Lettere dalla Curia. Diplomazia e politica nei carteggi e nei libri di lettere del Rinascimento, a c. di Lorenzo Geri e Marcello Simonetta

Il volume prende in esame la produzione epistolare di umanisti, uomini di lettere e diplomatici attivi nella Curia papale tra la metà del xiv secolo e la metà del xvi secolo. Nonostante la ricchezza dei documenti disponibili, tale corpus epistolare, connesso con la Curia ma distinto dalla produzione di carattere strettamente ufficiale, non è mai stato oggetto di uno studio complessivo. I saggi, affidati a specialisti di diversa formazione, offrono tessere preziose per la ricostruzione di un quadro di insieme. Gli autori presi in esame comprendono Petrarca e Leonardo Bruni, ai quali si devono due tra i più importanti libri di lettere del primo Umanesimo; personalità di spicco nella storia ecclesiastica e, al contempo, letteraria come Enea Silvio Piccolomini e Bernardo Bibbiena; Pietro Bembo, il cui epistolario, latino e volgare, rappresenta un vero e proprio snodo nella storia dell’epistolografia del Cinquecento; due figure relativamente poco note ma di notevole interesse come il poligrafo Dionigi Atanagi, antologista d’eccezione della produzione epistolare curiale in volgare, e Giovan Battista Sanga, segretario di Giovan Matteo Giberti e di Clemente vii

Insight into Elderly ALS Patients in the Emilia Romagna Region: Epidemiological and Clinical Features of Late-Onset ALS in a Prospective, Population-Based Study

Few studies have focused on elderly (>80 years) amyotrophic lateral sclerosis (ALS) patients, who represent a fragile subgroup generally not included in clinical trials and often neglected because they are more difficult to diagnose and manage. We analyzed the clinical and genetic features of very late-onset ALS patients through a prospective, population-based study in the Emilia Romagna Region of Italy. From 2009 to 2019, 222 (13.76%) out of 1613 patients in incident cases were over 80 years old at diagnosis, with a female predominance (F:M = 1.18). Elderly ALS patients represented 12.02% of patients before 2015 and 15.91% from 2015 onwards (p = 0.024). This group presented with bulbar onset in 38.29% of cases and had worse clinical conditions at diagnosis compared to younger patients, with a lower average BMI (23.12 vs. 24.57 Kg/m2), a higher progression rate (1.43 vs. 0.95 points/month), and a shorter length of survival (a median of 20.77 vs. 36 months). For this subgroup, genetic analyses have seldom been carried out (25% vs. 39.11%) and are generally negative. Finally, elderly patients underwent less frequent nutritional- and respiratory-supporting procedures, and multidisciplinary teams were less involved at follow-up, except for specialist palliative care. The genotypic and phenotypic features of elderly ALS patients could help identify the different environmental and genetic risk factors that determine the age at which disease onset occurs. Since multidisciplinary management can improve a patient’s prognosis, it should be more extensively applied to this fragile group of patients

Epidemiological, Clinical and Genetic Features of ALS in the Last Decade: A Prospective Population-Based Study in the Emilia Romagna Region of Italy

: Increased incidence rates of amyotrophic lateral sclerosis (ALS) have been recently reported across various Western countries, although geographic and temporal variations in terms of incidence, clinical features and genetics are not fully elucidated. This study aimed to describe demographic, clinical feature and genotype-phenotype correlations of ALS cases over the last decade in the Emilia Romagna Region (ERR). From 2009 to 2019, our prospective population-based registry of ALS in the ERR of Northern Italy recorded 1613 patients receiving a diagnosis of ALS. The age- and sex-adjusted incidence rate was 3.13/100,000 population (M/F ratio: 1.21). The mean age at onset was 67.01 years; women, bulbar and respiratory phenotypes were associated with an older age, while C9orf72-mutated patients were generally younger. After peaking at 70-75 years, incidence rates, among women only, showed a bimodal distribution with a second slight increase after reaching 90 years of age. Familial cases comprised 12%, of which one quarter could be attributed to an ALS-related mutation. More than 70% of C9orf72-expanded patients had a family history of ALS/fronto-temporal dementia (FTD); 22.58% of patients with FTD at diagnosis had C9orf72 expansion (OR 6.34, p = 0.004). In addition to a high ALS incidence suggesting exhaustiveness of case ascertainment, this study highlights interesting phenotype-genotype correlations in the ALS population of ERR