Medication-overuse headache : a widely recognized entity amidst ongoing debate

Medication overuse in primary headache disorders is a worldwide phenomenon and has a role in the chronification of headache disorders. The burden of disease on individuals and societies is significant due to high costs and comorbidities. In the Third Edition of the International Classification of Headache Disorders, medication-overuse headache is recognized as a separate secondary entity next to mostly primary headache disorders, although many clinicians see the disease as a sole complication of primary headache disorders. In this review, we explore the historical background of medication-overuse headache, its epidemiology, phenomenology, pathophysiology and treatment options. The review explores relevant unanswered questions and summarizes the current debates in medication-overuse headache

Noi refertiamo così… voi? Guida rapida per la valutazione sonologica della stenosi carotidea.

Da oltre quarant’anni si utilizzano gli ultrasuoni per rilevare una placca carotidea e per seguire nel tempo la sua evoluzione. I protocolli terapeutici hanno ridotto enormemente il suo impatto sulla salute delle persone ma la scelta fra terapia medica e chirurgica si fonda su una valutazione clinica e strumentale che è solo apparentemente semplice. Nei referti di un esame ultrasonografico riportiamo il più delle volte delle percentuali di stenosi, a volte puntuali, a volte in termini di range oppure ci esprimiamo con aggettivi che descrivono la gravità della stenosi ma spesso ci facciamo confondere dai numeri e dalle differenti modalità di calcolo del range di stenosi ed è indubbio che, a volte, le conclusioni risultano ambigue ed estremamente dipendenti dall’interpretazione dell’operatore. Il problema è che l’angiografia digitale, gold standard diagnostico per la stenosi carotidea, adotta delle metriche non del tutto riproducibili con gli ultrasuoni. Con questo documento vogliamo condividere la ricerca di un linguaggio comune, a partire dal referto dei nostri esami. Noi refertiamo così… voi

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Prove di Rilascio di un Edificio per Civile Abitazione Costruito nel Comune di Rapolla: Sistema Di Isolamento Isolatori Elastomerici

The results of the dynamic characterization tests, carried out during some release tests on an base isolated apartment building located in Rapolla, Potenza, are presented. The initial displacement impressed to the structure has the same order of magnitude of the design displacement. The design isolation system is made of High Damping Rubber Bearings (HDRB), on which mechanical qualification, and acceptance tests have been run. Also a dynamic check under environmental vibrations of a fixed-base building next to the isolated one has been done, in order to compare the results

VALUTAZIONE SPERIMENTALE DEL CARICO CRITICO DI ISOLATORI CILINDRICI IN ELASTOMERO ARMATO

In the Laboratory of DiSGG at the Basilicata University the buckling loads of a lot of cylindrical elastomeric bearings have been evaluated experimentally. The bearings have been tested imposing an initial shear deformation and keeping it constant while increasing axial load since the reaction to the initial shear deformation becomes zero. The corresponding value of axial load has been assumed as buckling load; in fact, shear stiffness decreases when the axial load increases and it becomes zero when buckling load has been reached. After a brief description of test equipment, a comparison among experimental buckling loads (PCR LIVELLO 3), buckling loads (PCR LIVELLO 2) obtained through Haringx theory using shear and axial stiffness of bearings experimentally measured, simplified expressions (CEN /9/ and Linee Guida italiane /10/) of buckling loads (PCR LIVELLO 1) obtained via the characteristics of the elastomer, are shown. Based on the experimental results, some suggestions for design and code provisions concerning the correct evaluation of buckling load and the influence of high compressive load on the shear stiffness of seismic elastomeric bearings are proposed

Definizione dell’impronta idrica del ciclo vita dell’actinidia

La scarsità idrica è riconosciuta come uno dei più importanti problemi ambientali a livello globale. Il presente lavoro ha come obiettivo la sperimentazione di modelli di analisi e definizione dell’impronta idrica al fine di incrementare il valore del prodotto ed aumentare la consapevolezza degli stakeholder in merito all’eco-profilo della produzione agricola. Il metodo utilizzato consiste nell’analisi del ciclo vita (LCA) finalizzato ad individuare le fasi più critiche dal punto di vista ambientale del processo produttivo per definire opportune strategie di miglioramento. Il lavoro è stato svolto in un impianto di Actinidia deliciosacv. Hayward, allevato a tendone ed irrigata a goccia. L’analisi LCA per definire l’impronta idrica è stata effettuata in conformità allo standard ISO 14046. Per l’analisi è stato definito l’obiettivo, lo scopo, l’analisi di inventario, l’analisi degli impatti, l’interpretazione del ciclo vita, l’analisi di sensitività e l’analisi d’incertezza. Sono stati raccolti dati direttamente sul campo, mentre, altri dati sono stati reperiti da letteratura e database ECOINVENT 3. Per la determinazione della WFP si è utilizzato come strumento per l’analisi il software SimaPro 8.0. I risultati di WFP sono stati riferiti ad 1 t di frutti di actinidia. Con la definizione dell’impronta idrica si esplicitano i potenziali impatti ambientali relativi all’uso dell’acqua, i conseguenti effetti sulla disponibilità per l’uomo e per l’ecosistema sia in termini qualitativi che quantitativi. Gli impatti analizzati sono: la scarsità, l’eutrofizzazione e l’acidificazione. Dai primi risultati possiamo concludere che l’attività di campo incide sulla WFP per il 97% se si considera la scarsità, per il 50% se si considera l’eutrofizzazione e il 63% se si considera l’acidificazione. L’analisi LCA ha permesso di valutare gli impatti su tutto il ciclo vita della produzione andando ad evidenziare quelle che sono le fasi critiche a seconda dell’impatto considerato

Prove di compressione ciclica su pilastri in c.a. confinati con staffe e/o con tessuti in fibra di carbonio

The paper shows main results of cyclic compression tests performed on R.C. columns confined by FRP jackets. The specimens are 250x250 mm square section columns, reinforced and unreinforced by steel bars and stirrups. Experimental results are compared with the analytical model performed by Braga-Laterza-Gigliotti (1998, 1999, 2001) that takes into account, at the same time, the confinement of FRP jackets and of the internal steel stirrups. The comparisons highlighted the good capability of the analytical model to evaluate the confined behaviour of the tested columns

Water resilient agriculture: sustainable irrigation strategies in fruit tree orchards

At global level, the climate changes are resulting in a significant and visible impact on the agriculture production. The agricultural sector needs to adapt to these changes through the use of sustainable management practices. The Southern Italy climate is always more characterized by low precipitation (~500 mm/year), mild winters and, dry summers. To increase water productivity at farm level is necessary to increase the efficiency of irrigation system, the plant Water Use Efficiency (WUE) and optimize the irrigation management. This paper summarises possible adaptation strategies aimed to improve soil water holding capacity by using specific soil management techniques in order to reduce the irrigation requirements in kiwifruit and peach orchards. In particular, canopy management and regulated deficit irrigation (RDI) technique will be presented. Under these conditions it is pivotal the correct irrigation volumes calculation and schedule to match plant needs. FAO crop coefficients (Kc) were revised and used in order to calculate the irrigation requirements (I) through the I = ET0 × Kc. Mismanagement of irrigation has been indicted as co-factor of leaching nitrate, hence this paper also focuses nitrate concentrations along the 0-90 cm soil layer concomitantly to soil moisture profile. The monitoring of soil moisture profiles, is a valid tool to use as Decision Support System (DSS) in order to optimize the irrigation volumes applied, preventing N leaching problem. Results reveal that environmental friendly management practices reduce approx. 1500 m3 ha-1 the irrigation water supply compared to conventional management. The adaptation to climate change by the agricultural sector will be achieved by considering the use of low cost management practices that can be easily adopted and have been proven to increase water productivity for the entire ecosystem