Patient perspectives on the use of indwelling pleural catheters in malignant pleural effusions

BACKGROUND

Indwelling pleural catheters are an effective treatment option for patients with malignant pleural effusions. Despite their popularity, there remains a paucity of data on the patient experience and key patient-centred outcomes.

OBJECTIVE

To investigate the experience of patients receiving an indwelling pleural catheter to better inform and identify potential areas for improvement in care.

METHODS

This was a multicentre survey study at three academic, tertiary-care centres in Canada. Patients with a diagnosis of malignant pleural effusion who had an indwelling pleural catheter inserted were included. An adapted questionnaire specific to indwelling pleural catheters was used with responses recorded on a 4-point Likert scale. Patients completed the questionnaire in-person or by phone at 2-week and 3-month follow-up appointments.

RESULTS

A total of 105 patients were enrolled in the study with 84 patients included in the final analysis. At the 2-week follow-up, patient-reported improvements in dyspnoea and quality of life from indwelling pleural catheter were high at 93% and 87%, respectively. The predominant issues identified were discomfort at time of insertion (58%), itching (49%), difficulty with sleeping (39%), discomfort with home drainage (36%) and the pleural catheter reminding patients of their disease (63%). Avoiding hospitalisation for the management of dyspnoea was important to 95% of patients. Findings were similar at 3 months.

CONCLUSIONS

Indwelling pleural catheters are an effective intervention to directly improve dyspnoea and quality of life but have important disadvantages for some; clinicians and patients should be aware of these when making an informed decision regarding treatment.

Clinical characteristics of chylothorax: results from the International Collaborative Effusion database

Background

Chylothorax is an uncommon medical condition for which limited data are available regarding the contemporary aetiology, management and outcomes. The goal of this study was to better define these poorly characterised features.

Methods

The medical records of adult patients diagnosed with chylothorax at 12 centres across Europe, America and South Africa from 2009-2021 were retrospectively reviewed. Descriptive and inferential statistics were performed.

Results

77 patients (median age 69 years, male to female ratio 1.5) were included. Subacute dyspnoea was the most typical presenting symptom (66%). The commonest cause of chylothorax was malignancy (68.8%), with lymphoma accounting for 62% of these cases. Other aetiologies were trauma (13%), inflammatory/miscellaneous conditions (11.7%) and idiopathic cases (6.5%). At the initial thoracentesis, the pleural fluid appeared milky in 73%, was exudative in 89% and exhibited triglyceride concentrations >100 mg·dL-1 in 88%. Lymphangiography/lymphoscintigraphy were rarely ordered (3%), and demonstration of chylomicrons in pleural fluid was never ascertained. 67% of patients required interventional pleural procedures. Dietary measures were infrequently followed (36%). No patient underwent thoracic duct ligation or embolisation. Morbidity included infections (18%), and thrombosis in malignant aetiologies (16%). The 1-year mortality was 47%. Pleural fluid protein >3.5 mg·dL-1 (sub-distribution hazard ratio (SHR) 4.346) or lactate dehydrogenase <500 U·L-1 (SHR 10.21) increased the likelihood of effusion resolution. Pleural fluid protein ≤3.5 mg·dL-1 (HR 4.047), bilateral effusions (HR 2.749) and a history of respiratory disease (HR 2.428) negatively influenced survival.

Conclusion

Chylothoraces have a poor prognosis and most require pleural interventions. Despite the standard recommendations, lymphatic imaging is seldom used, nor are dietary restrictions followed.

Investigation and outcomes in patients with non-specific pleuritis: Results from the International Collaborative Effusion (ICE) database

Introduction

We present findings from the International Collaborative Effusion database, an ERS clinical research collaboration. Non-specific pleuritis (NSP) is a broad term that describes chronic pleural inflammation. Various aetiologies lead to NSP, which poses a diagnostic challenge for clinicians. A significant proportion of patients with this finding eventually develop a malignant diagnosis.

Methods

12 sites across 9 countries contributed anonymised data on 187 patients. 175 records were suitable for analysis.

Results

The commonest aetiology for NSP was recorded as Idiopathic (80/175, 44%). This was followed by pleural infection (15%), benign asbestos disease (12%), malignancy (6%) and cardiac failure (6%). The malignant diagnoses were predominantly mesothelioma (6/175, 3.4%) and lung adenocarcinoma (4/175, 2.3%). The median time to malignant diagnosis was 12.2 months (range 0.8–32). There was a signal towards greater asbestos exposure in the malignant NSP group compared to the benign group (0.63versus0.27, p=0.07). Recurrence of effusion requiring further therapeutic intervention, nor initial biopsy approach were associated with a false negative biopsy. A computed tomography finding of a mass lesion was the only imaging feature to demonstrate a significant association (0.18versus0.01, p=0.02), though sonographic pleural thickening also suggested an association (0.27versus0.09, p= 0.09).

Discussion

This is the first multi-centre study of NSP and its associated outcomes. Whilst some of our findings are reflected by the established body of literature, other findings have highlighted important areas for future research, not previously studied in NSP.

Risk of iatrogenic pneumothorax based on location of transbronchial biopsy: a retrospective cohort study

OBJECTIVE

Transbronchial lung biopsy (TBB) is a commonly performed procedure to obtain parenchymal lung tissue during bronchoscopy. Pneumothorax is among the most common serious complications of TBB. The objective of this study was to assess whether location of TBB correlated with development of post-procedural pneumothorax. We also sought to identify additional risk factors associated with pneumothorax development. This was a single-centre, retrospective cohort study. All TBB performed between 2010 and 2020 underwent subsequent chart review. The primary outcome was radiologist reported pneumothorax on post-procedure chest x-ray. Multivariable logistic regression model was created with included variables chosen a priori based on clinical significance.

RESULTS

There were a total of 222 TBB performed that met inclusion criteria. Radiographic evidence of pneumothorax was reported in 38 patients (15.4%). Ten patients (4.1%) required a chest tube. In the multivariable analysis, risk of pneumothorax was significantly higher for biopsies obtained from the left upper lobe (OR 3.3; 95% CI 1.3-9.1). There was an increased risk of pneumothorax following TBB when obtained from the left upper lobe. Clinicians should be aware of the increased risk and should consider alternative locations in patients with diffuse lung disease.

Diagnostic sensitivity of pleural fluid cytology in malignant pleural effusions: systematic review and meta-analysis

BACKGROUND

Pleural fluid cytology is an important diagnostic test used for the investigation of pleural effusions. There is considerable variability in the reported sensitivity for the diagnosis of malignant pleural effusions (MPE) in the literature.

OBJECTIVE

The purpose of this review is to determine the diagnostic sensitivity of pleural fluid cytology for MPE, both overall and by tumour type, to better inform the decision-making process when investigating pleural effusions.

DATA SOURCES

A literature search of EMBASE and MEDLINE was performed by four reviewers. Articles satisfying inclusion criteria were evaluated for bias using the QUADAS-2 tool.

DATA EXTRACTION

For quantitative analysis, we performed a metaanalysis using a binary random-effects model to determine pooled sensitivity. Subgroup analysis was performed based on primary cancer site and meta-regression by year of publication.

SYNTHESIS

Thirty-six studies with 6057 patients with MPE were included in the meta-analysis. The overall diagnostic sensitivity of pleural fluid cytology for MPE was 58.2% (95% CI 52.5% to 63.9%; range 20.5%-86.0%). There was substantial heterogeneity present among studies (I² 95.5%). For primary thoracic malignancies, sensitivity was highest in lung adenocarcinoma (83.6%; 95% CI 77.7% to 89.6%) and lowest in lung squamous cell carcinoma (24.2%; 95% CI 17.0% to 31.5%) and mesothelioma (28.9%; 95% CI 16.2% to 41.5%). For malignancies with extrathoracic origin, sensitivity was high for ovarian cancer (85.2%; 95% CI 74.2% to 96.1%) and modest for breast cancer (65.3%; 95% CI 49.8% to 80.8%).

CONCLUSIONS

Pleural fluid cytology has an overall sensitivity of 58.2% for the diagnosis of MPE. Clinicians should be aware of the high variability in diagnostic sensitivity by primary tumour type as well as the potential reasons for false-negative cytology results.PROSPERO registration numberCRD42021231473.

Endoscopic nodal staging in oligometastatic non-small cell lung cancer (NSCLC) being treated with stereotactic ablative radiotherapy (ENDO-SABR)

Background

Research in treatment of non-small cell lung cancer (NSCLC) has shown promising results with stereotactic ablative radiotherapy (SABR) of oligometastatic disease, wherein distant disease may be limited to one or a few distant organs by host factors. Traditionally, PET/CT has been used in detecting metastatic disease and avoiding futile surgical intervention, however, sensitivity and specificity is limited to only 81 and 79%, respectively. Mediastinal staging still identifies occult nodal disease in up to 20% of NSCLC patients initially thought to be operative candidates. Endobronchial ultrasound and transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive tool for the staging and diagnosis of thoracic malignancy. When EBUS is combined with endoscopic ultrasound using the same bronchoscope (EUS-B), the diagnostic sensitivity and negative predictive value increase to 84 and 97%, respectively. Endoscopic staging in patients with advanced disease has never been studied, but may inform treatment if a curative SABR approach is being taken.

Methods

This is a multi-centre, prospective, cohort study with two-stage design. In the first stage, 10 patients with oligometastatic NSCLC (lung tumour ± hilar/mediastinal lymphadenopathy) with up to 5 synchronous metastases will be enrolled An additional 19 patients will be enrolled in the second stage if rate of treatment change is greater than 10% in the first stage. Patients will be subject to EBUS or combined modality EBUS/EUS-B to assess bilateral lymph node stations using a N3 to N2 to N1 progression. Primary endpoint is defined as the rate of change to treatment plan including change from SABR to conventional dose radiation, change in mediastinal radiation field, and change from curative to palliative intent treatment.

Discussion

If a curative approach with SABR for oligometastatic disease is being explored, invasive mediastinal staging may guide treatment and prognosis. This study will provide insight into the use of endoscopic mediastinal staging in determining changes in treatment plan of NSCLC. Results will inform the design of future phase II trials.

Trial registration

Clinicaltrials.gov identifier NCT04852588. Date of registration: April 19, 2021. Protocol version: 1.1 on December 9, 2021.

Effects of EDTA on chemiluminescent immunoassay measurement of ACTH, cortisol, and thyroid hormones in dogs

When measuring blood hormones, pre-analytical sample handling can impact the quality of the results. Previous studies have shown improved stability of canine cortisol in ethylenediaminetetraacetic acid (EDTA) plasma compared to serum and interchangeability of serum and plasma when cortisol is measured by radioimmunoassay. Additionally, cortisol samples were also interchangeable when measured by chemiluminescent immunoassay if the EDTA concentration was consistent with that of optimally filled tubes, whereas excess EDTA interfered with the measurement of cortisol and serum and EDTA plasma were not interchangeable when measuring total thyroxine (TT4). The main limitation of these studies was that they were performed by spiking pooled serum samples with EDTA or in previously collected blood samples submitted to a clinical pathology laboratory. The purpose of the present study was to evaluate the effect of EDTA on the measurement of adrenocorticotropic hormone (ACTH), cortisol, TT4, free thyroxine (FT4), and thyroid stimulating hormone (TSH) in healthy dogs using the Siemens IMMULITE 1000. Whole blood from forty dogs was aliquoted into three Monoject sample tubes: no additive, completely filled EDTA tube, and 50% filled EDTA tube. Handling and storage conditions were identical, and all samples were analyzed on the same day. Bland-Altman plots and Passing-Bablok regression were used to assess agreement and risks for error, respectively. Proportional errors were found between serum and plasma samples for ACTH, cortisol, TT4, FT4, and TSH; systematic errors were also found for FT4. There was poor agreement and clinically significant differences between the measured concentrations of all hormones in serum and plasma, proving that these sample types are not interchangeable. Incompletely filled EDTA tubes were associated with significantly lower ACTH concentrations compared to completely filled EDTA tubes. When measured by chemiluminescent immunoassays that utilize alkaline phosphatase at the reporter enzyme, serum should be used for cortisol, TT4, FT4, and TSH, while plasma from completely filled EDTA tubes should be used for ACTH.

Rapid On-site Evaluation (ROSE) in Capillary Pull Versus Suction Biopsy Technique With Endobronchial Ultrasound-transbronchial Needle Aspiration (EBUS-TBNA)

BACKGROUND

Suction and capillary pull are 2 biopsy techniques used in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Although these techniques have been shown to perform comparably in terms of overall diagnostic yield, we hypothesized that the capillary pull technique would be associated with improved rapid on-site evaluation (ROSE) adequacy rates thus allowing for a shorter procedure time.

METHODS

One hundred eighteen patients undergoing EBUS-TBNA for any indication were randomized to suction or capillary pull techniques for the first biopsy pass; the technique used for all subsequent passes was based on operator preference and was not recorded. The first pass was subjected to ROSE and an adequacy assessment was given. ROSE slides were also scored for cellularity of diagnostic/lesional cells and blood contamination. The overall procedure time was also recorded.

RESULTS

There were no significant differences between suction and capillary pull techniques in terms of ROSE adequacy rates. Cellularity of diagnostic/lesional cells and blood contamination scores were also comparable. There was no significant difference in procedure time for the 2 techniques.

CONCLUSION

This study suggests no differences in ROSE outcomes between suction and capillary pull techniques in EBUS-TBNA. The technique used should therefore be left to the discretion of the operator.

Avoid the Trap: Nonexpanding Lung

Nonexpanding lung is a mechanical complication in which part of the lung is unable to expand to the chest wall, preventing apposition of the visceral and parietal pleura. This can result from various visceral pleural disease processes, including malignant pleural effusion and empyema. Nonexpanding lung can be referred to as trapped lung or lung entrapment, both with distinct clinical features and management strategies. Early evaluation of pleural effusions is important to address underlying causes of pleural inflammation and to prevent the progression from lung entrapment to trapped lung. Some patients with trapped lung will not experience symptomatic relief with pleural fluid removal. Therefore, misrecognition of trapped lung can result in patients undergoing unnecessary procedures with significant cost and morbidity. We reviewed the current understanding of nonexpanding lung, which included causes, common presentations, preventative strategies, and recommendations for clinical care.

Comparison of thermal imaging and rectal temperature in the diagnosis of pyrexia in pre-weaned calves using on farm conditions

Measuring core body temperature is used as part of the diagnostic process in assessing the health of animals. Typically in calves, this is carried out using a rectal thermometer which can be time consuming, stressful to the calf and is invasive by nature. A non-invasive technique that is gaining recognition is thermal imaging. This study investigated the use of thermal imaging as a technique to assess core body temperature in pre-weaned artificially reared calves. A total of 125 male and female calves had rectal temperatures measured daily from day 7 until day 40 of life, and at the same time had a thermal image taken of the area around the medial canthus of the eye. A weak correlation (r = 0.28) was found between calf rectal temperature and thermal image temperature. A multivariable predictive model for core body temperature increased the correlation (r = 0.32) when including the environmental parameters of air temperature (p < .001) and wind speed (p < .001) as well as reconstituted milk replacer consumption (p < .01). The effectiveness of a predictive model including these parameters for the detection of calves with a core body temperature ≥ 39.5 °C was examined and found to have a sensitivity of 0% and a specificity of 100%. The results of this study demonstrate the need to take thermal environmental parameters into consideration when using thermal imaging to assess body temperature. However, the results suggest that accurate measures of core body temperature using thermal imaging cannot be achieved under commercial farm conditions. Further research is needed to determine what other factors could be measured to increase predictive ability.

Atezolizumab-induced sarcoid-like granulomatous reaction in a patient with urothelial cell carcinoma

A 61-year-old woman with locally advanced, high-grade urothelial cell carcinoma was treated with the anti-programmed death-ligand 1 antibody atezolizumab. She initially received neoadjuvant chemotherapy and surgery that led to clinical and radiographic remission at the time of atezolizumab initiation. Within 3 months she developed new mediastinal and hilar lymphadenopathy as well as pulmonary nodules in a pattern characteristic of pulmonary sarcoidosis. Mediastinal lymph node biopsy by endobronchial ultrasound demonstrated noncaseating granulomas without evidence of malignancy or infection. Within 4 weeks of initiation of prednisone and cessation of atezolizumab there was marked reduction in intrathoracic lymphadenopathy and perilymphatic nodules. This is the first reported case of atezolizumab-induced sarcoid-like granulomatous reaction.

The use of infrared thermography for detecting digital dermatitis in dairy cattle: What is the best measure of temperature and foot location to use?

Lameness in dairy cattle is a persistent problem, indicating pain caused by underlying disease states and is associated with reduced milk yields. Digital dermatitis is a common cause of lameness. Thermal imaging is a technique that may facilitate early detection of this disease and has the potential for use in automated detection systems. Previous studies with thermal imaging have imaged either the heels or the coronary band of the foot and typically only used the maximum temperature (Max) value as the outcome measure. This study investigated the utility of other statistical descriptors: 90th percentile (90PCT), 95th percentile (95PCT), standard deviation (SD) and coefficient of variation (CoV) and compared the utility of imaging the heel or coronary band. Images were collected from lame and healthy cows using a high-resolution thermal camera. Analyses were done at the cow and foot level. There were significant differences between lame and healthy feet detectable at the heels (95th percentile: P<0.05; SD: P<0.05) and coronary band (SD: P<0.05). Within lame cows, 95PCT values were higher at the heel (P<0.05) and Max values were higher at the coronary band (P<0.05) in the lame foot compared to the healthy foot. ROC analysis showed an AUC value of 0.72 for Max temperature and 0.68 for 95PCT at the heels. It was concluded that maximum temperature is the most accurate measure, but other statistical descriptors of temperature can be used to detect lameness. These may be useful in certain contexts, such as where there is contamination. Differentiation of lame from healthy feet was most apparent when imaging the heels.

Pharmacodynamics and pharmacokinetics of insulin aspart assessed by use of the isoglycemic clamp method in healthy cats

The objective of this study was to determine the pharmacodynamics (PD) and pharmacokinetics (PK) of insulin aspart in healthy cats following intramuscular (IM) and subcutaneous (SC) injection. Eight healthy, purpose-bred cats were used in a randomized, crossover study design. Each cat had 2 isoglycemic clamps performed, one after receiving 0.25 IU/kg of insulin aspart by IM injection and one after receiving the same dose by SC injection. The two isoglycemic clamps were performed on different days, at least 48 h apart. The blood glucose, plasma endogenous insulin, and plasma insulin aspart concentrations were measured and the glucose infusion rate (GIR) was recorded during the clamp. The GIR over time was used to create a time-action curve for each clamp which was used to describe the PD of insulin aspart. Data that are normally distributed are reported as mean ± SD, while data that are not normally distributed are reported as median (25-75 percentile). When compared to the PD data that have been reported for regular insulin in healthy cats, insulin aspart had a more rapid onset (IM: 10 min [10-21.25 min], SC: 12.5 min [10-18.75 min]) and shorter duration of action (IM: 182.5 ± 34.33 min, SC: 159.38 ± 41.87 min). The onset of action (P = 0.795), time to peak action (P = 0.499), duration of action (P = 0.301), and total metabolic effect (P = 0.603) did not differ with route of administration; however, SC administration did result in a higher maximum plasma insulin aspart concentration (IM: 1,265.17 pmol/L [999.69-1,433.89 pmol/L], SC: 3,278.19 pmol/L [2,485.29-4,132.01 pmol/L], P = 0.000) and larger area under the insulin aspart vs time curve (IM: 82,662 ± 30,565 pmol/L, SC: 135,060 ± 39,026 pmol/L, P = 0.010). Insulin aspart has a rapid onset of action and short duration of effect in healthy cats when administered by IM and SC injection. Although it cannot be assumed that the PD and PK of insulin aspart will be the same in cats with diabetic ketoacidosis (DKA), our data support further investigation into the use of SC insulin aspart as an alternative to regular insulin for the treatment of DKA in cats.

Homeless veterans' experiences with substance use, recovery, and treatment through photo elicitation

BACKGROUND

Homeless veterans often have addictions and comorbidities that complicate utilization of longitudinal health care services, such as primary care. An understanding of experiences of veterans enrolled in a Homeless Patient Aligned Care Team (H-PACT) may improve addiction treatment engagement in these settings. The authors aimed to describe H-PACT veterans' experiences with substance use (SU), substance use recovery (SUR), and substance use treatment (SUT).

METHODS

Homeless veterans were recruited from a veteran primary care medical home clinic between September 2014 and March 2015. Twenty veterans were given digital cameras and prompts for taking photographs about their health and health care and participated in 2 photo elicitation interviews. For this secondary analysis, transcripts from the audio-recorded interviews were analyzed by 2 coders using qualitative content analysis.

RESULTS

The majority of participants (75%, n = 15) discussed SU, SUR, and/or SUT in regards to their health and health care utilization. SU themes centered on disclosure of addiction or dependency; substances used; repercussions of SU; SU as a coping mechanism; and association of SU with military service. SUR themes included disclosure of length of sobriety; perceived facilitators of SUR in health, beliefs, social, environmental, financial, and creative pursuit domains; and perceived barriers to SUR in beliefs, social, and environmental domains. SUT themes focused on perceived facilitators of SUT in access to Department of Veterans Affairs (VA) and non-VA services and social domains and perceived barriers to SUT in the social domain.

CONCLUSIONS

Providers seeking to elicit addiction-related clinical history and facilitate SUR and SUT might look to the current findings for guidance. Provider training in motivational interviewing may be warranted, which allows for an exploration of health-related consequences of SU and supports patients' self-efficacy.

Hazardous alcohol use and cultural adjustment among U.S. college students abroad in Italy: Findings and recommendations for study abroad staff and researchers

BACKGROUND

Italy is a top destination for U.S. college students studying abroad. Both international and local Italian media outlets, such as city newspapers, have cited the discordance between Italian cultural norms and U.S. college students' drinking behaviors. Hazardous alcohol consumption abroad, such as binge drinking, can result in individual- (e.g., physical injury) and social- (e.g., promotion of negative stereotypes) level adverse consequences.

METHODS

We assessed the prevalence of hazardous alcohol use and recent binge drinking in a sample of U.S. college students studying abroad in Italy (n = 111). We evaluated associations among drinking and cultural adjustment and determined which sociocultural factors predicted binge drinking for students abroad.

RESULTS

Forty-six percent of students were classified as hazardous drinkers and 63% reported recent binge drinking. Socializing with American peers was a significant predictor for binge drinking abroad.

CONCLUSIONS

Binge drinking was quite prevalent in our sample of students studying abroad in Italy. Study abroad advisors, instructors, and staff should consider diverse strategies to screen, educate, prevent, and/or intervene on alcohol misuse with their students. These strategies should be personalized to both the student as well as the host culture's norms.

Predicted optimum ambient temperatures for broiler chickens to dissipate metabolic heat do not affect performance or improve breast muscle quality

An experiment was conducted to test the hypothesis that muscle damage in fast-growing broiler chickens is associated with an ambient temperature that does not permit the birds to lose metabolic heat resulting in physiological heat stress and a reduction in meat quality.

The experiment was performed in 4 climate chambers and was repeated in 2 trials using a total of 200 male broiler chickens. Two treatments compared the recommended temperature profile and a cool regimen. The cool regimen was defined by a theoretical model that determined the environmental temperature that would enable heat generated by the bird to be lost to the environment.

There were no differences in growth rate or feed intake between the two treatments. Breast muscles from birds on the recommended temperature regimen were lighter, less red and more yellow than those from the cool temperature regimen. There were no differences in moisture loss or shear strength but stiffness was greater in breast muscle from birds housed in the cool compared to the recommended regimen.

Histopathological changes in the breast muscle were similar in both treatments and were characterised by mild to severe myofibre degeneration and necrosis with regeneration, fibrosis and adipocyte infiltration. There was no difference in plasma creatine kinase activity, a measure of muscle cell damage, between the two treatments consistent with the absence of differences in muscle pathology.

It was concluded that breast muscle damage in fast-growing broiler chickens was not the result of an inability to lose metabolic heat at recommended ambient temperatures. The results suggest that muscle cell damage and breast meat quality concerns in modern broiler chickens are related to genetic selection for muscle yields and that genetic selection to address breast muscle integrity in a balanced breeding programme is imperative.

Direct comparison of the psychometric properties of multiple interview and patient-rated assessments of suicidal ideation and behavior in an adult psychiatric inpatient sample

OBJECTIVE

Compare the accuracy, agreement, internal consistency, and interrater reliability of 3 interviews to assess suicidal ideation and behavior in accordance with US Food and Drug Administration guidance about reporting categories.

METHOD

Adults admitted to a psychiatric inpatient unit (N = 199) completed 3 assessments of past month and lifetime suicidal ideation and behavior-the Columbia Suicide Severity Rating Scale (C-SSRS), the Suicide Tracking Scale (STS), and the Sheehan Suicidality Tracking Scale (S-STS)-in randomized, counterbalanced order. "Missing gold standard" latent class analyses defined categories for ideation and behavior. Analyses also evaluated the S-STS mapping to C-SSRS categories. Three trained judges re-rated 89 randomly selected interview videotapes. Cohen κ, the primary outcome measure, quantified agreement above chance. Data were collected between November 2011 and June 2013.

RESULTS

All 3 assessments showed excellent accuracy for suicidal ideation (κ = 0.72 to 1.00) and attempts (κ = 0.82 to 0.95) calibrated against latent classes. Interrater agreement ranged from κ = 0.52 to 1.00. Interrater agreement about more granular C-SSRS categories varied more widely (κ = 0.48 to 1.00), and the C-SSRS and S-STS assigned significantly different numbers of cases to many categories. Cronbach α was < 0.55 for the C-SSRS ideation and between 0.78 and 0.92 for the other scales.

CONCLUSIONS

All 3 assessments showed good accuracy for broad categories of suicidal ideation and behavior. More granular, specific categories usually were rated reliably, but the C-SSRS and S-STS differed significantly in regard to which patients were assigned to these subcategories. Using any of these interviews would improve reliability over unstructured assessment in evaluating suicidal ideation and behavior. Clinical predictive validity of these interviews, and particularly the more granular categories, remains to be shown.

Risk Factors and Outcomes in Cats with Acquired Myasthenia Gravis (2001-2012)

Background

Acquired myasthenia gravis (MG) in cats most commonly causes generalized weakness without megaesophagus and is more often associated with a cranial mediastinal mass, compared to dogs.

Hypothesis/Objectives

To extend the clinical findings described in the report of 2000 on MG in cats (J Am Vet Med Assoc 215:55–57).

Animals

Two hundred and thirty‐five cats with MG.

Methods

Retrospective case study to evaluate the long‐term outcome and incidence of spontaneous remission in myasthenic cats. Information including signalment, clinical presentation, presence of and type of cranial mediastinal mass, treatment including surgical versus medical, survival time, and outcome including spontaneous remissions was collected and analyzed in cats diagnosed at the Comparative Neuromuscular Laboratory, University of California San Diego by detection of acetylcholine receptor antibody titers >0.3 nmol/L by immunoprecipitation radioimmunosassay.

Results

Acquired MG in cats is associated with a euthanasia rate of 58%. Abyssinian and Somali cats had an increased incidence of MG compared to mixed breed cats or cats of other breeds. A cranial mediastinal mass, most commonly thymoma, was observed in 52% of the cats, which is higher than in the previous report. Spontaneous remission is not a characteristic of MG in cats.

Conclusions and clinical importance

Myasthenia gravis in cats is a chronic disease associated with a high incidence of a cranial mediastinal mass. Spontaneous remission is not common and clinicians should warn owners of the necessity for long‐term treatment. The clinical outcome with a cranial mediastinal mass did not differ between surgical or medical treatment.

Alternate-day dosing of itraconazole in healthy adult cats

The current available formulations of itraconazole are not ideal for dosing in cats. The capsular preparation often does not allow for accurate dosing, the oral solution is difficult to administer and poorly tolerated, and the bioavailability of compounded formulations has been shown to be poor in other species. The aim of this study was to evaluate every other day dosing of 100 mg itraconazole capsule in healthy adult cats. Ten healthy adult cats received a 100 mg capsule of itraconazole orally every 48 h for 8 weeks. Peak and trough serum concentrations of itraconazole were measured weekly using high-performance liquid chromatography (HPLC). Physical examination, complete blood count (CBC), and chemistry profiles were performed weekly. The dosage regimen achieved average therapeutic trough concentrations (>0.5 μg/mL) within 3 weeks. The protocol yielded no adverse effects in 8 of the 10 study cats, with affected cats recovering fully with discontinuation of the drug and supportive care. At 8 weeks, an average peak concentration of 1.79 ± 0.952 μg/mL (95% CI: 0.996-2.588) and an average trough concentration of 0.761 ± 0.540 μg/mL (95% CI: 0.314-1.216) were achieved. Overall, a 100 mg every other day oral dosage regimen for itraconazole in cats yielded serum concentrations with minimal fluctuation and with careful monitoring may be considered for treatment of cats with systemic fungal disease.

Are housestaff identifying malnourished hospitalized medicine patients?

Clinical nutrition and nutritional assessment are often a neglected component of medical school curriculums despite the high prevalence of malnutrition in hospitalized patients. This study found that medical housestaff performed nutritional assessments in only 4% of admitted patients despite a high rate of malnutrition (57%). Survey results show housestaff lack knowledge in the area of malnutrition. Medical schools and training programs must place greater emphasis of providing qualified physician nutrition specialists to implement effective nutrition instruction.

Diaphragm remodeling and compensatory respiratory mechanics in a canine model of Duchenne muscular dystrophy

Ventilatory insufficiency remains the leading cause of death and late stage morbidity in Duchenne muscular dystrophy (DMD). To address critical gaps in our knowledge of the pathobiology of respiratory functional decline, we used an integrative approach to study respiratory mechanics in a translational model of DMD. In studies of individual dogs with the Golden Retriever muscular dystrophy (GRMD) mutation, we found evidence of rapidly progressive loss of ventilatory capacity in association with dramatic morphometric remodeling of the diaphragm. Within the first year of life, the mechanics of breathing at rest, and especially during pharmacological stimulation of respiratory control pathways in the carotid bodies, shift such that the primary role of the diaphragm becomes the passive elastic storage of energy transferred from abdominal wall muscles, thereby permitting the expiratory musculature to share in the generation of inspiratory pressure and flow. In the diaphragm, this physiological shift is associated with the loss of sarcomeres in series (∼ 60%) and an increase in muscle stiffness (∼ 900%) compared with those of the nondystrophic diaphragm, as studied during perfusion ex vivo. In addition to providing much needed endpoint measures for assessing the efficacy of therapeutics, we expect these findings to be a starting point for a more precise understanding of respiratory failure in DMD.

Association between absolute tumor burden and serum bone-specific alkaline phosphatase in canine appendicular osteosarcoma

BACKGROUND

In dogs with appendicular osteosarcoma (OSA), increased pretreatment serum bone-specific alkaline phosphatase (BALP) activity is a negative prognostic factor, associated with shorter disease-free intervals and survival times, but a biologic basis for observed differential serum BALP activities in canine OSA patients remains incompletely defined.

OBJECTIVE

Serum BALP activity will correlate with absolute tumor burden in dogs with OSA.

ANIMALS

This study included 96 client-owned dogs with appendicular OSA.

METHODS

In canine OSA cell lines, the expression and membranous release of BALP was evaluated in vitro. The correlation between serum BALP activity and radiographic primary tumor size was evaluated in OSA-bearing dogs. In dogs developing visceral OSA metastases, serial changes in serum BALP activities were evaluated in relation to progression of macroscopic metastases, and visceral metastatic OSA cells were evaluated for BALP expression.

RESULTS

In vitro, BALP expression was not associated with either tumorigenic or metastatic phenotype, rather the quantity of membranous BALP released was proportional with cell density. In dogs devoid of macroscopic metastases, there was a positive correlation between serum BALP activity and absolute primary tumor size. In dogs with progressive OSA metastases, serum BALP activity increased and coincided with the development of macroscopic metastases. OSA cells derived from visceral metastatic lesions retained BALP expression.

CONCLUSIONS AND CLINICAL IMPORTANCE

Tumor burden is a determinant of serum BALP activity in dogs with appendicular OSA. The association between increased pretreatment BALP activity and negative clinical prognosis may simply be attributed to greater initial tumor burden, and consequently more advanced tumor stage.

Evaluation of juvenile hormone analogues as rodent feed-through insecticides for control of immature phlebotomine sandflies

The juvenile hormone analogues methoprene and pyriproxyfen were evaluated as rodent feed-through insecticides for control of immature stages of the sandfly Phlebotomus papatasi Scopoli (Diptera: Psychodidae). The development and survival of P. papatasi second-instar larvae fed faeces from Syrian hamsters, Mesocricetus auratus, that had been fed a diet containing methoprene (0, 9.788, 97.88 or 978.8 p.p.m.) or pyriproxyfen (0, 9.82, 98.2 or 982 p.p.m.) were evaluated. The faeces of methoprene-treated hamsters greatly reduced the percentage of larvae that pupated at all concentrations tested and prevented adult emergence at all but the lowest concentration (9.788 p.p.m.). Pyriproxyfen prevented both pupation and adult emergence at all concentrations tested. The results of this study suggest that a control strategy using rodent baits containing juvenile hormone analogues to control phlebotomine sandflies that live in rodent burrows and feed on rodent faeces may be possible. As rodent reservoirs and vectors of Leishmania major live in close association in many parts of the Middle East, control of the transmission of the agent of zoonotic cutaneous leishmaniasis may also be possible.

Forecasting Hotspots-A Predictive Analytics Approach

Current visual analytics systems provide users with the means to explore trends in their data. Linked views and interactive displays provide insight into correlations among people, events, and places in space and time. Analysts search for events of interest through statistical tools linked to visual displays, drill down into the data, and form hypotheses based upon the available information. However, current systems stop short of predicting events. In spatiotemporal data, analysts are searching for regions of space and time with unusually high incidences of events (hotspots). In the cases where hotspots are found, analysts would like to predict how these regions may grow in order to plan resource allocation and preventative measures. Furthermore, analysts would also like to predict where future hotspots may occur. To facilitate such forecasting, we have created a predictive visual analytics toolkit that provides analysts with linked spatiotemporal and statistical analytic views. Our system models spatiotemporal events through the combination of kernel density estimation for event distribution and seasonal trend decomposition by loess smoothing for temporal predictions. We provide analysts with estimates of error in our modeling, along with spatial and temporal alerts to indicate the occurrence of statistically significant hotspots. Spatial data are distributed based on a modeling of previous event locations, thereby maintaining a temporal coherence with past events. Such tools allow analysts to perform real-time hypothesis testing, plan intervention strategies, and allocate resources to correspond to perceived threats.

Oral treatment of rodents with insecticides for control of sand flies (Diptera: Psychodidae) and the fluorescent tracer technique (FTT) as a tool to evaluate potential sand fly control methods

In laboratory studies, insecticides (diflubenzuron, novaluron, methoprene and, pyriproxyfen) that have been incorporated into rodent diets were effective as feed-throughs against sand fly larvae. Novaluron also was effective against sand fly larvae at low concentrations and under simulated field conditions. Ivermectin has been shown to be effective as a systemic insecticide, killing 100% of blood-feeding sand flies for up to seven d after rodents were treated. The fluorescent tracer technique (FTT) is the use of certain fluorescent dyes (rhodamine B or uranine O) as feed-through transtadial biomarkers for phlebotomine sand flies, systemic biomarkers for blood-feeding sand flies, and permanent markers for nectar-feeding sand flies. The results of these laboratory studies provide proof of concept for the FTT and indicate that the FTT could be used to delineate specific foci with rodent/sand fly associations that would be susceptible to control by using feed-through or systemic insecticides, or foci where insecticide-treated sugar baits could be used against sand flies.

Temperature gradients in trailers and changes in broiler rectal and core body temperature during winter transportation in Saskatchewan

Temperature conditions inside commercial trailers transporting market-age broilers during four winter journeys were measured, and changes in the rectal and core body temperature of birds were quantified. Pre-selected modules were equipped with data loggers recording temperature every 72 s. Rectal temperatures were taken from eight birds in each of four modules immediately before and after each trip, and two or three birds, with temperature recording implants, were placed in each of two selected modules. Temperature heterogeneity was found among modules on all loads with average crate temperatures ranging from 10.9 to 30.7, 8.9 to 28.1, 2.5 to 26.1 and -0.7 to 16.5°C for transportation times of 191, 193, 178 and 18 min and ambient temperatures of -7.1, -27.1, -28.2 and -18.4°C, respectively. Wet birds, condensation and frost provided evidence for moisture accumulation during transportation. Body temperature recordings indicated the potential for the development of both hypothermia and hyperthermia, showing that cold stress can occur near air inlets and heat stress in poorly ventilated areas. Passive ventilation inside trailers resulted in crate temperatures 17.7 to 55.2°C above outside temperature. Mortality ranged from 0.7 to 1.4% but several deaths occurred during lairage, prior to processing. A heterogeneous distribution of airflow resulted in undesirable temperate and humidity conditions for some birds. Key words: Broiler, transportation, temperature gradient, mortality, cold weather

Effects of teacher attention on attending behavior of two boys at adjacent desks

The effects of teacher attention on the attending behavior of two boys seated at adjacent desks were investigated. Baseline records were obtained of the appropriate attending behavior of two boys who were described as the most disruptive pupils in a second-grade classroom of a poverty area school. During the first experimental phase, the teacher systematically increased the amount of attention for appropriate attending in one of the pair, Edwin. This resulted in a dramatic increase in his attending rate and a lesser, though significant, increase in attending behavior of the second boy, Greg. During the second experimental phase, systematic attention for attending was instituted for Greg and was discontinued for Edwin. This resulted in further increases in attending by Greg and a reduction in attending by Edwin. A brief withdrawal of reinforcement for attending in both Greg and Edwin reduced attending levels for both. Following this reversal appropriate attending for both boys was systematically reinforced and attending returned to high levels.

Feather-picking psittacines: histopathology and species trends

Histologic findings are described for 408 feather-picking or self-mutilating psittacines with the use of biopsies from clinically affected and unaffected skin. Inflammatory skin disease was diagnosed in 210 birds, and traumatic skin disease was diagnosed in 198 birds. Criteria used for the diagnosis of inflammatory skin disease included the presence of perivascular inflammation in the superficial or deep dermis of clinically affected and unaffected sites. The primary histologic criteria for the diagnosis of traumatic skin disease were superficial dermal scarring with or without inflammation in the affected sites and an absence of inflammation in the unaffected sites. The inflammatory cells associated with the lesions were typically lymphocytes and occasionally plasma cells, histiocytes, and granulocytes. A preponderance of inflammatory skin disease was seen in macaws (Ara spp.) and Amazon parrots (Amazona spp.). A preponderance of traumatic skin disease was seen in cockatoos (Cacatua spp.) and African grey parrots (Psittacus erithacus). The prevalence of each was approximately equal in several other species, including conures (Aratinga and Pyrrhura spp.), eclectus parrots (Eclectus roratus), quaker parrots (Myiopsitta monachus), cockatiels (Nymphicus hollandicus), parakeets (Cyanorhamphus and Psittacula spp.), and caiques (Pionites spp.). No geographic or gender-based trends were identified. These findings could be helpful for identifying and treating birds with feather-picking disorders.

Ivermectin as a rodent feed-through insecticide for control of immature sand flies (Diptera: Psychodidae)

Ivermectin was evaluated as a potential rodent feed-through for the control of immature stages of Phlebotomus papatasi. The survival of sand fly larvae fed feces of Syrian hamsters (Mesocricetus auratus) that had been fed a diet containing 0, 2, 6, 10, 20, 60, or 100 ppm ivermectin was measured. Sand fly larvae fed the feces of ivermectin-treated hamsters had significantly reduced survival, with 100% mortality of larvae fed feces of hamsters fed a diet containing 20, 60, and 100 ppm ivermectin. The results of this study suggest that a control strategy using rodent baits containing ivermectin to control phlebotomine sand flies may be possible. Because rodent reservoirs and sand fly vectors of Leishmania major live in close association in many parts of the Middle East, the control of transmission of the agent of zoonotic cutaneous leishmaniasis also may be possible.

Evaluation of novaluron as a feed-through insecticide for control of immature sand flies (Diptera: Psychodidae)

The development and survival of sand fly Phlebotomus papatasi Scopoli (Diptera: Psychodidae) larvae fed feces of Syrian hamsters, Mesocricetus auratus, that had been fed a diet containing novaluron were evaluated. In total, six larval diets were used in sand fly larval bioassays. Four groups of larvae were fed feces of hamsters that had been maintained on a diet containing either 0, 9.88, 98.8, or 988 ppm novaluron. Two additional groups were fed a larval diet composed of equal parts composted rabbit feces and rabbit chow containing either 0 or 988 ppm novaluron. No pupation, hence no adult emergence, occurred when larvae were fed feces of hamsters that were fed diets containing novaluron. The mortality of sand flies fed feces of treated hamsters occurred during larval molts. The results of this study suggest that a control strategy using rodent baits containing novaluron to control phlebotomine sand flies and zoonotic cutaneous leishmaniasis may be possible.

Effects of ractopamine supplementation on growth performance and carcass characteristics of feedlot steers differing in biological type

Effects of ractopamine hydrochloride (RAC) supplementation on growth performance and carcass characteristics of feedlot steers differing in biological type were investigated using British, Continental crossbred, and Brahman crossbred calf-fed steers (n = 420). Steers of each type were weighed at reimplantation [British, mean BW = 375 kg (SD = 38 kg); Continental crossbred, mean BW = 379 kg (SD = 42 kg); Brahman crossbred, mean BW = 340 (SD = 32 kg)] and sorted into 7 BW blocks, each block consisting of 2 pens (10 steers per pen) per type. Pens within a block x type subclass were randomly assigned to RAC treatments (0 or 200 mg x steer(-1) x d(-1) fed during the final 28 d of the finishing period). The type x RAC interaction did not affect (P > 0.05) any of the traits evaluated in this study. Feeding RAC improved (P = 0.001) ADG (1.50 vs. 1.73 +/- 0.09 kg) and G:F (0.145 vs. 0.170 +/- 0.005), but did not affect (P = 0.48) DMI of steers. Dressing percentage, adjusted fat thickness, KPH percentage, and yield grade were not affected by RAC supplementation. Carcasses of steers fed RAC had heavier (P = 0.01) HCW (359 vs. 365 +/- 4.9 kg), larger (P = 0.046) LM areas (81.7 vs. 84.0 +/- 1.1 cm(2)), and tended (P = 0.07) to have lower mean marbling scores (487 vs. 477 +/- 5.2; Slight = 400, Small = 500) than did carcasses of control steers. Among the 3 biological types, Brahman crossbred steers had the lowest DMI and produced the lightest-weight carcasses that had the lowest mean marbling score (P < 0.05). Compared with Continental crossbred and Brahman crossbred steers, British steers produced carcasses with the greatest (P = 0.001) mean marbling scores. Continental crossbred steers had the heaviest BW and greatest dressing percentages and produced the heaviest carcasses with the largest LM areas (P < 0.05) compared with British and Brahman crossbred steers. In the present study, 28 d of supplementation with RAC at a dosage rate of 200 mg x steer(-1) x d(-1) elicited consistent responses in growth performance and carcass traits among 3 diverse biological cattle types.

Clinical and cardiorespiratory effects of propofol in the spotted bamboo shark (Chylloscyllium plagiosum)

Sharks are important exhibit animals in aquariums and zoologic institutions worldwide. Although veterinarians are encountering these species more frequently in these institutions, our knowledge regarding safe restraint and anesthesia is limited. To date there have been only a few anecdotal reports or studies evaluating the effects of tricaine methane sulfonate (MS-222), ketamine hydrochloride, and tiletamine and zolazepam (Telazol) in sharks. The purpose of this study was to evaluate the clinical and cardiorespiratory effects of propofol in spotted bamboo sharks (Chylloscyllium plagiosum). Nine wild-caught adult female spotted bamboo sharks (mean weight 2.4 kg+/-SD 1.45 kg) were used in this study. Propofol (2.5 mg/kg) was administered over 30 sec via the caudal tail vein. Heart rate, respiratory rate, time to relaxation, escape response, loss of righting reflex, and response to noxious stimuli (fin pinch) were evaluated and recorded at baseline and 5, 10, 15, 30, 45, 60, and 75 min after propofol administration. A surgical plane of anesthesia was achieved when the shark lost its righting reflex, did not respond to noxious painful stimuli, and no longer resisted handling. The righting reflex was lost within 5 min of propofol administration, and a surgical plane of anesthesia was observed in all nine sharks. Heart rate (P = 0.5) and respiratory rate (P = 0.5) did not change significantly over time. The righting response returned within 60 min in 44% (4/9) of the sharks, 75 min in 22% (2/ 9) of the sharks, and over 200 min in 33% (3/9) of the sharks. All nine animals recovered uneventfully. Propofol provided a safe anesthetic event for spotted bamboo sharks.

Laboratory evaluation of diflubenzuron as a feed-through for control of immature sand flies (Diptera: Psychodidae)

The benzoylurea chitin synthesis inhibitor diflubenzuron was evaluated as a rodent feed-through for the control of immature stages of Phlebotomus papatasi Scopoli (Diptera: Psychodidae). The development and survival of second instars of P. papatasi larvae that were fed feces from Syrian hamsters, Mesocricetus auratus, that had been fed a diet containing 0, 8.97, 89.7, or 897 ppm diflubenzuron was evaluated. No pupation or adult emergence occurred when larvae were fed feces from hamsters that were fed diets containing diflubenzuron. The mortality of sand flies fed feces from treated hamsters was coincident with pupation of the controls, suggesting a specific effect on the larval-to-pupal molt. The results of this study suggest that a control strategy using rodent baits containing diflubenzuron for phlebotomine sand flies and zoonotic cutaneous leishmaniasis may be possible.

A Comparison of Breast Muscle Characteristics in Three Broiler Great-Grandparent Lines

Genetic selection of broiler chickens has led to a gross overdevelopment of the broiler breast muscle pectoralis major. This may have resulted in increased myopathy and detrimental effects on meat quality. The present study examined 3 commercial great-grandparent lines (lines A, B, and C). Lines A and B are female lines, and line C is a male line. The mean BW of line C (2.7 kg) was significantly greater than those of lines A and B (both 2.3 kg). However, the mean breast yield of both lines B and C (8.9 and 8.7%, respectively) was significantly greater than that of line A (6.9%). Line B therefore matched the meat yield of line A while maintaining a high reproductive capacity. The mean breast fillet weight of line A (169 g) was significantly lower than lines B (207 g) and C (235 g). No differences were observed between lines in either mean fiber size or amount of connective tissue. Therefore, additional fibers must provide the additional weight in the breast fillet of lines B and C, compared with A. Plasma creatine kinase activity, a commonly used marker of muscle damage, was significantly higher in line A (1368 IU/L) than in lines B (995 IU/L) and C (982 IU/L). However, qualitative evaluations of muscle pathology revealed no differences among lines. Selection for increased embryonic muscle fiber number, rather than for increased radial fiber growth, could improve growth potential and may also alleviate muscle damage.

Thermoregulatory capacity and muscle membrane integrity are compromised in broilers compared with layers at the same age or body weight

1. The effects of acute heat stress (2 h at 32 degrees C and 75% RH) on body temperature and indices of respiratory thermoregulation and skeletal muscle function were examined in two divergently selected male grandparent lines of broiler and layer-type chickens at two ages (35 and 63 d), or at a similar body weight (approximately 2.2 kg). 2. The two chicken lines exhibited markedly different baseline blood acid-base and skeletal muscle characteristics. At the same age or live weight, birds from the broiler line had significantly higher venous blood carbon dioxide tensions associated with lower blood pH. Plasma creatine kinase (CK) activities reflecting muscle membrane damage were also greatly elevated in the broiler line. 3. Exposure to acute heat stress caused an increase in deep body temperature, panting-induced acid-base disturbances and elevated plasma CK activity in both lines of chicken, an effect that increased with age. The extent of disturbances in acid-base regulation and heat-stress-induced myopathy were more pronounced in the broiler than the layer line at the same age or similar live weights. 4. It is suggested that genetic selection for high muscle growth in broiler lines has compromised their capacity to respond to an acute thermal challenge, leading to detrimental consequences for muscle function. This reduction in heat tolerance may have important implications for bird welfare and subsequent meat quality.

Skeletal muscle fibre growth and growth associated myopathy in the domestic chicken (Gallus domesticus)

1. Genetic selection of broilers may have pushed muscle fibres to their maximum functional size constraints. Broiler (B), female great-grandparent (GGP) and layer (L) lines were weighed, blood sampled and killed from 5 to 25 weeks of age. 2. At 25 weeks, Pectoralis major (Pm) fibre size reached by the B (65.9 microm) and GGP (59.8 microm) were 1.5 times greater than the L (38.1 microm). In the B and GGP lines, fibre growth of the Pm markedly exceeded that of the Biceps femoris (Bf) muscle. However, in the L line, fibre growth of the Pm and Bf muscle was comparable. Connective tissue content was generally higher in the Bf than in the Pm of all lines. 3. Centralised nuclei were observed predominantly in Pm, and may regulate fibre size. Both large muscle fibres and inadequate capillary supply may induce metabolic stress in B and GGP lines due to the large diffusion distances for oxygen, metabolites and waste products. 4. Enzyme markers of muscle damage (creatine kinase (CK), lactate dehydrogenase (LDH) and aspartate aminotransaminase (AST)) and histopathological analysis of Pm and Bf indicated greater myopathy in B and GGP vs L. 5. Regenerative processes were associated with oestrogen secretion. Reduced CK and LDH preceded egg yolk precursor production and increased calcium uptake for eggshell synthesis in all three lines. Oestrogen may stimulate muscle fibre regeneration and recovery as a myo-protective adaptation to potentially detrimental changes in calcium economy during egg production.

The prevalence of macroscopic sarcocysts in New Zealand cattle at slaughter

A survey carried out to determine the prevalence of visible Surcocystis spp. infection in 100 slaughtered cattle in a South Island abattoir revealed 64% infected. Although all ages, genders, breeds and export grades were infected, only host age had a statistically significant effect on the infection rate. Infections were most common in the rectus abdominis and the psoas muscles (47% and 41% respectively). Most infections were light, with less than ten macrocysts seen, though infections of more than 50 macrocysts occurred. The average macrocyst length was 4.WO.10 mm (SE) (n = 233), the average cyst wall thickness 5.3 +/- 0.2 microm (SE) (n = 45). It is thought that the actual prevalence of infection is higher than that recorded and reasons for this are discussed.

The role of sodium ions in the pathogenesis of skeletal muscle damage in broiler chickens

The effect of sodium ions (Na+) on calcium (Ca2+)-mediated muscle damage in broiler chickens was investigated using an in vitro muscle preparation. Muscle Ca2+ accumulation was determined by 45Ca2+ uptake. Muscle damage was assessed by measurement of the efflux of the intracellular enzyme creatine kinase (CK) into the incubation medium. Loading muscle cells with Na+ by means of the sodium ionophore monensin led to concentration-dependent (25 to 200 microM) increases in 45Ca2+ uptakes and corresponding and proportional CK losses. The greatest responses occurred at 100 microM ionophore or greater, reflected in a 49% increase (P < 0.05) in 45Ca2+ uptake and an associated 140%-fold increase (P < 0.001) in CK efflux. Inhibition of muscle Na+/K+-ATPase activity with ouabain (2 mM) induced a 56% increase in 45Ca2+ uptake and a 60%-fold increase (P < 0.001) in total CK loss. The combined use of ionophore and ouabain resulted in 90 and 130%-fold elevations in 45Ca2+ uptake and CK loss, respectively. In monensin-treated muscles, inhibition of external Ca2+ influx from the incubation medium by chelation with 1,2 bis(2-aminophenoxy)ethane-N,N,N',N' tetracetic acid (5 mM) markedly reduced 45Ca2+ uptake (38%: P < 0.05) but increased CK release by 85% (P < 0.001). The results demonstrate that initial elevations in muscle Na+ can facilitate increases in muscle Ca2+ and lead to alterations in muscle cell membrane integrity and CK loss. The Na+-induced increases in myocellular Ca2+ may be mediated via direct extracellular Ca2+ entry or redistribution from internal Ca2+ stores. It is proposed that in order to reduce or prevent myopathies in poultry, exposure to conditions that may lead to elevations in muscle Na+ (e.g., increased muscle activity and stress or accidental ionophore toxicosis) should be avoided. The findings of this study have implications for management strategies of bird welfare, muscle pathology, and product quality.

Myopathy in broiler chickens: a role for Ca(2+)-activated phospholipase A2?

The role of Ca(2+)-dependent phospholipase A2 (PLA2) in the mechanism of skeletal muscle damage in broiler chickens was examined in vitro using a novel, synthetic, PLA2-specific inhibitor Ro31-499/001 (Ro31). Muscle damage was assessed by measurement of creatine kinase (CK) efflux from isolated muscles into the incubation medium. Treatment with the specific Ca(2+)-ionophore 4-Br-A23187 (5 microM) caused a 72% elevation (P<0.05) in muscle 45Ca2+ accumulation, which was associated with a marked increase (P<0.001) in muscle CK efflux (7.6-fold). Incubation with Ro31 (50 microM) reduced (P<0.001) CK efflux from muscles treated with ionophore (45%) but was without effect on 45Ca accumulation. Treatment with the Na+ ionophore monensin (100 microM) induced 55% (P< 0.05) elevation in 45Ca2+ accumulation with a concomitant 2.5-fold increase (P<0.001) in CK loss. Muscles incubated with monensin in the presence of Ro31 exhibited a 49% reduction (P<0.001) in CK leakage but showed no change in 45Ca2+ uptake. The results indicate that increasing external Ca2+ entry, directly or indirectly, and elevation of intracellular Ca2+, significantly alters sarcolemmal integrity resulting in increased CK efflux from broiler skeletal muscle. This process is, at least in part, dependent upon activation of PLA2 activity and thus inhibitable by Ro31. It is further proposed that muscle damage in poultry induced by a range of stresses, and insults may also be mediated by a Ro31 sensitive, PLA2-dependent component. The findings have implications for strategies to reduce or prevent myopathies in poultry affecting bird welfare and product quality.

Welfare assessment of broiler breeders that are food restricted after peak rate of lay

1. Broiler breeder females were reared on one of three growth curves (ad libitum, conventional or modified restriction) and given rations containing a high or low concentration of crude protein. After the peak rate of lay they were fed ad libitum or a decreasing quantity of food in response to declining egg production. The welfare of the birds was assessed by determining the changes in indices of welfare at 36, 48 and 60 weeks of age. 2. Body weight increased rapidly in restricted birds fed ad libitum post-peak and water intake declined. 3. Post-peak food restriction was associated with a decrease in resting and increased drinking and spot-pecking activities. Birds that were food restricted during rearing spent more time foraging and spot-pecking at 36 and 48 but not 60 weeks of age. 4. Immune function increased with age but was not affected by the experimental treatments. The heterophil-lymphocyte ratio in birds fed ad libitum during rearing was numerically lower at 36 and higher at 48 and 60 weeks of age compared with restricted birds. 5. There was no effect of treatment on plasma corticosterone concentration. Creatine kinase activity was high at 60 weeks in treatments that were characterised by poor reproductive status and the activities of other enzymes reflected differences in reproductive status and mortality. 6. There was no long-term welfare or production advantage from feeding low protein rations or more generous feeding during the rearing period compared with conventional food restriction programmes.

Spontaneous squamous cell carcinoma of the tongue and multiple bronchioloalveolar carcinomas in a Virginia opossum (Didelphis virginiana)

Two primary tumours, squamous cell carcinoma of the tongue and multiple bronchioloalveolar carcinomas, were diagnosed in a Virginia opossum (Didelphis virginiana). Two oral masses were located in the right ventrolateral surface of the tongue, near the frenulum, and the lungs contained multiple, widely distributed, nodular masses. Microscopically, the oral masses were composed of invasive cords of pleomorphic, polyhedral cells, typical of squamous cells. The multiple pulmonary masses consisted of non-ciliated, cuboidal, columnar, or occasionally polyhedral cells arranged in an alveolar pattern with multifocal areas of necrosis. This is the first report of spontaneous oropharyngeal squamous cell carcinoma in the Virginia opossum. However, multiple pulmonary adenomas have been reported previously in this species, the lesions being similar to those in sheep pulmonary adenomatosis (jaagsiekte). In the present study, immunohistochemical examination of the pulmonary tumours with a rabbit polyclonal antiserum to jaagsiekte retroviral capsid protein proved negative.

Welfare assessment of modified rearing programmes for broiler breeders

1. Female broiler breeders were fed ad libitum or a restricted quantity of food to achieve either a recommended body weight curve or a modified (linear) growth curve that allowed more generous feeding between 6 and 15 weeks of age. The birds were fed a ration containing either a normal or low concentration of crude protein. The welfare of the birds was assessed using a profile of indices of welfare at 6, 12, 18 and 24 weeks of age. 2. The low-protein ration decreased the body weight of birds fed ad libitum and restricted birds were fed substantially more of the low-protein ration to meet target body weights from 3 to 14 weeks of age. 3. The modified restricted rearing programme did not have an effect on indices of welfare. 4. Water intakes and plasma corticosterone concentrations were lower in restricted birds fed the low-protein ration and they spent more time resting, and less time spot-pecking, than birds fed the high-protein ration. 5. Birds fed ad libitum on both rations spent more time resting and less time foraging, drinking and spot-pecking than food restricted birds and were more fearful than restricted birds at 6, 12 and 18 weeks of age. 6. The heterophil:lymphocyte ratio in restricted birds was higher at 6 weeks and lower at 24 weeks compared with birds fed ad libitum. Humoral immunity was lower at 6 weeks of age in birds fed ad libitum and was similar at other ages. Cell-mediated immunity was similar among all treatments. 7. Plasma corticosterone concentrations were higher in restricted birds compared with birds fed ad libitum. Plasma creatine kinase activity was higher in birds fed ad libitum at 6, 12 and 18 weeks of age. Alkaline phosphatase and lactate dehydrogenase activity were higher whereas AST was lower in restricted birds compared with those fed ad libitum. 8. There was no evidence to support the use of low protein rations or linear growth curves to improve welfare in restricted broiler breeder females.