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Beach sands from the Rosa Marina locality (Adriatic coast, southern Italy) were analysed mainly microscopically in order to trace the source areas of their lithoclastic and bioclastic components. The main cropping out sedimentary units were also studied with the objective to identify the potential source areas of lithoclasts. This allowed to establish how the various rock units contribute to the formation of beach sands. The analysis of the bioclastic components allows to estimate the actual role of organisms regarding the supply of this material to the beach. Identification of taxa that are present in the beach sands as shell fragments or other remains was carried out at the genus or family level. Ecological investigation of the same beach and the recognition of sub-environments (mainly distinguished on the basis of the nature of the substrate and of the water depth) was the key topic that allowed to establish the actual source areas of bioclasts in the Rosa Marina beach sands. The sedimentological analysis (including a physical study of the beach and the calculation of some statistical parameters concerning the grain-size curves) shows that the Rosa Marina beach is nowadays subject to erosion.

The Atlantic surfclam (Spisula solidissima) is a promising candidate for species diversification in the United States Northeast because it is native, grows rapidly, and is relatively recognizable to the public. However, gaps in the surfclam husbandry literature have left aquaculture practitioners without a complete understanding of how to best cultivate this species on commercial scales. In particular, relatively few studies have examined which culture conditions are necessary for rearing juvenile surfclams during the nursery phase. To fill this gap, controlled experiments were conducted to evaluate the efficacy of various gear types that are commonly used to rear other juvenile bivalve species. Specifically, growth and survival of early juvenile surfclams (0.4–2.7 mm) were compared when reared in different gear combinations, including downwellers, upwellers, and bell siphon systems. Similarly, growth and survival of late juvenile surfclams (1.1–18.0 mm) were compared when reared in upwellers and shallow raceways, with and without sand. Sediment accumulation, a proxy for culture cleanliness and system maintenance, was also monitored during the late nursery experiment. Results indicate that multiple rearing methods can effectively produce commercial-scale quantities of surfclams, but flow rate, food availability, and temperature are important factors that can limit gear efficiency. All early nursery gear systems performed similarly, while the late nursery upweller system performed significantly better than both types of shallow raceway systems. This study reinforces the feasibility of surfclams as a culture species that aligns well with the Northeast’s established shellfish farming framework.

Thalassemia is an inherited blood disorder characterized by defective hemoglobin production, ineffective erythropoiesis and chronic hemolytic anemia. Patients with both transfusion-dependent thalassemia (TDT) and non-transfusion dependent thalassemia (NTDT) have risk factors associated with severe SARS-CoV-2 infection including iron overload, endocrinopathies, massive splenomegaly or previous splenectomy and coagulopathy (Motta et al, Am J Hematol, 95: E198-E199., 2020). Although vaccination is encouraged for these patients, data on the efficacy and safety of anti Sars-CoV-2 vaccines are limited (Karimi, M, et al, Br J Haematol, 190: e137-e140, 2020; Mandana Zafari, et al, Hemoglobin, 45:1, 1-4, 2021) due to exclusion of these patients from clinical trials. In a single center, prospective, cohort study we compared 67 patients affected by TDT to 61 healthy controls (HC), matched for age and sex. Study population and HC received two doses of BNT162b2 anti-SARS-Cov-2 mRNA vaccine on days 1 and 21, between April 1st and May 15 th, 2021. Serological tests were performed by a commercially available immunoassay for the quantitative determination of anti-spike IgG antibodies to SARS-CoV-2. The results were reported as Arbitrary Units (AU)/mL, with a cut-off for defining response as 50 or greater AU/ml. Patients and HC samples were collected four weeks after the second dose of vaccine. Median age of patients was 43 years (range 19-77), 39% of them were male and 61% were female. Median age of HC was 39 years (range 19-86), 43% of them were male and 57% were female. All controls achieved a response (50 or greater AU/mL) to vaccination, whereas 66/67 (98,5%) patients responded. Antibody titers were significantly higher (p=0.0005) in the HC group (mean 9863 ± 7784; median 7712, range 1206-51664) compared to patients (mean 7945 ± 12326; median 4025, range 19-89202) (Figure 1). When analyzing the patients' factors, age, sex, transfusion interval, serum ferritin level, and spleen size did not impact on the response to vaccination. With a median follow-up of 12 weeks, no relevant side effects were recorded after vaccination and no case of COVID19 occurred among vaccinated TDT patients. In conclusion, BNT162b2 anti-SARS-Cov-2 mRNA vaccine demonstrated efficacy and safety in our cohort of TDT patients. Response rate was similar to that of HC. Nevertheless, antibody titers in TDT patients were significantly lower than in HC. Further observations are ongoing to assess duration of response, efficacy and possible factors influencing this finding.

Introduction

Protozoa are important enteric pathogens in patients with human immunodeficiency virus (HIV) infection. In this study the prevalence of intestinal protozoa in 154 HIV-infected patients, with or without diarrhoea, in our region (Apulia, South Italy) was evaluated between December 1993 and February 1998. In the majority of patients CD4+ T cell count was below 200/μl. The overall prevalence of intestinal protozoa was 43/154 (27·92%). Twenty-eight (43·08%) out of 65 patients with diarrhoea and 15 (16·85%) out of 89 non-diarrhoeic patients were parasitized. In particular, in the group of 65 patients with diarrhoea the following protozoa were identified: Cryptosporidium parvum in 14 (21·54%), Blastocystis hominis in 7 (10·77%), microsporidia in 6 (9·23%), Giardia lamblia in 4 (6·15%) and Isospora belli in 1 (1·54%). Three patients were Cryptosporidium parvum-microsporidia co-infected. In patients without intestinal symptoms, prevalence was 3/89 (3·37%) for Cryptosporidium parvum, 9/89 (10·11%) for Blastocystis hominis, 1/89 (1·12%) for microsporidia and 2/89 (2·25%) for Giardia lamblia. A significant (P<0·001) correlation was observed between protozoan infection and the presence of diarrhoea. In particular, Cryptosporidium parvum and microsporidia infections were significantly (P<0·001) and P=0·046, respectively) associated with diarrhoeal illness. Moreover, the majority of cases of cryptosporidiosis were first diagnosed in the periods of heaviest rainfall. Therefore, drinking water contamination may be a possible source of human infection in our area.

ABSTRACTSince 2017, 10 vaccines are compulsory for newborns in Italy and unvaccinated children are not admitted to kindergartens. Recently the Italian Government announced the perspective of reforming the law about the compulsory vaccination. A debated started about the presence, in the same class of the schools, of unvaccinated and immunocompromised children. Cancer is the one of the most important cause of immunodepression among children: after the chemoterapy, there is a period of 13–23 months in which the cancer survivors have to come back at the school and at to the “normal life” (even for psychological exigency) but remain at risk of infectious disease for the immunodepression. The most important chance to protect this subgroup of patients remains the herd immunity.

•Juvenile surfclam survival and growth were optimized at 20 °C.•Colder water increases survival but slows growth; warmer water can cause mortality.•Variation across clam cohorts suggests parentage influences temperature tolerance.•Commercial surfclam seed production is feasible in the Northeast USA.

No relevant conflicts of interest to declare.

We evaluated the effect of ketoconazole (KT) treatment in two adolescents with pituitary dependent Cushing's disease. Case 1 :a girl, aged 12.9 years, was given orally KT (200 mg/day), which induced a significant decrease of plasma cortisol levels for 3-4 months (mean±SD: 29.1±8.3 at start vs 6.2±1.2 µg/dl at 3 months, p<0.01; blood samples were taken at 4-h intervals, 8 a.m.-12 p.m.) but not after 6 months(24.2 ± 4.0 µg/dl), despite an increase of KT dose up to 600 mg/day. Mean plasma ACTH levels were 36.2±4.7, 23.2±8.5 and 30.2±14.2 pg/ml, at start, 3 and 6 months, respectively. Similarly, in Case 2, a boy aged 14.8 years, KT (400 mg/day) reduced mean plasma cortisol levels for 3 months (25.8±2.3 vs 18.8±2.7 µg/dl; p<0.005) but not after 6 months (30.7±5.3 µg/dl), again despite an increase of KT dose up to 1000 mg/day. Mean ACTH levels remained unchanged for 3 months (45.1±5.3 at start vs 40.6±12.8 pg/ml at 3 months), but increased after 6 months (73.5±3.8 pg/ml; p<0.005 vs initial values). Both patients showed a good clinical improvement with reduction of body weight and normalization of blood pressure for six months; KT was well tolerated. Coincident with the reoccurence of clinical symptoms, magnetic resonance features of pituitary microadenoma became evident at six months and both patients underwent transsphenoidal surgery. Our experience shows that Ketoconazole may have a short reducing effect on plasma cortisol in children with pituitary dependent Cushing's disease while awaiting therapeutic surgery.

The efficacy of GH-therapy(GHT)in isolated GH-dcficient children (GHD)could depend on interactions between GH-SH axis and their receptors(R). The aim of our study is to evaluate the effect of short term (ST) GHT on erythrocyte IgF1 receptors (ER). ER were assayed in 8 never GH treated GHD, 3-12 y. old, before (B), 1 week(1w), 2 and 3 months(m) after the start of GHT(synthetic GH, Saizen, Serono: 0.5 U/Kg/week in 3 divided doses s.c). Controls(C) were 6 age-matched normal children. ER were assayed in duplicate modifying Gambir's technique (Diabetes 27: 701, 1978). Standard IgFl was provided by Nuesch and Scheibli(Ciba-Geigy) and tracer IgFl by Amersham. We evaluated specific binding (SB) and, by Scatchard analysis, the nuabcr of receptorial sites per cell (RS). Mann-Whitney test was applied. SB and RS were lower in GHD than in C before and after 1w(p < 0.01), 2m (p<0.025 and <0.01 respectively) and 3m(p<0.01 and =0.05 respectively) of GHT. SB increased after 3m of GHT(B vs 3m:p < 0.01, 2m vs 3m:p<0.025). RS increased after 3m of GHT(B vs 3m:p=0.05). A regulation of IgFl R number by SM levels has been hypothesized “in vivo” in monocytes of newborns (Rosenfeld JCEM 48:456, 1979) and in GHD because of a IgF1 R decrease after a ST GHT (Rosenfeld JCEM 52:759, 1981). Our data do not confirm this effect of ST GHT, showing an increase of SB and RS after a 3 m GHT. Further studies are needed to confirm our preliminary data, to clarify their physiological significance and to elucidate if variations found in, not primary target cells for SM could reflect changes in critical target cells.

We determined GH release after 2 GRF tests (synthetic GRF, 1-44s, Sanofi, France) with 1 (GRF1) and 2 (GRF2) μg/Kg i.v. in 14 clinically prepubertal children affected by a partial (GH peak between 3 and 7 ng/ml) (PIGHD) (6 children) or total (GH peak < 3 ng/ml) (TIGHD) (8 children) isolated idiopatic GH-deficiency. GRF tests were performed in a casual succession with a 24 hour interval, at 9 a. m.. 9 children had a GH peak > 10 ng/ml (R): 6 children to both GRF tests and 3 children only to GRF1 (in 1 case it was the 1st test and in 2 cases the 2nd one); 5 children had a GH peak < 10 ng/ml to both GRF tests (no-R). All PIGHD and 3 TIGHD were in R-group. GH peak was higher in PIGHD (18.7 ± 9.2 ng/ml) than in TIGHD (9.2 ± 6.1 ng/ml) (p < 0.05). No significant correlation was found between GH peaks during conventional tests and GRF tests in R-group. Our data show that: -1 μg/Kg of GRF i.v. is able to evoke the serun maximal GH increase -there is no difference in GH peak according to the sequence of GRF stimulation and to the sex -R and no-R show a similar pattern of growth both before and during GH therapy-chronological, height and bone age do not affect the GH release after GRF -TIGHD is more frequently pituitary-dependent than PIGHD. We conclude that GRF test is not a reproducible test in GH-deficient children; therefore it is necessary to repeat it at least twice to exclude a hypophyseal source of GH-deficiency.

Glucose tolerance(GT) and ß-pancreatic function(PF) were both eva luated transversally in 18 thalassemia major children (Th) on i.m. or s.c. injection of DFO by OGTT. A longitudinal study was performed on 5 of them. Our data show a progressive impairment of GT (po sitive correlations between glycemic (BG) values and age, GT reduced in 25% of 6-10 y. Th and in 60% of 10-16 y. Th). This seems to depend on: 1) a progressive impairment of PF (slight insulin(IRI) increase in Th over 6 years with respect to control children (C), presence of positive correlations between IRI, C-peptide (Cp) and IRI/BG ratio values and age only in C); 2) a precocious impairment of IRI metabolism (greater IRI and IRI/Cp ratio basal values in 6-10 y. Th than in C, positive correlations between BG and IRI both as basal and as 30 min. values in C and between BG and Cp as 30 min. values in Th) probably secondary to a precocious liver damage (positive correlations between 60 and 120 min. BG values and some liver function tests). Only the PF impairment seems to be reversible and ferritin-dependent (positive correlations between variations in BG and IRI values and variations in ferritin (FE) values in the longitudinal study, in absence of any difference in individual sensitivity; absence of any correlation between variations in liver function tests and variations in FE levels).