Città storica e sostenibilità / Historic Cities and Sustainability

A subject that is inexplicably little studied at present, or indeed not at all, is that of the quest for possible applications and feasible objectives in the energy requalification of existing buildings, existing or planned open spaces, old city centres and the monumental and diffuse cultural heritage. At the present time it is crucial that the issues, research and techniques linked to the possibilities of an aware use of energy are applied to the old city centres and the existing heritage. This must start from a knowledge and investigation of the traditional building materials and techniques, which are in themselves inherently sustainable (comprising both the ancient city and the consolidated modern city and their historic stratifications). The historic environment indeed represents an infinite cultural and environmental resource and a very high percentage of the global architectural heritage

Architetture nel tempo

Architetture nel tempo represents the awareness of the duration, permanence and authenticity of places along the centuries and in their continuous contemporaneity, entrusted to the preservation which passes on to the future, to the dialogue between ancient and modern architecture and to the restoration project. Therefore, they are not only excellent artefacts, but also everyday architectures, artefacts born of necessity as well as of symbolic and grandiloquent will, which have however survived the passing of time in order to acquire the right to become memory and future, in order to exhibit a citizenship which is equally recognized at the borders of past and present, in order to become that material for history which, through research and investigation in the field, turns itself into history

Verso il restauro

The book brings together critical considerations and experiences linked to the work of the author, lecturer in restoration at the Florence University Faculty of Architecture, as supervisor of degree theses on restoration. The reflections concern teaching Restoration as a subject, the conditions within which the knowledge and culture of restoration can ripen within our universities and the most recent problems encountered by both the discipline and restoration projects. In the first part of the publication, these aspects are set out in broad and more precisely conceptual and methodological terms in chapters and themed paragraphs which also act as a guide to drawing up degree theses on restoration, as well as a contributing to the didactics and efficiency of the specific discipline. This is followed by a selection of degree theses on restoration discussed in recent years which show the route from the principles, general problems and intervention criteria for every case study to drawing up a project. They are projects that deal with analysis methods and techniques, surveys, specialist restorations, regeneration, and the relationship between old and new. In short, the projects are what gave the final stage in the university education meaning and substance, also in order to acquire fundamental keys to restoration culture and activities in the world after university

An experimental methodological approach aimed to preventive conservation and sustainable adaptive use of the cultural heritage

Abstract Microclimatic conditions play a key role in the conservation of art collections and architecture, results obtained by monitoring campaign are essential to define preventive conservation strategies. An experimental methodological approach was identified to analyze the microclimatic conditions, to evaluate environmental damage and decay phenomena and support the conservation of artworks. Results obtained from experimental measurements performed inside a historical Dominican convent, which is now the San Marco museum in Florence (Italy), were compared and discussed. The detailed investigation of thermo-physical and thermo-hygrometric behavior of building in response to internal and external stress, allows to define preventive conservation strategies and plant solutions in a perspective of its acclimatization and adaptive reuse of internal ambient

Malaria in an asylum seeker paediatric liver transplant recipient: diagnostic challenges for migrant population

Transplanted patients are particularly exposed to a major risk of infectious diseases due to prolonged immunosuppressive treatment. Over the last decade, the growing migration flows and the transplant tourism have led to increasing infections caused by geographically restricted organisms. Malaria is an unusual event in organ transplant recipients than can be acquired primarily or reactivation following immunosuppression, by transfusion of blood products or through the transplanted organ. We report a rare case of Plasmodium falciparum infection in a liver transplanted two years-old African boy who presented to one Italian Asylum Seeker Center on May 2019. We outlined hereby diagnostic challenges, possible aetiologies of post-transplantation malaria and finally we summarized potential drug interactions between immunosuppressive agents and antimalarials. This report aims to increase the attention to newly arrived migrants, carefully evaluating patients coming from tropical areas and taking into consideration also rare tropical infections not endemic in final destination countries

Lurasidone in adolescents and adults with schizophrenia: from clinical trials to real-world clinical practice

Introduction: Lurasidone is an atypical antipsychotic agent approved in the European Union for the treatment of schizophrenia in adults and adolescents (13-17 years). Clinical trials have shown a generally favorable balance between efficacy and tolerability. Areas covered: This paper provides a review and commentary regarding the use of lurasidone in adults and adolescents with schizophrenia. The available information about efficacy, tolerability, dosing, and switching is analyzed, highlighting the strategies that may be most useful in real-world clinical practice. Virtual case studies, designed based on the authors' clinical experience with real-world patients, are provided. Expert opinion: Lurasidone is efficacious in adolescents and adults in a wide range of symptoms of schizophrenia. Choosing the right dose for each patient and combining lurasidone with other medications is key to treatment success. Lurasidone has proven effective both in adolescents and adults in treating the acute phase of schizophrenia and reducing the risk of relapse. It has shown a relatively favorable tolerability profile, with minimal effects on metabolic parameters and prolactin levels

Clinical recommendations for diagnosis and treatment according to current updated knowledge on BIA-ALCL

Shared strategies and correct information are essential to guide physicians in the management of such an uncommon disease as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). A systematic review of the literature was performed to collect the most relevant evidence on BIA-ALCL reported cases. A panel of multidisciplinary experts discussed the scientific evidence on BIA-ALCL, and updated consensus recommendations were developed through the Delphi process. The lastest reported Italian incidence of BIA-ALCL is 3.5 per 100.000 implanted patients (95% CI, 1.36 to 5.78), and the disease counts over 1216 cases worldwide as of June 2022. The most common presentation symptom is a late onset seroma followed by a palpable breast mass. In the event of a suspicious case, ultrasound-guided fine-needle aspiration should be the first step in evaluation, followed by cytologic and immunohistochemical examination. In patients with confirmed diagnosis of BIA-ALCL confined to the capsule, the en-bloc capsulectomy should be performed, followed by immediate autologous reconstruction, while delayed reconstruction applies for disseminate disease or radically unresectable tumor. Nevertheless, a multidisciplinary team approach is essential for the correct management of this pathology

Efficacy and Safety of High-Dose Immunoglobulin-Based Regimen in Statin-Associated Autoimmune Myopathy: A Multi-Center and Multi-Disciplinary Retrospective Study

Statin-associated autoimmune myopathy is a rare muscle disorder, characterized by autoantibodies against HMGCR. The anti-HMGCR myopathy persists after statin, and often requires immunosuppressive therapy. However, there is not a standardized therapeutic approach. The purpose of this study is to report the effectiveness of the immunosuppressive treatment employed in a multi-center and multi-disciplinary cohort of patients affected by anti-HMGCR myopathy, in which an immunoglobulin (IVIG)-based treatment strategy was applied. We collected 16 consecutive patients with a diagnosis of anti-HMGCR myopathy, between 2012 and 2019, and recorded data on clinical and laboratory presentation (i.e., muscle strength, serum CK levels, and anti-HMGCR antibody titer) and treatment strategies. Our results highlight the safety and efficacy of an induction therapy combining IVIG with GCs and/or methotrexate to achieve persistent remission of the disease and steroid-free maintenance. Under IVIG-based regimens, clinical improvement and CK normalization occurred in more than two thirds of patients by six months. Relapse rate was low (3/16) and 2/3 relapses occurred after treatment suspension. Nearly 90% of the patients who successfully discontinued GCs were treated with a triple immunosuppressive regimen. In conclusion, an IVIG-based regimen, which particularly includes high-dose immunoglobulin, GCs and methotrexate, can provide a fast remission achievement with GC saving