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Allergic and immunologic skin diseases negatively impact the quality of life (QoL) of affected patients with detrimental consequences. Nonetheless, in everyday clinical practice the evaluation of QoL is often overlooked. Considering the increasing prevalence of atopic dermatitis, allergic contact dermatitis, hereditary angioedema, cutaneous mastocytosis, and urticaria, it is essential to determine the effects of allergic and immunologic skin diseases on QoL. A joint meeting (GET TOGETHER 2021) of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) aimed to summarize the features of the main QoL tools used in these diseases and to describe the extent of QoL impairment as well as the impact of treatments on QoL, particularly biologic therapies. The assessment of QoL in patients with allergic and immunologic skin diseases relies on generic, organ-specific and disease-specific questionnaires. While generic and organ-specific questionnaires allow comparison between different diseases, disease-specific questionnaires are designed and validated for specific cohorts: the QoL Index for Atopic Dermatitis (QoLIAD) and the Childhood Atopic Dermatitis Impact Scale (CADIS) in atopic dermatitis, the ACD-11 in allergic contact dermatitis, the Angioedema QoL Questionnaire (AE-QoL) and the Hereditary Angioedema QoL questionnaire (HAE-QoL) in hereditary angioedema, the Mastocytosis QoL Questionnaires (MCQoL e MQLQ) in cutaneous mastocytosis, and the Chronic Urticaria QoL questionnaire (CU-Q2oL) in urticaria. Among the many factors that variably contribute to QoL impairment, pruritus can represent the leading cause of patient discomfort. Biologic therapies significantly ameliorate QoL in atopic dermatitis, hereditary angioedema, mastocytosis and chronic urticaria. In general, adequate management strategies are essential for improving QoL in patients with allergic and immunologic skin diseases.

The prevalence of asthma in Italy is estimated to be around 4%; it affects approximately 2,000,000 citizens, and up to 80-90% of patients have mild-to-moderate asthma. Despite the clinical relevance of mild-to-moderate asthma, longitudinal observational data are very limited, including data on disease progression (worsening vs. improvement), the response to treatment, and prognosis. Studies are needed to develop long-term, observational, real-life research in large cohorts. The primary outcomes of this study will be based on prospective observation and the epidemiological evolution of mild and moderate asthma. Secondary outcomes will include patient-reported outcomes, treatments over time, disease-related functional and inflammatory patterns, and environmental and life-style influences.This study, called the Mild/Moderate Asthma Network of Italy (MANI), is a research initiative launched by the Italian Respiratory Society and the Italian Society of Allergology, Asthma and Clinical Immunology. MANI is a cluster-based, real world, cross-sectional, prospective, observational cohort study that includes 20,000 patients with mild-to-moderate asthma. (ClinicalTrials.gov Identifier: NCT04796844).Despite advances in asthma care, several research gaps remain to be addressed through clinical research. This study will add important new knowledge about long-term disease history, the transferability of clinical research results to daily practice, the efficacy of currently recommended strategies, and their impact on the burden and evolution of the disease.MANI:Mild/Moderate Asthma Network of ItalySANI:Severe Asthma Network ItalyGINA:Global Initiative for AsthmaSABA:short acting β2-agonistsICS:inhaled corticosteroidsCRF:Case Report Form.

The Damanhur Federation, situated in Valchiusella, Piedmont, Italy, is one of the most structured and long-lived esoteric communities in Europe. Beginning with a reconstruction of its history and organizational changes, from its foundation in 1975 to the present, this article aims to analyse how—by means of exoteric initiatives of a social nature, increasing gradually over the years—the original spiritual-esoteric Utopia meshed with the community’s need for self-sufficiency. With this objective in mind, we shall analyse the online (official websites) communication rhetoric with which Damanhur presents itself to the outside world as a spiritual community, while at the same time advertising and legitimizing itself as a cultural and commercial organization.

The aim of this article is to reflect on the spirituality concept which, although part of international sociological debate for about three decades, has still not become central to Italian empirical studies. Based on an analytical survey of this debate, we argue the heuristic usefulness of the spirituality concept in order to understand forms of religiosity emerging since the 1960s – both within and without traditional religions. We shall also claim that the religion and spirituality spheres, albeit analytically separate, reciprocally influence each other, benefitting from a relationship of exchange, loans and assimilation producing non-stop transformation and innovation within the religious field.

This article deals with an aspect of religious behavior that has remained in the shadows, both in the scientific literature and in public discourse: deconversion from New Religious Movements. The article analyses the deconversion from a magico-esoteric community located in Northern Italy: Damanhur. Founded in the 1970s, Damanhur is one of Europe’s major spiritual communities that counts about 400 devotees. The article starts with an outline of the process of deconversion, followed by a brief description of the religious organization studied. Lastly, the process of disaffiliation from Damanhur, is reconstructed, through the close reading of twenty narratives of deconversion of former Damanhurians interviewed in 2010. The process of deconversion is analysed, distinguishing four ideal-typical steps that repropose the main results of the research in this field. They are the coming out of a vague and unfocused discomfort; the attempt to deconstruct the discomfort; the opening of a reflexive instance; and the departure from the community.

Background: In this project the authors use a narrative medicine (NM) approach to assess the promotion of trust in the relationship between physicians and their asthma patients. Methods: Following a NM educational course for physicians, a research was carried out in which at least 5 written narratives (parallel charts) for each participating physician were collected and qualitatively analysed according to Bury’s classification and the Grounded Theory. Results: The results of this study were of speculative and clinical interest. In particular, 66 participants wrote 314 narratives (246 on adult and 68 on paediatric patients). As a result of applying the NM approach, when the relationships remained problematic, many physicians wrote with a moral style about their adult (67%), and paediatric patients (33%) - especially in cases of asthmatic children’s or adolescents’ overprotective or absent families (40%) -. On the contrary, physicians who were able to listen to their patients with empathy (35%) made more shared decisions with patients, even with those they initially had a bad relationship. The used words of welcome, interest and acceptance were promoting patients’ trust that lead to restoring their activities in 45% of cases, according to physicians self-reporting. Conclusions: These approaches of NM are useful in daily clinical practice, with the goal of improving the quality of life (QOL) of patients with severe asthma, even in cases in which the doctor-patient relationship isn’t initially good.

The aim of this article is to reflect on the spirituality concept which, although part of international sociological debate for about three decades, has still not become central to Italian empirical studies. Based on an analytical survey of this debate, we argue the heuristic usefulness of the spirituality concept in order to understand forms of religiosity emerging since the 1960s – both within and without traditional religions. We shall also claim that the religion and spirituality spheres, albeit analytically separate, reciprocally influence each other, benefitting from a relationship of exchange, loans and assimilation producing non-stop transformation and innovation within the religious field.

Background Omalizumab therapy is effective and safe in patients with chronic spontaneous urticaria (CSU) resistant to nonsedating histamine 1 (H 1 ) antihistamines (nsAHs). Objective To evaluate the efficacy and safety of omalizumab in elderly (aged ≥65 years) patients with nonsedating H 1 -antihistamine–refractory CSU in a real-life setting. Methods Patients with nonsedating H 1 -antihistamine–refractory CSU (n = 322) treated with omalizumab administered every 4 weeks in doses of 300 mg for 24 weeks were divided into 2 groups according to age at omalizumab treatment onset: 15 to 64 years and 65 years or older. Treatment response was assessed using a 7-day urticaria activity score (UAS7). Adverse effects of omalizumab therapy were recorded. Results Among patients, 32 (9.9%) were 65 years or older. At baseline, CSU characteristics were generally similar among the groups, although the presence of angioedema was statistically significantly lower in patients younger than 65 years. Any differences in weekly itch severity score, hive score, and UAS7 between the 2 age groups were not significant at weeks 4, 12, and 24, with the exception of the hive score at 24 weeks and the UAS7 at week 24. No significant between-group differences were seen in the proportion of patients with a UAS7 of 6 or lower and with a UAS7 score of 0 at weeks 4, 12, 24, and 40. The proportion of patients with at least one adverse event reported as suspected to be caused by study drug was 10% in the younger group vs 6.3% in the older group ( P = .53). Conclusion Our study found that omalizumab is a well-tolerated and effective therapy for elderly patients with nonsedating H 1 -antihistamine–refractory CSU.

In sociological discussion the relationship between traditional religion and alternative spirituality has been variously defined on the basis of two main theoretical positions which perceive them as either mutually exclusive – according to the ‘spiritual but not religious’ formula – or as interdependent. This debate, mostly taking place in Northern Europe and the United States, does not take into account the specific characteristics of other geographical areas such as Southern Europe. The aim of this article is to fill this gap in empirical research by presenting data from a sample survey and interviews with young people in various Italian cities. A qualitative/quantitative analysis of the data shows, on one hand, that alternative spirituality is defined under the cultural influence of traditional religion, which is to say Catholicism functioning as an exemplary model of reference and, on the other hand, suggests broadening the focus of reflection to the religion-spirituality-secularism triad, interrelated fields competing to shape young Italians’ beliefs and practices.

Set up of SHERPA website and social media account details

Uvula oedema is a condition characterized by a sensation of a foreign body in the oropharynx and difficulty to speak; sometimes, if associated with glottis oedema, difficulty to breathe and dysphonia are also present. Urticaria is a disease characterized by itching wheals on the skin, and sometimes angioedema. Chronic urticaria is spontaneous when the etiology is unknown. Chronic urticaria may be disabling and difficult to treat, with a negative impact on the patient's quality of life. Omalizumab administration is suggested for refractory patients as add-on therapy to the antihistamines, in a third line. In Italy, omalizumab may be used for the treatment of spontaneous chronic urticaria in patients older than 12 years, refractory to antihistamines, with UAS >3 and UAS7 > 16. We describe a case of a 62-year-old woman had had recurring uvula oedema and chronic urticaria, not responder to antihistamines and oral corticosteroids. After 6 months of treatment with omalizumab and antihistamines, no urticaria recurrence was reported and no new episodes of angioedema had occurred. Our experience showed that omalizumab might be effective in patients with recurrent uvula oedema associated with urticaria.

Half-way along the continuum linking religious and secular organizations can be found quasi-religious organizations, an example of hybridization characterized by the concurrence of commercial activity and symbolic practices connected with an implicitly religious dimension. Amway Corporation (a company operating in the direct-selling sector) is a representative example. This article presents the findings of ethnography carried out in Amway’s Italian context. In particular, it dwells on qualitative interviews conducted with sales operatives. From an analysis of the textual corpus, it becomes clear that belonging to the organization implies an experience of identity-transformation analogous to that of religious conversion.

The paper presents a study of the trajectories of apostasy from three religious movements, Jehovah’s Witnesses, the Soka Gakkai Buddhist institute and the Church of Scientology, through the analysis of a body of autobiographical narratives posted online by Italian apostates. Even more than being the account of a past religious experience, these narratives are the last stage in the gradual articulation of a voice with which the disaffected believers publicly express a critical view of the organizations they have left, charging them with using practices of interdiction to prevent dissent by their members. The common theme that emerges from these stories is not the loss of faith, but the discovery of a hidden deception, the breach of the implicit pact of trust that bound the narrator to the religious group.

SummaryBackground Urticaria is a common disorder that affects as many as 20% of all people at some time during their lifetime. Objectives To analyse the prevalence of various forms of urticaria according to an aetiological and clinical classification, we carried out a 4-year study in an outpatient clinic. Methods The study was carried out on 562 consecutive patients (178 males and 384 females; mean age 35·4 ± 16), who had been referred to our unit for the study of urticaria and angio-oedema. Baseline investigations included: the patient's family and personal history of allergy; duration of symptoms, presence of associated symptoms and objective signs of the current episode; clinical, laboratory and instrumental investigations; assessment of response to antihistamine treatment. Results A family history of atopy was present in 35% of patients and a personal history of allergy in 24%. We subdivided urticaria and angio-oedema into several groups on the basis of their clinical and aetiological aspects. Of the 562 patients, 424 (76%) presented with ordinary urticaria (43 acute urticaria, 311 chronic urticaria, 70 episodic urticaria), 80 (14%) physical urticaria, 49 (9%) angio-oedema without weals, six (1%) IgE-mediated contact urticaria and three (0·5%) urticarial vasculitis. In 64 cases (11%) urticaria/angio-oedema was associated with one or more symptoms. We identified 394 cases (82%) of idiopathic urticaria, 42 (9%) of immunological urticaria, 29 (6%) of non-immunological urticaria and 17 (3%) of urticaria secondary to infections. Of the treated subjects, 54% showed a good response to treatment with antihistamines. Conclusions Our data provide an overview of urticaria/angio-oedema in a large series of patients, based on clinical–aetiological aspects, and related to recent diagnostic guidelines.

The involvement of the synovium is common in phlogistic processes of various joint diseases. Apart from synoviocytes and the other cells in the synovial tissue, circulating cells recruited from peripheral blood also participate in the phlogistic process. The increased expression of adhesion molecules on both circulating and endothelial cell surface may further this recruitment. We studied 15 patients affected by serious gonarthrosis requiring a prosthetic implant (GPI) and 7 with knee prosthesis aseptic loosening (KPL) to evaluate adhesion molecule expression and phlogistic infiltration in the synovium using immunohistochemistry and microscopic analysis. As control we studied 10 subjects affected by degenerative meniscopathies undergoing a selective arthroscopic surgical meniscectomy. Analysis with Kruskal-Wallis test showed no statistical significant differences in the expression of CD54, CD11a, CD11b and CD18 in three groups examined. The model of variance analysis (Friedman test), showed that CD54 expression is greater in patients with GPI and KPL in comparison with the other molecules. Adhesion molecules and their functions are important in arthropathies not only because their evaluation can allow us to identify the degree of inflammation and to predict its evolution, but also because pharmacological control of their expression could have important therapeutic implications.

Silvia Scurati1, Franco Frati1, Gianni Passalacqua2, Paola Puccinelli1, Cecile Hilaire1, Cristoforo Incorvaia3, Italian Study Group on SLIT Compliance 1Scientific and Medical Department, Stallergenes, Milan, Italy; 2Allergy and Respiratory Diseases, Department of Internal Medicine, Genoa; 3Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, ItalyObjectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence.Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10.Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists.Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers.Keywords: adherence, sublingual immunotherapy, efficacy, cost, side effects

Summary Background Allergen-specific immunotherapy (SIT) is an effective treatment for patients with respiratory allergies. However, subcutaneous injection of allergens can provoke systemic side-effects. Objective This study was carried out to determine the incidence and risk factors of systemic reactions caused by SIT treatment, using extracts of different inhalant allergens, adsorbed in aluminium hydroxide and biologically standardized with the major allergens quantified in mass units. Methods Five hundred and fifty-five subjects with allergic rhinitis and/or asthma were evaluated on clinical history and skin prick test (SPT) reactions to common inhalant allergens. Subcutaneous SIT was administered to all patients, according to the suggested precautionary guidelines and administration schedule. Patients were treated with house dust mite, grass pollen, Parietaria judaica pollen and olive pollen extracts, each receiving one or two extracts. Results A total of 36 359 injections were administered in the 555 patients. We observed 34 episodes of serious systemic side-effects (0.093% of all injections), in 29 patients (5.2% of all patients), and no fatalities. About 55% of patients reported mild rhinitis and asthma. The majority (59%) of the serious systemic reactions (SSR), and all the anaphylactic reactions, were immediate (i.e. occurred within 30 min after the injection). Asthmatic subjects were at higher risk of SSR than patients with rhinitis (P = 0.01). Most of the side-effects observed occurred during the dose-increase phase (P

L'obiettivo di questo articolo è l'analisi del ruolo ricoperto dalle narrazioni nella formazione dell'identità all'interno dei percorsi di conversione religiosa. Le storie rappresentano, sul piano metodologico, lo strumento privilegiato per accedere all'esperienza della conversione religiosa per mezzo di interviste che sollecitino il racconto biografico; il racconto di conversione acquista inoltre una valenza sostantiva in quanto è esso stesso parte integrante dell'esperienza di conversione. Imparare a dare la propria testimonianza personale è una competenza cruciale nel percorso religioso: se da un lato l'ideologia del gruppo diventa la storia del soggetto e ne forma la memoria e l'autobiografia, dall'altro le testimonianze pubbliche di fede consolidano l'impegno mediante un rinnovamento esistenziale e confermano al gruppo la validità dei propri metodi e della propria visione del mondo. La storia di conversione è, del resto, il medium tra il neofita e i membri del gruppo, essendo la modalità con cui i convertiti, resocontando la loro esperienza ai potenziali nuovi membri, mostrano il cambiamento e il miglioramento che la fede ha prodotto nella loro vita. La condivisione e lo scambio di storie personali permette di attestare e dar prova del cammino spirituale compiuto, e la partecipazione alle storie fondamentali condivise collettivamente rinsalda i legami e genera il senso di appartenenza del singolo alla comunità, condizione, questa, che favorisce lo sviluppo di una morale condivisa (Poulton 2005). Al membro è infatti richiesta l'adesione all'ethos del gruppo, vale a dire l'insieme delle credenze, delle attività, del linguaggio e delle altre forme simboliche in cui l'organizzazione si riconosce, costituendosi come "comunità morale" all'interno della quale i membri hanno la tendenza a interpretare e assegnare significati analoghi agli eventi del mondo, generando frame condivisi.

To present the initial experience with laparoscopic technique of restoration after Hartmann procedure compared to open surgery.All patients submitted to Hartmann procedure from 2003 to 2008 were considered. The following parameters were evaluated: age, gender, comorbidities, American Society of Anesthesiologists score, indication for the procedure, Hinchey scale, interval between Hartmann and reversal procedure, total operative time of Hartmann reversal, pain management, delay in renewal of peristalsis, start of alimentation, length of hospital stay, morbidity, and mortality.Six patients were divided into groups A and B. Patients in group A underwent open Hartmann reversal and patients in group B underwent laparoscopic Hartmann reversal. Mean operative time was 136,6 min for group A and 95,6 min for group B. Mean postoperative duration of nasogastric tube placement was 2 days for group A and 1 day for group B. Group B showed a earlier return of bowel function and earlier restart of alimentation. Group B had shorter length of stay. There was no mortality or morbidity.Laparoscopic approach showed a shorter mean postoperative nasogastric tube time of placement and a shorter mean hospital stay, with faster resumption of bowel movements and early solid diet alimentation.

Allergen-specific immunotherapy (SIT) is an effective treatment for patients with respiratory allergies. However, subcutaneous injection of allergens can provoke systemic side-effects.This study was carried out to determine the incidence and risk factors o fsystemic reactions caused by SIT treatment, using extracts of different inhalant allergens, adsorbed in aluminium hydroxide and biologically standardized with the major allergens quantified in mass units.Five hundred and fifty-five subjects with allergic rhinitis and/or asthma were evaluated on clinical history and skin prick test (SPT) reactions to common inhalant allergens. Subcutaneous SIT was administered to all patients, according to the suggested precautionary guidelines and administration schedule. Patients were treated with house dust mite, grass pollen, Parietaria judaica pollen and olive pollen extracts, each receiving one or two extracts.A total of 36,359 injections were administered in the 555 patients. We observed 34 episodes of serious systemic side-effects (0.093% of all injections), in 29 patients (5.2% of all patients), and no fatalities. About 55% of patients reported mild rhinitis and asthma. The majority (59%) of the serious systemic reactions (SSR), and all the anaphylactic reactions, were immediate (i.e. occurred within 30 min after the injection). Asthmatic subjects were at higher risk of SSR than patients with rhinitis (P = 0.01). Most of the side-effects observed occurred during the dose-increase phase (P0.05). There was no association of SSR with age, gender, SPT reactivity or allergen type.SIT performed in patients with respiratory allergies by specialized staff with the allergen extracts studied, standardized in mass units, provoked a low rate of SSR. The significant risk factors for systemic reactions were asthma and the build-up period.