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There are only two Aphaenogaster species from the subterranea group in the western Mediterranean: A. ichnusa Santschi, 1925, from south-western Europe, and A. subterranea (Latreille, 1798), also occurring in central and eastern Europe. Historically, the two species have been widely misunderstood: A. ichnusa was long considered a Sardinian endemic subspecies of A. subterranea, while its continental populations were misidentified as A. subterranea s. str. Recently, A. ichnusa was elevated to species rank and its worker caste was redescribed with that of A. subterranea, allowing for their correct identification. Yet their distribution was documented in detail only for France and Sardinia. Furthermore, no morphological characters were described to distinguish the males and queens of the two species. By investigating private and museum collections, 276 new records of A. ichnusa are provided here and 154 of A. subterranea from the western Mediterranean. Additionally, qualitative and quantitative morphological characters were combined to identify their males and queens. We present the new southernmost, easternmost, and westernmost distribution limits for A. ichnusa. Based on our results, this species is widely distributed in Italy and Catalonia (Spain), also occurring on several Mediterranean islands, avoiding areas with continental climate and high altitudes. Sicily is the only island to host the less thermophilous A. subterranea, which otherwise extends westward to Galicia (Spain). Sympatric occurrence is not rare along the contact zone. Additional natural history observations are reported regarding foraging habits, associated myrmecophiles, habitat preferences, and colony structure in the two species.

Introduction Uncomplicated lower urinary tract infections (uLUTI) are a common problem in primary care. Current local guidelines recommend the use of a single 3 g dose of fosfomycin. However, most general practitioners (GP) prefer short-course therapies to single-dose therapy. No study has compared head-to-head short-course antimicrobial agents for uLUTIs. Therefore, the aim of this randomised clinical trial is to compare three different short-course antibiotic therapies with a single-dose of fosfomycin for these infections.Methods and analysis This will be a pragmatic, multicentre, parallel group, open trial. Women aged 18 or older and with symptoms of uLUTI and a positive urine dipstick analysis will be randomised to one of the following four groups: a single dose of 3 g of fosfomycin, 2 days of 3 g of fosfomycin o.d., 3 days of pivmecillinam 400 mg three times per day (t.i.d) or 5 days of nitrofurantoin 100 mg t.i.d. A total sample of 1120 patients was calculated. The primary endpoint is clinical effectiveness at day 7, defined as cure of symptoms reported by the patients in a diary including four symptoms: dysuria, urgency, frequency and suprapubic pain, which will be scored on a 4-point severity scale (not present/mild/moderate/severe). Follow-up visits are scheduled at days 7 (phone call), 14 and 28 for assessing evolution. Urine samples will be collected in the three on-site visits and urine cultures performed. If positive, antibiograms for the three antibiotics studied will be performed. Bacterial eradication will be measured at days 14 and 28.Ethics and dissemination The study was approved by the Ethical Board of IDIAP Jordi Gol (reference number: 21/173-AC) and Spanish Agency of Medicines and Medical Devices. The findings of this trial will be disseminated through research conferences and peer-review journals.Trial registration number NCT04959331; EudraCT Number: 2021-001332-26.Time schedule January 2022 to April 2023.

Abstract: Background and aims: Growing evidence suggests that the metabolic syndrome (MetS) has both a genetic and environmental basis. To evaluate the possibility of a further genetic analysis, we estimated prevalence rates and heritabilities for the MetS and its individual traits in the adult population of Linosa, a small and isolated Italian Island in the southern-central part of the Mediterranean Sea. Methods and results: The Linosa Study (LiS) group consisted of 293 Caucasian native subjects from 51 families (123 parents; 170 offsprings). The MetS was defined according to NCEP/ATP III criteria and the following prevalence rates were calculated: hyperglycaemia 20.3%; central obesity 34.9%; hypertension 43.4%; hypertriglyceridaemia 29.9%; “low HDL” 56.6%; MetS 29.9%. Waist circumference was significantly related to all the quantitative parameters included in the NCEP/ATP III MetS definition. The MetS showed a heritability of 27% (p =0.0012) and among its individual components, treated as continuous and discrete traits, heritability ranged from 10% for blood glucose to 54% for HDL-cholesterol. Among MetS subtypes, the clustering of central obesity, hypertriglyceridaemia and “Iow HDL” had the highest heritability (31%; p <0.001). Conclusion: These data showed high prevalence rates for the MetS and its related traits in an isolated and small Caucasian population. The appreciable heritability estimates for the MetS and some of its components/clusters in the LiS population might support the observation of genetic factors underlying the pathogenesis of the MetS and encourage further analysis to identify new susceptibility genes. [Copyright &y& Elsevier]

Background: The jejunal mucosa is the major site involved in celiac disease, but modifications have also been found in the gastric, rectal and esophageal mucosa. Few studies have focused on the histomorphological features of the oral mucosa in celiac disease patients. Our objectives were: (i) to assess the presence, quality and intensity of lymphocytic infiltrate in clinically healthy oral mucosa and its relation to celiac disease severity (villous height to crypt depth ratio); and (ii) to detect any other histological features connected to celiac disease. Methods: Twenty-one untreated celiac disease patients (age range 13–68 years) with clinically healthy oral mucosa were enrolled and compared with 14 controls. Intestinal and oral biopsies were carried out and specimens were evaluated after staining with hematoxylin and eosin. Results: Intra-epithelial lymphocyte B and T infiltrates of the oral mucosa were found to be similar in both groups; likewise, intensity of the lymphocytic infiltrate in the lamina propria was similar in both groups and was not related to intestinal damage; important signs of spongiosis were found to be more significantly present in celiac disease patients compared with controls ( P = 0.0002). Conclusions: Our study showed that the healthy oral mucosa of untreated patients does not reflect the intestinal damage by celiac disease, but it is unexpectedly affected by spongiosis, as being detected for the first time in the literature. This latter feature could be related to gliadin ingestion and could contribute to explain the higher susceptibility of celiac disease patients to suffering from oral mucosa lesions. [ABSTRACT FROM AUTHOR]

We present three examples of the use of ELF magnetic therapy, two cases of multiple sclerosis and one of chronic pulmonary disease. In each of the two MS cases the Seqex device was applied as an adjunct to antioxidant medication two times a week for six weeks. Radiological and MRI examination indicated improvement in the two MS patients and stabilization in the patient with obstructive pulmonary disease following merely five treatments. [ABSTRACT FROM AUTHOR]

Introduction Although serum creatinine is a well-recognised marker of prognosis in cirrhosis, it is only an indirect marker of renal function as it is affected by various extra-renal factors. The measurement of glomerular filtration rate (GFR) by the plasma clearance Cr-EDTA is an acceptable substitute of the gold standard of inulin clearance. We assessed the correlations of serum creatinine with GFR measured by Cr-EDTA in patients with cirrhosis in comparison with patients with renal disease. Method We analysed data from 298 consecutive patients who underwent GFR assessment by Cr-EDTA as part of their liver transplant work-up. We collected similar data on 187 consecutive non-cirrhotic patients who attended the renal outpatient clinic. GFR was assessed by bolus infusion of Cr-EDTA and single or serial serum measurements after 2, 4, 6 and 24 h. Spearman test was used to correlate serum creatinine and GFR in renal and liver patients. The significance of the difference between the correlations from the two groups was calculated by transforming the Spearman's r to Fischer's z-score, estimating the SE of difference between the two correlations and finally dividing the differences between the two z-scores by the SE. If the result was 1.96 or higher, then the difference in the correlation was considered significant in the 0.05 level. Results Serum creatinine significantly and inversely correlated with GFR in patients with cirrhosis (r=−0.702, p<0.001) and renal disease (r=−0.856, p<0.001), however the difference of the correlation was significant between patients with renal disease and patients with cirrhosis (p<0.05). When analysis was performed according to gender, there were significant correlations of serum creatinine and GFR in patients with cirrhosis (males r=−0.806 and females r=−0.699) and renal disease (males r=−0.877 and females r=−0.890). Moreover, the difference of the correlation was again significant among male and female patients with renal disease and cirrhosis and notably in male compared to female patients with cirrhosis (p<0.05). Therefore, for a given GFR, patients with cirrhosis have lower serum creatinine values than patients with renal disease. Moreover, female patients with cirrhosis have lower serum creatinine values than male patients with the same GFR. Conclusion Serum creatinine underestimates renal function in patients with cirrhosis compared to patients with renal disease. Serum creatinine cut-offs used to define renal failure in the general population are not applicable to patients with cirrhosis and should be re-evaluated as they systematically underestimate renal function. [ABSTRACT FROM PUBLISHER]

Introduction Hepatocellular carcinoma (HCC) is the main indication for 15% of liver transplants. Currently the criteria used for listing patients are the Milan criteria. However, as waiting time is increasing, patients may fall out these criteria while on the waiting list. Aim We retrospectively evaluated the effect of neo-adjuvant transarterial chemoembolization (TACE) in consecutive patients transplanted for HCC. Method We analysed data from consecutive patients who were transplanted for HCC between 1990 and 2010 as main indication in our unit. Laboratory, epidemiological, radiological and histological data were analysed. Survival was evaluated using multiple regression analysis. Results In total 148 patients were transplanted for HCC, of which 74 had TACE as neo-adjuvant therapy. Mean follow-up post-transplant was 31±29 months (range 1–145). Patients had a mean of 1.6±0.9 (range 1–5) TACE sessions and had a mean waiting list time of 2.5±2.4 months (range 0.5–12.3). TACE response was evaluated in explanted livers as follow: no response in 10 (16%), partial tumour necrosis in 35 (55%) and complete tumour necrosis in 19 (30%). Tumour recurred in 21 (14%) patients in a mean time of 5.1±14 months. Recurrence happened in 2/10 patients who did not respond to TACE, 1/35 who had a partial response and 0/19 who had a complete response (p=0.040). TACE as neo-adjuvant therapy was associated with less recurrence irrespective of histological response (18.3% recurrence in patients who did not have TACE vs 5.6% in patients who had, p=0.037). No serious adverse effects of TACE were noted. Conclusion TACE is an effective neo-adjuvant therapy in patients listed for liver transplantation, as it is associated with significantly less post-transplantation tumour recurrences. As waiting lists are getting longer, its use as a standard neo-adjuvant therapy should be further explored. [ABSTRACT FROM PUBLISHER]