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

Pregnancy-associated plasma protein A gene polymorphism in pregnant women with preeclampsia and intrauterine growth restriction

PubMed ID: 26520690Preeclampsia (PE) and intrauterine growth restriction (IUGR) are still among the most commonly researched titles in perinatology. To shed light on their etiology, new prevention and treatment strategies are the major targets of studies. In this study, we aimed to investigate the relation between gene polymorphism of one of the products of trophoblasts, pregnancy-associated plasma protein A (PAPP-A) and PE/IUGR.A total of 147 women (IUGR, n = 61; PE, n = 47; IUGR + PE, n = 37; eclampsia, n = 2) were compared with 103 controls with respect to the sequencing of exon 14 of the PAPP-A gene to detect (rs7020782) polymorphism. Genotypes "AA" and "CC" were given in the event of A or C allele homozygosity and "AC" in A and C allele heterozygosity. Our findings revealed that the rate of AA, CC homozygotes, and AC heterozygotes did not differ between groups. Moreover, there was no difference in the distribution of PAPP-A genotypes among the patients with IUGR, PE, IUGR + PE, or eclampsia. Finally, birth weight, rate of the presence of proteinuria, and total protein excretion on 24-hour urine were similar in the subgroups of AA, AC, and CC genotypes in the study group. Our study demonstrated no association between PAPP-A gene rs7020782 polymorphism and PE/IUGR. © 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.This work was supported by the Research Foundation of Ege University. -

THE DATABASE FOR SYSTEMIC SCLEROSIS IN TURKEY (SYS-WATCH): ANALYSIS OF PATIENTS WITH ELEVATED PULMONARY ARTERIAL PRESSURES ON ECHOCARDIOGRAPHIC SCREENING FOR PULMONARY HYPERTENSION

WOS: 00027920320020

Influence of Alpha and Gamma-Iron Oxide Nanoparticles on Marine Microalgae Species

The effects of alpha-iron oxide (α-Fe(2)O(3)) and gamma-iron oxide (γ-Fe(2)O(3)) nanoparticles (NPs) on marine microalgae species (Nannochloropsis sp. and Isochrysis sp.) were investigated in this study. Both Fe(2)O(3) NPs covered the surface of algae with the agglomerates of the nanoparticles. This form of physical NP toxicity significantly decreased the sizes of phytoplankton. Both NPs were toxic to the tested algal species, while α-Fe(2)O(3) showed less toxicity than γ-Fe(2)O(3) NPs for both algal species. A comparative analysis of growth data of the two algal species treated with α-Fe(2)O(3) or γ-Fe(2)O(3) NPs revealed that Isochrysis sp. are more sensitive than Nannochloropsis sp. Toxicity of these widely used NPs to primary producers forming the base of the food chain in aquatic environments might result in widespread adverse effects on aquatic environmental health