Attraversare le parole. La poesia nella Svizzera italiana: dialoghi e letture

«Scrivere in Svizzera significa, in primo luogo, misurarsi con un tipo di alterità e varietà che non è solo linguistica ma anche sociale e culturale; in secondo luogo, vuol dire assumere quell’alterità come parte della propria identità, non affermata e rivendicata come insegna o “etichetta”, ma più spesso discussa, negoziata, straniata. Quest’oggettività è forse uno dei tratti comuni alla maggiore poesia nella Svizzera italiana, quasi inscritto nel suo patrimonio genetico novecentesco». Nella sua prefazione, Niccolò Scaffai dipinge un quadro rappresentativo della possibilità di parlare della «particolarità» svizzera di una certa poesia contemporanea. Oggetto di grande apprezzamento, letture e studi negli ultimi anni, la poesia ticinese del Ventunesimo secolo è allo stesso tempo erede e testimone di una via aperta e legittimata da esponenti quali Francesco Chiesa, Giuseppe Zoppi, Giorgio Orelli, Fabio Pusterla e Alberto Nessi. Oggi, una volta superato il bisogno di definire la propria identità dall’interno, il bacino della creazione elvetica si è allargato, diventando un vero e proprio crocevia di incontri, voci e culture: con Alberto Nessi stesso e con Dubravko Pušek, Anna Ruchat, Fabiano Alborghetti, Pierre Lepori, Yari Bernasconi, i lettori sono invitati a osservare la realtà, tanto interiore quanto esteriore, con uno sguardo nuovo, con il piglio dell’esploratore, del viaggiatore, ma anche attraverso gli occhi e l’esperienza dell’emigrante. Una poesia vitale e ricca, che il volume Attraversare le parole. La poesia nella Svizzera italiana: dialoghi e letture cerca di rendere in tutte le sue mutevoli sfaccettature

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Charcoal fragments of Alpine soils as an indicator of landscape evolution during the Holocene in Val di Sole (Trentino, Italy)

Subalpine and Alpine soils in Val di Sole (Trentino, Italy) have been investigated in order to reconstruct vegetation changes and human impact during the Holocene period. Archaeological findings have demonstrated that Alpine sites have been populated since pre-historical times. Humans have had a great impact on the natural landscape evolution. One of the most-used tools has been fire. The use of fire has enabled the landscape to be cleared to provide new pastures for grazing and also to allow it to be used for agricultural purposes. The 14C dating of charcoal fragments found in subalpine and Alpine soils provide information about the type of vegetation, fires, human impact and soil formation throughout the Holocene. The degree of podzolisation indicates weathering effects and provides information about the stability of the surfaces. According to our results, a quick forest expansion establishment phase must have occurred shortly after the Lateglacial around 10 500 cal. BP. Pinus sylvestris, Pinus mugo as well as Larix decidua established in the investigation area in that period. Picea abies had not yet migrated into this region at the transition to the Boreal (around 9000 cal. BP). The vegetation of the investigated area has not substantially changed during the last 10 000 years. Pinus mugo was more widespread in some areas during the Older Atlanticum, and the treeline was about 150 m higher at the end of the Younger Dryas than today. Some other sites were most probably used as pasture during the Bronze Age and later abandoned, leading to a natural reforestation. In the investigated area 13 fire events in the past 10 700 years have been recognised, and seven of them can reasonably be attributed to human origin

Nationwide survey on the management of pediatric pharyngitis in Italian emergency units

Background Acute pharyngitis is a frequent reason for primary care or emergency unit visits in children. Most available data on pharyngitis management come from primary care studies that demonstrate an underuse of microbiological tests, a tendency to over-prescribe antibiotics and a risk of antimicrobial resistance increase. However, a comprehensive understanding of acute pharyngitis management in emergency units is lacking. This study aimed to investigate the frequency of rapid antigen test use to diagnose acute pharyngitis, as well as other diagnostic approaches, the therapeutic attitude, and follow-up of children with this condition in the emergency units.Methods A multicentric national study was conducted in Italian emergency departments between April and June 2022.Results A total of 107 out of 131 invited units (response rate 82%), participated in the survey. The results showed that half of the units use a scoring system to diagnose pharyngitis, with the McIsaac score being the most commonly used. Most emergency units (56%) were not provided with a rapid antigen diagnostic test by their hospital, but the test was more frequently available in units visiting more than 10,000 children yearly (57% vs 33%, respectively, p = 0.02). Almost half (47%) of the units prescribe antibiotics in children with pharyngitis despite the lack of microbiologically confirmed cases of Group A beta-hemolytic streptococcus. Finally, about 25% of units prescribe amoxicillin-clavulanic acid to treat Group A beta-hemolytic streptococcus pharyngitis.Conclusions The study sheds light on the approach to pharyngitis in emergency units, providing valuable information to improve the appropriate management of acute pharyngitis in this setting. The routinary provision of rapid antigen tests in the hospitals could enhance the diagnostic and therapeutic approach to pharyngitis

Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

BackgroundTocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients.MethodsA multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival.ResultsIn the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6-24.0, P=0.52) and 22.4% (97.5% CI: 17.2-28.3, P<0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline.ConclusionsTocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline.Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092)