Trace metal distributions in Posidonia oceanica and sediments from Taranto Gulf (Ionian Sea, Southern Italy)

Distribution of metals (Hg, Pb, Sn, Cu, Cd and Zn) was determined in sediments and in different tissues of Posidonia oceanica collected from San Pietro Island, Taranto Gulf (Ionian Sea, Southern Italy). In seagrass, results, compared with metal concentrations in sediments, showed that the highest concentrations of Hg, Pb, Sn and Cu were found in the roots, while in the green leaves were found the highest levels of Cd and Zn. Instead the lowest metal concentrations were found in the basal part of the leaf. Levels of  metals in the leaves were similar to those found by other authors in uncontaminated areas of the Mediterranean Sea. Mercury levels in roots were correlated to levels in sediments. This could demonstrate the plant memorizes sediments contamination . This study reinforces the usefulness and the relevance of Posidonia oceanica as an indicator of spatial metal contamination and an interesting tool for environmental quality evaluation

Late recovery with cyclosporine-A of an auto-immune sudden sensorineural hearing loss

Sensorineural hearing loss of immune-mediated origin may be present as a symptom in systemic autoimmune diseases or may occur as a primary disorder without other organ involvement (auto-immune inner ear disease). The diagnosis of auto-immune inner ear disease is still predicated on clinical features and to date specific diagnostic tests are not available. We report a case of right-sided sudden hearing loss in a female patient in which the clinical manifestations, in addition to ANA positivity and hypocomplementaemia allowed us to hypothesize an auto-immune inner ear disease. The immunosuppressive treatment with cyclosporine-A was capable of a recovery of the hearing that, however, occurred progressively with normalization of the hearing function after 1 year of treatment. cyclosporine-A could be proposed as a therapeutic option in case of auto-immune inner ear disease allowing the suspension of corticosteroids that, at high dose, expose patients to potentially serious adverse events

Heavy metals monitoring in mussels Mytilus galloprovincialis from the Apulian coasts (Southern Italy)

Concentrations of six heavy metals (Cd, Cr, Cu, Hg, Pb and Zn) and one semi-metal (As) were determined in tissues of mussels Mytilus galloprovincialis collected along the Apulian coasts (Mediterranean sea). This project, performed in 2009, was targeted toward the assessment of levels and spatial distribution of metals in the environment in order to evaluate the coastal water quality using mussels as bioindicators and health risk for mussel consumers.The concentrations (mg/kg d.w.) of these metals ranged from 6.35 to 76.17 for arsenic (As), 0.38 to 2.54 for cadmium (Cd), 0.96 to 9.46 for chromium (Cr), 5.26 to 19.22 for copper (Cu), 0.10 to 0.81 for mercury (Hg), 25.00 to 110.51 for zinc (Zn) and from 0.37 to 3.25 for lead (Pb). These levels were lower than the permissible limits set by European Commission and FAO with the exception for Cr in three sampling stations. Evaluation of the risk associated to molluscs consumption for human health suggested that there is no evident risk for a moderate Mytilus g. consumer, however heavy metals concentrations must be monitored periodically and carefully with respect to the consumers health

Safety of measles, mumps, and rubella vaccine in egg allergy: in vivo and in vitro management

Background: Egg allergy is the second most prevalent form of food allergy in childhood. In spite of the evidence accumulated, inoculating egg allergy children with attenuated vaccines grown on chick embryo cell cultures, such as the measles, mumps, and rubella (MMR) vaccine, is regarded (erroneously) as potentially dangerous or even anaphylactogenic, by many. An issue perceived as particularly conflicting also by Health Professionals. Case presentation: A 15-year-old boy, with a history of severe egg allergy in early infancy, who was still sensitized to egg allergens, including baked egg, had never received MMR vaccination, in fear of possible anaphylaxis, in spite of the fact that this vaccination is mandatory in the first year of life, in Italy. Because of that, he was not allowed to attend school, longer, and was referred to us in order to assess the potential risk of MMR vaccination. Upon thorough allergologic workup, sensitization to MMR vaccine components was excluded by an in vivo approach, consisting in skin prick tests, intradermal tests, and subcutaneous injection test, corroborated by vaccine-specific B-lymphocyte proliferation assay, ex vivo. T-cell proliferation in response to MMR vaccine was also excluded. Eventually, the boy was inoculated with MMR vaccine and was readmitted to school. Conclusions: The diagnostic strategy adopted appears feasible and easy-to-perform and may be adopted in controversial cases (as the one reported), characterized by previous severe allergic reactions to egg. The B-lymphocyte proliferation assay we developed may represent a useful and reliable tool not only in research but also in clinical practice

Improving sleep quality in cancer patients. a literature review on non-pharmacologic interventions

Objective: Disrupted sleep-in cancer patients is due to several factors. Pre-existing sleep disorders, mental status in cancer, or side effects of cancer treatment are all potential predictors of sleep disturbances in this vulnerable population. This review aims to evaluate and synthesise non-pharmaco-logic interventions for improving sleep quality and the associated benefits in cancer patients. Materials and Methods: A literature review was performed according to PRISMA guidelines. PubMed, Google Scholar, MEDLINE, CINAHL, and Embase databases were interrogated, selected the article with cancer, neoplasm, oncology, sleep-wake disorders, sleep disturbance, sleep problem, strategies, treat-ment, and intervention such as keywords. No time and geographic restrictions but paediatrics, children, and interventions unrelated to sleep improvement in cancer were excluded. Results: Overall, twenty-nine articles were included in the review after selection. The included studies analysed different types of cancer, like breast, lung, and prostate cancer and acute leukaemia. Most of the data gathered from the relevant research suggest that nonpharmacologic interventions significantly improved cancer patients’ sleep quality. Conclusions: Cancer survival rates are increasing; researchers and healthcare professionals should aim not just at survival but also to allow cancer patients just comfortably to live, considering the best quality of life possible. Nurses have a crucial role in the care of this patient population. Nursing implies an intimate relationship with patients and educating the patient to improve their mental and physical condition through non-pharmacological approaches, which should be considered a specific competence

Elderly patients with multimorbidity in the home setting: umbrella review on therapeutic non-adherence causes

Objective: The elderly population is the most at risk regarding adherence, especially in the coexistence of multiple diseases. This study aims to detect factors contributing to therapeutic non-adherence in elderly patients in home settings. Materials and methods: A review protocol was developed to conduct the umbrella review using the methodological framework of the Richardson et al study. The search strategy was developed in December 2022 to conduct a systematic search and to perform an Umbrella Review of systematic reviews, meta-analyses and integrative reviews published from 2012 to 2022 in English. Results: A total of 26,038 articles were identified and screened. 18 relevant articles were included in the study. Conclusions: Therapeutic adherence in elderly patients with comorbidities in polypharmacotherapy at home is a significant problem in public health and health care. Several factors of non-adherence have been identified in the studies reviewed, confirming that the problem is multifactorial. Reducing the number of medications prescribed would appear optimal, although often not possible, as this has been seen to have an immediate positive impact. A multidisciplinary approach makes it possible not to fragment care, ensuring positive feedback on therapeutic adherence

CT colonography followed by elective surgery in patients with acute diverticulitis : a radiological-pathological correlation study

Purpose: To perform a radiologic-pathologic correlation analysis of sigmoid colon in patients undergoing pre-operative CT Colonography (CTC) after an episode of acute diverticulitis (AD). Methods: Fifty-nine consecutive patients (31/28 M/F; 58 \ub1 13 years) underwent CTC 55 \ub1 18 days after AD, 8 \ub1 4 weeks before surgery. Thirty-seven patients (63%) underwent conventional abdominal CT at time of AD. An experienced blinded radiologist retrospectively analyzed all images: disease severity was graded according to the Ambrosetti classification on conventional CT and according to the diverticular disease severity score (DDSS) on CTC. A GI pathologist performed a dedicated analysis, evaluating the presence of acute and chronic inflammation, and fibrosis, using 0\u20133 point scale for each variable. Results: Of 59 patients, 41 (69%) had at least one previous AD episode; twenty-six patients (44%) had a complicated AD. DDSS was mild-moderate in 34/59 (58%), and severe in 25/59 (42%). All patients had chronic inflammation, while 90% had low-to-severe fibrosis. Patients with moderate/severe fibrosis were older than those with no/mild fibrosis (61 \ub1 13 versus 54 \ub1 13). We found a significant correlation between DDSS and chronic inflammation (p = 0.004), as well as DDSS and fibrosis (p = 0.005). Furthermore, fibrosis was correlated with complicated acute diverticulitis (p = 0.0.27), and with age (p = 0.067). At multivariate analysis, complicated diverticulitis was the best predictor of fibrosis (odds ratio 4.4). Patient age and DDSS were other independent predictors. Conclusion: DDSS-based assessment on preoperative CTC was a good predictor of chronic colonic inflammation and fibrosis. In addition, the presence of complicated diverticulitis on CT during the acute episode was most predictive of fibrosis

Monitoring soil wetness variations by means of satellite passive microwave observations: the HYDROPTIMET study cases

International audienceSoil moisture is an important component of the hydrological cycle. In the framework of modern flood warning systems, the knowledge of soil moisture is crucial, due to the influence on the soil response in terms of infiltration-runoff. Precipitation-runoff processes, in fact, are related to catchment's hydrological conditions before the precipitation. Thus, an estimation of these conditions is of significant importance to improve the reliability of flood warning systems. Combining such information with other weather-related satellite products (i.e. rain rate estimation) might represent a useful exercise in order to improve our capability to handle (and possibly mitigate or prevent) hydro-geological hazards. Remote sensing, in the last few years, has supported several techniques for soil moisture/wetness monitoring. Most of the satellite-based techniques use microwave data, thanks to the all-weather and all-time capability of these data, as well as to their high sensitivity to water content in the soil. On the other hand, microwave data are unfortunately highly affected by the presence of surface roughness or vegetation coverage within the instantaneous satellite field of view (IFOV). Those problems, consequently, strongly limit the efficiency and the reliability of traditional satellite techniques. Recently, using data coming from AMSU (Advanced Microwave Sounding Unit), flying aboard NOAA (National Oceanic and Atmospheric Administration) satellites, a new methodology for soil wetness estimation has been proposed. The proposed index, called Soil Wetness Variation Index (SWVI), developed by a multi-temporal analysis of AMSU records, seems able to reduce the problems related to vegetation and/or roughness effects. Such an approach has been tested, with promising results, on the analysis of some flooding events which occurred in Europe in the past. In this study, results achieved for the HYDROPTIMET test cases will be analysed and discussed in detail. This analysis allows us to evaluate the reliability and the efficiency of the proposed technique in identifying different amounts of soil wetness variations in different observational conditions. In particular, the proposed indicator was able to document the actual effects of meteorological events, in terms of space-time evolution of soil wetness changes, for all the analysed HYDROPTIMET test cases. Moreover, in some circumstances, the SWVI was able to identify the presence of a sort of "early" signal in terms of soil wetness variations, which may be regarded as a timely indication of an anomalous value of soil water content. This evidence suggests the opportunity to use such an index in the pre-operational phases of the modern flood warning systems, in order to improve their forecast capabilities and their reliability

The cost of inflammatory bowel disease management matches with clinical course: A single outpatient centre analysis

Inflammatory bowel diseases (IBD) have a large economic burden on health systems. Our single-centre observational retrospective study aimed to assess an economic evaluation in two IBD outpatient cohorts (biological and conventional therapy) in relation to disease activity within a three-year follow-up. Four hundred and seventeen consecutive IBD patients referred to our tertiary gastroenterology unit (Bari-Puglia-Southern Italy) on January 2014–December 2016 were included. For each group (conventional/biological), we assessed direct/indirect costs and clinical/endoscopic activity within the first year and along the three-year follow-up. Statistical analyses: Wilcoxon signed-rank test (continuous variables), chi-square and Fisher’s test (categorical variables), Spearman ranks (single outcome) and ANOVA (detection time, clinical/endoscopic scores) were used. Continuous variables were expressed as mean ± standard deviation and range and/or median, interquartile range and range; categorical variables were expressed as proportions with 95% confidence interval. Direct and indirect cost items of 2014 and 2014–2016 were higher in patients treated with biological than conventional therapy. Subjects on biological therapy were younger and showed clinical and endoscopic moderate-to-severe disease activity. After three years, they reached a significant improvement from baseline. Conversely, disease activity was mild when conventional treatment had a beneficial effect. In conclusion, overall IBD management cost matches with clinical course and needs long-term evaluation in critical patients

Assessing the potential of <i>SWVI</i> (Soil Wetness Variation Index) for hydrological risk monitoring by means of satellite microwave observations

International audienceIn the last years satellite remote sensing applications in hydrology have considerably progressed. A new multi-temporal satellite data-analysis approach has been recently suggested in order to estimate space-time changes of geophysical parameters possibly related to the increase of environmental and hydro-geological hazards. Such an approach has been already used both for flooded area mapping (using AVHRR data) and for soil wetness index estimation (using AMSU data). In this work, a preliminary sensitivity analysis of the proposed Soil Wetness Variation Index (SWVI) is made in the case of low intensity meteorological events by the comparison with hydrological (precipitation) data. This analysis, as a first step of a more complex work in progress, is targeted to a first evaluation of the reliability of the SWVI in describing soil response to precipitations of different duration and intensity