Small sharp exostosis tip in solitary osteochondroma causing intermittent knee pain due to pseudoaneurysm

Background: Complications of solitary or multiple osteochondromas are rare but have been reported in recent literature. Most reported complications arose in patients with multiple and/or sizable osteochondromas. Case presentation: A 22-year-old, female, Caucasian patient with obesity presented with intermittent knee pain and hematoma of the right calf. The MRI depicted a small, sharp exostosis tip of the dorsal distal femur with a surrounding soft-tissue mass. After profuse bleeding occurred during biopsy of the soft tissue mass, angiography revealed a pseudoaneurysm of the right popliteal artery. In a second-stage surgery the exostosis tip and pseudoaneurysm were resected. Conclusion: Complications can also arise in small, seemingly harmless osteochondromas. Surgical resection should be considered as a preventive measure when exostoses form sharp tips close to neurovascular structures regardless of total osteochondroma size.<br

Use of the Orbital Atherectomy System in Isolated, Chronic Atherosclerotic Lesions of the Popliteal Artery

The treatment of isolated calcified lesions involving the popliteal artery are demanding and they often require stent placement to achieve acceptable luminal gain. This study evaluates the safety and performance of the orbital atherectomy system (Cardiovascular Systems Inc.) and percutaneous transluminal angioplasty with a drug-coated balloon (PTA-DCB) for the treatment of chronic atherosclerotic lesions within the popliteal artery segment. From November 2018 to November 2019, a series of six patients with Rutherford classification stage III peripheral arterial disease with isolated, focal, calcified occlusions of the popliteal artery were treated with orbital atherectomy followed by PTA-DCB. No embolic protection devices were used. The technical success rate was 100%, the primary patency rate was 100% at 7.0 (±4.2) months of follow-up. The Rutherford classification improved in all patients from stage III to stage II and the mean ankle brachial pressure index after the procedure was 0.97 (±0.08), with a preoperative mean ankle brachial pressure index of 0.69 (±0.21). In one instance, spasm was noted in a distal arterial bed and it was successfully treated with local nitroglycerine. No distal embolisation, perforation or aneurysmal degeneration was observed. During follow-up there were no deaths, major amputations or revascularisation of target lesions. The use of orbital atherectomy system in combination with PTA-DCB was found to be safe and effective in modifying focal, chronic, calcified plaques in the popliteal artery segment in these six cases

Detecting volcanic sulfur dioxide plumes in the Northern Hemisphere using the Brewer spectrophotometer, other networks, and satellite observations

This paper demonstrates that SO 2 columnar amounts have significantly increased following the five largest volcanic eruptions of the past decade in the Northern Hemisphere. A strong positive signal was detected by all the existing networks either ground based (Brewer, EARLINET, AirBase) or from satellites (OMI, GOME-2). The study particularly examines the adequacy of the existing Brewer network to detect SO 2 plumes of volcanic origin in comparison to other networks and satellite platforms. The comparison with OMI and 45 GOME-2 SO 2 space-borne retrievals shows statistically significant agreement between the Brewer network data and the collocated satellite overpasses. It is shown that the Brewer instrument is capable of detecting significant columnar SO 2 increases following large volcanic eruptions, when SO 2 levels rise well above the instrumental noise of daily observations, estimated to be of the order of 2 DU. A model exercise from the MACC project shows that the large increases of SO 2 over Europe following the Bárðarbunga eruption in Iceland were not caused by local sources or ship emissions but are clearly linked to the eruption. We propose that by combining Brewer data with that from other networks and satellites, a useful tool aided by trajectory analyses and modeling could be created which can be used to forecast high SO 2 values both at ground level and in air flight corridors following future eruptions

When less is more: positive population-level effects of mortality

Experimental and theoretical studies show that mortality imposed on a population can counter-intuitively increase the density of a specific life-history stage or total population density. Understanding positive population-level effects of mortality is advancing, illuminating implications for population, community, and applied ecology. Reconciling theory and data, we found that the mathematical models used to study mortality effects vary in the effects predicted and mechanisms proposed. Experiments predominantly demonstrate stage-specific density increases in response to mortality. We argue that the empirical evidence supports theory based on stage-structured population models but not on unstructured models. We conclude that stage-specific positive mortality effects are likely to be common in nature and that accounting for within-population individual variation is essential for developing ecological theory

Prognostic factors in 264 adults with invasive Scedosporium spp. and Lomentospora prolificans infection reported in the literature and FungiScope

Invasive Scedosporium spp. and Lomentospora prolificans infections are an emerging threat in immunocompromised and occasionally in healthy hosts. Scedosporium spp. is intrinsically resistant to most, L. prolificans to all the antifungal drugs currently approved, raising concerns about appropriate treatment decisions. High mortality rates of up to 90% underline the need for comprehensive diagnostic workup and even more for new, effective antifungal drugs to improve patient outcome. For a comprehensive analysis, we identified cases of severe Scedosporium spp. and L. prolificans infections from the literature diagnosed in 2000 or later and the FungiScopeVR registry. For 208 Scedosporium spp. infections solid organ transplantation (n¼58, 27.9%) and for 56 L. prolificans infection underlying malignancy (n¼28, 50.0%) were the most prevalent risk factors. L. prolificans infections frequently presented as fungemia (n¼26, 46.4% versus n¼12, 5.8% for Scedosporium spp.). Malignancy, fungemia, CNS and lung involvement predicted worse outcome for scedosporiosis and lomentosporiosis. Patients treated with voriconazole had a better overall outcome in both groups compared to treatment with amphotericin B formulations. This review discusses the epidemiology, prognostic factors, pathogen susceptibility to approved and investigational antifungals, and treatment strategies of severe infections caused by Scedosporium spp. and L. prolificansWe thank Sabine Wrackmeyer for her private donation to support the projec

The Arthropod Fauna of Oak (Quercus spp., Fagaceae) Canopies in Norway

(1) We document the invertebrate fauna collected from 24 oak canopies in east and west Norway as a contribution to the Norwegian Biodiversity Information Centre’s ‘The Norwegian Taxonomy Initiative’. (2) A snap-shot inventory of the canopies was recorded by means of emitting a mist of natural pyrethrum into the canopies at night using a petrol-driven fogger and collecting the specimens in butterfly nets spread on the ground under the canopy. (3) Almost the entire catch of more than 6800 specimens was identified to 722 species. Out of 92 species new to the Norwegian fauna, 21 were new to science and, additionally, 15 were new to the Nordic fauna. Diptera alone constituted nearly half of the species represented, with 61 new records (18 new species). Additionally, 24 Hymenoptera (one new species), six oribatid mites (two new species) and one Thysanoptera were new to the Norwegian fauna. (4) Our study emphasizes the importance of the oak tree as a habitat both for a specific fauna and occasional visitors, and it demonstrates that the canopy fogging technique is an efficient way to find the ‘hidden fauna’ of Norwegian forests. The low number of red listed species found reflects how poor the Norwegian insect fauna is still studied. Moreover, the implication of the IUCN red list criteria for newly described or newly observed species is discussed.</jats:p

High Levels of Diversity Uncovered in a Widespread Nominal Taxon: Continental Phylogeography of the Neotropical Tree Frog

Species distributed across vast continental areas and across major biomes provide unique model systems for studies of biotic diversification, yet also constitute daunting financial, logistic and political challenges for data collection across such regions. The tree frog Dendropsophus minutus (Anura: Hylidae) is a nominal species, continentally distributed in South America, that may represent a complex of multiple species, each with a more limited distribution. To understand the spatial pattern of molecular diversity throughout the range of this species complex, we obtained DNA sequence data from two mitochondrial genes, cytochrome oxidase I (COI) and the 16S rhibosomal gene (16S) for 407 samples of D. minutus and closely related species distributed across eleven countries, effectively comprising the entire range of the group. We performed phylogenetic and spatially explicit phylogeographic analyses to assess the genetic structure of lineages and infer ancestral areas. We found 43 statistically supported, deep mitochondrial lineages, several of which may represent currently unrecognized distinct species. One major clade, containing 25 divergent lineages, includes samples from the type locality of D. minutus. We defined that clade as the D. minutus complex. The remaining lineages together with the D. minutus complex constitute the D. minutus species group. Historical analyses support an Amazonian origin for the D. minutus species group with a subsequent dispersal to eastern Brazil where the D. minutus complex originated. According to our dataset, a total of eight mtDNA lineages have ranges >100,000 km2. One of them occupies an area of almost one million km2 encompassing multiple biomes. Our results, at a spatial scale and resolution unprecedented for a Neotropical vertebrate, confirm that widespread amphibian species occur in lowland South America, yet at the same time a large proportion of cryptic diversity still remains to be discovered