Effect of dietary protein source on piglet meat quality characteristics

An experiment was conducted to examine the effects of different dietary protein sources (soybean meal vs whey protein) on piglet meat quality characteristics. Eighteen castrated male Large White × Duroc × Landrace piglets were randomly assigned to 2 groups. Piglets were kept in individual metabolic cages and fed ad libitum over a period of 38 days the following 2 diets: diet SB, which was formulated to meet the nutrient requirements of piglets using soybean meal as the main crude protein source and diet WP, where SB was totally replaced by a mixture of whey proteins on equal digestible energy and crude protein basis. At the end of the experiment, piglets were weighed and slaughtered. After overnight chilling, samples of Longissimus dorsi muscle were taken and were used for meat quality measurements.         No significant differences were observed in the values of pH, colour, water holding capacity, shear force and intramuscular fat content of L. dorsi muscle between the dietary treatments. Measurement of lipid oxidation values showed that dietary supplementation with different protein sources did not influence meat antioxidant properties during refrigerated storage. The SB piglets had lower 14:0 (P<0.01) and higher 18:3n-3 (P<0.001) levels in intramuscular fat in comparison with WP piglets. However, these changes were attributed to background differences in the dietary FA profile and not to a direct protein source effect. The results of this preliminary study indicate that the examined dietary protein sources (soybean meal or whey protein) do not have a significant effect on meat quality characteristics of piglets

Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis

Background Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy. Methods We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance. Results We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US appears to have a positive yield of 1.3%, with 89% of these being confirmed by venography. Conclusion Combined colour-doppler US techniques have optimal sensitivity, while compression US has optimal specificity for DVT. However, all estimates are subject to substantial unexplained heterogeneity. The role of repeat scanning is very uncertain and based upon limited data

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

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

The huge-sized deinothere Deinotherium proavum (Proboscidea, Mammalia) from the Late Miocene localities Pikermi and Halmyropotamos (Greece)

Presented here are the deinotheriid dental and postcranial remains from the Late Miocene localities Pikermi and Halmyropotamos (Greece). The study and comparison of the available juvenile dental material from Pikermi with other relevant specimens from Europe showed that it belongs to the huge-sized Deinotherium proavum (=D. gigantissimum). Additionally, several postcranial specimens from Pikermi, as well as from Halmyropotamos, present deinotheriid features, which distinguish them from elephantoids, and permit their attribution also to D. proavum. This species is known from the Turolian and represents the terminal evolutionary stage of the European deinotheres. Its presence in Pikermi and Halmyropotamos is compatible with the middle Turolian (MN 12) age of the localities. Additionally, the taxonomy of European deinotheres is discussed, as well as the biostratigraphical and geographical distribution of D. proavum. (C) 2016 Elsevier Ltd and INQUA. All rights reserved

Design of a Periodic Feedback Control Law for Systems with Higher Dimension

The problem considered in this paper is the design of a feedback control law such that the closed loop system meets desired performance specifications. Particularly, we are dealing with the exact model matching problem for systems with two-dimensions using periodic state and output feedback, assuming that the states and the output are accessible to measurements, and that noise is not present. The method leads to necessary conditions for the solution of the problem. To illustrate the procedure, two step-by-stem examples are presented

The Implementation of a National Trauma Registry in Greece. Methodology and Preliminary Results

Background: Trauma is a leading cause of death worldwide and a major health problem of the modem society. Trauma systems are considered the gold standard of managing patients with trauma. An integral part of any trauma system is a trauma registry. In Europe, and particularly in Greece, trauma registries and systems are in an embryonic stage. In this study, we present an attempt to record trauma in Greece. Methods: The Hellenic Society of Trauma and Emergency Surgery invited all the official representatives of the society throughout the country to participate in the study. In succeeding meetings of the representatives, the reporting form was developed and the inclusion criteria were defined meticulously. Inclusion criteria were defined as patients with trauma requiring admission, transfer to a higher level center, or arrived dead or died in the emergency department of the reporting hospital. All reports were accumulated by the Hellenic Trauma society, imported in an electronic database, and analyzed. Results: Thirty-two hospitals receiving patients with trauma participated in the country, representing 40% of the country’s healthcare facilities and serving 40% of the country’s population. In 12 months time, (October 2005 to September 2006), 8,862 patients were included in the study. Of them, 66.9% were men and 31.3% were women. The compilation rate of the reporting forms was surprisingly high, considering that the final reporting form included 150 data points and that there were no independent personnel in charge of filling the forms. Conclusions: Trauma registries are feasible even in health care systems where funding of medical research is sparse

Emergency room management of trauma patients in Greece: Preliminary report of a national study

Aim of the study: The aim of this study was to record and to evaluate the epidemiology of trauma in Greece and to assess the quality of management provided for trauma patients in the emergency department in Greek hospitals. Methods: The Hellenic Society of Trauma and Emergency Surgery invited all the official representatives of the society throughout the country to participate in the study. The representatives that responded positively, met with the Board of the society in succeeding meetings to establish the reporting form and the inclusion criteria. Inclusion criteria were defined as trauma patients requiring admission, transfer to a higher level center or arrived dead or died in the emergency department of the reporting hospital. All reports were accumulated by the Hellenic Trauma society, imported in an electronic data base and analyzed. The design of the study was prospective and observational. Results: In total 8862 patients were included in the study in 12 months time. Of them 68.7% (n = 6084) were male, aged 41.8 +/- 20.6 (mean +/- S.D.) and 31.3% were female (n = 2778), aged 52.7 +/- 24.1 (mean +/- S.D.). The mean duration of treatment in the emergency room department was I h and 28 min. Of the total number of patients, 2312 (26.1 %) were initially assessed and managed by a specialist and 6249 (70.5%) were initially assessed and managed by a resident. Conclusions: Data from this study show that there is substantial room for improvement in the patient care in the emergency department following trauma. Further evaluation will be required to identify particular management patterns that can be readily altered. (C) 2008 Elsevier Ireland Ltd. All rights reserved