[The efficacy of a combination herbal medicine in the treatment of functional dyspepsia].
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Biomedical subjects
Publications and source records attributed to M Ulbrich.
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BACKGROUND AND AIM: Functional dyspepsia is a heterogeneous clinical entity of incompletely known etiology. Overall, four randomized double-blind studies from the nineteen-nineties investigating acute treatment of this condition with the combination herbal medicine Iberogast, are available. A meta-analysis of the studieswas carried out to evaluate the overall therapeutic effect. PATIENTS AND METHODS: In all four, triple-arm, controlled multicentre studies, the efficacy of 4 weeks of treatment with 3 x 20 drops daily, applied after a washout phase, was investigated, the primary efficacy parameter being a specific gastrointestinal symptom score. Of the 592 participants in the studies, 196 were treated with Iberogast, 131 with placebo, and 61 with cisapride as positive control. The remaining 204 patients, who were treated with an experimental herbal preparation of similar composition, were not admitted to the final analysis. RESULTS: While overall appreciable improvement of the clinically relevant symptoms of moderate severity was seen under treatment with the combination herbal preparation, the individual studies differed in terms of the statistical significance of the results obtained. The meta-analysis of studies revealed a clear therapeutic effect for the herbal medicine (p < 0.0001). CONCLUSION: The clinical experience with the combination preparation for the treatment of functional dyspepsia was confirmed by the meta-analysis of the modern double-blind studies.
The validity of residues from hydrolysis of soya bean meal for production of lysine was tested in a growth experiment with 2 groups of 25 cross breeding lambs as well as in a N-balance trial with 5 lambs. The animals in the growth experiment started with an average body weight of 25 kg. An industrially produced concentrate for lamb fattening was given to the animals of the control group. To the second group a straw-concentrate mixture was given, containing 30% straw, 52% barley, 5% soya bean meal, 5% dried beet pulp and 5% of hydrolysis residue. The mixture included 10.71 MJ ME resp. 5.51 MJ net-energy fat (cattle) and 166 g digestible crude protein per kg dry matter. The lambs of group 2 showed an 8% lower intake of DM, connected with a 26% intake of energy and 32% lower intake of DCP in comparison to the control group. The average daily body weight gain was 374 g for the control group and 241 g for group 2 respectively, the difference being statistically significant. The feed/gain ratio was in group 2 = 14% higher for energy and 6% higher for DCP than in the control group. The N-balance trial resulted in a N-retention of 25 percent of the N-intake. The results approved the possible use of 5% of the hydrolysis residue product for 2% crude protein in straw-concentrate mixtures for ruminants.
In normally fed lambs (group 1) the content of ascorbic acid (AA) in the plasma on day 8, 18, 28, 38, 48, 60 and 100 after birth was the same as in lambs, that were fed on days 8 to 17 (group 2), 8 to 26 (group 3) and 8 to 35 (group 4) on the maintenance level. The restrictive feeding induced for a certain time a decrease in the glucose content of the plasma. In the lambs of group 2 and 3 there was no differences in the content of AA in 14 tissues compared to group 1. In the lambs of group 4 the body weight on the 35th day was only 54 and the mass of the hypophysis 60, of the lung 55.9, of the liver 51, of the heart 47.2, of the spleen 44.7 and of the kidney 38% of that of group 1; there was a tendency to a lower content of AA in most tissues. With increasing age the content of AA in the cerebrum, in the cerebellum, in the brain stem and in the testicles decreased; the highest content in the hypophysis was determined on day 180. The regulation of the synthesis of AA in the liver under normal and pathological conditions is discussed.
METHODS: The performance of five oscillometric blood pressure monitors was tested by means of a simulator. The oscillometric signals of two healthy patients were replayed. These signals were superimposed by sinusoidal artefacts with increasing amplitude, to examine the influence of artefacts on the accuracy of the measurement. Each measurement was repeated 15 times. RESULTS: The artefacts taken for this examination did affect the scattering of each single measurement rather than the mean value of the repeated measurements. The results did get worse with decreasing signal-to-artefact ratio. However, some monitors are able to handle these artefacts better than others. CONCLUSION: It is obvious that the implemented software for the artefact treatment and the determination of blood pressure values differs from manufacturer to manufacturer. Some devices were able to separate relevant signals from artefacts better than others. The most critical point of the oscillometric method is the correct determination of the maximum amplitude of the oscillations, because it directly influences the accuracy of the displayed blood pressure values. The availability of a simulator to test automated sphygmomanometers has shown to be a good tool to examine the performance of these devices.
The concentration of protein in the cerebrum of sheep after a period of feed restriction (group 2) was lower (94.5 +/- 10.2) than in normally fed sheep of group 4 (101.4 +/- 9.4 mg/g wet weight). In the group 2 the concentration of protein in the M. longissimus dorsi and in the M. semimembranosus was also smaller. A high DNA-concentration was determined in the intestinal lymph nodes, in the spleen and in the lung. The DNA-concentration of the testes of group 2 (7.17 +/- 2.92) was higher than that of the group 4 (4.46 +/- 1.70 mg/g w. w.), also that of the renal fat tissue (0.39 +/- 0.18 resp. 0.20 +/- 0.09). The highest protein: DNA-relation in group 4 was found in the fat tissue (203.5: 1) and the lowest in the spleen (15.3: 1). A high RNA-concentration was analysed in the lymph nodes, in the spleen and in the lung. The RNA-concentration in the fat tissue of group 2 (0.34 +/- 0.13) was higher that that in group 4 (0.15 +/- 0.08 mg/g w. w.).
In lambs after weaning with a body weight of 16.3 +/- 1.5 kg (group 1) and in sheep after a period of fattening with an increase of the body weight of 72.2 +/- 13.6 (group 2), of 184.4 +/- 12.2 (group 3) respectively of 302.1 +/- 24.3 g per day (group 4) the concentration of the components mentioned in the title was analysed in blood and plasma. The hematocrit, the concentration of Hb in the blood and that of total protein, of nonprotein-N, of Na, of Ca, of the iron-binding capacity and of Zn as well as the activity of the 5 enzymes in the plasma of the sheep of group 4 were higher than that of the group 2. Stress by the transport and stunning increased the concentration of free fatty acids in the plasma. The significance of the results for the clinical-chemical diagnosis is discussed.
Publications from Williams were the stimulation to study the relations between wool yield and cyst(e)ine concentration in blood plasma. Methodical experiments were carried out and the two methods used each provided clear results. At the same time the reversible binding of a part of the free cystine in the plasma with the plasma proteins and its effect on the analysis results might be considered. After an interpretation of the two methods their use is described taking into consideration the factors influencing the results of the analysis. It is concluded that the two methods are usable for the planned purpose.
In lambs with a very restricted intake of nutrients and an increase of the body mass of less than 60 g per day (group A) and in those with an increase of more than 220 g/day (group B), analyses of components of the blood and the plasma were performed at certain intervals. In the lambs of group A an anemia developed in the course of 77 days. The concentrations of alpha-amino-N, non-protein-N, urea, glucose and insulin as well as the activity of the alkaline phosphatase of the plasma of the lambs of group A were always lower than those of group B. The beta-hydroxybutyrate concentration of the lambs of group A on the 7th and 21st day of the experiment was higher than that of group B. The concentrations of inorganic phosphate and iron in the plasma of group A at most points during the study were lower than that in group B.
Analytical possibilities for nitrate determination in milk on the base of photometric methods are discussed. An automated method, similar to Nijhuis u. a. (1979), is proposed using flow stream analyser ADM 300. Natrium nitrate (5 g and 10 g/kg live weight resp.) was given to two dairy cows after morning feeding on the 1st and on the 3rd day of experiment. The increase of nitrate content in the milk was very quick, maximal concentrations after 2 h were found as 5.6 mg/l (animal 1) and 3.2 mg nitrate-N/l (animal 2). But nitrate also disappeared relatively quickly, after 24 h there only values were observed corresponding to normal range of 1 mg/l.
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In an N balance experiment with male crossbreeding lambs at an age of 3 ... 4 months four different rations were given differing in energy concentration (high greater than 700 EFU cattle/kg DM and low less than 650 EFU cattle/kg DM) and in the energy source (sugar, starch or crude fibre) with crude protein intake being almost equal. The rations contained 2% urea. Microbial protein synthesis in the rumen was assessed according to ROTH and KIRCHGESSNER (1978) (1), RYS et al. (1975) (2) and BICKEL-BAUMANN and LANDIS (1986) (3) on the basis of allantoin excretion in urine. The highest ruminal protein synthesis quotas were 868 ... 921 mg protein N per kg LW0.75 in (2). In (3) 723 ... 766 mg protein N/kg LW0.75 were synthesized. From the 15N labelling of the supplemented urea and the excreted allantoin it could be calculated that 26 ... 40% of the microbial protein resulted from the urea-N of the ration. Despite a high crude protein content of the ration of between 16 and 17% in the DM and a relation of NPN: pure protein of 0.95 the utilization of the NPN in the ration was relatively high but slightly lower than the utilization of pure protein. The variants with higher energy concentration showed as a tendency higher allantoin excretion in spite of slightly lower dry matter intake and a slightly higher NPN utilization than the variants with lower energy concentration.
Lambs of an age of 2 or 4 months and of an average live weight of 14.7 and 27.4 kg resp. received rations consisting of 44% cereals, 46% dried sugar beet pulp, 6% wheat starch, 2% urea and 2% mineral-vitamin mixture. The crude protein content was 17.1 and 15.9% resp. in the dry matter, that of native crude protein 10.6 and 9.4% resp. During a 6-day N balance period 8 and 16 g 15N urea resp. with a 15N excess (15N') of 9.26 and 9.40 atom-% were fed orally instead of commercial feeding urea. There were no significant differences between the two age groups with regard to the digestibility of the organic matter and the crude nutrients. The average N balance of 372 +/- 85 mg/kg LW 0.75/day were in the intermediate range of N retention capacity and accounted for 26 +/- 5% of the consumed N. N retention in per cent. was slightly lower in younger lambs. Projections of urea utilization in a quasi stationary state resulted in an efficiency of the utilization of 33 +/- 4%. The dismembering of the lambs at the end of the main period showed between 0.02 and 0.22 atom-% 15N' in the total N, TCA precipitable N and amino acid N of the meat. At between 0.24 and 0.38 atom-% 15N' they were highest in the heart and jaw muscles. The quota of 15N' amounts found in the total N of the meat were 10.6 +/- 3% of the 15N-intake and 20.1 +/- 5.1% of the 15N' amount remaining in the body. The bones contained 7.7 +/- 1.7% and the fleece 7.9 +/- 3.1% of the 15N'-intake. Generally seen, the total N and urea utilization was slightly lower in younger lambs than in older ones.
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Male calves between 15 and 26 days old and with a live weight between 45 and 46 kg received dried skim milk dissolved in water plus fat concentration from lard--suet mixtures made with a synthetic emulsifier of the type ethoxylated partial ester with and without soybean lecithin supplement. One group received bone fat with an emulsifier as sole fat component. In the course of 9 experiment weeks the calves of the lard--suet group without lecithin reached an average daily weight gain of 710 g, which was not significantly better than the gains of 689 g of the lard--suet group with lecithin and of 674 g of the bone fat group. The calves of the lard--suet group with lecithin did not digest the feed fat significantly better than the calves in the other two groups. The quota of fatty acids in the feed distinctly influenced the composition of the fatty acids in the intestines, the kidneys and the hypodermis. With the example of suet the general relationship between the fatty acid patterns of the feed and body fats are recognizable, with the fatty acids C 16:0, C 18:2 and C 18:3 having a lower and C 16:1, C 18:0 and C 18:1 having a higher quota in the suet than in the feed fat. Due to the application of high amounts of bone fat, vegetable oil or sea animal fat there are deviations from this rule. There is a higher quota of linolenic acid in the suet of the calves than in butter fat but a lower quota than in foreign fat.
Subsequent to a growth experiment with intensively fattened lambs the value of the carcasses of 4 animals each from 7 groups was determined. The control groups with mixed fattening feed for lambs and the groups with wheat and barley mixtures containing urea showed higher carcass yields, net gains, fat percentage and padding, dry matter and fat content of the carcass and lower quotas of important cuts as well as a lower crude protein content in the carcass than groups with grain without urea and groups with straw. This is due to the higher weight gains of the first-mentioned groups. There were no significant differences in the carcass characteristics between the animals of the control group and the grain-urea groups. The carcass quality of the male lambs was better than that of the female ones.
N balance experiments were carried out with lambs of the ages of 8, 12 and 15 weeks fed with wheat rations with and without 2% urea supplement (N 1 and N 2) as well as with 3% urea and 20% straw (N 3) or with a soya bean meal supplement (N 4). There were no significant differences in the digestibility of the crude nutrients and in per cent of N retention between the individual ages. The straw supplement decreased the digestibility of organic matter, crude protein, crude fibre and NfE. The supplements of soya bean meal or urea increased the crude protein content in comparison to the wheat ration without supplements by 6% in the dry matter and resulted in N intakes 55 ... 60% higher and in 23 ... 38% higher N retention, which was, however, lower in relation to N intake. There were no significant differences with regard to N retention between N 2, N 3 and N 4. Consequently urea supplement to the feed mixture with 14% native crude protein resulted in increased N retention, which was not lower than with a soya bean meal supplement.