First evidence for fin whale migration into the Pacific from Antarctic feeding grounds at Elephant Island

This study presents the first long-distance tracks of fin whales (Balaenoptera physalus) equipped with satellite transmitters off the Antarctic Peninsula. Southern Hemisphere fin whales were severely depleted by twentieth century industrial whaling, yet recently, they have returned to historical feeding grounds off the northern Antarctic Peninsula, forming large aggregations in austral summers. To date, our knowledge only extended to summer behaviour, while information regarding migration routes and the location of breeding and wintering grounds are lacking. During the austral autumn of 2021, we deployed nsatellite transmitters on four fin whales at Elephant Island. Two transmitters stopped working while the animals were still at the feeding grounds, while two continued to transmit during the transition from feeding activity to migration. Both migrating animals left the feeding ground on 15 April 2021, travelling northward into the Pacific and up along the Chilean coast. The most northerly position received before all tags stopped transmitting on 1 May 2021 was at 48°S. These tracks provide initial evidence of seasonal migratory routes and a first indication toward possible locations of winter destinations. This information, even if preliminary, is critical for investigations of population connectivity, population structure and the identification of breeding grounds of Southern Hemisphere fin whales.

Contact-Force Guided Posterior Wall Isolation as an Adjunctive Ablation Strategy for Persistent Atrial Fibrillation

Background

The efficacy of posterior wall isolation (PWI) on top of pulmonary vein isolation (PVI) in patients affected by persistent atrial fibrillation (AF) is still controversial and little is known about the impact of contact-force (CF) technology.

Objective

In this retrospective study, we present our experience with PWI using CF sensing catheters and its efficacy and safety as an adjunctive ablation strategy on top of PVI for management of patients with persistent and longstanding persistent AF.

Methods

A total of 73 consecutive patients (20.5% female) affected by persistent atrial fibrillation (10.9% long-standing) underwent PWI as an adjunctive therapy to PVI using CF sensing catheters. Outcomes were reported as incidence of atrial arrhythmic recurrences (ARs) lasting >30 seconds at follow up and in addition, in patients provided with insertable cardiac monitors (ICM), as burden of AF or atrial tachycardias (AT) at relevant time points.

Results

PWI was successfully achieved in 65 (89.0%) patients. Two (2.7%) minor vascular procedural complications were observed. At 1 and 2-year follow-up, ARs free survival was observed in 80.5% and 64.1% of patients, respectively with 75.3% of patients off antiarrhythmic drugs at the last follow-up. Ten patients underwent repeat ablations during the follow-up. At multivariate analysis, early ARs within 3 months after procedure, were associated with a two-fold increased risk of late ARs at follow-up. Among patients provided with ICM, PWI on top of PVI was able to reduce the mean AT/AF burden of more than 50% compared with pre-ablation time, reporting very low levels (≤ 5%) over 2 years.

Conclusions

In persistent atrial fibrillation, PWI on top of PVI using CF sensing catheters is safe and effective, providing great reduction of burden of ARs. Early ARs are associated with a greater risk of late recurrences.

Setting the scene for Mediterranean litterscape management: The first basin-scale quantification and mapping of floating marine debris

Plastic pollution has become one of the biggest environmental concerns of the Anthropocene as it represents a major threat to both wildlife and human health. Garbage patches in the world's oceans are well documented, but quantitative assessments of floating debris are still lacking in some major areas. The Mediterranean Sea is one such area, despite being one of the most plastic polluted environments. We used data from the first international basin-scale survey of the Mediterranean Sea to provide the first abundance estimate of floating mega-debris (>30 cm) and map their distribution over the entire Mediterranean Sea. We estimated the total number of floating mega-debris at 2.9 million items, taking into account imperfect detection. Items larger than 30 cm represent only one fourth of the complete load of anthropogenic debris (>2 cm) in the Mediterranean, which scales up the estimate to 11.5 million floating debris. The highest densities were observed in the central Mediterranean, and the lowest in the eastern basin. This acute marine pollution might threaten to disrupt entire ecosystems through its impact on marine fauna (entanglement, ingestion, contamination), eventually impacting the tourism industry and the well-being of Mediterranean populations.

First-episode psychosis at the West Bologna Community Mental Health Centre: results of an 8-year prospective study

BACKGROUND

Research mostly conducted in the UK and northern Europe has established that there are high rates of first-episode psychosis (FEP) in large cities and immigrant populations; moreover, psychosis has been found to be associated with cannabis use and early trauma. The present study aimed to evaluate the incidence rate of FEP and the distribution of several risk factors (e.g. age, ethnicity, substance abuse) in Bologna, Italy.

METHOD

The Bologna FEP (BoFEP) study is an 8-year prospective study. All FEP patients, 18-64 years old, consecutively referred to the West Bologna Community Mental Health Centre (CMHC) from 2002 to 2009 were evaluated. Sociodemographic information, migration history and clinical data were collected through an ad-hoc schedule. Psychiatric diagnoses were recorded using the Schedule for Clinical Assessment of Neuropsychiatry (SCAN).

RESULTS

The overall incidence rate (IR) in the BoFEP study was 16.4 per 100 000 person-years [95% confidence interval (CI) 13.9-18.9]. The incidence was higher in young people, men and migrants (MI).

CONCLUSIONS

The IR of FEP found by the Bologna study is lower than that found by other European studies. However, as in other studies, the incidence was higher in certain groups. This heterogeneity has implications for policy and mental health service development, and for understanding the aetiology of psychosis.

Intraoperative bronchoscopy for bronchial carcinoid parenchymal-sparing resection: a pediatric case report

Bronchial carcinoid tumors are the most common primary pulmonary neoplasm in the pediatric population. The widely accepted treatment for carcinoid tumors is surgical, specifically aiming at being as much as conservative on lung parenchyma, while the entire tumor is resected. A brief case is described, highlighting the importance and advantages of a surgical and endoscopic combined approach.

ECP02-03 - Research perspectives in transcultural psychiatry for young psychiatrists?

Introduction

Migration is a growing phenomenon in western countries. Several studies report a greater prevalence of psychiatric disorders among migrants. Some studies indicate a interesting relation between such disorders in migrants and their migration history, particularly the process of integration in the host country (Bhugra and Jhons 2005; Morgan et al 2010).

Aims

To present the Bologna Migration History Questionnaire, that is a research tool to study the migration history and identify the related determinants of psychiatric disorders.

Methods

We conducted a literature review on questionnaires used to study the determinants of psychiatric disorders in migrants and on etiopathogenetic hypotheses. We identified the main determinants to be investigated and expanded a research tool already used in a Mental Health Centre (MHC) of Bologna accordingly. A first version of this tool was discussed during a workshop with fieldworkers from different MHCs in Italy and with international experts on migration and mental health.

Results

The developed tool includes three sections: 1) Pre-migration phase; 2) Migration phase; 3) Post-migration phase. Through the tool, information is gathered on: socio-economic factors that precede and follow the migration, reasons and organization of the migration, relations and social support in the host country, detected changes and satisfaction achieved within different fields of experience. Information can be retrieved either from medical records or through semi-structured interviews with the patients within a month from the first contact.

Conclusions

Currently the tool has been distributed to different Italian MHC to assess its feasibility with regard to data collection and the appropriateness of questions. Young psychiatrists and trainees show great interest in this study. We discuss discuss research perspectives for young psychiatrists within international research projects to better investigate the relation between migration and mental health in western countries.

Dobutamine stress echocardiography for assessing the role of dynamic intraventricular obstruction in left ventricular ballooning syndrome

Background

Dynamic intraventricular obstruction has been observed in patients with left ventricular ballooning syndrome (LVBS) and has been hypothesized as a possible mechanism of the syndrome. The aim of this study was to assess the prevalence and significance of dynamic intraventricular obstruction in patients with LVBS.

Methods and Results

Dobutamine stress echocardiography was carried out in 22 patients with LVBS (82% apical), all women, aged 68 ± 9 years. At baseline 1 patient had a > 30 mmHg LV gradient; during stress a LV gradient > 30 mm Hg developed in 6/21 patients (28%) and was caused by systolic anterior motion of the mitral valve in the 3 patients with severe gradient (mean 116 ± 29 mmHg), who developed mitral regurgitation and impaired apical wall motion and by obstruction at mid-ventricular level in the other 3 with a moderate gradient (mean 46 ± 16 mmHg). Compared with patients without obstruction those with obstruction had a greater mean septal thickness (11.6 ± .6 vs 9.8. ± 3, p < .01), a higher prevalence of septal hypertrophy (71% vs 7%, p < .005) and a higher peak wall motion score index (1.62 ± .4 vs 1.08 ± .4, p < .01).

Conclusion

Spontaneous or dobutamine-induced dynamic LV obstruction is documented in 32% of patients with LVBS, is correlated with the presence of septal hypertrophy and may play a role in the development of LVBS in this subset of patients. In those without septal hypertrophy a dynamic obstruction is rarely induced with dobutamine and is unlikely to be a major pathogenetic factor of the syndrome.

Left ventricular apical ballooning syndrome: prevalence, clinical characteristics and pathogenetic mechanisms in a European population

BACKGROUND

Left ventricular apical ballooning syndrome (LVABS) is a cardiac syndrome mimicking acute myocardial infarction, whose prevalence in western populations and pathogenesis are not yet well defined. The aim of the study was to assess its prevalence, clinical characteristics and pathophysiological mechanisms in a European population of myocardial infarction patients.

METHODS

Of a series of 1457 patients with acute myocardial infarction 18 fulfilled the diagnostic criteria for LVABS. To evaluate the pathogenetic mechanisms we studied coronary blood flow with TIMI flow grade and corrected TIMI frame count (CTFC) in all patients and performed provocative testing with ergonovine and dobutamine echocardiography in 14.

RESULTS

All patients were women aged 72+/-9 years. A triggering event was identifiable in 39% of cases. LV ejection fraction in the acute phase was 46+/-5%. No deaths or major complications occurred during hospitalization. Response to ergonovine was negative in all 14 patients and dobutamine induced a dynamic LV obstruction in 4/14 (28%). Mean CTFC was abnormally prolonged in all 3 major coronary arteries and 16/18 patients (89%) had an abnormal CTFC in >/=1 coronary vessel. No cardiac deaths occurred during follow-up and 1 patient only had a recurrence.

CONCLUSIONS

The prevalence of LVABS is 1.2% among all patients with acute myocardial infarction, but rises to 4.9% in women. Short- and long-term prognosis is good. Abnormal CTFC suggests the presence of a coronary microvascular dysfunction, while dynamic LV obstruction can contribute to the development of LVABS in a minority of patients.

Skin biopsy of Mediterranean cetaceans for the investigation of interspecies susceptibility to xenobiotic contaminants

Various studies on Mediterranean cetaceans have revealed bioaccumulation of contaminants such as organochlorines (OCs) and heavy metals. The susceptibility of these animals to organic pollutants and the relationship between bioaccumulation and population decline (as in the case of Delphinus delphis) are unexplored fields. In this study, we used a non-destructive approach (skin biopsy) to explore OC bioaccumulation processes and mixed-function oxidase activity (BPMO) in four species of cetaceans: striped dolphin (Stenella coeruleoalba), bottlenose dolphin (Tursiops truncatus), common dolphin (D. delphis) and fin whale (Balaenoptera physalus). Significant differences in BPMO induction and OC levels were found between odontocetes and mysticetes, the former having mixed-function oxidase activities four times higher than the latter, binding with levels of OCs one order of magnitude higher in odontocetes. A significant correlation (P < 0.05) between BPMO activities and OC levels was found in B. physalus. In an ongoing project, fibroblast cultures have been used as an alternative in vitro method of evaluating interspecies susceptibility to contaminants such as OCs and polycyclic aromatic hydrocarbons (PAHs). These results suggest that cetacean skin biopsies are a powerful non-invasive tool for assessing ecotoxicological risk to Mediterranean marine mammals species.

Skin biopsies for cell cultures from Mediterranean free-ranging cetaceans

The aim of this study was to develop a useful method for obtaining viable tissue samples for establishing cell cultures from skin biopsies of free-ranging cetaceans. The skin biopsies were performed by two methods: dart from an air gun and dart from a crossbow. The dart tip was modified to collect tissue. The tissue was kept in tissue culture medium at ambient temperature, then processed within 24 h. Many modifications in culture technique, with respect to conventional culture methods for human fibroblasts, were made. The cultures thus obtained can be used for many purposes, including genetic and toxicological studies. In toxicology they are an alternative in vitro system for studying threatened animals such as marine mammals. In particular, fibroblasts can be used to test the vulnerability of cetaceans and pinnipeds to different environmental contaminants such as organochlorine compounds, heavy metals and polycyclic aromatic hydrocarbons.

Relationship between organochlorine contaminants and mixed function oxidase activity in skin biopsy specimens of Mediterranean fin whales (Balaenoptera physalus)

The relationship between organochlorine contaminants (PCBs and DDTs) and mixed function oxidase, benzo(a)pyrene monooxigenase activity (BPMO), was investigated in skin biopsy specimens from fin whales (Balaenoptera physalus) of the Mediterranean Sea. Skin biopsy material, sampled by a non invasive technique, is suitable for a wide range of chemical and biomarker analysis. In this study PCBs and DDTs were evaluated in subcutaneous blubber and MFO activity in epidermis. An interesting correlation was found in male specimens between the two variables.