Secretory Tissues and Volatile Components of Disc Florets in Several Wild Helianthus L. Species.

Although flower pollinator interactions are known to be mediated by floral traits, not enough attention has been paid to the research of secretory tissues and volatile components of sunflower disc florets as potentially important parameters in breeding programs. (1) To our knowledge, this is the first integrated study aimed at better understanding the attractiveness of sunflower capitula to insects. In the study, we have made a very detailed comparative analysis of secretory tissues and the characterization of the volatile components (VOCs) of disc florets in 10 wild perennial Helianthus species. (2) For anatomical analyses, cross-sections were obtained from the nectary zone of disc florets using a cryotechnique procedure. Micromorphological observation and morphological and anatomical analysis of disc florets were performed using light and scanning electron microscopy. For VOCs, we applied headspace, GC-FID, and GC/MS analyses. (3) The obtained results indicate that there is a difference between the analyzed traits among studied species. H. eggertii, H. hirsutus, H. mollis, H. resinosus, and H. tuberosus had high disc diameter values, a high cross-section area and disc floret corolla length, as well as the largest cross-section area and thickness of the disc florets nectary. In the analyzed VOCs, 30 different compounds were detected. The highest yield and quantity of α-Pinene was observed in H. mollis. (4) Inflorescence features, such as receptacle diameter, corolla and secretory tissue properties, and floret VOCs production and characterization, provided valuable information that can be used as guidelines in sunflower breeding programs to maximize pollinator attractiveness and increase seed yield.

The Anatomical Basis of Heavy Metal Responses in Legumes and Their Impact on Plant-Rhizosphere Interactions.

Rapid industrialization, urbanization, and mine tailings runoff are the main sources of heavy metal contamination of agricultural land, which has become one of the major constraints to crop growth and productivity. Finding appropriate solutions to protect plants and agricultural land from heavy metal pollution/harmful effects is important for sustainable development. Phytoremediation and plant growth-promoting rhizobacteria (PGPR) are promising methods for this purpose, which both heavily rely on an appropriate understanding of the anatomical structure of plants. Specialized anatomical features, such as those of epidermis and endodermis and changes in the root vascular tissue, are often associated with heavy metal tolerance in legumes. This review emphasizes the uptake and transport of heavy metals by legume plants that can be used to enhance soil detoxification by phytoremediation processes. Moreover, the review also focuses on the role of rhizospheric organisms in the facilitation of heavy metal uptake, the various mechanisms of enhancing the availability of heavy metals in the rhizosphere, the genetic diversity, and the microbial genera involved in these processes. The information presented here can be exploited for improving the growth and productivity of legume plants in metal-prone soils.

Post-operative opioid-related adverse events with intravenous oxycodone compared to morphine: A randomized controlled trial.

BACKGROUND: The value of intravenous oxycodone compared to morphine remains controversial. The purpose of this trial was to compare opioid-related adverse events (ORAES) of intravenous oxycodone and morphine after total hip arthroplasty. METHODS: Patients scheduled for total hip arthroplasty were enrolled in this study of post-operative pain treatment with intravenous oxycodone or intravenous morphine (ratio 1:1). After surgery, patients received similar drug regimens for titration in the post-operative care unit followed by intravenous patient-controlled analgesia (PCA). The primary outcome was the number of patients with ≥1 ORAEs within the first 24 hours defined as either nausea, vomiting, respiratory depression, pruritus, urinary retention requiring evacuation, allergy, hallucinations. Secondary outcomes included pain scores and opioid consumption. RESULTS: The analysis included 238 patients with similar characteristics. There were 55 patients with at least one ORAEs in the oxycodone group vs 46 in the morphine group: 48% vs 40%, P = .19; relative risk = 1.22 (0.91:1.63). Intravenous oxycodone vs intravenous morphine requirements were respectively (median, IQR): 6 (0-11) vs 8 (0-12) mg (P = .06) for titration, 15 (8-26) vs 8 (5-16) mg (P = .001) for PCA, and 22 (12-37) mg vs 19 (11-28) mg for cumulated intravenous consumption (P = .048). During the first 24 hours, there was no difference in secondary outcomes (oxycodone vs morphine, respectively, in %): nausea (15 vs 13), vomiting (5 vs 5), urinary retention (20 vs 12) or pain scores. CONCLUSION: This study demonstrates that IV oxycodone did not significantly reduce ORAEs within the first 24 hours compared to similar ratio of IV morphine.

Preoperative vaping prevalence and behavior of French surgical patients: A multicentre study.

INTRODUCTION: Prevalence and tobacco-related perioperative complications have been largely reported. The impact of vaping (e-cigarette use) on the perioperative period has been rarely evaluated. The purpose of this multicentre cross-sectional survey was to assess the prevalence of vaping and behaviour of patients undergoing elective surgery. METHODS: After institutional review board committee and patient approvals, patients (aged ≥18 years) scheduled for elective non-cardiac surgery in six French hospitals were assessed preoperatively. Demographic characteristics, and information on vaping, smoking or dual-use status and consumption were reported. RESULTS: In six centres, 1712 eligible patients were approached and 1664 patients were included in this study from June 2016 to January 2017. Of these, 62 patients used e-cigarettes in the preoperative period (3%; 95% CI: 2-4), including 24 exclusive e-cigarette users (1%; 95% CI: 1-2), 38 dual-users (2%; 95% CI: 2-3) and 365 smokers (22%; 95% CI: 20-24). Vapers were older than smokers (53 vs 47 years old; p=0.01). During the preoperative period, 12 patients (1%) reported vaping the morning of surgery. CONCLUSIONS: In the preoperative period, vaping was ten-fold less prevalent than smoking. Although the clinical relevance may be weak, further research is needed to explore the real impact of vaping on patients' outcomes and to elaborate on clinical recommendations.

Opioid-sparing effect of nefopam in combination with paracetamol after major abdominal surgery: a randomized double-blind study.

BACKGROUND: Because nefopam's morphine-sparing is debated when combined with paracetamol, this study aimed to assess pain relief by IV nefopam in combination with paracetamol after major abdominal surgery. METHODS: This was a prospective, double-blinded randomized controlled study including patients (ASA I-III, >18 years) scheduled for elective colectomy surgery by laparotomy. Patients were randomized into the nefopam group (N.=37, continuous IV 120 mg nefopam) or control group (N.=32, placebo, same infusion) for 48 hours after surgery (both groups: IV paracetamol 1 g/6 h + IV PCA morphine rescue). The primary endpoint was the total morphine consumption from the potential titration in the postoperative care unit to 48 hours (20% reduction in nefopam group). The secondary endpoints were adverse events and clinical outcomes. RESULTS: Both groups were similar for demographic characteristic, surgery, and anesthesia (including IV sufentanil 20 [20-25] µg for nefopam vs. 22.5 [20-25] µg for the control, P=0.6). Time in PACU and hospital stay were not statistically different. The number of patients requiring titration in PACU and the amount of IV morphine titration were similar. As the main endpoint, morphine consumption over the study period was similar between nefopam and the control group (respectively, 53±37 and 54±34 mg, P=0.86). No difference was observed for pain relief satisfaction between groups or total adverse events like PONV, ileus, desaturation, or confusion (nefopam 14±38 vs. control group 11±34, P=0.77). CONCLUSIONS: This prospective randomized study suggested that nefopam in combination with paracetamol has no benefit after open abdominal surgery.

Residual anxiety after high fidelity simulation in anaesthesiology: An observational, prospective, pilot study.

BACKGROUND: High fidelity simulation (HFS) in anaesthesiology intentionally provides stress on students, but anxiety may be detrimental if it goes on through debriefing. The primary goal of this study was to estimate the proportion of students with significant anxiety remaining after debriefing (residual anxiety [RA]). Secondary goals were to evaluate the instructors' ability to estimate students' RA and to identify potential risk factors for high RA. SUBJECTS AND METHODS: Following IRB approval and informed consent, data from a cohort of subjects were prospectively collected by an independent expert. State-anxiety after debriefing (RA) was prospectively measured using the State-Trait Anxiety Inventory (a score varying from 20 to 80/80). RA was considered significant when≥36/80. Instructors simultaneously estimated the levels of subjects' RA via a visual analogue scale. Data about subjects, stress during scenarios (including continuous heart rate monitoring), and debriefings (including DASH© quality scores) were also collected. RESULTS: Seventy study subjects (30 residents, 26 nurses and 14 anaesthetists) were enrolled during 52 HFS sessions. As concerns the primary endpoint, RA was≥36/80 in 15 subjects (21%; 95% CI: 13-32). The median RA was 30/80 [25-35]. For secondary endpoints, the instructors' estimations poorly correlated with measurements: rho=0.36 (P<0.01); limits of agreement: -16 and 22. Subjects with RA≥36/80 had significantly higher trait-anxiety (P<0.01). An easy scenario (P=0.04) and low quality debriefing (P=0.04) were associated with higher RAs. CONCLUSION: Most students experienced low anxiety after debriefing. Instructors seem to be unable to reliably estimate students' RA. Students with an anxious personality are more likely to be anxious after debriefing.

Continuous interscalene brachial plexus nerve block prolongs unilateral diaphragmatic dysfunction.

BACKGROUND AND OBJECTIVES: Single interscalene blocks (ISB) impair pulmonary function (<24h). We hypothesized that continuous ISBs would prolong pulmonary dysfunction until h48 compared with a single ISB. We compared the time course of spirometric and diaphragmatic dysfunction following single or continuous ISBs. METHODS: We prospectively included consecutive adult patients scheduled to undergo shoulder surgery under standard general anaesthesia with single (n=30) or continuous (n=31) ISB. Before ISB (baseline), spirometric tests were recorded and the diaphragm course was evaluated with a B-mode ultrasound technique every 12h until h48. ISBs were performed with 15mL 0.5% ropivacaine using an ultrasound technique approach. The continuous group received the same bolus followed by 0.2% ropivacaine 5mL·h-1 (48h). The primary end point was the reduction (> 25% from baseline) of forced vital capacity (FVC) over the study period (48h). RESULTS: Patient characteristics were similar in both groups. Thirty minutes after blocks in the PACU, all patients demonstrated a similar and significant unilateral diaphragm paralysis (< 25% from baseline). For the primary end point (FVC), no significant difference was observed between groups over the study period. A difference between single and continuous groups was observed at h24 for: FVC (-25%, P=0.038), FEV1s (-24%, P=0.036), diaphragmatic course (-26%, P=0.02), while no differences for other time points (h0-h48) were noted. Clinical respiratory evaluations (respiratory rate, SpO2, supplementary nasal O2), postoperative pain scores and additional opioid consumption were similar between groups. CONCLUSION: Over infusion, continuous ISB did not significantly prolong unilateral phrenic paresis and demonstrated a limited pulmonary impact.

Influence of Diaphragmatic Motion on Inferior Vena Cava Diameter Respiratory Variations in Healthy Volunteers.

BACKGROUND: The collapsibility index of inferior vena cava (cIVC) is widely used to decide fluid infusion in spontaneously breathing intensive care unit patients. The authors hypothesized that high inspiratory efforts may induce false-positive high cIVC values. This study aims at determining a value of diaphragmatic motion recorded by echography that could predict a high cIVC (more than or equal to 40%) in healthy volunteers. METHODS: The cIVC and diaphragmatic motions were recorded for three levels of inspiratory efforts. Right and left diaphragmatic motions were defined as the maximal diaphragmatic excursions. Receiver operating characteristic curves evaluated the performance of right diaphragmatic motion to predict a cIVC more than or equal to 40% defining the best cutoff value. RESULTS: Among 52 included volunteers, interobserver reproducibility showed a generalized concordance correlation coefficient (ρc) above 0.9 for all echographic parameters. Right diaphragmatic motion correlated with cIVC (r = 0.64, P < 0.0001). Univariate analyses did not show association between cIVC and age, sex, weight, height, or body mass index. The area under the receiver operating characteristic curves for cIVC more than or equal to 40% was 0.87 (95% CI, 0.81 to 0.93). The best diaphragmatic motion cutoff was 28 mm (Youden Index, 0.65) with sensitivity of 89% and specificity of 77%. The gray zone area was 25 to 43 mm. CONCLUSIONS: Inferior vena cava collapsibility is affected by diaphragmatic motion. During low inspiratory effort, diaphragmatic motion was less than 25 mm and predicted a cIVC less than 40%. During maximal inspiratory effort, diaphragmatic motion was more than 43 mm and predicted a cIVC more than 40%. When diaphragmatic motion ranged from 25 to 43 mm, no conclusion on cIVC value could be done.

Spontaneous uterine rupture at 14 weeks gestation during a pregnancy consecutive to an oocyte donation in a woman with Turner's syndrome.

We describe a spontaneous uterine rupture at 14 weeks gestation in a Turner patient. A 39 year-old patient was admitted for abdominal pain and hypotension at 14 weeks of pregnancy. The pregnancy had been obtained by oocyte donation and in vitro fertilization (IVF) because of Turner's syndrome. The abdominal ultrasound scan showed a normal pregnancy and a conserved foetal cardiac activity. It also showed a large amount of free fluid in the perihepatic space. Haemoglobin was 11.2 g/dL. After hemodynamic degradation, urgent laparoscopy showed an unrepairable uterine rupture with partial exteriorisation of the pregnancy, and placenta percreta. Urgent conversion to laparotomy allowed haemostatic hysterectomy. Uterine rupture during pregnancy obtained by oocyte donation in Turner's syndrome may be life threatening. The possibility of such a complication should be considered before oocyte donation for IVF in Turner's patients. Early spontaneous uterine rupture (second trimester) is a challenging diagnostic that should be evoked in case of non-specific abdominal pain in the presence of risk factors.

Beauty will save the world, but will the world save beauty? The case of the highly endangered Vavilovia formosa (Stev.) Fed.

MAIN CONCLUSION: Vavilovia formosa (Stev.) Fed. is a scientifically valuable common ancestor of the plant tribe Fabeae and also important in breeding and agronomy studies of the cultivated Fabeae, but it is close to extinction. A concerted academic and geovernmental effort is needed to save it. Since 2007, an informal international group of researchers on legumes has been working to increase awareness of Vavilovia formosa (Stev.) Fed., a relict and endangered wild-land relative to crop plant species. A majority of the modern botanical classifications place it within the tribe Fabeae, together with the genera vetchling (Lathyrus L.), lentil (Lens Mill.), pea (Pisum L.) and vetch (Vicia L.). V. formosa is encountered at altitudes from 1,500 m up to 3,500 m in Armenia, Azerbaijan, Georgia, Iran, Iraq, Lebanon, Russia, Syria and Turkey. This species may be of extraordinary importance for broadening current scientific knowledge on legume evolution and taxonomy because of its proximity to the hypothetical common ancestor of the tribe Fabeae, as well as for breeding and agronomy of the cultivated Fabeae species due to its perenniality and stress resistance. All this may be feasible only if a concerted and long-term conservation strategy is established and carried out by both academic and geovernmental authorities. The existing populations of V. formosa are in serious danger of extinction. The main threats are domestic and wild animal grazing, foraging, and early frosts in late summer. A long-term strategy to save V. formosa from extinction and to sustain its use in both basic and applied research comprises much improved in situ preservation, greater efforts for an ex situ conservation, and novel approaches of in vitro propagation.

Reversal of a rocuronium-induced grade IV anaphylaxis via early injection of a large dose of sugammadex.

AIM: To report rapid recovery from grade IV rocuronium-induced anaphylaxis with a large dose of sugammadex administered early after the onset of symptoms. CLINICAL FEATURES: A 22-yr-old female without relevant medical history developed an anaphylactic reaction within three minutes of rocuronium injection at induction of anesthesia for a routine cholecystectomy. During the first six minutes, she was unresponsive to usual treatment and her condition evolved to a grade IV anaphylaxis reaction despite a cumulated dose of epinephrine 0.7 mg. Sugammadex 14 mg·kg(-1), injected six minutes after rocuronium, resulted in total resolution of all manifestations of anaphylaxis within three minutes. The patient was discharged from hospital the next day. Allergy investigations confirmed rocuronium as the cause of anaphylaxis. CONCLUSION: Very early administration of a large dose of sugammadex may be an effective treatment for rocuronium-induced anaphylaxis.

Blood wastage reduction: a 10-year observational evaluation in a large teaching institution in France.

CONTEXT: Blood transfusion has increased significantly during the last decade and blood wastage reduction is a medical and economic challenge in hospital practice and for institutional quality, particularly in the ICU and operating theatre. OBJECTIVE: To evaluate the impact of multiple strategies in one hospital to reduce red blood cell wastage. DESIGN: Multicentre, prospective, comparative, observational study. SETTING: Over 10 years, the study was conducted over two time periods. During the first period (2000 to 2003), information was given to medical professionals about blood wastage, and audits (reasons for wastage) were performed, in a large teaching institution (more than 4% wastage in 1999). The second period (2004 to 2010) was designed to analyse the impact of seven strategies intended to minimise blood wastage. Blood wastage reduction in the local centre was compared with regional (64 institutions) and national centres (1470 institutions). Reduction was compared using the Mann-Kendall non-parametric trend test. PATIENTS: Local centre (22,572 transfused patients, Nîmes, France), regional centre (South France, 64 institutions, 208,525 transfused patients) and national centres (France, 1470 institutions). INTERVENTIONS: Medical and surgical procedures. MAIN OUTCOME MEASURES: The primary end-point was to describe the percentage of blood wastage for two periods in a local centre. The secondary objective was to compare the percentage of blood wastage in the local centre with wastage at regional and national centres. RESULTS: Over the 10 year study period the percentage of blood wastage in the local centre decreased, with a significant reduction in the second period, from more than 4% (1999) to less than 1% (2010; P < 0.05). Blood wastage at regional and national centres was never less than 1%. Inadequate containers for transport, absence of a temperature analyser in the ICU and inadequate intraoperative blood strategies (excessive orders of blood) were the main causes of wastage. Correction of these points affected the outcome favourably in the second period, but transfusion information was poor in the first period. CONCLUSION: Seven simple strategies (including transport containers with an effective temperature analyser and audits) decreased blood wastage, especially in the ICU and operating theatre.

Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use.

INTRODUCTION: To investigate whether respiratory variation of inferior vena cava diameter (cIVC) predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure (ACF). METHODS: Forty patients with ACF and spontaneous breathing were included. Response to fluid challenge was defined as a 15% increase of subaortic velocity time index (VTI) measured by transthoracic echocardiography. Inferior vena cava diameters were recorded by a subcostal view using M Mode. The cIVC was calculated as follows: (Dmax - Dmin/Dmax) × 100 and then receiver operating characteristic (ROC) curves were generated for cIVC, baseline VTI, E wave velocity, E/A and E/Ea ratios. RESULTS: Among 40 included patients, 20 (50%) were responders (R). The causes of ACF were sepsis (n = 24), haemorrhage (n = 11), and dehydration (n = 5). The area under the ROC curve for cIVC was 0.77 (95% CI: 0.60-0.88). The best cutoff value was 40% (Se = 70%, Sp = 80%). The AUC of the ROC curves for baseline E wave velocity, VTI, E/A ratio, E/Ea ratio were 0.83 (95% CI: 0.68-0.93), 0.78 (95% CI: 0.61-0.88), 0.76 (95% CI: 0.59-0.89), 0.58 (95% CI: 0.41-0.75), respectively. The differences between AUC the ROC curves for cIVC and baseline E wave velocity, baseline VTI, baseline E/A ratio, and baseline E/Ea ratio were not statistically different (p = 0.46, p = 0.99, p = 1.00, p = 0.26, respectively). CONCLUSION: In spontaneously breathing patients with ACF, high cIVC values (>40%) are usually associated with fluid responsiveness while low values (< 40%) do not exclude fluid responsiveness.

An increase in aortic blood flow after an infusion of 100 ml colloid over 1 minute can predict fluid responsiveness: the mini-fluid challenge study.

BACKGROUND: Predicting fluid responsiveness remains a difficult question in hemodynamically unstable patients. The author's objective was to test whether noninvasive assessment by transthoracic echocardiography of subaortic velocity time index (VTI) variation after a low volume of fluid infusion (100 ml hydroxyethyl starch) can predict fluid responsiveness. METHODS: Thirty-nine critically ill ventilated and sedated patients with acute circulatory failure were prospectively studied. Subaortic VTI was measured by transthoracic echocardiography before fluid infusion (baseline), after 100 ml hydroxyethyl starch infusion over 1 min, and after an additional infusion of 400 ml hydroxyethyl starch over 14 min. The authors measured the variation of VTI after 100 ml fluid (ΔVTI 100) for each patient. Receiver operating characteristic curves were generated for (ΔVTI 100). When available, receiver operating characteristic curves also were generated for pulse pressure variation and central venous pressure. RESULTS: After 500 ml volume expansion, VTI increased ≥ 15% in 21 patients (54%) defined as responders. ΔVTI 100 ≥ 10% predicted fluid responsiveness with a sensitivity and specificity of 95% and 78%, respectively. The area under the receiver operating characteristic curves of ΔVTI 100 was 0.92 (95% CI: 0.78-0.98). In 29 patients, pulse pressure variation and central venous pressure also were available. In this subgroup of patients, the area under the receiver operating characteristic curves for ΔVTI 100, pulse pressure variation, and central venous pressure were 0.90 (95% CI: 0.74-0.98, P < 0.05), 0.55 (95% CI: 0.35-0.73, NS), and 0.61 (95% CI: 0.41-0.79, NS), respectively. CONCLUSION: In patients with low volume mechanical ventilation and acute circulatory failure, ΔVTI 100 accurately predicts fluid responsiveness.

How the relationships between general practitioners and intensivists can be improved: the general practitioners' point of view.

INTRODUCTION: The present study assessed the opinion of general practitioners (GPs) concerning their relationships with intensivists. METHODS: An anonymous questionnaire was mailed to 7,239 GPs. GPs were asked about their professional activities, postgraduate intensive care unit (ICU) training, the rate of patient admittance to ICUs, and their relationships with intensivists. Relationship assessment was performed by using a graduated visual analogue scale (VAS) ranging from 0 (dissatisfaction) to 100 (satisfaction). A multivariate analysis with stepwise logistic regression was performed to isolate factors explaining dissatisfaction (VAS score, < 25th percentile). RESULTS: Twenty-two percent of the GPs (1,561) responded. The median satisfaction score was 57 of 100 (interquartile (IQ), 35 to 77]. Five independent factors of dissatisfaction were identified: no information provided to GPs at patient admission (odds ratio (OR) = 2.55 (1.71 to 3.80)); poor quality of family reception in the ICU (OR = 2.06 (1.40 to 3.02)); the ICU's family contact person's identity or function or both is unclear (OR = 1.48 (1.03 to 2.12)), lack of family information (OR = 2.02 (2.48 to 2.75)), and lack of discharge report (OR = 3.39 (1.70 to 6.76)). Three independent factors prevent dissatisfaction: age of GPs

The influence of the airway driving pressure on pulsed pressure variation as a predictor of fluid responsiveness.

OBJECTIVE: Assessing pulse pressure variation (PPV) to predict fluid responsiveness in mechanically ventilated patients with tidal volume (VT) and the impact of VT and airway driving pressure (P(plat) - PEEP) on the ability of PPV for predicting fluid responsiveness. DESIGN: Prospective interventional study. SETTING: ICU of a university hospital. PATIENTS: Fifty-seven mechanically ventilated and sedated patients with acute circulatory failure requiring cardiac output (CO) measurement. INTERVENTION: Fluid challenge was given in patients with signs of hypoperfusion (oliguria <0.5 ml kg(-1) h(-1), attempt to decrease vasopressor infusion rate). Fluid responsiveness was defined as an increase in the stroke index (SI) >or=15%. Receiver-operating characteristic (ROC) curves were generated for PPV and central venous pressure (CVP). RESULTS: The stroke index was increased >or=15% in 41 patients (71%). At baseline, CVP was lower and PPV was higher in responders. The areas under the ROC curves of PPV and CVP were 0.77 (95% CI 0.65-0.90) and 0.76 (95% CI 0.64-0.89), respectively (P = 0.93). The best cutoff values of PPV and CVP were 7% and 9 mmHg, respectively. In 30 out of 41 responders, PPV was <13%. Using a polytomic logistic regression (P(plat)--PEEP) was the sole independent factor associated with a PPV value <13% in responders. In these responders, (P(plat)--PEEP) was

Chemical composition of essential oil and leaf anatomy of Salvia bertolonii Vis. and Salvia pratensis L. (Sect. Plethiosphace, Lamiaceae).

The taxonomical relationship between Salvia pratensis and S. bertolonii has been unclear for a long time. Salvia bertolonii has alternatively been considered a synonym, a subspecies, a problematic subspecies and a form of Salvia pratensis. However, both these two species are sometimes used in traditional medicine instead of sage (Salvia officinalis) or as an adulteration for the same drug. In order to confirm the status of S. bertolonii, together with the potential identification characteristics for differentiation from sage, both taxa were analyzed through the analysis of their essential oils, together with the micromorphological characteristics of the leaf surface and the anatomy and morphology of the leaves. The obtained results show that there are clear differences in the quantity of essential oil (0.073% for S. pratensis and 0.0016% for S. berolonii). The major compound in the essential oil of S. pratensis was E-caryophyllene (26.4%) while in S. berolonii essential oil caryophyllene oxide was the major component (35.1%). The micromorphological differences are also pronounced in the leaf indumentum (density and distribution of certain types of non-glandular and glandular trichomes). Clear distinction between the investigated Salvia species is also observed in the leaf anatomy (in S. pratensis leaves are thinner, palisade tissue is made of 1-2 layers of cells, and leaves of S. bertolonii are characterized by 2-3 layers of palisade tissue cells, and consequently thicker).