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

Rapid identification of Acremonium lolii and Acremonium coenophialum endophytes through arbitrarily primed PCR

D. Liu , R. van Heeswijck, G. Latch, T. Leonforte d, M. Panaccio, C. Langford, P. Cunningham, K. Ree

Are Cognitive Habits in the Intellect? Durand of St.-Pourçain and Prosper de Reggio Emilia on Cognitive Habits.

Once Socrates has thought something, he comes to acquire an item such that he is then able to think such thoughts again when he wants, and he can, all other things being equal, do this with more ease than he could before. This item that he comes to acquire medieval philosophers called a cognitive habit which most medieval philosophers maintained was a new quality added to Socrates' intellect. However, some disagreed. In this paper, I will examine an interesting alternative theory put forward by Durand of Saint-Pourçain and Prosper de Reggio Emilia about the location of cognitive habits. On their view, cognitive habits are not to be located in the intellect but in something on the side of the body or sensitive soul

Latent semantic analysis: an improved method to measure cognitive performance in subjects of non-English-speaking-background

The present study examined the validity of cognitive assessment in older adults when administered in a second language (English). A battery of tests that included the MMSE, CAMCOG and the Logical Memory Test of the Wechsler Memory Scale III, was administered to 121 older community volunteers of either an English Speaking Background (ESB) or a Non-English Speaking Background (NESB) living in the metropolitan area of Perth, Western Australia. The logical memory test was scored using Latent Semantic Analysis. It was hypothesized that this scoring method would be less affected by cultural and linguistic differences than standard scoring methods. The results suggest that LSA is a more robust measure of cognitive function than traditional scoring methods and may therefore improve the validity of cognitive assessment results on subjects of NESB.Nicola T. Lautenschlager, John C. Dunn, Kathryn Bonney, Leon Flicker, and Osvaldo P. Almeid