Feed utilization and lactational performance of Friesian cows fed beet tops silage treated with lactic acid bacteria as a replacement for corn silage.

Thirty multiparous lactating Friesian cows were used to study the effect of partial or complete replacement of corn silage with lactic acid bacteria (LAB), molasses and calcium carbonate ensiled sugar beet tops for 3 months in a complete randomized experimental design with repeated measures. A week after parturition, cows were grouped into three treatments of 10 cows each and fed a control treatment containing corn silage at 300 g/kg DM. In the other treated diets, 50% or 100% of the control corn silage was substituted with beet tops silage treated with LAB included at 150 g or 300 g per kg diet. Ensiling of beet tops with LAB decreased its contents of oxalic acid and neutral detergent and acid detergent fibers but increased its contents of non-structural carbohydrate and calcium. Without affecting daily milk production and feed efficiency, beet tops silage treated with LAB diets decreased (p < 0.05) feed intake, total ruminal volatile fatty acids, acetate and propionate concentrations, energy-corrected milk yield and concentrations of milk total solids, fat, protein and energy. In conclusion, beet tops silage treated with LAB can replace corn silage in diets of lactating cows. An inclusion rate of 15% of beet tops silage treated with LAB (replacing 50% of corn silage) in the diet was the most suitable level for lactating cows under the current experimental conditions.

Prospective randomized controlled trial of an injectable esophageal prosthesis versus a sham procedure for endoscopic treatment of gastroesophageal reflux disease.

BACKGROUND: This study aimed to assess whether endoscopic implantation of an injectable esophageal prosthesis, the Gatekeeper Reflux Repair System (GK), is a safe and effective therapy for controlling gastroesophageal reflux disease (GERD). METHODS: A prospective, randomized, sham-controlled, single-blinded, international multicenter study planned final enrollment of 204 patients in three groups: up to 60 lead-in, 96 GK, and 48 sham patients. The sham patients were allowed to cross over to the GK treatment arm or exit the study at 6 months. The primary end points were (1) reduction in serious device- and procedure-related adverse device effects compared with a surgical composite complication rate and (2) reduction in heartburn symptoms 6 months after the GK procedure compared with the sham procedure. The secondary end point was improved esophageal pH (total time pH was <4) 6 months after the GK procedure compared with baseline. RESULTS: A planned interim analysis was performed after 143 patients were enrolled (25 lead-in, 75 GK, and 43 sham patients), and the GK study was terminated early due to lack of compelling efficacy data. Four reported serious adverse events had occurred (2 perforations, 1 pulmonary infiltrate related to a perforation, and 1 severe chest pain) at termination of the study with no mortality or long-term sequelae. Heartburn symptoms had improved significantly at 6 months compared with baseline in the GK group (p < 0.0001) and the sham group (p < 0.0001), but no significant between-group difference in improvement was observed (p = 0.146). Esophageal acid exposure had improved significantly at 6 months compared with baseline in the GK group (p = 0.021) and the sham group (p = 0.003), but no significant between-group difference in improvement was observed (p = 0.27). CONCLUSIONS: The GK procedure was associated with some serious but infrequent complications. No statistically significant difference in outcomes was observed between the treatment and control groups at 6 months compared with baseline.