Blood transfusions increase the risk of venous thromboembolism following ventral hernia repair.

BACKGROUND: Blood transfusions can affect the clotting cascade, leading to a hypercoagulable state. The association of a venous thromboembolic (VTE) event and perioperative blood transfusion has been identified previously in surgical patients, but not after ventral hernia repair (VHR). The aim of this study was to evaluate the risk of VTE in VHR patients who receive a perioperative blood transfusion. METHODS: The American College of Surgeons National Surgery Quality Improvement Program was queried for open (n = 34,687) and laparoscopic (n = 11,544) VHRs that occurred from 2013 to 2015. Regression analyses were used to determine factors predictive of VTE within 30-day post-operatively, the impact of bleeding requiring blood transfusion, and the influence of surgical approach on VTE. RESULTS: Post-operative VTE occurred in 246 (0.5%) VHR patients. Among those patients, 53.0% occurred after discharge. Increased age, operative time, and comorbidities increased the risk of VTE (p < 0.05). Controlling for surgical approach, perioperative blood transfusion increased the risk of VTE 10.2-fold (p < 0.0001) in open and 12.2-fold in laparoscopic VHR (p < 0.0001). CONCLUSION: Perioperative blood transfusions are associated with an increased rate of VTE following VHR, more than 50% of which occur after discharge. This study highlights the importance of identifying quality initiatives for at risk patients, including adequate VTE screening and potential prophylaxis for those who receive perioperative blood transfusions.

Effect of low-phytate barley or phytase supplementation to a barley-soybean meal diet on phosphorus retention and excretion by grower pigs.

Two studies were conducted to determine the effect of diets containing low-phytate barley or supplemented with phytase on P balance and excretion in grower pigs. In Exp. 1, eight 32-kg barrows were assigned to a repeated, 4 x 4 Latin square design and fed 4 diets that contained 96% barley: normal-phytate hulled barley (HB), low-phytate hulled barley (LPHB), normal-phytate hull-less barley (HLB), and low-phytate hull-less barley (LPHLB). The barley cultivars contained 0.16, 0.05, 0.24, and 0.03% phytate, respectively. Inorganic P (iP) was added to the HB and HLB diets to meet the 1998 National Research Council recommendation of available P (aP, 0.23%), whereas LPHB and LPHLB contained sufficient aP. The diets were fed at 2.5 times the maintenance requirement for ME. The apparent total tract digestibilities (ATTD) of P did not differ between the hulled and hull-less barley diets, but P retention (%) and excretion were greater in pigs fed the hull-less barley diets (P < 0.05). The ATTD of P was greater and P excretion was 35% lower in pigs fed the low-phytate compared with the normal-phytate diets (P < 0.001). The amount of P retained (g/d) was greater (P < 0.001) in pigs fed low-phytate barley, reflecting an ATTD of P of 65 and 49% for low-phytate and normal-phytate barley, respectively (P < 0.001). In Exp. 2, eight 21-kg barrows were assigned to a repeated, 4 x 4 Latin square design and fed 4 diets based on barley and soybean meal (SBM): HB-SBM, HB-SBM + iP, HB-SBM + phytase, and LPHB-SBM. The HB-SBM and HB-SBM + phytase diets were deficient in aP, whereas the HB-SBM + iP and LPHB-SBM diets had adequate aP. The feeding regimen was similar to that of Exp. 1. Adding iP to the HB-SBM diet did not affect the ATTD but increased the amount of P retained (g/d) and excreted (P < 0.001). The ATTD and amount of P retained (g/d) did not differ among pigs fed the HB-SBM + iP, HB-SBM + phytase, and LPHB-SBM diets. However, pigs fed the HB-SBM + phytase and LPHB-SBM diets excreted 32 and 29% less P, respectively, than pigs fed the HB-SBM + iP diet (P < 0.05), confirming that low-phytate barley is as effective as supplemental phytase in improving P digestibility and utilization and decreasing P excretion in grower pigs.

Distribution of Pathotypes of Rhynchosporium secalis and Cultivar Reaction on Barley in Alberta.

Forty-four barley accessions and commercial cultivars with different levels of resistance to scald caused by Rhynchosporium secalis were evaluated for scald reaction from 1997 to 1999 at various sites in Alberta. The accessions Hudson, Atlas, Atlas 46, Atlas 68, Abyssinian, and Kitchin that have the major resistance genes were resistant to pathotypes of R. secalis at all sites. Although scald levels were low for these accessions, they were significantly different among years. Pathotypes of R. secalis and environmental conditions affected diseases levels on 32 commercial cultivars, resulting in significantly different scald reactions among sites and seasons. Resistance in commercial cultivars, AC Stacy, Kasota, and Seebe, held up at most sites with the majority of cultivars being intermediate to moderately susceptible. Cultivars that were previously considered resistant were intermediate in reaction and became increasingly susceptible at some sites from 1997 to 1999. Pathogen virulence was more diverse at the sites where the cultivars became increasingly susceptible compared with sites where the same cultivars were resistant. Scald reactions of the commercial cultivars depended on location, which reflected the presence of different pathotypes, as well as variation in environmental conditions. Consequently, scald management via cultivar choice will be dependent on location.

Histopathological Study of Barley Cultivars Resistant and Susceptible to Rhynchosporium secalis.

ABSTRACT Differences in the penetration process by Rhynchosporium secalis were compared in resistant and susceptible barley cultivars at the seedling stage. Percent penetration and percent host cell wall alteration (HCWA) differed significantly among cultivars and isolates as revealed by light microscopy. Based on these two variables, the cultivars were statistically separated into two groups that corresponded to their disease reactions. The resistant cultivars, Johnston and CDC Guardian, showed 81.2 to 99.4% HCWA and 0.1 to 20.1% penetration at encounter sites, whereas the susceptible cultivars, Harrington, Argyle, and Manley, had 30.1 to 78.3% HCWA and 31.8 to 81.8% penetration. In the current study, cv. Leduc, which is susceptible at the seedling stage and resistant at the adult stage, showed the same percent HCWA and penetration as did susceptible cultivars. A significant negative correlation (P < 0.01) was found between percent penetration and percent HCWA for cultivars inoculated with two isolates of the pathogen. Isolate 1 was less virulent than isolate 2 with respect to percent penetration and induced significantly fewer HCWA. Scanning electron microscopy showed various shapes of fungal appressoria but no apparent difference in host reaction between resistant and susceptible cultivars. Transmission electron microscopy revealed interactions between the host and pathogen at various stages of penetration. The resistant cv. Johnston responded by producing appositions, as evidenced by a layer of compact osmiophilic material deposited on the inner side of the cell wall. Infection pegs produced by conidia were unable to penetrate the cuticle where an apposition had formed inside. When penetration occurred in the susceptible cv. Argyle, cytoplasmic aggregates and separation of the plasmalemma were visible from the host cell wall, but the layer of compact osmiophilic material was not always present. Data based on light microscopic observations suggested that HCWA may be one of the mechanisms responsible for resistance that is characterized as penetration prevention rather than as a slow rate of mycelial growth after successful penetration. HCWA occurred in response to attempted cuticle penetration, suggesting that HCWA may produce chemical barriers that help to prevent penetration.

Effect of whole crop cereal grain silage substituted for alfalfa silage on performance of lactating dairy cows.

Barley, oats, and triticale were planted at the University of Alberta Research Station May 22 to June 1, 1990, harvested August 5 to August 19, 1990, at the early to mid-dough stage, and ensiled. Second-cutting alfalfa was harvested at midbloom and ensiled. Twenty Holstein cows in early lactation and 24 in midlactation were subjected to a 21-d standardization period (covariate) and were fed a TMR (50:50, forage: concentrate). Forage was a combination of equal portions of silage of alfalfa, barley, oats, and triticale. Following the covariate period, cows were offered TMR for ad libitum intake for 12 wk in which the forage portion of the TMR was one of the four silages. Diets based on oat and triticale silages lowered DMI, but overall milk production was not significantly different across treatments. Digestibilities of DM, OM, CP, and ADF were highest for the alfalfa silage diet, intermediate for the barley silage diet, and lowest for diets based on oat and triticale silages. The high dietary NDF concentration in oat and triticale silage limited feed intake. However, forage source had no major effect on dairy cow performance when forage was fed for ad libitum intake; therefore, barley, oat, and triticale silages harvested at an early stage of maturity can be used effectively in dairy cow rations.