[Approaches of general practitioners and patients to multimorbidity. Qualitative study].

Background: For general practioners (GP) the treatment of patients suffering from multimorbidity is an everyday challenge. For these patients guidelines which each focus on a specific chronic disease cannot be applied comprehensively and equally; therefore, it is necessary to prioritize.

Objective: Given this situation the study aimed at analyzing how GPs and patients deal with this challenge and what their priorities are.

Coping with multimorbidity in old age--a qualitative study.

Background: Comparatively few studies address the problems related to multimorbidity. This is surprising, since multimorbidity is a particular challenge for both general practitioners and patients. This study focuses on the latter, analyzing the way patients aged 65-85 cope with multimorbidity.

Variation in growth and potentially associated health status in Hermann's and spur-thighed tortoise (Testudo hermanni and Testudo graeca).

Captive reptiles often show higher growth rates than in the wild, possibly due to higher feeding intensity. Although health problems are usually linked to inappropriate diets, fast growth itself, such as triggered by appropriate diets fed in high amounts, has traditionally also been considered unfavorable for tortoises. We document growth rates (based on age and mass) from private Testudo hermanni and T.

Prolonged storage of epididymal spermatozoa does not affect their capacity to fertilise in vitro-matured domestic cat (Felis catus) oocytes when using ICSI.

The impact of different storage conditions of epididymal spermatozoa (including prolonged storage, cryopreservation and freeze-drying) on their fertilisation capacity was tested using intracytoplasmic sperm injection (ICSI). This kind of information is urgently needed when applying assisted reproductive technology to endangered felids in zoos. In particular, the utilisation of epididymal spermatozoa of castrated or deceased felids often requires time-consuming transportation and is therefore susceptible to loss of gamete quality.

Condensing results of wet sieving analyses into a single data: a comparison of methods for particle size description.

Sieve analysis is used in feed analysis, and studies of digestive physiology with various approaches to describe an average value of particle size which can serve to compare different samples. To demonstrate the effects of such different approaches, we compared five particle size indicators to demonstrate advantages and disadvantages of each method, the modulus of fineness (MOF), the discrete mean (dMEAN) and median (dMED), and the continuous mean (cMEAN) and median (cMED), well aware of the fact that a gold standard for this procedure is lacking. Data were obtained from 580 individual faecal samples of different herbivore species by wet sieving over a cascade of nine sieves with mesh sizes ranging from 0.

Phylogenetic constraints on digesta separation: Variation in fluid throughput in the digestive tract in mammalian herbivores.

The relevance of the mean retention time (MRT) of particles through the gastrointestinal tract (GIT) is well understood and MRT(particle)GIT is an important parameter in digestion models. Solute markers have been used to estimate MRT(solute)GIT (or 'fluid passage') in animals, but the relevance of this measure is less evident and is usually sought in its relation to MRT(particle)GIT. The ratio between the two measures indicates the degree of 'digesta washing', with little washing occurring at ratios of 1, aborad washing at ratios >1 (where the solute marker travels faster than the particle marker), and orad (retrograde) washing at ratios <1 (where the solute marker travels slower than the particle marker).

Role of the double luteinizing hormone peak, luteinizing follicles, and the secretion of inhibin for dominant follicle selection in Asian elephants (Elephas maximus).

Elephants express two luteinizing hormone (LH) peaks timed 3 wk apart during the follicular phase. This is in marked contrast with the classic mammalian estrous cycle model with its single, ovulation-inducing LH peak. It is not clear why ovulation and a rise in progesterone only occur after the second LH peak in elephants.

Mating system, feeding type and ex situ conservation effort determine life expectancy in captive ruminants.

Zoo animal husbandry aims at constantly improving husbandry, reproductive success and ultimately animal welfare. Nevertheless, analyses to determine factors influencing husbandry of different species are rare. The relative life expectancy (rLE; life expectancy (LE) as proportion of longevity) describes husbandry success of captive populations.

A longitudinal study on avian polyomavirus-specific antibodies in captive Spix's macaws (Cyanopsitta spixii).

Avian polyomavirus (APV) causes a range of disease syndromes in psittacine birds, from acute fatal disease to subclinical infections, depending on age, species, and other unidentified risk factors. To determine the prevalence of APV-specific antibodies in a captive population of Spix's macaws (Cyanopsitta spixii) in Quatar, 54 birds were tested by blocking enzyme-linked immunosorbent assay. A prevalence of 48.

Comparative ingestive mastication in domestic horses and cattle: a pilot investigation.

It is often assumed that horses chew food more intensively during ingestion than cattle, which - as ruminants - complete part of the mastication during rumination. This has been proposed as a reason for more robust mandibles, larger masseter insertion areas and larger masseter muscles in horses as compared to cattle and other grazing ruminants. In this study, we evaluate results of comparative feeding trials with three horses (338-629 kg) and three cows (404-786 kg), on four different roughages.

To chew or not to chew: fecal particle size in herbivorous reptiles and mammals.

A major difference between reptile and mammalian herbivores is that the former do not masticate their food. Actually, food particle size reduction by chewing is usually considered one of the adaptations facilitating the higher metabolic rates of mammals. However, quantitative comparisons of ingesta particle size between the clades have, to our knowledge, not been performed so far.

Comparative investigations on digestion in grazing (Ceratotherium simum) and browsing (Diceros bicornis) rhinoceroses.

Rhinoceroses represent the largest extant herbivores with extensive dietary specialization for plant groups like browse (black rhino Diceros bicornis) or grass (white rhino Ceratotherium simum). However, it is not clear to what extent such diet selection patterns are reflected in adaptations of digestive physiology of the respective feeding types. In this study, feeding trials with four black and five white rhinos were conducted in four zoos.

Relevance of management and feeding regimens on life expectancy in captive deer.

Objective: To establish a demographic approach to facilitate the comparison of husbandry success for deer species in zoos and to test for factors that influence the performance of deer species in captivity.

Sample Population: Data collected from 45,736 zoo-kept deer that comprised 31 species.

Procedures: Data had been collected by the International Species Information System during the last 3 decades on zoo-kept deer around the world.

Passage marker excretion in red kangaroo (Macropus rufus), collared peccary (Pecari tajacu) and colobine monkeys (Colobus angolensis, C. polykomos, Trachypithecus johnii).

Ruminants are characterized by an efficient particle-sorting mechanism in the forestomach (FRST) followed by selective rechewing of large food particles. For the nonruminating foregut fermenter pygmy hippo it was demonstrated that large particles are excreted as fast as, or faster than, the small particles. The same has been suggested for other nonruminating foregut fermenters.

Circannual changes in the expression of vascular endothelial growth factor in the testis of roe deer (Capreolus capreolus).

Adult roe deer males show seasonal cycles of testicular growth and involution. The exact timing of these cycles requires endocrine regulation and local testicular control by autocrine/paracrine factors. Recent findings suggest that the vascular endothelial growth factor (VEGF) might have effects on both vascular and germinative cells in testis.

Physical characteristics of reticuloruminal contents of oxen in relation to forage type and time after feeding.

The stratification of reticulorumen (RR) contents has been described in domestic ruminants, but suspected to be absent in certain wild ruminant species. To investigate how such stratification could be quantified, we tested variables indicating stratification in three oxen with rumen cannulae, fed once daily for 3 h, one of three different forages (fresh grass FG, grass hay GH, lucerne hay LH). Ingesta samples from dorsal rumen (DR), ventral rumen (VR) and reticulum (RET) were taken at 0, 3, 6, 12 and 24 h after the last meal and analyzed for dry matter (DM) concentration, mean particle size and proportion of floating/sedimenting particles.

Sonomorphology of the reproductive tract in male and pregnant and non-pregnant female Rothschild's giraffes (Giraffa camelopardalis rotschildi).

The application of real-time-B-mode ultrasonography to wild and zoo animal medicine has been shown to improve the understanding of reproductive physiology in many species. Ultrasound technology is especially helpful for monitoring urogenital health, which in turn has advantages for giraffe breeding and welfare in captivity. This study aimed to ultrasonographically describe the genital organs of reproductively healthy male and female giraffes.

The intraruminal papillation gradient in wild ruminants of different feeding types: Implications for rumen physiology.

Browsing and grazing ruminants are thought to differ in the degree their rumen contents are stratified-which may be due to different characteristics of their respective forages, to particular adaptations of the animals, or both. However, this stratification is difficult to measure in live animals. The papillation of the rumen has been suggested as an anatomical proxy for stratification-with even papillation indicating homogenous contents, and uneven papillation (with few and small dorsal and ventral papillae, and prominent papillae in the atrium ruminis) stratified contents.

Changes in body weight, hematology and serum chemistry in captive plains viscachas (Lagostomus maximus) with presumptive diabetes type II after a diet change.

We report body weights (BW) and blood and serum analyses for 6 fully mature and 8 not-yet-mature captive plains viscachas before and 3, 6 and 9 months after switching from a low-fiber, high-energy diet to a high-fiber, low-energy diet. Initially, body weights, serum glucose, fructosamine and cholesterol levels were above the reference range in the fully mature animals. Furthermore, 4 of these animals had bilateral cataracts.

No easy solution for the fractionation of faecal nitrogen in captive wild herbivores: results of a pilot study.

Faecal nitrogen (FN) concentration is used as a marker for habitat quality and digestive efficiency in free-ranging herbivores. In herbivores, FN can be separated into undigested plant N (analysed as the N concentration of the neutral detergent residue) and metabolic faecal N (MFN). It has been suggested that by differential analysis of the faecal fibre-bound N, the MFN fraction can be further split into a bacterial N and an endogenous N fraction [Hesta et al.

More efficient mastication allows increasing intake without compromising digestibility or necessitating a larger gut: comparative feeding trials in banteng (Bos javanicus) and pygmy hippopotamus (Hexaprotodon liberiensis).

The digestion of plant material in mammalian herbivores basically depends on the chemical and structural composition of the diet, the mean particle size to which the forage is processed, and the ingesta retention time. These different factors can be influenced by the animal, and they can presumably compensate for each other. The pygmy hippopotamus, a non-ruminating foregut fermenter, has longer mean retention times than ruminants; however hippos do not achieve higher (fibre) digestibilities on comparable diets, which could be due to ineffective mastication.

Physical characteristics of rumen contents in two small ruminants of different feeding type, the mouflon (Ovis ammon musimon) and the roe deer (Capreolus capreolus).

In domestic ruminants, the stratification of forestomach contents - the results of flotation and sedimentation processes - is an important prerequisite for the selective particle retention in this organ. A series of anatomical and physiological measurements suggests that the degree of this stratification varies between browsing and grazing wild ruminants. We investigated the forestomach contents of free-ranging mouflon and roe deer shot during regular hunting procedures.

Split-sample comparison of directional and liquid nitrogen vapour freezing method on post-thaw semen quality in white rhinoceroses (Ceratotherium simum simum and Ceratotherium simum cottoni).

To increase the quality of cryopreserved sperm in white rhinoceros, the liquid nitrogen vapour (LN vapour) freezing and the multi-thermal gradient directional freezing methods were compared. Sixteen white rhinoceros (Ceratotherium simum sp.) were electro-ejaculated.

Higher masseter muscle mass in grazing than in browsing ruminants.

Using cranioskeletal measurements, several studies have generated evidence that grazing ruminants have a more pronounced mastication apparatus, in terms of muscle insertion areas and protuberances, than browsing ruminants, with the resulting hypothesis that grazers should have larger, heavier chewing muscles than browsers. However, the only investigation of this so far [Axmacher and Hofmann (J Zool 215:463-473, 1988)] did not find differences between ruminant feeding types in the masseter muscle mass of 22 species. Here, we expand the dataset to 48 ruminant species.