How uncomplicated total thyroidectomy could aggravate the laryngopharyngeal reflux disease?

Swallowing, voice disorders, throat discomfort and subjective neck discomfort are usually reported by patients with a known thyroid nodule and are correlated to nodular thyroid disease itself. Moreover, in endemic goitrous areas, total thyroidectomy (TT) is the most frequently performed surgical procedure. We are used to relate swallowing, voice and throat discomfort to the mechanical effects of nodular goiter or to thyroidectomy itself, but in both these cases the relationship between symptoms and the thyroid mass or its removal is not always clear or easily demonstrated. How can we explain the persistence of local neck symptoms after TT? And how can TT worsen the dysphagic or dysphonic disorders attributed to the goiter’s effect over the surrounding structures? During these years, many articles have analyzed the relationship between the thyroid disease and the laryngopharyngeal reflux, finding more and more evidences of their consensuality, leading to important new management considerations and notable medico-legal implications; if the reason of local neck symptoms is not the thyroid disease, we have to study and specially cure the reflux disease, with specific test and drugs. Therefore, the aim of our study, relying on the published literature, was to investigate how, in demonstrated presence of reflux laryngopharyngitis in patients with nodular goiter and local neck symptoms before and after uncomplicated TT, the surgery could influence our anti-reflux mechanism analyzing the anatomical connection as well as the functional coordination; can we play a part in the post-operative persistence of swallowing and voice alterations and throat discomfort

Progetto per il Campus universitario di Matera

Si mostrano i progetti prodotti dal corso di Architettura e composizione III tenuti dall'autore. L'interesse di mostrare questi progetti elaborati nell'ambito della didattica, deriva dal fatto che tutti hanno assunto come fonte ispiratrice dell'ideazione la problematica della città-natura che, in questo caso, si definisce in rapporto all'obiettivo strategico di rigenerare un'area centrale della prima periferia di Matera

IMMIGRATION AND RESILIENCE: THE CASE-STUDY OF INNER ITALIAN AREAS

The immigration phenomenon is involving the whole national territory with particular effect on small inland areas of the Italian regions and it happens for various reasons. The case-study will concern the observation of the town of Palazzo San Gervasio (Potenza) that, as a reality endowed with an identification and expulsion center (CIE), is evolving into a reality that not only intends to tighten solid and strong alliance for mutual growth, with immigrants, but aims to achieve a level of resilience that can avoid depopula-tion and the consequent disappearance of the same city. The community of Palazzo San Gervasio has found in the migrants a lifeblood able to trigger processes of “improve-ment” of the Community heritage of welcome and tolerance. This allowed the development of an European project designed to identify the causes of the problems before putting reception to discuss with each other, outside of institutional as well as administrative settings, doctors, prefecture, re-gional representatives and state organs with simple citizens, associations and, especially migrants. The first working tables have already shown some problematic processes, for example, in the allocation of recognition documents, beyond, the possibility to move in Europe, would give migrants the possibility to integrate, without legal problems, in the communities cozy and, on the other hand, they have shown that, especially the younger boys have received a non-charitable but absolutely time integration from peers. Therefore, contrary to what one might imagine, it is the youngest and the residents in the inland community to show greater sensitivity to the phenomenon. Of course much remains: to know the needs (housing, the social spaces, prayer space, market areas, etc.) of migrants but the case of small indoor areas, not only, shows a real aptitude of the same to a inherent resiliency, but also, such a sensitivity that you feel “ready to sail” each of the elements of conscious welcoming community that today we could all be forced to become migrants

La Città-Natura per il turismo sostenibile: fenomeni e strategie

L’idea di città-natura propone una nuova alleanza tra architettura e godimento dei luoghi, rigenerando la propria esistenza “virtuosa”, tra comprensione dell’eredità culturale ed esigenze di sostenibilità

LA SCOPERTA DELLA CITTÀ-NATURA E LE STRATEGIE DI RIGENERAZIONE

Iniziata a metà degli anni Novanta, con gli studi di “urbsturismo”, la sperimentazione sulla ri-generazione della città-natura, come oggetto di turismo sostenibile, si va compiendo in Italia con risultati molteplici e diversificati, ora oggetto di bilanci. Ci si riferisce anzitutto alle relazioni da noi presentate al VII (1997) e il XII (2003) rapporto sul Turismo italiano, alla Biennale di Barcellona (2003) e recentemente all’ incontro internazionale del 2005, “ Matera città-natura”, in preparazione del 1° Convegno internazionale sulla città-natura. Con quest’ultima locuzione si propone di legare le idee sul turismo sostenibile da un lato alle problematiche dei beni culturali e da un altro alle questioni dell’ambiente e della residenza. Partendo dall’esperienza dei Sassi di Matera, un centro storico italiano abbandonato, dichiarato patrimonio Unesco, e ora in gran parte recuperato, si ricostruisce una prima strategia di ri-generazione della città-natura, affidata all’idea imprenditoriale della città-albergo, posizionata tra un parco naturale-archeologico e un centro urbano che integra alberghi, beni culturali e nuove residenze. Affianco a questa si presentano altre due idee di ri-generazione, incentrate la prima sui progetti di parchi di città-albergo in rete, posizionate in vaste aree di “città-campagna”; la seconda su grandi parchi ad alta intensità ri-generativa, all’interno di aree metropolitane. Uno di questi è il “parco-spiaggia”. Conclusioni: valutazioni critiche sulle nostre esperienze dirette e su conoscenze acquisite con lo studio di circa 250 casi di città-natura nel mondo

Climate change in reclamation landscapes – Adaptation between module and modularity

Modern drainage of wetlands has produced landscapes that are expressions of a productive view of natural space. These landscapes result from a profound environmental transformation driven by economic, social, health, and cultural reasons. Today, these autonomous territorial machines face the effects of climate change, a challenge that will require significant changes and a paradigm shift leading to new ecologies and aesthetics. Through an unexplored comparison of reclamation landscapes between the Everglades, Florida (US) and Metaponto, Basilicata (Italy), this contribution reflects on the limits and possibilities of adaptation through the concepts of module and modularity. The emerging themes will inform future methodological and operational experimentations for adapting modern reclamation landscapes to climate change.   Article info Received: 10/09/2023; Revised: 18/10/2023; Accepted: 30/10/202

Order, complexity, measure. The project between architecture and nature

The paper aims to show how modern technologies, including those coming from established habits – today with great possibilities – have shifted towards new building horizons with an ‘ecological conscience’, avoiding uncritically referring to nature as a salvific model, to be imitated and evoked, perhaps with formal and superficial operations. The paper contains some varied project experiences. Even though the projects start from different premises, they develop experimental solutions identifying nature as a principle to elaborate by updating its rules. Among these, we find both a prototype of urban micro-design that incorporates vegetal processes and rules its aesthetic and functional benefits, where nature is integrated into the building technique, and projects with an indigenous origin important for the implementation of the symbiosis between nature and architecture in the built environment

Sentinel Lymph Node Analysis in Colorectal Cancer Patients Using One-Step Nucleic Acid Amplification in Combination With Fluorescence and Indocyanine Green

Purpose: Analysis of the sentinel lymph node (SLN) in colorectal cancer (CRC) patients was proposed for more accurate staging and tailored lymphadenectomy. The aim of this study was to assess the ability to predict lymph node (LN) involvement through analysis of the SLN with a one-step nucleic acid (OSNA) technique in combination with peritumoral injection of indocyanine green (ICG) and near-infrared (NIR) lymphangiography in CRC patients. Methods: A total of 34 patients were enrolled. Overall, 51 LNs were analyzed with OSNA. LNs of 17 patients (50%) were examined simultaneously with hematoxylin and eosin (H&E) and OSNA. Results: SLN analysis of 17 patients examined with H&E and OSNA revealed that OSNA had a higher sensitivity (1 vs. 0.55), higher negative predictive value (1 vs. 0.66) and higher accuracy (100% vs. 76.4%) in predicting LN involvement. Overall, OSNA showed a sensitivity of 0.69, specificity of 1, accuracy of 88.2%, and stage migration of 8.8%. Compared to those who were OSNA (−), OSNA (+) patients had a greater number of LN metastases (4.8 vs. 0.16, P = 0.04), higher G3 rate (44.4% vs. 4%, P = 0.01), more advanced stage of disease (stage III: 77.8% vs. 16%; P = 0.00) and were more rapidly subjected to adjuvant chemotherapy (39.1 days vs. 50.2 days, P = 0.01). Conclusion: SLN analysis with OSNA in combination with ICG-NIR lymphangiography is feasible and can detect LN involvement in CRC patients. Furthermore, it allows for more accurate staging reducing the delay between surgery and adjuvant chemotherap