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[The manuscript presents the first attempt to define the diagenetic conditions (burial and related paleo‐temperatures) for sulfur formation in relationship with the deposits generated by the Messinian salinit crisis. ​, Abstract Recent studies on the genesis of sedimentary native sulfur deposits indicate diagenetic mid‐low temperature Bacterial Sulfate Reduction (BSR) as the main process, involving organic compounds (kerogen/hydrocarbons), bacterial colonies and gypsiferous rocks. In the peri‐Mediterranean area (Southern Spain, Sicily, Northern Apennines, Israel), the main sulfur accumulations are always associated with late Miocene sulfates and organic‐rich successions encompassing the Messinian salinity crisis (MSC). In particular, the Messinian successions of the Apennine‐Adriatic foreland basin system, due to a large amount of high‐resolution stratigraphic data, represent a perfect case study for understanding the diagenetic conditions controlling the development of the BSR process during sedimentary basin evolution. In this work, thermal models performed in three sub‐basins in a sector of the Northern Apennines comprised of the Sillaro and Marecchia rivers (Italy), calibrated by means of organic and inorganic geothermometers, indicate a general thermal immaturity of the studied successions attained as a result of a constant heat flow similar to the present day one (ca. 40 mW/m2) since Late Tortonian and lithostatic loads between 615 and 1,710 m depending on different sub‐basins. These results suggest that the MSC deposits experienced maximum temperatures between about 39°C and 65°C. Temperatures derived from thermal models have been used to constraint occurrence of the diagenetic BSR associated with evaporitic deposits providing thermal constraints in sulfur genesis as well as new useful thermal‐constraints for basin analysis studies.]

Introduction Acute pediatric poisoning is an emerging health and social problem. The aim of this study is to describe the characteristics of a large pediatric cohort exposed to xenobiotics, through the analysis of a Pediatric Poison Control Center (PPCc) registry. Methods This study, conducted in the Pediatric Hospital Bambino Gesù of Rome, a reference National Pediatric Hospital, collected data of children whose parents or caregivers contacted the PPCc by phone (group “P”), or who presented to the Emergency Department (group “ED”), during the three-year period 2014–2016. Data were prospectively and systematically collected in a pre-set electronic registry. Comparisons among age groups were performed and multivariable logistic regression models used to investigate associations with outcomes (hospital referral for “P”, and hospital admission for “ED”group). Results We collected data of 1611 children on group P and 1075 on group ED. Both groups were exposed to both pharmaceutical and non-pharmaceutical agents. Pharmaceutical agent exposure increased with age and the most common route of exposure was oral. Only 10% among P group were symptomatic children, with gastrointestinal symptoms. Among the ED patients, 30% were symptomatic children mostly with gastrointestinal (55.4%) and neurologic symptoms (23.8%). Intentional exposure (abuse substance and suicide attempt), which involved 7.7% of patients, was associated with older age and Hospital admission. Conclusions Our study describes the characteristics of xenobiotics exposures in different paediatric age groups, highlighting the impact of both pharmacological and intentional exposure. Furthermore, our study shows the utility of a specific PPCc, either through Phone support or by direct access to ED. PPCc phone counselling could avoid unnecessary access to the ED, a relevant achievement, particularly in the time of a pandemic.

Background Numerous studies described the epidemiological link and main clinical features of pediatric COVID-19, during the first pandemic period. Our study encompasses several different phases since the National Lockdown in Italy. The primary outcome is (I) to analyze the prevalence of positive NST (Nasopharyngeal Swab Test) among the largest Italian Pediatric cohort admitted to a single regional PED Hub for COVID-19 during an eight-month period. Secondary outcomes are: (II) the description of trend of admissions in our PED and (III) the categorization of the positive patients according to clinical manifestations and epidemiological link. Methods We described 316 patients with a positive NST for SARS-CoV2, on a total of 5001 nasopharyngeal swabs performed among 13,171 admissions at our PED, over a period starting from March 17th, 2020 to December 1st, 2020. Age, epidemiological link, clinical features and hospitalizations were analyzed according to different lockdown phases. Data were collected anonymously from electronic records and analyzed using SPSS 22.00 statistics software (Chicago, IL). Results Thirty-six percent of total admissions have been tested. During the post lockdown period, we performed the highest percentage of NST (Nasopharyngeal Swab Test) 49.7%, and among them 7.9% were positive. The prevalence of infection during a 10-month period was 2.3%. Mean age was 6.5 years old. Familial Link accounted for the 67.7% of infection, while Extrafamilial and Unknown link accounted for 17 and 14.9%, respectively. Familial link is predominant during all phases. Seventeen patients showed an intra-scholastic link, and the highest prevalence was observed in the 7–10 years age group, with a prevalence of 12.8% (5 patients). Fever was the most frequent symptom (66%), in particular among preschooler children aged 0–6 years (71.9%). Older children were more frequently symptomatic. Seven patients were admitted with MIS-C diagnosis. Conclusions Different levels of containment measures caused important changes in number of positive NST for SARS-CoV2. Familial link was predominant in our cohort, during all phases of Lockdown. The risk of being infected at home is four time greater than the risk of being infected from an extra familial individual. Further studies are needed to evaluate the clear impact of intra-scholastic link. The constant improvement in knowledge on onset symptoms and risk factor for SARS-CoV2 infection and its complications (e.g. MIS-C), can impact on number of hospitalizations, ICU admissions and early management.

Background: Numerous studies described the epidemiological link and main clinical features of pediatric COVID-19, during the first pandemic period, while this is the first study that encompass several different phases of National Lockdown in a European country. We described the effects of different National Containment Measures on positive NST (Nasopharyngeal Swab Test) trend, epidemiological links and main clinical features of the largest Italian Pediatric cohort admitted to a single regional Pediatric Emergency Department Hub for COVID-19, during an eight-month period. Methods: We described 316 patients with a positive NST for SARS-CoV2, on a total of 5001 nasopharyngeal swabs performed among 13171 admissions at our PED, over a period starting from March 17th, 2020 to December 1st, 2020. Age, epidemiological link, clinical features and hospitalizations were analyzed according to different lockdown phases. Data were collected anonymously from electronic records and analyzed using SPSS 22.00 statistics software (Chicago, IL). Findings: Thirty-six percent of total admissions have been tested for SARS-CoV2. During the post Lockdown period we performed the highest percentage of NST (Nasopharyngeal Swab Test) 49,7% and found the highest percentage of positive NST on total NST effectuated 7,9%. Mean age was 6.5 years old. The 0-6 years age group accounted the highest number of positive NST. Familial link is predominant during all phases; however, we observed an increase of extra-familial and unknown link starting from the phase 4, especially among adolescents. Seventeen patients showed an intra-scholastic link. Older children were frequently symptomatic and accounted for the 1% admission in ICU (Intensive Care Unit). Seven patients were admitted with MIS-C diagnosis. Interpretation: Different levels of containment measures caused important changes in epidemiological link, mean age and number of admissions and hospitalization of patients with COVID-19. Familial link was predominant in our cohort, during all phases of Lockdown, yet the impact on extrafamilial link and intra-scholastic link should be further investigated. Adolescent and young adults could present more frequently with moderate/severe symptoms requiring, in rare cases, admission in ICU. Funding Statement: No funding was secured for this study. Declaration of Interests: The authors have no conflicts of interest to disclose. Ethics Approval Statement: This study was approved by the institutional review board of Bambino Gesu Children Hospital, IRCCS.

Background Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children’s hospital, composed by two different pediatric centers, one located in Rome’s city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED’s) and urgent hospitalizations compared to prepandemic period. Methods The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics. Results The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access. Conclusions In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn’t demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.

The lack of modern analogues for the thick primary selenite gypsum deposits formed in the Mediterranean area limits the understanding of the Messinian (Miocene) evaporitic systems and particularly of their lateral relationships, their evolution through time and their related ecosystems. Some complex stratigraphic relationships of these extreme environments are revealed in the Messinian Canos Formation along the northern flank of the Sierra Alhamilla at the southern boundary of the Sorbas Basin (southern Spain). Here, the bottom-grown selenite gypsum beds pinch-out against graded clastic carbonate beds (ooid grainstones, rudstones and mudstones) emplaced by gravity flows. We infer that these tabular bodies formed along a low gradient ramp, derived from the periodic erosion of coeval shallow-water to coastal carbonate factories located on top of the Sierra Alhamilla ridge. The carbonate deposits bear many similarities with the Terminal Carbonate Complex described in the northern, steeper margin of the basin; both deposits show a cyclical pattern given by the repetition of couplets consisting of coarser- and finer-grained deposits. This rhythmic facies organization recalls the precessional-controlled cyclic pattern of the gypsum unit. Clastic carbonates and gypsum were deposited during the same precessional hemicycle but appear to be mutually exclusive. In fact, the clastic carbonates represent the lateral equivalent of the gypsum beds, or are occasionally found at their base or at both their base and top, but never interstratified with them. Such an arrangement suggests that during the peak of the evaporitic phases a strong pycnocline acted as the top boundary for gypsum and the lower boundary for carbonate-bearing gravity flows, with the exception of debrites, high-density gravity flows and slumps. These facies architectures appear to be mainly controlled by the interplay between the variable depth of the pycnocline and the density of the brine within the evaporitic cycle.

Dear Editor,Although, most spiders in Italy basically have venom that is harmless to humans, one must consider some potentially dangerous species. Latrodectus tredecimguttatus (Rossi, 1790), also k...

To the Editors: The SFTPB gene encodes the hydrophobic pulmonary surfactant protein (SP)-B, which is essential for the build-up of the surfactant layer and lowering of surface tension in the airways. SP-B deficiency was the first reported genetic cause of lethal respiratory distress syndrome (RDS) in infants in 1993 [1]. The phenotype of infants with hereditary SP-B deficiency is of a typically full-term neonate with respiratory failure in the first 24–48 h of life; diagnosis can be delayed, as affected infants may show initially mild symptoms and not require ventilation or further medical support for some time. Chest radiography shows a bilateral, wide ground-glass pattern consistent with a diagnosis of hyaline membrane disease. Typical histological findings are the presence of periodic acid–Schiff-positive eosinophilic material in the alveoli, epithelial cell desquamation, enlarged alveolar macrophages with lamellar inclusions and accumulation of SP-A [2]. Since SP-B was found to be essential for the proteolytic processing of pro-SP-C, newborns with hereditary SP-B deficiency show aberrantly processed SP-C in the intra-alveolar lumen. Lung disease is rapidly progressive and fatal respiratory failure finally sets in within 3–6 months; lung transplantation is suggested as the only effective treatment. To our knowledge, heterozygous mutation has not previously been reported to cause clinical symptoms. A 6-month-old male was admitted to the Bronchopneumology …

Pneumorrhachis (air within the spinal canal) is rare and usually associated with other air leaks. Diagnosis is usually by high resolution CT scan. A 9-year-old boy had a 10-day history of persistent cough despite treatment with inhaled bronchodilators, systemic steroids and antibiotics before coming to hospital. Physical examination demonstrated good general condition, cervical subcutaneous emphysema and reduced breath sounds with widespread crackles and …