Diachronic analysis of the settlement structure in areas of hydraulic hazard: the case study of the municipality of L’Aquila

The themes of risk mitigation regardless of its nature, together with that of increased urban resilience and adaptation to climate change, now define crucial issues in the political agendas of public administrations. While on the one hand the extreme fragility of the Italian territory represents the invariant aspect of the problem, however on the other hand, the lack of an integrated and organic approach to the theme has sharpened over time the effects on the anthropization of environments. The potentially calamitous events, which follow one another with a reoccurrence within a few years, denounce the weaknesses of the Italian settlement each time, often with dramatic consequences in economic terms and with the loss of many lives. The current national settlement structure derives from a poor cogency of the vast area planning, which has given the municipalities more and more decision-making powers on the territorial transformations. Adding to this is the lack of a full awareness and perception of the risk on the part of the social component, which therefore has generated a substantial indifference towards the multiplicity of natural hazards and increasing their exposure to risk. The objective of the work is to therefore reconstruct the evolution of the settlement in the areas characterized by a high hydraulic hazard in the municipality of L’Aquila, before and after the approval of the F.D.E.P. (Flood Defense Excerpt Plan) that occurred in 2008, also in light of the transformative dynamics induced by the earthquake of the following year. The punctual analysis of the structural and functional characteristics of urban fabrics and of the environmental context also makes it possible to provide targeted indications aimed at mitigating risk in such areas

High concordance between trained nurses and gastroenterologists in evaluating recordings of small bowel video capsule endoscopy (VCE)

Background & Aims: The video capsule endoscopy (VCE) is an accurate and validated tool to investigate the entire small bowel mucosa, but VCE recordings interpretation by the gastroenterologist is time-consuming. A pre-reading of VCE recordings by an expert nurse could be accurate and cost saving. We assessed the concordance between nurses and gastroenterologists in detecting lesions on VCE examinations. Methods: This was a prospective study enrolling consecutive patients who had undergone VCE in clinical practice. Two trained nurses and two expert gastroenterologists participated in the study. At VCE pre-reading the nurses selected any abnormalities, saved them as “thumbnails” and classified the detected lesions as a vascular abnormality, ulcerative lesion, polyp, tumor mass, and unclassified lesion. Then, the gastroenterologist evaluated and interpreted the selected lesions and, successively, reviewed the entire video for potential missed lesions. The time for VCE evaluation was recorded. Results: A total of 95 VCE procedures performed on consecutive patients (M/F: 47/48; mean age: 63 ± 12 years, range: 27−86 years) were evaluated. Overall, the nurses detected at least one lesion in 54 (56.8%) patients. There was total agreement between nurses and gastroenterologists, no missing lesions being discovered at a second look of the entire VCE recording by the physician. The pre-reading procedure by nurse allowed a time reduction of medical evaluation from 49 (33-69) to 10 (8-16) minutes (difference:-79.6%). Conclusions: Our data suggest that trained nurses can accurately identify and select relevant lesions in thumbnails that subsequently were faster reviewed by the gastroenterologist for a final diagnosis. This could significantly reduce the cost of VCE procedure

Chapter Analysis of the theoretical settlement scenario implemented by the municipal plans. the case study of the Romagna coast municipalities

In Italy, the transformative predictions of the municipal urban planning instruments are very often far away from the socio-economic dynamics. In fact, the political component considers the oversizing of urban transformative projections as a solution to improve the situation of the territories in crisis for several aspects. This work analyses the projections of the urban planning instruments in force in the coastal municipalities of Emilia-Romagna. The work aims to highlight how the planned urban areas can change the future settlement structure in the case study area

The cardiovascular risk of young women with polycystic ovary syndrome: an observational, analytical, prospective case-control study

To evaluate the cardiovascular risk of polycystic ovary syndrome (PCOS), we investigated lipid profile, metabolic pattern, and echocardiography in 30 young women with PCOS and 30 healthy age- and body mass index (BMI)-matched women. PCOS women had higher fasting glucose and insulin levels, homeostasis model assessment score of insulin sensitivity, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels, and TC/high density lipoprotein cholesterol (HDL-C) ratio and lower HDL-C levels than controls. Additionally, PCOS women had higher left atrium size (32.0 +/- 4.9 vs. 27.4 +/- 2.1 mm; P < 0.0001) and left ventricular mass index (80.5 +/- 18.1 vs. 56.1 +/- 5.4 g/m(2); P < 0.0001) and lower left ventricular ejection fraction (64.4 +/- 4.1 vs. 67.1 +/- 2.6%; P = 0.003) and early to late mitral flow velocity ratio (1.6 +/- 0.4 vs. 2.1 +/- 0.2; P < 0.0001) than controls. When patients and controls were grouped according to BMI [normal weight (BMI, >18 and <25 kg/m(2)), overweight (BMI, 25.1-30 kg/m(2)), and obese (BMI, >30 kg/m(2))], the differences between PCOS women and controls were maintained in overweight and obese women. In normal weight PCOS women, a significant increase in left ventricular mass index and a decrease in diastolic filling were observed, notwithstanding no change in TC, LDL-C, HDL-C, TC/HDL-C ratio, and TG compared with controls. In conclusion, our data show the detrimental effect of PCOS on the cardiovascular system even in young women asymptomatic for cardiac disease

Landscape change in the European Mountain Areas. Settlement of the Alps: evolution and trajectories

The increasingly fast pace of urban conversion of land over the past fifty years in Italy is a phenomenon that has caused serious damage to the national landscape. The problem concerns the whole Italy but is most serious in those areas that produce important savings thanks to the quality of their landscape. In this sense, many references in the European Landscape Convention are recognizable in the Alps that are undoubtedly one of Italy's most iconic landscapes in international perception, along with the cities of art. This paper describes the results of a research on the features of urbanization in the fifties in the Italian Alps, based on uniform historical maps of the entire country. Geostatistical surveys were conducted to determine the distribution changes of urban concentration over time and analyses were developed to point out what landscape and morphological elements have emerged, and are basically confirming greater sensitivity to land artificialization. A number of comparisons based on specific indicators were produced that show the typological and geographic variations of development taking place in the time period studied. Important information has emerged on the different territorial policies implemented by the regions over the long-term

Endoscopic Submucosal Dissection of Gastric Neoplastic Lesions. An Italian, Multicenter Study

Endoscopic submucosal dissection (ESD) allows removing neoplastic lesions on gastric mucosa, including early gastric cancer (EGC) and dysplasia. Data on ESD from Western countries are still scanty. We report results of ESD procedures performed in Italy. Data of consecutive patients who underwent ESD for gastric neoplastic removal were analyzed. The en bloc resection rate and the R0 resection rates for all neoplastic lesions were calculated, as well as the curative rate (i.e., no need for surgical treatment) for EGC. The incidence of complications, the one‐month mortality, and the recurrence rate at one‐year follow‐up were computed. A total of 296 patients with 299 gastric lesions (80 EGC) were treated. The en bloc resection was successful for 292 (97.6%) and the R0 was achieved in 266 (89%) out of all lesions. In the EGC group, the ESD was eventually curative in 72.5% (58/80) following procedure. A complication occurred in 30 (10.1%) patients. Endoscopic treatment was successful in all 3 perforations, whereas it failed in 2 out of 27 bleeding patients who were treated with radiological embolization (1 case) or surgery (1 case). No procedure‐related deaths at one‐month follow‐up were observed. Lesion recurrence occurred in 16 (6.2%) patients (6 EGC and 10 dysplasia). In conclusion, the rate of both en bloc and R0 gastric lesions removal was very high in Italy. However, the curative rate for EGC needs to be improved. Complications were acceptably low and amenable at endoscopy

Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome

The aim of this study was to evaluate the presence of early vascular damage in young normal-weight women with polycystic ovary syndrome (PCOS).Thirty young normal-weight women with PCOS, who had no additional metabolic or cardiovascular diseases, and 30 healthy women (controls) matched for age and body mass index were studied. A complete hormonal assay was performed in each subject. Serum insulin and glucose levels were measured at baseline and after the oral glucose tolerance test. Plasma endothelin-1 levels and serum lipid profile were also assessed. The endothelial function was studied by flow-mediated dilation on the brachial artery, and arterial structure was evaluated by intima-media thickness measurement using Doppler ultrasound of both common carotid arteries.A significant (P < 0.05) difference in flow-mediated dilation (14.3 +/- 1.9% vs. 18.1 +/- 2.0% for PCOS patients and controls, respectively) and in intima-media thickness (0.53 +/- 0.09 mm vs. 0.39 +/- 0.08 mm for PCOS patients and controls, respectively) was found between PCOS and control subjects. Serum endothelin-1 levels were also significantly (P < 0.05) higher in PCOS patients compared with controls (1.1 +/- 0.4 pmol/liter vs. 0.5 +/- 0.2 pmol/liter for PCOS patients and controls, respectively).In conclusion, our data show that young, normal-weight, nondyslipidemic, nonhypertensive women with PCOS have an early impairment of endothelial structure and function

Dati sulla urbanizzazione italiana: verso la terza generazione

In this current period, several attempts to classify the “made artificial” areas are occurring and tend to identify the categories on which match the amount of adverse environmental deterioration. Today the “institutional” database does not exist in appropriate scales that can provide an o cial fact, uniform and reliable, whereas there are a number of methodologies and information from scientific sources and pseudo such

Multifocal gastrointestinal angiosarcoma: A challenging diagnosis?

Angiosarcoma rarely involves the gastrointestinal tract. Herein, we describe the case of a 68-year-old man with haemoptysis and melena who was eventually diagnosed with multifocal angiosarcoma of the stomach, small bowel, lungs, and thyroid. The peculiarity was that the histological feature of the polypoid lesions removed at endoscopy was initially misinterpreted as benign hyperplastic polyps, whilst their neoplastic nature was clinically suspected only when the videocapsule endoscopy revealed the presence of multiple variable-sized nodules with apical erosion or active bleeding in the small bowel. Based on the very low incidence, diagnosis of angiosarcoma involving the gastrointestinal tract may be misinterpreted by both the endoscopist and pathologist

Predictive accuracy of progesterone receptor B in young women with atypical endometrial hyperplasia and early endometrial cancer treated with hysteroscopic resection plus LNG-IUD insertion

Immunohistochemical expression of the isoform B of progesterone receptor (PRB) has shown promising results in predicting the response of atypical endometrial hyperplasia (AEH) and early endometrial cancer (EEC) to conservative treatment. We aimed to calculate the accuracy of PRB as a predictive marker of conservative treatment outcome in AEH or EEC