The effect of commensal microbiota and feeding corn or wheat/barley-based diets on the apparent gastrointestinal absorption of DL-methionine (MET) and 2-hydroxy-4-methylthiobutanoic acid (MHA-FA) was studied in conventional (n 5 32) and gnotobiotic pigs (n 5 24). Conventional pigs (CON) were vaginally delivered and sow-reared until weaning at 14 days of age. Gnotobiotic pigs were derived by caesarian section and reared in HEPA (high efficiency particulate air)-filtered isolator units with ad libitum access to a milk-based formula. Corn or wheat/barley-based diets were fed to all pigs from 14 to 24 days of age. At 24 days of age, after an overnight fast, pigs were fed 20 g/kg BW of experimental diet supplemented with 10 7 Bq of either 3 H-L-MET or 3 H-L-MHA-FA per kg of feed and chromic oxide (0.5% wt/wt). Pigs were killed for sample collection 3 h after consuming the meal. Residual 3 H-MET and 3 H-MHA-FA were estimated in gastrointestinal contents as the ratio of 3 H : chromic oxide in digesta samples to the ratio of 3 H : chromic oxide in feed. In CON pigs, feeding a wheat/barley-based diet increased (P , 0.05) total aerobes, whereas supplementation with MHA-FA increased (P , 0.05) total aerobes and lactobacilli populations in proximal small intestine (SI). Among the gnotobiotic pigs, bacterial contamination occurred such that eight pigs (two isolators) were monoassociated with a Gram-negative bacteria closely related to Providencia spp. and 16 pigs (four isolators) were monoassociated with Gram positive Enterococcus faecium. Species of monoassociated bacterial contaminant and diet composition did not affect residual methionine or MHA-FA in digesta. In both CON and monoassociated (MA) pigs, methionine and MHA-FA were retained in stomach (92%) but disappeared rapidly from proximal SI. Residual methionine and MHA-FA in digesta was not different in MA pigs; however, in CON pigs, less (P , 0.01) apparent residual methionine was found in digesta recovered at 25% (from cranial to caudal) and 75% of SI length compared with MHA-FA. Apparent residual methionine was 16% and 8% compared with 34% and 15% for MHA-FA, at the 25% and 75% locations, respectively. In proximal SI tissue, significantly (P , 0.05) higher radioactivity (cpm/mg wet tissue) was associated with MET pigs (8.56 6 0.47) as compared to MHA-FA ones (5.45 6 0.50). This study suggests that microbial metabolism of MHA-FA increases retention in small intestinal digesta relative to methionine and contributes, in part, to the lower bioefficacy of MHA-FA compared to methionine.
Based on previously performed in vitro studies, which showed that hulless barley varieties could reduce large intestinal Salmonella Typhimurium var. Copenhagen proliferation in pigs, two in vivo experiments were conducted to prove these observations. In Experiment (Exp.) 1, 126 weaning piglets were randomly allocated into pens of seven animals each and fed one of six experimental diets. Three diets contained (75% as-fed) one of three hulless barley varieties with beta-glucan (BG) contents ranging from 5 to 11% and amylose from 5 to 40%, and two diets contained a low BG and amylose hulless barley supplemented with isolated barley BG or raw potato starch. A hulled barley diet served as a control. Two piglets per pen ("Trojan" pigs) were orally infected with Salmonella Typhimurium var. Copenhagen (ST). The remaining five pigs per pen were designated "Contact" pigs. The ST shedding was determined over one week after infection. On day 6, the two Trojans and two random Contacts from each pen were euthanised and intestinal contents and mesenteric lymph nodes cultured for ST. Intestinal volatile fatty acids and microbial composition were determined. In Exp. 2, 126 piglets were assigned to one of three diets based on hulled or hulless barleys. The timeline, infection, sampling and analyses were similar as in Exp. 1 except samples were taken from four Contact pigs. Hulless barley varieties with high BG and amylose tended to decrease ST persistence in Exp. 1. Clostridia from cluster I in the colon were reduced with high amylose hulless barley or diets supplemented with potato starch (p < 0.05), whereas other microbial groups were not. Propionate increased (p < 0.05) and acetate decreased (p < 0.05) with hulless barley inclusion. Exp. 2 revealed a reduced ST shedding and reduced number of clostridia for high BG hulless barley as compared to common hulled barley and a low BG variety (p < 0.05). In conclusion, high BG hulless barley do not prevent ST colonisation but might help to reduce transmission in pigs, likely by supporting an intestinal environment limiting growth of this zoopathogen.
Background: Hypertension is the most common comorbid disease which can cause further complications in COVID-19 patients. On the contrary, the pandemic has also caused lower health services and adherence to hypertension therapy. This study aimed to examine the impact of the COVID-19 pandemic on medication adherence in people with hypertension in Indonesia.Methods: The research was conducted using an analytical quantitative method. Patients with hypertension from seven islands across Indonesia were recruited based on eligibility criteria during Bulan Bakti 2021, a social outreach by Ikatan Senat Mahasiswa Kedokteran Indonesia about basic health across Indonesia. The demographic and medication history of the respondents were recorded. The Indonesian version of the Morisky Medication Adherence Scale (MMAS-8) questionnaire was distributed, and the medication adherence level was assessed.Results: A total of 1155 patients, mainly females (62.2%) participated in this study. More than half of the patients had low adherence (55.25%). Males (Adjusted Odd Ratio (AOR) 0.777 [CI 95% 0.529–1.019]), employed (AOR 0.857 [CI 95% 0.495–1.483]), higher income (AOR 0.522 [CI 95% 0.393–0.713]), and those who had information from healthcare worker (AOR 0.583 [CI 95% 0.361–0.878]) were found to have better medication adherence in multivariate logistic regression test.Conclusion: Medication adherence level in patients with hypertension during the pandemic is markedly low. Integrated preventive and promotive measures, especially from healthcare workers, are needed to prevent further morbidity and mortality.
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