Type 1 diabetes (T1D) is a chronic illness that requires intensive lifelong management of blood glucose concentrations by means of external insulin administration. There have been substantial developments in the ways of measuring glucose levels, which is crucial to T1D self-management. Recently, continuous glucose monitoring (CGM) has allowed people with T1D to keep track of their blood glucose levels in near real-time. These devices have alarms that warn users about potentially dangerous blood glucose trends, which (...) can often be shared with ther people. CGM is consistently associated with improved glycemic control and reduced hypoglycemia and is currently recommended by doctors. However, due to the costs of CGM, only those who qualify for hospital provision or those who can personally afford it are able to use it, which excludes many people. In this paper, I argue that unequal access to CGM results in: (1) unjust health inequalities, (2) relational injustice, (3) injustice with regard to agency and autonomy, and (4) epistemic injustice. These considerations provide prima facie moral reasons why all people with T1D should have access to CGM technology. I discuss the specific case of CGM policy in the Netherlands, which currently only provides coverage for a small group of people with T1D, and argue that, especially with additional considerations of cost-effectiveness, the Dutch government ought to include CGM in basic health care insurance for all people with T1D. (shrink)

Uric acid has increasingly been associated with insulin resistance, hyperinsulinemia, and type 2 diabetes mellitus. Diabetic patients who are hyperuricemic have a risk of developing diabetic complications. Pathogenesis of uric acid may decrease nitric oxide bioavailability in vascular smooth muscle, endothelial cells and direct scavenging of nitric oxide by uric acid. A decrease in endothelial nitric oxide production by uric acid has also been associated with endothelial dysfunction and insulin resistance. This study aims to determine the relationship between uric acid (...) and glucose levels in patients with type 2 diabetes mellitus. The study included 161 Libyan patients (67 males and 94 females) diagnosed with type 2 diabetes mellitus. Both levels of serum uric acid and hemoglobin A1c (HbA1c) were determined. The patients were divided into two groups. The controllable diabetic group with HbA1c of less than 06.0% and the uncontrollable diabetic group with HbA1c of more than 06.0%. Patients who are suffering from type 2 diabetes mellitus without complications were included whereas patients with smoking, alcoholism, nephrotic disease, malignancy, hepatitis, and renal failure or kidney disease were excluded. The mean and standard deviation of uric acid, HbA1c and Pearson correlation coefficient test were considered. In the controllable diabetic group, serum uric acid mean was found to be 4.807±1.39 and HbA1c was found to be 5.032±1.39. In the uncontrollable diabetic group, serum uric acid was 4.897±1.66 and HbA1c was 8.396±1.65. Uric acid level has significantly been correlated with HBA1C in controlled and uncontrolled diabetic patients (p<0.05). In addition, the uric acid level was found to be higher in the uncontrolled diabetic group than that in the controlled group (p<0.05). A possible relationship between serum uric acid and the incidence of type 2 diabetes mellitus was noted. Thus, uric acid can be used as a potential biomarker to indicate impaired glucose metabolism. (shrink)

Diabetic ketoacidosis is a serious, medical emergency that can be fatal but treatable, we aimed to evaluate the clinical profile of patients admitted with diabetic ketoacidosis. This case series study enrolled 213 non-pregnant adult and adolescent patients admitted with diabetic ketoacidosis at Tripoli Diabetes Hospital from January to September 2023. Demographic data, clinical characteristics, laboratory findings, precipitating factors, and patient outcomes were extracted from medical records and analyzed. Type 1 diabetes mellitus was present in 187 (87.8%) of patients, the age (...) range 11-84 years, (30.26±13.28), with 130 patients ≤30 years old (61.0%), females accounting for 110 of the patients (51.6%), 109 had a diabetes duration of less than 10 years (51.2%). The most common precipitating factor was insulin omission 92 (43.2%) in patients with known diabetes mellitus, whereas, diabetic ketoacidosis as the first presentation of diabetes mellitus in 24 patients (11.7%), systolic blood pressure ranged 50-160 mmHg (112.82±16.19), diastolic blood pressure varied 30-100 mmHg (70.24±11.32). Plasma glucose at presentation ranged 183-1494 mg/dl (462.92±169.85), with Eu-glycemic diabetic ketoacidosis 100-249 mg/dl were in nine patients (4.2%), whereas most of cases (135 patients, 63.4%) present with plasma glucose 250-500 mg/dl, while hyperosmolar status (≥701 mg/dl) were present in 13 patients (6.1%). Venous pH varied from 6.7-7.42 (7.13±0.14), 132 (62.0%) patients presented with pH <7.24, while severe acidosis was pH < 7 in 32 of patients (14.6%), serum bicarbonate with 10.93±4.95, severe (<5 mmol) in 91 patients (42.7%) and moderate (5-10 mmol) were in 79 patients (37.08%). The mean length of hospital stay was 3.33 days, with an average of 2.11 days spent in the high-dependent unit. Serum potassium varied from 2.4-6.7 meq/L with 3.66± 0.63, most common complications of diabetic ketoacidosis treatment were hypokalemia observed in 82 (35.7%) of cases, and hypoglycemia was detected in 41 patients (19.2%). 170 patients were discharged in good condition (79.8%), and 17.8% of patients were transferred to another hospital to receive further management for co-morbid diseases with diabetes after controlling their hyperglycemic crises. The majority of patients presented with the critical status of diabetic ketoacidosis. The findings emphasize the importance of patient education about prevention measures prompt presentation to the hospital, and clinicians' awareness for early and aggressive treatment of hyperglycemic crises. (shrink)

Diabetes is a major public health issue that affects the nations of our time to a large extent and is described as a non-communicable epidemic. Diabetes mellitus is a common disease where there is too much sugar (glucose) floating around in your blood. This occurs because either the pancreas can’t produce enough insulin or the cells in body have become resistant to insulin. The concentration in this paper is on diagnosis diabetes by designing a proposed expert system. The main (...) goal of this expert system is to get the appropriate diagnosing of the illness, dealing with it quickly, and tips for permanent treatment whenever possible is given out. SL5 object expert system language was used for designing and implementing the proposed expert system. (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of (...) current practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

Endocrinologists apply the idea of feedback loops to explain how hormones regulate certain bodily functions such as glucose metabolism. In particular, feedback loops focus on the maintenance of the plasma concentrations of glucose within a narrow range. Here, we put forward a different, organicist perspective on the endocrine regulation of glycaemia, by relying on the pivotal concept of closure of constraints. From this perspective, biological systems are understood as organized ones, which means that they are constituted of a (...) set of mutually dependent functional structures acting as constraints, whose maintenance depends on their reciprocal interactions. Closure refers specifically to the mutual dependence among functional constraints in an organism. We show that, when compared to feedback loops, organizational closure can generate much richer descriptions of the processes and constraints at play in the metabolism and regulation of glycaemia, by making explicit the different hierarchical orders involved. We expect that the proposed theoretical framework will open the way to the construction of original mathematical models, which would provide a better understanding of endocrine regulation from an organicist perspective. (shrink)

Dual-process theories of higher order cognition (DPTs) have been enjoying much success, particularly since Kahneman’s 2002 Nobel prize address and recent book Thinking, Fast and Slow (2009). Historically, DPTs have attempted to provide a conceptual framework that helps classify and predict differences in patterns of behavior found under some circumstances and not others in a host of reasoning, judgment, and decision-making tasks. As evidence has changed and techniques for examining behavior have moved on, so too have DPTs. Killing two birds (...) with one stone, Evans and Stanovich (2013, this issue) respond to five main criticisms of DPTs. Along with addressing each criticism in turn, they set out to clarify the essential defining characteristics that distinguish one form of higher order cognition from the other. The aim of this commentary is to consider the defining characteristics of Type 1 and Type 2 processing that have been proposed and to suggest that the evidence can be taken to support quantitative differences rather than qualitatively distinct processes. (shrink)

Type 2 diabetes mellites (T2DM) is a common complex disease with multiple factors contributing to its development and progression. Dyslipidemia refers to the abnormality of lipid metabolism, characterized by elevated levels of low-density lipoprotein (LDL), total cholesterol (TC), triglycerides (TG), and decreased levels of high-density lipoprotein (HDL). It is a major risk factor for cardiovascular disease in type 2 diabetic patients. This study aimed to evaluate the diagnostic value of glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) in predicting (...) the risk of developing diabetic dyslipidemia. 86 clinically diagnosed Libyan patients with type 2 diabetes mellitus (44 males: 42 females), 30 years and 70 years of age were engaged in this study. Levels of HbA1C, blood glucose, TC, TG, LDL, and HDL were performed using a Lntegra Cobas 400+ analyzer. The findings showed that HbA1c exhibits a significant positive correlation with TC and TG with no significant correlation with LDL and HDL levels. Thus, this study suggests that HbA1c can be used as a potential dual marker of glycemic control and dyslipidemia in type 2 diabetes mellitus. (shrink)

The electric activities of cortical pyramidal neurons are supported by structurally stable, morphologically complex axo-dendritic trees. Anatomical differences between axons and dendrites in regard to their length or caliber reflect the underlying functional specializations, for input or output of neural information, respectively. For a proper assessment of the computational capacity of pyramidal neurons, we have analyzed an extensive dataset of three-dimensional digital reconstructions from the NeuroMorphoOrg database, and quantified basic dendritic or axonal morphometric measures in different regions and layers of (...) the mouse, rat or human cerebral cortex. Physical estimates of the total number and type of ions involved in neuronal electric spiking based on the obtained morphometric data, combined with energetics of neurotransmitter release and signaling fueled by glucose consumed by the active brain, support highly efficient cerebral computation performed at the thermodynamically allowed Landauer limit for implementation of irreversible logical operations. Individual proton tunneling events in voltage-sensing S4 protein alpha-helices of Na+, K+ or Ca2+ ion channels are ideally suited to serve as single Landauer elementary logical operations that are then amplified by selective ionic currents traversing the open channel pores. This miniaturization of computational gating allows the execution of over 1.2 zetta logical operations per second in the human cerebral cortex without combusting the brain by the released heat. (shrink)

Objective: The aim of this study was to compare oral Artemether-Lumefantrine to intravenous Quinine by exploring its effectiveness in cerebral malaria in hospitalized patients. Materials and Methods: A randomized prospective study was conducted among 64 hospitalized cases of cerebral malaria. One group of patients was treated with intravenous Quinine and another group was treated with oral Artemether-Lumefantrine. Response in clinical, laboratory parameters and outcome of treatment were noted every eight hours. Results: Oral Artemether-Lumefantrine showed almost similar response in clinical and (...) laboratory parameters with median temperature (101º F), pulse rate (102 b/m), systolic BP (110mmHg), GCS (12), hemoglobin (9.8 g/dl), WBC (9000/μl), platelet (130000/μl), B. glucose (101 mg/dl), S. creatinine (1.8 mg/dl), ALT (32 U/L), mean disappearance time of parasite from blood (40 hours), and mean time for regaining full consciousness (30 hours). Final outcome was also similar in both drugs with only 1 death (3.1%) reported in each group. Conclusion: In cerebral malaria intravenous Quinine or oral Artemether-Lumefantrine therapy does not have any statistically significant difference in terms of clinical parameter, laboratory parameter and final outcome. (shrink)

The cashew nut is essential for physical and emotional well-being. It is an energetic diet and the best food medication for many illnesses. Nuts protects from malignant growth, coronary illness, circulatory strain, and various degenerative infirmities connected to aging. It can be used for several medicinal purposes. Every part of cashew has some important medicinal properties. Cashew kernel contains proteins, carbohydrates, vitamins, and fats which help gain energy. Cashew nuts are used for many purposes like blood sugar, weight loss, cancer, (...) cold and flu, aging, urinary disorders, digestive disorders, and bone relaxation. In comparing cashew with other nuts, Cashew kernels have good properties, including proteins, carbohydrates, fibers, and minerals, then almond, hazelnut, and walnuts. Cashew kernels contain the highest number of proteins (21%) when compared with Almonds (20.8%), Hazelnuts (15.6%), and Macadamia Nuts (60.9%). Cashew contain large amount of carbohydrate (22%) compared to other nuts like almonds, walnuts, etc. There are some strong benefits of Cashew for health. They boost the immune system, act as an antioxidant, remove gallstones, and beneficial for anemia. They are good sources of healthy fats that are necessary for our body to absorb fat-soluble vitamins. Its bark is known as the antihypertensive and glucose-lowering part. It has beneficial effect on the eyes and skin. This is rich in vitamin C, so it can be used for skin problems like acne, flawless freckles, skin lines and protects from aging. (shrink)

The present investigation has been designed to study the effect of sub lethal concentrations of Nickel on the serum metabolites of Channa punctatus after exposure to 45 days. The present study shows that serum metabolites such as glucose and protein were significantly decreased while lipid was significantly increased. Thus, the result provides an overview of the manipulation of fish, Channa punctatus as a biomarker of heavy metals through alternation in serum biochemical parameters.

The peritoneum is the largest serous membrane in the body that covers the inner side of the abdominal wall and reflects over the abdominal viscera. Though the visceral peritoneum accounts for roughly four-fifth of the total surface area of the membrane, but the parietal peritoneum is the more important for peritoneal dialysis. Between the parietal and visceral layer of peritoneum there is potential space called peritoneal cavity, contain small amount of serous fluid. If dialysates remain more or less than normal (...) in the peritoneal cavity that may cause edema or hypovolemic shock. Hence transport across the peritoneal membrane need great attention to the nephrologist during dialysis. Solute and water transport from blood to peritoneal cavity by diffusion and osmic ultra-filtration whereas absorption to the blood via lymphatic has negatively affect between these two process. Another important thing that the peritoneum is lined by mesothelium. Therefore, primary complication of peritoneal dialysis is infection due to the presence of a permanent tube in the abdominal cavity. Mortality is higher in the elderly and if present in prolonged time. Peritoneal sclerosis is a fetal complication due to growth of a thick layer of fibrin within the peritoneum, in where every chance of the bowel obstruction. The fluids contain glucose for dialysis use as a primary osmotic agent but this may lead to peritonitis. The decline of kidney and peritoneal membrane function and negative health outcome. It is important to be aware about the sex difference of peritoneal membrane during dialysis. Retrograded menstruation may occur in any women as there is continuity of peritoneal membrane with the fallopian tube. If goes undetected will cause bloody dialysate and create concern of the patients. Therefore, anatomy of peritoneal membrane and its function has great value during peritoneal dialysis and thereby effecting its therapeutic efficacy. (shrink)

Abstract: Background: Vitamin D insufficiency/deficiency prevalent in all age groups across the world is common in obesity and may play an important role in the risk factors of metabolic syndrome (MS). Objectives: This cross-sectional study is to evaluate the relationship between levels of adiponectin and circulating 25(OH)D, and its effect on metabolic biomarker among overweight/obese female students. Methods: Three hundred female students; with mean age 20.9 ± 3.2 years were attending the Aljouf University, Sakaka, Saudi Arabia. They were randomly selected (...) from university during the studying year 2015 – 2016. Anthropometric and biochemical indices were determined. Results: The study showed 19% of the female’s student were either overweight or obese (15% and 4%, respectively). The frequency of MS diagnosis among the students was 17%, with 13% and 4% had either three or four risk factors, respectively. Overweight/obese subjects had significantly worse anthropometric and biochemical characteristics, including waist/hip ratio, blood pressure (BP), fasting blood glucose (BG), insulin, insulin resistance (HOMA-IR), triglyceride levels (TG), low-density lipoprotein cholesterol levels (LDL-C), leptin, adiponectin, leptin/adiponectin ratio and high-density lipoprotein cholesterol levels (HDL-C) compared to normal weight. Of the subjects diagnosed with MS, 59% had mild and 8.6% had severe 25(OH)D deficiency. There was negative association between 25(OH)D and both FBG and HOMA-IR among young women obese/overweight. Conclusion: In our study, it suggested that low level of adiponectin was strongly correlated with low 25(OH)D levels. Also, the prevalence of MS tends to increase with high occurrence rate of low circulating 25(OH)D levels that is, known cause poor glycemic control and prediction of cardiovascular outcomes. (shrink)

Vitamin D deficiency and its effect have attracted considerable research interest due to its relation to glucose homeostasis, insulin secretion, sensitivity and synthesis. This study aimed to evaluate vitamin D levels in patients with type II diabetes mellitus aged between 35-65 years and investigate their relations with glycemic control and obesity. The study included 74 Libyan patients with a known history of type II diabetes mellitus (33 males and 41 females). Serum glucose, glycosylated hemoglobin (HbA1c) and vitamin D (...) levels were biochemically estimated in these patients. Further, body mass index (BMI) was calculated for all diabetic patients (weight in kilogram per height in meter square). The mean level of plasma glucose level was 150.58±63.82 mg/dl (mean±SD). The mean of HbA1c level was 7.90±8.48% (mean±SD). The mean level of vitamin D was 22.75±14.97 ng/ml. The mean of BMI was 26.55±4.10 Kg per m2. The findings showed that 58.10% of the cases had vitamin D deficiency (Out of which 24.24% were males and 85.36% were females). This study showed significant differences in glucose, HbA1c, vitamin D and BMI between male and female patients. Moreover, elderly ages for both sexes had adverse effects on vitamin D status. Vitamin D levels have negatively been correlated with levels of glucose, HbA1c and BMI. It is concluded that vitamin D deficiency has an adverse effect on glucose homeostasis in patients with type II diabetes mellitus and this can be a contributing risk factor in complications of type II diabetes mellitus development in Libyan patients. (shrink)

Objective: To evaluate the potential of arterial spin labeling (ASL) as an alternative to FDG-PET in the diagnosis of disorders of consciousness (DOC), we conducted a comparative study of the two modalities. Methods: A total of 36 DOC patients (11 female; mean age = 49.67 ± 14.54 years) and 17 healthy control (HC) participants (9 female; mean age = 31.9 ± 9.6 years) underwent both FDG-PET scans that measure metabolism via glucose uptake and ASL scans that measure cerebral blood (...) flow (CBF). CBF and metabolism in DOC and HC were compared, globally and for seven functional networks. Comparability of the two modalities was estimated using Spearman partial correlation for both global and network levels. Furthermore, a support vector machine (SVM) algorithm was used to train two classifiers to distinguish DOC patients from HC with normalized CBF or metabolism values from the seven networks. Performance of these classifiers was first evaluated through leave-one-subject-out (LOSO) cross-validation within their respective modalities. Subsequently, cross-modal validation was conducted: testing the ASL-trained classifier with PET data (ASL-to-PET validation) and vice versa (PET-to-ASL validation). Performance of each classifier was assessed using receiver operating characteristic (ROC) analysis, with area under the curve (AUC) as the metric. Results: Both modalities showed agreement in decreased CBF and metabolism in DOC patients compared to HC, at both global and network levels. The global brain and most networks showed significant positive partial correlation between CBF and metabolism. SVM classifiers, utilizing activity from seven networks as features, performed well in the both LOSO cross-validation (ASL-trained classifier: accuracy = 83.02%, AUC = 0.95; PET-trained classifier: accuracy = 98.12%, AUC = 0.98) and cross-modal validation (ASL-to-PET validation: accuracy = 84.90%, AUC =0.92; PET-to-ASL validation: accuracy = 73.58%, AUC = 0.93). Conclusion: Our results demonstrate that ASL provides information comparable to FDG-PET for DOC patients; moreover, classifiers trained on ASL data perform comparably well to those trained on FDG-PET data. Therefore, ASL could be a valuable alternative to FDG-PET in the clinical diagnosis of DOC, especially in light of its advantages: ease of acquisition, avoidance of radiation exposure, brevity of scanning time, and lower-cost. (shrink)

Saturated free fatty acids-induced hepatocyte lipoapoptosis plays a pivotal role in non-alcoholic steatohepatitis. Theactivation of endoplasmic reticulum (ER) stress isinvolved in hepatocyte lipoapoptosis induced by thesaturated free fatty acidpalmitate (PA). However, the underlying mechanismsof the role of ER stress in hepatocyte lipoapoptosis remain largely unclear.In this study, we showed that PA and tunicamycin (Tun), a classic ER stress inducer, resulted in differential activation of ERstress pathways. Our data revealed that PA inducedchronic and persistent ER stress response, but Tuninduced acute and (...) transientER stress response. Compared with Tun treatment, PAinduced much lower glucose-regulated protein 78 (GRP78), a centralregulator of ER homeostasis, accumulation. It is noteworthy that GRP78 over-expression not only inhibited PA-induced ERstress but also decreased PA-induced apoptosis. Taken together, our data suggest that the differentialactivation of ER stresssignal plays an important role in PA-induced hepatocyte lipoapoptosis. More detailed studies on the mechanisms of PA inrepressing the accumulation of GRP78 will contribute to the understanding of molecular mechanisms of lipoapoptosis. (shrink)

Introduction: Metabolic syndrome (MetS) is an endocrinopathy with a combination of cardiovascular and metabolic compounds. In our study, it is expected to obtain results showing that mortality rate, loss of workforce, and treatment costs due to disorders caused by MetS can be reduced by physical exercise. The study analyses the effect of moderate exercise training on this Apolipoprotein E (ApoE), Apolipoprotein CIII (ApoCIII), adiponectin, resistin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) which are thought to have a role in the (...) deterioration of glucose and lipid metabolism in MetS. -/- Methods: This clinical experimental study consists of 3 groups. The MetS+E (n=24) group, which included the participants who agreed to participate in the exercise program in addition to their medical treatment, the MetS (n=23) group who received medical treatment but did not exercise, and the Control+E (n=25) group, which included healthy volunteers who had the same protocol as MetS+E ApoE, ApoCIII, adiponectin, resistin, IL-6, and TNF-α plasma levels of all participants were measured both at the beginning of the study and at the end of the protocol. -/- Results: At the end of the study we reached the following findings; insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) levels decreased in exercise groups (p=0,03). ApoCIII levels increased in all the groups after the study (p<0,01). IL-6 levels decreased in MetS+E (p<0,01) and Control+E (p=0,037). ApoE (p=0,01) and TNF-α (p=0,037) levels decreased only in the Control+E group. -/- Conclusion: Training showed metabolic, anti-inflammatory, and physical improvements independent of ApoE and ApoCIII in those with MetS. (shrink)

DOENÇAS CAUSADAS POR ALIMENTAÇÃO INADEQUADA    Emanuel Isaque Cordeiro da Silva Departamento de Zootecnia da UFRPE E-mail: [email protected] WhatsApp: (82)98143-8399  INTRODUÇÃO Das muitas doenças esporádicas que podem afetar os animais, as mais frequentes afetam o aparelho digestivo ou são causadas pelo consumo de alimentos inadequados. Nas alterações que ocorrem no estômago e intestino é muito estreita a relação entre as doenças e a alimentação. Por um lado, os alimentos em más condições, sujos, ácidos, umedecidos, contaminados ou administrados (...) em excesso, causam logo lesões; igual ocorre quando muda-se bruscamente o regime alimentar ou se o animal come plantas tóxicas. Seja por uma causa ou por outra, uma vez produzida a alteração digestiva, os animais aproveitam-se do pior dos alimentos, alterando-se, como consequência, a ruminação. Com essa ingestão inadequada de alimentos inadequados e/ou contaminados ou fora do padrão nutricional, produzem-se diarreias ou constipações e inclusive o animal deixa de comer, pelo que podem ocorrer novas perturbações e confusão dos efeitos com as causas. Em outros casos, a alimentação com rações mal calculadas e deficientes em algum elemento nutritivo necessário causa, ao cabo do tempo, sintomas de carências minerais e vitamínicas, e inclusive doenças que podem ser graves. DIARRÉIA  Quando as fezes expelidas pelos animais são mais líquidas do que o normal, são alteradas ou saem mais frequentemente do que o habitual, diz-se que têm diarreia. Na verdade, é um sintoma que pode ser devido a causas muito diversas. Frequentemente são produzidas por algum alimento inadequado ou por germes infecciosos cujas toxinas alteram o intestino. Se são graves podem levar o animal à óbito, sobretudo quando o mesmo é jovem. Para evitá-las há de se tomar precauções higiênicas como as seguintes: 1. Não dar aos lactentes mais leite do que o devido; ao preparar os leites artificiais devem ser utilizadas as proporções recomendadas pela casa que vende o produto e a temperatura adequada. As amas de leite automáticas e os recipientes que tenham contido leite devem ser lavados muito bem. Os restos de leite tornam-se, ligeiramente, em um ambiente propício para o aparecimento de nichos de micróbios. 2. Não utilizar os restos alimentares que ficam nos comedouros; estes devem ser limpos de cada vez, especialmente se foram administrados alimentos úmidos ou quando se tratam da alimentação de crias. 3. Não mude bruscamente a alimentação dos animais. Os alimentos novos devem ser fornecidos em quantidades muito pequenas; depois, a ração será gradualmente aumentada, à medida que os dias passam. Esse procedimento é realizável tanto para a administração de concentrados quanto para forragens. Um bom exemplo para a administração de novos alimentos é a graduação em 10/100, ou seja, colocar 10 partes do novo alimento em 100 da usada na propriedade. E ir aumentando esse percentual conforme o tempo passa. Observe um exemplo em que foi usado o farelo com milho e soja com o fornecimento de forrageira (capim-elefante): Fornecimento de alimentos por graduação Alimento Número de dias Quantidades Milho + Soja 1 - 10 100% 10 - 20 95% 20 - 30 90% 30 - 40 85% 40 - 50 80%  Capim-elefante 1 - 10 0% 10 - 20 5% 20 - 30 10% 30 - 40 15% 40 - 50 20% Tabela 1: Fornecimento graduado de novos alimentos na alimentação animal. FONTE: SILVA, E. I. C. da., 2019. A tabela acima demonstra um exemplo prático realizado em uma propriedade que obteve êxito. Consiste na explicação do método do fornecimento graduado de novos alimentos na dieta dos animais, uma vez que o fornecimento precoce de grandes quantidades de ingestão de alimentos alternativos e novos, podem acarretar complicações no aparelho digestivo do animal. Note que o fornecimento de capim-elefante, sendo uma forrageira, é essencial para a alimentação e dieta dos animais, porém ela é fornecida gradativamente aos animais, e não é totalmente substituível do concentrado. 4. Não aproveitar alimentos mofados ou alterados por fermentações anormais. Se forem resíduos de alimentação humana, deve-se cozinhá-los previamente. 5. Assegurar-se que a água é potável e não está contaminada. 6. Assegurar que a ração contenha sempre alimentos ricos em vitamina A (protege a mucosa intestinal, entre outras coisas). Ao nascer, os animais devem tomar colostro suficiente para adquirir as células de defesa do organismo. 7. Evitar qualquer contato ou relação entre os alimentos e os excrementos, procurando manusear os alimentos longe do solo, das camas, dos estrumes, dos aterros ou das coisas que entraram em contato com tais matérias. Os animais com diarreia devem ficar sem comer durante um dia (em muitos casos, devem ser amordaçados para que se consiga tal feito) e depois dar-lhes alimentos leves que sejam bem digeridos. Mas o mais importante é que bebam água o suficiente para evitar a desidratação. Melhor que a água é o soro, ou água em que se dissolveram 8 g de sal e uma pitada de bicarbonato por litro. Para os animais lactantes com diarreia, além de lhes suprimir o leite, são dados dois litros de infusão de chá ou água morna na qual se tenham dissolvido 9 g de sal e 50 g de glucose por litro (estas quantidades podem ser pesadas na farmácia). Em seguida, o veterinário irá aconselhar, em cada caso, o medicamento mais conveniente e o zootecnista a dieta mais adequada. METEORISMO OU TIMPANISMO É o acúmulo de gases no aparelho digestivo, especialmente na pança dos ruminantes e no ceco dos equinos. Não podendo expelir os gases (que geralmente formam espuma com os líquidos digestivos), o ventre vai inchando e pode atingir um volume enorme. Se o processo é agudo, o animal se prostra e mal pode respirar, de modo que em pouco tempo pode vir à óbito.  Com exceção do inchaço da pança causado por acidentes nos ruminantes (pedaços de batata atravessados no esófago) ou por certas doenças (por exemplo, inchaço dos gânglios tuberculosos), o meteorismo deve-se à ingestão inadequada de alimentos. Geralmente, o meteorismo ou timpanismo ocorre em animais que são forçados a mudar bruscamente de alimentação, passando de um regime rico em minerais e vitaminas em uma pequena quantidade (concentrados) a outro rico em fibras (volumosos), saem ao pasto pela primeira vez em primaveras chuvosas, comem forrageiras molhadas ou quentes ou ingerem, em pouco tempo, quantidades demasiadas de capins, alfafa ou demais forrageiras.  Os animais propensos, devem ser alimentados tendo em conta tais circunstâncias e deve-se buscar a melhor forma de evitar tais problemas; assim deve-se evitar o pastoreio de leguminosas muito jovens ou com orvalho, e convém dar algum feno antes de sair ao pasto pelas manhãs. Não convém as farinhas muito moídas. Quando o meteorismo já se encontra presente e o animal está inchado, pode-se tentar solucionar o problema dando-lhe quarto a meio litro de óleo de soja com água, mas é pouco efetivo. Outros aconselham leite, aguardente, silicones etc., porém não se consegue grande êxito. Não devem ser fornecidos produtos como o amoníaco, ou derivados deste, uma vez que dão sabor à carne, caso o animal seja destinado ao matadouro. Às vezes se consegue algo colocando o animal em uma inclinação (terço anterior mais alto) e movendo uma corda sob a língua enquanto ele é pressionado no ventre com os punhos para forçar o arroto. Observe um dos métodos utilizados em uma propriedade para o combate ao meteorismo:   São muito úteis as sondas de borracha ou de plástico que entram pela boca ou pelas narinas do animal e chegam até a pança. Em muitos casos, esse método de introdução da sonda esofágica permite a saída dos gases e resolve-se o meteorismo; além disso, servem para administrar os líquidos necessários, quando os animais lactantes se negam a ingeri-los. As sondas utilizadas em bovinos e equídeos medem, normalmente, 2,25 m de comprimento e cerca de 25 mm de diâmetro; as utilizadas em ovinos têm 1,5 m e 5 mm de diâmetro, porém as dimensões, para ambas as espécies, podem variar. Alguns agricultores combatem o meteorismo lançando pela sonda vários litros de água quente. Outros utilizam certos detergentes antiespumantes ou poloxaleno numa dosagem de 10-12 g/animal/dia em casos de meteorismo grave, mas o que se aconselha é chamar o veterinário para que aconselhe sobre o tratamento adequado. Em casos mais graves, faz-se necessário o uso do trócar para puncionar a pança dos ruminantes (furo no lado esquerdo) ou o ceco dos equídeos (lado direito) pelo método de tratamento denominado trocaterização. É um instrumento semelhante a um punhal de folha cilíndrica colocada numa cânula ou bainha; crava-se o instrumento no lado esquerdo do animal (bovinos) e depois deixa-se no animal a cânula oca para que por ela possam sair os gases (também são fornecidos líquidos por essa passagem). Observe:                         CONCLUSÃO A mal administração de alimentos numa propriedade pode ocasionar diversos problemas futuros, dois mais expressivos foram tratados nesse breviário. Os alimentos oferecidos aos animais devem ser de qualidade igual aos disponíveis para os humanos. Alimentos em contato com microrganismos (bactérias, fungos, protozoários, vírus etc.) podem servir de vetores a inúmeras doenças. A diarreia é uma doença que pode ser evitada mediante programas rígidos de manejo sanitário dos alimentos, na administração essencial e não exagerada e no manejo dos animais no pasto e na ingestão de alimentos. O timpanismo ou meteorismo é uma enfermidade que afeta, especialmente, o rúmen de bovinos e ovinos, além do ceco de equinos; uma enfermidade que pode ser tratada ou prevenida mediante os mesmos programas de análise e segurança dos alimentos fornecidos à pasto ou à cocho para os animais. Deve-se estar atento ao que os animais comem, pois muitas doenças são facilmente tratadas quando se sabem as causas e os sintomas para que, com isso, se possa fornecer o melhor tratamento e o remédio equivalente.           Respeite os direitos autorais. Todos os direitos são reservados para Emanuel Isaque Cordeiro da Silva. A reprodução total ou parcial do trabalho sem a autorização prévia do autor, confere infração ao artigo 184 do Código Penal e da Lei 9610/98, sendo assim, os respectivos infratores estarão submetidos à privação da liberdade por até um ano. Endereço para correspondência: [email protected]  Contato: (82)98143-8399 Recife, 2019.     REFERÊNCIAS BIBLIOGRÁFICAS BORGES, J. C. de A. Timpanismo em ruminantes. Infoescola. Disponível em: Acesso em: novembro de 2019. PATRÍCIO, A. M. P. C. As principais afecções gástricas dos bovinos. 2012. 107f. Dissertação (Mestrado em Medicina Veterinária). Faculdade de Medicina Veterinária, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, 2012. ROLLÁN, M. G. Sanidad ganadera. 2ª ed. Madrid: Servicio de Extensión Agraria, 1990. pp. 13-17. . (shrink)