A corn-fermented protein ingredient can be included in early nursey diets without compromising pig growth performance and health status.

In nursery diets, ingredients with high protein content and highly digestible nutrients, such as corn-fermented protein product with added yeast mass (GDDY), can be included as an alternative to common protein sources. This study investigated the dietary inclusion of GDDY as an alternative protein source on growth performance and intestinal health of weaned pigs. A total of 594 weaned pigs (5.7 ±â€…0.9 kg; 18.5 days of age) were allotted to 36 pens in a randomized incomplete block design. Pens were assigned to one of 4 dietary treatments: CON: a common nursery feeding program; SBM75: CON diet replacing 75% of soybean meal (SBM) with GDDY; FM/ESBM: CON diet without fish meal (FM) and enzyme-treated SBM (ESBM) + GDDY; GDDY50: CON diet replacing 50% of SBM, FM, and ESBM with GDDY. Experimental diets were formulated to meet nutrient requirements of nursery pigs and provided in meal form through four phases during the nursery period. Pig growth performance was assessed on days 7, 14, 21, 28, 42, and 53. Pen fecal score was assessed daily from days 0 to 14, and 3 times per week from days 15 to 35. Intestinal health was assessed based on plasma immunoglobulin A (IgA) concentration and the differential sugar absorption test. The total tract digestibility of dry matter (DM), crude protein (CP), gross energy (GE), and phosphorus was also evaluated. From days 0 to 7 and days 7 to 14, dietary treatment had no effect (P > 0.05) on BW, ADG, and ADFI. For the rest of the experimental period, ADG and ADFI were greater (P < 0.05) in pigs fed CON in comparison with those fed SBM75 and GDDY50 and did not differ from pigs fed FM/ESBM. Pigs fed GDDY50 tended (P = 0.082) to have greater serum IgA concentration on day 20 when compared with SBM75 and FM/ESBM pigs. There were no differences among dietary treatments for DM, CP, and GE digestibility. Phosphorus digestibility was higher in FM/ESBM (P < 0.05) compared with SBM75 and GDDY50. These results supported the hypothesis that GDDY can be incorporated in nursery pig diets during the first couple weeks after weaning without affecting growth performance. However, in the late nursery period, inclusion levels starting at 14% can compromise performance.

Nutritional value of high protein ingredients fed to growing pigs in comparison to commonly used protein sources in swine diets.

Two experiments were conducted to test the hypothesis that two high protein dried distillers with solubles and yeast mass added (GDDY) products fed to growing pigs had comparable amino acid (AA) digestibility and metabolizable energy (ME) to feeds commonly used in swine diets. In experiment 1, seven barrows with an initial body weight (BW) of 25 ±â€…0.8 kg were fitted with a simple T-cannula at the distal ileum to allow for digesta collection. Experimental diets were N-free diets and six cornstarch-based diets containing six ingredients as the sole source of AA: spray dried GDDY, ring dried GDDY, corn distillers dried grains with solubles (DDGS), soybean meal (SBM), enzymatically treated soybean meal (ESBM), and fish meal (FM) provided at 4% of BW. The experiment was conducted as a 7 × 7 Latin square design with seven collection periods of 7 d (5 d adaptation and 2 d ileal digesta collection). In experiment 2, a total of 28 barrows (28.8 ±â€…1.4 kg BW) were used in a two-period switch-back design with seven diets and four replicate pigs in each period (n = 8 reps per diet). Experimental diets were a corn-based basal diet and six corn-based diets containing spray dried GDDY, ring dried GDDY, DDGS, SBM, ESBM, and FM. Fecal and urine samples were collected using the marker-to-marker approach for 5 d after 7 d of adaptation to determine ME concentration. Overall, standardized ileal digestibility (SID) values were within the mean ±â€…SD of NRC (2012) values for all ingredients evaluated. The SID of AA was greater (P < 0.05) in ESBM than the other protein feedstuffs (90.09% vs. 78.71%-81.51%). There were no significant differences in SID of AA (P > 0.05) in SBM, FM, spray dried GDDY, and ring dried GDDY (81.49%, 78.71%, 81.52%, and 79.20%). With respect to the most common first limiting AA for swine, the SID of Lys was greater (P < 0.05) in spray dried GDDY than ring dried GDDY and DDGS (83.56% vs. 77.33% and 68.53%, respectively). There were no significant differences (P > 0.05) for ME in corn (3,313 kcal/kg), ESBM (3,323 kcal/kg), and FM (3,454 kcal/kg) when compared with spray dried GDDY and ring dried GDDY (3,995 and 3,442 kcal/kg respectively). However, spray dried GDDY had greater DE and ME when compared to SBM. Collectively, this study demonstrates that GDDY products have an AA profile and digestibility comparable to SBM; ME in GDDY products is not different from corn. Therefore, GDDY has the potential as a feed ingredient for pigs, which could provide an alternative source of protein and energy in swine diets.

Co-products such as distiller's dried grains with solubles (DDGS) from the ethanol industry are obtained through fermentation processes and removal of nonfermentable components; separation of soluble fiber and protein components can potentially increase their nutritional value in swine diets. With the development of new feed processing technologies, high protein DDGS with added yeast mass (GDDY) has been obtained by separating the protein fraction of DDGS. However, there is limited information on the nutritional value of these co-products for pigs. The first step in determining the suitability of novel co-product use in swine diets is to define the nutritional value. Therefore, the nutritional value of GDDY was determined by analyzing standardized ileal digestibility (SID) of amino acids (AA) and metabolizable energy (ME) in growing pigs compared with common protein and energy feeds used in growing pig diets. The results show that the AA profile and digestibility in GDDY products were not different from soybean meal (SBM) as is the case for lysine, the first limiting AA in pig diets. Similarly, ME concentration in GDDY does not differ from those in other energy sources. Therefore, GDDY could be an alternative source of protein and energy in swine diets, and the obtained data allow its inclusion in pig diets formulation.

Medical Clearance for Common Dental Procedures.

Medical consultations before dental procedures present opportunities to integrate cross-disciplinary preventive care and improve patient health. This article presents recommendations related to patients with certain medical conditions who are planning to undergo common dental procedures, such as cleanings, extractions, restorations, endodontic procedures, abscess drainage, and mucosal biopsies. Specifically, prophylactic antibiotics are not recommended for preventing prosthetic joint infections or infectious endocarditis except in certain circumstances. Anticoagulation and antiplatelet therapies typically should not be suspended for common dental treatments. Elective dental care should be avoided for six weeks after myocardial infarction or bare-metal stent placement or for six months after drug-eluting stent placement. It is important that any history of antiresorptive or antiangiogenic therapies be communicated to the dentist. Ascites is not an indication for initiating prophylactic antibiotics before dental treatment, and acetaminophen is the analgesic of choice for patients with liver dysfunction or cirrhosis who abstain from alcohol. Nephrotoxic medications should be avoided in patients with chronic kidney disease, and the consultation should include the patient's glomerular filtration rate. Although patients undergoing chemotherapy may receive routine dental care, it should be postponed when possible in those currently undergoing head and neck radiation therapy. A detailed history of head and neck radiation therapy should be provided to the dentist. Multimodal, nonnarcotic analgesia is recommended for managing acute dental pain.

Coccidioidomycosis (Valley Fever) in Primary Care.

Primary pulmonary coccidioidomycosis (valley fever) is caused by inhaling airborne spores of the fungus Coccidioides immitis or Coccidioides posadasii. Residing in or traveling to areas endemic for Coccidioides is required for the diagnosis; no person-to-person or zoonotic contagion occurs. The incidence of coccidioidomycosis is increasing in endemic areas, and it has been identified as the cause of as many as 17% to 29% of all cases of community-acquired pneumonia in some regions. Obtaining a travel history is recommended when evaluating patients with community-acquired pneumonia. Diagnosis usually relies on enzyme immunoassay with immunodiffusion confirmation, but these tests may not be positive for one to three weeks after disease onset. Antifungal agents are not recommended for treatment unless the patient is at risk of or shows signs of complicated or disseminated infection. When antifungals are used, fluconazole and itraconazole are most commonly recommended, except during pregnancy. Treatment may continue for as long as three to 12 months, although lifetime treatment is indicated for patients with coccidioidal meningitis. Monitoring of complement fixation titers and chest radiography is recommended until patients stabilize and symptoms resolve. In patients who are treated with antifungals, complement fixation titers should be followed for at least two years.

Ruminal fermentation, kinetics, and total-tract digestibility of lactating dairy cows fed distillers dried grains with solubles in low- and high-forage diets.

The objective of this study was to investigate the effects of concentrations of forages and corn distillers dried grains with solubles (DDGS) on ruminal fermentation, ruminal kinetics, and total-tract digestibility of nutrients in lactating dairy cows. Four lactating Holstein cows with ruminal cannulas were assigned to a 4 × 4 Latin square in a 2 × 2 factorial arrangement of treatments. Diets were formulated to contain low forage [LF; 17% forage neutral detergent fiber (NDF)] or high forage (HF; 24.5% forage NDF) and DDGS at 0 or 18% (0DG or 18DG) of diet dry matter (DM). Intake of DM was not affected by the diets. Daily mean ruminal pH was affected by forage NDF × DDGS interactions, as the lowest ruminal pH was observed among cows fed LF18DG (6.02). Apparent total-tract digestibility for DM, organic matter, crude protein, NDF, acid detergent fiber, and starch was not affected by diets. Cows fed LF diets had a greater total volatile fatty acid concentration compared with cows fed HF (122 vs. 116 mM). Molar proportions of acetate were greater for HF compared with that of LF diets (62.6 vs. 57.5 mmol/100 mmol) and greater for 0DG diet compared with that of 18DG diets (61.3 vs. 58.7 mmol/100 mmol) diets. The molar proportion of propionate was affected by forage × DDGS interaction as the greatest propionate molar proportion was observed with cows fed LF18DG diet (27.7 mmol/100 mmol). Also, molar proportion of butyrate was affected by forage × DDGS interaction, as the greatest butyrate molar proportion was observed in cows fed HF18DG diet (13.5 mmol/100 mmol). Average fractional dilution rate for all diets was 11.9%/h and was not affected by diets. Fractional passage rate of the solid phase was greater for HF than for LF (4.40 vs. 3.76%/h). The ruminal retention time of solid phase was greater for LF compared with HF diets (27.3 vs. 23.3 h). Fractional passage rate of DDGS was affected by forage × DG interaction, as the highest fractional passage rate of DDGS was observed with cows fed HF18DG diet (7.72%/h). Our results demonstrated that concentrations of forage, DDGS, and their interaction influence ruminal degradation and kinetics of diets fed. Diets formulated at 17% forage NDF at 17% (DM basis) can decrease milk fat concentration compared with diets formulated at 25% forage NDF. Additionally, feeding DDGS at 18% DM basis to lactating dairy cows did not affect milk fat concentration or yield.

Production of dairy cows fed distillers dried grains with solubles in low- and high-forage diets.

The objective of the study was to investigate the effects of dietary forage and distillers dried grains with solubles (DDGS) concentration on the performance of lactating dairy cows. Twelve Holstein cows were blocked by parity and milk production and assigned to replicated 4 × 4 Latin squares with a 2 × 2 factorial arrangement of treatments. Diets were formulated to contain low forage [LF; 17% forage neutral detergent fiber (NDF)] or high forage (HF; 24.5% forage NDF) and DDGS at 0 or 18% of diet dry matter. The forage portion of the diet consisted of 80% corn silage and 20% alfalfa hay (dry matter basis). A portion of the ground corn and all of the expeller soybean meal and extruded soybeans from 0% DDGS diets were replaced with DDGS to formulate 18% DDGS diets. Overall, we found no interactions of forage × DDGS concentrations for any of the production measures. We observed no effect of diet on dry matter intake. Milk yield was greater when cows were fed LF diets compared with HF diets (43.3 vs. 41.5 kg/d). Milk fat concentration (3.03 vs. 3.38%) was lower for cows fed LF diets compared with HF diets, whereas protein concentration (3.11 vs. 2.98%) and yield (1.34 vs. 1.24 kg/d) were greater for cows fed LF diets compared with HF diets. Yields of fat, total solids, energy-corrected milk, and feed efficiency were not affected by diets. Cows partitioned equally for milk, maintenance, and body reserves. Replacing starch from ground corn and protein from soybean feeds with DDGS at either 17 or 24.5% of forage NDF concentration in the diet was cost-effective and did not affect the production performance of lactating dairy cows.