Energy and protein requirements for maintenance of dairy goats during pregnancy and their efficiencies of use.

It has been suggested that maintenance requirements are similar among animals of different physiological stages; however, important physiological changes occur in the maternal body during pregnancy. Therefore, the aim of this study was to determine the energy and protein requirements for the maintenance of pregnant dairy goats and to estimate their efficiency of energy and protein utilization for maintenance and pregnancy. We used 66 multiparous pregnant goats having 49.0 ± 1.59 kg initial BW (around the third or fourth parturition) arranged in a randomized block design with a 3 × 3 factorial scheme including slaughter at different days of pregnancy (DOP; 80, 110, and 140 d) and feed restriction (0, 20, and 40% feed restriction). The comparative slaughter technique was used to estimate energy and protein maintenance requirements. Goats slaughtered at 140 DOP were subjected to digestibility trials at around 80, 110, and 140 DOP to estimate diet metabolizability and N balance (NBAL). Metabolizability decreased with feed restriction and was 63.3 ± 2.16, 55.7 ± 2.35, and 58.2 ± 2.30% at 0, 20, and 40% of feed restriction, respectively ( < 0.01). There was no effect of DOP on NE or the requirements of ME for maintenance (ME), which were 197 and 315 kJ/kg empty body weight (EBW), respectively, and the efficiency of ME utilization for maintenance (k) was 0.63. Similarly, DOP did not affect thedaily net protein requirements for maintenance (NP) estimated using the comparative slaughter technique (1.38 ± 0.512 g/kg EBW; = 0.003) or the NP estimated using NBAL (2.49 ± 0.594 g/kg EBW; < 0.01). The MP requirement for maintenance (MP) estimated using the comparative slaughter technique was not affected by DOP and was 3.22 g MP/kg EBW ( < 0.01). The efficiency of MP utilization for maintenance (k) was 0.43. The efficiency of ME utilization for pregnancy (k) increased with the progress of pregnancy and was 0.058, 0.10, and 0.19 at 80, 110, and 140 DOP, respectively. Similarly, the efficiency of MP utilization for pregnancy (k) increased with DOP and was 0.12, 0.21, and 0.43 at 80, 110, and 140 DOP, respectively. There was no evidence that pregnancy affected NE, ME, NP, and MP or k and k, which were also unaffected by DOP. However, k and k increased with pregnancy progress as a response to the physiological changes that pregnant females are subjected to.

Mineral Metabolism in Singleton and Twin-pregnant Dairy Goats.

During pregnancy, the maternal body undergoes significant physiological changes. The present study assessed the changes on calcium (Ca), phosphorus (P), magnesium (Mg), sodium (Na) and potassium (K) metabolism in singleton and twin-pregnant dairy goats. The 42 goats used (49.5 kg±7.6 body weight [BW]) were assigned at random to treatments that were factorially arranged to account for 2 breeds (Oberhasli and Saanen), 2 pregnancy types (singleton and twin) and 3 gestation periods (80, 110, and 140 days). Digestibility trials were performed at 80, 110, and 140 days of gestation. Mineral retention during pregnancy was determined in the maternal body, femur, uterus, mammary gland, fetus and fetal fluid. Blood samples were taken during pregnancy before and after a meal, and Ca, P, Mg, Na, K ions and alkaline phosphatase activity determined in serum. Bone mineral density was determined in the right femur. Statistical analyses were performed using the SAS MIXED procedure. Dry matter intake decreased linearly up to 140 days of gestation. Maternal BW gain, and Ca, P, and Mg retention (g/kg) decreased linearly with the advance of gestation days. Macromineral retention in maternal body (g/kg) was greater in Oberhasli than Saanen goats, and their fetuses had higher Ca, P, and Mg deposition (mg/g). Mineral retention (mg/g) increased in fetuses according to pregnancy development, with no differences between singleton and twin pregnancy. In the mammary gland, the retention of all minerals (g) increased with the days of pregnancy. In conclusion, related to Ca, P, and Mg metabolism can be divided into two stages. Up to 80 days of gestation, was characterized by the preparation of the maternal body reserves for future mineral demands. From 80 days of gestation onward, was characterized by the transfer of maternal body reserves for fetal development and colostrum production. Na and K supply was provided by adjustments in endogenous excretion and an increase in intestinal absorption. Finally, mineral metabolism was specific to each genotype and, except for Na, was not affected by the number of fetuses.

Risk factors for amputation in diabetic patients: a case-control study.

BACKGROUND: The objective was to quantify risk factors for lower extremity amputation in patients with diabetes mellitus in an attempt to prevent amputation. METHODS: This investigation was conducted as a case control study among diabetic males from 30-90 years of age with an average clinical duration of diabetes of 10 years: included were 80 cases which required a supracondyle amputation associated with diabetes mellitus, and 240 controls without injuries in the lower extremities. Measurements included the following: socioeconomic level, psychosocial risk factors, neuropathics, peripheral vascular factors, high blood pressure, smoking; environmental factors, health care, self care, and nutritional and metabolic factors in patients with diabetes mellitus before surgery. Statistically significant risk factors identified from analyses were: absence of lower leg vibratory perception (odds ratio = 14.9, 95% CI: 8.2-27.9); peripheral vascular disease (OR = 8.9, 95% CI: 5.3-15.9); high blood cholesterol > 450 mg (OR = 3.8, 95% CI: 2.9-8.6); low blood albumin < 3.5 g (OR = 7.9, 95% CI: 4.8-14.9); hyperurea blood nitrogen > 3.5 mg (OR = 3.1, 95% CI: 1.7-4.9); obesity (OR = 4.2, 95% CI: 1.51-9.8); time of evolution of diabetes mellitus > 10 years (OR = 3.47, 95% CI: 1.40-8.56); cracks in feet (OR = 3.45, 95% CI: 1.33-8.82); feet soaked in water (OR = 1.8, 95% CI: 1.07-2.93); ingrown toenails (OR = 2.0, 95% CI: 0.6-5.3), and lack of outpatient diabetes education (OR = 3.2, 95% CI: 1.5-6.7). CONCLUSIONS: Different risk factors for lower extremity amputation in diabetes mellitus patients were quantified, identifying certain aspects of preventive impact (patient education, glycemic control, careful daily foot hygiene, and appropriate footwear) which may be applicable in environmental factors and which have the possibility of success in lowering the rate of risk for lower extremity amputation.

Emergency management of atrial fibrillation and flutter: intravenous diltiazem versus intravenous digoxin.

STUDY OBJECTIVE: To compare the effects of i.v. diltiazem and i.v. digoxin on ventricular rate control in the emergency treatment of acute atrial fibrillation and flutter (AFF). METHODS: This prospective, randomized, open-label trial involved 30 consecutive patients who presented with acute AFF to the emergency department of an urban, 420-bed community teaching hospital from April 1993 through March 1994. Exclusion criteria included systolic blood pressure lower than 100 mm Hg, treatment with calcium-channel blockers other than diltiazem, lack of informed consent, and objection of the private physician. Patients were randomly assigned to receive either i.v. diltiazem alone, i.v. digoxin alone, or both. Heart rate control was defined as a ventricular rate of less than 100 beats/minute. I.v. digoxin, 25 mg, was given as a bolus at time 0 and at time 30 minutes. An initial dose of .25 mg/kg diltiazem was given intravenously over the first 2 minutes, followed by a dose of .35 mg/kg at time 15 minutes and then a titratable i.v. infusion at a rate of 10 to 20 mg/hour to maintain heart rate control. The dosing regimens were the same whether the drugs were given alone or in combination. Heart rhythm, heart rate, and blood pressure were measured at time 0, 5, 10, 15, 30, 60, 120, and 180 minutes. Statistical significance was assessed with the use of Student's t test and ANOVA methodology. RESULTS: At time 0, the heart rate (mean +/- SD) was 150 +/- 19 beats/minute in the diltiazem group and 144 +/- 12 in the digoxin group (difference not significant, P = .432). The decrease in heart rate from time 0 reached statistical significance at time 5 minutes in the diltiazem group (P = .0006); the mean rates at time 5 minutes were 111 +/- 26 beats/minute for diltiazem and 144 +/- 13 for digoxin. The decrease in heart rate achieved with digoxin did not reach statistical significance until time 180 minutes (P = .0099), at which time the rates were 90 +/- 13 for diltiazem and 117 +/- 22 for digoxin. CONCLUSION: Treatment of acute AFF with i.v. diltiazem decreases ventricular heart rate significantly within 5 minutes, compared with 3 hours for treatment with i.v. digoxin. No advantage was noted within 3 hours for i.v. treatment with a combination of diltiazem and digoxin. I.v. diltiazem is superior to i.v. digoxin in the emergency control of ventricular rate in acute AFF and should be considered as a drug of choice for this condition. This study was not large enough to adequately assess adverse effects, and further studies may be warranted for clinical validation.

[Prenatal testicular torsion. Presentation of a case and review of the literature]. / Torsión testicular prenatal. Presentación de un caso y revisión de la literatura.

This is a case report of extravaginal twisting of the spermatic cord in a neonate (third pregnancy, without prenatal care, obtained through iterative cesarean section), which occurred during the prenatal (in uterus) period since it was present at birth. Clinically found were: an enlargement of the right hemiscrotum, color changes (violet), induration, absence of the cremasteric reflex and no translumination. Ultrasonography showed homogeneous opaqueness of the right scrotal pouch. Right radical orchiectomy was carried out after finding testicular necrosis. The differential diagnosis includes: tumor, hematocele, testicular twist of the epidydimus appendexes, incarcerated hernia, scrotal abscess, supradrenal gland or ectopic spleen and the twisting of the spermatic cord. All of these conditions require immediate surgical exploration through the inguinal region in order to obtain a correct diagnosis and give prompt treatment. If there is twisting, contralateral fixation is necessary.