Urinary excretion of dietary Maillard reaction products in healthy adult female cats.

During processing of foods, the Maillard reaction occurs, resulting in the formation of advanced Maillard reaction products (MRP). Varying amounts of MRP have been found in commercially processed pet foods. Dietary MRP can be absorbed and contribute to the endogenous pool of MRP and possibly the etiology of age-related diseases. The aim of the present study was to determine urinary excretion of dietary MRP in cats fed commercial moist and dry foods. A pilot study with 10 cats, conducted to determine the adaptation time required for stable urinary excretion of MRP when changing to a diet with contrasting MRP content, showed an adaptation time of 1 d for all components. In the main study, 6 commercially processed dry and 6 moist diets were fed to 12 adult female cats in 2 parallel randomized, 36-d Latin square designs. The 24-h urine was collected quantitatively using modified litter boxes, and fructoselysine (FL), carboxymethyllysine (CML), and lysinoalanine (LAL) were analyzed using ultra high performance liquid chromatography (UHPLC) - mass spectrometer. Daily urinary excretion of FL and CML showed a positive relationship with daily intake in the dry ( = 0.03 and < 0.01, respectively) and moist ( < 0.01) foods. For LAL, no significant relationship was observed. Urinary recovery (% ingested) showed a negative relationship with daily intake for FL, CML, and LAL in the dry foods ( < 0.01, < 0.01, and = 0.08, respectively) and for CML and LAL in the moist foods ( < 0.01). The observed increase in urinary excretion with increasing dietary intake indicates that dietary MRP were absorbed from the gastrointestinal tract of cats and excreted in the urine. The adaptation time with change in diet indicates a likely effective excretion of MRP. Minimum apparent absorption of FL, CML, and LAL was found to range between 8% and 23%, 25% and 73%, and 6% and 19%, respectively. The observed decrease in urinary recovery suggests a limiting factor in digestion, absorption, metabolism, or urinary excretion. This study shows that dietary MRP in commercial diets are absorbed and excreted via the kidneys in cats.

Effects of acid extrusion on the degradability of maize distillers dried grain with solubles in pigs.

Commonly used feed processing technologies are not sufficient to affect recalcitrant nonstarch polysaccharides (NSP) such as arabinoxylans present in maize distillers dried grain with solubles (DDGS). Instead, hydrothermal treatments combined with acid catalysts might be more effective to modify these NSP. The objective of this experiment was to investigate the effects of hydrothermal maleic acid treatment (acid extrusion) on the degradability of maize DDGS in growing pigs. It was hypothesized that acid extrusion modifies DDGS cell wall architecture and thereby increases fermentability of NSP. Two diets, containing either 40% (wt/wt) unprocessed or acid-extruded DDGS, were restrictedly fed to groups of gilts (n=11, with 4 pigs per group; initial mean BW: 20.8±0.2 kg) for 18 d and performance and digestibility were analyzed. Acid extrusion tended to decrease apparent ileal digestibility (AID) of CP (approximately 3 percentage units [% units]); P=0.063) and starch (approximately 1% unit; P=0.096). Apparent digestibility of CP and starch measured at the mid colon (2% units, P=0.030, for CP and 0.3% units, P<0.01, for starch) and apparent total tract digestibility (ATTD; 3% units, P<0.01, for CP and 0.2% units, P=0.024, for starch) were lower for the acid-extruded diet compared with the control diet. Hindgut disappearance was, however, not different between diets, indicating that reduced CP and starch digestibility were mainly due to decreased AID. Acid extrusion tended to increase AID of NSP (6% units; P=0.092) and increased digestibility of NSP measured at the mid colon (6% units; P<0.01), whereas hindgut disappearance and ATTD of NSP did not differ between diets. Greater NSP digestibility was mainly due to greater digestibility of arabinosyl, xylosyl, and glucosyl residues, indicating that both arabinoxylan and cellulose degradability were affected by acid extrusion. In conclusion, these results show that acid extrusion did not improve degradation of DDGS for growing pigs. Although acid extrusion seemed to facilitate more rapid degradation of NSP and shifted fermentation to more proximal gastrointestinal segments, total extent of NSP degradation was not affected. More than 35% of the NSP from DDGS remained undegraded, independent of technological processing. Enzyme technologies that specifically target ester-linked acetyl, feroloyl, or coumaroyl groups were identified to be of interest for future research.

Evaluation of the threshold value for the Early Warning Score on general wards.

INTRODUCTION: The Early Warning Score (EWS) is used for early detection of deteriorating vital parameters and has been correlated with adverse outcomes. Unfortunately, neither its value on general wards nor the optimal cut-off value have been investigated. We aimed to find the optimal cut-off value for EWS on general wards, and investigated the possibility to raise this value from EWS ≥ 3 without compromising sensitivity too much. METHODS: From May 2010 until May 2011, EWS was calculated from vital parameters in all patients in medical and surgical wards in the Medical Centre Alkmaar. Cut-off value was defined as EWS ≥ 3, unless otherwise specified. Six responses were defined and categorised as interventions (infusion prescription, medication changes, ICU consultation) and other actions (no action, change EWS cut-off value, oxygen supplementation), and it was registered whenever the threshold was exceeded. RESULTS: 71,911 EWS values were obtained, 31,728 (44%) on medical wards and 40,183 (56%) on surgical wards. On medical wards, the cut-off value was exceeded 3734 times, and response was registered in 29% of the cases with 141 (12%) interventions. On surgical wards, the cut-off value was exceeded 3279 times, and response was registered in 19% of the cases with 633 (36%) interventions. Sensitivity and specificity for EWS ≥ 3 could not be calculated. For a calculated cut-off at EWS ≥ 4, sensitivity decreased to 74%. CONCLUSION: Raising the EWS threshold to 4 on general wards in the hospital would lead to an unacceptable decrease in sensitivity. Therefore, we recommend that the pre-defined cut-off should remain 3, with the possibility to personalise the threshold.

Ain't No Sunshine When She's Gone: Pseudohypoparathyroidism Discovered in an Adult.

An 18-year-old negroid woman presented with progressive cramps in both hands. She was Jamaican and had moved to The Netherlands 8 months before. On physical examination Trousseau's sign was positive. Laboratory analysis showed severe hypocalcaemia (1.17 mmol/L) and hyperphosphatemia (2.0 mmol/L). Urinary excretion of both calcium (0.8 mmol/day) and phosphate (5 mmol/day) was low, as is seen in hypoparathyroidism. However, the PTH level was increased (22.1 pmol/L), whereas 25-(OH)-vitamin D was low (31 nmol/L). An Ellsworth-Howard test showed only a fivefold increase in urinary phosphate excretion after administration of synthetic PTH, supporting the diagnosis pseudohypoparathyroidism. Upon treatment with calcium supplementation and alfacalcidol, her symptoms disappeared. Pseudohypoparathyroidism (PHP) is a rare hereditary disorder resembling hypoparathyroidism, although plasma PTH levels are elevated. PHP is caused by alterations in the PTH receptor, inducing target tissue resistance to PTH. This results in hypocalcaemia and hyperphosphatemia, while PTH levels are elevated. The diagnosis is confirmed by the Ellsworth-Howard test, which will show a 100-fold increase in phosphate excretion if the PTH receptor functions properly. Treatment is lifelong supplementation of calcium and alfacalcidol. In our patient, symptoms were probably evoked by the lack of sunlight in Dutch winter, decreasing vitamin D levels and thereby aggravating hypocalcaemia.

Gamma-glutamyltransferase: evaluation of a new method.

The determination of gamma-glutamyltransferase using a new donor substrate, L-gamma-glutamyl-3,5-dibromo-4-hydroxyanilide, was evaluated in two laboratories. Between-run and within-run precision are excellent and comparable with those of other methods for the determination of gamma-glutamyltransferase. The activity concentrations of gamma-glutamyltransferase from human sera obtained with the new donor substrate were slightly higher than those obtained with L-gamma-glutamyl-4-nitroanilide. The reverse was found for sera enriched with gamma-glutamyltransferase of animal origin. Temperature conversion factors (activity 37 degrees C/activity 30 degrees C) are given. The advantages of this method are discussed. The new assay appears to provide a good alternative for the method with L-gamma-glutamyl-4-nitroanilide or one of its derivatives as substrate.