Managing Adult-onset Still's disease: The effectiveness of high-dosage of corticosteroids as first-line treatment in inducing the clinical remission. Results from an observational study

To assess the effectiveness of the treatment with high dosage of corticosteroids (CCSs), as first-line therapy, in inducing remission in naïve Adult-onset Still's disease (AOSD) patients compared with low dosage of CCSs, after 6 months. To further evaluate the rate of patients maintaining the remission and the rate of CCSs discontinuation, after additional 12 months of follow-up.A retrospective evaluation of patients prospectively followed was designed to compare the rate of clinical remission in naïve AOSD patients treated with high dosages of CCSs (0.8-1 mg/kg/day of prednisone-equivalent) or low dosage of CCSs (0.2-0.3 mg/kg/day of prednisone-equivalent), after 6 months. An additional analysis was performed to compare the rate of monocyclic pattern between these groups, after further 12 months of follow-up.The clinical remission was achieved in a higher percentage of patients treated with the first-line treatment with high dosage of CCSs than treated the first-line treatment with low dosage of CCSs. At the end of 18 months of follow-up, a larger percentage of patients treated the first-line treatment with high dosage of CCSs was classified as monocyclic pattern and discontinued CCSs when compared with patients treated the first-line treatment with low dosage of CCSs. Patients defined as CCSs non-responder were treated with methotrexate (MTX)+CCSs or with combination therapy CCSs+MTX+biologic drug. The clinical remission was observed in a percentage of these patients.We showed the effectiveness of the first-line treatment with high dosage of CCSs in inducing clinical remission in naïve AOSD patients when compared with the first-line treatment with low dosage of CCSs. The first-line treatment with high dosage of CCSs was also associated with the achievement of monocyclic pattern and CCSs discontinuation, after 18 months of follow-up

Sustainability of technological innovation investiments. Photovoltaic panels case study

as photovoltaic panels. In the case study analysed are shown the benefits obtained from the investments of the central Italy after installing photovoltaic systems. The total expenditure for the electricity purchase is € 52.326, while the total benefit of the investment is € 18.789, equal in percentage to a 53% energy saving over a period of 20 years. The company expeniture in the absence of a photovoltaic system is equal to € 109.03, while in the presence of a plant, considering also all costs incurred for € 93.090, with a percentage of profit on the investment made equal to almost 15% in 20 years

East Coast/West Coast: The Long Tradition of Italian Immigrant Performers

This article discusses the role of the immigrant stage in representing, imagining, exporting and importing, the Italian identity. In particular the essay examines the differences between the Italian Diasporic communities on the  east Coast and in California and the diverse culture dello spettacolo they proposed to both American and Italian audiences

A window on the private sphere: advice columns, marriage, and the evolving family in 1950s Italy

No abstract availabl

Inhibitory effects of thought substitution in the think/no-think task: evidence from independent cues

When people try not to think about a certain item, they can accomplish this goal by using a thought substitution strategy and think about something else. Research conducted with the think/no-think (TNT) paradigm indicates that such strategy leads subsequently to forgetting the information participants tried not to think about. The present study pursued two goals. First, it investigated the mechanism of forgetting due to thought substitution, contrasting the hypothesis by which forgetting is due to blocking caused by substitutes with the hypothesis that forgetting is due to inhibition (using an independent cue methodology). Second, a boundary condition for forgetting due to thought substitution was examined by creating conditions under which the generation of appropriate substitutes would be impaired. In two experiments, participants completed a TNT task under thought substitution instructions in which either words or pseudo-words were used as original cues and memory was assessed with original and independent cues. The results revealed forgetting in both original and independent cue tests, supporting the inhibitory account of thought substitution, but only when cues were words, and not when they were non-words, pointing to the ineffectiveness of a thought substitution strategy when original cues lack semantic content

Preface

Thiis is the preface introducing the volum

Application of latent class analysis in assessing the awareness, attitude, practice and satisfaction of paediatricians on sleep disorder management in children in Italy.

AIM: To identify subgroups regarding paediatricians' awareness, attitude, practice and satisfaction about management of Sleep-Disordered Breathing (SDB) in Italy using Latent Class Analysis (LCA). METHODS: A cross-sectional study was conducted on a large sample of Italian paediatricians. Using a self-administered questionnaire, the study collected information on 420 Paediatric Hospital Paediatricians (PHPs) and 594 Family Care Paediatricians (FCPs). LCA was used to discover underlying response patterns, thus allowing identification of respondent groups with similar awareness, attitude, practice and satisfaction. A logistic regression model was used to investigate which independent variables influenced latent class membership. Analyses were performed using R 3.5.2 software. A p-value<0.05 was considered statistically significant. RESULTS: Two classes were identified: Class 1 (n = 368, 36.29%) "Untrained and poorly satisfied" and Class 2 (n = 646, 63.71%) "Trained and satisfied." Involving paediatric pneumologists or otorhinolaryngologists in clinical practice was associated with an increased probability of Class 2 membership (OR = 5.88, 95%CI [2.94-13.19]; OR = 15.95, 95% CI [10.92-23.81] respectively). Examining more than 20 children with SDB during the last month decreased the probability of Class 2 membership (OR = 0.29, 95% CI [0.14-0.61]). FCPs showed a higher probability of Class 2 membership than PHPs (OR = 4.64, 95% CI [3.31-6.55]). CONCLUSIONS: These findings suggest that the LCA approach can provide important information on how education and training could be tailored for different subgroups of paediatricians. In Italy standardized educational interventions improving paediatricians' screening of SDB are needed in order to guarantee efficient management of children with SDB and reduce the burden of disease

Hypnosis and memory: two hundred years of adventures and still going!

One of the most persistent beliefs about hypnosis is its ability to transcend mnemonic abilities. This belief has paved the way to the use of hypnosis in the clinical and legal arenas. The authors review the phenomena of hypnotic hypermnesia, pseudo-memories, and amnesia in light of current knowledge of hypnosis and memory. The investigation of the relation between hypnosis and memory processes has played an important role in our understanding of memory in action. Hypnosis provides a fertile field to explore the social, neuropsychological, and cognitive variables at play when individuals are asked to remember or to forget their past. We suggest promising avenues of research that may further our knowledge of the building blocks of memories and the mechanisms that leads to forgetfulness

Laterolateral teleradiography of the skull as a screening method for OSA/OSAS, in patients in orthodontic treatment

Aim: Obstructive sleep apnea syndrome (OSAS) is the most common type of sleep apnea and it is caused by complete or partial obstruction of the upper airway. Adenotonsillar hypertrophy, obesity, cranio-facial anomalies and neuromuscular diseases are the main risk factors for the development of OSAS in the pediatric age. Specially several studies identify the relationship between respiratory disorders in sleep and obesity, and, in particular, between OSAS and obesity, designing a prevalence of OSAS among obese subjects between 14 and 78%. The diagnosis of OSAS in the child is of great importance as it can lead to neurocognitive and behavioral complications, growth retardation, systemic arterial hypertension, pulmonary hypertension, cardiovascular disease and metabolism. The WHO (World Health Organization) has established the new criteria for the classification of Obesity on the basis of BMI and the risk of comorbidities, identifying a moderate risk for underweight subjects, a very low risk for normal weights and an increased risk from severe to severe for overweight and obese individuals respectively. According to that the aim of this study is to evaluate the correlation between obstructive sleep apnea syndrome and cephalometric variables in children considering age and BMI. Materials and methods: Children aged 7–10 years and 11-14 years with no genetic syndrome, previous otorhinolaryngologic or orthodontic therapy treatments are being selected from our Departments of Paediatric Dentistry, University of Palermo, and from the Department of Orthodontics, University of Messina (Italy). All patients so far recruited and visited for orthodontic problems were in mixed or early permanent dentition phase, with the first upper molars fully erupted and presented to the history of several symptoms of Osas, such as recurring episodes of shallow or paused breathing during sleep, waking up frequently to urinate, morning headaches, memory or learning problems and not be able to concentrate or feeling irritable. Dental records and lateral cephalometric radiographs were obtained for all of the patients and than they have been subjected to paediatric, otolaryngology and polysomnography visits. Subject with a positive diagnosis of Osas were studied and they were divided in group based on their BMI. In all groups the inter-molar distance in dental records was measured, and the cephalometric traces have been calculated. As reported by the study by Galeotti et al. the cephalometric measurements analysed are S-PNS, ad1-PNS, and ad2-PNS for the nasopharynx; p-pp and pa for oropharynx; H-H’ for the Hyoid bone; SNA for the maxilla; SNB;ANB and Go-Me for the mandible; S-Go, N-Me and P-A for facial Height; SN for cranial base; SN-MP and PP-MP for the typology, and angle ArGoMe for Growth prevision. At the time that children are still in the way of recruitment the results may not yet be defined; however it is necessary to emphasize the importance of the study, because in the child respiratory disturbances in the sleep, and in particular the OSAS, are often underestimated, despite representing the third place between the threats of health after the smoke and the excess of weight