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La salvaguardia del territorio è un punto cardine per sviluppo sostenibile, e risulta di fondamentale importanza adottare una politica che miri alla riduzione dei rischi naturali, poiché la loro pericolosità compromette, in maniera più o meno intensa, la vita umana, i beni e le risorse economiche, l?ambiente. I rischi geologici, com?è noto, interessano in maniera profonda il territorio calabrese, sia per il ruolo geodinamico fondamentale della Calabria nell'ambito del Mediterraneo, elemento di raccordo tra la catena siciliano-magrebide e la catena appenninica, sia per le modifiche naturali che si mettono in atto in questa area geologicamente giovane. La storia geologica della Calabria, sin dalla sua strutturazione, ha fatto si che questa terra nel tempo acquisisse un'estrema fragilità derivante dai suoi caratteri geologici, geomorfologici e strutturali. Gli ammassi rocciosi calabresi, costituiti per la maggior parte da rocce di natura cristallina pertanto maggiormente soggette ai processi alterativi, si mostrano estremamente fratturati e/o degradati con caratteristiche geotecniche scadenti, a cui si associa una vulnerabilità infrastrutturale tra le più alte di Italia. La complessità geologica intrinseca della Calabria congiuntamente all'uso inappropriato del territorio, per lungo tempo trascurato e violentato, mostra conseguenze disastrose in termini di esposizione al rischio. I rischi di rilevanza e gravità ingenti che espongono popolazioni e territorio calabresi fanno riferimento ad una molteplicità di fenomeni naturali: terremoto e/o tsunami, frane e smottamenti, alluvioni, erosione costiera, ecc. Se si guarda al passato, i fenomeni sismici verificatisi in Calabria sono tra i più catastrofici dell'area mediterranea, ricordiamo il terremoto del 1638 nel settore centro-settentrionale e il terremoto che nel 1905-1908, con una serie di violente scosse, colpi gran parte della regione. In termini di rischio idrogeologico la storia dell'ultimo ventennio calabro mostra eventi importanti, talvolta comprendenti porzioni estese di territorio (Soverato settembre 2000, Serre Vibonesi 2003, Cerzeto 2005, Vibo Valentia luglio 2006, intero territorio regionale autunno inverno 2009-2010, versante ionico reggino novembre 2015). L'intensità dei fenomeni di dissesto idrogeologico, connessi e acuiti da fenomeni atmosferici estremi legati ai cambiamenti climatici in atto, rappresentano importanti sorgenti di alterazione ambientale con conseguenze potenzialmente molto gravi in termini di ambiente, economia e vite umane. Le varie tipologie di eventi, coprono estensioni territoriali con scale spaziali comprese in intervalli molto diversificati, mentre la loro natura fenomenologica è intrinsecamente caratterizzata da notevole complessità ed instabilità temporale, con un comportamento fortemente dinamico ed un'evoluzione altrettanto variabile. Al fine di realizzare una corretta pianificazione e governo del territorio è necessario che si conoscano le caratteristiche intrinseche dell'evento (occorrenza, intensità, frequenza, durata), tali caratteristiche possono essere conosciute solo attraverso un attento studio ad ampio spettro. In questa prospettiva si inserisce il presente lavoro che propone, attraverso un caso studio di un'area del versante occidentale del Massiccio della Sila (San Pietro in Guarano), una metodologia di indagine che potrebbe fungere da linea guida in contesti geologici aventi le stesse caratteristiche.

Giuseppina Della Vittoria Scarpati,1,2 Celeste Fusciello,3 Francesco Perri,4 Francesco Sabbatino,5 Soldano Ferrone,5 Chiara Carlomagno,3 Stefano Pepe1,2 1Department of Medicine, University of Salerno, 2Division of Oncology, “San Giovanni di Dio e Ruggi d’Aragona” Hospital, Salerno, 3Department of Oncology, University “Federico II”, Naples, 4Head and Neck Medical Oncology Unit, National Tumor Institute, Naples, Italy; 5Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Abstract: Recently, “ipilimumab,” an anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) monoclonal antibody, has been demonstrated to improve overall survival in metastatic melanoma. “CTLA-4” is an immune-checkpoint molecule that downregulates pathways of T-cell activation. Ipilimumab, by targeting CTLA-4, is able to remove the CTLA-4 inhibitory signal, allowing the immune system to react to cancer cells. Due to its immune-based mechanism of action, ipilimumab causes the inhibition of CTLA-4-mediated immunomodulatory effects, the enhancement of antitumor specific immune response mediated by the weakening of self-tolerance mechanisms while exacerbating the development of autoimmune diseases and immune-related adverse events, including dermatitis, hepatitis, enterocolitis, hypophysitis, and uveitis. Keywords: melanoma, T-cells, CTLA-4, autoimmunity, adverse events

Head and neck squamous cell carcinoma (HNSCC) is strongly associated with alcohol and tobacco consumption. Lately, the incidence of human papillomavirus (HPV)-related tumors has shown a significant increase, and HPV-related tumors show distinctive features if compared with the HPV-negative counterpart. Locally advanced HNSCC can be treated with concomitant chemoradiotherapy, but early recurrences sometimes occur. Relapses are often related to an intrinsic radioresistance of the tumors. Alterations in intracellular pathways, primarily involved in cell proliferation, apoptosis, and DNA repair, can lead to radioresistance. Preclinical and clinical evidence highlighted that 3 main pathways, including the epidermal growth factor receptor (EGFR), the phosphotidylinositol-3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR), and the p53 signaling cascades, play a crucial role in radioresistance development. A future approach may consist in the association of radiotherapy (RT) and selective inhibition of the key pathways involved in radioresistance. Phase I, II, and III clinical trials are currently testing these novel treatment strategies. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

Background The burden of gastric precancerous conditions and factors associated with their detection have not been fully investigated in community-based settings. Little is known about adherence to Sydney system for histopathology of gastric biopsies. Objective We aimed to investigate what really happens in clinical practice with regard to the detection of gastric atrophy and intestinal metaplasia in dyspeptic patients. Methods We performed a nationwide survey of 979 consecutive patients (50–65 years old) with dyspeptic symptoms, examined at 24 gastrointestinal endoscopy units throughout Italy. Clinical information was collected from questionnaires; a standard bioptic mapping was performed in each unit, biopsies from each patient were analyzed by histopathology performed according to daily clinical practice in each local histopathology center. Results Separate descriptions of antral and corporal biopsies were included in 679 pathology reports (69%), whereas Sydney system was applied in 324 reports (33%). Gastric atrophy without intestinal metaplasia (GA) and gastric atrophy with intestinal metaplasia (GIM) were detected in 322 (33%) patients. The full adherence to Sydney system significantly increased the probability of detecting GIM (OR 9.6, 95% CI 5.5–16.7), GA (OR 1.92, 95% CI 1.07–3.44), and either of the conditions (OR 6.67, 95% CI 4.36–10.19). Conclusions This nationwide survey showed that in one-third of dyspeptic patients, gastric precancerous conditions are detected. In daily routine practice, only 1/3 of histology reports were worked out adhering to Sydney system showing that international guidelines are poorly observed in clinical practice. This may represent a critical element for surveillance strategies for gastric cancer.

Objective. Celiac disease (CD) has strongly been established as associated with some site-specific gastrointestinal malignancies. On the contrary, according to the few reports available, the risk of colon carcinoma in CD patients has been described similar to that of general population. In this cohort study, we describe the risk of colon carcinoma in a group of Italian celiac patients. Materials and methods. The study population included all CD patients diagnosed at the Collaborating Centers of the Italian Registry of CD between 1st January 1982 and 31st December 2006. Upon diagnosis of CD and upon at every subsequent clinical control, the Collaborating Centers filled in a validated form for each CD patient reporting information about demographic data, possible occurrence of a neoplasm and adherence to a gluten-free diet. Results. Out of 1757 celiac patients enrolled, 6 developed a colon carcinoma during the follow-up period (mean: 18.1 years). The standardized incidence ratio (SIR) resulted 0.29 (95% CI = 0.07–0.45). Stratifying the risk for the dietary gluten intake, the SIR dropped to 0.07 (95% CI = 0.009–0.27) for CD patients with a strict adherence to a gluten-free diet. Conclusion. We confirm the previous finding that there is low risk to develop a colon cancer in celiac patients.

The paper deals with the development of a multidisciplinary research on weathering profiles of granitoid and gneissic rocks related to tectonic and landscape evolution of the western Sila Grande Massif (Calabria, southern Italy). Field scale observations and petrographical andmineralogical features are used to characterize in detail the weathering processes. The weathering profiles of the granitoid cut slopes are generally simple showing a progressive weathering increase toward the top of the slopes, whereas the weathering profiles of the gneissic cut slopes are generally complexwith irregularities in the spatial distribution ofweathered horizons. The microfabric and petrographic analyses show that gneissic samples (classes V-VI of weathering grade) are characterized by higher percentage of altered minerals and microfracture and void rather than granitoid samples (classes V-VI of weathering grade). The main mineralogical changes concern the partial transformation of biotite and the partial destruction of feldspars (mainly plagioclases), associated with the neoformation of secondaryminerals (clay minerals and Fe-oxides) and with a substitution of the original rock fabric. Neoformed clay minerals and ferruginous products replaced feldspars and biotite during the most advanced weathering stage. Referred as physical changes coupled with chemical variations, the final results of weathering process are a soil-like material characterized by sand-gravel grain-size fraction for the granitoid rocks and by both silt-clay and sand-silt grain-size fraction for the gneissic rocks. This generally produces a greater value of the SGI (Sand Generation Index) for granitoids and explains the great productivity in sandy deposits of this lithology.

Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a total period of 31,801 person-years, collecting data about the frequency of gluten intake and the incidence of the enteropathy-associated T-cell lymphoma. Out of the nine celiac patients who developed an intestinal lymphoma [standard morbidity ratio of 6.42 (95% CI = 2.9-12.2; P < 0.001)], only two kept a strict gluten-free diet after the diagnosis of celiac disease and developed the malignancy after the peridiagnosis period of 3 years, dropping therefore the standard morbidity ratio to 0.22 (95%CI = 0.02-0.88; P < 0.001). The risk of developing an intestinal lymphoma for the celiac patients that used to have dietary gluten was significant (X(2 )= 4.8 P = 0.01). These results show that a strict gluten-free diet is protective towards the development of enteropathy-associated T-cell lymphoma.

Background The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this paper is to estimate the risk of developing a neoplasm among non diagnosed coeliac patients and to evaluate if this risk correlates with the age of patients at diagnosis of coeliac disease. Methods The study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005. Results The SIR for all cancers resulted to be 1.3; 95% CI = 1.0–1.7 p < 0.001. The specific SIRs for non Hodgkin lymphoma was 4.7; 95% CI = 2.9–7.3 p < 0.001, for the small bowel carcinoma 25; 95% CI = 8.5–51.4 p < 0.001, for non Hodgkin lymphoma 10; 95% CI = 2.7–25 p = 0.01, finally for the stomach carcinoma 3; 95% CI = 1.3–4.9 p < 0.08. The mean age at diagnosis of CD of patients that developed sooner or later a neoplasm was 47,6 ± 10.2 years versus 28.6 ± 18.2 years of patients who did not. Conclusion Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age.

DESIGN: Prospective, multicentre study. SETTING: The study was conducted at 11 gastroenterology hospital centres throughout Italy. PARTICIPANTS AND INTERVENTIONS: Two hundred and thirteen dyspeptic patients underwent gastroscopy with antral biopsies. At each centre, two of the following three tests for H. pylori diagnosis were performed: urease quick test, histology, and 13C-urea breath test. Samples of unstimulated saliva and venous blood were collected from each patient. Salivary and serum H. pylori IgG were determined with the EIA Helori-test IgG (Eurospital, Trieste, Italy). MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive values, and accuracy of the salivary and serum EIAs. RESULTS: By using a receiver operating characteristic curve, salivary EIA yielded 81% (95% confidence interval 73-87%) sensitivity, 73% (62-83%) specificity, 84% (76-90%) positive predictive value, 69% (58-79%) negative predictive value, and 78% (72-84%) accuracy. At the cut-off suggested by the manufacturer, serum EIA had 90% (84-95%) sensitivity, 78% (67-86%) specificity, 88% (81-93%) positive predictive value, 82% (71-90%) negative predictive value, and 86% (81-91%) accuracy. CONCLUSION: In this large multicentre study, detection of salivary H. pylori IgG with a commercial serological EIA was a fairly accurate diagnostic method. Data confirm that saliva testing does not compare favourably with serology in the assessment of H. pylori status.

Mesozoic siliciclastic mudrocks ('continental redbeds') at the base of the Stilo Unit of the northern sector of the Calabria-Peloritani Arc (southern Italy) are mainly composed of quartz, phyllosilicates (illite, illite/smectite mixed layers, kaolinite, chlorite), Fe-oxide (hematite) and feldspars. The

Purpose Methods and Materials Results Conclusion References Personal Information, Purpose: CT scanningof deceased for forensic purpose is an established technique in international literature. It is useful in determining the cause and the manner of death butcould bealso very important for identification of unknown victims. In this poster...

The association between celiac disease (CD) and several liver disorders has long been documented. About 40% of adult celiac patients have been reported to have mild to moderate hypertransaminasemia (up to five times the upper limit of normal) at the time of diagnosis of CD [1, 2]. In addition, CD has been found in roughly 10% of patients with unexplained hypertransaminasemia, and the majority of them have had their liver enzyme levels normalized after one year of following a strict gluten-free diet [3, 4]. In addition, an increased prevalence of primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis among CD patients has been reported [5, 6]. CD might also be linked to very severe liver conditions such as end-stage liver failure and hepatocellular carcinoma [7]. There is also evidence, even contrasting reports, about the association of CD with nonalcoholic steatohepatitis and fatty liver disease [8]. In contrast, no definitive evidence is available about the association between chronic hepatitis C (hepatitis C virus [HCV]) and CD. Fine et al. described a three-fold increase of CD prevalence among HCV patients compared to noninfected celiac individuals [9]. It has also been reported the activation of silent CD during the antiviral treatment for HCV with interferon-α and ribavirin, both alone and in combination [10]. Consequently, a routine serological screening for CD has been proposed in HCV patients before starting antiviral therapy. In case of HCV positivity, the achievement of the histological normalization of the intestinal mucosa after following a gluten-free diet has been advised before starting the therapy [10]. On the contrary, some recent prospective studies have not shown increased prevalence of CD among HCV patients and reported that the link between these two conditions is biased by the route of transmission [11, 12]. Among the 3,725 celiac patients included in the Italian Registry of the Complication of Celiac Disease, we identified 34 individuals (0.91%) that had an HCV chronic hepatitis at the time of diagnosis of CD. For the diagnosis of HCV, we considered the serological positivity of antiHCV antibodies. Some of the patients had the diagnosis made in the early 1980s, when the molecular tests for the detection of the viral antigens were not yet available. The demographic and clinical features of the patients with both CD and HCV with respect to those of patients with CD only are listed in Table 1. The prevalence of HCV among our celiac series is lower than the overall prevalence of HCV among the general population in Italy, matched for age and gender, which is estimated to be around 2% [13]. This finding does not support the hypothesis of a potential correlation between these two disorders. It has been assumed that antiviral therapy with INF-α and ribavirin may precipitate the onset of CD in susceptible individuals, promoting a Th1-specific response in the small intestine [14]. However, in our series, only 12 of the 34 celiac patients with HCV had antiviral therapy before CD diagnosis. Looking at our series, it seems more likely that an overall increased risk of CD in HCV patients exists, due to the predisposition for autoimmune diseases related to Eur J Clin Microbiol Infect Dis (2009) 28:1267–1269 DOI 10.1007/s10096-009-0769-6