Wooden breast myopathy links with poorer gait in broiler chickens.

Wooden breast myopathy, a condition where broiler breast muscles show a hardened consistency post-mortem, has been described recently. However, it is not known how wooden breast myopathy affects the bird activity or welfare. Altogether, over 340 birds of five commonly used commercial hybrids were housed in 25 pens, and sample birds killed at ages of 22, 32, 36, 39 and 43 days. Their breast muscle condition was assessed post-mortem by palpation. The birds were gait scored and their latency to lie was measured before killing. For further behavior observations, one affected and healthy bird in 12 pens were followed on 5 days for 20 minutes using video recordings. The connection of myopathy to gait score and activity was analyzed with mixed models. A higher gait score of wooden-breast-affected birds than that of unaffected birds (2.9 ± 0.1 v. 2.6 ± 0.1, P < 0.05) indicated a higher level of locomotor difficulties over all age groups. The wooden-breast-affected birds had fewer crawling or movement bouts while lying down compared with unaffected (P < 0.05). Wooden breast myopathy-affected birds were heavier (2774 ± 91 v. 2620 ± 91 g; P < 0.05) and had higher breast muscle yield (21 ± 1 v. 19 ± 1%; P < 0.05) than unaffected birds overall. Older birds had longer lying bouts, longer total lying time, fewer walking bouts, more difficulties to walk and to stand compared with younger birds (P < 0.05). Birds with poorer gait had longer total lying time and fewer walking bouts (P < 0.05). Birds with greatest breast muscle yield had the largest number of lying bouts (P < 0.05). It was concluded that wooden breast myopathy was associated with an impairment of gait scores, and may thus be partly linked to the common walking abnormalities in broilers.

Wooden Breast Myodegeneration of Pectoralis Major Muscle Over the Growth Period in Broilers.

Wooden breast (WB) myopathy of broiler chickens is a myodegenerative disease of an unknown etiology and is macroscopically characterized by a hardened consistency of the pectoralis major muscle. Our aim was to describe the development and morphology of WB over the growth period in broilers. Additionally, the effect of restricted dietary selenium on the occurrence of WB was examined by allocating the birds in 2 dietary groups: restricted and conventional level of selenium. The experiment included 240 male broilers that were euthanized at ages of 10, 18, 24, 35, 38, or 42 days and evaluated for WB based on abnormal hardness of the pectoralis major muscle. The severity and the distribution of the lesion and presence of white striping were recorded. The first WB cases were seen at 18 days; 13/47 birds (28%) were affected and the majority exhibited a mild focal lesion. In subsequent age groups the WB prevalence varied between 48% and 73% and the lesion was usually diffuse and markedly firm. White striping often coexisted with WB. Histological evaluation performed on 111 cases revealed a significant association of myodegeneration and lymphocytic vasculitis with WB. Vasculitis and perivascular cell infiltration were restricted to the veins. Restricted dietary selenium did not affect the occurrence of WB ( P = .44). Our results indicate that WB starts focally and spreads to form a diffuse and more severe lesion.

Myodegeneration with fibrosis and regeneration in the pectoralis major muscle of broilers.

A myopathy affecting the pectoralis major muscle of the commercial broiler has emerged creating remarkable economic losses as well as a potential welfare problem of the birds. We here describe the macroscopic and histologic lesions of this myopathy within 10 pectoralis major muscles of 5- to 6-week-old broilers in Finland. Following macroscopic evaluation and palpation of the muscles, a tissue sample of each was fixed in formalin, processed for histology, and histologically evaluated. The muscles that were macroscopically hard, outbulging, pale, and often accompanied with white striping histologically exhibited moderate to severe polyphasic myodegeneration with regeneration as well as a variable amount of interstitial connective tissue accumulation or fibrosis. All affected cases also exhibited perivenular lymphocyte accumulation. The etiology of this myodegenerative lesion remains yet open. Polyphasic myodegeneration is associated with several previously known etiologies, but palpatory hardness focusing on the pectoralis major, together with perivenular lymphocytes, has not been described in relation to them. The results of this study provide the pathological basis for further studies concerning the etiology of the currently described myopathy.

More evidence of declining incidence of amyloidosis associated with inflammatory rheumatic diseases.

OBJECTIVE: To assess the incidence, prevalence, and outcome of amyloidosis associated with inflammatory rheumatic diseases. METHODS: An observational study was performed in the outpatient department of Kainuu Central Hospital from 1993 to 2007. The following criteria were used for the performance of abdominal subcutaneous fat aspiration (ASFA) and/or rectal biopsies: erythrocyte sedimentation rate (ESR) > 40 mm/h at two consecutive visits; and proteinuria (> 0.5 g/day) or serum creatinine > 150 µmol/L. Renal biopsy was performed when there was a high suspicion of amyloidosis in cases with negative findings in the above-mentioned biopsies. In addition, amyloid staining was used routinely for mucosal specimens taken in gastroscopy and colonoscopy. The patients were followed until death or to the end of 2007. RESULTS: New diagnoses of amyloidosis in the consecutive 5-year periods from 1993 onwards numbered 11, 3, and 5, respectively. During the study period, there was a mean annual incidence of amyloidosis of 1.8 [95% confidence interval (CI) 1.1-2.8)/100,000]. At the end of 2007 there were eight subjects with amyloidosis, giving a point prevalence of 12.0/100,000 (95% CI 5.2-23.6). Five patients out of the 19 underwent haemodialysis because of terminal uraemia and three of them also had renal transplantation. Overall, 12 (63%) patients died after a median survival time of 6 (95% CI 4-8) years, one-third from amyloidosis. The 5-year survival rate of the series was 67% (95% CI 41-86). CONCLUSION: Amyloidosis is rarely encountered today. ASFA or rectal biopsy facilitates its early diagnosis.

Disparities in rheumatoid arthritis disease activity according to gross domestic product in 25 countries in the QUEST-RA database.

OBJECTIVE: To analyse associations between the clinical status of patients with rheumatoid arthritis (RA) and the gross domestic product (GDP) of their resident country. METHODS: The Quantitative Standard Monitoring of Patients with Rheumatoid Arthritis (QUEST-RA) cohort includes clinical and questionnaire data from 6004 patients who were seen in usual care at 70 rheumatology clinics in 25 countries as of April 2008, including 18 European countries. Demographic variables, clinical characteristics, RA disease activity measures, including the disease activity score in 28 joints (DAS28), and treatment-related variables were analysed according to GDP per capita, including 14 "high GDP" countries with GDP per capita greater than US$24,000 and 11 "low GDP" countries with GDP per capita less than US$11,000. RESULTS: Disease activity DAS28 ranged between 3.1 and 6.0 among the 25 countries and was significantly associated with GDP (r = -0.78, 95% CI -0.56 to -0.90, r(2) = 61%). Disease activity levels differed substantially between "high GDP" and "low GDP" countries at much greater levels than according to whether patients were currently taking or not taking methotrexate, prednisone and/or biological agents. CONCLUSIONS: The clinical status of patients with RA was correlated significantly with GDP among 25 mostly European countries according to all disease measures, associated only modestly with the current use of antirheumatic medications. The burden of arthritis appears substantially greater in "low GDP" than in "high GDP" countries. These findings may alert healthcare professionals and designers of health policy towards improving the clinical status of patients with RA in all countries.

Cost-effectiveness of infliximab in the treatment of rheumatoid arthritis in clinical practice.

OBJECTIVE: We evaluated the cost-effectiveness of infliximab therapy in Finnish RA patients in a real-life clinical setting and identified factors influencing it, using the national register of biological treatment (ROB-FIN). METHODS: A cost-utility analysis was performed, derived from EQ-5D, and related to HAQ score and disease activity using multiple regression. QALYs were calculated based on these utilities, using patient-level data up to the last control registered. Cost-effectiveness analyses included costs per ACR50 responder, and costs per low DAS28 score (<3.2) achieved, in combination with a clinically significant improvement (>1.2). The costs considered were direct medical costs of infliximab and cost of intravenous infusion. Patient-level costs were calculated based on dose and dosage frequency, and were related to the difference in QALYs resulting from infliximab therapy. RESULTS: The 297 patients had been treated with infliximab for an average of 21 months. The HAQ score and patient's global assessment improved significantly on infliximab therapy. More than two-thirds of the patients achieved a clinically important improvement in HAQ. A QALY gain occurred in 76%. 35% of these had an incremental cost-effectiveness ratio of < or =40,000 Euro/QALY gained, the median cost being 51,884 Euro. The cost per QALY gained was significantly lower for patients achieving an ACR50 response at 3, 12 and 24 months. CONCLUSION: Treatment with infliximab and aiming at ACR50 response appears cost-effective, remembering the restrictions of an observational study set up. Current Care guidelines, which require sufficient disease control when deciding on continuing biological therapy, get support from these findings.

The relative effect of dietary energy density on repleted and resting muscle glycogen concentrations.

The aim of this study was to assess the effect of dietary energy density on the glycogen concentration of bovine gluteus medius (GM) and longissimus thoracis et lumborum (LTL) muscles in castrated and intact males. Cattle received diet C (90% whole corn and supplement: 10% alfalfa haylage) or diet AH (100% alfalfa haylage) in three experiments involving a 2×2 factorial cross-over design. Cattle fed an AH diet for 70 days prior to the first experiment had high glycogen concentrations in the GM (129±9.9 mmol/kg) and LTL (108±7.6 mmol/kg) at the first biopsy session. These concentrations are similar to GM (133±6.2 mmol/kg) and LTL (105±5.8 mmol/kg) glycogen concentrations when these cattle subsequently received diet C for 30 or 37 days. Diet C increased muscle glycogen concentration, but the consistency of the increase in glycogen was dependent on the initial concentration. When the initial glycogen concentration was depleted to 50 µmol/g with one subcutaneous injection of adrenaline, repleted glycogen concentration was higher for diet C than AH (P<0.01) in all comparisons involving GM and LTL muscles of both steers and bulls. For resting muscle glycogen, the GM of bulls was more sensitive to the effect of diet C than the bull LTL or either muscle in steers. Diet was not a major determinant of resting muscle glycogen concentration. The ultimate pHs of GM, LTL and semimembranosus (SM) were not affected by diet and residual glycogen was lower in LTL of bulls fed either diet than for LTL of steers fed AH. Diet and male status did not affect residual glycogen in GM or SM.

Glycogen concentrations in bovine longissimus dorsi muscle.

The aim of this study was to assess the effect of location within bovine longissimus dorsi (thoracis et lumborum) muscle (LTL) when determining glycogen concentration. Six locations in Angus heifers were sampled post mortem (EXP-1) and eight locations in live Charolais crossbred steers were biopsied (EXP-2). In EXP-1, there was more glycogen in the animals' left LTL (64.1±1.6 mmol/kg) versus the right LTL (57.0±1.6 mmol/kg) (P<0.05). Locations along the cranial-caudal axis within LTL did not differ in glycogen concentration. Results for EXP-2 did not confirm the sidedness effect. Instead, it showed that glycogen concentration was lower at the cranial sampling locations near the 10th rib (89±2.5 mmol/kg) than at the middle (97±2.0 mmol/kg) or caudal locations (96±1.9 mmol/kg) (P<0.005). Taking lactate accumulation into account (glycolytic potential) rendered those differences insignificant. Nevertheless, the tendency remained clear. The potential for dilution of glycogen by intramuscular fat deposits is discussed. The results indicate that one needs to be cautious in performing repeated sampling on bovine LTL.

Bovine muscle glycogen concentration in relation to finishing diet, slaughter and ultimate pH.

The aim of this study was to investigate the effects of a high-energy diet provided for a rather short time prior to transportation to slaughter on muscle glycogen concentration on farm, after transportation and after refrigeration of the carcasses. The experiment involved 60 Ayrshire bulls which were fed either a low energy diet of 100% grass silage or a compound feed based diet providing 10.8 and 12.9 MJ of metabolizable energy per kg of dry matter, respectively. Identical setup of 30 bulls was carried out in spring and in summer. Three muscle samples were obtained from the longissimus dorsi and gluteus medius muscles: a biopsy prior to initiation of experimental feeding (B1); another biopsy after 14 days on diet (B2); a post mortem sample at 48 h after slaughter (3) (also M. semimembranosus). Initial resting muscle glycogen concentration affected the responsiveness of glycogen to diet. The more glycogen there was initially the less glycogen increased (r=-0.678, p<0.0001). However, compared to the low energy diet the high energy diet seemed to protect cattle from potentially glycogen-depleting stressors such as high temperatures and transportation. The cattle on high energy lost 7±4.0 (se) mmol/kg and 23±3.9 mmol/kg during transportation in spring (cool weather) and in summer (hot weather), respectively, whereas the cattle on low energy diet lost 16±3.8 mmol/kg in spring and 33±4.1 mmol/kg in summer. The overall protective effect of high energy diet corresponded to 0.65 pH units. The effects of diet were reflected all the way to ultimate pH values [5.69±0.03 (high energy); 5.93±0.03 (low energy)] (p<0.0001) and residual glycogen concentrations (p<0.0001). It seems indeed that providing a diet high in energy for a couple of weeks prior to transportation to slaughter is one of the many appropriate measures to take in the fight against bovine dark-cutting.

Some effects of residual glycogen concentration on the physical and sensory quality of normal pH beef.

The aim of this study was to assess the effects of residual glycogen concentration on the physical and sensory quality of normal-pH beef. Longissimus thoracis et lumborum muscles (n=42) having ultimate pH (48 h) between 5.50 and 5.75 were excised, assayed for residual glycogen concentration and divided into three categories according to the residual glycogen concentration. The categories were ⩽25 mmol/kg, 25.1-49.9 mmol/kg and ⩾ 50 mmol/kg. One half of every LTL muscle was aged for 28 days. All samples were evaluated for fresh meat colour, drip loss, shear force, thawing and frying losses and fried steak colour as well as sensory attributes of tenderness, juiciness, flavour and overall palatability. The independent significant effects of increasing residual glycogen concentration on the physical and sensory quality of normal-pH-beef were, although numerous, quite modest in magnitude. The water holding variables in the form of decreasing drip loss (p<0.061), increasing thawing loss (p<005), increasing sum of losses in thawing and frying (p<0.05), and decreasing sensory juiciness (p<0.05) were somewhat affected as were decreasing fresh meat redness (Minolta a*) (p<0.005), decreasing shear force (p<0.05) and increasing yellowness (Minolta b*) of the steak (p<0.0001). Beef of the lowest and highest glycogen category were the ones behaving slightly differently from each other, the intermediate category mostly followed the pattern of one or the other.

Variation of residual glycogen-glucose concentration at ultimate pH values below 5.75.

The aim of this study was to investigate the relationship between residual carbohydrate (glycogen-glucose) concentration and ultimate pH of beef. Ultimate pH of longissimus dorsi (LTL), gluteus medius (GM) and semimembranosus (SM) muscles was determined from the left side of 133 Ayrshire bull carcasses. Corresponding muscle samples (about 3 g) were obtained from the sites of the pH measurements. The relationship was curvelinear. At low pH values the total range of residual glucose concentration was up to 73 mmol/kg, maximum being 83 and minimum 10 mmol/kg. The concept of medium-stress beef, where the combination of low ultimate pH and low residual glycogen is an indication of diminished glycogen content at the time of slaughter, is introduced. The potential negative effects of low residual glycogen concentration on the shelf-life of ground beef is discussed.

The rupture type determines the outcome for ruptured abdominal aortic aneurysm patients.

BACKGROUND: The treatment of patients with ruptured abdominal aortic aneurysm (RAAA) poses a significant surgical challenge. To achieve improvement in survival, factors influencing case fatality must be identified and modified. The aim of the present survey was to determine the contribution of preoperative, perioperative and postoperative events in predicting the mortality among AAA patients undergoing an emergency operation. MATERIAL AND METHODS: Fifty-one consecutive patients with ruptured infrarenal abdominal aortic aneurysm and twenty-six patients with 'expanding symptomatic aneurysms' (EAAA) were reviewed retrospectively to determine the relative contributions of preoperative, perioperative and postoperative factors on mortality. RESULTS AND CONCLUSIONS: The 30-day mortality was 47% in the RAAA group and 12% in the EAAA group. The rupture type was the main predictor of the outcome for the RAAA patients, the mortalities being 88% and 29% among patients with free (n = 16) and contained (n = 35) ruptures, respectively. In conclusion, the best way of avoiding poor results in cases of emergency aneurysm repair is to aim at elective operations. After the rupture, the clinical course is mainly determined by the rupture type, which is unfortunately beyond the surgeon's control. Surgical expertise and the avoidance of technical error can significantly affect the survival.

Outcome of elective infrarenal abdominal aortic aneurysm repair--an analysis of 174 consecutive patients.

The aim of the study was to assess the surgical outcome of elective infrarenal abdominal aortic aneurysm (AAA) repair and the clinical and surgical factors that may predict this outcome. The series comprises 174 consecutive patients who underwent elective surgery for infrarenal AAA. Factors found to be predictive of early hospital death (4.5%) were aneurysm size (> 5 cm), ischaemic heart disease, chronic obstructive pulmonary disease (COPD), preoperatively elevated C-reactive protein (CRP) and a history of aneurysm-related pain preoperatively. The outcome was also very poor if the bacterial culture from the aneurysm sac was positive. On the whole, the abdominal aortic aneurysm operation effectively controls the disease and can be safely employed electively.