Use of a citrus by-product in broilers diets

The European Union is about to ban antibiotics as growth promoters in animal feeds. Organic products have been recently revalued and the animal science research showed a great interest in the study of alternative natural nutraceutical products in animal feeding. Flavonoids are plant pigments able to inhibit or kill many bacterial strains, to destroy some pathogenic protozoa and to scavenge free radicals

Letter to the Editor commenting on “Efficacy of serratus anterior plane block versus thoracic paravertebral block for postoperative analgesia after breast cancer surgery: a randomized trial”

We have read with very great interest the study published by Arora S et al.: “Efficacy of serratus anterior plane block versus thoracic paravertebral block for postoperative analgesia after breast cancer surgery: a randomized trial”, especially for the attention paid to the key points in the management of breast surgery: postoperative analgesia optimization, incidence of postoperative nausea and vomiting reduction, prevention of the onset of chronic pain and functional impotenc

Antimicrobial susceptibility to zinc bacitracin of Clostridium perfringens of rabbit origin

Zinc bacitracin is widely used in Italian rabbit farms to control both Epizootic Rabbit Enteropathy (ERE) and clostridiosis, and field results demonstrate useful activity. Nevertheless, data regarding the in vitro efficacy of zinc bacitracin against clostridia of rabbit origin are not available. In this study, the minimal inhibitory concentrations (MICs) of zinc bacitracin were evaluated in 123 C. perfringens strains isolated from rabbits in Italian fattening units. The agar dilution method was performed in Brucella Agar supplemented with laked sheep blood, haemin and vitamin K1, as recommended in NCCLS document M11-A6. Most strains (94.3%) had low MIC values (£ 0.5 mg/ml), and a few strains (4%) were inhibited by a concentration of 1 mg/ml. Two isolates (1.6%) had a MIC value of 16mg/ml. The MIC values of ATCC reference strains showed a good fit between each batch. MIC required to inhibit the 90% of organisms was 0.5 mg/ml and the presence of only two strains with MIC=16 mg/ml revealed the susceptibility to zinc bacitracin of Italian isolates of C. perfringens from rabbit and the absence of acquired resistance.Agnoletti, F.; Bacchin, C.; Bano, L.; Passera, A.; Favretti, M.; Mazzolini, E. (2007). Antimicrobial susceptibility to zinc bacitracin of Clostridium perfringens of rabbit origin. World Rabbit Science. 15(1):19-22. doi:10.4995/wrs.2007.609192215

Antibiotic De-Escalation in Emergency General Surgery

Background. Antibiotic treatment in emergency general surgery (EGS) is a major challenge for surgeons, and a multidisciplinary approach is necessary in order to improve outcomes. Intra-abdominal infections are at high risk of increased morbidity and mortality, and prolonged hospitalization. An increase in multi-drug resistance bacterial infections and a tendency to an antibiotic overuse has been described in surgical settings. In this clinical scenario, antibiotic de-escalation (ADE) is emerging as a strategy to improve the management of antibiotic therapy. The objective of this article is to summarize the available evidence, current strategies and unsolved problems for the optimization of ADE in EGS. Methods. A literature search was performed on PubMed and Cochrane using “de-escalation”, “antibiotic therapy” and “antibiotic treatment” as research terms. Results. There is no universally accepted definition for ADE. Current evidence shows that ADE is a feasible strategy in the EGS setting, with the ability to optimize antibiotic use, to reduce hospitalization and health care costs, without compromising clinical outcome. Many studies focus on Intensive Care Unit patients, and a call for further studies is required in the EGS community. Current guidelines already recommend ADE when surgery for uncomplicated appendicitis and cholecystitis reaches a complete source control. Conclusions. ADE in an effective and feasible strategy in EGS patients, in order to optimize antibiotic management without compromising clinical outcomes. A collaborative effort between surgeons, intensivists and infectious disease specialists is mandatory. There is a strong need for further studies selectively focusing in the EGS ward setting

The agroforestry heritage system of Sabana De Morro in El Salvador

Traditional agroforestry systems are recognized as having great importance for providing multiple benefits for local communities all over the world, especially in tropical countries. Thanks to their multifunctional role, they can support small farmers, contribute to hydrogeological risk reduction, water regulation, preservation of soil, agrobiodiversity and landscape, as well as being examples of mitigation and adaptation towards climate change. The Globally Important Agricultural Heritage Systems (GIAHS) programme of the Food and Agriculture Organization (FAO) aims to identify agricultural systems of global importance, preserving landscape, agrobiodiversity and traditional knowledge, through dynamic conservation principles. The Sabana de Morro is a traditional agroforestry system located in El Salvador based on cattle grazing in pastures with the presence of Crescentia alata and Crescentia cujete trees, locally called Morro or Jícaro. We documented the main characteristics of this system, that has never been deeply studied, in the Municipality of Dolores, in accordance with the five GIAHS criteria, and through detailed land use mapping, to assess the relations between landscape structure, agrobiodiversity and traditional silvopastoral practices. Sabana de Morro proved to be based on strong interactions between trees, cattle and farmers. The pulp of the Morro fruits is eaten by grazing cattle, completing their feeding and giving a peculiar taste to the locally produced cheese. Morro trees provide shade for the animals while cattle contribute by spreading their seeds that also take advantage of the manure. Results show that this agroforestry system contributes to the preservation of a rich agrobiodiversity and of the traditional landscape. At the same time, it supports local farmers’ livelihood and is consistent with the aim of the GIAHS programme, even if further surveys and research are needed to assess the real possibility of the inclusion in this FAO programme

Improving splenic conservation rate after trauma by applying a protocol for non-operative management and follow-up: A propensity-score analysis

Background: There are shared guidelines about Non-Operative Management (NOM) of splenic injuries, but some unanswered questions remain. The aim of the present study is to establish the usefulness of a standardized protocol for management and follow-up of NOM patients with splenic injuries. Methods: Multicenter retrospective observational study including patients with major blunt trauma (ISS.15) with splenic injuries managed between January 1st 2014 and December 31st 2016 in two Italian I level Trauma Centers: one with a standardized management and follow-up protocol for NOM (Bufalini Hospital, Cesena, BH), and the other without it (ASST Papa Giovanni XXIII Hospital, Bergamo, PG23H). Comparison between patients' outcomes were performed and a propensity score model was calculated. Results: 47 patients managed in BH and 49 patients in PG23H were included. In BH, a higher proportion of patients was treated with NOM (72.3 % vs. 53.1 %, p ¼ 0.051). There was no difference in complication rate and mortality in patients treated with NOM in the two hospitals. A borderline significant trend to a higher NOM failure rate in PG23H was found (BH 0.0 % vs. PG23H 11.3 %, p ¼ 0.076). The total splenic conservation rate was significantly higher in BH (BH 72.3 % vs. PG23H 46.9 %, p ¼ 0.011). After the Propensity Score based matching, 72 patients were included and the total splenic conservation rate was significantly higher in BH (BH: 77.8 % vs. PG23H: 50.9 %, p ¼ 0.014). Conclusions: The application of a protocol for in-hospital management and follow-up for NOM of patients with splenic injury could decrease the NOM failure rate and improve splenic conservation rate