Avaliação de um extrato vegetal na dieta sobre o comportamento produtivo de suínos estressados pelo calor

The exposure of pigs to heat stress (HS) affects the integrity of intestinal epithelia, compared to thermal neutral (TN) pigs, partially due to overproduction of free radicals. Herbal extracts (HE) from Capsicum spp., Pipper nigrum y Zingiber officinales possess antioxidant activity. The effect of adding this HE to the diet was analyzed on performance of 42 pigs (27±3 kg). The treatments were: TN-C, TN pigs with control diet, TN-P, pigs with control diet plus 0.02% HE; HS-C, HS pigs with control diet; and HS-P, HS pigs with control diet plus 0.02% HE. The experiment consisted of two periods; in period 1, all pigs were adapted to the control diet during 8 days under TN conditions, followed by a 7-day experimental period. Daily weight gain and feed intake were higher (P <0.05), and feed conversion ratio tended (P<0.10) to improve in HS-HE pigs compared to HS-C pigs. In conclusion, adding HE to the diet can improve some productive parameters in pigs exposed to HS conditions.La exposición de cerdos a estrés por calor (EC), en comparación con termo neutralidad (TN) afecta la integridad del epitelio intestinal, en parte debido a la sobreproducción de radicales libres. Extractos de hierbas (EH) como Capsicum spp., Pipper nigrum y Zingiber officinales poseen actividad antioxidante. Se evaluó el efecto de adicionar un extracto EH a la dieta en el desempeño productivo de 42 cerdos (27±3 kg) en EC. Los tratamientos fueron: TN-T, cerdos en TN alimentados con dieta testigo; EC-T y EC-EH, cerdos en EC alimentados con dieta testigo sin o con 0.2 % de EH. El experimento consistió de dos periodos; en periodo 1, todos los cerdos tuvieron 8 días de adaptación a la dieta testigo en TN, seguido del periodo experimental de 7 días. La ganancia de peso y consumo de alimento fueron mayores (P <0.05), y la conversión alimenticia tendió a ser mejor (P<0.10) en cerdos EC-EH que en cerdos EC-T. En conclusión, la adición del EH puede contribuir a mejorar algunos parámetros productivos cuando los cerdos están expuestos a EC.A exposição de suínos ao estresse térmico (CE), em comparação com a termoneutralidade (TN), afeta a integridade do epitélio intestinal, em parte devido à superprodução de radicais livres. Extratos de ervas (EH) como Capsicum spp., Pipper nigrum e Zingiber officinales possuem atividade antioxidante. Avaliou-se o efeito da adição de extrato de EH à dieta sobre o desempenho produtivo de 42 suínos (27±3 kg) em EC. Os tratamentos foram: TN-T, suínos em TN alimentados com dieta controle; EC-T e EC-EH, suínos em EC alimentados com dieta controle sem ou com 0,2% de EH. O experimento consistiu em dois períodos; No período 1, todos os suínos tiveram 8 dias de adaptação à dieta controle em TN, seguido do período experimental de 7 dias. O ganho de peso e o consumo de ração foram maiores (P < 0,05) e a conversão alimentar tendeu a ser melhor (P < 0,10) em porcos EC-EH do que em porcos EC-T. Em conclusão, a adição de EH pode contribuir para melhorar alguns parâmetros produtivos quando os suínos são expostos a CE

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Aim This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS-CoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks

Delaying surgery for patients with a previous SARS-CoV-2 infection

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