Cervical cancer incidence in young women: a historical and geographic controlled UK regional population study

Background:

The commencing age of cervical screening in England was raised from 20 to 25 years in 2004. Cervical cancer incidence in young women of England is increasing. It is not clear if this is due to either greater exposure to population risk factors or reduced cervical screening.

Methods:

We measured if the relative risk of cervical cancer in younger women (20–29 years) of the north-east of England (NE) differed to that of women aged 30yrs and above since 2004. We also measured average annual percentage change (AAPC) in the 3 yr moving average incidence for all age-groups. Regional screening coverage rate and population risk factors were reviewed. Comparisons were made with Wales where screening continues to commence from the age of 20 yrs.

Results:

Cervical cancer incidence in women aged 20–29 increased annually by an average of 10.3% between 2000 and 2009. The rise in women aged 30–39 was less steep (3.5%/year) but no significant rise was observed in women aged 40–49. Socioeconomic factors remained stable or improved during the time period except for the incidence of chlamydia, herpes simplex and in particular, genital warts, which increased significantly in young women. Data from Wales show similar results.

Conclusion:

The incidence of cervical cancers in young women of the NE is increasing. The rise in incidence is unrelated to the change in screening policy in 2004. Close monitoring of incidence in young women and a greater attempt to reverse the current decline in screening coverage of women aged 25–29 years are recommended.

Antimicrobial activity of butyrate glycerides toward Salmonella Typhimurium and Clostridium perfringens

The antimicrobial activities of n-butyric acid and its derivatives against Salmonella Typhimurium and Clostridium perfringens were studied. n-Butyric acid and its derivatives (monobutyrin and a mixture of mono-, di-, and tri-glycerides of butyric acid) were added at different concentrations (ranging from 250 to 7,000 mg/kg to a media inoculated with either Salmonella Typhimurium or C. perfringens. The antimicrobial activity of butyric acid against C. perfringens was measured at 2 bacterium concentrations and 2 inoculations involving ambient aerobic or anaerobic conditions. The most effective antimicrobial activity for Salmonella Typhimurium was observed with n-butyric acid, with 90% inhibition rate at a concentration of 1,500 mg/kg. Although minimal inhibition for Salmonella Typhimurium was observed with butyric acid glycerides, lipase addition to a mixture of mono-, di-, and triglycerides of butyric acid increased (P < 0.01) antimicrobial activity of these derivatives. Antimicrobial activity of butyric acid and its derivative against C. perfringens was higher when using a moderate initial inoculation concentration (10(5)) compared with a higher initial concentration (10(7)) of this bacterium. At a lower inoculation of C. perfringens (10(5)), >90% inhibition rate by all butyric acid glycerides was observed with prior aerobic inoculation at 2,000 mg/kg, whereas using anaerobic inoculation, only 50% monobutyrin maintained >90% inhibitory effect at 3,000 mg/kg. The antimicrobial effect of monobutyrin against C. perfringens was generally higher (P < 0.01) for 50% monobutyrin than for 100% monobutyrin. Either a mixture of butyric acid derivatives or 50% monobutyrin decreased (P < 0.01) C. perfringens in a media containing intestinal contents whereas only 50% monobutyrin decreased (P < 0.01) Salmonella Typhimurium within a media containing cecal contents from mature Leghorns. These results show that n-butyric acid and 50% monobutyrin could be used to control Salmonella Typhimurium or C. perfringens in poultry species.

Light intensity can influence plasma FSH and age at sexual maturity in domestic pullets

1. Shaver White and ISA Brown pullets were reared to 140 d in cage groups of 8 on a 10-h photoperiod of incandescent light and maintained at an illuminance of 3 or 25 lux, or transferred from 3 to 25 lux or from 25 to 3 lux at 63 or 112 d of age. 2. Plasma follicle stimulating hormone (FSH) concentration at 63 and 112 d was higher in both breeds for pullets maintained at an illuminance of 25 lux compared with 3 lux. After 2-4 d, and relative to constant-illuminance controls, plasma FSH increased significantly for ISA Brown transferred from 3 to 25 lux at 63 d and for Shaver White transferred at 112 d. Irrespective of genotype, plasma FSH for pullets given a decrease in illuminance at 63 or 112 d showed a tendency for less change than did constant-illuminance controls. 3. There was no significant difference in sexual maturity for ISA Brown maintained on 3 or 25 lux, but Shaver White pullets exposed to constant 3 lux matured later than those maintained on 25 lux. Shaver White matured later following an increase from 3 to 25 lux at 63 and 112 d, and earlier subsequent to a decrease from 25 to 3 lux at 112 d. ISA Brown pullets were not significantly affected by a change in illuminance at 63 or 112 d, though their responses were in the same direction as Shaver White. 4. Changes in plasma FSH in the 2- to 4-d period following a change in illuminance at 63 or 112 d were not significantly correlated with sexual maturity.

A questionnaire study of women's views regarding the effectiveness of serum Down screening in north west Wales

Questionnaires were circulated to 300 women awaiting mid-trimester anomaly scanning in north west Wales to determine women's views of the adequacy of counselling, availability of pretest scanning, method of receiving test results and whether the Down screening process in general was acceptable. Seventy-five per cent of respondents had serum Down screening; 80.3% of women agreed or strongly agreed that counselling prior to antenatal testing for Down syndrome was adequate; 80.7% of women agreed or strongly agreed that the consequences of a high risk result were explained before testing; 88.7% of women agreed or strongly agreed that they had a choice as to whether screening was accepted or not; 81.7% of women agreed or strongly agreed that they were involved in the decision process; and 40.0% of women having Down testing did not have previous ultrasound biometry. Routine pretest ultrasound scanning remains a resource priority.

Dietary lipids differentially affect membranes from different areas of rooster sperm

The present work aimed to compare the effect of dietary flax with other oil sources on rooster sperm membranes and on semen characteristics. White Leghorn roosters (16 per diet) were fed 1 of 4 treatments: control diet (CON), or a diet containing corn oil (CORN), fish oil (FISH), or flax seed (FLAX) as the lipid source. Semen from 4 birds (30 wk old) of each treatment was pooled, the sperm head (HM) and body membranes (BM) were isolated, and lipids were extracted and analyzed. Aspects of lipid composition tested were as follows: percentage of individual fatty acids (C14:0 to C24:1) in total fatty acids, percentage of fatty acid categories [saturated, monounsaturated, polyunsaturated (PUFA), n-3 and n-6 PUFA, and n-6:n-3 ratio] within total fatty acids, and percentage of phospholipids [phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylinositol, phosphatidylserine, and sphingomyelin] in total phospholipids. Sperm characteristics evaluated were as follows: volume, concentration, viability, percentage of motile cells, average path velocity, track speed, progressive velocity, lateral head displacement, straightness, and linearity. Diet did not affect membrane phospholipid ratios in either membrane but modified major fatty acids within certain phospholipids. Birds fed FISH and CORN showed, respectively, the highest and the lowest n-3 in sperm, causing reciprocal significant changes in n-6:n-3 ratio. Feeding FLAX caused intermediate effects in n-3, with values significantly lower than FISH but higher than CORN in HM (PC, PE, and phosphatidylinositol) and PC in BM (P < 0.05). In the PE phospholipids, FISH, followed by FLAX, increased n-3 in BM and decreased n-6 PUFA in HM. Sperm concentration was specifically correlated with the amount of 20:4n-6 in FLAX and 22:4n-6 in CON. In FLAX diets, straightness correlated with C18:0, n-3, and n-6:n-3 ratio. Diets containing distinct lipid sources differentially modify the lipid contents of HM and BM, with minor effects on sperm characteristics. Flax seed produced changes similar to fish oil and could be used as a substitute.

Development and evaluation of a dynamic model of calcium and phosphorus flows in layers

Phosphorus is an essential nutrient involved in most metabolic processes. Most of the interest in Ca metabolism relates to eggshell formation. Although the eggshell is composed of Ca carbonate, metabolism of both Ca and P is closely related such that a deficiency in one can interfere with proper utilization of the other. To understand Ca and P metabolism properly, modeling can be of paramount importance. A new dynamic and mechanistic model of P and Ca metabolism in layers has been developed to simulate diurnal changes in Ca and P and the hourly requirement of the layer for those minerals. The model consists of 8 state variables representing Ca and P pools in the crop, stomachs, plasma, and bone. The flow equations are described by Michaelis-Menten or mass action forms. An experiment that measured Ca and P uptake in layers fed different Ca concentrations during shell-forming days was used for model evaluation. The experiment showed that Ca retained in body and egg decreased from 62.5 to 50.5% of Ca intake when the Ca in diet was increased from 25 to 45 mg/g of feed. The model simulations were in agreement with the trend. Predictions of Ca retention in bone and egg were 63.2, 56.1, and 55.3% for low, medium, and high dietary Ca concentrations. The experimental results showed that P retention in body and egg increased significantly from 11.5% of absorbable P intake at the lowest Ca inclusion concentration to 24.1% at the highest. The model also predicted an increase in P retention in bone and egg from 8.4 to 25.4% of absorbable P intake at the lowest and highest concentration of Ca inclusion, respectively. The advantage of the model is that absorption and utilization can be monitored on an hourly basis and that adjustments can be made accordingly. The model successfully showed how the availability of one mineral affects the utilization of the other and is a useful tool to evaluate feeding strategies aimed at reducing P excretion to the environment in poultry manure.

Review: Energy partitioning in broiler chickens

In commercial nutrition and in research studies, metabolizable energy (ME) is the standard measure of energy used in describing energy requirements and diets for poultry. The provision of dietary energy will influence the intake of all other nutrients. Broilers exhibit an outstanding ability to control their energy intake by adjusting their feed intake as diet energy concentration changes. There is still considerable debate on the accuracy, precision and usefulness of different procedures used for determining ME values of diets and ingredients. ME intake is generally partitioned into energy retained (ER) in body tissues (mainly as fat and protein) and as heat production (HP): ME = HP + ER. There are few reported estimates of HP and its components, fasting heat production (FHP), heat production due to physical activity and the thermic effect of feeding (TEF). Requirements for maintenance (MEm), including major components of FHP and physical activity, are established at around 155 kcal kg BW0.60. We recentlyreported that maintenance requirements for young broilers based on kg BW0.75 were 8% lower than the values estimated using kg BW0.60, and that BW raised to the exponent 0.60, was a more precise estimator. Gross energy retained in the body as fat (TERF) and protein (TERP), together contribute most of the total energy retained (TER) in the body. Efficiency of ME utilization above maintenance varies from 70 to 84% for lipid deposition in adult birds and between 37 and 85% in growing birds. Key words: Energy, broiler, metabolic rate, energy retention

Assessment of the nitrogen correction factor in evaluating metabolizable energy of corn and soybean meal in diets for broilers

Three experiments were carried out to determine AME and AMEn of corn and soybean meal (SMB) in diets for growing broilers. In experiments 1 and 2, ingredient-specific basal diets or a combination of these basal diets with corn and SBM were prepared. For corn, the substitution was 25, 50, or 75% of the total diet, whereas SBM substitution was at 10, 20, or 30%. In experiment 1, birds were fed the experimental diets continuously from 0 to 33 d, and AME and AMEn were determined during 9 to 12 d and 30 to 33 d of age. In experiment 2, birds were fed the experimental diets only around the time of the collection period. The AMEn of corn was 95 to 97% of corresponding AME, whereas for SBM, AMEn was 93 to 88% of AME. Linear regression was used as an alternative method of calculating ingredient energy values resulting in a significant regression of diet AME and AMEn content on inclusion level, for each period of time and for each ingredient (corn and SBM). Based on varying inclusion levels of test ingredients in the diet, the extrapolated AME and AMEn of corn were estimated more precisely (R2 = 0.90 to 0.95) than those of SBM (R2 = 0.57 to 0.85), suggesting that the variability of AME and AMEn is better explained by a linear regression of AME or AMEn on percentage of inclusion. For corn, AME and AMEn were little affected by age, and the effect of N correction was consistent at around 3%. Determined energy values of SBM were more variable. Experiment 3 was conducted to assess the effect of formulating diets based on either AME or AMEn on broiler performance. A 2-sample t-test was implemented examining AME vs. AMEn formulation. The analyses for numerous production and carcass traits were nonsignificant except for the case of less abdominal fat in birds fed diets formulated to AME rather than AMEn (P < 0.01). These results showed that the use of the N correction imposed a penalty to corn of 3 to 5% and SBM of 7 to 12%.

Partitioning of retained energy in broilers and birds with intermediate growth rate

An experiment was conducted to study energy retained (TER) as fat (TERF) and protein (TERP) in 3 strains of birds with different growth rate; commercial broilers, Barred Plymouth Rock, and Leghorns. Birds were fed ad libitum a diet providing 3,100 kcal of AMEn/kg and 20% CP from 0 to 42 d. Body composition, TER, TERF, and TERP were determined at 0, 7, 10, 15, 19, 23, 28, 33, 37, and 42 d of age. The TER, TERF, and TERP were derived from whole body analyses. Linear and nonlinear models (quadratic, allometric, and Gompertz equation) were used as a means to characterize observed patterns of energy deposition. The TER, TERF, and TERP increased quadratically (P < 0.001) over time in all 3 strains of birds. Over 42 d, broilers deposited a constant proportion (50%) of body energy as fat and protein (P < 0.001). When applying the Gompertz equation to relate empty BW (EBW) to time, the estimated value for EBW at maturity of the broilers was unrealistically high (11.1 kg) and estimated poorly (SE 5.5 kg). Quadratic equations may be used as an alternative for Gompertz equations to represent growth of EBW, TER, TERF, or TERP vs. time in chickens between 0 and 42 d of age. Within the BW ranges that were evaluated in this study, allometric functions or Gompertz equations can be used to relate TERF and TERP to EBW, but model parameters differ between bird strains. Based on the Gompertz equation and in broilers, the maximum rate of TERF and TERP was reached at 1.16 and 1.22 kg of EBW, respectively, and then declines slowly as BW increases. Quantifying and partitioning TER as TERF and TERP as major components of ME requirements can be used to establish models that have economic consequences to the broiler industry.

Irradiation of poultry feed II. Effect on nutrient composition

Irradiation offers a potential method for effective microbial control of poultry feed. Birds fed such irradiated diets are not adversely affected and radiation status of the diet is unchanged. While radiation at 25–35 kGy is likely to raise feed temperature by only 5°C during processing, there seems to be loss in potency of certain nutrients. Most reports indicate loss in potency of all fat-soluble vitamins, and there are less consistent reports regarding thiamine and pyridoxine. At 25–35 kGy irradiation there will be around 15% loss of potency of these vitamins. Irradiation also causes increased peroxidation of fats, although this effect can be controlled by appropriate inclusion of antioxidants. There are no consistent reports of irradiation having any effect on protein quality or amino acid status of diets.

Relevance of nitrogen correction for assessment of metabolizable energy with broilers to forty-nine days of age

An experiment was conducted to reevaluate the concept of using AME vs. AME(n) values for broiler diets. Growing male broilers and adult Leghorn roosters were fed either a single standard diet from 0 to 49 d or a series of starter (0 to 21 d), grower (21 to 35 d), and finisher (35 to 49 d) diets. Apparent ME and AME(n) were determined during 4 to 7, 11 to 14, 18 to 21, 25 to 28, 32 to 35, 39 to 42, and 46 to 49 d of age. Using the single diet after 7 d, the broiler consistently derives higher AME than do roosters. This same effect was seen with the multiple diet series for broilers. However when N correction is applied, the converse situation is seen, in that roosters consistently attain higher AME(n) than do broilers at any given age. Using a single diet, rooster AME and AME(n) values were unaffected by time, whereas broilers exhibit a quadratic relationship for both AME and AME(n) through 49 d. Nitrogen retention of roosters was rarely different from zero (P > 0.05). For broilers, there was a significant (P < 0.01) increase in grams of N retained each day over time, although when expressed as a percentage of N intake, there was decline over time, especially after 28 d of age. The N correction imposes a 4 to 5% reduction on the AME value of a single diet. When a commercial series of diets was used, the correction declined from 5.3% at 7 d to 3.8% at 49 d, reflecting the decline in protein content of the diet and the decline in N retention over time. This information suggests that if AME rather than AME(n) values are accepted, then roosters provide a good estimate of values applicable for broiler nutrition, because values are little different. Because there was less variance in energy values expressed as AME(n) rather than AME, it appears that there was sufficient bird-to-bird variation in growth, N retention, or both, to warrant the use of the correction factor.

Effect of dietary lutein and flax on performance, egg composition and liver status of laying hens

Lutein is considered a protective nutrient against age-related macular degeneration in humans. An experiment was designed to study the long-term effect of feeding lutein in combination with flaxseed on layer performance, egg parameters, and lutein deposition in eggs and tissues. Laying hens were fed diets with 0 or 10% flax supplemented with 0, 125 or 250 ppm lutein for 11 consecutive 28-d periods beginning at 18 wk of age. Early production was reduced (P < 0.01) by feeding diets with 10% flax and when supplemented with 250 ppm lutein. Diet treatments had no effect on feed intake, egg weight or eggshell deformation. Addition of lutein to the diets significantly (P < 0.01) increased yolk color, and lutein content in the egg, liver, and the preen gland. Egg lutein content increased (P < 0.01) from a basal level of 0.10 mg to 1.60 mg 60g-1 egg by addition of lutein to the diet. Liver fat was lower (P < 0.05) in hens fed 10% flaxseed. Liver hemorrhage score was dramatically reduced (P < 0.01) in birds fed lutein. Key words: egg composition, flaxseed, lutein, layers

A semi-centennial report on the participants depicted in Joel Babb's portrait, 'the first successful kidney transplantation'

Joseph Murray performed the first successful human kidney transplant on December 23, 1954. Forty-three years later, he along with participants Francis Moore and Leroy Vandam, commissioned a painting of the event from artist Joel Babb (1). To document this unique record of medical history, we identify all those present at the operation and depicted in the portrait, describe how the artist created the work, explain irregularities and inaccuracies in the painting, provide a 50-year follow-up on everyone involved, and comment on any influence this landmark event may have had on their subsequent careers.