Effect of feeding rumen protected rice bran on calcium homeostasis of non-lactating multiparous cows.

Milk fever in dairy cows can be prevented by activating Ca homeostasis before calving. Homeostatic adaptation can be achieved by reducing dietary Ca availability. Formaldehyde-treated rice bran was studied to supply rumen protected phytic acid to reduce Ca availability. Twelve multiparous dry cows were used in a 3×3 Latin square change-over design with 5-day periods to test three dietary treatments. Diets consisted of a forage mix (maize silage, grass silage and hay), being 77% of ration dry matter, supplemented with three concentrates: Control (no formaldehyde-treated rice bran), T1 (100% formaldehyde-treated rice bran) and T2 (99.5% formaldehyde-treated rice bran with 0.6% Ca carbonate, to equal Ca content of Control). Dietary treatments did not affect urine pH (8.14, 8.13 and 8.11 for Control, T1 and T2 respectively) or dry matter intake (13.9, 13.7 and 13.8 kg for Control, T1 and T2 respectively). Including formaldehyde-treated rice bran in the diet resulted in lower urinary Ca/creatinine ratio (0.970, 0.457 and 0.618 for Control, T1 and T2 respectively). A sudden increase of urinary Ca excretion took place after withdrawal of T1 and T2 at introduction of Control, peaking on the first day and coming back down progressively in the second and third days. Peak was greatest after T1 and was not observed in transitions between rice bran treatments. This is understood as indirect evidence of activation of intestinal Ca absorption during formaldehyde-treated rice bran feeding, because renal adaptations to changes in blood Ca clearance are immediate and intestinal adaptations delay 2 days. It was concluded that including formaldehyde-treated rice bran in rations before calving may represent a dietary strategy to prevent milk fever without reducing dry matter intake.

Intima sarcoma of the pulmonary artery mimicking takayasu disease.

Pulmonary artery intima sarcoma is an uncommon but fatal tumor, which often masquerades chronic thromboembolic pulmonary hypertension (CTEPH) and in the present case Takayasu arteritis. Pulmonary arterial pressure is mildly elevated in the presence of extensive proximal lesions. A parenchyma thin-walled cavitary lesion may be a sign of pulmonary extravasation of the tumor.

Gefitinib monotherapy in advanced nonsmall cell lung cancer: a large Western community implementation study.

Epidermal growth factor receptor tyrosine kinase inhibitors represent a new treatment option for patients with advanced nonsmall cell lung cancer (NSCLC). This retrospective study examined to what extent previous clinical trial experience matches large-scale Western community implementation of this treatment. In the Belgian expanded access programme, the data from 513 patients with advanced or metastatic NSCLC, not suitable for further chemotherapy and receiving oral gefitinib 250 mg.day(-1) until disease progression, death or unacceptable toxicity, were analysed. The median (range) duration of gefitinib treatment was 2.3 months (0.0-32.7). Its use was predominantly in second- or third-line treatment. The overall response and disease control rates were 8.9 and 41.2%, respectively. In univariate analysis, response was more common in females and never-smokers. In multivariate analysis, female sex was the only significant predictive factor (odds ratio (OR) (95% confidence interval (CI)) 0.329 (0.129-0.839)). Symptom improvement was reported in 108 patients of whom 32 (29.6%) had an objective response, 66 (61.1%) experienced disease stabilisation and 10 (9.3%) progressed. Gefitinib was well tolerated; only 7.8% of the patients reported grade 3 or 4 toxicity. The overall median survival was 4.7 months, with a 1-yr survival rate of 21%. Survival was strongly influenced by a better performance status (PS) (good PS: hazard ratio (HR) (95%CI) 0.110 (0.077-0.157)) and adenocarcinoma with bronchioloalveolar carcinoma features histology (HR (95%CI) 0.483 (0.279-0.834)). In conclusion, the activity of gefitinib was confirmed in the present large Western community implementation study. Response, present in a small subgroup, led to a rewarding survival and could be predicted by sex only. Baseline performance status and adenocarcinoma with bronchioloalveolar carcinoma features histology were significant factors for survival.