This study demonstrated a nonsignificant lower rate of groin SSI in high-risk revascularization patients with NPWT compared with standard dressing. Owing to a lower than expected infection rate, the study was underpowered to detect a difference at the prespecified level. The NPWT group did show significantly shorter mean hospital duration of stay compared with the standard dressing group.

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We have identified the etiological agent of hemorrhagic nephritis enteritis of geese (HNEG), a fatal disease of European geese. HNEG has been recognized in almost all goose breeding areas, with an epizootic pattern, and up to now, the infectious agent has remained unknown. In order to identify the causative agent, infected tissues from HNEG-affected geese were inoculated to 1-day-old goslings, which then developed clinical signs typical of HNEG. Tissue homogenates from these birds were subjected to Freon extraction followed by sucrose density gradient ultracentrifugation. The resulting main band was examined by electron microscopy and consisted of spherical, naked, papovavirus-like particles approximately 45 nm in diameter. The virus was isolated and propagated in goose kidney cell primary culture. Tissue-or culture-purified virus allowed the experimental reproduction of the disease in goslings. Random PCR amplification of viral nucleic acid produced a 1,175-bp fragment which was shown to be associated with field samples collected from geese affected by HNEG on commercial farms in France. Sequence analysis of the PCR product revealed a unique open reading frame, showing 63 to 72% amino acid similarity with the major capsid protein (VP1) of several polyomaviruses. Finally, based on phylogenetic analysis, we conclude that the causative agent of HNEG is closely related to but clearly distinct from other polyomaviruses; we thus have named this newly identified virus Goose hemorrhagic polyomavirus.

Lobaria pulmonaria (L.) Hoffm. is an epiphytic lichen common to temperate deciduous forests where it copes with large changes in temperature and light levels through repeated annual cycles. Samples of L. pulmonaria were taken from a deciduous forest in southeastern Canada at 35-day intervals from February 1999 to February 2000 and also from a rare population in an evergreen forest in March and August 1999. At field-ambient temperatures and light levels, the realised photosystem II (PSII) electron transport was low both in the summer and winter, with transient peaks in the spring and autumn. In contrast, the seasonal pattern of potential electron transport measured at a fixed 20 degrees C peaked in winter, showing the importance of temperature in driving photosynthesis to low levels in the winter despite an acclimation of electron-transport potential to exploit the high ambient light. Realised gross CO2 uptake was correlated with PSII electron transport at mechanistically plausible rates at all sampling sites in the summer but not in the winter, indicating electron diversion away from CO2 fixation in the winter. Chlorophyll content was highest in the dark summer months. The amount of ribulose-1,5-bisphosphate carboxylase-oxygenase (RuBisCO) large subunit (LSU) was highest in spring. Changes in the level of this hyperabundant protein and in the activity of PSII maintained a relatively constant rate of maximum CO2 uptake per RuBisCO LSU from April through November, despite great changes in the seasonal light and temperature. L. pulmonaria acclimates between light and temperature stress in the winter months to light-limitation in the dark summer months. Transition intervals in the spring and autumn, with warm, bright and wet conditions, are likely the most amenable times for growth.

Elective and emergency abdominal surgery in patients 90 years of age or olderBackground: Few studies have examined perioperative outcomes in nonagenarians undergoing abdominal surgery, and fewer have reported on 1-year mortality. Our objectives were to determine the outcomes of abdominal surgery in nonagenarians and to assess the performance of Physiologic and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) and Portsmouth-POSSUM (p-POSSUM) as predictors of mortality. Methods:We conducted a retrospective chart review of all patients 90 years and older who underwent abdominal surgery between 2000 and 2007 at a tertiary care hospital. Results:We included 145 patients (median age 91, range 90-101 yr). The most common diagnoses were colorectal cancer (19.3%) and hernias (19.3%), and the most common procedures were bowel resection with anastomosis (25.5%) and hernia repair (18.6%). Overall in-hospital mortality was 15.2% (20.8% in the emergent group and 9.6% in the elective group; p = 0.06). The 1-year mortality (49.1% v. 27.8%; p = 0.016), complication (81.9% v. 61.6%; p = 0.007) and intensive care unit admission rates (44.4% v. 11.0%; p < 0.001) were significantly higher among emergent than elective surgical patients. The operative indications and procedures associated with the highest in-hospital mortality were large bowel obstruction (42.3%) and bowel resection with anastomosis (27.0%). Both the POSSUM and p-POSSUM scoring systems significantly overpredicted mortality, particularly in higher risk groups. Conclusion:Nonagenarians undergoing abdominal surgery have substantial operative morbidity and mortality, particularly in emergent surgical cases. Nearly 50% of patients who undergo emergency procedures die within 1 year after surgery. The POSSUM and p-POSSUM scoring systems were not reliable predictors of in-hospital mortality.Contexte : Peu d'études se sont penchées sur les résultats périopératoires de la chirurgie abdominale chez les nonagénaires, et moins encore ont mesuré leur mortalité à 1 an. Nous avions pour objectifs de déterminer l'issue de la chirurgie abdominale chez les nonagénaires et de mesurer les indices POSSUM (Physiologic and Operative Severity Score for enUmeration of Mortality and morbidity) et p-POSSUM (Portsmouth-POSSUM) en tant que prédicteurs de la mortalité. Résultats : Nous avons inclus 145 patients (âge médian 91 ans, éventail de 90 à 101 ans). Les diagnostics les plus fréquents étaient le cancer colorectal (19,3 %) et les hernies (19,3 %), tandis que les interventions les plus courantes ont été la résection intestinale avec anastomose (25,5 %) et la réparation de hernie (18,6 %). La mortalité perhospitalière globale a été de 15,2 % (20,8 % dans le groupe ayant subi une intervention d'urgence et de 9,6 % dans le groupe ayant subi une intervention élective; p = 0,06). Les taux à 1 an pour ce qui est de la mortalité (49,1 % c. 27,8 %; p = 0,016), des complications (81,9 % c. 61,6 %; p = 0,007) et des admissions aux unités de soins intensifs (44,4 % c. 11,0 %; ...

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A total of 43.8% of patients undergoing EVAR had a device-specific IFU violation, indicating that implanters are pushing the boundaries of device capabilities. Our study identified that any IFU violation was significantly associated with GRAEs over time. Caution should be applied to patients being considered for EVAR when IFU deviations exist.