Update on the management of acute pharyngitis in children

Streptococcal pharyngitis is a very common pathology in paediatric age all over the world. Nevertheless there isn't a joint agreement on the management of this condition. Some authors recommend to perform a microbiological investigation in suspected bacterial cases in order to treat the confirmed cases with antibiotics so to prevent suppurative complications and acute rheumatic fever. Differently, other authors consider pharyngitis, even streptococcal one, a benign, self-limiting disease. Consequently they wouldn't routinely perform microbiological tests and, pointing to a judicious use of antibiotics, they would reserve antimicrobial treatment to well-selected cases. It has been calculated that the number of patients needed to treat to prevent one complication after upper respiratory tract infections (including sore throat), was over 4000

Oxidative responsiveness to multiple stressors in the key Antarctic species, Adamussium colbecki: interactions between temperature, acidification and cadmium exposure.

Abstract: High-latitude marine ecosystems are ranked to be among the most sensitive regions to climate change since highly stenothermal and specially adapted organisms might be seriously affected by global warming and ocean acidification. The present investigation was aimed to provide new insights on the sensitivity to such environmental stressors in the key Antarctic species, Adamussium colbecki, focussing also on their synergistic effects with cadmium exposure, naturally abundant in this area for upwelling phenomena. Scallops were exposed for 2 weeks to various combinations of Cd (0 and 40 μgL-1), pH (8.05 and 7.60) and temperature (-1 and +1°C). Beside Cd bioaccumulation, a wide panel of early warning biomarkers were analysed in digestive glands and gills including levels of metallothioneins, individual antioxidants and total oxyradical scavenging capacity, onset of oxidative cell damage like lipid peroxidation, lysosomal stability, DNA integrity and peroxisomal proliferation. Results indicated reciprocal interactions between multiple stressors and their elaboration by a quantitative hazard model based on the relevance and magnitude of effects, highlighted a different sensitivity of analysed tissues. Due to cellular adaptations to high basal Cd content, digestive gland appeared more tolerant toward other prooxidant stressors, but sensitive to variations of the metal. On the other hand, gills were more affected by various combinations of stressors occurring at higher temperatur

Cellular adaptations of the scleractinian coral Madracis pharensis to chronic oil pollution in a Mediterranean shipwreck

Chemical pollution in marine ecosystems is a factor of stress interacting in multiple and complex ways with other major causes of deterioration, such as warming seas due to climate change. Here we surveyed epibenthic communities from a shipwreck in the Levantine Basin for temporal and spatial changes in the community in relation to chronic oil pollution, comparing results collected from an area of the wreck characterized by chronic oil leakage with another area not affected by oil. Polycyclic aromatic hydrocarbons (PAHs) bioaccumulation analyses were integrated with characterization of the efficiency of xenobiotics biotransformation processes and antioxidant network of the scleractinian coral Madracis pharensis, chosen as bioindicator species. Results highlighted the two areas hosting different epibenthic communities over a period of 11 years. Significant changes in the percentage cover of M. pharensis could be the result of recent mass mortality associated to Marine Heat Waves. Biological investigation conducted in M. pharensis tissues revealed an increased content of PAHs in specimens collected from the oil-impacted area, coupled with an increased capability of oxyradicals scavenging capacity and a lower functionality of phase II biotransformation mechanisms associated to glutathione S-transferase. Overall, the results suggest that M. pharensis has the capability to develop cellular and physiological adaptations to chemical-mediated stress, with yet unknown possible energy trade-offs to sustain stress response

Application of a Weight of Evidence Approach for Monitoring Complex Environmental Scenarios: the Case-Study of Off-Shore Platforms

Multidisciplinary investigations based on integration of chemical and biological measurements, represent an added value to monitoring and management protocols, and their use is recommended by European Directives to evaluate the environmental status of aquatic ecosystems. However, assessing the overall significance of results obtained in different typologies of studies is often a difficult challenge. The aim of this work was to present a quantitative Weight Of Evidence (WOE) model (Sediqualsoft) to integrate huge amounts of heterogeneous data and to validate this approach in complex monitoring scenarios. Using the case-study of an off-shore platform field in the Adriatic Sea, procedures are presented to elaborate different typologies of data (lines of evidence, LOEs), including chemical characterization of sediments, bioavailability, biomarkers, ecotoxicological bioassays and benthic communities around three platforms. These data are initially evaluated by logical flowcharts and mathematical algorithms, which provide specific hazard indices for each considered LOE, before their different weighting and overall integration in an environmental risk index. The monitoring study selected for the WOE elaboration consisted on chemical analyses of trace metals, aliphatic hydrocarbons, polycyclic aromatic hydrocarbons carried out on 60 sediment samples; the same samples were also characterized for the status of benthic communities; bioavailability of metals from sediments was assessed in laboratory conditions on the polychaete Hediste diversicolor, while bioaccumulation of inorganic and organic chemicals and biomarker responses were measured in native and transplanted mussels; ecotoxicological properties of sediments were evaluated through a battery of bioassays determining algal growth of the diatom Phaeodactylum tricornutum, bioluminescence of the marine bacterium Vibrio fischeri, survival of the copepod Acartia tonsa and embryotoxicity of sea urchin Paracentrotus lividus. Overall, almost 7000 analytical results were elaborated and summarized in specific hazard indices. The WOE integration of multiple typologies of data allowed more robust and weighted conclusions compared to the use of individual LOEs, highlighting the feasibility of this procedure for multidisciplinary monitoring and risk assessment approaches. On a practical side, the WOE evidences also suggested a revision of actual monitoring procedures. Overall, the proposed WOE model appeared as a useful tool to summarize large datasets of complex data in integrative indices, and to simplify the interpretation for stakeholders and decision makers, thus supporting a more comprehensive process of "site-oriented" management decisions

Value of real-time transesophageal 3-dimensional echocardiography in guiding ablation of isthmus-dependent atrial flutter and pulmonary vein isolation

In the past decade, both the range of indications and the efficacy and safety of interventional electrophysiology has improved considerably. This progress is attributed to both the accumulating experience of electrophysiologists and the advances in technological tools facilitating the diagnosis and treatment of cardiac arrhythmias. Real-time 3-dimensional transesophageal echocardiography (RT 3D TEE) has emerged as a new imaging tool in the clinical arena. Its ability to image in "real time" cardiac structures "en face" and the almost entire length of intracardiac catheters has made this technique a promising imaging tool to guide percutaneous catheter-based procedures. More recently it has been used in monitoring ablation procedures. In this review, the advantages and current limitations of RT 3D TEE during ablation of cavotricuspid isthmus-dependent atrial flutter and pulmonary vein isolation are described

Cellular adaptations of the scleractinian coral Madracis pharensis to chronic oil pollution in a Mediterranean shipwreck

Chemical pollution in marine ecosystems is a factor of stress interacting in multiple and complex ways with other major causes of deterioration, such as warming seas due to climate change. Here we surveyed epibenthic communities from a shipwreck in the Levantine Basin for temporal and spatial changes in the community in relation to chronic oil pollution, comparing results collected from an area of the wreck characterized by chronic oil leakage with another area not affected by oil. Polycyclic aromatic hydrocarbons (PAHs) bioaccumulation analyses were integrated with characterization of the efficiency of xenobiotics biotransformation processes and antioxidant network of the scleractinian coral Madracis pharensis, chosen as bioindicator species. Results highlighted the two areas hosting different epibenthic communities over a period of 11 years. Significant changes in the percentage cover of M. pharensis could be the result of recent mass mortality associated to Marine Heat Waves. Biological investigation conducted in M. pharensis tissues revealed an increased content of PAHs in specimens collected from the oil-impacted area, coupled with an increased capability of oxyradicals scavenging capacity and a lower functionality of phase II biotransformation mechanisms associated to glutathione S-transferase. Overall, the results suggest that M. pharensis has the capability to develop cellular and physiological adaptations to chemical-mediated stress, with yet unknown possible energy trade-offs to sustain stress response

Toxicological effects of cigarette butts for marine organisms

Cigarette butts (CBs), one of the most common litter items found on beaches, represent a still unexplored environmental hazard. This study aimed at a multidisciplinary characterization of their toxicological risks on marine organisms integrating chemical analyses of released compounds with a wide panel of biological responses, such as ecotoxicological bioassays on species of different trophic positions, molecular responses in an ex vivo model (Precision-Cut Tissue Slices, PCTS of mussels digestive glands), bioavailability and cellular biomarkers in mussels exposed to CBs in laboratory experiments. Trace metals, aliphatic and polycyclic aromatic hydrocarbons, nicotine and cotinine were released in artificial seawater after 24 h which determined a significant inhibition of bacterial bioluminescence, oyster embryo development and growth in different algal species. Modulation of peroxisomal proliferation and antioxidant gene expression was observed in mussels PCTS, while the in vivo exposure determined accumulation of chemicals and significant alterations of immune system, antioxidant and neurotoxic responses, peroxisomal proliferation and genotoxic damage. Using a quantitative Weight of Evidence model, the risks of CBs to the marine environment were summarized, highlighting the importance of integrating chemical analyses, batteries of ecotoxicological bioassays, molecular and cellular biomarkers to assess the impact of these hazardous materials on marine environment