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.

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.

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]. / Trattamento del "persistent postmastectomy pain" con Lidocaina cerotto 5%.

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.

Treatment of recalcitrant ulcers with allogeneic platelet gel from pooled platelets in aged hypomobile patients.

We evaluated growth factor contents and clinical efficacy of allogeneic platelet gel (PG) prepared with standard blood banking procedures from routine platelet concentrates (PCs) obtained from buffy coats. The PGs were used to treat 11 hypomobile very elderly patients unable to undergo autologous blood processing and previously ineffectively treated with expensive advanced medications for 8-275 weeks. PGs were prepared by platelet activation with human thrombin or commercial batroxobin. Median and range growth factor contents (ng/mL) were: platelet derived growth factor (PDGF-AB/-BB) 112 (31-157) and 20 (3.8-34); transforming growth factor (TGF-ß1/-ß2) 214 (48-289) and 0.087 (0.03-0.28); basic-fibroblast growth factor (b-FGF) 0.03 (0.006-0.214); vascular endothelial growth factor (VEGF) 1.15 (0.18-2.46); epidermal growth factor (EGF) 4.50 (0.87-6.64); insulin-like growth factor (IGF-l) 116 (72-156). In the clinical study, 222 PGs were used within 2 h of activation to treat 14 chronic skin ulcers in the 11 patients. No improvement was seen in 3 patients with 24, 27 and 30 cm(3) ulcers who could be treated for no more than 4, 7 and 8 weeks due to progressively worsening clinical conditions, while 11 ulcers with 3.2 cm(3) median size (range 0.2-3.6) in the remaining 8 patients showed 91 ± 14 % reduction after a median of 12 weeks (range 1-20). Cost of PG treatment (19,976 euro) amounted to about 10% of the ineffective advanced medication hospital reimbursement fees (191,236 euro). This study supports efficacy and feasibility of allogeneic PG to treat recalcitrant ulcers in very elderly hypomobile patients for whom autologous blood processing may be difficult.

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.

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]. / Ulcere da decubito in regione calcaneare: facile l'insorgenza, difficile la risoluzione.

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]. / Contributo alla risoluzione delle lesioni da decubito.

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).

Check-list of the valid genera of Dilepididae (Cestoda, Cyclophyllidaea), their synonyms and hosts.

The revised family Dilepididae contains 102 valid genera, 11 new genera included (Bona 1994 a,b, in press). The synonyms, old and new ones, and the sub-genera raised to generic rank are 41. The revision of the family was undertaken as a contribution to the "IIP Keys to the Cestode Parasites of Vertebrate" and with the intention to provide new elements for future suprageneric systematics of the group.

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.

A new genus of Metadilepididae (Cestoda: Cyclophyllidea) parasitic in Terpsiphone rufiventer (Aves: Muscicapidae) from the Ivory Coast.

Pseudadelphoscolex eburnensis, a new genus and species of metadilepidid Cyclophyllidea parasitic in the red-bellied paradise flycatcher, Terpsiphone rufiventer, from the Ivory Coast, is described. The new species is characterized by davaineidlike rostellar hooks, absence of a rostellar pouch, a huge cirrus pouch in gravid proglottids, a bilobed uterus that becomes progressively reticular, absence of a paruterine organ, and eggs with an internal coat forming a crescentic protuberance outside the embryophore. The presence of a single row of rostellar hooks together with the lack of spines on the sucker and the structure and position of the uterus exclude this new material from Davaineidae. It cannot be placed in Dilepididae due to the lack of a rostellar pouch or in Paruterinidae because of the lack of a paruterine organ. The position of the excretory ducts in relation to the genital pores and the alternance of these pores are the main characters used to exclude this new species from the known genera of Metadilepididae. The diversity of forms of Metadilepididae in intertropical terrestrial birds is increased, and the validity of this taxon is strengthened.

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.