Open Source evaluation of kilometric indexes of abundance.

Kilometric Abundance Index (KAI) is a common measure used in wildlife studies because it allows a straightforward comparison of species abundance in different sites or at different times. KAI expresses the ratio of the total number of individuals (or of signs of presence) observed along a transect by the total transect length covered at each site. v.transect.kia is a new tool for GRASS GIS, developed for automating the evaluation of KAI, reducing the risk of manual errors especially when handling large datasets. It can also split the transects according to one environmental variable (typically habitat type) and evaluate true 3D transect length. It calculates KAI using a point map of sightings and saves the results in the attribute table, the output can be displayed in any GIS or used for further statistical analysis. The tool has been tested on field data from Northern Italy for mountain hare (Lepus timidus), allowing a first wide-area estimate

Valproate induced hyperammonemic encephalopathy successfully treated with levocarnitine

Valproate-induced hyperammonemic encephalopathy is an unusual but serious adverse effect that is usually characterized by the acute. onset of impaired consciousness, focal neurological symptoms and increased seizure frequency. It has been reported to occur at therapeutic valproate levels. We report a patient who developed valproate-induced hyperammonemic encephalopathy after a short treatment with valproate and was successfully treated with levocamitine. We discuss this patient and review the literature regarding the use of levocarnitine in similar patients

Total endoscopic approach to the cauda in a patient with a tight filum

In this report we describe a patient with a tight filum associated with a small concentric lipoma that was treated by cutting the filum terminale through a totally endoscopic approach. Our approach required the creation of a midline surgical corridor provided by the placement of a telescopic self-retaining retractor over the ligamentum flavum at L5-S1, under endoscopic control. The ligamentum was partially removed, the dura and the arachnoid opened and the filum terminale and the roots of the cauda exposed. After neurophysiological confirmation of the absence of neural structures the filum was coagulated and cut, the dura was closed by a continuous suture and seated with fibrin glue. The entire surgery was performed under the illumination and magnification provided by a rigid endoscope working in an aerial environment. This case shows that the cauda can be explored and the filum terminale cut with a minimally invasive endoscopic approach that does not significantly compromise the structural integrity of the spine, requires only a short dural incision, therefore reducing the risk of postoperative cerebrospinal fluid leakage, and allows the use of multiple surgical instruments in an aerial environment. \ua9 Georg Thieme Verlag KG Stuttgart

Cerebral venous thrombosis at high altitude: A systematic review

Background and objective High altitude may be a factor associated with cerebral venous thrombosis (CVT). As our knowledge of CVT at high altitude is limited, it was decided to pool such information from the available case studies to determine whether high altitude can predispose to CVT. Methods A systematic review of the literature was performed for cases reporting CVT at high altitude. Searches of the PubMed database (up to July 2016) were performed for publications, using \u2018cerebral venous thrombosis\u2019 and \u2018high altitude\u2019 as keywords. Cross-referencing was also done to complete the search. Results Ultimately, 13 articles were included in our systematic review. The population consisted of 17 patients, predominately male (14/17), with a mean age of 32 (range: 19\u201347) years. Altitude range was 3000\u20138200\ua0m. Nine patients stayed at high altitude for\ua0>\ua02 weeks; the duration of high altitude stay was unknown for the remainder. A hypercoagulable state was found in nine patients: secondary polycythemia in five; protein C deficiency in one; protein S deficiency in one; and factor V Leiden mutations in two. No comorbidities were found in any of these patients. Conclusion Long-term stays at high altitude in association with a hypercoagulable state\ua0\u2013\ua0in particular, congenital or acquired thrombophilia\ua0\u2013\ua0appears to predispose to CVT. The association of CVT with a single exposure to high altitude seems low, but the risk cannot as yet be specifically estimated

Pattern of care and outcome in elderly patients with glioblastoma: Data in 151 patients from 3 Lombardia Hospitals

The appropriate treatment approach for elderly patients with glioblastoma multiforme (GBM) is unclear, although different studies suggest survival benefit in fit patients treated with radiotherapy and chemiotherapy after surgery. We performed a retrospective analysis of 151 patients older than 65years with GBM treated in 3 Lombardia Hospitals. In univariate regression analysis higher KPS (p=0.02), macroscopical total resection (p70years), presence of seizure at onset and additional resection after tumor recurrence did not influence OS. Multivariate analysis revealed radiotherapy (HR 0.2 p<0.0001) and extent of surgery (HR 0.3, p=0,0063) as positive independent prognostic factors. Patients receiving radio-chemiotherapy displayed more treatment-related toxicities with a slightly prolonged OS versus those receiving hypofractionated radiotherapy. With the limits of a retrospective study, our data suggest that in elderly fit patients extensive surgery should be considered, moreover adjuvant treatments led to an increase in OS. Randomized controlled study are needed to develop treatment guidelines for elderly GBM patients and to assess whether the combination of post-surgical radio and chemiotherapy may be superior to hypofractionated radiotherapy and chemiotherapy in fit patients