Analysis of the 2020 Taal Volcano tephra fall deposits from crowdsourced information and field data.

After 43 years of dormancy, Taal Volcano violently erupted in January 2020 forming a towering eruption plume. The fall deposits covered an area of 8605 km2, which includes Metro Manila of the National Capital Region of the Philippines. The tephra fall caused damage to crops, traffic congestion, roof collapse, and changes in air quality in the affected areas. In a tropical region where heavy rains are frequent, immediate collection of data is crucial in order to preserve the tephra fall deposit record, which is readily washed away by surface water runoff and prevailing winds. Crowdsourcing, field surveys, and laboratory analysis of the tephra fall deposits were conducted to document and characterize the tephra fall deposits of the 2020 Taal Volcano eruption and their impacts. Results show that the tephra fall deposit thins downwind exponentially with a thickness half distance of about 1.40 km and 9.49 km for the proximal and distal exponential segments, respectively. The total calculated volume of erupted fallout deposit is 0.057 km3, 0.042 km3, or 0.090 km3 using the exponential, power-law, and Weibull models, respectively, and all translate to a VEI of 3. However, using a probabilistic approach (Weibull method) with 90% confidence interval, the volume estimate is as high as 0.097 km3. With the addition of the base surge deposits amounting to 0.019 km3, the volume translates to a VEI of 4, consistent with the classification for the observed height and umbrella radius of the 2020 main eruption plume. VEI 4 is also consistent with the calculated median eruption plume height of 17.8 km and sub-plinian classification based on combined analysis of isopleth and isopach data. Phreatomagmatic activity originated from a vent located in Taal Volcano's Main Crater Lake (MCL), which contained 42 million m3 of water. This eruptive style is further supported by the characteristics of the ash grain components of the distal 12 January 2020 tephra fall deposits, consisting dominantly of andesitic vitric fragments (83-90%). Other components of the fall deposits are lithic (7-11%) and crystal (less than 6%) grains. Further textural and geochemical analysis of these tephra fall deposits contributes to better understand the volcanic processes that occurred at Taal Volcano, one of the 16 Decade Volcanoes identified by the International Association of Volcanology and Chemistry of the Earth's Interior (IAVCEI) because of its destructive nature and proximity to densely populated areas. The crowdsourcing initiative provided a significant portion of the data used for this study while at the same time educating and empowering the community to build resilience. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00445-022-01534-y.

Control of source fertility on the eruptive activity of Piton de la Fournaise volcano, La Réunion.

The eruptive activity of basaltic hotspot volcanoes displays major fluctuations on times scales of years to decades. Theses fluctuations are thought to reflect changes in the rate of mantle melt supply. However, the crustal filter generally masks the mantle processes involved. Here, we show that the cyclic and generally increasing activity of the Piton de la Fournaise volcano (La Réunion) since the mid 20th century is tightly linked to the fertility of its source, as recorded by 87Sr/86Sr and incompatible trace elements ratios of lavas. We identify a twofold control of source fertility on eruptive activity: melt extraction from fertile, incompatible element-enriched veins initiates decadal-scale eruptive sequences, so that vein distribution in the plume source directly controls the cyclic activity. Indirectly, reactive flow of enriched melts increases mantle porosity and promotes melts extraction from the peridotite matrix. This process is thought to have caused a fourfold increase in magma supply between 1998 and 2014 at Piton de la Fournaise, and could also explain magma surges at other frequently active hotspot volcanoes, such as Kilauea, Hawaii. The short-term eruptive activity of hotspot volcanoes appears to be ultimately linked to the distribution and size of lithological heterogeneities in mantle plumes.

Plasma endothelin in NIDDM patients with and without complications.

OBJECTIVE: To measure plasma endothelin 1 (ET-1) levels in uncomplicated non-insulin-dependent diabetes mellitus (NIDDM) and investigate whether ET levels may be related to angiopathy, blood pressure, metabolic control, or duration of illness. RESEARCH DESIGN AND METHODS: Plasma levels of ET-1 were measured in 44 NIDDM patients, of whom 24 had uncomplicated diabetes, 20 had angiopathy, and 10 had hypertension. In 21 patients, the duration of illness was > 10 years, and in 23 the duration of illness was < 10 years. Serum creatinine levels, microalbuminuria, and HbA1c were determined simultaneously. Thirty normotensive healthy (nondiabetic) individuals (20 men and 10 women) served as control subjects. RESULTS: No significant statistical differences in plasma ET-1 levels were found among all diabetic patients, diabetic patients with and without angiopathy, diabetic patients with different durations of diabetes, and normal subjects. No significant correlation of plasma ET-1 with blood pressure, age, serum creatinine level, duration of diabetes, HbA1c, or diabetic complications was found. CONCLUSIONS: Plasma ET-1 levels are similar in patients with NIDDM and healthy subjects and do not seem to act as a marker of diabetic complications.

Plasma endothelin in essential hypertension and diabetes mellitus.

This study was designed to determine plasma endothelin-1 levels in patients with essential hypertension and diabetes mellitus. Endothelin immunoreactivity was measured in normal controls (n = 30), mild-moderate essential hypertensives (n = 25), Type II diabetic normotensives (n = 25) and hypertensive patients (n = 20). In addition, in ten patients of each group we investigated the relationships of endothelin with other vasoactive hormones. Plasma endothelin concentrations were similar in healthy controls, in essential hypertensives and in diabetic patients with or without hypertension, averaging 8.23 +/- 1.68 pg/ml, 7.7 +/- 1.1 pg/ml, 5.05 +/- 0.94 pg/ml, 7.88 +/- 1.41 pg/ml, respectively. No correlations were observed between endothelin and concentrations of plasma renin activity, aldosterone, catecholamines, atrial natriuretic peptide and arginine-vasopressin. The present study suggests that Type II diabetic patients with or without essential hypertension do not have demonstrably higher values of plasma endothelin than essential hypertensives or healthy subjects.

Prevention and treatment of aluminum overload in uremic patients: long-term results.

The authors evaluate the efficacy of a protocol of prevention and treatment of aluminum (Al) overload in RDT patients during a 7-year period (from 1981, 164 patients, to 1987, 161 patients). Al in dialysate solutions was always less than 25 micrograms/l. Baseline Al levels greater than 100 micrograms/l were found in 22% of patients in 1981 but in none in 1987, while the percentage of values less than 60 micrograms/l increased from 55 to 91%. DFO tests were positive in 54% and 7% of cases in 1981 and 1987, respectively. A clinical diagnosis of Al intoxication was performed in 6 patients in 1981, and no further cases were diagnosed later. DFO treatment (50 mg/kg once a week) was employed preventively in 31 patients owing to positive DFO-tests, and in the 6 Al-intoxicated patients therapeutically. In the former patients none developed clinical intoxication. In the latter group clinical improvement was only temporary in the three parathyroidectomized patients. Al hydroxide [Al(OH)3] as a phosphate binder was tapered off in 1981 and substituted by Al-free chelants. In 1987, 66% of patients were given CaCO3 or Mg (OH)2 alone or in association, while 34% still needed Al(OH)3, although at low dosages (less than 2 g/day). The conclusion is that such a protocol is able to prevent and to treat cases of Al intoxication, albeit only partially.

Repeated albumin infusions do not lower blood pressure in preeclampsia.

Since intravascular volume contraction is regarded as an important pathological feature in preeclampsia, it has been proposed that plasma volume expansion could be a therapeutic manoeuver that interrupts the pathogenetic chain of hypovolemia inducing increased vascular resistance. Furthermore, tissue perfusion should be improved and, if albumin is used as plasma expander agent, interstitial edema should also be reduced. We report the results observed in an open pilot study in ten preeclamptic patients treated with daily albumin infusions (0.4 to 1 g/kg) from 7 to 36 days. No acute effects were shown on blood pressure, and the need for antihypertensive therapies did not decrease in the following days. Serial evaluation after at least five or ten days of repeated albumin infusions did not show stable changes in electrolytes excretion, renal clearances, serum protein concentration and hematocrit value, nor in aldosterone, renin and atrial natriuretic peptide basal levels, while proteinuria tended to increase. Uteroplacental and fetoplacental blood flow acutely ameliorated in 3 cases only after albumin 1 g/Kg, but reached basal values again on the next day. The clinical implications are that daily albumin infusions with this schedule dosage do not lower blood pressure and that they are unable to induce stable changes in renal function, uteroplacental and fetoplacental resistance. No maternal complications were observed during the conservative management, but fetal mortality was high (6/10). Given the uncontrolled study, we cannot know whether similar results had been achieved by conventional therapy only.

Correlations between bone histopathology and serum biochemistry in uremic patients on chronic hemodialysis.

To define which noninvasive investigations are of value in predicting bone histology, we analyzed transiliac bone specimens (66 biopsies, 14 autopsies) from 80 uremic patients on chronic dialysis. Results were compared with values of different measurements of parathyroid hormone (PTH), alkaline phosphatase (APH), osteocalcin, calcitonin, baseline and post-deferroxamine (DFO) aluminium (Al),--beta 2 microglobulin, ferritin and bone mineral density. Among histomorphometric parameters, woven osteoid, active osteoblastic surface and resorption surface showed the best correlations with dynamic and biochemical marks of active bone metabolism. Among biochemical parameters, intact PTH and APH were better related to histomorphometric and dynamic bone parameters than other PTH measurements as well as osteocalcin, while calcitonin was related to no parameters. Stainable Al alone, and not total bone Al content was related to bone histology. Baseline Al was related to lamellar osteoid, while post-DFO Al was related to stainable Al. beta 2 microglobulin was positively related to active osteoid surface and ferritin was inversely related to the mineral apposition rate, while bone mineral density was related only to total bone volume. We conclude that, though definite diagnosis requires the use of histological methods, few simple biochemical parameters may offer insight to the bone metabolic status, useful to the physician in day to day clinical practice.

[Permanent vascular catheters for extracorporeal dialysis. Preliminary study: Canaud and Tesio catheters]. / Catetere vascolare a permanenza per dialisi extracorporea. Studio preliminare: cateteri di Canaud e Tesio.

The use of alternative permanent vascular accesses has recently become increasingly common. The possibility of using the catheterization of central venous vessels has therefore been taken into consideration, in particular the internal jugular vein. During an observation period of 32 months the catheterization of the internal jugular vein (IJV) was used as a definitive access in 34 patients (12 M, 22 F; mean age 67.5, mean dialytic age 56 months in 18 patients, in 16 patients the insertion was by primary intention). A total of 44 IJV catheters were used, of which 18 Tesio and 26 Canaud. The authors examined the immediate complications following insertion and the episodes occurring during the observation period, including the problem of infection. The insertion of catheters was possible in all cases. In terms of catheter function, blood flow was adequate for the various purifying techniques. No severe complications were reported: gaseous embolism, pneumothorax, hemothorax, hemomediastinum. Infection was observed in 11 patients and 13 catheters, of which 70% were mainly provoked by Staphylococcus aureus and epidermidis. During the observation period there was a drop-out of 14 patients, 11 of whom died (3 following sepsis that failed to respond to antibiotic therapy). This preliminary experiment shows that permanent jugular catheters may be regarded as a valid access for hemodialytic treatment both in patients with severe problems of vascular access and for patients who present a short-term prognosis of dialysis and life expectancy at the time of starting hemodialysis.

[Permanent central venous catheters for dialysis. The situation in Piedmont-Aosta Valley]. / Cateteri venosi centrali a permanenza per dialisi. Realtà in Piemonte-Valle d'Aosta.

BACKGROUND: Permanent central venous catheters for hemodialysis have become increasingly important as vascular accesses for extracorporeal dialysis. The aim of this study was to evaluate the prevalence and various aspects of these catheters in the chronic dialysis population in Piedmont and Aosta Valley on 30-6-1998 using a multiple-choice questionnaire. METHODS: A total of 2389 patients were receiving chronic hemodialysis. Permanent central venous catheters were present in 6.2% of the population (149 patients), arteriovenous fistulas in 83.1%, vascular prostheses in 9.3% and temporary catheters in 1.4%. The site chosen for permanent catheters was the internal jugular vein in 88.6% of cases, the subclavian vein in 8.7% of cases and the femoral vein in 2.7% of cases. The double catheter is the most frequently used. In 76% of centres catheters are positioned by nephrologists. Thrombosis prophylaxis is performed in 98% of cases with heparin and the most frequently used disinfectant to dress the cutaneous exit is iodopovidone. RESULTS: This study highlights the important role played by permanent catheters. The double catheter was used in 64.4% of the entire population, confirming the greater efficiency of these catheters as reported in the literature. Operating autonomy is relative in 76.2% of centres where catheters are positioned by nephrologists who often use the collaboration of other specialists. CONCLUSIONS: The authors stress the need to reflect on the use of iodopovidone is to dress the cutaneous exit of catheters since this disinfectant is contraindicated by one of the largest manufacturers of silicone catheters owing to its harmful medium long-term effects.

[Instantaneous clearances: standard heparin versus low molecular weight heparin]. / Clearances istantanee: eparina standard verso eparine a basso peso molecolare.

Standard heparin is still considered as a reference point for anticoagulation in CEC, although its use is not totally devoid of long-term and short term side effects, considering the risk of hemorrhage that patients undergo during dialysis. Numerous attempts have been made in the search for an alternative anticoagulating method. The recent discovery that low molecular weight fractions (LMWH) of standard heparin (UFH) assure the same antithrombotic effect but with a minor anticoagulating action, points to such a drug as an interesting alternative to the traditional use of heparin during dialysis. Our present task is to evaluate the purifying efficiency of different cuprophan and synthetic membranes with two LMWH and UFH, measuring the instantaneous ureic clearance of different dialysers at the start and end of each dialysis. N. 43 chronic patients were examined whilst undergoing different methods of treatment; using 12 different kinds of membrane, for a total of 22 filters. Every patient underwent a dialysis using each kind of heparin at least once, for a total of 189 dialysis. Neither the initial nor the final ureic clearances, nor the percentage of decreasing had changed by using different types of heparin and membranes with diverse thrombogenicity and ultrafiltration capacities. We may conclude from the results of the tests that the purifying efficiency of small molecules, judging from the istantaneous clearances, do not significant results compared to UFH.

[Renal insufficiency due to cholesterol embolism. 4 cases]. / Insufficienza renale da embolia colesterinica. Quattro casi.

Atheroembolic disease is a complication of atheromatous disease and is quite often misunderstood. A precise diagnosis can be made difficult, by the lack of specific tests. The first case, in which we identified this disease, resulted from a bladder biopsy, in the instance of a patient with a suspected carcinoma. The experience, with this initial patient, led us to identification of a further 3 cases, within our previous 2 years case histories. One must consider the possibility of atheroembolic disease during the differential diagnosis of acute renal failure in geriatric patients, given the serious prognosis.

[Temporary dialysis access in patients with acute renal failure. Protocols of the dialysis centers in the Piedmont and Valled'Aosta]. / Accessi temporanei per dialisi nei pazienti con IRA. Protocolli dei centri dialisi del Piemonte e della Valle d'Aosta.

BACKGROUND: A retrospective study was performed using a multiple-choice questionnaire in order to analyse the normal procedures and trends regarding the insertion and management of emergency dialysis access in patients with acute renal failure in 23 Centres in Piedment and the Aosta Valley, regions in the north of Italy with about 4.5 million inhabitants. METHODS: The observation period ran from January 1996 to July 1997. A questionnaire with 19 main questions and 90 possible multiple answers sent to 22 Centres for adults and the only pediatric centre in both regions. RESULTS: An analysis of the results showed that the most frequently used site in these regions is the subclavian vein (37.8%), followed by the internal jugular vein (32%), the femoral site (28.8%) and peritoneal catheter (1.4%); in pediatric patients, 5% used the femoral site, 10% the subclavian vein, 20% the internal jugular vein and 65% the peritoneal catheter. In 4 centres (18.2%), nephrologists do not position any type ofd access for acute renal failure. In 50% of centres, all doctors insert femoral catheters autonomously. CONCLUSIONS: Some choices, such as the subclavian route, are open to criticism and may perhaps be linked to customary procedures used by anesthetists and intensive care specialists. Some centres only have relative automomy for insertion, and lastly some types of catheters and techniques are not used. The peritoneal catheter has been abandoned by adult centres as an access in acute kidney failure patients.

[Weekly dialysis integrated with low-protein diet and essential amino acids. Preliminary data]. / Dialisi monosettimanale integrata con dieta ipoproteica e aminoacidi essenziali. Dati preliminari.

The possibility of applying a once-a-week dialysis programme supplemented with hypoproteic diet as an adequate technique for starting the uraemic patient on dialysis is examined. Thirteen patients have been so treated, 7 of them currently under treatment for a global period of observation of 46 months. At the moment dialysis began, mean glomerular filtrate was 5.14 ml/min. Once-a-week dialytic treatment with bicarbonate dialysis was associated with a hypoproteic diet of 0.5 g/kg/die of proteins, supplemented with essential amino acids. This treatment showed excellent dialytic tolerance, the values of dialysis start blood nitrogen were lower than 200 mg/dl and dialytic efficiency was compatible with a Kt/v greater than 1.1. There was no observation of any subjective or objective symptomatology that could be related to dialytic inadequacy. Taken as a whole these results make it possible to state that this type of approach permits a gradual start to dialysis and deserves further study.

[Canaud central venous catheters: 4-year experience]. / Cateteri venosi centrali di canaud: esperienza di oltre quattro anni.

BACKGROUND: The use of central venous catheters for permanent vascular access has become increasingly important because of the characteristics and the clinical problems of incident patients or patients already undergoing chronic hemodialysis. In this study a short and medium term evaluation was made of a double permanent central venous catheter positioned in the right internal jugular vein. The Canaud catheter was evaluated both from the point of view of practical use and for various technical and clinical problems. METHODS: During the observation period, July 1995 - September 1999, these catheters were used in 39 patients (mean age 72 years), 22 females and 17 males; 31% were diabetic patients and 46% were older than 75 years. Forty-five catheters were positioned with an average dwelltime of 347 days. RESULTS: Utilization was almost immediate and the resulting blood flow was suitable for all depurative techniques (blood flow more than 250 ml/min), with an average recirculation of 11.9% and an average resistance index of 0.54. Among the most serious complications during surgery a respiratory block was observed followed by the complete recovery of the patient. Some clinical complications were noted (5 venous thrombosis), as were some technical ones: 12% well as related to problems with the adapter, 24.3% to reversible thrombosis of the catheters occurred in 23 catheters in 22 patients. Infections. CONCLUSIONS: Overall Canaud catheters appear to represent a valid alternative to other more recent catheters for permanent vascular access. If necessary, they can be easily substituted due to the absence of a subcutaneous cuff.

[Obesity and non-insulin-dependent diabetes mellitus. Considerations on an epidemiological study]. / Obesità e diabete mellito non insulino dipendente. Considerazioni tratte da uno studio epidemiologico.

We have investigated the age of onset of diabetes mellitus and the body weight in an ethnically homogeneous population of type II diabetics (737 subjects, of whom 248 newly diagnosed). In newly diagnosed diabetics the mean age of onset of diabetes was significantly (p less than 0.001) lower in males than in females. The mean percentage of overweight was significantly (p less than 0.001) higher in female than in male diabetics. In percent, newly diagnosed female diabetics were more obese than newly diagnosed male diabetics. In males, no correlation was found between age and weight, at the moment of diagnosis, while in females a poorly significant (p less than 0.05) negative correlation was found. Our results seem to indicate that in an ethnic group, besides overweight, other (genetic?, dietetic?, environmental?) factors can be prevalent causes of diabetes mellitus.

[Effect of chronic alcohol consumption on blood lipid levels and angiopathy in diabetics]. / Studio dell'influenza dell'assunzione cronica di alcool sulla lipemia e sull'angiopatia in soggetti diabetici.

It is known that chronic alcoholics and type II diabetics show hyperlipidemia, characterized by hypertriglyceridemia and in a minor degree by hypercholesterolemia. The mechanisms underlying the effect of ethanol and carbohydrates on plasma lipids seem to be different; therefore in diabetic subjects chronic alcohol consumption could produce a more severe hyperlipidemia and so accelerate atherosclerotic events. In order to verify it we have measured plasma cholesterol, HDL-cholesterol, and triglycerides and investigated the presence of micro- and macroangiopathy in two groups of non-insulin-dependent diabetics, differing each other for daily alcohol intake (18 chronic male alcoholics and 30 male subjects consuming respectively more than 150 g and less than 50 g of alcohol daily). In alcoholics, no clinical features, laboratory and echographic findings of cirrhosis and pancreatic disease were present. In order to avoid a possible interference of other factors on the metabolism of plasma lipids, in our study patients were selected with the following criteria: 1) only male subjects; 2) age 40-60 years; 3) nonsmokers; 4) moderate coffee drinkers; 5) average physical activity; 6) with BMI less than 28; 7) in good diabetic control (HbA1c less than 6%, n.v. 4.4%-5.6%); 8) normal kidney function (plasma creatinine less than 1.3 mg%) and 24 hr proteinuria absent;) 9) in treatment with diet alone or diet plus low doses of sulphonylureas or biguanides. The data were analyzed by Student's "t" and chi-squared tests. No significant differences could be detected (alcoholics/occasional drinkers, means +/- 1 SD) either in the plasma levels of cholesterol (181.7 +2- 39.3/198.2 +/- 32.5), HDL-cholesterol (43.4 +/- 12.7/38.5 +/- 11.9), and triglycerides (105.5 +/- 56.4/159.7 +/- 114.8) and in the frequency of micro (22.2%/16.6%) and macroangiopathy (16.6%/26.6%) between the two studied groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hyperthyroidism and cholestasis: a case report]. / Ipertiroidismo e colestasi: descrizione di un caso clinico.

Intrahepatic cholestasis has rarely been observed in patients with thyrotoxicosis and generally occurs in association with coexistent congestive heart failure. We report the case of a 63-year-old man who was referred to our Institution because of jaundice and hyperthyroidism. During his hospital stay, his plasma bilirubin level reached 27.41 mg/dL. Clinical, biohumoral, and instrumental examinations excluded heart failure and autoimmune or viral hepatitis. After the start of therapy with methimazole, thyroid hormone and plasma bilirubin levels decreased progressively and simultaneously, eventually returning to normal. Plasma bilirubin values as high as the ones we recorded, in the absence of congestive heart failure or autoimmune chronic hepatitis, have not, to our knowledge, been previously reported.

Appearance of severe jaundice after radiometabolical treatment of thyrotoxicosis.

The appearance of moderate jaundice with mildly raised levels of plasma bilirubin is an uncommon complication of thyrotoxicosis and is usually accompanied by signs of right heart failure. Some described cases were actually related, at least in part, to autoimmune chronic hepatitis. In this paper we describe a case of thyrotoxicosis accompanied by deep jaundice with very high levels of bilirubin occuring in the absence of cardiac failure and with no signs of hepatitis. Jaundice disappeared shortly after the start of thyrostatic drug treatment, supporting a possible detrimental effect of hyperthyroidism on the hepatic bilirubin metabolism.

Short term ethanol ingestion can affect the testicular response to single-dose human chorionic gonadotropin in normal subjects.

Ten sober adult male subjects, with normal sexual development and function, were examined under basal conditions and after a short-term period (7 days) of alcohol ingestion (200 g/daily). Plasma concentrations of testosterone (T), 17 beta estradiol (E2), progesterone (P) and 17-hydroxyprogesterone (17-OH P) were measured on blood samples drawn before and then every 24 h until the 96th h following a single dose of human chorionic gonadotropin (hCG, 2,000 IU im). Basal plasma T was significantly decreased after short-term ethanol ingestion (p less than 0.01) whereas E2, P and 17-OH P were comparable in both conditions. The magnitude of the T response to hCG injection was significantly lower after ethanol ingestion but still significantly higher than the corresponding one obtainable in chronic alcoholics. At the 7th day of ethanol ingestion plasma LH levels were higher than controls (p less than 0.05). These results demonstrate that short-term ingestion of 200 g ethanol daily can lead to altered testicular response to hCG in normal adult males and corroborate the view that ethanol is a gonadal toxin.