"Mezziuomini, mezzedonne e piglianculo". Rappresentazioni e relazioni nella Sicilia Occidentale

Se nei confronti degli “uomini” è possibile attribuire, per inferenza, qualità quali la coerenza, la libertà di giudizio e l'onestà, sia i “mezzi uomini” che, di rimando, le “mezze donne” e i “piglianculo” nascondono un lato oscuro, una percentuale imprecisata di disvalore. Essa è fornita dalle stigmatizzazioni periodiche a cui sono sottoposti nell’incontro con gli altri. Perché, se gli ominicchi scimmiottano, i pigliainculo non avendo, dal termine che li addita, una “integrità autoriflessiva”, e subendo una espropriazione relazionale del proprio sé autentico, sperimentano in modi differenti l’incontro con l’altri. Il sagggio ripercorre alcuni lemmi che dalla vita quotidiana alla letteratura siciliana ripercorrono le rappresentazioni che dell'omosessualità la società insulare ha a lungo conservato. Svolge poi, attraverso i risultati una ricerca condotta fra giovani omossessuali dichiarati siciliani, un confronto con le attuali rappresentazioni dell'omosessualità

Biliary injuries after pancreatic surgery: Interventional radiology management

Bile duct injuries are among the most feared complications after pancreatic surgery. Most of these surgical complications are related to iatrogenic injuries and include bile leakage, biliary duct obstruction or stricture and infection. A wide range of Interventional Radiology treatment options are currently available. The options include percutaneous transhepatic cholangiography (PTC), percutaneous transhepatic biliary drainage (PTBD), percutaneous balloon dilatation and stenting, image-guided percutaneous abscess drainage. The purpose of this review is to describe the current evidence in this continuously evolving field

Gd-EOB-DTP-enhanced MRC in the preoperative percutaneous management of intra and extrahepatic biliary leakages: Does it matter?

Postoperative bile leakage is a common complication of abdominal surgical procedures and a precise localization of is important to choose the best management. Many techniques are available to correctly identify bile leaks, including ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI), being the latter the best to clearly depict "active" bile leakages. This paper presents the state of the art algorithm in the detection of biliary leakages in order to plan a percutaneous biliary drainage focusing on widely available and safe contrast agent, the Gb-EOB-DPA. We consider its pharmacokinetic properties and impact in biliary imaging explain current debates to optimize image quality. We report common sites of leakage after surgery with special considerations in cirrhotic liver to show what interventional radiologists should look to easily detect bile leaks

Geositi nel paesaggio mediterraneo: confronto tra aree costiere maltesi e siciliane.

Le isole maltesi mostrano aspetti geologici, geomorfologici e ambientali comparabili con quelli siciliani che danno luogo alla presenza di elementi paesaggistici ad elevata potenzialit\ue0 turistica, ad oggi non sufficientemente valorizzati. Nell\u2019ambito di un progetto di ricerca internazionale volto alla realizzazione di reti ecologiche transfrontaliere Malta-Sicilia (RE.MA.SI.), sono stati condotti studi sulla valorizzazione, divulgazione e corretta fruizione del patrimonio geologico di alcuni territori di queste due isole. Vengono qui presentati i risultati preliminari che hanno portato all'identificazione e valorizzazione di geositi di interesse geomorfologico, le cui caratteristiche sono state analizzate qualitativamente e quantitativamente, tramite l\u2019applicazione di metodologie gi\ue0 sperimentate a livello internazionale e basate sulla stima del loro valore scientifico, addizionale e di fruibilit\ue0. Sono state analizzate principalmente forme di rilevante interesse scientifico, didattico e paesaggistico, quali morfotipi costieri, evidenze morfologiche di processi gravitativi e di erosione idrica e forme carsiche

Pulmonary embolism in COVID-19: Ventilation and perfusion computed tomography

This is an illustrated case about CT ventilation and perfusion in Covid patient

Mobility of daughter elements of U-238 decay chain during leaching by In Situ Recovery (ISR) : New insights from digital autoradiography

In highly permeable sedimentary rock formations, U extraction by in-situ leaching techniques (ISR - In-Situ Recovery) is generally considered to have a limited environmental impact at ground level. Significantly, this method of extraction produces neither mill tailings nor waste rocks. Underground, however, the outcome for U-238 daughter elements in aquifers is not well known because of their trace concentrations in the host rocks. Thus, understanding the in-situ mobility of these elements remains a challenge. Two samples collected before and after six months of ISR experiments (Dulaan Uul, Mongolia) were studied with the help of a digital autoradiography technique (DA) of alpha particles, bulk alpha spectrometry, and complementary petrographic observation methods. These techniques demonstrate that before and after leaching, the radioactivity is concentrated in altered and microporous Fe-Ti oxides. Most of the daughter elements of U remain trapped in the rock after the leaching process. DA confirms that the alpha activity of the Fe-Ti oxides remains high after uranium leaching, and the initial secular equilibrium of the U-238 series for Th-230 to Po-210 daughter elements (including Ra-226) of the fresh rocks is maintained after leaching. While these findings should be confirmed by more systematic studies, they already identify potential mechanisms explaining why the U-daughter concentrations in leaching water are low.Peer reviewe

Molecular mimicry in the post-COVID-19 signs and symptoms of neurovegetative disorders?

Many individuals who have severe forms of COVID-19 experience a suite of neurovegetative signs and symptoms (eg, tachycardia) after their recovery, suggesting that the imbalance of the sympathetic-parasympathetic activity of the autonomic nervous system1 could continue for many weeks or months after respiratory symptoms stop. Moreover, a reduction of the parasympathetic tone could have a role in restricting the cholinergic anti-inflammatory pathway, thus favouring hyperinflammation and cytokine storm in the most severe phases of the disease. As reported by Guglielmo Lucchese in The Lancet Microbe,2 SARS-CoV-2 can damage the nervous system via an indirect mechanism, resulting in a high prevalence of autoantibodies, mainly against unknown autoantigens in the brain, in cerebrospinal fluid from patients with neurological complications.2 The cause of low vagal tone and SARS-CoV-2 has not yet been investigated sufficiently and here we would like to share some original data supporting the putative role of molecular mimicry as the culprit of COVID-19 pathogenesis, including the post-COVID-19 neurovegetative syndrome.2, 3, 4, 5 Using methods that have been previously described,3 we looked specifically at the human proteins expressed in vagal nuclei and ganglia. As shown in the appendix (pp 1–2), we found that 22 of these proteins share peptides that could putatively generate a T-cell or B-cell driven autoimmune response. The location and function of these proteins are described in the appendix (pp 3–24). Fibres of the vagal nerve originate from four nuclei located in the medulla oblongata—ie, the dorsal motor nucleus, the nucleus ambiguus, the solitary nucleus, and, to a lesser extent, the spinal trigeminal nucleus. These fibres contribute to the somatic and visceral motricity, somatic and visceral sensibility, and the sense of taste. The visceral motor inputs originate specifically from the dorsal motor nucleus and nucleus ambiguus and are directed towards the heart, the airways, and the gastrointestinal system. Moreover, the vagal visceral innervation includes two sensory ganglia of the peripheral nervous system—the nodose ganglion and the jugular ganglion. In particular, peripheral fibres of the neurons of the nodose ganglion not only innervate the taste buds on the epiglottis, the chemoreceptors of the aortic bodies, and baroreceptors in the aortic arch, but they also provide sensory innervation to the circulatory, respiratory, and gastrointestinal systems. An impairment of the vagal innervation of the heart can lead to tachycardia at rest, which is often seen by clinicians during physical examination of patients who have recovered from a severe form of COVID-19.1 We found that the dorsal motor nucleus, nucleus ambiguus, nodose ganglion, and jugular ganglion can all host neurons presenting proteins with epitopes in common with SARS-CoV-2 proteins, and the peptide TGRLQSL is embedded in one immunoreactive linear epitope that has already been experimentally validated in the human host (Immune Epitope Database and Analysis Resource identification number 36724) to be able to generate an autoimmune response. We share our findings to prompt further studies assessing whether severe forms of COVID-19 could produce transitory or permanent damage in some vagal structure and whether this can, in turn, be responsible for the low vagal tone and the related clinical signs and symptoms

Cooled tip radiofrequency ablation of benign thyroid nodules: preliminary experience with two different devices

Background: Thyroid nodules are very common in general population. Even if benign, they may require a treatment in case of symptoms or cosmetic concerns. In the last years, minimally invasive treatments alternative to surgery have been developed, in particular ultrasound (US) guided radiofrequency ablation (RFA). Methods: Twenty-four patients (9 males; 15 females; mean age 57.9 years) were treated and divided in two groups (A and B) according to the RFA needle used (18 gauge needle, AMICA; 17 gauge needle, COVIDIEN). Nodules and patients characteristics, together with procedural data were registered pretreatment and at 1-month follow-up. US visibility of the needle, volume of the nodules, symptoms and cosmetic concerns, complications were registered. Results: Visibility of the needle was not significantly different in the two groups (P=0.0787). At 1 month the mean volume of the nodules dropped from 37.1 to 25 mL in group A and from 23.2 to 15.4 mL in group B; shrinkage rate (36.9% and 39.5%, respectively) was not significantly different (P=0.3137). Symptoms decreased from 3.1 to 1.4 in group A and from 4 to 1.6 in group B: no significant differences in reductions were observed (P=0.3305). Cosmetic score decreased from 3.7 to 3.4 in group A and from 3.9 to 3.6 in group B: no significant differences in reductions were observed (P=0.96). Total complication rate (18.2% in group A vs. 23.1% in group B) did not showed significant differences (P=0.5049). Conclusions: The two systems used in our study resulted equivalent in terms of US needle visibility, efficacy, symptom/cosmetic relief, safety. More patients and a longer follow-up are necessary to confirm our results

A multi-scale regional landslide susceptibility assessment approach: the SUFRA_SICILIA (SUscettibilit\ue0 da FRAna in Sicilia) project

The SUFRA project is based on a three level susceptibility mapping. According to the availability of more detailed data, the three scale for susceptibility mapping are increased respect to the ones suggested by the TIER group to 1:100,000, 1:50,000 and 1:25,000/1:10,000. The mapping levels exploit climatic, soil use (CORINE2009) and seismic informative layers, differentiating in the details of the core data (geology and topography), in the quality and resolution of the landslide inventory and in the modelling approach (Tab. 1). SUFRA_100 is based on a heuristic approach which is applied by processing a geologic layer (produced by ARTA integrating pre-CARG 1:100,000 geologic maps); the DEM exploited are IGMI 250m and the mapping units are 1km side square cells. Models are validated with respect to the PAI LIPs (Landslide Identification Points) which are reclassified adopting a simplified scheme. Output cuts of SUFRA100 will be referred to administrative boundaries (provinces). SUFRA50 is based on statistical analysis of new CARG geologic maps and 20m (ITA2000) - 2m (ATA2007) DEM. The mapping units are 500m and 50m cells, hydrographic and hydro-morphometric units. The landslide inventory is the IFFI2012_LIPs (first level) which is the result of the conversion in IFFI format of the PAI archive, which will be supported by remote landslide mapping (exploiting the ATA2007 aerial photos), according to the IFFI first level approach. Validation of the models will be performed exploiting both random spatial partition and temporal partition methods. Output cuts of SUFRA50 will be based on physiographic (basin) and administrative (municipalities) boundaries. SUFRA10/25 is based on statistical analysis of new CARG geologic maps (remotely and field adapted) and 2m (ATA2007) DEM. The mapping units are the slope units (SLUs) which are derived by further partitioning the hydro-morphometric units so to obtain closed morphodynamic units. The landslide inventories is the IFFI2012 which is the results of a field supported (on focus) landslide remote systematic mapping, according to the IFFI full level approach. Examples of SUFRA_100, SUFRA_50 and SUFRA_10 are presented for some representative key sector of Sicily. First results attest for the feasibility and goodness of the proposed protocol. The SUFRA program aims at enabling the regional governmental administration to cope with landslide prevision, which is the required operational concept in land management and planning. PAI has been a great advance with respect to the \u201cpre-SARNO\u201d conditions, but it is very exposed to fail: it is a blind approach for new activations; it is critically dependent on the quality of the landslide inventories; it cannot project the susceptibility outside the landslide area

Post-neurosurgical multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intrathecal colistin. A new case and a systematic review of the literature

Introduction: Post-neurosurgical nosocomial meningitis has become an important subgroup of bacterial meningitis in the hospital setting. The increase in meningitis caused by multidrug-resistant (MDR) Acinetobacter baumannii has resulted in a significant reduction in available treatment options. Case report and literature review: We report the case of a 36-year-old man with a complex craniofacial trauma, who developed a nosocomial meningitis due to MDR A. baumannii that was cured by intrathecal colistin. The case is contextualized among all the published cases of Acinetobacter meningitis treated with topical colistin found through a MEDLINE search of the literature. To date, including the present case, eight reported cases of Acinetobacter meningitis have been treated with colistin administered by an intrathecal route and 24 by an intraventricular route. The daily dose of colistin used ranged from 1.6 mg every 24 h to 20 mg every 24 h in adult patients. Themedian time necessary to obtain cerebrospinal fluid sterilization was 4.1 days, and treatment was always successful even if in two cases Acinetobacter meningitis relapsed. Toxicity probably or possibly related to the topical administration of colistin was noted in five out of the 32 patients. Conclusions: Topical colistin can be an effective and safe treatment for MDR Acinetobacter meningitis