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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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon’s clinical performance. Methods Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Results Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Conclusions Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate antibacterial effects of oregano and thyme essential oils (EOs) on some food-borne bacteria. GC-MS analysis of EOs was performed in order to determine their composition and phenols were predominant constituents. The investigation of the antibacterial effects of EOs was performed on Salmonella Enteritidis, Salmonella Thyphimurium, Staphylococcus aureus , methicillin resistant Staphylococcus aureus , Escherichia coli and Bacillus cereus , and MICs were determined by broth microdilution method. EOs exhibited antibacterial activity against all tested microorganisms. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the effect of breed line and age on pH in broiler chicken breast muscles. pH values of m. pectoralis major muscle were compared within 6 groups - each line (Cobb, Ross, Hubbard) was divided into two groups aged 42 and 50 days. pH values were recorded 15 minutes, 24 and 48 hours after slaughtering. Older broilers showed significantly lower pH than younger ones. Interactions between breed line and age were found, except for pH after 24 hours. Meat quality of broilers can be estimated quickly by determining the pH-value of breast meat. [ABSTRACT FROM AUTHOR]

The probability of contamination of domestic refrigerators seems to be greater for Salmonella , than other, distinctly psychrotolerant bacteria. This survey investigated Salmonella spp. contamination of domestic refrigerators in households ( n = 100). The presence of Salmonella species was found in 13.95% of households that kept eggs in designated egg storage in refrigerators ( n = 86). We identified 12 serotypes of Salmonella spp. with antimicrobial resistance, of which 50% were identified as S. Typhimurium. The results obtained confirm the need to strongly advise consumers how to properly arrange different foodstuffs inside household refrigerators. [ABSTRACT FROM AUTHOR]

Relationships among conjugated linoleic acid (CLA) in pig nutrition and carcass quality parameters (hot carcass weight, carcass yield and meatiness) and meat quality parameters (initial and pH value after 24, 48 and 72 h, temperature, drip loss, sensory color and marbling) were determined in pigs (crossbreeds Yorkshire x Landrace). Commercial CLA preparation containing 60% CLA isomers was included in the diet. No significant differences in performance parameters were found between pigs fed with CLA and control group during 60 days period. CLA supplementation in feed significantly increased SFA and decreased MUFA and PUFA fraction in pig muscles. [ABSTRACT FROM AUTHOR]

Compared with other well-studied parasitic diseases, fish-borne parasitic zoonoses do not get enough attention, especially because these zoonoses have been limited for the most part to populations living in low- and middle-income countries in Europe. Human fishery product-borne parasitic diseases caused by nematodes are the results of infection following ingestion of viable parasites, or as allergic reactions against parasite antigens. With the globalization of the seafood industry, the risk of humans acquiring anisakiasis in developed countries appears to be underestimated. For allergy, the only implicated parasite in fishery products is the nematode Anisakis simplex . [ABSTRACT FROM AUTHOR]

Objective: Prolonged alveolar air leak (PAAL) is a frequent occurrence after lobectomy or lesser resections. The resulting complications and their impact are not well understood. Our aims are to prospectively determine the incidence and severity of PAAL after pulmonary resection using the Thoracic Morbidity & Mortality classification system and to identify risk factors. Methods: A prospective collection of Thoracic Morbidity & Mortality data was performed for all consecutive pulmonary resections (n = 380; January 2008 to April 2010). Demographics, comorbidities, and preoperative cardiopulmonary assessment were retrospectively identified. The incidence and severity (grades I-V) of burden from PAAL were quantified using the Ottawa Thoracic Morbidity & Mortality system. Risk factors for PAAL and severe PAAL (defined as leading to major intervention, organ failure, or death) were sought with univariate and multivariate analyses. Results: The incidences of PAAL and severe PAAL were 18% and 4.8%, respectively. PAAL prolonged the median hospital stay by 4 days. The majority of complications associated with PAAL were limited to pulmonary and pleural categories (90%). Significant predictors of PAAL from multivariate analysis include severe radiologic emphysema (odds ratio [OR], 2.8; confidence interval [CI], 1.2-6.2), histopathologic emphysema (OR, 1.9; CI, 1.1-3.6), percentage of predicted value for forced expiratory volume in 1 second less than 80% (OR, 1.9; CI, 1.1-3.3), and lobectomy (OR, 4.9; CI, 1.-14.1). Risk factors for severe PAAL include radiologic emphysema, percentage of predicted value for forced expiratory volume in 1 second less than 80%, forced expiratory volume in 1 second/forced vital capacity ratio less than 70%, and intraoperative difficulties (P < .05). Conclusions: PAAL leads to longer hospital stays, and approximately 4.8% of patients undergoing pulmonary resection experience PAAL that necessitates placement of additional chest drains, bronchoscopy, reoperation, or life support. Further study is required to assess the cost-effectiveness of measures to reduce PAAL. [Copyright &y& Elsevier]

Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Minimizing adverse events after surgery is widely recognized as an important indicator of quality; yet no consensus has been reached on how to standardize the reporting of adverse events after surgical procedures. Our objectives were to develop a standardized classification system to monitor both the presence and severity of thoracic morbidity and mortality, and to evaluate its reliability and reproducibility among a national cohort of thoracic surgeons. Methods: To assess the Thoracic Morbidity and Mortality classification system (based on the Clavien-Dindo classification of adverse events), a 31-item questionnaire was sent to all members of the Canadian Association of Thoracic Surgeons in August 2009, consisting of a general description of the Thoracic Morbidity and Mortality severity grades, 20 case-based questions of postoperative adverse events to be classified, and questions regarding personal judgments. We derived descriptive and quantitative information using weighted Kappa statistics. Results: Fifty-two (54.7%) thoracic surgeons completed the questionnaire; 41 (78.8%) of the respondents were affiliated with an academic teaching hospital. A total of 1,326 individual weighted Kappa statistics were calculated for all distinct pairs of raters, of which 1,152 (87%) were greater than 0.81, a range that is interpreted as “almost perfect agreement.” A further 174 (13%) were in the range between 0.61 and 0.8, interpreted as “substantial agreement.” All results were statistically significant (p < 0.0001). The classification system was regarded as straightforward (98% of the respondents), reproducible (94%), logical (92%), and useful (98%). Conclusions: The modified classification system appears to offer objective, reliable, and reproducible reporting of thoracic morbidity and mortality, and thus may assist continuous quality improvement in thoracic surgery. [ABSTRACT FROM AUTHOR]

Background: Objective reporting of postoperative complications is the foundation of surgical quality assurance. We developed a system to identify both presence and severity of thoracic morbidity and mortality, and evaluated its feasibility and utility over the first two years of its implementation. Methods: The system was based on the Clavien-Dindo classification, in which the severity of a complication is proportional to the effort to treat it. Definitions were developed by peer review and questionnaire. All patients undergoing thoracic surgery (January 2008 to December 2009) were prospectively evaluated. Results: A total of 953 patients (mean age 61 years; range, 14 to 95) underwent thoracic surgery (total # cases 1260), of which 369 patients had at least one complication (29.3% procedures). Grades I and II include minor complications requiring no therapy or pharmacologic intervention only. Grades III and IV are major complications that require surgical intervention or life support. Grade V complications result in patient death. Grades I, II, III, and IV complications comprised 4.9%, 63.9%, 21.1%, and 7.8% of all complications; overall mortality rate (grade V) was 2.2%. The most common complications were prolonged air leak (18.8%) and atrial fibrillation (18.2%) after pulmonary resection, and atrial fibrillation (11.5%) after esophagectomy-gastrectomy. Prolonged air leak led to a major complication (13%), readmission (17%), or prolonged hospital stay (29%) to a greater extent than atrial fibrillation (3%, 2%, and 7%, respectively). Conclusions: This standardized classification system for identifying presence and severity of thoracic surgical complications is feasible, facilitates objective comparison, identifies burden of illness of individual complications, and provides an effective method for continuous surgical quality assessment. [ABSTRACT FROM AUTHOR]

Copyright of Facta Universitatis: Series Physical Education & Sport is the property of Facta Universitatis, Series Physical Education & Sport and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)