Invasive Colonic Entamoebiasis in Wild Cane Toads, Australia.

We detected a disease syndrome in free-ranging Australian cane toads involving atypical behavior and emaciation that is associated with a previously undescribed Entamoeba sp. that infiltrates the colonic lining, causing it to slough. The organism may become seasonally pathogenic when toads are under hydric and nutritional stress.

Gastro-intestinal ascariasis--an unusual autopsy case report.

Ascaris lumbricoides or roundworms' propensity to produce large number of eggs that are resistant to extremes of environmental conditions have made them one of the highly prevalent and geographically well distributed nematodes among poor socio-economic regions throughout the world. We present an unusual case of fatal gastro-intestinal ascariasis where general neglect, and firm and prolonged reliance on traditional healing methods led to aggregation of roundworms to such an extent that otherwise seems improbable in modern times and, hence, is worth reporting.

A case of the large retroperitoneal solitary fibrous tumor.

A rare autopsy case of the extremely large retroperitoneal solitary fibrous tumor is reported. A 52-year-old female with a huge abdominal distention was found dead at home. She showed remarkable emaciation. The autopsy revealed a huge retroperitoneal tumor weighing 11.9kg (36×30×20cm in size), which occupied the entire intraperitoneal cavity. Histologically, the tumor consisted of spindle parenchymal cells with fibrous tissues. Immunohistochemically, CD34 was positively stained, whereas S-100, smooth muscle actin, and factor VIII were negative. Her cause of death was diagnosed as emaciation due to the compression of the entire intestine by the tumor. This is a rare case of the extremely large retroperitoneal solitary fibrous tumor, which caused the occasional intestinal obstruction. This disease should be considered in the differential diagnosis of retroperitoneal large tumors that cause accidental deaths in forensic autopsies.

Histopathological alterations in the antral ovarian follicles in dairy cows with a tendency to emaciation.

The aim of the study was to define interrelationships between histopathological alterations in ovarian antral follicles and body condition in dairy cows with a tendency to emaciation (BCS 1 and 2) compared with dairy cows with normal body condition (BCS 3). The ovaries were recovered from slaughtered cyclic dairy cows (at the luteal phase of the cycle) of Czech Fleckvieh and Holstein breeds at different times of the post-partum period. The animals were estimated as belonging to certain grade of body condition score (BCS) according to a 5-point scale. Only dairy cows with BCS1 (emaciation; n=6), BCS2 (tendency to emaciation; n=5) and BCS3 (optimal body condition status; n=6) were available for the experiment. The ovarian samples were embedded into Technovit 7100 resin; the tissue sections were stained with buffered basic fuchsine with toluidine blue. For acidic mucopolysaccharides (aMPS) a combination of PAS-technique with Alcian blue was used. Histological analysis showed that emaciation was associated with an increased occurrence of late (cystic) and luteinization-related atresia in granulosa and theca cells and increased levels of aMPS in small atretic follicles. Our observations indicate that dairy cows with a tendency to emaciation (BCS 2) or emaciated (BCS 1) have elevated occurrence of late atresia and atresia with luteinization, while initial atresia is less. This expands our basic knowledge of ovarian histopathology providing new insight into the association of antral follicle atresia and body condition status in dairy cows.

Child starvation and neglect: a report of two fatal cases.

Fatal starvation is a rare cause of death in industrialised countries. In such cases, investigation of death is never an easy task for forensic pathologists who need to couple autopsy findings with full investigation of the crime scene and family record to establish if death results from deliberate neglect, maltreatment and withholding of food. The present article describes two cases of death caused by child neglect. The first case involved a 16-month-old female who died from starvation with dehydration as a contributing factor. In the second case a 7-year-old girl died from ultimate aspiration of stomach contents that had been vomited during the child's last meal because of the fecal concretions blocking the intestinal passage. In both cases macroscopic and histological findings revealed severe chronic malnutrition; crime scene investigations confirmed stories of child maltreatment and neglect.

Magnetic resonance imaging features of serous atrophy of bone marrow fat in the distal limb of three horses.

Emaciated human patients have changes in the fat content in medullary bone that are consistent with serous atrophy of the bone marrow histologically. Serous atrophy has been identified at postmortem examination in horses; however, the magnetic resonance (MR) characteristics have not been documented. Herein we describe the abnormalities of the bone marrow and medullary bone detected by low-field and high-field MR imaging of the distal limbs of three emaciated horses. These low- and high-field MR imaging abnormalities are characterized by a decrease in signal intensity on T1-weighted images in combination with an increase in signal intensity on short tau inversion recovery images in all areas of trabecular bone in the distal limbs, in the absence of lameness. Serous atrophy was confirmed microscopically in two horses. Appreciating the sensitivity of MR imaging for detection of bone marrow changes may assist in assessment of fat atrophy in welfare cases where starvation is suspected.

Canine distemper virus infection in fennec fox (Vulpes zerda).

Fifteen 8-month-old fennec foxes imported from Sudan showed fever, mucopurulent ocular discharge, diarrhea, severe emaciation, seizures, and generalized ataxia, and died. Three of the 15 animals were presented for diagnostic investigation. Severe dehydration, brain congestion, and gastric ulcers were observed in all animals. In one animal, the lungs had failed to collapse and were multifocally dark red in appearance. Histopathologically, there were lymphohistiocytic meningoencephalitis with malacia, mild interstitial pneumonia, lymphoid depletion of lymphoid tissues and organs, and intestinal villous atrophy with intralesional coccidia. There were many intracytoplasmic and/or intranuclear inclusion bodies in the epithelial cells of the medullary velum, lungs, liver, kidneys, trachea, pancreas, stomach, gall bladder, urinary bladder, and ureters, and in macrophages of malacia foci and lymphocytes and macrophages of lymphoid organs. Additionally, intestinal coccidia were confirmed to be Isospora species by a fecal test. To our knowledge, this is the first report of canine distemper with intestinal coccidiosis in fennec fox.

Risk and indicators of condemnation of male turkey broilers in western France, February-July 2006.

A field study was conducted to estimate the sanitary condemnation proportion in male turkey broiler flocks, to describe the reasons for condemnation and the related macroscopic lesions, and to investigate whether primary production information would predict the risk of condemnation. Male turkey standard broiler flocks (117) were randomly selected in the 13 slaughterhouses located in Western France, from February to July 2006. The flocks were monitored from their arrival at the slaughterhouse until the results of the post mortem sanitary inspection. Information about rearing conditions, health history, catching and loading conditions, transportation to the slaughterhouse and slaughtering was also collected. Sampling design was considered in the calculations and the condemnation proportion was modelled using a negative binomial regression, accounting for clustering within slaughterhouse. The within-flock weighted average condemnation proportion was 1.8% (95% confidence interval, 1.3-2.3%). Emaciation, arthritis-polyarthritis and congestion were the main reported official reasons for condemnation, representing 76% of the condemned carcases. Three variables were significantly associated with increased risk of condemnation: observed locomotor disorders on the farm, high cumulative mortality 2 weeks before slaughter, and clinical signs observed by the Veterinary Services during the ante mortem inspection at the slaughterhouse. The final model explained 35% of the total variation in condemnation risk. Half of this explained variation could be attributed to locomotor disorders observed during rearing. The sensitivity and specificity of the model to predict a high flock condemnation risk were 80% and 74%, respectively, when using an optimum threshold of 0.95% to define high risk. The results of this study suggested that the variables found to be associated with condemnation proportion were markers of increased risk and could be used as indicators. These risk indicators can easily be retrieved from the pre-existing regulatory document transmitted before flock arrival at the slaughterhouse and could be used to screen flocks before slaughter, according to their expected risk of condemnation.

Mineral density and biomechanical properties of bone tissue from male Arctic foxes (Vulpes lagopus) exposed to organochlorine contaminants and emaciation.

We investigated the impact from dietary OC (organochlorine) exposure and restricted feeding (emaciation) on bone mineral density (BMD; g hydroxy-apatite cm(-2)) in femoral, vertebrate, skull and baculum osteoid tissue from farmed Arctic blue foxes (Vulpes lagopus). For femur, also biomechanical properties during bending (displacement [mm], load [N], energy absorption [J] and stiffness [N/mm]) were measured. Sixteen foxes (EXP) were fed a wet food containing 7.7% OC-polluted minke whale (Balaenoptera acutorostrata) blubber in two periods of body fat deposition (Aug-Dec) and two periods of body fat mobilisation (Jan-July) in which the food contained less energy and only 2% blubber. SigmaOC food concentration in the food containing 7.7% whale blubber was 309 ng/g wet mass. This corresponded to a SigmaOC exposure of ca. 17 microg/kg body mass/d and a responding SigmaOC residue in subcutaneous adipose tissue of ca. 1700 ng/g live mass in the 8 EXP fat foxes euthanized after 16 months. A control group (CON) composed of 15 foxes were fed equal daily caloric amounts of clean pork (Sus scrofa) fat. After 16 months, 8 EXP and 7 CON foxes were euthanized (mean body mass=9.25 kg) while the remaining 8 EXP and 8 CON foxes were given restricted food rations for 6 months resulting in a body weight reduction (mean body mass=5.46 kg). The results showed that only BMD(skull) vs. BMD(vertebrae) were significantly correlated (R=0.68; p=0.03; n=10) probably due to a similar composition of trabecular and cortical osteoid tissue. No difference in any of the BMD measurements or femoral biomechanical properties was found between EXP and CON foxes although BMD baculum was 1.6-folds lower in the EXP group. However, lean summer foxes had significantly lower femoral biomechanical properties measured as displacement (mm), energy absorption (J) and time (s) biomechanical properties than fat winter foxes (all p<0.004). This indicates lower stiffness and softer bones from fasting which is in agreement with previous studies. Further, it should be kept in mind when studying bone tissues in Arctic mammals also in order to avoid confounding effects from body condition.

Disseminated pilocytic astrocytoma involving brain stem and diencephalon: a history of atypical eating disorder and diagnostic delay.

The association of weight loss and pediatric brain tumors that affect the diencephalon or brain stem with weight loss is a recognized, but not fully understood phenomenon. Tumors located in the hypothalamic region may induce the diencephalic syndrome (DS), which is characterized by profound emaciation with almost complete loss of subcutaneous fatty tissue. Tumors that compress or infiltrate the brain stem rarely cause both psychological disturbance and emaciation. The clinical presentation may be different, depending on the location of the lesion and age of the patient. In this report we present an unusual case of severe emaciation in a 4(9)/(12)-year-old girl with a juvenile pilocytic astrocytoma of the hypothalamic region and brain stem with neuroaxis dissemination. This case illustrates the importance of considering intracranial mass-lesions in the differential diagnosis of weight loss, psychological disturbance and atypical eating disorder. We discuss the importance of tumor multifocality and the role of patient age in the clinical presentation with reference to the literature.

The Shetland Islands scrapie monitoring and control programme: analysis of the clinical data collected from 772 scrapie suspects 1985-1997.

There were 574 scrapie positive suspects (histopathological scrapie lesions present) and 198 scrapie negative suspects (histopathological scrapie lesions absent). The greatest number of scrapie cases were recorded in sheep of 2, 3 and 4 years of age which represented 17%, 36% and 23% of the scrapie positive suspects, respectively. The sign sensitivities and specificities for the ten recorded signs were, respectively: pruritus (62%, 42%), ataxia (23%, 74%), hyperaesthesia (32%, 74%), wool loss (25%, 73%), fleece discolouration (29%, 85%), bruxism (23%, 69%), nibbling reflex (17%, 58%), head rubbing (47%, 78%), poll rubbing (25%, 83%). These single signs had poor discriminatory values with likelihood ratios close to one (range 0.89-1.21); combinations of the four signs, pruritus, wool loss, ataxia, hyperaesthesia and emaciation were more discriminatory (range 0.30-4.3). This study covered a time period when bovine spongiform encephalopathy (BSE) might have been introduced into the sheep population on the Shetland Islands via contaminated feed. No temporal changes could be detected in the age structure of the affected animals.

Change in signal intensity on MRI of fat in the head of markedly emaciated patients.

The amount of fat in various parts of the body decreases in emaciated patients, but responds differently to disease processes. The order of disappearance of fat in various parts of the head has rarely been studied with MRI. We imaged ten patients with anorexia nervosa and one cachectic patient with a psychiatric disorder with a 1.5 T imager. Signal intensities of bone marrow of the skull, subcutaneous tissue, and orbits were assessed on T1- and T2-weighted images, and correlated with the body mass index (BMI) and haemoglobin concentration (Hb). On T1-weighted images, five patients (BMI 15.6-17.8 kg/m2, mean 16.6 kg/m2; Hb 10.1-14.2 g/dl, mean 13.8 g/dl) showed the normal pattern of fat. One (BMI 13.6 kg/m2, Hb 10.4 g/dl) lost the high signal of bone marrow, but high signal of subcutaneous tissue and the orbits was preserved. High signal from bone marrow and subcutaneous tissue disappeared in three patients (BMI 11.5-13.5 kg/m2, mean 12.5 kg/m2; Hb 7.9-9.7 g/dl, mean 8.7 g/dl), but orbital high signal was preserved. The remaining two patients (BMI 9.3 and 13.5 kg/m2, mean 11.5 kg/m2; Hb 7.6 and 8.9 g/dl, mean 8.3 g/dl) showed complete loss of high signal from fat in the head. The order of disappearance of fat (bone marrow, subcutaneous fat, then orbits) correlated with both BMI and Hb. Atrophy of bone marrow was demonstrated on T2-weighted images in five patients with BMI 13.5 kg/m2 or less, and Hb 9.7 g/dl or less.

Effect of emanciation on liver histology of alpine chamois during winter.

With the aim of describing the effect of severe feed restriction on the liver histology, morphometrical analysis of liver sections of 10 alpine chamois (Rupicapra rupicapra) was performed. Five animals were found dead during the winter season 1995-96 and five were collected during the hunting season 1996. Hepatocyte nuclear size was measured in squared micrometers using Image-Pro Plus software. A significant decrease in the mean size of the nuclei of hepatocytes in emaciated chamois, as compared to harvested animals was observed. The reduction in cell nuclear size may be linked to the mobilization of body protein to prevent ketosis during severe food restriction, as hypothesized for other wild ungulates. The change in hepatocyte size may be the consequence of a strategy to minimize energy expenditure and may be proposed as an index of metabolic stress during winter undernutrition.

Mass stranding of wedge-tailed shearwater chicks in Hawaii.

Unusual numbers of wedge-tailed shearwater (Puffinus pacificus) chicks stranded on Oahu (Hawaii, USA) in 1994. Compared to healthy wedge-tailed shearwater (WTSW) chicks, stranded chicks were underweight, dehydrated, leukopenic, lymphopenic, eosinopenic, and heterophilic; some birds were toxemic and septic. Stranded chicks also were hypoglycemic and had elevated aspartate amino transferase levels. Most chicks apparently died from emaciation, dehydration, or bacteremia. Because many birds with bacteremia also had severe necrosis of the gastrointestinal (GI) mucosa associated with bacteria, we suspect the GI tract to be the source of disseminated bacterial infection. The identity of the bacteria was not confirmed. The daily number of chicks stranded was significantly related to average wind speeds, and the mortality coincided with the fledging period for WTSW. Strong southeasterly winds were a distinguishing meteorologic factor in 1994 and contributed to the distribution of stranded chicks on Oahu. More objective data on WTSW demographics would enhance future efforts to determine predisposing causes of WTSW wrecks and their effects on seabird colonies.

Fine structure of rat liver, adrenal, testis and seminal vesicle in experimental emaciation.

Experimentally emaciated male rats were produced by a bilateral electrical destruction of a part of hypothalamus. In a typical case, when the animals were fixed by perfusion, dissected, and organs weighted, the body weight became 1/2 of the control in 10 weeks. The weight of the viscera (including the subserous fat) was more decreased in comparison with the controls than the weight of the body wall (including extremities and the subcutaneous fat). The weight of the liver became 1/3, the adrenal 1/4, the testis 1/6 and the seminal vesicle 1/19 of the control. Light and electron microscopic examinations showed atrophy and fatty degeneration in the liver, atrophy of the zona reticularis in the adrenal, failure of spermatogenesis, especially at its spermiogenetic stage, in the testis, and an apoptosis in glandular epithelial cells of the seminal vesicle. Two weeks after partial hypothalamus destruction, the weight of the body wall was more decreased in comparison with the controls than the weight of the viscera. Possible pathophysiological mechanisms are discussed. An experimental model of electron microscopical research of apoptosis are presented.

Morphologic and histochemical evaluation of muscle in patients with chronic pulmonary emphysema manifesting generalized emaciation.

Twelve severely emaciated patients with emphysema and 4 control patients with mild emaciation were studied. Arterial blood gas analysis, pulmonary function tests, and muscle biopsy were performed. According to the percentage of ideal body weight (%IBW), patients were divided into two groups of 6 patients each; one with %IBW values greater than 70.0 (group 1) and the other with %IBW values less than 70.0 (group 2), and 4 control patients with emphysema whose %IBW values were greater than 85.5. %FEV1.0, PaO2 and Hugh-Jones scores in group 2 patients were consistent with significantly greater deterioration as compared with those in group 1 patients and controls. In the muscle fibers of 11 patients and 4 controls, nicotinamide and adenosine dinucleotide tetrazolium reductase activity was studded with spots. Nemalin rods were detected in 3 specimens in group 2 and in 1 specimen each in both group 1 and controls. These changes probably result from chronic hypoxemia. Fiber type grouping accompanied by type II dominant fiber atrophy was demonstrated in 5 patients of group 2, whereas type II fiber atrophy was shown in 2 specimens from patients of group 1. Diameters of both types I and II fibers in group 2 were smaller than those in group 1 and controls. Significant correlations were observed between fiber diameters and %IBW, %FEV1.0 and %IBW, and PaO2 and %IBW. Neurogenic and disuse muscular atrophy due to both hypoxic axonal disorder and disuse is likely to be the cause of the emaciation, and a 'vicious circle' between muscular atrophy, respiratory function and hypoxemia probably exists in group 2. Since mild or moderate emaciation was observed in controls and group 1 in spite of the lack of fiber atrophy, involvement of fat and connective tissue should also be taken into consideration to determine the cause of emaciation.

Causes of owl mortality in Hawaii, 1992 to 1994.

Eighty-one barn owls (Tyto alba) and five Hawaiian owls or pueo (Asio flammeus sandwichensis) from Kauai, Oahu, Lanai, Molokai, Maui and Hawaii (USA) were evaluated for cause of death, November 1992 through August 1994. The most common cause of death in barn owls was trauma (50%) followed by infectious disease (28%) and emaciation (22%). Most traumas apparently resulted from vehicular collisions. Trichomoniasis was the predominant infectious disease and appeared to be a significant cause of death in barn owls in Hawaii. Pasteurellosis and aspergillosis were encountered less commonly. No predisposing cause of emaciation was detected. Stomach contents from 28 barn owls contained mainly insects (64%) of the family Tetigoniidae and Gryllidae, and rodents (18%); the remainder had mixtures of rodents and insects or grass. Three pueo died from trauma and one each died from emaciation and pasteurellosis. We found no evidence of organochlorine, organophosphorus, or carbamate pesticides as causes of death in pueo or barn owls.

Assessment of emaciation in relation to threat to life in anorexia nervosa.

Twenty patients with anorexia nervosa and a body weight below 60% of the standard weight were studied. One died of starvation; the others survived. Four patients, including the deceased, had such severe weakness that they could not sit up without support, and another five could sit up only from a lateral position. Serum albumin or hemoglobin levels at the beginning of therapy could not be used for nutritional assessment because of dehydration, while increased blood urea nitrogen was associated with acute illness. The present results together with data from previous studies of fatal anorexia indicate that the risk of mortality may be quite low when body weight is above 60% of the standard. We suggest that gross muscle weakness in addition to body weight for height can be a valuable indicator to assess the criticalness in anorexia nervosa.