Early colonisation of urban indoor carcasses by blow flies (Diptera: Calliphoridae): An experimental study from central Spain

Due to their ubiquity and synanthropy, blow flies (Diptera: Calliphoridae) are generally the first colonisers of cadavers and, therefore, frequently used to estimate a minimum post-mortem interval (minPMI). Whereas in outdoor situations blow flies are expected to locate and colonise exposed cadavers within hours or even minutes after death, it is usually assumed that the colonisation of a cadaver indoors might be delayed for an uncertain period of time. This uncertainty severely limits the informativity of minPMI estimates based on entomological evidence. Moreover, these limitations are emphasised by the lack of experimental data on insect colonisation of indoor carrion and by the fact that most of the forensic cases involving entomological evidence have been reported to occur indoors. In this study we investigate the early colonisation of pig carcasses placed indoors in a building located in the centre of an urban environment in central Spain. Three carcasses were placed in three equal rooms with a window half opened during five experimental trials: summer 2013, autumn 2013, winter 2014, spring 2014 and summer 2014. The species composition and their contribution to the carrion colonisation differed among seasons. Calliphora vicina Robineau–Desvoidy was the sole coloniser of carcasses in winter and colonised the carcasses within the first 24–48 h in every season, although Lucilia sericata (Meigen) was the first coloniser of most summer carcasses. On the other hand, Calliphora vomitoria (L.) and Chrysomya albiceps (Wiedemann) colonised the carcasses significantly later in spring and in spring and summer, respectively, with a delay of several days. In autumn, however, there were no significant differences in the colonisation times by C. vicina, L. sericata and Ch. albiceps. C. vicina and L. sericata showed a clear preference for ovipositing in the natural orifices of the carcasses, whereas Ch. albiceps oviposited more frequently on the trunk and legs.The attached document is the author’s final accepted/submitted version of the journal article. You are advised to consult the publisher’s version if you wish to cite from it

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

Effect of Temperature on the Survival and Development of Three Forensically Relevant Dermestes Species (Coleoptera: Dermestidae)

This article has been accepted for publication in the Journal of Medical Entomology, published by Oxford University Press. The attached document is the author’s final accepted version of the journal article. You are advised to consult the publisher’s version if you wish to cite from it

Environmental correlates of species diversity for sarcosaprophagous Diptera across a pronounced elevational gradient in central Spain

<div><p></p><p>Measuring the biological diversity in a given area can provide valuable approaches not only to conserve ecological systems, but also to understand their functioning and organization. The current paper analyzes the species richness and diversity patterns of sarcosaprophagous Diptera across an elevational gradient of natural habitats in central Spain, and the relationship between the species diversity and the environmental variables defining each habitat. The calculation of randomized species richness curves and non-parametric estimators confirmed the representativeness of the inventories. Oromediterranean habitats, i.e. those located at highest elevation, showed significantly lower species richness than mesomediterranean and supramediterranean levels. Slope and solar radiation were significantly and negatively correlated with diversity, whereas the correlation between mean temperature and diversity was significantly positive. A significantly negative correlation was found between diversity and the percentage of forest surface, whereas the correlation between diversity and the percentage of urban surface was positive and close to significance. Possible explanations for these observed patterns are considered and discussed. This study also supports the use of different, complementary diversity measurements in order to obtain a proper assessment of the diversity of a given area.</p></div

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase 3 randomized trials. The EXPosurE Registry RiociguaT in patients with pulmonary hypertension (EXPERT) study was designed to monitor the long-term safety of riociguat in clinical practice. Methods: EXPERT was an international, multicenter, prospective, uncontrolled, non-interventional cohort study of patients treated with riociguat. Patients were followed for at least 1 year and up to 4 years from enrollment or until 30 days after stopping riociguat treatment. Primary safety outcomes were adverse events (AEs) and serious adverse events (SAEs) coded using Medical Dictionary for Regulatory Activities preferred terms and System Organ Classes version 21.0, collected during routine clinic visits and collated via case report forms. Results: In total, 956 patients with CTEPH were included in the analysis. The most common AEs in these patients were peripheral edema/edema (11.7%), dizziness (7.5%), right ventricular (RV)/cardiac failure (7.7%), and pneumonia (5.0%). The most common SAEs were RV/cardiac failure (7.4%), pneumonia (4.1%), dyspnea (3.6%), and syncope (2.5%). Exposure-adjusted rates of hemoptysis/pulmonary hemorrhage and hypotension were low and comparable to those in the long-term extension study of riociguat (Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase–Stimulator Trial [CHEST-2]). Conclusion: Data from EXPERT show that in patients with CTEPH, the safety of riociguat in routine practice was consistent with the known safety profile of the drug, and no new safety concerns were identified

Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56–1.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.Results: A total of 3288 patients were included in the analysis, of whom 301 (9.2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P &lt; 0.001). There were no significant differences in rates of readmission between these groups (6.6 versus 8.0 per cent; P = 0.499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0.90, 95 per cent c.i. 0.55 to 1.46; P = 0.659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34.7 versus 39.5 per cent; major 3.3 versus 3.4 per cent; P = 0.110).Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients