Effect of feeding ractopamine hydrochloride on growth performance and responses to handling and transport in heavy-weight pigs.

The impact of feeding ractopamine hydrochloride (RAC) on growth performance and responses to handling and transport in heavy BW pigs was evaluated in a study performed as a split-plot design with a 3 × 3 factorial arrangement of treatments: 1) RAC level (0 vs. 5 vs. 7.5 mg/kg of feed) and 2) handling intensity (HI; gentle vs. moderate vs. aggressive); RAC level was the main plot and HI was the subplot. A total of 288 pigs housed in groups of 8 were used to evaluate growth performance over a 28-d RAC feeding period (98.5 ± 4.58 to 131.5 ± 7.45 kg BW). On d 29 of the study, the HI treatment was applied to 216 pigs (6/pen; 2/pen on each HI). This was followed by transportation for 1 h on a livestock trailer at the end of which pigs were subjected to a final handling procedure. Blood samples (to measure acid-base, cortisol, and catecholamine levels) were collected and rectal temperature was measured 2 h before the HI treatment (baseline) and after the final handling procedure (final). Feeding RAC (5 and 7.5 mg/kg) improved ( < 0.01) ADG (9.9 and 9.0% for 5 and 7.5 mg/kg RAC, respectively) and G:F (8.8 and 11.8%, respectively) compared to controls, with no differences ( > 0.05) between the 2 RAC levels. Increasing the intensity of handling decreased ( < 0.001) final blood pH, bicarbonate, and base excess and increased ( < 0.001) final blood lactate and plasma cortisol and norepinephrine levels. Aggressive compared to gentle handling increased ( < 0.05) the incidence of pigs exhibiting open-mouth breathing and skin discoloration after the final handling procedure but had no effect ( > 0.05) on the incidence on nonambulatory, noninjured pigs. There was no effect ( > 0.05) of feeding RAC on final rectal temperature or blood acid-base measurements. Feeding 7.5, but not 5, compared to 0 mg/kg RAC increased ( < 0.05) final plasma epinephrine levels and the incidence of nonambulatory, noninjured pigs. This study confirms the improved growth performance of pigs fed RAC and the negative effects of aggressive handling on physical, metabolic, and physiological responses of pigs. It also suggests that pigs fed 5 compared to 0 mg/kg RAC showed similar responses to transport and handling. However, pigs fed 7.5 mg/kg of RAC had a greater incidence of nonambulatory, noninjured pigs when subjected to the handling/transport model and this warrants further investigation.

Cinacalcet treatment of primary hyperparathyroidism.

Although parathyroidectomy remains the only curative approach to most primary hyperparathyroidism cases, medical treatment with cinacalcet HCl has been proven to be a reasonable alternative for several patient subgroups. Cinacalcet almost always controls hypercalcemia and hypophosphatemia sufficiently. PTH levels are lowered, and cognitive parameters improve. While an increase in bone mineral density DEXA scan scores was not demonstrated in cinacalcet trials, the same applies to more than half of patients after parathyroidectomy. Medical therapy should be first choice in patients with hyperplasia in all glands rather than an isolated adenoma (10-15%), patients with persisting HPT following unsuccessful surgery or inoperable cases due to comorbidities, and patients detected in lab screens for hypercalcemia before developing symptoms who should be treated early but are usually reluctant to undergo surgery. Nephrolithiasis was not found to occur more frequently in cinacalcet trial groups, but urine calcium excretion as one major risk factor of this complication of primary HPT may increase on cinacalcet. Patients carrying the rs1042636 polymorphism of the calcium-sensing receptor gene respond more sensitively to cinacalcet and have a higher risk of calcium stone formation. Cinacalcet is usually administered twice daily but three or four doses per day should be discussed to mimic the beneficial pulsatile PTH-pattern.

Serum copper and zinc concentrations in patients with burns in relation to burn surface area.

Serum zinc and copper concentrations were measured by flame atomic absorption spectroscopy in 34 patients between 1 and 3 weeks after thermal injury. Mean (range) admission burn surface area was 29.8% (10% to 79%), and mean (range) serum zinc and copper concentrations within the first postburn week were 0.59 (0.2 to 1.5) and 0.74 (0.1 to 1.6) mg/L, respectively. Serum copper concentration was inversely correlated with burn surface area (r = -0.611, p < 0.01), whereas serum zinc concentration showed no such association. In the first postburn week hypocupremia (< 0.7 mg/L) was found in 15 of 32 (48%) of patients and hypozincemia (< 0.7 mg/L) in 21 of 32 (68%). Serum copper concentrations in patients with less than 15% burns remained within normal limits throughout the study period, but hypozincemia was found in patients irrespective of burn surface area. Long-term monitoring of two patients with 79% and 70% burns showed initial hypocupremia and hypozincemia. Hypocupremia only resolved in the patient with 79% burns when skin healing was almost complete 75 days after burns. Postburn hypozincemia was found to be very variable and not associated with either serum albumin concentration or periods of clinical sepsis. Because major burn injuries are associated with hypocupremia, serial monitoring is recommended with appropriate copper supplementation.

[Preliminary comments on existential analytic psychosomatic medicine]. / Vorbemerkungen zu einer existenzanalytischen Psychosomatik.

Existential analysis as a personal and meaning orientated psychotherapy describes a person in the performance of its existence. The anthropological and therapeutic concept of the existential analysis are presented in essential points (intentionality, self-transcendence, will to meaning, ability of self-detachment, corporability and responsibility) as a way of approach and interpretation. Psychosomatic illness is understood as a mode of personal existence. The integral "gestalt" of a person in its subjectivity, biography and corporality is reflected on with regard to its abilities and revealing of individual possibilities of meaning. The under determination of psychosomatic phenomena shows itself as an expression of a person's relative freedom to decide about its own development.