Contribution of L-Arginine supplementation during gestation on sow productive performance and on sow microbial faecal profile

Arginine plays an important role during reproduction, however, the amount of supplementation in sow diet is still uncertain. The aim of the study was to verify the efficacy of a gestating diet enriched or not with a low dose of L-arginine (Arg) on sow productive performance in terms of numbers and weight of piglets at birth and at weaning, frequency of intrauterine growth retardation (IUGR) and piglets' mortality, sow placenta weight and salivary humoral immunity and intestinal microbial balance of the sows. 205 sows (Landrace x Large White) were divided into two experimental groups: a control group (CON) (102 sows) and a group supplemented with 0.25% of Arg (ARG) for the whole pregnancy period. Saliva and faecal samples were collected two days before farrowing and used for immunoglobulins and microbial analysis, respectively. Arg improved the number of total born piglets (p = .043) and tended to improve the number of total born alive (p = .086) and to reduce IUGR % (p = .090) and dead piglets at d0–d3 (p = .088). The weight of placenta and humoral immunity were not influenced by Arg. Arg did not modify the faecal microbial structure (alpha and beta indices) but increased the relative abundance of Bacteroidaceae family and Bacteroides genera (p = .0001). The results support the knowledge that Arg plays a key role in nutrition and physiology of pregnant sows without compromising gut eubiosis.HighlightArg supplementation of sows' gestation diet increased the number of total bornsArg supplementation of sows' gestation diet did not negatively affect the sows' gut eubiosisArg plays a significant role in the nutrition of pregnant sows. Arg supplementation of sows' gestation diet increased the number of total borns Arg supplementation of sows' gestation diet did not negatively affect the sows' gut eubiosis Arg plays a significant role in the nutrition of pregnant sows

Iron Speciation and Iron Binding Proteins in Arthrospira platensis Grown in Media Containing Different Iron Concentrations

Cyanobacteria are characterized by high iron content. This study investigated the effects of varying iron concentrations (1, 5, and 10 mg L−1) in the culture media on the biochemical composition and the iron bioaccumulation and speciation in Arthrospira platensis F&M‐C256. Iron content measured in biomasses varied from 0.35 to 2.34 mg g−1 dry weight depending on the iron concentration in the culture media. These biomasses can be considered of interest for the production of spirulina‐based supplements with low and high iron content. Iron speciation was studied using size exclusion chromatography followed by atomic absorption spectrometry and proteomic analysis. The role of C‐phycocyanin as an iron binding protein was also investigated. Overall, the present results provide a better understanding of iron metabolism in cyanobacteria and a foundation for further studies

Bowel preparation for elective colorectal resection: multi-treatment machine learning analysis on 6241 cases from a prospective Italian cohort

background current evidence concerning bowel preparation before elective colorectal surgery is still controversial. this study aimed to compare the incidence of anastomotic leakage (AL), surgical site infections (SSIs), and overall morbidity (any adverse event, OM) after elective colorectal surgery using four different types of bowel preparation. methods a prospective database gathered among 78 Italian surgical centers in two prospective studies, including 6241 patients who underwent elective colorectal resection with anastomosis for malignant or benign disease, was re-analyzed through a multi-treatment machine-learning model considering no bowel preparation (NBP; No. = 3742; 60.0%) as the reference treatment arm, compared to oral antibiotics alone (oA; No. = 406; 6.5%), mechanical bowel preparation alone (MBP; No. = 1486; 23.8%), or in combination with oAB (MoABP; No. = 607; 9.7%). twenty covariates related to biometric data, surgical procedures, perioperative management, and hospital/center data potentially affecting outcomes were included and balanced into the model. the primary endpoints were AL, SSIs, and OM. all the results were reported as odds ratio (OR) with 95% confidence intervals (95% CI). results compared to NBP, MBP showed significantly higher AL risk (OR 1.82; 95% CI 1.23-2.71; p = .003) and OM risk (OR 1.38; 95% CI 1.10-1.72; p = .005), no significant differences for all the endpoints were recorded in the oA group, whereas MoABP showed a significantly reduced SSI risk (OR 0.45; 95% CI 0.25-0.79; p = .008). conclusions MoABP significantly reduced the SSI risk after elective colorectal surgery, therefore representing a valid alternative to NBP

Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort

background: In italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. the aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery. methods: a database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. the primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. the results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i. results: a total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). group a versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51-0.70; P < 0.001). a mean postoperative duration of stay difference of 0.86 days was detected between groups. no difference was recorded between the two groups for all the other endpoints. conclusion: this study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery

Intraoperative neuromonitoring in thyroidectomy: The learning curve

AIM: To evaluate the learning curve in the use of intraoperative neuromonitoring of recurrent laryngeal nerve and vagus in thyroid surgery. MATERIALS OF THE STUDY: We analyzed 140 pts treated consecutively for thyroid disease. All the patients were neuromonitored with Intraoperative neuromonitoring of recurrent laryngeal nerve and vagus. We divided these patients in 7 groups to collect the adverse events during our learning curve. RESULTS: We monitored consecutively 271 nerves. The incidence of transient paralysis was 0.73%.No significant differences were recorded in the groups about the calceium values,the mean operative time. Sensitivity was 100%, specificity 99%, Predictive positive value was 33%, negative predictive value was 100%. DISCUSSION: The recurrent laryngeal nerve injury is the most frequent adverse event in thyroid surgery. The causes of the lesion are different. The introduction of non-invasive monitoring devices that define the standard of IONM in thyroidectomy is increasing in the last period. In our study we performed the neuromonitoring in four times finding several benefits: avoid damage from excessive traction of the thyroid; early identification of RLN extra-laryngeal branches; identification and preservation of the parathyroid glands. CONCLUSION: The use of neuromonitoring in course of thyroidectomy helps the surgeon to early localization, identification, visualization and dissection of the RLN. It is important highlight that for the surgeon, especially the less experienced, the opportunity to immediately verify the absence of nerve structures and the presence of lesions is very important especially in education and research. We confirm that real learning curve requires at least 60 consecutive cases as reported by others in literature

Analysis of indication for laparoscopic right colectomy and conversion risks

Laparoscopic surgery developed continuously over the past years becoming the gold standard for some surgical interventions. Laparoscopic colorectal surgery is well established as a safe and feasible procedure to treat benign and malignant pathologies. In this paper we studied in deep the role of laparoscopic right colectomy analysing the indications to this surgical procedure and the factors related to the conversion from laparoscopy to open surgery. We described the different surgical techniques of laparoscopic right colectomy comparing extra to intracorporeal anastomosis and we pointed out the different ways to access to the abdomen (multiport VS single incision). The indications for laparoscopic right colectomy are benign (inflammatory bowel disease and rare right colonic diverticulitis) and malignant diseases (right colon cancer and appendiceal neuroendocrine neoplasm): we described the good outcomes of laparoscopic right colectomy in all these illnesses. Laparoscopic conversion rates in right colectomy are reported as 12-16%; we described the different type of risk factors related to open conversion: patient-related, disease-related and surgeon-related factors, procedural factors and intraoperative complications. We conclude that laparoscopic right colectomy is considered superior to open surgery in the shortterm outcomes without difference in long-term outcomes

Relationship between postoperative complications and survival after gastrectomy for cancer

MATERIALS AND METHODS: We've analyzed patients treated for gastric cancer at our Operative Unit of ent, extent of lymphadenectomy and survival. General Surgery and Organ Transplantation of the University Hospital of Parma from January 2006 till December 2010, relating the occurrence of eventual complications to sex, age at diagnosis, definitive histological examination, type and duration of surgical treatment. BACKGROUND: Surgical resection remains the main curative treatment for gastric cancer but is still affected by high postoperative morbidity and mortality rates, especially in Western countries. RESULTS: The surgically treated cases were 152 (30.4 gastrectomies per year on average). 62 patients developed at least one adverse event during the postoperative period, reaching 108 total events. Among these, 71 were minor complications (grade I-II in Clavien-Dindo's classification), while 26 were major ones (grade III). Postoperative mortality affected 8 patients (5.3%). Data analysis did not stress any statistically significant correlation between the valued variables and the global incidence of complications. For severe ones, some risk factors emerged such as the type of gastrectomy, the execution of a multi-visceral resection and the operative time. Five-year overall survival has been 36.7%, lower in patients with severe complications (29%) when compared to patients without severe complications (38%). Radicality of operation, the lymph node involvement and the occurrence of severe complication emerged as significant prognostic factors for five-year overall survival. CONCLUSIONS: Surgery is still the mainstay of treatment for gastric cancer and the only one able to grant a curative therapy. When performed in high-volume centres, with more than 20 gastrectomies per year, it represents a safe treatment, affected by low mortality. Attention must be paid to careful preoperative selection, to treatment of pre-existent comorbidities, to plan a therapeutical strategy to minimize surgical stress, to postoperative monitoring and to managing complications', as they're able to impact not only low-term outcomes but also overall and disease-free survival. The poor prognosis for these patients is mainly related to advanced stage at presentation, thus confirming the need to increase early diagnosis in order to detect in larger percentages the tumor in its early stage

Gastrointestinal stromal tumors: A single center retrospective 15 years study

Background: Gastro Intestinal Stromal Tumors (GISTs) are defined as mesenchymal tumours that develop within the wall of the gastrointestinal tract. Surgery is the treatment of choice and may be indicated for locally advanced or previously non resectable disease after a favorable response to preoperative therapy with tyrosine kinase inhibitors. Methods: A retrospective analysis was conducted for all patients with a confirmed or suspected diagnosis of GIST who were admitted to the University Hospital of Parma from January 2000 to January 2015- The following parameters were reviewed and analyzed: age, sex, blood type, symptoms on presentation, tumor site, tumor size, mitotic rate, risk grade, histopathology and immunohistochemistry assays, type of cells. Results: All patients underwent elective surgery. Between January 2000 and January 2015, 61 patients were admitted to the OU General Surgery and Organ Transplantation, University Hospital of Parma and received surgical treatment for GISTs. Thirty-five were male (57-4%) and 26 female (42.6%). The mean age at diagnosis was 69.03 ± 10.07 years (range 29 - 89 years); males 69.6 ± 9.3 years (range 49 - 89 years) and females 68 ± 12.4 years (range 29 - 86 years). Larger tumor size, higher mitotic rate, higher risk rate, margin status contributed to poorer outcome (lower OS and DFS) as independent factors. Conclusions: Radical surgery is the treatment of choice for resectable GISTs. Very low and low-risk tumor can be treated with surgery alone

The prognostic role of tumor size in patients with gastric cancer

The identification of prognostic factors in gastric cancer is important for predicting patients' survival and determining therapeutic strategies