A hydrogeochemical approach to the characterization of low-enthalpy geothermal systems: the Scordia – Lentini graben (Sicily, Italy)

We describe the geochemical characteristics of groundwater samples collected in 23 water wells located on the northern margin of the Hyblean plateau (East Sicily). This area, mostly made of highly permeable carbonate rocks, is rich in low temperature (T < 50° C) hydrothermal groundwaters, distributed in an active sismogenetic zone, with several ENE-WSW-directed tectonic structures that drove magma to the surface during Upper Pliocene and Pleistocene. The chemical features suggest complex mixing between rainwater, CO2-rich groundwater, steam-heated groundwater and geothermal brines, as highlighted by Principal Component Analysis (PCA). Some parameters, however, indicate widespread pollution of the aquifers from human activities. Stable isotopes analysis confirms the meteoric origin of groundwater and supports the origin of dissolved CO2 mostly from mantle degassing through deep tectonic faults. Geothermometric estimates, mostly based on quartz and Saturation Indexes geothermometers, suggest minimum reservoir temperature between 100 and 120° C

DEGASSAMENTO DI RADON E MODIFICHE DEL DNA DELLA POPOLAZIONE SICILIANA: POSSIBILI RELAZIONI CON IL TERREMOTO DEL 1908

I risultati delle indagini condotte su base geochimica e genetica nell’area delle Stretto di Messina si incrociano proponendo uno scenario assolutamente nuovo su ciò che un terremoto può indurre anche come effetti sulla salute umana, con modifiche di tipo genetico. Le ricerche svolte nell’ambito del progetto INGV-Dipartimento Protezione Civile su “Valutazione del potenziale sismogenetico e probabilità dei forti terremoti in Italia”, hanno mostrato che nell’area dello Stretto di Messina persistono anomalie di degassamento dai suoli di CO2, metano e radon, diversi ordini di grandezza al di sopra dei valori normali, per esempio con concentrazioni dinamiche di Rn fino oltre 80.000 Bq/m3 La valutazione di un degassamento naturale di tale intensità in situazione di quiete sismica, ha assunto significato anche nella valutazione degli effetti del Rn sulla salute umana, che, sebbene conosciuti da tempo come seconda causa di tumore al polmone dopo il fumo, si mostrano sorprendentemente come i possibili protagonisti delle mutazioni genetiche riscontrate nella popolazione vivente intorno allo Stretto Radon e DNA La presenza di antigeni indicano di modifiche del DNA, ed uno in particolare denominato DR11 è presente con la frequenza più alta intorno a Messina e a Reggio (54% della popolazione) per poi diminuire verso Caltanissetta e Vibo Valentia (44%) con un minimo a Trapani (38%; figura 1). Una tale modifica del DNA è in contrasto con la Legge di Hardy –Weimberg, secondo la quale in una popolazione in cui gli accoppiamenti avvengono a caso, e in assenza di pressioni evolutive e di forti migrazioni dovrebbe essere mantenuta una generale omogeneità. Questo tipo di distribuzione, molto eterogenea, ma non irregolare e disordinata, non può essere attribuita a fluttuazioni casuali o a deriva genetica, e neanche alle invasioni che nel passato queste regioni hanno subito da parte di popoli stranieri.L’ordinata e graduale riduzione di frequenza del DR11, funzione dalla distanza dallo stretto, unitamente alle valutazioni basate sulla riduzione nel tempo della frequenza del DR11, portano a concentrare l’attenzione su un evento con epicentro nello stretto accaduto circa un secolo fa, identificabile come il terremoto del 1908. Tenuto conto che non ci sono effetti diretti di un sisma in grado di interagire con la saluteumana (se non ferite, paura) si ipotizza che non sia direttamente il terremoto come tale la causa scatenante della mutazione genetica osservata ma qualcosa che ad un forte evento sismico possa essere legata. Fluidi e terremoti I risultati ottenuti in varie aree sismiche italiane (p.e. Umbria, Friuli, Appennino Tosco Emiliano) hanno mostrato che i fluidi cambiamo composizione e intensità del rilascio durante l’evolversi della sismogenesi. Le modifiche si registrano prima, durante e dopo gli eventi sismici mostrando che oltre alla fratturazione anche le deformazioni della crosta provocano modificazioni nei fluidi circolanti. Una aumentata emissione di radon durante il processo che ha portato al terremoto del 1908 è assolutamente ipotizzabile in accordo con quanto osservato durante la crisi sismica dell’Umbria (1997-98) e con le misure effettuate nell’area dello Stretto (Figura 2). Una contaminazione da gas radon dovuta alla sismogenesi, che si è protratta per tempi probabilmente lunghi, prima durante e dopo il catastrofico evento, può essere la causa delle mutazioni genetiche osservate, avendo indotto gli organismi a reagire per tutelarsi rispetto ad una pressione esterna pericolosa.Un simile scenario, che vede i processi sismogenetici strettamente legati ai fluidi anche con attivi processi di degassamento, richiede ulteriori indagini che oltre a contribuire alla riduzione del rischio sismico permettono la conoscenza di quegli aspetti legati alle interazioni uomo-ambiente su medio-lungo termine anche come possibili responsabili di cambiamenti profondi come quelli identificati del DNA dei siciliani

Assessment of the Geochemical Potential in a Complex Tectonic Environment of South-East Sicily: New Insights From Hydrochemical Data

We analyzed a large dataset (143 water sampling sites, 22 variables) of chemical parameters in local groundwaters from the south-east sector of Sicily, namely the Hyblean plateau, in order to set an original evaluation of its geothermal potential using applied geochemistry. The area was affected by volcanism until about 1.4 Ma. Today, though no active volcanism occurs, it is site of surface gas manifestations of focused degassing to which a mantle source has been attributed. We identified and thence selected the most promising sites (water springs and wells) based both on their main geochemical characteristics and on their calculated equilibrium temperature (resulting in the range between 50 and 140 °C). We then applied Principal Component Analysis (PCA) to this restricted dataset and we were able to discriminate between different sources of solutes, both natural and anthropogenic. Finally, we mapped the factor scores obtained from PCA and we focused on those likely related with geothermal conditions in order to highlight the areas with the highest geothermal potential

Robotic resection of mediastinal left vagus neurofibroma

Neurogenic tumors represent 10 to 34% of all mediastinal tumors and among them, neurofibroma originating from the vagus nerve are rare entities. We present a case of a neurofibroma with cystic degeneration originating from the left branch of the vagus nerve in a 27-years-old man without von Recklinghausen disease. A complete robotic resection of the mediastinal mass has been performed, with amputation of the vagus nerve enclosed in the mass. The postoperative course was uneventful and the patient was discharged in two days

SARS-CoV-2 vaccination modelling for safe surgery to save lives : data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.Peer reviewe

A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0-18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records (n = 2453) of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n = 1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05-0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers

Group IV Phospholipase A2α Controls the Formation of Inter-Cisternal Continuities Involved in Intra-Golgi Transport

The enzyme phospholipase A2 (cPLA2α) is involved in the formation of intercisternal tubules that mediate transport of proteins within the Golgi complex

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p &lt; 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription