Interpolation and symbol elimination

We prove several results related to local proofs, interpolation and superposition calculus and discuss their use in predicate abstraction and invariant generation. Our proofs and results suggest that symbol-eliminating inferences may be an interesting alternative to interpolation

Perfil de susceptibilidade a antimicrobianos em amostras de cocos Gram-positivos, catalase negativos, isoladas de mastite subclínica bubalina Profile of antimicrobial susceptibility in strains of Gram positive cocos, negative catalase, isolated from buffalo subclinical mastitis

Estudou-se o perfil de susceptibilidade a antimicrobianos em cocos Gram-positivos catalase negativos (21 amostras de Lactococcus garvieae e 6 de Enterococcus gallinarum), isoladas do leite de fêmeas com mastite subclínica e pertencentes a uma população composta por seis rebanhos bubalinos localizados no Estado do Rio de Janeiro. O teste utilizado foi o da difusão de discos em agar Müller Hinton, segundo recomendações do National Committee for Clinical Laboratory Standards - NCCLS, tendo sido testados discos com ampicilina (10mg), cefalotina (30mg), cefotaxima (30mg), cefoxitina (30mg), cloranfenicol (30mg), eritromicina (15mg), gentamicina (10mg), nitrofurantoína (300mg), norfloxacina (10mg), penicilina (10 UI), tetraciclina (30mg) e vancomicina (30mg). Os resultados evidenciaram que em se tratando de Lactococcus garvieae, o antimicrobiano mais eficiente foi o nitrofurantoína com 85,71% de sensibilidade, seguido da cefotaxima (61,90%), vancomicina (52,38%), norfloxacina (47,62%) e cefalotina (47,62%). A maior resistência foi desenvolvida frente a penicilina e ampicilina, com 95,24% de resistênciapara os dois antimicrobianos testados. O perfil de susceptibilidade desenvolvido pelas amostras de Enterococcus gallinarum, mostrou baixa sensibilidade frente aos antimicrobianos testados, onde os maiores índices foram observados frente eritromicina e gentamicina, com 33,34% de sensibilidade para ambos; quanto à resistência desenvolvida, foi possível observar 100% de resistência com relação a vancomicina e tetraciclina, seguindo-se cloranfenicol, penicilina, ampicilina, cefoxitina, cefalotina, cefotaxima, norfloxacina e nitrofurantoína, todas evidenciando uma resistência de 83,33% das amostras testadas.<br>The susceptibility of antimicrobials was studied in Gram positive and catalase negative cocci (21 samples of Lactococcus garvieae and 6 Enterococcus gallinarum), isolated from the milk of cows with subclinical mastitis, belonging to six buffalo herds in the State of Rio de Janeiro. The test used was diffusion of disks in agar Müller Hinton, according to recommendations of the National Committee for Clinical Laboratory Standards - NCCLS. There were tested disks with ampicillin (10mg), cefalotin (30mg), cefotaxime (30mg), cefoxitin (30mg), cloranfenicol (30mg), eritromycin (15mg), gentamycin (10mg), nitrofurantoin (300mg), norfloxacin (10mg), penicillin (10 IU), tetracyclin (30mg) and vancomycin (30mg). The results showed that with Lactococcus garvieae, the most efficient antimicrobial was nitrofurantoin, revealing 85.71% sensibility, followed by cefotaxime (61.90%), vancomycin (52.38%), norfloxacin (47.62&) and cefalotin (47.62%). The highest resistance was developed against penicillin and ampicillin, with 95.24% resistance for the two antimicrobials. The susceptibility profile developed by the strains of Enterococcus gallinarum showed low sensibility against the tested antimicrobials; the highest resistance observed was against eritromycin and gentamycin, with 33.34% sensibility for both. The antimicrobial evaluation showed 100% resistance against vancomycin and tetracyclin, followed by cloranfenicol, penicillin, ampicillin, cefoxitin, cefotaxim, norfloxacin and nitrofurantoin; all of them showed a resistance of 83.33% with the samples tested

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

Background Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. Methods This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. Results Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51–19.97) than planned admissions (OR: 2.32, 95% CI: 1.43–3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8–51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. Conclusions After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease