Altered breathing mechanics and ventilatory response during exercise in children born extremely preterm.

BACKGROUND: Extreme preterm birth confers risk of long-term impairments in lung function and exercise capacity. There are limited data on the factors contributing to exercise limitation following extreme preterm birth. This study examined respiratory mechanics and ventilatory response during exercise in a large cohort of children born extremely preterm (EP). METHODS: This cohort study included children 8-12 years of age who were born EP (≤28 weeks gestation) between 1997 and 2004 and treated in a large regionalised neonatal intensive care unit in western Canada. EP children were divided into no/mild bronchopulmonary dysplasia (BPD) (ie, supplementary oxygen or ventilation ceased before 36 weeks gestational age; n=53) and moderate/severe BPD (ie, continued supplementary oxygen or ventilation at 36 weeks gestational age; n=50). Age-matched control children (n=65) were born at full term. All children attempted lung function and cardiopulmonary exercise testing measurements. RESULTS: Compared with control children, EP children had lower airway flows and diffusion capacity but preserved total lung capacity. Children with moderate/severe BPD had evidence of gas trapping relative to other groups. The mean difference in exercise capacity (as measured by oxygen uptake (VO2)% predicted) in children with moderate/severe BPD was -18±5% and -14±5.0% below children with no/mild BPD and control children, respectively. Children with moderate/severe BPD demonstrated a potentiated ventilatory response and greater prevalence of expiratory flow limitation during exercise compared with other groups. Resting lung function did not correlate with exercise capacity. CONCLUSIONS: Expiratory flow limitation and an exaggerated ventilatory response contribute to respiratory limitation to exercise in children born EP with moderate/severe BPD.

Effect of prenatal testosterone treatment on nitrogen utilization and endocrine status of ewe lambs.

Thirty-eight pregnant Suffolk ewes were assigned randomly to a control group or implanted with approximately 2 g of testosterone propionate (TP) when they were between d 40 and 60 of gestation. Implants were removed 3 wk prior to lambing. Five ewe lambs born to implanted ewes and ten ewe lambs born to nonimplanted ewes were utilized in this experiment. Ram lambs were not used in this trial. No differences (P greater than .10) were observed for fecal, urinary and total N excretion and amount of N absorbed. Nitrogen retained (percentage of N intake and g/d) was higher (P less than .05) in prenatally androgenized ewe lambs than in control ewe lambs. Plasma insulin concentrations averaged 99% higher (P less than .05) in prenatally androgenized ewe lambs. Plasma insulin-like growth factor I (IGF-I) concentrations averaged 29% higher (P less than .06) in ewe lambs treated prenatally with testosterone. Nonesterified fatty acid (NEFA) concentrations averaged 41% higher (P less than .05) in prenatally androgenized ewe lambs. Significant (P less than .05) treatment x time effects were observed in plasma thyroxine, glucose and urea N concentrations of prenatally androgenized vs control ewe lambs. These significant modifications in the plasma metabolite and endocrine status could be an important element of the physiological mechanism(s) by which prenatal androgenization improves growth performance and leanness of ewe lambs.

Effect of prenatal trenbolone acetate treatment on lamb performance and carcass characteristics.

Forty-three pregnant Dorset and Dorset crossbred ewes were assigned randomly to a control group or implanted with either 300 mg trenbolone acetate (Low TBA) or 1,200 mg trenbolone acetate (High TBA) between d 40 and 60 of gestation. Adjusted weaning weights for ewe lambs were 23.3% less (P less than .10) with vs without TBA treatments. Postweaning ADG of ewe lambs was lower (P less than .05) but ADG of ram lambs was greater (P less than .05) for high TBA vs low TBA. Ewe lambs receiving high TBA had 19% less (P less than .05) gain per unit of feed than those receiving low TBA. Days on test for ewe lambs was greater (P less than .05) due to TBA treatment and for high TBA vs low TBA. Days on test for ram lambs was decreased (P less than .05) due to high TBA compared to low TBA. Subcutaneous fat over the ribeye and lower rib were greater (P less than .05) for high-TBA ewe lambs vs low-TBA ewe lambs. Percentage kidney and pelvic fat of ewe lambs was lower (P less than .05) due to TBA treatments. Ribeye area per unit of carcass weight was lower (P less than .05) in high-TBA ewe lambs vs low-TBA ewe lambs. Yield grade of ewe lambs was lower (P less than .05) for low TBA vs high TBA. Prenatal trenbolone acetate treatment of ewe lambs did not improve their subsequent postnatal growth performance and carcass traits. In addition, TBA implantation of the pregnant ewe produced dystocia and less milk production, as evidenced by the need for more lambs to be grafted.

Effects of prenatal testosterone treatment and postnatal steroid implantation on growth performance and carcass traits of heifers and steers.

Two experiments were conducted to evaluate the effect of prenatal testosterone treatment in combination with postnatal steroid implantation (Exp. 1) and to assess the effect of time of prenatal testosterone treatment in conjunction with postnatal steroid implantation (Exp. 2) on animal performance and carcass characteristics. In Exp. 1, seventy-six pregnant cows were assigned randomly to a control group or implanted with testosterone propionate (TP) silastic implants between d 40 and 80 of gestation. Half the heifer calves were selected randomly to be implanted with 200 mg TP plus 20 mg estradiol benzoate (EB); the other half of the steer calves were implanted with 200 mg progesterone plus 20 mg EB on d 1 and 85 of the feedlot trial. Daily gain of heifers was increased 10.4% (P less than .08) due to prenatal testosterone treatment (P) and 16.4% (P less than .05) by postnatal steroid implantation (I). Feed efficiency was 12.9% greater (P less than .05) due to P and 9.5% greater (P less than .05) due to I. Prenatal testosterone treatment decreased (P less than .05) kidney, pelvic and heart fat and final yield grade but increased (P less than .05) ribeye area of heifers. Heifers had greater (P less than .07) liver weights per unit of carcass weight due to P. In Exp. 2, one hundred seventy-four pregnant cows were assigned randomly to a control group or implanted with TP silastic implants on d 42, 63, 84 or 105 of gestation. Half the heifer and steer calves were selected randomly to be implanted on d 1 and 112 of the feedlot trial. Time of P caused a quadratic effect (P less than .08) on birth weight of heifers. There was a quadratic effect (P less than .05) of time of P on daily gain and final weight per day of age of heifers. Feed efficiency of heifers was improved (P less than .05) due to P. Postnatal steroid implantation increased (P less than .05) daily gain and feed efficiency of heifers by 9.6% and 8.6%, respectively. No changes were observed in growth performance of steers due to P. Results from these two trials suggest that the combination of prenatal testosterone treatment and postnatal testosterone and estradiol implantation produced an additive improvement of daily gain, feed efficiency and carcass merit of heifers.

The role of sigmoidoscopy for asymptomatic patients. Results of three annual screening sigmoidoscopies, polypectomy, and subsequent surveillance colonoscopy in a primary-care setting.

A total of 329 asymptomatic patients (aged 50 or older) underwent flexible sigmoidoscopy to screen for colonic neoplasia. Of these, 258 underwent a second examination after 1 year and 143 underwent a third examination after another year. Of 60 patients in whom polyps were found on one of the three examinations, 58 underwent colonoscopy and polypectomy; 77 adenomatous polyps were present in 39 of these patients. The incidence of adenomatous polyps was 7.9% for the first examination, 3.9% for the second, and 2.1% for the third. Of patients with an index polyp found by sigmoidoscopy, 57.5% had synchronous polyps discovered by colonoscopy. Thirty-six of 77 polyps in 24 patients showed dysplasia; 9 were less than 0.5 cm, 14 were 0.5 cm to 0.9 cm, and 13 were 1 cm or larger. Forty-four surveillance colonoscopies (done after initial colonoscopy and polypectomy) have been performed in 28 patients. Eighteen examinations resulted in finding 30 adenomatous polyps, of which 10 showed dysplasia. This study 1) is the first report of flexible sigmoidoscopy data to support the American Cancer Society recommendation of two serial screening sigmoidoscopies a year apart, 2) reinforces the concept that an index polyp indicates a need for a complete colonoscopy, 3) reinforces the need for ongoing surveillance by colonoscopy after detection of adenomas, and 4) adds to reports of dysplasia in diminutive polyps.

Effect of prenatal androgenization on growth performance and carcass characteristics of steers and heifers.

Two experiments were conducted in which pregnant crossbred cows were randomly assigned to a control group or implanted with testosterone propionate/silastic implants between d 110 and 140 of gestation in Exp. 1 and between d 80 and 110 of gestation in Exp. 2. Androgenized heifers (TH) and treated steers (TS), born to implanted dams, possessed similar birth weights compared with control heifers (CH) and steers (CS), respectively, in both experiments. In Exp. 1, yield grades were lower (P less than .05) for TH than for CH. In Exp. 2, TH possessed 9.4% greater (P less than .07) 205-d adjusted weaning weights and 9.8% heavier (P less than .05) adjusted yearling weights than CH. In Exp. 2, daily gain was 19.5% faster (P less than .05) and feed intake was 13.6% greater (P less than .05) for TH than for CH. In Exp. 2, TH possessed less (P less than .05) s.c. fat, greater (P less than .10) carcass weight gains and lower (P less than .05) yield grades than CH. Liver weight per unit of carcass weight was greater (P less than .07) for TH than for CH in Exp. 2. Androgenized heifers had lower (P less than .07) lipid content in the 9-10-11th rib section than did CH. Calving intervals were similar for implanted and nonimplanted cows in both experiments. Results from these two trials suggest that efficiency of heifers for producing carcass beef can be improved by prenatal testosterone exposure.

Effect of prenatal androgenization on lamb performance, carcass composition and reproductive function.

Two experiments were conducted in which pregnant crossbred ewes were randomly assigned to a control group or implanted with testosterone propionate/silastic implants between d 40 and d 60 of gestation. Implants contained approximately 2 g testosterone propionate and provided a constant delivery of 8.7 mg/d. Androgenized ewes (TE), born to implanted dams, had lower adjusted birth weights (P less than .05) than control ewes (CE) in both experiments. Treated rams (TR) also displayed lower birth weights than control rams (CR) in both experiments, but the difference was significant only in Exp. 2. Average daily gain was 16.4% more (P less than .05) for TE than for CE in Exp. 1. In Exp. 2, TE gained 9.6% faster (P less than .05) and had 14.6% (P less than .05) more weight per unit of feed consumed than CE. In both experiments, average daily gain and gain-to-feed ratio were similar for TR and CR. In Exp. 2, prenatal androgenization of ewes reduced (P less than .05) 12th rib fat thickness and decreased (P less than .05) percent kidney and pelvic fat. Yield grades of TE were lower than CE in both Exp. 1 (P less than .10) and Exp. 2 (P less than .05). From additional measurements taken in Exp. 2, liver weight per unit of carcass weight was greater (P less than .05), anogenital distance was greater (P less than .01) and test tube penetration into the vestibule was less (P less than .01) for TE than CE. The TE did not exhibit regular estrous cycles, while CE displayed recurring estrous cycles.