A cross-sectional field study on potential associations between feed quality measures and usage of antimicrobials in commercial mink (Neovison vison).

Feed quality is generally assumed to affect health status in animal production. In previous studies, the feed producer has been found to affect the occurrence of gastrointestinal disease and antimicrobial use in Mink (Neovison vison). Mink are fed with moist, freshly produced feed, based on perishable ingredients. The objective of this study was to investigate the potential effect of specific feed parameters on antimicrobial use on herd level. The study was cross-sectional, including 1472 mink herds, responsible for 97% of oral antimicrobials prescribed for Danish mink during the study period, 2012-2014. Data were obtained from the national veterinary prescription database (VetStat), Kopenhagen Fur database, and the Voluntary Feed Control (Mink producers Organization). All feed batches subject to feed control were included. A multi-variable variance analysis was carried out analysing the effect of the feed parameters total volatile nitrogen, dry matter, crude protein and fat; total bacterial count (21°C), and counts of sulphite producing bacteria (21°C), Clostridium spp., faecal cocci (FC) (44°C), yeast, and mould; presence of Salmonella spp. and Clostridium perfringens (dichotome). Three outcome variables were applied: prescription of oral antimicrobial on herd level within time slots of 3, 5 or 7days after feeding of an included batch. Two binomial models were developed, adjusting for significant effects (p<0.0001) of Ps. aeruginosa infection, herd size, month (season) and year. Antimicrobial prescription was significantly (p<0.0001) associated with FC (all time slots, both models). A negative association (p<0.0001) with crude protein on antimicrobial prescription within a 7day slot suggested an association between low content of crude protein and antimicrobial use. The associations need to be confirmed in controlled studies, and ideally, potential causalities should be investigated. The perspective of such findings could be the development of tests for control of feed ingredients prior to use in the feed production.

Farm specific risk factors for Campylobacter colonisation in Danish and Norwegian broilers.

Campylobacteriosis has become the leading bacterial zoonosis in humans in the European Union and other developed countries. There are many sources of human Campylobacter infections, but broilers and broiler meat have been shown to be the most important. In order to implement effective interventions that reduce the probability of Campylobacter colonisation of broiler flocks, it is essential to fully understand the risk factors involved. We present a bi-national risk factor survey comprising Campylobacter data from more than 5200 Danish and Norwegian indoor, conventional broiler flocks and the responses to a standardised questionnaire, with more than 40 explanatory variables from 277 Danish and Norwegian farms. We explored several models by using different combinations of the Danish and Norwegian data, including models with single-country datasets. All models were analysed using a generalized linear model using backwards elimination and forward selection. The results show that Norwegian broiler flocks had a lower risk of being colonised than Danish flocks. Farm specific variables that increased the risk of flocks becoming colonised with Campylobacter in both countries were: broiler houses older than five years; longer downtime (no. of days between flocks), probably a consequence of longer downtimes being associated with less focus on maintaining a high biosecurity level; broiler houses without a separate ante-room or barrier; and the use of the drinker nipples with cups or bells compared with nipples without cups. Additional country specific risk factors were also identified. For Norway, the risk of colonisation increased with increasing numbers of houses on a farm and when the water used for the broilers originated from surface water or bore holes instead of mains. For Denmark, having boot dips or low stocking density increased the risk of a flock becoming Campylobacter positive. The different model approaches allowed us to explore the effect of having a large number of data available to identify the significant variables. To a large extent, the country specific models identified risk factors that were also found in the bi-national model. However, the bi-national model identified more risk factors than the country specific models. This indicated that combining the data sets from the two countries did not disrupt the results but was beneficial due to the greater strength achieved in the statistical analyses and the possibility of examining interactions terms with the variable Country.

Factors associated with usage of antimicrobials in commercial mink (Neovison vison) production in Denmark.

The American mink (Neovison vison) is used for commercial fur production in Denmark. In recent years, antimicrobial prescription for Danish mink has been increasing. In this study, the patterns and trends in antimicrobial use in mink were described and a multi-variable variance analysis was carried out with the objective of identifying risk factors for antimicrobial use on herd level. The study was based on register data for 2007-2012. Information on antimicrobial use was obtained from the national database VetStat, monitoring all medicinal products used for animals on prescription level. Data on microbiological feed quality was obtained from the Voluntary Feed Control under the Mink producers Organization, and data on herd size and the relation between farm and feed producer was obtained from the registers at Kopenhagen Fur, based on yearly reporting from the mink producers. Descriptive analysis showed a clear significant effect of season on antimicrobial use, with a peak in "treatment proportions", TP (defined daily doses per kg biomass-days) in May, around the time of whelping, and a high level in the following months. In autumn, a minor peak in antimicrobial use occurred throughout the study period. From 2007 to 2011, a 102% increase in annual antimicrobial TP was noted; on herd level, the increase was associated with an increasing frequency of prescription, and a decrease in the amounts prescribed in months with prescription. A binomial model showed that on herd level, the annual number of months with antimicrobial prescription was significantly (p<0.01) affected by feed producer, veterinarian, disease (specific laboratory diagnosis) infection, herd size and year, with an interaction between feed producer and year. A log-normal model showed that in months with antimicrobial use, the TP on herd level was significantly (p<0.001) affected by year, month (season), feed producer, feed quality score, veterinarian, herd size and laboratory confirmed diagnosis of specific infections; additionally the interaction terms year×feed producer and herd size×month were significant (p<0.001). In conclusion, antimicrobial use on herd level was significantly associated with the microbiological food quality, the feed producer, and the veterinarian. The prescription patterns varied significantly between veterinarians, and some veterinarians were associated with both larger and more frequent prescriptions of antimicrobials at herd level. Herd size is associated with different prescription patterns. Finally, infection with Pseudomonas aeruginosa, astrovirus, influenza virus and Salmonella spp. was associated with an increase in antimicrobial use.

Analysis of factors important for the occurrence of Campylobacter in Danish broiler flocks.

For more than a decade human campylobacteriosis has been the leading zoonosis in many developed countries. Consumption of poultry or poultry products has been identified as the primary source of infection in humans. This study was conducted to identify risk factors for the occurrence of Campylobacter in Danish broiler flocks. The study was based on a large data set consisting of Campylobacter positive status for nearly 6000 broiler flocks and 43 explanatory variables. Data were obtained from the Danish Campylobacter surveillance programme in poultry and from the responses to a standardized questionnaire answered via interviews with broiler farm owners. Two hundred and forty broiler farms, comprising 539 broiler houses, were included in the study and their Campylobacter status was followed over a 2-year period (1999-2000). The large number of observations made it possible to carry out a multivariate analysis including all 43 variables. A multivariate analysis was conducted using a generalized linear model, and the correlations between the houses from the same farms were accounted for by adding a variance structure to the model. The procedures for analyses included backward elimination, forward selection and expanding of the number of observations used in the variance analysis along with the reduction of the number of parameters in the model. The unit of analysis was 'broiler house', meaning that all results from a broiler house were aggregated into one prevalence figure (number of positive flocks/total number of flocks delivered over the 2-year period). The following factors were found to be significantly associated with the occurrence of Campylobacter in the broiler flocks: old broiler houses, late introduction of whole wheat in the feed, relatively high broiler age at slaughter, improper rodent control, large number of chimneys on the broiler house, farm located in an area with a high density of cattle farms, having more than one broiler house on the farm, and improper storage of wheat. This large-scale study confirms several risk factors identified in previous studies. The results concerning chimneys may be explained by the easier access that flies have to the broiler houses, which seems in agreement with recent Danish studies on the significance of fly-screens to reduce Campylobacter in broiler flocks. The results of this study may be used in identification of effective interventions aimed at controlling Campylobacter in Danish broiler flocks.

Survival of Salmonella on cuts of beef carcasses subjected to dry aging.

AIMS: The aim of this study was to determine the survival of 15 different strains of Salmonella of selected serotypes during prolonged cold storage of beef. METHODS AND RESULTS: Fifteen strains of eight different serotypes of Salmonella were spiked onto fresh cuts beef portions, and the survival was followed during storage in a laboratory cooling system. Over a 14-day period, all strains were reduced significantly in numbers; however, strains of Salmonella Typhimurium DT104 and Salmonella Enteritidis PT4 and PT8 survived significantly longer than strains of the serovars Dublin, Derby, Infantis and Newport. For five selected strains, the observations were verified in a pilot plant cooling facility mimicking industrial cooling. No significant differences in reduction were found between the two cooling methods. CONCLUSIONS: A significant reduction in Salmonella can be obtained by dry aging of beef during cold storage but the survival is strain dependent. SIGNIFICANCE AND IMPACT OF THE STUDY: From a hygienic point of view, cold storage of unpacked beef, which is still performed in small slaughterhouses, is a good alternative to vacuum packaging.

[The influence of posture on transmission and absorption of vibration energy in whole body vibration exercise]. / Zur Bedeutung der Körperhaltung auf Energietransmission und -absorption beim Vibrationstraining.

Muscle exercise using whole body vibration platforms is well known as an alternative physical exercise in therapy as well as in high performance sports. Various studies could show an effectiveness in particular to improve maximal strength and springiness. Using these platforms there is no consideration to posture although the damage potential of vibration stress i. e. on intervertebral discs is well-known. Therefore the effect of posture on the transmission and absorption of vibration loads in bipedal standing was examined in a study with 20 sport students. They were exposed to a whole body vibration load in bipedal standing at a vibration frequency of 25 Hz. The transmission of energy was measured at the head in different postural positions. An average transmission of 9 % was measured in spontaneous bipedal standing. It significantly decreased with gradual changes of posture. After 6 weeks posture conditioning exercise this effect was significantly improved. In conclusion different posture in bipedal standing implies not only different energy absorption but also different effects on muscle performance which can explain the partly inconsistent results after vibration exercise. In addition whole body vibration exercise in a prone or sitting position may increase the risk of overload and should be avoided because of reduced energy absorption capacity.

Accuracy of blind versus fluoroscopically guided caudal epidural injection.

STUDY DESIGN: A prospective observational study of a case series of patients with low back pain referred for epidural injection of corticosteroid. OBJECTIVES: To evaluate the accuracy of caudal epidural injections performed without the use of fluoroscopic guidance and to determine the value of specific clinical tests performed during the procedure in predicting successful epidural needle placement. SUMMARY OF BACKGROUND DATA: Epidural injection of corticosteroid is one of many treatments currently used in the nonsurgical management of low back pain. The face validity of many studies evaluating the efficacy of epidural corticosteroid injections has been criticized for use of a blind technique. Although there currently is no consensus in the spine literature as to whether epidural injection of corticosteroid (by any technique) is effective, it is imperative first to establish the accuracy of the technique being used. METHODS: A total of 54 consecutive patients underwent fluoroscopically guided caudal epidural injections. Needle insertion was performed blindly (without the use of fluoroscopic guidance), and the success of needle placement was predicted according to the presence of palpable landmarks, palpation of subcutaneous airflow, and the subjective impression that the needle was in a satisfactory position. These clinical criteria then were compared with the position of the needle as seen under fluoroscopy and the spread of radio-opaque contrast in the epidural space after the procedure. RESULTS: Successful injection placement on the first attempt occurred in 74.1% of the patients. Results were improved when anatomic landmarks were identified easily (87.5%) and no air was palpable subcutaneously over the sacrum when injected through the needle (82.9%). The combination of these two signs predicted a successful injection in 91.3% of attempts. CONCLUSIONS: Caudal epidural injection is performed ideally with fluoroscopic guidance as the gold standard for accurate drug placement. If fluoroscopic guidance is unavailable, impractical, or contraindicated, the presence of readily palpable anatomic landmarks at the sacral hiatus and the absence of palpable subcutaneous airflow over the sacrum significantly increase the operator's confidence in the likelihood of an accurate injection even before any products are administered into the epidural space.

Examination of reproducibility in microbiological degradation experiments.

Experimental data indicate that certain microbiological degradation experiments have a limited reproducibility. Nine identical batch experiments were carried out on 3 different days to examine reproducibility. A pure culture, isolated from soil, grew with toluene as the only carbon and energy source. Toluene was degraded under aerobic conditions at a constant temperature of 28 degrees C. The experiments were modelled by a Monod model--extended to meet the air/liquid system, and the parameter values were estimated using a statistical nonlinear estimation procedure. Model reduction analysis resulted in a simpler model without the biomass decay term. In order to test for model reduction and reproducibility of parameter estimates, a likelihood ratio test was employed. The limited reproducibility for these experiments implied that all 9 batch experiments could not be described by the same set of parameter values. However, experiments carried out the same day (within the same run) were more uniform than experiments carried out on different days (between runs), and a common set of parameter estimates could be accepted for experiments within runs, but not for experiments from different runs. The limited reproducibility may be caused by variability in the preculture, or more precisely, variations in the physiological state of the bacteria in the precultures just before used as inoculum.

The patient in jeopardy: how the low back pain patient becomes disabled.

Dr. Sommer divides the low back pain episode into four stages that can lead to patient disablement. Contributing factors include: suboptimal training for the diagnosis and management of musculoskeletal disorders and resultant physician anxiety; a compensation system that demands proof; physician wariness of chronic pain patients; transformation of worker from person to patient to claimant; and the complexities of determining impairment and disability.

Sensory nerve conduction studies of the L-1/L-2 Dorsal rami.

OBJECTIVE: This report describes a technique for performing sensory nerve conduction studies of the lateral cutaneous branches of the dorsal rami of the L-1/L-2 nerve roots for use in the evaluation of unilateral low back pain without lower limb referral. SUBJECTS: Eleven healthy adult volunteers (9 men and 2 women) ranging in age from 25 to 36 years with no current complaint of low back pain. DESIGN: Prospective determination of reference sensory nerve conduction values using a deep near nerve stimulation technique. RESULTS: Reproducible sensory nerve action potentials were evoked in all subjects. The mean distal onset latency was 3.5 +/- 0.7msec with a mean conduction velocity of 59.5 +/- 11m/ sec and a mean SNAP amplitude of 3.6 +/- 2.7 microV. The mean side-to-side difference in onset latency was 0.5 +/- 0.4msec. CONCLUSIONS: This study demonstrates a simple and reliable electrodiagnostic technique that may be useful in the evaluation of certain patients with unilateral low back pain. An onset latency of > 4.9msec (mean + 2 SD) or a side-to-side latency difference of > 1.3msec (mean + 2 SD) may represent a low back pain syndrome in which the cutaneous branches of the L-1 or L-2 dorsal rami have a primary role and which is possibly caused by entrapment of one of the cutaneous branches as it traverses the iliac crest in a fibro-osseous tunnel.

Proliferating cell nuclear antigen and Ki-67 immunohistochemistry of oligodendrogliomas with special reference to prognosis.

BACKGROUND: The biologic behavior of oligodendrogliomas is somewhat unpredictable. A supplementary prognostic factor is, therefore, desirable. METHODS: Thirty-two pure supratentorial oligodendrogliomas were investigated using proliferating cell nuclear antigen (PCNA) and Ki-67 immunohistochemical analyses. The correlation of PCNA and Ki-67 labeling index (LI) with prognosis were studied, and the correlation of LI with clinical data was evaluated. RESULTS: The PCNA LI had a range of 0-17% (mean, 5.27%; standard deviation [SD] = 4.65), and the Ki-67 LI had a range of 0-29% (mean, 4.19%; SD = 5.66). In general, the PCNA LI seemed to be higher than the Ki-67 LI. The mean survival time was 4.4 years, and 5- and 10-year survival rates were 38% and 19%, respectively. Ki-67 and PCNA staining indicated that patients with a high LI (> 3% and > 4%, respectively) had a significantly higher mortality, with mean survival time of 23.5 months and 26.2 months, respectively. No significant correlation between LI (or survival) and tumor size, cerebral localization, radiation, resection/biopsy, sex, age, or cytologic atypia was found. CONCLUSIONS: The use of Ki-67 and PCNA LI higher than 3% and 4%, respectively, appears reliable as prognostic factors when investigating pure supratentorial oligodendrogliomas.

Effect of foot posture on the incidence of medial tibial stress syndrome.

This study reviewed the assessment of medial tibial stress syndrome (MTSS), a common lower limb overuse injury among athletes and dancers. The purpose of the study was twofold: 1) to determine whether abnormal foot alignment is positively correlated with a previous diagnosis of MTSS and 2) to assess the interrater reliability of the proposed methods. We therefore studied foot alignment retrospectively both qualitatively and quantitatively in both a closed and open kinetic chain manner. The specific measures evaluated were: 1) standing foot angle (SFA), 2) nonweight-bearing hindfoot angle, and 3) nonweight-bearing forefoot angle. Qualitative parameters were used for the non weight-bearing measures along the continuum: varus-neutral-valgus. The authors made their measurements independently and were blinded to the previous authors results. Case limbs (as defined as the symptomatic limb in a subject with the diagnosis of MTSS) were found to have a SFA < controls (P = 0.0001). Case limbs also tended towards having a higher incidence of hindfoot (P = 0.017) as well as forefoot (P = 0.08) varus alignment. We found that a SFA of < 140 degrees and a varus alignment of the hindfoot and/or forefoot, were predictive of a previous history of MTSS. These methods were found to be reliable and can be performed in an office setting without any special equipment.

[Early functional conservative therapy of fresh fibular capsular ligament rupture from the socioeconomic viewpoint]. / Die früh-funktionelle konservative Therapie der frischen fibularen Kapsel-Band-Ruptur aus sozial-ökonomischer Sicht.

The expected direct and indirect costs following a fresh fibular rupture of the capsular ligament, and hence the socioeconomic burden on the patient, was investigated by a prospective randomised study comprising 120 males and females between 18 and 45 years of age. A comparison of three different conservative treatment methods A (immobilisation in a plaster cast for three weeks, followed by mobilisation with the aircast splint), B (mobilisation with the aircast splint) and C (Unna's paste dressing for two weeks with subsequent tape dressings and in each case immediate mobilisation) showed a significantly better stability after 6 months in the groups B (2.6 +/- 2.3) and C (3.6 +/- 3.8) than in A (4.8 +/- 3.5). The direct subsequent costs were also significantly lower in the groups B (DM 175.-) and C (DM 206.-) than in A (DM 340,-). Taking an average daily hospital care fee of DM 319.- (1991 in West Germany) as basis, the direct costs sequential to early functional treatment are the lowest also in comparison with surgical treatment in a hospital. The indirect sequential costs due to loss of working hours are mainly dependent on professionally conditioned physical stress but increase with the period of immobilisation after a fresh fibular rupture of the capsular ligament.

[Subcutaneous muscle and tendon ruptures]. / Subcutane Muskel- und Sehnenrupturen.

Reasons for subcutaneous ruptures of muscles and tendons are discussed from biomechanical and kinesiological points of view Experimental findings and clinical diagnostic procedures applied in muscle and tendon rupture are discussed. It is concluded that the aim of repair in the case of either muscle or tendon must be the reconstruction of their physiological length in order to avoid loss of muscle strength, which would increase the frequency of muscle and tendon injuries and cause a decline in sports performance. Therefore, surgical repair of complete muscle and tendon rupture has to be regarded as the therapy of choice especially in young patients and those engaged in competitive sport. It must be taken into account, however, that both surgical and non-surgical repair lead to the same weight-bearing capacity. Therefore, functional, non-surgical treatment must be preferred in the case of partial muscle and/or tendon rupture and in older patients.

Functional treatment of recent ruptures of the fibular ligament of the ankle.

A prospective randomised study was undertaken to compare the results of functional and operative treatment of recent ruptures of the fibular ligament of the ankle in 80 patients, aged from 18 to 45 years, with similar injuries. The best results were obtained from functional treatment and it is to be hoped that early movement and a stable ankle will avoid later osteoarthritis.

Patellar chondropathy and apicitis, and muscle imbalances of the lower extremities in competitive sports.

The jumping motion of 15 competitive basketball and volleyball players was tested until exhaustion in a cinematographic study. A stereotyped motion pattern was recognisable. The knee joint shows an evasive movement into a valgus and internal rotation position during the acceleration phase before take-off. Furthermore, the knee shows a brief stabilisation in overextension at heel strike. An imbalance of the muscles which stabilise the pelvis and the lower extremities can be regularly found in these athletes and could be a possible cause for this jump motion. It leads to a shortening of the hip flexors and adductors and of the knee extensors with the final evasive action of the knee joint. Though the anatomical condition of the joint is not directly observed, such a motion pattern must be the cause of additional shear forces and peak loads in the area of the patellofemoral joint and of the apex patellae. Clinical experience shows that an active correction of the evasive motion can be achieved by systematic physiotherapy. It ensures muscular balance of the pelvic region and lower extremities and thus lasting good results.