The study includes separate papers, which are all linked by their emphasis on the effect of different diets on the impact of the development of the small intestine of the young ostrich. This abstract is intended to provide readers with a broad overview of the outcomes of the study. Part 1: Yolk utilisation and the development of the small intestines Chapter 2 deals with the composition of egg yolk as it is absorbed by starved ostrich Struthio camelus L. ) chicks from one to seven days post-hatching and for ostrich (Struthio camelus L.) chicks from one to sixteen days post-hatching on a pre-starter broiler diet. Chapter 3 provides information on the intestinal enzymes of ostrich (Struthio camelus L. ) chicks from one to sixteen days post-hatching on a pre-starter broiler diet. The effect of growth on enzyme activity immediately post-hatching up to sixteen days of age was studied. Chapter 4 details a histological and morphological study of the gastrointestinal tract of ostrich (Struthio camelus L.) chicks from two to sixteen days post-hatching on a pre-starter broiler diet. The effect of growth on histological and morphological changes in the various parts of the small intestines was examined. Part 2: Influence on various pre-starter diets on growth and the development of the intestinal tract Chapter 5 discussed a growth and digestibility study of ostrich (Struthio camelus L.) chicks on eight different pre-starter diets. The performance, growth and physiological development of the chicks on high and low variations of different nutritional components were examined. Chapter 6 provides information on certain intestinal enzymes of ostrich (Struthio camelus L.) chicks on the eight different pre-starter diets. Chapter 7 dealt with the histological and morphological changes of the gastrointestinal tract of ostrich (Struthio camelus L.) chicks as a result of high and low variations of different nutritional components in prestarter diets. Implications The first part of this study revealed that although it appeared that yolk content was absorbed faster in starved ostrich chicks, intake of external feed had a positive influence on the absorption of fat from the yolk. The changes in the fatty acid composition of the yolk fat content that were observed may indicate that ostrich chicks have the ability to withdraw certain fatty acid components, especially unsaturated fatty acids. The digestive tract of ostrich chicks was compared with that of broiler chicks and differences observed in amylase and lipase activity between the birds in this trial and in poultry could be due to genetic differences between species. It could also be due to the genetic homogeneity of the poultry chicks that were used in the trials, whereas ostrich chicks have not been subjected to the same extent of advanced breeding improvement to date. Results on histological and morphological growth of the small intestines of the ostrich chick indicate increased absorption with an increase in age. The second part of this study revealed that ostrich chicks performed differently on diets formulated with different nutritional components. It appears that a high fat and low sugar content in the diet is advantageous in ostrich pre-starter diets. Although there were a few mortalities during the trials, there is no clear indication as to why the chicks died, as the causes of mortalities were not investigated. Differences in composition of the eight pre-starter diets did not seem to have an influence on the protein content or enzyme activity of the small intestines of ostrich chicks. An anti-nutritional factor within certain feedstuffs may, however, have had an influence on enzyme activity. Similar results were obtained for the histological and morphological parameters which were measured in chicks fed the different diets. There was no single diet that promoted intestine development, although it seemed as if the small intestines of the chicks fed the high protein diet were under higher digestive stress than those of the chicks fed the other diets. / Thesis (PhD)--University of Pretoria, 2011. / Anatomy and Physiology / Unrestricted

Surveys of human intestinal protozoa in the United States have been confined mostly to Eastern sections of the country and to the Pacific coast. There has been little work done concerning these parasites in western mountain states, and no previous surveys have been made of these organisms in the Intermountain West. It is important that the kinds oand numbers of these parasitic protozoa be dtermined for this locality; and it is only through surveys that the harmful, as well as the commensal, intestinal protozoa can be determined and treated. In 1933, teh city of Chicago experienced a general epidemic of amoebic dysentry, believed to be caused by a Endameba histolytica carrier. The seriousness of this epidmic led to the realization that the amoebic dysentary of the tropics could occur in tempearte regions. It is one of the purposes of surveys to recognized the incidence of pathogenic protozoa, with the purpose of averting possible epidemics of dysentary, diarrhea and other minor intestinal disturbances.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20804号 / 医博第4304号 / 新制||医||1025(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 河本 宏, 教授 松田 文彦, 教授 柳田 素子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Både i Sverige och internationellt endoskoperar specialistsjuksköterskor mer och mer på grund av den ökade efterfrågan av nedre intestinala endoskopier. Trots stora volymer av undersökningar är kunskap om patienternas upplevelser och tillfredsställelse bristfälligt beskrivet. Syftet med studien var att beskriva aspekter som påverkade patienternas upplevelse av en nedre intestinal endoskopi utförd av en endoskoperande specialistsjuksköterska. Metoden som valdes var en litteraturstudie. Först gjordes en fritextsökning på Google Scholar, sedan gjordes sökningar på PubMed och Cinahl med riktade sökord. De sökord som användes var: Nurse Endoscopist, Patient satifaction, Patient experience, Nurse, Colonoscopy, Sigmoidscopy och Endoscopy. Artiklarna lästes igenom, granskades och analyserades gällande innehåll och vetenskaplig kvalitet. Sammanlagt valdes 19 artiklar att ingå i litteraturöversikten. Patienterna såg den nedre intestinala endoskopin som en process, där processen kan delas in i före, under och efter undersökningen. I resultatet framkom att tydlig och förståelig information under hela undersökningsprocessen är viktigt för patienten. Välinformerade patienter upplevde en högre tolerans samt har mindre oro inför undersökningen. Undersökningen upplevdes som intim och förknippad med smärta, obehag och oro. Att bli undersökt av en skicklig endoskopist av samma kön var viktigt. En endoskoperande specialistsjuksköterska utför undersökningar på ett högkvalitativt sätt ur ett medicinskt perspektiv, med helhetssyn på patientens situation och med hög patientnöjdhet. Slutsatsen var att undersökningen kan vara påfrestande för patienterna men trots det var majoriteten av patienterna nöjda med att bli undersökta av en specialistsjuksköterska som genomför undersökningen med hög kvalitet både medicinsk och omvårdnadsmässigt. Det var viktigt att göra patienten delaktig samt att skapa ett samspel mellan endoskopist och patient för att öka tryggheten hos patienten.

The objective of this research was to use Bacillus subtilis-based probiotics alone or combined with various additional antibiotic alternatives (yeast-derived prebiotics and zinc supplementation) to maintain gut health and improve growth performance of antibioticree broilers. Three consecutive studies have been conducted to evaluate dietary effects on intestinal morphology, digestive organ development, microbiota, and growth performance of commercial broilers under different coccidia-challenge circumstances. In the first study, broilers were raised under commercial conditions, without coccidia-challenge (Chapter III). Broilers fed diets supplemented with antibiotics exhibited the highest body weight gain (BWG) from d 15 to 27. Broilers fed diets supplemented with B. subtilis or prebiotics + B. subtilis exhibited higher BWG from d 28 to 41 and higher BWG from d 0 to 41 as compared to birds fed control diets. In the second study, broilers were exposed to a clinical coccidia-challenge (Chapters IV and V). Interaction and main effects of the dietary supplement and coccidial vaccination were studied. Diets supplemented with Prebiotics + B. subtilis facilitated broilers to reach a similar feed conversion ratio (FCR) as to the antibiotic control group from d 0 to 56. Feeding diets supplemented with B. subtilis to coccidial vaccinated broilers reduced microbiota diversity by increasing the proportion of an antibiotic-resistant bacterium, Rikenella microfusus. In the third study, interaction and main effects of the subclinical coccidia-challenge and the dietary supplement were studied (Chapters VI and VII). The dietary anticoccidial supplementation increased feed intake and BWG and decreased FCR of broilers from d 15 to 28. However, dietary B. subtilis supplementation did not improve any growth performance of broilers. The combined use of zinc and B. subtilis lowered the high mortality of broilers fed diet supplemented with B. subtilis or zinc alone. Additionally, the dietary supplementation of zinc lowered the proportion of Clostridium in cecal contents of broilers. In conclusion, different nutrition strategies should be considered when broiler chickens are under different health circumstances. Bacillus subtilis-based probiotics have potential to replace the antibiotics, but not anticoccidial feed additives.

Intensified poultry production to meet global food demands has faced challenges associated with the removal of in-feed antibiotics due to concerns over antibiotics resistance. The reduction of low-dose antibiotics in feed has allowed for reemergence of intestinal diseases that diminish animal welfare and producer economics. Alternative mechanisms to preventing disease are therefore required. The objective of this dissertation was to examine factors that contribute to chicken development and health including intestinal structure and function, environment, and genetic selection. Chapter 2 investigated the host response to infection of the parasite Eimeria maxima that predisposes chickens to a bacterial infection Clostridium perfringens. Intestinal structure, function, inflammatory response, and epithelial composition was examined during a mild subclinical infection. Analysis of E. maxima and C. perfringens as individual infections revealed how each pathogen contributes to a co-infection. E. maxima caused a more severe inflammatory response, increasing pathology scores, shortening intestinal villi, and elongating crypts in the jejunum at peak infection. C. perfringens was shown to manipulate intestinal epithelial composition by influencing stem cells to differentiate into secretory goblet cells. The most deleterious effects were observed when the pathogens were introduced together, increasing pathology scores further, damaging intestinal villi, and increasing crypt depth. The introduction of C. perfringens and E. maxima also increased signaling for the production of reactive oxygen species, stimulation of tumor necrosis factor- that is involved in innate immunity, and decreased transcription of Hes1, which is involved in Notch signaling towards absorptive cell differentiation. Hes1 has previously been shown to be involved in the inflammatory response and could be an area of interest in determining new treatments to prevent or relieve the effects of E. maxima and C. perfringens. Chapter 3 applied an environmental perspective to disease prevention and examined the properties of C. perfringens that allow it to persist in the poultry house environment. Spores resist treatments used to sanitize poultry houses and litter has been shown to be a reservoir for disease, potentially increasing occurrence in certain houses. The metabolic and physiological properties of C. perfringens were utilized to separate the microbe from other poultry litter bacteria to enumerate spores within houses. A selective and differential medium combined with a heat treatment was developed to isolate C. perfringens spores from poultry litter samples. On average, houses that had histories of necrotic enteritis harbored a greater abundance of C. perfringens spores. Colonies that were isolated on the specialized medium were confirmed using PCR as C. perfringens. Lastly, Chapter 4 examined how genetic selection for multiple traits has influenced early intestinal development compared to divergently selected lines based on eight-week body weight. This study showed the morphological and gene expression differences between lines and revealed that most pathways involved in intestinal development are conserved through genetic selection. The major differences between lines were an increase in peptide transporter PepT1 on d5 and d7 in chicks selected for low eight-week body weight (LWS) compared to high weight selected (HWS) chicks and modern broiler Cobb500 chicks. In HWS chicks, the opposite mechanism was observed with an increase in expression of secretory goblet cell marker Muc2. The findings of these studies give multiple perspectives into poultry production and how major factors in management including nutrition, environment, and genetics can be used to increase efficiency while preventing disease. / Doctor of Philosophy / In poultry production, it is important to use management methods that help chickens grow efficiently while preventing illnesses. A few factors that contribute to the success of a producer include the use of nutrition to enhance intestine health and efficiency, a healthy environment in the poultry house, and using genetics to select for multiple traits to increase productivity. These factors have become even more significant after concerns of antibiotic resistance has eliminated the use of in-feed antimicrobials, allowing for reemergence of diseases that were suppressed. Therefore, the objective of this dissertation was to utilize each of these management strategies to determine how a common disease to the poultry industry affects the chicken intestine, how the environment influences the occurrence of this disease, and how genetic selection impacts the early development of chicks that may contribute to how they handle incidences of disease. Chapter 2 investigated how the bacteria Clostridium perfringens and parasite Eimeria maxima that are commonly seen together in the industry impact the intestinal function, structure, and how the chicken's immune systems respond to invasion by these pathogens. The major finds of this chapter included an increased inflammatory response after E. maxima infection that damaged intestinal structures. These pathogens also decreased the expression of a gene involved in absorptive cell formation that contributes to the inflammatory response. In Chapter 3, environment was investigated to determine if poultry houses that harbored more C. perfringens spores, which are resistant to sanitary treatments, predispose chickens to disease. On average, houses with more spores were correlated with increased disease occurrence. The method developed to determine isolate C. perfringens spores can also be used to monitor the abundance in poultry litter and used as a management tool to prevent or diagnose disease outbreaks. In Chapter 4, the influence of genetic selection on early intestinal development was studied using a modern line of broiler chicks compared to chicks selected for low or high body weights. This study gave insight into how intestinal development is mostly conserved after selecting for multiple genetic traits or a single trait (growth). The main differences were greater body weight in the modern line and high weight selected chicks compared to low weight selected chicks and an increase in gene expression of a peptide transporter in low weight chicks and a decrease in secretory cell expression in high weight chicks. These projects investigated multiple management strategies to address intestinal development and response to pathogens, disease occurrence, and genetic selection as tools to shape intestinal structure and composition.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24517号 / 医博第4959号 / 新制||医||1065(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 妹尾 浩, 教授 松田 道行, 教授 小濱 和貴 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Background and aims: Chronic intestinal failure (CIF) has been long-recognized, however the underlying etiology and risk factors have not been historically well-studied. We aim to study the underlying etiologies of CIF and predictive factors for long-term parenteral support (PS). Methods: We retrospectively identified patients with newly diagnosed CIF who received PS to maintain nutrition at the Cleveland Clinic between 2000 and 2017. Long-term PS was defined as a duration of more than 3 months. Univariable and multivariable logistic regression analyses were performed to identify the predictors of the need for long-term PS. Results: We identified 350 patients with CIF, 150 (43%) and 200 (57%) were diagnosed before and after 2010, respectively. The most common etiology was Crohn's disease (CD) in both cohorts (34.7% versus 30.5%, p = 0.41). Graft-versus-host-disease (GVHD) was a less frequent cause of CIF after 2010 (12.7% versus 2.5%, p = 0.0002). The type of PS was mostly total parenteral nutrition before and after 2010, 95% and 96%, respectively (p = 0.55). On univariable analysis, absence of ileocecal valve (p < 0.0001), ischemic bowel disease (p = 0.009), and whole colon resection (p = 0.033) were associated with the need for long-term PS. On multivariable analysis, absence of ileocecal valve (OR 2.19, p = 0.011) and ischemic bowel disease (OR 3.04, p = 0.003) remained statistically significant predictors of long-term PS. Conclusion: In our cohort of patients with CIF, CD remains the leading etiology over the last 20 years, whereas GVHD is less common after 2010. The absence of ileocecal valve and ischemic bowel disease were reliable predictive factors for requiring long-term PS.

Introducción: El incremento de pacientes con diabetes ha forjado la búsqueda de nuevas investigaciones y de nuevos enfoques terapéuticos preventivos de esta enfermedad. En los últimos años viene cobrando gran importancia el estudio de la asociación entre la diabetes tipo 2 y los microorganismos que habitan en el tracto gastrointestinal, responsables de modificar y contribuir positiva o negativamente con el metabolismo del huésped. Metodología: En el estudio participaron 26 pacientes con diabetes mellitus tipo 2 atendidos en el servicio de Endocrinología de un hospital nivel 4, durante el periodo de agosto de 2016 a febrero de 2017. De cada paciente se colectaron muestras de heces, datos clínicos y la frecuencia de consumo de alimentos. Se identificaron 13 bacterias de la microbiota intestinal en muestras fecales de pacientes diabéticos tipo 2 metabólicamente controlados frente a no controlados mediante la técnica de reacción en cadena de la polimerasa (PCR). Resultados: Se identificó al menos un género de bacterias colónicas en pacientes diabéticos controlados y no controlados en 5 (71,4%) y 11 (57,9%) de los casos respectivamente. Los géneros de bacterias más frecuentes encontrados en los pacientes controlados fueron Proteobacteria, Firmicutes y Prevotella; mientras que en los pacientes no controlados se encontró con mayor frecuencia Prevotella, Firmicutes y Clostridium. Conclusiones: La comunidad bacteriana que reside en el colon es única en cada individuo y varía constantemente. Se observó la presencia de 11 bacterias en total. No se encontró diferencia estadística en la comparación de ambos grupos. / Introduction: The increasing incidence of patients with the diagnosis of Diabetes Mellitus type 2 (DM2) has shifted the focus of new research on preventative therapeutic approaches. Recent evidence suggests an important association between the prognosis of patients with DM2 and their gastrointestinal bacterial microbiota linked to modifications that may positively or negatively change the host’s metabolism. Methodology: The study included 26 patients diagnosed with Diabetes Mellitus Type 2 in the Endocrinology service of a tertiary referral hospital, between August 2016 and February 2017. Stool samples were collected from each patient as well as their food consumption frequency record and relevant clinical data. The fecal bacterial microbiota was analyzed by polymerase chain reaction (PCR) to identify 13 different genera of bacterias from type 2 diabetic patients metabolically controlled versus uncontrolled type 2 diabetic patients. Results: At least one genus of colonic bacteria was identified in controlled and non-controlled diabetic patients in 5 (71.4%) and 11 (57.9%) respectively. The most frequent bacterial genera found in the controlled patients were Proteobacteria, Firmicutes and Prevotella; while in the non-controlled patients were Prevotella, Firmicutes and Clostridium Conclusions: The gut microbiota of a host is unique to each patient and varies constantly. It was observed the presence of 11 bacteria in total. No statistical difference was found in the comparison of both groups. / Tesis

Diminutive polyps found on flexible sigmoidoscopy are predominantly hyperplastic, but it is impossible to rely on endoscopic appearance to make an accurate diagnosis. Colonoscopy, polypectomy, and full pathologic evaluation are recommended for all such polyps. Follow-up care varies depending on the nature of the lesion.