Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Marine Algae-PLA composites as de novo alternative to porcine derived collagen membranes

Resorbable and volume-stable collagen matrices have been preferred as grafting materials for diverse clinical applications in recent years. On the other hand, there is always an existing risk of transmission of infection with the cells or the tissues of the graft in using such collagen matrices. Moreover, considering the economic aspects, there is also a need for cost-efficient alternative materials. In this sense, marine algae can be considered as alternatives since they represent vast and cheap source of potential biopolymers. This work covers a comprehensive cytocompatibility study of composite biopolymers derived from different types of marine algae

Biocompatibility of individually designed scaffolds with human periosteum for use in tissue engineering.

Contains fulltext : 88733.pdf (Publisher’s version ) (Closed access)The aim of this study was to evaluate and compare the biocompatibility of computer-assisted designed (CAD) synthetic hydroxyapatite (HA) and tricalciumphosphate (TCP) blocks and natural bovine hydroxyapatite blocks for augmentations and endocultivation by supporting and promoting the proliferation of human periosteal cells. Human periosteum cells were cultured using an osteogenic medium consisting of Dulbecco's modified Eagle medium supplemented with fetal calf serum, Penicillin, Streptomycin and ascorbic acid at 37 degrees C with 5% CO(2). Three scaffolds were tested: 3D-printed HA, 3D-printed TCP and bovine HA. Cell vitality was assessed by Fluorescein Diacetate (FDA) and Propidium Iodide (PI) staining, biocompatibility with LDH, MTT, WST and BrdU tests, and scanning electron microscopy. Data were analyzed with ANOVAs. Results: After 24 h all samples showed viable periosteal cells, mixed with some dead cells for the bovine HA group and very few dead cells for the printed HA and TCP groups. The biocompatibility tests revealed that proliferation on all scaffolds after treatment with eluate was sometimes even higher than controls. Scanning electron microscopy showed that periosteal cells formed layers covering the surfaces of all scaffolds 7 days after seeding. Conclusion: It can be concluded from our data that the tested materials are biocompatible for periosteal cells and thus can be used as scaffolds to augment bone using tissue engineering methods.1 april 201

Economic analysis of agricultural enterprises in Turkey according to their level of success Análise econômica de empresas agrícolas na Turquia de acordo com seu nível de sucesso

In this study, agricultural enterprises in Turhal, Tokat were grouped based on their degree of success, their structural characteristics have been identified and their outcomes of activities discussed. The objective of the study was to determine the aspects that render successful agricultural enterprises different from other agricultural enterprises. The point to be achieved through the study is to assist agricultural enterprises with a more effective utilization of existing means in order to help them to develop. Data has been collected from 71 agricultural enterprises, which have been determined by Neyman's Method that is a stratified sampling method, via questionnaires. The Criterion of Agricultural Income Per Enterprise Land Decar has been applied for the classification of the enterprises according to their level of success. When the agricultural income was sufficiently examined in the enterprises, moderate successful and unsuccessful enterprises cannot obtain agricultural income to meet family labor force cost. Their agricultural level is quite below the sum of the family labour wage equivalent and the real interest of the equivalent capital. Therefore, the agricultural income of the examined enterprises is considered insufficient. The rate of the net product to the active capital is 3.45% in successful enterprises, 0.57% in those with moderate success, and for the unsuccessful ones, it has a negative value of -2.22%. This ratio for successful enterprises is close to 5%. Accordingly, the successful enterprises work more efficiently in comparison to the other enterprise groups.<br>Neste estudo, empresas agrícolas de Turhal, Tokat foram agrupadas com base em seu grau de sucesso, suas características foram identificadas e seus resultados de atividades discutidos. O objetivo do estudo é determinar os aspectos que diferenciam empresas agrícolas de sucesso das demais. O ponto a ser alcançado pelo estudo é assistir as empresas agrícolas com um uso mais efetivo. O ponto a ser alcançado pelo estudo é assistir as empresas agrícolas com um uso mais efetivo dos meios existentes, para ajudar a desenvolvê-las. Foram utilizados dados de 71 empresas selecionadas pelo método estratificado de Neyman, através de questionários. O "Criterion of Agricultural Income Per Interprise Land Decar" foi aplicado para a classificação em relação ao nível de sucesso. Quando a renda agrícola foi suficientemente examinada, as empresas de sucesso moderado e as sem sucesso não podem obter renda agrícola suficiente para atender ao custo do trabalho familiar. Seu nível agrícola está muito abaixo da soma dos salários familiares e do juro real do capital equivalente. Por isso, a renda agrícola das empresas examinadas é considerada insuficiente. A relação entre o produto líquido e o capital ativo é 3,45% nas empresas de sucesso, 0,57% nas de moderado sucesso e -2,22% nas sem sucesso. Nesta relação, o limite do juro normal é de 5% para empresas de sucesso. Assim, empresas de sucesso trabalham mais eficientemente em comparação a outros grupos empresarias