Cd content in phosphate fertilizer: Which potential risk for the environment and human health?

Cadmium (Cd) is a heavy metal that accumulates in soil and in living organisms and causes severe and permanent damage. Its presence in the soil depends largely on the use of phosphate fertilizers. Phosphorite and apatite rocks used in phosphate fertilizers production contain several other minerals, including Cd. The amount of Cd incorporated in phosphate fertilizers depends on the type of phosphorite and apatite rocks (with low or high Cd content). Cd is present in soil mainly in insoluble form and has no bioavailability for plants. However, plants can increase Cd solubility by releasing root exudates that change the pH of the rhizosphere, therefore increasing Cd accumulation. Once crops absorb Cd, it enters the food chain. Food is the primary source of Cd exposure (for the non-smoking population), with cereals, nuts and legumes, and fish and shellfish being the major contributors. Progressive accumulation of Cd in humans impairs kidney function, affects the liver, and causes bone demineralization. Cd classification as a human carcinogen goes back to the 1990s. The European Union adopted Regulation (EU) 2019/1009, limiting Cd content in organo-mineral fertilizer having total phosphorus (P) content of 5% P2O5 equivalent at 60 mg kg−1 P2O5. This threshold seems inadequate compared to the threshold values for Cd currently in place in some EU countries: 12 member states have a Cd threshold between 20 and 50 mg kg−1 P2O5, 8 have the same threshold as that proposed in the regulation, and 2 have a higher threshold. Meanwhile, the new EU Regulation on CAP Strategic Plans explicitly references soil health and fertility protection and the limitation of contaminants in fertilizers. Fertilizers with low Cd content, with thresholds no higher than 20 mg kg−1 P2O5, would effectively limit bioaccumulation. As stopping P fertilizer application cannot be an option, strategies such as the use of P fertilizers with low Cd content, the use of cultivars that accumulate less Cd in their consumed parts, production of mineral P fertilizers with higher nutrient use efficiency than those actually produced, the decadmiation of P rocks from the raw materials, soil phytoremediation before crops cultivation, and increased use of recovered nutrients, should be adopted

Comparison of Pheochromocytoma-Specific Morbidity and Mortality among Adults with Bilateral Pheochromocytomas Undergoing Total Adrenalectomy vs Cortical-Sparing Adrenalectomy

Importance: Large studies investigating long-term outcomes of patients with bilateral pheochromocytomas treated with either total or cortical-sparing adrenalectomies are needed to inform clinical management. Objective: To determine the association of total vs cortical-sparing adrenalectomy with pheochromocytoma-specific mortality, the burden of primary adrenal insufficiency after bilateral adrenalectomy, and the risk of pheochromocytoma recurrence. Design, Setting, and Participants: This cohort study used data from a multicenter consortium-based registry for 625 patients treated for bilateral pheochromocytomas between 1950 and 2018. Data were analyzed from September 1, 2018, to June 1, 2019. Exposures: Total or cortical-sparing adrenalectomy. Main Outcomes and Measures: Primary adrenal insufficiency, recurrent pheochromocytoma, and mortality. Results: Of 625 patients (300 [48%] female) with a median (interquartile range [IQR]) age of 30 (22-40) years at diagnosis, 401 (64%) were diagnosed with synchronous bilateral pheochromocytomas and 224 (36%) were diagnosed with metachronous pheochromocytomas (median [IQR] interval to second adrenalectomy, 6 [1-13] years). In 505 of 526 tested patients (96%), germline mutations were detected in the genes RET (282 patients [54%]), VHL (184 patients [35%]), and other genes (39 patients [7%]). Of 849 adrenalectomies performed in 625 patients, 324 (52%) were planned as cortical sparing and were successful in 248 of 324 patients (76.5%). Primary adrenal insufficiency occurred in all patients treated with total adrenalectomy but only in 23.5% of patients treated with attempted cortical-sparing adrenalectomy. A third of patients with adrenal insufficiency developed complications, such as adrenal crisis or iatrogenic Cushing syndrome. Of 377 patients who became steroid dependent, 67 (18%) developed at least 1 adrenal crisis and 50 (13%) developed iatrogenic Cushing syndrome during median (IQR) follow-up of 8 (3-25) years. Two patients developed recurrent pheochromocytoma in the adrenal bed despite total adrenalectomy. In contrast, 33 patients (13%) treated with successful cortical-sparing adrenalectomy developed another pheochromocytoma within the remnant adrenal after a median (IQR) of 8 (4-13) years, all of which were successfully treated with another surgery. Cortical-sparing surgery was not associated with survival. Overall survival was associated with comorbidities unrelated to pheochromocytoma: of 63 patients who died, only 3 (5%) died of metastatic pheochromocytoma. Conclusions and Relevance: Patients undergoing cortical-sparing adrenalectomy did not demonstrate decreased survival, despite development of recurrent pheochromocytoma in 13%. Cortical-sparing adrenalectomy should be considered in all patients with hereditary pheochromocytoma

Nuovi ospiti nei canali di bonifica della provincia di Ferrara

L’immissione più o meno accidentale e l’acclimatazione di specie ittiche alloctone nella rete di canali di bonifica della provincia di Ferrara è, da alcuni anni, un fenomeno inarrestabile (Melotti & Resta, 1987; Rossi et al., 1992; Gandolfi, 1993; De Curtis & Rossi, 1999). Molteplici fattori sono alla base della continua comparsa di specie non indigene: esse concorrono ad acuire le problematiche di sopravvivenza dell’ittiofauna autoctona, per la cui gestione risulta importante disporre di informazioni in tempo reale. Nell’ambito del monitoraggio della rete di canali di bonifica della provincia di Ferrara, nel 2003 sono state segnalate due nuove specie alloctone: l’aspio e la blicca

Emorragia gastrica da malattia di Dieulafoy: diagnosi angiografica e trattamento mediante embolizzazione

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Prima segnalazione di aspio, Aspius aspius (Linnaeus, 1758) e blicca, Abramis bjoerkna (Linnaeus, 1758), Osteichthyes, Cypriniformes, nelle acque interne della provincia di Ferrara

The presence of the allochthonous species, asp, Aspius aspius (Linnaeus, 1758) and white bream, Abramis bjoerkna (Linnaeus, 1758) is to be mentioned for the first time in the freshwater canals of province of Ferrara, Northern Italy. The hydraulic system of artificial canals (4000 km) in the province of Ferrara (2630 Km2) is divided in more sub-basins, all related to the Burana-Volano canal that crosses the overall territory from west to east and is used for both irrigation and drainage. Particularly, the main sub-basins, named Canale Burana, Po di Volano, Po Morto di Primaro, Canal Bianco, Canale Navigabile, Canale Circondariale, were considered in this study. The classification to the species level was supported by the morpho-meristic parameters, in agreement with the range of variability described for the two species. Moreover, biometrical data of some white breams are in disagreement with the standards, probably indicating the presence of hybrids between Blicca bjoerkna and Abramis brama

Prima segnalazione e distribuzione di rodeo amaro, Rhodeus seiceus (Pallas, 1776), Osteichthyes Cypriniformes, nelle acque interne della provincia di Ferrara

The presence of the exotic species, bitterling, Rhodeus sericeus (Pallas, 1776), is reported for the first time in the freshwater canals of province of Ferrara, Northern Italy. The classification to the species level was supported by the morpho-meristic parameters, in agreement with the range of variability described for the species. The specie was firstly recorded in Italy in the 1990, in the Menago river located in province of Verona, tributary of the Canal Bianco where it was found the following year, and connected to the Po river through the Governolo (MN) and Voltagrimana (RO) navigation canals. In some canals of the province of Modena it was recorded in 1996 and in the lower Secchia River in 1999, while the species was not found in the Panaro River and in the Burana basin whose homonymous canal crosses the province of Ferrara, from west to east. The hydraulic system of artificial canals (4000 km) in the province of Ferrara (2630 Km) is divided in more sub-basins, all related to the Burana-Volano-Navigabile canal that crosses the overall territory from west to east and is used for both irrigation, driving Po River water derived at Stellata (Bondeno. FE) and drainage. The main sub-basins, considered in this study, are the Canale Burana, Po di Volano, Canal Bianco, Canale Navigabile and Canale Circondariale

Trattamento percutaneo dell'insufficienza venosa degli arti inferiori secondaria a sindrome da congestione pelvica

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Sindrome di Budd-Chiari associata a LES: diagnostica per immagini e trattamento percutaneo . Budd-Chiari syndrome associated with systemic lupus erithematosus: diagnostic imaging and percutaneous treatment

Riportiamo un caso di LES associato ad anticorpi antifosfolipidi caratterizzato da trombosi venosa del sistema femoro-iliaco-cavale e sindrome di Budd-Chiari in cui un corretto inquadramento diagnostico ed il trattamento percutaneo con tecniche di radiologia interventistica hanno consentito la risoluzione del quadro clinico e la sua stabilizzazione ad un follow-up di 8 ann