Le ferite sociali prodotte dalla criminalità organizzata, come categoria interpretativa del cambiamento

Il presente contributo vuol essere una cornice epistemologica degli interventi seguenti, proponendo una riflessione di carattere sociologico sulle “ferite sociali” derivanti dalla violenza delle azioni della criminalità organizzata nel tessuto sociale e sulle conseguenze che queste ferite innescano a livello collettivo. Di fronte al dolore e alla sofferenza, la società civile riesce ad attivare meccanismi di resilienza che danno impulso a capacità pro-attive, che diventano strumenti di trasformazione positiva di dinamiche distorte come quelle messe in atto dalla criminalità organizzata e di dinamiche negative che hanno afflitto e affliggono la società in precisi momenti e contesti storici

Il trattamento riabilitativo integrato alla terapia farmacologica con anticorpo anti RANK-L

abstract pubblicato su atti congressual

Family Issues. Difficulties in Migrant Family Life Exacerbated by the Pandemic.

Most of the time, when we talk about the family, we think of the indigenous family, but what happens when the focus shifts to foreign families? Furthermore, in a time of pandemic, what repercussions and impacts have there been on foreign families? And have the interventions proposed by the government to deal with COVID-19 and to support families, taken foreign families into account? The issue is quite complex because it has to deal, on the one hand, with definitional problems related to the difficulties in identifying types of foreign families (Ambrosini, 2020) present in Italy, and, on the other hand, with an analysis of the impact that the virus has had on family structures. Migrant families represent heterogeneous contexts where there is constant, dynamic interaction between structural dimensions, cultural aspects and subjective choices, and during the pandemic, these have become “families in the balance”, vulnerable actors, subjected to extreme marginality. There are many issues, such as the home, which, for example, has become a space/place where to spend one’s time and experiment with forms of smart working, but many of the homes where migrant families live are not organised to cope with the pandemic and often reflect a pronounced inequality. Moreover, one should remember that, in Italy in 2019, 65.5% (Istat, 2020) of foreigners were employed in the service sector. It is difficult to imagine activities in these sectors being carried out at a distance. This paper, taking its cue from the cognitive questions posed, will propose a reflection on the situation in Sicily with a focus on the city of Palermo

Synergistic Effect of Physical Therapy Plus Pharmacological Therapy with Eperisone in Tension-Type Cervicalgia

Background. This study assessed the effect of eperisone + physical therapy compared with physical therapy alone on the alleviation of pain and disability experienced by patients with tension-type cervicalgia. Methods. Patients with tension-type cervicalgia were randomized to eperisone + physical therapy (Group A) or physical therapy alone (Group B). Patients were assessed at baseline (T0), after 4-weeks’ treatment (T1), and at 2 months’ follow-up (T2). Outcome measures included the Numerical Rating Scale, the Italian version of the Neck Pain and Disability Scale, the Short Form-McGill Pain Questionnaire, and the Italian version of the Neck Disability Index. Results. Ninety-eight patients (50 patients in Group A and 48 patients in Group B) completed the study. Pain and disability scores for all outcome measures were significantly lower at both T1 and T2 for patients in Group A compared with Group B (all p<0.001). A small, improvement between T1 and T2 was observed in Group A patients but not in Group B patients, and significantly more Group B than Group A patients were worse at 2 months’ follow-up (all p<0.001). Conclusions. Eperisone in synergy with physical therapy can be a valuable tool in the therapeutic management of patients suffering from tension-type cervicalgia

Sustainable greenhouse horticulture in Europe

The European greenhouse horticulture represents one of the most intensive energy sector in agriculture and strongly contributes to increase the energy and environmental vulnerability within regions having a large greenhouse farming systems. Specifically, the European greenhouse farming sector is facing a trend that responds to the changing consumer’s demands in a society that, globally, is increasingly affluent but more aware about some negative consequences, such as high energy-demand processes, and CO2 emissions. About 200,000 hectares of greenhouses in Spain, Italy, The Netherlands and Greece is the estimated covered surface, with not less than 3.4 MTOE of energy consumption and 9.2 MtCO2eq, and an yearly economy value of 7 billions of Euros. The installed energy power load of greenhouses in Europe depends on local climate conditions, and varies from 50-150 W/m2 (Southern regions of Europe) to 200-280 W/m2 (Northern and Central regions), while complete conditioning could even reach an energy load of 400 W/m2 (heating, lighting, cooling). Nowadays, the proportion of renewable use in the total energy consumption of greenhouse farming in Europe is very low, and there are no clear priorities set in this area, yet. Comprehensive and complete studies that evaluate the opportunities of renewable options in greenhouse sector are still not completeted. This, strongly hinders the process of setting concrete goals and legislative targets to support a wider introduction of sustainable energy technology, and appropriate legislation in greenhouse regions of Europe. This paper deals with the proposal of supporting the organization of a sustainable greenhouse agriculture, based on renewable energy sources, i.e. geothermal energy at low temperature, photovoltaic solar energy and solid biomass, in tune with the specific local assets, the local geo-climatic conditions and the protection of landscapes rather than with a careless perspective for local environment and potential societal costs

Early Introduction of Cenobamate in Uncontrolled Focal Epilepsy: Insights from a Structured Controversy

Introduction: Drug-resistant focal epilepsy, as defined by the International League Against Epilepsy (ILAE), is characterized by the failure to achieve seizure control despite the use of at least two appropriately chosen and adequately dosed antiseizure medications (ASMs). This condition affects approximately 30% of patients and represents a significant clinical challenge. Cenobamate, a novel ASM with a unique dual mechanism of action—enhancing inhibitory GABAergic currents and attenuating persistent sodium currents—has emerged as a promising therapeutic option for drug-resistant focal epilepsy. Methods: This expert consensus document was developed using a structured controversy methodology, integrating real-world experience and a narrative review of the literature focusing on the role of cenobamate in the management of drug-resistant focal epilepsy. This manuscript synthesizes current evidence on cenobamate and provides clinical recommendations for its integration into epileptological practice. Results: The expert panel findings support the early use of cenobamate following the failure of two ASMs, emphasizing its efficacy in achieving substantial seizure reduction and increasing the likelihood of seizure freedom. Early prescription of cenobamate may offer a valuable therapeutic opportunity for patients with refractory focal epilepsy, potentially reducing seizure-related complications and improving quality of life. Identified challenges include limited long-term safety data in specific populations and regional disparities in drug access. Conclusion: Cenobamate represents a significant advancement in the treatment of drug-resistant focal epilepsy. Its early adoption in clinical practice has the potential to enhance patient outcomes. The expert panel provides recommendations that underscore individualized treatment planning, close monitoring during titration, and advocacy for improved accessibility. Continued research and policy initiatives are essential to fully realize the therapeutic potential of cenobamate

Additional Treatment for Digital Ulcers in Patients with Systemic Sclerosis A Prospective Open-Label Multi-Arm Study for the use of Platelet Rich Plasma Lipofilling and Ultrasound-Based Treatments

Background: Local treatments such as ultraviolet-A (UVA) phototherapy, topical calcitriol, injection of autologous fat grafting, Platelet-Rich Plasma (PRP), hyaluronic acid (HA) and local ultrasound (US) treatment are considered alternative approaches for skin involvement in Systemic sclerosis (SSc). The aim of our study was to evaluate the efficacy of PRP injection and lipofilling or local ultrasound in the treatment of SSc-related digital ulcers (DUs). Methods: We enrolled 28 patients with SSc. At baseline time (T0), all patients were treated with Iloprost intravenous infusions. Then, twelve patients (group 1) received a first inoculation of PRP, after 15 days a second inoculation of PRP and after 15 days a third of lipofilling. Six patients continued only the Iloprost therapy (controls). Ten patients (group 2) underwent medical sessions with ultrasound treatment for 10 days. Clinical evaluation was assessed at baseline, after 3 and 12 months of treatment for all patients. Results: In our study have shown an improvement in cutaneous and microvascular level, in quality of life, in mobility of extremities of upper limbs and a reduction of administration of Iloprost after PRP-Lipofilling or US treatment. Conclusions: Our findings suggest that PRP coupled with lipofilling or ultrasound treatment in SSc patients, can be considered additional procedures in the management of DUs

Association between the donor to recipient ICG-PDR variation rate and the functional recovery of the graft after orthotopic liver transplantation: A case series

Background: Despite current advances in liver transplant surgery, post-operative early allograft dysfunction still complicates the patient prognosis and graft survival. The transition from the donor has not been yet fully understood, and no study quantifies if and how the liver function changes through its transfer to the recipient. The indocyanine green dye plasma disappearance rate (ICG-PDR) is a simple validated tool of liver function assessment. The variation rate between the donor and recipient ICG-PDR still needs to be investigated. Materials and methods: Single-center retrospective study. ICG-PDR determinations were performed before graft retrieval (T1) and 24 hours after transplant (T2). The ICG-PDR relative variation rate between T1 and T2 was calculated to assess the graft function and suffering/recovering. Matched data were compared with the MEAF model of graft dysfunction. Objective: To investigate whether the variation rate between the donor ICG-PDR value and the recipient ICG-PDR measurement on first postoperative day (POD1) can be associated with the MEAF score. Results: 36 ICG-PDR measurements between 18 donors and 18 graft recipients were performed. The mean donor ICG-PDR was 22.64 (SD 6.35), and the mean receiver's ICG-PDR on 1st POD was 17.68 (SD 6.60), with a mean MEAF value of 4.51 (SD 1.23). Pearson's test stressed a good, linear inverse correlation between the ICG-PDR relative variation and the MEAF values, correlation coefficient -0.580 (p = 0.012). Conclusion: The direct correlation between the donor to recipient ICG-PDR variation rate and MEAF was found. Measurements at T1 and T2 showed an up- or downtrend of the graft performance that reflect the MEAF values

Risk factors for acquisition of hepatitis C virus infection: a case series and potential implications for disease surveillance

BACKGROUND: Transmission of hepatitis C vims (HCV) is strongly associated with use of contaminated blood products and injection drugs. Other "non-parental" modes of transmission including sexual activity have been increasingly recognized. We examined risk factors for acquiring HCV in patients who were referred to two tertiary care centers and enrolled in an antiviral therapy protocol. METHODS: Interviews of 148 patients were conducted apart from their physician evaluation using a structured questionnaire covering demographics and risk factors for HCV acquisition. RESULTS: Risk factors (blood products, injection/intranasal drugs, razor blades/ toothbrushes, body/ear piercing, occupational exposure, sexual activity) were identified in 141 (95.3%) of participants; 23 (15.5%) had one (most frequently blood or drug exposure), 41 (27.7%) had two, and 84 (53.4%) had more than two risk factors. No patient reported sexual activity as a sole risk factor. Body piercing accounted for a high number of exposures in women. Men were more likely to have exposure to street drugs but less exposure to blood products than women. Blood product exposure was less common in younger than older HCV patients. CONCLUSION: One and often multiple risk factors could be identified in nearly all HCV-infected patients seen in a referral practice. None named sexual transmission as the sole risk factor. The development of a more complete profile of factors contributing to transmission of HCV infection may assist in clinical and preventive efforts. The recognition of the potential presence of multiple risk factors may have important implications in the approach to HCV surveillance, and particularly the use of hierarchical algorithms in the study of risk factors

Adjunctive Brivaracetam in People with Epilepsy and Intellectual Disability: Evidence from the BRIVAracetam Add-On First Italian netwoRk Study

Introduction: Subjects with intellectual disability are usually excluded from clinical trials and there is limited evidence-based guidance for the choice of antiseizure medications in this vulnerable population. The study explored the effectiveness of brivaracetam (BRV) in people with epilepsy and intellectual disability. Methods: BRIVAracetam add-on First Italian netwoRk Study (BRIVAFIRST) was a 12-month retrospective, multicenter study including adults prescribed adjunctive BRV. Main outcomes included the rates of seizure‐freedom, seizure response (≥ 50% reduction in baseline seizure frequency), and treatment discontinuation. The occurrence of adverse events (AEs) was also considered. Analyses by the presence and severity of intellectual disability were performed. Results: Subjects with intellectual disability were 253 (24.6%) out of 1029 participants. The 12-month rates of seizure freedom were 18.4% and 10.3% in participants without and with intellectual disability, respectively; the corresponding values for seizure response were 40.0% and 28.9%. Intellectual disability was not an independent predictor of seizure outcomes. The rates of treatment discontinuation were 25.8% and 26.4% in participants without and with intellectual disability. respectively. There were no statistically significant differences in the rates of any AEs, somnolence, nervousness/agitation, and aggressiveness by the presence and degree of intellectual disability. Conclusion: Brivaracetam can be a suitable treatment option and offer opportunities for clinical improvement in subjects with intellectual disability and uncontrolled seizures