Enhanced Recovery After Surgery Protocol in Minimally Invasive Lumbar Fusion Surgery Reduces Length of Hospital Stay and Inpatient Narcotic Use.

Background: The application of enhanced recovery after surgery (ERAS) has the potential to improve outcomes, hasten patient recovery, and reduce costs. ERAS has been applied to spine surgery for several years, but data are limited around the impact of ERAS on minimally invasive spine surgery, specifically. The authors report their experience implementing a multimodal ERAS protocol for patients receiving minimally invasive transforaminal lumbar interbody fusion. Methods: The ERAS protocol was implemented at The Valley Hospital Hospital in Ridgewood, New Jersey in January 2020. Following implementation, all patients receiving minimally invasive transforaminal lumbar interbody fusion by a single surgeon were studied. The authors analyze the impact of the protocol on length of stay (LOS), disposition post discharge, and opioid consumption postoperatively in the inpatient and outpatient settings. Results: Sixteen patients were enrolled in the protocol and compared with 17 historical controls. LOS was significantly shorter in the ERAS cohort (1.6 vs. 2.4 days, P = 0.022). There was no significant difference between the groups with respect to disposition; the majority of patients were discharged to home without need for in-home medical services. Patients in the ERAS cohort consumed significantly fewer opioid analgesics postoperatively in the inpatient setting (51 mg morphine milligram equivalents vs. 320 mg morphine milligram equivalents, P = 0.00016). On average, patients in the ERAS cohort were prescribed fewer opioids analgesics post discharge. Conclusions: ERAS application to minimally invasive transforaminal lumbar interbody fusion was safe and effective, significantly reducing LOS and inpatient opioid consumption. These data reflect the importance of uniformly applying a multimodal ERAS protocol to accelerate recovery and reduce narcotic use.

Apilarnil reduces fear and advances sexual development in male broilers but has no effect on growth.

1. An experiment was conducted to determine the possibility of stimulating sexual development at an early age in male and female broiler chickens by administration of apilarnil, a natural bee product, in the pre-pubertal period. 2. From 28 to 55 d of age, birds were given apilarnil orally. The effects of low (2.5 g/bird) and high (7.5 g/bird) doses of apilarnil on growth performance, testicular weight, secondary sexual characteristics, blood lipids, testosterone and fearful behaviour were evaluated. 3. Apilarnil administration did not cause a positive effect on growth performance of male and female broilers suggesting that apilarnil did not have an anabolic effect. 4. Apilarnil administration suppressed blood glucose and cholesterol. 5. Birds receiving apilarnil remained immobile for a shorter period in a tonic imobiliy test and showed less home-cage avoidance responses suggesting a lower level of fearfulness. 6. Increases in testicular weight, testosterone concentration and comb growth in males receiving apilarnil implied that it stimulates the sexual maturation at an early age. However, a similar stimulation of secondary sexual characteristics was not observed in females.

Effect of heat stress on oxidative stress, lipid peroxidation and some stress parameters in broilers.

1. This study was conducted to determine the effects of heat stress on fearfulness, leucocyte components, oxidative stress and lipid peroxidation in two commercial broiler strains, Cobb (C) and Ross (R). 2. At 36 and 37 d of age birds were exposed to 38 +/- 1 degree C for 3 h. Rectal temperatures, duration of tonic immobility (TI), haematocrit values, proportions of leucocyte components (heterophil, lymphocyte, basophil, eosinophil, monocyte), malondialdehyde (MDA) concentrations and antioxidant enzyme activities (CAT, SOD, GPx) of all the birds were determined, before and after heat treatment. 3. Rectal temperatures increased and haematocrit values decreased in birds exposed to heat stress. Heat stress caused a significant increase in heterophil/lymphocyte and in basophil ratios. 4. Exposing birds to heat stress increased duration of TI, suggesting heat-stressed birds tended to be more fearful. 5. Heat stress resulted in a significant Genotype x Treatment interaction for MDA concentration. CAT, SOD and GPx activities; MDA concentrations in heat-stressed R strain birds were greater than in heat-stressed C strain birds.

Effects of some egg characteristics on the mass loss and hatchability of ostrich (Struthio camelus) eggs.

1. This study was conducted to examine some egg characteristics and determine the effects of eggshell thickness and eggshell porosity on water loss and hatchability of eggs in ostriches. 2. Shell thickness did not correlate significantly with hatchability. However, eggs of low shell thickness lost more mass (13.03%) than those with intermediate (11.22%) and high (10.36%) shell thickness. Mass loss during incubation was higher in hatched (11.98%) than unhatched eggs (11.09%). Shell thickness was negatively correlated to egg mass loss (r = -0.65). 3. The pore density was correlated with hatchability. Hatchability was 50% lower in eggs with low pore densities (40.93%) than with high densities (80.94%). Pore density was positively correlated with egg mass loss (r = 0.63). Incubation mass losses of hatched and unhatched eggs were not significantly different. 4. Mean eggshell water vapour conductance (G) value and shell conductance constant (k) were 87.77 +/- 4.21 mg H2O/d/Torr and 2.44 respectively (n = 15). 5. Because of eggshell functional properties and resulting low egg mass loss hatchability is low when ostrich eggs are artificially incubated. The mass of eggs used in the experiment was relatively high and their eggshell water vapour conductance was low. As a result, egg incubation mass loss was lower than it should be. It is concluded that incubator humidity should be low (25%) to allow enough mass loss during incubation from the eggs.

The effect of short-term fasting on performance traits and rectal temperature of broilers during the summer season.

1. The present study was conducted to determine if detrimental effects of high temperature on broiler performance could be overcome by short-term fasting and to examine the effect of food withdrawal on the responses of two commercial strains (S1 and S2). 2. An experimental design was used with three feeding groups and two strains. Birds in the control (C) group were fed ad libitum during the experimental period (0 to 6 weeks), while feed was withdrawn in the other groups between 10:00 and 16:00 h during weeks 5 and 6 (F1) or week 6 (F2), respectively. After standard brooding for the first 3 weeks temperature and humidity varied according to outside climate between 4 and 6 weeks of age. 3. Feeding strategy significantly affected body weight at week 6 (BW6) and daily weight gain during week 6 (DWG5-6). F2 gave the best results in BW6 and DWG5-6. Strain effect was significant on DWG4-5 and DWG5-6; S1 had higher DWG4-5 and S2 gained more at the last stage. S1C broilers had greater BW6 than S2C but the S2 strain gave a better response to short-term fasting compared with S1 and this resulted in significant strain by feeding interaction effect on BW6 and DWG5-6. 4. It was shown that short-term fasting was an effective method for controlling rectal temperature (RT) of broilers at 5 and 6 weeks of age. 5. Total food consumption (FCO-6), food conversion ratio (FCRO-6), mortality, and carcase characteristics were not affected by short-term fasting in the experimental conditions. 6. In conclusion, it can be recommended that broiler producers may practise 6 h of fasting during the hot period of the day without any adverse effect on slaughter weight and FCR when the birds are close to the average slaughter weight and a heat wave is expected. Strain differences in RT measurements also indicate the importance of choosing strains to be used in hot and warm climate conditions with attention to the thermoregulation ability of broilers.

Effects of heat stress on growth, some blood variables and lipid oxidation in broilers exposed to high temperature at an early age.

1. This study was conducted to determine metabolic and physiological responses of 2 commercial broiler strains, Hubbard (H) and Cobb (C), exposed to an ambient temperature of 38 degrees +/- 1 degree C for 2 h at 14 and 15 d of age. 2. Exposure to high temperature at an early age resulted in weight loss in strain C, which was not compensated for by 35 d of age but there was no weight loss in strain H. 3. Exposure of broilers to heat stress (38 degrees +/- 1 degree C) at 35 d of age resulted in an increase in rectal temperature, regardless of previously high temperature experience but acid-base balance and haematocrit values were not affected by heat stress. 4. Malondialdehyde concentration was higher in unexposed birds than in previously exposed ones and did not significantly differ between strains.

Body weights, carcase characteristics, organ weights, abdominal fat, and lipid content of liver and carcase in two lines of Japanese quail (Coturnix coturnix japonica), unselected and selected for four week body weight.

1. The present study was conducted on quails to evaluate the effects of line and sex on body weight, carcase characteristics and organ weights and also to evaluate the effect of line on sex organs, and on carcase and liver lipid content of male quails. 2. Chicks of both sexes were weighed weekly until 6 weeks when they were slaughtered. Carcase yield, parts yield and measurement, weight of liver, heart, gizzard, abdominal fat and sex organs were obtained. Carcase and liver lipid content of male quails were determined. 3. Weights of body, carcase, breast, thigh, liver, heart, gizzard, abdominal fat, tests and ovary, yield of testes were affected by line. Line had no significant effect on the yields of carcase, breast, thigh, liver, heart, gizzard plus heart plus liver, abdominal fat and ovary. Carcase and liver lipid contents of male quails were affected by line.