Objective
To investigate the effect of an Enhanced Recovery After Surgery (ERAS) program on complications and length of stay (LOS) after radical cystectomy (RC) and to assess if the number and type ...of components of ERAS play a key role on the decrease of surgical morbidity.
Materials and methods
We analyzed the data of 277 patients prospectively recruited in 11 hospitals undergoing RC initially managed according to local practice (Group I) and later within an ERAS program (Group II). Two main outcomes were defined: 90-day complications rate and LOS. As secondary variables we studied 90-day mortality, 30-day readmission and transfusion rate.
Results
Patients in Group II had a higher use of ERAS measures (98.6%) than those in Group I (78.2%) (
p
< 0.05). Patients in Groups I and II experienced similar complications (70.5% vs. 66%,
p
= 0.42). LOS was not different between Groups I and II (12.5 and 14 days, respectively,
p
= 0.59). The risk of having any complication decreases for patients having more than 15 ERAS measures adopted RR = 0.815; 95% confidence interval (CI) 0.667–0.996;
p
= 0.045. Avoidance of transfusion and nasogastric tube, prevention of ileus, early ambulation and a fast uptake of a regular diet are independently associated with the absence of complications.
Conclusions
Complications and LOS after RC were not modified by the introduction of an ERAS program. We hypothesize that at least 15 measures should be applied to maximize the benefit of ERAS
The onset of age-related benign prostate hyperplasia (BPH) is linked with changes in the expression of specific prostatic chemokines. The aim of this work was to characterize those most relevant ...changes through the simultaneous analysis of 34 chemokines in both prostatic tissue and serum in rats at different ages with the aim to identify clinically workable parameters for the detection of early prostatic alterations. The study included 28 healthy Sprague-Dawley male rats that were distributed in four groups, 1 month-old (prepuberal; n = 7), 3 months-old (young; n = 7), 6 months-old (mature; n = 7) and 12 months-old (elder; n = 7). Chemokines were analyzed through a commercial mini-array system specially designed for rat tissues. Serum testosterone levels and prostatic histological status were also evaluated. Histological lesions indicative of BPH were detected in three mature rats and in all elder ones. Mini-arrays from prostatic tissue showed that young animals had an overall decreased expression of most of the analyzed chemokines when compared with prepuberal rats, with the exception of agrin, which showed a significant (P < 0.05) increase (100.0 ± 1.3, arbitrary units in prepuberal rats vs.148.2 ± 4.1, arbitrary units in young ones). Older animals showed further specific changes in 4 out 34 analyzed chemokines, namely agrin, platelet-derived growth factor (PDGF), tissue inhibitor of metalloproteinase-1 (TIMP-1) and vascular endothelial growth factor (VEGF). Additionally, elder rats showed the lowest intensity levels of agrin combined with the highest ones for PDGF, TIMP1 and VEGF when compared with all other groups. Finally, a significant increase of serum VEGF was detected in elder, BPH-affected rats when compared with young ones. Results indicated that the onset of both rat puberty and BPH would be related with specific changes in the prostatic expression of chemokines such as VEGF. Otherwise, the observed changes in serum VEGF levels could suggest the future possible utilization of serum VEGF levels to detect early pathological prostatic processes.
•Rat age-related benign prostate hyperplasia (BPH) onset is linked with specific changes in prostate chemokines expression.•The BPH onset is linked with parallel increases in prostate and blood serum levels of the vasculogenic factor VEGF.•Collected data suggest a possible utilization of serum VEGF levels to detect early prostate alterations.
Wood of Quercus pyrenaica has suitable properties for the wine ageing process. However, the forest available for the barrel making from this particular type of tree is very limited. Nevertheless, it ...is highly advisable to use this kind of wood in order to manufacture alternative oak products. This study presents the results of ageing the same red wine using different pieces of wood (chips and staves) of Spanish oak (Q. pyrenaica), American oak (Quercus alba) and French oak (Quercus petraea) in conjunction with small, controlled amounts of oxygen. In addition, the phenolic parameters, colour and sensory analysis point out that wines aged with Q. pyrenaica pieces have similar enological characteristics to those aged with American or French oak pieces of wood (chips and staves). Furthermore, the total oxygen consumed and its relation with sensory properties also has been studied in this article in order to know how the oxygen behaves in these processes. Besides, it is going to put forward the fact that chips and staves from Q. pyrenaica oak are suitable for the ageing of red wines and better considered than American or French ones, showing higher aromatic intensity, complexity, woody, balsamic and cocoa. Finally, the tasters valued highly the wines with staves, pointing out its flavour and roundness in mouth.
Abstract
Anecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes ...(ASIP—appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain). The number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020 and 835 in 2021. This 1/3rd reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. Surgical standards suffered a step back during the first wave: Lower laparoscopic approach and longer length of stay. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances. Luckily these standards improved again in 2021. The positive COVID-19 status itself did not have a direct impact on mortality. Strikingly, none of the 33 surgically treated COVID positive patients during both years died postoperatively. This is an interesting finding which, if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.
The aim of this study is to assess the use of polymeric cartridges with diode array detection to extract the main low-molecular mass phenolic compounds from red wine samples. This method expanded and ...improved permitted to quantify 20 compounds in red wines made and aged under different conditions. These conditions included aging in barrels and in tanks with chips or staves as well as micro-oxygenation. The study of wine development during its wood storage period and the compounds transferred from the wood to the wine during this period provide useful important information concerning the impact of wine aging methods on the chemical makeup of the resulting wines. The main compounds that differentiated wine aging systems were identified to be 5-hydroxymethyl-2 furaldehyde, gallic acid, p-hydroxybenzoic aldehyde, syringic acid and sinapic acid.
This work analyzed the expression of prostate polysaccharides in rats with age-related benign prostatic hyperplasia (BPH) for a better understanding of the possible relationship between prostate ...polysaccharides secretion and BPH onset. For this, prostatic glands from 1 month-old, 3 months-old, 6 months-old and 12 months-old Sprague-Dawley rats were processed in order to identify their overall polysaccharide content. Additionally, serum testosterone was also determined. One-month old rats showed significantly (P < 0.05) lower testosterone levels (0.77 ng/mL±0.12 ng/mL) compared with the other groups, which showed no significant difference among them. PAS staining showed positive polysaccharides markings in both the prostatic lumen and inside of luminal prostatic cells in all groups. Semiquantitative analysis of intraluminal PAS showed that one month-old rats had significantly (P < 0.005) lower PAS intensity when compared with all other groups (100.0 ± 0.5, arbitrary units vs. 107.3 ± 0.6, arbitrary units in 3 months-old ones), whereas 12 months-old ones showed significantly (P < 0.005) higher values when compared with all other groups (133.6 ± 3.5, arbitrary units in 12 months-old rats vs. 108.6 ± 1.4, arbitrary units in 6 months-old ones). The PAS + content practically disappeared when tissues were pre-incubated with either α-amylase or amyloglucosidase, regardless of a previous incubation with proteinase K. Incubation of prostate extracts from 12 months-old rats for 2h with α-amylase yielded a significantly higher amount of free glucose (1.47 nmol/mg protein±0.23 nmol/mg protein vs. 0.32 nmol/mg protein±0.01 nmol/mg protein in untreated extracts). Similar results were obtained when extracts were pre-incubated with amyloglucosidase. Contrarily, pre-incubation with N-glycosidase induced a significantly (P < 0.05), much lower increase of free glucose. Pre-treatment with proteinase K did not significantly modify these results, which indicate that BPH is related to an increase in the secretion of low ramified ductal α-glycosydic polysaccharides that were not protected against lysis by any type of protein protective core. These changes seem to not be related with concomitant variations in serum testosterone levels.
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•The onset of both rat age-related benign prostate hyperplasia (BPH) is concomitant with an increase in intraductal polysaccharide content.•The intraductal prostate polysaccharide content is, mainly composed by low ramified α-glycosydic chains.•The onset of rat BPH is concomitant with a noticeable increase of the overall polysaccharide metabolism of prostate ductal cells.
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