<p>Teleosts take up metals by two major pathways: gills and/or gut. Past research is heavily focused on branchial uptake despite evidence that the gastro-intestinal tract (GIT) is the dominant route in some natural environments. To address this information gap, my thesis characterizes uptake mechanisms of Cd and Ca along the GIT of <em>Oncorhynchus mykiss</em>. Toxic effects of Cd, protective effects of Ca against Cd uptake, and Cd distribution within fish after ingestion are also explored.</p> <p>Four-week dietary Cd exposure affected growth and Ca regulation, while causing toxicity at the subcellular level. Elevated Ca in diets protected against accumulation and altered subcellular handling of Cd. Pre-exposure to different diets changed unidirectional uptake and binding rates of Cd and Ca, although they remained highly correlated. Binding rates of Cd to mucus can predict absorption rates of Cd<strong>.</strong></p> <p>A variety of <em>in vitro </em>and <em>in vivo </em>experiments on four distinct GIT segments (stomach, anterior-, mid-, and posterior- intestine) were undertaken to determine specific mechanisms of Cd and Ca uptake in freshwater trout. Cd transport was unaffected by solvent drag, but was stretch- and temperature- sensitive. Strong evidence for a common pathway for Ca and Cd transport was obtained. Cd also appeared to be taken up in part by zinc (ZIP-like) transporters and the divalent metal transporter DMT1. Ca uptake along the GIT appeared to be carrier-mediated, time- and concentration- dependent, but was not affected by solvent drag, or by Na concentration. Mucosal Cd did not inhibit Ca uptake. Ca, but not Cd, uptake rates were much lower in sea water-acclimated trout. Seawater and freshwater fish accumulated similar whole body Cd concentrations when fed contaminated diets for three weeks, but the majority of Cd in seawater trout remained in the posterior intestine tissue, while freshwater trout had higher internal burdens.</p> <p>This thesis advances the knowledge of metal uptake along the GIT of trout.</p> / Doctor of Science (PhD)

L’usage des produits microbiens administrés directement (aussi appelés probiotiques) gagne de l’intérêt comme alternative à l’utilisation des antibiotiques comme promoteurs de croissance dans les élevages. Cependant, très peu d’informations existent quant à l’influence des probiotiques sur la modulation du microbiote gastrointestinal et la réponse immunitaire innée chez le veau laitier. Les objectifs de cette thèse visaient à (1) Étudier l’effet de Lactobacillus acidophilus BT 1386 ou de Saccharomyces cerevisiae boulardii CNCM 1- 1079 sur les constituants sanguins, biochimiques / chimiques du sang. (2) Déterminer les mécanismes potentiels d’une réponse immunitaire renforcée de Lactobacillus acidophilus BT 1386 et de Saccharomyces cerevisiae boulardii CNCM 1-1079. (3) Déterminer comment Lactobacillus acidophilus BT 1386 ou Saccharomyces cerevisiae boulardii CNCM 1-1079 modulent la composition de la communauté microbienne GIT de veau par séquençage de nouvelle génération de la région V3-V4 du gène ARNr 16S. (4) Comparer l'efficacité de ces deux DFM avec la tetracycline-néomycine, un promoteur de croissance antibiotique. Quatre traitements ont été distribués aléatoirement à 48 veaux âgés de 2 à 7 jours (n=12). TÉMOIN : lactoremplaceur (LR) suivi d’une moulée de démarrage (MD); SCB) TÉMOIN + Saccharomyces cereviseae var. boulardii CNCM I-1079 [7,5 × 108 unités formatrices de colonie (CFU)/L de LR + 3 × 109 CFU/kg de MD]; LA) TÉMOIN + Lactobacillus acidophilus BT 1386 (2,5 × 108 CFU/L de LR + 1 × 109 CFU/kg de MD); ATB) TÉMOIN + traitement antibiotique composé de chlortétracycline (528 mg/L de LR + 55 mg/kg de MD) et de néomycine (357 mg/L de LR). Les animaux ont été élevés selon les procédures d’élevage conventionnelles pendant les 96 jours de la période expérimentale. Des échantillons de sang ont été prélevés de la veine jugulaire à différents moments pendant les périodes de pré-sevrage (jours 1 à 42), de sevrage (jours 43 à 53) et de post-sevrage (jours 54 à 96). Aux jours 33 et 96 dans chacun des groupes, 4 veaux ont été euthanasiés afin de prélever des échantillons de tissus et de digesta. Des SCB viables ont été retrouvées tout au long du tractus gastrointestinal, ainsi que dans les fèces des veaux en périodes pré- et post-sevrage. Autour du sevrage, les fèces du groupe SCB contenaient une population de lactobacilli plus importante que celles du groupe TÉMOIN. Au cours de la période pré-sevrage, la distribution des lactobacilli évoluait graduellement à travers les sections du tube digestif (colon > contenu iléal > rumen > muqueuse iléale). À l’exception du rumen, tous les autres compartiments présentaient une population de lactobacilli réduite en post- vs. en pré-sevrage. Comparativement aux groupes TÉMOIN et LA, la profondeur et la largeur des cryptes du colon des groupes SCB et ATB étaient réduites. Toujours comparativement aux groupes TÉMOIN et LA, le nombre de cellules caliciformes contenant des mucines neutres tendait à augmenter pour les groupes SCB et ATB, alors que le nombre de mucines acides augmentaient. Globalement, les traitements n’ont pas affecté les performances des animaux. Pendant le sevrage, une amélioration de la stimulation oxydative et de la phagocytose, ainsi qu’une augmentation des concentrations des protéines de la phase aiguë, ont été observées chez les groupes SCB et LA. L’ajout de probiotiques à la diète du veau a eu moins d’impact sur la diversité bactérienne mais a tout de même modifié significativement l’abondance des différentes populations microbiennes, et ce plus particulièrement dans l’iléon. L’ajout de SCB ou de LA a réduit l’abondance de certains genres bactériens pathogènes, tels que Streptococcus et Tyzzerella_4, alors que cela a augmenté l’abondance de bactéries potentiellement bénéfiques pour l’hôte tel que celles appartenant au genre Fibrobacter. Par ailleurs, d’autres bactéries bénéfiques tel que Rumminococcaceae UCG 005 et Olsenella étaient aussi plus abondantes, mais seulement pour le traitement SCB. Les bactéries pathogènes Peptoclostridium et Ruminococcus_2 étaient respectivement moins abondantes lorsque les traitements SCB et LA étaient ajoutés à la ration. Les analyses de prédiction fonctionnelle ont montré qu’en plus des effets observés sur les voies métaboliques locales impliquées dans le cycle cellulaire, la sécrétion biliaire et les voies de signalisation de l’AMPc et du proteasome, l’ajout des deux formes de probiotiques a également affecté d’importantes voies impliquées au sein d’autres tissus comme la synthèse des hormones thyroïdiennes ou le fonctionnement des synapses dopaminergiques. Cette étude suggère que les probiotiques, et plus particulièrement SCB, devraient être davantage considérés comme modulateur de la santé gastro-intestinale du veau laitier. Aussi, la supplémentation en SCB, en améliorant la réponse immunitaire innée, permettrait de stimuler le système immunitaire du veau avant l’infection, le préparant ainsi à mieux affronter les périodes plus sensibles comme celle du sevrage. Le SCB et le LA ont modifié la composition en bactéries du GIT. Dans l’ensemble, cette étude a montré une démonstration remarquable de l’importance du DFM sur le microbiote de la TI. Cependant, il faut mieux comprendre les molécules et les mécanismes qui déterminent le rôle du microbiote, puis exploiter ces connaissances pour améliorer la santé et augmenter la production animale / L’usage des produits microbiens administrés directement (aussi appelés probiotiques) gagne de l’intérêt comme alternative à l’utilisation des antibiotiques comme promoteurs de croissance dans les élevages. Cependant, très peu d’informations existent quant à l’influence des probiotiques sur la modulation du microbiote gastrointestinal et la réponse immunitaire innée chez le veau laitier. Les objectifs de cette thèse visaient à (1) Étudier l’effet de Lactobacillus acidophilus BT 1386 ou de Saccharomyces cerevisiae boulardii CNCM 1- 1079 sur les constituants sanguins, biochimiques / chimiques du sang. (2) Déterminer les mécanismes potentiels d’une réponse immunitaire renforcée de Lactobacillus acidophilus BT 1386 et de Saccharomyces cerevisiae boulardii CNCM 1-1079. (3) Déterminer comment Lactobacillus acidophilus BT 1386 ou Saccharomyces cerevisiae boulardii CNCM 1-1079 modulent la composition de la communauté microbienne GIT de veau par séquençage de nouvelle génération de la région V3-V4 du gène ARNr 16S. (4) Comparer l'efficacité de ces deux DFM avec la tetracycline-néomycine, un promoteur de croissance antibiotique. Quatre traitements ont été distribués aléatoirement à 48 veaux âgés de 2 à 7 jours (n=12). TÉMOIN : lactoremplaceur (LR) suivi d’une moulée de démarrage (MD); SCB) TÉMOIN + Saccharomyces cereviseae var. boulardii CNCM I-1079 [7,5 × 108 unités formatrices de colonie (CFU)/L de LR + 3 × 109 CFU/kg de MD]; LA) TÉMOIN + Lactobacillus acidophilus BT 1386 (2,5 × 108 CFU/L de LR + 1 × 109 CFU/kg de MD); ATB) TÉMOIN + traitement antibiotique composé de chlortétracycline (528 mg/L de LR + 55 mg/kg de MD) et de néomycine (357 mg/L de LR). Les animaux ont été élevés selon les procédures d’élevage conventionnelles pendant les 96 jours de la période expérimentale. Des échantillons de sang ont été prélevés de la veine jugulaire à différents moments pendant les périodes de pré-sevrage (jours 1 à 42), de sevrage (jours 43 à 53) et de post-sevrage (jours 54 à 96). Aux jours 33 et 96 dans chacun des groupes, 4 veaux ont été euthanasiés afin de prélever des échantillons de tissus et de digesta. Des SCB viables ont été retrouvées tout au long du tractus gastrointestinal, ainsi que dans les fèces des veaux en périodes pré- et post-sevrage. Autour du sevrage, les fèces du groupe SCB contenaient une population de lactobacilli plus importante que celles du groupe TÉMOIN. Au cours de la période pré-sevrage, la distribution des lactobacilli évoluait graduellement à travers les sections du tube digestif (colon > contenu iléal > rumen > muqueuse iléale). À l’exception du rumen, tous les autres compartiments présentaient une population de lactobacilli réduite en post- vs. en pré-sevrage. Comparativement aux groupes TÉMOIN et LA, la profondeur et la largeur des cryptes du colon des groupes SCB et ATB étaient réduites. Toujours comparativement aux groupes TÉMOIN et LA, le nombre de cellules caliciformes contenant des mucines neutres tendait à augmenter pour les groupes SCB et ATB, alors que le nombre de mucines acides augmentaient. Globalement, les traitements n’ont pas affecté les performances des animaux. Pendant le sevrage, une amélioration de la stimulation oxydative et de la phagocytose, ainsi qu’une augmentation des concentrations des protéines de la phase aiguë, ont été observées chez les groupes SCB et LA. L’ajout de probiotiques à la diète du veau a eu moins d’impact sur la diversité bactérienne mais a tout de même modifié significativement l’abondance des différentes populations microbiennes, et ce plus particulièrement dans l’iléon. L’ajout de SCB ou de LA a réduit l’abondance de certains genres bactériens pathogènes, tels que Streptococcus et Tyzzerella_4, alors que cela a augmenté l’abondance de bactéries potentiellement bénéfiques pour l’hôte tel que celles appartenant au genre Fibrobacter. Par ailleurs, d’autres bactéries bénéfiques tel que Rumminococcaceae UCG 005 et Olsenella étaient aussi plus abondantes, mais seulement pour le traitement SCB. Les bactéries pathogènes Peptoclostridium et Ruminococcus_2 étaient respectivement moins abondantes lorsque les traitements SCB et LA étaient ajoutés à la ration. Les analyses de prédiction fonctionnelle ont montré qu’en plus des effets observés sur les voies métaboliques locales impliquées dans le cycle cellulaire, la sécrétion biliaire et les voies de signalisation de l’AMPc et du proteasome, l’ajout des deux formes de probiotiques a également affecté d’importantes voies impliquées au sein d’autres tissus comme la synthèse des hormones thyroïdiennes ou le fonctionnement des synapses dopaminergiques. Cette étude suggère que les probiotiques, et plus particulièrement SCB, devraient être davantage considérés comme modulateur de la santé gastro-intestinale du veau laitier. Aussi, la supplémentation en SCB, en améliorant la réponse immunitaire innée, permettrait de stimuler le système immunitaire du veau avant l’infection, le préparant ainsi à mieux affronter les périodes plus sensibles comme celle du sevrage. Le SCB et le LA ont modifié la composition en bactéries du GIT. Dans l’ensemble, cette étude a montré une démonstration remarquable de l’importance du DFM sur le microbiote de la TI. Cependant, il faut mieux comprendre les molécules et les mécanismes qui déterminent le rôle du microbiote, puis exploiter ces connaissances pour améliorer la santé et augmenter la production animale. / There is interest in the use of direct-fed microbials (DFM) as substitutes for antibiotic growth promoters in farm animal production. However, little information exists on the effects of Lactobacillus acidophilus BT 1386 (LA) and Saccharomyces cereviseae boulardii CNCM I-1079 (SCB) on the modulation of the gastrointestinal tract (GIT) microbiota and innate immune responses in dairy calves. Therefore, the objectives of this thesis were to (1) investigate the effect of Lactobacillus acidophilus BT 1386 or Saccharomyces cerevisiae boulardii CNCM 1-1079 on blood cellular and biochemical/chemical constituents; (2) determine the potential mechanisms of enhanced immune response by Lactobacillus acidophilus BT 1386 and Saccharomyces cerevisiae boulardii CNCM 1-1079; (3) determine how Lactobacillus acidophilus BT 1386 or Saccharomyces cerevisiae boulardii CNCM 1-1079 modulate calf GIT microbial community composition by next-generation sequencing of the V3-V4 region of the 16S rRNA gene and (4) compare the efficacy of these two DFM with tetracycline-neomycin, an antibiotic growth promoter. Forty eight calves (2 to 7 days old) were randomly allocated to four treatments: 1) Control (CTRL) fed milk replacer (MR) and starter feed (SF); 2) CTRL supplemented with Saccharomyces cerevisiae boulardii CNCMI-1079 (SCB; 7.5 × 108 (CFU)/L MR + 3 × 109 CFU/kg SF); 3) CTRL supplemented with Lactobacillus acidophilus BT1386 (LA; 2.5 × 108 CFU/L MR + 1 × 109 CFU/kg SF); and 4) CTRL supplemented with antibiotics (ATB) chlortetracycline and neomycin (528 and 357 mg/L MR, respectively), and chlortetracycline (55 mg/kg SF). Animals were raised for 96 days following standard management procedures. Growth parameters (body weight and feed intake) of calves were recorded weekly. Four calves per treatment were euthanized on day 33 (pre-weaning) and an additional four calves per treatment on day 96 (post-weaning) to sample rumen and ileum tissues for real time quantitative polymerase chain reaction and colon for histomorphology. The ileum, colon and rumen were also analyzed for viability. Furthermore, samples of digesta (colon, ileum and rumen) and mucosa (colon and ileum) for bacterial characterization by sequencing the V3-V4 region of 16S rRNA gene. Weekly feces samples were collected for viability analysis. Blood samples were also collected for isolation of neutrophils and peripheral blood mononuclear cells for oxidative burst and phagocytosis analyses by flow cytometry. Serum measurements of acute phase proteins were done by ELISA. Viable SCB were recovered throughout the GIT and in the feces pre- and post-weaning. The feces of SCB-treated calves showed a greater lactobacilli population compared with CTRL (P < 0.01) around weaning. In the pre-weaning period, the distribution of lactobacilli population differed along the digestive tract (colon > ileum content > rumen > ileum mucosa; P < 0.001). The lactobacilli population were significantly reduced in all compartments (P = 0.02) post-weaning compared to pre-weaning, except in the rumen. Crypts depth and width of the colon decreased (P < 0.01) whereas number of goblet cells containing neutral mucins tended to increase (P = 0.058) while acidic mucins increased (P < 0.05) in SCB- and ATB-treated calves compared with CTRL and v LA-treated calves. Overall, growth performances were not affected by treatment. There was improvement of both oxidative burst and phagocytosis by SCB and LA during weaning in calves. Similarly, the concentrations of acute phase proteins (C-reactive proteins and serum amyloid A proteins) were increased by SCB and LA during weaning. The DFM had less impact on the bacteria diversity but had significant impact on the abundance of the bacteria community with most changes associated to treatments occurring in the ileum. SCB and LA reduced some pathogenic bacteria genera such as Streptococcus, Tyzzerella_4 and increased some potential beneficial bacteria such as fibrobacter. Meanwhile, Rumminococcaceae UCG 005 and Olsenella, also beneficial, were increased only by SCB treatment. The potential pathogenic bacterium, Peptoclostridium, was reduced by SCB only while LA reduced Ruminococcus_2. The functional prediction analyses indicated that besides affecting local pathways such as cell cycle, bile secretion, proteasome or cAMP signaling pathway, both DFM might also affect important pathways in other tissues such as thyroid hormone synthesis or Dopaminergic synapse in the brain. Our results suggest that SCB is a modulator of gastrointestinal health and could prime the immune system prior to infection leading to an enhanced innate immune response in calves especially during periods of stress (e.g., weaning). Consequently, SCB might have the potential to strengthen calf immune system in the critical periods of disease susceptibility. Both SCB and LA changed the bacteria composition of the GIT. Overall, this study showed a remarkable demonstration of the importance of DFM on the GIT microbiota. However, what is needed is a complete and better understanding of the molecules and mechanisms driving the roles played by the microbiota and then to exploit this knowledge to improve health and increase animal production.

Streptococcus thermophilus est la bactérie lactique la plus utilisée après Lactococcus lactis dans l'industrie laitière pour la fabrication de yaourts et de fromages à pâte cuite (Emmental, gruyère), filée (Mozarella) ou pressée (Cheddar). Il s'agit du seul streptocoque à avoir le statut de bactérie GRAS (Generally Recognized As Safe). Dans un premier temps le potentiel probiotique de 30 souches de S. thermophilus de différentes origines a été testé par l'étude de leurs capacités à résister aux différentes conditions de stress rencontrées pendant leur passage dans le tractus gastro-intestinal (bas pH, sels biliaires et stress oxydant), de leur capacité à adhérer aux cellules épithéliales intestinales et de leurs propriétés immunomodulatrices. La majorité des souches réduit la production d'interleukine IL-8 (pro-inflammatoire) alors qu'elles induisent la production d'interleukine IL-10 (anti-inflammatoire) et l'IL-12 (pro-inflammatoire). Sur la base du rapport IL-10/IL-12, qui permet d'apprécier le potentiel anti-inflammatoire d'une souche, nous avons observé que certaines d'entre-elles pourraient avoir un fort potentiel anti-inflammatoire. L'Analyse en Composantes Principales (ACP) nous a permis de séparer les souches en 6 catégories différentes présentant des propriétés distinctes. A l'intérieur de chaque classe, une variabilité entre les souches a été observée et des caractéristiques intéressantes identifiées. Cependant, aucune des classes ne peut être considérée comme contenant le probiotique « parfait ». Suite à cette étude et sur la base de sa résistance aux stress gastriques et de ses capacités d'adhésion, et sachant que la séquence de son génome est disponible, la souche LMD-9 a été sélectionnée pour la deuxième partie de ce travail, à savoir la construction d'un outil basé sur la technologie R-IVET pour étudier l'état physiologique de S. thermophilus dans le tractus digestif. L'outil R-IVET mis au point se compose de deux éléments: un vecteur plasmidique portant le gène cre codant une recombinase spécifique dépourvu de son promoteur et une cassette chromosomique composée d'un gène de résistance à la spectinomycine flanqué par des sites loxP, reconnus par la recombinase Cre. La fonctionnalité de l'outil R-IVET a ensuite été testée par le clonage de trois promoteurs différents de S. thermophilus (PprtS, Pshsp and Plac) en amont de cre. Le système a été valide in vitro avec les trois promoteurs et in vivo avec le promoteur Plac / Streptococcus thermophilus is a lactic acid bacterium used after Lactococcus lactis in the dairy industry for the production of yogurt and cheeses like Emmental, Gruyere, Mozarella and Cheddar. It is the only streptococcus to have the GRAS (Generally Recognized As Safe) status. In this work, the probiotic potential of 30 S. thermophilus strains from different origins was tested by studying their ability to resist different stress conditions encountered during their passage through the GIT (low pH, bile salts and oxidative stress), their ability to adhere to intestinal epithelial cells and their immunomodulatory properties. Majority of the strains reduced the production of interleukin IL-8 (pro-inflammatory) and induced the production of interleukin IL-10 (anti-inflammatory) and IL-12 (pro-inflammatory). On the basis of the ratio IL-10/IL-12 which allows to evaluate the anti-inflammatory potential of a probiotic, several strains appeared to have a high the anti-inflammatory potential. Principal Component Analysis (PCA) allowed us to classify strains in 6 different categories with different properties. Within each class, variability and interesting features were observed, but none of the classes could be considered as containing the perfect probiotic. Following this study and on the basis of its resistance to gastric stress and its adhesion capacity and knowing that its genome sequence is available, the strain LMD-9 was selected for the second part of this work, namely the construction of a tool based on R-IVET to study the physiological state of S. thermophilus in the digestive tract. This tool is composed of two elements: a plasmid vector (pULNcreB), carrying the gene cre encoding a site-specific recombinase without its promoter and a chromosomal cassette composed of a gene of resistance to spectinomycin flanked by loxP sites which are recognized by the recombinase Cre. The functionality of the tool R-IVET was then tested by cloning three different promoters of S. thermophilus (PprtS, Pshsp and Plac) upstream of cre. System was valid in vitro with all the three promoters and in vivo by using the lactose operon promoter Plac

One of the aims included in the United Nations Millennium Development Goals is to decrease the number of the world’s population without access to sanitation and water that is safe, by half by the year 2015. The use of water that is not safe for consumption leads to water–related diseases. For the purpose of this study gastro–intestinal disease was redefined as diseases of the gastro–intestinal tract caused by pathogens that spread via contaminated drinking water, poor sanitation and inadequate hygiene. Information obtained regarding the use of gastro–intestinal disease medication, may provide information about the prevalence of gastro–intestinal disease in South Africa. The general objective of this study was to determine the prescribing patterns of gastro–intestinal medication in different geographical areas in the private health care sector of South Africa. A retrospective drug utilisation review was conducted on data obtained from a medicine claims database of a pharmacy benefit management company for 2007 and 2008. A pharmacoepidemiological approach was followed in order to determine the prevalence of gastro–intestinal disease as well as the use of gastro–intestinal medication in South Africa as well as the different provinces of South Africa. The impact of water quality and sanitation on the prevalence of gastro–intestinal disease was also investigated. Gastro–intestinal medication (used in the treatment of gastro–intestinal disease) included the following pharmacological groups according to the MIMS®–classification: antivertigo and anti–emetic agents (group 1.8), antispasmodics (group 12.3), antidiarrhoeals (group 12.7), minerals and electrolytes (group 20.4, selected according to specified NAPPI–codes) and antimicrobials (group 18). Antimicrobials had to be prescribed in combination with one of the specified gastro–intestinal medication groups in order to be classified as a gastro–intestinal medication. In 2007 and 2008 respectively, 428864 and 340921 gastro–intestinal medication items were prescribed. The most frequently prescribed gastro–intestinal medication pharmacological groups in 2007 and 2008 were beta–lactam antimicrobials (with proportion percentages of 22.77% and 20.85% in 2007 and 2008 respectively), antivertigo and anti–emetic agents, antispasmodics, antidiarrhoeals and quinolone antimicrobials. Minerals and electrolytes represented only a small proportion (2.99% and 2.56% in 2007 and 2008 respectively) of the prescribed gastro–intestinal medication in South Africa. In the Free State and Western Cape antivertigo and anti–emetic agents were the most frequently prescribed gastro–intestinal medication items, while in other provinces beta–lactam antimicrobials ranked the highest. In all provinces except the Western Cape and the Northern Cape, amoxicillin/clavulanic acid was the most frequently prescribed gastro–intestinal medication active ingredient. In the Western Cape loperamide was the most frequently prescribed active ingredient, while ciprofloxacin ranked highest as active ingredient in the Northern Cape in 2008. Based on the prescribing patterns of gastro–intestinal disease medications the treatment of gastro–intestinal disease in this section of the private health care sector of South Africa, does not fully comply with the Standard Treatment Guidelines with regard to the use of antimicrobials and electrolyte replacement therapy. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

One of the aims included in the United Nations Millennium Development Goals is to decrease the number of the world’s population without access to sanitation and water that is safe, by half by the year 2015. The use of water that is not safe for consumption leads to water–related diseases. For the purpose of this study gastro–intestinal disease was redefined as diseases of the gastro–intestinal tract caused by pathogens that spread via contaminated drinking water, poor sanitation and inadequate hygiene. Information obtained regarding the use of gastro–intestinal disease medication, may provide information about the prevalence of gastro–intestinal disease in South Africa. The general objective of this study was to determine the prescribing patterns of gastro–intestinal medication in different geographical areas in the private health care sector of South Africa. A retrospective drug utilisation review was conducted on data obtained from a medicine claims database of a pharmacy benefit management company for 2007 and 2008. A pharmacoepidemiological approach was followed in order to determine the prevalence of gastro–intestinal disease as well as the use of gastro–intestinal medication in South Africa as well as the different provinces of South Africa. The impact of water quality and sanitation on the prevalence of gastro–intestinal disease was also investigated. Gastro–intestinal medication (used in the treatment of gastro–intestinal disease) included the following pharmacological groups according to the MIMS®–classification: antivertigo and anti–emetic agents (group 1.8), antispasmodics (group 12.3), antidiarrhoeals (group 12.7), minerals and electrolytes (group 20.4, selected according to specified NAPPI–codes) and antimicrobials (group 18). Antimicrobials had to be prescribed in combination with one of the specified gastro–intestinal medication groups in order to be classified as a gastro–intestinal medication. In 2007 and 2008 respectively, 428864 and 340921 gastro–intestinal medication items were prescribed. The most frequently prescribed gastro–intestinal medication pharmacological groups in 2007 and 2008 were beta–lactam antimicrobials (with proportion percentages of 22.77% and 20.85% in 2007 and 2008 respectively), antivertigo and anti–emetic agents, antispasmodics, antidiarrhoeals and quinolone antimicrobials. Minerals and electrolytes represented only a small proportion (2.99% and 2.56% in 2007 and 2008 respectively) of the prescribed gastro–intestinal medication in South Africa. In the Free State and Western Cape antivertigo and anti–emetic agents were the most frequently prescribed gastro–intestinal medication items, while in other provinces beta–lactam antimicrobials ranked the highest. In all provinces except the Western Cape and the Northern Cape, amoxicillin/clavulanic acid was the most frequently prescribed gastro–intestinal medication active ingredient. In the Western Cape loperamide was the most frequently prescribed active ingredient, while ciprofloxacin ranked highest as active ingredient in the Northern Cape in 2008. Based on the prescribing patterns of gastro–intestinal disease medications the treatment of gastro–intestinal disease in this section of the private health care sector of South Africa, does not fully comply with the Standard Treatment Guidelines with regard to the use of antimicrobials and electrolyte replacement therapy. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Il y a actuellement une pression mondiale pour revoir les pratiques d'utilisation des antimicrobiens (UAM) en production animale afin de limiter la propagation de bactéries résistantes aux antibiotiques. Conséquemment, les Producteurs de Poulet du Canada examinent la possibilité de réduire leur UAM en supprimant les antibiotiques médicalement importants en médecine humaine (AIM) des programmes préventifs avec la mise en place de leur stratégie de réduction de l’UAM. Cependant, les informations sont rares sur les conséquences de telles approches dans un contexte canadien. L'objectif de cette thèse était d'étudier les impacts sur les performances zootechniques, le contrôle des maladies intestinales et le microbiote cécal de deux stratégies de réduction de l'UAM dans des troupeaux commerciaux de poulets de chair par rapport à une UAM conventionnelle. Sur sept fermes commerciales de poulets de chair, un poulailler a été attribué aux traitements de réduction des antibiotiques pour six troupeaux consécutifs, tandis qu'un poulailler similaire sur le même site a été alloué à l'UAM conventionnelle (CONV) pour six troupeaux consécutifs (n = 84). Les stratégies de réduction des antibiotiques consistaient en l'utilisation continue d'ionophores dans l'alimentation sans (TX1) ou avec de l'acide butyrique (TX2). Aucune différence statistique (p > 0.05) n’a été notée entre TX1, TX2 et CONV sur les performances zootechniques et la santé intestinale. Les comptes d’oocystes d’Eimeria spp. étaient significativement (p < 0.05) inférieurs entre 22 et 34 jours d'âge dans les troupeaux CONV comparé aux TX1 et TX2. Le type de programme antibiotique a eu un impact relativement mineur (valeur R = 0.039), mais statistiquement significatif (p = 0.002), sur le microbiote cécal, tandis que les facteurs environnementaux ont montré les corrélations significatives (p = 0.001) les plus fortes avec le microbiote. Parmi les composantes du microbiote cécal associées à la croissance, le gain quotidien moyen (GMQ) était significativement associé à la Richesse bactérienne (p < 0.05). L’abondance relative de la famille bactérienne Lachnospiraceae fut la mesure la plus fortement corrélée à un GMQ augmenté, tandis que l’abondance relative de nombreuses familles bactériennes, incluant les Porphyromonadaceae, les Planococcaceae et les Veillonellaceae, fut corrélée à un faible GMQ. Ces taxons défavorables formaient un vaste réseau de corrélations positives entre elles, et négativement corrélées aux Lachnospiraceae. En conclusion, ces travaux ont contribué à améliorer la résilience de l'industrie avicole en fournissant des stratégies alternatives aux AIM pour prévenir les maladies intestinales. Des connaissances importantes sur le microbiote cécal des poulets de chair furent générées et pourront considérablement influencer les directions futures de la manipulation du microbiote pour favoriser la croissance. Par exemple, un paradigme important a été remis en question en illustrant que les additifs médicamenteux dans l'alimentation n’influencent que marginalement le microbiote cécal et que ce sont plutôt des facteurs environnementaux qui sont fortement impliqués dans la formation des communautés bactériennes cécales. La clé pour développer un microbiote cécal idéal chez les poulets de chair pourrait résider dans la capacité d'influencer ces facteurs, plus particulièrement l'exposition précoce à des communautés bactériennes bénéfiques et le contrôle de la flore résidente spécifique à la ferme. / There is a global pressure to review current antimicrobial use (AMU) practices in animal production and limit large-scale propagation of antibiotic resistant microorganisms. Consequently, the Chicken Farmers of Canada are examining the possibility to responsibly reduce AMU by discontinuing medically important antibiotics (MIAs) for humans from disease prevention programs of broiler chicken flocks through the implementation of their Antimicrobial Use Reduction Strategy. However, information is sparse on the consequences of such approaches in a Canadian commercial poultry production context. The general objective of this thesis was to investigate the impacts of two strategies reducing AMU in commercial broiler chicken flocks on zootechnical performance, control of intestinal diseases and the cecal microbiota compared to conventional AMU. On seven commercial broiler chicken farms, a house was allocated to the antibiotic reduction treatments for six consecutive flocks, while a similar house on the same premises was assigned to the conventional AMU (CONV) for six consecutive flocks (n = 84). The antibiotic reduction strategies consisted of continuous in-feed ionophores without (TX1) or with butyric acid (TX2). There were no statistical differences (p > 0.05) between TX1, TX2 and CONV for zootechnical performance and intestinal health. Predicted Eimeria spp. oocysts were significantly lower (p < 0.05) between 22 to 34 days of age in CONV flocks compared to TX1 and TX2. The type of antibiotic program had a relatively minor impact (R-value = 0.039), but statistically significant (p = 0.002), on the cecal microbiota composition, while environmental factors such as the farm and flock cycle showed the strongest statistically significant (p = 0.001) correlations with the microbiota composition (R-values of 0.239 and 0.374, respectively). Amongst the cecal microbiota components associated with weight gain, the average daily gain (ADG) was significantly associated with bacterial Richness (p < 0.05). The relative abundance of the bacterial family Lachnospiraceae was the most important measure correlated with ADG, while the relative abundance of numerous bacterial families, including Porphyromonadaceae, Planococcaceae and Veillonellaceae, were correlated with decreased growth rate. These unfavourable taxa formed a large network of positive correlations, indicating potential co-occurring synergies between these undesirable taxa. This network was also negatively correlated to Lachnospiraceae. In conclusion, the findings in this work contributed to improve the sustainability of the modern poultry industry by providing feasible alternatives to the practice of using MIAs for the prevention of intestinal diseases in broiler chickens. This project also generated important knowledge on the cecal microbiota of broiler chickens that could considerably influence future directions of microbiota manipulation in a perspective of improving zootechnical performance. For instance, an important paradigm was challenged by the indication that in-feed antibiotics and prebiotics may only influence marginally the microbiota during grow-out. Rather, this work suggests environmental factors are strongly involved in shaping the bacterial communities residing in the ceca of broiler chickens. Hence, the key to successfully develop an ideal cecal microbiota in broiler chickens may reside in the ability to influence such factors, more specifically the early exposure to beneficial bacterial communities and the control of farm-specific resident flora.

O cuidador familiar é aquela pessoa da família com ou sem experiência na área da saúde, que assume os cuidados ao familiar no domicílio, ajudando-o a suprir suas necessidades proporcionando conforto, lazer e garantindo o bem-estar a pessoa necessitada. Neste sentido este estudo caracteriza o cuidador familiar de pacientes submetidos à cirurgia gastro-intestinal de grande porte quanto a idade, sexo, religião, parentesco, estado marital, ocupação, grau de instrução e também quanto a pessoa que ajuda, experiências anteriores e tempo de dedicação aos cuidados. Outro objetivo proposto foi identificar os cuidados realizados no domicílio pelos cuidadores familiares quanto a higiene e conforto, sono e repouso, cuidados com a pele, cuidados com sondas e/ou drenos e/ou catéteres e/ou bolsas coletoras, alimentação e hidratação, eliminações intestinal e urinária, administração de medicamentos, atividade física e de lazer. Identifica, ainda, a utilização de materiais e equipamentos, bem como de adaptações feitas no ambiente físico no domicílio do doente e o uso de terapias complementares desenvolvidas para a realização do cuidado. Por fim, identifica as vias de contato utilizadas pelos cuidadores familiares voltadas para esclarecimento de dúvidas. É um estudo do tipo descritivo, exploratório, correlacional, de campo, longitudinal com abordagem quantitativa, constando de uma amostra de 15 cuidadores que residiam no município de São Paulo, tinham como cuidador principal alguém da família e concordavam em participar do estudo. Os dados foram coletados pela pesquisadora no período de janeiro a abril de 2001 no domicílio dos doentes em dois momentos, sendo o primeiro entre o 2o e 4o dia após a alta hospitalar e o segundo entre o 10o e 12o dias. O estudo mostrou que os cuidadores familiares deixaram de lado suas atividades profissionais ou não, para estarem disponíveis ao familiar durante o dia e a noite, realizando atividades até então só observadas durante a internação hospitalar. Durante as entrevistas constatou-se estarem inseguros, com dúvidas no cuidar, sozinhos, indecisos, inseguros, com dúvidas no cuidado, mas permaneciam firmes superando todos os obstáculos. / The familiar caregivers is the person from the family with or without experience in the health area that assumes the cares to the family in the home, helping her/him to provide their needs giving comfort, spare time and assuring the person well being. In this course this study characterizes the family caregiver of patients underwent to a large gastrointestinal surgery related to age, sex, religion, relationship, marital status, occupation, education level and about the person that care, her/his previous experiences and period of dedication to the cares. Another proposed aim was to identify the achieved cares in the home by family caregivers regarding to the hygiene and comfort, sleep and rest, skin cares, probe and/or drain and/or catheter and/or collect bag, nutrition and hydration, urinary and intestinal elimination, medicine administration, physical and spare time activities This study identifies yet the use of material and equipments as well as adaptation realized in the physical environment. In the patient home and the use of complementary therapies developed for the care realization. At last it identifies the contact ways used by family caregivers turned to the doubts explanation. It is a descriptive, exploratory, co-relational and longitudinal study, of field, with quantitative approach, consisting of a sample of 15 caregivers that lived in São Paulo City and that have as a main caregiver the family member and they agreed with participate of this study. Researcher collected the data in the period from January to April 2001, on patients home in two moments, being the first between the 2th and 4th day after the discharge from hospital. The second moment occurs between the 10th and 12th days. The study showed that the family caregivers have laid aside their professional activities or not aiming to be available to the family during the day and the night, realizing activities up until then only observed during the nosocomial admission. During the interviews it was verified that the caregivers were alone, hesitant, insecure, with doubts about the care, they have no one to help them, but they stay resolute to overcome difficulties.

This diploma thesis focuses on the description of a chosen gastro-intestinal disease - colorectal carcinome, unspecified chronic intestinal infections, and ulcerous gastroduodenal disease. It pursues the causes, symptoms, diagnosis, treatment, and most attention is given to the prevention of a chosen disease in gastro-intestinal tract. Concerning prevention, it focuses also on nutrition because that is what plays a significant role in keeping human population healthy. The empiric part of the thesis has been processed using a qualitative research survey, using the method of an in-depth semi-standardized interview. The first research group was formed by healthy individuals. The second research group was formed by nurses working with a practical doctor at the internal department and at the gastro-enterological department. The third research group was formed by patients suffering from gastroduoenal disease. The fourth research group was formed by patients sufferring from non-specific chronic intestinal infections. The fifth research group was formed by patients suffering from colorectal carcinome. The obtained results have proven that people know what a healthy lifestyle is, but compliance to it is rather difficult. One of its positive effects is that most people get their medical check-up regularly. The research group of ill individuals proves that the area of terciary or quarterly prevention is not made clear to the probands. The nurses´ research group has proven the fact that the prevention area is not made properly clear to the nurses, thus they do not provide the patients with sufficient information about their illness. This diploma thesis should aim at nurses and make sure they do not ignore the necessity of gastro-intestinal disease preention. T inform patients about options of prevention they have available. Patients themselves also need to realize how important their health is in their lives. Research survey results have been processed to form an information brochure meant for gastro-intestinal disease patients. To deepe knowledge about this issue we suggest offering the obtained results to be published in an expert magazine called Gastroenterology and Haemathology - Czech Gastroenterological Society.

Quattro diversi esperimenti sono stati eseguiti per investigare i fattori che influenzano la fermentazione ruminale delle diete altamente fermentescibili e per sviluppare un modello per studiare la permeabilità gastro-intestinale nei ruminanti. Nello studio 1, quattro ibridi di mais sono stati valutati per la digeribilità ruminale delle loro frazioni. I risultati suggeriscono che i genotipi e le fasi di maturità influenzano fortemente la digeribilità della sostanza secca e dell’amido nel rumine. Nello studio 2, i risultati della fermentazione in vitro di diversi zuccheri ha rivelato che il lattulosio può essere uno zucchero indicatore per studiare la permeabilità intestinale nei ruminanti, grazie alla sua bassa fermentescibilità ruminale. Nello studio 3, per la prima volta un modello di enteropatia indotta da indometacina è stato utilizzato per valutare nei ruminanti la permeabilità dell’intestino tenue attraverso il test del lattulosio. I risultati mostrano che il lattulosio è passato dall'intestino al sangue modificando alcuni parametri metabolici e dell'infiammazione. Nello studio 4, una acidosi acuta è stata indotta in pecore per testare la permeabilità gastro-intestinale con il test del lattulosio. I risultati hanno dimostrato che l'acidosi acuta compromette il funzionamento della barriera gastro-intestinale consentendo l'assorbimento e la traslocazione di LPS e altre sostanze nocive e incrementa l'infiammazione. / Four different experiments were performed for the better understanding of the factors that affect rumen fermentation of highly fermentable diets and to develop a model to study GI permeability in ruminants. In study 1, four corn hybrids recommended for corn silage were evaluated for ruminal starch digestibility of their grain fractions. Results suggest that the genotypes and maturity stages greatly influenced the DM and starch digestibility in rumen. In study 2, the results of the in vitro rumen fermentation of different naturally occurring and synthetic sugars revealed that lactulose can be a good probe sugar to study GI tract permeability in ruminants due to its low and slow fermentation rate in rumen. In study 3, for the first time an indomethacin-induced enteropathy model was used in ruminants to assess small intestinal permeability by the lactulose test. The results established that lactulose passed from the intestine to blood with perturbation of some metabolic parameters and inflammation. In study 4, acute acidosis was induced in sheep to test GI permeability during acidosis condition by lactulose test. The results demonstrated that acute acidosis impair the GI barrier function which allow absorption and translocation of LPS and other harmful substances and increase inflammation.

O cuidador familiar é aquela pessoa da família com ou sem experiência na área da saúde, que assume os cuidados ao familiar no domicílio, ajudando-o a suprir suas necessidades proporcionando conforto, lazer e garantindo o bem-estar a pessoa necessitada. Neste sentido este estudo caracteriza o cuidador familiar de pacientes submetidos à cirurgia gastro-intestinal de grande porte quanto a idade, sexo, religião, parentesco, estado marital, ocupação, grau de instrução e também quanto a pessoa que ajuda, experiências anteriores e tempo de dedicação aos cuidados. Outro objetivo proposto foi identificar os cuidados realizados no domicílio pelos cuidadores familiares quanto a higiene e conforto, sono e repouso, cuidados com a pele, cuidados com sondas e/ou drenos e/ou catéteres e/ou bolsas coletoras, alimentação e hidratação, eliminações intestinal e urinária, administração de medicamentos, atividade física e de lazer. Identifica, ainda, a utilização de materiais e equipamentos, bem como de adaptações feitas no ambiente físico no domicílio do doente e o uso de terapias complementares desenvolvidas para a realização do cuidado. Por fim, identifica as vias de contato utilizadas pelos cuidadores familiares voltadas para esclarecimento de dúvidas. É um estudo do tipo descritivo, exploratório, correlacional, de campo, longitudinal com abordagem quantitativa, constando de uma amostra de 15 cuidadores que residiam no município de São Paulo, tinham como cuidador principal alguém da família e concordavam em participar do estudo. Os dados foram coletados pela pesquisadora no período de janeiro a abril de 2001 no domicílio dos doentes em dois momentos, sendo o primeiro entre o 2o e 4o dia após a alta hospitalar e o segundo entre o 10o e 12o dias. O estudo mostrou que os cuidadores familiares deixaram de lado suas atividades profissionais ou não, para estarem disponíveis ao familiar durante o dia e a noite, realizando atividades até então só observadas durante a internação hospitalar. Durante as entrevistas constatou-se estarem inseguros, com dúvidas no cuidar, sozinhos, indecisos, inseguros, com dúvidas no cuidado, mas permaneciam firmes superando todos os obstáculos. / The familiar caregivers is the person from the family with or without experience in the health area that assumes the cares to the family in the home, helping her/him to provide their needs giving comfort, spare time and assuring the person well being. In this course this study characterizes the family caregiver of patients underwent to a large gastrointestinal surgery related to age, sex, religion, relationship, marital status, occupation, education level and about the person that care, her/his previous experiences and period of dedication to the cares. Another proposed aim was to identify the achieved cares in the home by family caregivers regarding to the hygiene and comfort, sleep and rest, skin cares, probe and/or drain and/or catheter and/or collect bag, nutrition and hydration, urinary and intestinal elimination, medicine administration, physical and spare time activities This study identifies yet the use of material and equipments as well as adaptation realized in the physical environment. In the patient home and the use of complementary therapies developed for the care realization. At last it identifies the contact ways used by family caregivers turned to the doubts explanation. It is a descriptive, exploratory, co-relational and longitudinal study, of field, with quantitative approach, consisting of a sample of 15 caregivers that lived in São Paulo City and that have as a main caregiver the family member and they agreed with participate of this study. Researcher collected the data in the period from January to April 2001, on patients home in two moments, being the first between the 2th and 4th day after the discharge from hospital. The second moment occurs between the 10th and 12th days. The study showed that the family caregivers have laid aside their professional activities or not aiming to be available to the family during the day and the night, realizing activities up until then only observed during the nosocomial admission. During the interviews it was verified that the caregivers were alone, hesitant, insecure, with doubts about the care, they have no one to help them, but they stay resolute to overcome difficulties.