The 2013 election results: protest voting and political stalemate

The economic crisis, the fall of the Berlusconi's cabinet in November 2011 and the formation of the technocratic cabinet led by Mario Monti provided the ground for the general elections held in February 2013, which reached a stalemate, contrary to what most observers expected. The center-left coalition won in the Chamber but not in the Senate. The result in the Senate made it impossible to form a majority coalition between Bersani's left and Monti's center, which many considered the most likely outcome of these elections. In the end, the only available option for the PD, the winner in the Chamber, was to form a cabinet with Berlusconi's PdL. There are many factors explaining this destabilizing result. The first and most important is the success of a brand new anti-establishment party, the Five Star Movement, which attracted voters from across the political spectrum and became the largest party in the country. The second is the inability of the center-left not only to extend its electoral base at a time when the center-right lost almost half of the votes received in 2008, but also to keep its previous electorate. The third factor is the peculiar nature and functioning of the electoral system for the Senate

The new Italian electoral system and its effects on strategic coordination and disproportionality

On 26 October 2017, the Italian Parliament approved a new electoral system nicknamed Rosatellum after Ettore Rosato, head of the Partito Democratico’s (PD, Democratic Party) parliamentary group in the Chamber, who was the first proponent of the law. The new electoral system is the fourth since 1993. It is a mixed system, like the others, and it applies to both the Chamber and the Senate. Roughly two thirds of the seats are assigned with a proportional formula in multi-member districts. The remaining seats are assigned in single-member districts with plurality rule. The impact of the new electoral system in terms of party representation has been more proportional than majoritarian. No party or coalition won an absolute majority of seats. However, if we look at its overall per- formance the picture is mixed. After all, the SMDs are a potent tool and they have made the difference in terms of voting behaviour and pattern of competition. Two pre-electoral coalitions have been formed, the centre-left and the centre-right, which presented themselves, along with M5S, as potential government alternatives. The agreements made among their members acted as a constraint on possible post-electoral alliances making diffi- cult to form a government. This is one of the main reasons of the long stalemate

Effects of Ultramicronized Palmitoylethanolamide (um-PEA) in COVID-19 Early Stages: A Case-Control Study

Ultramicronized palmitoylethanolamide (um-PEA), a compound with antioxidant, anti-inflammatory and neuroprotective properties, appears to be a potential adjuvant treatment for early stages of Coronavirus disease 2019 (COVID-19). In our study, we enrolled 90 patients with confirmed diagnosis of COVID-19 that were randomized into two groups, homogeneous for age, gender and BMI. The first group received oral supplementation based on um-PEA at a dose of 1800 mg/day for a total of 28 days; the second group was the control group (R.S. 73.20). At baseline (T0) and after 28 days of um-PEA treatment (T1), we monitored: routine laboratory parameters, inflammatory and oxidative stress (OS) biomarkers, lymphocytes subpopulation and COVID-19 serological response. At T1, the um-PEA-treated group presented a significant reduction in inflammation compared to the control group (CRP p = 0.007; IL-6 p = 0.0001; neutrophils to lymphocytes ratio p = 0.044). At T1, the controls showed a significant increase in OS compared to the treated group (FORT p = 0.05). At T1, the um-PEA group exhibited a significant decrease in D-dimer levels (p = 0.0001) and higher levels of IgG against SARS-CoV-2 (p = 0.0001) compared to the controls. Our data demonstrated, in a randomized clinical trial, the beneficial effects of um-PEA in both asymptomatic and mild-symptomatic patients related to reductions in inflammatory state, OS and coagulative cascade alterations

Intracranial Hemorrhage from Dural Arteriovenous Fistulas: What Can We Find with CT Angiography?

Background: Dural arteriovenous fistulas (DAVF) represent a rare acquired intracranial vascular malformation, with a variety of clinical signs and symptoms, which make their diagnosis difficult. Intracranial hemorrhage is one of the most serious clinical manifestations. In this paper the authors’ goal was to verify the accuracy and utility of contrast-enhanced brain CT angiography (CTA) for the identification and the characterization of dural arteriovenous fistulas (DAVFs) in patients who presented with brain hemorrhage compared to 3D digital subtraction angiography (3D DSA); (2) a retrospective study of 26 patients with DAVFs who presented with intracranial hemorrhage to our institution was performed. The information reviewed included clinical presentation, location and size of hemorrhage, brain CTA and 3D DSA findings; (3) results: 61% (16/26) of DAVFs were identified by CTA. The vast majority of patients were male (69%, 18/26) and the most common presenting symptom was sudden onset headache. All DAVFs had cortical venous drainage and about one-third were associated with a venous varix. The most common location was tentorial (73%, 19/26); (4) conclusions: CTA can represent a valid alternative diagnostic method to 3D DSA for the study of DAVF in the initial and preliminary diagnostic approach, especially in emergency situations. In fact, it represents a fast, inexpensive, non-invasive and above all, easily accessible and available diagnostic technique, unlike DSA or MRI, allowing to provide information necessary for the identification, classification and treatment planning of DAVF

Years of life that could be saved from prevention of hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) causes premature death and loss of life expectancy worldwide. Its primary and secondary prevention can result in a significant number of years of life saved. AIM: To assess how many years of life are lost after HCC diagnosis. METHODS: Data from 5346 patients with first HCC diagnosis were used to estimate lifespan and number of years of life lost after tumour onset, using a semi-parametric extrapolation having as reference an age-, sex- and year-of-onset-matched population derived from national life tables. RESULTS: Between 1986 and 2014, HCC lead to an average of 11.5 years-of-life lost for each patient. The youngest age-quartile group (18-61 years) had the highest number of years-of-life lost, representing approximately 41% of the overall benefit obtainable from prevention. Advancements in HCC management have progressively reduced the number of years-of-life lost from 12.6 years in 1986-1999, to 10.7 in 2000-2006 and 7.4 years in 2007-2014. Currently, an HCC diagnosis when a single tumour <2 cm results in 3.7 years-of-life lost while the diagnosis when a single tumour 65 2 cm or 2/3 nodules still within the Milan criteria, results in 5.0 years-of-life lost, representing the loss of only approximately 5.5% and 7.2%, respectively, of the entire lifespan from birth. CONCLUSIONS: Hepatocellular carcinoma occurrence results in the loss of a considerable number of years-of-life, especially for younger patients. In recent years, the increased possibility of effectively treating this tumour has improved life expectancy, thus reducing years-of-life lost