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We tested the application of the concept of hemeroby and generalism at community level, on a set of birds occurring in various habitats of central Italy characterized by different level of disturbance. In each habitat-related bird community, we applied the recently published species-specific score in hemeroby (a proxy of habitat-related disturbance; HSi) and hemerobiotic diversity (a proxy of generalism; H’Hi) to local species frequency, obtaining weighted values at community level (HStotand H’Htot). The relationship between HStotvs. H’Htotshowed an increasing trend moving from reed beds through forests and mosaics to urban communities. Quadratic model (best fit) evidenced a significant correlation between these variables and a tendency toward a hump-shaped curve, corroborating results already observed at species level (intermediate generalism hypothesis). The co-inertia analysis discriminated four groups of habitat-related communities, characterized by species with different levels of disturbance-sensitivity (expressed by HSi) and generalism (expressed by hemerobiotic diversity; H’Hi): (i) forest type-related, where mature wood communities were separated from a coppiced wood one; (ii) communities of moderately disturbed agricultural habitats; (iii) communities embedded in highly disturbed mosaics, and (iv) a group including either a highly disturbed urban habitat or a low disturbed wetland reed bed, with highly specialized species (respectively, synanthropic species and water-related species). Total scores in hemeroby and hemerobiotic diversity, expressing the composition in species with different disturbance preference and generalism, might act as good community-based indicators of degree of naturalness, especially for forest habitat types.

We tested the application of the concept of hemeroby and generalism at community level, on a set of birds occurring in various habitats of central Italy characterized by different level of disturbance. In each habitat-related bird community, we applied the recently published species-specific score in hemeroby (a proxy of habitat-related disturbance; HSi) and hemerobiotic diversity (a proxy of generalism; H’Hi) to local species frequency, obtaining weighted values at community level (HStotand H’Htot). The relationship between HStotvs. H’Htotshowed an increasing trend moving from reed beds through forests and mosaics to urban communities. Quadratic model (best fit) evidenced a significant correlation between these variables and a tendency toward a hump-shaped curve, corroborating results already observed at species level (intermediate generalism hypothesis). The co-inertia analysis discriminated four groups of habitat-related communities, characterized by species with different levels of disturbance-sensitivity (expressed by HSi) and generalism (expressed by hemerobiotic diversity; H’Hi): (i) forest type-related, where mature wood communities were separated from a coppiced wood one; (ii) communities of moderately disturbed agricultural habitats; (iii) communities embedded in highly disturbed mosaics, and (iv) a group including either a highly disturbed urban habitat or a low disturbed wetland reed bed, with highly specialized species (respectively, synanthropic species and water-related species). Total scores in hemeroby and hemerobiotic diversity, expressing the composition in species with different disturbance preference and generalism, might act as good community-based indicators of degree of naturalness, especially for forest habitat types.Supporting InformationSupporting Information

Le suicide est un problématique de santé publique majeure. Depuis mars 2017 les soignants en France doivent déclarer tout évènement indésirable grave associé aux soins (EIGS). Plus de 20 % de ces évènements déclarés concerne des tentatives de suicide (TS). Ces tentatives de suicide sont majoritairement déclarées en établissements de santé et leurs caractéristiques n'ont jamais été décrites. Leur analyse est pourtant primordiale pour mieux les prévenir.

FSH receptor (FSHR) expression is restricted to gonads, where it drives FSH-dependent cell differentiation; in addition, FSHR plays an important role in the regulation of ovarian angiogenesis. Recently, FHSR expression has been shown in blood vessels of various tumors. However, pancreatic neuroendocrine tumors (p-NET), which have high-degree blood supply, were not included in that study. The aim of this study was to evaluate FSHR expression in p-NET. FSHR expression was evaluated in tumor samples from 30 patients with p-NET by immunohistochemistry and Western blot; fluorescence microscopy was used to localize FSHR in specific cells from tissue samples. von Willebrand factor (vWF) and chromograninA (chrA) was used as blood vessel and NET cells marker, respectively, to co-localize FSHR. FSHR expression was detected in all p-NET by immunohistochemistry. Western blot confirmed FSHR expression on p-NET although different FSHR isoforms, ranging from 240 kD to 55 kD were found in the samples studied. Surprisingly, FSHR co-localized with chrA but not with vWF, suggesting that neoplastic cells of neuroendocrine origin rather than blood vessels expressed FSHR. No relationship was found between degree of FSHR expression and histology of p-NET. FSHR may be aberrantly expressed in neoplastic cells from p-NET and not in tumor blood vessels; however, its biological significance as well as its clinical relevance remains to be elucidated.

The management of craniocerebral penetrating injury currently represents a challenge for neurosurgeons and neuroradiologists and requires innovative planning. This report describes the case of a worker admitted to hospital with an intracranial piece of concrete-cutting saw stuck through the right eye. At the time of admission the patient was conscious and this fact influenced the choice of a particular approach. This patient escaped without neurological deficit or complications, except for the inevitable removal of an eye.

Ketamine acts mainly as a N-methyl-D-aspartate receptor (NMDAr) antagonist. Originally developed as a general anesthetic, it is now seldom employed as such in richer countries due to the relatively high risk of psychotomimetic adverse effects. Recently, low – dose regimens in the range of 0.25 – 0.5 mg/kg as an initial bolus followed by 50 – 500 μg/kg/h have been proposed as an adjuvant for postoperative analgesia and for the reduction of exogenous opioid – induced hyperalgesia. In this review, we examine the evidence for clinical usefulness of perioperative ketamine infusion and its role in the context of general and/or regional anesthesia.

Ketamine acts mainly as a N-methyl-D-aspartate receptor (NMDAr) antagonist. Originally developed as a general anesthetic, it is now seldom employed as such in richer countries due to the relatively high risk of psychotomimetic adverse effects. Recently, low-dose regimens in the range of 0.25-0.5 mg/kg as an initial bolus followed by 50-500 g/kg/h have been proposed as an adjuvant for postoperative analgesia and for the reduction of exogenous opioid-induced hyperalgesia. In this review, we examine the evidence for clinical usefulness of perioperative ketamine infusion and its role in the context of general and/or regional anesthesia.

Hepatitis C virus is an important cause of acute and chronic hepatitis and it is an agent parenterally transmitted. Workers handling biological materials may be exposed to high concentration of virus-infected fluids. The seroprevalence of hepatitis C virus antibodies was investigated in a population of 809 subjects exposed to varying levels of biological risk owing to the handling of human fluids or tissues and in 408 controls. The exposed group was subdivided in three subgroups according to low and occasional (262), intermediate but continuous (311), and high (236) exposure to biological materials. The seroprevalence of hepatitis C antibodies was low (1.40%) in all subjects. The risk groups showed no significant differences with respect to the control group; the most exposed group showed a seroprevalence of 1.27%. Age but not sex appeared significantly correlated with seroprevalence of positive antibodies (χ² = 5.949, P < 0.025). Aspartate aminotransferase and alanine aminotransferase showed a highly significant increase (P < 0.01 and P < 0.001, respectively) in subjects with positive hepatitis C antibodies, other than a high significant prevalence of values above the normal limit (χ² = 26.613, P < 0.001 and χ² = 39.164, P < 0.001, respectively). Among 17 positive hepatitis C virus subjects, 8 (47.1%) were positive for hepatitis B virus, but not for its antigen. Hepatitis C virus infection appears to be a low risk for people employed in the biomedical field, yet infection is associated with a significant liver involvement. Am. J. Ind. Med. 35:532–535, 1999. © 1999 Wiley-Liss, Inc.

Abstract: Selective block of the femoral and sciatic nerves was performed on 601 patients undergoing knee arthroscopy. The results were good in 87%, adequate in 12%, and poor in 1%. The whole knee surface was covered by the nerve blockade. The duration of anesthesia was 152 21 min and that of analgesia, was 336 18 min. No correlation was observed between the effectiveness of the anesthesia and type of surgery performed. The technique described thus proved adequate for knee arthroscopic surgery, reproducibility was excellent, costs and hospital stays were reduced with respect to general anesthesia, and surgeon and patient satisfaction was high.

We have compared interscalene brachial plexus block performed with ropivacaine or mepivacaine in 60 healthy patients undergoing elective shoulder surgery. Patients were allocated randomly to receive interscalene brachial plexus anaesthesia with 20 ml of 0.5% ropivacaine (n = 15), 0.75% ropivacaine (n = 15), 1% ropivacaine (n = 15) or 2% mepivacaine (n = 15). Readiness for surgery (loss of pinprick sensation from C4 to C7 and inability to elevate the limb from the bed) was achieved sooner with 1% ropivacaine (mean 10 (SD 5) min) than with 0.5% ropivacaine (22 (7) min) (P < 0.001) or 2% mepivacaine (18 (9) min) (P < 0.02). Postoperative analgesia was similar with the three ropivacaine concentrations (11.5 (5) h, 10.7 (2) h and 10 (2.4) h with 0.5%, 0.75% and 1% concentrations, respectively) and nearly two-fold longer compared with 2% mepivacaine (5.1 (2.7) h) (P < 0.001).

Background Through a prospective study, we evaluated the efficacy of an integrated autotransfusion regimen comprised of predeposit-hemodiluition and intra and post-operative blood salvage in major orthopaedic surgery.Methods We examined the records of 2303 consecutive patients (1524 females and 779 males, mean age 62.7, standard deviation 11 years (range 16–90 yrs), pre-operative haemoglobin (Hb) concentration 13.5 (SD 1.4) (range 6.7–19.3) g/dl undergong total hip arthroplasty (THA 1582 patients), THA after the removal of internal fixation devices (RFD+THA, 25 patients), total knee arthroplasty (TKA, 347 patients), revision surgery of the hip (HR, cup+stem revision, 248 patients; cup revision 64 patients; stem revision 23 patients) and total knee revision (TKR 14 patients). We estimated that the number of predonations (MSBOS - maximum surgery blood order schedule) was 2 units for THA, TKA and TKR, and 3 units for partial or total hip revision and for total hip arthroplasty with fixation removal.Results It was possible to obtain the MSBOS in 2070 patients (89.8%). Homologous red blood cell (HRBC) transfusion were carried out in 184 patients (8%). We found that the need to use HRBC was significantly associated with failure to meet the number of MSBOS, female sex, lower pre-operative Hb concentration, use of calcium heparin for antithrombosis prophylaxis, more extensive surgery, a higher ASA rating and co-existing diseases such as coronary artery disease.Conclusions Cooperation among anaesthesis, transfusionists and surgeons in the application of an integrated autotransfusion regimen enabled us to treat 92% of our patients with only autotransfusion.

An integrated sampling of both active (cells in water column) and resting stages (cysts sinking to the bottom) of phytoplankton, was carried out on March 1996 in the Mar Piccolo of Taranto. At least 46 taxa were recognized in the water column. Cyst sinking rate was about 23,000 m-2 d-1. Out of 37 recognized morphotypes, mainly dinoflagellates, 18 were previously unrecorded from the area. The present sampling represents the preliminar test to outline an experimental design to an integrated study of plankton dynamics.

Cardiovascular responses after epidural alkalinized lignocaine and subarachnoid hyperbaric bupivacaine administration were studied using a non-invasive cardiac output measurement in 32 ASA Grade I-II patients undergoing orthopaedic leg surgery (hip hemi arthroplasty or Ender nailing). All patients achieved adequate surgical anaesthesia. The block onset time was faster (P=0.003), and the range of final sensory level wider (P=0.006) in patients receiving spinal anaesthesia compared with the epidural group. Diastolic arterial pressure was significantly reduced when compared with base-line (P=0.002) only in the spinal group. No significant changes in stroke volume, systemic vascular resistance or left ventricular stroke work were observed in either group. Heart rate and cardiac index were significantly reduced in the spinal group when compared both with base-line (P=0.002; P=0.04) and the epidural group (P=0.001; P=0.006). The results demonstrated that the block onset time and the cardiovascular effects produced by lumbar epidural anaesthesia, with alkalinized solutions, remain less than after spinal anaesthesia involving the same segments.

2-Aminomethyl-4-(1,1-dimethylethyl)-6-iodophenol hydrochloride or MK-447, is a chemically novel diuretic agent which produced diuretic and saluretic effects in rats, dogs and chimpanzees. At doses ranging from 0.1 to 10 mg/kg p.o. (0.32-32 mumol/kg) MK-447 was more effective then furosemide at the same or higher doses in increasing the excretion of Na+, K+ and Cl- in rats and dogs. At single oral doses, MK-447 had antihypertensive activity in spontaneously hypertensive rats and renal hypertensive dogs. Other diuretics are known to lower arterial pressure in these models only by repeated administration. The antihypertensive and diuretic effects of MK-447 in spontaneously hypertensive rats were reduced by indomethacin.

In vitro, 2-[3-(2-thiazolylthio)phenyl]propionic acid (TPA) at plasma concentrations ranging from 0.02 to 1.0 microgram/ml prevents aggregation of human platelets induced by various aggregating agents. Oral administration of TPA to guinea pigs inhibits platelet aggregation; the estimated dose to reduce aggregation by 50% is 0.3 mg/kg. TPA protects rabbits against arachidonate-induced thromboembolic death (50% protection at 0.79 mg/kg i.p.). TPA is a potent hypotriglyceridemic agent in rats when present in the diet in concentrations as low as 0.003%. In chimpanzees, TPA is uricosuric at oral doses of 0.625 and 2.5 mg/kg. This rare combination of pharmacological properties suggests that TPA is a potentially useful antithrombotic agent.

A new device called the Lars Rotational Laxiometer (Lars Inc, Dijon, France) is introduced to aid in the diagnosis of posterolateral rotatory instability of the knee. This device assigns a quantitative value for tibial external rotation. Three examiners each evaluated a separate group of 30 different subjects (total 180 knees) to obtain side-to-side differences. The subjects had no history of injury, pain, or instability. An external rotation measurement was performed at 30 degrees and 90 degrees of knee flexion. At 90 degrees, the mean side-to- side difference was 4.4 degrees (range, 3.7 degrees to 5.1 degrees); at 30 degrees it was 5.5 degrees (range, 4.7 degrees to 6.3 degrees). There was no significant difference with gender or age. The purpose of this study is to establish baseline side-to-side values for the posterolateral complex in normal knees. Objective values are obtainable with the Laxiometer. Arthroscopy 1998 Jul-Aug;14(5):489-94

Cardiovascular responses after epidural alkalinized lignocaine and subarachnoid hyperbaric bupivacaine administration were studied using a non-invasive cardiac output measurement in 32 ASA Grade I-II patients undergoing orthopaedic leg surgery (hip hemiarthroplasty or Ender nailing). All patients achieved adequate surgical anaesthesia. The block onset time was faster (P=0.003), and the range of final sensory level wider (P=0.006) in patients receiving spinal anaesthesia compared with the epidural group. Diastolic arterial pressure was significantly reduced when compared with base-line (P=0.002) only in the spinal group. No significant changes in stroke volume, systemic vascular resistance or left ventricular stroke work were observed in either group. Heart rate and cardiac index were significantly reduced in the spinal group when compared both with base-line (P=0.002; P=0.04) and the epidural group (P=0.001; P=0.006). The results demonstrated that the block onset time and the cardiovascular effects produced by lumbar epidural anaesthesia, with alkalinized solutions, remain less than after spinal anaesthesia involving the same segments.

The excretory pattern for MK-196 is ocmpatible with that of other weak organic acids such as salicylate and probenecid. Tubular secretion of MK-196 is strongly inhibitied by probenecid and high loads of p-aminohippurate. Urinary excretion of MK-196 is increased 10-fold when the urine is alkaline. Clearances of MK-196 were not corrected for plasma protein binding of the drug which is very high (greater than 99%). Bidirectional transport processes are operative in that MK-196 is secreted by the renal tubule and passively back diffuses across the tubular epithelium by a pH-dependent process. MK-196 is able to overcome pyrazinoate-induced urate retention, whereas probenecid is not when studied by conventional clearance techniques. The uricosuric activity of MK-196 appears to be somewhat less with pyrazinoate than in its absence. When MK-196 is administered prior to pyrazinoate an attenuated uricosuric response was observed. This finding cannot be ascribed to a temporal decline in uricosuric action. Diuresis and saluresis produced by MK-196 are not influenced by pyrazinoate. The interaction of MK=196 and pyrazinoate on urate excretion is in direct contrast to results obtained with probenecid and pyrazinoate. A model has been proposed to explain this unique finding.

The saluretic and uricosuric responses elicited by a novel agent, MK-196, have been studied in a great ape, the chimpanzee. This agent is orally active at very low doses and has a prolonged duration of action. Probenecid does not appear to influence the saluretic and uricosuric properties of MK-196. Net tubular secretion of urate was reduced by MK-196. Urinary pH changes did not compromise the efficacy of this new agent. On a dose basis, MK-196 was more saluretic (and uricosuric) than ethacrynic acid or furosemide and possessed a longer duration of action. Because of the marked natriuresis caused by MK-196, some increase in potassium excretion occurred.

A derivative of probenecid, 2-nitroprobenecid, was studied in chimpanzees and Cebus monkeys. The uricosuria induced by the drug could be diminished by the infusion of p-aminohippurate (chimpanzee) or hippurate (monkey). Both hippurates inhibited the secretion of the drug and it is likely that the diminished response was the result of decreased access of 2-nitroprobenecid to its site of action. In contrast, pyrazinoate diminished the response to 2-nitroprobenecid without disturbing its renal disposition (both species). This action of pyrazinoate is attributed to its ability to inhibit the secretory flux of urate. The effect of pyrazinoate is diminished at high levels of 2-nitroprobenecid, i.e., it appears as if pyrazinoate causes a shift to the right of the concentration-response curve of 2-nitroprobenecid. A mathematical model is developed which seems to explain this apparent shift in the concentration-response curve. This model requires that the transepithelial fluxes for urate be very large. In the chimpanzee the action of salicylate resembles that of pyrazinoate but it is less prominent.

The racemate and the d-isomer of 6,7-dichloro-2,3-dihydro-5-(2-thienylcarbonyl)benzofuran-2-carboxylic acid exhibited diuretic activity in the chimpanzee, dog and rat. In the chimpanzee, the diuresis and natriuresis presumably resulted from a site of action in the thick ascending limb of Henle's loop. The l-isomer was uricosuric but devoid of any diuretic action in the chimpanzee and similarly was not diuretic in the dog and rat. Various proportions of the two isomers were tested in the chimpanzee in an attempt to produce an optimal diuretic and uricosuric profile. It was concluded that the racemic mixture, under these experimental conditions, was responsible for the most effective overall response. This is apparently the first time in which there is a distinct separation of diuretic and uricosuric actions in the enantiomers of a racemic diuretic uricosuric agent.

A drug interaction study in the chimpanzee by using indomethacin and hydrochlorothiazide has shown conclusively that the diuretic and saluretic properties of hydrochlorothiazide were not compromised by indomethacin. This was true whether hydrochlorothiazide or indomethacin was administered first. The renal clearance of hydrochlorothiazide was not influenced by indomethacin nor was the renal clearance of indomethacin significantly altered by hydrochlorothiazide. Indomethacin alone caused a small but significant increase in sodium, potassium and chloride excretion and in Curate/glomerular filtration rate. In control experiments with placebo, potassium excretion was also significantly increased. The implications of these observations remain obscure. In all experiments utilizing hydrochlorothiazide, the well known renal effects of this agent were clearly evident under these experimental conditions.

We have evaluated the influence of speed of intrathecal injection on lateral distribution of 0.5% hyperbaric bupivacaine. We studied 60 patients undergoing lower limb surgery who were placed in the lateral position with the operative side in the dependent position. After dural puncture (25-gauge Whitacre spinal needle), the needle aperture was turned towards the dependent side and 0.5% hyperbaric bupivacaine 8 mg was injected randomly at a rate of 0.02 ml s-1 (group slow, n = 30) or 0.25 ml s-1 (group fast, n = 30). Lateral position was maintained for 15 min while a blinded observer recorded loss of pinprick sensation and degree of motor block on both surgical and non-surgical sides. There were no differences between the groups. Forty-five minutes after patients were turned to the supine position, spinal anaesthesia was unilateral in 17 patients in group slow (56%) and in 13 patients in group fast (43%). We conclude that using extremely low speeds for intrathecal injection were not clinically advantageous in obtaining unilateral spinal anaesthesia.

with N2and Ar additives has been investigated using RF power intensities of 0.4‐0.7 W/cm2and pressures of 60‐90 mtorr.