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BACKGROUND: The prenatal diagnosis of an isolated congenital heart defect is a matter of concern for parents. The decision of whether to terminate the pregnancy according to the different types of congenital heart defects has not been investigated yet.OBJECTIVE: This study aimed to evaluate the frequency of voluntary termination of pregnancy after the prenatal diagnosis of a congenital heart defect in a tertiary care center.STUDY DESIGN: This was a retrospective study of patients who were referred to our center from January 2013 to December 2019, underwent fetal echocardiography, and were counseled by a perinatologist and a pediatric cardiologist. The following data were collected: prenatal diagnosis, including genetic testing; gestational age at diagnosis; and outcome of pregnancy. The diagnoses were stratified retrospectively according to the type of congenital heart defect and its severity (low complexity, moderate complexity, and high complexity) by a perinatologist and a pediatric cardiologist.RESULTS: Of 704 women who received a diagnosis of fetal congenital heart defect, 531 (75.4%) were seen before 23 weeks' gestation, which is the upper limit imposed for the termination of pregnancy by the Italian legislation. Congenital heart defects were apparently isolated in 437 of 531 cases (82.3%). Overall, 108 of 531 patients (20.3%) requested a termination of pregnancy. The rate of termination of pregnancy was found to vary according to the severity of congenital heart defects: low complexity, 0%; moderate complexity, 12.1%, and high complexity, 33.2% (P

Introduction: Coarctation of the aorta (CoA) is common and can lead to neonatal emergency. Despite its burden, antenatal detection of this condition remains inaccurate. Objective: To evaluate the diagnostic performance of fetal echocardiography and to design a scoring system for risk stratification of CoA in suspected cases. Design: A retrospective cohort study. Setting: S. Orsola Hospital, Bologna, Italy. Population: About 140 fetuses referred for suspected CoA to our tertiary center in a 9-year period. Methods: The following parameters were systematically obtained at fetal echocardiography: ventricular disproportion, great vessels asymmetry, transverse aortic arch hypoplasia, flow turbulence, and Z-scores of the ascending aorta and of the aortic isthmus. Associated anomalies were recorded, if present. When CoA was not confirmed at birth, neonates were followed up for 12 months to identify also a tardive onset of this condition. Main outcome measures: The primary outcome was the presence of COA after birth. Results: 108 fetuses were eligible for the purpose of the study. CoA was confirmed postnatally in 55 neonates (50.9%). Arch hypoplasia yielded the highest correlation with CoA. The affected neonates presented also significantly lower Z scores of the ascending aorta and of the aortic isthmus. Earlier gestational age at referral was positively correlated with neonatal CoA. An odds ratio-based multiparametric model was designed to build a scoring system (AUC 0.89). Conclusion: In our cohort, no single ultrasound parameter was sufficiently accurate to predict postnatal CoA. The scoring system permitted a better identification of the affected fetuses.

The influence of human activities on the role of inland waters in the global carbon (C) cycle is poorly constrained. In this study, we investigated the impact of human land use on the degradation of terrestrial dissolved organic matter (DOM) and its potential impact on bacterial respiration in ten independent catchments of the Lake Geneva Basin. Sites were selected along a gradient of human disturbance (agriculture and urbanization), and we monitored bacterial respiration in parallel to DOM bioavailability. Fluorescence spectroscopy was used to determine the influence of human land uses on DOM sources and composition as well as the dynamic of degradation or production of the fluorophores identified in our study sites. Higher bacterial respiration measured in agro-urban streams related to a short-term bioreactive pool (0–6 days of incubation) from autochthonous origin, whose the size increased with human disturbance. On the other hand, the degradation of terrestrial DOM was not impacted by human activities and was not found to contribute substantially to aquatic bacterial respiration. Although human land uses controlled DOM sources, composition and bioavailability at the basin scale, our results showed that human activities in the Lake Geneva Basin had a limited impact on the net C exchanges between inland waters and the atmosphere related to DOM mineralization. Considering that greater proportion of autochthonous-DOM signature is a common feature in human-impacted catchments, the implications of our results likely apply more widely. Yet, on a global scale, the influence of human activities remains to be determine given the large diversity of effects of agriculture and urbanization on freshwater DOM depending on the local environmental context.

The rates of gross primary production (GPP), ecosystem respiration (R), and net ecosystem production (NEP) provide quantitative information about the cycling of carbon and energy in aquatic ecosystems. In lakes, metabolic rates are often diagnosed from diel oxygen fluctuations recorded with high-resolution sondes. This requires that the imprint of ecosystem metabolism can be separated from that of physical processes. Here, we quantified the vertical and temporal variability of the metabolic rates of a deep, large, mesotrophic lake (Lake Geneva, Switzerland–France) by using a 6-month record (April–October 2019) of high-frequency, depth-resolved (0–30 m) dissolved oxygen measurements. Two new alternative methods (in the time and frequency domain) were used to filter low-frequency basin-scale internal motions from the oxygen signal. Both methods proved successful and yielded consistent metabolic estimates showing net autotrophy (NEP = GPP − R = 55 mmol m −2 day −1) over the sampling period and depth interval, with GPP (235 mmol m −2 day −1) exceeding R (180 mmol m −2 day −1). They also revealed significant temporal variability, with at least two short-lived blooms occurring during calm periods, and a vertical partitioning of metabolism, with stronger diel cycles and positive NEP in the upper ∼10 m and negative NEP below, where the diel oxygen signal was dominated by internal motions. The proposed methods expand the range of applicability of the diel oxygen technique to large lakes hosting energetic, low-frequency internal motions, offering new possibilities for unveiling the rich spatiotemporal metabolism dynamics in these systems.

BACKGROUND Hypoxia caused by inadequate intracardiac mixing owing to a restrictive foramen ovale is a potentially life-threatening complication in neonates with dextro-transposition of the great arteries. An urgent balloon atrial septostomy is a procedure of choice in such cases, but dependent on the availability of a 24-hour interventional cardiology facility. The prenatal identification of predictors for an urgent balloon atrial septostomy at birth would help in optimizing the management of these neonates, minimizing the risk of hypoxic damage. OBJECTIVE This study aimed to predict with prenatal echocardiography the need of urgent balloon atrial septostomy in neonates with dextro-transposition of the great arteries. STUDY DESIGN This was a retrospective cohort study of patients with a prenatal diagnosis of transposition of the great arteries that were delivered in our center between 2010 and 2019, for whom fetal ultrasound echocardiograms obtained at less than 3 weeks before delivery were available. The following parameters were systematically obtained at fetal echocardiography: size and appearance of the foramen ovale, septum primum excursion (foramen ovale flap angle at the maximal excursion), diameters of the atria, and size of the ductus arteriosus. Balloon atrial septostomy was defined as urgent if performed within 12 hours from birth in neonates with restrictive foramen ovale. Neonatal follow-up was obtained through medical records analysis. RESULTS From November 2007 to April 2019, 160 fetuses with complete transposition of the great arteries were referred to our echocardiography laboratory and 60 of these were included in the analysis; 27 underwent urgent balloon atrial septostomy, 11 elective balloon atrial septostomy, and 22 no balloon atrial septostomy. The size of the foramen ovale was the best predictor of an urgent balloon atrial septostomy. A measurement of >6.5 mm had a sensitivity of 100% and a false positive rate of 45%. CONCLUSION Fetal echocardiography predicts the need of an urgent balloon atrial septostomy in fetuses with dextro-transposition of the great arteries although with a limited precision. In our experience, a measurement of the foramen ovale within 3 weeks of delivery had the greatest accuracy.

Objective: Maternal plasma is a source of circulating placental nucleic acids. This study was designed to detect aberrantly expressed placental mRNA genes circulating in the maternal plasma of pregnancies affected with fetal conotruncal anomalies (CNTRA) and left-ventricular outflow tract (LVOT) obstruction in the second trimester of pregnancy. Methods: This was a retrospective monocentric study conducted from 1 Jan 2016 to 31 Dec 2016. NanoString technology was used to identify aberrantly expressed genes, comparing 36 women carrying a fetus with CNTRA or LVOT obstruction to 42 controls at 19–24 weeks of gestation. The genes with differential expression were subsequently tested using real-time polymerase chain reaction. Linear discriminant analysis was used to combine all the mRNA species with discriminant ability for CNTRA and LVOT obstruction. A multivariable receiver operating characteristic (ROC) curve having the estimated discriminant score as an explanatory variable was generated for the two affected groups versus controls. Results: Three genes with differential expression, namely MAPK1, IQGAP1 and Visfatin were found. The ROC curves yielded detection rates of 60 and 62.5% at a false-positive rate of 5% for CNTRA and LVOT, respectively. Conclusions: These data suggested that molecular screening of CNTRA and LVOT obstruction in the second trimester is feasible. Prospective studies are needed to test the discriminant ability of these genes and to calculate the predictive positive value in the general population.

The Gulf of La Spezia (northern Tyrrhenian Sea, Italy) is a commercially important area both as a shipping port and for mussel farming. Recently, there has been increased concern over environmental disturbances caused by anthropogenic activities such as ship traffic and dredging and the effects they have on the health of farmed mussels. This paper reports the results of microbiological and histological analyses, as well as of measurement of several biomarkers which were performed to assess the health status of mussels (Mytilus galloprovincialis) from four rearing sites in the Gulf of La Spezia. Mussels were collected between October 2015 and September 2016 and histological analyses (including gonadal maturation stage), as well as the presence of pathogenic bacteria (Vibrio splendidus clade, V. aestuarianus and V. harveyi), viruses (Herpes virus and ostreid Herpes virus 1) and protozoa (Marteilia spp., in the summer season only) were carried out on a monthly basis. Conversely, biomarker responses in haemocyte/haemolymph (total haemocyte count, haemocyte diameter and volume, lysozyme and lactate dehydrogenase activities in cell-free haemolymph, and micronuclei frequency) and in gills and digestive gland (cortisol-like steroids and lipid peroxidation levels), were evaluated bimonthly. Microbiological data indicated that mussels contain a reservoir of potentially pathogenic bacteria, viruses and protozoa that in certain environmental conditions may cause a weakening of the immune system of animals leading to mortality episodes. The percentage of parasites detected in the mussels was generally low (9.6% for Steinhausia mytilovum, that is 17 samples out of 177 examined females; 3.4% for Proctoeces maculatus; 0.9% for Mytilicola intestinalis and 2% for ciliated protozoa), while symbiont loads were higher (31% for Eugymnanthea inquilina and Urastoma cyprinae). Interestingly, a previously undescribed haplosporidian was detected in a single mussel sample (0.2%) and was confirmed by in situ hybridization. Cells morphologically similar to Perkinsus sp. trophozoites were observed in 0.7% of the mussels analysed; however, infection with Perkinsus spp. could neither be confirmed by ISH nor by PCR. Different pathological aspects, such as host defence responses and regressive/progressive changes were detected in the gills, digestive glands, gonads and mantle. Only one single case of disseminated neoplasia (0.2%) was observed. As for the biomarker evaluation, the MANOVA analysis revealed the statistically significant effect that the variable "sampling site" had on the biological parameter measured, thus suggesting that the multibiomarker approach was able to differentiate the rearing sites.

Objectives: To predict neonatal outcome in cases with complete transposition of the great arteries (TGA) basing on foramen ovale (FO) morphology at fetal echocardiography. The primary outcome was the necessity of urgent Rashkind procedure. Methods: This was a retrospective cohort study. Patients referred to our tertiary centre for suspected complete TGA in a 12‐year period.The following parameters were systematically obtained at fetal echocardiography at 34–37 weeks: presence of restrictive (FO), FO diameter, right atrium diameter. Neonatal follow‐up was obtained through medical records analysis. Results: From November 2007 to April 2019, 71 fetuses with complete TGA were referred to our echocardiography laboratory. Of these, three were lost at follow up. Of the 68 remaining cases, 31 underwent urgent Rashkind procedure, 22 elective Rashkind procedure and 15 no procedure. Cases with restrictive FO had a significantly higher risk of urgent Rashking procedure compared with cases with normal FO (p below 0.05). Cases with smaller FO diameter and larger right atrium at fetal echocardiography had a significantly increased risk of urgent Rashkind procedure (p below 0.05). Conclusions: In cases with complete TGA a restrictive or narrow FO and a large right atrium at fetal echocardiography are associated with a worse neonatal outcome.

Infection during pregnancy is common and the developing fetal brain is vulnerable to vertical transmission due to immaturity of the fetal immune system. Infection is a major cause of multiple organ abnormalities, including the neuraxis, due to the neurotropism of the infectious agents. This review sets out to give an overview of fetal infection, review the general principles of the nature and timing of the infectious insult with respect to outcomes, review the neuroimaging of infection by ultrasound and magnetic resonance imaging (MRI), and review the various pathogens involved, including the two most common, cytomegalovirus (CMV) and Toxoplasma, and also other common viral and nonviral infections.

La malattia nodulare branchiale (NGD) rappresenta uno dei maggiori problemi sanitari negli allevamenti italiani di trota iridea (Oncorhynchus mykiss). Episodi di NGD sono stati descritti in passato in salmerini alpini (Salvelinus alpinus) e salmoni reali (Oncorhynchus tshawytscha) allevati in acqua dolce. A marzo 2017, durante un monitoraggio di NGD in trote iridee nella Provincia di Trento, sono stati osservati i primi casi di malattia nodulare branchiale nella trota fario. Le trote fario infette provenivano da due allevamenti dove erano contemporaneamente presenti episodi di NGD nelle trote iridee. I pesci, di taglia compresa tra i 20-25 g (vasca 1) e 40-45 g (vasca 2), venivano allevati in vasche a fondo naturale alimentate con acqua di pozzo e sorgente. La temperatura dell’acqua variava da 5,5 a 7,2°C nella vasca 1 e da 8,9 a 11,2°C nella vasca 2. Da ogni vasca sono stati prelevati mensilmente 25 pesci a marzo, aprile e maggio 2017 per un totale di 150 soggetti. Le trote sono state sottoposte ad esami necroscopici ed analisi microscopiche. Le branchie sono state sezionate e fissate in formalina tamponata al 10% per l’esame istologico. In seguito i campioni sono stati processati, inclusi in paraffina, sezionati a 4 μm e colorati con soluzione di Giemsa. Le trote fario osservate in vasca non mostravano né grave sintomatologia respiratoria né alte mortalità tipiche di NGD nelle trote iridee. In 53 pesci su 150 sono state osservate branchie dall’aspetto rigonfio e pallido con presenza di noduli biancastri lungo gli apici dei filamenti. Microscopicamente le branchie colpite mostravano reazioni proliferative a carico dei filamenti con fusione delle lamelle, specialmente nelle porzioni distali. Le lesioni descritte, sia a livello macroscopico che microscopico, erano tipiche delle infezioni da NGD. L’esame microscopico ha permesso di osservare trofozoiti di amebe (di diametro di circa 15 x 20 μm) lungo la superficie dei filamenti iperplastici. Le analisi istologiche hanno evidenziato iperplasia ed ipertrofia dell’epitelio branchiale e delle cellule mucipare, necrosi e presenza di amebe lungo la superficie dei filamenti in 32 trote su 150 campionate. Nonostante l’assenza di gravi sintomatologie respiratorie e di alte mortalità, le alterazioni proliferative delle branchie associate alla presenza di amebe hanno mostrato come anche la trota fario possa essere interessata dalla malattia nodulare branchiale. Ulteriori studi appaiono necessari per chiarire gli aspetti eziopatogenetici della NGD in questa specie ed il suo coinvolgimento nella diffusione della patologia nelle troticolture italiane.

Le microsporidiosi ittiche rappresentano problematiche di rilievo sanitario e commerciale nel settore ittico e sono sostenute da parassiti endocellulari obbligati a trasmissione diretta. Alcuni generi di microsporidi si caratterizzano per la formazione di una struttura denominata xenoma, che rappresenta uno stato di iperbiosi della cellula parassitata abnormemente ipertrofica e spesso visibile anche macroscopicamente. Con il presente lavoro si intende riportare l’attenzione sulla microsporidiosi da Loma salmonae (Microsporidia) nella trota iridea (Oncorhynchus mykiss), malattia che in Italia è probabilmente sottostimata per il suo decorso apparentemente sub-clinico. In una troticoltura intensiva del nord Italia nel corso del 2016-2017, durante alcuni campionamenti eseguiti a scopo diagnostico in corso di episodi di mortalità, sono stati osservati numerosi esemplari di trota iridea che all’esame anatomo-patologico mostravano anemia branchiale e, all’apertura della cavità corporea, un esteso emopericardio. All’esame microscopico a fresco delle branchie si evidenziavano formazioni cistiche a carico dei filamenti e delle lamelle che, ad elevato ingrandimento, presentavano ammassi di piccole spore riferibili a microsporidi. Porzioni di branchie e di organi viscerali sono state quindi fissate in formalina tamponata al 10% e sottoposte ad esame istologico. Il quadro istopatologico ha permesso di confermare nelle branchie la presenza diffusa di formazioni cistiche morfologicamente riferibili a xenomi e contenenti all’interno spore di microsporidi, presumibilmente riferibili alla specie Loma salmonae. Nei filamenti branchiali gli xenomi apparivano all’interno delle arteriole a carico dell’endotelio; a livello delle lamelle i capillari risultavano dilatati per la presenza degli xenomi, che presentavano una sottile parete. Nel cuore si rilevavano, fra gli eritrociti presenti nella cavità atriale e ventricolare, spore libere aggregate o singole e talvolta circondate da una sostanza eosinofila fibrillare. Rare spore sono state riscontrate nell’epicardio del ventricolo in presenza di estesa reazione flogistica con infiltrazione linfocitaria e macrofagica. Si osservavano alcuni xenomi anche nel parenchima splenico circondati da linfociti e con presenza di cellule giganti multinucleate. Il rene non presentava lesioni di rilievo correlate alla presenza di rari microsporidi. Dalle numerose descrizioni presenti in letteratura i parassiti reperiti nelle branchie e a livello cardio-circolatorio rappresenterebbero rispettivamente spore e stadi merogonici morfologicamente riferibili a Loma salmonae. In base alle nostre conoscenze non risultano descritti attualmente in Italia casi di microsporidiosi da L. salmonae nelle trote, sebbene diversi colleghi ne testimonino la presenza in numerosi allevamenti sul territorio nazionale. Alla luce dell’importanza di L. salmonae in salmonicoltura, in particolare nei salmoni del genere Oncorhynchus, quale causa primaria di mortalità e di marcato peggioramento degli indici produttivi, ulteriori indagini si rendono necessarie per chiarire il ruolo di questi microrganismi come agenti primari di malattia nella trota iridea oppure in grado di esacerbare/predisporre ad altre patologie.

Introduction: Nodular gill disease (NGD) represents one of the most serious pathology affecting freshwater farmed rainbow trout (Oncorhynchus mykiss) in Italy. This disease has also been observed in arctic char (Salvelinus alpinus) and Chinook salmon (Oncorhynchus tshawytscha) cultured in freshwater environment. The first case of branchitis associated with amoebic infection is detected in farmed brown trout (Salmo trutta L.) in March 2017, during an investigation of NGD in rainbow trout in the province of Trento (Northern Italy). Methodology: In a NGD affected rainbow trout farming an outbreak of low mortality occurred in brown trout in one earth tank supplied by spring water with temperature of 6°C. The average weight of the fish was 20-25g. Twenty five fish from the affected tank were collected for necropsy, microscopical and parasitological analysis. Gills were dissected and fixed in 10% neutral buffered formalin solution for histological examination. The samples were dehydrated, embedded in paraffin wax, sectioned (4 μm) and stained with Hematoxylin Eosin and Giemsa solution. Results: The fish did not exhibit the typical respiratory symptoms described in NGD of the rainbow trout. The gill tissue appeared pale and swollen at the necropsy with whitish nodules in 9 out of 25 sampled trout. Microscopically numerous Gyrodactylus spp. were observed on the skin. The affected gills showed a proliferative reaction of some filaments, especially in the distal part. These lesions were typical of NGD infection. The microscopic examination of gill tissue revealed the presence of amoebic organisms (approximately 15 x 20 μm). The histology showed multi-focal epithelial hyperplasia of the gills causing lamellar fusion, mucous cells hypertrophy, cellular necrosis and presence of limited number of amoebae along the surface of the affected filaments in 6 out of 25 collected gills. Conclusions: Despite absence of respiratory symptoms and high mortality rate, gill proliferative lesions associated with amoebae shows that brown trout may be affected by nodular gill disease. Studies are in progress to clarify pathogenesis, biological and environmental determinants of NGD in brown trout and to define the involvement of this species in the spread of the disease in Italian trout farms.

Meagre (Argyrosomus regius) represents a promising fish species for the diversification in European aquaculture, on the basis of its rapid growth performances. Nevertheless, there are still several bottlenecks for optimization of meagre production, among which the Systemic Granulomatous Syndrome (SGS) is considered a widespread emerging threat. In order to evaluate the impact of SGS on the health of farmed meagre in Croatia, a histopathological investigation has been carried out. A total of 98 meagres were monthly sampled during the period July 2015-May 2016 from three cages with different feeding protocols: commercial pellet, hydrated commercial pellet and frozen sardines. From each sampled fish, portions of gills, stomach and intestine, liver, kidney, spleen and heart were fixed in 10% neutral buffered formalin and processed for histology. The SGS has been observed in the meagre from the 3 cages throughout the period under study. Few days after introduction of 6 g fish from a foreign hatchery, the SGS was already evident, with a disseminated granulomatosis in the kidney, mild granulomatosis in the liver and macrovacuolar hepatic steatosis. No significative differences in the fish from the three different cages have been observed, as well as a worsening of granulomatosis throughout the study period. In general, in all the examined fish the kidney and, to a lesser extent, the liver were the organs principally affected by SGS, with mild to severe granulomatosis, usually disseminated, in some case with coalescent granulomas. In the liver, the observation of macrovacuolar steatosis was constant. Based on histological observation and the few data from literature, SGS in meagre seems to be a pathological condition caused by concurrent factors, such as the presence of a Calcium/ Phosphorus imbalance (high CO2), worsened by the co-occurrence of a particularly susceptible life stage (0+ juvenile) and influenced by cold-water temperatures during winter period.When the ongrowing phase starts with fish showing an already established SGS during the nursery/hatchery phase, it greatly hampers health and productivity of meagre during the following production cycle. An improvement of knowledge on the optimization of diet in farmed meagre and related health issues is necessary to overtake one of the main bottlenecks that still limit the productivity of meagre.

Introduction: In the latest years the nodular gill disease (NGD) is one of the most serious health problem in rainbow trout cultured in Northern Italy. This disease caused by amoebae has been reported to affect salmonids farmed in freshwater environment of Northern Europe and North America. Relatively little is known about epidemiology and pathogenesis of NGD. Methodology: To clarify the possible risk factors related to the occurrence of NGD, a study area (province of Trento - Northern Italy) was identified where an epidemiological investigation at farm level was planned. Data required were collected during onsite visits by a veterinarian. A standardized questionnaire, implemented and tested during the first steps of the project, is being used for data collection. Information on disease status, species stocked, farm activities undertaken, risk factors related to NGD introduction and spread are included in the questionnaire together with data on management practices and biosecurity measures applied at farm level. Anamnestic and clinical information related to the health status of each farm are reported in the questionnaire. To assess distances from case farms identified as hazards and upstream-downstream proximity to other farms, data on the location of farms, stored in a regional web GIS, will be available. A database will be implemented in order to validate, store and analyze the data collected during the project. Data collection started in November 2017 and is still in progress. To understand the pathogenesis of NGD three tanks, respectively from three trout farms located in the province of Trento, were monitored every fifteen days from September 2016 to March 2017. Ten fish from each tank (five samples at the inlet and five at the outlet) were taken during each monitoring phase and subjected to necropsy and to microscopic and histological examination of the gills. Expected results: The epidemiological investigation provides information about the real diffusion of NGD in the province of Trento and identify the factors that may favor the development of disease. The study of pathogenesis could reveal the timing and mode of NGD development.

The humphead wrasse, Cheilinus undulatus, also known as Napoleon wrasse or Maori, is one of the giant coral reef fish of the Indo-Pacific Area. In public aquaria C. undulatus is frequently exhibited for its huge body size, longevity and as a conservation ambassador of reef ecosystems. The knowledge about diseases of this precious and rare fish species is very limited and only a few disorders have been reported in literature. In May 2008 one humphead wrasse was introduced to the Cattolica Aquarium, Italy and exhibited in a 56,000 l tank together with a mixed population of teleosts, sharks and rays. In February 2017 the fish, weighing 15 kg, died and no clinical signs were observed in the days before its death. The fish was immediately necropsied and standard parasitological, bacteriological and histological exams were carried out in order to investigate causes of death. At necropsy, fish showed slightly pale gill and the presence of a severe fibrinous peritonitis. In the posterior part of the kidney, a diffuse area of necrosis with suppurative-like aspect was also observed. No gross lesions were noticed in other organs and no parasites have been found both macro and microscopically. After 24 h of incubation at 25±1°C, from all the inoculated organs (kidney, spleen, liver and brain) a number of morphologically similar colonies grew on TSA+1.5% NaCl and TCBS plates respectively. The isolates were identified as Vibrio harveyi and antibiotic sensitivity test was performed by Kirby-Bauer disk diffusion method. Histological exams showed the presence of bacterial aggregatesassociated to necrosis in most of the internal organs, especially in the kidney. Macrovacuolar liver steatosis was also observed. Furthermore several elongated fungal hyphae were found only in liver blood vessels. This case is to our knowledge the first report of systemic infection by Vibrio harveyi in a humphead wrasse and highlights the potential pathogenic role of these microorganisms in fish kept under confined condition.

Objective To assess the risk of 22q11.2 deletion in fetuses with a prenatal diagnosis of right aortic arch without intracardiac anomalies (RAA-no ICA). Methods This was a retrospective study of all fetuses with RAA-no ICA diagnosed prenatally at three referral centers, between 2004 and 2014. A detailed sonographic examination was performed in each case, including visualization of the thymus and of the head and neck vessels to identify the presence of an aberrant left subclavian artery (ALSA). Karyotyping and fluorescence in situ hybridization analysis for diagnosis of 22q11.2 deletion were always offered either prenatally or postnatally. Clinical and echocardiographic examinations were performed in livebirths and a postmortem examination in cases of termination of pregnancy. Results During the study period, 85 fetuses were diagnosed prenatally with RAA-no ICA. Genetic or clinical data were not available for three cases and these were excluded from analysis. 22q11.2 deletion was found in 7/82 cases (8.5% (95% CI, 3.8–17.3%)). The thymus was small or non-visualized in all seven cases and additional abnormal sonographic findings were present in four. Conclusion 22q11.2 deletion is present in a clinically significant proportion of fetuses with a prenatal diagnosis of RAA-no ICA. In such cases, a detailed sonographic examination, with assessment of the thymus in particular, may be useful to further define the level of risk for 22q11.2 deletion. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.