Colostrum immunoglobulin G concentration of multiparous Jersey cows at first and second milking is associated with parity, colostrum yield, and time of first milking, and can be estimated with Brix refractometry.

The objective of this study was to evaluate colostrum IgG concentration harvested at first and second milking from multiparous Jersey cows, the dam's lactation number, colostrum yield, and time of first milking. In addition, we validated the use of a Brix refractometer to estimate IgG concentration in colostrum from multiparous Jersey cows using radial immunodiffusion as the reference method. Colostrum samples and total weight of colostrum harvested at first (n = 134) and second (n = 68) milking were collected from 134 multiparous Jersey cows housed in a California herd. Fresh colostrum samples were analyzed for IgG concentration with Brix refractometry and frozen samples by radial immunodiffusion. A total of 90.4 and 42.7% of the samples from first and second milking met industry standards of quality for IgG concentration (>50 g/L). Second and third lactation cows had similar colostrum IgG concentration but lower than cows on their fourth and greater lactation. At second milking, 56.4% of cows on their fourth or greater lactation had colostrum IgG concentrations >50 g/L. When colostrum yield increased from low (<3 kg), medium (3 to 6 kg), to high (>6 kg), IgG concentration decreased. Higher IgG concentration was observed on colostrum harvested at <6 h (short) versus 6 to 11 h (medium) after calving. However, IgG concentration in colostrum harvested after 11 h (long) was similar to that harvested at short and medium time. Readings of %Brix were highly correlated with IgG at first (r = 0.81) and second (r = 0.77) milking. The best Brix threshold to identify colostrum from first milking with >50 IgG g/L was 20.9% based on logit equations with Youden's index criterion and 18.0% based on accuracy criterion. For colostrum harvested at second milking, similar Brix thresholds were obtained, 19.2 and 19.0%, regardless of whether Youden's index or accuracy was used as the selection criterion. Our results indicate that the dam's lactation number, colostrum yield, and time of first milking relative to calving are associated with IgG concentration in colostrum from multiparous Jersey cows. Second milking colostrum from mature Jersey cows should be evaluated to extend colostrum supply on dairies especially during times of shortage. Readings of %Brix can be used to rapidly estimate IgG concentration in Jersey colostrum harvested at first and second milking.

[Nutritional and Functional assessment of peritoneal dialysis patients in the clinical practice: Report from MITO-DP Group]. / Valutazione Nutrizionale e Funzionale dei pazienti in dialisi peritoneale nella pratica clinica: l'esperienza del Gruppo Medico-Infermieristico Toscano di Dialisi Peritoneale (M.I.TO.-DP).

Nutritional abnormalities and physical inactivity are risk factors of increased morbidity and mortality in patients with ESRD. Identify and define malnutrition, in particular protein-energy depletion (PEW), is an important task in the management of renal patients. The aim of this multicenter observational study was to implement the assessment of nutritional status and functional capacity in patients on peritoneal dialysis, including tests and validated methods which are relatively easy to apply in daily clinical practice. The study includes all the 133 prevalent patients (80 m, 53 f, age 65 14 years), in peritoneal dialysis treatment (vintage 26 19 months) in 9 centers in Tuscany. We performed anthropometry, bioimpedance (BIA), clinical biochemistry, evaluation of habitual physical activity (RAPA tests) and performance (Sit-To-Stand test), appetite-evaluation questionnaire, and indices including the Malnutrition Inflammation Score (MIS), Geriatric Nutrition Risk Index (GNRI), Charlson comorbidity index, Barthel and Karnowsky index. The latter showed a condition of dependence in 7.2% and 19.7% of cases, respectively. Poor appetite was recorded in 48.2%. The majority of patients fell within the overweight / obesity range (51%) with waist circumference values associated with increased cardiovascular risk in 51% of males and 60% of females. At the BIA analysis, a BCMI <8 kg/m2 was detected in 39% of patients; an estimated protein intake <1.0 g / kg/d was found in 59% of cases; 34% of patients had serum albumin <3.5 g / dl; control of acidosis was good (bicarbonate 25.4 3.8 mM) but hyperphosphatemia was present in 64.6% of patients. A condition of sedentary or light physical activity was reported by 65.1% of patients, vigorous activity only by 11.9%. The 86.5% of patients able to perform the Sit-to-stand test reported a lower than the reference values for age and sex. A diagnosis of PEW was possible in 8% of our series, while a MIS score> 11, indicative of PEW, took place in 12.7% of cases. The values of the MIS correlated directly with age and the degree of comorbidity and inversely with the sit-to-stand test, RAPA tests and appetite level. The data in this study show that single tests indicative of malnutrition disorders are frequent to be found in our series of peritoneal dialysis patients. However, a diagnosis of PEW is quite infrequent. A large percentage of patients are overweight with increased abdominal adiposity, and reduced cell mass and protein intake below recommended levels; the level of habitual physical activity is low, and the level of physical capability is scarce. Therefore it is conceivable a nutritional counseling intervention to increase the intake of proteins, limiting the phosphorus and (when indicated) energy intake and to stimulating spontaneous physical activity or arranging assisted programs for functional rehabilitation. Close monitoring of the nutritional status and implementation of programs of adapted physical activity should have a prominent role in the clinical management of patients on peritoneal dialysis.

[Experience with new teaching methods and testing in psychiatric training]. / Neue Lehr- und Prüfungsformen im Fach Psychiatrie. Erfahrungen mit einem reformierten Kurrikulum.

In 1999, the Charité Medical University in Berlin, Germany, implemented a reformed medical study course (RMSC) along with traditional undergraduate medical education. The RMSC is characterized by problem-based learning (PBL), training in communication skills with "simulated patients", and interdisciplinary seminars. The curriculum is organized into blocks according to organ system and age (period od life). In a new intensive 4-week psychiatric block, 4th-year students get practical experience in psychiatric wards. Furthermore, PBL groups and workshops are offered that focus on frequent psychiatric disorders. By providing interactive courses with simulated patients, students are intensively trained in taking psychiatric histories and in generating psychopathological findings. Defined learning objectives are tested using multiple-choice items and objectively structured clinical examinations at semester end. First positive results indicate that this course represents an appropriate and practicable curriculum for teaching psychiatry in Germany.

In vivo effects of corticotropin-releasing hormone on femoral adipose tissue metabolism in women.

OBJECTIVE: To investigate whether i.v. injected corticotropin-releasing hormone (CRH) (1 microg/kg) has a direct effect on adipose tissue metabolism in humans. DESIGN: Double-blinded, placebo-controlled, crossover study. SUBJECTS: Twelve healthy normal weight female volunteers (age 20-37 years, body mass index: 22.75+/-1.33 kg/m(2)) MEASUREMENTS: Assessment of local generation of glycerol, and glucose in adipose tissue by microdialysis. Measurement of adipose tissue and skin blood flow by laser Doppler flowmetry. RESULTS: Injection of CRH acutely increases interstitial concentrations of glycerol (19.0+/-5.4%, P<0.05) and glucose (13.5+/-5.8%, P<0.05) reaching peak levels after 15 min. Plasma glycerol increases in parallel (Delta=16.7+/-5.9% after 15 min (P<0.05)), whereas plasma glucose remains unaffected. Changes in tissue blood flow do not explain interstitial metabolite alterations. Initial CRH effects on adipose tissue metabolism are short lasting and disappear after 15 min. CONCLUSIONS: The importance of CRH on human energy metabolism is underlined by the present in vivo study demonstrating peptidergic effects on lipolysis and glucose homeostasis in human subcutaneous adipose tissue.

Laser-Doppler flowmetry reveals rapid perfusion changes in adipose tissue of lean and obese females.

The present study aimed to evaluate adipose tissue blood flow (ATBF) by means of laser-Doppler flowmetry (LDF) in humans. Lower body negative pressure (LBNP) and straining known to affect epidermal blood flow through the autonomic nervous system were performed in 11 lean and 11 obese female volunteers. ATBF changes were compared between both groups and also discriminated from skin blood flow (SBF) responses of the immediate vicinity. Additionally, LDF measurements were compared with flow measurements using (133)xenon washout in 10 lean subjects during whole body cooling. LDF estimations of SBF and ATBF showed a positive correlation to (133)Xe during cooling. SBF and ATBF were reduced to the same extent in both lean and obese subjects during LBNP. Straining induced divergent changes in SBF and ATBF: initially SBF decreased while ATBF increased, but toward the end of straining SBF increased above baseline and ATBF returned down to baseline level. Those changes were similar in both weight groups. Interestingly, only in obese subjects, both LBNP and straining were followed by ATBF augmentation, while SBF levels remained stable. In conclusion, LDF compares with (133)Xe washout in monitoring ATBF during tonic perfusion changes. Its strength, however, lies in the detection of rapid flow alterations within the subcutaneous tissue, allowing the evaluation of reflex responses of the subcutaneous microcirculation. Interestingly, those rapid changes in SBF and ATBF can be both concordant and discordant. With regard to ATBF, vasoconstrictor components of the reflex responses were similar in lean and obese subjects, whereas vasodilatory responses were more pronounced in obese volunteers.

[On the angio-architecture of intramuscularly implanted Yoshida-sarcoma in untreated and lithium carmine-treated rats (author's transl)]. / Zur Angioarchitektur des intramuskulär implantierten Yoshida-Sarkoms bei unbehandelten und bei mit Lithiumkarmin behandlten Ratten

Investigations were made on the angio-architecture of intramuscularily implanted Yoshida-sarcomas in untreated Wistar-rats and in animals treated with lithium carmine. The injected quantity of lithium carmine led to RES-activation according to the data in the literature. The presentation of the vessels was made by corrosion technique using the synthetic material KALLOCRYL after rinsing the vessels with the proper ester. The pre-existent vessels in the surrounding of the tumor showed an adaptation the expansive growth of the tumor. After starting the experiment the tumor-owned vessels showed an increasing tendency to grow out. The vessels of the treated animals rected in a more regularly and orientated course than those of the untreated animals. In the following time vascularisation in the untreated animals was considerably decreasing, whereas a clear vascularisation was evident in the treated animals until the end of the study. These different findings may be the expression of a local vascular reaction in the implanted tumor following RES-activation induced by lithium carmine.