Thrombotic side-effects of lower limb venography The use of heparin-saline flush

In a prospective study of 256 postoperative patients, bilateral lower limb venography was performed using meglumine iothalamate followed by heparin-saline flushing of the deep veins, and the complications of the procedure were assessed. No patient developed clinical evidence of deep-vein thrombosis after the venogram. In 117 patients fibrinogen uptake was performed 24 hours after the venogram. A new positive area on the uptake scan developed in 3 patients (2,6%). Local swelling or haematoma at the injection site occurred in 15 patients (5,9%), cellulitis in 2 (0,8%) and minor contrast reactions in 6 (2,3%). There were no major reactions and no procedure-related mortality. The reasons for the wide variation in the reported incidence of post-venogram thrombosis are considered and the importance of heparin-saline flushing of the deep veins to prevent this complication is discussed

Mass transfer of anthocyanins during extraction from pre-fermentative grape solids under simulated fermentation conditions: effect of convective conditions

The colour of red wine is largely determined by the concentration of anthocyanins that are extracted from grape skins during fermentation. Because colour is a key parameter in determining the overall quality of the finished product, understanding the effect of processing variables on anthocyanin extraction is critical for producing a red wine with the desired sensorial characteristics. In this study, the effect of convective conditions (natural and forced) on the mass transfer properties of malvidin-3-glucoside (M3G) from pre-fermentative grape solids was explored at various liquid phase conditions representing stages of fermentation. A mathematical model that separates solid and liquid phase mass transfer parameters was applied to experimental extraction curves, and in all cases, provided a coefficient of determination exceeding 0.97. Calculated mass transfer coefficients indicated that under forced convective conditions, the extraction process was controlled by internal diffusion whereas under natural convection, both internal diffusion and liquid-phase mass transfer were relevant in determining the overall extraction rate. Predictive simulations of M3G extraction during active fermentation were accomplished by incorporating the current results with a previously developed fermentation model, providing insight into the effect of a dynamic liquid phase on anthocyanin extraction.Patrick C. Setford, David W. Jeffery, Paul R. Grbin and Richard A. Muhlac

Potential for diagnosis of infectious disease from the 100,000 Genomes Project Metagenomic Dataset: Recommendations for reporting results

The identification of microbiological infection is usually a diagnostic investigation, a complex process that is firstly initiated by clinical suspicion. With the emergence of high-throughput sequencing (HTS) technologies, metagenomic analysis has unveiled the power to identify microbial DNA/RNA from a diverse range of clinical samples (1). Metagenomic analysis of whole human genomes at the clinical/research interface bypasses the steps of clinical scrutiny and targeted testing and has the potential to generate unexpected findings relating to infectious and sometimes transmissible disease. There is no doubt that microbial findings that may have a significant impact on a patient's treatment and their close contacts should be reported to those with clinical responsibility for the sample-donating patient. There are no clear recommendations on how such findings that are incidental, or outside the original investigation, should be handled. Here we aim to provide an informed protocol for the management of incidental microbial findings as part of the 100,000 Genomes Project which may have broader application in this emerging field. As with any other clinical information, we aim to prioritise the reporting of data that are most likely to be of benefit to the patient and their close contacts. We also set out to minimize risks, costs and potential anxiety associated with the reporting of results that are unlikely to be of clinical significance. Our recommendations aim to support the practice of microbial metagenomics by providing a simplified pathway that can be applied to reporting the identification of potential pathogens from metagenomic datasets. Given that the ambition for UK sequenced human genomes over the next 5 years has been set to reach 5 million and the field of metagenomics is rapidly evolving, the guidance will be regularly reviewed and will likely adapt over time as experience develops. © 2019 Magiorkinis G et al

Is the European Union in Need of a Competence Catalogue? Insights from Comparative Federalism

This article assesses the value of a detailed and rigid catalogue of competencies for curbing the process of European centralization and increasing the overall legitimacy of the EU. The article first details the reasons, and the actors who put the search for a catalogue of competencies on to the European agenda. Drawing from comparative federalism, it then lists five arguments why a detailed and rigid competence catalogue is neither feasible nor desirable. Finally, alternatives are provided leading to competence delimitation by other means. The main arguments are illustrated with reference to the European Convention's draft Constitutional Treaty. Copyright Blackwell Publishing Ltd 2004.