, trichrome staining, and an immunofluorescence assay identified 11, 15, and 26 samples as positive respectively. Using culture as a standard, the sensitivity of Lugol's stain was 36.7%, trichrome staining was 50%, and the IFA stain was 86.7%. The specificity of Lugol's stain was 91%, trichrome staining was 100%, and the IFA stain was 97.3%. In the group of 27 IBS and IBD patients, using all methods combined, we detected Blastocystis in 67% (18/27) of the patients. Blastocystis was detected in 33% (2/6) of IBD patients and 76% (16/21) of IBS patients. For comparison, trichrome staining alone, the method most frequently used in many countries, would have only identified Blastocystis infection in 29% (6/21) of the IBS patients. No parasitic co-infections were identified in the IBS/IBD patients. Most Blastocystis-positive IBS/IBD patients were over 36 with an average length of illness of 4.9 years. CONCLUSIONS: Most IBS patients in this study were infected with Blastocystis. IFA staining may be a useful alternative to stool culture, especially if stool specimens have been chemically preserved

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council

Associations of feed efficiency with circulating IGF-1 and leptin, carcass traits and meat quality of lambs

The aim of this study was to investigate the effects of feed efficiency classifications on live animal measurements, circulating IGF-1 and leptin concentrations, and carcass, non-carcass and meat quality traits of lambs. One-hundred and two lambs approximately 70 days-old with initial live weight of 24.6 ± 3.71 kg (mean ± SD) were individually fed for 56 days to determine residual feed intake (RFI) and residual feed intake and gain (RIG). Lambs were then classified as phenotypically Low-, Medium- or High-RFI and Low-, Medium- or High-RIG phenotypes. Circulating leptin and IGF-1 concentrations were higher in more efficient lambs (Low-RFI or High-RIG). Variation in RFI and RIG did not affect meat redness or tenderness, but High-RIG lambs had darker meat. These findings show that the phenotypically more efficient Low-RFI and High-RIG lambs produced carcasses with similar characteristics and meat quality as the less efficient High-RFI and Low-RIG lambs but have a strategic advantage of lower feed intake to achieve similar production outcomes

Efeito dos níveis de concentrado sobre as características de carcaça de ovinos Morada Nova em confinamento Effect of concentrate levels on carcass characteristics of the Morada Nova breed sheep in feedlot

Avaliaram-se as características de carcaça e os rendimentos dos cortes medidos in vivo e na carcaça de ovinos Morada Nova terminados em confinamento com dietas contendo diversos níveis de concentrado. Utilizaram-se 32 cordeiros castrados, Morada Nova, com 8,11 ± 1,15 meses de idade e peso inicial de 19,67 ± 2,97 kg, em delineamento de blocos casualizados, cada um com oito repetições. Os animais foram abatidos com 30,0 kg e alimentados com quatro níveis de concentrado (20, 40, 60 ou 80%). Houve efeito linear crescente do nível de concentrado da dieta sobre o peso do corpo vazio e peso e o rendimento da carcaça fria e efeito linear decrescente sobre o conteúdo do trato digestório e o número de dias em confinamento. Os níveis de concentrado tiveram efeito linear crescente sobre o peso e rendimento de pescoço e efeito linear decrescente sobre os rendimentos da paleta e perna, ao passo que o peso do costilhar foi influenciado de forma quadrática pelos tratamentos. Nas medidas in vivo, apenas o perímetro da perna sofreu efeito decrescente. Nas medidas na carcaça, houve efeito linear crescente sobre a largura do tórax e a compacidade, que aumentaram com o nível de concentrado na dieta, enquanto a largura da garupa teve efeito quadrático. O uso de concentrado na dieta eleva os pesos e os rendimentos de carcaça fria, mas não aumenta os pesos e rendimentos dos cortes da carcaça de cordeiros Morada Nova.<br>The in vivo carcass characteristics and the cut yields measured in the carcass of Morada Nova sheep finished in feedlot system fed increasing levels of dietary concentrate were evaluated. Thirty-two castrated Morada Nova lambs with 8.11 ± 1.15 months of age and 19.67 ± 2.97 kg of initial body weight were used in this trial. The experimet was analyzed as a completely randomized block design with eight replicates per treatment. Animals were slaughtered at 30.0 kg BW and fed diets with four concentrate levels: 20, 40, 60 or 80%. Linear increasing effect of dietary concentrate on empty body weight and cold carcass weight and yield and linear decreasing effect on digestive tract content and feedlot period were observed. The neck weight and yield linearly increased and the percentage of shoulder and leg linearly decreased with the concentrate levels, while the rib weight showed quadratic effect. In the in vivo measurements, only leg perimeter presented significant effect. There was a linear increasing effect for thoracic width and carcass compactness, while the hind width showed quadratic effect. The use of concentrate in the diet increased the weight and yields of cold carcass; however this maximization did not increase the weights and yields of commercial cuts from Morada Nova lambs