Laparoscopic colorectal cancer surgery combined with enhanced recovery after surgery protocol (ERAS) reduces the negative impact of sarcopenia on short-term outcomes.

INTRODUCTION: Progressive skeletal muscle loss (sarcopenia) is a negative prognostic factor in patients treated for colorectal cancer. Nevertheless, the clinical impact of those changes in body composition has been analyzed only in patients undergoing open resections. The aim of the study was to assess whether laparoscopy may eliminate the deleterious prognostic impact of sarcopenia and whether the combination with enhanced recovery after surgery (ERAS) protocol may improve postoperative recovery also in sarcopenic patients. METHODS: The study included 124 (73M/51F, mean age 65.9 years) patients undergoing elective laparoscopic colorectal resection for cancer. In all of them 16-item ERAS protocol was applied. The L3 skeletal muscle area identified on a preoperative CT scan was used to calculate skeletal muscle index and assess for sarcopenia and myosteatosis. The entire study group was divided into groups regarding the presence of sarcopenia or myosteatosis. The outcome measures were: length of hospital stay, complication rate and functional recovery parameters. RESULTS: The prevalence of sarcopenia and myosteatosis was 27.4% and 38.7%, respectively. There was no association between the presence of sarcopenia or myosteatosis and postoperative complications. There were also no differences in the length of stay or readmission rates. Functional recovery (time to first flatus, oral diet tolerance and mobilization) was similar regardless of the presence of muscle depletion. CONCLUSIONS: In contrary to traditional surgical approach, laparoscopy can reduce the negative impact of sarcopenia and myosteatosis on treatment results. ERAS protocol does not affect negatively the surgical outcomes in sarcopenic patients, compared to patients without changes in body skeletal mass.

The distribution of enterotoxin and enterotoxin-like genes in Staphylococcus aureus strains isolated from nasal carriers and food samples.

Staphylococcus aureus strains were examined for the presence of 18 enterotoxin (se) and enterotoxin-like (sel) genes by PCR and four classic enterotoxins SEA to SED by reverse passive latex agglutination. We screened three groups of isolates: 53 recovered from food samples collected in years 2004-2005, 18--from food samples collected in the 1960s and 1970s and 30--from nasal carrier samples collected in the years 2000-2002. Eighty percent of all tested strains were se and sel positive, but the frequency of these genes was higher among nasal carrier strains (93%) than among food samples isolates (circa 76%). The enterotoxin genes cluster (egc) was the most prevalent among carrier strains (18/30-60%) and the least--among food strains isolated in the 1960s and 1970s (6/18 strains--33%). sea coding enterotoxin A, which was recognised as the major cause of staphylococcal food poisoning so far, was more often found among carrier strains than among the years 2004-2005 food strains (27% versus 11%), but it was the most frequent se/sel gene among food strains isolated in the 1960s and 1970s (10/18 strains). Moreover in our results certain se and sel genes coexisted, which was in accordance with current knowledge about movable genetic elements carrying those genes. The exception was for only one strain, which harboured the sole selr gene on a possibly new genetic element not yet described. As we found both types of egc, as well as seh (especially food samples strains) occurred alone in a majority of positive strains for each of those genes. The analysis of the results obtained by SET-RPLA method for the productivities of classical enterotoxins A-D and the results obtained by PCR for the presence of sea-sed genes revealed the correlation between each other. Only three of all sea-sed positive strains had silent genes--sed.

[Determination of histamine content in canned fish products determined by the colorimetry method of Hardy and Smith]. / Oznaczanie histaminy w konserwach rybnych metoda kolorymetryczna wg Hardy-Smitha.

The content of histamine in 79 samples of imported canned fish products (sardines, mackerel) was determined. Histamine was assayed by colorimetric method of Hardy and Smith. In 18% of tested products (sardines) levels of histamine were exceeded 20 mg/100 of product. Usefulness of this method in routine quantitative determination of histamine content in canned fish products was documented.

[Detection of salmonella in food products]. / Wykrywanie paleczek salmonella w produktach spozywczych.

The Rappaport-Vassiliadis (RV) medium prepared under laboratory conditions from its different components was found to be equally suitable as the commercial RV Oxoid medium for routine detection of Salmonella in food products. The best detection (30 of 113 examined samples) was obtained using 0.1 ml of culture and 10 ml of medium. In case of 1 ml of culture and 10 ml of medium Salmonella was isolated only from 3 samples. Only 7 positive samples were obtained using MK medium. Necessity of preliminary toxicity verification for malachite green oxalate colour used in RV medium, to standard Salmonella strains, prior to routine food products tests, was found.