Liver abscesses are a significant problem in the United States' cattle feeding industry, costing the industry an estimated $15.9 million annually in liver condemnation, trim losses, and reduced carcass weights and quality grades. Recent reported incidence rates of liver abscesses at slaughter range from 10 to 20%. Liver abscess incidence may be influenced by a number of factors including: breed, gender, diet, days on feed, cattle type, season, and geographical location. Liver abscesses typically occur secondary to rumen insults caused by acidosis or rumenitis. It has been proposed that pathogens associated with liver abscess formation enter the blood stream through damaged rumen epithelium and are transported to the liver through the portal vein where they cause infection, manifested as liver abscesses. Severe liver abscesses have been linked to reduction in hot carcass weight, dressing percentage, yield grade, longissimus muscle area, and marbling scores of carcasses when compared to those with normal livers. However, the effect of liver abscesses on meat tenderness and sensory attributes has not been previously investigated.
Strip loin steaks (n = 119) were used to evaluate the association between liver abscess severity and USDA quality grade and meat tenderness and sensory attributes of steaks from finished feedlot cattle. Steaks were used in a 3 × 2 factorial treatment structure using a completely randomized design and were collected at a commercial abattoir located in northwest Texas. All cattle were sourced from a single feedlot and fed a common diet that did not include tylosin phosphate. Treatments were USDA quality grades of Select (SEL) and Low Choice (LC) and liver abscess scores of normal (NORM; healthy liver, no abscesses), mild (M; 1 abscess less than 2 cm in diameter to 4 abscesses less than 4 cm in diameter), and severe (SV; 1 abscess greater than 4 cm in diameter or greater than 4 small abscesses). All steak samples were collected on the same day, approximately 36-h post-mortem and were cut from the left side of the carcass at the 13th rib by a trained abattoir employee. Steaks were vacuum-packaged, and aged at 3 ± 1°C for 14-d post-mortem. Warner-Bratzler Shear Force (WBSF) and Slice Shear Force (SSF) analyses were conducted and cook-loss percentage was measured. A trained sensory panel analyzed samples for juiciness, tenderness, and flavor attributes. There were no differences among liver abscess scores for WBSF or SSF (P > 0.52). Warner-Bratzler Shear Force was lower for LC-SV than SEL-SV (P = 0.04). Sensory attributes of initial and sustained juiciness, and overall tenderness were all greater for LC than for SEL steaks (P < 0.04) and connective tissue amount was less for LC steaks when compared to SEL (P = 0.03). Liver abscess score had no effect on any sensory attributes (P > 0.70); however, there was an interaction between quality grade and liver score for myofibillar tenderness (P = 0.03). Within LC steaks, liver abscess score had no effect on myofibrillar tenderness (P > 0.05), however, in SEL steaks, M steaks were more tender than SV steaks (P < 0.03). These results indicate that within quality grades, meat tenderness or sensory attributes were not influenced by liver abscess score but that mild liver abscesses may affect the myofibrillar tenderness of SEL steaks.
All health care professionals have a responsibility to integrate current evidence‐based medicine into their clinical practice to ensure the best possible patient care. Clinical practice guidelines (CPGs) play a major role in helping clinicians identify when and how to implement evidence into routine clinical practice to improve patient outcomes. The primary intent of CPGs is to benefit patients by improving the quality of care; however, CPGs also improve efficiency and effectiveness within the health care system. The process used to develop CPGs is important to ensure the recommendations are trustworthy, based on the highest‐quality evidence, and free of significant conflicts of interest. The National Academy of Medicine (NAM) published guidance on best practices for developing CPGs in 1990 and again in 2011. Additional guidance is provided by various reporting checklists for CPGs, such as the Appraisal of Guidelines for Research & Evaluation (AGREE) II and Reporting Items for Practice Guidelines in Healthcare (RIGHT) instruments. However, analyses of published CPGs show inconsistent application of these best practices. This paper discusses the benefits of CPGs, reviews the guideline development process, discusses limitations in this process and in applying CPGs to patient care, identifies opportunities for improvement, provides considerations for educating learners and other health care professionals about CPGs, and examines the role of pharmacists in CPG development, dissemination, and implementation.
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