Welfare Assessment of Two Free-range Laying Hen Flocks in Turkey.

This study aimed to determine the prevalence of keel bone deviations and feather damage of laying hens in two different free-range housing systems under commercial conditions. Both of the free-range systems had an indoor barn and an outdoor range area. The floor of the indoor barn consisted of litter and either perches (litter and perch, LP) or slats (litter and slats, LS). The hens of both flocks were raised under identical conditions in the same house during the rearing period and then divided and transferred to two different free-range housing systems for the laying period. Examinations were conducted on the flocks at the end of the production cycle. Hens from the LP group had a greater prevalence of keel bone deviation and feather damage compared to hens from the LS group. The highest percentage of severe feather damage was found in the back and tail body regions in both flocks. The findings of this study are based upon the evaluation of two Turkish laying flocks. Therefore further research with more replicates of these treatments is needed to reach a general conclusion.

Keel bone damage assessment: consistency in enriched colony laying hens.

Damage to the keel bone is a major issue in the laying hen industry. The goal of this study was to compare palpation results of live laying hens to digital computed tomography (CT) images, to assess changes in palpation reliability as training and familiarity increased, and to examine keel bone morphology over time. The longitudinal study consisted of 2 trials of 3 observation periods using 40 different (n = 120) W-36 hens housed in enriched colony cages. The first trial began when hens were 52 to 58 wk of age repeating the trial when the same birds were 74 to 81 wk of age. At 52 wk of age, each hen's keel bone was palpated by a single individual for keel bone caudal tip fractures (Tip), sagittal deviations (Evenness), and transverse deviations (Straightness). After palpation, each hen was placed in a motion limiting restraint and scanned using CT. The hens spent the next 21 d in their cages and on day 21, the hens were collected, palpated, and CT scanned again. The CT scans were imported into Mimics analysis software, 3D models of each keel bone were constructed and evaluated. Each bone and 3D model was scored (0, 1, 2) on the measurement of transverse deviation based on <0.5 cm, 0.51 to 1.0 cm, and >1.0 cm total deviation, respectively. Analysis of data using Proc Freq and Means in SAS 9.3 revealed minimal to moderate kappa values and moderate agreement percentages between palpators and digital analysis. The computer generated 3D models of individual keel bones were compared to palpation scores for Tip, Evenness, and Straightness at the beginning and end of each trial. The visual observations of the 3D models were qualitative, performed by a single individual. Overall, we found CT scanning to be a useful tool in observing changes to the keel bone, we observed changes in palpation accuracy as training/familiarity increased, and examined changes in keel morphology, specifically in the tip, after 52 wk of age.

[Cardiac tamponade following sternal puncture. Usefulness of ultrasound focussed assessment with sonography for trauma]. / Taponamiento cardíaco tras punción esternal. Utilidad de la ecografía focussed assessment with sonography for trauma.

One of the aims of the medical profession is to be able to detect complications in patients during diagnostic tests and treatments. The early diagnosis of these complications can prevent a fatal outcome. The diagnosis is often based on clinical symptoms and supported by complementary tests. Diagnostic tests have been developed in the last few years that are rapid and easy to use, as well as being cost effective and minimally invasive. Focussed assessment with sonography for trauma ultrasound (echo-FAST) was introduced in the 1990s in the field of resuscitation as a test for the rapid detection of intra-abdominal and pericardial fluid in multiple injury patients, but its uses in other cases not involving trauma still raise doubts and controversy. A case is presented of a patient subjected to a sternal puncture for a bone marrow aspirate, who had a complication of a secondary cardiac tamponade, which was diagnosed early using echo-FAST.

The effect of keel fractures on egg production, feed and water consumption in individual laying hens.

The impact of keel bone fractures on egg production, egg weight and feed and water consumption in individual laying hens. A total of 165 Lohmann brown laying hens were obtained from a commercial farm that consisted of 105 with keel fractures and 60 without keel fractures. 2. After a 4-d period of acclimatisation, hens were individually housed and provided with ad libitum food and water for a 24-h period. The number of eggs laid, egg weight, feed and water consumption during this period were recorded. Keel bone strength was also assessed. 3. Hens free from keel fractures laid more eggs (91.7% vs. 84.9%) of significantly heavier weight (61.9 g vs. 60.2 g), ate less feed (139 g vs. 151 g) and drank less water (212 ml vs. 237 ml) than hens with fractures. 4. There was a significant positive association between keel fracture severity and water consumption, and a significant negative association between keel fracture severity and egg weight and keel bone strength. 5. This small-scale study on individual birds shows that keel bone fractures may have an impact on the economics of egg production.

Less-lethal hybrid ammunition wounds: a forensic assessment introducing bullet-skin-bone entity.

Agencies all around the world now use less-lethal weapons with homogeneous missiles such as bean bag or rubber bullets. Contusions and sometimes significant morbidity have been reported. This study focuses on wounds caused by hybrid ammunition with the pathologists' flap-by-flap procedure. Twenty-four postmortem human subjects were used, and lesions caused on frontal, temporal, sternal, and left tibial regions by a 40-mm hybrid ammunition (33 g weight) were evaluated on various distance range. The 50% risk of fractures occurred at 79.2 m/sec on the forehead, 72.9 m/sec on the temporal, 72.5 m/sec on the sternum, and 76.7 m/sec on the tibia. Skin lesions were not predictors of bone fracture. There was no correlation between soft and bone tissue observed lesions and impact velocity (correlated to distance range). Lesions observed with hybrid ammunition were the result of bullet-skin-bone entity as the interaction of the projectile on skin and bone tissues.

Sternal fractures are frequent among polytraumatised patients following high deceleration velocities in a severe vehicle crash.

INTRODUCTION: Sternal fractures are a rare entity. We hypothesised that a sternal fracture is an indicator of injury severity following traffic accidents. METHODS: Analysis of technical indicators of the collision, preclinical and clinical data of patients with sternal fractures from 1985 to 2004 among 42,055 injured patients assessed by an Accident Research Unit. RESULTS: Only 267/42,055 patients (0.64%) suffered a sternal fracture within the 20-year period. Soft tissue bruises are most often concomitant injuries (55%), followed by cervical spine injuries (23%), multiple rib fractures (14%) and lung injuries (12%). Eighteen percent of patients were polytraumatised, with 11.2% dying at the scene, 2.3% in hospital. Deceleration velocity (DeltaV) was significantly correlated with injury severity score (ISS, r2=0.92, y=0.408x-4.1573) as with maximal abbreviated injury scale (MAIS, r2=0.81). Patients suffering a sternal fracture being polytraumatised had significantly higher deceleration velocity (60+/-17km/h versus 37+/-16km/h [37.3+/-10.6mph versus 23+/-9.9mph], p=0.0001). Patients dying with a sternal fracture had a significant higher deceleration velocity (61km/h, 37.9mph) versus those surviving (38km/h, 23.6mph, p=0.0001). Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 patients), followed by 0.19% (5/2633 patients) driving motorbikes, and 0.11% (4/3258 patients) driving a truck. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33/255 car/trucks), with an airbag malfunction in 18%. 22% were not admitted to hospital, 28% were admitted to a trauma ICU with a sternal fracture. CONCLUSION: In 1/5 of cases sternal fractures encountered in polytraumatised patients following significantly higher deceleration velocities during the crash. Typically car drivers without a functioning airbag suffer a sternal fracture.

Diagnostic values of sonography for assessment of sternal fractures compared with conventional radiography and bone scans.

OBJECTIVE: This study was prospectively undertaken to evaluate the diagnostic value of sonography for detection of sternal fractures. We compared sonographic, conventional radiographic, and bone scan examinations of sternal fractures. METHODS: Fifty consecutive patients (26 male and 24 female; mean age, 45.2 years) were evaluated. Conventional radiography and sonography were performed in all patients, and bone scans were performed in 39 patients. All patients had acute pain and tenderness in anterior midline chest areas. Sonography was performed by 2 musculoskeletal radiologists within 1 to 2 days after admission. Patients underwent conventional radiography at admission and bone scans within 4 to 7 days after admission. Two radiologists reviewed all imaging findings by means of consensus. In addition, sonography was performed in 20 asymptomatic patients in a normal control group. RESULTS: Conventional radiography depicted sternal fractures in 12 of 50 patients. Sternal fractures were detected in 31 of 50 patients on sonography. Fractures on sonography were located in the manubrium (8 cases), upper sternal body (11 cases), mid sternal body (5 cases), and lower sternal body (7 cases). Bone scans showed sternal hot uptakes (accumulations of the radionuclide used) in 18 of 39 patients. In the control group, there were no bony defects or abnormal contours. CONCLUSIONS: We could detect sternal fractures more effectively with sonography than with conventional radiography and bone scans. In addition, sternal fracture locations showed relatively even distributions, and focal fractures in the manubrium were not easily detected on bone scans.

Sternal fracture with or without associated injuries. Assessment of the difference in the diagnosis, management and complications. Eighteen years of experience.

AIM OF THE STUDY: To determine the incidence of sternal fracture as an isolated injury as well as those which presented with concomitant injuries, and compare them in order to manage them more effectively. The Greek and International Literature related to the subject was also reviewed. MATERIAL AND METHODS: From 1984 to 2002 the Authors treated 134 patients with sternal fracture in the Department of Thoracic Surgery of their hospital, 59 males and 45 females, age from 17 to 84 years. Ninety patients had isolated sternal fracture and 44 sustained in addition fractured ribs, flail chest, pneumo-haemothorax, pneumo-haemomediastinum, some of them experienced respiratory failure, vertebral fractures, myocardial infarction, heart contusion, pericarditis, head injuries, fractures of upper lower limbs and intraperitoneal bleeding. Twelve patients were admitted in ITU and 4 with multiple trauma were fatally injured. Aortic tears or ruptures didn't occur in any of our patients. Sternal fracture as an isolated injury has a better prognosis compared to those with associated injuries. CONCLUSIONS: The management of sternal fracture is usually conservative with a good outcome, provided early diagnosis and treatment of concomitant injuries is offered from a well-trained and experienced medical team.

Blunt cardiac trauma caused by fatal falls from height: an autopsy-based assessment of the injury pattern.

BACKGROUND: Falls from height are contributing widely to population morbidity and mortality, especially in urban settings. The presence of blunt cardiac injuries can increase morbidity among these patients, leading even to death. Some clinical studies and case reports have been published on the subject, but a systematic autopsy-based approach to the subject is missing in the literature of recent decades. METHODS: This study reviewed 61 cases of fatal fall from height that were subjected to a full autopsy at the Institute of Legal Medicine, Hamburg, Germany, from 1998 to 2002. The autopsy protocols and available clinical information were evaluated for assessment of the cardiac injury pattern. RESULTS: Cardiac injuries were found in 33 cases (54%), all of which involved falls from heights exceeding 6 m. In 16 cases, the cardiac injuries were the cause of death or contributed to the fatal outcome. In five of these cases, the individuals possibly could have recovered from their trauma if their heart injury had been sufficiently diagnosed and adequately treated in time. The most frequent finding was pericardial tearing (45%). Tears caused by stretching of the epicardium in the area wherein the inferior vena cava leads into the right atrium and epicardial hematoma were present in 11 cases (33%). Endocardial tears of the atria were found in six cases (18%), and did not occur during falls from heights lower than 11 m. Transmural tears to the right atrium were present in 10 cases (39%), and to the left atrium in 6 cases (18%). These tears occurred with increasing frequency in relation to greater heights. When the heights were lower than 15 m, these tears were smaller than 1 cm in diameter, but when the heights exceeded 15 m, extensive irregular tears were observed. Sternal fractures were seen in 76% of all cases involving heart injuries. In 16% of these cases, the fractures were multiple. Only 18% of the cases without cardiac injuries had sternal fractures, and none of these was multiple. Thus, the presence of severe sternal fractures can be used as an indicator of possible cardiac trauma. CONCLUSIONS: A thorough cardiologic diagnosis should always be performed for patients who survive a fall from height. These patients should be transported to a unit capable of performing cardiopulmonary bypass, and explorative thoracotomy should be considered.

The evaluation of diagnostic accordance between plain radiography and bone scintigraphy for the assessment of sternum and rib fractures in the early period of blunt trauma.

OBJECTIVE: To evaluate the diagnostic accordance between scintigraphy and radiography in the early period following blunt thoracic trauma. DESIGN: Double-blind, prospective clinical study. METHODS: Thirty-four adult patients with blunt thoracic trauma were examined by plain radiography and scintigraphy within 24 hours of trauma. RESULTS: Radiography displayed pathologies in 25 (73.5%), while scintigraphy suggested pathologies in 24 (70.5%) patients. Rib fractures were identified radiographically in 16 (47%) and scintigraphically in 17 (50%) patients. Lateral radiograph of the sternum showed fracture in 10 (52.6%), while scintigraphy suggested fracture in 14 (73.6%) patients with suspected sternal trauma. CONCLUSION: Scintigraphy gave better results in the evaluation of sternal fractures during the early period of thorax trauma. Conventional plain radiography is thought to be the initial imaging modality, because it saves time and shows hemothorax or pneumothorax besides the osseous abnormality.

MR imaging in the presence of small circular metallic implants. Assessment of thermal injuries.

PURPOSE: The thermal effects of MR imaging in the presence of circular nonferro-magnetic metallic implants were studied in 6 rabbits. MATERIAL AND METHODS: A sternotomy was performed and fixed with stainless steel wires, and small titanium rings (diameter 3 mm) were placed on the surface of the ascending aorta and subcutaneous tissue of the thigh. Four of the rabbits were exposed to an imaging procedure with a 1.5 T scanner applying a T1-weighted spin-echo sequence and a gradient echo sequence. Two of the animals served as unexposed controls. Thirty-six hours after the exposure, tissues adjacent to the implants were examined histologically and compared with corresponding samples of the control animals. RESULTS: In the area of the titanium rings, histologic analysis revealed slight inflammatory changes apparently caused by the operation. No evidence of thermal injury was found, suggesting that the presence of the rings does not contraindicate MR examinations. Necrosis was noted in all of the sternal specimens. This was probably post-operative, but it impaired the assessment of thermal injury in this area.

Diagnostic value of ultrasonography and conventional radiography for the assessment of sternal fractures.

This study compares the sonographic and conventional radiographic examination of sternal fractures. Forty-five patients with a suspected sternal fracture were examined radiographically and sonographically. Sixteen had a sternal fracture which could be identified sonographically. In 15 of the 16 cases an equivalent diagnosis could be made radiologically. In one case no definite statement could be made radiologically but the sonographic finding together with the clinical aspect of the patient proved the diagnosis of a fracture. In four sternal fractures displaced by more than one anteroposterior thickness, the fracture itself was shown by sonography whereas the extent of the injury could not be displayed. Ultrasonic investigation of the sternum is a useful way to demonstrate fractures that provides a similar sensitivity to conventional radiography. In contrast sonography is not suited for portraying the grade of displacement. In case of doubt after radiological examination the ultrasonic examination serves as a valuable tool but conventional plain radiography remains the standard means of documenting a sternal fracture.

Radiographic imaging in assessment of combined manubriosternal and spinal fracture.

Deceleration injuries combined with hyperflexion of the torso as seen in motor vehicle accidents can result in combination of sternal and spinal fractures. This type of injury is associated with abnormalities of the soft tissue structures of the thorax. This publication reviews a case report of a deceleration injury and emphasizes the imaging modalities necessary to evaluate this constellation of abnormalities.

Sternal fractures--the natural history.

A five-year retrospective study was undertaken to analyze the natural history of sternal fractures and to scrutinize the current method of management. Sixty-six patients with documented sternal fractures were evaluated. The most common mechanism of injury was motor vehicle accidents (59%). Most of these victims did not wear seat belts. Thirty-five patients (53%) had associated injuries, of which rib fractures were the most common. Thirty-one patients (47%) had sternal fractures with no associated injury. The incidence of myocardial contusion in our study was 18%. Of the patients without associated injuries, the incidence of myocardial contusion was 6%. There were no mortalities in our study population, and there was no significant morbidity necessitating mechanical or pharmacologic support. The majority of these patients were managed by admission, observation, IV therapy, and placement of monitored beds. Our findings of no life-threatening sequelae suggest that we might question the necessity of current management criteria. This proves to be of special interest in view of the economic restraints imposed on health care today.