Ragioni d'amore

This text proposes a rereading of the Decameron that traces the female figures - 'constrained' as we are told in the Proem, by the 'wishes', 'desires' and 'orders' of fathers, mothers, brothers and husbands - in their attempt to open up areas of personal life. The possession of the female body, considered as part of the family property in a social context governed by a commercial rationale, is an instrument of the violence characterising all social relations, which Boccaccio indicates as a cause for the wrath of God that exploded in the plague of 1348. Moreover, their bodies also become an instrument in the hands of the women themselves when they decide - with all the ambiguity which the context imposed (even on the author) - to repossess the same to use it as a weapon of revenge, an occasion of joy or a gift of love.Il testo propone una rilettura del Decameron seguendo le figure femminili "costrette", come dice il Proemio, "da' voleri, da' piaceri, da' comandamenti de' padri, delle madri, de' fratelli e de' mariti" nei loro tentativi di aprire spazi di vita propria. Il possesso del corpo delle donne, parte del patrimonio familiare nel contesto sociale guidato dalla ragion di mercatura, è uno strumento della violenza che connota tutti i rapporti sociali, e che il Boccaccio indica come causa dell'ira di Dio esplosa nella peste del 1348. Ma diviene anche strumento delle donne quando decidono con tutta l'ambiguità che il contesto imponeva (anche all'Autore) di riappropriarsene per farne arma di vendetta, occasione di gioia, o dono d'amore

Total Parathyroidectomy with Subcutaneous Parathyroid Forearm Autotransplantation in the Treatment of Secondary Hyperparathyroidism: A Single-Center Experience.

Abstract Introduction Secondary hyperparathyroidism is common in chronic kidney disease. Parathyroidectomy is indicated in refractory hyperparathyroidism when medical treatments and so the parathyroid hormone levels cannot be lowered to acceptable values without causing significant hyperphosphatemia or hypercalcemia. The aim of this study is to compare the efficacy and safety of total parathyroidectomy with subcutaneous forearm autotransplantation with total parathyroidectomy with intramuscular forearm autotransplantation. Materials and Methods A single-center retrospective cohort study of total parathyroidectomy with forearm autotransplantation from January 2002 to February 2013 was performed. According to the surgical technique, patients were divided into an intramuscular group (Group 1) and a subcutaneous group (Group 2). 38 patients with secondary hyperparathyroidism were enrolled; 23 patients were subjected to total parathyroidectomy with parathyroid tissue replanting in the subcutaneous forearm of the upper nondominant limb, while 15 patients were subjected to replanting in the intramuscular seat. Results A total of 38 patients (56 ± 13 years) were enrolled. In both groups, the preoperative iPTH value was markedly high, 1750 ± 619 pg/ml in the intramuscular autotransplantation group and 1527 ± 451 pg/ml in the subcutaneous autotransplantation group (p = 0.079). Transient hypoparathyroidism was shown in 7 patients, and 1 patient showed persistent hypoparathyroidism (p = 0.387). 2 patients showed persistent hyperparathyroidism (p = 0.816), and in 2 others was found recurrent hyperparathyroidism (p = 0.816); 3 of them underwent autograftectomy. The anterior compartment of the forearm nondominant limb was sacrificed in 1 case of intramuscular autotransplantation with functional arm deficit. Conclusions The efficacy and safety of parathyroid tissue autotransplantation in the subcutaneous forearm of the upper nondominant limb is confirmed with a good rate of tissue engraftment and with a comparable number of postsurgical transient and persistent hypoparathyroidism and hyperparathyroidism incidence in both techniques. Furthermore, this technique preserves arm functionality in the case of autograftectomy. Consequently, it is our opinion that total parathyroidectomy with subcutaneous forearm autotransplantation is currently the best choice

assessing natural mineral water microbiology quality in the absence of cultivable pathogen bacteria

Abstract Italian Directives recommend the good quality of natural mineral waters but literature data assert a potential risk from microorganisms colonizing wellsprings and mineral water bottling plants. We evaluated the presence of microorganisms in spring waters (SW) and bottled mineral waters (BMW) samples. Routine microbiological indicators, additional microorganisms like Legionella spp., Nontuberculous mycobacteria (NTM) and amoebae (FLA) were assessed in 24 SW and 10 BMW samples performing cultural and molecular methods. In 33 out of 34 samples, no cultivable bacteria ≥10 CFU/L was found. Cultivable FLA were detected in 50% of water samples. qPCR showed the presence of Legionella qPCR units in 24% of samples (from 1.1 × 102 to 5.8 × 102 qPCR units/L) and NTM qPCR units in 18% of samples (from 1 × 102 to 1 × 105 qPCR units/L). Vermamoeba vermiformis and Acanthamoeba polyphaga were recovered respectively in 70% of BMW samples (counts from 1.3 × 103 to 1.2 × 105 qPCR units/L) and 42% of SW samples (from 1.1 × 103 to 1.3 × 104 qPCR units/L). Vahlkampfia spp. was detected in 42% of SW and 70% of BMW samples (from 1.2 × 103 to 1.2 × 105 qPCR units/L). Considering the presence of FLA, we underline the importance of a wider microbiological risk assessment in natural mineral waters despite the absence of cultivable bacteria

Biofilm growth on orthopedic implantable materials: static or dynamic condition what is the most appropriate methodological tools to study device-related infections?

Aim Study of biofilm growth under static and dynamic conditions to evaluate the most suitable orthopedic materials on the prevention of device-related infections. Method Biofilms of Staphylococcus epidermidis (ATCC 35984) icaA and icaD genes positive and Pseudomonas aeruginosa (DSM 939) were generated under static and dynamic conditions, adding the bacterial inocula on titanium, carbon, polycarbonate and carbon-peek coupons housed in flat bottom test tubes or in the CDC Biofilm Reactor (CBR) system respectively. Biofilm growth was evaluated by MTT assay after 48 hours. Results Results of dynamic model showed a better capacity of S.epidermidis to grow with a rotation between 120-60 rpm on each tested materials (Mann-Whitney test, p-value < 0,05) than P.aeruginosa. Titanium was thematerial on which the bacterial strains adhered less, whereas carbon and polycarbonate allowed greatest adherence of P.aeruginosa (Mann-Whitney test, p-value < 0,05). Results of static model showed that both species grew on each materials without distinction (Kruskal-Wallis test, p-value 0,95). S.epidermidis growth was better also under static condition. Conclusions the static model was not able to evaluate the different adhesion capacity of the strains to the materials, confirming the dynamic model is the most suitable tool for the study of orthopedic materials on the prevention of device-related infections. This research was funded by the University of Pisa, PRA 2017_18 Projec

Epidural analgesia and cesarean delivery in multiple sclerosis post-partum relapses: the Italian cohort study

BACKGROUND: Few studies have systematically addressed the role of epidural analgesia and caesarean delivery in predicting the post-partum disease activity in women with Multiple Sclerosis (MS).The objective of this study was to assess the impact of epidural analgesia (EA) and caesarean delivery (CD) on the risk of post-partum relapses and disability in women with MS. METHODS: In the context of an Italian prospective study on the safety of immunomodulators in pregnancy, we included pregnancies occurred between 2002 and 2008 in women with MS regularly followed-up in 21 Italian MS centers. Data were gathered through a standardized, semi-structured interview, dealing with pregnancy outcomes, breastfeeding, type of delivery (vaginal or caesarean) and EA. The risk of post-partum relapses and disability progression (1 point on the Expanded Disability Status Sclae, EDSS, point, confirmed after six months) was assessed through a logistic multivariate regression analysis. RESULTS: We collected data on 423 pregnancies in 415 women. Among these, 349 pregnancies resulted in full term deliveries, with a post-partum follow-up of at least one year (mean follow-up period 5.5±3.1 years). One hundred and fifty-five patients (44.4%) underwent CD and 65 (18.5%) EA. In the multivariate analysis neither CD, nor EA were associated with a higher risk of post-partum relapses. Post-partum relapses were related to a higher EDSS score at conception (OR=1.42; 95% CI 1.11-1.82; p=0.005), a higher number of relapses in the year before pregnancy (OR=1.62; 95% CI 1.15-2.29; p=0.006) and during pregnancy (OR=3.07; 95% CI 1.40-6.72; p=0.005). Likewise, CD and EA were not associated with disability progression on the EDSS after delivery. The only significant predictor of disability progression was the occurrence of relapses in the year after delivery (disability progression in the year after delivery: OR= 4.00; 95% CI 2.0-8.2; p<0.001; disability progression over the whole follow-up period: OR= 2.0; 95% CI 1.2-3.3; p=0.005). CONCLUSIONS: Our findings, show no correlation between EA, CD and postpartum relapses and disability. Therefore these procedures can safely be applied in MS patients. On the other hand, post-partum relapses are significantly associated with increased disability, which calls for the need of preventive therapies after delivery

Diagnosis of prostate cancer with magnetic resonance imaging in men treated with 5-alpha-reductase inhibitors

Purpose The primary aim of this study was to evaluate if exposure to 5-alpha-reductase inhibitors (5-ARIs) modifies the effect of MRI for the diagnosis of clinically significant Prostate Cancer (csPCa) (ISUP Gleason grade >= 2).Methods This study is a multicenter cohort study including patients undergoing prostate biopsy and MRI at 24 institutions between 2013 and 2022. Multivariable analysis predicting csPCa with an interaction term between 5-ARIs and PIRADS score was performed. Sensitivity, specificity, and negative (NPV) and positive (PPV) predictive values of MRI were compared in treated and untreated patients.Results 705 patients (9%) were treated with 5-ARIs [median age 69 years, Interquartile range (IQR): 65, 73; median PSA 6.3 ng/ml, IQR 4.0, 9.0; median prostate volume 53 ml, IQR 40, 72] and 6913 were 5-ARIs naive (age 66 years, IQR 60, 71; PSA 6.5 ng/ml, IQR 4.8, 9.0; prostate volume 50 ml, IQR 37, 65). MRI showed PIRADS 1-2, 3, 4, and 5 lesions in 141 (20%), 158 (22%), 258 (37%), and 148 (21%) patients treated with 5-ARIs, and 878 (13%), 1764 (25%), 2948 (43%), and 1323 (19%) of untreated patients (p < 0.0001). No difference was found in csPCa detection rates, but diagnosis of high-grade PCa (ISUP GG >= 3) was higher in treated patients (23% vs 19%, p = 0.013). We did not find any evidence of interaction between PIRADS score and 5-ARIs exposure in predicting csPCa. Sensitivity, specificity, PPV, and NPV of PIRADS >= 3 were 94%, 29%, 46%, and 88% in treated patients and 96%, 18%, 43%, and 88% in untreated patients, respectively.Conclusions Exposure to 5-ARIs does not affect the association of PIRADS score with csPCa. Higher rates of high-grade PCa were detected in treated patients, but most were clearly visible on MRI as PIRADS 4 and 5 lesions.Trial registration The present study was registered at ClinicalTrials.gov number: NCT05078359

Aseismic transient driving the swarm-like seismic sequence in the Pollino range, Southern Italy

Tectonic earthquake swarms challenge our understanding of earthquake processes since it is difficult to link observations to the underlying physical mechanisms and to assess the hazard they pose. Transient forcing is thought to initiate and drive the spatio-temporal release of energy during swarms. The nature of the transient forcing may vary across sequences and range from aseismic creeping or transient slip to diffusion of pore pressure pulses to fluid redistribution and migration within the seismogenic crust. Distinguishing between such forcing mechanisms may be critical to reduce epistemic uncertainties in the assessment of hazard due to seismic swarms, because it can provide information on the frequency–magnitude distribution of the earthquakes (often deviating from the assumed Gutenberg–Richter relation) and on the expected source parameters influencing the ground motion (for example the stress drop). Here we study the ongoing Pollino range (Southern Italy) seismic swarm, a long-lasting seismic sequence with more than five thousand events recorded and located since October 2010. The two largest shocks (magnitude Mw = 4.2 and Mw = 5.1) are among the largest earthquakes ever recorded in an area which represents a seismic gap in the Italian historical earthquake catalogue. We investigate the geometrical, mechanical and statistical characteristics of the largest earthquakes and of the entire swarm. We calculate the focal mechanisms of the Ml > 3 events in the sequence and the transfer of Coulomb stress on nearby known faults and analyse the statistics of the earthquake catalogue. We find that only 25 per cent of the earthquakes in the sequence can be explained as aftershocks, and the remaining 75 per cent may be attributed to a transient forcing. The b-values change in time throughout the sequence, with low b-values correlated with the period of highest rate of activity and with the occurrence of the largest shock. In the light of recent studies on the palaeoseismic and historical activity in the Pollino area, we identify two scenarios consistent with the observations and our analysis: This and past seismic swarms may have been ‘passive’ features, with small fault patches failing on largely locked faults, or may have been accompanied by an ‘active’, largely aseismic, release of a large portion of the accumulated tectonic strain. Those scenarios have very different implications for the seismic hazard of the area

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon