Gonad development and reproduction in the monoecious species Chlorophthalmus agassizi (Actinopterygii: Aulopiformes: Chlorophthalmidae) from the Sardinian Waters (Central-Western Mediterranean)

Background. The shortnose greeneye, Chlorophthalmus agassizi Bonaparte, 1840, is a species with a circumglobal distribution and is among the most abundant commercial fishes in some Mediterranean areas. The knowledge of the biology and ecology of this species is poor and geographically limited, then the aim of this study is to provide a contribution to the knowledge on the reproductive biology of this monoecious deep-sea fish in Sardinian waters. Materials and Methods. In this paper the morphology and the development of the gonads, the mean size at maturity, the monthly evolution in the percent frequency of the maturity stages, and of the indices related to reproduction of the shortnose greeneye were examined. Individuals were caught by trawls, between 270 and 504 m of depth in the Sardinian seas. Results. The ovarian pattern is of an asynchronous type, characterized by releasing of eggs in successive batches. Seven stages of development for the ovary and four for the testis were identified on the basis of macroscopic and histological features. The female portion is the most evident component and shows a later maturation than the male portion. The spawning period is unique and takes place from May to September. Conclusion. The identification of spawning period and the adopted reproductive strategy is essential to obtain a better understanding of its biology and a good management of its fisheries

Intake by Lactating Goats Browsing on Mediterranean Shrubland

In Mediterranean regions goat feeding systems are mainly based on shrubland that contain a wide variety of species. There are only a few equations for predicting feed intake of stall-fed goats (Luo et al., 2004). The objective of this study was to develop a model for predicting the intake of lactating goats browsing on Mediterranean shrubland

Radiopacity of Sodium Zirconium Cyclosilicate in Computed Tomography: a case of a patient with Hyperkalemia and kidney disease

Sodium Zirconium Cyclosilicate (SZC) is commonly used for treating hyperkalemia because it sequesters gastrointestinal potassium ions, thereby reducing serum potassium levels. However, a less-discussed aspect of SZC is its radiopacity on x-ray-based imaging techniques. The European Medicines Agency (EMA) has only vaguely addressed this issue. Radiopaque substances like SZC can interfere with diagnostic imaging, creating challenges for clinicians and radiologists. We present the case of a 34-year-old Italian male to illustrate these concerns

Exploring relationships between the distribution of giant red shrimp Aristaeomorpha foliacea (Risso, 1827) and environmental factors in the Central-Western Mediterranean Sea

Mediterranean giant red shrimp Aristaeomorpha foliacea (Risso, 1827) is one of the dominant species in deep-sea megafaunal assemblages, plays a key role in deep-sea communities and it is considered one of the most important targets of deep-water trawl fishing. Although a large number of studies have analysed the spatial distribution of epibenthic crustaceans in bathyal habitats with respect to environmental, geomorphological and hydrological factors, as well as fishing pressure, the manner in which these variables synergistically affect the spatio-temporal changes of giant red shrimp is unclear. To analyse the possible effects of abiotic predictors on the spatio-temporal distribution of giant red shrimp, Generalized Additived Models (GAMs) and Regression Trees were produced. Biological data were collected during the MEDITS trawl surveys carried out in the Sea of Sardinia (2009-2014), during which environmental data were obtained with a multiparametric probe. A longitudinal (west-east) trend was found, with higher abundances at depths of 400-600 m, corresponding to salinity values of 38.1-38.5 psu and temperatures of 13.6-13.8°C. Our results confirm the existence of a tight linkage between the distribution of the Levantine Intermediate Water (LIW) from the eastern Mediterranean Sea and the preferential habitat characteristics of the giant red shrimp. We suggest that a deeper knowledge of the relationships between abiotic (hydrological) factors in the water column and the distribution of Mediterranean resources, such as the giant red shrimp, can provide valuable support for their better management, at the local scale (Sardinia) and across the whole Mediterranean Sea. al use only

Prescribing Hemodialysis or Hemodiafiltration: When One Size Does Not Fit All the Proposal of a Personalized Approach Based on Comorbidity and Nutritional Status

There is no simple way to prescribe hemodialysis. Changes in the dialysis population, improvements in dialysis techniques, and different attitudes towards the initiation of dialysis have influenced treatment goals and, consequently, dialysis prescription. However, in clinical practice prescription of dialysis still often follows a “one size fits all” rule, and there is no agreed distinction between treatment goals for the younger, lower-risk population, and for older, high comorbidity patients. In the younger dialysis population, efficiency is our main goal, as assessed by the demonstrated close relationship between depuration (tested by kinetic adequacy) and survival. In the ageing dialysis population, tolerance is probably a better objective: “good dialysis” should allow the patient to attain a stable metabolic balance with minimal dialysis-related morbidity. We would like therefore to open the discussion on a personalized approach to dialysis prescription, focused on efficiency in younger patients and on tolerance in older ones, based on life expectancy, comorbidity, residual kidney function, and nutritional status, with particular attention placed on elderly, high-comorbidity populations, such as the ones presently treated in most European centers. Prescription of dialysis includes reaching decisions on the following elements: dialysis modality (hemodialysis (HD) or hemodiafiltration (HDF)); type of membrane (permeability, surface); and the frequency and duration of sessions. Blood and dialysate flow, anticoagulation, and reinfusion (in HDF) are also briefly discussed. The approach described in this concept paper was developed considering the following items: nutritional markers and integrated scores (albumin, pre-albumin, cholesterol; body size, Body Mass Index (BMI), Malnutrition Inflammation Score (MIS), and Subjective Global Assessment (SGA)); life expectancy (age, comorbidity (Charlson Index), and dialysis vintage); kinetic goals (Kt/V, normalized protein catabolic rate (n-PCR), calcium phosphate, parathyroid hormone (PTH), beta-2 microglobulin); technical aspects including vascular access (fistula versus catheter, degree of functionality); residual kidney function and weight gain; and dialysis tolerance (intradialytic hypotension, post-dialysis fatigue, and subjective evaluation of the effect of dialysis on quality of life). In the era of personalized medicine, we hope the approach described in this concept paper, which requires validation but has the merit of providing innovation, may be a first step towards raising attention on this issue and will be of help in guiding dialysis choices that exploit the extraordinary potential of the present dialysis “menu”

Where Are You Going, Nephrology? Considerations on Models of Care in an Evolving Discipline

Nephrology is a complex discipline, including care of kidney disease, dialysis, and transplantation. While in Europe, about 1:10 individuals is affected by chronic kidney disease (CKD), 1:1000 lives thanks to dialysis or transplantation, whose costs are as high as 2% of all the health care budget. Nephrology has important links with surgery, bioethics, cardiovascular and internal medicine, and is, not surprisingly, in a delicate balance between specialization and comprehensiveness, development and consolidation, cost constraints, and competition with internal medicine and other specialties. This paper proposes an interpretation of the different systems of nephrology care summarising the present choices into three not mutually exclusive main models (“scientific”, “pragmatic”, “holistic”, or “comprehensive”), and hypothesizing an “ideal-utopic” prevention-based fourth one. The so-called scientific model is built around kidney transplantation and care of glomerulonephritis and immunologic diseases, which probably pose the most important challenges in our discipline, but do not mirror the most common clinical problems. Conversely, the pragmatic one is built around dialysis (the most expensive and frequent mode of renal replacement therapy) and pre-dialysis treatment, focusing attention on the most common diseases, the holistic, or comprehensive, model comprehends both, and is integrated by several subspecialties, such as interventional nephrology, obstetric nephrology, and the ideal-utopic one is based upon prevention, and early care of common diseases. Each model has strength and weakness, which are commented to enhance discussion on the crucial issue of the philosophy of care behind its practical organization. Increased reflection and research on models of nephrology care is urgently needed if we wish to rise to the challenge of providing earlier and better care for older and more complex kidney patients with acute and chronic kidney diseases, with reduced budgets

The Diet and Haemodialysis Dyad: Three Eras, Four Open Questions and Four Paradoxes. A Narrative Review, Towards a Personalized, Patient-Centered Approach

The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients’ lives. In the early years of dialysis, potassium was identified as “the killer”, and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the “third era” finds us combating protein-energy wasting. This review discusses four questions and four paradoxes, regarding the diet-dialysis dyad: are the “magic numbers” of nutritional requirements (calories: 30–35 kcal/kg; proteins > 1.2 g/kg) still valid? Are the guidelines based on the metabolic needs of patients on “conventional” thrice-weekly bicarbonate dialysis applicable to different dialysis schedules, including daily dialysis or haemodiafiltration? The quantity of phosphate and potassium contained in processed and preserved foods may be significantly different from those in untreated foods: what are we eating? Is malnutrition one condition or a combination of conditions? The paradoxes: obesity is associated with higher survival in dialysis, losing weight is associated with mortality, but high BMI is a contraindication for kidney transplantation; it is difficult to limit phosphate intake when a patient is on a high-protein diet, such as the ones usually prescribed on dialysis; low serum albumin is associated with low dialysis efficiency and reduced survival, but on haemodiafiltration, high efficiency is coupled with albumin losses; banning plant derived food may limit consumption of “vascular healthy” food in a vulnerable population. Tailored approaches and agreed practices are needed so that we can identify attainable goals and pursue them in our fragile haemodialysis populations

Intradialytic Nutrition and Hemodialysis Prescriptions: A Personalized Stepwise Approach

Dialysis and nutrition are two sides of the same coin—dialysis depurates metabolic waste that is typically produced by food intake. Hence, dietetic restrictions are commonly imposed in order to limit potassium and phosphate and avoid fluid overload. Conversely, malnutrition is a major challenge and, albeit to differing degrees, all nutritional markers are associated with survival. Dialysis-related malnutrition has a multifactorial origin related to uremic syndrome and comorbidities but also to dialysis treatment. Both an insufficient dialysis dose and excessive removal are contributing factors. It is thus not surprising that dialysis alone, without proper nutritional management, often fails to be effective in combatting malnutrition. While composite indexes can be used to identify patients with poor prognosis, none is fully satisfactory, and the definitions of malnutrition and protein energy wasting are still controversial. Furthermore, most nutritional markers and interventions were assessed in hemodialysis patients, while hemodiafiltration and peritoneal dialysis have been less extensively studied. The significant loss of albumin in these two dialysis modalities makes it extremely difficult to interpret common markers and scores. Despite these problems, hemodialysis sessions represent a valuable opportunity to monitor nutritional status and prescribe nutritional interventions, and several approaches have been tried. In this concept paper, we review the current evidence on intradialytic nutrition and propose an algorithm for adapting nutritional interventions to individual patients

DISTRIBUTION OF SPAWNING AND NURSERY GROUNDS FOR DEEP–WATER RED SHRIMPS IN THE CENTRAL WESTERN MEDITERRANEAN SEA

The presence of spawning and nursery grounds of Aristeids in the central western Mediterranean Sea were investigated using fishery-independent data (trawl surveys, 1994–2012). Spatial distributions were generated for mature animals and recruits, for both spring/summer and autumn data, using an inverse distance weighted deterministic interpolation. The persistence index was used to identify stable spawning and nursery grounds in the Sardinian slope region for Aristaeomorpha foliacea and Aristeus antennatus. Areas of aggregation for recruits and mature females appear connected with important physical habitat features. The analysis also suggests a seasonal bathymetric distribution for nursery areas. The recruits of A. foliacea are located in the upper part of the continental slope (377-450 m) in spring-summer and reach greater depths (468-628 m) in autumn. For A. antennatus, for which nursery areas only emerge in autumn, there is presumably an opposite ontogenic migration, from deep sea to upper slope, during the summer (575-681 m). Results indicate also a partial overlap between the nursery and spawning grounds of both species. In this particular areas, local environmental conditions such as upwelling events or the presence of canyons and seamounts seem to play an important role in their distribution. This study generated also relevant information on the spatial and temporal distribution of seasonal or persistent aggregations of spawners and recruits, providing scientific elements to suggest the feasibility of protecting these important resources