Nutritive value of a vegetable amaranth cultivar for growing lambs.

Current interest in amaranth as a food resource for humans and animals has been stimulated by activities in germplasm collection and testing in the U.S. Fifteen growing, intact male lambs weighing 18.7 kg were assigned randomly to three diets (five lambs/diet) for a 14-d growth trial followed immediately by an 8-d (4-d adjustment, 4-d collection) digestion and N balance trial to determine the utilization of the forage component (leaves and stems) of an African cultivar (Zimbabwe cultivar PI 482049, Amaranthus cruentus L.) All diets contained 40.95% ground corn, 8.0% soybean meal and 1.05% mineral-vitamin supplement plus either 50% ground alfalfa hay, 25% ground alfalfa hay plus 25% ground amaranth forage or 50% ground amaranth forage. Lambs had ad libitum access to feed during the growth trial and at 4% of BW daily during the digestion and N balance period. Replacement of half or all the alfalfa in the diet with amaranth had no effect on weight gain or feed utilization. Apparent digestibility of cell contents, NDF, ADF, cellulose, ADL, N and GE and percentage of absorbed N retained did not differ among the three diets. The amaranth vegetable cultivar Zimbabwe PI 482049 promoted weight gain and feed utilization equal to that obtained with alfalfa as the sole forage for growing lambs. Additional research is needed to evaluate further the potential role of forage/vegetable amaranth as an animal feed resource.

Reduced pupillary sensitivity to topical phenylephrine associated with the relaxation response.

Human pupillary dilatation after topical instillation of phenylephrine was assessed in a prospective, randomized, controlled experiment to measure alterations in alpha-end-organ responsivity after regular elicitation of the relaxation response. Baseline pupillometric measurements were taken in both experimental and control subjects. The experimental subjects then practiced daily a technique that elicited the relaxation response while the control subjects sat quietly for comparable periods of time without eliciting the relaxation response. After four to six weeks, both groups returned to the laboratory for an assessment identical to that of the first visit. Comparison between visits revealed that the pupillary dilatation in the experimental group was significantly diminished (p less than .02) as compared to that of the control group. This observation is consistent with reduced end-organ responsivity to an exogenous alpha-adrenergic agent after regular elicitation of the relaxation response.

Amaranth and its oil inhibit cholesterol biosynthesis in 6-week-old female chickens.

All amaranth varieties contain tocotrienols and squalene compounds which are known to affect cholesterol biosynthesis. Therefore, in the present study, the influence of dietary supplementation of whole seed, popped, and milled amaranth and amaranth oil on cholesterogenesis was studied in 6-wk-old female chickens. Serum total cholesterol and LDL-cholesterol were lowered 10-30% and 7-70% (P < 0.01), respectively, in birds fed amaranth-containing diets. HDL-cholesterol was not affected by amaranth supplementation. Activities of liver cholesterol 7alpha-hydroxylase (the enzyme responsible for cholesterol breakdown into bile acids) were 10-18% higher (P < 0.01) than those of controls for birds fed most forms of amaranth and its oil, whereas activities of liver 3-hydroxy-3-methylglutaryl coenzyme A reductase (the rate-limiting enzyme for cholesterol biosynthesis) were lowered by about only 9% (P < 0.01) by popped, milled amaranth and its oil. This lack of marked inhibition of this enzyme suggests the presence of some other potent cholesterol inhibitor(s) apart from tocotrienols and squalene in amaranth.

Is upper gastrointestinal radiography necessary in the initial management of uncomplicated dyspepsia? A randomized controlled trial comparing empiric antacid therapy plus patient reassurance with traditional care.

STUDY OBJECTIVE: To compare two strategies for the evaluation and management of patients who have had acute dyspepsia for four days or more: empiric high-dose antacid therapy combined with patient reassurance (empiric care) versus therapy based on prompt upper gastrointestinal radiography (traditional care). DESIGN: Prospective, randomized trial. The patients in the empiric care group were reassured that upper gastrointestinal radiography was not necessary and were subsequently treated with high-dose empiric antacid therapy (15-30 ml of high-potency antacid one and three hours after meals and at bedtime). The traditional care group after meals and at bedtime). The traditional care group received upper gastrointestinal radiography as part of the initial evaluation. Subsequent treatment was determined by individual physicians based on test results. SETTINGS: Fee-for-service, hospital-based primary care practice and Veteran's Administration medical center outpatient clinic. PATIENTS: All patients were less than 70 years of age and without gastrointestinal bleeding, anemia, significant weight loss, or other specified symptoms of severe acid peptic disease. Fifty patients were randomized to traditional care, and 51 to empiric care. Pre-randomization clinical features were identical with the exception of sex distribution and baseline disability. MEASUREMENTS AND MAIN RESULTS: After six months of follow-up, there were no significant differences in symptom scores, disability, satisfaction, and quality of life measures (as measured by the Sickness Impact Profile scores) between the two groups. Findings were unchanged when adjusted for sex, study site, alcohol consumption, and cigarette smoking. Of the radiographs obtained in the traditional care group, 13 (27%) showed duodenal ulcer disease, gastritis, or duodenitis. There were no serious complications of ulcer disease or therapy noted in either group. The average costs per patient associated with traditional care at one study site were greater, $286 versus $116 (p less than 0.0001). CONCLUSIONS: Select patients with dyspepsia receiving a combination of reassurance and empiric antacid therapy do as well as patients whose initial management strategy includes upper gastrointestinal radiography, at a substantially lower cost.

The diagnostic value of upper gastrointestinal radiography.

We reviewed the indications for and results of 788 consecutive upper gastrointestinal radiographs (UGIs) performed for ambulatory patients. Sixty-three percent of tests were ordered for the evaluation of abdominal pain, dyspepsia, or esophageal reflux. Of these tests, only 4.8% yielded results of major clinical importance to patient management. The yield for patients greater than 50 years of age was greater than for patients less than 50, 6.9 versus 3.0% (p = 0.04). There was a significant increase in yield with increasing age (chi trend = 11.6, p less than 0.001). Among patients with an indication of esophageal reflux alone (n = 62), there were no patients younger than age 60 with a test result that would significantly affect therapy or outcome. Among patients evaluated for fecal occult blood or weight loss (n = 120), 11.7% of tests ordered showed a finding of major clinical importance. In this group, the yield was higher in those greater than or equal to 50 years of age than in those less than 50, 14.7 versus 6.7%, (p = 0.2). These results indicate that UGIs ordered to evaluate pain or symptoms of esophageal reflux in the absence of bleeding or weight loss rarely yield results that significantly influence therapy. Such patients may be best served by an initial trial of empiric therapy or some other test. The UGI has greatest value when indications for it include bleeding or weight loss.