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Editoriale sulla riapertura della scuola: discuterne oltre le misure sanitari

In direzione ostinata e contraria: per una scuola che può fare la differenza

Dopo la pandemia da Covid-19, l'invasione russa dell'Ucraina con la brutalità della guerra interroga il senso dell'educare e del fare scuola. costruireEducare, come genitori o insegnanti, porta con sé la responsabilità di costruire una cultura che legga criticamente l’esistente nelle sue tracce di disumanizzazione e renda pensabile un orizzonte di convivenza impregnato di nuovo umanesimo

Alpha1-antitrypsin deficiency and cardiovascular disease: questions and issues of a debated relation

Alpha1-antitrypsin (AAT) is one of the major inhibitors involved in protease/antiprotease homeostasis, and it is mainly produced by hepatocytes and pulmonary epithelial cells. Its deficiency, called alpha1-antitrypsin deficit (AATD), leads to severe hepatic and respiratory issues. Also, AAT is released into the bloodstream providing systemic anti-inflammatory effects. Apart from acting as an acute-phase anti-inflammatory protein, it can be a biomarker for monitoring disease evolution. A reduced or defective production leads to a loss of anti-inflammatory function, protease-antiprotease imbalance and cellular engorgement due to polymers deposition, with system-wide repercussions. This review aims to evaluate AATD condition in the major vessels of the head and neck, thoracic and abdominal districts. Also, a dedicated focus on autoimmune vascular diseases will be provided. A critical revision of the main literature findings starting from the 1980s until now has been performed. Studies conducted over the years have provided several contradictory pieces of evidence. Most authors acknowledge the protective and anti-inflammatory AAT role on the vascular endothelium. However, correlations between AATD and major arteries, cerebral and cardiovascular conditions, and autoimmune diseases remain unclear. Most studies recognize the role of AATD in vascular diseases but only as a cofactor inducing cellular and tissue structure impairments. However, this condition alone is not enough to determine new disease onset. Due to the opposing results reported over the years, there is still a considerable lack of knowledge on the role covered by AATD in vascular diseases. A renewed interest in this research field should be encouraged to grant new solid evidence and validate the putative role of AATD screening and replacement therapy as useful diagnostic and treatment tools

The Impact of Covid-19 Pandemic on Community Psychiatric Services in Northern Italy

The Covid-19 pandemic, started brutally in February 2020 in Northern Italy (first European area hit by virus), has induced the most drastic and prolonged containment measures by a European government. The most affected areas of the Italian territory were Lombardy and Veneto. A severe and global lock-down was ordered for more than two months, with the closure of essential medical services among others. All health resources have been diverted to address the health crisis caused by the pandemic. During the lock-down, however, the only community medicine services that remained open were mental health services: psychiatry, the area of addictions, child neuropsychiatry. The community facilities have always provided services favoring, on the one hand, the maintenance of care and rehabilitation paths for patients in care, and on the other, allowing anyone who needs to have access to treatment. The operators were also involved at the forefront in the management of covid + patients and in the support paths for the management of the operators’ stress. In this chapter, we want to describe the working conditions and the organizational responses of our services, referring to a large catchment area of the region most affected by covid-19

Z-alpha1-antitrypsin polymers and small airways disease: a new paradigm in alfa-1 anti-trypsin deficiency-related COPD development?

The presence of Alpha1-Antitrypsin (AAT) polymers, known to promote a sustained pro-inflammatory activity, has been previously demonstrated in bronchial biopsies of subjects with Z-AAT deficiency (AATD) suggesting a possible role in the development of COPD through a small airway disease impairment. The study aimed to assess the presence of small airways dysfunction and the potential correlation with the presence of Z-AAT polymers obtained by Exhaled Breath Condensate (EBC) collection in PiZZ subjects, as compared with matched healthy PiMM subjects. We enrolled 19 asymptomatic, never smoker subjects: 9 PiZZ and 10 PiMM as controls, without obstructive ventilatory defect (i.e., normal FEV1/VC% ratio). All subjects underwent complete pulmonary function tests (PFT). EBC was collected in all subjects. ELISA test was applied to search for Z-AAT polymers. The PiZZ subjects showed normal lung volumes and DLCO values. However, in comparison with PiMM subjects, the single breath test N2 wash-out revealed significant differences regarding the phase III slope (1.45±0.35 N2/L vs. 0.96±0.40 N2/L) (p<0.02) in the PiZZ subjects, while the closing volume/vital capacity ratio (14.3±4.5 % vs. 11.3±6.3 %) was not significantly increased. The ELISA test detected the presence of Z-AAT polymers in 44% of PiZZ patients. Asymptomatic, never smoker PiZZ subjects with normal spirometry and lung diffusion capacity showed airways impairment when compared to PiMM subjects. Although Z-AAT polymers were found only in 44% of PiZZ subjects, these findings suggest the possibility that chronic bronchiolitis can develop as a result of the long-term pro-inflammatory activity of Z-AAT polymers in subjects with Z-related AATD

Assessment of respiratory function and exercise tolerance at 4-6 months after COVID-19 infection in patients with pneumonia of different severity

The evaluation of COVID-19 systemic consequences is a wide research field in which respiratory function assessment has a pivotal role. However, the available data in the literature are still sparse and need further strengthening

Fare la differenza reimmaginando la scuola, ogni giorno - Reimagining schools to make a difference, every day

L'impatto che il COVID ha avuto sull'organizzazione scolastica e sugli studenti è stato considerevole. Le criticità sono però preesistenti e il COVID ha agito da lente. I problemi di apprendimento e le criticità che emergono a livello di salute mentale pongono una domanda di una diversa qualità del far scuola. Prendendo spunto da documenti internazionali si pone la necessità di ripartire dall'educazione

Quale scuola avremo nel nuovo anno scolastico? Dipende. Non solo dal Covid-19 Which school will we have in the new school year? It depends. Not only on Covid-19

Dopo la chiusura dell'a.s. 2019/2020, si prepara la riapertura del nuovo anno scolastico. Si parla molto di sicurezza, norme e misure sanitarie, ma alla scuola serve anche altro

Le ragioni di un Working Paper

Il capitolo presenta la genesi e le ragioni di questo working paper che intende valorizzare alcune delle esperienze di prevenzione e intervento sulla dispersione scolastica incontrate durante la ricerca ' Leggere le fragilit\ue0 educative a scuola per intervenire' (Girelli C., Bevilacqua A.)