[Is alfalfa hay an alternative to meadow hay in equine nutrition?] / Luzerne in der Pferdefütterung, eine Alternative zu Wiesenheu?

INTRODUCTION: Roughage alternatives for equine nutrition must be found due to the increasing climatic challenges. The aim of this study was to examine the nutrient composition and feed hygiene of alfalfa hay in comparison to meadow hay and to investigate the acceptance, weight development and faecal quality of broodmares fed alfalfa hay. The feed used was examined for nutrient content and hygiene status according to the standards of the Verband Deutscher Landwirtschaftlicher Untersuchungs- und Forschungsanstalten (VDLUFA). Twenty adult pregnant warmblood mares were fed in two groups (n=10) with a defined amount of alfalfa hay or meadow hay in a controlled study with a wash-out phase and subsequent crossing of the groups. Alfalfa hay intake was observed daily, and bodyweight was recorded weekly. On day 0 (T0) and day 28 (T28) of each study period, fresh faecal samples were collected and analyzed for pH, dry matter (DM) and short-chain fatty acids (SCFA). The hygienic quality of the alfalfa and meadow hay was slightly reduced (quality level II) on average. The intake of the alfalfa hay was carried out in all mares without backweighing. The median crude protein content of the alfalfa hay was 134 g/kg DM, the median calcium content was 13,9 g/kg DM and the median magnesium content was 1,50 g/kg DM. Horses fed alfalfa showed a significantly greater median percent weight gain of 3,25 % compared to hay-fed horses (1,68 %) (p.

INTRODUCTION: En raison des défis climatiques croissants, des alternatives de fourrage grossier doivent être trouvées dans l'alimentation des chevaux. L'objectif de cette étude était de vérifier la composition nutritionnelle et l'hygiène alimentaire du foin de luzerne par rapport au foin de prairie, ainsi que d'étudier l'acceptance, l'évolution du poids et la qualité des fèces chez des juments d'élevage nourries au foin de luzerne. La teneur en nutriments et le statut hygiénique des aliments utilisés ont été analysés selon les méthodes de l'Association allemande des instituts de recherche et d'analyse agricoles (VDLUFA). Vingt juments adultes de sang en gestation ont été réparties en deux groupes (n=10) dans le cadre d'une étude contrôlée avec une phase de wash-out suivie d'un croisement des groupes avec une quantité définie de foin de luzerne ou de foin de prairie. L'acceptance concernant l'ingestion de foin de luzerne a été observée quotidiennement, le relevé de la masse corporelle a été effectué chaque semaine. Au jour 0 (J0) et au jour 28 (J28) de chaque période d'essai, des échantillons de fèces fraîchement émis ont été collectés et analysés pour en déterminer le pH, le taux de matière sèche (MS) et la teneur en acides gras à chaîne courte (AGCC). La qualité hygiénique du foin de luzerne et de prairie était en moyenne légèrement dégradée (niveau de qualité II). Le foin de luzerne a été ingéré par toutes les juments sans pesée de retour. La teneur médiane en protéines brutes du foin de luzerne était de 134 g/kg de MS, sa teneur médiane en calcium de 13,9 g/kg de MS et sa teneur médiane en magnésium de 1,5 g/kg de MS. Les chevaux nourris à la luzerne ont présenté un pourcentage de gain de poids médian significativement plus élevé (3,25 %) que ceux nourris au foin de prairie (1,68 %) (p.

Identification of new mutations in Israeli patients with X-linked adrenoleukodystrophy.

X-linked adrenoleukodystrophy (ALD) is a peroxisomal disorder characterized by impaired peroxisomal betaoxidation of very-long-chain fatty acids (VLCFAs). This is probably due to reduced activation of the VLCFAs and results in demyelination of the nervous system and adrenocortical insufficiency. The ALD gene is localized on Xq28, has 10 exons and encodes a protein of 745 amino acids with significant homology to the membrane peroxisomal protein PMP70. Characterizing the disease causing mutations is of importance in prenatal diagnosis because 12-20% of women who are obligatory carriers show false-negative results when tested for VLCFA in plasma. We have analyzed DNA from blood samples of 7 Jewish (5 Sephardi and 2 Ashkenazi) and 3 Arab Israeli families suffering from ALD. Five missense-type mutations were identified: R104H, Y174C, L229P, R401Q, and G512C. A single mutation, R464X, was nonsense, and two, Y171 frameshift and E471 frameshift, were frameshift. Interestingly, a single mutation was identified in three families of Moroccan Jewish descent, probably due to a founder effect.

Falls among older people: relationship to medication use and orthostatic hypotension.

OBJECTIVE: To assess the risk of falls attributable to medication use and orthostatic hypotension. DESIGN: Prospective cohort study. SETTING: Two self-care, apartment-style residential facilities in the Toronto area. PARTICIPANTS: A total of 100 consecutive older volunteers (mean age = 83, range 62-96) who were independent in activities of daily living and able to stand unaided. MEASUREMENTS: Prescription medications used by each subject were documented at baseline. Blood pressure measurements were performed supine, immediately after standing, and after 5 minutes. Subjects reported falls weekly, by postcard, for a period of 1 year; nonreporters were contacted by telephone. RESULTS: Fifty-nine percent of subjects fell at least once during the 1-year follow-up. Antidepressant use was associated with an increase in the risk of experiencing one or more falls (RR = 1.6, P = .02). The use of other drug classes examined, including diuretics and sedative-hypnotics, was not associated with an increased risk of falling. Orthostatic hypotension was not predictive of falls. Surprisingly, there was an increase in the diastolic blood pressure of fallers, after 5 minutes, that was not seen in the nonfallers (3.3 vs -0.2 mm Hg, P = .05). Possible explanations for this previously unreported observation are explored. CONCLUSION: Patients using antidepressants should be followed closely because the risk of falls is increased. Previously reported relationships between benzodiazepines and diuretics and falls are not supported by the present findings. Clinical detection of orthostatic hypotension is unlikely to be useful in predicting future risk of falling.

A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population.

BACKGROUND: An ability to predict risk of future falling is needed in order to target high-risk individuals for preventive intervention. The purpose of this study was to compare the ability of different measures of postural balance to predict risk of falling prospectively in an ambulatory and independent elderly population. METHODS: Balance tests were performed on 100 volunteers (aged 62-96), and falling was then monitored prospectively over a one-year period. The balance testing comprised measurements of: (a) spontaneous postural sway, (b) induced anterior-posterior sway, (c) induced medial-lateral sway, (d) anticipatory adjustments preceding volitional arm movements, (e) timed one-leg stance, and (f) performance on a clinical balance assessment scale. Small pseudorandom platform motions were used to perturb balance in the induced-sway tests. Using force plates, the spontaneous- and induced-sway responses were quantified in terms of the amplitude, speed, and mean frequency of the center-of-pressure displacement; input-output models were also used to parameterize the induced-sway performance. RESULTS: Although a number of measures showed evidence of significant differences between fallers and nonfallers, the differences were most pronounced for measures related to the control of lateral stability. Lateral spontaneous-sway amplitude (blindfolded conditions) was found to be the single best predictor of future falling risk, particularly for the large group of falls that were precipitated by a biomechanical perturbation. This measure was able to predict future falling risk with moderate accuracy, even in those individuals with no recent history of falling. CONCLUSIONS: The results suggest that control of lateral stability may be an important area for fall-preventative intervention. The ability of a simple and safe force-plate measure of spontaneous postural sway to predict future falling risk suggests a possible clinical application as a preliminary screening tool for risk of falling.

Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall?

OBJECTIVE: To determine whether an activity-based test of balance and gait is predictive of the risk of: (1) falling in situations that are related to specific tasks evaluated as part of the test, (2) experiencing falls precipitated by different classes of biomechanical events, or (3) falling in general; and to compare the predictive ability of the activity-based test for the falls described in (2) and (3) to that of a posturography test that has been found previously to be predictive of falling risk. DESIGN: Cohort study. SETTING: Baseline tests performed in balance laboratory; subsequent history of falling monitored prospectively for 1 year in two residential-care facilities. PARTICIPANTS: Seventeen male and 83 female consecutive volunteers (mean age = 83, SD = 6) who were independent in activities of daily living and able to stand unaided. MEASUREMENTS: Independent variables were derived from an activity-based balance-and-gait test and a posturography test. Dependent variables were the numbers of subjects with one or more: (1) falls in specific situations related to activity-based test items, (2) falls related to general classes of biomechanical precipitant, and (3) falls in general. MAIN RESULTS: Subjects who were rated as "abnormal" in activity-based test items related to transfers, turning or reaching were more likely to experience one or more falls in related situations in everyday life. Activity-based scores were predictive of risk of experiencing falls with no obvious biomechanical precipitant and falls precipitated by center-of-mass perturbation, but not falls precipitated by base-of-support perturbation. In comparison, a posturographic measure of spontaneous medial-lateral postural sway (blindfolded conditions) failed to predict falls having no biomechanical precipitant, but provided the best predictions of both center-of-mass and base-of-support falls, as well as risk of falling in general. CONCLUSIONS: Activity-based testing of certain tasks (transfer, turning, reaching) may be useful in indicating a specific need for intervention to reduce the risk of falling during related everyday activities. In terms of predicting falling risk, a static posturography test may provide better prediction overall of the different classes of falls and may be useful as a quick and simple screening tool to help identify high-risk individuals.

Bladder volume estimation in the elderly using a portable ultrasound-based measurement device.

We assessed the accuracy and ease of use of the BladderScan (BVI 2000) portable ultrasound-based bladder volume measurement device in a geriatric outpatient population. The Geriatric Continence Clinic nurse and physician each made 73 measurements on 36 subjects. Although the correlation coefficients between the true and ultrasound measurements were highly significant the mean differences were significantly different from zero. We suggest that, rather than considering the correlation coefficient, the accuracy required of the device should be described by a function of estimated versus true bladder volume. This function should vary depending on each particular decision-making process in which the estimate of volume is to be used. This instrument automatically estimates bladder volume once the user has completed the image creation and selection part of the process. The users in this study had difficulties with this imaging process. Possible ways in which the device's automated signal processing and volume calculation algorithms could be improved became evident during this study and are discussed.

Fear of falling and postural performance in the elderly.

A cross-sectional study was performed to investigate the association between fear of falling and postural performance in the elderly. One hundred ambulatory and independent volunteers (aged 62-96) were subjected to five types of balance tests: (a) spontaneous postural sway, (b) induced anterior-posterior sway, (c) induced medial-lateral sway, (d) one-leg stance, and (e) a clinical balance assessment scale. Pseudorandom platform motions were used in the induced-sway tests. The subjects were classified into both "faller"/"nonfaller" and "fear"/"no-fear" categories, to allow the influence of fear of falling and falling history to be separated in the analyses. Subjects who expressed a fear of falling were found to exhibit significantly poorer performance in blindfolded spontaneous-sway tests and in eyes-open, one-leg stance tests. The clinical scale was the only balance measure that showed a significant association with retrospective, self-reported falling history. We could not ascertain whether the fear of falling affected balance-test performance in an artifactual manner, or whether the fear and poorer performance were related to a true deterioration in postural control. Until this issue can be resolved, balance-test performance should be interpreted with caution when testing apprehensive individuals. Furthermore, studies of postural control and falling should allow for the potentially confounding influence of fear of falling.

Estimation of bladder wall location in ultrasound images.

A method of automatically estimating the location of the bladder wall in ultrasound images is proposed. Obtaining this estimate is intended to be the first stage in the development of an automatic bladder volume calculation system. The first step in the bladder wall estimation scheme involves globally processing the images using standard image processing techniques to highlight the bladder wall. Separate processing sequences are required to highlight the anterior bladder wall and the posterior bladder wall. The sequence to highlight the anterior bladder wall involves Gaussian smoothing and second differencing followed by zero-crossing detection. Median filtering followed by thresholding and gradient detection is used to highlight as much of the rest of the bladder wall as was visible in the original images. Then a 'bladder wall follower'--a line follower with rules based on the characteristics of ultrasound imaging and the anatomy involved--is applied to the processed images to estimate the bladder wall location by following the portions of the bladder wall which are highlighted and filling in the missing segments. The results achieved using this scheme are presented.

An evaluation of computer aided design of below-knee prosthetic sockets.

Forty-eight below-knee amputees compared sockets designed using CANFIT computer aided design (CAD) software with sockets designed using conventional methods. Each subject was fitted by one prosthetist who used conventional techniques and one who used the CANFIT system to design the socket. Prosthetists alternated design methods for each new subject. The prosthetist using the conventional techniques was allowed up to 2 design attempts and the prosthetist using the CANFIT system was allowed up to 5 design attempts. After 2 design attempts with each method 21% of the subjects preferred the CANFIT design socket. Following up to 5 attempts 54% preferred the CANFIT designed socket. A jury of experts made an assessment of the CANFIT system and of CAD in prosthetics. The jury did not think that the version of the system tested was cost effective but that at the rate that it was improving it would become such within 3 to 5 years. The jury noted that, as well as monetary benefits, CAD presents the possibility of benefits in other areas such as research and teaching. A number of specific suggestions regarding the use and development of CAD in prosthetics were also made.

Computer-aided design and computer-aided manufacturing (CAD/CAM) in prosthetics.

Computer-aided design and computer-aided manufacturing (CAD/CAM) systems for the design and manufacture of limb prostheses have recently become commercially available. However, rigorous evaluations of these systems have not been performed to determine whether they produce sockets that fit as well as or better than sockets made using conventional design methods. A controlled evaluation protocol, in which computer-designed sockets are compared with conventionally designed sockets, has been developed and pilot tested at the authors' facility. A full trial of one of the commercially available systems for transtibial sockets is currently in progress. In preliminary findings, the CAD/CAM socket was preferred by one-half of the first 20 subjects. During the course of this trial, it was noted that the CAD/CAM technique seems to be better suited to some prosthetists than others.