Background: Laparoscopic cholecystectomy is commonly performed, and several factors increase the

Cut-off values with highest sensitivity and specificity for the synovial fluid white cell and differential count will facilitate the accurate diagnosis of infection in total knee (TKR) and total hip replacement (THR). All patients undergoing revision TKR or THR for suspected prosthetic joint infection between 2009 and 2011 at two hospitals were identified. A total of 75 patients were included with a mean age of 70.3 years (38 to 89). Synovial fluid was aspirated pre-operatively and peri-prosthetic tissue samples were taken intra-operatively for histological and microbiological examination. Receiver operating characteristic (ROC) plots were constructed for white cell and differential counts in aspirated fluid. The optimal cut-off for TKR and THR was 1590 white cells/µl and 65% neutrophilia. The white cell count cut-off value identified for THR was notably lower than previously quoted in the literature. A cut-off value for white cell count in synovial aspirate in suspected prosthetic joint infection of between 1100 and 1700 white cells/µl is likely to be applicable to both THR and TKR.

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Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.

Alfalfa (Medicago sativa L.), a forage crop unique in that it has high potential in terms of both yield and quality, has considerable capacity for animal production when grazed under management that is based on its growth and development. Two grazing experiments, using balanced change‐over designs, were set up to measure the ingestive behavior of beef heifers (Bos taurus) during the first, second, and third hours of grazing sessions on alfalfa pastures established on Maury silt loam (fine, mixed, mesic Typic Paleudalfs). In Exp. I where the herbage mass, in terms of dry matter (DM), was 3.06 Mg ha−1 and the herbage DM allowance was 6.1 kg h−1 per heifer, animals ingested DM at 2.96, 1.88, and 1.56 kg h−1 during their first, second, and third hours of grazing, respectively. The mean rates of biting were 26, 21, and 19 bites min−1 for the same periods. Herbage DM intake per bite declined linearly from 1.96 to 1.54 to 1.36 g for each hour increment in grazing time. Forage utilization was 51, 32, and 27% for the same increments. In Exp. II where the herbage mass (DM) was 1.74 Mg ha−1 and the allowance was 3.4 kg h−1, heifers ingested 2.35, 1.47, and 1.20 kg h−1 during their first, second, and third hours of grazing, respectively. The mean rates of biting were 34, 22, and 18 bites min−1 during the same periods within the grazing session. Herbage DM intake per bite averaged 1.17 g and did not vary within the grazing session. Forage utilization was 75, 47, and 37% during the three consecutive hours within the grazing session. Maximum rates of herbage intake were characterized by larger bites and relatively slow rates of biting. Rates of herbage intake were considerably higher during the first hour of grazing than during the second and third hours. In a 3‐h grazing session, animals consumed 47, 29, and 24% of their intake during the first, second, and third hours, respectively.