Element variability in lacustrine systems of Terra Nova Bay (Antarctica) and concentration evolution in surface waters.

Major, minor and trace elements were determined in freshwater of lacustrine systems in Terra Nova Bay, along Victoria Land coast, Antarctica, as well as in algae and mosses. The samples were collected during some of the sampling campaigns between 2007 and 2011 (and the one of 2002) within the framework of the Italian National Program of Research in Antarctica (PNRA). Data were processed with chemometric techniques. Results showed that elements typically considered as potential anthropogenic pollutants (e.g. As, Pb, Zn, Cu and Ni) present a strong correlation with the lithogenic elements (e.g. Al, Si, Fe) in all matrices, suggesting that their origin is connected to natural phenomena. Metal concentrations in vegetation samples are in the same range as previously published data. The obtained results were compared with older literature data (since the early '90s) from the same lacustrine systems, in order to present a historical overview of element concentrations. This approach furnishes important information on surface water evolution as a function of time. A considerable variability was observed in metal concentrations but no clear trend was identified. This suggests that their concentration evolution is hardly correlated to specific natural or anthropic phenomena. No evidence of an increase of concentrations over time was apparent. Our results represent new important data about metal concentrations in lacustrine systems in Antarctica, furnishing ranges of values that can be considered as a reference. These data, therefore, could be used to detect or monitor future local and/or global anthropogenic contaminations.

Appropriateness of clinical and organizational criteria for intra-articular injection therapies in osteoarthritis. A Delphi method consensus initiative among experts in Italy.

OBJECTIVE: The aim of the study was to identify the main aspects involved in patient selection, the choice of therapeutic agents and the safety profile, as well as the medico-legal and organizational aspects of intra-articular injection therapies for osteoarthritis. METHODS: A committee of 10 experts from Italian universities, public hospitals, territorial services, research institutes and patient associations was set up. Fifty-two clinicians from a large number of Italian medical centers specialized in intra-articular injection therapy took part in a Delphi process aimed at obtaining consensus statements among the participants. RESULTS: Large consensus was obtained for statements grouped under the following main themes: treatment indications; drug/medical device choice; treatment efficacy; and appropriate setting. CONCLUSIONS: The consensus statements developed by a large number of experts may be used as a practical reference tool to help physicians treat osteoarthritis patients by means of intra-articular injection therapies.

Optical and photochemical characterization of chromophoric dissolved organic matter from lakes in Terra Nova Bay, Antarctica. Evidence of considerable photoreactivity in an extreme environment.

Water samples from shallow lakes located in Terra Nova Bay, Antarctica, were taken in the austral summer season and characterized for chemical composition, optical features, fluorescence excitation-emission matrix (EEM) and photoactivity toward the generation of (•)OH, (1)O2, and (3)CDOM* (triplet states of chromophoric dissolved organic matter). The optical properties suggested that CDOM would be largely of aquagenic origin and possibly characterized by limited photochemical processing before sampling. Moreover, the studied samples were highly photoactive and the quantum yields for the generation of (3)CDOM* and partially of (1)O2 and (•)OH were considerably higher compared to water samples from temperate environments. This finding suggests that water in the studied lakes would have considerable ability to photosensitize the degradation of dissolved compounds during the austral summer, possibly including organic pollutants, also considering that the irradiance conditions of the experiments were not far from those observed on the Antarctic coast during the austral summer.

[Healthcare delivery to patients with heart failure: from healthcare networks to management of end-stage disease]. / Assistenza allo scompenso cardiaco cronico: dalla rete assistenziale alla gestione della terminalità

In geriatrics, end-stage chronic heart failure, old age and death are often an almost obliged clinical and existential continuum. Accompanying these patients to death with dignity and relief is an issue deserving a high degree of cultural attention not only by our discipline, but also by all other specialties and scientific societies that are devoted to the management of terminal illness. Involved professionals are too often in troubles in identifying the conditions that mark the boundary between continuing or stopping the specific treatments. Management of terminal illness requires the ability to identify and treat the complexity of patient's frailty; to discern when continuing therapy is still appropriate; to prepare young physicians in the soft communicative modalities needed to cope with such delicate problems; to face with patient's family expectations in front of death. It is also necessary to distinguish technocratic medicine from humanistic medicine, including human, cultural and overall coordinating capabilities and sharing these capabilities with all actors involved, focusing attention mainly on patient's dignity. Advanced or end-stage chronic heart failure is a peculiar clinical arena that requires close interaction among hospitals, outpatient health district services, and families' needs, expectations and support. Multidimensional assessment teams, firstly introduced into daily clinical practice by geriatricians, address individualized choices and share part of knowledge with cardiology teams. Dichotomy and cultural and scientific debate between aggressive treatment and euthanasia should not prevent from discussing crucial issues such as therapy withdrawal.

Accumulation of heavy metals from contaminated soil to plants and evaluation of soil remediation by vermiculite.

We evaluated the distribution of 15 metal ions, namely Al, Cd, Cu, Cr, Fe, La, Mn, Ni, Pb, Sc, Ti, V, Y, Zn and Zr, in the soil of a contaminated site in Piedmont (Italy). This area was found to be heavily contaminated with Cu, Cr and Ni. The availability of these metal ions was studied using Tessier's sequential extraction procedure: the fraction of mobile species, which potentially is the most harmful for the environment, was much higher than that normally present in unpolluted soils. This soil was hence used to evaluate the effectiveness of treatment with vermiculite to reduce the availability of the pollutants to two plants, Lactuca sativa and Spinacia oleracea, by pot experiments. The results indicated that the addition of vermiculite significantly reduces the uptake of metal pollutants by plants, confirming the possibility of using this clay in amendment treatments of metal-contaminated soils. The effect of plant growth on metal fractionation in soils was investigated. Finally, the sum of the metal percentages extracted into the first two fractions of Tessier's protocol was found to be suitable in predicting the phytoavailability of most of the pollutants present in the investigated soil.