Preliminary geochemical characterization of groundwater drained by the Roman emissary of Lake Albano (Italy)

Many lakes have been the object of hydraulic works in historical times, and the drainage tunnel carved by Romans for regulating the level of Lake Albano (Central Italy) can be considered as one of the most important historical hydraulic tunnels in the world. We sampled and analysed lake water, as well as groundwater samples from the Lake Albano emissary and another hydraulic work in the area (Ninfeo), which were analysed for their geochemical and isotopic composition in order to extract useful information for a possible reuse of the tunnel for anthropogenic purposes. The collected water samples exhibit common chemical features, typical of water–rock interaction processes in volcanic areas. Analyses of minor and trace elements confirmed the abovementioned results, indicating the presence of an atmospheric pollution source for heavy metals, although their concentrations are mostly below the Maximum Admitted Concentrations for drinking water issued by the World Health Organization. The chemical composition of dissolved gases indicated that both lake and groundwater are mainly enriched in CO2. Isotopic analyses suggested a clear volcanic origin for CO2 dissolved in lake water, while carbon dioxide in groundwater from the Roman emissary is produced by soil respiration. As further confirmed by Oxygen and Deuterium isotopic composition, the Roman emissary drains local suspended aquifers neither in contact with the lake water body nor influenced by volcanic activity, suggesting the opportunity to use the tunnel as a “zero-condition” monitoring site for individuating a possible future renewal of volcanic activity

Endoscopic retrograde cholangiopancreatography in the elderly: results of a retrospective study and a geriatricians’ point of view

Abstract Background The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated. Methods We retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely. The mean age of the study population (n = 363) was 79.9 years old (range 70–95), with 190 subjects aged 70–79 and 173 older than 80. We recorded demographics, Charlson Comorbidity index (CCI), American Society of Anesthesiologists (ASA) physical status classification score, indication for the use of the ERCP procedure, and clinical outcomes. Then, we tested all variables to identify the potential risk factors for complications associated with the procedure. Results The older group (those ≥80 years old) showed significantly more patients with ASA Classes III-IV than the younger one (those ≤79 years old). Interestingly, the CCI was higher in the younger group (p = 0.009). The overall complication rate was 17.3% without inter-group differences. Older age, sex, CCI and intra-ERCP procedures were not related to a higher risk of complications, and the multivariate regression did not identify any of the considered variables to be an independent risk factor for complications. Conclusion ERCP appears as safe in the patients aged 80 years and older, as it is in those aged 70–79 years old in our study, however, a selection bias may affect these findings. A study including a comprehensive geriatric assessment will contribute to shedding light on this issue