Altering the progression of human alveolar bone loss with the non-steroidal anti-inflammatory drug flurbiprofen

The treatment of human periodontal diseases relies on mechanical and antimicrobial suppression of the etiologic bacteria. The ability to alter the progression of periodontitis by additionally blocking host pathways involved in the destructive process is an area of current research. Prostaglandins and other metabolites of arachidonic acid are believed to be important host mediators of the bone resorption of diseases such as periodontitis. We have previously examined the effect of inhibitors of prostaglandin production, non-steroidal anti-inflammatory drugs (NSAIDs), on inhibiting alveolar bone loss in beagles. The present study was designed to examine the effect of the NSAID, flurbiprofen, on slowing the radiographic loss of alveolar bone in the human. Fifty-six individuals with radiographic evidence of alveolar bone loss were recruited for study. Forty-four patients remained in the study for the data analysis of loss of alveolar bone. Following a 6 month baseline pretreatment period to measure the radiographic progression of bone loss, half of the patients were administered flurbiprofen, 50 mg. b.i.d., while half were administered a placebo. All patients received a subgingival scaling and pumice by a hygienist every 6 months. The rate of alveolar bone loss in a 2 year treatment period was compared to the baseline 6 month pretreatment period within and between patient groups. Throughout the study, teeth exhibiting obvious loss of bone were exited from study and treated with conventional mechanical therapy. At the end of the pretreatment period both patient groups had a similar mean rate of alveolar bone loss.(ABSTRACT TRUNCATED AT 250 WORDS)

The use of a biodegradable antibiotic-loaded calcium sulphate carrier containing tobramycin for the treatment of chronic osteomyelitis: a series of 195 cases

We report our experience using a biodegradable calcium sulphate antibiotic carrier containing tobramycin in the surgical management of patients with chronic osteomyelitis. The patients were reviewed to determine the rate of recurrent infection, the filling of bony defects, and any problems with wound healing. A total of 193 patients (195 cases) with a mean age of 46.1 years (16.1 to 82.0) underwent surgery. According to the Cierny-Mader classification of osteomyelitis there were 12 type I, 1 type II, 144 type III and 38 type IV cases. The mean follow-up was 3.7 years (1.3 to 7.1) with recurrent infection occurring in 18 cases (9.2%) at a mean of 10.3 months post-operatively (1 to 25.0). After further treatment the infection resolved in 191 cases (97.9%). Prolonged wound ooze (longer than two weeks post-operatively) occurred in 30 cases (15.4%) in which there were no recurrent infection. Radiographic assessment at final follow-up showed no filling of the defect with bone in 67 (36.6%), partial filling in 108 (59.0%) and complete filling in eight (4.4%). A fracture occurred in nine (4.6%) of the treated osteomyelitic segments at a mean of 1.9 years (0.4 to 4.9) after operation. We conclude that Osteoset T is helpful in the management of patients with chronic osteomyelitis, but the filling of the defect in bone is variable. Prolonged wound ooze is usually self-limiting and not associated with recurrent infection.

Management of infected nonunion of the long bones by a multidisciplinary team

Infected nonunion of a long bone continues to present difficulties in management. In addition to treating the infection, it is necessary to establish bony stability, encourage fracture union and reconstruct the soft-tissue envelope. We present a series of 67 infected nonunions of a long bone in 66 patients treated in a multidisciplinary unit. The operative treatment of patients suitable for limb salvage was performed as a single procedure. Antibiotic regimes were determined by the results of microbiological culture. At a mean follow-up of 52 months (22 to 97), 59 patients (88%) had an infection-free united fracture in a functioning limb. Seven others required amputation (three as primary treatment, three after late failure of limb salvage and one for recalcitrant pain after union). The initial operation achieved union in 54 (84%) of the salvaged limbs at a mean of nine months (three to 26), with recurrence of infection in 9%. Further surgery in those limbs that remained ununited increased the union rate to 62 (97%) of the 64 limbs treated by limb salvage at final follow-up. The use of internal fixation was associated with a higher risk of recurrent infection than external fixation.

In vivo evaluation of resorbable bone graft substitutes in a rabbit tibial defect model

Calcium sulfate as a bone graft substitute is rapidly resorbed in vivo releasing calcium ions but fails to provide long-term three-dimensional framework to support osteoconduction. The setting properties of calcium sulfate however allow it to be applied in a slurry form making it easier to handle and apply in different situations. This study examines the in vivo response of calcium sulfate alone and as a carrier for a coralline hydroxyapatite in an established bilateral corticocancellous defect model in rabbits. Defects were filled flush to the anterior cortex with a resorbable porous ceramic alone and in combination with calcium sulfate slurry, calcium sulfate slurry alone or calcium sulfate pellets and examined at time points up to 52 weeks. Specimens where assessed using Faxitron X-ray, light and electron microscopy. Calcium sulfate in either slurry or pellet form does indeed support new bone formation alone however, complete filling of the bone defect is not observed. Calcium sulfate in slurry form does however improve the surgical handling of particulate bone graft substitutes such as Pro Osteon 200 R, which remained as an osteoconductive scaffold for up to 52 weeks and may have played an important role in the ultimate closure of the cortical windows.

Classroom posture and self-reported back and neck pain in schoolchildren

The study reported here aims to identify the extent of back pain experienced by 11-14 year old schoolchildren, and establish the intensity, duration and frequency of exposure to physical risk factors present in schools. This paper considers the sitting postures of schoolchildren in the classroom. The sitting postures of 66 children were recorded in normal lessons using the Portable Ergonomic Observation Method (PEO). The study found significant associations between flexed postures and low back pain. Static postures and neck and upper back pain were also associated. This study has implications for schools, designers and people in the field of work related musculoskeletal disorders. Further research is required to examine the association between sitting posture and pain reported at different spinal locations.

SARS-CoV-2 suppresses mRNA expression of selenoproteins associated with ferroptosis, endoplasmic reticulum stress and DNA synthesis

Higher selenium status has been shown to improve the clinical outcome of infections caused by a range of evolutionally diverse viruses, including SARS-CoV-2. However, the impact of SARS-CoV-2 on host-cell selenoproteins remains elusive. The present study investigated the influence of SARS-CoV-2 on expression of selenoprotein mRNAs in Vero cells. SARS-CoV-2 triggered an inflammatory response as evidenced by increased IL-6 expression. Of the 25 selenoproteins, SARS-CoV-2 significantly suppressed mRNA expression of ferroptosis-associated GPX4, DNA synthesis-related TXNRD3 and endoplasmic reticulum-resident SELENOF, SELENOK, SELENOM and SELENOS. Computational analysis has predicted an antisense interaction between SARS-CoV-2 and TXNRD3 mRNA, which is translated with high efficiency in the lung. Here, we confirmed the predicted SARS-CoV-2/TXNRD3 antisense interaction in vitro using DNA oligonucleotides, providing a plausible mechanism for the observed mRNA knockdown. Inhibition of TXNRD decreases DNA synthesis which is thereby likely to increase the ribonucleotide pool for RNA synthesis and, accordingly, RNA virus production. The present findings provide evidence for a direct inhibitory effect of SARS-CoV-2 replication on the expression of a specific set of selenoprotein mRNAs, which merits further investigation in the light of established evidence for correlations between dietary selenium status and the outcome of SARS-CoV-2 infection.

Back pain in nurses: epidemiology and risk assessment

It is widely recognized that back pain is a serious problem within the nursing profession. This paper commences with a review of epidemiological data concerning the magnitude of this problem: first, with regard to the excess prevalence of back pain in nurses (as compared with the general population); second, with regard to the impact of back pain in terms of sickness absence, and labour turnover; and third, with regard to the association between back pain and patient handling. There follows a formalized assessment of the level of risk inherent in a number of common patient-handling procedures. (This is based upon a new analysis of a number of existing sources of data which have not been gathered together before.) For each procedure, intra-abdominal pressure (IAP) is calculated as a function of patient weight and the level of risk is measured in terms of the probability of a criterion level of 45 mmHg (6.0 kPa) being violated. The paper concludes with a discussion of the implications of these findings for an ergonomic approach to the design of safe systems of work.

A cross-sectional study of self-reported back and neck pain among English schoolchildren and associated physical and psychological risk factors

This study set out to identify the associations between ergonomics and other factors with back and neck pain among schoolchildren. Self-reported questionnaires were used to record health outcomes and potential risk factors in state schools. Six hundred and seventy-nine schoolchildren from Surrey in the United Kingdom aged 11-14 years took part. Twenty-seven percent of children reported having neck pain, 18% reported having upper back pain, and 22% reported having low back pain. A forward stepwise logistic regression was performed with pain categories the dependent variables. Neck pain was significantly associated with school furniture features, emotional and conduct problems, family history of low back pain and previous treatment for musculoskeletal disorders. Upper back pain was associated with school bag weight (3.4-4.45 kg), school furniture features, emotional problems and previous treatment for musculoskeletal disorders. Low back pain was associated with school furniture features, emotional problems, family history and previous injury or accident. It is important to recognise the influence of physical, psychological and family factors in children's pain.

Psychological barriers to Internet usage among older adults in the UK

The Internet is an important tool in assisting the older population to lead independent and social lives. However, the majority of Internet users are under 55. This study investigated the following psychological barriers to Internet use by older adults: perceived usefulness, perceived ease of use, Internet efficacy, perceived complexity of navigation and perceived complexity of terminology. Twenty-three subjects (aged 55 - 75 years) were interviewed in the UK. The influences of age, computer and Internet experience, and training on these psychological barriers were explored. The results showed that the majority of the older adults who had a positive perception of usefulness, ease of use, and efficacy of the Internet or e-mail, used the Internet or e-mail more often. In addition, it was found that computer or Internet experience increased perceptions of ease of use and efficacy of the Internet and reduced perceived complexity of navigation. There was no difference between the two age groups (55 - 65 and 66 - 75 years) in these psychological barriers. It was concluded that increased marketing of the Internet (aimed at the older user), more simple and uniformly designed Internet pages, more user-friendly online help and error message terminology, and increased provision of training for the older user would assist uptake of the World Wide Web.

Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial

Background

Bone and joint infection in adults arises most commonly as a complication of joint replacement surgery, fracture fixation and diabetic foot infection. The associated morbidity can be devastating to patients and costs the National Health Service an estimated £20,000 to £40,000 per patient.

Current standard of care in most UK centres includes a prolonged course (4–6 weeks) of intravenous antibiotics supported, if available, by an outpatient parenteral antibiotic therapy service. Intravenous therapy carries with it substantial risks and inconvenience to patients, and the antibiotic-related costs are approximately ten times that of oral therapy. Despite this, there is no evidence to suggest that oral therapy results in inferior outcomes.

We hypothesise that, by selecting oral agents with high bioavailability, good tissue penetration and activity against the known or likely pathogens, key outcomes in patients managed primarily with oral therapy are non-inferior to those in patients treated by intravenous therapy.

Methods

The OVIVA trial is a parallel group, randomised (1:1), un-blinded, non-inferiority trial conducted in thirty hospitals across the UK. Eligible participants are adults (>18 years) with a clinical syndrome consistent with a bone, joint or metalware-associated infection who have received ≤7 days of intravenous antibiotic therapy from the date of definitive surgery (or the start of planned curative therapy in patients treated without surgical intervention). Participants are randomised to receive either oral or intravenous antibiotics, selected by a specialist infection physician, for the first 6 weeks of therapy. The primary outcome measure is definite treatment failure within one year of randomisation, as assessed by a blinded endpoint committee, according to pre-defined microbiological, histological and clinical criteria. Enrolling 1,050 subjects will provide 90 % power to demonstrate non-inferiority, defined as less than 7.5 % absolute increase in treatment failure rate in patients randomised to oral therapy as compared to intravenous therapy (one-sided alpha of 0.05).

Discussion

If our results demonstrate non-inferiority of orally administered antibiotic therapy, this trial is likely to facilitate a dramatically improved patient experience and alleviate a substantial financial burden on healthcare services.

Trial registration

ISRCTN91566927 - 14/02/2013

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-015-1098-y) contains supplementary material, which is available to authorized users.

Profiling schoolchildren in pain and associated demographic and behavioural factors: a latent class approach

Musculoskeletal pain in adolescence is common and individuals frequently report pain in different sites. However, statistical analysis is often limited to considering one or a few pain sites. In this study latent class analysis was used to classify individuals into latent classes in terms of their patterns of endorsing ten musculoskeletal sites. Previously established covariates of musculoskeletal pain in adolescents were then assessed across emergent latent classes. The study was a cross sectional survey of adolescents attending post-primary schools in England. A total of 679 took part in the study with an age range from 11 to 14 years. Pain was operationalised as the occurrence of pain for one day or more in the past month. Schoolchildren self-reported on the incidence of pain aided by a nordic manikin. A three-class model emerged as the best fit. Classes were labelled 'Pain free' (63.4%), 'Neck and back' pain (28.2%) and 'Widespread' pain (8.4%). The 'Widespread' pain class was significantly related with Age (OR=1.79; 95%CI 1.24-2.57), Sex (OR=0.35, 95%CI 0.16-0.79), bag weight to body weight (OR=1.12, 95%CI 1.03-1.22), bag carrying method (OR=2.08, 95%CI 1.08-3.97), Schoolwork difficult (OR=2.78, 95%CI 1.27-6.07), and headaches (OR=2.13, 95%CI 1.65-2.76). While Strengths and Difficulties Questionnaire scores (OR=1.05, 95%CI 1.01-1.11), and Headaches (OR=1.78, 95%CI 1.39-2.26) were significant for the 'Back and neck' class. It is suggested that research should seek to identify typical pain profiles for adolescents, rather than concentrating on specific pain sites since some risk factors may be obscured or inflated by inappropriately amalgamating or segregating pain sites.

Lack of interaction between two antihistamines, mizolastine and cetirizine, and ethanol in psychomotor and driving performance in healthy subjects

The pharmacodynamic interaction between mizolastine, a new H1 antihistamine, and ethanol was assessed in a randomized, double-blind, three-way crossover, placebo-controlled study. Eighteen healthy young male volunteers received mizolastine 10 mg, or cetirizine 10 mg or placebo once daily for 7 days with a 1-week wash-out interval. An oral dose of ethanol or ethanol placebo, given 2 h after dosing on days 5 or 7 of each treatment period, was administered to achieve a peak blood alcohol concentration (BAC) of 0.7 g/l then maintained for 1 h by two further doses of ethanol. Driving ability and psychomotor performance were evaluated using actual and simulated driving tests, critical flicker fusion threshold (CFF), adaptive tracking and divided attention (DAT) tasks. Ethanol produced a significant decrement in all tasks up to 5.5 h after administration: an increase in steering movements of 4.6, in lateral deviation of 0.45 m, in braking reaction time of 80 ms, in driving test and DAT performance of + 3.2; and a decrease in CFF and in tracking speed of 2.6 m.s-1. Neither mizolastine nor cetirizine significantly impaired driving ability or arousal (CFF) compared with the placebo. However, both drugs significantly impaired DAT performance 6:00 h post-dose (increase of + 2.1 for mizolastine and + 2.4 for cetirizine). The tracking speed was significantly decreased 7:50 h after mizolastine administration (-1.3 m.s-1) and more consistently from 1:30 to 7:50 h after cetirizine administration (-1.4 m.s-1). No significant adverse interaction, i.e. potentiation, occurred between ethanol and either antihistamine.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of Ilizarov Bifocal, Acute Shortening and Relengthening with Bone Transport in the Treatment of Infected, Segmental Defects of the Tibia

This prospective study compared bifocal acute shortening and relengthening (ASR) with bone transport (BT) in a consecutive series of complex tibial infected non-unions and osteomyelitis, for the reconstruction of segmental defects created at the surgical resection of the infection. Patients with an infected tibial segmental defect (>2 cm) were eligible for inclusion. Patients were allocated to ASR or BT, using a standardized protocol, depending on defect size, the condition of soft tissues and the state of the fibula (intact or divided). We recorded the Weber-Cech classification, previous operations, external fixation time, external fixation index (EFI), follow-up duration, time to union, ASAMI bone and functional scores and complications. A total of 47 patients (ASR: 20 patients, BT: 27 patients) with a median follow-up of 37.9 months (range 16-128) were included. In the ASR group, the mean bone defect size measured 4.0 cm, and the mean frame time was 8.8 months. In the BT group, the mean bone defect size measured 5.9cm, and the mean frame time was 10.3 months. There was no statistically significant difference in the EFI between ASR and BT (2.0 and 1.8 months/cm, respectively) (p = 0.223). A total of 3/20 patients of the ASR and 15/27 of the BT group needed further unplanned surgery during Ilizarov treatment (p = 0.006). Docking site surgery was significantly more frequent in BT; 66.7%, versus ASL; 5.0% (p < 0.0001). The infection eradication rate was 100% in both groups at final follow-up. Final ASAMI functional rating scores and bone scores were similar in both groups. Segmental resection with the Ilizarov method is effective and safe for reconstruction of infected tibial defects, allowing the eradication of infection and high union rates. However, BT demonstrated a higher rate of unplanned surgeries, especially docking site revisions. Acute shortening and relengthening does not reduce the fixator index. Both techniques deliver good functional outcome after completion of treatment.

Population Ecology of European Tortoises: Review of Field Techniques

Abstract

Field techniques used in recent studies of the population ecology of European tortoises are discussed. An efficient marking system suitable for large sample sizes is described. The dual problems ofageing adults and sexing juveniles are highlighted. The relative merits of sampling techniques are dependent on habitat and population density. Mark-recapture techniques are most suitable when sampling is conducted within a grid system which enables results to be stratified, allowing for differential ease of location. However, grid sampling is only practical where tortoise densities are high. At low density sites, or for brief surveys, recording numbers observed per man hour along random paths is the most convenient method, but allowances must be made for differential observer skill. Existing sampling methods bias against finding inactive animals and where these form a large proportion of the population, sample size is strongly influenced by habitat type.

The ecology of a Mediterranean tortoise (Testudo hermanni): a declining population

In France, wild tortoises occur at low densities (< 3/ha) in the mixed forest and maquis of the Massif des Maures. In an evergreen oak forest with scattered, traditional cultivations, distinct subpopulations still exist at relatively high density (> 10/ha). The population structure is heavily skewed in favour of old adults and recruitment is low. The population is declining due to habitat loss, both from fire and through the decline in traditional horticultural practices, leading to a reduction in nest site availability. The increase in nest density in the few suitable sites remaining leaves the eggs highly vulnerable to predation and losses of over 90% cannot be sustained. The active season is from March to November, but there is evidence of some activity during the hibernation period. Adult males maintain small, fixed home ranges, while females undertake distinct migrations to and from nesting sites in the spring and can switch to new home ranges. Juveniles are sedentary up to the age of 4 or 5 years, after which they may wander considerable distances in no particular direction, until the onset of sexual maturity. Sex ratio does not differ significantly from parity within any age cohort.

Suture strength and angle of load application in a suture anchor eyelet

PURPOSE

To assess the effect of suture material, anchor orientation, and anchor eyelet design on the static loading properties of suture anchors.

TYPE OF STUDY

Biomechanical bench study.

METHODS

Two metallic suture anchors, Mitek GII (Mitek, Westwood, MA) and Corkscrew (Arthrex, Naples, FL) and a bioabsorbable anchor (Biocorkscrew; Arthrex) were tested with single strand of No. 2 Ethibond (Ethicon, Norderstedt, Germany) or No. 2 FiberWire (Arthrex) suture. Suture pull angle was varied through 0 degrees, 45 degrees, and 90 degrees with the anchor rotation angle in either a sagittal or coronal plane. Constructs were tested to failure using an MTS 858 Bionix testing machine (Material Testing Systems, Eden Prairie, MN). Peak loads, stiffness, energy to peak load, and failure modes were determined for all samples.

RESULTS

FiberWire showed superior static mechanical properties when compared with single-strand Ethibond over all testing conditions (P < .05). Suture pull angle had a significant effect on load to failure with both metallic anchors but not on the bioabsorbable anchor (P < .05).

CONCLUSIONS

Suture pull angle and anchor rotation angle play an important role in the failure load of suture when placed in an eyelet. The polyaxial nature of the Biocorkscrew eyelet allows for increased degrees of freedom but introduces failure of the suture eyelet as a new failure mode.

CLINICAL RELEVANCE

The loading direction and placement of the suture anchor plays a role in the performance of the suture anchor-suture complex.

Modular endoprosthetic replacement for failed internal fixation of the proximal femur following trauma

PURPOSE

Although originally designed for reconstruction after primary malignant bone tumour resection, modular endoprosthetic replacement (EPR) can be used in salvage surgery for complex periprosthetic fracture and failed internal fixation. The purpose of this study was to assess the functional outcome following EPR for failed internal fixation of the proximal femur.

METHODS

We assessed clinical and functional outcomes of using a modular tumour endoprosthesis to reconstruct the proximal femur following failed internal fixation in eight consecutive patients between 2001 and 2008.

RESULTS

There were four men and four women, with a mean age of 67.5 (range 50-79) years and a mean follow-up of 16.5 (6-36) months. All patients had failed internal fixation for traumatic proximal femoral fractures--four 31.A2.3, two 31.A3.1, two 31.A3.3 using the Arbeitsgemeinshaft für Osteosynthesefragen (AO) fracture classification. Mean time from the first attempted internal fixation to definitive EPR was 34 (6-102) months, and the median number of previous surgical procedures was two (1-11). Histology revealed infection (two cases), uninfected nonunion (five cases) and plasmocytoma (one case). The EPR was carried out as a one-stage procedure in six cases and a two-stage procedure in two cases. Mean postoperative Harris Hip Score was 71.4 (range 64-85). There were no surgical complications. One patient died as a result of systemic complications of myeloma several years following EPR.

CONCLUSIONS

EPR is an effective salvage procedure for failed fixation of traumatic proximal femoral fractures. Immediate weightbearing and a good functional outcome can be expected in this difficult group of patients.

Osteomyelitis of the Pelvic Bones: A Multidisciplinary Approach to Treatment

Background and Purpose: A case series review of chronic pelvic osteomyelitis treated with combined medical and surgical treatment by a multidisciplinary team. Methods: All patients treated with surgical excision of pelvic osteomyelitis at our tertiary referral centre between 2002 and 2014 were included. All received combined care from a clinical microbiologist, an orthopaedic surgeon and a plastic surgeon. The rate of recurrent infection, wound healing problems and post-operative mortality was determined in all. Treatment failure was defined as reoperation involving further bone debridement, a requirement for the use of long-term suppressive antibiotics or sinus recurrence. Results: Sixty-one adults (mean age 50.2 years, range 16.8-80.6) underwent surgery. According to the Cierny-Mader classification of osteomyelitis there were 19 type II, 35 type III and 7 type IV cases. The ischium was the most common site of infection. Osteomyelitis was usually the result of contiguous focus infection associated with decubitus ulcers, predominantly in patients with spinal or cerebral disorders. Most patients with positive microbiology had polymicrobial infection (52.5%). Thirty patients required soft tissue reconstruction with muscle or myocutaneous flaps. Twelve deaths occurred a mean of 2.8 years following surgery (range 7 days-7.4 years). Excluding these deaths the mean follow-up was 4.6 years (range 1.5-12.2 years). Recurrent infection occurred in seven (11.5%) a mean of 1.5 years post-operatively (92 days - 5.3 years). After further treatment 58 cases (95.1%) were infection free at final follow-up. Interpretation: Patients in this series have many comorbidities and risk factors for poor surgical outcome. Nevertheless, the multidisciplinary approach allows successful treatment in the majority of cases.

Wide-field Fizeau imaging telescope: experimental results

A nine-aperture, wide-field Fizeau imaging telescope has been built at the Lockheed-Martin Advanced Technology Center. The telescope consists of nine, 125 mm diameter collector telescopes coherently phased and combined to form a diffraction-limited image with a resolution that is consistent with the 610 mm diameter of the telescope. The phased field of view of the array is 1 murad. The measured rms wavefront error is 0.08 waves rms at 635 nm. The telescope is actively controlled to correct for tilt and phasing errors. The control sensing technique is the method known as phase diversity, which extracts wavefront information from a pair of focused and defocused images. The optical design of the telescope and typical performance results are described.

Summer Activity Patterns of Testudo hermanni GMELIN in Greece and France

Abstract

Daily activity patterns of Testudo hermanni in summer are described for two sites, Alyki, a coastal heathland in Greece, and the Massif des Maures, a woodland in France. Activity was bimodal in the former and unimodal in the latter. Habitat type was thought to be more important than latitude and climate in accounting for this pattern. AtAlyki there was a sex ratio of encounters of2. 7 ♂: 1 ♀ in summer, but no differences between the sexes in daily activity pattern. In the Massif des Maures, the ratio varied through the season, from 0.5 ♂: 1 9 in June, to 2.6 ♂: 1 9 in September, suggesting seasonal differences in activity of the sexes. Population density at Alyki was 5 times greater than in the Massif des Maures, yet sighting frequency was similar. This was accounted for by the increased ease offinding active animals in the woodland from the noise they made in the leaf litter.