A reassessment of the vitamin D requirements of modern broiler genotypes

We hypothesized that performance and bone mineralization of 2 broiler lines will benefit from increasing vitamin D (vitD) supplementation above current commercial levels and by partial substitution of D3 by 25-OH-D3. Male Ross 308 and 708 chicks (n = 576), were offered diets with low (LD; 1,000), medium (MD; 4,000) or high levels of D3 (HD; 7,000 IU/kg), and medium levels of vitD where the majority of D3 was substituted by 25-OH-D3 (25MD; 1,000 D3+3,000 25-OH-D3 IU/kg). Performance was measured at the end of starter (day 10), grower (day 24), and finisher periods (day 38). Three birds per pen were dissected at the end of each period to assess tibia and femur ash percentage (%), ash weight, bone breaking strength (BBS), and serum levels of 25-OH-D3. Remaining birds were gait scored (GS) at day 37 of age. Genotype and diet did not interact for any trait, whilst performance was not affected by diet. Ross 708 had lower body weight (P < 0.005), higher feed conversion ratio over the grower period (P < 0.05), similar levels of 25-OH-D3, but higher GS (P < 0.05) than Ross 308. Serum 25-OH-D3 levels were affected by diet at the end of the starter and grower periods (P < 0.05), being lowest for LD and highest for 25MD. Diet affected GS (P < 0.01), being higher in LD than 25MD. Femur ash % was higher at the end of the starter and grower periods for 25MD than LD and for both HD and 25MD than LD (P < 0.05). Femur and tibia ash weight were higher for 25MD in comparison to LD birds (P < 0.05) at the end of the grower period. Femur and tibia BBS were higher (P < 0.05) for 25MD in comparison to LD at the end of the grower and finisher periods, respectively. Overall, effects of vitD supply were more pronounced for femur than for tibia mineralization. Results do not suggest supplementation of vitD above current maximum levels and support partial substitution by 25-OH-D3.

Once small always small? To what extent morphometric characteristics and post-weaning starter regime affect pig lifetime growth performance

Background

The aim of this study was to determine the effect of piglet morphometric characteristics and starter regime on postnatal growth. Some piglets born light are able to grow faster than others, and identifying which piglets are more at risk to remain light and at which stages of growth is essential. A nutrient enriched starter regime may allow lightweight pigs to improve their post-weaning growth. A total 1487 newly born piglets from 137 litters originating from 8 consecutive farrowing batches were followed from birth (BiW) to weaning (WW, d28) and finishing (d99). At birth morphometric measurements were taken, including body mass index (BMI), ponderal index (PI) and BiW:cranial circumferences (BiW:CC). At weaning pigs were randomly allocated to one of two experimental regimes: either a nutrient enriched regime with a 20% higher essential amino acids (EAA): energy ratio (HIGH) or a standard regime (CTRL). Piglets were retrospectively allocated to 4 different weight classes (C) using percentiles at birth, weaning and finishing, with C1 representing the lightest and C4 the heaviest class. A series of novel statistical models were used to determine which factors were able to predict performance.

Results

For BiW C1 piglets, BMI (P = 0.003) and BiW relative to birth litter (P = 0.026) were positively associated with pre-weaning performance, whereas BiW:CC (P = 0.011) and WW (P = 0.001) were positively associated with post-weaning growth. Post-weaning the best predictors of piglets weaned light (WW C1) were PI (P = 0.037), BiW:CC (P < 0.001) and WW (P < 0.001). Starter regime did not influence (P > 0.05) post-weaning performance.

Conclusion

Our results show that not all light pigs are the same and that their performance is under the influence of body shape rather than BiW. Therefore, pig producers should discriminate between light pigs based on birth characteristics to improve the effectiveness of intervention strategies at the different stages of growth. Irrespective of weight class piglets did not benefit from the EAA enriched regime applied.

Electronic supplementary material

The online version of this article (10.1186/s40813-018-0098-1) contains supplementary material, which is available to authorized users.

The impact of depression and cardiophobia on quality of life in patients with essential hypertension

Patients with chronic conditions like hypertension may experience many negative emotions which endorse the development of anxiety and depression symptomatology, thus they increase their risk for poor quality of life. Several studies have shown an association between symptoms of psychological distress and hypertension. In this study we aimed to quantify the link between depression, cardiophobia and quality of life in hypertensive patients. A cross-sectional design was employed. A sample of 197 hypertensive patients (89 men-108 women, mean age 53 years, SD=12 ranged 25-78) from a university outpatient hypertension clinic in Greece participated. Ninety-four (47.7%) of the participants suffered from essential grade I hypertension; 68 (34.5%) were grade II; 16 (8.1%) were categorized as grade III, while only 11 (5.6%) patients were recorded as normotensives with high normal values. The questionnaires included: (a) question for the recording of social-demographic characteristics and clinical features, (b) The Short Form (SF-36) Health Survey, (c) The Beck Depression Inventory -I, and (d) The Cardiac Anxiety Questionnaire. There were no significant differences between the two genders with exception of marital status (p=0.010), dyslipidemia (p=0.050), grade of hypertension (p=0.014), cardiac left ventricular hypertrophy (p=0.004), renal failure (p=0.043) and stroke (p=0.024). Lower levels of quality of life and higher levels of depression and cardiophobia were observed compared to the general population. There were no significant differences on psychological measures between the two sexes (p>0.05). Cardiophobia was positively related to depressive symptomatology (r=0.533, p=0.000) while negatively to both physical and mental health summary measures of SF-36 health survey (r=-0.467, p=0.000 r=-0.537, p=0.000 respectively). Multiple linear regression models found that for psychical health depression and cardiac anxiety, avoidance activities had an influence on levels of quality of life in hypertensive patients, after controlling for age and other socio-demographic variables and clinical characteristics (Beta=-0.133, p=0.007, Beta=-0.364 p=0.000 and Beta=-0.167 p=0.006, respectively). For mental component summary depression and cardiophobia, heart focused attention had also impact on mental health in hypertensives (Beta=-0.438, p=0.016, Beta=-0.564, p=0.000 and Beta=-0.223, p=0.037, respectively) after adjustments. Heart focused anxiety symptoms-as avoidance activities and/or attention and monitoring cardiac activity, are related to hypertensive patients' present deteriorated depressive symptoms and levels of quality of life. Both depressive symptomatology and heart focused anxiety may be a mechanism partly responsible for hypertensive patients' present impaired levels of quality of life.

Optimal lysine:DE ratio in growing pigs is independent of starch or fat as main energy source at two energy intake levels

In a 2 × 2 factorial arrangement, 28 growing boars (initial BW of 24.7 ± 1.5 kg) were used to examine the effects of energy source (high starch vs. high fat) and DE level (2.2 vs. 2.7 times the DE requirements for maintenance) on Lys requirements. Pigs were allotted to 1 of 4 dietary treatments. A within-animal Lys titration technique was used to assess the responses to changes in Lys to energy ratio. The amount of apparent ileal digestible Lys in the diet decreased stepwise from 1.74 to 0.5 g/MJ DE in 8 equidistant steps of 3 d each. From 48-h urinary nitrogen excretion, the optimal Lys to energy ratio was estimated for each pig using a linear-plateau model. Feces were collected quantitatively over 27 d to determine apparent total tract digestibility (ATTD) of nutrients. The DE to ADG ratio, but not DE intake and ADG, tended ( < 0.1) to be 4% lower in the high-starch group than in the high-fat group. The ATTD of energy and CP tended ( < 0.1) to be lower (0.8% and 0.9% units, respectively) at the high DE level. The ATTD of energy was 2.2% units greater ( < 0.001) for pigs fed the high-starch diet, but the ATTD of CP was not affected by ES. Estimates for the intercept (21.2% to 22.8%), slope (57.4 to 59.6), transition point (0.84 to 0.86 g Lys/MJ DE), and plateau (70.6% to 72.3%) of the linear-plateau Lys titration curves were not affected by the dietary treatments. In conclusion, ES does not affect Lys requirements in growing pigs regardless the level of DE intake.

Sensitivity of periparturient breakdown of immunity to parasites to dietary protein source

Effects of increased MP supply on the degree of periparturient relaxation of immunity (PPRI) in sheep may be dependent on quality of supplied MP. Here we tested the hypothesis that additional MP supply from rations based on xylose-treated soybean meal would be more effective than from rations based on faba beans in reducing the degree of PPRI, as indicated by nematode egg excretion. Twenty-four multiple-bearing ewes were trickle infected with Teladorsagia circumcincta larvae from d -56 to d 31 relative to start of lactation (d 0). From d -26 onwards, ewes were fed at either 0.8 (LP) or at 1.2 times their respective calculated MP requirements using either xylose-treated soybean (HPS) or faba beans (HPB). Litter size was adjusted to 2 lambs at parturition. Feeding treatments did not affect nematode egg excretion, ewe BW or BCS during late pregnancy (P > 0.10), but HPS and HPB ewes had reduced plasma pepsinogen concentrations (P = 0.003). During lactation, HPS and HPB feeding increased ewe BW gain (P < 0.001) and BCS (P = 0.017), and reduced plasma pepsinogen concentrations (P = 0.008) to the same extent, compared with LP feeding. However, only HPS feeding increased litter weight gain (P = 0.017) and reduced nematode egg excretion (P = 0.015), which were both similar between HPB and LP (P > 0.10). The results support the view that extra MP supply from xylose-treated soybean based rations is more effective in reducing parasitism than MP from faba bean-based rations, suggesting that protein source and/or quality are important factors to consider for the nutritional control of parasitism.

Posttraumatic stress disorder and preparatory grief in advanced cancer

PURPOSE

The purpose of the current study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and its association with sociodemographic variables and preparatory grief in patients with advanced cancer.

METHODS

195 advanced cancer patients participated in the study. Out of them, 170 had PTSD and 25 had other anxiety disorders. The diagnoses were made in strict accordance with Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I)-Clinician version. Patients completed also the Preparatory Grief in Advanced Cancer Patients (PGAC) scale.

RESULTS

Patients with PTSD were younger (63.54 ± 12.07 years) than those without PTSD (70.36 ± 13.03 years, p=0.010). Patients with PTSD revealed more preparatory grief (37.69 ± 12.11) than those without PTSD (29.58 ± 14.04, p= 0.003). Multiple logistic regression analysis showed that preparatory grief (p=0.012), and metastatic disease (p=0.009) remained in the model whereas age showed a trend for independent significance (p=0.067).

CONCLUSION

In advanced cancer stages, younger patients, those with metastatic disease or patients with elevated scores on preparatory grief seemed to have a greater likelihood to develop PTSD. Thus, given the prevalence of PTSD in advanced cancer patients, health care professionals should be able to better recognize those who are at risk for or exhibit symptoms of this disorder so that appropriate treatment referrals can be made.

Consultation-Liaison psychiatric service delivery: results from a European study

The reported findings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from 11 European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reliability tested method of patient data collection, and data were collected describing pertinent characteristics of the hospital, the C-L service, and the participating consultants. The consultation rate of 1% (median; 1.4% mean) underscores the discrepancy between epidemiology and the services delivered. The core function of C-L services in general hospitals is a quick, comprehensive emergency psychiatric function. Reasons to see patients were the following. deliberate self-harm (17%), substance abuse (7.2%), current psychiatric symptoms (38.6%), and unexplained physical complaints (18.6%) (all means). A significant number of patients are old and seriously ill. Mood disorders and organic mental disorders are most predominant (17.7%). Somatoform and dissociative disorders together constitute 7.5%. C-L services in European countries are mainly emergency psychiatric services and perform an important bridge function between primary, general health, and mental health care.

European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative Study

The authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in 11 European countries. The authors found differences in the types of patients referred to the services, and there were significant differences between countries. The first difference lays in whether services saw patients for deliberate self-harm and for substance abuse. German psychosomatic C-L services saw virtually no such patients, although in other C-L services these patients constituted one-quarter to one-third of the patients referred. The second difference lays in the remaining group of referred patients. This group is best characterized by two dimensions. One describes the severity of psychopathology -- ranging from organic mental conditions to somatization. The other describes the clarity of the physical diagnosis -- ranging from patients referred by surgical wards to those referred by general medicine and neurology wards.

European Consultation-Liaison Psychiatric Services: the ECLW Collaborative Study

OBJECTIVE

To describe the patterns of organization of consultation-liaison (C-L) services in 11 European countries in relation to hospital characteristics and national approaches to C-L psychiatry.

METHOD

Cross-sectional survey.

RESULTS

Services can best be described in terms of their size and seniority of their staff and whether or not they are multidisciplinary. Single-discipline services are based upon the standard medical consultant model, whereas those with multidisciplinary teams work in a way that is comparable with community mental health teams. German psychosomatic C-L services belonged to either model. National differences were found.

CONCLUSION

This first international study provides empirical evidence for the wide variation in the organization of C-L services. In view of the increasing numbers of patients with psychiatric disorder who are being treated in general hospitals and the changing patterns of medical care there are important implications for clarification and improvement of the role of C-L services.

Dependence on zolpidem: a case report

We report the case of a patient with a history of zolpidem dependence. The patient, after a stressful life event, started using zolpidem. She rapidly developed tolerance and dependence, taking 50-100 mg, and sometimes up to 300 mg, of zolpidem daily. Also, our patient suffered episodes of altered consciousness, accompanied by visual hallucinations.