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BACKGROUND Gastric decompression after pancreatic surgery has been a routine procedure for many years. However, this procedure has often been waived in non-pancreatic abdominal surgeries. The aim of this meta-analysis was to determine the necessity of routine gastric decompression (RGD) following pancreatic surgery. METHODS PubMed, the Cochrane Library, EMBASE, and Web of Science were systematically searched to identify relevant studies comparing outcomes of RGD and no gastric decompression (NGD) after pancreatic surgery. The overall complications, major complications, mortality, delayed gastric emptying (DGE); clinically relevant DGE (CR-DGE), postoperative pancreatic fistula (POPF), clinically relevant POPF (CR-POPF), secondary gastric decompression, and the length of hospital stay were evaluated. RESULTS A total of six comparative studies with a total of 940 patients were included. There were no differences between RGD and NGD groups in terms of the overall complications (OR = 1.73, 95% CI 0.60-5.00; p = 0.31), major complications (OR = 2.22, 95% CI 1.00-4.91; p = 0.05), incidence of secondary gastric decompression (OR = 1.19, 95% CI 0.60-2.02; p = 0.61), incidence of overall DGE (OR = 2.74; 95% CI 0.88-8.56; p = 0.08; I2 = 88%), incidence of CR-POPF (OR = 1.28, 95% CI 0.76-2.15; p = 0.36), and incidence of POPF (OR = 1.31, 95% CI 0.81-2.14; p = 0.27). However, RGD was associated with a higher incidence of CR-DGE (OR = 5.45; 95% CI 2.68-11.09; p  less then  0.001, I2 = 35%), a higher rate of mortality (OR = 1.53; 95% CI 1.05-2.24; p = 0.03; I2 = 83%), and a longer length of hospital stay (WMD = 5.43, 95% CI 0.30 to 10.56; p = 0.04; I2 = 93%). CONCLUSIONS Routine gastric decompression in patients after pancreatic surgery was not associated with a better recovery, and may be unnecessary after pancreatic surgery.INTRODUCTION The population rate of familial cluster headache (CH) has been reported to be as high as 20% however this varies considerably across studies. To obtain a true estimate of family history in CH, we conducted a systematic review and meta-analysis of previously published data. METHODS Our systematic review involved a search of electronic databases (Medline, EMBASE, PubMed, CINAHL) to identify and appraise studies of interest utilising the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. To further ameliorate the accuracy of our analysis we included an additional unpublished cohort of CH patients recruited at a tertiary referral centre for headache, who underwent detailed family history with diagnostic verification in relatives. Data was extracted and meta-analysis conducted to provide a true estimation of family history. RESULTS In total, we identified 7 studies which fulfilled our inclusion criteria. The estimated true prevalence of CH patients with a positive family history was 6.27% (95% CI4.65-8.40%) with an overall I2 of 73%. Fitted models for gender subgroups showed higher estimates 9.26% (95% CI 6.29-13.43%) in females. However the I2 for the female model was 58.42% and significant (p = 0.047). CONCLUSION Our findings estimate a rate of family history in CH to be approximately 6.27% (95% CI 4.65-8.40%). While estimates were larger for female probands, we demonstrated high heterogeneity in this subgroup. These findings further support a genetic role in the aetiology of CH.BACKGROUND Induction of general anesthesia increases the hemodilution resulting from infusion of crystalloid fluid, which is believed to be due to slower distribution caused by arterial hypotension. When normal distribution returns is not known. METHODS An intravenous infusion of 25 mL kg- 1 of Ringer's lactate was infused over 30 min to 25 volunteers just after induction of general anesthesia for open abdominal hysterectomy. A two-volume model was fitted to the repeated measurements of the blood hemoglobin concentration and the urinary excretion using mixed-effects modelling software. Individual-specific covariates were added in sequence. RESULTS Distribution of infused fluid was interrupted during the first 20 min of the infusions. During this time 16.6 mL kg- 1 of lactated Ringer's had been infused, of which virtually all remained in the circulating blood. Thereafter, the fluid kinetics was similar to that previously been found in awake volunteers except for the elimination rate constant (k10), which remained to be very low (0.86 × 10- 3 min- 1). Redistribution of infused fluid from the interstitium to the plasma occurred faster (higher k21) when the arterial pressure was low. No covariance was found between the fixed parameters and preoperatively concentrated urine, the use of sevoflurane or propofol to maintain the anesthesia, or the plasma concentrations of two degradation products of the endothelial glycocalyx, syndecan-1 and heparan sulfate. CONCLUSIONS Induction of general anesthesia interrupted the distribution of lactated Ringer's solution up to when 16.6 mL kg- 1 of crystalloid fluid had been infused. Plasma volume expansion during this period of time was pronounced. Sodium acrylate mw TRIAL REGISTRATION Controlled-trials.com (ISRCTN81005631) on May 17, 2016 (retrospectively registered).BACKGROUND Water availability and nutrient-status of soils play crucial roles in seedling establishment and plant survival in coal-spoiled areas worldwide. Restoration of spoils pertains to the application of proper doses of nutrients and water, and selection of particular plant species for efficient revegetation. This study aimed at examining the potential effects of different combinations of soil-water and fertilizers (nitrogen, N and phosphorus, P) on morpho-physiological and biochemical attributes of Amorpha fruticosa grown in coal-mined spoils. Three factors five-level central-composite-design with optimization technique response surface methodology (rsm) was used to optimize water irrigation and fertilizer application strategies. RESULTS Our results revealed a strong correlation between experimental data and predicted values developed from the rsm model. The best responses of A. fruticosa in terms of plant height, stem diameter, root length, and dry biomass were observed under a high-water regime. Low-water regime caused a notable reduction in growth-associated parameters, and fertilization with either N or P did not show positive effects on those parameters, indicating that soil-water was the most influential factor for growth performance.
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