Prevalence of combined abnormalities of tibial and femoral torsion in patients with symptomatic hip dysplasia and femoroacetabular impingement

2020 ◽  
Vol 102-B (12) ◽  
pp. 1636-1645
Author(s):  
Till D. Lerch ◽  
Emanuel F. Liechti ◽  
Inga A. S. Todorski ◽  
Florian Schmaranzer ◽  
Simon D. Steppacher ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Dysplasia ◽  
Ct Scans ◽  
Control Group ◽  
Femoral Torsion ◽  
High Prevalence ◽  
Hip Preserving Surgery ◽  
Derotation Osteotomy ◽  
Torsional Malalignment ◽  
Asymptomatic Control

Aims The prevalence of combined abnormalities of femoral torsion (FT) and tibial torsion (TT) is unknown in patients with femoroacetabular impingement (FAI) and hip dysplasia. This study aimed to determine the prevalence of combined abnormalities of FT and TT, and which subgroups are associated with combined abnormalities of FT and TT. Methods We retrospectively evaluated symptomatic patients with FAI or hip dysplasia with CT scans performed between September 2011 and September 2016. A total of 261 hips (174 patients) had a measurement of FT and TT. Their mean age was 31 years (SD 9), and 63% were female (165 hips). Patients were compared to an asymptomatic control group (48 hips, 27 patients) who had CT scans including femur and tibia available for analysis, which had been acquired for nonorthopaedic reasons. Comparisons were conducted using analysis of variance with Bonferroni correction. Results In the overall study group, abnormal FT was present in 62% (163 hips). Abnormal TT was present in 42% (109 hips). Normal FT combined with normal TT was present in 21% (55 hips). The most frequent abnormal combination was increased FT combined with normal TT of 32% (84 hips). In the hip dysplasia group, 21% (11 hips) had increased FT combined with increased TT. The prevalence of abnormal FT varied significantly among the subgroups (p < 0.001). We found a significantly higher mean FT for hip dysplasia (31°; SD 15)° and valgus hips (42° (SD 12°)) compared with the control group (22° (SD 8°)). We found a significantly higher mean TT for hips with cam-type-FAI (34° (SD 6°)) and hip dysplasia (35° (SD 9°)) compared with the control group (28° (SD 8°)) (p < 0.001). Conclusion Patients with FAI had a high prevalence of combined abnormalities of FT and TT. For hip dysplasia, we found a significantly higher mean FT and TT, while 21% of patients (11 hips) had combined increased TT and increased FT (combined torsional malalignment). This is important when planning hip preserving surgery such as periacetabular osteomy and femoral derotation osteotomy. Cite this article: Bone Joint J 2020;102-B(12):1636–1645.

scholarly journals High prevalence of hip lesions secondary to arthroscopic over- or undercorrection of femoroacetabular impingement in patients with postoperative pain

2021 ◽  
Author(s):  
Malin K. Meier ◽  
Till D. Lerch ◽  
Simon D. Steppacher ◽  
Klaus A. Siebenrock ◽  
Moritz Tannast ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Dysplasia ◽  
Cartilage Damage ◽  
Imaging Findings ◽  
Femoral Torsion ◽  
Postoperative Imaging ◽  
Dichotomous Data ◽  
Cam Deformity ◽  
High Prevalence ◽  
Incremental Increase

Abstract Objectives To compare the prevalence of pre- and postoperative osseous deformities and intra-articular lesions in patients with persistent pain following arthroscopic femoroacetabular impingement (FAI) correction and to identify imaging findings associated with progressive cartilage damage. Methods Retrospective study evaluating patients with hip pain following arthroscopic FAI correction between 2010 and 2018. Pre- and postoperative imaging studies were analyzed independently by two blinded readers for osseous deformities (cam-deformity, hip dysplasia, acetabular overcoverage, femoral torsion) and intra-articular lesions (chondro-labral damage, capsular lesions). Prevalence of osseous deformities and intra-articular lesions was compared with paired t-tests/McNemar tests for continuous/dichotomous data. Association between imaging findings and progressive cartilage damage was assessed with logistic regression. Results Forty-six patients (mean age 29 ± 10 years; 30 female) were included. Postoperatively, 74% (34/46) of patients had any osseous deformity including 48% (22/46) acetabular and femoral deformities. Ninety-six percent (44/46) had an intra-articular lesion ranging from 20% (9/46) for femoral to 65% (30/46) for acetabular cartilage lesions. Prevalence of hip dysplasia increased (2 to 20%, p = 0.01) from pre- to postoperatively while prevalence of cam-deformity decreased (83 to 28%, p < 0.001). Progressive cartilage damage was detected in 37% (17/46) of patients and was associated with extensive preoperative cartilage damage > 2 h, i.e., > 60° (OR 7.72; p = 0.02) and an incremental increase in postoperative alpha angles (OR 1.18; p = 0.04). Conclusion Prevalence of osseous deformities secondary to over- or undercorrrection was high. Extensive preoperative cartilage damage and higher postoperative alpha angles increase the risk for progressive degeneration. Key Points • The majority of patients presented with osseous deformities of the acetabulum or femur (74%) and with intra-articular lesions (96%) on postoperative imaging. • Prevalence of hip dysplasia increased (2 to 20%, p = 0.01) from pre- to postoperatively while prevalence of a cam deformity decreased (83 to 28%, p < 0.001). • Progressive cartilage damage was present in 37% of patients and was associated with extensive preoperative cartilage damage > 2 h (OR 7.72; p = 0.02) and with an incremental increase in postoperative alpha angles (OR 1.18; p = 0.04).

Prevalence and diagnostic accuracy of in-toeing and out-toeing of the foot for patients with abnormal femoral torsion and femoroacetabular impingement

2019 ◽  
Vol 101-B (10) ◽  
pp. 1218-1229 ◽  
Author(s):  
Till D. Lerch ◽  
Patric Eichelberger ◽  
Heiner Baur ◽  
Florian Schmaranzer ◽  
Emanuel F. Liechti ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Femoroacetabular Impingement ◽  
Hip Dysplasia ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Controlled Study ◽  
Femoral Torsion ◽  
Foot Position

Aims Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT. Patients and Methods A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed. Results We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified. Conclusion In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218–1229

Femoroacetabular Impingement Patients With Decreased Femoral Version Have Different Impingement Locations and Intra- and Extraarticular Anterior Subspine FAI on 3D-CT–Based Impingement Simulation: Implications for Hip Arthroscopy

2019 ◽  
Vol 47 (13) ◽  
pp. 3120-3132 ◽  
Author(s):  
Till D. Lerch ◽  
Adam Boschung ◽  
Inga A.S. Todorski ◽  
Simon D. Steppacher ◽  
Florian Schmaranzer ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Control Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Hip Impingement ◽  
Femoral Version ◽  
Asymptomatic Control

Background: It remains unclear whether decreased femoral version (FV) causes anterior intra- or extra-articular femoroacetabular impingement (FAI). Therefore, we evaluated symptomatic hips with decreased FV, with and without cam and pincer FAI, by using computed tomography (CT)–based virtual 3-dimensional (3D) impingement simulation and compared this group with patients with normal FV and with asymptomatic hips. Purpose: To investigate (1) the osseous range of motion, (2) the osseous femoral and acetabular impingement zones, and (3) whether hip impingement is extra- or intra-articular in symptomatic hips with FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: An institutional review board–approved, retrospective comparative analysis was performed on a total of 84 hips in 68 participants. Of these, 37 hips in 24 symptomatic patients with FAI had decreased FV. These hips were compared with 21 hips of 18 symptomatic patients with anterior FAI with normal FV (10°-25°) and 26 asymptomatic hips with no FAI and normal FV. All patients with FAI were symptomatic and had anterior hip pain and a positive anterior impingement test. They underwent pelvic CT scans to measure FV. Decreased FV was defined as FV less than 5°. The 37 hips with decreased FV presented both with and without cam and pincer FAI. All 84 hips were evaluated by use of CT-based 3D models and a validated 3D range of motion and impingement simulation. Asymptomatic hips were contralateral normal hips imaged in patients undergoing total hip arthroplasty. Results: Hips with FAI combined with decreased FV had a significantly ( P < .001) lower mean flexion (114°± 8° vs 125°± 13°) and internal rotation (IR) at 90° of flexion (18°± 6° vs 32°± 9°, P < .001) compared with the asymptomatic control group. Symptomatic patients with FAI and normal FV had flexion of 120°± 16° and IR at 90° of flexion of 23°± 15°. In a subgroup analysis, we found a significantly ( P < .001) lower IR in 90° of flexion in hips with FV less than 5° combined with mixed-type FAI compared with hips with FV less than 5° without a cam- or pincer-type deformity. The maximal acetabular impingement zone for hips with decreased FV was located at the 2-o’clock position and ranged from 1 to 3 o’clock. In hips with decreased FV, most of the impingement locations were intra-articular but 32% of hips had combined intra- and extra-articular FAI in internal rotation in 90° of flexion. During the flexion-adduction-IR test performed in 10° and 20° of adduction, extra-articular subspine FAI had significantly ( P < .001) higher prevalence (68% and 84%) in hips with decreased FV compared with normal hips. Conclusion: Hips with FAI and decreased FV had less flexion and internal rotation in 90° of flexion compared with the asymptomatic control group. The majority of hip impingement due to low FV was intra-articular, but one-third of samples had combined intra- and extra-articular subspine FAI. Anterior extra- and intra-articular hip impingement can be present in patients who have FAI with decreased FV. This could be important for patients undergoing hip arthroscopy.

scholarly journals Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia

2021 ◽  
Vol 2 (10) ◽  
pp. 813-824
Author(s):  
Till Dominic Lerch ◽  
Adam Boschung ◽  
Florian Schmaranzer ◽  
Inga A. S. Todorski ◽  
Jan Vanlommel ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Sagittal Balance ◽  
Hip Dysplasia ◽  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
External Rotation ◽  
Acetabular Retroversion ◽  
Control Group ◽  
Acetabular Version ◽  
Iliac Wing

Aims The effect of pelvic tilt (PT) and sagittal balance in hips with pincer-type femoroacetabular impingement (FAI) with acetabular retroversion (AR) is controversial. It is unclear if patients with AR have a rotational abnormality of the iliac wing. Therefore, we asked: are parameters for sagittal balance, and is rotation of the iliac wing, different in patients with AR compared to a control group?; and is there a correlation between iliac rotation and acetabular version? Methods A retrospective, review board-approved, controlled study was performed including 120 hips in 86 consecutive patients with symptomatic FAI or hip dysplasia. Pelvic CT scans were reviewed to calculate parameters for sagittal balance (pelvic incidence (PI), PT, and sacral slope), anterior pelvic plane angle, pelvic inclination, and external rotation of the iliac wing and were compared to a control group (48 hips). The 120 hips were allocated to the following groups: AR (41 hips), hip dysplasia (47 hips) and cam FAI with normal acetabular morphology (32 hips). Subgroups of total AR (15 hips) and high acetabular anteversion (20 hips) were analyzed. Statistical analysis was performed using analysis of variance with Bonferroni correction. Results PI and PT were significantly decreased comparing AR (PI 42° (SD 10°), PT 4° (SD 5°)) with dysplastic hips (PI 55° (SD 12°), PT 10° (SD 6°)) and with the control group (PI 51° (SD 9°) and PT 13° (SD 7°)) (p < 0.001). External rotation of the iliac wing was significantly increased comparing AR (29° (SD 4°)) with dysplastic hips (20°(SD 5°)) and with the control group (25° (SD 5°)) (p < 0.001). Correlation between external rotation of the iliac wing and acetabular version was significant and strong (r = 0.81; p < 0.001). Correlation between PT and acetabular version was significant and moderate (r = 0.58; p < 0.001). Conclusion These findings could contribute to a better understanding of hip pain in a sitting position and extra-articular subspine FAI of patients with AR. These patients have increased iliac external rotation, a rotational abnormality of the iliac wing. This has implications for surgical therapy with hip arthroscopy and acetabular rim trimming or anteverting periacetabular osteotomy (PAO). Cite this article: Bone Jt Open 2021;2(10):813–824.

Arthroscopic Management of Subspinous Impingement in Borderline Hip Dysplasia and Outcomes Compared With a Matched Cohort With Nondysplastic Femoroacetabular Impingement

2020 ◽  
Vol 48 (12) ◽  
pp. 2919-2926
Author(s):  
Daniel Feghhi ◽  
Jonathan Shearin ◽  
Srino Bharam
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Dysplasia ◽  
Control Group ◽  
Matched Cohort ◽  
Arthroscopic Management ◽  
Hip Impingement ◽  
Outcome Score

Background: Arthroscopic management of femoroacetabular impingement (FAI) in the setting of borderline hip dysplasia is controversial. Recently, there has been increased awareness of a prominent anterior inferior iliac spine (AIIS) resulting in subspinous impingement. Purpose/Hypothesis: The purpose was to report outcomes of arthroscopic subspinous decompression in patients with symptomatic hip impingement and borderline hip dysplasia compared with a matched cohort with nondysplastic FAI. Addressing a prominent subspinous region and cam/pincer lesion in the borderline dysplastic hip may lead to favorable outcomes comparable with those of patients undergoing arthroscopic management of nondysplastic FAI. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with symptomatic hip impingement, borderline dysplasia (lateral center-edge angle [LCEA], 18°-24°), and prominent AIIS (BDSI group) whose nonoperative management failed and who subsequently underwent arthroscopic subspinous decompression were retrospectively identified. Three-dimensional computed tomography imaging was used to categorize AIIS morphology into type 1, 2, or 3 (Hetsroni classification). Patient-reported outcome (PRO) scores consisting of the modified Harris Hip Score (mHHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), and Hip Outcome Score–Sport-Specific Subscale (HOS-SSS) were obtained preoperatively and at an average of 44 months postoperatively (range, 23-61 months). Exclusion criteria were Tönnis osteoarthritis grade >1 and a history of previous hip procedures. An age-, sex-, and body mass index–matched cohort of patients without dysplasia (LCEA, >25°) who underwent arthroscopic FAI surgery with a minimum 2-year follow-up were selected to serve as the control group. Results: Eighteen patients, 19 hips (14 women and 4 men; average age, 28 years) were included. Of the 19 hips in the BDSI group, the average LCEA and alpha angle were 21.8° and 66.2°, respectively; 14 hips were Hestroni type 2, and 5 hips were type 1. There were no postoperative complications or additional procedures performed since the last follow-up. Repeated-measures analysis of variance revealed a significant improvement in all PRO scores from preoperatively to the last follow-up: mHHS, 64.7 to 87.7 ( P < .001); HOS-ADL, 62.1 to 92.1 ( P < .001); HOS-SSS, 26.5 to 87.1 ( P < .001). An analysis of covariance revealed that patients with type 2 AIIS had a significantly higher postoperative mHHS than those with a type 1 morphology (88.3 and 95.6, respectively; P < .01) The BDSI group had a significantly lower preoperative HOS-SSS (26.5; P < .001) in comparison with the control group. However, there was no significant difference in postoperative outcome scores between groups. The BDSI group underwent significantly more microfracture, capsular plication, and ligamentum teres debridement (15.8%; P = .04). Conclusion: Arthroscopic AIIS decompression in patients with coexisting borderline dysplasia and subspinous impingement is a safe and effective method of treatment that produces outcomes comparable with those of a cohort with nondysplastic FAI.

MRI Assessment of Supra- and Infratrochanteric Femoral Torsion: Association With Femoroacetabular Impingement and Hip Dysplasia

2018 ◽  
Vol 211 (1) ◽  
pp. 155-161 ◽  
Author(s):  
Benjamin Fritz ◽  
Susanne Bensler ◽  
Michael Leunig ◽  
Patrick O. Zingg ◽  
Christian W. A. Pfirrmann ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Dysplasia ◽  
Femoral Torsion

ANTICYTOKINE ACTIVITY OF THE PROTOZOA BLASTOCYSTIS SPP

2020 ◽  
pp. 44-48
Author(s):  
Bugero N.V. ◽  
Ilyina N.A. ◽  
Aleksandrova S.M.
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Diseases ◽  
Control Group ◽  
Ulcer Disease ◽  
Cytokine Balance ◽  
High Prevalence ◽  
Blastocystis Spp ◽  
High Level ◽  
Eukaryotic Organisms ◽  
High Degree

In addition to the classical pathogens, which are well understood and well identified, new pathogens with the potential to spread epidemiologically are being identified. Some of these little-known organisms are the simplest Blastocystis spp. blastocystostosis. The clinical significance of Blastocystis spp. and its pathogenicity are still under discussion. This parasite belongs to a group of single-celled eukaryotic organisms living in the colon of the human intestine. Blastocystis spp. is known to be found both in people with reduced immune status and in individuals without any clinical manifestation. It has been established that a sufficiently high degree of invasiveness is observed in persons with gastrointestinal tract diseases, dermatosis, allergic reactions, in patients with carriers of the human immunodeficiency virus, etc. Possessing persistence factors, protozoa blastocysts contribute to the inactivation of host defensive mechanisms, providing a stable anthogonistic effect. In recent years, many works have been devoted to the characteristics of the persistent properties of Blastocystis spr., however, individual properties of blastocysts, in particular, anticytokine activity (ACA), have not yet been studied. In this regard, the work studied the anticytokine activity of microorganisms isolated from healthy subjects and patients with gastrointestinal tract diseases. A high prevalence of the studied characteristic in the subjects was shown. The expression of anticytokine activity in the obtained isolates of blastocysts was the highest in the group of persons with gastric ulcer disease, which decreased in the order of duodenal ulcer, chronic cholecystitis, chronic gastritis, etc. The data obtained in this work on the high level of ACA expression in blastocyst isolates obtained from individuals with gastrointestinal diseases as compared with the control group enables to conclude that their exometabolites may influence the local cytokine balance [1], which supports the inflammatory process.

Prevalence of Toxoplasma gondii and Toxocara canis among Myositis Patients in Southwest of Iran

2019 ◽  
Vol 20 ◽  
Author(s):  
Jasem Saki ◽  
Karim Mowla ◽  
Reza Arjmand ◽  
Forough Kazemi ◽  
Somayeh Fallahizadeh
Keyword(s):  
Toxoplasma Gondii ◽  
Nested Pcr ◽  
Healthy Subjects ◽  
Toxocara Canis ◽  
Control Group ◽  
Igg Antibodies ◽  
Healthy Individuals ◽  
High Prevalence ◽  
Acute Toxoplasmosis ◽  
Southwest Of Iran

Introduction: Parasitic myositis is caused by some parasites such as T. gondii and T. canis. So, the aim of the study was to evaluate the prevalence T. gondii and T. canis in patients with myositis and healthy individuals. Methods: A total of 108 samples were randomly selected as the control (54 healthy individuals) and test (54 myositis patients) groups. IgG and IgM antibodies against T. gondii and IgG antibodies against T. canis were measured by the ELISA. The detection of chronic and acute toxoplasmosis was performed by the ELISA IgG avidity. The presence of T. gondii in blood was evaluated by the nested-PCR. Results: Of 108, 33 (30.6%) cases were detected positive for IgG against T. gondii that 19 (35.2%) and 14 (25.9%) were observed in myositis patients and healthy individuals, respectively (P=0.296). Of 19 positive cases, 12 (63.2%) and 7 (36.8%) cases were detected as chronic and acute toxoplasmosis, respectively, while, all positive cases in the control group had chronic toxoplasmosis (P=0.013). One (1.9%) sample was detected positive for anti- Toxoplasma gondii IgM and two (3.7%) samples were found positive for IgG against T. canis by the ELISA that these positive cases were observed only in myositis patients (P=1.000 P=0.495, respectively). B1 T. gondii gene was amplified in 12 (63.2%) and 1 (7.1%) in myositis patients and healthy subjects (P=0.001). Conclusions: Our findings showed that there was a relatively high prevalence of acute toxoplasmosis in myositis patients in comparison with the control subjects in southwest of Iran.

Aortic tortuosity index as a predictor of type A aortic dissection

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Scalbert ◽  
O Milleron ◽  
M Para ◽  
R Raffoul ◽  
Q Pellenc ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Ct Scans ◽  
Control Group ◽  
Type A Aortic Dissection ◽  
Total Length ◽  
A Value ◽  
Straight Line ◽  
Patients At Risk ◽  
Geometric Length

Abstract Introduction The risk ok type A aortic dissection (AAD) depends on the degree of aortic wall's alteration, which can result in dilatation or tortuosity. The estimate of this risk relies solely on the evaluation of the diameter of the ascending aorta. Purpose The purpose of this study is to evaluate the presence and importance of aortic tortuosity in patients with type A aortic dissection. Method Postoperative CT scans of patients with type A aortic dissection were compared with CT scans from controls matched for gender and age. After 3D reconstruction, total length (actual distance along aortic center line = Ltot) and geometric length (length of a straight line between start and end of the aortic segment = Lgeo) were measured to calculate the tortuosity index (TI = Ltot / Lgeo). Results Ltot, Lgeo and TI from different aortic segments of the AAD group were higher than in the control group. Ltot and TI of the whole aorta (from aortic valve to bifurcation) were greater in patients with type A aortic dissection (527.7±46.1 mm vs. 475.8±39.7, p&lt;0.0001; and 2.05±0.24 vs. 1.98±0.21, p=0.002 respectively). Total length and TI were greater after exclusion of the ascending part, and a value of this TI &gt;1.3 identifies AAD patients with an accuracy of 74.8% (AUC = 0.792, p&lt;0.0001). TI is altered by risk factors for aortic dissection: it increases with hypertension and age but not by tobacco use, and TI decreases in diabetes. Conclusions Type A aortic dissection is associated with longer aorta and increased aortic tortuosity. This index may help recognize patients at risk for type A aortic dissection. Calculation of tortuosity indexes Funding Acknowledgement Type of funding source: None

scholarly journals Impact of On-Farm Interventions against CTX-Resistant Escherichia coli on the Contamination of Carcasses before and during an Experimental Slaughter

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 228
Author(s):  
Michaela Projahn ◽  
Jana Sachsenroeder ◽  
Guido Correia-Carreira ◽  
Evelyne Becker ◽  
Annett Martin ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Broiler Chickens ◽  
Stocking Density ◽  
Resistant Bacteria ◽  
Control Group ◽  
Cross Contamination ◽  
High Prevalence ◽  
On Farm ◽  
The Impact ◽  
Slow Growing

Cefotaxime (CTX)-resistant Enterobacteriaceae are still an ongoing challenge in human and veterinary health. High prevalence of these resistant bacteria is detected in broiler chickens and the prevention of their dissemination along the production pyramid is of major concern. The impact of certain on-farm interventions on the external bacterial contamination of broiler chickens, as well as their influence on single processing steps and (cross-) contamination, have not yet been evaluated. Therefore, we investigated breast skin swab samples of broiler chickens before and during slaughter at an experimental slaughter facility. Broiler chickens were previously challenged with CTX-resistant Escherichia coli strains in a seeder-bird model and subjected to none (control group (CG)) or four different on-farm interventions: drinking water supplementation based on organic acids (DW), slow growing breed Rowan × Ranger (RR), reduced stocking density (25 kg/sqm) and competitive exclusion with Enterobacteriales strain IHIT36098(CE). Chickens of RR, 25 kg/sqm, and CE showed significant reductions of the external contamination compared to CG. The evaluation of a visual scoring system indicated that wet and dirty broiler chickens are more likely a vehicle for the dissemination of CTX-resistant and total Enterobacteriaceae into the slaughterhouses and contribute to higher rates of (cross-) contamination during processing.

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