Weaned piglets prefer feed with hydroxychloride trace minerals to feed with sulfate minerals

The aim of this study was to determine whether newly weaned piglets had a preference for diets containing hydroxychloride trace minerals (HTM). To test this, two preference tests were set up. In Exp. 1, the piglets could choose between HTM or inorganic, originating from sulfate trace minerals (STM) in the form of sulfates. Two treatments were applied with high Cu levels (160 ppm Cu added) or low Cu levels (15 ppm Cu added). All diets contained 110 ppm added Zn from the same source as Cu in the respective diet. The pigs could choose between a diet with hydroxychloride Cu and Zn or with Cu and Zn originating from sulfates at the same mineral levels. The piglets were included in the study from weaning until 34 d after weaning. In Exp. 2, the piglets could also choose between HTM and STM. However, automated feeding stations were used to collect individual feed intake data. Similarly two treatments were applied, one with high Cu levels (160 ppm added Cu) and one with slightly lower Cu levels (140 ppm added Cu until 28 d after weaning, thereafter 15 ppm added Cu). All diets contained 110 ppm added Zn from the same source as Cu in the respective diet. The piglets were followed until 35 d after weaning. The current studies showed that when piglets were given a choice, they preferred diets with HTM. This effect resulted only in a significant (P < 0.05) preference for HTM at high dietary Cu levels (160 ppm) ranging from 76% to 81% in the first and second week of Exp. 1 to between 53.4% and 57.8% in the overall experiment period of Exp. 2. This preference was less pronounced at levels of 140 ppm added or less. Individual feed intake and gain measurements did not show any link between the preference and the performance.

[Cause for referral by family physicians and obstetricians in Amsterdam in (threatened) miscarriage as reflected in the guideline '(Threatened) abortion' of the Dutch Society for Family Physicians]

OBJECTIVE

To determine the reasons general practitioners (GPs) and midwives have for referring patients with symptoms of imminent miscarriage to hospital and the management in hospital.

DESIGN

Prospective and descriptive.

SETTING

Research Centre Primary/Secondary Health Care, University Hospital Free University, the "Onze Lieve Vrouwe Gasthuis' hospital, both in Amsterdam, the Netherlands.

METHOD

During the period August 1994-February 1995 anamnesis, diagnostics, diagnosis and further management were recorded for all patients who visited the "Onze Lieve Vrouwe Gasthuis' hospital with blood loss and/or pain in the first 16 weeks of gestation. Patients revealed their wishes concerning referral by filling in questionnaires. Their GPs/midwives were asked about the referral motives in a telephone interview.

RESULTS

In the hospital 105 patients were recorded; 34% came on their own initiative. In hospital none of the patients with the diagnosis "imminent miscarriage' was referred back to the GP/midwife. Only 59% of the GPs/midwives performed the physical examinations the (imminent) miscarriage guideline of the Dutch College of General Practitioners advises. In 56% of the 32 patients referred there was no reason for referral according to the (imminent) miscarriage guideline.

CONCLUSION

The (imminent) miscarriage guideline issued by the Dutch College of General Practitioners was not always followed because patients went to the hospital on their own account, GPs/midwives did not agree with the guideline, patients wanted another policy and obstetricians kept patients in their own care.

[Does the '(Imminent) miscarriage standard of the Dutch College of Family Physicians correspond to the management by gynecologists?]

OBJECTIVE

To determine if the '(Imminent) miscarriage' standard issued by the Dutch College of General Practitioners corresponds to the management by obstetricians.

DESIGN

Postal questionnaire.

SETTING

Research Centre Primary/Secondary Health Care, Free University Hospital Amsterdam.

METHOD

A postal questionnaire was sent in 1994 to all partnerships of obstetricians (n = 122) in the Netherlands about their management in case of an imminent miscarriage.

RESULTS

The response rate was 86% (n = 105). Nearly all partnerships (94%) had an agreement about their management in case of an imminent miscarriage, but the individual protocols varied. In case of a miscarriage or an imminent miscarriage 10% and 28% respectively of all partnerships said they would refer the woman to the GP or midwife. Furthermore, 21% of all partnerships said that the GP or midwife could not have an ultrasound scan made themselves, i.e. without referring to the obstetrician. Many respondent knowing the GP standard (64%) did not agree with the guidelines restricting ultrasound scans (39%) or advising expectative management (24%). They thought that an ultrasound scan was essential to diagnosis and that an expectative management would increase the risk of severe blood loss. On the other hand 15% agreed to all the guidelines.

CONCLUSION

The management of obstetricians with respect to (imminent) miscarriage is diverse and does not correspond to the guidelines of the '(Imminent) miscarriage' GP standard, notably with respect to the advised expectative management.