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        In-field evaluation of clinoptilolite feeding efficacy on the reduction of milk aflatoxin M1 concentration in dairy cattle

        Katsoulos, Panagiotis D.,Karatzia, Maria A.,Boscos, Constantinos,Wolf, Petra,Karatzias, Harilaos Korean Society of Animal Sciences and Technology 2016 한국축산학회지 Vol.58 No.7

        Background: Clinoptilolite is a natural zeolite with high adsorption capacity for polar mycotoxins such as aflatoxins. The efficacy of clinoptilolite in ameliorating the toxic effects of aflatoxicosis has been proven in monogastric animals, but there is no such evidence for ruminants. The aim of this study was to evaluate, under field conditions, whether the dietary administration of clinoptilolite in dairy cows could reduce the concentration of aflatoxin M1 ($AFM_1$) in bulk-tank milk, in farms with higher than or close to $0.05{\mu}g/kg$ of milk (European maximum allowed residual level). An objective of the present study was also to investigate the effect of particle size of clinoptilolite on aflatoxin binding. Methods: Fifteen commercial Greek dairy herds with AFM1 concentrations in bulk tank milk ${\geq}0.05{\mu}g/kg$ were selected. Bulk tank milk AFM1 was determined prior to the onset and on day 7 of the experiment. Clinoptilolite was added in the total mixed rations of all farms at the rate of 200 g per animal per day, throughout this period. Two different particle sizes of clinoptilolite were used; less than 0.15 mm in 9 farms (LC group) and less than 0.8 mm in 6 farms (HC group). Results: Clinoptilolite administration significantly reduced $AFM_1$ concentrations in milk in all farms tested at an average rate of 56.2 % (SD: 15.11). The mean milk $AFM_1$ concentration recorded on Day 7 was significantly (P < 0.001) lower compared to that of Day 0 ($0.036{\pm}0.0061$ vs. $0.078{\pm}0.0074{\mu}g/kg$). In LC group farms the reduction of milk $AFM_1$ concentration was significantly higher than HC group farms ($0.046{\pm}0.0074$ vs. $0.036{\pm}0.0061{\mu}g/kg$, P = 0.002). As indicated by the Pearson correlation, there was a significant and strong linear correlation among the milk $AFM_1$ concentrations on Days 0 and 7 (R = 0.95, P < 0.001). Conclusions: Dietary administration of clinoptilolite, especially of smallest particle size, at the rate of 200 g per cow per day can effectively reduce milk $AFM_1$ concentration in dairy cattle and can be used as a preventive measure for the amelioration of the risks associated with the presence of aflatoxins in the milk of dairy cows.

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        Robotic-assisted versus laparoscopic paraesophageal hernia repair: a systematic review and meta-analysis

        Symeonidou Elissavet,Gkoutziotis Ioannis,Petras Panagiotis,Mpallas Konstantinos,Kamparoudis Apostolos 대한내시경로봇외과학회 2023 Journal of Minimally Invasive Surgery Vol.26 No.3

        surgeons. This systematic review aims to compare the outcomes of robotic-assisted and conventional laparoscopic approaches for paraesophageal hernia repair, specifically examining postoperative complications, operative time, hospital stay, and recurrence. Methods: A systematic review including thorough research through PubMed, Scopus, and Cochrane, was performed and only comparative studies were included. Studies concerning other types of hiatal hernias or children were excluded. A meta-analysis was conducted to compare overall postoperative complications, hospital stay, and operation time. Results: Ten comparative studies, with 186,259 participants in total, were included in the meta-analysis, but unfortunately, not all of them reported all the outcomes under question. It appeared that there is no statistically significant difference between the conventional laparoscopic and the robotic-assisted approach, regarding the overall postoperative complication rate (odds ratio [OR], 0.56, 95% confidence interval [CI], 0.28–1.11), the mean operation time (t = 1.41; 95% CI, –0.15–0.52; p = 0.22), and the hospital length of stay (t = –1.54; degree of freedom = 8; 95% CI, –0.53–0.11; p = 0.16). Only two studies reported evidence concerning the recurrence rates. Conclusion: Overall, the robotic-assisted method did not demonstrate superiority over conventional laparoscopic paraesophageal hiatal hernia repair in terms of postoperative complications, operation time, or hospital stay. However, some studies focused on cost and patient characteristics of each group. Further comparative and randomized control studies with longer follow-up periods are needed for more accurate conclusions on short- and long-term outcomes.

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