Background
Anastomotic leakage of pancreaticojejunostomy (PJ) remains the single most important source of morbidity after pancreaticoduodenectomy (PD). The primary aim of this randomized clinical ...trial comparing PG with PJ after PD was to test the hypothesis that invaginated PG would result in a lower rate and severity of pancreatic fistula.
Methods
Patients undergoing PD were randomized to receive either a duct‐to‐duct PJ or a double‐layer invaginated PG. The primary endpoint was the rate of pancreatic fistula, using the definition of the International Study Group on Pancreatic Fistula. Secondary endpoints were the evaluation of severe abdominal complications (Clavien–Dindo grade IIIa or above), endocrine and exocrine function.
Results
Of 123 patients randomized, 58 underwent PJ and 65 had PG. The incidence of pancreatic fistula was significantly higher following PJ than for PG (20 of 58 versus 10 of 65 respectively; P = 0·014), as was the severity of pancreatic fistula (grade A: 2 versus 5 per cent; grade B–C: 33 versus 11 per cent; P = 0·006). The hospital readmission rate for complications was significantly lower after PG (6 versus 24 per cent; P = 0·005), weight loss was lower (P = 0·025) and exocrine function better (P = 0·022).
Conclusion
The rate and severity of pancreatic fistula was significantly lower with this PG technique compared with that following PJ. Registration number: ISRCTN58328599 (http://www.controlled-trials.com).
This pancreaticogastrostomy technique is superior
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Behaviour represents a reaction to the environment as fish perceive it and is therefore a key element of fish welfare. This review summarises the main findings on how behavioural changes have been ...used to assess welfare in farmed fish, using both functional and feeling-based approaches. Changes in foraging behaviour, ventilatory activity, aggression, individual and group swimming behaviour, stereotypic and abnormal behaviour have been linked with acute and chronic stressors in aquaculture and can therefore be regarded as likely indicators of poor welfare. On the contrary, measurements of exploratory behaviour, feed anticipatory activity and reward-related operant behaviour are beginning to be considered as indicators of positive emotions and welfare in fish. Despite the lack of scientific agreement about the existence of sentience in fish, the possibility that they are capable of both positive and negative emotions may contribute to the development of new strategies (e.g. environmental enrichment) to promote good welfare. Numerous studies that use behavioural indicators of welfare show that behavioural changes can be interpreted as either good or poor welfare depending on the fish species. It is therefore essential to understand the species-specific biology before drawing any conclusions in relation to welfare. In addition, different individuals within the same species may exhibit divergent coping strategies towards stressors, and what is tolerated by some individuals may be detrimental to others. Therefore, the assessment of welfare in a few individuals may not represent the average welfare of a group and vice versa. This underlines the need to develop on-farm, operational behavioural welfare indicators that can be easily used to assess not only the individual welfare but also the welfare of the whole group (e.g. spatial distribution). With the ongoing development of video technology and image processing, the on-farm surveillance of behaviour may in the near future represent a low-cost, noninvasive tool to assess the welfare of farmed fish.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
A wide spectrum of clinical and clinicopathological findings in dogs with canine leishmaniosis (CanL) due to Leishmania infantum exists. However, the majority of clinical descriptions have been ...published a long time ago and recent studies in Europe are almost lacking. In addition, clinical classification of sick dogs is not well-standardized, with different classification systems used by clinical and epidemiological studies, making comparison of studies a difficult task. The aims of the study were to describe the clinicopathological findings of dogs naturally infected with L. infantum at the time of diagnosis and to review and compare the various clinical classification systems for CanL available in the literature. Eighty-one healthy dogs and fifty-one dogs with CanL were studied and clinical and clinicopathological data were recorded. The most common clinical findings at diagnosis were skin lesions (78.4%), lymphadenomegaly (64.7%) and weight loss (47.1%). The most frequent clinicopathological abnormalities included mild to moderate non-regenerative anemia (62.7%), lymphopenia (25.5%), hyperproteinemia (52.9%) dysproteinemia (78.4%). and proteinuria (47.8%). Renal azotemia was rare (5.9%). Only 5.9% of the patients studied were classified in similar categories (mild, moderate and severe disease) when five clinical classifications systems were compared, while 11.8% of cases were classified in similar categories when only two clinical classification systems were considered based on the fact that they included therapeutic and prognosis recommendations. In conclusion, anemia and protein-related alterations are common in dogs with CanL. In contrast, renal azotemia is infrequent despite the high percentage of diseased dogs with proteinuria, indicating kidney involvement. Adequate clinical staging system is desirable in order to establish proper management, treatment and prognosis in dogs with CanL and to facilitate the comparison of clinical and epidemiological studies.
•Skin lesions, lymphadenomegaly and weight loss are the most common clinical signs in dogs with leishmaniosis.•Dogs infected with L. infantum show nonregenerative anemia, lymphopenia, dysproteinemia and proteinuria. Azotemia is rare.•The establishment of a common clinical staging system would improve comparability of clinical and epidemiological studies.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
•Depression is associated with impulse-compulsive behaviors in Parkinson’s disease.•Pathological gambling, eating behavior, and hobbyism-punding were related to depression.•Quality of life is worse ...in patients who have impulse-compulsive behaviors to add to depression.
Depression and impulse control disorders (ICDs) are both common in Parkinson’s disease (PD) patients and their coexistence is frequent. Our aim was to determine the relationship between depression and impulsive-compulsive behaviors (ICBs) in a large cohort of PD patients.
PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were included in the study. The QUIP-RS (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale) was used for screening ICDs (cutoff points: gambling ≥6, buying ≥8, sex≥8, eating≥7) and compulsive behaviors (CBs) (cutoff points: hobbyism-punding ≥7). Mood was assessed with the BDI-II (Beck Depression Inventory – II) and major, minor, and subthreshold depression were defined.
Depression was more frequent in PD patients with ICBs than in those without: 66.3% (69/104) vs 47.5% (242/509); p<0.0001. Major depression was more frequent in this group as well: 22.1% 23/104 vs 14.5% 74/509; p=0.041. Considering types of ICBs individually, depression was more frequent in patients with pathological gambling (88.9% 8/9 vs 50.2% 303/603; p=0.021), compulsive eating behavior (65.9% 27/41 vs 49.7% 284/572; p=0.032), and hobbyism-punding (69% 29/42 vs 49.4% 282/571; p=0.010) than in those without, respectively. The presence of ICBs was also associated with depression (OR=1.831; 95%CI 1.048-3.201; p=0.034) after adjusting for age, sex, civil status, disease duration, equivalent daily levodopa dose, antidepressant treatment, Hoehn&Yahr stage, non-motor symptoms burden, autonomy for activities of daily living, and global perception of QoL.
Cross-sectional design.
Depression is associated with ICBs in PD. Specifically, with pathological gambling, compulsive eating behavior, and hobbyism-punding.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
OBJECTIVES: To stablish within-study and between study variations in incremental cost-utility ratios (ICUR) of direct oral anticoagulants (DOAC) versus vitamin K antagonists (VKA) for atrial ...fibrillation (AF) patients across EU-5 countries. Additionally, we aimed to perform a descriptive comparison between total sales per country and ICURs identified. METHODS: OVID-Medline and Embase were systematically searched for original publications of cost-utility analyses reporting ICURs for any DOAC versus VKA in AF in France, Germany, Italy, Spain or United Kingdom (UK) published between 2010 and 2017. Minimum and maximum ICURs and one-way sensitivity analyses (OWSA) results were collected. ICURs reported for UK were transformed into Euros (€). DOACs sales from April 2016 to March 2017 were extracted for each country from QuintilesIMS MIDAS database. Sold units per AF patient were calculated based on reported prevalence per country and overall population in 2016. RESULTS: A total of 624 unique references were identified, 16 publications reporting 26 cost-utility analyses for France (2), Germany (7), Italy (5), Spain (5) and the UK (7) were included. Minimum and maximum ICUR per country were 12.227€ and 15.838€ for France, 15.207€ and 294.349€ for Germany, 6.800€ and 16.162€ for Italy, 6.397€ and 29.957€ for Spain and 5.637€ and 25.886€ for UK. The variable with the highest impact on ICURs in OWSA was risk of ictus associated to DOAC, followed by drug acquisition cost and time horizon. Italy was the country with the highest DOAC units sold per AF patient followed by Germany, UK, France and Spain. CONCLUSIONS: Differences between DOACs ICURs and sales per AF patient arose across countries. Italy was the country for which a lowest DOAC vs VKA ICUR was reported and it was also associated with the highest DOAC units sold per AF patient. However, there seems to be additional criteria other than ICUR driving DOAC's use.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To identify factors related to a poor health-related and global quality of life (QoL) in a cohort of non-demented Parkinson's disease (PD) patients and compare to a control group.
The data correspond ...to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures.
QoL was worse in PD patients (n = 692; 62.6 ± 8.9 years old, 60.3% males) than controls (n = 206; 61 ± 8.3 years old, 49.5% males): PDQ-39, 17.1 ± 13.5 vs 4.4 ± 6.3 (p < 0.0001); PQ-10, 7.3 ± 1.6 vs 8.1 ± 1.2 (p < 0.0001); EUROHIS-QOL8, 3.8 ± 0.6 vs 4.2 ± 0.5 (p < 0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (r = 0.72; p < 0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (r = 0.65; p < 0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire FOGQ) provided the highest contribution to the model (β = 0.32, 0.28, and 0.27, respectively; p < 0.0001); whereas mood and gait problems contributed the most to global QoL (PQ-10, β = -0.46 and −0.21, respectively; EUROHIS-QOL8, β = -0.44 and −0.23, respectively).
QoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.
•Non-motor symptoms (NMS) are frequent in Parkinson's disease (PD) patients during the first steps of the disease.•Health-related and global perceived quality of life (QoL) are worse in PD patients than controls.•Strong correlation was observed between PQ-10 and EUROHIS-QOL8, both scales to provide global QoL.•NMS burden, mood, and gait problems are the most significant factors contributing to a worse QoL.•In practice, it is necessary to ask about NMS, mood, and gait problems in PD patients during their first years of evolution.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Aim of study: To describe the common behaviour of flathead grey mullet (Mugil cephalus) under rearing conditions. Area of study: Tepic, Mexico. Material and methods: Behaviours exhibited by mullets ...were videorecorded with submersible cameras installed inside of three tanks. A total of 690 min per day (07:30 - 18:30 h) were recorded per tank during a week. Afterwards, the different behaviours exhibited by juvenile M. cephalus were described, identified and characterized in an ethogram and grouped into two categories: a) locomotion, including three different observed behaviours (resting, swimming and fast swimming) and b) feeding, including three behaviours (surface feeding, bottom feeding and rubbing). Each of the behavioural variables were quantified. Main results: M. cephalus is a species with a constant locomotion associated to feeding, since fish showed continuous movement during most of day light period. On the contrary, fish exhibited reduced movement during dark periods. Mullets were observed to be a non-aggressive fish species under conditions of the present study, since the absence of dominance and aggression towards conspecifics was observed, which suggested a high predisposition for adaptation to captivity. Finally, behavioural frequencies of grey mullet juveniles were similar among the three tanks for most of the behavioural variables analysed (p>0.05) except for the variable bottom feeding (p=0.02). Research highlights: Results from this study could be of interest for the aquaculture industry to optimize rearing techniques and welfare for the production of grey mullet.
•28 ionic liquids (ILs) were prepared from the core tri(n-octyl)phosphine.•ILs containing Br–, Tf2N–, PF6–, and BF4– anions were prepared in one or two steps.•Elimination reaction and products were ...identified during quaternization reactions.•Some ILs containing linear moieties are solids, contrary to what would be expected.•Some physical property trends are intuitive while others remain unclear.
During the investigation of room temperature ionic liquids (RTILs) produced from tri(2-ethylhexyl)phosphine, it was discovered that the common core tri(n-octyl)phosphine was also significantly underreported. This void in the literature prompted an investigation to explore the influence of branched versus linear substituents’ influence on physical properties. To facilitate a thorough structure-property relationship study, 28 ionic liquids were prepared from tri(n-octyl)phosphine to compare against their branched counterparts. Thermal behavior was investigated by utilizing visual melting point determination, differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA), with emphasis placed on the examination of physical states, phase transitions (including solid-solid), and degradation. Remarkably, all materials produced here are ionic liquids (mp < 100 °C), with 16 of the 28 being liquids at room temperature. Standard analytical methods were utilized to assess the physical properties of the compounds, namely density, viscosity, surface tension, and solubility/miscibility. Structure-property relationships were assessed, particularly focusing on the differences in physical properties between the tri(n-octyl)phosphine and tri(2-ethylhexyl)phosphine cores.
Display omitted
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PDF
