Application of colon leakage score in the left-sided colorectal surgery.

Background: Colon leakage score (CLS) was developed for risk prediction of anastomotic leak (AL) in the left-sided colorectal surgery. Although the risk factors for leakage are well known and accepted by the surgical community, an accurate forecast of AL is still a difficult task. Objective: The study aims to apply the CLS in patients undergoing left-sided colorectal surgery. Methods: Retrospective study in patients with the left-sided colorectal surgery and primary anastomosis without diverting stoma. CLS was calculated in patients, who were classified in AL and NO-AL groups. Predictive value of CLS was evaluated by receiver operator characteristic. Correlation between CLS and AL was determined. 208 patients (55% male, mean age 59 years) were included in the study. Results: Overall, AL was 7.2%. Mean CLS of all patients was 7.2 ± 3.2 (0-17). Patients with AL had a higher CLS (11.8 ± 2.3) than NO-AL patients (6.8 ± 3) (p = 0.0001). The area under the curve for the prediction of AL by CLS was 0.898 ([CI] 0.829-0.968, p = 0.0001). A CLS of 8.5 had 93% sensitivity and 72% specificity. There was a statistically significant odds ratio for CLS and AL (0.58: [CI] 0.46-0.73, p = 0.0001). Conclusion: CLS is a useful tool to predict AL in the left-sided colorectal surgery.

Antecedentes: La puntuación de fugas de colon (CLS) se desarrolló para la predicción del riesgo de fuga anastomótica (AL) en la cirugía colorrectal del lado izquierdo, con la finalidad de obtener un pronóstico preciso. Objetivo: Este estudio tiene el objetivo de aplicar el CLS en pacientes con cirugía colorrectal de lado izquierdo. Método: Estudio retrospectivo en pacientes con cirugía colorrectal izquierda y anastomosis primaria sin estoma de derivación. Se calculó el CLS en los pacientes, los cuales fueron clasificados en los grupos con AL y sin AL. Resultados: La media del CLS de todos los pacientes fue de 7.2 ± 3.2 (0-17). Los pacientes con AL tenían un CLS más alto (11.8 ± 2.3) que los pacientes sin AL (6.8 ± 3) (p = 0.0001). El área bajo la curva para la predicción de la AL mediante el CLS fue de 0.898 (intervalo de confianza (CI) 0.829-0.968; p = 0.0001). Un CLS de 8.5 tuvo una sensibilidad del 93% y una especificidad del 72%. Además, se obtuvo un Odds Ratio con una diferencia estadísticamente significativa para el CLS y AL (0.58; CI 0.46-0.73; p = 0.0001). Conclusión: La CLS es una herramienta útil para predecir la AL en la cirugía colorrectal del lado izquierdo.

Modelling the effect of density vegetation coverage and the occurrence of peridomestic infestation by Triatoma infestans in rural houses of northwest of Córdoba, Argentina.

To better understand the dispersion strategies of Triatoma infestans (Klug) (Hemiptera: Reduviidae, Triatominae), we evaluated the spatial effect of infested peridomicile and density vegetation cover in a historically endemic area for Chagas disease. The study was conducted in rural houses of the northwest of Córdoba province, Argentine, during 2012-2013. Active search of triatomines were made in domicile and peridomicile habitats. To characterize vegetation coverage, a thematic map was obtained considering five types of vegetation cover (closed/open forest, closed/open shrubland and cultural land). From each house we extracted the area of vegetation coverage, housing density and infested peridomiciles density. We used generalized linear models to evaluate the effect of these variables on the occurrence of infested peridomicile. According to our results, the probability of a peridomicile to be infested increases by 1.34 (95%CI [0.98; 1.90]) times more when peridomicile structures are in environments with higher housing density and by 1.25 (95%CI [0.84; 1.88]) more times when houses are surrounded by open shrublands. Among the multiple ecological determinants of peridomestic infestation, the influence of vegetation cover has been poorly studied. In this study we discussed the effect of the vegetation as a potential modulator of the dispersion strategies of T. infestans.

Dynamics of feeding and defecation behavior of Triatoma infestans hybrids.

Triatoma platensis is occasionally found coexisting with Triatoma infestans in chicken coops in Argentina. Some authors have reported the presence of hybrid specimens of both species in chicken coops and other peridomestic habitats. Given the coexistence of T. infestans with T. platensis and the possibility of generating fertile hybrids, it is important to evaluate the vectorial competence of these hybrids. The objective of this study was to record the dynamics of feeding-defecation behavior in fifth-stage nymphs and adults of hybrids between both species and to compare it with T. platensis and T. infestans. Three experimental groups were formed separated by stage and sex: Hybrid group, T. infestans group, and T. platensis group. During feeding, the following variables were recorded for each group: (i) blood meal size, (ii) feeding time, (iii) number of defecations during feeding, and (iv) number of defecations at 10 and 30 min after feeding. The results indicate that adults and fifth-instar nymphs of hybrids have a feeding and defecation behavior similar to T. infestans: they achieve feeding in a short time and first defecation occurs during or just after feeding. Nevertheless, hybrid's ingestion of blood occurs at higher velocity and they require higher blood intake to provoke early defecations. Considering the blood ingestion velocity, the amount of blood ingested, and the short time required for the production of the first defecation, the results of this study suggest that hybrid can be a competent Trypanosoma cruzi vector.

Delusional disorder in old age and the risk of developing dementia: a nationwide register-based study.

OBJECTIVE: To examine whether very late first-contact delusional disorder carries a risk for later development of dementia. METHODS: By linkage of the psychiatric and the somatic nationwide registers of all out- and in-patients with hospital contact in Denmark, we included all 60+ patients with first ever from 1 January 1994 to 31 December 2001 with the index main diagnosis: delusional disorder. First contact osteoarthritis patients as well as the general population were used as controls. A total of 1,437 patients with persistent delusional disorder and 7,302 patients with osteoarthritis were included. Median follow-up time until first diagnosis of dementia at discharge was 1.87 and 4.40 years, respectively. The probability of getting a dementia diagnosis was estimated using Poisson regression models with dementia as the outcome of interest. RESULTS: Patients with very late first-contact delusional disorder had an 8.14 (95% CI, 6.51; 10.19) times increased rate of subsequently developing dementia compared with very late first contact osteoarthritis patients. Compared with the general population the rate ratio was 5.49 (95% CI, 4.81; 6.26). CONCLUSION: Very late first-contact delusional disorder increases the risk of subsequently getting a diagnosis of dementia 5-8 times compared with osteoarthritis patients and the general population.

No increased risk of developing Alzheimer disease in patients with glaucoma.

PURPOSE: To investigate whether primary open-angle glaucoma (POAG) is associated with increased risk of developing Alzheimer disease (AD). METHODS: In a nationwide case register linkage study of patients with hospital admission or outpatient contact during the period from 1977 to 2001 in Denmark, the rate of subsequent AD for patients with a diagnosis of POAG was compared with the rate for patients with primary angle-closure glaucoma (PACG), cataract, and osteoarthritis (OA) and with the rate for the general population. RESULTS: A total of 11,721 patients with a diagnosis of POAG (including normal tension glaucoma), 5975 patients with PACG, 162,640 patients with cataract, and 230,208 patients with OA were identified in the registers. Patients with POAG did not have increased rate of subsequent AD compared to patients with PACG, cataract, or OA or compared with the general population. CONCLUSIONS: POAG was not associated with increased risk of developing AD. It cannot be excluded that this negative finding is due to diagnostic misclassification as register data were used.

The impact of particle-bound cadmium on bioavailability and bioaccumulation: A pragmatic approach.

Studying the bioavailability of sediment-bound contaminants is complicated by many reasons, such as the variable composition of the particles, their temporal variations, the low levels of contaminant concentrations, their partitioning between diverse aqueous and particulate phases, and the variety of uptake routes that may involved with the biota. Therefore, simple and innovative methodologies should be tested as analogues for natural sediments. Among them, a diverse selection of artificial particles with well-defined surface properties, in the presence and absence of commercially available humic acids, has been proposed and used to investigate the bioavailability of several organic pollutants. For this work, this model was applied to investigate the uptake and accumulation of cadmium by the freshwater oligochaete Lumbriculus variegatus. The results showed that the uptake of the metal depended on the free dissolved Cd(II) species, while the contribution from the particles was negligible. Thus, the extent of cadmium bioaccumulated from each test system could be predicted as a function of the rate of absorption of the free dissolved Cd(II) species. These species were calculated either from the particle-water partition coefficients, or by using the MINEQL+ computer program. In general, the estimated accumulation levels were in good agreement with the experimental results.

Influence of humic acids on the toxicity of cadmium to Lumbriculus variegatus

The effects of dissolved humic concentrations on the uptake and toxicity of cadmium using the freshwater oligochaete Lumbriculus variegatus as a sentinel monitor of environmental pollution were investigated. Acute static bioassays were performed and the data showed that both the uptake and lethality of cadmium decreaed with increasing humic acid concentrations. These results confirm that free cationic species correlate better than total dissolved metal concentration with cadmium bioavailability and toxicity...