ANESTHETIC MANAGEMENT OF FEMORAL FRACTURE REPAIR IN A PATIENT WITH CERVICAL MYELOPATHY, AUTONOMIC DYSFUNCTION, AND DIFFICULT AIRWAY.

Spinal stenosis is a potentially serious condition that can lead to myelopathies and autonomic instability, both of which, as a result, may complicate anesthetic management. Additionally, neuraxial anesthesia appears to increase the risk of worsened neurological outcomes in this population. A 56-year-old female with spinal stenosis, autonomic dysfunction, and known difficult airway who required anesthesia for repair of a femur fracture is presented. After pre-operative arterial line and femoral block placement, an ultrasound guided subarachnoid block was safely placed. This supports the notion that in the appropriate setting, a safe, successful neuraxial blockade can be performed when a general anesthetic may be fraught with more risk.

Semiochemistry of the goldeneyed lacewing Chrysopa oculata: attraction of males to a male-produced pheromone.

Gas chromatographic-electroantennographic detection (G3C-EAD) experiments showed that antennae of males and females of the goldeneyed lacewing, Chrysopa oculata Say (Co. = Chrysopa), consistently responded to four compounds extracted from the abdominal cuticle of males:nonanal, nonanol, nonanoic acid, and (1R*,2S*,5R*,8R*)-iridodial. These compounds were not detected from abdominal cuticle of females. Thoracic extracts of both sexes contained antennal-stimulatory 1-tridecene and EAD-inactive skatole. Chrysopa oculata adults were most sensitive to (1R,2S,5R,8R)-iridodial standard at an EAD-response threshold between 0.1 and 1 pg, which was 10-100 times lower than thresholds for nonanal and nonanoic acid, and up to 10,000 times lower than thresholds for other compounds tested. A similar EAD response pattern was also found in another Chrysopa sp. (Co. quadripunctata Burmeister). In field-trapping experiments, (1R,2S,5R,8R)-iridodial was the only male-specific compound that attracted Co. oculata males. Males also were weakly attracted to (1R,4aS,7S,7aR)-nepetalactol (an aphid sex pheromone component), probably due to the 5% (1R,2S,5R,8R)-iridodial present in the synthetic sample as an impurity. A herbivore-induced plant volatile, methyl salicylate, increased attraction of males to (1R,2S,5R,8R)-iridodial, whereas 1-tridecene was antagonistic. No females were caught in the entire study. Scanning electron micrographs revealed numerous male-specific, elliptical epidermal glands on the 3rd-8th abdominal sternites of Co. oculata, which are likely the pheromone glands. Another lacewing species, Chrysoperla rufilabris (Burmeister) (Cl. = Chrysoperla), did not produce male-specific volatiles or possess the type of gland presumed to produce pheromone in Co. oculata males, but (Z)-4-tridecene was identified as a major antennal-stimulatory compound from thoracic extracts of both sexes of Cl. rufilabris. Thus, (1R,2S,5R,8R)-iridodial (or its enantiomer) is now identified as a male-produced male aggregation pheromone for Co. oculata, the first pheromone identified for lacewings.