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Here we revise all the paleontological sample of Notarchirico, including historical collections and new findings collected during 2016-2023 excavations. Notarchirico is one of the most significant sites for the study of human evolution and terrestrial ecosystem dynamics during the Early-Middle Pleistocene Transition, preserving nearly 100.000 years of environmental and climatic changes constrained between 695 ± 6 ka and 614 ± 12 ka. The deposit yielded the oldest human fossil of the Italian Peninsula, and one of the oldest European evidence of Homo heidelbergensis, as well as one of the earliest evidence of bifacial tools in western Europe, commonly associated with the Acheulean techno-complex. Our paleontological results revealed the presence of three different mammal complexes, documenting faunal dynamics in response of climatic driven-changes recognized during the early Middle Pleistocene. The lower complex (levels I2-G) indicates the dominance of wooded spaces, sparse steppes, and the existence of water bodies (lakes or ponds), indicating a deterioration of the fully interglacial conditions recorded during the end of MIS 17; the middle complex (levels G-C) with a low number of mammal remains can be attributed to the glacial conditions of MIS 16; the upper complex (levels B-above α) indicates an improvement in climate, transitioning towards the full interglacial conditions of the of MIS 15. The faunal sample of Notarchirico, based on its firm chronological setting, offers important data for the Biochronological Scheme of European Land Mammals, including one of the oldest records of Palaeoloxodon antiquus and Cervus elaphus in Europe, Panthera spelaea in southwestern Europe, Dama cf. roberti in Italian Peninsula, and one of the latest occurrences of Bison schoetensacki in Europe., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Mecozzi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

A skull of Hippopotamus recovered from the area of Tor di Quinto, within the urban area of Rome (central Italy) is here redescribed. Despite being one of the most complete specimens of hippopotamuses of the European Pleistocene, the Tor di Quinto skull did not attract much research interest, due to long-standing uncertainties on its provenance. This work begun in 2021, when the skull was restored, within a large renovation project on the vertebrate exposed at the Earth Science University Museum of Sapienza University of Rome. Original sediments were found inside the cranial and mandible cavities during the restoration work, which were sampled for petrographic analyses. By combining a review of the old paleontological, archeological and geological literature published during the 19th and 20th century on the Rome basin and the correlation of these new sedimentological and petrographic information with the lithostratigraphic and synthemic units of the national geological cartography, we clarify that the Hippopotamus skull was most likely to have been collected from a quarry called Cava Montanari, from a formation dated between 560 and 460 ka. Morphological and biometric analyses clearly support an attribution of the Cava Montanari specimen to the extant species Hippopotamus amphibius. The reassessment of the stratigraphic and geological data on Cava Montanari implies that the studied specimen is the earliest confirmed occurrence of Hippopotamus amphibius in the European fossil record., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Mecozzi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

During the last century, Grotta Romanelli (Southern Italy) has been a reference site for the European Late Pleistocene stratigraphy, due to its geomorphological setting and archaeological and palaeontological content. The beginning of the sedimentation inside the cave was attributed to the Last Interglacial (MISs 5e) and the oldest unearthed evidence of human occupation, including remains of hearths, was therefore referred to the Middle Palaeolithic. Recent surveys and excavations produced new U/Th dates, palaeoenvironmental interpretation and a litho-, morpho- and chrono-stratigraphical reassessment, placing the oldest human frequentation of the cave between MIS 9 and MIS 7, therefore embracing Glacial and Interglacial cycles. These new data provide evidence that the sea reached the cave during the Middle Pleistocene and human occupation occurred long before MISs 5e and persisted beyond the Pleistocene- Holocene boundary., (© 2022. The Author(s).)

Here, we describe a partial cranium of a large canid dated at 406.5 ± 2.4 ka from the Middle Pleistocene of Ponte Galeria (Rome, Italy). The sample represents one of the few Middle Pleistocene remains of a wolf-like canid falling within the timeframe when the Canis mosbachensis-Canis lupus transition occurred, a key moment to understand the spread of the extant wolf (Canis lupus) in Europe. CT-based methods allow studying the outer and inner cranial anatomy (brain and frontal sinuses) of a selected sample of fossil and extant canids. Morphological and biometric results allowed to: (I) ascribe the cranium from Ponte Galeria to an adult Canis lupus, representing the first reliable occurrence of this taxon in Europe; (II) provide the content for a biochronological revision of the Middle Pleistocene record of European wolves., (© 2022. The Author(s).)

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

In the last decades, many studies have focused on the description of fossil badger materials from Eurasia and several evolutionary hypotheses have been proposed. Nevertheless, the debate on taxonomy of the Late Villafranchian-Aurelian European badgers is still far from being solved and several species/subspecies were established over time. Herein, we described for the first time the craniodental and postcranial remains of Meles meles from Grotta Laceduzza (Apulia, Southern Italy), representing the largest sample of this taxon in the European Pleistocene record. Morphological and morphometric comparisons with fossils coming from the European Pleistocene sites were carried out; morphometric data were also compared with those of several extant populations of the European badger. The results of this work suggest that the badger fossil remains from the Mediterranean region can be considered as an ecomorphotype of this highly polymorphic species, showing a great morphological and morphometric variability throughout its wide geographical range. This variability is mainly expressed in some craniodental features and body size and could reflect local ecological adaptations, also linked to glacial/interglacial cycles.

Lymphangioma is a rare benign tumor caused by failure in the development of the lymphatic communicating system. The corresponding nomenclature is confusing. In recent years ''renal lymphangiectasia'' is the preferred name. Although this disease may occur in any site of the body, the neck (75%) and axillary area (20%) are the most common sites, and the kidney is occasionally involved. We report a case of lymphangioma communicating with the urinary system in a 61-year-old man diagnosed by CT scan treated with nephrectomy and histological confirmation.

Aim: Vena cava filters are used for the prevention of pulmonary embolism in cases of contraindication, failure or complications of the anticoagulant therapy. There are no certain data in the literature concerning the effectiveness of vena cava filters and, above all, the possible long-term complications are not known. For this reason increasing attention is paid to permanent/removable filters that permit exploitation of the short-term advantages of vena cava interruption, eliminating the possible long-term complications. We have reported the results of a multicentre experience concerning ALN permanent/removable vena cava filters in a total of 276 patients., Methods: Vena cava filters were placed in 276 patients via the jugular, femoral and brachial vein. The filter was removed in 43 patients after 3 months and in 28 patients after 6 months., Results: In 1 case, due to incomplete opening of the filter, immediate percutaneous removal was performed and another filter was positioned. In 5 cases it was not possible to remove the filter, in 1 case due to inexperience and in the remaining cases due to adhesion of the head or claws of the filter to the wall of the vein. No problems occurred in the other cases., Conclusions: The ALN vena cava filter is safe, easy to position and remove even a long time after placement. Currently permanent filters should be used only for patients with poor survival expectancy whereas in all other cases the use of removable filters is preferable.

Water samples were collected from a wastewater treatment plant and from two lakes in the vicinity of Rome (Italy) for detection and genotypic characterization of Giardia. All wastewater samples and all but two of the lake samples were scored by immunofluorescence as positive for Giardia. In addition, Giardia cysts were detected, by nested PCR, in all of the examined samples. Analysis of the SSU-rRNA gene sequences showed that all Giardia isolates belonged to Assemblage A. The presence of Assemblage A genotype in wastewater and surface bathing water represents an important public health concern. In fact, isolates showing this genotype are considered to be potential human pathogens and also have zoonotic implications.

Purpose: To calculate the itemised and overall costs (including staff, technical equipment, and materials) of the services of a radiology department in order to ensure clearer communications between the service providers and clients concerning the service and its costs. The analysis was carried out in the radiology department of a city general hospital., Materials and Methods: An Activity Based Cost Analysis was used to study the production process for each type of service delivered, considering all the direct and indirect costs. These calculations resulted in an itemised list of costs per service that included all of the cost components of a radiological examination, overcoming the limits of cost accounting based on specific factors only (e.g. physician time used). The contents of the itemised cost analysis - human resources, equipment and consumables, gathered from the staff were compared with the actual consumption data for a 4-month period of normal activity. The evaluation was completed by an analysis of the quality perceived by clients relative to the levels and costs of the service., Results: Itemised cost analyses were obtained and verified for 72 categories of services defined by similar types and costs. Thanks to this process-oriented approach, costs could also be differentiated by patient referral group (in-patient, out-patient, emergency department) to compare the impact on the organisation of the three patient categories. Emergency department and in-patient services were found to have a greater impact than out-patient services, and the latter proved more cost-effective than the other two. Emergency department services were found to be considerably less cost-effective due to the fact that the service is guaranteed 24 hours a day / 7 days a week, but seldom fully exploited. While confirming that the Regional charges are inadequate, our analysis supplied all the data needed to precisely evaluate the cost drivers and to update the charges to reflect the actual costs. As regards quality, the patients judged the processes positively, but as a result of their growing expectations they expressed a need for more information., Conclusions: This itemized cost analysis has proved to be an excellent tool for communicating service costs, and can be used effectively as a benchmarking instrument to verify the cost-effectiveness of similar services, especially if integrated with an in-depth quality analysis (to be carried out by all clients). The results obtained have allowed us to determine the impact of service delivery processes on patients from various referral categories and to develop an up-to-date internal price list that better reflects the actual costs compared to current charges.

In the diagnosis of osteoporosis there are, today, several techniques for investigating bone mineral density. In this work the authors evaluate the sensitivity of Computed Tomography in the diagnosis of this metabolic disease, because of the built-in competence of this method in determining the density of the anatomical tissues. In a randomised study the Authors performed Single Energy Quantitative Computed Tomography (SEQCT) in estimating the bone mineral density of lumbar vertebrae in 44 female patients. The data obtained were correlated, using the Student "t" test, to the measurements acquired, in the same group of patients, employing Dual Energy X-ray Absorptiometry (DEXA), 27 patients, and Total Body DEXA, 17 patients. Results revealed a good correlation between SEQCT and DEXA (R = 0.89) and statistical significance (p < 0.001). On the contrary there is not a good correlation (R = 0.58) if SEQCT is compared to Total Body DEXA. According to our experience Quantitative Computed Tomography is useful in diagnosis osteoporosis and it should be performed in all post-menopausal patients. This method, which has a high level of precision, is cheap and easily adaptable to every Computed Tomography. Because of the high X-ray dose rate, only DEXA should be performed in monitoring patients undergoing therapy.

At first, the authors mention indications and way of placement of the Angelchik prosthesis. Then after a wide review of the literature, they describe the complications and results. Finally a case of penetration into the stomach of an Angelchik prosthesis is reported. It was favourably resolved by an operation.

An account is given of a study of 118 patients, including 67 with renal failure of varying severity, examined nephrangiotomographically with the aid of both a non-ionic contrast medium (iopamidol) and a conventional medium (sodium diatrizoate and methylglucamine). It is shown that the advantages presented by rapid injection of the medium, and the obtaining of prompt vascular data, are accompanied by those offered by the non-ionic medium, since it induces reduced osmotic diuresis, which permits satisfactory visualisation of the excretory ducts, even in patients with very low glomerular filtration values.