Anxiety Symptoms, COVID-19-Related Stress Reactions in the Italian General Population, and Validation of the Italian COVID Stress Scales (CSS-I)

Background. The COVID Stress Scales (CSS) assess COVID-related stress experienced in the past week related to danger and contamination fears, socioeconomic consequences, xenophobia, compulsive checking, and reassurance seeking, and traumatic stress symptoms. Our objective was to provide a translation into Italian, replication, and psychometric validation of the CSS in the general population. Moreover, we aimed to test the convergent and discriminant validity of the Italian CSS (CSS-I) with respect to anxiety, stress, and depressive symptoms in the general Italian population. Method. Adult participants (n = 935) over the age of 18 years were recruited from the general population in Italy. Psychological status was assessed using multiple validated measures, including the CSS, Depression, Anxiety and Stress Scales-21 (DASS-21), and the Prejudice Against Immigrants Scale (PAIS). Results. Our confirmatory factor analysis supported a 6-factor model, including danger fears (DAN), socioeconomic consequences (SEC), xenophobia (XEN), compulsive checking and reassurance seeking (CHE), contamination fears (CON), and traumatic stress symptoms (TSS). Strong reliability of the CSS-I (Cronbach's α = 0.863-0.936) and convergent validity with the DASS-21 and PAI were established with positive correlations between total and scale scores across measures. Conclusions. The CSS-I is a valid and reliable instrument to measure COVID-19-related distress in the Italian population.

Levels and congener pattern of polychlorinated biphenyl and organochlorine pesticide residues in bluefin tuna (Thunnus thynnus) from the Straits of Messina (Sicily, Italy)

The aim of this study is to assess the accumulation of OCs and PCBs in Thunnus thynnus and to elucidate the suitability of this species as a bioindicator for monitoring contaminations of these compounds in the marine ecosystems of the Straits of Messina. This investigation was conducted on fat, liver and muscle samples of 14 T. thynnus collected during April 2004. Quantitative determination of OCs and PCBs in the various samples examined has been carried out using GC-ECD and GC-MS. The results obtained show the presence of low concentrations of p,p'-DDE and PCB congeners (138, 153 and 180) in all fat, liver and muscle samples caught in the Straits of Messina. Concentrations of p,p'-DDE and PCB congeners (138, 153 and 180) in all the samples examined were below MRLs (CE n. 97/41, 1999/65 and 1999/71).

High resolution mini-gammacamera and 99mTc [HMPAO] - leukocytes for diagnosis of infection and radioguided surgery in diabetic foot

Discovery of osteitis may be delayed because of late appearance of X-ray signs in patients with diabetic foot. Scintigraphy with labelled leukocytes is able to detect flogosis but often misses bone involvement, due to inadequate resolution of Anger camera, the commonest detector used in nuclear medicine. Radioguided surgery and biopsy with high resolution scintigraphy (HRS) started to be studied since 2000: although this method had never been tested for planning and guiding diabetic foot surgery, in our opinion it can help early diagnosis and surgical treatment of diabetic foot. Five patients with diabetic foot and suspected infection were studied with standard 99mTc [HMPAO]-leukocyte scan. In the same patients 2 mm spatial resolution HRS was performed 24 hours after administration of labelled WBC, using our inch2 field-of-view portable mini-gammacamera. Operations were done just after the 24h scan and were guided with the portable high resolution device in the four patients who showed positive scan. Scintigraphy with Anger camera and HRS were positive in four patients. HRS showed a bar-shaped radioactivity corresponding to small phalanges, close to the main inter-digital hot spot. The presence of osteitis on phalanges that had been shown by HRS was confirmed at surgery, that was successfully driven with the high resolution mini-camera. In conclusion HRS is able to diagnose early osteitis of diabetic foot and to guide diabetic foot surgery.

[Small bowel lymphomas: a case report]

The Authors, reporting a recent case of small bowel lymphoma, review progress in diagnosis, methodology and therapeutical approach. They also stress the crucial role of surgery as diagnostic and therapeutic tool, sometimes curative in early stages, and however necessary for a proper staging and definition of these rare neoplasms of intestinal tube.

[Diagnosis and therapy of severe acute colitis, still an open issue. Our experience]

From a review of a series of 12 cases of whom 52 operated and of the literature, the Authors discuss about aetiology, pathogenesis and diagnosis of severe colitis. Clinical and laboratory findings, CT and plain films of the abdomen and at last colonoscopy should be evaluated very carefully for certainty diagnosis of a severe acute colitis or toxic megacolon. They suggest a multidisciplinary approach as fundamental for medical management, for indications and correct timing of surgical procedures and to decrease postoperative morbility and mortality. Total colectomy with ileostomy is recommended in emergency surgical treatment of this colonic acute diseases, whereas for urgency operation, performed not later than 48-72 hour of adequate medical treatment, colectomy is suggested with ileorectal or ileoanal anastomosis and ileostomy.

Evaluation and host specificity of two seed flies Mesoclanis polana and M. magnipalpis (Diptera: Tephritidae): biological control agents for Chrysanthemoides monilifera (Asteraceae) in Australia

Larvae of the South African tephritid flies Mesoclanis polana Munro and M. magnipalpis Bezzi feed in the developing seeds of Chrysanthemoides monilifera. Host specificity evaluation using 109 plant species from 25 families indicated that complete development was restricted to their natural host C. monilifera. Minor feeding and limited development was detected on 18 species, but was of no ecological or economic significance. Mesoclanis polana and M. magnipalpis have been released in Australia and M. polana has established and dispersed widely. Mesoclanis magnipalpis has not yet become naturalized. Parasitism of M. polana in Australia by several species of Hymenoptera has been detected, but is not expected to limit the establishment and impact of these flies.

[Endoscopic fragmentation of gastric phytobezoars as a valid alternative, in selected cases, to traditional surgery]

Three cases of gastrointestinal bezoar are described. Two were submitted to conventional surgery and one to endoscopic fragmentation. The natural and postoperative pathophysiologic mechanisms responsible for the formation of bezoars were studied. The condition is generally asymptomatic, the clinical presentation being similar to that of gastritis and/or duodenitis. Endoscopy is the non-invasive technique of choice in the diagnosis of gastric bezoars. Treatment of these lesions in day-endoscopy consists in removal of the bezoar if less than 3 cm in diameter and fragmentation if larger in diameter followed by extraction of any fragments over 1 cm to prevent the risk of intestinal obstruction. Long term maintenance therapy with cisapride or metoclopramide is then immediately administered for preventive purposes, and it is also used in patients submitted to traditional gastric and/or duodenal surgery.

[Apudomas: nosographic and physiopathological aspects]

The authors intend to contribute to the knowledge of this complex and in part not fully defined subject of apudomas, in particular with regard to classification criteria and physiopathological aspects. After having examined the characteristics of these neoplasias (probably common embryonal origin, similar radioimmunological, immunohistochemical and ultrastructural characteristics, the capacity to convert amine precursors into amines), the authors focus on the most significant aspect of these carcinoids which, in the light of current knowledge, possess varying but undisputed degrees of biological aggressiveness. They also highlight the importance of the gastroenteric tract as an organ with an endocrine function and lastly affirm the value of the classification which, using the pancreas as the reference organ, distinguishes endocrine neoplasias in this tract into entopic and ectotopic examples.

[Phyllodes breast tumors: apropos 2 cases]

The observation of two cases of phyllode tumors of the breast, one benign and the other malignant, brought the Authors to focus the fundamental aspects of these neoplasias. The histologic coexistence of both epithelial and connectival components, a relative unpredictable clinical evolution, the high frequency of recurrences, the stromal hyperproduction and modifications as expression of malignancy, and the need for large excisions are the fundamental characteristics of these tumors, which are considered transitional forms between benignity and malignancy.

[Indications and surgical treatment of Crohn disease]

On the basis of their experience (a series of 21 surgical approaches), the authors subdivide the indications for surgical treatment into absolutes and relatives. They recommend to operate also for relative indications in order to improve the patient's way of life, avoiding the establishment of extensive adhesions, under-nourishment and invalid subocclusive symptomatology. As the surgical treatment is not curative and is burdened from repeated operations, the authors suggest using a conservative surgery. They confirm the uninfluence, to prevent fistula and/or local recurrence, to carry out an anastomosis on healthy or slightly macroscopic disease tissues.

[The role and problems of the surgical approach in adrenal incidentalomas]

The authors report a series of 5 incidentalomas: 4 nonfunctioning adrenocortical adenomas and 1 nonfunctioning pheochromocytoma. They emphasise the importance of US, CT, MRN, and scintigraphy in differential diagnosis compared to laboratory tests. In addition, they affirm that a correct oncological approach necessarily involves radical surgery and rule out the possibility of adopting a "wait and see" policy based on relative factors such as tumour size, function and the patient's age. The authors suggest using a posterior or anterior access route depending on the nature and size of the incidentaloma and recommend reserving the lateral incision for special cases.

[Current diagnostic-therapeutic trends in carcinoids of the papilla of Vater]

Diagnosis and treatment of carcinoid tumor of the ampulla of Vater: case report. The carcinoid tumour of the ampulla of Vater is extremely rare. The authors report one case. Therefore, they dwell upon the problem connected with classifications, symptomatology and diagnosis of these neoplasms which present difficulty to diagnose preoperatively. At last, they reaffirm the primary role of pancreaticoduodenectomy with lymphadenectomy and, if it is possible, the necessity to extirpate the liver metastases.

[Primary non-Hodgkin's lymphomas of the stomach]

Histological and staging classifications of gastric non-Hodgkin lymphomas are reported. On the basis of their experience and taking into account the above mentioned principles, the authors dwell upon the advantages and limits of endoscopy for the diagnosis of such neoplasms. The primary role of surgery in the management of gastric lymphomas is also confirmed.

[Bronchopulmonary carcinoids: neoplasms with attenuated malignancy or true and proper malignant tumors?]

The authors, in reporting their series of 6 bronchopulmonary carcinoids, dwell upon the criteria used to classify such neoplasms pointing out the related diagnostic problems. The presence of metastases and/or local recurrences as well as the impossibility to define the aggressiveness of the tumor brought the authors to consider such tumors as malignant. They conclude for a surgical approach which should be conservative: segmentectomy and lobectomy in elective procedures, whereas pneumonectomy and endoscopic resection should be reserved to particular cases.

[Early gastric cancer: staging and diagnostic-therapeutic trends]

The Authors in reviewing the main epidemiological and histological features of Early Gastric Cancer, dwell upon the atypical symptomatology pointing out the importance of an early diagnosis for a successful surgical treatment. Furthermore, they affirm the primary role of subtotal gastrectomy, associated with regional lymphadenectomy and omentectomy. At last, the need to extend postoperative follow-up to the main abdominal and thoracic organs for the frequency of synchronous or metachronous neoplasms is stressed.