Iuav: paesaggi della contemporaneità

La pubblicazione introdotta da uno scritto di Mario Virano (Commissario governativo per l'Alta Velocità in Val Susa) presenta gli elaborati sviluppati nel Laboratorio integrato di Progettazione Architettonica nella Laurea specialistica Architettura per il Paesaggio, condotto dai proff. S. Maffioletti, M. Virano, B. Zan, D. Trabucco, P. Ceccon. Il tema proposto riguarda la riprogettazione di tre aree di sosta e servizio autostradale lungo il tratto veneto della A4. Tali aree sono caratterizzate dalla presenza o di manufatti rilevanti, quali il "cubo" di Costantino Dardi progettato per ENI-AGIP e un autogrill a ponte progettato da Pierluigi Nervi con Antonio Nervi e Melchiorre Bega, o di un paesaggio naturale e culturale di rilevante importanza (il Carso e il castello di Duino). Gli studenti sono stati fortemente impegnati nell'aggiornamento del ruolo di un'area di sosta/sevizio rispetto al dibattito e alle proposte internazionali, cercando un'impegnativa contestualizzazione sia naturalistica che architettonica e una notevole articolazione dell'offerta funzionale. I progetti sono stati presentati allo IUAV in una mostra, alla cui inaugurazione hanno partecipato tra altri Marc Augé, la Fondazione Benetton, l'a.d. di Autostrade per l'Italia Castellucci

Intracranial bleeding risk after minor traumatic brain injury in patients on antithrombotic drugs

Background: Intracranial haemorrhage (ICH) risk after minor traumatic brain injury (mTBI) in patients on antithrombotic treatment is unclear. We compared ICH rates in mTBI patients on single, double and no antithrombotic therapy. Antithrombotic drugs encompassed vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs) and antiplatelets. Secondary aim was to identify potential predictors of ICH.Methods: We retrospectively analysed consecutive adults referred to our emergency department for mTBI. All clinical information was retrieved by patients' charts review. Patients were divided in 5 groups: 1) no antithrombotic users, 2) antiplatelet users, 3) vitamin K antagonist users, 4) direct oral anticoagulants users, and 5) double antithrombotic users.Results: A total of 1846 patients were enrolled, mean age 71 years (IQR 46-83); 1222 (66.2%) were in group 1, 407 (22.0%) in group 2, 120 (6.5%) in group 3, 51 (2.7%) in group 4 and 46 (2.5%) in group 5. At entry, 1387 (75.1%) patients underwent brain CT, 787 (64.4%) in group 1, 387 (95.1%) in group 2, 119 (99.2%) in group 3 and 51 (100%) in group 4 and 43 (93.5%) in group 5. ICH was documented in 36 patients (4.6%; CI 95%: 3.2-6.3) in group 1, 22 (5.9%; CI 95%: 3.6-8.5) in group 2, 5 (4.2%; CI 95%: 1.4-9.5) in group 3, 2 (3.9%; CI 95%: 0.5-13.5) in group 4 and 3 (7.0%; CI 95%: 1.5-19.1) in group 5 (p-value for across groups comparison = 0.86). At multivariable analysis GCS < 15 (OR 7.95 CI 95%: 3.12-20.28), post-traumatic amnesia (OR 6.49; CI 95%: 3.57-11.82), vomiting (OR 4.45 CI 95%: 1.47-13.50), clinical signs of cranial fractures (OR 8.41 CI 95%: 2.12-33.33), scalp lesions (OR 2.31 CI 95%: 1.09-4.89), but none of antithrombotic drugs were independently associated with ICH.Conclusion: mTBI-related ICH rate was similar in patients with and without antithrombotic use. Potential predictors of ICH can be drawn from patients' clinical examination

The second generation of HIV-1 vertically exposed infants: A case series from the Italian Register for paediatric HIV infection

Background: In the Highly Active Antiretroviral Therapy (HAART) era, the prognosis of children perinatally infected with HIV-1 has significantly improved, so the number of perinatally-infected females entering child-bearing age and experiencing motherhood is increasing.Methods: A description of the medical history and pregnancy outcomes of women with perinatal acquired HIV-1 infection enrolled in the Italian Register for HIV infection in Children.Results: Twenty-three women had 29 pregnancies. They had started an antiretroviral therapy at a median of 7.7 years (interquartile range, IQR 2.3 - 11.4), and had experienced a median of 4 therapeutic regimens (IQR 2-6). Twenty women (87%) had taken zidovudine (AZT) before pregnancy, in 14 cases as a starting monotherapy. In 21 pregnancies a protease inhibitor-based regimen was used. At delivery, the median of CD4+ T lymphocytes was 450 mu L (IQR 275-522), and no viral load was detectable in 15 cases (reported in 21 pregnancies). Twenty-eight children were delivered through caesarean section (median gestational age: 38 weeks, IQR 36-38, median birth weight: 2550 grams, IQR 2270 -3000). Intravenous AZT was administered during delivery in 26 cases. All children received oral AZT (median: 42 days, IQR 31 - 42), with no adverse events reported. No child acquired HIV-1 infection.Conclusions: Despite a long history of maternal infection, multiple antiretroviral regimens and, perhaps, the development of drug-resistant viruses, the risk of mother-to-child transmission does not seem to have increased among the second-generation of HIV-1 exposed infants