PACE: a model for integrated care of frail older patients. Program of All-inclusive Care for the Elderly

The Program of All-inclusive Care for the Elderly (PACE) is a model of care that pools Medicare and Medicaid funds to provide acute and long-term care services for older patients through the use of interdisciplinary teams. Services include physician visits, prescription drugs, rehabilitation services, personal care workers, hospitalization, and nursing home care, if needed. PACE programs may also offer social services intervention, case management, respite care, or extended home care nursing. The PACE site assumes financial responsibility for all services. Now that PACE programs can become permanent providers under Medicare, their number is expected to grow.

Effect of protein and lysine supply on performance, nitrogen balance, and body composition changes of sows during lactation

Using 73 Large White gilts, we studied the lysine requirement during lactation. Sow and pig performance and nitrogen balance of sows were measured during the total 21-d lactation period. Variation in body composition of sows between farrowing and weaning was determined by the comparative slaughter technique. Two levels of crude protein (15.5 and 17.1%) were combined with two levels of L-lysine HCl supplementation (0 and .16%), resulting in four diets termed P1L1, P1L2, P2L2, and P2L3, containing .66, .77, .77, and .87% crude lysine, and 15.5, 15.5, 17.1, and 17.1% crude protein, respectively. Sows' feed intake, litter growth rate, and milk energy and protein output were not affected by the diet. Nitrogen balance over the total lactation increased (P < .001) with an increase in lysine and(or) protein (-11.7, -7.0, -3.4, and .4 g N/d for P1L1, P1L2, P2L2, and P2L3 diets, respectively). The losses of body weight and muscle weight were higher in P1L1 gilts (P < .01 and .05, respectively) than in gilts on other treatments, whereas the loss of adipose tissue and backfat was similar for the four groups. Multiple linear relationships between lysine intake and milk nitrogen output as predictors and nitrogen balance (N balance = -15.8 + 1.22 lysine - .63 N milk, R2 = .89) or variation of muscle weight (Vm = -477 + 30.1 lysine - 14.7 N milk, R2 = .70) as predicted values were calculated to estimate lysine requirement according to production performance of sows. Calculations show that for achieving a zero protein balance, 45 to 55 g/d of crude lysine are required for normal to high-yielding sows, respectively.

Energy metabolism in pregnant sows and newborn pigs

Measurements of heat production(HP; indirect calorimetry) and its partition between maintenance, physical activity, thermoregulation, and thermic effect of feed or energy gain were carried out in sows maintained in different situations: primiparous or multiparous; pregnant or nonpregnant; thermoneutral or cold conditions; varied feeding levels; and varied body weights (BW). Metabolizable energy requirements for maintenance average 420 kJ/kg BW.75 at thermoneutrality and moderate physical activity. This value is not significantly affected by parity, pregnancy, and stage of pregnancy. Physical activity is a major factor causing differences in energy balance between sows because activity is variable and its energy cost (27 kJ.kg BW-.75.100 min-1 standing) is four to five times higher than in other species. Lower critical temperature (LCT) is approximately 20 degrees C in pregnant and individually housed sows, and daily HP is increased by approximately 15 kJ/kg BW.75 for each degree Celsius decrease of ambient temperature below LCT. Efficiencies of utilization of ME for meeting energy requirements for maintenance, maternal gain, and uterine gain are 77, 75, and 50%, respectively. Equations for predicting energy deposition in the uterus and mammary gland are proposed. In addition to activity and thermoregulation, energy requirements of pregnant sows depend on body reserves of energy. Studies with newborn pigs indicate that they are quite sensitive to ambient temperature (i.e., +25 J.kg BW-.75.min-1 for each degree Celsius decrease of temperature), and their LCT is 32 to 34 degrees C. The energy demand of pigs for thermoregulation just after birth relies mainly on carbohydrates from glycogen reserves or colostrum. Survival of newborn pigs is highly dependent on the supply of colostrum.

Effect of number of pig embryos in the uterus on their survival and development and on maternal metabolism

The effects of pig embryo number on fetal survival and growth and maternal metabolism were evaluated with 114 Large White gilts. Gilts were assigned at 38 kg to three treatments: control (CTR), ligature of the left oviduct (LIG), or right hemi-hysteroovariectomy (HHO). Insemination occurred at 311 +/- 18 d of age. A laparotomy was performed at d 35 of gestation, and gilts were slaughtered at d 112. Ovulation rate per uterine horn was 4.30, 8.70, and 17.12 in the LIG, CTR, and HHO groups, respectively. The hierarchy was the same for litter size at d 35 of gestation, but the relative differences were reduced (3.24, 5.98, and 8.40 fetuses/uterine horn, respectively). Litter size per uterine horn was similar in the CTR and HHO groups at d 112 of pregnancy (2.93, 4.69, and 4.76 fetuses in the LIG, CTR, and HHO groups, respectively). Early (before d 35 of gestation), late, and total fetal mortality increased with embryo potential per uterine horn. There was a compensation between early and late fetal mortality in the CTR and HHO groups. Fetal weight at d 112 was related to litter size in early pregnancy (1.50, 1.38, and 1.27 kg in the LIG, CTR, and HHO groups, respectively). Uterine capacity limits litter size and fetal development, even in sows with a conventional potential of embryos. Availability of energetic and gluconeogenic substrates was higher at 110 than at 60 d of gestation in the three groups. Blood substrate levels suggested that lipid mobilization and glucose uptake were higher in the gilts with a larger litter weight.

Reconstitution of body reserves in multiparous sows during pregnancy: effect of energy intake during pregnancy and mobilization during the previous lactation

Multiparous Large White sows were used in two experiments to determine the effects of energy intake on the reconstitution of body reserves during pregnancy. In Exp. 1, 21 sows received one of three different energy levels during pregnancy: 7.4, 8.8, or 10.4 Mcal DE/d. In Exp. 2, two energy levels (7.9 and 9.2 Mcal DE/d) were fed to 36 sows that mobilized low or high amounts of body reserves during the previous lactation (6 or 12 pigs per litter, respectively). Nitrogen balances were conducted during five 7-d periods at 11, 32, 53, 82, and 104 d of gestation. All the experimental sows were slaughtered and dissected at the end of pregnancy; 24 control sows were similarly slaughtered at mating in order to estimate composition of BW gain, according to the comparative slaughter technique. In the two experiments, average nitrogen (N) retention increased linearly with energy supply from 9.9 to 14.5 g/d in Exp. 1 (P < .001) and from 10.2 to 12.5 g/d in Exp. 2 (P < .05). Nitrogen retention was not affected by the extent of mobilization of body reserves during the previous lactation in Exp. 2. In both experiments, carcass weight (P < .001), muscle weight (P < .01), and dissectable fat weight (P < .001, Exp. 1; P < .01, Exp. 2) increased with energy supply. We conclude that in high-producing modern multiparous sows, energy supply during gestation is a limiting factor for N retention and muscle weight gain and should be approximately 8,500 kcal DE/d to ensure adequate restoration of body reserves.

Effect of light regimen under various ambient temperatures on sow and litter performance

Primiparous Large White females were exposed to one of two light regimens characterized by an increase (from 12 to 16 h/d, LONG treatment) or a decrease (from 12 to 8 h/d, SHORT treatment) in photoperiod during gestation. Two successive replicates were conducted, and farrowings occurred in January and July. During the last month of gestation, during lactation and after weaning, ambient temperatures varied between 18 and 25 degrees C and between 25 and 38 degrees C for the first and second replicates, respectively. Weaning occurred at 3 wk postpartum. Percentage of sows in estrus within 10 d after weaning was higher (P < .05) in the SHORT than in the LONG group for both replicates and when farrowing occurred in January compared with July for both photoperiod groups (SHORT-January: 92%, LONG-January: 53%, SHORT-July: 32%, LONG-July: 14%). Loss of live weight in sows during lactation was higher in July than in January and higher in the SHORT than in the LONG photoperiod (P < .05). Live weight of pigs at birth was higher in July than in January, whereas growth rate of pigs until weaning was higher in January (P < .05). Temperature may have a greater influence on sow and litter performance than photoperiod.

Influence of the nutritional deficit of foetal survival and growth and plasma metabolites in rabbit does

Two experiments were conducted in order to determine the influence of nutritional deficit on foetal survival and growth in rabbits does. All females were mated within 12 h of parturition and all the young were removed at that time. In experiment 1, females were fed close to ad libitum (C1, n = 20), or restricted to 100% (M1, n = 20) or 75% (R1, n = 19) of the maintenance energy requirement. On d 28 of gestation, foetal mortality was similar in the 3 groups, whereas foetal weight and protein content of the litters were reduced in feed-restricted groups (P < 0.001). In experiment 2, females were fed ad libitum (C2, n = 12) or were restricted to the same level as in R1 (R2, n = 13). Blood samples were collected on d 17 and 28 of gestation before and after (1 and 3 h) a standardized meal. Pre- and postprandial concentrations of non-esterified fatty acids and urea were lower in the R2 than in the C2 females (P < 0.01). Preprandial concentrations of glucose were similar in both groups at d 17, and higher in the R2 groups than in the C2 group at d 28. The postprandial concentration of glucose was higher 1 h after the meal and lower 3 h after the meal in the R2 group (P < 0.01). Progesterone was significantly higher in the R2 females at d 17 (P < 0.001). These results suggest that nutrient deficit may be responsible for reduced foetal growth in concurrently pregnant and lactating does.

Laparoscopic Nissen fundoplication: detailed analysis of 132 patients

With the world-wide use of laparoscopy, new applications have been found, particularly in the field of esophageal and gastric surgery. From January 1991 through April 1992, 132 patients underwent laparoscopic Nissen fundoplication. The indication for laparoscopic intervention was symptomatic gastroesophageal reflux disease (GERD) not responding to medical treatment. The preoperative assessment included esophagogastroscopy, barium meal, esophageal manometry, and, in selected cases, 24 h pH studies. There was no operative-related mortality. The overall morbidity was 7.5%. Ninety-eight patients were seen 3 months after surgery and evaluated for control of reflux symptoms. One patient complained of mild recurrence of reflux symptoms; however, endoscopic examination revealed no evidence of recurrent esophagitis. Three complained of occasional dysphagia and two, of mild dysphagia. One individual required reoperation for persistent, severe dysphagia. The excellent results observed so far with this procedure have led us to believe that laparoscopic Nissen fundoplication is the procedure of choice for patients with intractable GERD.

Effects of administration of growth hormone-releasing factor to sows during late gestation on growth hormone secretion, reproductive traits, and performance of progeny from birth to 100 kilograms live weight

The effects of growth hormone-releasing factor (GHRF) injections to sows during late gestation were investigated in two experiments. In the first one, four treatments were applied to eight catheterized sows according to two 4 x 4 Latin squares: oral administration of 2 mg of pyridostigmine, a cholinesterase inhibitor, per kilogram of BW (PYR group); i.m. injection of 50 micrograms of GHRF/kg BW (GHRF group); a combination of the pyridostigmine and GHRF treatments (PYR+GHRF); or i.m. injection of glucose (control). Pyridostigmine slightly increased the plasma concentration of growth hormone (GH). Growth hormone responses to GHRF and PYR+GHRF treatments were similar, with significantly elevated GH concentrations from 5 to 240 min after GHRF injection. In the second experiment, 36 sows were allocated to two treatments at 102 d of gestation. Until farrowing, they were injected twice daily with 50 micrograms of GHRF/kg BW (GHRF group) or isotonic glucose (control). The DM, N, fat, and energy content of 24 pigs per group was determined at weaning at 22 d. Six pigs per litter had ad libitum access to feed until slaughter at 100 kg BW and their carcasses were evaluated. Treatment with GHRF increased pregnancy duration (114.8 vs 113.6 d, P less than .05), weight of pigs at 13 d (3.69 vs 3.54 kg, P less than .05) and at weaning (5.74 vs 5.48 kg, P less than .05), and improved pig survival (86 vs 71%, P less than .05). Lipid (on a DM basis) and energy contents of the pigs slaughtered at weaning were significantly higher in the GHRF group than in the control group (14.4 vs 12.5% and 2,178 vs 2,029 kcal/kg, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of exogenous thyrotropin-releasing hormone (TRH) administration on plasma levels of triiodothyronine (T3), thyroxine (T4) and growth hormone (GH) in chronically catheterized suckling piglets

The purpose of the present study was to determine experimental conditions to stimulate secretion of thyroid hormones (T3 and T4) with thyrotropin-releasing hormone (TRH) injections in suckling piglets during the first weeks of postnatal life. Three consecutive experiments were conducted. Four 10-20 d old piglets were i.m. injected with 0, 20, 100, 500 micrograms (experiment 1) or 0, 4, 20, 100 micrograms TRH/kg BW (experiment 2) according to a 4 X 4 latin square design involving different litters in each experiment. Blood samples were taken -15, -1, 15, 30, 45, 60, 90, 120 180 and 300 min after TRH injection in experiment 1, and -.25, -.08, .25, .5, 1, 2, 4, 6, 8, 12, 24, 30, 36, 48, 60 and 72 hr after TRH injection in experiment 2. T3 and T4 levels were significantly (P less than .01) increased as soon as 30 and 45 min after TRH injection, respectively. Maximal levels of T3 and T4 were obtained 2 and 4 hr after the injection of 100 micrograms TRH. T3 and T4 returned to basal levels within 6 and 8 hr post injection, respectively. Plasma pGH levels were significantly (P less than .001) increased 15 min after TRH injection in piglets injected with 500 micrograms. In experiment 3, 100 micrograms TRH/kg BW were injected i.m. either daily or every other day from 10 to 23 days of age. Results showed that T4 response to TRH did not decrease after repeated injections. These results indicate that daily i.m. injections of 100 micrograms TRH/kg BW can be used to increase thyroid hormone levels for at least 13 d in the young suckling piglet.

Energy utilization in pregnant and lactating sows: modeling of energy requirements

Data on energy metabolism and body composition changes of the pregnant and lactating sow have been considered in order to propose methods for determination of energy requirements according to a factorial approach. Daily requirements for maintenance at thermoneutrality amounts to about 105 and 110 kcal ME/kg BW.75 in pregnant and lactating sows, respectively. During pregnancy, maintenance represents 75 to 85% of the total requirements and is affected greatly by environmental temperature and activity of the animals. Requirements for total uterine gain are low, but they increase with advancement of pregnancy. In addition, the daily ME requirements during pregnancy depend on the amount and composition of maternal weight gain and on the previous lactation body weight loss. The factorial approach indicates clearly that daily ME recommendation in pregnant sows varies from 6 to more than 10 Mcal and must be adapted to each sow within a herd. A method for prediction of ME requirements in lactating sows that considers a relatively precise estimate of energy output in milk is proposed. Results indicate that daily ME requirements are particularly high (15 to more than 20 Mcal) and generally are not met by voluntary feed intake. Emphasis also has been given to prediction of body composition changes that occur over the reproductive life of the sow. Data from the factorial approach allow for optimization of sow energy nutrition to ensure a normal evolution of body weight changes and to avoid major changes in body weight and composition. However, no available data demonstrate whether such a strategy is concomitant with optimal lifetime reproductive performance.

Estimation of sow milk nutrient output

Ten replicates of two littermate gilts were used during a 21-d lactation in order to calculate relationships between milk nutrient intake and piglet growth rate and composition of gain. Gilts were fed 14.2 or 10.4 Mcal ME/d and litter size was standardized to 9 or 10 piglets. Piglets had no access to creep feed. Milk production was measured on 10 sucklings over 12 h on d 1, 5, 9, 13, 17 and 21 by the weigh-suckle-weigh method. Heat production of the piglets was measured (RQ method) on the same days in a confinement chamber. Milk composition was determined on the days following milk production measurements. Four to ten piglets/litter were slaughtered at weaning and their body composition was determined. Milk nutrient production during part of lactation was related closely to piglet weight gain and body weight (R2 = .80 to .96). Milk DM, energy and N output over the entire lactation were predicted from piglet ADG (R2 = .87 to .90) when, for each litter, the difference between energy in piglet daily weight gain measured by the slaughter technique and energy in piglet daily weight gain estimated by the RQ method was included in the model. This variable corrects for milk production measurement errors. The relationships were slightly improved, especially for energy output, when the composition of piglet weight gain was taken into account (R2 = .93 to .97).

The role of amino acid decarboxylase in the stimulation of gastrin release in man

As amino acid-induced gastrin release is dependent on amino acid decarboxylase activity in rat, we examined the gastrin response to intragastric phenylalanine before and after treatment with carbidopa in 12 healthy male volunteers; carbidopa is an inhibitor of aromatic amino acid decarboxylation. Our results showed no significant difference between the pre- and postcarbidopa periods in the same subjects, suggesting that decarboxylation is not a necessary step for amino acids to stimulate G-cells in man. However, carbidopa seems to have an inhibitory effect on gastrin release, independently of its action on decarboxylase activity.

Treatment with cisapride of the gastrointestinal and urological sequelae of spinal cord transection: case report

We describe the case of a paraplegic patient who suffered traumatic spinal cord injury at the level of the twelfth thoracic vertebra. Within a short period of time following the injury, urinary (neuropathic bladder) and gastrointestinal (atomic colon) sequelae arose. Treatment with Cisapride (R 51 619, Janssen Pharmaceutica) was undertaken in an attempt to increase colonic motility and to reduce urinary retention. These goals were reached rapidly with a dose of 10 mg q.i.d.; the effect has been maintained for at least 18 months since starting the therapy.

[Effect of a serotonin S2 receptor antagonist on portal hypertension due to cirrhosis. Preliminary results of a heart and liver hemodynamic study]

In 10 cirrhotic patients, with two balloon catheters introduced in the right internal jugular vein, the following parameters were measured before and after injection of ketanserine (0.1 mg/kg): cardiac output using the thermo-dilution method, free supra-hepatic pressure, wedged supra-hepatic pressure at rest and during cough, right atrial pressure, pulmonary capillary and arterial pressures. After 30 minutes, the following modifications were recorded: the cardiac output goes from 8.0 +/- 2.4 l/min to 8.7 +/- 2.5 l/min (p less than 0.05); the mean arterial pressure goes from 107.0 +/- 18.8 mmHg to 94.7 +/- 25.9 mmHg (p less than 0.02); the wedged supra-hepatic pressure, during coughing goes from 85.2 +/- 36.1 mmHg to 64.6 +/- 23.1 mmHg (p less than 0.005). As in non-cirrhotic patients, ketanserine causes a drop in the mean arterial pressure and a transient elevation of the cardiac output. Ketanserine is able to lower portal pressure of cirrhotic patients at rest as well as during coughing. These results seem to indicate that the activation of serotonin S2 receptors may play a role in determining the portal hypertension in cirrhotic patients.

Metabolic utilization of energy and maintenance requirements in lactating sows

Metabolizable energy (ME), heat production (measured by indirect calorimetry in respiration chambers), milk energy output and body energy mobilization were measured in 20 gilts (10 replicates of two littermates) during a 21-d lactation. Two energy levels were used: 14.2 and 10.4 Mcal ME X d-1 X sow-1 in the high energy (HE) and low energy (LE) groups, respectively. The daily supply of other nutrients in the diets was identical in both treatments. Measurements of metabolic rate and energy balance of the litters were carried out. These data were used to estimate the maintenance requirements of the sows (MEm) and the efficiencies of utilization of energy of food (kl) and body reserves (krl) for energy production in milk. Nitrogen balance of the sows was also determined. Energy mobilization was increased by energy restriction (-5.35 vs -2.04 Mcal X d-1 X sow-1 for HE and LE gilts, respectively) and by the increment of milk production with the advancement of lactation. Energy restriction (LE vs HE gilts) resulted in increased weight loss consisting mainly of fat tissue depletion. Muscle depletion represented a rather large proportion of weight loss, even in sows fed the high energy level. Maintenance requirements amounted to 109 kcal ME X kg weight-.75 X d-1. The estimations for kl and krl were 72 and 88%, respectively. These results show that the overall efficiency of energy storage during pregnancy and its mobilization during lactation (68.6 to 70.9%) is similar to that of direct utilization of ME during lactation.

Effects of age and live weight on the sexual development of gilts and boars fed two planes of nutrition

The aim of the present study was to determine the respective influences of age and live weight on the sexual development of boars and gilts. The Large White animals used were fed on a liberal plane of nutrition close to ad libitum (CTRL group) or restricted on a live weight basis (SA and SW groups). CTRL and SW pigs were slaughtered and their genital tracts examined at 125 kg of live weight; those in the SA group were slaughtered and examined at the same age as their CTRL littermates. Control and SA boars and gilts were about 180 and 200 days old, respectively, while SW boars and gilts were about 240 and 260 days old, respectively. The SA group pigs weighed about 90 kg. Testis weight was influenced by live weight but not by age, while epididymis and seminal vesicle weights and bulbourethral gland weight and length were dependent on both age and live weight. Age had a significant influence on puberty attainment in gilts while live weight had nearly no effect. Percentages of cyclic gilts in the CTRL, SW and SA groups were 32, 79 and 20, respectively. Ovarian weight was mainly dependent on live weight in cyclic as well as in prepuberal gilts. In the latter animals, the weight and length of uterine horns and cervix were influenced by both age and live weight, whereas in cyclic gilts the only obvious effect was that of age on uterine horn weight. Season of birth (autumn vs spring) had no effect on the puberty attainment of gilts.

Body composition, metabolic rate and utilization of milk nutrients in suckling piglets

The oxygen (O2) consumption, carbon dioxide (CO2) production, heat production (HP) and milk nutrient intake of 22 litters of suckling piglets were recorded every 4 days from the day after birth to weaning at 22 days of age. At weaning, 147 representative piglets of these litters were slaughtered to measure their chemical composition and to calculate the energy and nutrient balance of individual piglets and litters between birth and weaning. O2 consumption, CO2 production and HP were constant over the suckling period when expressed per kg of body weight0.68 (BW0.68); O2 consumption and HP averaged 34.4 liters and 168 kcal per kg of BW0.68 and per day, respectively. The respiratory quotient (RQ) (CO2/O2) was 0.84. Average daily gain between birth and weaning (ADG) ranged from 35 to 285 g (mean: 186 g). Dry matter, fat and energy contents of piglets at weaning were positively correlated with ADG while protein and ash contents were negatively correlated with ADG. The daily amounts of protein, fat, ash and energy deposited were linearly related to ADG, so that the chemical composition of additional gain was constant: 410, 141, 197 and 28 mg/g and 2,960 cal/g for dry matter, protein, fat, ash and energy, respectively. The deposition of 1 g of protein or fat was associated with 5.20 or 1.17 g of weight gain, respectively. Finally, 55% of the energy and 85% of the nitrogen supplied by milk were retained in piglet weight gain.

Effect of energy level in lactating sows on yield and composition of milk and nutrient balance of piglets

The effects of energy level on milk yield, milk composition and growth of the piglets were studied in 20 gilts (10 replicates of two littermates) and their litters during a 21-d lactation. The metabolizable energy (ME) levels were 14.2 and 10.4 Mcal ME X d-1 X sow-1 in the high energy (HE) and low energy (LE) groups, respectively. The daily supply of other nutrients in the diets was identical in both treatments. Milk yield measured every 4 d was lower in the LE group. But fat (8.0 vs 6.9%), energy (1.27 vs 1.14 Mcal/g) and nitrogen (.78 vs .74%) contents of milk were significantly higher in the LE gilts compared with the HE gilts. The daily output of energy and nitrogen was therefore equivalent in both treatments (respectively, 8.28 Mcal and 51.8 g/d), but the fat output was higher in the energy-restricted gilts (532 vs 490 g/d). Growth rate of the litter was similar in both treatments, but piglets suckling LE dams had higher dry matter, fat and energy contents in their body at weaning. Piglets retained 89, 54 and 55% of nitrogen, fat and energy, respectively, of milk between birth and weaning. The results suggest that the ability of sows to mobilize body lipids in order to maintain the output of energy in milk is reduced as body fat reserves are depleted.

Candida albicans septicemia with folliculitis in heroin addicts

Disseminated candidiasis occurring in heroin abusers has been reported in the recent years as a peculiar type of septicemia. Dermatological lesions consist of folliculitis with Candida albicans within hair shafts.

[Compression of the cervical spinal cord in achondroplasia]

Two cases of tetraparesis due to cervico-occipital spinal cord compression in infants with achondroplasia are reported. Neurological disorders in achondroplasia are produced by structural anomalies of the cranium and spinal canal. They can be divided into two categories: hydrocephalus and radicular and spinal cord compression syndromes. Cervico-occipital compression is more frequent in childhood and may occur very early, in the first months of life. Early diagnosis of this complication and anatomic evaluation can now be obtained by computed tomography, which shows the exact dimensions of the foramen magnum, and myelography. Achondroplasia requires very close neurologic monitoring and, when findings are abnormal, radiologic investigations of the cervico-occipital zone. This allows for early surgical management which is the only means of obtaining significant therapeutic results.

Effects of zearalenone (F2) on estrous activity and reproduction in gilts

The effects of zearalenone on swine reproduction were investigated in two trials involving a total of 82 gilts which were allotted into three groups at puberty, mated at second estrus and slaughtered 80 d postbreeding. A control diet without mycotoxin (group 1) or an experimental diet containing 3.61 ppm (first trial) or 4.33 ppm zearalenone (second trial) were fed at a mean daily level of 2 kg/animal. The experimental diet was fed from puberty to mating (group 2) or during pregnancy (group 3). No difference was observed between the two trials. When fed to nonpregnant gilts, zearalenone induced a pseudopregnancy state in 45% of the animals; no estrus was detected within 50 d following puberty and corpora lutea developed at puberty were maintained. The uterine horns were edematous. Reproductive performance measured at 80 d postmating (ovulation rate, weight of corpora lutea, number of normal and abnormal fetuses, embryonic mortality) were not affected by zearalenone intake. But when zearalenone was fed during pregnancy, weights of uterus, placental membranes and fetuses were significantly decreased in comparison with those of control gilts and heterogeneity of fetuses in the same litter was increased. Hematocrit and erythrocyte count were lower in fetuses from gilts ingesting zearalenone, but hematology of the dams remained unaffected. No mycotoxin residue could be detected in gilts or fetal tissues despite the great consequences observed on cyclicity of the females or on the development of embryos. This experiment showed evidence of the estrogenic properties of zearalenone in mature gilts.

Cellularity of adipose tissue in fetal pig

Adipose tissue cellularity was studied in the 85-day-old Large-White pig fetus. The aim of this work was to count the adipose cells of forming tissue in an animal species which could be a possible model for studying adipose tissue in humans. Using a morphometric method with electron microscopy, mean triglyceride volume per cell was determined independently of mean cell volume. This method is suitable for counting adipose cells in the early stage of differentiation whatever their size and lipid inclusion volume. Site-by-site dissection of adipose tissue was not feasible in the 85-day old fetus and adipose cell number was computed by dividing total carcass triglyceride volume by mean triglyceride volume per cell. The carcass triglyceride seemed to originate only from adipose cells. The mean total carcass triglyceride volume per fetus (1.84 g) was low but, owing to the low mean triglyceride volume per cell (180.28 microns3), the adipose cell number (11.15 X 10(9)) was relatively important, as it represented about 27% of the extramuscular adipose cell number in the Large-White adult pig (41 X 10(9)).

[Effects of feeding corn infested by Fusarium to sows]

The effects of feeding Gilts with mouldy Corn containing 3,61 mg/kg zearalenone were tested. Ingestion of this mycotoxin by puberous Gilts blocked the sexual cycles in more than half of the animals. Uterine horns were enlarged and corpora lutea didn't regress into corpora albicantia. The presence of zearalenone in the diet of pregnant Gilts had no effect on embryonic mortality at 80 days of pregnancy, but reduced foetal weight by 26%.

Natural occurrence of trichothecenes (nivalenol, deoxynivalenol, T2) and zearalenone in corn

Samples of corn suspected of causing infertility and refusal symptoms were analyzed and found to contain nivalenol, deoxynivalenol, T2 toxin and zearalenone, metabolites from Fusarium species.