Exploring the differences in psychological traits between surgical specialties at an academic hospital in Bloemfontein.

BACKGROUND: Studies have attempted to categorise undergraduate medical and postgraduate students and specialists into personality types, to determine what influences personality has on specialty choice and job satisfaction. This study explored the personality characteristics of doctors in four surgical and three consulting specialties at an academic hospital in Bloemfontein, South Africa. METHOD: This analytical cross-sectional study used the Zuckerman-Kuhlman Personality Questionnaire as a measuring tool which included five scales: impulsive sensation seeking (subscales impulsivity and sensation seeking), neuroticismanxiety, aggression-hostility, sociability (parties and friends and isolation intolerance), and activity ( work activity and general activity). Overall, 70 consultants and senior registrars from surgical specialties (anaesthesiology, obstetrics and gynaecology, orthopaedic surgery, surgery), (response rate 60.3%) and 58 consultants and senior registrars from three consulting specialties (internal medicine, paediatrics, family medicine) (response rate 71.6%) participated. RESULTS: Respondents from four surgical specialties had higher medians than the overall consulting group for the subscale sensation seeking. The subscale sensation seeking scored higher than impulsivity across surgical and consulting groups. The surgical group scored lower than the consulting group in neuroticism-anxiety, with anaesthesiology scoring the highest (42.1%) and orthopaedic surgery scoring the lowest (15.8%). Orthopaedic surgery scored the highest (50.0%) in aggressionhostility, sociability (52.9%), parties and friends (44.4%) and isolation intolerance (65.5%). The surgical group scored significantly higher than the consulting group for activity (p < 0.01). CONCLUSION: In exploring the personality types of specialists, the orthopaedic surgeons in specialist departments in Bloemfontein seem unique in their sociability and aggression-hostility traits, anaesthesiologists scored strongly on the sensation seeking and neuroticism-anxiety scales, while the obstetricians and gynaecologists did not manifest either of these traits strongly. This data contributes to a growing discussion on personality choice and job satisfaction.

The Profile of deliberate self-poisoning cases presenting at the emergency department of pelonomi regional hospital

Background Deliberate self-poisoning (DSP) remains a common method employed for suicide worldwide. Despite its frequent occurrence and the high cost required in its management, only few studies have been carried out on this subject in South Africa. Inadequate research into DSP in South Africa is a great concern as this may inadvertently result in an inadequate knowledge of health professionals on the general approach to victims presenting at emergency departments. This may consequently result in a poor clinical outcome of these cases. This study was aimed at determining the demographics of DSP cases presenting to the emergency department (ED) of Pelonomi hospital and also to enquire into the drugs/agents commonly used, reasons for DSP and the clinical outcome of these cases

Association between personality factors and consulting specialty of practice of doctors at an academic hospital in Bloemfontein, South Africa

Background. Studies found an association between personality types and field of specialty. The current study could assist aspiring specialists in deciding which specialty they are best suited for by comparing their own personalities with the results.. To explore the personality characteristics of doctors in three consulting and four surgical specialties at an academic hospital in Bloemfontein,South Africa.Methods. In this analytical cross-sectional study, questionnaires, including the Zuckerman-Kuhlman Personality Questionnaire, were handed out.Overall, 58 consultants and senior registrars from the departments of Family Medicine, Paediatrics and Internal Medicine (response rate 71.6%) and 70 consultants and senior registrars from surgical specialties (response rate 60.3%) participated.Results. Family medicine had the lowest median score for impulsive sensation seeking (21.1%) and aggression-hostility (11.8%), and highest for parties and friends (33.3%). Paediatrics scored highest for neuroticism-anxiety (44.7%) and aggression-hostility (23.5%). Internal medicine scored highest for sociability (25.0%) and isolation intolerance (37.8%), and lowest for neuroticism-anxiety (36.8%) and activity (47.1%). Overall, the consulting group scored lower than the surgical group for impulsive sensation seeking, aggression-hostility, sociability and activity, and higher for neuroticism-anxiety. Conclusion. The study identified personality types of some specialties, and revealed differences between characteristics of local specialists compared with findings from studies elsewhere

The bird's-eye perspective: how do district health managers experience the impact of family physicians within the South African district health system? A qualitative study

Background: Health policy-makers in Africa are looking for local solutions to strengthen primary care teams. A South African national position paper (2015) described six aspirational roles of family physicians (FPs) working within the district health system. However, the actual contributions of FPs are unclear at present, and evidence is required as to how this cadre may be able to strengthen health systems.Methods: Using semi-structured interviews, this study sought to obtain the views of South African district health managers regarding the impact made by FPs within their districts on health system performance, clinical processes and health outcomes.Results: A number of benefits of FPs to the health system in South Africa were confirmed, including: their ability to enhance the functionality of the local health system by increasing access to a more comprehensive and coordinated health service, and by improving clinical services delivered through clinical care, capacitating the local health team and facilitating clinical governance activities.Conclusions: District managers confirmed the importance of all six roles of the FP and expressed both direct and indirect ways in which FPs contribute to strengthening health systems' performance and clinical outcomes. FPs were seen as important clinical leaders within the district healthcare team. Managers recognised the need to support newly appointed FPs to clarify their roles within the healthcare team and to mature across all their roles. This study supports the employment of FPs at scale within the South African district health system according to the national position paper on family medicine

Effect of feeding 25-hydroxyvitamin D3 with a negative cation-anion difference diet on calcium and vitamin D status of periparturient cows and their calves.

Holstein cows (>1 gestation) were fed 1 of 3 diets during the last 13 d of gestation (ranged from 22 to 7 d). The control diet (16 cows) was formulated to provide 18,000 IU/d of vitamin D3 and had a dietary cation-anion difference (DCAD) of 165mEq/kg (DCAD=Na + K - Cl - S). The second diet (DCAD + D) provided the same amount of vitamin D3 but had a DCAD of -139mEq/kg (17 cows). The third diet (DCAD + 25D) had no supplemental vitamin D3 but provided 6mg/d of 25-(OH) vitamin D3 [25-(OH)D3] with a DCAD of -138mEq/kg (20 cows). Diets were fed until parturition and then all cows were fed a common lactation diet that contained vitamin D3. Negative DCAD diets reduced urine pH, with the greatest decrease occurring with the DCAD + D treatment. Urinary Ca excretion was greatest for cows fed DCAD + 25D followed by cows fed DCAD + D. Urinary pH was negatively correlated with urinary excretion of Ca for cows fed DCAD + D. No such correlation was observed with the DCAD + 25D treatment because substantial excretion of urinary Ca occurred at moderate urinary pH values for that treatment. Cows fed DCAD + 25D had greater serum concentrations of 25-(OH)D3 than other treatments from 5 d after supplementation started through 7 d in milk. Concentrations of 1,25-(OH)2D3 in serum were greatest in DCAD + 25D cows starting at 2 d before calving and continued through 7 d in milk. Serum Ca concentrations 5 d before calving were greatest for cows fed DCAD + 25D, but at other time points before and after parturition treatment did not affect serum Ca. Incidence of clinical hypocalcemia was not statistically different between treatments, but cows fed DCAD + 25 had the highest incidence rate (12.5, 0, and 20% for control, DCAD + D, and DCAD + 25D). Calves born from cows fed DCAD + 25D had greater concentrations of 25-(OH)D3 in serum at birth than calves from other treatments (before colostrum consumption), but concentrations were similar by 3 d of age. Concentrations of 25-(OH)D3 in colostrum and transition milk were increased by feeding DCAD + 25D, but by 28 d in milk treatment effects no longer existed. Overall, feeding 25-OH vitamin D with a negative DCAD diet increased vitamin D status of the cow and her newborn calf but had minimal effects on calcium status and did not have positive effects on the incidence of hypocalcemia.

Effects of 3-nitrooxypropanol on methane emission, digestion, and energy and nitrogen balance of lactating dairy cows.

The objective was to measure effects of 3-nitrooxypropanol (3 NP) on methane production of lactating dairy cows and any associated changes in digestion and energy and N metabolism. Six Holstein-Friesian dairy cows in mid-lactation were fed twice daily a total mixed ration with maize silage as the primary forage source. Cows received 1 of 3 treatments using an experimental design based on two 3 × 3 Latin squares with 5-wk periods. Treatments were a control placebo or 500 or 2,500 mg/d of 3 NP delivered directly into the rumen, via the rumen fistula, in equal doses before each feeding. Measurements of methane production and energy and N balance were obtained during wk 5 of each period using respiration calorimeters and digestion trials. Measurements of rumen pH (48 h) and postprandial volatile fatty acid and ammonia concentrations were made at the end of wk 4. Daily methane production was reduced by 3 NP, but the effects were not dose dependent (reductions of 6.6 and 9.8% for 500 and 2,500 mg/d, respectively). Dosing 3 NP had a transitory inhibitory effect on methane production, which may have been due to the product leaving the rumen in liquid outflow or through absorption or metabolism. Changes in rumen concentrations of volatile fatty acids indicated that the pattern of rumen fermentation was affected by both doses of the product, with a decrease in acetate:propionate ratio observed, but that acetate production was inhibited by the higher dose. Dry matter, organic matter, acid detergent fiber, N, and energy digestibility were reduced at the higher dose of the product. The decrease in digestible energy supply was not completely countered by the decrease in methane excretion such that metabolizable energy supply, metabolizable energy concentration of the diet, and net energy balance (milk plus tissue energy) were reduced by the highest dose of 3 NP. Similarly, the decrease in N digestibility at the higher dose of the product was associated with a decrease in body N balance that was not observed for the lower dose. Milk yield and milk fat concentration and fatty acid composition were not affected but milk protein concentration was greater for the higher dose of 3 NP. Twice-daily rumen dosing of 3 NP reduced methane production by lactating dairy cows, but the dose of 2,500 mg/d reduced rumen acetate concentration, diet digestibility, and energy supply. Further research is warranted to determine the optimal dose and delivery method of the product.

Amylase addition increases starch ruminal digestion in first-lactation cows fed high and low starch diets.

The objective of this study was to evaluate the effect of an exogenous amylase preparation on digestion of low- and high-starch diets in dairy cattle. Rumen and total-tract nutrient digestibility were measured in a 4×4 Latin square design with 28-d periods using 4 first-lactation cows cannulated at the rumen and duodenum. Corn silage-based diets had 20 or 30% starch, attained by changing the composition of concentrate, with or without addition of an exogenous amylase preparation. Effects of the enzyme additive were observed on ruminal digestibility but not at the total-tract level. Ruminal digestibility of starch increased from 75% in control to 81% with amylase supplementation. This difference in ruminal starch digestion was compensated postruminally, so that the total-tract digestibility of starch was almost complete and did not differ between treatments. The amylase supplement also increased the true ruminal digestibility of organic matter but did not affect microbial N flow to the duodenum. Amylase supplement reduced the proportion of acetate and butyrate and increased that of propionate, particularly in the high-starch diet, where it tended to increase the concentration of total volatile fatty acids in the rumen. Other effects were a higher amylase activity in the solid-associated microbial community and a tendency for lower numbers of protozoa. In contrast, we observed no changes in intake, production, dry matter and fiber (neutral detergent fiber and acid detergent fiber) digestibility, or ruminal digestion, and no or small changes on selected fibrolytic and amylolytic bacteria and on the microbial community in general. We conclude that the exogenous amylase improved starch digestion in the rumen in first-lactation cows with moderate intake and production levels.

Influence of the combination of 25-hydroxyvitamin D3 and a diet negative in cation-anion difference on peripartal calcium homeostasis of dairy cows.

Around parturition, many dairy cows experience varying degrees of hypocalcemia, which increases the incidence of several diseases in early lactation. In the current study, an established concept of feeding a diet negative in cation-anion difference (DCAD) was combined with oral supplementation of 25-hydroxyvitamin D(3) (25-OHD(3)) from d 270 of gestation until parturition. Fifty-six dairy cows were divided into 2 feeding groups (low DCAD and control). Fourteen animals of each group received a daily dosage of 3mg of 25-OHD(3). From the beginning of the treatment to d 10 after parturition, plasma samples for analysis of 25-OHD(3), 1,25-dihydroxyvitamin D(3), parathyroid hormone (PTH), Ca(2+), phosphate, the bone resorption marker CrossLaps, and osteocalcin were collected every other day, at calving, and at 6, 12, and 24h after calving. Urine samples for determination of macrominerals and measures of acid-base status were collected on d 6 of treatment and on d 6 after calving. The induction of a compensated metabolic acidosis by the animals on the DCAD diet could be demonstrated by decreased urinary pH. A linear correlation between treatment duration and the plasma concentration of 25-OHD(3) indicated effective absorption of 25-OHD(3) in supplemented animals. The mean plasma concentrations of Ca(2+) from d -4 prepartum to d 4 postpartum were significantly higher in animals treated with the combination of the low DCAD diet and 25-OHD(3) supplementation (1.24±0.02 mmol/mL) compared with the 3 other groups (low DCAD: 1.17±0.02 mmol/mL; control diet plus 25-OHD(3): 1.16±0.02 mmol/mL; control diet: 1.18±0.02 mmol/mL). We postulate that the increased tissue responsiveness to parathyroid hormone induced by the low DCAD is crucial for the observed positive effects of the 25-OHD(3) treatment.

Milk production and nutrient digestibility by dairy cows when fed exogenous amylase with coarsely ground dry corn.

The digestibility of starch provided by coarsely ground corn is often low, which reduces the digestible energy (DE) concentration of the diet. We hypothesized that adding exogenous amylase to diets based on coarsely ground dent corn would increase dietary DE resulting in greater milk production. Total-tract nutrient digestibility was measured in a partially replicated Latin square experiment (6 cows and 4 periods) with a 2 × 2 factorial arrangement of treatments. Diets had 26 or 31% starch with or without exogenous amylase (amylase was added to the concentrate mixes at the feed mill). In the low and high starch diets, coarsely ground dry corn (mean particle size=1.42 mm) provided 43 and 62% of total dietary starch (corn silage provided most of the remaining starch). No treatment interactions were observed. High starch diets had greater dry matter (DM), organic matter, and energy digestibility than low starch diets, and diets with amylase had greater neutral detergent fiber digestibility than diets without amylase. Digestibility of starch averaged 88% and was not affected by treatment. A long-term (98-d) lactation study with 48 Holstein cows (74 d in milk) was conducted using 3 of the diets (low starch diets with and without amylase and the high starch diet without amylase). Addition of amylase to a diet with 26% starch did not affect intake, milk yield, milk composition, body weight, or body condition. Cows fed the diet with 31% starch had greater DM and DE intakes; yields of milk, fat, and protein; and feed efficiency than those fed diets with 26% starch. Milk composition was not affected by starch concentration. Adding exogenous amylase to a lower starch diet did not make the diet nutritionally equivalent to a higher starch diet.

Effect of feeding a reduced-starch diet with or without amylase addition on lactation performance in dairy cows.

The objective of this study was to determine lactation performance responses of high-producing dairy cows to a reduced-starch diet compared with a normal-starch diet and to the addition of exogenous amylase to the reduced-starch diet. Thirty-six multiparous Holstein cows (51+/-22 DIM and 643+/-49kg of body weight at trial initiation) were randomly assigned to 1 of 3 treatments in a completely randomized design: a 3-wk covariate adjustment period during which the cows were fed the normal-starch diet, followed by a 12-wk treatment period during which the cows were fed their assigned treatment diets. The normal-starch TMR did not contain exogenous amylase (NS-). The reduced-starch diets, formulated by partially replacing corn grain with soy hulls, were fed without (RS-) and with (RS+) exogenous amylase added to the TMR. Starch and NDF concentrations averaged 27.1 and 30.6%, 21.8 and 36.6%, and 20.7 and 36.6% (dry matter basis) for the NS-, RS-, and RS+ diets, respectively. Dry matter intake for cows fed the RS- diet was 2.4 and 3.2kg/d greater than for cows fed the NS- and RS+ diets, respectively. Intake of NDF ranged from 1.19 to 1.52% of body weight among the treatments, with the RS- diet being 28% greater than the NS- diet and 13% greater than the RS+ diet. Milk yield averaged 50.4kg/d and was unaffected by treatment. Fat-corrected milk yield was 2.9kg/d greater for cows fed the RS- diet than for cows fed the NS- diet. Body weight and body condition score measurements were unaffected by treatment. Fat-, solids-, and energy-corrected milk feed conversions (kilograms/kilogram of DMI) were 12 to 13% greater for cows fed the RS+ diet than for cows fed the RS- diet. Dry matter and nutrient digestibilities were lowest for cows fed the NS- diet and greatest for cows fed the RS+ diet, and were greater for cows fed the RS+ diet than for cows fed the RS- diet, with the exception of starch digestibility, which was similar. Greater conversion of feed to milk for dairy cows fed reduced-starch diets that include exogenous amylase may offer potential for improving economic performance.

Differential tissue-specific protein markers of vaginal carcinoma.

The objective was to identify proteins differentially expressed in vaginal cancer to elucidate relevant cancer-related proteins. A total of 16 fresh-frozen tissue biopsies, consisting of 5 biopsies from normal vaginal epithelium, 6 from primary vaginal carcinomas and 5 from primary cervical carcinomas, were analysed using two-dimensional gel electrophoresis (2-DE) and MALDI-TOF mass spectrometry. Of the 43 proteins identified with significant alterations in protein expression between non-tumourous and tumourous tissue, 26 were upregulated and 17 were downregulated. Some were similarly altered in vaginal and cervical carcinoma, including cytoskeletal proteins, tumour suppressor proteins, oncoproteins implicated in apoptosis and proteins in the ubiquitin-proteasome pathway. Three proteins were uniquely altered in vaginal carcinoma (DDX48, erbB3-binding protein and biliverdin reductase) and five in cervical carcinoma (peroxiredoxin 2, annexin A2, sarcomeric tropomyosin kappa, human ribonuclease inhibitor and prolyl-4-hydrolase beta). The identified proteins imply involvement of multiple different cellular pathways in the carcinogenesis of vaginal carcinoma. Similar protein alterations were found between vaginal and cervical carcinoma suggesting common tumourigenesis. However, the expression level of some of these proteins markedly differs among the three tissue specimens indicating that they might be useful molecular markers.

Staphylococcus aureus on Computer Mice and Keyboards in Intensive Care Units of the Universitas Academic Hospital; Bloemfontein; and ICU staff's Knowledge of its Hazards and Cleaning Practices

Nosocomial infections result in severe health and financial difficulties for patients and healthcare facilities. The objective of the study was to determine the presence of Staphylococcus aureus on computer mice and keyboards in the intensive care units (ICUs) of Universitas Academic Hospital; Bloemfontein; and ICU staff's knowledge regarding cleaning of computer mice and keyboards and their potential hazard as reservoirs for pathogens. Swab specimens from computer mice and keyboards (14 each) were investigated for S. aureus. Swabbing was repeated six months later. Standard microbiology laboratory methods were used to culture and identify organisms. An anonymous questionnaire completed by the ICU staff determined their awareness of computer mice and keyboards as potential sources of nosocomial infections. In addition to various environmental microorganisms and normal human flora; S. aureus was initially isolated from one computer mouse; and from two keyboards and five mice six months later. The questionnaire response rate was 85.6. Seventy-one percent of respondents stated that they regarded keyboards and mice as an important source of nosocomial infections. Nevertheless; 62of doctors and 40.3of nurses indicated that they never washed their hands before or after using the computer. Ninety-seven percent of respondents were not aware of an official cleaning policy for computer equipment. In order to prevent nosocomial infections resulting from microbial transmission between equipment; staff and patients; proper cleaning policies should be implemented

Net nutrient absorption and liver metabolism in lactating dairy cows fed supplemental dietary biotin.

The effect of feeding supplemental biotin on net absorption and metabolism of nutrients by the portal-drained viscera (PDV; the gut, pancreas, spleen and associated fat) and liver of lactating dairy cows was measured. Three cows in early to mid-lactation catheterised for measurements of net nutrient absorption and metabolism by the PDV and liver were fed a total-mixed ration with or without supplemental biotin at 20 mg/day using a switch-back design (ABA v. BAB) with three 2-week periods. There were no effects of feeding biotin on dry matter intake (22.2 kg/day), milk yield (29.5 kg/day) or milk composition. There was also no effect of feeding biotin on net release of glucose by the liver, net liver removal of glucose precursors (propionate, alanine, lactate) or net liver release of ß-hydroxybutyrate. Feeding biotin increased net PDV release of ammonia. Reasons for the response are not certain, but a numerical increase in net PDV release of acetate suggests that rumen or hindgut fermentation was altered. Results of the present study do not support the hypothesis that supplemental biotin increases liver glucose production in lactating dairy cows.

Knowledge of and Attitude towards Pain Relief during Labour of Women Attending

Objective: This study determined women's knowledge of and attitudes to pain relief during labour. Methods : This descriptive study included 151 women; 18 years or older; attending the antenatal clinic of Cecilia Makiwane Hospital. Women were interviewed using a questionnaire that determined their knowledge of and attitudes regarding pain relief. Results : The median age of the women was 29 years and most was pregnant for a second or third time. More than half the women (56.3) indicated that they knew about pain relief and most had received their information from a previous labour experience (56.5) or from friends and relatives (55.3). Of the women who had knowledge of pain relief (n=85); 65.9 had experienced severe pain during previous labour and 65.3 indicated injections. Half the women (51.7) believed that they should experience mild pain; however; while 55.7 of these had found the experience to be unacceptable. Most women (59.8) who had been pregnant were not told what to expect when in labour. Of those who had been told (n=41); 75.6) and good (31.2 found the information useful. The women who had previously delivered in a health facility rated the service received in relieving labour pain as fair (47.3)). Most of the women (99.3) believed that the staff had an important role to play in helping to relieve labour pain. Most of the women (78) expressed no concern about problems associated with pain relief methods; while a large number (83.4)expressed little or no confidence in labour pain relief.Conclusion : Most of the women gained knowledge regarding pain relief from past experiences or from friends and relatives. Even though the few women who received information about what to expect during labour found the information useful; most expressed little confidence in labour pain relief

Protein expression patterns in primary carcinoma of the vagina.

Protein patterns in six samples from primary vaginal cancers, in five from normal vaginal tissue and in five primary cervical cancers, were analysed using two-dimensional polyacrylamide gel electrophoresis (2-DE). Protein expression profile was evaluated by computer-assisted image analysis (PDQUEST) and proteins were subsequently identified using matrix-assisted laser desorption/ionisation mass spectrometry. The aim was to analyse the protein expression profiles using the hierarchical clustering method in vaginal carcinoma and to compare them with the protein pattern in cervical carcinoma in order to find a helpful tool for correct classification and for increased biomedical knowledge. Protein expression data of a distinct set of 33 protein spots were differentially expressed. These differences were statistically significant (Mann-Whitney signed-Ranked Test, P<0.05) between normal tissue, vaginal and cervical cancer. Furthermore, protein profiles of pairs of primary vaginal and cervical cancers were found to be very similar. Some of the protein spots that have so far been identified include Tropomyosin 1, cytokeratin 5, 15 and 17, Apolipoprotein A1, Annexin V, Glutathione-S-transferase. Others are the stress-related proteins, calreticulin, HSP 27 and HSP 70. We conclude that cluster analysis of proteomics data allows accurate discrimination between normal vaginal mucosa, primary vaginal and primary cervical cancer. However, vaginal and cervical carcinomas also appear to be relatively homogeneous in their gene expression, indicating similar carcinogenic pathways. There might, further, be a possibility to identify tumour-specific markers among the proteins that are differentially expressed. The results from this study have to be confirmed by more comprehensive studies in the future.

Effect of canthaxanthin content of the maternal diet on the antioxidant system of the developing chick.

1. Effects of canthaxanthin supplementation of the maternal diet on the antioxidant system of the developing chick were investigated. 2. Three hundred and twenty female broiler breeder birds were housed in one of 4 controlled environment rooms with 3 replicates for all treatments, with the exception of the control treatment of which there were 4 replicates. All birds received one of 5 diets: control low xanthophyll diet, or the same diet supplemented with 3, 6, 12 or 24 mg/kg canthaxanthin in the form of Carophyll Red. At 30 weeks of age 60 eggs from each of the 5 groups were incubated. At d 16 of the embryo development, at d 1 and d 7 posthatch tissue samples were collected and analysed by HPLC-based methods. 3. Canthaxanthin accumulation in the egg yolk was proportional to dietary content. Furthermore, at 12 to 24 mg/kg canthaxanthin was associated with an increase in gamma-tocopherol concentration in the egg yolk. Canthaxanthin was transferred from the egg yolk to the developing embryo and, as a result, its concentration in the liver of the embryo at 16 and in 1-d-old chicks was increased. Even at d 7 posthatch canthaxanthin concentration in the chicken liver was elevated. 4. Canthaxanthin supplementation of the maternal diet at 12 mg/kg was associated with an increased alpha-tocopherol concentration in the liver of 1-d-old chicks and resulted in decreased tissue susceptibility to lipid peroxidation. 5. Canthaxanthin supplementation at 6 to 24 mg/kg was also associated with a delay in alpha-tocopherol depletion from the liver for 7-d posthatch. As a result of the increased canthaxanthin and vitamin E concentrations in the liver of 7-d-old chicks, tissue susceptibility to lipid peroxidation decreased. 6. The results support an idea that dietary carotenoids can modulate antioxidant systems of the developing chicken.

Pancreatic hyperenzymaemia and hypertransaminasaemia in healthy subjects. Report of three cases.

Three healthy subjects, two from Italy and one from the United States, showing a chronic increase in serum pancreatic enzymes and transaminases are described. The enzyme elevations reached very high levels but were not constant; rather, they fluctuated and sometimes returned to normal. Furthermore, tests for non-hepatic diseases that can be accompanied by an increase in serum transaminases, such as coeliac disease, were normal. The intervals between the first finding of the pancreatic hyperenzymaemia and the hypertransaminasaemia and this study ranged from 2 to 6 years (mean 4.3 years), during which the three subjects remained healthy, with no clinical, laboratory or imaging evidence of disease. These data support the conclusion that these increases in enzymes are benign; however, monitoring of these three subjects is already underway. Awareness of this anomaly is important, both to relieve the distress of the persons involved, as well as to avoid the numerous, sometimes invasive, complex and expensive examinations that might otherwise be unnecessarily performed.