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Italy is the leading producer of rice in Europe, but this crop is increasingly threatened by many factors such as pathogens' resistance, pollution and climate change. To date, few works keep in consideration the ecological role that the open irrigation system can play in the dispersion of important opportunistic species, and if it is affected by agricultural management and environmental seasonal changing. This work carried out the mycological characterization of a rice field irrigation system located in Vistarino (Pavia, Lombardy, Italy). Three main sections of an irrigation system (canal, ditch and paddy) were sampled during the summer 2018 (irrigation season of the rice crop). Water samples processing underlined how the irrigation system is rich of fungal diversity (59 species isolated). In order of abundance, the canal samples are characterized by the dominance of Aspergillus, Cladosporium, Fusarium and Trichoderma genera, while the ditch samples by Alternaria, Cladosporium, Fusarium, and Penicillium genera, and the paddy samples by Alternaria, Cladosporium, Fusarium and Trichoderma genera. Results showed that the three environments are mycologically independent of each other: fungi do not exploit the irrigation system for their dispersion in paddy. Probably fungi prefer others dispersion systems such as air dispersion. This means that an open irrigation system is not to be considered as a continue system with free circulation of fungi. Indeed, each sector of the system appears characterized by a typical funga, which undergoes variations during the sampled season due to agricultural management and environmental conditions., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The inoculation of plants with plant-growth-promoting microorganisms (PGPM) (i.e., bacterial and fungal strains) is an emerging approach that helps plants cope with abiotic and biotic stresses. However, knowledge regarding their synergic effects on plants growing in metal-rich soils is limited. Consequently, the aim of this study was to investigate the biomass, ecophysiology, and metal accumulation of the facultative Ni-hyperaccumulator Alyssoides utriculata (L.) Medik. inoculated with single or mixed plant-growth-promoting (PGP) bacterial strain Pseudomonas fluorescens Migula 1895 (SERP1) and PGP fungal strain Penicillium ochrochloron Biourge (SERP03 S) on native serpentine soil ( n = 20 for each treatment). Photosynthetic efficiency (Fv/Fm) and performance indicators (PI) had the same trends with no significant differences among groups, with Fv/Fms > 1 and PI up to 12. However, the aboveground biomass increased 4-5-fold for single and mixed inoculated plants. The aboveground/belowground dry biomass ratio was higher for plants inoculated with fungi (30), mixed (21), and bacteria (17). The ICP-MS highlighted that single and mixed inocula were able to double the aboveground biomass' P content. Mn metal accumulation significantly increased with both single and mixed PGP inocula, and Zn accumulation increased only with single PGP inocula, whereas Cu accumulation increased twofold only with mixed PGP inocula, but with a low content. Only Ni metal accumulation approached the hyperaccumulation level (Ni > 1000 mg/kg DW) with all treatments. This study demonstrated the ability of selected single and combined PGP strains to significantly increase plant biomass and plant tolerance of metals present in the substrate, resulting in a higher capacity for Ni accumulation in shoots.

Purpose: The aim of the study was to evaluate indexes of insulin resistance and cardiometabolic risk in a large population of workers with overweight or obesity, in order to identify a possible efficient, cheap and simple strategy to apply in workers' health surveillance., Methods: The evaluation of IR and cardiometabolic risk indexes (HOMA, QUICKI, Ty/HDLC, TyG, insuTAG, Castelli risk indexes 1 and 2, non-HDLC, TRL-C, AIP, and VAI) was performed in a population of 1195 working-age subjects with overweight or obesity (322 males, mean age 49 ± 11 years)., Results: The prevalence of IR and cardiometabolic risk was higher among males for all indexes. Aging, waist circumference, BMI, blood pressure, glucose, CRP, fibrinogen and uric acid were correlated more frequently with IR/cardiometabolic indexes in women, homocysteine in men. The percentage of the workers identified as insulin resistant (IR+) or at higher cardiometabolic risk greatly vary according to the different index used., Conclusion: With a small group of biomarkers and anthropometric measures (fasting glucose and insulin, lipid profile, BMI and waist circumference) is possible to calculate a number of IR/cardiometabolic indexes, which, likely reflecting different pathophysiological aspects also related to gender, might help in a personalized evaluation of IR and cardiometabolic risk. Graphical abstract., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The co-growth and synergistic interactions among fungi and bacteria from the rhizosphere of plants able to hyper accumulate potentially toxic metals (PTMs) are largely unexplored. Fungi and bacteria contribute in an essential way to soil biogeochemical cycles mediating the nutrition, growth development, and health of associated plants at the rhizosphere level. Microbial consortia improve the formation of soil aggregates and soil fertility, producing organic acids and siderophores that increase solubility, mobilization, and consequently the accumulation of nutrients and metals from the rhizosphere. These microorganism consortia can both mitigate the soil conditions promoting plant colonization and increase the performance of hyperaccumulator plants. Indeed, microfungi and bacteria from metalliferous soils or contaminated matrices are commonly metal-tolerant and can play a key role for plants in the phytoextraction or phytostabilization of metals. However, few works deepen the effects of the inoculation of microfungal and bacterial consortia in the rhizosphere of metallophytes and their synergistic activity. This mini-review aimed to collect and report the data regarding the role of microbial consortia and their potentialities known to date. Moreover, our new data had shown an active fungal-bacteria consortium in the rhizosphere of the hyperaccumulator plant Alyssoides utriculata ., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Cecchi, Di Piazza, Rosatto, Mariotti, Roccotiello and Zotti.)

Contamination of marine sediments by organic and/or inorganic compounds represents one of the most critical problems in marine environments. This issue affects not only biodiversity but also ecosystems, with negative impacts on sea water quality. The scientific community and the European Commission have recently discussed marine environment and ecosystem protection and restoration by sustainable green technologies among the main objectives of their scientific programmes. One of the primary goals of sustainable restoration and remediation of contaminated marine sediments is research regarding new biotechnologies employable in the decontamination of marine sediments, to consider sediments as a resource in many fields such as industry. In this context, microorganisms-in particular, fungi and bacteria-play a central and crucial role as the best tools of sustainable and green remediation processes. This review, carried out in the framework of the Interreg IT-FR Maritime GEREMIA Project, collects and shows the bioremediation and mycoremediation studies carried out on marine sediments contaminated with ecotoxic metals and organic pollutants. This work evidences the potentialities and limiting factors of these biotechnologies and outlines the possible future scenarios of the bioremediation of marine sediments, and also highlights the opportunities of an integrated approach that involves fungi and bacteria together.

Is it possible to improve the efficiency of bioremediation technologies? The use of mixed cultures of bacteria and fungi inoculated at the rhizosphere level could promote the growth of the associated hyperaccumulating plant species and increase the absorption of metals in polluted soils, broadening new horizons on bioremediation purposes. This work investigates interactions between Ni-tolerant plant growth-promoting bacteria and fungi (BF) isolated from the rhizosphere of a hyperaccumulating plant. The aim is to select microbial consortia with synergistic activity to be used in integrated bioremediation protocols. Pseudomonas fluorescens ( Pf ), Streptomyces vinaceus ( Sv ) Penicillium ochrochloron ( Po ), and Trichoderma harzianum group ( Th ) were tested in mixes ( Po-Sv , Po-Pf , Th-Pf , and Th-Sv ). These strains were submitted to tests (agar overlay, agar plug, and distance growth co-growth tests), tailored for this aim, on Czapek yeast agar (CYA) and tryptic soy agar (TSA) media and incubated at 26 ± 1 °C for 10 days. BF growth, shape of colonies, area covered on plate, and inhibition capacity were evaluated. Most BF strains still exhibit their typical characters and the colonies separately persisted without inhibition (as Po-Sv ) or with reciprocal confinement (as Th-Sv and Th-Pf ). Even if apparently inhibited, the Po-Pf mix really merged, thus obtaining morphological traits representing a synergic co-growth, where both strains reached together the maturation phase and developed a sort of mixed biofilm. Indeed, bacterial colonies surround the mature fungal structures adhering to them without any growth inhibition. First data from in vivo experimentation with Po and Pf inocula in pot with metalliferous soils and hyperaccumulator plants showed their beneficial effect on plant growth. However, there is a lack of information regarding the effective co-growth between bacteria and fungi. Indeed, several studies, which directly apply the co-inoculum, do not consider suitable microorganisms consortia. Synergic rhizosphere BFs open new scenarios for plant growth promotion and soil bioremediation.

Composting is a complex process in which various micro-organisms, mainly fungi and bacteria, are involved. The process depends on a large number of factors (biological, chemical, and physical) among which microbial populations play a fundamental role. The high temperatures that occur during the composting process indicate the presence of thermotolerant and thermophilic micro-organisms that are key for the optimization of the process. However, the same micro-organisms can be harmful (allergenic, pathogenic) for workers that handle large quantities of material in the plant, and for end users, for example, in the indoor environment (e.g., pots in houses and offices). Accurate knowledge of thermotolerant and thermophilic organisms present during the composting stages is required to find key organisms to improve the process and estimate potential health risks. The objective of the present work was to study thermotolerant and thermophilic mycobiota at different time points of compost maturation. Fungi were isolated at four temperatures (25, 37, 45, and 50 °C) from compost samples collected at five different steps during a 21-day compost-maturation period in an active composting plant in Liguria (northwestern Italy). The samples were subsequently plated on three different media. Our results showed a high presence of fungi with an order of magnitude ranging from 1 × 10 4 to 3 × 10 5 colony-forming units (CFU) g -1 . The isolated strains, identified by means of specific molecular tools (ITS, beta-tubulin, calmodulin, elongation factor 1-alpha, and LSU sequencing), belonged to 45 different species. Several thermophilic species belonging to genera Thermoascus and Thermomyces were detected, which could be key during composting. Moreover, the presence of several potentially harmful fungal species, such as Aspergillus fumigatus , A. terreus, and Scedosporium apiospermum, were found during the whole process, including the final product. Results highlighted the importance of surveying the mycobiota involved in the composting process in order to: (i) find solutions to improve efficiency and (ii) reduce health risks.

Background: A large number of systemic diseases can be linked to oral candida pathogenicity. The global trend of invasive candidiasis has increased progressively and is often accentuated by increasing Candida albicans resistance to the most common antifungal medications. Photodynamic therapy (PDT) is a promising therapeutic approach for oral microbial infections. A new formulation of 5-aminolevulinic acid (5%ALA) in a thermosetting gel (t) (5%ALA-PTt) was patented and recently has become available on the market. However, its antimicrobial properties, whether mediated or not by PDT, are not yet known. In this work we characterised them., Methods: We isolated a strain of C. albicans from plaques on the oral mucus membrane of an infected patient. Colonies of this strain were exposed for 1 24 h, to 5%ALA-PTt, 5%ALA-PTt buffered to pH 6.5 (the pH of the oral mucosa) (5%ALA-PTtb) or not exposed (control). The 1 h-exposed samples were also irradiated at a wavelength of 630 nm with 0.14 watts (W) and 0.37 W/cm 2 for 7 min at a distance of <1 mm., Results and Conclusion: The 5% ALA-PTt preparation was shown to be effective in reducing the growth of biofilm and inoculum of C. albicans. This effect seems to be linked to the intrinsic characteristics of 5%ALA-TPt, such acidic pH and the induction of free radical production. This outcome was significantly enhanced by the effect of PDT at relatively short incubation and irradiation times, which resulted in growth inhibition of both treated biofilm and inoculum by ∼80% and ∼95%, respectively., Competing Interests: Declaration of Competing Interest All the authors disclose any conflict of interests and no financial supports were obtained for conducting the present investigation., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Contaminated sediments represent an important management problem that also concerns their remediation. Indeed, port dredging activities produce huge volumes of contaminated sediments that, in turn, require proper handling because of their quantity of inorganic and organic substances. Conventional management-remediation strategies of polluted sediment involve sediment washing, electron-chemical separation, and thermal treatment. Recently, bioremediation strategies have also been proposed as a promising answer to the problem of contaminated sediments. In this context, fungi are pioneer microorganisms known to bioconcentrate, bioaccumulate, and biostabilize heavy metals. These capabilities suggest the potential to employ indigenous fungal strains to remediate polluted port sediments. In the framework of the European Project SEDITERRA (Guidelines for the sustainable treatment of dredged sediments in the Marittimo area), the aim of this paper is to characterize the fungal communities of port sediments of Genoa and present an innovative mycoremediation protocol to evaluate the capability of indigenous fungal strains in the heavy metal remediation. In this study, Penicillium expansum Link and Paecilomyces formosus (Sakag., May. Inoue & Tada) Houbraken & Samson have been selected as fungal species for the mycoremediation treatments. The protocol requires a fungal membrane system and the results highlight efficient bioremoval of Cu and Zn from sediments.

This study faces the characterization of the culturable microbiota of the facultative Ni-hyperaccumulator Alyssoides utriculata to obtain a collection of bacterial and fungal strains for potential applications in Ni phytoextraction. Rhizosphere soil samples and adjacent bare soil associated with A. utriculata from serpentine and non-serpentine sites were collected together with plant roots and shoots. Rhizobacteria and fungi were isolated and characterized genotypically and phenotypically. Plants and soils were analyzed for total element concentration using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Serpentine and non-serpentine sites differ in terms of elements concentration in soil, plant roots and shoots. Ni and Co are significantly higher on serpentine site, while Ca is more abundant in non-serpentine site. Bacteria and fungi were significantly more abundant in rhizosphere than in bare soil and were dominated by genera Arthrobacter, Bacillus and Streptomyces, Penicillium and Mucor. The genus Pseudomonas was only found in rhizospheric serpentine soils (<2% of total serpentine isolates) and with Streptomyces sp. showed highest Ni-tolerance up to 15 mM. The same occurred for Trichoderma strain, belonging to the harzianum group (<2% of the total microfungal count) and Penicillium ochrochloron (<10% of the total microfungal count, tolerance up to Ni 20 mM). Among serpentine bacterial isolates, 8 strains belonging to 5 genera showed at least one PGPR activity (1-Aminocyclopropane-1-Carboxylic Acid (ACC) deaminase activity, production of indole-3-acetic acid (IAA), siderophores and phosphate solubilizing capacity), especially genera Pantoea, Pseudomonas and Streptomyces. Those microorganisms might thus be promising candidates for employment in bioaugmentation trials., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Glycated haemoglobin (HbA1c) test, introduced for diagnosing prediabetes and diabetes by the American Diabetes Association for some years, is currently under extensive discussion for contradictory data on the concordance between this test and the oral glucose tolerance test (OGTT)., Hypothesis: To assess concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in subjects with overweight or obesity, focusing on possible gender-related differences., Methods: A total of 949 outpatients with overweight or obesity at risk for diabetes (mean age 50 ± 15 years; 660 F) were enrolled and underwent HbA1c test and OGTT., Results: In both genders, HbA1c test identified more patients with prediabetes than OGTT (42% vs 22% in males, 40% vs 18% in females, respectively): a slight concordance between HbA1c and OGTT (60% of total tests in both genders). In subjects diagnosed by OGTT, post-OGTT insulin levels and HOMA INDEX were significantly higher than those found in HbA1c(+) cases. Instead, those diagnosed with HbA1c were significantly older and showed higher uric acid than those with both tests (-)., Conclusions: HbA1c test and OGTT did not reach full concordance for the diagnosis of diabetes and prediabetes in both genders. The two tests likely reflect different physiopathological aspects of dysglycaemia, suggesting that the 'diagnostic thresholds' could be reconsidered in light of the discordance observed., (© 2019 John Wiley & Sons Ltd.)

Evidence of pyrite dissolution by Telephora terrestris Ehrh were observed for the first time in the abandoned sulphide Libiola mine in May 2017 (Sestri Levante, Liguria, Italy). This fungus is an ectomycorrhizal species able to colonize this extreme environment and bioaccumulate metals such as copper and silver in its fruiting bodies, and it is known to establish symbiosis with maritime pines present in the area, thus favouring their recolonization of the site. This paper presents evidence of T. terrestris promoted dissolution of sulphide minerals. This species can remove from soil not only metals possibly toxic to the pine trees, but it can also contribute to the ions bioaccumulation through the bioweathering of sulphide mineral grains (especially pyrite).

The present study reports the mycological data collected from two corpses preserved in controlled conditions and monitored for 6 weeks at the mortuary. On the whole during the monitoring more than 70 fungal CFU (Colony Forming Units) were sampled from the corpses. The data collected were used to map the body fungal colonization of the corpses during 6 weeks. The two body maps show a huge difference between these cases, mainly due to the perimortem conditions. In particular, in the case one the facial area colonised by fungi rose from 15% to 63% in six weeks, while the fungal colonization of case two was about 1% for the whole monitoring period. This work shows, for the first time, the data about the pattern of colonization and distribution of fungi on real corpses after death and argues about the influence of perimortem settings on fungal colonization. Moreover, the paper suggests exploiting the study of fungal colony development and maturation to assess post-mortem interval (PMI)., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Abandoned industrial sites and mines may constitute possible hazards for surrounding environment due to the presence of toxic compounds that may contaminate soils and waters. The possibility to remove metal contaminants, specifically nickel (Ni), by means of fungi was presented exploiting a set of fungal strains isolated from a Ligurian dismissed mine. The achieved results demonstrate the high Ni(II) tolerance, up to 500 mg Ni l -1 , and removal capability of a Trichoderma harzianum strain. This latter hyperaccumulates up to 11,000 mg Ni kg -1 , suggesting its possible use in a bioremediation protocol able to provide a sustainable reclamation of broad contaminated areas.

Metal contamination constitutes a major source of pollution globally. Many recent studies emphasized the need to develop cheap and green technologies for the remediation or reclamation of environmental matrices contaminated by heavy metals. In this context, fungi are versatile organisms that can be exploited for bioremediation activities. In our work, we tested silver (Ag) bioaccumulation capabilities of three microfungal strains (Aspergillus alliaceus Thom & Church, Trichoderma harzianum Rifai, Clonostachys rosea (Link) Schroers, Samuels, Seifert & W. Gams) isolated from a silver polluted site. The aim was to select silver tolerant native strains and test their potential silver uptake. Among the three species tested, T. harzianum was the most efficient strain to tolerate and accumulate silver, showing an uptake capability of 153 mg L -1 taken at the Ag concentration of 330 mg L -1 . Our study highlights the potential use of native microfungi spontaneously growing in sulphide-rich waste rock dumps, for silver bioaccumulation and bioremediation.

Due to the wide range of applications in high-tech solutions, Rare Earth Elements (REEs) have become object of great interest. In the last years several studies regarding technologies for REE extraction from secondary resources have been carried out. In particular biotechnologies, which use tolerant and accumulator microorganisms to recover and recycle precious metals, are replacing traditional methods. This paper describes an original biometallurgical method to recover REEs from waste electrical and electronic equipment (WEEE) by using a strain of Penicillium expansum Link isolated from an ecotoxic metal contaminated site. The resulting product is a high concentrated solution of Lanthanum (up to 390ppm) and Terbium (up to 1520ppm) obtained from WEEE. Under this perspective, the proposed protocol can be considered a method of recycling exploiting biometallurgy. Finally, the process is the subject of the Italian patent application n. 102015000041404 submitted by the University of Genoa., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Boletus edulis and allied species (BEAS), known as "porcini mushrooms", represent almost the totality of wild mushrooms placed on the Italian market, both fresh and dehydrated. Furthermore, considerable amounts of these dried fungi are imported from China. The presence of Tylopilus spp. and other extraneous species (i.e., species edible but not belonging to BEAS) within dried porcini mushrooms - mainly from those imported from China and sold in Italy - may represent an evaluable problem from a commercial point of view. The purpose of the present study is to evaluate near-infrared spectroscopy (NIRS) as a rapid and effective alternative to classical methods for identifying extraneous species within dried porcini batches and detecting related commercial frauds. To this goal, 80 dried fungi including BEAS, Tylopilus spp., and Boletus violaceofuscus were analysed by NIRS. For each sample, 3 different parts of the pileus (pileipellis, flesh and hymenium) were analysed and a low-level strategy for data fusion, consisting of combining the signals obtained by the different parts before data processing, was applied. Then, NIR spectra were used to develop reliable and efficient class-models using a novel method, partial least squares density modelling (PLS-DM), and the two most commonly used class-modelling techniques, UNEQ and SIMCA. The results showed that NIR spectroscopy coupled with chemometric class-modelling technique can be suggested as an effective analytical strategy to check the authenticity of dried BEAS mushrooms., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Copper is one of the most dangerous soil contaminants. Soils affected by high copper concentrations show low biodiversity and, above all, inadequate environmental quality. Microorganisms such as fungi can play a key role in metal-polluted ecosystems via colonization and decontamination. The study is devoted to characterize the microfungal community in highly Cu-contaminated bare soil from derelict Fe-Cu sulphide mines and to isolate microfungal strains able to tolerate and accumulate Cu. 11 Different taxa to be isolated has been isolated during two sampling campaigns (in Autumn and in Spring). Among these, Clonostachys rosea, Trichoderma harzianum, and Aspergillus alliaceus were tested at increasing Cu(II) concentrations and showed a Cu(II)-tolerance capability ranging from 100 to 400 mg L(-1). Moreover, the strains of T. harzianum and C. rosea presented a high Cu(II)-bioaccumulation capability, 19628 and 22,222 mg kg(-1), respectively. These microfungi may be fruitfully exploited in mycoremediation protocols., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: The role of prognostic variables in the treatment of hepatocellular carcinoma (HCC) by transarterial chemoembolisation (TACE) is controversial., Aims: To evaluate the survival of patients with HCC on cirrhosis treated with TACE and to analyse the prognostic factors affecting survival., Methods: From 1996 to 2006, 580 consecutive patients with HCC in cirrhosis were observed. Of these 194 patients underwent TACE. The primary end-point was survival. Independent predictors of survival were identified using the Cox model., Results: The cumulative 1-year, 3-year, and 5-year survival rates were 96%, 60%, and 41%, respectively. The multivariate analysis showed significant reduction of survival among patients with serum bilirubin values >2mg/dl compared to patients with values <2mg/dl (Hazard ratio 3.84; CI 95% 1.70-8.66; p-value=0.001). Multivariate analysis performed in the group of patients treated with TACE alone showed that elevated serum bilirubin (Hazard ratio 2.96; CI 95% 1.20-7.3; p-value 0.02) and incomplete tumour response (Hazard ratio 2.88; CI 95% 1.18-7.05; p-value 0.02) are correlated with a worse outcome., Conclusions: TACE was well tolerated and overall survival rate was 41% after 5 years. Complete tumour response and serum bilirubin <2mg/dl were identified as predictors of survival., ((c) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Consultation in nursing is not only a question of technique and method. For nursing personnel to qualify as consultants they are compelled to confront its goals and its significance. Moreover, the part of the nurses within consultation must be clarified and the question of the particularities of consultation in nursing should be dealt with. The following article covers this subject with particular attention to the area of Pediatric Nursing. Long ago, job requirements for nursing staff in this area have involved looking not only after the sick child but after its entire family, too. Consultation in nursing is considered an independent plan designed to support the family in coping both with wellness and sickness and the latter's consequences. The adequate education and training will help nursing staff to perform these duties.

In 14 patients with cirrhosis and chronic portosystemic encephalopathy, the effectiveness of treatment with a new non-assorbable antibiotic (rifaximine) was compared to neomycin. The parameters evaluated were: bradylalia, flapping tremor, performance, visual evoked potentials and the trial making test. Both treatments were combined with lactulose. The analysis of results showed a rate of positive results in the patients treated with rifaximine greater than that with neomycin. Differences, however, were not significant.

A prospective controlled study of the diagnostic accuracy of blind percutaneous liver biopsy in comparison to laparoscopy plus guided biopsy for the recognition or exclusion of cirrhosis has been performed. One hundred twenty-six patients with a clinical diagnosis of chronic, diffuse, well-compensated liver disease were randomized into two groups and submitted either to percutaneous blind liver biopsy (PB: 64 patients) or to laparoscopy with guided biopsy (LB: 62 patients), in order to assess the accuracy of either procedure in diagnosing cirrhosis. PB correctly recognized or ruled out cirrhosis in 52 patients (82%). Inconclusive results were mostly false negative, as demonstrated by the presence on endoscopy of esophageal varices or by subsequent LB. LB demonstrated presence or absence of cirrhosis in all patients. The difference between the rate of accurate results of the two procedures is statistically significant. It is concluded that in patients without esophageal varices, LB should be the investigation of choice for the assessment of liver structure since the presence of cirrhosis can be missed in up to 20% of cases by PB.

Scanning of 31 cirrhosis and 25 cancer-cirrhosis patients has been carried out using 198Au and then 67Ga. In 23/25 cancer-cirrhotic patients 67Ga was picked up in areas cold to 198Au (8% false negatives); such behaviour was not observed in any of the 31 cirrhotics (no false positive).