No abstract

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

Many eukaryotes host mutualistic, maternally transmitted prokaryotic symbionts. Two kinds of evolution within symbiont genomes threaten to erode the benefits of these associations. First, because symbionts reproduce asexually, are sequestered within hosts, and undergo bottlenecks at infection, they are subject to the long-term accumulation of deleterious mutations through Muller's ratchet. Second, "selfish" mutations, benefiting symbionts at host expense, could cause the ultimate decline of both host and symbionts. We performed simulations to assess how the fate of each mutation type is affected by host population size, numbers of symbionts transmitted to progeny, selection within and between hosts, and mutation rate. Fixation rate always increases with decreasing host population size. However, fixation rates for uniformly deleterious and selfish mutations are oppositely affected by varying transmission numbers, with increased numbers slowing accumulation of strictly deleterious mutations, especially for effects concentrated within hosts, but speeding fixation of "selfish" mutations. In aphid symbionts, most genes underlie basic cellular processes and are probably selected at both levels, but a substantial minority of genes contribute only to host fitness. No inoculum size is optimal for minimizing deleterious evolution for both categories of gene.

Infantile regurgitation is a frequently occurring problem. Throughout the world, anxious parents are imploring physicians to eliminate their infant's regurgitation. General practitioners, pediatricians and pediatric gastroenterologists strive to alleviate infantile regurgitation and its related parental stress. In this paper we define the scope of the problem and analyze the optimal, cost-efficient management approach to simple regurgitation in infants. The intent of this paper is to disseminate this information to practicing physicians and other health care professionals in an attempt to minimize the impact of this annoying problem of infancy and to eliminate confusion and expensive diagnostic tests and use of sub-optimal treatment modalities. Parental reassurance and dietary management by feeding thickened formula are important components in managing regurgitation in infants while maintaining optimal nutritional intake for adequate growth and development.

Sampling of lamb (n = 100) and beef (n = 100) carcasses in abattoirs in Northern Ireland produced no evidence of Campylobacter spp. contamination and when retail packs of beef (n = 50) and pork (n = 50) were sampled these were also apparently free of Campylobacter spp. However, 38% of retail packs of chicken pieces (n = 120), yielded Campylobacter spp. These packs were purchased over a period of 1 year and came from a single local producer. After the species of the isolates had been determined (Campylobacter jejuni and Camp. coli were found in approximately equal numbers) they were subtyped using both polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and the random amplified polymorphic DNA (RAPD) method of typing. All of the poultry isolates were successfully typed by these methods, in contrast to the results obtained with serotyping where several isolates were found to be untypable. PCR-RFLP typing showed that specific subtypes were isolated repeatedly over a period of 1 year in the output of the producer studied. The more discriminating RAPD confirmed this observation, but with fewer isolates. This appears to indicate recurrent infection of broilers whose source can now be investigated using the methodologies developed.