The transformation of the Radical Right Gender Gap: The case of the 2014 EP Election

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Parole in jeans: poesia e telematica

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La sorveglianza del morbillo per la Regione Liguria negli ultimi cinque anni.

Introduzione: Il virus del morbillo appartiene al genere Morbillivirus della famiglia dei Paramixoviridae. Il virione contiene un RNA non\u2013segmentato, a singolo strand, di senso negativo di circa 16 kb. Il genoma contiene 6 geni che codificano per 6 proteine: proteina del nucleocapside (N), fosfoproteina (P), proteina della matrice (M), proteina di fusione (F), emoagglutinina (H) e proteina grande (L). Il virus del morbillo \ue8 nato come una zoonosi da quello della peste bovina (bovini peste). Ad oggi l'uomo \ue8 l'unico serbatoio naturale del virus. Il contagio avviene per via aerea, con il virus trasportato dalle goccioline di Flugge ovvero le micro gocce di saliva che vengono emesse attraverso il respirare lo starnutire o il tossire, e per contatto diretto o indiretto con i fluidi corporei di una persona malata (saliva, sperma, muco). Il virus penetra attraverso le mucose respiratorie e la congiuntiva e raggiunge i linfonodi dove si moltiplica e si diffonde cos\uec per via sistemica. L'incubazione dura circa 10 giorni. La viremia ha un picco in corrispondenza del 12\ub0 giorno dopo il contagio. E' una patologia particolarmente contagiosa per cui rientra tra le patologie da notifica obbligatoria. E' disponibile un vaccino. Il PNPV 2017-2019 prevede il Vaccino anti Morbillo-Parotite-Rosolia. Il sistema di sorveglianza WHO si pone l\u2019obiettivo di eliminare la trasmissione endemica mantenendo alti i livelli delle vaccinazioni e implementando il sistema di sorveglianza in particolar modo nell\u2019ambito del WHO Global Measles and Rubella laboratory Network . A livello nazionale \ue8 stata istituita una rete di laboratori afferenti alla rete MoRoNet con obbligo di notifica all'Istituto Superiore di Sanit\ue0 dei casi confermati positivi. Oggetto di questa tesi \ue8 la descrizione dell'attivit\ue0 di sorveglianza per il morbillo della Regione Liguria negli ultimi cinque anni di lavoro. Materiali e metodi: Il laboratorio dell\u2019UO Igiene dell\u2019Ospedale Policlinico San Martino IRCCS, Universit\ue0 di Genova, raccoglie urine e tampone faringeo di pazienti con probabile o possibile morbillo, i casi da confermare e notificare su piattaforma MoRoNet quindi vengono analizzati come segue: estrazione degli acidi nucleici, amplificazione e sequenziamento del gene NP. Ottenuta la sequenza \ue8 possibile determinare il genotipo del virus circolante e confrontarlo con altre sequenze di riferimento disponibili o con altri casi di morbillo. Questa informazione si ottiene costruendo un albero filogenetico con programmi bioinformatici di allineamento di sequenze e analisi di omologia tra sequenze. Risultati: Nel laboratorio di riferimento della Regione Liguria nel periodo 2015-2019 abbiamo raccolto 114 casi di morbillo da confermare. Di questi 57 casi sono stati confermati positivi. La media dell'et\ue0 sul periodo \ue8 risultata essere 26,8 anni e la mediana 32 anni. In particolare abbiamo riscontrato la presenza dei focolai epidemici nella provincia di Imperia tra la fine 2017 e l' 2018. I risultati dei test di caratterizzazione molecolare hanno permesso di identificare nei campioni raccolti nel 2018 un\u2019unica variante di genotipo B3 circolante, mentre nel 2019 si \ue8 osservata la circolazione di diverse varianti appartenenti al genotipo D8 clade Manchester.UNK/3. Precedentemente le stagioni epidemiologiche sono state caratterizzate dalla circolazione della variante B3, quindi si conclude considerando attualmente una alternanza quasi annuale delle varianti circolanti di virus del morbillo. Conclusioni e discussione: Il morbillo continua a circolare in Italia e causare epidemie per le coperture vaccinali inadeguate nel corso degli anni, che hanno portato all\u2019accumulo di ampie quote di popolazione suscettibili all\u2019infezione. Le adesioni alla prima e alla seconda dose di vaccino MPR sono in aumento ma ancora inferiori al target del 95% e con una rilevante variabilit\ue0 tra regioni. Inoltre l'elevata et\ue0 mediana dei casi indica che esistono ampie sacche di giovani adulti suscettibili, mentre i casi tra gli operatori sanitari Imperiesi evidenziano il problema della bassa copertura vaccinale tra questi ultimi. E' infine evidente la necessit\ue0 di individuare nel Piano nazionale per l'eliminazione del morbillo e della rosolia congenita nuove azioni rispetto a quanto previsto nei precedenti Piani, per esempio rafforzare la copertura nella popolazione adulta. Si conclude ricordando che l'obiettivo generale da raggiungere entro il 2023 \ue8: incidenza <1 caso di morbillo / 1,000,000 popolazione, e tra gli obiettivi specifici rimane fondamentale raggiungere e mantenere una copertura vaccinale maggiore o uguale al 95% per la prima dose di morbillo.Introduction: Measles virus belongs to the genus Morbillivirus of the Paramixoviridae family. The virion contains a non-segmented RNA, a single strand, of a negative sense of approximately 16 kb. The genome contains 6 genes that code for 6 proteins: nucleocapsid protein (N), phosphoprotein (P), matrix protein (M), fusion protein (F), hemagglutinin (H) and large protein (L). Measles virus originated as a zoonosis from that of the bovine plague ( Rinderpest) . To date, man is the natural reservoir user of the virus. Contagion occurs by air, with the virus carried by the droplets of Flugge or the micro drops of saliva that are emitted through breathing, sneezing or coughing, and by direct or indirect contact with the body fluids of a sick person (saliva, sperm, mucus). The virus penetrates through the respiratory mucous membranes and the conjunctiva and observes the lymph nodes where it multiplies and spreads systemically. Incubation lasts approximately 10 days. The viraemia peaks in the correspondence on the 12th day after the infection. It is a particularly contagious pathology for which it falls under the pathologies of mandatory notification. A vaccine is available. The PNPV 2017-2019 provides for the measles-mumps-rubella vaccine.nThe WHO surveillance system aims to eliminate endemic transmission by keeping vaccination levels high and by implementing the surveillance system especially within the WHO Global Measles and Rubella laboratory Network. At national level, a network of laboratories has been set up belonging to the MoRoNet network with the obligation to notify the Istituto Superiore di Sanit\ue0 of confirmed positive cases. The subject of this thesis is the description of the surveillance activity for measles of the Liguria Region in the last five years of work. Materials and methods: The laboratory of the Hygiene Unit of the Policlinico San Martino IRCCS Hospital, University of Genoa, collects urine and pharyngeal swab of patients with probable or possible measles, the cases to be confirmed and notified on the MoRoNet platform are therefore analyzed as follows: extraction of nucleic acids , amplification and sequencing of the NP gene. Once the sequence is obtained, it is possible to determine the genotype of the circulating virus and compare it with other available reference sequences or with other cases of measles. This information is obtained by building a phylogenetic tree with bioinformatic programs of sequence alignment and homology analysis between sequences. Results: In the reference laboratory of the Liguria Region in the period 2015-2019 we collected 114 cases of measles to be confirmed. Of these 57 cases were confirmed positive. The average age over the period was 26.8 years and the median 32 years. In particular, we found the presence of epidemic outbreaks in the province of Imperia between the end of 2017 and 2018. The results of the molecular characterization tests made it possible to identify a single circulating variant of genotype B3 in the samples collected in 2018, while in 2019 the circulation of several variants belonging to the D8 clade Manchester genotype was observed.UNK / 3. Previously the epidemiological seasons have been characterized by the circulation of the B3 variant, therefore it concludes considering at present an almost annual alternation of the circulating variants of measles virus. Conclusions and discussion: Measles continues to circulate in Italy and cause epidemics for inadequate vaccination coverage over the years, which have led to the accumulation of large portions of the population susceptible to infection. The adhesions to the first and second dose of MPR vaccine are increasing but still lower than the target of 95% and with a significant variability between regions. Furthermore, the high median age of the cases indicates that there are large pockets of susceptible young adults, while the cases among Imperia health workers highlight the problem of low vaccination coverage among the latter. Lastly, there is a clear need to identify new actions in the National Plan for the elimination of measles and congenital rubella compared to the previous Plans, for example to strengthen coverage in the adult population. It concludes by recalling that the general objective to be achieved by 2023 is: incidence <1 case of measles / 1,000,000 population, and among the specific objectives it remains essential to achieve and maintain a vaccination coverage greater than or equal to 95% for the first dose of measles

Pneumomediastinum after transbronchial cryobiopsy

Pneumomediastinum is defined as the presence of air or gas within the mediastinum and it rarely complicates bronchoscopy. We report, to our best knowledge, the first case of pneumomediastinum following a transbronchial cryobiopsy (TBLC). TBLC is considered a safe procedure as compared with both transbronchial biopsy and surgical lung biopsy. Systematic reviews, metanalysis and a Pubmed research, revealed that in literature no pneumomediastinum has been mentioned after TBLC. We report this case for to make it known to interventional pulmonologists the possibility that a pneumomediastinum can follow a TBLC. In our case the spontaneous resolution in few days did not require any intervention

Airway responsiveness to methacholine: effects of deep inhalations and airway inflammation.

Abstract We determined the dose-response curves to inhaled methacholine (MCh) in 16 asthmatic and 8 healthy subjects with prohibition of deep inhalations (DIs) and with 5 DIs taken after each MCh dose. Flow was measured on partial expiratory flow-volume curves at an absolute lung volume (plethysmographically determined) equal to 25% of control forced vital capacity (FVC). Airway inflammation was assessed in asthmatic subjects by analysis of induced sputum. Even when DIs were prohibited, the dose of MCh causing a 50% decrease in forced partial flow at 25% of control FVC (PD(50)MCh) was lower in asthmatic than in healthy subjects (P < 0.0001). In healthy but not in asthmatic subjects, repeated DIs significantly decreased the maximum response to MCh [from 90 +/- 4 to 62 +/- 8 (SD) % of control, P < 0.001], increased PD(50)MCh (P < 0.005), without affecting the dose causing 50% of maximal response. In asthmatic subjects, neither PD(50)MCh when DIs were prohibited nor changes in PD(50)MCh induced by DIs were significantly correlated with inflammatory cell numbers or percentages in sputum. We conclude that 1) even when DIs are prohibited, the responsiveness to MCh is greater in asthmatic than in healthy subjects; 2) repeated DIs reduce airway responsiveness in healthy but not in asthmatic subjects; and 3) neither airway hyperresponsiveness nor the inability of DIs to relax constricted airways in asthmatic subjects is related to the presence of inflammatory cells in the airways

Competence in transbronchial cryobiopsy

Over the last decade transbronchial lung cryobiopsy (TBLC) has proven to be an “innovative application” of an “old procedure” for the histologic diagnosis of diffuse interstitial lung diseases (DI LDs). Thus, the technique of TBL cryobiopsy is now adopted for diagnostic purposes, transbronchially in peripheral airways to sample lung parenchyma, whereas this same technique was traditionally employed in the past for therapeutic purposes, essentially for the management of malignant obstruction of central airways. When patients with interstitial lung diseases (ILDs) need histopathological data in their diagnostic pathway, this bioptic approach could be a valid alternative to surgical lung biopsy, that is still the gold standard at the moment. TBL cryobiopsy has a good safety profile, its sensitivity and specificity appear good overall in idiopathic pulmonary fibrosis. In the last ten years, many papers have been published about this procedure defining modalities by which cryobiopsy should be performed. These studies have shown that TBL cryobiopsy is feasible, it allows to obtain larger lung parenchymal specimens (3 times larger than “classic” transbronchial biopsies), characterized by unaltered and artefact-free morphology, and it represents a safe and poorly invasive diagnostic tool for the histologic diagnosis of ILDs. The technical aspects are really important, and they still need a complete standardization. TBL cryobiopsy should be part of an equipment of the modern interventional pulmonologist, who should know indications and contraindications of this methodic and the technical aspects of the procedure. This is a complex procedure requiring to be performed by endoscopists working in specialized centers with specific knowledge of DILDs, and a multidisciplinary approach, which represent pre-requisites for admission to training in this procedure

Changes in lung volumes and airway responsiveness following haematopoietic stem cell transplantation

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Complicanza fatale alla rimozione di protesi metallica tracheale in paziente con tracheobroncomalacia, case report e revisione della letteratura

Una nota dell'FDA del 2005(1) già consigliava di non utilizzare stent bronchiali metallici in pazienti con stenosi secondarie a patologie benigne. Il gold standard, in questo senso, è l'uso delle protesi bronchiali siliconiche, più facilmente removibili rispetto alle metalliche, anche se anch'esse non scevre di complicanze. La tracheobroncomalacia, essendo una patologia con caratteristiche dinamiche, determina una serie di complicanze aggiuntive e sinergiche di cui è necessario tener conto nel momento in cui si opta per posizionare uno stent endobronchiale