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Objective: The aim of this study is to present a series of 8 patients, describing their clinical picture and assessing their treatment using plantar approach. Methods: We retrospectively assessed 8 patients, all of which had a history of trauma. The clinical characteristics of these cases and postoperative results were investigated. Results: Seven men and 1 woman with a mean age of 29 years were included. The follow-up period ranged from 6 to 28 months (mean 22 months). The deformity manifested from 5 to 24 months after the triggering injuries (mean 9.8 months). The hallux was the only digit affected in 1 patient, while the others presented with involvement of 1 or more small toes. There were no postoperative complications, and patients showed to be satisfied with functional outcomes. Conclusion: Post-traumatic digital flexion contracture is an infrequent disease of unknown etiology. Lengthening of the flexor hallucis longus using a plantar approach, whether at the level of the midfoot or the toe, represents an alternative with satisfactory outcomes. Level of Evidence IV; Therapeutic Study; Case Series.

We report the occurrence of the European Brook Lamprey, Lampetra planeri (Bloch, 1784), in the Lao river in the Calabria region (southern Italy). This record extends the species’ known distribution limit southwards. Information regarding some morphometric and ecological data are provided and discussed.

Parasitological, hematological, and ecotoxicological analyses were carried out on a population of lesser spotted dogfish Scyliorhinus canicula from the central Mediterranean Sea. Parasitological analyses highlighted a poor helminthic community, highly dominated by a single taxon represented by the cestode Nybelinia sp. No differences in the parasitic load between females and males were observed. Hematological analyses showed that the number of leukocytes was significantly lower in the sharks that resulted in parasitism, and this could be due to the ability of some trace elements, such as arsenic, weakening the immune system and exposing animals to a higher risk of parasite infection, although further hematological and parasitological analyses are required on a larger number of samples. Trace elements analyses in the vertebrae, skin, and liver highlighted that the most abundant and potentially toxic elements were lead (Pb), arsenic (As), and cadmium (Cd). Other trace elements were also abundant, such as manganese (Mn), zinc (Zn), nickel (Ni), copper (Cu), and iron (Fe). Pb, As, and Mn showed the highest concentrations in vertebrae, while Cd, Cu, and Zn were the highest in the liver, probably due to their concentration in the prey items of the sharks; Fe and Ni showed the highest concentrations in the skin, due to their presence in the water column, especially along the coast where animals were collected. The concentration of some trace elements analyzed in the vertebrae decreased with the growth of the sharks. These results confirm that elasmobranchs, being predators at the apex of the marine food chain, act as final receptors for a series of polluting elements regularly discharged into the sea.

Objective: To assess the involvement of the hallux interphalangeal (IP) joint after first metatarsophalangeal joint (MTPJ) arthrodesis and propose a treatment consisting of MTPJ resection arthroplasty associated with phalangeal osteotomy or IP joint arthrodesis. Methods: We retrospectively analyzed 9 patients treated with MTPJ resection arthroplasty associated with phalangeal osteotomy or hallux IP joint arthrodesis from November 2006 to January 2017. Results: The main causes of MTPJ arthrodesis that subsequently evolved to IP involvement were severe hallux valgus and sequelae or complications of previous hallux valgus operations. Additionally, the reasons leading to rescue surgery were pain, deformity, and/or discomfort. Conclusion: This therapeutic modality is able to relieve symptoms by a simple procedure, with acceptable functional and esthetic results. Level of Evidence IV; Therapeutic Studies; Case Series.

Objective: To report our experience with intramedullary fixation and osteosynthesis of the tibia with suprapatellar approach and semiextended positioning. Methods: This study retrospectively assessed 6 patients with tibial fracture treated with suprapatellar intramedullary nail fixation and osteosynthesis from September 2015 to September 2018. Results: There was acceptable bone fixation. Mean healing time was 6 months (range: 4-10 months). Postoperative pain was assessed using a visual analog scale, and the knee was divided into 9 quadrants to help locate the specific site of pain; all participants reported that pain was located at distal quadrants. Knee function was completely restored. Conclusion: Suprapatellar approach with the knee in the semiextended position is a good surgical technique for extra-articular proximal tibial fractures or those associated with soft tissue involvement at the conventional infrapatellar entry site. Thus, this analysis led us to believe that the technique should also be applicable to middle diaphyseal fractures or fractures in general, regardless of their location. Level of Evidence IV, Therapeutic Studies; Case Series.

Background: The world, and Italy on the front lines, has experienced a major medical emergency due to the novel coronavirus outbreak. Cancer patients are one of the potentially most vulnerable cohorts of people, but data about their management are still few.Patients and Methods: In this monocentric retrospective study we included all SARS-CoV-2 oncological patients accepted, between March 27th and April 19th 2020, at the Onco-COVID Unit at San Luigi Gonzaga Hospital, one of the few Italian oncological-COVID wards. Data were obtained from medical records.Results: Eighteen cancer patients with COVID-19 were included. The mean (±SD) age of patients was 67 ± 14 years, 89% were men. Seven (39%) developed infection in communities and 11 (61%) during hospitalization. Lung cancer was the most frequent type of cancer (10, 56%). Seven patients (39%) were symptomatic for COVID-19 at the time of diagnosis and symptoms began 2 (±2) days before. The most common were shortness of breath and diarrhea. Fever was present in 5 patients (28%). Among the 11 asymptomatic patients, 8 (73%) became symptomatic during the hospitalization (mean time of symptoms onset 4 days ±4). Six patients (33%) were on active anti-tumor treatment: 2 (33%) received anti-tumor therapy within 2 weeks before the infection diagnosis and 2 (33%) continued oncological treatment after SARS-CoV-2 positivity. Eight (44%) patients died within a mean of 12 days (±8) from the infection diagnosis.Conclusions: Our series confirms the high mortality among cancer patients with COVID-19. The presence of asymptomatic cases evidences that typical symptoms and fever are not the only parameters to suspect the infection. The Onco-Covid unit suggests the importance of a tailored and holistic approach, even in this difficult situation.

La displasia epifisaria hemimélica o enfermedad de Trevor es una deformidad osteocartilaginosa en la región epifisaria. Es poco frecuente y predomina en el sexo masculino. Se desarrolla en la infancia cuando los cartílagos de crecimiento están abiertos, y afecta principalmente el tobillo y la rodilla. Su origen es desconocido. Se presentan tres casos con distinto grado de compromiso y las alternativas terapéuticas. Un solo caso quirúrgico por equino irreductible. Se detallan la técnica quirúrgica, el manejo posoperatorio y el resultado de anatomía patológica. Se recomienda operar sólo a pacientes con alguna limitación funcional o severa deformidades por el alto índice de recidiva.

Background: Luteinized thecoma with sclerosing peritonitis (LTSP) is a very rare condition, and its clinical management is not evidence-based. Here we describe a case of long-term disease control achieved with leuprorelin and tamoxifen therapy. Case presentation: A 18-year-old woman with acute abdomen underwent surgical removal of an ovarian mass and received diagnosis of LTSP. Treatment plan consisted of leuprorelin and tamoxifen, followed by a good instrumental response. After 5 years, leuprorelin was stopped, and the patient continued tamoxifen alone. Ten years after diagnosis, she is still disease free. Conclusion: Even in the absence of solid evidence, the combination of leuprorelin and tamoxifen could be considered as a possible medical treatment of LTSP. Considering the limitations related to the rarity of disease, further studies are needed to improve its management. Keywords: Thecoma, Sclerosing, Peritonitis, Hormonal, Therapy, Ovary

Chondrichthyans are one of the most threatened marine taxa worldwide. This is also the case in the Mediterranean Sea, which is considered an extinction hotspot for rays and sharks. The central position of the Italian peninsula makes it an ideal location for studying the status and changes of this sea. There is a lack of biological, ecological and historical data when assessing shark populations, which is also highlighted in the Red List of Threatened Species compiled by the International Union for the Conservation of Nature (IUCN). Historical data can provide important information to better understand how chondrichthyan populations have changed over time. This study aims to provide a clearer understanding of the changes in distribution and abundance of eight shark species in the Italian seas that are currently classified as at risk of extinction by the IUCN. In this respect, a bibliographic review was conducted on items from the 19th century to the first half of the 20th century, focusing on the selected species. The results show that all sharks were considered common until the beginning of the 20th century but have declined since, with a clear negative trend, mainly in the past 70 years. The strong local decline has been attributed to overexploitation, bycatch, habitat loss, depletion of prey items and environmental pollution. Furthermore, historical data also allow us to avoid the issue of a ‘shifting baseline’, in which contemporary abundances are assumed to be “normal”. Using historical data to further our knowledge of the marine environment is becoming increasingly common, and is fundamental in understanding human impact and evaluating mitigation measures to manage and conserve marine species and environments.

White sharks, Carcharodon carcharias, are often described as elusive, with little information available due to the logistical difficulties of studying large marine predators that make long-distance migrations across ocean basins. Increased understanding of aggregation patterns, combined with recent advances in technology have, however, facilitated a new breadth of studies revealing fresh insights into the biology and ecology of white sharks. Although we may no longer be able to refer to the white shark as a little-known, elusive species, there remain numerous key questions that warrant investigation and research focus. Although white sharks have separate populations, they seemingly share similar biological and ecological traits across their global distribution. Yet, white shark’s behavior and migratory patterns can widely differ, which makes formalizing similarities across its distribution challenging. Prioritization of research questions is important to maximize limited resources because white sharks are naturally low in abundance and play important regulatory roles in the ecosystem. Here, we consulted 43 white shark experts to identify these issues. The questions listed and developed here provide a global road map for future research on white sharks to advance progress toward key goals that are informed by the needs of the research community and resource managers.

Background The blue shark (Prionace glauca, Linnaeus 1758) is one of the most abundant epipelagic shark inhabiting all the oceans except the poles, including the Mediterranean Sea, but its genetic structure has not been confirmed at basin and interoceanic distances. Past tagging programs in the Atlantic Ocean failed to find evidence of migration of blue sharks between the Mediterranean and the adjacent Atlantic, despite the extreme vagility of the species. Although the high rate of by-catch in the Mediterranean basin, to date no genetic study on Mediterranean blue shark was carried out, which constitutes a significant knowledge gap, considering that this population is classified as “Critically Endangered”, unlike its open-ocean counterpart. Methods Blue shark phylogeography and demography in the Mediterranean Sea and North-Eastern Atlantic Ocean were inferred using two mitochondrial genes (Cytb and control region) amplified from 207 and 170 individuals respectively, collected from six localities across the Mediterranean and two from the North-Eastern Atlantic. Results Although no obvious pattern of geographical differentiation was apparent from the haplotype network, Φst analyses indicated significant genetic structure among four geographical groups. Demographic analyses suggest that these populations have experienced a constant population expansion in the last 0.4–0.1 million of years. Discussion The weak, but significant, differences in Mediterranean and adjacent North-eastern Atlantic blue sharks revealed a complex phylogeographic structure, which appears to reject the assumption of panmixia across the study area, but also supports a certain degree of population connectivity across the Strait of Gibraltar, despite the lack of evidence of migratory movements observed by tagging data. Analyses of spatial genetic structure in relation to sex-ratio and size could indicate some level of sex/stage biased migratory behaviour.

Host traits can significantly influence patterns of infection and disease. Here, we studied the helminths parasitizing the Italian edible frog Pelophylax kl. hispanicus, giving special attention to the relationship between parasites and host traits such as sex, snout vent length, weight and body condition. The helminth community was composed of seven species: three trematode species (Diplodiscus subclavatus, Gorgodera cygnoides, Pleurogenes claviger), three nematode species (Icosiella neglecta, Oswaldocruzia filiformis, Rhabdias sp.) and one acanthocephalan species (Pomphorhychus laevis). We found that prevalence was positively correlated with snout-vent length and weight, but did not differ with body condition or sex. We found that prevalence and mean species richness increased with age. Our results show that abundance of Icosiella neglecta was positively correlated with higher values for host body condition. In fact, we found that high prevalence and mean species richness do not necessarily imply poorer body condition in the parasitized host. In conclusion, our results show that the helminth community in this taxon has great diversity, and this host-parasite system seems to be evolved to low levels of virulence, helminths maintaining a commensal relationship with this frog.

This paper reports information about the presence of three allochthonous reptiles species in Calabria: Testudo marginata, Trachemys scripta elegans and Chamaeleo chamaeleon. The first one was found in three sites located in the Catena Costiera Massif and in the Crati Valley (Northern Calabria). The slider turtle was found in seven different sites throughout all the region. It massively colonised the Angitola artificial lake: here, this turtle lives in natural conditions and its reproduction was confirmed by the presence of nests, eggs and hatchlings. C. chamaeleon is present in sandy coastal habitats near Palmi and Gioia Tauro (Southern Calabria). From a conservationistic point of view, serious damages to autochtonous species could be caused by the spreading of T. scripta elegans: this species has already determined the local extinction of Angitola’s Emys orbicularis populations.

[Display omitted] Within the Great Lakes, contaminants of emerging concern (CECs) have been detected in urban surface waters. Understanding the human and ecological health consequences of environmentally-relevant exposures to persistent CECs, particularly as complex mixtures, is essential. Surface water and a limited number of sediment samples were collected over two years (Spring and Fall 2018–2019) at multiple locations in the Lake Huron to Lake Erie corridor to investigate more than 150 CECs. Surface water was analyzed for pharmaceutical and personal care products (PPCPs), pesticides, and per- and polyfluoroalkyl substances (PFAS). Sediment was analyzed for PFAS. Fifty compounds were detected at ng/L or ng/kg levels. Synthetic sweeteners accounted for 55.7% of the cumulative concentration of all compounds detected across sampling events, followed by pesticides (27.5%), pharmaceuticals (11.7%), and stimulants (3.5%), with 14 compounds consistently detected: acesulfame-potassium, sucralose, sulfamethoxazole, acetaminophen, lidocaine, atenolol, gemfibrozil, iohexol, atrazine, diaminochlorotriazine, deethyl-atrazine, deisopropylatrazine, 2,4-Dichlorophenoxyacetic acid, and caffeine. Compound mixtures became increasingly complex downstream and indicated that the downstream Lake Huron to Erie corridor is wastewater effluent-dominated, whereas the aquatic environment associated with Lake St. Clair is influenced by a mixed urban, suburban, and agricultural landscape. These results will inform follow-up studies on persistent contaminant mixtures and multiple stressors, and offer science-based priorities and evaluation objectives for natural resource and public health agencies/initiatives. [ABSTRACT FROM AUTHOR]

Abstract: The morphology and development of the larval oral apparatus of Rana dalmatina, Bombina variegata, Bufo bufo, and Bufo viridis are described and compared using scanning electron microscopy. The species show different arrangements of the mouthparts. The small oral apparatus of R. dalmatina larvae has three labial tooth rows on the upper labium, while there are four tooth rows on the lower labium with a medial gap in row proximal to the mouth. The margins of the oral apparatus are defined by papillae that encircle the lower labium. B. variegata tadpoles have two upper labial tooth rows and three lower labial tooth rows that are uninterrupted, unlike the ones of R. dalmatina. The mouth is encircled by papillae that are larger than those of R. dalmatina. The oral discs of tadpoles of both B. bufo and B. viridis are similar. They are defined by two upper labial tooth rows (the second of which is interrupted by a medial gap) and by three lower tooth rows that differ in lengths in the two Bufo species. Both species develop papillae on the mouth angles and in two rows on the upper labium. Some morphological differences among the oral discs of R. dalmatina, B. variegata, B. bufo, and B. viridis tadpoles can be attributed to phylogenetic differences, but most can be related to their varying feeding habits and/or to their dietary specializations. [Copyright &y& Elsevier]