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Introduction Assessment of nutritional status in the clinical setting is difficult and often poorly achieved. Bioelectrical impedance analysis (BIA)-derived phase angle (PA) is a simple and non-invasive tool which refines the determination of nutritional status, reflects body cell health, and has prognostic value. However BIA is not much used in clinical practice because of protocols which oblige the patient to be starved and on bed-rest. The research underpinning these protocols is dated and insecure; thus the restrictions may not be necessary. Method Aim To determine whether eating and exercise affect BIA-derived Phase Angle. Methods BIA measurements (Bodystat Quadscan 4000) were made on 17 in-patients who were starved and rested. It was then repeated on two occasions: following exertion and after eating breakfast. Inclusion Criteria - Adult in-patients with capacity to consent. Exclusion Criteria - Nil by mouth, pregnancy, too unwell or otherwise unable to exercise. Statistical analysis SPSS: Wilcoxon signed-rank test for non-parametric data. Results PA measurements were typical of a hospital patient cohort. Neither exercise nor eating made a statistically nor clinically significant difference to the PA mean PA= 4.312, mean PA= 4.376, (pre-exercise and food vs. post-exercise: p = 0.057), mean PA= 4.335 (pre-exercise and food vs. after food: p = 0.651) Conclusion In summary, the current protocols of starving and resting patients appear unnecessary and outdated (with due recognition of our small sample size). It is probable that PA measurement is a practical means to improve assessment of nutritional status in hospitalised patients. Disclosure of interest None Declared.

IntroductionMalnutrition affects at least one in three hospital inpatients1. It prolongs hospital stay and affects the recovery process. Early detection and intervention are essential to tackling malnutrition. Current nutritional assessment tools are dependent upon clinician experience and vary in their detection rates of malnutrition. We assess whether bioelectrical impedance analysis (BIA)-derived phase angle (PA), plasma markers such citrulline and pre-albumin could aid assessment and if current starving and resting protocols are required for BIA.MethodEighty adult in-patients were recruited over a 40 week period. The Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA) were performed. Serum was analysed for citrulline and pre-albumin. PA was measured using Bodystat 4000 in three different metabolic states: rested and fasted, post-exercise and post food and exercise. The reference standard for malnutrition was determined using SGA. MUST score >0 indicated malnutrition risk, severe if >2. PA was considered to define malnutrition if lower than reference ranges for sex and age; severe malnutrition was indicated as >2 integers below reference range. Statistical analysis included paired t test and logistical regression.Results80 patients took part in the study; 47 (59%) male (20–86 years) and 33 (41%) female (18–87 years). Sixty-six patients completed all arms of the study; Fourteen patients did not consent to a blood test but completed all other aspects.1. SGA and PA identified 47 (59%) and 50 (63%) patients with malnutrition compared to 9 (11%) by MUST2. SGA and PA identified 15 (19%) and 10 (13%) patients with severe malnutrition compared to 2 (0.03%) by MUST3. Compared to SGA, PA had sensitivity of 91% (95% CI 80%>98%) and specificity of 36% (95% CI 11%>69%). Positive predictive value was estimated at 86% (95% CI 80%>91%). Negative predictive value was estimated at 50% (95% CI 23%>77%)4. There were no food or exercise related difference in PA (p=0.1837; p=0.1344 respectively)5. Pre-albumin co-related with SGA (p=0.003), citrulline did not (p=0.348)ConclusionThese results show that BIA-derived PA is an objective measurement suitable for use in nutritional assessment. It is sensitive for detecting malnutrition and has a highly significant association with SGA. Furthermore, current fasting and resting protocols surrounding its use were found to be invalid. Pre-albumin is a useful biomarker in nutritional status assessment.Reference. British Association of Parenteral and Enteral Nutrition (BAPEN): “The cost of malnutrition in England and potential cost savings from nutritional interventions” Accessed: 20 February 2017 at: http://www.bapen.org.uk/pdfs/economic-report-short.pdfDisclosure of InterestNone Declared

So-called runting stunting syndrome (RSS) afflicts chicks worldwide. The present study in Georgia chicks is the first report of unique histologic features of RSS pathology in chicks in the United States. Various combinations of avian nephritis virus, enterovirus-612, and reovirus were always isolated from chick small intestines. Ultrastructurally, only small round viruses were seen in small intestinal lesions. Although finding intralesional virus in small intestinal segments from chicks with signs and gross lesions consistent with RSS constitutes a reasonable criterion for making a diagnosis of this disease, chicks without intralesional viruses and with bacterial or protozoal enteritis may also be small and abnormally feathered. Because just what constitutes RSS remains a diagnostic dilemma, we recommend that the use of the imprecise acronym \"RSS\" be discontinued

The histopathology of reovirus-infected small intestines from clinically ill commercial broiler chicks afflicted with so-called runting stunting syndrome is described. We do not speculate that a cause-and-effect relationship necessarily exists between intralesional reovirus and illness in chicks in the present study. We propose that, in the future, similar cases be termed reovirus-associated enteritis (RAE). RAE must be differentiated from lesions attributed to infections by enterovirus-like particles

Spiking mortality syndrome (SMS) in chickens resembles cocklebur toxicity in cattle, sheep, pigs, and rats. In order to determine if cockleburs are toxic to broiler chicks, crushed burs were fed (25% wt:wt) to broilers for 21 days. Ingestion of cockleburs resulted in significant failure to properly gain body weight. Otherwise, chicks did not develop clinical signs of illness of gross of microscopic lesions. Although there were some significant differences in serum chemistry values among chick groups, there were no consistent patterns. Severe hypoglycemia is said to be a characteristic finding in chicks that die with SMS. Because glucose levels were not low in chicks that were fed cockleburs, we feel certain that cockleburs do not cause SMS

The search for a solitary cause of spiking mortality (so-called spiking mortality syndrome) among broiler chicks has been thwarted by the fact that multiple agents cause similar mortality histograms. In the present case report, we describe intralesional herpesvirus, reovirus-like virus particles, and bacteria in small and large intestines from chicks with a spiking mortality histogram, diarrhea, and enterotyphlitis. We attributed the spiking mortality histogram to starvation coupled with diarrhea

For the past few years prisons have attracted much media attention, due to substantial increases in the prison population and the deteriorating conditions in which prisoners are held. In addition, there has been industrial action by prison officers and a series of disturbances and riots by prisoners. Following the riot at Strangeways prison in Manchester in 1990 Lord Justice Woolf was called to conduct an inquiry into the riots and their causes. Prisons After Woolf serves as a basic source of information on prison issues and reviews them in the light of the Woolf proposals. In so doing, its contributors, drawn from all areas of the legal and prison system, present an important broad perspective on the major questions in penology today.

Utilizing the acid α-naphthyl acetate esterase histochemical staining technique, cells with established T-cell (thymus-derived) staining characteristics could be consistently demonstrated in the periarteriolar lymphatic sheaths of the spleen and the diffusely infiltrated area of the cloacal bursa. The same areas failed to stain positively in significant numbers following a preincubation period with a specific inhibitor for carboxyl esterase. Lymphoid cells in the thymus, the splenic follicles, and bursal follicles were mostly negative.