O101 Increased contractile activity through electrical stimulation attenuates postoperative loss of muscle mass and function, even in the presence of inadequate nutrition

Introduction

Significant muscle atrophy occurs after major abdominal surgery. Lack of physical activity and protein intake may play a significant role. This study assesses the efficacy of neuromuscular electrical stimulation (NMES) in attenuating loss of muscle mass and function following open colorectal resection.

Methods

Fifteen patients were recruited, and their lower limbs randomised to control (CON) or NMES (STIM). Vastus Lateralis (VL) cross sectional area (CSA), muscle thickness (MT) and knee extensor strength (KES) were measured preoperatively and repeated on postoperative day (POD) 5. Dietary intake was recorded, and nutritional intake calculated. Fifteen minutes of NMES was applied to the quadriceps of the STIM leg twice a day on POD 1–4. All outcomes were analysed using linear mixed model approaches. The study was approved by the NHS REC (ref 20/EM/069).

Results

NMES significantly reduced the loss of CSA (mean difference (MD) 1.18, 95%CI: 0.75–1.61, p<0.001), MT (MD 0.12, 95%CI: 0.04–0.2, p=0.001) and KES (MD 4.48, 95%CI: 0.00–8.97, p=0.03). Total energy and protein intakes over POD1 - 4 were 42.6% (± 19.7) and 21.1% (± 11.4) of the ESPEN recommended daily amount for perioperative patients. No adverse events occurred, and patients reported that NMES caused minimal or no discomfort.

Conclusion

NMES has been demonstrated to reduce loss of muscle mass and function following major abdominal surgery and may be an important tool in aiding recovery to normal functional state.

Further studies should establish the efficacy of bilateral whole-leg NMES for improving patient centred outcomes.

Take-home message

Loss of muscle mass and function after major abdominal surgery causes significant morbidity. Neuromuscular electrical stimulation reduces this muscle loss and should be investigated further as a potential therapy.

[Confirmation of Tick-borne encephalitis virus in an European hedgehog (Erinaceus europaeus)]

INTRODUCTION

European hedgehogs (Erinaceus europaeus) have a high exposure to various ticks, which could transmit pathogens with direct health significance for the host and may have zoonotic potential. Tick-borne meningoencephalitis (FSME) is an important tick-borne disease in Switzerland, caused by the tick-borne encephalitis virus. About its occurrence in the European hedgehog population is little known. The present study examined various organs, blood and ticks of 65 European hedgehogs to obtain data of FSME virus presence in this species in Switzerland. Real-time RT-PCR from the lungs, liver, spleen and kidney of 56 hedgehogs and of 114 infesting ticks (Ixodes hexagonus or Ixodes ricinus) were used for the detection of viral RNA. In addition, 19 blood samples were tested for antibodies against FSME by ELISA. FSME virus antibodies were detected for the first time in the serum of a European hedgehog. Lung and spleen tissue samples of the same animal tested also weak virus positive on RT-PCR. Clinically, the hedgehog showed neurological symptoms, although these symptoms could have originated from an other diseases. No viral RNA was detected in any of the ticks. This study could not confirm if the meningoencephalitis in the hedgehog was triggered by the FSME viral infection. Nevertheless, the simultaneous detection of antibodies and virus RNA in the same animal makes the European hedgehog a competent host of the tick-borne encephalitis virus and leads to the assumption that this species can act as a reservoir.

Ultrasonographic findings in two sheep with enzootic calcinosis

INTRODUCTION

This report describes 2 sheep with enzootic calcinosis characterized by abnormal cardiovascular and respiratory findings and ascites causing abdominal distension. Both sheep were anorexic and listless and had increased heart and respiratory rates. Auscultation of the heart revealed a gallop rhythm in sheep 1 and a loud systolic heart murmur in sheep 2. The activities of liver enzymes were severely increased in both sheep. Abdominal ultrasonography showed severe ascites and congestion of the liver and caudal vena cava. Echocardiography in sheep 2 showed hyperechoic and markedly thickened mitral and aortic valves with moderate-severe mitral insufficiency and generalized cardiomegaly. Both sheep were euthanized and examined postmortem. In addition to ascites and pleural effusion, the principal lesions were nodular thickening of the heart valves and calcification of the aorta and other arteries. Nutrition of the sheep did not include hay pellets, but the sheep were kept together with alpacas and lamas and had access to the hay pellets of these animals. In addition visitors were allowed to feed the sheep with hay pellets offered by the zoo in a dispenser. The two types of hay pellets had Vit D concentrations of 9'900 IU VitD3/kg and 7'000 IU Vit D2/kg, respectively. The definitive diagnosis was enzootic calcinosis.

[Veterinary care of birds of prey: Development from 1985 to 2015]

INTRODUCTION

A retrospective study was conducted which analysed the patient histories of free-living birds of prey presented to the Clinic of Zoo Animals, Exotic Pets and Wildlife of the University of Zürich from 2009 to 2015. The data were compared with a previous study on the period from 1985 to 1994. The average number of cases presented per year increased from 55 to 109. Most cases are presented in the months of February, June and July. Surgical problems were most frequently diagnosed and occurred in 61.5% of the cases, with 66.5% of patients presenting with one or more fractures. Regarding medical cases (29.5%) the most frequent finding was unspecified weakness (47.8%). Ophthalmic pathologies were diagnosed in 9% of the patients. With respect to outcome 41.7% of the patients could be released, 47.3% and 11.0% had to be euthanized or died, respectively. In 6 of 9 of the most frequently presented species the rate of release increased significantly compared to the previous study.

Healing after dental extractions in men with HIV infection

To determine the incidence of delayed healing after dental extractions in men with HIV infection, a retrospective audit was conducted of all extractions performed in a dedicated dental clinic over a 26-month period. The incidence of delayed healing in patients with HIV was compared with the incidence in those patients without HIV. Eighty men with HIV had 163 teeth extracted, which resulted in five dry sockets (3.01%). Thirty-six men thought not to have HIV had 70 extractions and three dry sockets (4.28%). All three dry sockets in the control group occurred in men who had tested negative for HIV antibodies in the year before their extraction. There were no other incidents of delayed healing. These findings contrast with other reports since they reveal no increase in delayed healing after extractions in men with HIV and do not support recommendations that prophylactic antimicrobials are required for extractions in this group of patients.