Educational inequalities in cervical cancer screening participation in 24 European countries.

OBJECTIVES: Cervical cancer screening (CCS) is an important public health measure for early detection of cervical cancer and prevents a large proportion of cervical cancer deaths. However, participation in CCS is relatively low and varies substantially by country and socio-economic position. This study aimed to provide up-to-date participation rates and estimates on educational inequalities in CCS participation in 24 European countries with population-based CCS programmes. STUDY DESIGN: This was a cross-sectional study. METHODS: Using data from the European Health Interview Survey (EHIS) conducted in 2019, 80,479 women aged 25-64 years were included in the analyses. First, standardized participation rates and standardized participation rates by educational attainment were calculated for all 24 countries based on each country-specific screening programme organization. Second, a series of generalized logistic models was applied to assess the effect of education on CCS participation. RESULTS: Screening participation rates ranged from 34.1% among low-educated women in Romania to 97.1% among high-educated women in Finland. We observed that lower-educated women were less likely to attend CCS than their higher-educated counterparts. Largest educational gaps were found in Sweden (odds ratio [OR] = 6.36, 95% confidence interval [CI] = 3.89-10.35) and Poland (odds ratio = 5.80, 95% CI = 4.34-7.75). CONCLUSION: Population-based screening initiatives have successfully reduced participation differences between women with medium and high educational attainment in some countries; however, persistent disparities still exist between women with low and high levels of education. There is an urgent need to increase participation rates of CCS, especially among lower-educated women.

Prevalence and management of arterial hypertension in the population aged 25-64 in the Czech Republic with a focus on diabetic patients.

OBJECTIVE: The aim of the study was to determine the prevalence of arterial hypertension and its awareness rate and control rate among diabetes mellitus (DM) patients in the Czech Republic between 25-64 years of age and to compare the results with those in age-matched non-diabetic patients. MATERIALS AND METHODS: Blood pressure measurement data of 1 170 respondents (467 men and 703 women) obtained during the EHES study in 2014 were analysed. DM was diagnosed in 95 (8.2%) respondents (44 men and 51 women). RESULTS: Mean systolic blood pressure in DM patients was 130.7 ± 18.3 vs. 123.2 ± 16.8 mmHg in non-DM subjects (p < 0.001). The difference in diastolic blood pressure was on the borderline of statistical significance (82.2 ± 9.4 mmHg in DM vs. 80.0 ± 10.6 mmHg in non-DM subjects, p = 0.051). Among the study population, 69.5% of DM and 34.2% of non-DM subjects suffered from arterial hypertension (p < 0.001). The hypertension awareness rates were 87.9% in the DM group and 66.8 % in the non-DM group. (p = 0.001). The percentage of treated arterial hypertension was 94.8% in DM patients vs. 80.5% in the non-DM group (p = 0.010). The blood pressure target of < 140/90 mmHg was achieved in 47.3% of DM patients vs. 60.6% in non-DM subjects (p = 0.077). Using a blood pressure target of < 130/80 mmHg, adequate arterial hypertension control was achieved in only 29.1% of DM patients. When comparing the achievement of the blood pressure targets recommended for diabetic patients (< 130/80 mmHg) and non-DM patients (< 140/90 mmHg), the difference between these groups was statistically significant (p < 0.001) in favour of the non-diabetic group. CONCLUSION: The study has shown the prevalence of arterial hypertension to be twice as high in DM patients aged 25-64 compared to the age-matched non-DM subjects in the Czech Republic. The adequate blood pressure control rate is significantly lower in DM patients than in the non-diabetic population. The study results indicate that the blood pressure targets recommended for diabetic patients (< 130/80 mmHg) are not always reached in clinical practice.

MODY diabetes and screening of gestational diabetes.

OBJECTIVE: The aim of this article is to present a summary of the actual diagnostic possibilities and differentiation of MODY (Maturity-Onset Diabetes of the Young) from gestational diabetes (GDM) found during routine screening, and specific aspects of care and treatment of MODY during pregnancy and early postpartum period. DESIGN: Rewiev. SETTINGS: Centre for Research of Diabetes, Metabolism and Nutrition; Second Department of Internal Medicine University Hospital Královské Vinohrady and Third Faculty of Medicine, Prague. Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague. METHODS: Recent publications selected in PubMed with the key words MODY, gestational diabetes. RESULTS: Many patients with MODY, especially the glucokinase MODY, can be first diagnosed during pregnancy. It is estimated that MODY patients account for up to 5% of GDM cases found in routine screening of GDM. MODY should be considered in lean women around 25 years of age, with a positive family history of diabetes in one of the parents. The differentiation of MODY from GDM is of particular importance not only for the different management and goals of antidiabetic therapy and planning ultrasound controls of fetal growth during pregnancy, but also because of the risk of hyperinsulinemic hypoglycemia in newborns. CONCLUSION: Recognition of MODY during pregnancy and adherence to existing recommendations concerning specific care of these patients is essential for the optimal course of their pregnancy and proper care of the newborn in the early postpartum period.

[Changes in weight and diabetes compensation (HbA1c) in patients with diabetes mellitus type 2 after adding exenatide (Byetta) to the current treatment in 28 diabetology departments in the Czech Republic -  BIBYII study (observations lasting 24 months)]. / Zmeny hmotnosti a kompenzace diabetu (HbA1c) u nemocných s diabetes mellitus 2. typu po pridání exenatidu (Byetta) ke stávající lécbe ve 28 diabetologických ambulancích v CR -  studie BIBYII (sledování 24 mesícu).

UNLABELLED: BIBYII STUDY OBJECTIVE: To obtain experience with longterm (24 months) exenatide treatment (Byetta) in patients with diabetes mellitus type 2 from a common clinical practice of diabetology departments in the Czech Republic. TYPE OF OBSERVATION: Observational study conducted by a randomly selected group of outpatient medical practitioners from 28 diabetology departments in the Czech Republic. OBSERVED AND ASSESSED POPULATION: From the original population of 465 patients, who underwent a minimum of three months Byetta treatment, 169 patients (36.6%) remained during the second prolonged observation after 18 months, and 76 patients completed 24 months of uninterrupted Byetta treatment. The following basic information about the patients was collected: year of birth, sex, age when diabetes mellitus (DM) manifested, height, maximum weight before diabetes and when DM manifested. The study recorded the following values in three- month intervals: weight, waistline, glycated haemoglobin (HbA1c), and DM treatment. The population of the prolonged observation comprised 50.3% women and 49.7 % men, and the average age at the time of DM2 manifestation was 48.0 (20- 73 years). RESULTS: At the beginning of Byetta treatment, the average maximum BMI in the subpopulation observed for 24 months was 38.44; after 3, 6, 9, 12 and 24 months the following levels were measured, respectively: 36.79, 36.22, 35.91, 35.57 and 35.58. The original HbA1c level of 7.44% at the beginning of Byetta treatment decreased after 3, 6, 9, 12 and 24 months to 6.33, 5.98, 5.83, 5.86 and 5.93%. CONCLUSION: Adding Byetta to the currently applied treatment of obese patients with diabetes mellitus type 2 over a period of 24 months has led to an improvement in HbA1c level by 1.51%, and BMI level was reduced by 2.37 after two years of Byetta treatment.

[Changes in weight and diabetes compensation (HbA(1c)) in patients with diabetes mellitus type 2 after adding exenatide (Byetta) to the current treatment in 28 diabetology departments in the Czech Republic - BIBY-I study (observations lasting 3 to 12 months)]. / Zmeny hmotnosti a kompenzace diabetu (HbA(1c)) u nemocných s diabetes mellitus 2. tpu po pridání exenatidu (Byetta) ke stávající lécbe ve 28 diabetologických ambulancích v CR--studie BIBY-I (sledováni 3-12 mesícu).

UNLABELLED: BIBY STUDY OBJECTIVE: To obtain experience with exenatide treatment (Byetta) in patients with diabetes mellitus type 2 in a common clinical practice ofdiabetology departments. TYPE OF OBSERVATION: Observational study conducted by a randomly selected group of outpatient medical practitioners from 28 diabetology departments in the Czech Republic. OBSERVED AND ASSESSED POPULATION: 465 patients underwent at least three months of Byetta treatment; 347 persons (74.6% ofthe research population) stayed forthe extended observation of 6-12 months. Apart from the basic identification data (year of birth, sex, age when diabetes mellitus manifested, height, maximum patient weight before diabetes and when diabetes mellitus manifested), the following information was recorded in three-month intervals: weight, waistline, glycated haemoglobin (HbA(1c)), and diabetes mellitus treatment The population included 50.3% women and 49.7% men, and the average age at the time of diabetes manifestation was 48 (20-73 years). The period between the diabetes manifestation and the start of exenatide treatment was 8.3 years on average. RESULTS: The average maximum BMI value before the detection of diabetes was 39.05 (+/- 6.73); at the time of the diabetes manifestation 37.88 (+/- 6.40); and at the start of Byetta treatment 39.01 (+/- 6.22). The BMI after three, six, and 12 months of treatment was as follows: 37.86 (+/- 6.12), 37.18 (+/- 6.0), and 36.60 (+/- 6.21); it decreased by > or = 0.5 in 83.3% patients who were under observation for 12 months. HbA(1c) value decreased in the first three months from 7.39% (+/- 1.57) to 6.41% (+/- 1.34), p < 0.0001. In the period of three-six months, the value decreased to 6.22% (+/- 1.34), and after 12 months, HbA(1c) was at 6.04 (+/- 1.20). An improvement in HbA(1c) value of 0.5-2.0% occurred after the first year in 49% of our research population. The waistline was measured on a regular basis in only 267 patients (58.9%). The average initial value of 120.7 cm was reduced within three months of the treatment to 118.3 cm, and within six and 12 months to 117.3 and 112.6 cm respectively. CONCLUSION: Adding Byetta to the currently applied treatment of obese patients with diabetes mellitus type 2 led, in 66.8% of the population, to a statistically significant reduction in HbA(1c) levels in the first three-six months of the treatment; after 12 months of treatment, 25% of the population was still showing an improvement in HbA(1c) of > 2.0%. Of observed patients, 74.4% significantly reduced their BMI (by > 0.5) during the first three months; 39.6% of patients reduced their BMI in the period of three-six months.

The supplementation of low-P diets with microbial 6-phytase expressed in Aspergillus oryzae increases P and Ca digestibility in growing pigs.

A trial was conducted to evaluate the dose response of a novel microbial 6-phytase expressed in Aspergillus oryzae (Ronozyme HiPhos; DSM Nutritional Products, Basel, Switzerland) in pigs. Forty-eight individually housed pigs (Landrace × Pietrain; 52 kg BW; 24 males and 24 females) were distributed among 6 experimental treatments consisting of a low-P diet (3.5 g P/kg; 1.1 g digestible P/kg), which was supplemented with 500, 1000, 2000, or 4000 units of phytase activity/kg, and a standard-P diet (4.5 g P/kg; 1.8 g digestible P/kg) that was supplemented with CaHPO(4). After 17 d, fresh feces were sampled from all pigs and the apparent total tract digestibility of DM, OM, ash, P, and Ca was measured using TiO(2) as indigestible marker. Blood samples were also obtained from each pig and serum was analyzed for P and Ca concentrations. The nonsupplemented low-P diet increased Ca and reduced P blood serum concentrations (P < 0.05) relative to the standard-P diet (10.8 vs. 10.2 and 6.7 vs. 7.7 mg/dL, respectively). Phytase supplementation of the low-P diet reduced Ca (from 10.8 to 9.9 mg/dL; linear, P < 0.001) and increased P concentrations (from 6.7 to 8.0 mg/dL; linear and quadratic, P < 0.001) in serum and reduced P concentration in feces (from 13.7 to 7.6 g/kg DM; linear and quadratic, P < 0.001). Phytase improved the total tract digestibility of P (from 29.0 to 62.3%; linear and quadratic, P < 0.001 and P < 0.05), Ca (from 54.0 to 75.7%; quadratic, P < 0.01), and ash (from 46.2 to 57.7%; quadratic, P < 0.01). In conclusion, the microbial 6-phytase tested improves the apparent total tract digestibility of P in growing pigs and reduces P excretion in feces in a dose-dependent manner.

The supplementation of low-P diets with microbial 6-phytase expressed in Aspergillus oryzae improves P digestibility in sows.

Two trials were conducted to evaluate a novel microbial 6-phytase expressed in Aspergillus oryzae (Ronozyme HiPhos; DSM Nutritional Products, Basel, Switzerland) in gestating and lactating sows. In the first trial, 24 sows (Duroc × Landrace; 223 kg BW) were offered, at 16 d of gestation, a low-P control diet (formulated to provide 4.0 g total P/kg; 1.5 g digestible P/kg) supplemented with 0, 500, or 1000 phytase activity (FYT)/kg of phytase. Two weeks later, fresh feces were sampled from all sows and the apparent total tract digestibility of P was measured using TiO(2) as indigestible marker. Phytase supplementation did not (P > 0.10) affect the total tract digestibility of P but reduced (P < 0.05) P concentration in feces (from 14.5 to 12.0 and 12.0 g/kg DM). In the second trial, 32 lactating sows (Duroc × Landrace; 282 kg BW) were used. They were offered, at 7 d of lactation, a low-P control diet (formulated to provide 6.1 g total P/kg; 3 g digestible P/kg) or the same diet supplemented with 500 FYT/kg of phytase. After 2 wk, fresh feces were sampled from all sows and the apparent total tract digestibility of P was measured using TiO(2) as indigestible marker. Phytase supplementation improved (P < 0.001) the apparent total tract digestibility of P from 27.5 to 38.7% and reduced (P < 0.001) P concentration in feces (from 27.5 to 21.4 g/kg DM). In conclusion, the microbial 6-phytase tested increased the apparent total tract digestibility of P in sows and reduced P excretion in feces.

The effects of supplementation of a novel bacterial 6-phytase on mineral digestibility and plasma minerals in lactating sows.

Pigs digest P in plant feedstuffs poorly because pigs do not produce sufficient endogenous phytase to hydrolyze P from phytate (inositol hexaphosphate). Supplementation of phytase to diets of piglets and grower-finisher pigs increased digestibility of minerals including P and Ca; however, data on phytase efficacy in lactating sows are scarce. Therefore, effects of adding a bacterial 6-phytase expressed in a strain of Aspergillus oryzae (Ronozyme HiPhos; DSM Nutritional Products, Basel, Switzerland) on apparent total tract digestibility (ATTD) of P and Ca was assessed in 45 lactating sows. Three diets were prepared: (i) positive control (PC; 0.52% available P), a regular sow diet containing inorganic P, (ii) negative control (NC; 0.20% available P) without inorganic P, and (iii) NC + 500 units of phytase/kg diet. Each diet was fed randomly to 15 sows for 21 d (from 5 d prior to farrowing to 15 d after farrowing). At day 15 after farrowing, ATTD of P did not differ between PC and NC. Phytase supplementation to NC increased (P < 0.05) ATTD of P from 34 to 46% compared to NC but did not affect (P > 0.05) ATTD of CP and Ca. On day 1 after farrowing, plasma P was 0.66 mmol/L lower (P < 0.05) in sows fed NC than PC. Phytase supplementation to NC increased (P < 0.05) plasma P by 0.40 mmol/L on day 1 but not on day 15 after farrowing. In conclusion, phytase supplementation increased P bioavailability in lactating sows.

The degradation of arabinoxylan-rich cell walls in digesta obtained from piglets fed wheat-based diets varies depending on digesta collection site, type of cereal, and source of exogenous xylanase.

The objective of the present study was to compare the ability of experimental and commercial xylanases to degrade, in vitro, the arabinoxylan (AX) fraction in digesta from 28-d-old piglets fed a wheat (Triticum aestivum)-based diet (49% wheat). Pigs were euthanized at 1, 2, 3, or 4 h after feeding; stomach and ileum contents were isolated and frozen and later used for the in vitro studies. Xylan solubilization provided information regarding the ability of the enzymes to degrade AX during the harsh in vivo conditions prevailing in the gastrointestinal tract. The hydrolytic capacity of a commercial xylanase was compared with that of an experimental xylanase using stomach digesta (pH 1.8) obtained at 4 h after feeding. Relative to the control, both enzymes increased (P < 0.001) xylan solubilization 3-fold. In the ileal digesta (1 h), xylan solubilization was increased by 36% (P < 0.001). Inclusion of arabinofuranosidases (Ara f) with xylanases increased xylan solubilization in stomach samples (P = 0. 007 and P = 0. 030) but not in ileal samples (P = 0.873 and P = 0.997). Our results illustrate clearly the importance of using different conditions and substrates when enzyme performance is studied in vitro as a prescreening tool for setting up in vivo trials.

Effects of a mono-component endo-xylanase supplementation on the nutritive value of wheat-based broiler diets.

1. Two trials were conducted to evaluate the effects of a mono-component thermostable endo-1,4-ß-xylanase derived from Thermomyces lanuginosus on the nutritive value of wheat-based broiler diets. In a 5-week growth trial, the efficacy of xylanase supplementation at 0, 100, 150, 200, 400 and 4000 FXU/kg diet was evaluated. A short-term balance trial was carried out according to a 4 × 2 factorial arrangement of treatments, involving 4 wheat cultivars and endo-xylanase at 0 or 200 FXU/kg. 2. In the growth trial, enzyme supplementation from 0 to 400 FXU/kg reduced feed intake and improved feed conversion linearly. Digesta viscosity was significantly reduced by all enzyme inclusion levels by 49·6-56·9%, in a quadratic manner. 3. In the balance trial, xylanase supplementation resulted in a significant improvement of protein, lipid and dry matter apparent digestibility coefficients of diets, accompanied by improved dietary AME(N) values. There was a significant wheat × enzyme interaction on AME(N) and lipid digestibility. There was a significant effect of wheat cultivar on dry matter digestibility.

Adiponectin inhibits spontaneous and catecholamine-induced lipolysis in human adipocytes of non-obese subjects through AMPK-dependent mechanisms.

Adiponectin is an adipokine increasing glucose and fatty acid metabolism and improving insulin sensitivity. The aim of this study was to investigate the role of adiponectin in the regulation of adipocyte lipolysis. Human adipocytes isolated from biopsies obtained during surgical operations from 16 non-obese and 17 obese subjects were incubated with 1) human adiponectin (20 microg/ml) or 2) 0.5 mM AICAR - activator of AMPK (adenosine monophosphate activated protein kinase). Following these incubations, isoprenaline was added (10(-6) M) to investigate the influence of adiponectin and AICAR on catecholamine-induced lipolysis. Glycerol concentration was measured as lipolysis marker. We observed that adiponectin suppressed spontaneous lipolysis by 21 % and isoprenaline-induced lipolysis by 14 % in non-obese subjects. These effects were not detectable in obese individuals, but statistically significant differences in the effect of adiponectin between obese and non-obese were not revealed by two way ANOVA test. The inhibitory effect of AICAR and adiponectin on lipolysis was reversed by Compound C. Our results suggest, that adiponectin in physiological concentrations inhibits spontaneous as well as catecholamine-induced lipolysis. This effect might be lower in obese individuals and this regulation seems to involve AMPK.

Influence of benzoic acid and phytase in low-phosphorus diets on bone characteristics in growing-finishing pigs.

In 2 simultaneous experiments (Exp. 1 and Exp. 2), the effects of benzoic acid (BA) and phytase (Phy) in low-P diets on bone metabolism, bone composition, and bone stability in growing and growing-finishing pigs were examined. Experiment 1 was conducted with 16 crossbred gilts in the BW range of 25 to 66 kg of BW, whereas in Exp. 2, 32 crossbred gilts (25 to 108 kg of BW) were used. All pigs were individually housed in pens and restrictively fed 1 of 4 diets throughout the experiment. Total P content of the wheat-soybean diets was 4 g/kg (all values on an as-fed basis). The experimental diets were 1) unsupplemented control diet; 2) control diet with 0.5% BA; 3) Phy diet with 750 Phy units (FTU) of Phy/kg and no BA; and 4) PhyBA, control diet with 750 FTU of Phy/kg and 0.5% BA. Blood samples were taken at the beginning of the experiment, wk 3 (only for pigs in Exp. 1), wk 6, and before slaughter to determine P and Ca in serum and concentrations of total alkaline phosphatase, serum crosslaps (marker for bone resorption), and osteocalcin (marker for bone formation). Ash, P, and Ca contents of bones and bone stability were examined using the left metatarsal bones and tibia of the pigs after slaughter. Benzoic acid did not influence any of the blood variables (P > 0.09). The addition of Phy increased (P < or =0.03) P concentration in serum from 2.71 +/- 0.08 to 3.03 +/- 0.07 mmol/L at wk 3 and content of serum crosslaps from 0.39 +/- 0.02 to 0.45 +/- 0.02 ng/mL at wk 6 and decreased (P < 0.05) osteocalcin at wk 6 by 160 ng/mL. No long-term effect of diets on serum mineral concentrations, alkaline phosphatase, and bone markers in serum could be detected. Benzoic acid negatively affected (P < or = 0.03) Ca content in bones and distal bone mineral density, especially in the younger pigs. In the control diet with 0.5% BA and the control diet with 750 FTU of Phy/kg and 0.5% BA, the CA content in bones and distal bone mineral density were reduced by 6 and 11%, respectively. Throughout the whole growing and finishing period, Phy increased (P < or =0.02) ash, P, and Ca contents in bones by 29.4, 4.8, and 11.6 g/kg of DM, respectively. Bone mineral density and bone mineral content were greater in diets with Phy (P < or = 0.03), as well as breaking strength of tibia (+22%) and metatarsal bones (+27%; P < 0.01). The results of this study indicate that for a healthy skeleton, BA should not be used in low-P diets without the addition of Phy.

Three novel mutations in MODY and its phenotype in three different Czech families.

AIMS/HYPOTHESIS: MODY (Maturity Onset Diabetes of the Young) is an autosomal dominant inherited type of diabetes with significant genetic heterogeneity. New mutations causing MODY are still being found. A genetically confirmed diagnosis of MODY allows application of individualized treatment based on the underlying concrete genetic dysfunction. Detection of novel MODY mutations helps provide a more complete picture of the possible MODY genotypes. MATERIALS AND METHODS: We tested 43 adult Czech patients with clinical characteristics of MODY, using direct sequencing of HNF1A (hepatocyte nuclear factor 1-alpha), HNF4A (hepatocyte nuclear factor 4-alpha) and GCK (glucokinase) genes. RESULTS: In three Czech families we identified three novel mutations we believe causing MODY-two missense mutations in HNF1A [F268L (c.802T>C) and P291S (c.871C>T)] and one frame shift mutation in GCK V244fsdelG (c.729delG). Some of the novel HNF1A mutation carriers were successfully transferred from insulin to gliclazide, while some of the novel GCK mutation carriers had a good clinical response when switched from insulin or oral antidiabetic drugs to diet. CONCLUSION: We describe three novel MODY mutations in three Czech families. The identification of MODY mutations had a meaningful impact on therapy on the mutation carriers.

Prevalence of active infection with Chlamydia pneumoniae and human cytomegalovirus in patients with type II diabetes mellitus.

By promoting the inflammatory process in the arterial wall, Chlamydia pneumoniae (CPN) and human cytomegalovirus (CMV) participate in the pathogenesis of cardiovascular disease (CVD). Since patients with diabetes mellitus (DM) are at high risk of CVD, we studied markers of CMV and CPN infection in DM patients as possible predictors of cardiovascular complications. The seroprevalence rates of CMV in 44 DM patients and matched controls were 74 and 88%, respectively. Compared with controls, patients showed lower titers of IgG against CMV (p < 0.001) and higher titers of genus-specific IgA against CPN (p = 0.006). The titers of genus-specific IgG and prevalence rates of type-specific anti-CPN IgA, IgG or IgM were similar in both DM patients and controls. Serological markers of either active or recent CPN infection were detected in 54% of patients and 59% of controls. However, CPN DNA was not detected in the blood of any DM patient. CMV DNA was found in the blood of 1 (2.3%) patient. The results do not indicate an increased rate of CMV or CPN infection in patients with type II DM.

Effect of benzoic acid on growth performance, nutrient digestibility, nitrogen balance, gastrointestinal microflora and parameters of microbial metabolism in piglets.

In order to investigate the effects of benzoic acid on growth performance, nutrient digestibility, nitrogen balance and gastrointestinal microflora of piglets, we conducted a performance experiment and a separate balance study. The performance experiment involved four different dietary treatments: (1) basal diet (negative control); (2) basal diet supplemented with benzoic acid at 5 g/kg; (3) basal diet supplemented with benzoic acid at 10 g/kg; (4) basal diet supplemented with potassium diformate at 12 g/kg. Each dietary treatment was assigned to nine replicate groups, each consisting of two piglets. Live weight, daily weight gain, feed intake and feed conversion ratio were monitored as performance parameters over a 35-day period. Supplementation of the diet with benzoic acid resulted in a dose-dependent increase in feed intake and body weight gain and an improved feed conversion ratio. Piglets fed the diet supplemented with benzoic acid at 10 g/kg outperformed the control piglets in mean feed intake, body weight gain and feed conversion ratio by 9%, 15% and 6% respectively. Growth performance of the piglets fed the diet with benzoic acid at 10 g/kg was similar to that of piglets fed the diet supplemented with potassium diformate. In the balance experiment three groups of six piglets each were fed either a control diet or diets supplemented with benzoic acid at 5 or 10 g/kg respectively. Benzoic acid did not significantly affect nutrient digestibility but increased nitrogen retention. Piglets fed the diets supplemented with benzoic acid at 5 or 10 g/kg retained 5% and 6% more nitrogen, respectively, than control piglets. Supplementation of benzoic acid did not influence the pH value or the concentration of ammonia in the gastrointestinal tract but reduced the number of bacteria in the digesta. In the stomach the number of total aerobic, total anaerobic, lactic acid forming and gram-negative bacteria was reduced; in the duodenum the presence of benzoic acid reduced the number of gram-negative bacteria and in the ileum the number of total aerobic bacteria in a dose-dependent manner. Benzoic acid also considerably reduced the concentration of acetic acid in the duodenum. In conclusion, the data of this study suggest that benzoic acid exerts strong antimicrobial effects in the gastrointestinal tract of piglets and therefore enhances growth performance and nitrogen retention.

[Glibenclamide instead of insulin: a new chance for MODY 3 type diabetes patients: case report]. / Glibenklamid místo inzulinu: nová sance pro pacienty s diabetem MODY 3: kazuistika.

MODY 3 belongs to monogenic forms of diabetes mellitus and is caused by monoallelic mutation in gene for transcription factor HNF-1alpha, essential for regulation of beta-cell function. Clinical presentation of MODY 3 is similar to that of type 1 diabetes. Although MODY 3 patients are not threatened by ketoacidosis, tight metabolic control is important for prevention of chronic diabetic complications. In the sibbling pair diabetes was manifested by osmotic symptoms resulting from hyperglycaemia at the age of 18 years (brother) resp. 15 years (sister) and both of them started being treated with intensified insulin treatment. Metabolic control of the brother was very tight with HbA1c 3.3 % but frequent hypoglycaemias occured. On the contrary metabolic control of the sister was very poor due to her non-compliance (HbA1c 10.9 %, IFCC). Molecular-genetic testing proved HNF-1alpha gene mutation (Arg200Gly). In accordance with the references treatment with sulphonylurea derivate glibenclamide was initiated [at the doses 1.25 (brother) resp. 7.5 (sister) mg/day] and insulin treatment was discontinued. The treatment change led to better quality of life and metabolic control in both the patients and suprisingly to the lower frequency of the hypoglycaemias in the brother (HbA1c decreased from 3.3 % to 2.8 % in three months in the brother resp. from 10.9 % to 10.0 % in two months in the sister). Molecular-genetic testing enables the change of treatment leading to better quality of life and metabolic control, although its longterm safety and efficacy will have to be confirmed.

Effects of an experimental phytase on performance, egg quality, tibia ash content and phosphorus bioavailability in laying hens fed on maize- or barley-based diets.

A 24-week performance trial was conducted to evaluate the efficacy of an experimental phytase on performance, egg quality, tibia ash content and phosphorus excretion in laying hens fed on either a maize- or a barley-based diet. At the end of the trial, an ileal absorption assay was conducted in order to determine the influence of phytase supplementation on the apparent absorption of calcium and total phosphorus (P). Each experimental diet was formulated either as a positive control containing 3.2 g/kg non-phytate phosphorus (NPP), with the addition of dicalcium phosphate (DCP), or as a low P one, without DCP addition. Both low P diets (containing 1.3 or 1.1 g/kg NPP) were supplemented with microbial phytase at 0, 150, 300 and 450 U/kg. The birds were housed in cages, allocating two hens per cage as the experimental unit. Each of 10 dietary treatments was assigned to 16 replicates. Low dietary NPP (below 1.3 g/kg) was not able to support optimum performance of hens during the laying cycle (from 22 to 46 weeks of age), either in maize or barley diets. Rate of lay, daily egg mass output, feed consumption, tibia ash percentage and weight gain were reduced in hens fed low NPP diets. The adverse effects of a low P diet were more severe in hens on a maize diet than in those on a barley diet. Low dietary NPP reduced egg production, weight gain, feed consumption and tibia ash content and microbial phytase supplementation improved these parameters. Hens given low NPP diets supplemented with phytase performed as well as the hens on positive control diets containing 3.2 g/kg of NPP. A 49% reduction of excreta P content was achieved by feeding hens on low NPP diets supplemented with phytase, without compromising performance. Phytase addition to low NPP diets increased total phosphorus absorption at the ileal level, from 0.25 to 0.51 in the maize diet and from 0.34 to 0.58 in the barley diet. Phosphorus absorption increased linearly with increasing levels of dietary phytase. Mean phosphorus absorption was higher in barley diets than in maize diets (0.49 vs 0.39).