Distribution, frequency and occurrence of cereal nematodes on the Central Anatolian Plateau in Turkey and their relationship with soil physicochemical properties

The distribution of important plant-parasitic and free-living nematodes in the cereal production areas of the Central Anatolian Plateau (CAP) of Turkey was investigated with systematic surveys. Two important plant-parasitic nematode groups were found widely distributed; cereal-cyst nematodes (78.3%) and root-lesion nematodes (42.6%). Cereal cyst nematodes (CCN) were identified as Heterodera filipjevi in 18 provinces. Heterodera latipons was found in only one province. Pratylenchus thornei and P. neglectus were the most widely distributed species of root-lesion nematodes. Other frequently recorded plant-parasitic nematodes belonged to the genera Geocenamus (52.4%), Pratylenchoides (35.6%), Helicotylenchus (29.7%) and Paratylenchus (19.2%). Konya on the southern CAP had a significantly high incidence of P. neglectus as well as free-living nematodes. The incidence of CCN was greatest in areas of sandy soils on the CAP, with densities of up to 95 cysts (100 g soil)-1. Population densities of Geocenamus, Pratylenchus and Pratylenchoides were high in some locations. Soil physicochemical properties were investigated for their relationship to nematode distribution. There was a slight positive correlation of P. thornei and clay content; conversely, there was a significant negative correlation of P. neglectus with clay and a positive correlation with sand. Electrical conductivity (EC) was positively correlated with P. neglectus. Nematodes in the genera Helicotylenchus, Paratylenchus, Trophurus and Tylenchorhynchus were only recorded at low population densities in the sampled area. By contrast, nematodes in the genera Aphelenchus, Aphelenchoides, Ditylenchus, Dorylaimus, Tylenchus and bacterivorous genera had relatively high populations. Total free-living nematodes were positively correlated with EC and zinc (Zn) concentration. The Zn content of soil was generally at a level deficient for plant growt

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely