La sindrome da anticorpi antifosfolipidi e la gravidanza

Gli anticorpi antifosfolipidi sono anticorpi (Ab) circolanti diretti contro i fosfolipidi e associati a trombosi arteriose e venose, trombocitopenia e/o aborti ricorrenti. Gli anticorpi anticardiolipina sono stati riconosciuti come marker di un aumentato rischio di trombosi. L’associazione tra Ab antifosfolipidi e aumentato rischio di trombosi nei pazienti con sindrome da Ab antifosfolipidi è probabilmente causata da molti meccanismi, tra cui l’effetto che gli Ab esplicano sulle proteine leganti i fosfolipidi, come la B2-glicoproteina I e la protrombina. Esami di laboratorio: 1) “test della miscela”; 2) test specifici per i fattori della via intrinseca della coagulazione; 3) misura dell’attività di uno o più di questi fattori; 4) test al veleno di vipera di Russell; 5) test aggiuntivi. Trattamento: è preferibile non utilizzare cumarinici in gravidanza per il rischio di embriopatie e di perdite fetali, ma queste possono essere evitate se si sostituiscono con l’eparina alla 6ª settimana di gestazione. Le eparine a basso peso molecolare sono più sicure e più convenienti di quelle non frazionate, e oggi sono i farmaci di scelta da utilizzare in gravidanza

Efficacy of IV Immunoglobulins on Psychiatric Symptoms: A Case Report

Borderline personality disorder (BPD) is a fairly common psychiatric illness with a prevalence between 1.8% and 2% in the general population..

Fix Your Eyes in the Space You Could Reach: Neurons in the Macaque Medial Parietal Cortex Prefer Gaze Positions in Peripersonal Space

Interacting in the peripersonal space requires coordinated arm and eye movements to visual targets in depth. In primates, the medial posterior parietal cortex (PPC) represents a crucial node in the process of visual-to-motor signal transformations. The medial PPC area V6A is a key region engaged in the control of these processes because it jointly processes visual information, eye position and arm movement related signals. However, to date, there is no evidence in the medial PPC of spatial encoding in three dimensions. Here, using single neuron recordings in behaving macaques, we studied the neural signals related to binocular eye position in a task that required the monkeys to perform saccades and fixate targets at different locations in peripersonal and extrapersonal space. A significant proportion of neurons were modulated by both gaze direction and depth, i.e., by the location of the foveated target in 3D space. The population activity of these neurons displayed a strong preference for peripersonal space in a time interval around the saccade that preceded fixation and during fixation as well. This preference for targets within reaching distance during both target capturing and fixation suggests that binocular eye position signals are implemented functionally in V6A to support its role in reaching and grasping

Cistite interstiziale: un nuovo approccio diagnostico e terapeutico

La cistite interstiziale è una malattia cronica caratterizzata da dolore vescicale, frequenza e urgenza urinaria. Dato che una definizione univoca non esiste ancora, così come non esistono criteri diagnostici specifici, oggi si parla di sindrome vescicale dolorosa, riservando la diagnosi di cistite interstiziale a una malattia con caratteristiche cistoscopiche e istologiche tipiche. I pazienti con questo complesso sintomatologico potrebbero avere altre patologie che bisogna escludere attraverso l’esame delle urine, l’endoscopia o altri esami specifici. Le misure generali e di supporto si sono rivelate di grande importanza, così come l’educazione e l’informazione. La terapia orale con amitriptilina, pentosano polisolfato sodico, antistaminici e analgesici, inclusi i FANS, possono risultare utili. È stata anche provata l’efficacia della somministrazione intravescicale di dimetilsulfossido (DMSO) e/o dell’eparina.La modulazione neurosacrale rappresenta un’eccitante prospettiva per coloro che non rispondono alla terapia tradizionale; le tecniche chirurgiche continuano ad evolversi e si attendono valutazioni a lungo termine. Le valutazioni sull’efficacia dei trattamenti risultano comunque difficili

Turismo inbound e ricettività in Sicilia: un’analisi della distribuzione spaziale

In the last few years a significant increase in tourist accommodation has taken place in Sicily, both in hotels and in other hospitality. The increased number of accommodation beds has been encouraged by a multilevel policy of investments – both regional and European – aimed at filling the qualitative and quantitative gap penalizing Sicily in the field of tourism and accommodation competition. In some way, it may seem that the purpose of improving the accommodation supply in our Island has been obtained: indeed, while in 2000, the year when the previous European planning started, the number of accommodation beds in hotels was, in Sicily, of 4,2% of the national amount, in 2008 the Island rate has gone up to 5,3 (ISTAT source). What remains to be verified – being the main object of the paper – is whether there is an increase in demand corresponding to the dynamical evolution of Sicilian tourist accommodation sector in the last few years. In other words, whether the inbound tourist flows to Sicily in the last ten years manifest a trend similar to what can be observed, in the same time, for the tourist accommodation supply

Heterogeneous 3-D Perception across Visual Fragments-EYESHOTS

FP7-ICT, grant no. 217077 The project started from the idea of investigating the cognitive value of eye movements when one is engaged in active exploration of the peripersonal space. In particular, we argued that, to interact effectively with the environment, humans use complex motion strategies at ocular level (but possibly extended to other body parts, e.g., head and arms, so possibly using multimodal feedback), to extract information useful to build representations of the 3D space which are coherent and stable with respect to time. All the EYESHOTS\u2019 processing modules build on distributed representations in which sensorial and motor aspects coexist explicitly or implicitly. The models resort to a hierarchy of learning stages at different levels of abstraction, ranging from the coordination of binocular eye movements (e.g., learning disparity-vergence servos), to the definition of contingent saliency maps (e.g., learning of object detection properties), up to the development of the sensorimotor representation for bidirectional eye-arm coordination. On our opinion, this can be considered, an interesting methodological result of the project. Through the distributed coding, indeed, it is possible to avoid a sequentialization of sensorial and motor processes, that is certainly desirable for the development of cognitive abilities at a pre-interpretative (i.e., sub-symbolic) level, e.g., when a system must learn binocular eye coordination, handling the inaccuracies of the motor system, and actively measure the space around it

Morpho-sedimentary setting and evolution of Marettimo Valley (Egadi Islands, Sicily) during middle-late Quaternary: interaction between sea level changes and oceanographic circulation

We present morphological and stratigraphic results coming from surveys acquired in a NNW-SSE trending submarine depression (Marettimo Valley) located in the Egadi Islands (western Sicily offshore). In this area the seafloor is characterized by both depositional and erosional features generated under a variety of sedimentary processes. We identified two seismic facies units that are correlatable to: A) the progradation of shallow water (coastal to offshore) deposits during forced-regression sedimentary process, and B) contourite drifts emplaced by geostrophic currents through the Marettimo Valley. This unusual association of very shallow water contourites and shelf margin deposits originates, during middle-late Pleistocene glacio-eustatic cycles, from enhanced sedimentary dynamics establishing mutual interaction between progradational growth of the margin and bottom current depositio

Eustatic and oceanographic control on sedimentary evolution of middle-late Quaternary shelf margin-to-upper slope deposits on the Egadi Islands offshore (Italy)

During the past decades a number of sequence stratigraphy studies illustrated how, during Quaternary, interaction between sea level changes and sediment supply controlled the depositional evolution along continental margins, giving a cyclic signature to the sedimentary infilling. However, as both deposition and erosion are processes ultimately controlled by balance between environmental energy and sedimentary influx, also the oceanographic regime takes part in controlling the sedimentary growth along the continental margin. This is exactly what occurs on physiographic settings as islands offshore areas, where bottom currents can be very energetic. In the western Sicily offshore, southwards of Egadi Islands, the sea floor is characterized by depositional and erosional features formed under a variety of sedimentary processes and offers opportunity to investigate as sea level change and oceanographic regime combine each other to control depositional evolution. In this area, located along the clockwise flow of the Levantine Intermediate Water around the western Sicily margin, the sea floor morphology is very irregular as consequence of isolated reliefs and narrow submarine valleys, such as the Marettimo Valley which separates Favignana and Marettimo islands. We analysed and interpreted a grid of high-resolution (1 kJ Sparker) seismic reflection profiles integrated with multibeam bathy-morphologic data of selected areas; a 270 cm long gravity core has been also collected for sedimentology and biostratigraphy. The sedimentary succession accommodated along the eastern flank of the Marettimo Valley shows two different seismic units: unit A displays reflection-free seismic facies and thin, low- amplitude, inclined reflectors with downlap terminations onto the lower boundary, and erosional truncation at the upper boundary; these seismic facies are referable to oblique-tangential clinoforms and show a wedge-shaped external geometry. Unit B shows continuous, parallel, slightly concave reflectors and, towards the central sector of the Valley, continuous, sub-horizontal reflectors that form a deposit having a very broad low-mounded geometry; lateral transition in between concave and sub-horizontal reflectors is characterized by channelized erosional truncations. The two seismic units can be interpreted as the sedimentary response of different depositional processes: unit A accumulated by progradation of shallow-water deposits during eustatic forced-regression; unit B is referable to contourite drifts deposited by bottom currents through the Marettimo Valley. This unusual interbedding of very shallow water contouritic and shelf margin deposits derives from enhanced sedimentary dynamics during sea-level fall and lowstand stages when, as consequence of decreased water depth of the Marettimo Valley, bottom currents accelerated scouring channelized erosional surfaces; in the same time, deposition of forced regression across the shelf margin buried contourite drifts

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Inferring Population Structure from Early Life Stage: The Case of the European Anchovy in the Sicilian and Maltese Shelves

The European anchovy is an important fishing resource in the Sicilian Channel that supports a high recruitment success variability. The presence of two spawning areas, the drifting of the larvae along the currents and the different oceanographic conditions within the region suggest the presence of different larvae subpopulations. Morphometric and biochemical approaches have been used to analyze the differences among larvae collected. The amino acid composition discriminates two larval groups closely related to the spawning regions: Adventure Bank and the shelf between the South of Sicily and Malta. In addition, there are morphometric and growth differences between recently hatched larvae in these two regions, reinforcing the hypothesis of two larval subpopulations and suggesting differences in the parental reproduction effort. Between the South of Sicily and Malta there are growth and biochemical composition differences since larvae from the Maltese coast present a higher protein content and a bigger growth rate than those from Sicily, pointing out that Malta is an area with a better nutritional condition environment. No differences in the growth rate have been observed between the Adventure Bank area and the Maltese shelf, therefore, a diverse nutritional condition cannot be suggested between these two areas despite the Maltese larvae having a higher protein content present