Inflammation, ECG changes and pericardial effusion: Whom to biopsy in suspected myocarditis?

The role of endomyocardial biopsies in patients with clinically suspected acute myocarditis, myocarditis in the past, and dilated cardiomyopathy is discussed controversially. In fact, it is still under discussion whether information obtained from endomyocardial biopsies is relevant for further clinical decisions. Therefore this Critical Perspective will deal with the question, which patient should undergo endomyocardial biopsy investigations for an etiopathogenic differentiation of the disease and for the possible choice of immunomodulatory treatment strategies

The intraruminal papillation gradient in wild ruminants of different feeding types: implications for rumen physiology

Browsing and grazing ruminants are thought to differ in the degree their rumen contents are stratified – which may be due to different characteristics of their respective forages, to particular adaptations of the animals, or both. However, this stratification is difficult to measure in live animals. The papillation of the rumen has been suggested as an anatomical proxy for stratification – with even papillation indicating homogenous contents, and uneven papillation (with few and small dorsal and ventral papillae, and prominent papillae in the atrium ruminis) stratified contents. Using the surface enlargement factor (SEF, indicating how basal mucosa surface is increased by papillae) of over 55 ruminant species we demonstrate that differences between the SEFdorsal or SEFventral and the SEFatrium are significantly related to the percentage of grass in the natural diet. The more a species is adapted to grass, the more distinct this difference, with extreme grazers having unpapillated dorsal and ventral mucosa. The relative SEFdorsal as anatomical proxy for stratification, and the difference in particle and fluid retention in the rumen as physiological proxy for stratification, are highly correlated in species (n=9) for which both kind of data are available. The results support the concept that the stratification of rumen contents varies among ruminants, with more homogenous contents in the more browsing and more stratified contents in the more grazing species

Forestomach pH in hunted roe deer (Capreolus capreolus) in relation to forestomach region, time of measurement and supplemental feeding and comparison among wild ruminant species

There is a debate whether supplemental feeding of deer bears the risk of inducing health problems, in particular acidosis. Here, the pH values of forestomach contents of free-ranging roe deer (Capreolus capreolus) shot in areas with and without supplemental winter feeding were compared. pH was similar in the dorsal and ventral rumen, but lower at these sites than in the Atrium ruminis, where it was again lower than in the reticulum; this pattern corresponds to expectations based on differences in the presence of saliva at the different sites of the forestomach. pH was lower with increasing time that elapsed between death of the animal and measuring pH in unsupplemented animals and was lower in unsupplemented animals in May/June than later in the year. Animals with supplemental winter feeding had significantly lower rumen pH (5.5) than animals without food supplementation (5.7). These data suggest that supplemental feeding of roe deer has the potential to lower forestomach pH. Although pH values measured in supplemented animals in this study would be considered indicative of rumen acidosis in domestic cattle, they are within the range previously measured in various free-ranging Odocoilid species, including roe deer; were of a similar magnitude as the May/June values of unsupplemented roe deer in this study; and must be considered with respect to potentially rapid declines in pH between death of the animal and pH measurement. Given methodological problems, analyses of literature data from free-ranging wild ruminants provide little evidence for a systematic variation of rumen pH with feeding type and body mass, but lead to the hypothesis that some New World cervids, including the roe deer, might either naturally have lower pH values than other ruminants or rumen contents whose pH drops rapidly after death