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Introduction: Immunotherapy dramatically changed history of melanoma patients with a clinical benefit never seen before. Nevertheless, severe and unexpected adverse effects can occur, fortunately rarely. Case presentation: We reported the case of a 75-year-old male patient affected by metastatic melanoma who developed myocarditis and acute rhabdomyolysis with secondary diaphragmatic dysfunction and consequent pulmonary restrictive syndrome after Nivolumab monotherapy. Blood tests and ultrasonography of the diaphragm revealing left hypokinesis suggested a Nivolumab-related rhabdomyolysis, as an immune-mediated adverse event. The rhabdomylolysis involved the diaphragm with consequent diaphragmatic weakness and respiratory distress. Management & outcome: The patient had a slow but slight and progressive improvement of symptoms and vital signs post-treatment with high-dose corticosteroids. Discussion: With this case report, we want to highlight the importance of rapid recognition and treatment of rare and unexpected, but potential serious immune-related adverse events. These events might happen despite the remarkable clinical benefits of immune checkpoint inhibitors. We do not know which patients will benefit from these therapies and why, when and in which cases adverse event will occur: we must not lower our attention. [ABSTRACT FROM AUTHOR]

Yield and different nut parameters were measured for two growing seasons on mature (28–29 years) trees of 11 pecan cultivars grown in an experimental orchard located in the Puglia Region, Southeastern Italy. 'Shoshoni' and 'Shawnee' pecan seedlings were inoculated with three truffle species (Tuber borchii—known as the 'whitish truffle', T. aestivum—called the 'summer truffle', and T. melanosporum—the common 'Black truffle') and investigated for six months. The level of ectomycorrhizal colonization was assessed 6 and 12 months after inoculation. Results indicated that 'Wichita', 'Shoshoni', and 'Pawnee' performed well in the pedoclimatic conditions of the area with a yield higher than 20 kg/tree and a kernel dry weight of ≅3 g. These preliminary yield results suggested that some pecan cultivars could deserve consideration for cultivation in the Puglia Region, whereas others with low yield and a stronger alternate bearing should not be considered. Plant height, number of leaves, chlorophyll content (expressed as a SPAD unit) and stem diameter partially indicated the increase in ecological fitness in truffles-inoculated plants. Successful mycorrhization indicated 'Shoshoni' and 'Shawnee' as suitable to establish ectomycorrhizal symbiosis with T. aestivum, T. borchii, and T. melanosporum cultivation under Puglia climatic conditions. The results also showed that the applied protocol was adequate to obtain healthy mycorrhized seedlings appropriate for commercialization and plantation for truffles production on pecan in the future. [ABSTRACT FROM AUTHOR]