Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy.

PURPOSE: To determine whether motion preservation following oblique cervical corpectomy (OCC) for cervical spondylotic myelopathy (CSM) persists with serial follow-up. METHODS: We included 28 patients with preoperative and at least two serial follow-up neutral and dynamic cervical spine radiographs who underwent OCC for CSM. Patients with an ossified posterior longitudinal ligament (OPLL) were excluded. Changes in sagittal curvature, segmental and whole spine range of motion (ROM) were measured. Nathan's system graded anterior osteophyte formation. Neurological function was measured by Nurick's grade and modified Japanese Orthopedic Association (JOA) scores. RESULTS: The majority (23 patients) had a single or 2-level corpectomy. The average duration of follow-up was 45 months. The Nurick's grade and the JOA scores showed statistically significant improvements after surgery (p < 0.001). 17% of patients with preoperative lordotic spines had a loss of lordosis at last follow-up, but with no clinical worsening. 77% of the whole spine ROM and 62% of segmental ROM was preserved at last follow-up. The whole spine and segmental ROM decreased by 11.2° and 10.9°, respectively (p ≤ 0.001). Patients with a greater range of segmental movement preoperatively had a statistically greater range of movement at follow-up. The analysis of serial radiographs indicated that the range of movement of the whole spine and the range of movement at the segmental spine levels significantly reduced during the follow-up period. Nathan's grade showed increase in osteophytosis in more than two-thirds of the patients (p ≤ 0.01). The whole spine range of movement at follow-up significantly correlated with Nathan's grade. CONCLUSIONS: Although the OCC preserves segmental and whole spine ROM, serial measurements show a progressive decrease in ROM albeit without clinical worsening. The reduction in this ROM is probably related to degenerative ossification of spinal ligaments.

Differences in diet between the two largest breeding colonies of Audouin's gulls: the effects of fishery activities

We analysed and compared the diet of Audouin´s gulls Larus audouinii between their two largest breeding sites in the world: the Ebro Delta and the Chafarinas Islands (western Mediterranean). These two localities showed marked differences in the features of the commercial fishing fleet: in the Ebro Delta area a large fishing fleet produced large amounts of discards, while in the Chafarinas the fleet discarded smaller amounts of fish and marine invertebrates, due to the smaller number of vessels. It is also likely that the percentage of discards from total catches is also lower around the Chafarinas than at the Ebro Delta. We distinguished two types of fishing to compare diet compositions: diurnal (only trawling activity) and diurnal and nocturnal (trawling and purse-seine activity, respectively). We also differentiated regurgitates from young nestlings (up to 20 days old) and from older nestlings or adult birds. At the two localities, fish was the main food of Audouin´s gulls, with epipelagic prey (mainly clupeoids) being more important when both diurnal and nocturnal fisheries were operating. This confirms that epipelagic prey either caught actively by the gulls or linked to fisheries was particularly important in the feeding habits of Audouin´s gulls. Nevertheless, differences between the two colonies appear mainly when only trawlers operated: while at the Ebro Delta gulls showed higher consumption of benthic-mesopelagic prey (probably linked to a higher trawler discard availability), gulls from the Chafarinas Islands consumed higher biomass of epipelagic prey probably caught actively at night. When both fleets operated around the two colonies, the average biomass of prey in a regurgitate of younger chicks was significantly higher at the Ebro Delta than at Chafarinas, and the opposite trend was recorded for older nestlings and adults. Niche width was broader in Chafarinas than in the Ebro Delta for both age classes and for any fishing fleet schedule, suggesting again that the exploitation of discards was higher at the Ebro Delta than at the Chafarinas, where gulls showed a more varied diet. Despite the fact that availability of discards was probably higher at the Ebro Delta than at Chafarinas, the per capita availability was not so different at both localities due to the increasing seabird community population at the Ebro Delta, which ca. doubled that at Chafarinas in the last decade.

Impact of fisheries on activity, diet and predatory interactions between yellow-legged and Audouin's gulls breeding at the Chafarinas Is.

Interactions between yellow-legged Larus cachinnans and Audouin´s Larus audouinii gulls and fisheries operating around the Chafarinas Islands, located 4.5 km off the Moroccan Mediterranean coast, are reviewed. At the Chafarinas archipelago two distinct types of fisheries operate: trawlers and purse seines. Gulls take advantage of both fisheries. They scavenge trawler discards and congregate around shoals of fish attracted to the surface by the purse-seine lamps. When both trawlers and purse-seine boats are in operation, the diet of both gull species is similar, with epipelagic fish accounting for over 60% of the biomass, partially collected in association with the purse-seine fishery. When only trawlers operated yellow-legged gulls, but not Audouin´s gulls, augmented their diet mainly with human waste from refuse dumps, suggesting that competition for food between the two species is mainly limited to the periods when resources made available by fishery activities are abundant. Likewise, when only trawlers operated, there was an increase in the predation pressure on eggs and chicks of Audouin´s gulls. In particular, during the week of celebrations for the holy lamb festival when neither fishery operated, egg losses of Audouin´s gull increased dramatically, suggesting that severe food shortage caused by the cessation of fishing can result in an increased predation pressure by yellow-legged gulls, affecting Audouin´s gull productivity. These results suggest a novel socio-ecological link between gulls, fisheries and local feasts.

Kleptoparasitism, disturbance and predation of yellow-legged gulls on Audouin's gulls in three colonies of the western Mediterranean

The impact of yellow-legged gulls on Audouin´s gulls was studied by means of observations from a blind, at the Ebro Delta, the Chafarinas Islands and the Columbretes Islands colonies, during different stages of Audouin´s Gulls breeding cycle. The rates of predation (upon eggs and chicks) and kleptoparasitism (aerial and on courtship and chick-feeding regurgitates) were recorded to evaluate this impact. Kleptoparasitism and predation rates recorded at the three colonies may be considered low when compared with similar studies dealing with other gull species. It seems that interactions did not represent a threat to the population dynamics of Audouin´s Gulls in any of the three colonies. The highest rates of aerial kleptoparasitism, courtship feeding and chick mortality were recorded at the Columbretes Islands, and the lowest at the Ebro Delta. The ratio of the number of yellow-legged gulls to the number of Audouin´s gulls seems to influence the rate of disturbances. Food availability was also likely to play an important role in the number of interactions, which increased when food was in shorter supply. The study at the Ebro Delta and Chafarinas Islands was restricted to some subcolonies and hence results may not be necessarily representative of the entire colonies. The existence of some yellow-legged gull individuals specialised as predators was recorded. Finally, we discuss the suitability of several conservation measures commonly applied in colonies where both species breed syntopically.

Comunidade microbiana e mesofauna edáficas em solo sob caatinga no semi-árido da Paraíba

A atividade biológica do solo é responsável por inúmeras transformações físicas e químicas dos resíduos orgânicos que são depositados, mantendo, assim, a sustentabilidade do ambiente. O presente estudo objetivou avaliar a distribuição da comunidade microbiana e da mesofauna edáfica no semi-árido da Paraíba. Para determinação da população de microrganismos, foram coletadas amostras de solo na profundidade de 0-15 cm. A contagem total de fungos e de bactérias foi realizada em meios de cultura específicos. A extração da mesofauna foi feita pelo método de Berlese-Tullgren modificado. Oscilações no conteúdo de água do solo e na temperatura promoveram variações na população microbiana. A população de fungos foi superior à de bactérias nos dois anos de observação, provavelmente devido ao pH do solo da área de estudo, que é ligeiramente ácido. O índice de diversidade de Shannon (H) e o de Pielou (e) variaram de acordo com a época de coleta. Os grupos mais freqüentes da mesofauna do solo foram Diptera (42,5 %), Acarinae (40,3 %) e Collembola (8,8 %), indicando que esses organismos possuem papel importante na ciclagem de nutrientes em área de Caatinga.

Intrathecal analgesia and restrictive perioperative fluid management within enhanced recovery pathway: hemodynamic implications.

BACKGROUND: Intrathecal analgesia and avoidance of perioperative fluid overload are key items within enhanced recovery pathways. Potential side effects include hypotension and renal dysfunction. STUDY DESIGN: From January 2010 until May 2010, all patients undergoing colorectal surgery within enhanced recovery pathways were included in this retrospective cohort study and were analyzed by intrathecal analgesia (IT) vs none (noIT). Primary outcomes measures were systolic and diastolic blood pressure, mean arterial pressure, and heart rate for 48 hours after surgery. Renal function was assessed by urine output and creatinine values. RESULTS: One hundred and sixty-three consecutive colorectal patients (127 IT and 36 noIT) were included in the analysis. Both patient groups showed low blood pressure values within the first 4 to 12 hours and a steady increase thereafter before return to baseline values after about 24 hours. Systolic and diastolic blood pressure and mean arterial pressure were significantly lower until 16 hours after surgery in patients having IT compared with the noIT group. Low urine output (<0.5 mL/kg/h) was reported in 11% vs 29% (IT vs noIT; p = 0.010) intraoperatively, 20% vs 11% (p = 0.387), 33% vs 22% (p = 0.304), and 31% vs 21% (p = 0.478) for postanesthesia care unit and postoperative days 1 and 2, respectively. Only 3 of 127 (2.4%) IT and 1 of 36 (2.8%) noIT patients had a transitory creatinine increase >50%; no patients required dialysis. CONCLUSIONS: Postoperative hypotension affects approximately 10% of patients within an enhanced recovery pathway and is slightly more pronounced in patients with IT. Hemodynamic depression persists for <20 hours after surgery; it has no measurable negative impact and therefore cannot justify detrimental postoperative fluid overload.

Produtividade e nutrição de mamona cultivada em área de reforma de canavial tratada com lodo de esgoto

A utilização de lodo de esgoto (LE) em solos agrícolas é uma das maneiras mais viáveis de destinação desse resíduo. O objetivo deste trabalho foi avaliar o efeito da aplicação de LE na nutrição e na produtividade da mamona cultivada em área de reforma de canavial, num Argissolo Vermelho-Amarelo distrófico textura argilosa. Os tratamentos testados constaram de quatro doses de lodo de esgoto: 0, 5, 10 e 20 t ha-1 (base seca), calculadas para fornecer N equivalente a 0, 37,5, 75 e 150 kg ha-1; um tratamento com fertilização mineral N-P2O5-K2O (75-40-80 kg ha-1respectivamente) e um controle sem qualquer fertilização. Os tratamentos com LE também receberam 40 kg ha-1 de P2O5 e 80 kg ha-1 de K2O. A mamoneira, cultivar IAC-Guarani, foi cultivada por cerca de 180 dias entre novembro de 2004 e maio de 2005. A aplicação de LE resultou em incremento estatisticamente significativo (p < 0,05) na produtividade e em outras características biométricas da mamona. A aplicação da dose equivalente a 10 t ha-1 de lodo resultou em um índice de eficiência agronômica de 85 %, em relação à adubação mineral. A disponibilidade de N foi o fator mais limitante no crescimento e na produtividade da mamona, e a taxa de mineralização do N utilizada subestimou o fornecimento de N pelo lodo em campo. Houve aumento significativo de Cu e Zn no solo com a aplicação das doses de lodo, mas tanto os teores no solo quanto na planta estiveram dentro dos limites aceitos pela legislação ambiental.

CO2, CH4 and N2O fluxes in an Ultisol treated with sewage sludge and cultivated with castor bean

Organic residue application into soil alter the emission of gases to atmosphere and CO2, CH4, N2O may contribute to increase the greenhouse effect. This experiment was carried out in a restoration area on a dystrophic Ultisol (PVAd) to quantify greenhouse gas (GHG) emissions from soil under castor bean cultivation, treated with sewage sludge (SS) or mineral fertilizer. The following treatments were tested: control without N; FertMin = mineral fertilizer; SS5 = 5 t ha-1 SS (37.5 kg ha-1 N); SS10 = 10 t ha-1 SS (75 kg ha-1 N); and SS20 = 20 t ha-1 SS (150 kg ha-1 N). The amount of sludge was based on the recommended rate of N for castor bean (75 kg ha-1), the N level of SS and the mineralization fraction of N from SS. Soil gas emission was measured for 21 days. Sewage sludge and mineral fertilizers altered the CO2, CH4 and N2O fluxes. Soil moisture had no effect on GHG emissions and the gas fluxes was statistically equivalent after the application of FertMin and of 5 t ha-1 SS. The application of the entire crop N requirement in the form of SS practically doubled the Global Warming Potential (GWP) and the C equivalent emissions in comparison with FertMin treatments.

Male body size and breeding tubercles are both linked to intra-sexual dominance and reproductive success in the minnow

Male dominance hierarchies are usually linked to relative body size and to weapon size, that is, to determinants of fighting ability. Secondary sexual characters that are not directly used as weapons could still be linked to dominance if they reveal determination or overall health and vigour and hence, indirectly, fighting ability. We studied the mating behaviour of the minnow, Phoxinus phoxinus, a cyprinid fish in which males develop breeding tubercles during the spawning season. The function of these breeding tubercles is still not clear. Using microsatellite markers, we determined male reproductive success under controlled conditions. The minnows were territorial and quickly established a dominance hierarchy at the beginning of the spawning season. Dominance was strongly and positively linked to fertilization success. Although body size and number of breeding tubercles were not significantly correlated in our sample, both large males and males with many breeding tubercles were more dominant and achieved higher fertilization success than small males or males with few tubercles. We found multimale fertilization in most clutches, suggesting that sperm competition is important in this species. Females showed behaviour that may be linked to spawning decision, that is, male dominance might not be the only determinant of male reproductive success in minnows

Place de la laparoscopie dans le traitement du cancer de l'endomètre [Laparoscopy in the management of endometrial cancer]

Les récents progrès de la laparoscopie ont modifié l'approche chirurgicale des patientes atteintes d'un cancer de l'endomètre. Le centre Swissendos Fribourg en collaboration avec l'AGO (Groupe de travail pour la gynécologie oncologique) et l'AGE (Groupe de travail pour la gynécologie endoscopique) ont entrepris d'élaborer un consensus basé sur l'évidence pour la pratique de la laparoscopie dans le traitement du cancer de l'endomètre. L'objectif a été de définir une approche propre à la Suisse en fournissant aux praticiens une aide à la prise en charge. Recent advance in laparoscopy have changed the surgical approach of endometrial cancer patients. The Swissendos Center, Fribourg, in collaboration with AGO (Groupe de travail pour la gynécologie oncologique) and AGE (groupe de travail pour la gynécologie endoscopique) have established a consensus based on the available evidence for the use of laparoscopy in the management of patients with endometrial cancer The main objective was to define Swiss clinical practice guidelines appropriate to the country and consistent with the needs of the physicians.