Risk factors associated with the colonization of group b streptococcus during pregnancy: preliminary results

In Spain, the rate of colonization with GBS in pregnant women is 11%-18.2% and in Catalonia between 13-16%. The vertical transmission rate is 50%, and in the absence of avoidance manoeuvres, between 1-2% of new-borns develop GBS infection, which is the main bacterial agent in neonatal sepsis precocious

Risk factors associated with the colonization of group b streptococcus during pregnancy: preliminary results

In Spain, the rate of colonization with GBS in pregnant women is 11%-18.2% and in Catalonia between 13-16%. The vertical transmission rate is 50%, and in the absence of avoidance manoeuvres, between 1-2% of new-borns develop GBS infection, which is the main bacterial agent in neonatal sepsis precocious

The inclusion of rapeseed meal in fattening pig diets, as a partial replacer of soybean meal, alters nutrient digestion, faecal composition and biochemical methane potential from faeces

[EN] The effects of including rapeseed meal (RSM) as an alternative source of vegetable protein in pig diets on animal performance, nutrient digestibility and methane production from faeces was investigated. A total of 96 pigs of 42.4 (±4.04) kg of body weight (BW) were allocated into two dietary treatments (48 animals/treatment). One group was fed a conventional diet (C) and the other with a diet containing RSM (R). The level of RSM in the R diet was 120 g/kg during the growing phase (40 70 kg BW; days 1 34 of study) and 200 g/kg during the finishing phase (70 114 kg BW; days 35 76 of study). Average daily gain (ADG), average daily feed intake and feed conversion ratio were measured throughout the study. During the finishing phase, faeces were collected and analysed for dry matter (DM), organic matter (OM), crude protein (CP), crude fat, fibre fractions, pH, volatile fatty acids and biochemical methane potential (B0). Additionally, the coefficient of total tract apparent digestibility (CTTAD) of nutrients was measured using the acid-insoluble ash method. At slaughter (114 ± 12.2 kg BW), the main carcass and meat quality characteristics were registered and the fatty acid (FA) profile of the subcutaneous fat and muscle was analysed. During the growing phase, R animals showed lower ADG compared with C animals (818 vs. 890 g/d; P<0.05). These differences disappeared during the finishing phase. Faeces from treatment R showed a lower B0 compared to those from treatment C (308 vs. 351 mL methane/g OM). Animals from R group showed a lower DM, OM and CP CTTAD than C animals (0.790, 0.826 and 0.729 vs. 0.832, 0.865 and 0.818, respectively; P<0.05) and tended to show lower fibre digestion rates. Consequently, animals from R group showed a higher amount of these components in faeces. However, fat digestion was not affected. No differences were found between treatments on most carcass characteristics. Overall, the inclusion of high levels of RSM in pig diets decreased final BW and nutrient digestibility (except fat) in the finishing phase. However, faeces from animals fed RSM were less degradable, producing less methane per gram of OM.This research was supported by the company Vall Companys Group (Lleida, Spain), the Instituto Valenciano de Investigaciones Agrarias (Valencia) and the Universitat Politecnica de Valencia (Valencia).Torres-Pitarch, A.; Moset, V.; Ferrer Riera, P.; Cambra López, M.; Hernández, P.; Coma, J.; Pascual Amorós, MDLD.... (2014). The inclusion of rapeseed meal in fattening pig diets, as a partial replacer of soybean meal, alters nutrient digestion, faecal composition and biochemical methane potential from faeces. Animal Feed Science and Technology. 198:215-223. https://doi.org/10.1016/j.anifeedsci.2014.09.017S21522319

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)