Oxidative stability of beef from steers finished exclusively with concentrate, supplemented, or on legume-grass pasture

The objective of this study was to evaluate the effects of three finishing systems based on concentrate and legume-grass pasture on beef. Steers were finished for 91 days with an exclusively whole corn grain-based (GRAIN) diet, grazed on legume-grass pasture plus 1.4% of body weight of whole corn grain supplementation (SUPP), or grazed on legume-grass pasture (PAST) only. Lipid and myoglobin oxidation, pH, objective color, and α-tocopherol concentrations were evaluated on M. longissimus thoracis steaks. Dietary treatments did not affect pH and minimally affected protein carbonylation. Steaks from steers fed GRAIN were less red, showed higher lipid oxidation during retail display, and higher metmyoglobin formation from day 7 to 13 when compared to PAST. Levels of α-tocopherol were higher in steaks from steers fed diets containing legume and grass. Inclusion of roughage in finishing diets is essential to maintain retail color and prevent lipid and myoglobin oxidation.

Effects of feeding legume-grass pasture and different concentrate levels on fatty acid profile, volatile compounds, and off-flavor of the M. longissimus thoracis

Pasture-finished beef is becoming more popular among consumers due to concerns related to fatty acid content and sustainable practices. The effects of finishing crossbred steers on legume-grass pasture comprised of oats, ryegrass, and clover (PAST), legume-grass pasture plus whole corn grain (WCG) supplementation (SUPP), and only with WCG (GRAIN) on fatty acids profile, volatile compounds, sensory, and texture attributes were studied. Pasture diets (PAST and SUPP) led to lower n-6/n-3 ratio (P < 0.001), and highest deposition of C18:2 cis-9 trans-11 (P < 0.001) in the lean. Beef from steers fed GRAIN had the highest values of volatile compounds associated with lipid oxidation. Off-flavor intensity was significantly greater on beef from steers fed GRAIN when compared to PAST. Overall, muscles from steers finished on PAST and SUPP showed similar attributes but differ when compared to GRAIN. The presence of forage is essential to improve fatty acid profile, decrease volatile compounds associated with lipid oxidation, and minimize off-flavor.

[Day Surgery. An opportunity for postgraduate surgeons' training]

BACKGROUND

It is widely acknowledged that day surgical procedures must be performed by expert personnel or carried out under their supervision. Recent regulations introduced by Schools of Postgraduate Surgery oblige postgraduate surgeons to carry out a number of minor and medium-sized operations. The characteristics of day surgery make it an appropriate organisational model for complying with the requirements of these directives. Interventional research has shown that adequate training permits education to be coupled with good results.

METHODS

The postgraduate surgeons are trained to perform hernioplasty using Trabucco's method through surgical training based on an initial phase of at least 20 operated patients during which they act as the second surgeon, and a phase of 10 patients during which they are the first surgeon working alongside a tutor with proven experience. Five doctors are completing their training, having acted as first surgeon assisted by a tutor during the period 01/11/1999 - 31/10/00 in 60 hernioplasty operations using Trabucco's method out of a total of 143 carried out in the same period, with an average of 12 operations each. Specific informed consent was obtained from all patients. All operations were performed under local anesthesia.

RESULTS

There was no need to convert to general anesthesia. Complications were comparable to those occurring during surgery performed by experienced colleagues. No recurrences were reported. The mean follow-up was 10 months.

CONCLUSIONS

An evaluation of these data confirms the real possibility of dedicating a number of ambulatory surgical procedures to training postgraduate surgeons. This would not lead to a reduced efficacy of treatment and does not increase the percentage of complications.

Surgical treatment for incisional hernias

BACKGROUND

A great variety of surgical techniques have been proposed to repair large abdominal incisional hernias, but the best results are achieved using synthetic grafts as in the Rives' or Ramirez' procedure.

METHODS

During the period September 1993-May 2001, a total of 145 patients, 54 males and 91 females, mean age 52 (range 16-88) with large incisional hernia were observed. Ninety-two hernias were bigger than 10 cm. The average follow-up was 3 years (1-72 months). All successfully underwent surgery using the following techniques: 19 (13.1%) simple fascial sutures, 68 (46.9%) implants of retromuscolar polypropylene grafts (Rives' or Ramirez' technique), 24 (16.5%) subcutaneous meshes, 17 (11.7%) preperitoneal meshes (14 polypropylene, 2 glycolic acid, 1 Goretex), 4 (2.75%) intraperitoneal implants of polypropylene meshes, 13 (9.05%) intraperitoneal glycolic acid grafts plus retromuscular polypropylene graft.

RESULTS

One patient died in postoperative for heart failure. Morbidity was 8 subcutaneous hemorrhagic suffusions, 10 seromas which were resolved by repeated percutaneous drainage, 4 suppurating wounds that did not require graft removal, 2 little recurrences treated by a new mesh repair under local anaesthesia, 2 sinus for mesh intollerance and 1 fistula requiring a new intervention.

CONCLUSIONS

In this report we discuss the tolerability and reliability of mesh repair, especially in Rives' and Ramirez' technique.

[A case of presacral myelolipoma]

Myelolipoma is a rare benign pathology whose pathogenesis is still unclear. It is most frequently localised in the adrenal gland, followed by the presacral region, mediastinum, and perirenal and hepatic region. It varies in size from a few millimetres to several centimetres. The lesion is usually capsulated, detachable from the surrounding tissues and hypovascularised. In histological terms, it is composed of lipomatous and hematopoietic tissues. A 65-year-old female patient was referred to our unit after the finding of a nonbiopsied, pelvic mass during earlier surgery. The patient was in considerable pain owing to the extrinsic compression of the mass on abdominal and pelvic organs. Preoperative tests confirmed the presence of a voluminous presacral neoformation that appeared to have a possible medullary origin (chordoma or schwannoma). During surgery, the lesion was found to be capsulated and mainly adherent to the rectum. Histological analysis confirmed the myelolipomatous nature of the lesion. A review of 21 cases reported in the literature is presented.

[Solitary fibrous tumor of the pleura. Clinical case]

Solitary fibrous tumors of the pleura represent a rare clinicopathological entity: 456 cases only have been reported since 1991. A interesting case of solitary fibrous tumor of the pleura is described here, because it turned up in a female patient followed up for a bilateral breast cancer and so with the exact determination of the period of beginning. The complex morphological picture is illustrated in relation to other cases reported in the literature. Immunohistochemical results are stressed, particularly as regards the coexpression of vimentin and desmin without necrosis and the low number of mitosis. As there are no criteria to determine the possible aggressive or malignant behaviour of the tumor, surgical resection of the lesion is indispensable both to resolve the diagnosis and to carry out the only proposable therapy.

One surgical experience in regime of day hospital: considerations on the first one-hundred patients treated

The development of surgery in regime of day hospital proceeds swiftly, especially in Anglo-saxon countries, so that at the beginning of the second millennium it can be foreseen that in USA alone, 75% of all surgery will be carried out in this manner. From March 1st to September 1st 1994, 100 patients were submitted to operations in ODS (One Day Surgery). We had 3 reconversions into ordinary hospitalization (3%), 2 for social-economic reasons and one for headache and vomiting due to intolerance to local anesthetics. As has been seen we have encountered no important complications, all patients were satisfied. From the analysis of our experience we have deducted useful indications that oblige us to partially modify our attitude: we want to transform our service into a free standing center where the patient can undergo preoperative exams, anesthesiologic examinations and surgery on the same day; we are just about to verify the possibility, thanks to an accurate anamnesis, to not request preoperative routine exams in patients with ASA 1 and 2 physical status; to look for a possible asymptomatic crural hernia in patients that undergo inguinal hernioplasty; we do not submit patients to ODS if they do not have assistance at home; or if they live too far from our service.

[Postoperative hyperamylasemia: the evaluation of the efficacy of ranitidine in prevention]

The paper examines the role of ranitidine in the prevention of postoperative hyperamylasemia, a complication following major biliary tract surgery, especially if associated with intraoperative cholangiography. Forty patients underwent cholecystectomy and intraoperative cholangiography: calculosis of the choledochus was observed in 11 patients and a revision of the VBP was therefore carried out involving the transcystic insertion of Kehr's tube. Patients were randomly subdivided into two groups: group A (treated with 50 mg ranitidine 4 times a day e.v.) and group B (no anti H2 treatment). No significant differences were noted between the two groups with regard to the onset of hyperamylasemia, although it is worth reporting that ranitidine virtually eliminated all hemorrhagic complications due to ulcer or postoperative gastritis.

[Solitary splenic abscess. Clinical picture, diagnosis and treatment]

Splenic abscess, especially the solitary type, is a rarely seen condition, although it has been seen more frequently in recent years. On the basis of a case of splenic abscess with unusual features, the literature on the subject, 171 cases published in Italy, Britain, France and Spain in the past 10 years, is reviewed. It is pointed out that the diagnosis is generally difficult only because abscess is not considered. The diagnostic methods with the best results are ultrasonography and CT scanning, although a checkup after the event showed that straightforward X-ray of the chest, if correctly interpreted, may be enough. Scintigraphy is not indicated and arteriography should only be used in the event of special problems. The clinical picture is scanty and insignificant. The various aetiological agents and changes in these over recent years are illustrated, with special attention with regard to immunodepressed patients. The usual treatment is surgical removal. Other methods with more limited indications, such as drainage and medical treatment, are described.