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

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

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

Towards a common language in neurosurgical outcome evaluation: the NEON (NEurosurgical Outcome Network) proposal

BACKGROUND: The aim of this study was to achieve a consensus on the minimum set of outcome measures and predictors to be used in the neurosurgical practice and on the timing of outcome assessment. METHODS: A consensus building approach was employed. All neurosurgical departments in Lombardy (Italy) were invited to participate by the Carlo Besta Neurologic Institute IRCCS Foundation. Three workshops were organized during which a multidisciplinary group called Neurosurgical Outcome Network (NEON) was created and the methodology to select outcome measures, predictors, and timing of outcome assessment was established. Eight working groups were created for the different neurosurgical diseases (neuro-oncological, skull base, vascular, traumatic, spinal, peripheral nervous system, malformation, functional) and 8 workshops were organized to identify the outcome measures and predictors specific for each of the neurosurgical diseases based on the experts’ clinical practice and the existing literature. RESULTS: A total of 20 neurosurgical departments participated in this study. Specific outcome measures, predictors and the timing of outcome assessment were identified for each of the 8 neurosurgical diseases. Moreover, a list of variables common to all pathologies were identified by the NEON group as further data to be collected. CONCLUSIONS: A consensus on the minimum set of outcome measures and predictors and the timing of outcome assessments for 8 neurosurgical diseases was achieved by a group of neurosurgeons of the Lombardy region, called NEON. These sets could be used in future studies for a more homogeneous data collection and as a starting point to reach further agreement also at national and international level