Different Polyphenolic Parenchyma Cell and Phloem Axial Resin Duct-Like Structure Formation Rates in Cupressus sempervirens Clones Infected with Seiridium cardinale.

The aim of this study was the characterization of constitutive and induced defense mechanisms in the bark tissues of Cupressus sempervirens before and after infection with the bark fungus Seiridium cardinale, which is responsible for cypress canker disease. The time-course development of polyphenolic parenchyma (PP) cells and phloem axial resin duct (PARD)-like structures in the phloem was investigated in two C. sempervirens clones, one resistant and one susceptible to the disease, through anatomical and histological observations carried out by light microscope during a 19-day trial. PP cells were constitutively more abundant in the canker-resistant clone (R clone) compared with the susceptible clone (S clone), whereas PARD-like structures were not present in the bark of untreated plants of both clones. PP cells increased in both clones as a response to infection, but in the R clone, they were more abundant 5 and 12 days after inoculation. After inoculation, PARD-like structures appeared in the phloem after 5 days in the R clone and only after 12 days in the S clone. Even the number of cells surrounding the PARD-like structures was higher in the R clone 5 and 12 days after inoculation compared with the S clone. These observations demonstrate a faster phloem response of the R clone in the early phase of the infection. This may slow down initial growth of the fungus, contributing to the resistance mechanism.

Association of preoperative anaemia with postoperative morbidity and mortality: an observational cohort study in low-, middle-, and high-income countries.

BACKGROUND: Anaemia is associated with poor postoperative outcomes, but few studies have described the impact of preoperative anaemia in low- and middle- (LMICs), and high-income countries (HICs). METHODS: This was a planned analysis of data collected during an international 7 day cohort study of adults undergoing elective inpatient surgery. The primary outcome was in-hospital death, and the secondary outcomes were in-hospital complications. Anaemia was defined as haemoglobin <12 g dl-1 for females and <13 g dl-1 for males. Hierarchical three-level mixed-effect logistic regression models were constructed to examine the associations between preoperative anaemia and outcomes. RESULTS: We included 38 770 patients from 474 hospitals in 27 countries of whom 11 675 (30.1%) were anaemic. Of these, 6886 (17.8%) patients suffered a complication and 198 (0.5%) died. Patients from LMICs were younger with lower ASA physical status scores, but a similar prevalence of anaemia [LMIC: 5072 (32.5%) of 15 585 vs HIC: 6603 (28.5%) of 23 185]. Patients with moderate [odds ratio (OR): 2.70; 95% confidence interval (CI): 1.88-3.87] and severe anaemia (OR: 4.09; 95% CI: 1.90-8.81) were at an increased risk of death in both HIC and LMICs. Complication rates increased with the severity of anaemia. Compared with patients in LMICs, those in HICs experienced fewer complications after an interaction term analysis [LMIC (OR: 0.92; 95% CI: 0.87-0.97) vs HIC (OR: 0.86; 95% CI: 0.84-0.87); P<0.01]. CONCLUSIONS: One-third of patients undergoing elective surgery are anaemic. These patients have an increased risk of complications and death. The prevalence of anaemia is similar amongst patients in LMICs despite their younger age and lower risk profile. CLINICAL TRIAL REGISTRATION: ISRCTN51817007.

Postoperative pharmacokinetics of meloxicam in horses after surgery for colic syndrome.

NSAIDs are often used in horses with colic syndrome during the postoperative period, due to their ability to contrast endotoxemia and to promote an analgesic and anti-inflammatory effect. As the pharmacokinetics of a drug are often modified in unhealthy animals compared to healthy subjects, the aim of this study was to evaluate the pharmacokinetic profile of meloxicam after i.v. administration in horses undergoing laparotomy for colic syndrome. Eight horses received 0.6 mg/kg of meloxicam i.v. towards the end of surgery. Blood samples were taken at scheduled time points during the following 24 hr. The serum concentration of the drug was determined by HPLC. Terminal half-life (6.88 ± 2.96 hr), volume of distribution at steady-state (186.53 ± 61.20 ml/Kg) and clearance (27.91 ± 5.72 ml kg-1  hr-1 ) were similar to those reported in literature for healthy horses. This result suggests that no adjustment of the approved dose should be necessary when meloxicam is used to treat horses in the immediate postoperative period after surgery for colic syndrome.

Pharmacokinetics and tolerability of a new formulation of omeprazole in the horse.

A new formulation of omeprazole in gastro-resistant granules was tested with regard to its pharmacokinetics and tolerability. Twenty-four horses were randomly divided into three groups (8 horses/group) and treated, according a parallel study design, as follows: Group A untreated (control group), Group B received 4 mg/kg of omeprazole, and Group C received 12 mg/kg of omeprazole, both of which were treated orally once a day for 90 days. Blood samples, taken from Group B subjects during the 1st and the 29th day of treatment at pre-established time points, were used to determine the concentration-time curves of omeprazole. The treatments were found to be safe and well tolerated by the horses. The serum hematological and biochemical values were within reference ranges for the entire observational time. No accumulation of the drug was found after 29 days of treatment. Lower Cmax and AUCs were obtained at the 29th day of treatment.

Pharmacokinetic profiles of meloxicam in turtles (Trachemys scripta scripta) after single oral, intracoelomic and intramuscular administrations.

Meloxicam is an anti-inflammatory and analgesic drug used to treat many pathological conditions in turtles. With the aim to fill the lack of data about its pharmacokinetic in this species, eighteen turtles (Trachemys scripta scripta) were divided in three groups and treated with a single dose of meloxicam (0.2 mg/kg) by intramuscular, intracoelomic and oral route, respectively. At scheduled time points, blood samples were collected and meloxicam concentrations were determined by HPLC. Pharmacokinetic parameters were calculated from the obtained concentration-time curves. After intramuscular treatment, a plasma peak of meloxicam equal to 1590.03 ± 1845.32 ng/mL (mean ± SD) and a Tmax of 1.17 ± 0.45 h were reached, indicating a quick absorption of the drug. The intracoelomic administration brought to the largest AUC (12621.04 ± 6203.79 h*ng/mL) and to a Cmax and a Tmax equal to 1154.52 ± 662.78 ng/mL and 2.82 ± 1.39 h, respectively. Following oral treatment, the plasma concentrations of meloxicam were very low indicating a scarce absorption. Further studies are warranted to determine the effective plasma concentration of meloxicam in turtles and, consequently, the dosage regimen.

Different allergenicity of pollen extracts of three Mediterranean cypress species accounted for cytological observations.

BACKGROUND: Cypresses play an important role in the urban landscape of the Mediterranean region, releasing a huge amount of allergenic airborne pollen which causes a specific pollinosis in exposed people. OBJECTIVE: The aim of this work is to evaluate, in vivo and in vitro, the potential allergenicity of Cupressus macrocarpa pollen, and to compare it with the allergenicity observed for C. arizonica and C. sempervirens. METHODS: Pollen extracts of the three species were prepared, to determine their protein profile through SDS PAGE analysis and to evaluate their allergenic potential through EAST inhibition assays and SPT. Pollen grain composition was evaluated using a cytochemical approach with optical microscopy. RESULTS: SDS PAGE, EAST inhibition and SPT indicated the higher allergenic potential of C. arizonica compared to C. sempervirens and C. macrocarpa. No significant differences in allergenic potential were found between the latter two species. Cytochemical observations reveal higher ß-glucans and protein content in the intine of C. arizonica during hydration. CONCLUSION: The higher protein content found in C. arizonica pollen grains extract may be due to higher enzyme activity leading to the movement of ß-glucans and pectins from the intine to the partially developed pollen cell wall during hydration. This could explain the higher potential allergenicity of C.arizonica in respect to C. macrocarpa and C. sempervirens.

Intra-articular administration of lidocaine in anaesthetized dogs: pharmacokinetic profile and safety on cardiovascular and nervous systems.

The intra-articular administration of lidocaine is a frequent practice in human orthopaedic surgical procedures, but an eventual absorption of the drug into the bloodstream can lead to toxicity, mainly concerning the central nervous system and the cardiovascular systems. The purpose of this study was to determine the pharmacokinetic profile and the safety, in terms of cardiovascular and CNS toxicity, of lidocaine after intra-articular administration to anesthetized dogs undergoing arthroscopy. Lidocaine 2% was administered to eight dogs before surgery in differing amounts, depending on the volume of the joints involved, and blood samples were taken at predetermined time points. The maximum serum concentration of lidocaine ranged from 0.50 to 3.01 µg/mL (mean ± SD: 2.18 ± 0.91 µg/mL), and the time to reach it was 28.75 ± 15.74 min. No signs of cardiac toxicity were detected during the entire procedure, and possible signs of CNS toxicity were masked by the anaesthesia. However, concentrations reported in literature as responsible for neurotoxicity in dog were achieved in three of eight investigated subjects. Pending further studies, veterinarians should consider the possibility of side effects occurring following the intra-articular administration of local anaesthetics.

Possible land management uses of common cypress to reduce wildfire initiation risk: a laboratory study.

Accurate determination of flammability is required in order to improve knowledge about vegetation fire risk. Study of the flammability of different plant species is essential for the Mediterranean area, where most ecosystems are adapted to natural fire but vulnerable to recurrent human-induced fires, which are the main cause of forest degradation. However, the methods used to evaluate vegetation flammability have not yet been standardized. Cupressus sempervirens is a native or naturalized forest tree species in the Mediterranean area that is able to tolerate prolonged drought and high temperatures. The aim of this study was to characterize the flammability of C. sempervirens var. horizontalis at particle level by using different bench-scale calorimetry techniques (mass loss calorimeter, epiradiator and oxygen bomb) to determine the main flammability descriptors (ignitability, sustainability, combustibility and consumability) in live crown and litter samples. Our findings indicate that this variety of cypress is relatively resistant to ignition because of the high ash content, the high critical heat flux, the high time to ignition displayed by both crown and litter samples and the ability of the leaves to maintain a high water content during the summer. We also discuss the possibility of exploiting some morphological, functional and ecological traits of the species to construct a barrier system (with selected varieties of cypress) as a promising complementary land management tool to reduce the fire spread and intensity in a Mediterranean context.

Pharmacokinetics and residue depletion of erythromycin in gilthead sea bream Sparus aurata L. after oral administration.

Erythromycin (ERY) is an antibiotic effective against Streptococcus iniae, a microorganism responsible for significant losses in aquaculture. No data are available on the pharmacokinetics and residue depletion of ERY in sea bream. The aim of this study was thus to evaluate the pharmacokinetics of ERY in this species after a single oral administration at 75 mg kg(-1) b.w. and to assess its residue depletion from tissues after prolonged treatment for 10 days. ERY was rapidly absorbed in sea bream (Cmax  = 10.04 µg g(-1) and Tmax =1 h), with a half-life of 9.35 h and an AUC0-24 of 56.81 (h µg mL(-1) ). The data obtained and the evaluation of pharmacokinetic/pharmacodynamic parameters allowed us to hypothesize that dosage used in this study should be effective against S. iniae. A rapid reduction in erythromycin concentrations was observed in tissues, with the drug being detectable only during the first day post-treatment. In Europe, the use of ERY in aquaculture is allowed by off-label prescription with a withdrawal time of 500 °C day(-1) . The absence of ERY residues in tissues already at 24 h post-treatment suggests that ERY in sea bream should not pose human food safety issues.

The Epidemic Spread of Seiridium cardinale on Leyland Cypress Severely Limits Its Use in the Mediterranean.

Leyland cypress (× Hesperotropsis leylandii) is a fast-growing conifer used in most temperate regions as an ornamental tree for hedges and screens, and is one of the most commercially important trees in Europe. In recent years, severe diebacks and mortality due to cypress canker have been observed on Leyland cypress plantations in Southern Europe. This study was conducted to evaluate (i) the spread and impact of cypress canker caused by Seiridium cardinale in plantations of a sample area of 1,250 km2 in central Italy, (ii) the response of the most commonly grown Leyland cypress varieties to artificial inoculation with to S. cardinal, and (iii) the pathogenicity of S. cardinale isolates obtained from Leyland cypress. Of the 1,411 surveyed trees, 11.4% had been killed by cypress canker and 43.9% of the living trees were affected by the disease. The number of diseased or dead trees and the percentage of cankered trunks was significantly correlated with the mean trunk diameter of the plantations. Six months after inoculation, the size of developed cankers was significantly different among the inoculated Leyland cypress cultivars but all of them showed markedly larger cankers than the C. sempervirens canker-resistant control clone. All of the tested S. cardinale isolates obtained from Leyland cypress also caused cankers on Cupressus sempervirens when inoculated as conidial suspensions or mycelia. Leyland cypress is highly prone to contract cypress canker in the Mediterranean due to its high susceptibility to S. cardinale infections, low genetic variability among the grown cultivars, and cracks which form on fast-growing trunks, favoring entry of the fungus into the inner bark and the occurrence of infections.

A pharmacokinetic/clinical approach to postulate a local action of intra-articular xylazine administration in the horse: a preliminary study.

The study aims to evaluate whether the analgesic effect of intra-articular (IA) route of xylazine administered to horses following arthroscopic surgery is due to a local or a systemic action. Two connected studies were performed. In the first, 1 mg/kg b.w. of xylazine was injected IA, and blood samples were taken to assess drug systemic absorption. In addition, systemic effects of the drug (sedation, ataxia or reduction of respiratory and cardiac rate) were registered. Control horses injected with saline IA were included in the study to exclude the influence of anaesthesia in the occurrence of these manifestations. In the second study, 1 mg/kg b.w. of xylazine was administered intravenously (i.v.) in healthy horses. Blood samples were collected to determine the concentrations of xylazine, and the same signs of systemic effects of the drug were recorded. By correlating these parameters, a systemic 'no effect' concentration was defined. Pharmacokinetic data after IA administration resulted in some xylazine absorption (bioavailability equal to 58.12%) with values above the systemic 'no effect' concentration. The occurrence of some signs related to systemic effects in horses receiving IA xylazine was significant compared with horses receiving saline. In conclusion, a systemic action of the drug after IA administration cannot be excluded.

Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study.

BACKGROUND: This 'real-life' study aimed to analyze the time from the start of neostigmine or sugammadex administration to recovery to a train of four ratio (TOFr) of 0.9 in a real-life in patients receiving rocuronium. The secondary aims were to assess the proportion of patients: presenting TOFr < 0.9 after 5, 10, and 20 min from reversal agent administration, receiving opioids for intraoperative analgesia and extubated in the post-anesthesia care unit (PACU). METHODS: This was a multisite, prospective, nonrandomized, observational real-life study. Reversal agent was administered at either T2 reappearance or at a post-tetanic count of 1 or 2. Drugs dosages were free according to each investigator's usual practice. RESULTS: Three hundred fifty-nine patients were enrolled onto the study. Time from reversal administration to TOFr to 0.9 is significantly faster in the sugammadex group than in the neostigmine group (shallow block: 2.2 vs. 6.9 min, respectively; P < 0.0001; deep block: 2.7 vs. 16.2 min, respectively; P < 0.0001). The number of patients with TOFr < 0.9 at 5, 10, and 20 min post-reversal agent administration was higher in the neostigmine than in the sugammadex group. Just five patients did not receive opioids. All patients were extubated in the operative room except for a single patient in the sugammadex group who was extubated following PACU admission. CONCLUSIONS: This real-life study confirms that reversal time is faster in patients receiving sugammadex than in those receiving neostigmine. TOFr < 0.9 20 min after reversal was only present in patients treated with neostigmine.

Florfenicol depletion in edible tissue of rainbow trout, Oncorhynchus mykiss (Walbaum), and sea bream, Sparus aurata L.

An increase in fish production has consequently brought an increase in infectious diseases in fish farms. The use of chemotherapic drugs is the most effective instrument against common bacterial agents. The number of registered drugs for use in aquaculture is limited and often veterinary practitioners resort to the off-label use of chemotherapic agents authorized for different food-producing animal species. Florfenicol is well known for its outstanding effect against various pathogenic bacteria affecting fish, and therefore, it may be a useful drug for off-label use in aquaculture. The aim of this study was to evaluate the depletion of florfenicol and its major metabolite, florfenicol amine, from the edible tissue of two fish species, rainbow trout and sea bream, following treatment with medicated feed at a dosage of 10 mg kg(-1) of bw day(-1) , for 10 consecutive days. At prefixed time points after the end of administration (0.25, 1, 2, 3, 4, 6, 7, 10, 14 and 21 days after treatment), edible tissues (muscle plus adherent skin) from 15 individuals in each group were collected and analysed by HPLC, to determine concentration of the drug in the tissue. On the basis of the obtained concentrations, withdrawal times of florfenicol in the two species were calculated. The results indicate that a drug withdrawal time of 500 °C-day, as established by Directive 2004/28/EC, for off-label drug use is more than satisfactory to guarantee the healthiness of fish products against the risk of drug residues.

Pharmacokinetics and residue depletion of erythromycin in rainbow trout Oncorhynchus mykiss (Walbaum).

Erythromycin (ERY) is a drug active against Gram-positive bacteria such as Lactococcus garvieae, a pathogen responsible for an important disease that may cause a substantial decrease in rainbow trout Oncorhynchus mykiss (Walbaum) production, the species of fish most commonly produced in Italy. In the literature, studies on the kinetics behaviour of ERY in fish are limited. Therefore, the aim of the present study was to evaluate the pharmacokinetics of ERY in rainbow trout after a single oral treatment with 75 mg kg⁻¹ body weight (b.w.) of ERY and the residue depletion after multiple oral administration of 75 mg kg⁻¹ b.w. day⁻¹ of ERY for 10 days. Blood concentrations of ERY increased up to 20.24 ± 13.32 µg mL⁻¹ at 6 h, then decreased to 5.97 ± 3.89 µg mL⁻¹ at 24 h. The time during which the antibiotic remains in the bloodstream at concentrations exceeding the MIC (T > MIC) and the area under the serum concentration-time curve (AUC)/MIC are both pharmacokinetic-pharmacodynamic (PK/PD) predictors of ERY efficacy, and the data obtained allowed us to hypothesize that a dosage of 75 mg kg⁻¹ b.w. day⁻¹ of ERY could treat the lactococcosis in trout. Regarding the study of ERY depletion, rapid elimination was observed in tissue (muscle plus adherent skin); in fact the concentrations were below the limit of quantification in all samples (except two) by day 10 post-treatment. ERY is not licensed in Europe for use in aquaculture, and its use is possible only by off-label prescription with a precautionary withdrawal time of 500 degree-days, as established by Directive 2004/28/EC. From the data obtained in this study, a withdrawal time of 8.90 days was calculated, corresponding, in our experimental conditions, to 117.5 degree-days, a value significantly lower than that established by the European directive.

II Italian intersociety consensus statement on antithrombotic prophylaxis in orthopaedics and traumatology: arthroscopy, traumatology, leg immobilization, minor orthopaedic procedures and spine surgery.

Pharmacological prophylaxis for preventing venous thromboembolism (VTE) is a worldwide established procedure in hip and knee replacement surgery, as well as in the treatment of femoral neck fractures, but few data exist in other fields of orthopaedics and traumatology. Thus, no guidelines or recommendations are available in the literature except for a limited number of weak statements about knee arthroscopy and lower limb fractures. In any case, none of them are a multidisciplinary effort as the one here presented. The Italian Society for Studies on Haemostasis and Thrombosis (SISET), the Italian Society of Orthopaedics and Traumatology (SIOT), the Association of Orthopaedic Traumatology of Italian Hospitals (OTODI), together with the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) and the Italian Society of General Medicine (SIMG) have set down easy and quick suggestions for VTE prophylaxis in a number of surgical conditions for which only scarce evidence is available. This inter-society consensus statement aims at simplifying the approach to VTE prophylaxis in the single patient with the goal to improve its clinical application.

First Report of Botryosphaeria iberica Associated with Dieback and Tree Mortality of Monterey Cypress (Cupressus macrocarpa) in Algeria.

Stem cankers and branches showing bark discoloration, fissuring, resin exudation leading to dieback, crown wilting, and tree mortality have been observed since late spring 2008 on 40-year-old Cupressus macrocarpa (Hartw.) trees planted in forests mixed with Juniperus oxycedrus L. and Acer monspessulanum L. in Taffet, near Ain Abbessa, in the district of Bougaa, Algeria (36°18'57″N; 05°06'33″E; 1,400 m elevation). In 2010, approximately 60% of the C. macrocarpa trees were diseased. For fungal isolations, cankered branches were surface sterilized with ethanol. After removal of the outer bark, fragments of necrotic inner bark taken from the margin of cankers were plated on potato dextrose agar (PDA). Most of the colonies were identified as Botryosphaeria iberica (Phillips, Luque & Alves) based on comparison of morphological traits and DNA sequences with known isolates of the fungus (1). Pestalotiopsis funerea colonies were also obtained, although with less frequency. B. iberica colonies on PDA were dark green with aerial mycelium and optimum growth at 25°C. Pycnidia were produced after 3 weeks of incubation at 20°C under a 12-h near UV light photoperiod on water agar amended with autoclaved cypress seeds. Conidia were brown, one-septate, oval to oblong, and 24.2 (20.1 to 27.4) × 11.2 µm (8.8 to 14.1) (n= 50). An isolate was deposited at the Centralbureau voor Schimmelculture as CBS 130984. DNA was extracted from freeze-dried mycelium and amplified using primers ITS1 and ITS4. The amplified DNA sequence of B. iberica isolate CBS 130984 from Algeria (GenBank Accession No. JN836991) showed 100% homology with sequences of B. iberica isolates obtained from dead and cankered bark of oaks from Spain and Italy (GenBank Accession Nos. AY573216, AY573214, AY573213, AY573210, AY573202, and AY573201). Stem inoculations were performed in the greenhouse on 10 4-year-old, grafted plants of C. macrocarpa growing in 5-liter pots using isolate CBS 130984. A 3-mm plug taken from the margin of a colony grown on PDA for 1 week was inserted in a circular wound of the same size made in the bark with a cork borer where the stem diameter was approximately 1 cm. Inoculations were repeated in June 2010 and June 2011. Five months after inoculations, small rounded to elongated lesions (1.0 to 2.5 cm long), sometimes with resin exuding cracks, were visible on all inoculated stems. Control trees, inoculated with sterile PDA plugs, showed no canker development. B. iberica was successfully reisolated from the necrotic bark surrounding the inoculation sites. No significant differences in canker size were observed between the two replicated experiments. Some Botryosphaeria species that are found on a variety of hosts are also known to cause cankers and dieback of cypress; among these are B. stewensii, B. obtusa, B. dothidea, and B. ribis, often acting as weak pathogens (2,3). Considered weakly virulent in causing dieback of grapevine (4) and, to our knowledge, reported here for the first time on Cupressaceae, B. iberica caused cankers and dieback of C. macrocarpa trees that had probably been weakened by repeated drought events occurring in Algeria during the last 10 years. References: (1) A. Phillips et al. Mycologia 97:513, 2005. (2) E. Punithalingam and J. M. Waller. IMI Descriptions of Fungi and Bacteria 40, Sheet 394, 1973; (3) E. Punithalingam and P. Holliday. IMI Descriptions of Fungi and Bacteria. 40, Sheet 395, 1973; (4) R. Úrbez-Torres et al. Plant Dis. 93:584, 2009.

Insights into a hydration regulating system in Cupressus pollen grains.

BACKGROUND AND AIMS: Hydration, rupture and exine opening due to the sudden and large expansion of intine are typical of taxoid-type pollen grains. A hemispheric outgrowth external to the exine was observed on Cupressus and Juniperus pollen grains before the intine swelling and exine release. However, the actual existence of this permanent or temporary structure and its precise role in pollen hydration is still being debated. The aim of this paper is to collect information on the actual presence of this peculiar outgrowth on the surface of the Cupressus pollen grain, its structure, composition and function. METHODS: Pollen grains of several Cupressus species were observed using various techniques and methodologies, under light and fluorescence microscopy, phase-contrast microscopy, confocal microscopy, scanning electron microscopy, and an environmental scanning electron microscope. Observations were also performed on other species with taxoid-type pollen grains. KEY RESULTS: A temporary structure located just above the pore was observed on Cupressus pollen grains, as well as on other taxoid-type pollens. It is hemispheric, layered, and consists of polysaccharides and proteins. The latter are confined to its inner part. Its presence seems to regulate the entrance of water into the grains at the beginning of pollen hydration. CONCLUSIONS: The presence of a temporary structure over the pore of taxoid-type pollen grains was confirmed and its structure was resolved using several stains and observation techniques. This structure plays a role in the first phases of pollen hydration.

Sequence and simple-sequence repeat analyses of the fungal pathogen Seiridium cardinale indicate California is the most likely source of the cypress canker epidemic for the Mediterranean region.

Seiridium cardinale is the pathogenic fungus of unknown origin responsible for a world pandemic known as cypress canker affecting several species of Cupressaceae in both the Northern and Southern Hemisphere. In this study, a comparative genetic analysis of worldwide populations was performed using sequence analysis of a portion of the ?-tubulin locus and seven polymorphic simple-sequence repeat (SSR) loci on 96 isolates. Sequence analysis identified two distinct ?-tubulin alleles, both present in California. Only one of the two alleles was detected in the Mediterranean basin, while two isolates from the Southern Hemisphere were characterized by the presence of the allele absent from the Mediterranean. SSRs identified a total of 46 multilocus genotypes (MGs): genotypic diversity was always higher in the California population, and calculations of the index of association (I(A)) determined the presence of linkage disequilibrium associated with the absence of sexual reproduction only in the Mediterranean population but not in California. In 50 instances, the same MG was found at great geographic distances, implying a role played by humans in spreading the disease. Network analysis performed on SSR data identified three clusters of MGs: California, Morocco, and the rest of the Mediterranean. Both the Morocco and the Mediterranean clusters were linked to the California cluster. Coalescent analysis identified insignificant migration between California and Italy, as expected in the presence of a single introduction event, and very high migration from Italy into Greece, as expected of an outbreak still in exponential growth phase and starting from an Italian source.

Italian intersociety consensus statement on antithrombotic prophylaxis in hip and knee replacement and in femoral neck fracture surgery.

Anticoagulant prophylaxis for preventing venous thromboembolism (VTE) is a worldwide established procedure in hip and knee replacement surgery, as well as in the treatment of femoral neck fractures (FNF). Different guidelines are available in the literature, with quite different recommendations. None of them is a multidisciplinary effort as the one presented. The Italian Society for Studies on Haemostasis and Thrombosis (SISET), the Italian Society of Orthopaedics and Traumatology (SIOT), the association of Orthopaedists and Traumatologists of Italian Hospitals (OTODI), together with the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) have set down easy and quick suggestions for VTE prophylaxis in hip and knee surgery as well as in FNF treatment. This inter-society consensus statement aims at simplifying the grading system reported in the literature, and its goal is to benefit its clinical application. Special focus is given to fragile patients, those with high bleeding risk, and those receiving chronic antiplatelet (APT) and vitamin K antagonists treatment. A special chapter is dedicated to regional anaesthesia and VTE prophylaxis.

Knowledge of residual curarization: an Italian survey.

BACKGROUND: The use of neuromuscular blocking agents (NMBAs) is widespread in anesthetic practice; little is known about the current use of these drugs in Italy. This survey was conducted to obtain information about the most commonly used clinical tests and the train-of-four (TOF) ratios that are considered as being reliable for assessing recovery from neuromuscular blockade at the end of anesthesia and the estimated occurrence rates of post-operative paralysis in Italian hospitals. METHODS: The questionnaire was given to Italian anesthesiologists attending the 62nd National Congress of the Italian Society of Anesthesia, Analgesia and Intensive Therapy. Collected data were stratified by age and the total number of surgical procedures performed in the hospitals concerned. RESULTS: Seven hundred and fifty-four correctly compiled questionnaires were collected (response rate 88.7%). Seventy three percent of the respondents only used clinical tests for monitoring the level of neuromuscular blockade. The main clinical tests cited for the evaluation of residual paralysis were keeping the head lifted up for 5 s, protruding the tongue and opening the eyes. TOF was used by 35% of the respondents on a routine basis. Only 24% of the interviewed anesthesiologists reported that before extubation, a TOF ratio of at least 0.9 should be reached. CONCLUSIONS: Most Italian anesthetists assess the recovery from neuromuscular blockade only by clinical signs. There is poor awareness about the inability of such techniques to indicate even a significant amount of residual neuromuscular block. A more extensive use of quantitative instrumental monitoring is required for the more rational use of NMBAs.