Dataset of a flow intermittency study: Benthic communities of 13 alpine intermittent rivers

In the last few decades, perennial mountain streams are becoming increasingly intermittent, due to global climate change and anthropogenic pressures. This phenomenon leads to negative effects on benthic communities' biodiversity and river ecosystems functionality. However, the impact of flow intermittency in previously perennial Alpine streams is still poorly investigated. This dataset consists of all the data collected during a spring sampling campaign performed in April-May 2017 along 13 mountain streams located in the SW Italian Alps. These watercourses have been selected because it was possible to identify two different sampling sites: one perennial, where water has always been flowing throughout the years, and one intermittent, which showed flowing water during the sampling campaign but, in the last decade, has experienced summer dry phases. All the sites have been characterized defining the microhabitats in which samples were retrieved, and physico-chemical data were collected at each site. Biological sampling included benthic macroinvertebrates and diatoms. Therefore, the present dataset offers various biological, ecological and physico-chemical information regarding Alpine streams which have recently become intermittent. Potentially, it could be used for comparisons with different benthic communities present in mountain rivers worldwide which are facing drying events too. The broad range of information present in this dataset offers the possibility to examine only the perennial sites themselves, as an example of good river functionality due to continuous flowing water, or only the intermittent ones, to better understand the effects of drying events on these peculiar ecosystems.

A diatom-based approach to refine nutrient concentrations compatible with the "good" status of Northern Italy rivers

The identification of ecologically sound thresholds represents an important step toward improving the ecological status of rivers through appropriate measures to contain nutrient loads. The aim of the present study was to estimate phosphorus and nitrogen concentrations compatible with the achievement of the "good" ecological status of rivers from data collected in the Po River District, the largest hydrographic system in Italy. For this purpose, relationships between the diatom index used in Italy for the national assessment of the stream ecological status, the ICMi (Intercalibration Common Metric index), and total phosphorus and nitrate concentrations were analyzed using monitoring data collected between 2009 and 2019. The Po River Basin encompasses five distinct river types, from Alpine to Mediterranean to Lowlands, characterized by different anthropogenic pressures and water quality. Through regression analysis between the ICMi and nutrient concentrations, we estimated ranges of the latter values corresponding to a "good" ecological status for each river type. The resulting thresholds are far more stringent than the limits set by the Italian legislation for water quality classification. This is particularly true for total phosphorus, whose threshold value should be roughly halved for all river types. For nitrates, the results are more differentiated according to river type: the estimated thresholds are much more stringent than those currently in use for siliceous Alpine and Mediterranean rivers. Moreover, the availability of such a large database allowed also to assess the influence of one nutrient over the other on the diatom community and to highlight some critical issues in the formulation of ICMi for Mediterranean rivers.

Hidden Decomposers: the Role of Bacteria and Fungi in Recently Intermittent Alpine Streams Heterotrophic Pathways

The frequency of flow intermittency and drying events in Alpine rivers is expected to increase due to climate change. These events can have significant consequences for stream ecological communities, though the effects of reduced flow conditions on microbial communities of decomposing allochthonous leaf material require additional research. In this study, we investigated the bacterial and fungal communities associated with the decomposition of two common species of leaf litter, chestnut (Castanea sativa), and oak (Quercus robur). A sampling of experimentally placed leaf bags occurred over six collection dates (up to 126 days after placement) at seven stream sites in the Western Italian Alps with historically different flow conditions. Leaf-associated bacterial and fungal communities were identified using amplicon-based, high-throughput sequencing. Chestnut and oak leaf material harbored distinct bacterial and fungal communities, with a number of taxonomic groups differing in abundance, though bacterial community structure converged later in decomposition. Historical flow conditions (intermittent vs perennial rivers) and observed conditions (normal flow, low flow, ongoing drying event) had weaker effects on bacterial and fungal communities compared to leaf type and collection date (i.e., length of decomposition). Our findings highlight the importance of leaf characteristics (e.g., C:N ratios, recalcitrance) to the in-stream conditioning of leaf litter and a need for additional investigations of drying events in Alpine streams. This study provides new information on the microbial role in leaf litter decomposition with expected flow changes associated with a global change scenario.

Hydrological intermittency drives diversity decline and functional homogenization in benthic diatom communities

Over the last decades, the combined effects of global climate changes and severe land use modifications have been exacerbating river hydrological alterations and habitat fragmentation in many Mediterranean rivers. This trend is predicted to intensify, with expected significant impacts on taxonomic and functional diversity of benthic communities in the next future. By comparing perennial and intermittent reaches, the present research aims at investigating the role of flow intermittency, driven by the combined effects of climatic variables and land use changes, on benthic diatom communities in Mediterranean streams (NW Italy), by analysing data collected over 11 years. In order to avoid potential confounding effects related to water quality, sites characterized by "poor" or "bad" water quality were excluded a priori. We observed significant differences between permanent and intermittent sections in terms of both climatic variables and land use: higher temperatures and lower precipitations, coupled with an extensive anthropic land use, intensify the natural flow intermittency in intermittent sites. This led to a significant decline in diatom species diversity, at both local and regional scales, and to changes to life history traits. In particular, communities of intermittent reaches were taxonomically and functionally different and less heterogeneous than assemblages characterizing perennial ones, showing higher percentages of small, mainly stalked and pioneer taxa belonging to the low profile guild. Conversely taxa colonizing permanent reaches were bigger, belonging to the high profile guild and able to produce colonies, thus indicating high environmental stability. Our results highlighted how hydrological alterations are profoundly threatening Mediterranean streams and the diatom communities inhabiting them, therefore representing an important benchmark in view of the improvement of biological indices for the assessment of intermittent rivers.

Functional Feeding Groups of Aquatic Insects Influence Trace Element Accumulation: Findings for Filterers, Scrapers and Predators from the Po Basin

For this study, we measured the concentrations of 23 trace elements (Al, As, Ba, Bi, Cd, Cr, Co, Cu, Fe, Ga, Hg, In, Li, Mn, Mo, Ni, Pb, Se, Sr, Ti, Tl, V, and Zn) in the whole bodies of three functional feeding groups (FFG) (filterers-Hydropsychidae, scrapers-Heptageniidae, and predators-Odonata) of aquatic insects collected from two sites in the Po basin (Po Settimo and Malone Front, Northwest Italy) to determine: (a) how FFG influence trace element accumulations, (b) if scrapers accumulate higher elements compared to the other FFG, since they graze on periphyton, which represents one of the major sinks of metals, and (c) the potential use of macroinvertebrates to assess the bioavailability of trace elements in freshwater. The hierarchical clustering analysis generated three main groups based on trace element concentrations: the most abundant elements were Fe and Al, followed by Sr, In, Zn, V, Mo, and Cu. Tl was below the limit of detection (LOD) in all FFG. Ga was detected only in scrapers from both sites and Hg only in predators from Po Settimo. The principal component analysis showed that concentrations of Al, As, Bi, Cd, Co, Cr, Ga, Fe, In, Mn, Pb, Ni, and Sr were highest in scrapers, suggesting that trace elements accumulate from the ingestion of epilithic periphyton (biofilm). Odonata (predators) accumulate certain elements (Ba, Hg, Li, Se, V, Ti, and Zn) in higher concentrations by food ingestion composed of different aquatic organisms. Differently, Cu and Mo concentrations were the highest in filterers due to their bioavailability in the water column. Non-metric multidimensional scaling clearly differentiated the FFG based on their ability to accumulate trace elements. The findings from this study represent an important step toward the definition of an innovative approach based on trace element accumulation by macroinvertebrates.

Modeling the avoidance behavior of zooplankton on phytoplankton infected by free viruses

In any ecosystem, chaotic situations may arise from equilibrium state for different reasons. To overcome these chaotic situations, sometimes the system itself exhibits some mechanisms of self-adaptability. In this paper, we explore an eco-epidemiological model consisting of three aquatic groups: phytoplankton, zooplankton, and marine free viruses. We assume that the phytoplankton population is infected by external free viruses and zooplankton get affected on consumption of infected phytoplankton; also, the infected phytoplankton do not compete for resources with the susceptible one. In addition, we model a mechanism by which zooplankton recognize and avoid infected phytoplankton, at least when susceptible phytoplankton are present. The zooplankton extinction chance increases on increasing the force of infection or decreasing the intensity of avoidance. Further, when the viral infection triggers chaotic dynamics, high zooplankton avoidance intensity can stabilize again the system. Interestingly, for high avoidance intensity, nutrient enrichment has a destabilizing effect on the system dynamics, which is in line with the paradox of enrichment. Global sensitivity analysis helps to identify the most significant parameters that reduce the infected phytoplankton in the system. Finally, we compare the dynamics of the system by allowing the infected phytoplankton also to share resources with the susceptible phytoplankton. A gradual increase of the virus replication factor turns the system dynamics from chaos to doubling state to limit cycle to stable state and the system finally settles down to the zooplankton-free equilibrium point. Moreover, on increasing the intensity of avoidance, the system shows a transcritical bifurcation from the zooplankton-free equilibrium to the coexistence steady state and remains stable thereafter.

Effectiveness of artificial floods for benthic community recovery after sediment flushing from a dam

The number of dams is predicted to increase worldwide under the current global change scenario. A major environmental problem associated with dams is the release of large quantities of fine sediment downstream. Therefore, future studies in river conservation will largely be focused on the management of sediments trapped by reservoirs. The aim of this study was to investigate the downstream ecological impacts of sediment flushing from a dam and the effectiveness of artificial flash floods as a recovery strategy. Artificial flash floods have often been employed to remove large amounts of sediment from riverbeds, but their importance in improving the biological quality of lotic environments is almost unknown. We carried out a series of quantitative macroinvertebrate samplings over a 2-year period that started before sediment release and included the artificial flushing events. We characterized the macroinvertebrate community in its structural and functional aspects and tested the performance of two biomonitoring indexes, comparing their diagnostic ability. Our results demonstrated that sediment flushing significantly altered the structure and composition of benthic communities for more than 1 year. Flash floods exacerbated the overall biological quality, but we believe that this treatment was useful because, by removing large amounts of sediment, the biological recovery process was accelerated. Finally, regarding the water quality assessment, we found that the biomonitoring index for siltation, composed of a selection of taxonomical and functional metrics, was more reliable than the generic one.

Randomized controlled study on the effectiveness of animal-assisted therapy on depression, anxiety, and illness perception in institutionalized elderly

AIM

The aim of this study was to verify dog-assisted therapy's effectiveness on depression and anxiety in institutionalized elderly. Patients' illness perception was examined to identify core beliefs regarding mood, personal control, and illness coherence because they can affect treatment compliance. Subjective perception of pain, social interaction, and setting-bound observable variables were also studied.

METHODS

This study involved a randomized sample of institutionalized patients 65 years of age and older; the treatment group had 17 subjects and the control group had 14 subjects. All patients were administered the Mini-Mental State Examination, 15-item Geriatric Depression Scale, Positive and Negative Affect Schedule, Generalized Anxiety Disorder 7, Illness Perception Questionnaire, and Numeric Pain Rating Scale. Intra- and inter-group data analysis was performed before and after treatment. Over the course of 10 weeks, patients participated in individual 30-min sessions. An observational methodology was developed to record verbal and non-verbal interactions between the elderly, the dog, and the dog handler.

RESULTS

A large effect size and a statistically significant decrease in 15-item Geriatric Depression Scale scores were identified in the treatment group. No significant differences were detected in the Generalized Anxiety Disorder 7, Positive and Negative Affect Schedule, and Numeric Pain Rating Scale. However, the Positive and Negative Affect Schedule and the Numeric Pain Rating Scale showed a moderate decrease. The Illness Perception Questionnaire's timeline (acute/chronic) and treatment control subscales showed a clinically relevant, large effect size.

CONCLUSIONS

Dog-assisted therapy has proved to be effective in reducing symptoms of depression in institutionalized elderly. The increase in verbal interactions with the handlers throughout the study suggests the dog acts as a facilitator of social interaction, eliciting positive emotional responses. Dog-assisted therapy shows promising results in the perception of illness timeline and treatment control, indicating potential enhancement of the sense of treatment-related empowerment. However, further study is required.

Trophic availability buffers the detrimental effects of clogging in an alpine stream

Clogging, the streambed colmation by fine sediments, is an important widespread source of impact affecting freshwaters. Alterations in stream morphology and hydrology, added to the effects of global climate change, are responsible for this phenomenon, that is particularly pernicious in mountainous lotic systems naturally characterized by coarse substrates. Among the studies investigating this issue some were descriptive, while others used artificial substrates to compare ongoing fine sediment accumulation and macroinvertebrate assemblage recruitment. Other studies used from the outset artificial substrates arranged with different levels of clogging. Our study fits into this line, but adding an innovative element simulating different availability of coarse particulate organic matter, i.e. the main trophic input in low-order, mountainous stream. To investigate how clogging and CPOM can influence macroinvertebrate communities, we placed 135 artificial substrates in the upper Po river (NW Italy). We set up a three way factorial design with three different levels of sedimentation and terrestrial leaf material. Artificial substrates were removed on three different dates. Benthic invertebrates were identified and classified according to their bio-ecological traits. We also measured macroinvertebrate dry mass and CPOM degradation in the different trap types. Our findings show that clogging acts as a selective filter influencing taxa richness, density, functional composition and biomass of benthic assemblage. Moreover, fine sediments affect the energetic dynamics in the river ecosystem, decreasing the mass loss rate of terrestrial leaves. Interestingly, our results clearly demonstrate that high availability of CPOM can buffer the negative effect of clogging, suggesting that an adequate input of allochthonous organic matter may lessen the impact of fine sediment deposition. Because land use transformation and removal of wooded riparian areas increase clogging and simultaneously reduces the input of CPOM, our findings stress the importance to include the management of river basins in the conservation strategies of mountainous streams.

Urbanization drives community shifts towards thermophilic and dispersive species at local and landscape scales

The increasing conversion of agricultural and natural areas to human-dominated urban landscapes is predicted to lead to a major decline in biodiversity worldwide. Two conditions that typically differ between urban environments and the surrounding landscape are increased temperature, and high patch isolation and habitat turnover rates. However, the extent and spatial scale at which these altered conditions shape biotic communities through selection and/or filtering on species traits are currently poorly understood. We sampled carabid beetles at 81 sites in Belgium using a hierarchically nested sampling design wherein three local-scale (200 × 200 m) urbanization levels were repeatedly sampled across three landscape-scale (3 × 3 km) urbanization levels. First, we showed that communities sampled in the most urbanized locations and landscapes displayed a distinct species composition at both local and landscape scale. Second, we related community means of species-specific thermal preferences and dispersal capacity (based on European distribution and wing morphology, respectively) to the urbanization gradients. We showed that urban communities consisted on average of species with a preference for higher temperatures and with better dispersal capacities compared to rural communities. These shifts were caused by an increased number of species tolerating higher temperatures, a decreased richness of species with low thermal preference, and an almost complete depletion of species with very low-dispersal capacity in the most urbanized localities. Effects of urbanization were most clearly detected at the local scale, although more subtle effects could also be found at the scale of entire landscapes. Our results demonstrate that urbanization may fundamentally and consistently alter species composition by exerting a strong filtering effect on species dispersal characteristics and favouring replacement by warm-dwelling species.

Local versus landscape spatial influence on biodiversity: a case study across five European industrialized areas

Land use change-mostly habitat loss and fragmentation-has been recognized as one of the major drivers of biodiversity loss worldwide. According to the habitat amount hypothesis, these phenomena are mostly driven by the habitat area effect. As a result, species richness is a function of both the extent of suitable habitats and their availability in the surrounding landscape, irrespective of the dimension and isolation of patches of suitable habitat. In this context, we tested how the extent of natural areas, selected as proxies of suitable habitats for biodiversity, influences species richness in highly anthropogenic landscapes. We defined five circular sampling areas of 5 km radius, including both natural reserves and anthropogenic land uses, centred in five major industrial sites in France, Italy and Germany. We monitored different biodiversity indicators for both terrestrial and aquatic ecosystems, including breeding birds, diurnal butterflies, grassland vegetation, odonata, amphibians, aquatic plants and benthic diatoms. We studied the response of the different indicators to the extent of natural land uses in the sampling area (local effect) and in the surrounding landscape (landscape effect), identified as a peripheral ring encircling the sampling area. Results showed a positive response of five out of seven biodiversity indicators, with aquatic plants and odonata responding positively to the local effect, while birds, vegetation and diatoms showed a positive response to the landscape effect. Diatoms also showed a significant combined response to both effects. We conclude that surrounding landscapes act as important biodiversity sources, increasing the local biodiversity in highly anthropogenic contexts.

Microalgae treatment removes nutrients and reduces ecotoxicity of diluted piggery digestate

Liquid digestate is considered as an important by-product of anaerobic digestion of agriculture wastes. Currently, it is very often directly spread on local agricultural land. Yet recently concerns on its environmental risk of this processing has begun to rise. On the other hand, investigations on the effectiveness of microalgae for wastewater treatment have started to consider also this complex matrix. In this study, we cultured the green alga Chlorella vulgaris in diluted digestate coming from the anaerobic digestion of pig slurry and corn, with the aim to significantly reduce its toxicity and its very high nutrient concentration. For this purpose, a battery of toxicity tests composed of four acute and two chronic bioassays was applied after the alga cultivation. Results were compared with those obtained in the initial characterization of the digestate. Results show that highly diluted piggery digestate can be a suitable medium for culturing microalgae, as we obtained a high removal efficiency (>90%) for ammonia, total nitrogen and phosphate, though after a few days phosphorus limitation occurred. Toxicity was significantly reduced for all the organisms tested. Possible solutions for optimizing this approach avoiding high dilution rates are discussed.

Is digestate safe? A study on its ecotoxicity and environmental risk on a pig manure

Digestate represents a precious by-product in particular in agriculture, however its impact on the environment and human health is still unexplored. In this work, the toxicity of a pig slurry digestate was assessed through 7 ecotoxicity tests and considering 10 different endpoints. Besides, a synthetic index was applied to the outputs of the battery of tests for the environmental risk assessment, in order to evaluate the opportunity to use directly this kind of digestate in agriculture or to introduce an additional treatment. All the organisms were sensitive to digestate toxicity (EC50 ranged from 14.22% for Cucumissativus to 0.77% for Raphidocelis subcapitata). The physical-chemical features at the base of this toxicity seem to be the high content of ammonium, salinity, COD, phosphate and colour. The synthetic index showed that the digestate was very toxic and associated to an extremely high environmental risk. Thus, a pre-treatment is needed to reduce its toxicity and environmental impact, whatever could be its exploitation.

Environmental drivers of phototrophic biofilms in an Alpine show cave (SW-Italian Alps)

The proliferation of lampenflora is a major threat for the conservation of show caves, since phototrophic organisms cause physical, chemical and aesthetic damage to speleothems. In this paper we examine the environmental factors influencing the presence and the growth of the three main photosynthetic groups composing phototrophic biofilms in the Bossea show cave (SW-Italian Alps). The presence and the primary production of cyanobacteria, diatoms and green algae were detected with BenthoTorch®, an instrument for in situ measurement of chlorophyll a concentration that has never been used before in caves. By means of different techniques of regression analysis, we highlighted the response of the three photosynthetic groups to different environmental factors. Illuminance proved to be the main factor influencing positively both the probability of the presence and the productivity of the three groups. The presence of seeping water on the substrate and the distance from the cave entrance proved to play an important role in determining patterns of colonization. By means of GIS techniques, we provide thematic maps of the cave, providing a representation of pattern of the density of the three examined photosynthetic groups within different areas of the cave. The same approach may apply to other show caves, aiming at providing suggestions for the cave management (i.e. cleaning of the cave walls and positioning of artificial lights) and reduce impact caused by tourism.

[Treatment of persistent postmastectomy pain with 5% Lidocaine medicated plaster]

Persistent postmastectomy pain (PPMP) syndrome is characterized by neuropathic pain that develops following surgery in breast cancer patients. The reported incidence of PPMP ranges between 30% and 50% and is estimated to increase as the number of women surviving cancer continues to rise. Though effective, today's drug treatments are poorly tolerated, limiting their use and reducing adherence to therapy. Since neuropathic pain is localized, international guidelines suggest that topical treatment with 5% Lidocaine medicated plaster either alone or combined with systemic drugs can be considered for pain management. In this retrospective study we reviewed the medical records of 11 patients treated with 5% lidocaine medicated plaster for moderate-to-severe PPMP at our institute between November 2013 and October 2014. Analysis showed that treatment with 5% Lidocaine medicated plaster, either alone or in combination with systemic drugs, achieved significant pain control already after the first week of therapy. The effectiveness and tolerability of 5% Lidocaine medicated plaster we observed suggests that it is a viable option in the management of PPMP.

Management of ischemic diabetic foot

Diabetic foot pathology represent the more disabling complication of diabetes. More the 1 million of diabetes patients undergo a lower limb amputation per year; 85% of these amputation are preceded by un ulcer that can be avoided by a prevention program. Critical limb ischemia (CLI), the only independent cause of major amputation in diabetic population, can be correctly treated when an early diagnosis is made. Both endoluminal and surgical revascularization procedures can be applied in diabetes with high rate of success when performed by skilled operator. Infection of diabetic foot, in particular in patients suffering from peripheral artery disease (PVD), may rapidly evolves in severe local or systemic infection putting the patient at high risk of major amputation or death. Together with an early diagnosis of infection and ischemia it is mandatory to apply a correct medical and surgical treatment protocol with the aim to control infection and to improve blood perfusion to the foot. In case of infection surgical procedure should be applied first while revascularization procedure will follow soonest. Antibiotic therapy should be chosen considering different local biological pattern and different type of infection. Reconstructive surgery, the last step in treatment of any diabetic foot lesion, must obtain a functional residual foot or a stump that will allow the patient to go back walking soonest with residual good walking capacity.

Growth of three microalgae strains and nutrient removal from an agro-zootechnical digestate

In this paper three microalgae strains (Neochloris oleoabundans, Chlorella vulgaris and Scenedesmus obliquus) were cultivated on an agro-zootechnical digestate in comparable conditions. The material used as growth media was obtained from a pilot plant anaerobic digestor used to digest several mixes of cattle slurry and raw cheese whey. The main aims were to compare the algae growth, their tolerance with respect to the various dilutions of digestate, their nutrient removal efficiency and their role in the transformation of nitrogen compounds. C. vulgaris presented the highest elimination capacity of ammonium in 1:10 digestate sample; it was also observed that only 4% of ammonia was removed with stripping, microalgal and bacterial consortium recovered the remaining 96%. The three strains almost completely removed different nitrogen forms and phosphate in 11d. The results show that microalgal biomass production offers real opportunities for addressing issues such CO2 sequestration, biofuel production and wastewater treatment.

Higher frequency of early local side effects with aqueous versus depot immunotherapy for hymenoptera venom allergy

Venom immunotherapy has proven a very effective method for the treatment of allergy to Hymenoptera venom. Aqueous instead of depot extracts are prevalently used for this immunotherapy. The advantage of using aqueous extracts has not been fully investigated. We made an open, non-controlled study on 45 subjects sensitized to either Apis mellifera or Vespula spp. Patients were assigned to either a depot (N=27) or an aqueous (N=18) immunotherapy regimen, and side effects were monitored during the induction and the 3-year maintenance phase. The effect of naturally occurring stings during the treatment and after its interruption was recorded as well. Side effects were less frequent with the depot extract both on a "per patient" (22.2% versus 50.0%) and on a "per dose" (2.9% versus 10,2%) basis (p=0.026 and p<0.000, respectively). Better tolerance was mainly due to the lower frequency of local side effects occurring at early times after vaccination. The efficacy of vaccination was comparable in the 2 cohorts, as expected. We conclude that depot immunotherapy to Hymenoptera venom should be preferred to aqueous immunotherapy for the lower occurrence of local side effects. This might influence a better compliance with this potentially life-saving treatment.

Benthic macroinvertebrate communities as indicators of river environment quality: an experience in Nicaragua

Biotic indexes are one of several types of measures that are routinely used in biological monitoring in temperate streams and offer interesting possibilities to assess the environmental quality of rivers in the neotropics. Macroinvertebrate communities of seven southeastern Nicaraguan streams were monitored and seven ecological indexes were applied. The results suggest that information from the Indice Biótico Esteso (I.B.E.) is closely correlated to the results of other methods, but the I.B.E. index is easier to apply as well as avoiding high costs and time-consuming procedures. A calibration of the method is necessary for rapid assessment approaches in the neotropics.

Helicobacter pylori antibodies (CagA and VacA) detection. The link between cancer and infection

BACKGROUND

Infection with different genotypes of virulent Helicobacter pylori (Hp) strain, CagA and/or VacA positive, can play a role in the development of atrophic gastritis, duodenal ulcer (DU), and gastric carcinomas (GC). This study was undertaken to investigate if patients with GC with Hp negative histological Giemsa staining had a past infection by virulent strains of Hp CagA and/or VacA positive.

METHODS

Twenty GC, (average age +/- SD) 68.14+/-9.8 years old, Hp negative to histological take part to the study. Two-control group were included: 19 Hp infected patients with DU eradicated 10 years before, 58+/-18.2 yrs. Hp negative status was determined every year with histology and follow-up after therapy was 120+/-32 months; range 96-144 months. Twenty asymptomatic children, 7+/-4.47 yrs, with Hp negative faecal test. The immunoblot assay was used to detect serum antibodies against CagA and VacA.

RESULTS

Prevalence of CagA and VacA seropositivity was 90 and 95% in GC, 84 and 84% in DU Hp negative, 25 and 5% in children Hp negative, respectively. CagA and VacA antibody positivity was not significantly different between GC and patients with DU eradicated 10 years before. A true significant positivity was found against children (''t''-Student test; p<0.0001). Statistical difference was found in age between groups p<0.03.

CONCLUSIONS

Patients with GC, although Hp negative at present, could be infected by Hp before the appearance of the disease as confirmed by CagA and VacA seropositivity. These data may reinforce the idea to consider Hp as a direct carcinogenetic agent of GC.

[Decubitus ulcer in the calcaneus region: rapid development, difficult recovery]

Heel pressure sores frequently arise in patients kept in bed for a long time independently of their primary disease. In account of this event the authors completed a study concerning possible mutual relations between heel pressure sores and primary disease of the patients; to validate the pharmacological treatment in less severe sores and the surgical resolution in more serious cutaneous lesions. In the last 3 years (1992-1995) at the Rehabilitation Centre of Montescano the authors have treated 39 patients suffering from 63 different severe cutaneous lesions: from phlycten to deep necrosis. The therapeutic plane utilized pharmacological treatment for 1st, 2nd, 3rd degree pressure sores, and surgical treatment for 4th degree. Pharmacological treatment included: enzymatic drugs, bactericidal and bacteriostatic medicines and cicatrizing substances. Different healing times were related to different pressure sore severity. Surgical treatment consisted of transposition of flap into wound defect. This system caused considerable reduction in resolution times. The authors noticed how easily pressure sores arise in the heel region, and how difficultly they heal. This is probably connected with particular anatomical and vascular characteristics of this region.

[The treatment of decubitus lesions]

The authors present a plan for pharmacological treatment of pressure sores in patients affected by neurological pathologies: cerebrovascular accidents, head injuries, spinal cord injuries. This plan is easily applicable to all pressure sores included between first and third degree of the Reuler and Cooney classification. Authors identified some drugs specifically usefull in different cutaneous lesion degrees. Skin lesions and employed medicines are described as follows: Erythema: semi occlusive bandage with porous adsorbing membrane. This dressing must be left in for five days at least. Excoriation: bactericidal or bacteriostatic medicines if it's situated in a non pressed area while the same dressing utilized for erythema if it's localized in a pressed area. Pressure sores: if there is local infection cleanse the wound from bacterial defilement using topic antibiotics apply compresses with vitamin C if the cutaneous lesion is larger than deeper, Cadexomero lodico if it's deeper than larger. Fistulas: wadding with tablets of collagen. Necrobiosis: complete or partial surgical removal of eschar preceded by the use of enzymatic drugs when eschar is firmly adherent to subcutaneous tissues. The first group collects 9 patients with stroke and head injury: 8 with sacral and 1 with heel pressure sores. First degree pressure sores heal within 45 days and third degree lesions within 160 days. The second group collects 10 spinal cord injury patients mostly with complete lesion among which: 7 sacral, 1 heel, 1 ischiatic and 1 malleolar lesions. First degree pressure sores heal within 30 days, third degree pressure sores heal within 200 days. Healing time are considered acceptable. Pressure sores recovery swiftness can be related to different factors such as pressure sores sterness, neurological pathology and arising of clinical complication (hyperthermia, infections, low serum albumin values, etc).

Dubowitz' syndrome with special characteristics

The Authors describe the main characteristics of Dubowitz' syndrome: retarded growth, microcephaly, cranio-facial deformations and dysmorphia of the extremities, psycho-motor development varying between normal and retarded, thin hair, cryptorchism, hyperactivity and others. They report a case which was brought to their attention in which, in addition to numerous anomalies and dysmorphia which justify its inclusion in Dubowitz' syndrome, there was marked bilateral metacarpal hypoplasia with strongly and permanently adducted thumbs. The aim of this report was to add to the mosaic of data relating to this highly polymorphous syndrome.

Surgical treatment of craniosynostosis

The authors report their experience with the cranial recontouring techniques in the treatment of craniosynostoses. The results obtained treating sixteen children suggest that these techniques can be tolerated well by patients, with very limited postoperative complications. It is underlined that the precocity of the surgical treatment is an indispensable prerequisite in order to obtain satisfactory clinical and cosmetic results.

[Phytotoxic activity of asymmetric N,N-dialkylnaphthamides]

Asymmetric N,N-dialkylnaphthamides, prepared and tested in pre- and post-emergence tests against some representative weeds, showed good or excellent phytotoxicity often with selectivity of action against Echinochloa and Setaria. These amides are characterized by the presence on the amide nitrogen of a sec.butyl or a 1-methylbutyl or a 1-ethylpropyl group together with another alkyl substituent of varying weight and nature. As reference compounds we prepared and tested N,N-dialkyl-alpha-naphthamides, isomers of the compounds under test, bearing on the N atom an alkyl group of avrying composition and a ter.butyl in place of sec. butil or a 1-ethylprophyl or other alpha-branched alkyl in place of the 1-methylbutyl. The results show the importance of alpha-substitution on at least one of the alkyl groups on the amide N as regards the degree of phytotoxicity. Some of the alpha-naphthamides giving interesting results with the weed species tested were further studied using plants of agricultural interest.

[Asymmetric N,N-dialkyl-3,5-dichlorobenzamides having phytotoxic activity]

Asymmetric N,N-dialkyl-3,5-dichlorobenzamides bearing on the amide N a sec.butyl group or a 1-methylbutyl or 1-ethylpropyl and a second C3 or C4 alkyl group which may be branched or linear, saturated or unsaturated, were prepared and tested for phytotoxicity in pre- and post-emergence experiments. As reference compounds were prepared and tested 3,5-dichlorobenzamides, isomers of the first series, characterized by the presence on the amide N of a n.butyl or ter.butyl in place of the sec.butyl, of a 1-ethylpropyl or other branched alkyl in place of the 1-methylbutyl and a second alkyl group (C2 leads to C4) of varying weight and nature. The results show that all the 3,5-dichlorobenzamides studied have high phytotoxic activity and good selectivity in respect of the two graminaceous weeds tested. The amides proving most active against the weeds were tested against some species of agricultural interest. The substances proving active against the weeds and atoxic for the agrarian species were characterized by the presence on the amide N of a branched C4 or C5 group and a second C3 or C4 group.

[Phytotoxic activity of asymmetric 3,4-dichlorobenzoic acid dialkylamides]

The phytotoxicity of asymmetric N,N-dialkyl-3,4-dichlorobenzamides was studied in pre- and post-emergence tests against some weed species. The amide groups were characterized by the presence of a sec.butyl or 1-methylbutyl group and a variable second alkyl group either linear, branched, saturated or unsaturated. Isomers of the above compounds were also prepared and tested as useful comparison materials; these isomers have n.butyl or ter.butyl in place of sec.butyl or a 1-ethylpropyl in place of 1-methylbutyl or other branched alkyl groups with 5 or 6 carbon atoms, always having a methyl group in the alpha position, in place of the 1-methylbutyl and a second substituent in C2 leads to C4. The results show that compounds with phytotoxicity and selective action as regards Echinochloa and Setaria are obtained if a sec.butyl group, a 1-methylbutyl or a 1-ethylpropyl group is retained and the second substituent on the N-amide is varied appropriately. The compounds with greater phytotoxicity towards the weeds were further tested against some species of agricultural interest.