Association between Use of Enhanced Recovery after Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery after Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)

Importance: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. Objective: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). Design, Setting, and Participants: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. Exposures: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. Main Outcomes and Measures: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. Results: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P =.22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P =.02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P <.001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P <.001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P <.001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P <.001). Conclusions and Relevance: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes

Deployment of mating disruption dispensers before and after first seasonal male flights for the control of Aonidiella aurantii in citrus

The rejection of citrus fruit caused by infestations of the California red scale (CRS), Aonidiella aurantii (Maskell) (Hemiptera: Diaspididae), raises concerns about its management. This fact has led to the introduction of new integrated control methods in citrus orchards, including the implementation of techniques based on pheromones. Previous works described efficient mating disruption pheromone dispensers to control A. aurantii in the Mediterranean region. The main aims of the present study were to adjust the timing of dispenser applications and study the importance of controlling the early first generation of A. aurantii by testing two different application dates: before and after the first CRS male flight. The efficacy of the different mating disruption strategies was tested during 2010 in an experimental orchard and these results were confirmed during 2011 in a commercial citrus farm. Results showed that every mating disruption strategy achieved significantly lower male captures in monitoring pheromone traps compared with untreated plots, as well as mean fruit infestation reductions of about 80 %. The control of the first CRS generation is not essential for achieving a good efficacy as demonstrated in two locations with different pest pressure. The late application of MD dispensers before the second CRS male flight has proven to be effective, suggesting a new advantageous way to apply mating disruption.The authors want to thank Fernando Alfaro from Denia, Antonio Caballero, and Javier Macias from Rio Tinto Fruit S.A. (Huelva, Spain) for field support. We also thank Ecologia y Proteccion Agricola SL for the pheromone supply. This work has been funded by the Spanish Ministry of Science and Innovation (project AGL2009-10725) and Agroalimed Foundation. The translation of this paper was funded by the Universidad Politecnica de Valencia (Spain).Vacas González, S.; Alfaro Cañamás, C.; Primo Millo, J.; Navarro-Llopis, V. (2015). Deployment of mating disruption dispensers before and after first seasonal male flights for the control of Aonidiella aurantii in citrus. Journal of Pest Science. 88(2):321-329. https://doi.org/10.1007/s10340-014-0623-1S321329882Avidov Z, Balshin M, Gerson U (1970) Studies on Aphytis coheni, a parasite of the California red scale, Aonidiella aurantii in Israel. Biocontrol 15:191–207Barzakay I, Hefetz A, Sternlicht M, Peleg BA, Gokkes M, Singer G, Geffen D, Kronenberg S (1986) Further field trials on management of the California red scale, Aonidiella aurantii, by mating disruption with its sex-pheromone. Phytoparasitica 14:160–161Bedford ECG (1996) Problems which we face in bringing red scale, Aonidiella aurantii (Maskell), under biological control in citrus in South Africa. Proc Int Soc Citriculture 1:485–492Campos-Rivela JM, Martínez-Ferrer MT, Fibla-Queralt JM (2012) Population dynamics and seasonal trend of California red scale (Aonidiella aurantii Maskell) in citrus in Northern Spain. Span J Agric Res 10:198–208Collins PJ, Lambkin TM, Bodnaruk P (1994) Suspected resistance to methidation in Aonidiella aurantii (Maskell) (Homoptera: diaspididae) from Queensland. J Aust Entomol Soc 33:325–326Corma A, Muñoz-Pallares J, Primo-Yufera E (1999) Production of semiochemical emitters having a controlled emission speed which are based on inorganic molecular sieves. World Patent WO9944420Corma A, Muñoz-Pallares J, Primo-Yufera E (2000) Emitter of semiochemical substances supported on a sepiolite, preparation process and applications. World Patent WO0002448DeBach P (1959) New species and strains of Aphytis (Hymenoptera: Eulophidae) parasitic on the California red scale, Aonidiella aurantii (Mask.), in the Orient. Ann Entomol Soc Am 52:354–362DeBach P, Argyriou L (1967) The colonization and success in Greece of some imported Aphytis spp. (Hymenoptera: Aphelinidae) parasitic on citrus scale insects (Homoptera: Diaspididae). Biocontrol 12:325–342Desneux N, Decourtye A, Delpuech JM (2007) The sublethal effects of pesticides on beneficial arthropods. Ann Rev Entomol 52:81–106Diari Oficial de la Comunitat Valenciana (DOCV) (2008) DOCV no. 5901, 26. Resolution 27 October 2008 of Consellería de Agricultura, Pesca y Alimentación; November 2008. http://www.docv.gva.es/datos/2008/11/26/pdf/2008_13692.pdfDomínguez-Ruiz J, Sanchis J, Navarro-Llopis V, Primo J (2008) A new long-life trimedlure dispenser for Mediterranean fruit fly. J Econ Entomol 101:1325–1330Eliahu M, Blumberg D, Horowitz AR, Ishaaya I (2007) Effect of pyriproxyfen on developing stages and embryogenesis of California red scale (CRS), Aonidiella aurantii. Pest Manag Sci 63:743–746Furness G, Buchanan G, George R, Richardson N (1983) A history of the biological and integrated control of red scale, Aonidiella aurantii on citrus in the lower Murray Valley of Australia. Biocontrol 28:99–212Grafton-Cardwell EE, Gu P (2003) Conserving vedalia beetle, Rodolia cardinalis (Mulsant) (Coleoptera : Coccinellidae), in citrus: a continuing challenge as new insecticides gain registration. J Econ Entomol 96:1388–1398Grafton-Cardwell EE, Reagan CA (1995) Selective use of insecticides for control of armored scale (Homoptera: Diaspididae) in San-Joaquin Valley California citrus. J Econ Entomol 88:1717–1725Grafton-Cardwell EE, Vehrs SLC (1995) Monitoring for organophosphate-resistant and carbamate-resistant armored scale (Homoptera: Diaspididae) in San-Joaquin Valley citrus. J Econ Entomol 88:495–504Grafton-Cardwell EE, Lee JE, Stewart JR, Olsen KD (2006) Role of two insect growth regulators in integrated pest management of citrus scales. J Econ Entomol 99:733–744Grout TG, Richards GI (1991a) Effect of buprofezin applications at different phenological times on California red scale (Homoptera: Diaspididae). J Econ Entomol 84:1802–1805Grout TG, Richards GI (1991b) Value of pheromone traps for predicting infestations of red scale, Aonidiella aurantii (Maskell) (Homoptera: Diaspididae), limited by natural enemy activity and insecticides used to control citrus thrips, Scirtothrips aurantii Faure (Thysanoptera: Thripidae). J Appl Entomol 111:20–27Grout TG, Du Toit WJ, Hofmeyr JH, Richards GI (1989) California red scale (Homoptera: Diaspididae) phenology on citrus in South Africa. J Econ Entomol 82:793–798Hefetz A, Kronengerg S, Peleg BA, Bar-zakay I (1988) Mating disruption of the California red scale Aonidiella aurantii (Homoptera: Diaspididae). In: Proceeding 6th International Citrus Congress, Tel Aviv (Israel), pp 1121–1127Hernández-Penadés P, Rodríguez-Reina JM, García-Marí F (2002) Umbrales de tratamiento para cóccidos diaspídidos en cítricos. Bol San Veg Plagas 28:469–478Hothorn T, Bretz F, Westfall P (2008) Simultaneous Inference in General Parametric Models. Biometrical J 50:346–363Ioratti C, Anfora G, Tasin M, De Cristofaro A, Witzgall P, Lucchi A (2011) Chemical ecology and management of Lobesia botrana (Lepidoptera: Tortricidae). J Econ Entomol 104:1125–1137Kehat M, Anshelevich L, Harel M, Dunkelblum E (1995) Control of the codling moth (Cydia pomonella) in apple and pear orchards in Israel by mating disruption. Phytoparasitica 23:285–296Kennett CE, Hoffmann RW (1985) Seasonal development of the California red scale (Homoptera: Diaspididae) in San Joaquin Valley citrus based on degree-day accumulation. J Econ Entomol 78:73–79Levitin E, Cohen E (1998) The involvement of acetylcholinesterase in resistance of the California red scale shape Aonidiella aurantii to organophosphorus pesticides. Entomol Exp Appl 88:115–121Lykouressis D, Perdikis D, Samartzis D, Fantinou A, Toutouzas S (2005) Management of the pink bollworm Pectinophora gossypiella (Saunders) (Lepidoptera: Gelechiidae) by mating disruption in cotton fields. Crop Prot 24:177–183McLaren IW, Buchanan GA (1973) Parasitism by Aphytis chrysomphali Mercet and A. melinus Debach of Californian red scale, Aonidiella aurantii (Maskell), in relation to seasonal availability of suitable stages of the scale. Austr J Zool 21:111–117Moreno DS, Kennett CE (1985) Predictive year-end California red scale (Homoptera: Diaspididae) orange fruit infestations based on catches of males in the San-Joaquin Valley. 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Doñana. Acta vertebrata. vol 17 (2)

Tres ejemplos de aplicación de métodos indirectos para la estimación de parametros poblacionales en cérvidoAlimentación de la garza real (Ardea cinerea) en la cuenca del Duero (España) durante el periodo reproductoDistribución y tamaño de colonias de buitre leonado (Gyps fulvus) en el alto Ebro y zona Cantábrica próximaDistribución y hábitat del visón americano (Mustela vison Schreber) en el sistema CentraRégimen alimentario del erizo (Erinaceus europaeus L.) durante verano y otoño en setos de la provincia de León (NO de España)Señales sociales de la espátula (Platalea leucorodia) durante el periodo reproductivoVariación del peso corporal en Arvicola terrestris (Rodentia, Arvicolidae) del nordeste ibéricoSobre el dimorfismo sexual en el cráneo del gato montés Felix silvestris Schreber, 1777 del sudoeste ibéricoUn nuevo núcleo poblacional de Apodemus flavicollis (Melchior, 1834) en la Península Ibérica.Selección de la lechuza común (Tyto alba) sobre el topillo común (Microtus duodecimcostatus)Importancia de la vegetación emergente en el comportamiento alimenticio de la fochaObservaciones sobre el papel del lagarto ocelado (Lacerta lepida Daudin), el erizo (Erinaceus europaeus L.) y el tejón (Meles meles L.) en la dispersión de semillasComentarios sobre los estimadores empleados en el método de la batida.El uso de la batida como método de censo: una replicaPeer reviewe

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Fish oil in rheumatoid arthritis: a randomised, double blind trial comparing high dose with low dose

Susanna Proudman, Llew Spargo, Cindy Hall, Leah McWilliams, Anita Lee, Maureen Rischmueller, Robert Gibson, Michael James and Leslie G. Clelan