Hydrocarbons removal from real marine sediments: Analysis of degradation pathways and microbial community development during bioslurry treatment.

In this study, real marine sediments polluted by petroleum compounds were treated by means of a bioslurry pilot scale reactor. The treatment performance was evaluated by measuring the removal of total petroleum hydrocarbon (TPH), coupled to further analyses required to understand the mechanisms involved in the biodegradation process. The maximum TPH-removal efficiency reached 86 % at the end of experiments. Moreover, high throughput 16S RNA gene sequencing was used to describe the microbiome composition in sediment prior to, and after, bioslurry treatment, in order to identify the taxa mostly entailed in the TPH removal process. The raw sediment was mostly colonized by members of Sulfurimonas genus; after bioslurry treatment, it was noticed a shift in the microbial community composition, with Proteobacteria phylum dominating the remediation environment (high increase in terms of growth for Hydrogenophaga and Sphingorhabdus genera) along with the Phaeodactylibacter genus (Bacteroidetes). Furthermore, the assessment of gaseous emissions from the system allowed to quantify the volatile hydrocarbon component and, consequently, to obtain a more accurate evaluation of TPH-removal pathway by the bioslurry system. Finally, phytotoxicity tests on sediment samples highlighted an increase of the treated sample quality status compared to the untreated one.

Gas exchange threshold as a predictor of severe postoperative complications after lung resection in mild-to-moderate chronic obstructive pulmonary disease.

Low exercise capacity is considered predictive for postoperative complications or death after thoracic and general surgery. However, in recent literature no agreement has been found about the predictive cut-off values for preoperative exercise parameters. The aim of this work was to investigate whether peak oxygen consumption (V'o2) and noninvasive anaerobic threshold (AT) determined by gas exchange threshold (GET) can be reliable preoperative predictors of mortality and morbidity after lung resection in patients with mild-to-moderate (forced expiratory volume in one second (FEV1) > 50% predicted) chronic obstructive pulmonary disease (COPD). Fifty tour COPD patients were studied before lung surgery: 12 had severe complications, 16 had mild and 26 had no complications. Peak V'O2 sensitivity and specificity in predicting severe postoperative complications were 41.6% and 95.5% respectively (using 75% of the predicted value as cut-off), while for GET they were 91.6% and 97.6% respectively (using 14.5 mL.kg-1.min-1 as cut-off value). Only one patient (3.5%) with a peak V'O2 > 20 mL.kg-1.min-1 suffered severe complications. On the other hand 11 out of the 26 patients (42.3%) with peak V'O2 < 20 mL.kg-1.min-1 had serve complications. In patients with peak V'O2 < 20 mL.kg-1.min-1, 11 out of 12 (91.6%) with a GET < or = 14.5 mL.kg-1.min-1 suffered severe complications, whereas 15 out of 15 (100%) with a GET > 14.5 mL.kg-1.min-1 showed no or mild complications. In conclusion, peak oxygen consumption values > 20 mL.kg-1.min-1 can be considered a safe upper cut-off limit for pulmonary resection. In patients with a peak oxygen consumption value < 20 mL.kg-1.min-1, gas exchange threshold determination can improve significantly the predictivity of a cardiopulmonary test for severe complications and must be routinely considered.

Effects of oral lacidipine on cardiopulmonary function at rest and during exercise in normal subjects.

A randomized, double-blind, crossover, placebo-controlled study was carried out to evaluate the effects of a single oral 4-mg dose of lacidipine vs. placebo on cardiopulmonary circulation at rest and during exercise. Twelve healthy volunteers were randomized to receive either placebo or 4 mg of lacidipine once daily for 2 days, followed by a 3-day washout period, after which they received alternate treatment. Patients were assessed before and at 60, 90, and 180 min after dosing. At 120 min, a maximum exercise test with a treadmill was performed according to the Bruce protocol. No relevant changes with placebo or lacidipine were observed in the respiratory function tests whereas 4 mg of lacidipine increased pulmonary effective blood flow (Qp. eff.) and stroke volume index (SVI) at 60 min, reaching a peak at 90 min; at 180 min, these effects, although diminished, were still present. The arteriovenous oxygen difference [C(a-v)O2] decreased, but reverted to normal values by 180 min. No differences in maximum attained Qp. eff. and oxygen consumption (VO2) during exercise were observed. Only the heart rate was higher both before and after treatment with lacidipine. Lacidipine increased Qp. eff. in these normal subjects without relevant effects on respiratory function. Performance on exercise testing after dosing was normal, although drug-induced vasodilation was present.

[Progressive changes in the lymphocyte subpopulations and the clinical picture in 2 brothers with familial dilated cardiomyopathy]. / Modificazioni progressive delle sottopopolazioni linfocitarie e del quadro clinico in due fratelli affetti da cardiomiopatia dilatativa familiare.

We report two brothers, aged 22 and 34, affected by dilated cardiomyopathy. At the first examination both patients were in NYHA functional class I. Their echocardiograms showed dilated and hypokinetic ventricles. Their clinical condition remained stable for three years, during which the peripheral immunophenotyping of T-lymphocyte subsets showed T-helper/T-suppressor ratio values lower than normal (normal value for our laboratory = 1.64 +/- 0.53) due both to low T-helper and to high T-suppressor subsets. Subsequently, the clinical condition of both patients deteriorated, exercise tolerance decreased and echocardiographic ventricular diameters increased. T-helper/T-suppressor ratio progressively increased from the initial values of 0.8 and 0.42 to 2.5 and 2.24, respectively. A few months later, both patients died, one because of refractory heart failure and the other one suddenly. Histologic examination of myocardial tissue in one patient showed a diffuse necrotizing disease involving myocytes with focal lymphocyte infiltrates, granulation tissue and endocardial thrombosis. The reported data underline the importance of genetic and familial factors in the pathogenesis and evolution of dilated cardiomyopathies. The increasing T-helper/T-suppressor ratio value which matched the deterioration of the clinical status, is proposed as a useful evolutive and prognostic marker.

[Lymphocyte subpopulations in idiopathic dilatational cardiomyopathy]. / Sottopopolazioni linfocitarie nella cardiomiopatia dilatativa idiopatica.

Lymphocyte subsets have been examined in 23 patients affected by idiopathic dilated cardiomyopathy (IDCM). Patients were divided according to their functional class showing that compromised subjects exhibited high T-lymphocyte helper/suppressor ratio whereas the contrary was observed in the other patients. It has therefore suggested that IDCM is characterized by 2 distinct phases, each of them with different helper/suppressor ratio.

[Aneurysm of the sinus of Valsalva and late rupture of the interventricular septum due to infective endocarditis. Is the two-dimensional echocardiography of endocarditic extension into the interventricular septum possible?]. / Aneurisma del seno di Valsalva e rottura tardiva del setto interventricolare per endocardite infettiva. E possibile la diagnosi ecocardiografica bidimensionale di estensione endocarditica al setto interventricolare?

In a 54 year old woman affected by infective endocarditis, with bicuspid aortic valve and aneurysm of sinus of Valsalva protruding into the right atrium, two-dimensional echocardiography helped to identify altered myocardial echo patterns of the interventricular septum at basal level. Because of the proximity with valvular lesions due to endocarditis, we could interpret these appearances as produced by invasion of the infective process into the septum. The autopsy report of septum rupture in the same area further supports our interpretation of the echocardiographic finding.

[Change in ventricular repolarization associated with acute spontaneous pneumothorax]. / Modificazioni della ripolarizzazione ventricolare associate a pneumotorace spontaneo acuto.

Cases of acute pneumothorax admitted in the period 1975-1978 were examined to determine the presence of changes in ventricular repolarization. A significant elongation of the QT segment was noted in 23/126 cases. The series did not include subjects with chronic heart and /or bronchopulmonary disease, or other clinical features that might explain such elongation. The ECG changes bore no relation to the site and extent of the pneumothorax. Agreement is expressed with the view that their explanation lies in the existence of a reflex mechanism acting on the autonomous nervous system.

[Surgical treatment of echinococcal cysts with double hepatic and pulmonary localizations]. / Sul trattamento chirurgico delle cisti da echinococco a doppia localizzazione epatica e polmonare.

On the basis of some personal cases and with reference to world literature on the subject, the surgical treatment of liver and lung localized echinococcus cyst is discussed. Special attention is paid to 1) thoracotomy which may in some cases become a thoraco-phreno-laparatomy, the only approach which leads to really effective control of the field; 2) problems of suction drainage, particularly as regards diaphragm mobility in cases of thoraco-phreno-laparatomy.