Non-indigenous macrozoobenthic species on hard substrata of selected harbours in the Adriatic Sea

The intense shipping traffic characterising the Adriatic Sea favours the spread of marine organisms. Yet, a study of 12 Adriatic ports (4 on the western side and 8 on the eastern side of the basin) found that non-indigenous species (NIS) accounted for only 4% of the benthic communities settled on hard substrates. The cirripeds Amphibalanus amphitrite and Balanus trigonus, found in 8 harbours, were the most common invaders followed by Amphibalanus eburneus, the ascidian Styela plicata, and the bivalve Magallana gigas. The highest percentage of NIS was recorded in Venice and Ploče, the harbours with the least rich native communities; the lowest percentage was retrieved in Trieste, Koper, Pula, and Rijeka, the harbours hosting the highest species diversity. In contrast, the ports of Bari and Ancona showed both high NIS percentages and highly diversified communities.

Functional biodiversity of marine soft-sediment polychaetes from two Mediterranean coastal areas in relation to environmental stress

Biological Traits Analysis (BTA) was used to identify functional features of infaunal polychaete assemblages associated with contamination in two Italian coastal areas: the harbour of Trieste (Adriatic Sea) and the Mar Piccolo of Taranto (Ionian Sea). The analysis was performed on 103 taxa, collected at four stations in each area. The two areas differed in species composition. The low diversity and the presence of stress-tolerant species in more polluted sites were not reflected in functional diversity, due to species contributing little to community functions or being functionally redundant. Sand and clay fractions were significant drivers of trait category expressions, however other environmental parameters (depth, total organic carbon and nitrogen, and Hg in sediments) influenced traits composition. Motile was the prevalent trait in environments with coarse sediments, and tube-builder were related to fine-grained ones. Motile, endobenthic and burrower were essential traits for living in contaminated sediments. Epibenthic and sessile polychaetes dominated at stations subjected to high organic loads. BTA offers an integrative approach to detect functional adaptations to contaminated sediments and multiple anthropogenic stressors.

Benthic ecosystem functioning in the severely contaminated Mar Piccolo of Taranto (Ionian Sea, Italy): focus on heterotrophic pathways

The benthic ecosystem functioning is a rarely applied holistic approach that integrates the main chemical and biological features of the benthic domain with the key processes responsible for the flux of energy and C through the system. For the first time, such conceptual model, with an emphasis on the heterotrophic pathways, has been applied to the sediments at four stations within one of the most polluted coastal areas in Italy: the Mar Piccolo of Taranto. The functioning of the benthic ecosystem was different according to the investigated site. Nearby the military arsenal, i.e., the main source of organic contaminants and heavy metals, the system seemed inhibited at all the investigated structural and functional levels. Slow microbial processes of C reworking together with very limited densities of benthic fauna suggested a modest transfer of C both into a solid microbial loop and to the higher trophic levels. On the other hand, the ingression of marine water through the "Navigabile" channel seemed to stimulate the organic matter degradation and, consequently, the proliferation of meiofauna and macrofauna. In the innermost part of the basin, the system functioning, to some extent, is less impacted by contaminants and more influenced by mussel farms. The organic matter produced by these bivalves fueled faster C reworking by benthic prokaryotes and enhanced the proliferation of filter feeders.

Diabetes and Obesity as Independent Risk Factors for Osteoporosis in Postmenopausal Women: A Population Study

We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. We studied 2,756 postmenopausal subjects out of ≥10,000 records from the ROIS registry in the frame of the PROF Project, a population study carried out in Salento (Taranto, Brindisi, Lecce) from 2009 to 2012. All subjects were assessed by phalangeal Quantitative Ultrasound (QUS) to evaluate their bone mineralization (assessed by Amplitude Dependent Speed of Sound, AD-SoS) and the association between demineralization and the presence of other conditions or risk factors. Mean age was 64±9.5 years and mean BMI was 28.7±3.5 Kg/m2. Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (P<0.001). By using multivariate logistic regression analysis, we observed significant values of Odds Ratios of osteoporosis (adjusted for age, physical activity and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (CI: 1,05–1,83) and 1.46 (CI: 1.20–1.78), respectively. A statistically significant linear trend of higher Odds Ratios of osteoporosis was found for increasing values of BMI. The percent change in the odds of vertebral fractures per single SD decrease of AD-SoS was 47% (P<0.001). Diabetes and obesity in postmenopausal women are likely to represent independent risk factors for osteoporosis. Phalangeal QUS showed a good power of predictivity in identifying subjects with vertebral fractures.

Alendronate: new formulations of an old and effective drug to improve adherence avoiding upper gastrointestinal side effects

OBJECTIVE

Alendronate is a second generation bisphosphonate which has been widely used in medical practice for two decades to treat osteoporosis and prevent fragility fractures both in elderly people and in younger patients.

METHODS

Since many papers have been recently published and new formulations or dosages have been developed, our aim was to review the most significant medical literature addressing the issues of efficacy, safety, posology and formulations of the treatment with alendronate in osteoporotic patients.

RESULTS

The efficacy of alendronate in reducing the risk of vertebral and non-vertebral fractures has been demonstrated in several studies. Despite favourable data coming from clinical trials, tolerability of alendronate represented a critical issue since its introduction into real clinical practice, possibly leading to early discontinuation of the therapy, especially when combined with lack of motivation of the patient. For this reason, new dosages and formulations of alendronate have been developed, alone or in combination with vitamin D, which have shown to reduce the impact of gastro-oesophageal adverse events, and minimize discomfort due to the need of adopting unfavourable postural positions every day, fasting for at least one hour.

CONCLUSIONS

Alendronate is the most frequently used antifracture therapy among those currently available. The increasing use of the 70 mg weekly dosages and newest formulations of this drug are expected to reduce adverse events and increase adherence to the antifracture therapy, thus resulting in better clinical outcomes when treating osteoporotic patients.

Coronary artery disease is detectable by multi-slice computed tomography in most asymptomatic type 2 diabetic patients at high cardiovascular risk

OBJECTIVE

Non-invasive testing often does not identify coronary artery disease (CAD) in diabetic subjects. This study was designed in order to examine the prevalence of CAD in a cohort of asymptomatic type 2 diabetic patients at high cardiovascular risk and negative nuclear imaging, using multi-slice computed tomography (MSCT) angiography.

METHODS

In total, 770 type 2 diabetic patients were screened from January 2008 through July 2010. Of these, 132 Caucasians with diabetic nephropathy and asymptomatic for angina were eligible for a cross-sectional study. Patients underwent MSCT after ischaemia was excluded by myocardial Single Photon Emission Computed Tomography (SPECT) at rest and after dynamic exercise. When obstructive plaques were found (≥ 50% lumen narrowing), patients were sent to conventional coronary angiography (CCA).

RESULTS

Six subjects were not included in the analysis because of motion artefacts. MSCT was positive for CAD in 114 patients (90%). Within patients with positive MSCT, 60 (48% of all) showed one or more obstructive plaques. CCA confirmed significant stenosis (≥ 50%) in 48 of these 60 patients (80%). Some 21 (35%) showed stenosis ≥ 75% and were submitted to the revascularisation procedure.

CONCLUSION

MSCT seems to better identify CAD than myocardial SPECT in asymptomatic patients with type 2 diabetes and diabetic nephropathy.

Desmopressin is a safe drug for the treatment of enuresis

OBJECTIVE

To verify the safety of desmopressin treatment and its associated side-effects in a large number of patients.

MATERIAL AND METHODS

The study was conducted in accordance with the guidelines of the Italian Club for Nocturnal Enuresis, whose criteria are: age >5 years; absence of malformations and infections of the urinary tract; absence of psychological disorders or neurological alterations; number of "wet nights" >5-7; control of liquid intake during the afternoon and evening; monitoring of serum electrolytes before beginning treatment; control of body weight before the beginning of treatment and during the first 4-5 days of therapy; and the informed consent of the parents. The therapeutic regimen provided for a maximum dose of desmopressin of 40 microg/day (four puffs/nostril or two tablets), starting from an initial dosage of 20 microg/day (two puffs/nostril or one tablet) 1 h before going to bed. The study involved two groups of patients with monosymptomatic enuresis: some of them had been administered desmopressin in the form of a spray and others in the form of tablets.

RESULTS

A small percentage of patients presented mild, transient side-effects; in no case were severe side-effects verified.

CONCLUSION

Desmopressin is a safe drug with a low incidence of side-effects.

An evaluation of patients with hyperprolactinemia: have dynamic tests had their day?

Except for a few particular conditions, the diagnostic evaluation of hyperprolactinemia is easy since the routine use of magnetic resonance imaging (MRI) scan has permitted to identify even small microadenomas. Other conditions include the identification of large PRL molecular complex, dimers, trimers or polymers of PRL, called "big or big-big PRL", and of PRL autoantibodies and the biochemical finding of "high dose PRL hook effect". Finding elevated serum PRL levels should be considered as the beginning and not the conclusion of a diagnostic evaluation: first, a careful anamnesis should exclude possible physiologic, pharmacologic and organic causes of hyperprolactinemia; second, possibly one laboratory only, undergoing regularly quality controls, should analyze blood samples; serial serum PRL measurements at 0, 30, 60 min is a valuable and simple measure to identify stress-related hyperprolactinemia. In the past two decades several pharmacological tests were used in order to distinguish between small microprolactinomas and "non-tumoral hyperprolactinemia": the controversial results of these tests together with the availability of MRI has excluded all pharmacological tests in the work-up of hyperprolactinemia. MRI is preferred to computed tomography (CT) due to its better definition of very small lesions in the pituitary sella and better anatomical definition prior to surgery. Finally, once the diagnosis of prolactinoma is suspected, patients should be referred to a specialist centre for further assessment and treatment.