Beach-cast seagrass wrack: A natural marine resource improving the establishment of dune plant communities under a changing climate

Seagrass wrack plays multiple ecological roles in coastal habitats but is often removed from beaches and used for economical processing, neglecting its potential role in sustaining dune plant establishment under changing climate scenarios. Rainwater shortage is a major stress for seedlings and reduced precipitations are expected in some coastal areas. We investigated in mesocosm how wrack influenced seedling performance of Cakile maritima, Thinopyrum junceum, and Calamagrostis arenaria under current and reduced precipitation. We also assessed wrack water holding capacity and leachate chemical/physical properties. Wrack stimulated seedling growth while reduced precipitation decreased root development. Wrack mitigated the effects of reduced precipitation on T. junceum and C. arenaria biomass. Wrack retained water up to five-fold its weight, increased water pH, conductivity, and nutrient content. Wrack promotes dune colonization by vegetation even under rainwater shortage. Thus, the maintenance of this natural resource on beaches is critical for improving dune resilience against climate changes.

Effects of TiO2 ultraviolet filter and sunscreens on coastal dune plant performance and competitive interactions

Ultraviolet filters (UVFs) added to sunscreens (SS) are emerging contaminants in marine environments due to their adverse effects on organisms and ecosystems. UVFs have also been detected in beach-dune systems, but their influence on resident organisms has not been explored yet. Native plants are fundamental components of coastal dunes, and these ecologically/economically important systems are currently among the most threatened globally. Thus, understanding whether UVFs may act as threats to dune plants is crucial. This field study evaluated and compared the effects of titanium dioxide nanoparticles (nTiO2), one of the inorganic UVFs most commonly added to sunscreens, and those of a commercial sunscreen product containing it (SS-nTiO2) on the performance of adult dune plants of a native (Thinopyrum junceum) and a non-native invasive species (Carpobrotus sp. pl.) and their competitive interactions at environmentally realistic concentrations. The effects of nTiO2, SS-nTiO2 and of a sunscreen product containing just organic UVFs (SS-OF) on early life stages of T. junceum were also examined. Ti bulk content in sand and plants at the study site ranged from 970 to 1069 mg kg-1 and from 2 to 7.9 mg kg-1, respectively. Thinopyrum junceum adult plants periodically exposed during the summer season to seawater contaminated by SS-nTiO2 produced less biomass than un-exposed plants and nTiO2 exposed plants. nTiO2 and SS-nTiO2 reduced the capacity of T. junceum to control the spread of Carpobrotus. Both SS-nTiO2 and SS-OF reduced seedling emergence in T. junceum whereas nTiO2 did not. These results demonstrated that the periodical exposures of native dune plants to sunscreens could reduce their establishment success and growth and favor invasive plant spread potentially resulting in community structure changes. They also emphasize the need to assess the phytotoxicity not only of single UVFs but especially that of complete sunscreen products to design more eco-friendly formulations in the future.

Plastic litter changes the rhizosphere bacterial community of coastal dune plants

The presence of plastic litter in coastal environments like beach-dune systems has been well documented, and recent studies have shown that this pollutant can influence sand properties as well as dune vegetation. However, the effects of plastics on rhizosphere bacterial communities of dune plants have largely been neglected. This is an ecologically relevant issue since these communities may play an important role in improving plant growth and resilience of dune systems. Here, we explored the impact of plastic litter made of either non-biodegradable polymers (NBP) or biodegradable/compostable polymers (BP) on the structure and composition of rhizosphere bacterial communities associated with two widespread species along coastal European dunes, Thinopyrum junceum and Sporobolus pumilus, by using a one-year field experiment combined with metabarcoding techniques. Both plastics did not affect neither the survival nor the biomass of T. junceum plants, but they significantly increased alpha-diversity of rhizosphere bacterial communities. They also changed rhizosphere composition by increasing the abundance of the phyla Acidobacteria, Chlamydiae, and Nitrospirae, and of the family Pirellulaceae, and reducing the abundance of the family Rhizobiaceae. NBP reduced drastically the survival of S. pumilus while BP increased its root biomass compared to controls. BP also increased the abundance of the phylum Patescibacteria of the rhizosphere bacterial communities. Our findings provide the first evidence that NBP and BP can change rhizosphere bacterial communities associated with dune plants and highlight the importance of investigating how these changes can affect the resilience of coastal dunes to climate change.

Plastic litter in coastal sand dunes: Degradation behavior and impact on native and non-native invasive plants

Pollution associated to marine plastic litter is raising increasing concerns due to its potential harmful effects on human health, biota, and coastal ecosystems. However, limited information is available on the degradation behavior of plastics, especially biodegradable ones, in dune habitats. Moreover, the effects of plastics on dune plant growth and ability to withstand environmental stresses and invasion by non-native plants have been largely neglected. This is a particularly relevant issue since biological invasions are major threats to dune ecosystems. In this 18-month study, we examined the degradation behavior of two plastic bags, non-biodegradable (NBP) or biodegradable/compostable (BP), in the dune environment by visual observations and analytical techniques. Concomitantly, we investigated the individual and combined effects of bag type and sand burial (no burial vs. partial burial) on the performance of a native dune plant (Thinopyrum junceum) and an invasive plant (Carpobrotus sp.) and on their interaction. NBP did not show relevant degradation signs over the experimental period as expected. BP exhibited gradual surface modifications and changes in chemical functionality and were almost disintegrated after 18 months. Bags and burial reduced independently T. junceum survival and growth, and most plants died within 8 months of plastic exposure. Bags and burial did not affect Carpobrotus survival. However, burial decreased Carpobrotus growth while NBP increased it. Both plastics increased Carpobrotus competitive ability, and no T. junceum plants survived to co-occurrent Carpobrotus, BP, and burial. These findings indicate that removing all littered plastics from beach-dune systems not only is critical to reduce plastic pollution but also to prevent further spread of invasive species in coastal dunes.

Virus contamination and infectivity in beach environment: Focus on sand and stranded material

To assess the exposure of beachgoers to viruses, a study on seawater, sand, and beach-stranded material was carried out, searching for human viruses, fecal indicator organisms, and total fungi. Moreover, for the first time, the genome persistence and infectivity of two model viruses was studied in laboratory-spiked sand and seawater samples during a one-week experiment. Viral genome was detected in 13.6 % of the environmental samples, but it was not infectious (Human Adenovirus - HAdV, and enterovirus). Norovirus and SARS-CoV-2 were not detected. The most contaminated samples were from sand and close to riverine discharges. In lab-scale experiments, the infectivity of HAdV5 decreased by ~1.5-Log₁₀ in a week, the one of Human Coronavirus-229E disappeared in <3 h in sand. The genome of both viruses persisted throughout the experiment. Our results confirm viral contamination of the beach and suggest HAdV as an index pathogen for beach monitoring and quantitative risk assessment.

Early evidence of the impacts of microplastic and nanoplastic pollution on the growth and physiology of the seagrass Cymodocea nodosa

Microplastics (MPs) and nanoplastics (NPs) are ubiquitous in natural habitats and the risks their presence poses to marine environments and organisms are of increasing concern. There is evidence that seagrass meadows are particularly prone to accumulate plastic debris, including polystyrene particles, but the impacts of this pollutant on seagrass performance are currently unknown. This is a relevant knowledge gap as seagrasses provide multiple ecosystem services and are declining globally due to anthropogenic impact and climate-change-related stressors. Here, we explored the potential effects of a 12 day-exposure of seagrasses to one concentration (68 μg/L) of polystyrene MPs and NPs on the growth, oxidative status, and photosynthetic efficiency of plants using the foundation species Cymodocea nodosa as a model. Among plant organs, adventitious roots were particularly affected by MPs and NPs showing complete degeneration. The number of leaves per shoot was lower in MPs- and NPs-treated plants compared to control plants, and leaf loss exceeded new leaf production in MPs-treated plants. MPs also reduced photochemical efficiency and increased pigment content compared to control plants. Shoots of NPs-treated plants showed a greater oxidative damage and phenol content than those of control plants and MPs-treated plants. Biochemical data about oxidative stress markers were consistent with histochemical results. The effects of MPs on C. nodosa could be related to their adhesion to plant surface while those of NPs to entering tissues. Our study provides the first experimental evidence of the potential harmful effects of MPs/NPs on seagrass development. It also suggests that the exposure of seagrasses to MPs/NPs in natural environments could have negative consequences on the functioning of seagrass ecosystems. This stresses the importance of implementing cleaning programs to remove all plastics already present in marine habitats as well as of undertaking specific actions to prevent the introduction of these pollutants within seagrass meadows.

Leached degradation products from beached microplastics: A potential threat to coastal dune plants

Plants play a fundamental role in maintaining coastal dunes but also accumulate littered microplastics (MPs). Migration tests suggest that naturally weathered MPs can leach out a broader range of potentially phytotoxic chemicals than virgin MPs. Thus, assessing MPs effects on plants using beached-collected particles rather than virgin ones is critically important. Here, the effects on plants of leachates from two pools of beach-collected and virgin MPs, high-density polyethylene (HDPE) and polypropylene (PP), and their mixture, were explored combining toxicity tests and chemical analyses. Phytotoxicity of MP leachates at different dilutions was evaluated under standard laboratory conditions using test species and under environmentally realistic conditions using the dune species Thinopyrum junceum. Leachates from beached PP and HDPE adversely affected all species, and the extent of these effects varied according to polymer type, concentration, and species. Virgin MPs had weaker effects than beached ones. Several potentially phytotoxic oxidized compounds were detected in water by GC/MS analysis, and their amount estimated. Results indicate that the molecular species leaching from beached MPs - at ppm concentration levels for the individual chemical species - can inhibit plant growth, and the effects of leachates from mixtures of degraded MPs can differ from those from individual polymers, highlighting the need for further investigation of MPs consequences for coastal ecosystems.

Impact of storms and proximity to entry points on marine litter and wrack accumulation along Mediterranean beaches: Management implications

Beach litter can affect public health and economic activities worldwide forcing local authorities to expensive beach cleaning. Understanding the key mechanisms affecting the accumulation of this waste on beaches, such as sea state and proximity to entry points, is critical to plan effective management strategies. In this one-year study, we estimated the impact of storm events and waterways runoff on litter abundance and local economy using as a model a managed, peri-urban beach facing a north-western sector of the Mediterranean Sea. We also investigated the relationship between litter composition/density and beach proximity to major/closest harbors/rivers at regional scale by combining our data with those on litter density available in literature. Autumn/winter storms caused larger litter depositions than spring/summer ones in the peri-urban beach. No preferential accumulation occurred near to waterway mouths. Litter mainly consisted of plastic, and its composition in terms of micro-categories varied over seasons. In total, 367,070 items were deposited along 4.7 km of beach over one year, and the cost for the removal of this waste amounted to approximately 27,600 euros per km/year. At regional scale, beach litter density was positively correlated to the proximity of major harbors while its composition was related to the proximity to both major harbors and rivers. Results indicate that autumn/winter storms are important drivers of marine litter deposition. They also suggest that beaches in front of the convergence zone of littoral currents and close to major harbors can be particularly subjected to this kind of pollutant. To increase their effectiveness, litter mitigation/cleaning activities should be planned based on predictions of major storm events and performed at spatial scales encompassing at least coastal regional sectors.

Substrate Type Influences the Structure of Epiphyte Communities and the Growth of Posidonia oceanica Seedlings

Epiphytes colonizing adult seagrasses highly contribute to seagrass ecosystem functioning and plant growth. Yet, little information exists on epiphytic communities developing on seagrass seedlings. Moreover, for some species our knowledge about seedling performance is limited to early establishment phases, and the role of substrate type in affecting their growth is still unclear. These are considerable knowledge gaps, as seedlings play an important role in meadow expansion and recovery from disturbance. In this study, seedlings of Posidonia oceanica, a keystone species of the Mediterranean, were grown in a shallow (1.5 m deep) coastal area along the Tuscany coast (Italy). After five years of growth (July 2009), seedlings were collected and, through multivariate analysis, we examined whether the epiphytic communities of leaves (both internal and external side) and rhizomes, as well as the growth characteristics differed between rock and sand substrate. The epiphytic communities of seedlings largely reflected those found on adult shoots. Epiphyte cover was similar between the two leaf sides, and it was higher on seedlings grown on rock than on sand, with encrusting algae dominating the community. No differences in epiphyte cover and community structure on rhizomes were found between substrates. Seedling growth characteristics did not differ between substrates, apart from the number of standing leaves being higher on rock than on sand. No correlation was found among epiphyte communities and seedling growth variables (i.e., leaf area, maximum leaf length, number of leaves, total number of leaves produced, rhizome length, total biomass, and root to shoot biomass ratio). Results indicate that epiphytes successfully colonize P. oceanica seedlings, and the surrounding micro-environment (i.e., substrate type) can influence the leaf epiphytic community. This study provides new valuable insights on the biological interactions occurring in seagrass ecosystems and highlights the need for better understanding the effects of seedling epiphytes and substrate on the formation of new meadows.

Microbial communities of polyhydroxyalkanoate (PHA)-based biodegradable composites plastisphere and of surrounding environmental matrix: a comparison between marine (seabed) and coastal sediments (dune sand) over a long-time scale

Most researches on the plastisphere in coastal environments deal with plastics floating in seawater. Comparatively smaller attention has been devoted to the plastisphere of plastics buried in marine sediments, and very little is known on that of plastics on coastal sand dunes. Yet, limited information is available on the impact of plastics, especially biodegradable plastics, on microbial organisms in their surroundings. Nevertheless, a large amount of plastics sink on the seabed or is deposited on beach-dune systems. We investigated the succession of plastisphere microbial community on two biodegradable composites based on poly(hydroxybutyrate-co-hydroxyvalerate) (PHBV) and seagrass fibres (PHBV/PO), buried in seabed and dune sediments over a 27 months period in mesocosm. PHBV is regarded as a valuable alternative to conventional plastics and PHBV/PO has recently been designed for applications in coastal habitat restoration. We also examined the degradation rate and impact of these plastics on the microbial communities of surrounding sediments. Microbial communities of the surface of PHBV and PHBV/PO in seabed and dune sand differ from those of surrounding sediments, displaying a lower richness. Plastics colonization occurs largely from bacteria present in surrounding sediments, although the contribution from the water column bacterial pool could be not negligible for plastics in the seabed. No significant differences were detected between the communities of the two plastics and no significant impact of plastics on microbial community of the surrounding sediments was detected. The exceptional long duration of this study allowed to gain information on the succession of a plastisphere community over a previously unexplored time scale. Succession appears highly dynamic in dune sand even after two years, while the community structure in seabed seems to reach stability after one year. These findings highlight the importance of performing long-term studies when trying to characterize composition and dynamics of plastisphere bacterial communities.

Plastics and sedimentation foster the spread of a non-native macroalga in seagrass meadows

Plastics are found in marine environments worldwide, and their effects on macrophytes (seagrasses and macroalgae) colonizing sandy bottoms are still poorly known. Seagrass meadows are valuable but declining ecosystems due to local and global-change related stressors, including sediment disturbance and introduced macroalgae. Understanding whether plastics pose a further threat to seagrasses is critically important. In two simultaneous additive experiments performed in an aquaculture tank, we examined the individual and combined effects of macroplastics (non-biodegradable high-density polyethylene and biodegradable starch-based) and sedimentation (no and repeated sedimentation) on the performance (in terms of biomass and architectural variables) of a native Mediterranean seagrass (Cymodocea nodosa) and an introduced macroalga (Caulerpa cylindracea), and on the intensity of their interactions. Macroplastics were still present in sediments after 18 months. Cymodocea nodosa produced a greater biomass and longer horizontal rhizome internodes forming clones with more spaced shoots probably to escape from plastics. Plastics prevented C. nodosa to react to sedimentation by increasing vertical rhizome growth. Under C. cylindracea invasion, C. nodosa allocated more biomass to roots, particularly to fine roots. In the presence of C. nodosa, C. cylindracea performance was reduced. High-density polyethylene (HDPE) plastic and sedimentation shifted species interactions from competitive to neutral. These results suggest that both HDPE and biodegradable starch-based macroplastics, if deposited on marine bottoms, could make seagrasses vulnerable to sedimentation and reduce plant cover within meadows. HDPE plastic and sedimentation could contribute to the decline of seagrass habitats by facilitating the spread of non-native macroalgae within meadows. Overall, the study highlights the urgent need to implement more effective post-marketing management actions to prevent a further entering of plastics in natural environments in the future, as well as to establish to conservation measures specifically tailored to protect seagrass habitats from plastic pollution.

Combined effect of plastic litter and increased atmospheric nitrogen deposition on vegetative propagules of dune plants: A further threat to coastal ecosystems

Large amounts of non-biodegradable plastics are currently deposited on beach-dune systems, and biodegradable plastics could enter these already declining habitats in coming years. Yet, the impacts of plastics on vegetative recruitment, a plant strategy playing a key role in dune stabilization, are unknown. Whether these pollutants interact with increased atmospheric nitrogen (N) deposition, a major global driver of plant biodiversity loss, in affecting plant communities of such nutrient-poor habitats, and how plant-plant interactions mediate their effects need to be explored. In a one-year field experiments, we examined individual and combined effects of plastic (non-biodegradable, biodegradable), N deposition (ambient, elevated) and biotic condition (no interaction, interaction with a conspecific or with a hetero-specific) on the colonization success and growth of vegetative propagules of dune plants. Thinopyrum junceum and Sporobolus pumilus were chosen as models because they co-occur along Mediterranean dunes and differ in ecological role (dune- vs. non dune-building) and photosynthetic pathway (C3 vs. C4). For both species, survival probability was reduced by non-biodegradable plastic and elevated N by up to 100%. Thinopyrum junceum survival was also reduced by S. pumilus presence. Elevated N and biodegradable plastic reduced T. junceum shoot biomass when grown alone and with a conspecific, respectively; these factors in combination mitigated their negative individual effects on root biomass. Biodegradable plastic increased S. pumilus shoot and root biomass, and in combination with elevated N caused a greater biomass investment in belowground (root plus rhizome) than aboveground organs. Non-biodegradable plastic may be a further threat to dune habitats by reducing plant colonization. Biodegradable plastic and increased N deposition could favour the generalist S. pumilus and hinder the dune-building T. junceum. These findings highlight the urgency of implementing measures for preventing plastic deposition on beaches and reducing N input.

Use of bio-containers from seagrass wrack with nursery planting to improve the eco-sustainability of coastal habitat restoration

Traditional revegetation techniques employed to restore seagrass meadows and coastal dunes have recently been criticized for their impact on donor populations as well as for the installation of plant anchoring structures made of non-biodegradable or not natural materials in recipient habitats. To improve the ecological sustainability of restoration practices, a novel plantable biodegradable container made of beach-cast seagrass wrack and a bio-based polymer was produced. The long-term performance of two seagrasses, Cymodocea nodosa and Zostera noltei, and two dune plants, Euphorbia paralias and Thinopyrum junceum, grown in nurseries from seeds using the bio-container or a non-biodegradable container of equal size/form made of a conventional plastic (control) was also examined. In addition, the development of bio-container-raised C. nodosa plants in the field was compared to that of plants removed from control containers at the installation and anchored with a traditional system. The bio-container degraded slowly in seawater and in sand and lost its functionality after about three years. In nurseries, all the tested species grown in bio-containers performed as well as, or better than, those raised in non-biodegradable ones. Six months after transplanting into the field, 80% of the C. nodosa nursery-raised plants installed with their bio-container have colonized the surrounding substrate while most of those planted with the traditional system was lost. These results indicate that the new bio-container may support plant growth, and it may also provide protection and anchorage to plants in the field. The use of this bio-container in combination with nursery techniques could improve the environmental sustainability of coastal restoration interventions by providing large plant stocks from seed, thus reducing the impact of collection on donor populations. This approach would also limit the introduction of extraneous materials in recipient habitats and offer an opportunity for valorizing seagrass beach-cast material.

Exposure of coastal dune vegetation to plastic bag leachates: A neglected impact of plastic litter

The presence of plastic bags on coastal dunes worldwide is well documented. Plastic bags contain additives that during rainfall events can leach out from bags into sand dune and be absorbed by seeds and roots of plants. Dune plants play a fundamental role in dune system formation, yet the possible impact of bag leaching on their establishment and development has been neglected. We assessed in laboratory whether (i) not biodegradable bags (high-density polyethylene, PE) and new generation of compostable bags (Mater-bi®, MB) would influence via leaching water chemical/physical properties and (ii) leachates would affect germination and seedling growth using Thinopyrum junceum and Glaucium flavum as models. Leachates were obtained from different amounts of not-exposed and bags exposed to beach or marine conditions simulating various pollution degrees (none, low, intermediate and high pollution). All water variables were affected by leaching. The magnitude of these alterations depended on bag type and environmental exposure. Seeds of T. junceum treated with the high concentration of marine-exposed MB bag leachate germinated later than controls while those of G. flavum treated with the remaining leachates germinated earlier. For both species, leachates from the low concentration of PE and MB marine-exposed bags increased seed germinability. A short radicle was observed in T. junceum seedlings treated with not-exposed MB bag leachates. Glaucium flavum seedlings treated with beach- and marine-exposed PE bags and not-exposed MB bags leachates showed a greater below-aboveground length ratio and those grown with the low concentration of not-exposed PE bag leachate had a longer hypocotyl compared to controls. Leachates from the high concentration of PE and MB bag caused seedling anomalies in both species. These findings indicate that not biodegradable and compostable bags may interact with abiotic/biotic factors and affect via leaching germination phenology, seedling establishment and plant interactions with consequences on dune community structure.

Adverse effects of non-biodegradable and compostable plastic bags on the establishment of coastal dune vegetation: First experimental evidences

Non-biodegradable and compostable plastic bags on beaches negatively affect the development of coastal dune vegetation by drastically reducing seedling emergence and growth.

Biodegradable plastic bags on the seafloor: A future threat for seagrass meadows?

Marine plastic litter is a global concern. Carrier bags manufactured from non-biodegradable polymers constitute a large component of this litter. Because of their adverse impact on marine life, non-biodegradable bags have recently been replaced by biodegradable ones. However, growing evidence shows that these latter are not readily degradable in marine sediments and can alter benthic assemblages. The potential impact of biodegradable bags on seagrasses inhabiting sandy bottoms, which are the most widespread and productive ecosystems of the coastal zones, has been ignored. Mesocosm experiments were conducted to assess the effect of a commercialized biodegradable bag on a common seagrass species of the Mediterranean, Cymodocea nodosa, both at the level of individual plant (clonal growth) and of plant community (plant-plant relationships), under three culture regimes (plant alone, in combination with a neighbour of the same species or of the co-existing seagrass Zostera noltei) simulating different natural conditions (bare substrate, monospecific meadows or mixed meadows). The bag behaviour in marine sediment and sediment physical/chemical variables were also examined. After six months of sediment exposure, the bag retained considerable mass (85% initial weight) and reduced sediment pore-water oxygen concentration and pH. In the presence of bag, C. nodosa root spread and vegetative recruitment increased compared to controls, both intra- and interspecific interactions shifted from neutral to competitive, and the growth form changed from guerrilla (loosely arranged group of widely spaced ramets) to phalanx form (compact structure of closed spaced ramets) but only with Z. noltei. These findings suggest that biodegradable bags altering sediment geochemistry could promote the spatial segregation of seagrass clones and influence species coexistence.

[Attempted suicide during interferon therapy: a case report and literature review]

Occasionally, in the medical literature, attempted or successful suicides during interferon therapy are reported. We report a case of a 32-year-old man who developed a psychotic syndrome with attempted suicide at the third month of treatment. The cessation of interferon and an appropriate psychiatric therapy determined a complete remission of symptoms. A medical literature review, through several computerized searches, showed a lack of research into the subject. The main conclusion of our article emphasizes the importance of recognizing the early neuropsychiatric symptoms, that are reversible at the cessation of treatment.

[The immunogenicity of the hepatitis B vaccine in drug addicts with human immunodeficiency virus infection]

In order to evaluate the antibody response to anti-hepatitis B vaccine, 21 heroin addicted with HIV infection previously vaccinated, were studied. 18 patients were asymptomatic and 3 were at the LAS stage. An antibody response was estimated at 1 and 12 months after the end of the vaccination. The first control showed that 62% presented a protective anti-HBs (higher than 10 mU/ml); after one year 70% of responders had a persistent immunity. The antibody response showed no correlation with the value of immunologic tests; the vaccine showed neither a significant evidence of side-effects nor a negative influence on the HIV infection.

[Multiple myeloma in HIV infection]

The Authors describe a case of multiple myeloma in a patient with HIV infection: this is an exceptional observation in young people and in HIV seropositive patients. The marked proliferation of lymphocyte B polyclones, typically found in the advanced stages of HIV infection, could be a determining factor in the appearance of a malignant clone, causing the onset of multiple myeloma.

[2-year follow-up of a series of cases of asymptomatic carriers of HBsAg antigen]

20 asymptomatic carriers of HBsAg antigen have been subjected to haemato-chemical examinations and liver biopsy and followed up after two years. The only altered serological test result regarded transaminases, except for one case where other liver function indices were irregular, and these were up in 13 cases at the first control and in 6 at the second. The histological changes observed in respectively 18 and 17 patients were in the majority of cases of persistent chronic hepatitis type. In one case the histopathological picture was related to active chronic hepatitis. It is therefore concluded that the term asymptomatic carrier is often inexact as the subjects are suffering from clinically silent chronic hepatitis.

[Australia antigen and viral hepatitis. Clinico-statistical considerations]

204 cases of viral hepatitis, 192 related to the MS1 form and 12 to MS2, were studied for the presence of Au. antigen and possible relations between this and the course of the disease. The antigen was encountered in 12 cases of the first group (6.2%) and in 7 of the second (58.3%). The disease was more serious and developed more slowly in Au.-positive cases compared to negative cases, it was also observed that only after the disappearance of the antigen from the serum was clinical cure possible.

[Case of severe renal insufficiency appearing during a course of viral hepatitis]

Notes on the literature data concerning renal alterations observed in the course of virus diseases, and on the results of experiments designed to show the nephrotoxic action of viruses and their possible investigation of certain nephropathies, are followed by the presentation of a case of serious renal insufficiency in a young woman with virus hepatitis. The clinical data, the history and the results of blood chemistry and function tests showed this to be attributable to glomerulonephritis, probably caused by the same virus.

[2 cases of toxic epidermal necrolysis or Lyell's syndrome]

Two cases of Lyell's syndrome (toxic necrolysis of the epidermis) are reported on account of their rarity. The differential diagnosis of this form and its aetiopathogenesis and treatment are described.