A Weight of Evidence approach to support the assessment of the quality of Manila clam farming sites in a coastal lagoon.

Aquaculture productivity in coastal lagoons is endangered by a complex interplay of anthropogenic and environmental factors, amplified by the effects of climate change in these sensitive areas. To reach a more comprehensive assessment of farming sites quality, a quantitative Weight of Evidence approach (QWoE) is applied for the first time to data collected at four Manila clam (R. philippinarum) farming sites in the Venice lagoon (Italy). This included sediment quality, chemical bioaccumulation, and biological responses. Results revealed a greater hazard for sites closer to the open sea. In these areas, the combination of sediment characteristics and a higher frequency of salinity and temperature stress could explain the alterations measured at a transcriptional and biomarker level. The findings demonstrate that a QWoE approach that integrates multiple sources of evidence should also include physicochemical conditions in order to better understand the impacts of human activities and other stressors on clam aquaculture productivity.

Use of the gonadotropin-releasing hormone (GnRH) stimulation test to monitor gonadal function in intact adult male cats.

The gonadotropin-releasing hormone (GnRH) stimulation test is a common procedure used to investigate normality of the pituitary-gonadal axis in mammals. There is very little information on the technique, its efficacy and side effects in small animals and in particular no information for male cats. In dogs, such test is performed by intravenous (IV) administration. With cats, the number of times the animal needs to be restrained for blood sampling should be the least possible. The purpose of this study was to assess efficacy and side effects of the GnRH stimulation test in tomcats comparing the IV with the intramuscular (IM) route of administration. A GnRH stimulation test was performed in eight adult tomcats through IM or IV administration of 50 µg gonadorelin. The response of the pituitary-gonadal axis was assessed by measuring serum testosterone on blood samples collected prior to and 1 hr following treatment. When considering each single group of cats, the post-stimulation serum testosterone values were significantly higher than the pre-treatment ones (p < .05). When comparing the two groups of cats, basal testosterone concentrations did not differ, and also post-GnRH testosterone concentrations did not differ. In conclusion, in the cats of our study, the GnRH stimulation test produced the same results following the IM or the IV route of administration. Therefore, in tomcats, the IM route can be considered as effective as the IV one and should be preferred when doing a GnRH test.

An unusual case of extra-abdominal desmoid tumour.

Desmoid tumour is relatively rare and generally non-metastatisizing lesion of mesenchymal origin composed of fibrous tissue and fitting in the group of aggressive fibromatosis; it is a locally aggressive proliferative soft-tissue lesion with controversial nature. This tumour accounts for 0.03% of all tumours and 3% of soft-tissue tumours with annual incidence of two to four cases per million. Although desmoid tumours are more common in persons aged 10-40 years than in others, they do occur in young children and older adults; in children the sex incidence is equal. This is a rare case of extra-abdominal desmoid tumour in a 14-year-old girl affected by spastic tetraparesis. To our knowledge no similar cases are present in literature to date.

Bilateral testicular torsion: an extremely tragic rare condition.

Bilateral intrauterine torsion of the testes and neonatal testicular torsion are rare conditions that sometimes result in a catastrophic event. Surgical exploration is mandatory and sometimes a second-look management should be considered. After describing a rare condition, the authors came to the conclusion that bilateral orchidectomy should be performed only in patients with bilateral necrotic testes.

Pelvi-ureteric junction obstruction and renal function after pyeloplasty: a retrospective study in 29 children.

AIM: Actually, unilateral obstruction is not indicated for surgery, especially if renal function is unaffected. This retrospective study focused on the renal function after pyeloplasty for unilateral obstruction in children. METHODS: Twenty-nine children were retrospectively reviewed. To compare the ultrasound readings in patients with different ages, the comparative-length-index (index) of each renal unit (RU) was calculated. MAG3 dynamic scintigraphy was applied to diagnose any obstructions. RESULTS: Children with left obstruction were younger than children with right obstruction, when surgery was performed. Scintigraphic scan of right RUs with obstruction operated later was a lower at diagnosis than jet of the normal contralateral. Normal scintigraphic scan at diagnosis of left RUs with obstruction operated early revealed that RU was slightly reduced after the operation. At both diagnosis and follow-up the index between obstructed RUs and normal contralateral was comparable, even if it was significantly higher in left obstructed RUs. At follow-up, however, the scintigraphic scan revealed that RUs were more reduced in patients who were treated late. CONCLUSION: Early pyeloplasty partially safeguard kidney function in children with unilateral obstruction, whose renal function was normal at birth. The reduced kidney function observed before surgery was not proportionally improved after surgery with respect to the contralateral that was not affected.

Intraoperative double-J stent insertion in children with scintigraphic impaired renal function and obstructive urinary tract malformation.

AIM: Ureteral double-J (DJ) stents are frequently used in modern urologic practice. At present the role of stents in urological and surgical practice and their efficacy in paediatric age are not yet clear. The aim of this study is to evaluate advantages and efficacy of ureteral stents, correlating clinical and radiological data with the permanence of stent in situ. METHODS: Between July 1999 and July 2004 surgery with ureteral stenting was performed on 24 consecutive patients aged between 2 and 13.5 months with scintigraphic impaired renal function due to an obstructive urinary tract malformation. During the study the performance and the efficacy of indwelling stent have been evaluated through clinical and radiological variables: pre-, intra-, and post stenting blood tests, ultrasonographic and scintigraphic parameters were also evaluated. RESULTS: The stent insertion was useful to improve renal parenchymal thickness and renal growth. No correlation was found between improved blood tests and scintigraphic values. The improvements of clinical and radiological data were strictly correlated with the time of stenting (>3 months). CONCLUSION: The insertion of DJ stents as long-term internal urinary diversion is useful and safe. Late complications related to the use of stents are not frequent.

Two patients with tumours presenting as inguino-scrotal masses.

Inguinal masses in children may indicate different conditions and pathologies, ranging from congenital anomalies to neoplasms. Although inguinal hernias represent the majority 'masses' in the inguinal canal, there are other rare lesions that may occur. For this reason, irreducible masses shall always receive an appropriate preoperative diagnosis. In this report, we describe two interesting cases of inguinal masses in children first diagnosed as irreducible inguinal hernia. Appropriate investigations before surgery and local surgical excision are therefore recommended.

Intussusception due to a cecal duplication cyst: a rare cause of acute abdomen. Case report.

Duplications of the alimentary tract are rare congenital anomalies. The ileum is the most common site, whereas rectal, duodenal, gastric and cecal duplications are extremely rare. Duplication cysts of the cecum, in a neonate, are even rarer, with only 19 cases reported in medical literature to date. We report a case of intestinal intussusception due to a cecal duplication cyst.

Botryoid rhabdomyosarcoma of the biliary tract in children: a unique case report.

Rhabdomyosarcoma (RMS) is the most common tumour of the biliary tree in childhood. In children, it is a rare lesion, accounting for about 1% of all RMS. Hepatobiliary botryoid RMS is a disease affecting young children at a median age of about 3 years. In literature, the radiological findings of hepatobiliary RMS have been described in small series and some case reports. In this case report, we present a rare case of RMS of the extrahepatic biliary tree initially diagnosed as a choledochal cyst.

Complete pancreatic ectopia in a gastric duplication cyst: a case report and review of the literature.

Ectopic tissue can be histologically detected in gastric duplication cysts. The authors describe the case of a complete pancreatic ectopia in a prenatally diagnosed symptomatic gastric duplication cyst in a 6-month-old male infant. Surgical removal of the cystic formation was curative. In view of the rarity of the lesion, a full clinical and diagnostic classification of the condition proved possible only after radical surgical resection and histological examination. Immunohistochemical investigation enabled us to detect the complete pancreatic ectopia.

[The role of continent perineal colostomy in surgical emergencies of the distal bowel]. / Il ruolo della colostomia perineale continente nelle emergenze chirurgiche del grosso intestino.

Diverting colostomy is commonly required in surgical emergencies of the distal colon, especially if the patient is in poor condition. This paper shows that the colostomy could be unnecessary in most cases. In the last 10 years, 6 patients (4 with high-risk or postoperative complicated Hirschsprung disease, 1 with intestinal neuronal dysplasia and 1 with iatrogenic rectal stenosis obstruction) have been submitted to primary continent perineal colostomy-modified Duhamel's procedure. The modified technique consists of the exteriorization of the normal colon or ileum by a retrorectal and trans-anal way, while the excision of redundant tissue and rectal spur section are postponed at least for 10 days. In personal experience this peculiar surgical approach allows to avoid not only the complications due to the fashioning of a contraindicated primary anastomosis, but even those due to stomy performance and its closure, promoting good anatomo-functional results in all patients. The advantages of modified Duhamel's operation compared to other procedures (Swenson-Pellerin or Soave pull-through) depend on the rapidity of execution and on the quality of short and long term outcome.

[Reconstruction of the vas deferens: an experimental study on the rat]. / Ricostruzione deferenziale. Studio sperimentale sul ratto.

BACKGROUND: A microsurgical technique for reconstruction of the vas deferens on an absorbable transanastomotic stent in the rat is described. METHODS: A microsurgical end-to-end anastomosis of the vas deferens was performed in a group of 10 rats (group A) by suturing with Nylon 10-0 interrupted stitches. In another 10 rats (group B) the same microsurgical anastomosis was performed after insertion of a 0.5 cm long intraluminal chromic catgut 4.0 stent. RESULTS: Sixty days postoperatively all 20 animals were submitted to roentgenography of the vas deferens. The vas deferens proved radiographically undetectable in 8/10 rats in the unstented group A (80%), whereas the entire course of the vas could be traced in 9/10 rats in group B (90%). CONCLUSIONS: The encouraging results obtained with this alternative technique, even on structures of limited diameter, suggests that it may be possible to use this procedure in children.

Lipid, lipoprotein, and apolipoprotein assessment during an 8-wk very-low-calorie diet.

The influence of a very-low-calorie diet (VLCD) on lipid pattern is controversial. To evaluate the long-term effect of semistarvation on lipid patterns, a group of severely obese patients [aged 37 +/- 12 y, body mass index (BMI) 40.0 +/- 0.9] underwent a VLCD for 8 wk. Total cholesterol (TC), LDL cholesterol (LDL-C), and HDL cholesterol (HDL-C), triglycerides (TGs), apolipoproteins A1 (apo A1) and B (apo B) were analyzed every week. TC (6.07 +/- 0.23 vs 5.53 +/- 0.25 mmol/L, P less than 0.0008), HDL-C (mmol/L 1.26 +/- 0.06 vs 1.04 +/- 0.05 mmol/L, P less than 0.0001), TGs (1.46 +/- 0.19 vs 1.06 +/- 0.10 mmol/L, P less than 0.0008), and apo A1 (1.57 +/- 0.06 vs 1.32 +/- 0.06 g/L, P less than 0.0002) decreased, whereas LDL-C and apo B showed a biphasic behavior: they significantly fell during the first 3 wk, but during the last weeks returned to their initial values.

[Comparison of three methods for the rapid determination of body composition]. / Tre metodiche a confronto per una rapida determinazione della composizione corporea.

The study of body composition is becoming increasingly important in the field of nutritional medicine. The possibility of assessing body composition easily and economically has therefore raised considerable interest. Using straightforward correlations, we have compared the data obtained from the assessment of BF% using plicometry, impedance analysis and the interactivity of close-infrared rays; in addition, we studied the possible influence of the distribution of fatty tissue, expressed as W/H, on the results obtained using these methods. One hundred and forty-eight subjects (51 M and 97 F) were studied aged between 13 and 76 years old, with BMI ranging between 16.8 and 56.4; subjects were divided into three groups according to BMI and W/H. The three methods proved to be well correlated in patients with BMI less than 30 (r between 0.92 and 0.74), whereas correlations were less marked and less significant in groups with BMI greater than 30. W/H seemed capable of influencing results obtained using these methods and this was more evident in results obtained using impedance analysis (p less than 0.0001). The three methods studied were comparable in normal weight and slightly overweight patients, whereas contrasting findings were obtained in patients with moderate and severe obesity. Extreme caution must therefore be used in interpreting the data obtained in these subjects.