Physical activity levels in female breast cancer patients and survivors in Ekurhuleni, South Africa.

Background: By using complementary therapies, such as exercise rehabilitation during and after cancer treatment, breast cancer patients and survivors can improve their quality of life and overall health while also negating the deleterious effects of breast cancer and its treatment. Objectives: The aim of this study was to determine the physical activity levels of female breast cancer patients and survivors in Ekurhuleni, South Africa. Methods: The International Global Physical Activity Questionnaire (2002) determined participants' physical activity levels during work, travel and leisure. The questionnaire was disseminated to medical facilities in hard copy format and online via the Google Forms platform. Statistics were computed using the Statistical Package for Social Science (SPSS) with the level of significance set at 95% (p < 0.05). Results: One hundred female breast cancer patients and survivors with a mean age of 55 years from Ekurhuleni, South Africa participated in this study. The findings reflected that most participants (59%) were meeting the American College of Sports Medicine's physical activity guidelines when considering activity done during work, travel and leisure. No significant difference was seen in physical activity participation between breast cancer patients and breast cancer survivors, or those attending private and public facilities. Conclusion: For the breast cancer patient, physical activity and exercise may be a promising and effective adjuvant treatment both during and after anticancer therapies, improving quality of life, playing a role in increasing treatment tolerance, mitigating a range of symptoms and side effects brought on by cancer diagnosis and treatments and enhancing outcomes.

Physical activity levels in female breast cancer patients and survivors in Ekurhuleni, South Africa

Background: By using complementary therapies, such as exercise rehabilitation during and after cancer treatment, breast cancer patients and survivors can improve their quality of life and overall health while also negating the deleterious effects of breast cancer and its treatment. Objectives: The aim of this study was to determine the physical activity levels of female breast cancer patients and survivors in Ekurhuleni, South Africa. Methods: The International Global Physical Activity Questionnaire (2002) determined participants' physical activity levels during work, travel and leisure. The questionnaire was disseminated to medical facilities in hard copy format and online via the Google Forms platform. Statistics were computed using the Statistical Package for Social Science (SPSS) with the level of significance set at 95% (p < 0.05). Results: One hundred female breast cancer patients and survivors with a mean age of 55 years from Ekurhuleni, South Africa participated in this study. The findings reflected that most participants (59%) were meeting the American College of Sports Medicine's physical activity guidelines when considering activity done during work, travel and leisure. No significant difference was seen in physical activity participation between breast cancer patients and breast cancer survivors, or those attending private and public facilities. Conclusion: For the breast cancer patient, physical activity and exercise may be a promising and effective adjuvant treatment both during and after anticancer therapies, improving quality of life, playing a role in increasing treatment tolerance, mitigating a range of symptoms and side effects brought on by cancer diagnosis and treatments and enhancing outcomes

The influence of grass silage-to-maize silage ratio and concentrate composition on methane emissions, performance and milk composition of dairy cows.

It is well-established that altering the proportion of starch and fibre in ruminant diets can alter ruminal and post-ruminal digestion, although quantitative evidence that this reduces enteric methane (CH4) production in dairy cattle is lacking. The objective of this study was to examine the effect of varying grass-to-maize silage ratio (70 : 30 and 30 : 70 DM basis), offered ad libitum, with either a concentrate that was high in starch or fibre, on CH4 production, intake, performance and milk composition of dairy cows. A total of 20 cows were allocated to one of the four experimental diets in a two-by-two factorial design run as a Latin square with each period lasting 28 days. Measurements were conducted during the final 7 days of each period. Cows offered the high maize silage ration had a higher dry matter intake (DMI), milk yield, milk energy output and lower CH4 emissions when expressed per kg DMI and per unit of ingested gross energy, but there was no difference in total CH4 production. Several of the milk long-chain fatty acids (FA) were affected by forage treatment with the most notable being an increase in 18:0, 18:1 c9, 18:2 c9 c12 and total mono unsaturated FA, observed in cows offered the higher inclusion of maize silage, and an increase in 18:3 c9 c12 c15 when offered the higher grass silage ration. Varying the composition of the concentrate had no effect on DMI or milk production; however, when the high-starch concentrate was fed, milk protein concentration and milk FAs, 10:0, 14:1, 15:0, 16:1, increased and 18:0 decreased. Interactions were observed for milk fat concentration, being lower in cows offered high-grass silage and high-fibre concentrates compared with the high-starch concentrate, and FA 17:0, which was the highest in milk from cows fed the high-grass silage diet supplemented with the high-starch concentrate. In conclusion, increasing the proportion of maize silage in the diets of dairy cows increased intake and performance, and reduced CH4 production, but only when expressed on a DM or energy intake basis, whereas starch-to-fibre ratio in the concentrate had little effect on performance or CH4 production.

Effect of vitamin E supplementation and diet on fatty acid composition and on meat colour and lipid oxidation of lamb leg steaks displayed in modified atmosphere packs.

Groups of 8 lambs were allocated to one of five concentrate diets supplemented with all-rac-α-tocopheryl acetate containing 30 (C30), 60 (C60), 120 (C120), 250 (C250) and 500 (C500) mg/kg dry matter. Two other groups were fed grass silage and 400 g/day concentrate with 60 (S60) or 500 (S500) mg α-tocopheryl acetate/kg dry matter. Within diet, vitamin E level did not affect growth performance or carcass characteristics. Basal diet did not affect final live weight, conformation and fatness scores. M. semimembranosus from S lambs contained more α-tocopherol than that of C lambs on the same intake and by day 6 in MAP (75%O2/25%CO2) chroma and a* were below acceptable levels in C30 lambs. TBARS were higher in C30 and C60 muscle than in other treatments (P<0.001) after 3 and 6 days display. Muscle fatty acid composition varied with basal diet but lipid oxidation depended more on vitamin E concentration with an initial concentration of 1.9 µg/g muscle preventing significant lipid oxidation.

Effect of a supplement containing trans-10,cis-12 conjugated linoleic acid on the performance of dairy ewes fed 2 levels of metabolizable protein and at a restricted energy intake.

Trans-10,cis-12 conjugated linoleic acid (CLA) inhibits milk fat synthesis in dairy ewes, but the effects under varying dietary metabolizable protein (MP) levels when energy-limited diets are fed have not been examined. The objectives of the study were to evaluate the response of lactating dairy ewes to CLA supplementation when fed diets limited in metabolizable energy (ME) and with either a low or high MP content. Twelve multiparous ewes in early lactation were randomly allocated to 1 of 4 dietary treatments: a high MP (110% of daily MP requirement) or low MP (93% of daily MP requirement) diet unsupplemented or supplemented with a lipid-encapsulated CLA to provide 2.4 g/d of trans-10,cis-12 CLA, in each of 4 periods of 25 d each in a 4×4 Latin square design. All diets were restricted to supply each ewe with 4.6 Mcal of ME/d (equivalent to 75% of ME requirement). Supplementation with CLA decreased milk fat percentage and yield by 33% and 24%, respectively, and increased milk, milk protein, and lactose yields by 16, 13, and 17%, respectively. Feeding the high MP diet increased the yields of milk, fat, protein, and lactose by 18, 15, 19, and 16%, respectively. Milk fat content of trans-10,cis-12 CLA (g/100g) was 0.09 and <0.01 for the CLA-supplemented and unsupplemented ewes, respectively. Ewes supplemented with CLA had a reduced yield (mmol/d) of fatty acids of C16, although the effect was greatest for C16. Plasma urea concentrations were lowest in ewes supplemented with CLA compared with those unsupplemented (6.5 vs. 7.4 mmol/L, respectively) and receiving low compared with high MP diets (5.6 vs. 8.3 mmol/L, respectively). In conclusion, dairy ewes fed energy-limited diets and supplemented with CLA repartitioned nutrients to increase yields of milk, protein, and lactose, with the response to CLA supplementation and additional MP intake being additive.

Effects of immunostimulants on ranched southern bluefin tuna Thunnus maccoyii: immune response, health and performance.

Ranched southern bluefin tuna Thunnus maccoyii were fed baitfishes supplemented with vitamins (predominantly E and C) or vitamins and immunostimulants, nucleotides and ß-glucans, over 12 weeks after transfer and monitored for enhancement in immune response, health and performance through their 19 week grow-out period. Fish from two different tows were sampled separately at three different sampling points: at transfer to grow-out pontoons, at 8 weeks post-transfer and at harvest, 19 weeks post-transfer. Lysozyme activity was enhanced during vitamin supplementation compared to control fish. Performance (i.e. survival, condition index and crude fat), health (i.e. blood plasma variables including pH, osmolality, cortisol, lactate and glucose) and alternative complement activity were not commonly improved through diet supplementation. There were some tow-specific improvements in performance through vitamin supplementation including survival, selected parasite prevalence and intensity, and alternative complement activity. Immunostimulant supplementation also showed a tow-specific improvement in plasma cortisol level. Tow-specific responses may suggest that life history, previous health condition and husbandry can affect the success of vitamin and immunostimulant enhancement of immune response, health and performance of ranched T. maccoyii.

Influence of vitamin E supplementation and basal diet on the vitamin E status, performance and tissue fatty acid concentration in lambs.

In order to determine the effect of dietary vitamin E level and basal diet on vitamin E status, performance and tissue fatty acid content, five groups of eight Suffolk × Charollais wether lambs with an initial live weight of 28.4 (s.d. 1.6) kg were allocated to one of five concentrate-based diets supplemented with all-rac-α-tocopheryl acetate to contain 30 mg (C-30), 60 mg (C-60), 120 mg (C-120), 250 mg (C-250) or 500 mg (C-500) α-tocopheryl acetate/kg dry matter (DM), for 63 days. Two additional groups of eight lambs entered the study at 31.2 (s.d. 3.3) kg and were fed grass silage and 400 g/day concentrate for 56 days, with the whole diet providing the equivalent of 60 mg (S-60) or 500 mg (S-500) α-tocopheryl acetate/kg DM. Lambs were weighed and blood samples obtained by venipuncture weekly. Dietary vitamin E level did not affect performance (P > 0.05), but lambs fed grass silage grew more slowly (P < 0.001) and had a higher (P < 0.001) feed conversion ratio (kg feed/kg gain) than those fed concentrates. At day 0 plasma α-tocopherol concentrations were 0.8 µg/ml and did not differ between treatments (P > 0.05). Plasma α-tocopherol concentrations then decreased in all lambs except for those fed S-500, which increased, and at slaughter were (µg/ml) 0.07, 0.23, 0.39, 0.76 and 1.57 in C-30, C-60, C-120, C-250 and C-500 and 1.18 and 1.93 in S-60 and S-500, respectively. At slaughter, muscle and liver α-tocopherol concentrations were in the deficiency range for lambs fed C-30, C-60 or C-120, whereas plasma creatine kinase and tissue polyunsaturated fatty acids were unaffected by dietary vitamin E level, but creatine kinase levels were higher (P < 0.05) and glutathione peroxidise levels lower (P < 0.001) in lambs fed grass silage than concentrates alone. Muscle and liver α-tocopherol concentrations were 1.8- and 4.1-fold higher in lambs fed S-60 than C-60, but there was less of a difference between lambs fed S-500 or C-500 with muscle and liver differences of 0.4- and 0.7-fold, respectively. Tissue n-3 polyunsaturated fatty acid concentrations were higher (P < 0.05) and n-6 fatty acids lower in lambs receiving the grass silage compared to concentrate-based diets, but were not affected by dietary vitamin E level. It is concluded that lower plasma and tissue levels of α-tocopherol are present in lambs supplemented with all-rac-α-tocopheryl acetate on a concentrate compared to a mixed diet of silage and concentrates, and that normal growth can be achieved at tissue levels previously considered to represent deficiency.

Diagnostic radiation procedures and risk of prostate cancer.

Exposure to ionising radiation is an established risk factor for many cancers. We conducted a case-control study to investigate whether exposure to low dose ionisation radiation from diagnostic x-ray procedures could be established as a risk factor for prostate cancer. In all 431 young-onset prostate cancer cases and 409 controls frequency matched by age were included. Exposures to barium meal, barium enema, hip x-rays, leg x-rays and intravenous pyelogram (IVP) were considered. Exposures to barium enema (adjusted odds ratio (OR) 2.06, 95% confidence interval (CI) 1.01-4.20) and hip x-rays (adjusted OR 2.23, 95% CI 1.42-3.49) at least 5 years before diagnosis were significantly associated with increased prostate cancer. For those with a family history of cancer, exposures to hip x-rays dating 10 or 20 years before diagnosis were associated with a significantly increased risk of prostate cancer: adjusted OR 5.01, 95% CI 1.64-15.31 and adjusted OR 14.23, 95% CI 1.83-110.74, respectively. Our findings show that exposure of the prostate gland to diagnostic radiological procedures may be associated with increased cancer risk. This effect seems to be modified by a positive family history of cancer suggesting that genetic factors may play a role in this risk association.

Effect of dietary oil source on the flavour and the colour and lipid stability of lamb meat.

This study investigated the influence of five sources of dietary oil (linseed oil (LO), fish oil (FO), a protected lipid supplement (PLS, 18:2 to 18:3 ratio 3:1), fish oil/marine algae (FOMA) and PLSMA) on the colour and lipid stability of lamb muscle and the flavour of grilled loin chops. LO produced the highest proportion of 18:3n-3 in muscle phospholipid, the highest ratings for lamb flavour intensity and overall liking and the lowest ratings for abnormal flavour intensity. PLS increased the proportion of 18:2n-6 which reduced lamb flavour intensity and increased abnormal lamb flavour intensity. Diets containing FO or MA increased proportions of the longer chain n-3 fatty acids and similar reduced ratings for lamb flavour as the PLS diet. FO-containing diets increased fishy flavour notes, especially when in combination with MA. 'Putty' and 'fish oil' odours were recognised as being present more frequently in cooked subcutaneous lamb fat from lambs fed FO and FOMA than other diets. Lambs fed MA, FO and the combination of the two produced meat that was oxidatively less stable and had a reduced colour and lipid oxidative shelf-life, which was at least partially due to the lower vitamin E content of the muscle. These results have significant implications for the formulation of diets that may improve nutritional ratios in lamb meat but which adversely affect flavour and meat stability.

The effect of fish oil supplementation of pregnant and lactating ewes on milk production and lamb performance.

Supplementation of pregnant ewes with long-chain n-3 polyunsaturated fatty acids (PUFA) demonstrably improves indicators of neonatal lamb vigour, potentially improving the number of lambs reared per ewe. The present study investigated the effect of supplementing ewes with fish oil and vitamin E (α-tocopherol acetate) throughout both pregnancy and lactation on the performance of lactating ewes and sucking lambs. Forty-eight ewes were supplemented with one of four concentrates containing either Megalac or fish oil plus a basal (50 mg/kg) or supranutritional (500 mg/kg) concentration of vitamin E from 6 weeks pre-partum until 4 weeks post partum in a two-by-two factorial randomised-block design. All concentrates were formulated to contain approximately 60 g/kg supplemental fatty acids. Ewes were housed, penned on sawdust and offered straw ad libitum. Blood samples were taken from ewes and lambs at intervals throughout the experiment and milk samples were obtained at 21 days into lactation. There was no notable effect of dietary vitamin E concentration upon ewe or lamb performance. Ewe dry-matter (DM) intake and yield were unaffected by dietary treatment, although ewes fed fish oil lost less weight during lactation (-1.88 kg compared with -3.97 kg for Megalac-supplemented ewes; P < 0.01). Milk fat concentrations (67.3 g/kg compared with 91.8 g/kg; P < 0.01) and yields (6.65 g/h v. 9.26 g/h; P < 0.01) were reduced in ewes fed fish oil and these decreases were associated with lower litter-growth rates (0.49 g/day compared with 0.54 g/day; P < 0.05). Milk protein yield was increased by fish oil supplementation (3.82 g/h) compared with Megalac supplementation (3.28 g/h; P < 0.05); moreover, there was an interaction between fat source and vitamin E concentration in that both protein concentration and yield were significantly lower in milk from ewes fed treatment with Megalac + basal vitamin E (MB) compared with the other three treatments. Fish oil supplementation increased the concentrations of C18:1 trans-, cis-9, trans-11 conjugated linoleic acid (CLA), C20:5 (n-3) and C22:6 (n-3) within ewe plasma, milk and lamb plasma. The mechanisms by which fish oil supplementation affects milk composition warrants further investigation.

Manipulation of the n-3 polyunsaturated fatty acid content of muscle and adipose tissue in lambs.

Fifty Suffolk-crossbred wether lambs, with an initial live weight of 29 +/- 2.1 kg, were allocated to one of five concentrate-based diets formulated to have a similar fatty acid content (60 g/kg DM), but containing either linseed oil (high in 18:3n-3); fish oil (high in 20:5n-3 and 22:6n-3); protected linseed and soybean (PLS; high in 18:2n-6 and 18:3n-3); fish oil and marine algae (fish/algae; high in 20:5n-3 and 22:6n-3); or PLS and algae (PLS/algae; high in 18:3n-3 and 22:6n-3). Lambs were slaughtered when they reached 40 kg. Growth performance and intake were similar (P > 0.35) among treatments. By contrast, gain:feed was higher (P < 0.05) in lambs fed the fish oil compared with the linseed oil or PLS/algae diets. Total fatty acid concentration (mg/100 g) in the neutral lipid of the longissimus muscle was not affected by treatment (P > 0.87) but was least (P < 0.05) in the phospholipid fraction in lambs fed the linseed oil diet. Lambs fed either diet containing marine algae contained the highest (P < 0.05) percentage of 22:6n-3 in the phospholipid (mean of 5.2%), 2.8-fold higher than in sheep fed the fish oil diet. In lambs fed the fish/algae diet, the percentage of 20:5n-3 was highest (P < 0.05), contributing some 8.7, 0.8, and 0.5% of the total fatty acids in the muscle phospholipid, neutral lipids, and adipose tissue, respectively. The percentage of 18:3n-3 in the phospholipid fraction of the LM was highest (P < 0.05) in lambs fed the linseed oil diet (6.9%), a value double that of sheep fed the PLS diet. By contrast, lambs fed the PLS diet had twice the percentage of 18:3n-3 in the muscle neutral lipids (3.8%) than those offered the linseed oil diet, and 5.5-fold greater than lambs fed the fish/algae treatment (P < 0.05), an effect that was similar in the adipose tissue. The percentage of 18:2n-6 was highest (P < 0.05) in lambs fed the PLS diet, where it contributed 33.7, 10.1, and 11.2% in the muscle phospholipid, neutral lipids, and adipose tissue, respectively. The highest (P < 0.05) muscle PUFA-to-saturated fatty acid (P:S) ratio was obtained in lambs fed the PLS diet (0.57), followed by the PLS/algae diet (0.46), and those fed the fish oil or linseed oil diets had the lowest ratios (0.19 and 0.26, respectively). The favorable P:S ratio of lambs fed the PLS/algae diet, in conjunction with the increased levels of 20:5n-3 and 22:6n-3, enhanced the nutritional qualities of lamb to more closely resemble what is recommended for the human diet.

Biohydrogenation of dietary n-3 PUFA and stability of ingested vitamin E in the rumen, and their effects on microbial activity in sheep.

The present study investigated the susceptibility of dietary n-3 PUFA to ruminal biohydrogenation, the stability of ingested vitamin E in the rumen and the subsequent uptake of PUFA and vitamin E into plasma. Six cannulated sheep were assigned to six diets over five 33 d periods, in an incomplete 6x5 Latin square. The diets, based on dried grass, were formulated to supply 50 g fatty acids/kg DM using three lipid sources: Megalac (calcium soap of palm fatty acid distillate; Volac Ltd, Royston, Herts., UK), linseed (formaldehyde-treated; Trouw Nutrition, Northwich, Ches., UK) and linseed-fish oil (formaldehyde-treated linseed+fish oil). The diets were supplemented with 100 or 500 mg alpha-tocopheryl acetate/kg DM. Fat source or level of vitamin E in the diet did not alter microbial activity in the rumen. Biohydrogenation of linoleic acid (18 : 3n-6; 85-90 %), linolenic acid (18 : 3n-3; 88-93 %), docosahexaenoic acid (22 : 6n-3; 91 %) and EPA (20 : 5n-3; 92 %) was extensive. Feeding formaldehyde-treated linseed elevated concentrations of 18 : 3n-3 in plasma, whilst 22 : 6n-3 and 20 : 5n-3 were only increased by feeding the linseed-fish oil blend. Duodenal recovery of ingested vitamin E was high (range 0.79-0.92 mg/mg fed). High dietary vitamin E was associated with increased plasma alpha-tocopherol (2.57 v. 1.46 microg/ml for 500 and 100 mg alpha-tocopheryl acetate/kg DM respectively), although all concentrations were low. Plasma vitamin E levels, however, tended to decrease as the type and quantity of PUFA in the diet increased. The present study illustrates that nutritionally beneficial PUFA in both fish and linseed oils are highly susceptible to biohydrogenation in the rumen. Although alpha-tocopheryl acetate resisted degradation in the rumen, plasma vitamin E status remained deficient to borderline, suggesting either that uptake may have been impaired or metabolism post-absorption increased.

Effects of dietary n-3 polyunsaturated fatty acids, breed and dietary vitamin E on the fatty acids of lamb muscle, liver and adipose tissue.

The effect of feeding n-3 PUFA on the fatty acid composition of muscle, adipose tissue and liver of lambs was investigated. Groups of eight ram lambs per breed, SuffolkxLleyn (24 kg live weight) and Scottish Blackface (18 kg live weight), were each fed one of six diets containing one of three fat sources (50 g fatty acids/kg DM; Megalac((R)) (calcium soap of palm fatty acid distillate; Volac Ltd, Royston, Herts., UK) and formaldehyde-treated whole linseed (Trouw Nutrition UK, Northwich, Ches., UK) either alone or with fish oil (1:1, w/w) and either 100 or 500 mg alpha-tocopheryl acetate/kg DM. Feed was offered ad libitum until slaughter at approximately half breed mature live weight. The type of dietary fat had no effect on intake, growth rate or feed conversion ratio. The 3.0-fold higher concentration of 18 : 3n-3 in the linseed compared with the Megalac((R)) diet approximately doubled (P<0.001) the concentration in the neutral and polar lipid fractions of musculus semimembranosus and liver, and in adipose tissue it increased 2.5-fold. Feeding protected linseed also increased (P<0.001) concentrations of 20 : 5n-3 and 22 : 5n-3 in muscle polar lipids and both lipid fractions of liver. The linseed-fish oil raised the 20 : 5n-3 concentrations above those for the linseed diet and also increased 22 : 6n-3. Scottish Blackface lambs had lower concentrations of 18 : 3n-3 in all lipids compared with Suffolk x Lleyn lambs, but more 20 : 5n-3 in the polar lipids of muscle and liver. High levels of dietary vitamin E were associated with small decreases in the concentration of monounsaturated fatty acids and increases in PUFA. Linseed raised the PUFA : saturated fatty acid ratios in liver and adipose tissue but not in muscle, and improved the n-6 : n-3 fatty acid ratio, as did the linseed-fish oil. Different combinations of dietary fatty acids and better protection against rumen biohydrogenation are required to improve muscle PUFA : saturated fatty acids ratios.

Synchrony of nutrient supply to the rumen and dietary energy source and their effects on the growth and metabolism of lambs.

The objective of the current series of experiments was to assess the effects of dietary synchrony of OM and N supply to the rumen, achieved by altering the sequence of feeding individual ingredients and in diets with different energy sources, on the metabolism and performance of growing lambs. In Exp. 1, the in situ degradability coefficients of OM and N were determined for five feed ingredients and subsequently was used to formulate two diets, based either on barley or sugar beet pulp, to have a similar predicted nutrient content. Within each diet, specific ingredients were shifted between the 0900 and 1600 feeding to provide either a synchronous, intermediate, or asynchronous supply of OM and N to the rumen. In Exp. 2, these diets were fed at a restricted level to 48 growing lambs with an initial live weight of 25.1 +/- 4.22 kg and a slaughter weight of 41.4 +/- 1.94 kg. There was no significant effect of dietary treatment on live weight gain or feed conversion efficiency. Lambs fed the synchronous diets deposited more kidney knob and channel fat than lambs on the asynchronous or intermediate diets (P < 0.05), whereas lambs fed the barley-based diets deposited more carcass (P < 0.05) and noncarcass (P < 0.001) fat than lambs on the sugar beet-based diets. Lambs fed the asynchronous diets retained less energy over the course of the experiment than lambs on the intermediate or synchronous diets (P < 0.05), and had a lower energy efficiency (0.079, 0.097, and 0.093 MJ retained/ MJ of intake, respectively, P < 0.05). Lambs fed the barley-based diets retained more energy than lambs on the sugar beet-based (P < 0.001) and had a higher energy balance (0.095 vs. 0.084 MJ retained/MJ intake, respectively; P < 0.01). Plasma ammonia concentrations mirrored ruminal ammonia concentrations on the barley-based diets, but not sugar beet-based diets. In Exp. 3, lambs fed the sugar beet-based diets had a higher digestibility of OM and NDF (P < 0.001). By contrast, lambs on the barley-based diets had a higher level of purine derivative excretion and microbial N production (P < 0.001). The results indicate that neither dietary synchrony nor energy source significantly influenced growth rate. However, both the asynchronous and sugar beet pulp-based diets resulted in a lower efficiency of dietary energy use, and the avoidance of asynchronous patterns of nutrient release within the rumen can improve energy efficiency in growing lambs.

Effects of dietary fat source and breed on the carcass composition, n-3 polyunsaturated fatty acid and conjugated linoleic acid content of sheep meat and adipose tissue.

Seventy-two 8-week-old ram lambs from three breeds, Suffolk, Soay and Friesland, were offered one of four diets based on dried grass and formulated to have a similar fatty acid content (60 g/kg DM) and containing: Megalac (high in 16 : 0, control; Volac Ltd, Royston, Herts., UK), whole linseed (18 : 3n-3), fish oil (20 : 5n-3 and 22 : 6n-3) or whole linseed plus fish oil. The lambs were slaughtered at approximately half of their mature live weight (43, 21 and 43 kg for Suffolk, Soay and Friesland lambs, respectively). Fish oil reduced DM intake and lamb live-weight gain (P<0.001), while DM intake, live-weight gain and subcutaneous fat content were highest in Suffolk and lowest in Soay lambs. Linseed feeding doubled the proportion (x100) of 18 : 3n-3 in the longissimus dorsi from 1.4 to 3.1 and in the subcutaneous adipose tissue from 1.2 to 2.6 (P<0.001). Suffolk and particularly Soay lambs contained higher proportions of 18 : 3n-3 than Friesland lambs in the longissimus dorsi, while in the adipose tissue, Suffolk lambs had the highest level. Feeding fish oil increased the muscle proportion (x100) of 20 : 5n-3 from 0.7 to 2.3 and 22 : 6n-3 from 0.3 to 0.8 (P<0.001). By contrast, the proportions of the longer-chain n-3 polyunsaturated fatty acids were similar across all three breeds. All three lipid supplements containing n-3 polyunsaturated fatty acids increased the content of muscle trans-18 : 1 relative to the control values, but conjugated linoleic acid (cis-9,trans-11-18 : 2) only increased in the muscle of lambs fed linseed. Feeding linseed or fish oil lowered the n-6 : n-3 ratio in sheep meat, but neither diet nor breed had much effect on the polyunsaturated fatty acid: saturated fatty acid ratio.

Renal and haemodynamic effects of amlodipine and nifedipine in hypertensive renal transplant recipients.

BACKGROUND: Immunosuppressive treatment with cyclosporin A (CsA) improves the survival of renal allografts, but is associated with renal vasoconstriction and hypertension. Previous reports suggest that the calcium-channel blockers nifedipine and amlodipine may improve graft function in CsA-treated patients. We have compared the effects of amlodipine (5-10 mg once daily) and nifedipine retard (10-40 mg twice daily) on renal function and blood pressure in renal transplant recipients treated with CsA. METHODS: This was a multicentre, two-way, crossover study in 27 evaluable hypertensive patients with renal insufficiency following renal transplantation, who were maintained on a stable dose of CsA. Patients received either amlodipine (5-10 mg once daily) or nifedipine retard (10-40 mg twice daily) for 8 weeks, and were then crossed over to the other treatment for a further 8 weeks. RESULTS: Trends were seen during amlodipine treatment towards larger improvements, in serum creatinine (by 8% of baseline on amlodipine vs 4% on nifedipine), lithium clearance (13% vs 2%), and glomerular filtration rate 11% vs 7%). Effective renal plasma flow was increased by 11% of baseline on nifedipine vs 9% on amlodipine. There were no significant differences between treatments. Amlodipine and nifedipine lowered systolic blood pressure to a similar extent (21 mmHg vs 15 mmHg respectively, P=0.25), but amlodipine was more effective than nifedipine in lowering diastolic blood pressure (13 mmHg vs 8 mmHg, P=0.006). Both treatments were well tolerated. CONCLUSION: Once-daily amlodipine is at least as effective as twice-daily nifedipine retard in controlling blood pressure and does not adversely affect graft function in hypertensive renal allograft recipients.

Responsiveness of pain scales: a comparison of three pain intensity measures in chiropractic patients.

OBJECTIVE: To compare the responsiveness of three pain scales. DESIGN: Longitudinal prospective single cohort. SETTING: Chiropractic college outpatient clinic. SUBJECTS: Seventy-nine new patients. INTERVENTION: Treatment of painful complaint by senior student interns under supervision of clinical tutors. OUTCOME MEASURES: Pain intensity using the visual analogue scale (VAS), the verbal rating scale (VRS) and the 11-point numerical rating scale (NRS). RESULTS: Mean usual levels of pain were consistently higher than those of current pain. Asking patients to report their current pain levels showed the NRS to be the most responsive of the measures (effect size = 0.86) compared with the VAS (effect size = 0.77) and the VRS (effect size = 0.76). When asking patients to report on their usual level of pain, the responsiveness of all the pain scales was enhanced (effect size = 1.34, 1.34 and 1.12 for the NRS, VAS and VRS, respectively). CONCLUSION: Given the relative ease of use and scoring of the 11-point NRS, and the obvious advantages of using responsive evaluative measures, this scale is recommended for pain intensity measurement in most types of outcome studies. Furthermore, asking patients to report their usual pain levels, rather than current levels, enhances the responsiveness of the measures and is a more representative perspective of their pain experience. The findings of this study have important implications for investigators who wish to select the most appropriate pain scale for use an outcome measure in treatment evaluative trials.

A non-pharmacological approach to pain relief.

Effective pain management programmes must acknowledge the subjective nature of pain. Non-pharmacological pain management can be as effective, on occasions, as pharmacological pain management. Stress and anxiety evoke a similar physiological response to acute pain, highlighting the need for efficient cognitive management programmes.

Calcification and fatigue failure in a polyurethane heart value.

The prosthetic heart valves were fabricated from a polyurethane containing a 4,4'-diphenylmethane diisocyanate hard segment, chain-extended with butanediol and with a polyether soft segment. The rate of calcification of these polyurethane heart valves was much slower in a dynamic in vitro test system than similar bioprosthetic heart valves. The calcified deposits were located exclusively at regions of material failure. Fourier transform infrared (FTIR) spectroscopy indicated the involvement of the polyether soft segments of the polymer directly in the calcification process. Calcification of polymer fractions also suggested that small molecular weight extractable components are accelerating factors in the calcification process.

Calcification and stress distribution in bovine pericardial heart valves.

There is a strong relationship between mechanical stress and calcification in biological prosthetic heart valves. A dynamic in vitro calcification test has been used to study the relationship between stress distributions in the leaflets of bovine pericardial valves and the deposition of calcium over the leaflet surfaces. Intuitive stress regions have been defined over the leaflet surfaces. Calcium uptake by the leaflets has been assayed directly by ashing of leaflet material and analysis of the ash by atomic absorption spectrophotometry. Calcium and phosphorus distribution over the leaflet surface has been analyzed using energy-dispersive x-ray analysis by scanning electron microscope and data points assigned to the appropriate stress region. The uptake of calcium is assessed by comparing stress regions, surfaces, and the degree of calcification of the valve. Differences between stress regions and surfaces are significant. Uptake of calcium in these valves appears to be strongly related to the degree and type of stress present in the valve leaflets.