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Biological communities are currently facing multi-stressor scenarios whose ecological impacts are challenging to estimate. In that respect, considering the complex nature of ecosystems and types and interaction among stressors is mandatory. Microcosm approaches using free-living nematode assemblages can effectively be used to assess complexity since they preserve the interactions inherent to complex systems when testing for multiple stress effects. In this study, we investigated the interaction effects of three stress factors, namely i-metallic mixture of Cu, Pb, Zn, and Hg (control [L0], low, [L1] and high [L2]), ii- CO 2 -driven acidification (pH 7.6 and 8.0), and iii- temperature rise (26 and 28 °C), on estuarine free-living nematode assemblages. Metal contamination had the greatest influence on free-living nematode assemblages, irrespective of pH and temperature scenarios. Interestingly, whilst the most abundant free-living nematode genera showed significant decreases in their densities when exposed to contamination, other, less abundant, genera were apparently favored and showed significantly higher densities in contaminated treatments. The augmented densities of tolerant genera may be attributed to indirect effects resulting from the impacts of toxicity on other components of the system, indicating the potential for emergent effects in response to stress. Temperature and pH interacted significantly with contamination. Whilst temperature rise had potentialized contamination effects, acidification showed the opposite trend, acting as a buffer to the effects of contamination. Such results show that temperature rise and CO 2 -driven acidification interact with contamination on coastal waters, highlighting the importance of considering the intricate interplay of these co-occurring stressors when assessing the ecological impacts on coastal ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Interactive effects of trace metal contamination, ocean warming, and CO 2 -driven acidification on the structure of a meiofaunal benthic community was assessed. Meiofauna microcosm bioassays were carried out in controlled conditions in a full factorial experimental design which included three fixed factors: metal contamination in the sediment (3 levels of a mixture of Cu, Pb, Zn, and Hg), temperature (26 and 28 °C) and pH (7.6 and 8.1). Metal contamination caused a sharp decrease in the densities of the most abundant meiobenthic groups and interacted with temperature rise, exacerbating deleterious effects for Nematoda and Copepoda, but mitigating effects for Acoelomorpha. CO 2 -driven acidification resulted in increased acoelomorphs density, but only in sediments with lower levels of metals. Copepod densities, in turn, were lower in the CO 2 -driven acidification scenario regardless of contamination or temperature. The results obtained in the present study showed that temperature rise and CO 2 -driven acidification of coastal ocean waters, at environmentally relevant levels, interacts with trace metals in marine sediments, differently affecting the major groups of benthic biota., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Natural pH values in coastal waters vary largely among locations, ecosystems, and time periods; still, there is an ongoing acidification trend. In this scenario, more acidic pH values can alter bioavailability of organic contaminants, to organisms. Despite this, interactive effects between pH and chemical substances are not usually considered in Ecological Risk Assessment protocols. This study investigated the effects of pH on the toxicity of a hydrophobic organic compound on a benthic community using a microcosm experiment setup to assess the response of nematode assemblages exposed to environmentally relevant concentrations of Irgarol at two natural pH conditions. Estuarine nematode assemblages were exposed to two concentrations of Irgarol at pH 7.0 and 8.0 for periods of 7 and 35 days. Lower diversity of nematode genera was observed at the highest tested Irgarol concentration (1281 ± 65 ng.g -1 ). The results showed that the effects of Irgarol contamination were independent of pH variation, indicating no influence of acidification within this range on the toxicity of Irgarol to benthic meiofauna. However, the results showed that estuarine nematode assemblages are impacted by long-term exposure to low (but naturally occurring) pHs. This indicates that estuarine organisms may be under naturally high physiological pressure and that permanent changes in the ecosystem's environmental factors, such as future coastal ocean acidification, may drive organisms closer to the edges of their tolerance windows., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

We tested the hypothesis that the ubiquity of marine meiofaunal nematodes and their indiscriminate passive dispersal create assemblages that are less limited by its environment; whereas the relatively smaller population sizes of macrofauna, associated with their ability to track environmental conditions before settlement, renders their distribution more environmentally-restricted. We compared the empirical distribution of macrofauna and nematode species with that of communities simulated under different assumptions of selection (e.g. environmental filtering) and non-selection (e.g. dispersal limitation) processes. Selection processes were the prime driver of both meio- and macrofauna assemblages, with rare species strongly contributing to this component. The total number of species explained by non-selection processes was 27% higher in nematodes than in macrofauna. Our results underline the importance of a species-level approach to determine the contribution of selection and non-selection assembly processes. Moreover, they highlight the important yet overlooked role of dispersal and stochastic processes in determining species dynamics., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The present study compared the short-term effects of a diesel oil spill on the strucure and function of nematode and macrobenthic assemblages between tidal flats with different history of exposure to oil perturbation. A manipulative field experiment was conducted, where oil exposed treatments were contrasted with controls, during four successive times, two before and two after the oil spills. During the oil spill the death and the presence of diverse debilitated macrofaunal organisms were observed in the oil treatments. However, 24 h later no significant changes were identified, suggesting that the impacted plots were quickly recolonized. Nematode assemblages showed a decrease in overall density and an increase of r-strategist traits such as non-selective deposit feeders and colonizers at perturbed treatments from one of the historically non-perturbed tidal flats. We discuss the mechanisms responsible by distinctive patterns of response observed between the two benthic components., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The usual approaches used in ecological risk assessment have been based on individual and population level standard procedures. Although these have been important tools to assess adverse effects on ecosystems, they are generally simplified and therefore lack ecological realism. Microcosm studies using meiobenthic communities offer a good compromise between the complexity of the ecosystem and the often highly artificial settings of laboratory experiments. An experiment was designed to investigate the potential of the microcosm approach using meiofauna as a tool for ecotoxicological studies. The experiment tested the ecological effects of exposure to sewage-impacted pore water simultaneously at the community level using meiofauna microcosms and at the individual level using laboratory fecundity tests with the copepod Nitokra sp. Specifically, the experiment tested the toxicity of pore water from three sites according to a contamination gradient. Both approaches were efficient in detecting differences in toxicity between the less and more contaminated sites. However, only multivariate data from community analysis detected differences in the gradient of contamination. In addition to information about toxicity, the community level microcosm experiment gave indications about sensitive and tolerant species, indirect ecological effects, as well as raised hypothesis about contamination routes and bioavailability to be tested. Considering the importance of meiofauna for benthic ecosystems, the microcosm approach using natural meiobenthic communities might be a valuable addition as a higher tier approach in ecological risk assessment, providing highly relevant ecological information on the toxicity of contaminated sediments., (Copyright © 2017 Elsevier Inc. All rights reserved.)

About 80% of all pancreatic ductal adenocarcinoma patients suffer from a wasting syndrome referred to as the "cancer anorexia-cachexia syndrome" (CACS) characterized by abnormally low weight, weakness and loss of skeletal muscle mass with or without loss of body fat, which directly impacts overall survival, quality of life, and physical activity. The aim of this review was to examine recent findings about CACS' pathophysiology and to describe the current pharmacological approaches. In recent years many efforts were made to improve our knowledge of CACS; currently we know that cachexia arises from a complex and multifactorial interaction between various mechanisms including inflammation, anorexia/malnutrition, alterations of protein and lipid metabolism; consequently its management requires multidisciplinary and multipharmacological approach that should address the different causes underlying this clinical event. On these premises, several drugs have been proposed starting from the first pharmacological treatment based on progestational agents or corticosteroids; most of them are in the preclinical phase, but some have already reached the clinical experimentation stage. In conclusion, to date, there is no standard effective treatment and further studies are needed to unravel the basic mechanisms underlying CACS and to develop newer therapeutic strategies with the hope to improve the quality of life of pancreatic cancer patients., (Copyright © 2014 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Objectives: Patients who survive an episode of acute necrotizing pancreatitis may develop endocrine and exocrine pancreatic functional impairment; often these patients have undergone pancreatic surgery during the acute episode. Aim of this study is to report the results of a long-term follow-up of patients recovering from an episode of acute necrotizing pancreatitis which had not been treated surgically during the index hospital admission., Design and Subjects: Sixty-five consecutive patients enrolled between January 1990 and December 1993, prospectively followed through December 2006., Results: Median follow-up period was 179.5 months (range 156-203). 40 patients (61.5%) who completed follow-up were analysed. Endocrine function: 2 patients (5%) were diabetic before the pancreatitis episode, and 6 (15.7%) developed overt diabetes; diabetes appeared within the 3rd year after acute pancreatitis in 2 patients, between the 3rd and 4th year in 2 patients, and between the 5th and 6th year in the last 2 patients. Exocrine function: 9 patients (22.5%) showed fecal elastase impairment; in all patients ultrasound was normal and fecal elastase returned above the normal limit during follow-up., Conclusions: After an episode of acute necrotizing pancreatitis treated without surgery, the endocrine and exocrine function is not frequently impaired after long-term follow-up. Reduction in exocrine function is transient and complete recovery is achieved in all patients within a few years., (Copyright (c) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Purpose: This study was addressed to assess the clinical characteristics of patients presenting with chronic hyperamylasemia unrelated to pancreatic diseases (CHUPD). Almost all patients presenting with chronic hyperamylasemia undergo expensive, long, difficult, and often unnecessarily repeated diagnostic procedures. This is in conjunction with the poor knowledge of the fact that besides hyperenzymemia secondary to pancreatic diseases and systemic illnesses, various non-pathological forms of chronic hyperamylasemia without relevant pathologic consequence can occur in clinical practice., Material and Methods: Data of all patients with CHUPD were retrospectively reviewed (June 1997-December 2009). Fifty one patients were included in the study; median follow up was 48 months (range 8-112 months). Their pre-enrolment diagnoses were: chronic pancreatitis in 31 cases (60.7%) and recurrent pancreatitis in 13 cases (25.4%); the remaining 7 patients (13.7%) were without a specific diagnosis., Results: Our observations, supported by diagnostic procedures (Ca19-9 serum levels, abdominal ultrasonography, computed tomography and magnetic resonance, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography) revealed that CHUPD was secondary to: a) benign pancreatic hyperamylasemia, 20 patients (39.2%); b) macroamylasemia, 18 patients (35.2 %) and c) salivary hyperamylasemia, 13 patients (25.4%)., Conclusions: Due to the poor familiarity with CHUPD, the occurrence of this condition quite frequently leads to unnecessarily repeated diagnostic procedures.

Nailfold videocapillaroscopy (NVC) is one of the best diagnostic non-invasive imaging techniques to evaluate microcirculation in vivo and is increasingly employed in the field of rheumatology. Indeed, at present, the most important utility of NVC is in the identification of microvascular involvement in many rheumatic diseases, particularly in systemic sclerosis. More recently, this technique has been shown to be applicable to the study of many other extra-rheumatic diseases, such as arterial hypertension, diabetes mellitus, acromegaly, hyperthyroidism, cardiac syndrome X, primary biliary cirrhosis, Crohn's disease, psoriasis, familial Mediterranean fever. This article sets down the methodology of examination and normal pattern of capillary vessels and reviews the applications of NVC in clinical practice and its results in rheumatic and non-rheumatic diseases.

Background: Septic arthritis (SA) of the sternoclavicular joint (SCJ) is an uncommon form of arthritis, generally described in patients with predisposing risk factors such as primary or secondary immunosuppressive disorders, systemic or localized infections and central venous catheters. More rarely the infection occurs in patients without these risk factors, thus rendering difficult an early diagnosis., Material and Methods: We report two cases of SA of the SCJ occurred in two patient, without known predisposing risk factors, hospitalized in our Internal Medicine Unit., Results: The clinical characteristics didn't significantly differ from clinical course of the disease occurring in patients with predisposing risk factors. Imaging techniques were useful to suspect diagnosis, but only fine-needle aspiration biopsy with culture of specimens leaded to identify the pathogen and its antibiotic sensitivity (in both patients Staphylococcus aureus). One patient was treated with surgical adequate curettage, drainage and intravenous methicillin, while the other one received only medical treatment with intravenous teicoplanin and ceftazidime. The outcome was uneventful with a complete recovery in both cases., Conclusions: Even if SA of SCJ is uncommon in subjects without predisposing risk factors, the clinician must have a high index of suspicion to consider this disease in differential diagnosis of arthritis also in previously healthy subjects with negative or unsettling instrumental investigations. In fact, prompt diagnosis is essential to obtain a successful outcome, avoiding the prolongation of the hospitalization and the sequelae of a chronic infection.

Objective: The objective of this study was to complete a teacher questionnaire on a sample of children (N = 232) in nine fourth grade classes in schools in two regions of central Italy to assess the frequency of occurrence of symptoms of attention-deficit hyperactivity disorder (ADHD) and the rates of probable cases in the sample., Method: Each ADHD symptom was rated by the teacher as either absent (0), sometimes present (1) or frequently present (2)., Results: Of the children 3.9% had eight or more DSM-III-R Criterion A symptoms of ADHD scored at a "frequent" level (score of 2) and were considered to be "likely cases" of ADHD; an additional 6.9% did not meet this threshold but had a total score of 16 or more on the scale and were considered to be "possible cases.", Conclusions: The findings suggest the need for more systematic epidemiological investigations to evaluate the true prevalence of the syndrome and its risk factors in the Italian population.