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This article discusses a pulmonary artery pseudoaneurysm (PAP) formation following pulmonary artery catheter (PAC) placement for cardiac surgery. The patient, an 82-year-old female with a history of hypertension and chronic heart failure, underwent elective mitral and tricuspid valve surgery. After surgery, bleeding was observed in the endotracheal tube, indicating a potential complication. Fiberoptic bronchoscopy revealed bleeding mainly in the right bronchus. Subsequent computed tomography pulmonary angiogram (CTPA) confirmed the presence of a small pseudoaneurysm in a branch of the pulmonary artery. Prompt collaboration between anesthesiologists, cardiac surgeons, and interventional radiologists led to the successful embolization of the pseudoaneurysm with a minimally invasive approach by using the PAC as a guide catheter to reach the PAP. The article outlines the potential causes of PAP formation, clinical presentation, and management strategies. While conservative, surgical, and interventional approaches are discussed, the preferred treatment is coil embolization due to its effectiveness and minimal invasiveness. The authors emphasize the importance of rapid diagnosis, multidisciplinary collaboration, and the feasibility of using the pulmonary artery route for embolization to rapidly reach the lesion to stabilize. Overall, the case demonstrates the successful resolution of a life-threatening complication through timely intervention and coordinated teamwork. [ABSTRACT FROM AUTHOR]

perioperative hyperglycemia is common in patients undergoing cardiac surgery and it is associated with increased risks of mortality and morbidity1. The pathogenesis of perioperative dysglycemia is a complex interaction between underlying patient's condition (diabetes, metabolic syndrome) and surgical stress. This study evaluates an intraoperative glucose control protocol designed according to the European Association for Cardio-Thoracic Surgery (EACTS) guidelines2 to manage blood glucose levels during surgery. we developed an intraoperative blood glucose (BG) control protocol (figure 1) with a target of BG <180 mg/dL. Patients were divided into three risk categories: very high (HH) for type 1 diabetes, high (H) for insulin-dependent or non-insulin- dependent diabetes, metabolic syndrome, or chronic steroid therapy, and low (L) for patients without these conditions. BG was measured first after general anesthesia induction, subsequently every 30-40 minutes, the last measurement was at ICU admission. Insulin therapy was started at BG>180 mg/dL for H and L groups, and BG>110 mg/dL for HH group. Patients with urgent or emergent surgeries were treated as H group regardless their comorbidities. 1-year retrospective analysis (March, 2023 – March, 2024). Data were analyzed by Sigmastat 11 (SPSS inc. Chicago, IL) and presented as mean ± SD or median [interquartile range], t-test was used for comparisons. 495 patients were treated with this protocol. Data from 442 patients (HH=1; H=266; L=175) were analyzed, while 53 patients (10%) were excluded due to incorrect protocol application. Overall 180 (41%) patients underwent glycemic control protocol as described above (HH n=1, 100%, H n=125, 46% and L n=54, 31%).344 patients underwent elective surgery and 35% of these (n=120; group L n= 53, 44%; group H n= 67, 56%) needed insulin protocol. Urgent surgeries showed a higher prevalence of hyperglycemia, affecting 60 of 97 patients (62%). Figure 2 describes intraoperative BG (off-pump surgery n=16, 3%; on-pump surgery n=426, 96% with CPB time = 107 [88-128] minutes). At the end of surgery, BG was on average under 180 mg/dl in all groups and urgent surgery. In the elective group BG at ICU admission was 145±40 mg/dL in patients with intraoperative insulin protocol, versus 136±25 mg/dL in patients who did not require insulin (p=0.010). A higher difference (<0.01) was observed in BG at ICU admission between patients that required insulin protocol and who did not (165±59 versus 129±24 mg/dL). Mild hypoglycemia was observed in 3 cases, all during elective surgery. Two patients in group H (BG 69 and 66 mg/dL) and one patient in group L (BG 57 mg/dL), treated without any complication. The protocol showed to be effective in managing intraoperative hyperglycemia, as reflected by a good glycemic control at ICU admission. The stratification of patients by risk allowed a more tailored approach which optimal BG control and minimal hypoglycemia risk. Furthermore, urgent surgery remains a significant trigger for hyperglycemia, resulting in more patients requiring the protocol application with less efficacy than the elective group. [ABSTRACT FROM AUTHOR]

Ustekinumab (UST) and vedolizumab (VDZ) are biologic therapies for moderate-to-severe Crohn's disease (CD) in patients who failed or had contraindication to anti-TNF treatment. To evaluate ustekinumab efficacy as third-line treatment after swapping from VDZ for failure. We conducted a monocentric, retrospective, observational study where CD patients were followed for 12 months from the beginning of UST therapy. We assessed clinical activity (HBI) and laboratory markers (CRP) at the initiation of UST therapy (T0) and after 2(T2), 6(T6) and 12(T12) months. Endoscopic activity was recorded at T0 and T12. We registered data regarding their clinical history and previous biologic treatments. Steroid-free clinical remission was defined as HBI ≤ 4 without need for steroids. Clinical response was defined as HBI reduction of at least three points or the suspension of steroids. 27 CD patients treated with UST after VDZ failure had a minimum follow up of 12 months and were included. All patients had previously been treated with anti-TNF agents. After 12 months, steroid-free clinical remission was evident in 15 (55.5%) patients, 5 (18.5%) had clinical response, while 7 (26%) had suspended for failure or persisted on treatment after optimization. Ustekinumab should be considered as third-line biologic treatment in multi-refractory CD patients. [ABSTRACT FROM AUTHOR]

Crohn's disease represents a heterogeneous entity, but its location tends to be relatively stable overtime. For extensive refractory Crohn's colitis, ileorectal anastomosis after colectomy is an engaging option, since the necessity of a permanent ileostomy is avoided. In our study, the long-term outcome of two groups of patients with Crohn's colitis who underwent colectomy and ileorectal anastomosis was compared. The first group had isolated colonic Crohn's disease without rectal involvement and perianal disease, while the second group included patients who had rectal and/or ileal involvement, with or without perianal disease. Between 1996 and 2016, in a single IBD tertiary center, 80 patients with a history of colectomy and ileorectal anastomosis for refractory Crohn's colitis were retrospectively identified. Recurrence of disease was diagnosed in 57/64 of patients with Crohn's colitis with rectal and/or ileal and/or perianal involvement compared with 1/16 of patients with isolated Crohn's colitis without rectal and perianal disease in a median time of recurrence of 2 years (IQR 1–6 years, minimum to maximum, 1–18 years, p < 0.001). Only 6 patients (7,5%) underwent definitive end ileostomy without proctectomy (1 in the noIRP group and 5 in the IRP group). Our data suggest that colectomy with ileorectal anastomosis may represent a curative option in patients with refractory isolated colitis without rectal and perianal involvement. [ABSTRACT FROM AUTHOR]

Italy has been one of the most affected countries in the world by COVID-19. There has been increasing concern regarding the impact of COVID‐19 on patients with inflammatory bowel disease (IBD), particularly in patients treated with immunosuppressants or biologics. The aim of our study is to understand the incidence of COVID-19 in a large cohort of patients with IBD. Furthermore, we analyzed possible risk factors for infection and severity of COVID-19. This was an observational study evaluating the impact of COVID-19 on IBD patients in a single tertiary center. A 23 multiple-choice-question anonymous survey was administered to 1200 patients with IBD between March 10th and June 10th 2020. 1158 questionnaires were analyzed. The majority of patients had Crohn's disease (CD) (60%) and most of them were in clinical remission. Among the 26 patients (2.2%) who tested positive for COVID-19, only 5 (3CD) were on biological treatment and none required hospitalization. Two patients died and were on treatment with mesalazine only. Of the 1158 patients, 521 were on biological therapy, which was discontinued in 85 (16.3%) and delayed in 195 patients (37.4%). A worsening of IBD symptoms was observed in 200 patients on biological therapy (38.4%). Most of these patients, 189 (94.5%), had stopped or delayed biological treatment, while 11 (5.5%) had continued their therapy regularly (p <0.001). Our data are in line with the current literature and confirm a higher incidence compared to the general population. Biological therapy for IBD seems to not be a risk factor for infection and should not be discontinued in order to avoid IBD relapse. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of clinical and ultrasonographic musculoskeletal involvement in Italian patients with inflammatory bowel disease (IBD). In this cross-sectional multicenter study, 148 consecutive patients with IBD were evaluated by a gastroenterologist and a rheumatologist. All patients underwent a B-mode and power Doppler ultrasonographic examination of 6 pairs of entheses and of knee and ankle joints. A positive history for at least one musculoskeletal manifestation was reported by 40.5% of patients, more frequently in ulcerative colitis (UC) (p = 0.033). Inflammatory back pain was reported by 13.5% of patients, and a past history of peripheral arthritis by 14.9%, entheseal inflammation by 14.2% and dactylitis by 2.7%. At clinical examination, arthritis was observed in 19.6% of patients and enthesitis in 33%. Oligoarthritis and enthesitis at clinical examination were more frequently observed in UC than in Crohn disease (CD). 37.8% of total IBD patients fulfilled ASAS classification criteria for axial and/or peripheral spondyloarthritis, 8.1% ASAS classification criteria for axial spondyloarthritis, and 29.7% ASAS classification criteria for peripheral spondyloarthritis. With ultrasonographic examination, signs of entheseal involvement were observed in 87.8% of patients, while at power Doppler, ≥1 abnormality was observed in 27.1%. ASAS+ patients compared to those ASAS- had a significantly higher frequency at ultrasonography of acute entheseal abnormalities, power Doppler entheseal positivity and joint involvement. These abnormalities at ultrasonography were also observed in 34%, 13% and 12% of ASAS- patients. Musculoskeletal manifestations occur frequently in patients with IBD. Ultrasonographic entheseal and joint involvement were also observed in asymptomatic patients. [ABSTRACT FROM AUTHOR]

Uncontrolled Donation after Cardiac Death (uDCD) is a donation path following cardiac arrest (CA) without further indications for resuscitation efforts. This represents a unique opportunity for organ procurement since incidence of brain death is decreasing. Despite its potential, this procedure is limited nowadays due to its logistic and relational complexity and the concern regarding organs' function after long warm ischemia time (WIT)., We developed a local decision protocol to assign patients with CA to three possible different pathways:1) Extracorporeal Cardio-Pulmonary Resuscitation (E-CPR), 2) normothermic regional perfusion (NRP), 3) standard Advanced Life Support (ALS) (Figure 1). Here we present the first two cases of uDCD happened in Legnano, Milan, Italy in January 2023, after the protocol introduction. Two patients, aged 66 and 61, reported witnessed out-of-hospital cardiac arrests (OHCA) but no bystander Cardio-Pulmonary Resuscitation (CPR) was performed. The Emergency Medical System (EMS) started ALS procedures with mechanical CPR (mech-CPR) during transport to the hospital; according to the protocol both patients were deemed ineligible for E-CPR due to the long no flow time. When resuscitation efforts were no longer indicated, clinical conditions, prognosis and all the care performed were reported to the closest relatives. The Italian Transplant Information System (SIT) for Living Will was consulted but no records were found. After that, they were informed about the possibility of organ donation through uDCD protocol and they declared no opposition. Before interruption of mech-CPR small sheath introducers were placed in femoral vessels and full dose heparin was given. According to the Italian law 20 minutes of isoelectric EKG was recorded. After cardiac death declaration, cannulation procedure was performed. Aortic occlusion balloon was inflated to exclude upper circulation and NRP started to recondition abdominal organs. The process of organ retrieval began after 6 and 6.5 hours of NRP, respectively. Figure 2 presents the timeline of the two cases: patients' WIT were 147 and 164 minutes. Overcoming the WIT limits illustrated in the protocol, in these two uDCD cases, the livers were successfully transplanted in both cases, while kidneys in one of them. Despite the difficulties, this simple protocol permits managing and triaging patients undergoing refractory CA in three different pathways (ECPR, uDCD, ALS), depending on CA timing and patient features. Long WIT, known difficulty in uDCD, did not prevent the successful transplanted organs outcome. These results suggest the need for further research about organ WIT, in order to potentially increase organs availability through DCD path. [ABSTRACT FROM AUTHOR]

The use of «creativity», «creative industries», or «creative cities» as leitmotifs within the literature on urban development is not new and it finds its antecedents in other more classical approaches such as the role of «bohemians», «cultural industries» and «culture-led urban regeneration». Creativity has led to different paradigm shifts in productive relations and in the generation of innovation over the course o f history (Jason 2011). The context of prosperity and growth that took a turn for the worse in 2008 had unequivocal consequences also for the creative sectors. Several authors that have geared their research towards this field (Banks and Deuze 2009; Gill and Pratt 2008 among others), debunked the concepts o f creativity and creative class, as defined by Florida and provided empirical evidence that address the emergence of new forms of relationships between workers in creative sectors which have lot in common with the collaborative economy paradigm. This article addresses collaborative economy as a new way of conceptualizing collaboration and competition within creating industries. Departing from an analysis of the most recent literature on the topic (Botsman - Rogers 2010; Arvidsson - Peitersen 2013; Kostakis - Bauwens 2014; Benkler 2004), the overall objective o f this article is to apply an understanding of how collaborative economy is redefining creative sectors. [ABSTRACT FROM AUTHOR]

Ecotoxicology provides data to inform environmental management. Many testing protocols do not consider offspring fitness and toxicant sensitivity. Cadmium (Cd) is a well-studied and ubiquitous toxicant but little is known about the effects on offspring of exposed parents (transgenerational effects). This study had three objectives: to identify endpoints related to offspring performance; to determine whether parental effects would manifest as a change in Cd tolerance in offspring and how parental exposure duration influenced the manifestation of parental effects. Adult snails were exposed to Cd 0, 25, 50, 100, 200 and 400 μg Cd/L for eight weeks. There were effects on adult endpoints (e.g., growth, reproduction) but only at the highest concentrations (>100 μg/L). Alternatively, we observed significant transgenerational effects at all Cd concentrations. Surprisingly, we found increased Cd tolerance in hatchlings from all parental Cd exposure concentrations even though eggs and hatchlings were in Cd-free conditions for 6 weeks. Explicit consideration of offspring performance adds value to current toxicity testing protocols. Parental exposure duration has important implications for offspring effects and that contaminant concentrations that are not directly toxic to parents can cause transgenerational changes in resistance that have significant implications for toxicity testing and adaptive responses. [ABSTRACT FROM AUTHOR]

Chemical contamination is often suggested as an important contributing factor to amphibian population declines, but direct links are rarely reported. Population modeling provides a quantitative method to integrate toxicity data with demographic data to understand the long-term effects of contaminants on population persistence. In this study we use laboratory-derived embryo and larval toxicity data for two anuran species to investigate the potential for toxicity to contribute to population declines. We use the southern toad ( Anaxyrus terrestris) and the southern leopard frog ( Lithobates sphenocephalus) as model species to investigate copper (Cu) toxicity. We use matrix models to project populations through time and quantify extinction risk (the probability of quasi-extinction in 35 yr). Life-history parameters for toads and frogs were obtained from previously published literature or unpublished data from a long-term (>35 yr) data set. In addition to Cu toxicity, we investigate the role of climate change on amphibian populations by including the probability of early pond drying that results in catastrophic reproductive failure ( CRF, i.e., complete mortality of all larval individuals). Our models indicate that CRF is an important parameter for both species as both were unable to persist when CRF probability was >50% for toads or 40% for frogs. Copper toxicity alone did not result in significant effects on extinction risk unless toxicity was very high (>50% reduction in survival parameters). For toads, Cu toxicity and high probability of CRF both resulted in high extinction risk but no synergistic (or greater than additive) effects between the two stressors occurred. For leopard frogs, in the absence of CRF survival was high even under Cu toxicity, but with CRF Cu toxicity increased extinction risk. Our analyses highlight the importance of considering multiple stressors as well as species differences in response to those stressors. Our models were consistently most sensitive to juvenile and adult survival, further suggesting the importance of terrestrial stages to population persistence. Future models will incorporate multiple wetlands with different combinations of stressors to understand if our results for a single wetland result in a population sink within the landscape. [ABSTRACT FROM AUTHOR]

Organismal energetics provide important insights into the effects of environmental toxicants. We aimed to determine the effects of pyraclostrobin on Lymnaea stagnalis by examining energy allocation patterns and life history traits. Juvenile snails exposed to pyraclostrobin decreased feeding rate and increased apparent avoidance behaviors at environmentally relevant concentrations. In adults, we found that sublethal concentrations of pyraclostrobin did not affect reproductive output, however, there were significant effects on developmental endpoints with longer time to hatch and decreased hatching success in pyraclostrobin-exposed egg masses. Further, there were apparent differences in developmental effects depending on whether mothers were also exposed to pyraclostrobin suggesting this chemical can exert intergenerational effects. Pyraclostrobin also affected protein and carbohydrate content of eggs in mothers that were exposed to pyraclostrobin. Significant effects on macronutrient content of eggs occurred at lower concentrations than effects on gross endpoints such as hatching success and time to hatch suggesting potential value for these endpoints as early indicators of ecologically relevant stress. These results provide important insight into the effects of a common fungicide on important endpoints for organismal energetics and life history. [ABSTRACT FROM AUTHOR]

Generally, ecotoxicologists rely on short-term tests that assume populations to be static. Conversely, natural populations may be exposed to the same stressors for many generations, which can alter tolerance to the same (or other) stressors. The objective of this study was to improve our understanding of how multigenerational stressors alter life history traits and stressor tolerance. After continuously exposing Daphnia magna to cadmium for 120 days, we assessed life history traits and conducted a challenge at higher temperature and cadmium concentrations. Predictably, individuals exposed to cadmium showed an overall decrease in reproductive output compared to controls. Interestingly, control D. magna were the most cadmium tolerant to novel cadmium, followed by those exposed to high cadmium. Our data suggest that long-term exposure to cadmium alter tolerance traits in a non-monotonic way. Because we observed effects after one-generation removal from cadmium, transgenerational effects may be possible as a result of multigenerational exposure. [ABSTRACT FROM AUTHOR]

Carbon nanotubes are attractive candidates for the development of scaffolds able to support neuronal growth and differentiation thanks to their ability to conduct electrical stimuli, to interface with cells and to mimic the neural environment. We developed a biocompatible composite scaffold, consisting of multi-walled carbon nanotubes dispersed in a poly- l -lactic acid matrix able to support growth and differentiation of human neuronal cells. Moreover, to mimic guidance cues from the neural environment, we also designed synthetic peptides, derived from L1 and LINGO1 proteins. Such peptides could positively modulate neuronal differentiation, which is synergistically improved by the combination of the nanocomposite scaffold and the peptides, thus suggesting a prototype for the development of implants for long-term neuronal growth and differentiation. From the Clinical Editor The study describes the design and preparation of nanocomposite scaffolds with multi-walled carbon nanotubes in a poly-L-lactic acid matrix. This compound used in combination with peptides leads to synergistic effects in supporting neuronal cell growth and differentiation. [ABSTRACT FROM AUTHOR]

Background & aims The optimal level and modality of glucose control in critically ill patients is still debated. A protocolized approach and the use of nearly-continuous technologies are recommended to manage hyperglycemia, hypoglycemia and glycemic variability. We recently proposed a pato-physiology-based glucose control protocol which takes into account patient glucose/carbohydrate intake and insulin resistance. Aim of the present investigation was to assess the performance of our protocol with an automated intermittent plasma glucose monitoring device (OptiScanner™ 5000). Methods OptiScanner™ was used in 6 septic patients, providing glucose measurement every 15′ from a side-port of an indwelling central venous catheter. Target level of glucose was 80-150 mg/dL. Insulin infusion and kcal with nutritional support were also recorded. Results 6 septic patients were studied for 319 h (1277 measurements); 58 [45-65] hours for each patient (measurements/patient: 231 [172-265]). Blood glucose was at target for 93 [90-98]% of study time. Mean plasma glucose was 126 ± 11 mg/dL. Only 3 hypoglycemic episodes (78, 78, 69 mg/dL) were recorded. Glucose variability was limited: plasma glucose coefficient of variation was 11.7 ± 4.0% and plasma glucose standard deviation was 14.3 ± 5.5 mg/dL. Conclusions The local glucose control protocol achieved satisfactory glucose control in septic patients along with a high degree of safeness. Automated intermittent plasma glucose monitoring seemed useful to assess the performance of the protocol. [ABSTRACT FROM AUTHOR]

Latent effects result from embryonic experiences but manifest in later stages of ontogeny. Our objective was to better understand how developmental exposure to contaminants influence life history traits and tolerance to novel stress in the freshwater gastropod, Physa pomilia. Ten egg masses were exposed to each of three initial treatments including control, 2.5 μg/L cadmium (Cd), and 10 μg/L Cd; there was no effect of this initial treatment on hatching success. At hatching, snails were transferred to cadmium-free water. Three weeks later, snails were divided among four secondary treatments including control, 50 μg/L Cd, 150 μg/L Cd, and 35 °C. Developmental Cd exposure plus secondary temperature stress caused the most adverse effects. Surprisingly, developmental Cd exposure alone was enough to cause significant decreases in reproductive success a generation later. That effects can manifest as transgenerational decrements in reproductive success suggests that latent effects are important and have longer lasting consequences than previously considered. [Copyright &y& Elsevier]

A significant challenge in ecotoxicology and risk assessment lies in placing observed contaminant effects in a meaningful ecological context. Polychlorinated biphenyls (PCBs) have been shown to affect juvenile snapping turtle survival and growth but the ecological significance of these effects is difficult to discern without a formal, population-level assessment. We used a demographic matrix model to explore the potential population-level effects of PCBs on turtles. Our model showed that effects of PCBs on juvenile survival, growth and size at hatching could translate to negative effects at the population level despite the fact that these life cycle components do not typically contribute strongly to population level processes. This research points to the utility of using integrative demographic modeling approaches to better understand contaminant effects in wildlife. The results indicate that population-level effects are only evident after several years, suggesting that for long-lived species, detecting adverse contaminant effects could prove challenging. [Copyright &y& Elsevier]

Invasive species are costly and difficult to control. In order to gain a mechanistic understanding of potential control measures, individual-based models uniquely parameterized to reflect the salient life-history characteristics of invasive species are useful. Using invasive Australian Rhinella marina as a case study, we constructed a cohort- and individual-based population simulation that incorporates growth and body size of terrestrial stages. We used this allometric approach to examine the efficacy of nontraditional control methods (i.e., tadpole alarm chemicals and native meat ants) that may have indirect effects on population dynamics mediated by effects on body size. We compared population estimates resulting from these control methods with traditional hand removal. We also conducted a sensitivity analysis to investigate the effect that model parameters, specifically those associated with growth and body size, had on adult population estimates. Incremental increases in hand removal of adults and juveniles caused nonlinear decreases in adult population estimates, suggesting less return with increased investment in hand-removal efforts. Applying tadpole alarm chemicals or meat ants decreased adult population estimates on the same level as removing 15-25% of adults and juveniles by hand. The combined application of tadpole alarm chemicals and meat ants resulted in ~80% decrease in adult abundance, the largest of any applied control method. In further support of the nontraditional control methods, which greatly affected the metamorph stage, our model was most sensitive to changes in metamorph survival, juvenile survival, metamorph growth rate, and adult survival. Our results highlight the use and insights that can be gained from individual-based models that incorporate growth and body size and the potential success that nontraditional control methods could have in controlling established, invasive Rhinella marina populations. [ABSTRACT FROM AUTHOR]

Abstract: Parental effects manifest as alterations in offspring phenotype resulting from the parental phenotype and/or parental environment. We evaluated the effects of parental diet quality and mating strategy on the toxicant tolerance of offspring in Biomphalaria glabrata snails. We raised snails either individually (self-fertilizing) or in groups of three (outcrossing) on a diet of uncooked lettuce, fish food, cooked lettuce, or cooked lettuce plus fish food. We then exposed their offspring to cadmium and malathion challenges. Cadmium tolerance varied with parental diet and was greater in the offspring of outcrossing snails than self-fertilizing snails. Malathion tolerance was not affected by parental diet but was greater in the offspring of outcrossing snails. These results indicate that offspring responses to stressors are heavily influenced by parental experience, but may depend on the specific stressor and the mechanism of action and/or detoxification. [Copyright &y& Elsevier]

Population models can be used to place observed toxic effects into an assessment of the impacts on population-level endpoints, which are generally considered to provide greater ecological insight and relevance. We used an individual-based model of mink to evaluate the population-level effects of exposure to polychlorinated biphenyls (PCBs) and the impact that different remediation strategies had on mink population endpoints (population size and extinction risk). Our simulations indicated that the initial population size had a strong impact on mink population dynamics. In addition, mink populations were extremely responsive to clean-up scenarios that were initiated soon after the contamination event. In fact, the rate of PCB clean-up did not have as strong a positive effect on mink as did the initiation of clean-up (start time). We show that population-level approaches can be used to understand adverse effects of contamination and to also explore the potential benefits of various remediation strategies. [Copyright &y& Elsevier]

A large data gap for reptile ecotoxicology still persists; therefore, ecological risk assessments of reptiles usually incorporate the use of surrogate species. This necessitates that (1) the surrogate is at least as sensitive as the target taxon and/or (2) exposures to the surrogate are greater than that of the target taxon. We evaluated these assumptions for the use of birds as surrogates for reptiles. Based on a survey of the literature, birds were more sensitive than reptiles in less than 1/4 of the chemicals investigated. Dietary and dermal exposure modeling indicated that exposure to reptiles was relatively high, particularly when the dermal route was considered. We conclude that caution is warranted in the use of avian receptors as surrogates for reptiles in ecological risk assessment and emphasize the need to better understand the magnitude and mechanism of contaminant exposure in reptiles to improve exposure and risk estimation. [Copyright &y& Elsevier]

Laparoscopy is widely used in the surgical treatment of a number of diseases. Its advantages are generally believed to lie on its minimal invasiveness, better cosmetic outcome and shorter length of hospital stay based on surgical expertise and state-of-the-art equipment. Thousands of laparoscopic surgical procedures performed safely prove that mechanical ventilation during anaesthesia for laparoscopy is well tolerated by a vast majority of patients. However, the effects of pneumoperitoneum are particularly relevant to patients with underlying lung disease as well as to the increasing number of patients with higher-than-normal body mass index. Moreover, many surgical procedures are significantly longer in duration when performed with laparoscopic techniques. Taken together, these factors impose special care for the management of mechanical ventilation during laparoscopic surgery. The purpose of the review is to summarise the consequences of pneumoperitoneum on the standard monitoring of mechanical ventilation during anaesthesia and to discuss the rationale of using a protective ventilation strategy during laparoscopic surgery. The consequences of chest wall derangement occurring during pneumoperitoneum on airway pressure and central venous pressure, together with the role of end-tidal-CO2 monitoring are emphasised. Ventilatory and non-ventilatory strategies to protect the lung are discussed. [Copyright &y& Elsevier]

Although anthropogenic pollutants are thought to threaten reptilian species, there are few toxicity studies on reptiles. We evaluated the toxicity of Pb as lead acetate to the Western fence lizard (Sceloporus occidentalis). The acute lethal dose and sub-acute (14-day) toxicity studies were used to narrow exposure concentrations for a sub-chronic (60-day) study. In the sub-chronic study, adult and juvenile male lizards were dosed via gavage with 0, 1, 10 and 20 mg Pb/kg-bw/day. Mortality was limited and occurred only at the highest dose (20 mg Pb/kg-bw/d). There were statistically significant sub-lethal effects of 10 and 20 mg Pb/kg-bw/d on body weight, cricket consumption, organ weight, hematological parameters and post-dose behaviors. Of these, Pb-induced changes in body weight are most useful for ecological risk assessment because it is linked to fitness in wild lizard populations. The Western fence lizard is a useful model for reptilian toxicity studies. [Copyright &y& Elsevier]