Piattaforma peri-urbana strategica. Modelli e tecnologie per la valorizzazione di paesaggi complessi

This study - developed for the Doctorate thesis in «Design and Technologies for the improvement of Cultural Heritage» - highlights, from a theoretical and operative point of view, the potentialities of peri-urban environments, within a general strategic framework for the requalification and improvement of 'new' landscapes, originating from sudden present-day social, cultural and economic transformations of territories

Complex sports infrastructure and urban resilience: technologies and paradigms

The theme of resilience applied to complex sports infrastructure is as pressing a topic today as it is little analysed in an organic, systematic manner. The social, economic and environmental repercussions of these examples of architecture are, at the urban as much as at the regional scale, equally strategic, especially evaluated in relation to the impact that the practice of sport has on contemporary society, with clear ramifications for the health sector. An overview coming from studies and researches on the current European and Italian sports infrastructure scene makes it possible to pinpoint some interesting, innovative trends which evidence, in this sector as in others, ever increasing attention the themes of eco-systemic, urban and social resilience as applied to sports infrastructure

Is the clinical pattern of pediatric celiac disease changing? A thirty-years real-life experience of an Italian center

Objectives Clinical presentation of pediatric celiac disease (CD) is heterogeneous and ever-evolving. Our aim is to highlight its changes throughout the years. Methods Data about clinical presentation of CD in children diagnosed between 1990 and 2020 at the CD Center of Maggiore Hospital, Bologna, were collected. Patients were stratified into groups based on the date [P1 (1990-2011), P2 (2012-2020)] and age [G1 (< 2 years), G2 (2-5), G3 (6-11), G4 (12-18)] at diagnosis, then investigated by comparing CD clinical presentation in different periods and ages. Results 1081 children were selected. Mean age at diagnosis increases from 5.9 to 6.6 years from P1 to P2. Gastrointestinal Symptoms (GIs) are predominant, with a decline of diarrhea (47%VS30%) and an increase of constipation (4%VS19%) (p < 0.001). Among Extraintestinal symptoms (EIs) a decrease of anemia (76%VS43%, p = 0,001) is observed. Failure to Thrive (FTT) is stable throughout the years (p = 0.03), while screenings show a trend of increment (19%VS23%). GIs' frequency decline from G1 to G4 (p = 0,001), with reduction of diarrhea (p < 0.001), and rise of recurrent abdominal pain (p = 0,02). EIs are more frequent at older ages, FTT in younger patients. Conclusions Changes in clinical presentation of CD have occurred in the last 30 years. We observe a reduction of severe and classic gastroenterologic symptoms and a rise of atypical ones, together with a growth of serological screenings and higher age at diagnosis. Awareness about CD clinical trends is crucial for a proper approach and early diagnosis

A year in review in Minerva Anestesiologica 2014

Year in revie

Anxiety and depression in Charcot-Marie-Tooth disease: data from the Italian CMT national registry

Background There is little information about neuropsychiatric comorbidities in Charcot-Marie-Tooth disease (CMT). We assessed frequency of anxiety, depression, and general distress in CMT.Methods We administered online the Hospital Anxiety-Depression Scale (HADS) to CMT patients of the Italian registry and controls. HADS-A and HADS-D scores >= 11 defined the presence of anxiety/depression and HADS total score (HADS-T) >= 22 of general distress. We analysed correlation with disease severity and clinical characteristics, use of anxiolytics/antidepressants and analgesic/anti-inflammatory drugs.Results We collected data from 252 CMT patients (137 females) and 56 controls. CMT patient scores for anxiety (mean +/- standard deviation, 6.7 +/- 4.8), depression (4.5 +/- 4.0), and general distress (11.5 +/- 8.1) did not differ from controls and the Italian population. However, compared to controls, the percentages of subjects with depression (10% vs 2%) and general distress (14% vs 4%) were significantly higher in CMT patients. We found no association between HADS scores and disease duration or CMT type. Patients with general distress showed more severe disease and higher rate of positive sensory symptoms. Depressed patients also had more severe disease. Nineteen percent of CMT patients took antidepressants/anxiolytics (12% daily) and 70% analgesic/anti-inflammatory drugs. Patients with anxiety, depression, and distress reported higher consumption of anxiolytics/antidepressants. About 50% of patients with depression and/or general distress did not receive any specific pharmacological treatment.Conclusions An appreciable proportion of CMT patients shows general distress and depression. Both correlated with disease severity and consumption of antidepressants/anxiolytics, suggesting that the disease itself is contributing to general distress and depression

Frequency, entity and determinants of fatigue in Charcot-Marie-Tooth disease

Fatigue, a disabling symptom in many neuromuscular disorders, has been reported also in Charcot-Marie-Tooth disease (CMT). The presence of fatigue and its correlations in CMT was investigated

Use, tolerability, benefits and side effects of orthotic devices in Charcot-Marie-Tooth disease

Background: Shoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and tolerance are scanty. Methods: We administered to Italian CMT Registry patients an online ad hoc questionnaire investigating use, complications and perceived benefit/tolerability/emotional distress of shoe inserts, orthopaedic shoes, AFOs and other orthoses/aids. Patients were also asked to fill in the Quebec User Evaluation of Satisfaction with assistive Technology questionnaire, rating satisfaction with currently used AFO and related services. Results: We analysed answers from 266 CMT patients. Seventy per cent of subjects were prescribed lower limb orthoses, but 19% did not used them. Overall, 39% of subjects wore shoe inserts, 18% orthopaedic shoes and 23% AFOs. Frequency of abandonment was high: 24% for shoe inserts, 28% for orthopaedic shoes and 31% for AFOs. Complications were reported by 59% of patients and were more frequently related to AFOs (69%). AFO users experienced greater emotional distress and reduced tolerability as compared with shoe inserts (p<0.001) and orthopaedic shoes (p=0.003 and p=0.045, respectively). Disease severity, degree of foot weakness, customisation and timing for customisation were determinant factors in AFOs' tolerability. Quality of professional and follow-up services were perceived issues. Conclusions: The majority of CMT patients is prescribed shoe inserts, orthopaedic shoes and/or AFOs. Although perceived benefits and tolerability are rather good, there is a high rate of complications, potentially inappropriate prescriptions and considerable emotional distress, which reduce the use of AFOs. A rational, patient-oriented and multidisciplinary approach to orthoses prescription must be encouraged

explorative study on the use of omalizumab in patients suffering from interstitial cystitis bladder pain syndrome

The aim of this study was to evaluate the efficacy of omalizumab in the treatment of Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS), evaluated by visual analogue score for pain and urgency- frequency, O'Leary-Sant IC symptom and problem index questionnaire, Pain Urgency Frequency questionnaire and Patient Global Assessment questionnaire. Four female patients with a diagnosis of IC/BPS were included in the study, with an age between 20 and 39 years. In the first patient the subjective final evaluation was of a marked improvement. The second patient had a moderate improvement of the subjective final evaluation. The third patient considered her overall clinical situation to have slightly improved after treatment. One 32-year-old patient, with multiple allergies, discontinued treatment after 3 months and could not complete the study due to side effects. Omalizumab was subcutaneously administered to patients with IC/PBS; it induced both a subjective and objective improvement of symptoms in 2 patients enrolled in the study