Survival after Ivor Lewis versus McKeown esophagectomy for cancer: propensity score matched analysis.

It is unknown whether Ivor Lewis (IL) or McKeown (McK) esophagectomy is preferred in patients with potentially curable esophageal or gastro-esophageal junction (GEJ) cancer. Patients with mid- and distal esophageal and GEJ cancer without distant metastases who underwent IL or McK esophagectomy in the Netherlands between 2015 and 2017, were selected from the Netherlands Cancer Registry. Patients were propensity score matched for sex, age, American Society of Anesthesiologist classification, comorbidity, tumor type, tumor location, clinical stage, neoadjuvant treatment and year of diagnosis. The primary outcome was a 3-year relative survival (RS). Secondary outcome parameters were number of lymph nodes examined, number of positive lymph nodes, radical resection rate, tumor regression grade, post-operative complications and mortality. A total of 1627 patients who underwent IL (n = 1094) or McK (n = 533) esophagectomy were included. Patient and tumor characteristics were balanced after propensity score matching, leaving 658 patients to be compared. The 3-year RS was 54% after IL and 50% after McK esophagectomy, P = 0.140. The median number of lymph nodes examined, median number of positive lymph nodes, radical resection rate and tumor regression grade were comparable between both groups. Recurrent laryngeal nerve palsy (2 vs. 5%, P = 0.006) occurred less frequently after IL esophagectomy. No differences were observed in post-operative anastomotic leakage rate, pulmonary complication rate and mortality rates. There was no statistically significant difference in the 3-year RS between IL and McK esophagectomy. Based on these results, both IL and McK esophagectomy can be performed in patients with mid to distal esophageal and GEJ cancer.

Towards a pituitary apoplexy classification based on clinical presentation and patient journey.

PURPOSE: The condition of pituitary apoplexia contains the clinical spectre from life-threatening emergency to asymptomatic self-limiting course, which partly determines diagnostic delay and management. Outcome evaluation of course and management of pituitary apoplexia is hampered by the diverse presentation of this condition and requires appraisal. This study aimed to describe the patient journey, clinical presentation, and management of various types of pituitary apoplexy in a new classification to facilitate future outcome evaluation and identify unmet needs in the care process. METHODS: A single-center retrospective patient chart study was conducted between 2005-2021 (N = 98). Outcome measures were clinical symptoms at first presentation in hospital, being headache, consciousness, visual acuity, visual field defects (VFD), ophthalmoplegia, nausea, vomiting, fever, and hypopituitarism and care process characteristics. RESULTS: Mean age was 47.6 ± 16.6 years (51.0% male). We describe their patient journey and identified three different types, differing in clinical presentation, in-hospital route, and final treatment, e.g., Acute (type A, 52%), Subacute (type B, 22.5%), and Non-acute (type C, 25.5%). Type A generally presents with acute onset headaches, VFD, or ophthalmoplegia emergency setting, with lowest mean visual acuity of both eyes and frequent hypocortisolism. CONCLUSIONS: Pituitary apoplexy can be approached as a spectrum of disease with 3 main subtypes, with a different initial presentation, different in-hospital route resulting in different management. Acknowledging subtypes with particular needs for (emergency) referrals to Pituitary Tumors Center of Excellence (PTCOE) will serve patient care improvements, outcome evaluations and address areas for improvement.

Predictors of undergoing multivisceral resection, margin status and survival in Dutch patients with locally advanced colorectal cancer.

BACKGROUND: The aim of this nationwide observational study was to evaluate factors associated with multivisceral resection (MVR), margin status and overall survival in locally advanced colorectal cancer (CRC). MATERIAL AND METHODS: Patients with (y)pT4, cM0 CRC between 2006 and 2017 were selected from the Netherlands Cancer Registry. Cox-proportional hazards modelling was used for survival analysis, stratified for T4a and T4b. Annual hospital volume cut-off was 75 for colon and 40 for rectal resections. RESULTS: A total of 11.930 patients were included and 2410 patients (20.2%) underwent MVR. Factors associated with MVR for colon and rectal cancer besides cT4 category were more recent diagnosis (OR 3.61, CI 95% 3.06-4.25 (colon) and OR 2.72, CI 95% 1.82-4.08 (rectum)) and high hospital volume (OR 1.20, CI 95% 1.05-1.38 (colon) and OR 2.17, CI 95% 1.55-3.04 (rectum)). Patients ≥70 year were less likely to undergo MVR for colon cancer (OR 0.80, 95% CI 0.70-0.90). Risk factors for incomplete resection were cT4 (OR 3.08, CI 95% 2.35-4.04 (colon) and OR 1.82, CI 95% 1.13-2.94 (rectum)) and poor/undifferentiated tumors (OR 1.41, CI 95% 1.14-1.72 (colon) and OR 1.69, CI 95% 1.05-2.74 (rectum)). More recent diagnosis was independently associated with less incomplete resections in colon cancer (OR 0.58, CI 95% 0.40-0.76). Independent predictors of survival were age, resection margin, nodal status and adjuvant chemotherapy, but not MVR. CONCLUSION: Treatment of locally advanced CRC with MVR at population level was influenced by year of diagnosis and hospital volume. Margin status in colon cancer improved substantially over time.

[Carcinoma of the colon with bladder invasion; what is the role of preoperative chemotherapy?] / Coloncarcinoom met doorgroei in de blaas.

Preoperative chemotherapy followed by surgery was applied in three patients, aged 68 years (male), 48 years (female), and 80 years (male) with locally advanced cancer of the colon with bladder invasion. Achieving a resection with free margins (R0) is essential in colon-cancer surgery, but the role of preoperative chemotherapy in colon cancer remains unknown. When a tumour is presumed to be unresectable, guidelines recommend discussing the case and possibly referring the patient to an oncological expertise centre, where each patient will be individually assessed for the most suitable preoperative treatment and surgery during a multidisciplinary tumour board meeting. All three patients showed that preoperative chemotherapy led to down-staging and reduction of the tumour size, although removal of the bladder was still necessary in one patient. All patients underwent a complete resection, which resulted in long-term disease-free and overall survival.

"Tailored" approach to selected recurrent cranio-cervical chordomas: experience and lessons learned.

BACKGROUND: Among chordoma patients, recurrent cases are by far more complex to be managed, and cranio-cervical junction (CCJ) localizations represent a particular challenge due to the complexity of the anatomical region which makes it difficult to obtain a radical resection. METHODOLOGY: We report our personal experience in treating four patients with recurrent CCJ chordoma with "personalized" multiportal and eventually multistage approaches. CONCLUSIONS: Endoscopic endonasal approaches have gained widespread acceptance and are considered the workhorse in most cases of craniocervical junction chordomas. Nonetheless, in some cases of recurrence, or in presence of very lateralized lesions/ anatomical variations midline approaches are either contraindicated or very difficult to perform. In all these cases it seems reasonable to consider a versatile strategy including different approaches, modulating the surgical needs with different answers and solutions offered by the different routes. In other words to personalize as much as possible the approach, being creative and not dogmatic.

Effects of three major protein sources on performance, gut morphology and fermentation characteristics in broilers.

1. This study determined the effects of three protein sources (PS), each at two digestibility crude protein (DCP) levels, on performance, gut morphology and fermentation characteristics in the hindgut of broilers.2. It was hypothesised that broilers fed ingredients high in indigestible CP, i.e. rapeseed meal (RSM) or maize gluten (MG), could potentially cause reduced growth, impaired gut health, and more protein fermentation products in caecal digesta. Increasing the DCP level in each of the indigestible CP diets may compensate for these detrimental effects.3. In total, 288 one-d-old male Ross 308 broilers were used in a completely randomised 3 × 2 factorial design, with six replicate pens per treatment. Three PS: soybean meal (SBM), rapeseed meal (RSM) or maize gluten (MG), and two DCP levels: 15.8 and 17.2% were used.4. Broilers fed SBM had increased feed intake and BWG and improved FCR compared with those fed RSM and MG diets. Broilers fed high DCP had better performance compared with those on low DCP. No significant effects of PS or DCP level were found on gastrointestinal tract development, caecal ammonia or volatile fatty acid concentrations.5. Broilers fed SBM had longer villi, smaller crypts and increased villus height to crypt depth ratio compared with those fed RSM and MG diets. Broilers fed RSM diet had a lower caecal pH, and had 16.5% and 14.9% more branched chain fatty acid contents in caecal digesta compared with those fed SBM and MG diets, respectively, indicating more proteolytic fermentation.6. Replacing SBM by RSM and MG negatively affected growth performance and gut morphology. Hindgut protein fermentation was substantially increased in RSM fed birds.7. To a certain extent, retarded growth performance in RSM and MG fed birds could be counterbalanced by increasing the dietary level of digestible CP.

Hospital volume and outcome in rectal cancer patients; results of a population-based study in the Netherlands.

BACKGROUND: Clinically staged T1-3 rectal cancer (cT1-3) is generally treated by total mesorectal excision(TME) with or without neoadjuvant therapy and sometimes requires beyond TME-surgery, whereas cT4 rectal cancer often requires both. This study evaluates the outcome of cT1-3 and cT4 rectal cancer according to hospital volume. METHODS: Patients undergoing rectal cancer surgery between 2005 and 2013 in the Netherlands were included from the National Cancer Registry. Hospitals were divided into low(1-20), medium(21-50) and high(>50 resections/year) volume for cT1-3 and low(1-4), medium(5-9) and high(≥10 resections/year) volume for cT4 rectal cancer. Cox-proportional hazards model was used for multivariable analysis of overall survival (OS). RESULTS: A total of 14.050 confirmed cT1-3 patients and 2.104 cT4 patients underwent surgery. In cT1-3 rectal cancer, there was no significant difference in 5-year OS related to high, medium and low hospital volume (70% vs. 69% vs. 69%). In cT4 rectal cancer, treatment in a high volume cT4 hospital was associated with a survival benefit compared to low volume cT4 hospitals (HR 0.81 95%CI 0.67-0.98) adjusted for non-treatment related confounders, but this was not significant after adjustment for neoadjuvant treatment. Patients with cT4-tumours treated in high volume hospitals had a significantly lower age, more synchronous metastases, more patients treated with neoadjuvant therapy and a higher pT-stage. CONCLUSION: Hospital volume was not associated with survival in cT1-3 rectal cancer. In cT4 rectal cancer, treatment in high volume cT4 hospitals was associated with improved survival compared to low volume cT4 hospitals, although this association lost statistical significance after correction for neoadjuvant treatment.

Inclusion of sainfoin (Onobrychis viciifolia) silage in dairy cow rations affects nutrient digestibility, nitrogen utilization, energy balance, and methane emissions.

Sainfoin (Onobrychis viciifolia) is a tanniniferous legume forage that has potential nutritional and health benefits preventing bloating, reducing nematode larval establishment, improving N utilization, and reducing greenhouse gas emissions. However, the use of sainfoin as a fodder crop in dairy cow rations in northwestern Europe is still relatively unknown. The objective of this study was to evaluate the effect of sainfoin silage on nutrient digestibility, animal performance, energy and N utilization, and CH4 production. Six rumen-cannulated, lactating dairy cows with a metabolic body weight (BW(0.75)) of 132.5±3.6kg were randomly assigned to either a control (CON) or a sainfoin (SAIN)-based diet over 2 experimental periods of 25 d each in a crossover design. The CON diet was a mixture of grass silage, corn silage, concentrate, and linseed. In the SAIN diet, 50% of grass silage dry matter (DM) of the CON diet was exchanged for sainfoin silage. The cows were adapted to 95% of ad libitum feed intake for a 21-d period before being housed in climate-controlled respiration chambers for 4 d, during which time feed intake, apparent total-tract digestibility, N and energy balance, and CH4 production was determined. Data were analyzed using a mixed model procedure. Total daily DM, organic matter, and neutral detergent fiber intake did not differ between the 2 diets. The apparent digestibility of DM, organic matter, neutral detergent fiber, and acid detergent fiber were, respectively, 5.7, 4.0, 15.7, and 14.8% lower for the SAIN diet. Methane production per kilogram of DM intake was lowest for the SAIN diet, CH4 production as a percentage of gross energy intake tended to be lower, and milk yield was greater for the SAIN diet. Nitrogen intake, N retention, and energy retained in body protein were greater for the SAIN than for the CON diet. Nitrogen retention as a percentage of N intake tended to be greater for the SAIN diet. These results suggest that inclusion of sainfoin silage in dairy cow rations reduces CH4 per kilogram of DM intake and nutrient digestibility. Moreover, sainfoin silage improves milk production and seems to redirect metabolism toward body protein accretion at the expense of body fat.

Diet structure, butyric acid, and fermentable carbohydrates influence growth performance, gut morphology, and cecal fermentation characteristics in broilers.

An experiment with 288 male (Ross 308) 1-d-old broilers was conducted to test the hypothesis that a coarse diet supplemented with butyric acid (BA) and fermentable carbohydrates (FC) improves performance of broilers with a poorly digestible protein source. The interaction effects of diet structure (fine or coarse), FC supplementation (with or without), and BA supplementation (with or without) in a poorly digestible diet based on rapeseed meal (RSM) were tested in a factorial arrangement of 8 (2×2×2) dietary treatments. The coarseness of the diet affected feed intake (FI) (P<0.001), BW gain (P=0.001), and the feed conversion ratio (FCR) (P=0.001) positively. Broilers fed the coarse diets had, on average, 14% heavier gizzards and 11, 7, 5, and 6% lower relative empty weights of the crop, duodenum, jejunum, and ileum, respectively, compared with those fed the fine diets. Dietary coarseness resulted in, on average, 6% greater ileal protein digestibility, 20% lower gizzard pH, 19% greater villus height, 18% lower crypt depth, and 23% reduced cecal branched chain fatty acids (BCFA) compared with chickens fed the fine diets. Broilers fed BA-supplemented diets had an improved FCR (P=0.004) and decreased crypt depth (P<0.001) compared with those fed diets without BA. Fermentable carbohydrate supplementation did not influence growth performance, gut development, or contents of total BCFA and total biogenic amines in the cecal digesta (P>0.05). Supplementation with FC, however, decreased the cecal concentration of spermine by approximately 31% compared with broilers fed diets without FC (P=0.002). In conclusion, feeding a coarse diet supplemented with BA improved performance of broilers fed a diet containing a poorly digestible protein source. The negative effects of a poorly digestible protein source can thus be partly counterbalanced by coarse grinding and BA supplementation in the diet.

Adaptation of faecal microbiota in sows after diet changes and consequences for in vitro fermentation capacity.

In vitro gas production studies are routinely used to assess the metabolic capacity of intestinal microbiota to ferment dietary fibre sources. The faecal inocula used during the in vitro gas production procedure are most often obtained from animals adapted to a certain diet. The present study was designed to assess whether 19 days of adaptation to a diet are sufficient for faecal inocula of pigs to reach a stable microbial composition and activity as determined by in vitro gas production. Eighteen multiparous sows were allotted to one of two treatments for three weeks: a diet high in fibre (H) or a diet low in fibre (L). After this 3-week period, the H group was transferred to the low fibre diet (HL-treatment) while the L group was transferred to the diet high in fibre (LH-treatment). Faecal samples were collected from each sow at 1, 4, 7, 10, 13, 16 and 19 days after the diet change and prepared as inoculum used for incubation with three contrasting fermentable substrates: oligofructose, soya pectin and cellulose. In addition, inocula were characterised using a phylogenetic microarray targeting the pig gastrointestinal tract microbiota. Time after diet change had an effect (P<0.05) on total gas production for the medium-fast fermentable substrates; soya pectin and oligofructose. For the more slowly fermentable cellulose, all measured fermentation parameters were consistently higher (P<0.05) for animals in the HL-treatment. Diet changes led to significant changes in relative abundance of specific bacteria, especially for members of the Bacteroidetes and Bacilli, which, respectively, increased or decreased for the LH-treatment, while changes were opposite for the HL-treatment. Changing the diet of sows led to changes in fermentation activity of the faecal microbiota and in composition of the microbiota over time. Adaptation of the microbiota as assessed by gas production occurred faster for LH-animals for fast fermentable substrates compared with HL-animals. Overall, adaptation of the large intestinal microbiota of sows as a result of ingestion of low and high fibre diets seems to take longer than 19 days, especially for the ability to ferment slowly fermentable substrates.

Protein source and dietary structure influence growth performance, gut morphology, and hindgut fermentation characteristics in broilers.

An experiment with 210 male (Ross 308) 1-d-old broilers was conducted to test the hypothesis that a coarse diet improves performance of broilers fed a poorly digestible protein source. A highly digestible diet based on soybean meal was gradually replaced by a low digestible diet based on rapeseed meal (RSM) in 5 steps (RSM-0%, RSM-25%, RSM-50%, RSM-75%, and RSM-100%). Two diet structures (fine and coarse) were used as an additional factor. These 2 factors and their interactions were tested at different ages in a factorial arrangement with 10 dietary treatments. An increase in indigestible dietary protein negatively affected feed intake (P = 0.003), BW gain (P = 0.008), and feed conversion ratio (P = 0.034). This increase in dietary indigestible protein contents resulted in a decrease (P = 0.001) in total cecal volatile fatty acid concentration from 209.1 to 125.9 mmol/kg of DM digesta in broilers with increasing RSM in diets. Increase in the indigestible protein level, from RSM-0% to RSM-100%, resulted in a decrease (P = 0.042) in villus heights (1,782 vs. 1,574 µm), whereas crypt depths increased (P = 0.021; 237 vs. 274 µm). A coarse diet improved feed intake (P = 0.006), BW gain (P = 0.014), and feed conversion ratio (P = 0.009). Broilers fed coarse diets had approximately 11, 24, and 10% lower relative empty weights of the crop, proventriculus, and jejunum, respectively, whereas a 15% heavier gizzard was found compared with those fed the fine diets. Dietary coarseness resulted in approximately 16% lower gizzard pH, 21% greater villus heights, 27% lower crypt depths, 24% reduced branched-chain fatty acids, and 12% lower biogenic amines in the cecal digesta compared with broilers fed fine diets. In conclusion, feeding coarse particles improved broiler performance irrespective of digestibility of the diet. Hindgut protein fermentation can be reduced by coarse grinding of the diet.

Determinants of altered sleep-wake rhythmicity in patients treated for nonfunctioning pituitary macroadenomas.

CONTEXT AND OBJECTIVE: In a cohort of 17 patients treated for nonfunctioning pituitary macroadenoma (NFMA), we observed alterations in polysomnographic sleep characteristics and actigraphic sleep-wake rhythmicity, and subjective fatigue, daytime somnolence, and low sleep quality. We aimed to confirm the actigraphic data in a larger scale cohort of NFMA patients, powered to address risk factors for altered rhythmicity, including the effects of hydrocortisone replacement. METHODS: Sleep-wake rhythmicity in treated NFMA patients was measured using actigraphy for 7 days, and subjective sleep quality and quality of life (QoL) with validated questionnaires. To assess the influence of hydrocortisone dependency, we additionally studied patients with Addison's disease (AD). The results were compared with matched healthy controls. RESULTS: We included 69 NFMA patients in long-term remission after trans-sphenoidal surgery on stable replacement therapy for hypopituitarism, 21 AD patients, and 58 controls. NFMA patients reported severely impaired QoL, sleep quality, and increased daytime sleepiness. The day-night dichotomy of activity was fragmented, with decreased daytime activity and a tendency for increased nighttime activity. Preoperative visual field defects (VFD) were associated with this fragmentation, and vasopressin deficiency with decreased sleep efficiency, independent of age, hypopituitarism, or radiotherapy. AD patients showed similar decreases in daytime functioning, but normal subjective and objective sleep, and no daytime sleepiness. CONCLUSION: NFMA patients suffer from altered sleep-wake rhythmicity. Hydrocortisone dependency may explain part of the decreased daytime functioning, but the independent influence of VFD and differences between AD and NFMA patients point towards a role for dysfunction of the adjacent suprachiasmatic nucleus (SCN).

Evaluation of free water and water activity measurements as functional alternatives to total moisture content in broiler excreta and litter samples.

Litter moisture contents vary greatly between and within practical poultry barns. The current experiment was designed to measure the effects of 8 different dietary characteristics on litter and excreta moisture content. Additionally, free water content and water activity of the excreta and litter were evaluated as additional quality measures. The dietary treatments consisted of nonstarch polysaccharide content (NSP; corn vs. wheat), particle size of insoluble fiber (coarse vs. finely ground oat hulls), viscosity of a nonfermentable fiber (low- and high-viscosity carboxymethyl cellulose), inclusion of a clay mineral (sepiolite), and inclusion of a laxative electrolyte (MgSO4). The 8 treatments were randomly assigned to cages within blocks, resulting in 12 replicates per treatment with 6 birds per replicate. Limited effects of the dietary treatments were noted on excreta and litter water activity, and indications were observed that this measurement is limited in high-moisture samples. Increasing dietary NSP content by feeding a corn-based diet (low NSP) compared with a wheat-based diet (high NSP) increased water intake, excreta moisture and free water, and litter moisture content. Adding insoluble fibers to the wheat-based diet reduced excreta and litter moisture content, as well as litter water activity. Fine grinding of the oat hulls diminished the effect on litter moisture and water activity. However, excreta moisture and free water content were similar when fed finely or coarsely ground oat hulls. The effects of changing viscosity and adding a clay mineral or laxative deviated from results observed in previous studies. Findings of the current experiment indicate a potential for excreta free water measurement as an additional parameter to assess excreta quality besides total moisture. The exact implication of this parameter warrants further investigation.

Identifying the limitations for growth in low performing piglets from birth until 10 weeks of age.

The evolution of hyper-prolific pig breeds has led to a higher within-litter variation in birth weight and in BW gain during the nursery phase. Based on an algorithm developed in previous research, two populations from a pool of 368 clinically healthy piglets at 6 weeks of age were selected: a low (LP) and a high (HP) performing population and their development was monitored until the end of the nursery phase (10 weeks of age). To understand the cause of the variation in growth between these populations we characterized the LP and HP piglets in terms of body morphology, behaviour, voluntary feed intake, BW gain, and apparent total tract and ileal nutrient digestibility. Piglets were housed individually and were fed a highly digestible diet. At selection, 6 weeks of age, the BW of LP and HP piglets were 6.8±0.1 and 12.2±0.1 kg, respectively. Compared with the LP piglets the HP piglets grew faster (203 g/day), ate more (275 g/day) from 6 to 10 weeks of age and were heavier at 10 weeks (30.0 v. 18.8 kg, all P<0.01). Yet, the differences in average daily gain and average daily feed intake disappeared when compared per kg BW0.75. Assuming similar maintenance requirements per kg BW0.75 the efficiency of feed utilization above maintenance was 0.1 g/g lower for the LP piglets (P=0.09).The gain : feed ratio was similar for both groups. LP piglets tended to take more time to touch a novel object (P=0.10), and spent more time eating (P<0.05). At 10 weeks, LP piglets had a higher body length and head circumference relative to BW (P<0.01). Relative to BW, LP had a 21% higher small intestine weight; 36% longer length, and relative to average FI, the small intestinal weight was 4 g/kg higher (both P=<0.01). Apparent total tract and ileal dry matter, N and gross energy digestibility were similar between groups (P>0.10). We concluded that the low performance of the LP piglets was due to their inability to engage compensatory gain or compensatory feed intake as efficiency of nutrient utilization and feed intake per kg BW0.75 was unaffected. LP piglets tend to be more fearful towards novel objects. The morphological comparisons, increased body length and head circumference relative to BW imply that LP piglets have an increased priority for skeletal growth.

Peripartal calcium homoeostasis of multiparous dairy cows fed rumen-protected rice bran or a lowered dietary cation/anion balance diet before calving.

Milk fever is one of the most important metabolic diseases in dairy cattle. Reducing the dietary cation/anion balance (DCAD) with anionic salts is a common prevention strategy. However, many small European farms cannot use total mixed rations (TMR) in the close-up period. Including anionic salts in compound feeds can result in feed refusals and moderate inclusions to preserve feed palatability results in insufficient DCAD reduction. Rumen-protected rice bran induces the adaptation of Ca metabolism in dairy cows by a reduction of Ca intake and by a reduction of the availability of dietary Ca. In the presence of a negative control, rumen-protected rice bran (2.8 kg/day) was compared with a lowered DCAD diet (from 269 to 4 meq/kg DM) in their effect to prevent milk fever. In a randomized block design, 45 multiparous Holstein cows joined the trial sequentially from 21 days before the expected calving date and were observed until the 8th week of lactation. Feed and nutrient intakes were recorded, and Ca, P, Mg in serum and urine, urine pH, serum NEFA and milk production in early lactation were compared. Feeding rumen-protected rice bran before calving improved the recovery of calcaemia after calving and had a positive effect on DMI after calving. The moderately low DCAD diet did not positively influence serum Ca at calving. Calcaemia recovered even later than in control, and cows showed reduced DMI post-calving and higher NEFA levels in the first 36 h after calving. This moderate reduction of DCAD did not provide an intermediate prevention level indicating that DCAD needs to be reduced to the recommended levels to prevent milk fever. Rumen-protected rice bran may be a suitable feed to reduce hypocalcaemia post-partum and can be included in pre-calving compound feeds representing a palatable alternative to anionic salts.

Predicted high-performing piglets exhibit more and larger skeletal muscle fibers.

Postnatal (muscle) growth potential in pigs depends on the total number and hypertrophy of myofibers in skeletal muscle tissue. In a previous study an algorithm was developed to predict piglet BW at the end of the nursery period (10 wk of age) on the basis of BW at birth, at weaning, and at 6 wk of age. The objective of this study was to determine whether the differences in growth performance between poor (PP) and high (HP) performing piglets could be the result of different skeletal muscle properties. Therefore, from a total of 368 piglets (offspring from Hypor sows bred to TOPIGS sires) 2 groups with a divergent growth performance were selected at 6 wk of age: HP (n = 20, predicted BW at 10 wk of age 26.8-30.9 kg) and PP (n = 20, predicted BW at 10 wk of age 16.0-22.9 kg). Piglets were euthanized at 10 wk of age, and samples of the semitendinosus muscle (STN) were collected for histochemistry and gene expression analysis using quantitative PCR (qPCR). At 10 wk of age, realized BW did not differ from predicted BW in either group (P > 0.880). The HP piglets exhibited greater ADG and ADFI from 6 to 10 wk and greater BW at birth and 6 and 10 wk of age (P ≤ 0.002) compared with the PP piglets, whereas G:F ratio was similar (P = 0.417). Superior growth performance of HP piglets was associated with a 1.27-fold higher IGF1 plasma concentration at 10 wk compared with the PP piglets (P = 0.044). The greater weight and muscle cross-sectional area of STN in HP piglets was due to a 1.20-fold increase in total muscle fiber number (TFN; P = 0.009) and 1.34-fold increase in fiber cross-sectional area (FCSA; P = 0.004) compared with the PP piglets. The number of myonuclei per red and intermediate fiber was greater in HP piglets (P ≤ 0.097), but the nucleus-to-cytoplasm ratio was unaffected by the performance group (P = 0.861). The mRNA expression of proliferating cell nuclear antigen (PCNA), paired box 7 (PAX7), myogenic factor 5 (MYF5), and myogenic differentiation factor (MYOD) did not differ between groups (P ≥ 0.327). However, IGF2-specific mRNA expression was numerically higher in the HP piglets (P = 0.101). The greater myofiber number, the higher degree of myofiber hypertrophy, and the increased muscular mRNA expression of IGF2 indicate that HP piglets exhibit a greater capacity for lean accretion and may grow faster until market weight. In summary, pigs that were selected for predicted high BW at 10 wk of age using a complex selection model had a superior muscularity in terms of greater TFN and FCSA, which may be of advantage for lean mass accretion in later life and for meat quality.

Moisture content in broiler excreta is influenced by excreta nutrient contents.

High litter moisture content, often referred to as wet litter, is a major problem in poultry production. Wet litter is often related to poor management, diseases, and digestive problems. In this experiment, the objective was to study the relationship between nutrient content and the moisture content of the excreta of broilers. A dataset containing 351 observations was built and contained the nutrient contents data including moisture content of excreta samples collected in 8 different broiler feeding trials. A biological based model approach was used to create a model with 10 and another one with 14 variables that may explain the excreta moisture level response. Subsequently, these models were compared with a statistical model that was built automatically and adjusted only if this improved the biological model. The R(2) of the 10 variable model was 0.54, in which Zn content and the interaction of NDF × K and Ca × P content were negatively associated with excreta moisture. Sodium, P, and Ca content and the interaction between content of NDF × Na were positively associated with excreta moisture. The R(2) of the 14 variable model was 0.58, in which Zn and K content and the interaction of NDF × protein and Ca × P content were negatively associated with excreta moisture, and Na, protein, P, and Ca content and the interactions in contents of NDF × Na, NDF × Zn, and K × Cu were positively associated with excreta moisture content. In conclusion, the models confirmed the effect of Na, protein, P, and Ca on excreta moisture content. Furthermore, hitherto unknown nutrient interactions that contribute to excreta moisture level were identified. As excreta levels of most nutrients can be manipulated by adjusting dietary nutrient levels, dietary formulation can be adjusted with the findings of this analysis to change levels of excreted nutrients and, consequently, also moisture output.

Progression of vertebral fractures despite long-term biochemical control of acromegaly: a prospective follow-up study.

BACKGROUND: In active acromegaly, pathologically elevated GH and IGF-1 levels are associated with increased bone turnover and a high bone mass, the latter being sustained after normalization of GH values. In a cross-sectional study design, we have previously reported a high prevalence of vertebral fractures (VFs) of about 60% in patients with controlled acromegaly, despite normal mean bone mineral density (BMD) values. Whether these fractures occur during the active acromegaly phase or after remission is achieved is not known. OBJECTIVE: Our objective was to study the natural progression of VFs and contributing risk factors in patients with controlled acromegaly over a 2.5-year follow-up period. METHODS: Forty-nine patients (mean age 61.3 ± 11.1 years, 37% female) with controlled acromegaly for ≥ 2 years after surgery, irradiation, and/or medical therapy and not using bisphosphonates were included in the study. Conventional spine radiographs including vertebrae Th4-L4 were assessed for VFs according to the Genant method. VF progression was defined as development of new/incident fractures and/or a minimum 1-point increase in the Genant scoring of preexisting VFs. BMD was assessed by dual-energy x-ray absorptiometry (Hologic 4500). RESULTS: Prevalence of baseline VFs was 63%, being highest in men, and fractures were unrelated to baseline BMD. VF progression was documented in 20% of patients, especially in men and in case of ≥ 2 VFs at baseline. VF progression was not related to BMD values or BMD changes over time. CONCLUSION: Findings from this longitudinal study show that VFs progress in the long term in 20% of patients with biochemically controlled acromegaly in the absence of osteoporosis or osteopenia. These data suggest that an abnormal bone quality persists in these patients after remission, possibly related to pretreatment long-term exposure to high circulating levels of GH.

Ileal microbiota composition of broilers fed various commercial diet compositions.

Microbiota plays a role in the release and absorption of nutrients from feed components, thereby affecting digesta composition and moisture content of the excreta. The objective of the current study was to determine the effects of 5 different diets varying in ingredients (medium-chain fatty acids, nonstarch polysaccharides, and starch) on the microbiota composition of ileal digesta of broiler chickens and excreta DM content. Each treatment was repeated 6 times in cages each containing 18 Ross 308 broilers, with growth performance measured from 0 to 34 d of age and excreta DM and ileal microbiota composition analyzed at 34 d of age. Microbiota composition was evaluated using a novel ribosomal RNA microarray technology containing 370 different probes covering various genera, groups of microbial species, and individual species of the chicken gut microbiota, of which 321 had a signal above the background threshold. Replacing part of the animal fat and soybean oil in the wheat-based diet with medium-chain fatty acids (MCFA; 0.3% C10 and 2.7% C12) improved feed efficiency compared with the other dietary treatments. This coincided with a suppression of gram-positive bacteria belonging to the phylum of the Firmicutes, including Lactobacillus species, and species belonging to the family of the Enterococcaceae and Micrococcaceae, whereas the gram-negative bacteria belonging to the family of the Enterobacteriaceae were promoted. None of the other diets used in the present study notably changed the ileal digesta bacteria composition. Excreta DM content was not affected by dietary treatment. The variation between individual birds per dietary treatment was more pronounced than variation caused by feed composition, with the exception of the digesta microbiota of the birds fed the MCFA diet. It is concluded that a diet with MCFA significantly changes the ileal microbiota composition, whereas the effect of the other diets on the composition of the microbiota and excreta DM content is small in broiler chickens.

Genetic correlations between lactation performance and growing-finishing traits in pigs.

Genetic selection for increased litter size of sows increases the risk of a large negative energy balance during lactation. Furthermore, the feed intake capacity of the lactating sows might be reduced due to the simultaneous selection for greater feed efficiency during the growth phase when sows were actually reared as finishers but later on selected for breeding. There is a need to improve lactation performance of sows and continue selection for feed efficiency of grower-finishers in commercial breeding. Therefore, this study was conducted to estimate genetic correlations between growing-finishing traits and lactation performance traits. An additional objective was to study the impact of including additive social effects in the animal model on genetic correlation estimates. Analyses were performed on a population of 1,149 commercial crossbred sows with repeated observations on lactation performance traits and their 7,723 grower-finisher offspring. The genetic correlation between daily BW gain of grower-finishers and starting BW of lactating sows was positive (rg = 0.24; P < 0.05). The correlation between off-test backfat of grower-finishers and fat mass of lactating sows was also positive (rg = 0.53; P < 0.05). The genetic regulation of feed intake from the beginning of lactation seems to differ from the genetic regulation of feed intake during the growing-finishing period, as the correlation between these 2 traits was low (rg = +0.23; P < 0.05). Feed efficiency during growing-finishing and lactation phases showed similar tendencies as the genetic correlation between residual feed intake of the grower-finisher and lactation efficiency of sows was -0.51 (P < 0.05). Taking heritable social effects into account for daily BW gain and feed intake did not affect the genetic correlation estimates, either within growing-finishing traits or between growing-finishing traits and lactation performance traits. It was concluded that in the absence of antagonistic genetic correlations, selection for growing-finishing traits in dam lines could be combined with selection for lactation performance traits.