Ruminal degradation and intestinal digestibility of protein and amino acids in high-protein feedstuffs commonly used in dairy diets

A study was conducted to determine the rumen degradation and intestinal digestibility of crude protein (CP) and AA, and AA composition of the rumen-undegradable protein (RUP) from 3 sources of blood meal (BM1, BM2, and BM3), canola meal (CM), low-fat distillers dried grains with solubles (LFDG), soybean meal (SBM), and expeller soybean meal (ESBM). Two Holstein cows fitted with ruminal and proximal duodenal cannulas were used for in situ incubation of 16h and for the mobile bag technique. To correct for bacterial contamination of the RUP, 2 methods were used: purines and DNA as bacterial markers. Ruminal degradations of CP were 85.3, 29.8, 40.7, 75.7, 76.9, 68.8, and 37.0 ± 3.93% for BM1, BM2, BM3, CM, LFDG, SBM, and ESBM, respectively. Ruminal degradation of both total essential AA and nonessential AA followed a similar pattern to that of CP across feedstuffs. Based on the ratio of AA concentration in the RUP to AA concentration in the original feedstuff, ruminal incubation decreased (ratio <1) the concentrations of His, Lys, and Trp, and increased (ratio >1) the concentrations of Ile and Met across feedstuffs. Compared with purines, the use of DNA as bacterial marker resulted in a higher estimate of bacterial CP contamination for CM and lower estimates for LFDG and ESBM. Intestinal digestibility of RUP could not be estimated for BM1, BM3, and SBM due to insufficient recovery of residue. For the remaining feedstuffs, intestinal digestibility of RUP was highest for ESBM, followed by BM2 and LFDG, and lowest for CM: 98.8, 87.9, 89.7, and 72.4 ± 1.40%, respectively. Intestinal absorbable dietary protein was higher for BM2 compared with CM and LFDG, at 61.7, 17.9, and 20.7 ± 2.73% CP, respectively. As prices fluctuate, intestinal absorbable protein or AA may be used as a tool to aid in the selection among feedstuffs with different protein quality.

Clinical evaluation of a new in-line continuous blood gas monitor

Two methodologies for obtaining accurate blood gas and electrolyte values during cardiopulmonary bypass (CPB) are traditional laboratory analyzers, which use an electrochemical technology, and continuous in-line monitoring systems, which use a fluorometric and/or spectrophotometric technology. The purpose of the present study was to evaluate the accuracy of a new continuous in-line monitor, the 3M CDI Blood Parameter Monitoring System 500, which provides continuous in-line measurements of pH, PCO2, PO2, potassium (K+), oxygen saturation, hematocrit, hemoglobin, and temperature, during partial or complete CPB. Study parameters included arterial pH, PCO2, PO2, and K+ values. Overall performance was analyzed by calculating the mean difference (expressed as the bias) between the CDI system 500 and the laboratory analyzer for each parameter. The accuracy of the arterial pH, PCO2, and K+ values provided by the CDI system 500 was then evaluated using target values established in the acceptable performance standards for laboratory analyzers from the Clinical Laboratory Improvement Act of 1988 (CLIA '88). The accuracy of the PO2 value provided by the CDI system 500 was evaluated using a target value of +/- 10% of the reference, or laboratory analyzer, value. A prospective multi-center trial was conducted following Institutional Review Board approval. A total of 75 cases was included in the analyses, with over 200 data points from 4 clinical locations. Results for pH, PCO2, and K+ were within the target values established by CLIA '88. pH bias was 0.00 +/- 0.02 pH units. PCO2 bias was -0.3 +/- 3.3 mm Hg. K+ bias was approximately +0.12 +/- 0.31 mmole/l. Results for PO2 were within 10% of the reference value. PO2 bias was 7.5 +/- 13.8 mm Hg. The results of this clinical trial show that the CDI System 500 continuous in-line monitoring system provides values that meet the accuracy standards for laboratory analyzers for arterial pH, PCO2, PO2, and K+.

AHA meeting focuses on federal budget: "the only game in town"

The Gramm-Rudman-Hollings budget balancing law still casts a long shadow over this year's Symposium on Federal Relations sponsored by the American Hospital Association. However with more Democrats in Congress, bills on catastrophic coverage and indigent care might have a chance to see the light of day.

Effective quality controls: the credentialing process and medical staff leadership

Two presentations given at the AMRA Annual Meeting in Denver received high praise from participants for the way in which they addressed physician-related quality assurance issues. Some of the material developed by Sue King, CMSC, who spoke on "Physician Credentialing Systems," and by William Jessee, MD, who gave a presentation entitled "Developing Medical Staff Leadership for Effective Quality Assurance," is offered to the wider JAMRA audience in the following article.

Physicians and medical record practitioners--maximizing cooperation, minimizing conflict

The transactions between physicians and medical record practitioners have rarely been stress-free, and the advent of the prospective payment system (PPS) has put additional pressure on both groups. However, a smooth working relationship is not an impossible dream. This article offers advice on how to find common ground with the majority of physicians and a few suggestions on way to relate more effectively to those few who cause persistent problems.

Women: health care's new decision makers

For six years, women members of the American College of Healthcare Executives (ACHE) had talked about the feasibility of sponsoring a conference on women's roles in health care. On May 15-16, 1986, this conference came to fruition as women in a variety of health care roles met in Chicago to exchange experience, frustrations, ad ambitions for their careers and the health care establishment as a whole.

Mental health record section meeting focuses on quality

Medical record practitioners working in psychiatric facilities face some special challenges. This report of a Chicago workshop sponsored by the Mental Health Record Section is offered to the wider JAMRA audience in order that other psychiatric practitioners may benefit and that RRAs and ARTs working in other settings might learn about the mental health field. In addition, the meeting and the article present information that is relevant to practitioners working in all types of settings.

Congressmen give AHA economics lesson

For years, Congress has been promising to balance the federal budget. Such talk has become commonplace and easy to ignore. However, if the Congressmen who addressed the American Hospital Association's Symposium on Federal Relations are typical, it's time to sit up and take notice. They mean business, they have a tough new law to prove it, and the consequences for health care providers could be dire.

Medical records and the Middle East: a partnership in development

Mention the Middle East and many people think of giant oil exports. However, medical record professionals have been importing their expertise to the region for more than 20 years, and in the process, making a valuable contribution to modernizing the health care systems in these countries. This article describes the experiences of some of these medical record pioneers and offers insights into changes in the region which will affect future expatriates.

Entrepreneurs turn problems into opportunities

The need for products and services to accommodate changes in medical record practice and the increasing number of women going into business for themselves are combining to create new opportunities for the medical record professional who wants to start a business. JAMRA interviewed several entrepreneurs in the medical record field to find out about their experiences, where they see today's opportunities, and what advice they have for would-be entrepreneurs.