Necrodes littoralis (Coleoptera: Silphidae) visiting and breeding on a carcass in Italy.

The community that progressively colonizes a decaying corpse can be considered a small ecosystem mostly composed of sarcosaprophagous arthropods belonging to the orders Diptera and Coleoptera. Studies on these species are often performed through animal models to obtain data on their succession, behaviour and life cycle, together with information on habitat, corpse conditions, season and association with other species. These data may be relevant for forensic investigations, especially concerning the estimation of Post Mortem Interval (PMI). An investigation on the sarcosaprophagous insect community in a rural area was set in Calabria (Southern Italy), using a pig, Sus scrofa Linnaeus, 1758 (Artiodactyla: Suidae) as experimental model. Analyses of the community of Diptera and Coleoptera revealed the massive presence of Necrodes littoralis (Linnaeus, 1758) (Coleoptera: Silphidae). Adults of this species reached the carcass during the bloated stage and a large amount of larvae was detected from the decay stage onwards, simultaneous to the sharp decrease in dipteran larvae and pupae. The occurrence and the activity of N. littoralis should be considered to avoid misinterpretation and errors in estimating PMI in forensic investigation.

Necrodes littoralis (Coleoptera: Silphidae) visiting and breeding on a carcass in Italy

@#The community that progressively colonizes a decaying corpse can be considered a small ecosystem mostly composed of sarcosaprophagous arthropods belonging to the orders Diptera and Coleoptera. Studies on these species are often performed through animal models to obtain data on their succession, behaviour and life cycle, together with information on habitat, corpse conditions, season and association with other species. These data may be relevant for forensic investigations, especially concerning the estimation of Post Mortem Interval (PMI). An investigation on the sarcosaprophagous insect community in a rural area was set in Calabria (Southern Italy), using a pig, Sus scrofa Linnaeus, 1758 (Artiodactyla: Suidae) as experimental model. Analyses of the community of Diptera and Coleoptera revealed the massive presence of Necrodes littoralis (Linnaeus, 1758) (Coleoptera: Silphidae). Adults of this species reached the carcass during the bloated stage and a large amount of larvae was detected from the decay stage onwards, simultaneous to the sharp decrease in dipteran larvae and pupae. The occurrence and the activity of N. littoralis should be considered to avoid misinterpretation and errors in estimating PMI in forensic investigation.

Fine Structure of Maxillary Palps in Adults of Hermetia illucens (Diptera: Stratiomyidae).

A relevant species in waste management but also in forensic, medical, and veterinary sciences is the black soldier fly, Hermetia illucens (Linnaeus; Diptera: Stratiomyidae). An ultrastructural study by scanning electron microscopy (SEM) was conducted for the first time on maxillary palps of both sexes, describing in detail the morphology and distribution of sensilla and microtrichia. The maxillary palps, composed of two segments, show sexual dimorphism in length and shape. In both sexes, the first segment is covered only by microtrichia, but the second one is divided into two parts: the proximal one, covered only by microtrichia, and the distal one containing both microtrichia and sensory structures. These structures include two types of sensory pits and one of chaetic sensilla. Due to sexual dimorphism in palp size, females have a higher number of sensory pits. The sexual dimorphism of palps and the presence and role of sensilla in H. illucens was discussed in comparison to other species of the family Stratiomyidae and of other Diptera. This study may represent a base for further investigations on mouthpart structures of this species, involved in key physiological activities, such as feeding, mating and oviposition.

Salivary biomarkers for diagnosis of systemic diseases and malignant tumors. A systematic review.

BACKGROUND: Saliva evaluation could be a possible alternative to blood and/or tissue analyses, for researching specific molecules associated to the presence of systemic diseases and malignancies. The present systematic review has been designed in order to answer to the question "are there significant associations between specific salivary biomarkers and diagnosis of systemic diseases or malignancies?". MATERIALS AND METHODS: The Preferred Reporting Item for Systematic Reviews and Meta-analysis (PRISMA) statement was used to guide the review. The combinations of "saliva" and "systemic diseases" or "diagnosis" or "biomarkers" or "cancers" or "carcinoma" or "tumors", were used to search Medline, Scopus and Web of Science databases. Endpoint of research has been set at May 2019. Studies were classified into 3 groups according to the type of disease investigated for diagnosis: 1) malignant tumors; 2) neurologic diseases and 3) inflammatory/metabolic/cardiovascular diseases. Assessment of quality has been assigned according to a series of questions proposed by the National Institute of Health. Level of evidence was assessed using the categories proposed in the Oxford Center for Evidence-Based medicine (CEMB) levels for diagnosis (2011). RESULTS: Seventy-nine studies met the inclusion and exclusion criteria. Fifty-one (64%) investigated malignant tumors, 14 (17.5%) neurologic and 14 (18.5%) inflammatory/cardiovascular/metabolic diseases. Among studies investigating malignant tumors, 12 (23.5%) were scored as "good" and 11 of these reported statistically significant associations between salivary molecules and pathology. Two and 5 studies were found to have a good quality, among those evaluating the association between salivary biomarkers and neurologic and inflammatory/metabolic/cardiovascular diseases, respectively. CONCLUSIONS: The present systematic review confirms the existence of some "good" quality evidence to support the role of peculiar salivary biomarkers for diagnosis of systemic diseases (e.g. lung cancer and EGFR).

Morphology of the Antenna of Hermetia illucens (Diptera: Stratiomyidae): An Ultrastructural Investigation.

The black soldier fly, Hermetia illucens (L.) (Diptera: Stratiomyidae), is a relevant species in waste and pest management, but is also of forensic and medical importance. A scanning electron microscopy (SEM) investigation of the antennae of both sexes of H. illucens is presented here for the first time. The antenna is composed of three regions: the scape, the pedicel, and the flagellum. The first two regions are single segments, whereas the third region, the longest one, is composed of eight flagellomeres. The scape and pedicel have microtrichia, chaetic sensilla, and rounded perforations. The flagellum is covered by different microtrichia, the morphology of which is described in detail. Two types of sensory pit are found on flagellomeres 1 to 6. An oval depression with trichoid sensilla extends from flagellomeres 4 to 6. On both sides of flagellomere 8 is a lanceolate depression covered by hair-like microtrichia. Morphometric and morphological analyses revealed some sex-related differences. The results of the SEM investigations are compared with those obtained on other species of the family Stratiomyidae and other brachyceran Diptera. The possible role of sensilla in sensory perception is also discussed in comparison with nondipteran species.

Immunocytochemical identification and ontogeny of adenohypophyseal cells in a cave fish, Phreatichthys andruzzii (Cypriniformes: Cyprinidae).

The morphogenesis of the pituitary gland and the chronological appearance of adenohypophyseal cells were investigated for the first time in the Somalian cave fish Phreatichthys andruzzii by immunocytochemistry. The adult adenohypophysis contained: a rostral pars distalis, with prolactin (PRL) cells arranged in follicles and adrenocorticotropic (ACTH) cells, a proximal pars distalis with somatotropic (GH), ß-thyrotropic (TSH), ß-gonadotropic type I (FSH) and type II (LH) cells and a pars intermedia with α-somatolactin (SL), α-melanotropic (MSH) and ß-endorphin (END) cells. All regions were deeply penetrated by neurohypophyseal branches. At hatching (24 h post-fertilization) the pituitary was an oval cell mass, close to the ventral margin of diencephalon. The first immunoreactive cells appeared as follows: PRL at 0·5 days after hatching (dah), GH and SL at 1·5 dah, END at 2 dah, TSH, ACTH and MSH at 2·5 dah, FSH at 28 dah and LH at 90 dah. The neurohypophysis appeared at 5 dah and branched extensively inside the adenohypophysis at 130 dah, but there was no boundary between rostral pars distalis and proximal pars distalis at this stage. The potential indices of prolactin and growth hormone production increased until 28 and 60 dah, respectively. The potential index of growth hormone production correlated positively with total length. Activity of PRL and GH cells, measured as ratio of cell area to nucleus area, was significantly higher in juveniles than in larvae.

Ultrastructural Morphology of the Antenna and Maxillary Palp of Sarcophaga tibialis (Diptera: Sarcophagidae).

A scanning electron microscopy investigation of the antenna and maxillary palp of the adult of Sarcophaga tibialis Macquart (Diptera: Sarcophagidae), a species of medical, veterinary, and forensic relevance, is presented for the first time. Adults of both sexes used in this study were obtained from larvae collected in a case of traumatic myiasis in a domestic cat in northern Italy. The antenna of S. tibialis is that typical of cyclorrhaphan Diptera, consisting of three segments: the scape, the pedicel, and the postpedicel, bearing the arista. The scape is covered by microtrichia and has a row of long chaetic sensilla. The pedicel is also covered by microtrichia and has three types of chaetic sensilla and a cluster of setiferous plaques. Trichoid, styloconic, clavate, and basiconic sensilla are distributed among the microtrichia on the postpedicel. Invaginated basiconic-like sensilla and olfactory pits are also present, the latter ones more numerous in the female. Our results are compared with those obtained for other calyptrate flies, mainly in the family Sarcophagidae. The data obtained may represent a basis for electrophysiological studies on the sensorial activity of the species related to the search for food sources, mates, and suitable larviposition sites, and for comparative morphological studies with other Diptera.

Furuncular Myiasis Caused by Cordylobia rodhaini (Diptera: Calliphoridae): A Case Report and a Literature Review.

Some African flies may cause myiasis not only in animals but also in humans, representing a serious health problem for the local population and for tourists. We report a rare case of furuncular myiasis due to larvae of Lund's fly Cordylobia rodhaini Gedoelst (Diptera: Calliphoridae), a species which usually parasitizes small mammals. The myiasis was diagnosed in Italy in a tourist guide who travelled in Central African rainforests of Uganda. The clinical case and the morphological criteria used for species identification are described here, together with a review of all literature cases of human furuncular myiasis due to C. rodhaini.

Scanning Electron Microscopy Investigations of Third-Instar Larva of Cordylobia rodhaini (Diptera: Calliphoridae), an Agent of Furuncular Myiasis.

A scanning electron microscopy study of the third larval instar of Cordylobia rodhaini Gedoelst (Diptera: Calliphoridae), causing obligatory furuncular myiasis, is presented here for the first time. The larvae were collected from a patient exposed to them in the tropical rainforest of Kibale National Park (Uganda). Distinctive features are described in sequence from the anterior region to the posterior region, highlighting the morphological features of antennae, maxillary palps, structures related to mouth opening, sensory structures, thoracic and abdominal spines, and anterior and posterior spiracles. The results are compared with those of other Calyptrata flies, mainly from the family Calliphoridae and, when possible, with Cordylobia anthropophaga Blanchard (Diptera: Calliphoridae), the only other species of genus Cordylobia investigated by scanning electron microscopy.

Posterior Reversible Encephalopathy Syndrome in late postpartum eclampsia.

Posterior Reversible Encephalopathy Syndrome (PRES) is a neurological complication associated with several medical conditions and it has been described in clinical findings of seizures, headache, vomiting, altered mental status, and visual changes and focal neurologic deficit, in conjunction with radiological findings of primarily posterior cerebral white matter edema of both cerebral hemispheres. PRES can develop in a wide array situations including pregnancy and postpartum in patients with or without symptoms and signs of eclampsia. A prompt diagnosis of PRES by magnetic resonance imaging and an immediate antihypertensive and anticonvulsant therapy can help to prevent serious complications. The clinical case presented deals with a 35 year-old pregnant woman whose history of eclampsia was observed after a cesarean section.

Hemangioma arteriovenoso en región geniana derecha. A propósito de un caso / Arteriovenous hemangioma of the right-hand genial region. A case report

El hemangioma arteriovenoso, también denominado malformación arteriovenosa, esla anomalía vascular congénita benigna menos común dentro de las malformaciones vasculares, con una incidencia del 1,5% del total de casos reportados. Su principal localización es facial, seguida de la región intraoral, la vulvar y las extremidades, pero se puede localizar en cualquier parte del cuerpo. Afecta con mayor frecuencia a adultos de edad media, sin predominio de género. Se presenta un caso clínico de un paciente varón, con un hemangioma arteriovenoso localizado en la región geniana derecha a nivel de la mucosa yugal, sin sintomatología dolorosa y en íntima relación con el conducto de Stenon derecho. Tras el estudio radiológico pertinente, se procede a su extirpación quirúrgica mediante un abordaje intraoral y previa tutorización del conducto de Stenon con sonda lacrimal. Posteriormente el análisis anatomopatológico confirmó el diagnóstico de presunción. La revisión bibliográfica realizada en este artículo confirma que la exéresis completa del hemangioma arterio venoso es el tratamiento de elección para la mayoría de los autores (AU)

Arteriovenous hemangioma, also known as arteriovenous malformation, is the least common of the benign congenital vascular anomalies among vascular malformations, representing 1·5% of reported cases. Its principal location is facial, followed by theintraoral region, the vulvar region and the extremities, but it can occur in any part of the body. It mainly affects middle-aged adults of both sexes. The case is that of a male patient with an arteriovenous hemangioma located in the right-hand genial region at the level of the yugal mucous, with no painful symptoms and closely related to the right-hand parotidduct. After x-ray it was surgically removed by intraoral approach following tutoring of the parotid duct with a lacrimal probe. The presumed diagnosis was later confirmed by anatomic pathology analysis. The review of professional literature for this article confirms that complete removal of the arteriovenous hemangioma is the treatment of choice for most authors (AU)

[Obesity and outcomes in the ICU: an observational study]. / Obesità ed outcome in UTI: uno studio osservazionale.

OBJECTIVES: We examined the relationships among Body Mass Index (BMI) with or without Metabolic Syndrome (MetS), ICU length of stay (ICU-LOS), duration of mechanical ventilation and mortality among ICU patients. MATERIALS AND METHODS: This prospective observational study included all patients hospitalized in a 10-bed polyvalent ICU over a period of one year and seven months. We divided the studied population into 4 groups by BMI values: group A: between 18.5 and 24.9 (n=369); group B1: 25-39.9 without MetS (n=86); B2 group: 25-39.9 with MetS (n=72); group C: >40 (n=42). Major exclusion criteria were: age <18 years, death or cerebral death within 24 hours from ICU admission. The chi square test and the variance analysis were used to compare groups. Variables significantly associated with ICU mortality were entered in a multiple regression model, allowing the determination of independent predictors. RESULTS: 620 patients were included in the study. Their SOFA score was between 8 and 15. Significant differences between B1 and B2 subgroups were observed in ICU-LOS (p <0.01), duration of mechanical ventilation (p <0.01) and ICU mortality (p <0.01). We found no statistically significant differences in mortality between B2 and C groups, as well as between A and B1 groups (42.34%/45.15% vs 16.27%/19.07%, respectively). We found that a BMI >25 with MetS was an independent predictive factor of: lower ICU-LOS, lower duration of mechanical ventilation, higher mortality rate. CONCLUSIONS: In our study, a BMI >25 with MetS was significantly associated with increased morbidity and mortality in ICU patients.

Fascitis nodular en el territorio maxilofacial. Presentación de dos casos y revisión de la literatura / Nodular fascitis of the maxillofacial region. Two case reports and a review of the literature

La fascitis nodular es una entidad clínica relativamente poco frecuentecaracterizada por una tumoración de crecimiento rápido, aunquede comportamiento clínico benigno y de características histológicas pseudosarcomatosas.Su aparición en el territorio maxilofacial es poco común,por lo que presentamos dos casos que acudieron por nódulos de consistenciadura, indoloros, en las regiones cigomática y paramandibular, quefueron diagnosticados de fascitis nodular. Destacamos estos casos por tratarsede fascitis nodular de localización atípica y revisamos su histopatología(AU)

Nodular fasciitis is a relatively rare clinical entity that ischaracterized by a rapidly growing tumor-like mass, although it hasa benign clinical behavior and pseudosarcomatous histological characteristics.Its appearance in the maxillofacial area is unusual, andtwo cases are presented of patients that attended as a result ofnodules that were hard in consistency, non-tender, in the zygomaticregion beside the mandible, and that were diagnosed as nodularfasciitis. The cases are highlighted because of the atypical locationof the nodular fasciitis and the histopathology is revised(AU)

Osteotomía de avance del marco orbitario para el tratamiento del exoftalmos endocrino severo / Advancement osteotomy of the orbital rim for the treatment of severe endocrine exophthalmos

La orbitopatía tiroidea es una enfermedad debilitante del sistemavisual caracterizada por presentar cambios en los tejidos blandos orbitariosy periorbitarios debidos a un proceso inflamatorio, o a la consecuenciadel mismo, y que se relaciona con alteraciones sistémicas de la glándulatiroides. Aparte de las alteraciones estéticas que ocasiona, los pacientespueden presentar queratitis de repetición por exposición, diplopia, dolorretrobulbar, compresión del nervio óptico e incluso ceguera. La cirugíaconstituye el tratamiento definitivo del exoftalmos en la orbitopatía deGraves, mejorando la proptosis y la visión, así como diminuyendo la sintomatologíaocular, con una morbilidad mínima. Presentamos un casode exoftalmos severo que fue intervenido mediante osteotomía y avancedel marco orbitario superior, lateral e inferior, remoción parcial de dos paredesorbitarias y lipectomía. Los resultados estéticos y el alivio de la sintomatologíaocular resultaron satisfactorios

Thyroid-associated orbitopathy is a debilitating diseaseof the visual system that is characterized by changes in the softtissuesof the orbit and periorbita as a result of an inflammatoryprocess, or as a consequence of this, and related to systemic disordersof the thyroid gland. Apart from the aesthetic changes that arise,patients may also present persistent keratitis due to exposure,diplopia, retrobulbar pain, compression of the optic nerve and evenblindness. Surgery represents the definitive treatment forexophthalmos in Graves’ orbitopathy as improvements are shownin proptosis and vision. A decrease is also experienced in ocularsymptomatology and there is minimal morbidity. We present thecase of severe exophthalmos that was surgically operated on withan advancement osteotomy of the supero-, lateral- and infraorbitalrim, with partial removal of two of the orbital walls with lipectomy.The aesthetic results and the relief of the ocular symptoms weresatisfactory