A selected organosilicone spray adjuvant does not enhance lethal effects of a pyrethroid and carbamate insecticide on honey bees.

As part of the agricultural landscape, non-target organisms, such as bees, may be exposed to a cocktail of agrochemicals including insecticides and spray adjuvants like organosilicone surfactants (OSS). While the risks of insecticides are evaluated extensively in their approval process, in most parts of the world however, authorization of adjuvants is performed without prior examination of the effects on bees. Nevertheless, recent laboratory studies evidence that adjuvants can have a toxicity increasing effect when mixed with insecticides. Therefore, this semi-field study aims to test whether an OSS mixed with insecticides can influence the insecticidal activity causing increased effects on bees and bee colonies under more realistic exposure conditions. To answer this question a pyrethroid (Karate Zeon) and a carbamate (Pirimor Granulat) were applied in a highly bee attractive crop (oil seed rape) during bee flight either alone or mixed with the OSS Break-Thru S 301 at field realistic application rates. The following parameters were assessed: mortality, flower visitation, population and brood development of full-sized bee colonies. Our results show that none of the above mentioned parameters was significantly affected by the insecticides alone or their combination with the adjuvant, except for a reduced flower visitation rate in both carbamate treatments (Tukey-HSD, p < 0.05). This indicates that the OSS did not increase mortality to a biologically relevant extent or any of the parameters observed on honey bees and colonies in this trial. Hence, social buffering may have played a crucial role in increasing thresholds for such environmental stressors. We confirm that the results of laboratory studies on individual bees cannot necessarily be extrapolated to the colony level and further trials with additional combinations are required for a well-founded evaluation of these substances.

Surgical treatment of cephalic arch stenosis by central transposition of the cephalic vein.

PURPOSE: After creation of a brachiocephalic (BC) arteriovenous fistula (AVF), stenosis of the cephalic vein close to its junction with the axillary vein (cephalic arch stenosis, CAS) can develop. Flow impairment and access thrombosis are the consequences, sometimes complicated by prestenotic aneurysm of the cephalic vein. We here report our experience with cephalic vein transposition (CVT) for CAS. METHODS: From March 2007 through February 2012, symptomatic CAS was detected in 25 patients (13 female) with either dysfunction (n=14) or thrombosis (n=11) of their BC AVF. All were treated by CVT: the vein was ligated and cut distally to the stenotic segment, then tunneled subcutaneously to the medial aspect of the upper arm and anastomosed to the proximal brachial or basilic vein in an end-to-side fashion. Simultaneous thrombectomy of the cephalic vein was performed in 11 patients and aneurysmorrhaphy in 9. In addition, one patient had a proximal new AV anastomosis, another angioplasty of an in-stent restenosis of the access-draining subclavian vein. RESULTS: After CVT, two acute complications (8%) occurred: access thrombosis (one) and bleeding (one). During follow-up (1 to 54 months, median 13 months, 34.5 patient-years), six patients died with functioning AVF, three were successfully transplanted. Primary (secondary) 1-year patency was 79% (90%), with a reintervention rate of 0.1/patient/year. CONCLUSIONS: Primary 1-year access patency rates after CVT compare favorably with those after interventional treatment, and reintervention rates are lower. Frequently occurring prestenotic aneurysms could be repaired simultaneously. CVT should therefore be regarded as the treatment of choice for CAS.

Benefits of intraoperative digital subtraction angiography in primary arteriovenous fistula creation.

Digital subtraction angiography (DSA) is an ideal procedure for improving vascular surgery results, not yet in use for arteriovenous fistula (AVF) creation. In a prospective study, the practicability and benefits of intraoperative completion DSA (CDSA) for this purpose were investigated. When the arteriovenous anastomosis was completed and clinically judged as running, DSA via percutaneous or open-site puncture was conducted. Findings and consequences were prospectively documented. From July 2005 to September 2006 a primary AVF was created in 54 patients. Fifty of these could be included in the study (68, 39-91 yrs). In 44 a forearm fistula, and in six patients an elbow fistula was newly created. In two cases we were unable to insert a cannula into the A. brachialis (study escape). In the remaining 48 cases, CDSA visualized afferent artery, anastomosis and draining vein. No complications occurred associated with CDSA; 3.5, 2-12 ml, contrast agent were required per patient. In 13 cases, CDSA revealed problems with the AVF that could be corrected immediately: the vein was freed from restraining soft tissue (n=4), a stealing venous branch was ligated (n=6), transluminal thrombectomy was conducted (n=1) or anastomosis was newly created (n=3). AVF could be successfully created proven by ongoing dialysis in 30 cases, and in eight cases as demonstrated by clinical and sonographic evaluations, resulting in a primary 1-yr patency rate of 79.2%. CDSA in AVF surgery is practicable and reveals conditions that can be corrected immediately, thus improving surgical outcome. Long since standard in other areas of vascular surgery, CDSA should become a routine procedure in AVF creation.

Thoracoscopy versus thoracotomy: a prospective comparison of trauma and quality of life.

BACKGROUND: Reliable comparisons of thoracoscopy (TCC) and anterolateral thoracotomy (ATT) with regard to trauma and post-operative quality of life are rare. This study was conducted to quantify the results of TCC, which was expected to show an advantage. METHODS: Using a matched-pair design (matching criteria: comparable intracavitary procedure, benign/malignant disease and sex), 22 patients were compared who underwent either TCC or ATT (Wilcoxon matched-pairs signed-ranks test, P<0.05). RESULTS: Incision and operation time were shorter for TCC (TCC 5.3 vs ATT 23.7 cm, P=0.003; TCC 64 vs ATT 87 min, P=0.029). Differences in favor of TCC were detected for interleukin 6 (IL6) (TCC 17.2 vs ATT 105.6 pg/ml, P=0.036) in the immediate postoperative period, C-reactive protein (CRP) (TCC 28.2 vs ATT 86.6 mg/l; P=0.010) on the day 1 after the operation, forced vital capacity (FVC) (TCC 2.5 vs ATT 1.5 l, P=0.0173), elevation of the arm (EA) (TCC 143 vs ATT 109; P=0,026), pain on coughing (CP) (TCC 2.5 vs ATT 6.9 patients; P=0.009) and Spitzer Index (SI) (TCC 9.2 vs ATT 7,1 patients; P=0.009), as well as CP (TCC 1.4 vs ATT 4.4 patients; P=0,005) on day 4 after the operation. Forced expiratory volume in the first second, pain, creatin kinase, blood glucose and neopterin showed no differences. CONCLUSIONS: In terms of surgical trauma and quality of life ICC is superior to ATT in the immediate postoperative period. With the exception of pain and coughing, there were no differences after postoperative day 4.