Does Double Mean Trouble? Coexistence of Myeloproliferative and Lymphoproliferative Neoplasms.

Background: The occurrence of myeloproliferative neoplasms (MPNs) that evolve into each other is well-described, as is this occurrence of lymphoproliferative neoplasms (LPNs). However, less is known about rare MPN/LPN coexistence, and the aim of our study was to analyze charachteristics of these patients after long term follow-up. Methods: Fourteen patients with MPN/LPN coexistence were diagnosed and treated according to guidelines at a single university center across two decades. Results: The overall median age was 53 years (22-69). MPNs patients with subsequent LPNs had a shorter period of second malignancy development and a more aggressive course of LPN, which can cause fatal outcomes. Polycythemia vera and chronic lymphocytic leukemia were most commonly associated (36%). The JAK2V617F mutation had 2/3 and cytogenetic abnormalities occurred in 1/3 of patients. MPN/LPN coexistence cases had significantly higher thrombotic potential (42.8%) and a higher third malignancy accruement frequency (21.4%) versus those without such malignancies. Conclusions: Considering the younger ages at MPN diagnosis, it is recommended to check regularly for blood lymphocytosis or lymphadenopathy occurrences and organomegaly progression faster than expected for MPN, with the aim of timely LPN diagnoses. The presence of molecular-cytogenetic abnormalities in a majority of patients indicate possible genetic instability and increased risk of development of multiple neoplasms, thus elevating thrombotic risk.

Easily Applicable Predictive Score for Differential Diagnosis of Prefibrotic Primary Myelofibrosis from Essential Thrombocythemia.

Essential thrombocythemia (ET) and prefibrotic primary myelofibrosis (prePMF) initially have a similar phenotypic presentation with thrombocytosis. The aim of our study was to determine significant clinical-laboratory parameters at presentation to differentiate prePMF from ET as well as to develop and validate a predictive diagnostic prePMF model. This retrospective study included 464 patients divided into ET (289 pts) and prePMF (175 pts) groups. The model was built using data from a development cohort (229 pts; 143 ET, 86 prePMF), which was then tested in an internal validation cohort (235 pts; 146 ET, 89 prePMF). The most important prePMF predictors in the multivariate logistic model were age ≥ 60 years (RR = 2.2), splenomegaly (RR = 13.2), and increased lactat-dehidrogenase (RR = 2.8). Risk scores were assigned according to derived relative risk (RR) for age ≥ 60 years (1 point), splenomegaly (2 points), and increased lactat-dehidrogenase (1 point). Positive predictive value (PPV) for pre-PMF diagnosis with a score of ≥points was 69.8%, while for a score of ≥3 it was 88.2%. Diagnostic performance had similar values in the validation cohort. In MPN patients with thrombocytosis at presentation, the application of the new model enables differentiation of pre-PMF from ET, which is clinically relevant considering that these diseases have different prognoses and treatments.

Microstructure of Croatian Wild Grapevine (Vitis vinifera subsp. sylvestris Gmel Hegi) Pollen Grains Revealed by Scanning Electron Microscopy.

Wild grapevine (Vitis vinifera subsp. sylvestris Gmel Hegi) is dioecious with male and female plants, whereas domesticated grapevine is mostly hermaphrodite with self-fertile hermaphrodite flowers. The pollen morphology of wild grapevine has been poorly studied. There is no detailed palynological study of V. sylvestris in Croatia and neighboring countries. Here, scanning electron microscopy (SEM) was used to analyze the pollen of V. sylvestris from male and female individuals growing at two natural sites in Croatia. The selective APT3 marker was used to confirm the flower phenotype with the genetic background. SEM analysis showed that the pollen grains of V. sylvestris were isopolar and radially symmetrical, with foveolate perforated ornamentation, regardless of the flower type of the individuals. All male flowers were 3-colporate and prolate in shape, whereas female individuals varied from subprolate to spheroidal and had inaperturate pollen grains. Pollen shape, dimensions and exine ornamentation proved very informative, and here we address the most polymorphic traits in the analyzed V. sylvestris individuals. Principal component analysis (PCA) and clustering based on pollen morphology variables clearly differentiated individuals by their flower type, and no grouping specific to population was observed, pointing to the conserved pollen structure of V. sylvestris. The results indicate the need to continue the palynological study of V. sylvestris and serve as a good phenotypic basis for functional genetic studies on genes involved in pollen morphology and function.

Specific Physical Ability Prediction in Youth Basketball Players According to Playing Position.

This study investigated the hierarchical structure of physical characteristics in elite young (i.e., U17-U19) basketball players according to playing positions. In addition, their predictive value of physical characteristics was determined for the evaluation of players' physical preparedness. Sixty elite male basketball players performed 13 standardized specific field tests in order to assess the explosive power of lower limbs, speed, and change-of-direction speed. They were divided into three groups according to playing positions (guard [n = 28], forward [n = 22], center [n = 10]). The basic characteristics of the tested sample were: age = 17.36 ± 1.04 years, body height = 192.80 ± 4.49 cm, body mass = 79.83 ± 6.94 kg, and basketball experience = 9.38 ± 2.10 years for guards; age = 18.00 ± 1.00 years, body height = 201.48 ± 3.14 cm, body mass = 90.93 ± 9.85 kg, and basketball experience = 9.93 ± 2.28 years for forwards; and age = 17.60 ± 1.43 years; body height = 207.20 ± 3.29 cm, body mass = 104.00 ± 9.64 kg, and basketball experience = 9.20 ± 1.62 years for centers. For all playing positions factor analysis extracted three factors, which cumulatively explained 76.87, 88.12 and 87.63% of variance, respectively. The assessed performance measures were defined as significant (p < 0.001), with regression models of physical performance index (PPINDEX). PPINDEX of guards = -6.860 + (0.932 × t-test) - (1.656 × Acceleration 15 m) - (0.020 × Countermovement jump); PPINDEX of forwards = -3.436 - (0.046 × Countermovement jump with arm swing) - (1.295 × Acceleration 15 m) + (0.582 × Control of dribbling); PPINDEX of centers = -4.126 + (0.604 × Control of dribbling) - (1.315 × Acceleration 15 m) - (0.037 × Sargent jump). A model for the evaluation of physical performance of young basketball players has been defined. In addition, this model could be used as a reference model for selection procedures, as well as to monitor the efficacy of applied training programmes within the short, medium and long-term periodization.

Assessments of Ground Reaction Force and Range of Motion in Terms of Fatigue during the Body Weight Squat.

The purpose of this study was to analyse in detail body weight squat (BWS)' fatigue effect on the range of motions (ROM) of the hip, knee, ankle and ground reaction forces (GRF). Twenty male recreational athletes (24.0 ± 3.1 years, 178.85 ± 7.12 cm and 78.7 ± 11.45 kg) participated in this study. BWS were performed on four load cell platforms until the participants failed to continue. Participants performed 73 ± 27 repetitions and the duration to complete of the repetitions was 140.72 ± 62.28 s during the BWS exercise. The forefoot and hindfoot of the feet were on two load cells, thus, there were two under each foot. All of the data collected was divided into three sections for analysis (24 ± 9 repetitions for each). In terms of GRF of the fore feet and hind feet, significant differences and medium to large effect size were found between each section (p = 0.006~0.040, ES = 0.693~0.492). No significant differences were found between right and left leg in all sections. Significant differences were found in the ROM of the hip between the sections of first-third (p = 0.044, ES = 0.482) and second-third (p = 0.034, ES = 0.510), the ROM of the knee first-third (p = 0.014, ES = 0.602) and second-third (p = 0.005, ES = 0.701) and for the ROM of the ankle first-second (p = 0.045, ES = 0.479). As a result, end-of-exercise fatigue caused an increase in the ROM of the hip, knee and ankle. Thus, it is observed that fatigue induced increased ROM, also increases the GRF towards the forefeet.

Horizon Scanning for pharmaceuticals and effective health care programming: 2 years' experience at the Italian Medicines Agency.

The Italian Medicines Agency (AIFA) developed Horizon Scanning (HS) methodology to address programming and sustainability challenges posed by accelerating pharmaceutical innovation and increasing costs. From July 2018 to June 2020, 563 new potential treatments (new medicines and new indications of existing medicines) with an expected impact in 2020-2022 were identified. In this review, we assess and discuss these HS results, including medicine characteristics related to higher prioritization scores, such as clinical areas of major development. After exclusions because of the selection process, 213 (40.6%) new potential treatments were included in the prioritization tool; 25 (11.7%) were shown to be possibly associated with a major impact on healthcare systems (HCSs) according to overall prioritization criteria. Lessons learned from the process led to HS system improvements.

Correction to: Postoperative Adverse Events are Associated with Oncologic Recurrence Following Curative­intent Resection for Lung Cancer.

The original version of this article unfortunately contained a mistake in author names. The given and family names of all the authors was transposed. The author names are corrected with this correction. The original article has been corrected.

Postoperative Adverse Events are Associated with Oncologic Recurrence Following Curative-intent Resection for Lung Cancer.

BACKGROUND: Up to 50% of patients suffer short-term postoperative adverse events (AEs) and metastatic recurrence in the long-term following curative-intent lung cancer resection. The association between AEs, particularly infectious in nature, and disease recurrence is controversial. We sought to evaluate the association of postoperative AEs on risk of developing recurrence and recurrence-free survival (RFS) following curative-intent lung resection surgery. METHODS: All lung cancer resections at a single institution (January 2008-July 2015) were included, with prospective collection of AEs using the Thoracic Morbidity & Mortality System. Cox proportional hazards models were used to estimate the effect of AEs on recurrence, with results presented as hazard ratio (HR) with 95% confidence interval (CI). An a priori, clinically driven approach to predictor variable selection was used. Kaplan-Meier curves were used examine the relationship between AE and RFS. p < 0.05 was considered statistically significant. RESULTS: 892 patients underwent curative-intent resection. 342 (38.3%) patients experienced an AE; 69 (7.7%) patients developed infectious AEs. 17.6% (n = 157) of patients had disease recurrence after mean follow-up of 26.5 months. Severe (Grade IV) AEs were associated with increased risk of recurrence (3.40; 95% CI 1.56-7.41) and a trend to decreased RFS. Major infectious AEs were associated with increased risk of recurrence (HR 1.71; CI 1.05-2.8) and earlier time to recurrence (no infectious AE 66 months, minor infectious 41 months, major infectious 54 months; p = 0.02). CONCLUSION: For patients undergoing curative-intent lung cancer resection, postoperative AEs associated with critical illness or major infection were associated with increased risk of oncologic recurrence.

Real-World Observational Study on the Characteristics and Treatment Patterns of Allergic Asthma Patients Receiving Omalizumab in Canada.

BACKGROUND: Omalizumab is a treatment option for pediatric and adult patients with moderate to severe allergic asthma poorly controlled with standard inhaled therapies. Clinical trials and observational studies have demonstrated the efficacy of omalizumab. There is limited real-world evidence on the characteristics and treatment patterns of Canadian asthma patients receiving omalizumab. OBJECTIVE: We profiled Canadian omalizumab users to estimate time to omalizumab discontinuation and to assess changes in concurrent medication usage before, during, and after therapy. METHODS: This was a retrospective, observational, cohort study that analyzed data from Canadian prescription claims databases. An algorithm was used to select naïve users of omalizumab with an inferred diagnosis of GINA 5-asthma who made a claim for omalizumab from February 1, 2007, to June 2, 2015. Demographic and baseline characteristics were assessed at index. Outcomes examined over the analysis period included (i) daily omalizumab dose per patient and per claim; (ii) omalizumab discontinuation (defined as ≥100-day gap in making omalizumab claims) and its potential predictors (ie, age, sex, province of residence, drug insurer; assessed by Cox Proportional Hazards Model); and (iii) for patients who discontinued omalizumab, changes in concurrent medication usage before, during, and 6 months after omalizumab usage. RESULTS: The final study cohort consisted of 1160 patients (mean age: 45.8 ± 15.2 years; 64.7% female). During the first year of omalizumab therapy, 29.5% of patients discontinued treatment. The singular characteristic that predicted omalizumab discontinuation with statistical significance was age group (20‒34 years vs 12‒19 years; hazard ratio 1.75, 95% confidence interval 1.11-2.76; P<0.05). There were significant reductions in the use of some concurrent inhaled and oral asthma medications during and/or after omalizumab use (P<0.05). CONCLUSION: Nearly one-third of patients who initiated omalizumab in Canada for refractory, moderate to severe allergic asthma discontinued treatment during the first year.

Real-world utilization of methotrexate or prednisone co-therapy with etanercept among Canadian patients with rheumatoid arthritis: a retrospective cohort study.

Objective: To evaluate whether initiation of etanercept therapy among patients with rheumatoid arthritis (RA) impacts use of co-therapy with methotrexate or prednisone, and to describe etanercept dosing dynamics compared to product monograph in the Canadian real-world setting. Methods: A retrospective cohort study was conducted using claims-level data from IQVIA Private Drug Plan database, Ontario Public Drug Plan database and Régie de l'assurance maladie du Québec database. Bio-naïve RA patients initiating etanercept between July 2014 and June 2015 were identified and their claims for methotrexate or prednisone were analyzed. Utilization of methotrexate or prednisone was calculated as average weekly dose in milligrams, and compared in the 6 months pre-initiation versus 12 months post-initiation of etanercept. Weekly etanercept dosing of each patient was calculated and analyzed to determine whether patients had at least 20% higher or lower average dose than monograph recommended dose (50 mg/week), and were then flagged as above-monograph or below-monograph, respectively. Results: A total of 2876 patients with RA (66% female, 76% aged 18-65) were included; 62% (n = 1,140) used methotrexate and 27% used prednisone (n = 498) both pre- and post-initiation of etanercept. In methotrexate patients, the average weekly dose dispensed was 25.4 mg in the 6 months pre-etanercept, and 25.0 mg in the 12 months post-etanercept initiation (p = .5282). In prednisone patients, the average weekly dose dispensed reduced from 122.6 mg pre-etanercept to 107.1 mg post-etanercept initiation (p = .2173). Among patients who were already on methotrexate or prednisone, after initiating on etanercept 16% (n = 213) and 34% (n = 254) of patients stopped methotrexate and prednisone, respectively. When compared to the recommended dose, 12% (n = 168) of patients were below-monograph and 7.1% of patients were above-monograph during their first year of etanercept therapy. Average etanercept dosing was consistently lower than product monograph during the follow-up year. Conclusions: Patients had a modest but not statistically significant decrease in prescribed doses of co-therapy with methotrexate and prednisone when etanercept was added to patients' therapy. In addition, 12-14% of patients stopped their co-therapy with methotrexate or prednisone. Further study is needed to understand the impact on patient outcomes and safety.

The Horizon Scanning System at The Italian Medicines Agency.

The new era of medical innovation is a great opportunity for healthcare; but it poses new challenges for affordability of healthcare systems. To enable timely implementation of value-based clinical care and payment approaches, it is important to look beyond usual timescales to inform decision makers about forthcoming disruptive technologies early. Horizon scanning could represent an efficient tool in support of decision making and rational use of available resources. Different horizon scanning programmes exist in Europe and there is a need for further international cooperation between competent authorities. In relation to this, the present review aims to highlight the importance of early information availability and illustrates the Italian Medicines Agency Horizon Scanning System in the context of the European regulatory network.

Survival of Salmonella spp. in minced meat packaged under vacuum and modified atmosphere

Abstract The effect of different modified atmosphere packaging regimes on the behavior of Salmonella spp. on minced meat was studied. Minced meat was experimentally contaminated with a Salmonella spp. cocktail (S. Enteritidis, S. Typhimurium, S. Infantis and S. Arizonae), packaged under vacuum or modified atmosphere with initial headspaces containing 20%O2/50%CO2/30%N2 and 20%O2/30%CO2/50%N2) and stored at 3 ± 1 °C for 12 days. Samples were analyzed for Salmonella spp., viable and lactic acid bacteria count every third day. Salmonella spp. counts decreased during storage in all packaging types, with reductions of about 1.5 log CFU/g. A significant difference (p < 0.01) was noted between Salmonella spp. counts in meat packaged in vacuum and modified atmospheres, although there was no significant difference in Salmonella spp. count between meat packaged in 50%CO2, and meat packaged in 30%CO2. At the end of the study, there were significant differences (p < 0.01; p < 0.05) in total viable and lactic acid bacterial counts between meat packaged in vacuum and modified atmosphere, and the lowest counts were noted in meat packaged in modified atmosphere with 50%CO2.

Enhancing Pharmacovigilance Capabilities in the EU Regulatory Network: The SCOPE Joint Action.

In November 2013, a team of European regulators initiated the Strengthening Collaboration for Operating Pharmacovigilance in Europe (SCOPE) Joint Action. Funded by the Health Programme of the European Union, and with contributions from the involved Member States, SCOPE gathered information and expertise on how regulators in Member States run their national pharmacovigilance systems to meet the requirements of the pharmacovigilance legislation that came into effect in June 2012. The SCOPE project evaluated then-current practices and developed tools to further improve the skills and capability in the pharmacovigilance network. The project was divided into eight separate work streams, five of which concentrated on pharmacovigilance topics-collecting information on suspected adverse drug reactions, identifying and managing safety issues (signals), communicating risk and assessing risk minimisation measures, supported by effective quality management systems. The other three work streams focused on the functional aspects-coordination, communication and evaluation of the project. Through the project, SCOPE delivered guidance, training in key aspects of pharmacovigilance, and tools and templates to support best practice. The deliverables provide practical guidance that those working in the European national competent authorities can take to strengthen their national systems. The SCOPE outputs can be useful for other stakeholders involved in pharmacovigilance activities, including the pharmaceutical industry, healthcare professionals, patient and consumer organisations, and academia.

Long-term etanercept retention patterns and factors associated with treatment discontinuation: a retrospective cohort study using Canadian claims-level data.

To examine 12-month retention rates over 6 years of etanercept patients in Canada, and to identify factors associated with treatment discontinuation. A retrospective cohort study was conducted using longitudinal prescription drug claims data from IQVIA Private Drug Plan database (PDP), Ontario Public Drug Plan database (OPDP), and Régie de l'assurance maladie du Québec database (RAMQ). Between 07/2008 and 06/2010, bio-naïve patients who initiated etanercept were identified and followed for 72 months. Twelve-month retention rates were estimated in one-year increments and factors associated with time to discontinuation over the 72-month period were identified using a Cox proportional hazards regression model. The study identified 4528 etanercept patients (61% female, 85% rheumatic diseases, and 15% psoriasis). Twelve-month etanercept retention rates increased significantly for patients following their first year on therapy (p < 0.0001), with 66% of patients retained at year 1 vs. 79, 82, 84, 83, and 79% at years 2, 3, 4, 5, and 6, respectively. 17.1% (n = 771) of patients were retained for the entire 72-month study. Patients with psoriasis were at increased risk (HR 1.199; p < 0.0001); while public drug coverage plan patients (OPDP HR 0.721; p < 0.0001 and RAMQ HR 0.537; p < 0.0001) were at decreased risk of treatment discontinuation. Twelve-month etanercept retention rates increased significantly for patients following their first year on therapy. Indication and drug coverage plan were associated with patients' time to etanercept discontinuation. With a better understanding of factors associated with retention, programs can be designed to address the specific needs of at-risk groups while supporting patients stable on therapy.

Survival of Salmonella spp. in minced meat packaged under vacuum and modified atmosphere.

The effect of different modified atmosphere packaging regimes on the behavior of Salmonella spp. on minced meat was studied. Minced meat was experimentally contaminated with a Salmonella spp. cocktail (S. Enteritidis, S. Typhimurium, S. Infantis and S. Arizonae), packaged under vacuum or modified atmosphere with initial headspaces containing 20%O2/50%CO2/30%N2 and 20%O2/30%CO2/50%N2) and stored at 3±1°C for 12 days. Samples were analyzed for Salmonella spp., viable and lactic acid bacteria count every third day. Salmonella spp. counts decreased during storage in all packaging types, with reductions of about 1.5logCFU/g. A significant difference (p<0.01) was noted between Salmonella spp. counts in meat packaged in vacuum and modified atmospheres, although there was no significant difference in Salmonella spp. count between meat packaged in 50%CO2, and meat packaged in 30%CO2. At the end of the study, there were significant differences (p<0.01; p<0.05) in total viable and lactic acid bacterial counts between meat packaged in vacuum and modified atmosphere, and the lowest counts were noted in meat packaged in modified atmosphere with 50%CO2.

Impact of Surgeon Self-evaluation and Positive Deviance on Postoperative Adverse Events After Non-cardiac Thoracic Surgery.

As an innovative approach to improve quality of surgical care, we combined surgeon self-assessment and anonymized peer comparison with continuous quality improvement seminars using positive deviance (CQI/PD) to identify surgeon(s) with the lowest rates of adverse events (AEs) to guide group practice recommendations. Our objective was to quantify the impact these interventions on postoperative AEs rates after major non-cardiac chest operations. All postoperative AEs after all thoracic operations (n = 1,084, March, 2013 to February, 2016, single-center) were prospectively collected using the thoracic morbidity and mortality system, based on Clavien-Dindo schema. Online software provided surgeons (n = 6) with self-evaluation and peer comparison at all times. In addition, quarterly CQI/PD seminars (n = 8, September, 2013 to December, 2015) focused on common impactful AEs: atrial fibrillation (AFIB), prolonged alveolar air leak (PAAL), and anastomotic leak (AL). Impact was analyzed using univariate statistics 6, 9, and 12 months before and after implementation. We observed reductions of postoperative AEs after CQI/PD: a decrease (all time periods) in AFIB, greatest at 6 months (10.1% vs. 6.7%; p = .36); a decrease (all time periods) in PAAL, greatest at 12 months (18.9% vs. 11.7%; p < .05); and decrease (6 and 9 months) in AL, greatest at 6 months (11.1% vs. 8.3%; p = .82). Improvements in AE rates after individual surgeon self-evaluation and CQI/PD seminars provide encouraging results that merit further investigation.

All grades of severity of postoperative adverse events are associated with prolonged length of stay after lung cancer resection.

OBJECTIVE: To determine whether all grades of severity of postoperative adverse events are associated with prolonged length of stay in patients undergoing pulmonary cancer resection. METHODS: This was a retrospective cohort study of all patients who underwent pulmonary resection with curative intent for malignancy at The Ottawa Hospital, Division of Thoracic Surgery (January 2008 to July 2015). Postoperative adverse events were collected prospectively with the Thoracic Morbidity & Mortality System, based on the Clavien-Dindo severity classification. Patient demographics, comorbidities, preoperative investigations, cardiopulmonary assessment, pathologic staging, operative characteristics, and length of stay were retrospectively reviewed. Prolonged hospital stay was defined as >75th percentile for each procedure performed (wedge resection 6 days, segmentectomy 6 days, lobectomy 7 days, extended lobectomy 8 days, pneumonectomy 10 days). Univariable and multivariable logistic regression analyses were conducted to identify factors associated with prolonged hospital stay. RESULTS: Of 1041 patients, 579 (55.6%) were female, 610 (58.1%) were >65 years old, 232 (22.3%) experienced prolonged hospital stay, and 416 (40.0%) patients had ≥1 postoperative adverse event. Multivariable analyses identified significant (P < .05) factors associated with prolonged hospital stay to be (odds ratio; 95% confidence interval): lower diffusion capacity of the lung for carbon monoxide (0.99; 0.98-0.99), surgical approach: open thoracotomy (1.8; 1.3-2.5), and presence of any postoperative adverse event: Grade I (5.8; 3.3-10.2), Grade II (6.0; 4.0-8.9), Grade III (11.4; 7.0-18.7), and Grade IV (19.40; 7.1-55.18). CONCLUSIONS: Lower diffusion capacity of the lung for carbon monoxide, open thoracotomy approach, and the development of any postoperative adverse event, including minor events that required no additional therapy, were factors associated with prolonged hospital stay.

Inhibition of Salmonella by thyme essential oil and its effect on microbiological and sensory properties of minced pork meat packaged under vacuum and modified atmosphere.

The antibacterial activity of thyme essential oil (TEO) was evaluated against four serovars of Salmonella (S. Enteritidis, S. Typhimurium, S. Montevideo and S. Infantis), experimentally inoculated (106CFU/g) in minced pork, which was treated with different concentrations of the TEO (0.3%, 0.6% and 0.9%) packaged under vacuum or MAP (30%O2/50%CO2/20% N2) and stored at 3±1°C for 15days. GC-MS analysis of the TEO was performed in order to determine composition, and the predominant constituent was thymol (50.48%), followed by p-cymene and linalool. The minimum inhibitory concentration was determined for each Salmonella serovar studied. Among the tested active compounds, thymol and carvacrol exhibited the greatest inhibitory effect followed by TEO, with minimum inhibitory concentrations of 320 to 640µg/ml. S. Enteritidis was the most sensitive serovar. During the storage period, Salmonella counts in pork were reduced by 1.69-4.05logCFU/g. The influence of TEO on Enterobacteriaceae, lactic acid bacteria and total viable count was determined in control mince with no added Salmonella. The most pronounced antibacterial effect was achieved by the combination MAP and 0.9% TEO. Although the antibacterial activities of all studied concentrations of TEO in pork were evident and significant (P<0.05), sensory analysis showed that 0.3% TEO was the most acceptable to trained panellists.

Impact of Adverse Events and Length of Stay on Patient Experience After Lung Cancer Resection.

BACKGROUND: Postoperative adverse events (AEs), prolonged length of stay (PLOS), and patient experience are common quality measures after thoracic surgical procedures. Our objective was to investigate the relationship of postoperative AEs on patient experience and hospital length of stay (LOS) after lung cancer resection. METHODS: AEs (using Thoracic Morbidity and Mortality system based on Clavien-Dindo schema) and LOS were prospectively collected for all patients undergoing lung cancer resection. A 21-item questionnaire, retrospectively asking about patient experience, was mailed to patients twice (October 2015 and January 2016). The impact of AEs on experience was investigated and stratified by hospital LOS, with PLOS defined as the 75th percentile. Univariate analysis used parametric (t test) and nonparametric (Mann-Whitney) tests according to test conditions. RESULTS: Of 288 patients who responded to the survey (70% response rate), 175 (61%) had no AEs, 113 (39%) had experienced at least one AE, and 52 (18%) had experienced PLOS. Lung cancer patients who experienced PLOS showed significantly decreased experience on several questionnaire items, including their impression of comprehensiveness of surgeons information provision during inpatient period (p = 0.008), inpatient recovery from operation (p = 0.001), quality of life 30 days after operation (p = 0.032), follow-up care, (p = 0.022), and satisfaction with outcome 1 year after operation during follow-up care (p = 0.022). The presence of postoperative AEs led only to reduced impression about inpatient recovery from the operation (p = 0.01). CONCLUSIONS: In this cohort, postoperative AEs were minimally associated with negative patient experience. However, patients who experienced PLOS demonstrated a marked reduction in experience after thoracic surgical procedures.

Effect of lairage time, behaviour and gender on stress and meat quality parameters in pigs.

The objective of this study was to determine the effects of lairage time (short vs. long), behavior (aggressive vs. non-aggressive) and gender (gilts, barrows and boars) on stress and meat quality parameters in pigs (n = 100). In the group with short lairage, aggressive behavior of gilts and boars was observed. At exsanguination, blood samples were collected and levels of blood lactate and plasma cortisol were determined. Post mortem pH value, temperature, drip loss, sensory and instrumental color and meat quality class were determined on the muscle Longissimus dorsi. Higher blood lactate concentration (P < 0.05) and skin blemish score (P <0.001), lower temperature (P < 0.05) and drip loss (P < 0.01), as well as darker, less red and yellow meat color (P < 0.001) were found after long lairage compared to short lairage. Gilts had higher plasma cortisol concentrations than barrows (P < 0.05), while barrows had lower skin blemish scores (P < 0.05) than gilts and boars after long lairage. The highest incidence of PSE (pale, soft and exudative) meat was observed in barrows (100.00%) and boars (91.67%) after short lairage, while the lowest incidence of PSE meat was found in barrows (28.89%) after long lairage. Aggressiveness affected meat temperature, as aggressive pigs had higher meat temperature (P < 0.05) than non-aggressive pigs.