The projected increase of vertebral osteomyelitis in Germany implies a demanding challenge for future healthcare management of aging populations.

PURPOSE: Since an increase in the occurrence of native vertebral osteomyelitis (VO) is expected and reliable projections are missing, it is urgent to provide a reliable forecast model and make it a part of future health care considerations. METHODS: Comprehensive nationwide data provided by the Federal Statistical Office of Germany were used to forecast total numbers and incidence rates (IR) of VO as a function of age and gender until 2040. Projections were done using autoregressive integrated moving average model on historical data from 2005 to 2019 in relation to official population projections from 2020 to 2040. RESULTS: The IR of VO is expected to increase from 12.4 in 2019 to 21.5 per 100,000 inhabitants [95% CI 20.9-22.1] in 2040. The highest increase is predicted in patients over 75 years of age for both men and women leading to a steep increase in absolute numbers, which is fourfold higher compared to patients younger than 75 years. While the IR per age group will not increase any further after 2035, the subsequent increase is due to a higher number of individuals aged 75 years or older. CONCLUSIONS: Our data suggest that increasing IR of VO will seriously challenge healthcare systems, particularly due to demographic change and increasing proportions of populations turning 75 years and older. With respect to globally fast aging populations, future health care policies need to address this burden by anticipating limitations in financial and human resources and developing high-level evidence-based guidelines for prevention and interdisciplinary treatment.

Effect of diisobutyl adipate on the expression of biomarker genes that respond to endocrine disruption and on gonadal sexual differentiation in Japanese medaka (Oryzias latipes).

Phthalate and non-phthalate plasticizers are used in polymer materials, such as plastic and rubber. It has recently been found that diisobutyl adipate (DIBA), which is considered an environmentally safe non-phthalate plasticizer, potentially acts as a thyroid disruptor in fish. Here, we investigated the sexual hormone effects of DIBA based on the expression levels of genes that respond to endocrine disruption and sexual hormone activity in the livers and gonads, and on gonadal sexual differentiation in Japanese medaka. Compared with the control group, the mRNA expression of chgH, vtg1, vtg2, and esr1 was significantly suppressed in the livers of DIBA exposed XX individuals. Furthermore, the mRNA expression of gsdf was significantly upregulated and downregulated in the gonads of XX and XY individuals, respectively. The mRNA expressions of esr1 and esr2b were significantly suppressed by DIBA exposure in the gonads of both XX and XY individuals. These observations suggest that DIBA has potential androgenic activity in Japanese medaka. However, normal testes and ovaries were observed in respective XY and XX medaka after DIBA exposure; therefore, these results suggest that DIBA may have weak androgenic activity.

Comparison of ALIF and PLIF in Isthmic Lumbosacral Spondylolisthesis. A Multicenter Surveillance Study of 602 cases from the German Spine Registry (DWG Register).

BACKGROUND: Isthmic spondylolisthesis most commonly occurs in the lumbosacral junction and can cause backpain and radicular pain as well as stiffness with progressive immobilization, with a negative impact on an individual's ability to work and quality of life. Multiple operative treatments are currently available. This study aims to compare complications, demography, and clinical features between anterior lumbar interbody fusion (ALIF) and posterior lumber body fusion (PLIF) in the operative treatment in isthmic spondylolisthesis. METHODS: An analysis of data from the German spine registry (Deutsche Wirbelsäulengesellschaft [DWG]-Register) of patients who underwent operative treatment (PLIF and ALIF) for isthmic spondylolisthesis in the sacrolumbar junction in 170 departments between January 2017 and May 2021 was performed. Age, gender, American Society of Anesthesiologists (ASA) score, surgical approach, smoker/nonsmoker, as well as severeness of the spondylolisthesis according to the Meyerding classification were evaluated. RESULTS: In total, 602 patients undergoing fusion in L5/S1 were identified in the registry, n = 570 PLIF (group 1) and n = 32 ALIF (group 2). A significant difference in the ASA score between the two groups was noted; group 1 had more patients suffering a more debilitating disease in comparison to group 2. There was no significant difference in gender, grade of spondylolisthesis, age, or smoking status. Significant differences were found in operative and postoperative variables and complications (fusion material, dura injury). CONCLUSION: No difference was found between the two procedures in terms of symptomatic benefit of patients who underwent either ALIF or PLIF. According to the DWG Register, PLIF was the preferred method to treat isthmic spondylolisthesis in the sacrolumbar junction in Germany. To compare these two spine fusion techniques, further studies with an adequate sample size and follow-up period are required.

Sublethal Biochemical Effects of Polyethylene Microplastics and TBBPA in Experimentally Exposed Freshwater Shrimp Palaemonetes argentinus.

The biochemical effects of sublethal exposure to polyethylene microplastics (PEM) of 40-48 µm particle size and the flame retardant tetrabromobisphenol A (TBBPA), a plastic additive, on the freshwater shrimp Palaemonetes argentinus were assessed. Here, we postulate that the use of enzyme and thyroid hormones as biomarkers contributes to the knowledge of the effects of microplastics and plastic additives on freshwater crustaceans. To address this, we evaluated the activities of acetylcholinesterase (AChE), glutathione S-transferase (GST), and carboxilesterase (CbE, using 1-naphthyl acetate (NA) as substrate) and levels of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) after shrimp were exposed (for 96 h) to these xenobiotics at environmentally realistic concentrations. The results showed that the mixture of both xenobiotics led to a decrease in AChE and GST activities and increased T4 levels. We suggest that physiological processes could be compromised in freshwater organisms when exposed to microplastics and TBBPA together, and this could ultimately affect upper levels of the food web.

Effects of plasticizer diisobutyl adipate on the Japanese medaka (Oryzias latipes) endocrine system.

Plasticizer pollution of the water environment is one of the world's most serious environmental issues. Phthalate plasticizers can disrupt endocrine function in vertebrates. Therefore, this study analyzed thyroid-related, reproduction-related, and estrogen-responsive genes in Japanese medaka (Oryzias latipes) to determine whether non-phthalate diisobutyl adipate (DIBA) plasticizer could affect endocrine hormone activity or not. Developmental toxicity during fish embryogenesis was also evaluated. At a concentration of 11.57 mg/l, embryonic exposure to DIBA increased the mortality rate. Although abnormal development, including body curvature, edema, and lack of swim bladder inflation, was observed at 3.54 and 11.57 mg/l DIBA, growth inhibition and reduced swimming performance were also observed. In addition, DIBA exposure increased the levels of thyroid-stimulating hormone beta-subunit (tshß) and deiodinase 1 (dio1) but decreased the levels of thyroid hormone receptor alpha (trα) and beta (trß). These results suggest that DIBA has thyroid hormone-disrupting activities in fish. However, kisspeptin (kiss1 and kiss2), gonadotropin-releasing hormone (gnrh1), follicle-stimulating hormone beta (fshß), luteinizing hormone beta (lhß), choriogenin H (chgH), and vitellogenin (vtg1) expression did not change dose-dependently in response to DIBA exposure, whereas gnrh2 and vtg2 expression was elevated. These results indicate that DIBA has low estrogenic activity and does not disrupt the endocrine reproduction system in fish. Overall, this is the first report indicating that non-phthalate DIBA plasticizer is embryotoxic and disrupt thyroid hormone activity in fish.

Impact of Obesity on Perioperative Complications on Treatment of Spinal Metastases: A Multicenter Surveillance Study from the German Spine Registry (DWG-Register).

Background The spine is a common location for the development of primary and metastatic tumors, spinal metastases being the most common tumor in the spine. Spinal surgery in obesity is challenging due to difficulties with anesthesia, intravenous access, positioning, and physical access during surgery. The objective was to investigate the effect of obesity on perioperative complications by discharge in patients undergoing surgery for spinal metastases. Methods Retrospective analysis of data from the DWG-register on patients undergoing surgery for metastatic disease in the spine from January 2012 to December 2016. Preoperative variables included obesity (≥ 30 kg/m 2 ), age, gender, and smoking status. In addition, the influence of pre-existing medical comorbidity was determined, using the American Society of Anesthesiologists (ASA) score. Results In total, 528 decompressions with and without instrumentation undergoing tumor debulking, release of the neural structures, or tumor extirpation in metastatic disease of the spine were identified; 143 patients were obese (body mass index [BMI] ≥ 30 kg/m 2 ), and 385 patients had a BMI less than 30 kg/m 2 . The mean age in the group with BMI 30 kg/m 2 or higher (group 1) was 67 years (56.6%). In the group with BMI less than 30 kg/m 2 (group 2), the mean age was 64 years. Most of the patients had preoperatively an ASA score of 3 and 4 (patients with severe general disease). The likelihood of being obese in the logistic regression model seems to be protective by 47.5-fold for blood loss 500 mL or higher. Transfusions occurred in 321/528 (60.7%) patients (group 1, n = 122 and group 2, n = 299; p = 0.04). A total of 19 vertebroplasties with percutaneous stabilization (minimally invasive spine [MIS]), 6 vertebroplasties, and 31 MIS alone were identified. The variables between these groups, with exception of preoperative status (ASA-score; p = 0.02), remained nonsignificant. Conclusion Obese patients were predisposed to have blood loss more than 500 mL more often than nonobese patients undergoing surgery for spinal metastases but with perioperative blood transfusions, invasiveness, nor prolonged hospitalization. Early postoperative mobilization and a low threshold for perioperative venous thromboembolism (VTE) are important in obese patients to appropriately diagnose, treat complications, and minimize morbidity.

Does color play a predominant role in the intake of microplastics fragments by freshwater fish: an experimental approach with Psalidodon eigenmanniorum.

Microplastics (MPs) have been reported in fish species from several freshwater environments. However, the mechanisms underlying MPs ingestion by fish are still unclear, although they are important to determine the pathway of MPs along freshwater environments food webs. Here, we investigates a fundamental question of why wild freshwater fish ingest plastic. To address this, we conducted a laboratory experiment to assess MP fragments intake according to color (red, green, yellow, white, black, and blue) by a small omnivorous fish species Psalidodon eigenmanniorum (Characidae). Results showed that yellow and blue were the most consumed fragments, whereas fish avoided white fragments. Although it is not yet clear how plastic coloration relates to the selectivity and feeding of freshwater fish, the visual skills at a species-specific level could plausibly explain why certain colors are attractive or deterrent to a particular fish species. This data set can be used as a screening tool that could help to understand the mechanisms underlying the patterns of plastic ingestion by fish, with special emphasis on the color of plastic particles. Future research on mechanisms MPs intake by fish, also providing a multi-species approach is highly recommended.

Challenging the dogma to "always operate" acute hip fractures: a proof-of-concept pilot study for nonoperative management of undisplaced femoral neck fractures.

BACKGROUND: The notion that all acute hip fractures are a surgical entity requiring either surgical fracture fixation or hip replacement represents a historic dogma, particularly within the orthopaedic community of the United States. The present study from a European regional trauma center was designed to challenge the notion that stable and undisplaced femoral neck fractures represent an absolute indication for surgical management. METHODS: The purpose of this study was to investigate the hypothesis that stable and undisplaced femoral neck fractures of the Garden types 1 and 2 can be safely managed nonoperatively. A retrospective observational cohort study was carried out at a regional orthopaedic trauma center in Germany from January 1, 2016 to June 30, 2021. The inclusion criteria specified patients older than 18 years suffering a < 24 h, traumatic, femoral neck fracture Garden types 1 and 2. Exclusion criteria included Garden types 3 and 4 femoral neck fractures, pregnancy, active infection or previous surgery, tumor-associated fractures, medical history of femoral neck necrosis, vascular injury associated with femoral neck fractures, nerve injury associated to a femoral neck fracture and ≥ 24 h femoral neck fracture. The primary intention of this research was to identify deterioration of fracture retention with an ensuing unplanned trip to the operating room in femoral neck fractures Garden types 1 and 2. Secondary were included unplanned readmissions and complications such as surgical site infection. RESULTS: A total of 41 undisplaced femoral neck fractures (Garden types 1 and 2) were included in this study; n = 20 were in the resulting admission operatively treated (group 1) and n = 21 were treated conservatively. The mean age in group 1 was 76 years; women (70%). In group 2 it was 81 years with a female dominance (71.4%). Admission status: Garden types 1 and 2, group 1 n = 13/7 and group 2 n = 15/6. Subsequent femoral neck fracture displacement (Y/N) (in case of operation, before operation) group 1 n = 14/6 and group 2 n = 6/15. CONCLUSION: According with our results, patients sustaining Garden type 1 femoral neck fractures, depending on age and comorbidities, should be treated conservatively with weight bearing and under physiotherapeutic instructions. In case of femoral neck fractures Garden type 2, a surgical treatment should be performed in order to avoid femoral neck fractures to slip after weight bearing by lacking of fracture impaction.

Uso de Antibióticos y Resistencia Antimicrobiana en la Unidad de Cuidado Intensivo Neonatal / Use of antibiotics and antimicrobial resistance in the Neonatal Intensive Care Unit

Resumen La sepsis neonatal constituye una de las principales causas de mortalidad neonatal en los países en desarrollo. Los neonatos, en particular los prematuros, tienen un mayor riesgo de infecciones bacterianas, por lo que el manejo con antibióticos constituye la terapia más frecuente en la Unidad de Cuidado Intensivo Neonatal (UCIN), estimándose en hasta un 70%. La presentación clínica de la sepsis neonatal es inespecífica en muchas ocasiones, lo que hace que la antibioticoterapia empírica se inicie tempranamente para evitar consecuencias deletéreas para los pacientes; su inespecificidad la caracteriza como un reto diagnóstico, por lo que diferentes autores han diseñado estrategias para determinar neonatos candidatos a terapia antimicrobiana. La microbiología permanece en contacto estrecho con la clínica ya que conocer los gérmenes frecuentemente asociados a la sepsis neonatal ayuda a determinar el espectro antibiótico a usar. De igual forma, el conocimiento de la farmacología antibiótica es clave puesto que el tratamiento antibiótico no es inocuo y puede asociarse a aumento de morbilidad o mortalidad. El tiempo de evolución y los factores de riesgo maternos están asociados a los gérmenes responsables esperados, ya descritos por múltiples estudios descriptivos a nivel mundial. El uso indiscriminado de antibióticos de amplio espectro para el manejo de infecciones en los recién nacidos ha generado un aumento en la resistencia antibiótica, lo que a su vez lleva a tasas más altas de fallo terapéutico con el uso de las terapias antibióticas empíricas. A razón de lo anterior, los Programas de Vigilancia de Uso de Antibióticos juegan un papel determinante para monitorear el cambio en la resistencia a nivel local para ajustar y homogeneizar la práctica médica que logre regular el uso de antibióticos y mitigar la emergente resistencia bacteriana.

Abstract Neonatal sepsis constitutes one of the main causes of neonatal mortality in developing countries. Newborns, particularly premature newborns, have a higher risk of bacterial infections that result in frequent administration of antibiotics in the Neonatal Intensive Care Units (NICU), which is estimated to be as high as 70%. The clinical presentation of neonatal sepsis is nonspecific, prompting the early use of empirical antibiotic prescription to avoid adverse consequences in the patients. Its non-specificity characterizes it as a challenging diagnostic, this aspect led several authors to design strategies to determine which newborns are true candidates for antimicrobial therapy. Microbiology is closely linked to clinical practice. Thus, knowing the most frequent bacteria associated with neonatal sepsis will be closely related to the antibiotic spectrum that should be used to treat it. Furthermore, knowledge on basic pharmacology is key inasmuch as the antimicrobial treatment is not innocuous and can be related to an increase in mortality and morbidity. Clinical course and maternal risk factors are associated with the expected responsible germs that are already described in multiple descriptive studies worldwide. Indiscriminate use of broad-spectrum antibiotics for the management of newborn infections is leading to antibiotic resistance increase. At the same time, this is related to even higher rates of therapeutic failure with empiric antimicrobial treatment. Based on this, Antimicrobial Stewardship Programs play a determinant role to monitor the changes in local resistance to adjust and homogenize medical practice to regulate the use of antibiotics and mitigate the emergent and threatening antimicrobial bacterial resistance.

Accumulation of PBDEs and MeO-PBDEs in notothenioid fish from the South Shetland Islands, Antarctica: An interspecies comparative study.

Concentrations of polybrominated diphenyl ethers (PBDEs) and methoxylated polybrominated diphenyl ethers (MeO-PBDEs); are reported in specimens of fish notothenioids Chaenocephalus aceratus (SSI), Trematomus bernacchii (ERN), and Nototheniops nudifrons (NOD) from the South Shetland Islands, Antarctica. Significant differences in the accumulation of 2'-MeO-BDE-68 and 6-MeO-BDE-47 were detected among the analysed species. MeO-BDEs were significantly higher in SSI (11.7, 8.6, and 14.1 ng g-1 lw) than in NOD (1.63, 1.63, and 3.0 ng g-1 lw) in muscle, liver, and gill, respectively. Feeding ecology traits explain the accumulation patterns of MeO-PBDEs. SSI has a higher feeding activity with a broader diet, followed by ERN, whereas NOD is a benthic/sedentary fish with a narrower diet. The accumulation of PBDEs was neither species-, nor tissue-specific. The current study expands the knowledge concerning the accumulation of PBDEs and MeO-PBDEs in Antarctic marine fish and supports the importance of species-specificity in the accumulation of MeO-PBDEs.

Impact of dietary lipid level on esterase enzyme activities in the non-target freshwater shrimp Macrobrachium borellii exposed to chlorpyrifos.

This study increases our understanding of how diet-driven phenotypic plasticity can help non-target aquatic invertebrates deal with chlorpyrifos (CPO) exposure. A bioassay was performed over 6 days with the freshwater shrimp Macrobrachium borellii. Experimental treatments included CPO-treated shrimps (10 µg L-1) were fed with (i) a lipid-rich diet, (ii) a lipid-medium diet, or (iii) a lipid-poor diet. Control shrimps (no CPO exposure) received the same diets as detailed above. Cholinesterases and carboxylesterases were determined as an indicator of CPO exposure. Results showed that diets with a medium-to-high lipid content were important inducers of esterase activity, while shrimps exposed to CPO under a lipid-poor diet showed a significant enzymatic inhibition. This diet-dependent esterase induction suggests that the intake of fatty dietary items mitigates the esterase enzyme inhibition caused by CPO exposure.

Microanalytical flow system for the simultaneous determination of acetic acid and free sulfur dioxide in wines.

Free sulfur dioxide and volatile acidity are parameters related to the quality of wines. Traditional methods for their determination are tedious, time consuming and require analysis in decentralized laboratories, therefore corrective actions cannot be applied on time. This may be more complex in aging wine cellars, where hundreds of individual barrels containing almost finished wines should be monitored. To achieve this aim, a portable microanalytical flow system for the simultaneous detection of free SO2 and acetic acid during the ageing of wines is proposed in this work. The miniaturized system is based on the use of a gas-diffusion membrane and a pH-ISFET, and can be easily installed in barrels. The system was optimized in the range of 5-60 mg L-1 and 0.15-1.40 g L-1 for SO2 and acetic acid, respectively. It was validated with different sets of wine samples by comparing the results with standard methods, demonstrating a good agreement between methods.

A self-calibrating and multiplexed electrochemical lab-on-a-chip for cell culture analysis and high-resolution imaging.

In vitro analysis requires cell proliferation in conditions close to physiological ones. Lab-on-a-chip (LoC) devices simplify, miniaturize and automate traditional protocols, with the advantages of being less expensive and faster due to their shorter diffusion distances. The main limitation of current LoCs is still the control of the culture conditions. Most LoCs employ off-chip equipment to determine cell culture activity, which confers limited monitoring capacity. The few systems integrating transducers on-chip present important functional problems mostly associated with the attachment of biomolecules to the transducer surface (i.e., biofouling) and the impossibility of re-calibrating the sensors during cell culturing. This limitation is addressed in the present LoC containing a network of micro-channels and micro-chambers, which allows (i) cell seeding and cultivation, avoiding biofouling risk, (ii) multiplexed analysis of cell culture, reactivation and recalibration of the (bio)sensors without compromising cell viability, (iii) cell imaging and (iv) reference electrode compartmentalization to guarantee stability. The activity of the culture is monitored with four independent electrochemical micro-electrodes for glucose, hydrogen peroxide, conductivity and oxidation reduction potential. Electrochemical analysis is complemented with high-resolution confocal microscopy analysis. This paper demonstrates the suitability of the current configuration for cell culture monitoring and future applications in drug screening or organ-on-a-chip development.

Individual diet specialisation in sparrows is driven by phenotypic plasticity in traits related to trade-offs in animal performance.

Individual diet specialisation (IS) is frequent in many animal taxa and affects population and community dynamics. The niche variation hypothesis (NVH) predicts that broader population niches should exhibit greater IS than populations with narrower niches, and most studies that examine the ecological factors driving IS focus on intraspecific competition. We show that phenotypic plasticity of traits associated with functional trade-offs is an important, but unrecognised mechanism that promotes and maintains IS. We measured nitrogen isotope (δ15 N) and digestive enzyme plasticity in four populations of sparrows (Zonotrichia capensis) to explore the relationship between IS and digestive plasticity. Our results show that phenotypic plasticity associated with functional trade-offs is related in a nonlinear fashion with the degree of IS and positively with population niche width. These findings are opposite to the NVH and suggest that among individual differences in diet can be maintained via acclimatisation and not necessarily require a genetic component.

Assessing biochar impact on earthworms: Implications for soil quality promotion.

Potential harmful effects of spent coffee grounds (SCGs)-derived biochar on earthworms (Lumbricus terrestris) were investigated through two complementary experiments, which assessed the avoidance response of earthworms to biochar-amended soils (experiment 1), and the response of oxidative stress biomarkers and digestive enzymes (experiment 2). The main results were: 1) the highest dose of biochar (5% w/w) caused a significant avoidance response of earthworms (75% individuals avoided these treated soils after 48 h); 2) signs of oxidative stress were early detected in earthworms exposed to biochar (1 and 5% w/w) as indicated by the integrated biological response index; 3) earthworms exposed to biochar-amended soils for 30 d experienced a significant increase of digestive enzyme activities measured in both the gastrointestinal tissue and the luminal content; 4) interaction between earthworms and biochar led to a higher soil extracellular enzyme activities in the 1% biochar treatment than that of control and 5% biochar treatments. These findings suggest that the joint application of SCG-biochar and L. terrestris is a workable approach for improving soil quality in terms of soil biochemical promotion, although earthworms may develop some physiological mechanisms of biochar tolerance (antioxidant defenses).

Incidence of early postoperative complications requiring surgical revision for recurrent lumbar disc herniation after spinal surgery: a retrospective observational study of 9,310 patients from the German Spine Register.

BACKGROUND: The recurrence rate in lumbar disc herniations (LDH) has been reported between 5 and 25%. There are only few data about this phenomenon that occurs within days of the initial operation. We analyse early recurrent LDH by analysis of data from the German Spine register. METHODS: Data from patients undergoing disc herniation surgery in the lumbar region were extracted from the German Spine Registry between 1st January 2012 and 31st December 2016. Patients with early recurrent LDH within days of initial surgery were separately analysed. RESULTS: A total of 9310 surgeries for LDH were documented in the German Spine Register. From these patients 115 (1.2%) presented an early recurrent disc surgeries within days of the initial surgery. The mean age was 70 ± 2.50 years. Most affected segment was L4/5 (47 cases, 41%), followed by L3/4 (45 cases, 39%). The most of our patients showed a normal or overweight Body Mass Index. Surgery for early recurrent LDH was associated with a high rate of incidental durotomies (20 cases, 17.6%). In 3 cases (2.6%) therapy with a lumbar drain was necessary. CONCLUSIONS: The rate of early recurrent LDH within days of surgery is 1.2%. Age seems to be an important factor in early recurrent LDH while obesity does not. The data of the German Spine Register seems to have a reliable data collection system that can perform multicentre data analysis. The databases from this Register could be used in the future for various purposes, such as the evaluation of multicentre surgical techniques, results in patients with various surgical procedures and basic research in spine surgery.

Predictors of hydrocephalus as a complication of non-traumatic subarachnoid hemorrhage: a retrospective observational cohort study in 107 patients.

BACKGROUND: The predictors of shunt dependency such as amount of subarachnoid blood, acute hydrocephalus (HC), mode of aneurysm repair, clinical grade at admission and cerebro spinal fluid (CSF) drainage in excess of 1500 ml during the 1st week after the subarachnoid hemorrhage (SAH) have been identified as predictors of shunt dependency. Therefore our main objective is to identify predictors of CSF shunt dependency following non-traumatic subarachnoid hemorrhage. METHODS: We performed a retrospective study including patients from January 1st 2012 to September 30th 2014 between 16 and 89 years old and had a non-traumatic subarachnoid hemorrhage in cranial computed tomography (CCT). We excluded patients with the following characteristics: Patients who died 3 days after admittance, lesions in brainstem, previous surgical treatment in another clinic, traumatic brain injury, pregnancy and disability prior to SAH.We performed a descriptive and comparative analysis as well as a logistic regression with the variables that showed a significant difference (p < 0.05). Hence we identified the variables concerning HC after non traumatic SAH and its correlation. RESULTS: One hundred and seven clinical files of patients with non-traumatic SAH were analyzed. Twenty one (48%) later underwent shunt treatment. Shunt patients had significantly clinical and corroborated with doppler ultrasonography vasospasmus (p = 0.015), OR = 5.2. The amount of subarachnoidal blood according to modified Fisher grade was (p = 0.008) OR = 10.9. Endovascularly treated patients were less often shunted as compared with those undergoing surgical aneurysm repair (p = 0.004). CONCLUSION: Vasospasmus and a large amount of ventricular blood seem to be a predictor concerning hydrocephalus after non-traumatic SAH. Hence according to our results the presence of these two variables could alert the treating physician in the decision whether an early shunt implantation < 7 days after SAH should be necessary.

Response of digestive enzymes and esterases of ecotoxicological concern in earthworms exposed to chlorpyrifos-treated soils.

Assessment of organophosphorus (OP) pesticide exposure in non-target organisms rarely involves non-neural molecular targets. Here we performed a 30-d microcosm experiment with Lumbricus terrestris to determine whether the activity of digestive enzymes (phosphatase, ß-glucosidase, carboxylesterase and lipase) was sensitive to chlorpyrifos (5 mg kg-1 wet soil). Likewise, acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activities were measured in the wall muscle and gastrointestinal tissues as indicators of OP exposure. Chlorpyrifos inhibited the acid phosphatase (34% of controls), carboxylesterase (25.6%) and lipase activities (31%) in the gastrointestinal content. However, in the gastrointestinal tissue, only the carboxylesterase and lipase activities were significantly depressed (42-67% carboxylesterase inhibition in the foregut and crop/gizzard, and 15% lipase inhibition in the foregut). Chlorpyrifos inhibited the activity of both cholinesterases in the gastrointestinal tissues, whereas the AChE activity was affected in the wall muscle. These results suggested chlorpyrifos was widely distributed throughout the earthworm body after 30 d of incubation. Interestingly, we found muscle carboxylesterase activity strongly inhibited (92% of control) compared with that detected in the gastrointestinal tissues of the same OP-exposed individuals. This finding was explained by the occurrence of pesticide-resistant esterases in the gastrointestinal tissues, which were evidenced by zymography. Our results suggest that digestive processes of L. terrestris may be altered by chlorpyrifos, as a consequence of the inhibitory action of the insecticide on some digestive enzymes.

Influence of the State of the Subarachnoid Space of the Cranial Base in Hydrocephalus Resolution after Endoscopy.

Objective To compare the resolution rate of hydrocephalus after endoscopy (predominantly endoscopic third ventriculostomy [ETV]) using flexible endoscopes during a 5-year period in patients with a permeable and a nonpermeable subarachnoid space (SAS). Material and Methods We conducted a retrospective cohort study of the videos and records of 150 hydrocephalic patients chosen randomly who underwent ETV (and other endoscopic procedures) with a flexible endoscope. The patients were classified into two groups based on the neuroendoscopic findings. The first group included patients with a permeable SAS, and the second group included patients with a nonpermeable SAS. A normal SAS or one with slight arachnoiditis was considered permeable. Adhesive arachnoiditis and immature or mechanically obliterated SASs were considered nonpermeable. Results We found a success rate of 70% in patients with a permeable SAS versus 33% in patients with a nonpermeable SAS. The baseline characteristics of both groups were homogeneous. We obtained a statistically significant difference (p < 0.0001) with hazard ratio (HR) 3.42 (95% confidence interval [CI], 1.88-6.22). Another important factor involved was age that showed a statistically significant difference (p < 0.0018) with HR 3.28 (95% CI, 1.55-6.93). Conclusion The permeability of the SAS is an important prognostic factor in the resolution rate of hydrocephalus after ETV (and other endoscopic procedures) using flexible neuroendoscopes. Therefore we recommend that the characteristics of the SAS be examined following every endoscopic procedure for hydrocephalus to identify patients at risk of recurrence.