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I tiranti sono i presidi antisismici più antichi utilizzati negli edifici in muratura, in quanto presentano un elevato grado di efficacia per il contrasto dei pericolosi meccanismi di collasso fuori dal piano delle pareti. Sono applicabili con estrema facilità, presentano elevata reversibilità e sono altamente economici. Anche i recenti terremoti hanno sottolineato la notevole propensione delle costruzioni murarie ad esibire modalità di collasso delle pareti per cinematismi da azioni fuori dal piano. Il tema, pertanto, è stato ritenuto di notevole interesse per gli autori, che propongono una metodologia speditiva di dimensionamento. Il metodo si basa sull’elaborazione di abachi di immediata lettura che forniscono, in funzione del meccanismo di ribaltamento considerato, la stima del tiro da affidare al tirante. Analogamente vengono svolte analisi dimensionali per il capochiave, al fine di predeterminare le dimensioni geometriche, considerando una tipologia a paletto ed a piastra circolare. I risultati mostrati si riferiscono al meccanismo di ribaltamento semplice di parete monolitica ad un livello. Il procedimento fornisce uno strumento molto rapido sia per la progettazione dei tiranti che per la verifica di idoneità in esercizio, risultando particolarmente utile nei casi di implementazione su larga scala di tali interventi come nei processi di ricostruzione post-sisma.

A seguito dell’evento sismico de L’Aquila del 6 Aprile 2009 si sono attivate procedure di rilevamento delle agibilità post-sisma delle costruzioni su larga scala. L’analisi speditiva dei fabbricati mediante la scheda di agibilità AeDES (Dipartimento di Protezione Civile) ha fornito un database di parametri sulla qualità strutturale e sul danno rilevato negli edifici esistenti molto utili allo sviluppo di nuove metodologie di analisi territoriale per la gestione del rischio sismico. Le azioni predisposte per la redazione dei Piani di Ricostruzione (PdR) hanno comportato lo studio delle caratteristiche degli edifici e degli effetti indotti dal sisma. Nella presente memoria si illustrano i risultati principali della fase di acquisizione dei dati e di analisi dell’edificato dei centri storici abruzzesi di Goriano Sicoli e Gagliano Aterno della Valle Subequana, di Cocullo nella Valle del Sagittario e di San Demetrio ne’ Vestini nella Valle dell’Aterno. I comuni, tutti appartenenti al cratere sismico, si collocano in contesti territoriali diversi per condizioni geologiche, orografiche e culturali, evidenziando ciascuno, proprie problematiche di ricostruzione e forti fragilità ambientali. Le attività di rilievo sintetizzate forniscono indicazioni sulle principali tipologie costruttive rilevate e consentono di caratterizzare la tipologia di danno strutturale che il recente sisma ha evidenziato.

The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19–35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

Introduction: The total mesorectal excision (TME) for rectal tumours was introduced in 1982 by Heald and coll. and has led both to a 5% decrease of local recurrences 5 and 10 years after the operation if confronted with the cases treated with conventional surgery and to the increase of survival up to five years estimated in 80% of the cases. In Italy, TME firstly introduced for distal rectal cancer about 20 years ago, this surgical technique has shown the same rate of local recurrences reported by Heald. The aim of our work is to highlight TME advantages and demonstrate how this more demanding and longer method, has an acceptable risk for the surgery of rectal tumours. Materials and method: We have confronted two groups of patients operated for rectal carcinoma; the first group (no TME, including 50 patients) was treated with the standard surgery technique, while the second group (TME, 44 patients) underwent the total mesorectal excision. 14 no TME patients belong to Dukes stage A, 20 to stage B, 12 to C and the remaining 4 had miscellaneous diagnosis; whereas in the TME group 12 patients belonged to Dukes stage A, 16 to B, 6 to C and the remaining 10 patients had miscellaneous diagnosis. The patients of both groups were undergone the exams of follow up (blood test, hepatic echography, abdominal TC, thorax RX), the follow up pattern expect periodic controls with check-up to three and six months, one and five years. Results: postoperative complications in the groups considered do not show important differences in rates, although, the second group (TME) had 9 cases with postoperative complications confronted with the 11 cases of the first group (no TME). The complications taken into consideration were: anastomotic bleeding (2 patients TME, 4% vs 3 patients no TME, 6%), intestinal obstruction (1 patient TME, 2% vs 1 patient no TME, 2%), paretal infection (3 patients TME, 7% vs 4 patients no TME, 8%), anastomotic fistulae (2 patients TME, 4% vs 2 patients no TME, 4%), retention of urine and vesicular disorder (1 patient TME, 2% vs 1 patient no TME, 2%). Tumours closer to the anus have shown more complications compared with higher ones. As a matter of fact, 10 cases of no TME and TME patients with low placed tumours have undergone complications compared with the 3 cases of no TME and TME patients with tumours being more distant from the anus. A lower rate of local recurrences was noticed in the TME group: 3 (7%) compared with the no TME group: 18 (36%) with P < 0,001. Other tardy complications taken into consideration were: hepatic metastasis (5 patients no TME, 10% vs 6 patients TME, 14%), pulmonary metastasis (5, 10% of the no TME vs 3, 7% of the TME), anastomotic stenosis (4, 8% of the no TME vs 3, 7% of the TME), impotence and orgasm sine materia (2, 4% of the no TME vs 3, 7% of the TME). We also noticed that most of the tardy complications in the TME group belonged to Dukes stage C. Conclusion: from our experience, we deduced that, in TME patients, complications are lower than in no TME patients with no important P; the seat of the tumour affects the appearance of complications which are more frequent in distal localizations. The important result is a minor incidence of recurrences (P < 0,001) which brings us to the conclusion that TME can be considered a valid method with an acceptable risk for the surgery of rectal tumours.

To clarify the possible role of persistent thrombocytosis after splenectomy as being a predisposing factor causing thromboembolism. Blood coagulation profiles were studied in 35 patients (20 M and 15 F, mean age 42 +/- 17.5) suffering from thrombocytosis (> 500,000/dl) who underwent splenectomy for non-malignant and non-traumatic diseases. Seventy healthy subjects acted as a control group. Tests were performed 6 months after the operation and for both groups (patients and controls) blood samples were collected for: platelets, fibrinogen, PT, APTT, AT III, plasminogen, F1 + 2, t-PA and DNA analysis for F V, F II and MTHFR. After one year all subjects were controlled for thrombocytosis, genomic abnormalities and venous thrombosis. All the analyses were performed according to the Statistical Package for Social Science. The significance of the differences in means was evaluated by non-parametric tests, differences with a P value < 0.05 being considered significant. Increased plasma levels of fibrinogen, D-dimer, F1 + 2 and PAI-1 were found in the patients compared with the control group. TPA was significantly lower in the patients than in the controls. At the one year follow-up, two patients with genetic polymorphism had suffered deep venous thrombosis. Our findings indicate that splenectomy contributes to abnormal platelet aggregation and endothelial cell activation with hypercoagulability. To clarify the possible role of persistent thrombocytosis after splenectomy as being a predisposing factor causing thromboembolism. Blood coagulation profiles were studied in 35 patients (20 M and 15 F, mean age 42 +/- 17.5) suffering from thrombocytosis (> 500,000/dl) who underwent splenectomy for non-malignant and non-traumatic diseases. Seventy healthy subjects acted as a control group. Tests were performed 6 months after the operation and for both groups (patients and controls) blood samples were collected for: platelets, fibrinogen, PT, APTT, AT III, plasminogen, F1 + 2, t-PA and DNA analysis for F V, F II and MTHFR. After one year all subjects were controlled for thrombocytosis, genomic abnormalities and venous thrombosis. All the analyses were performed according to the Statistical Package for Social Science. The significance of the differences in means was evaluated by non-parametric tests, differences with a P value < 0.05 being considered significant. Increased plasma levels of fibrinogen, D-dimer, F1 + 2 and PAI-1 were found in the patients compared with the control group. TPA was significantly lower in the patients than in the controls. At the one year follow-up, two patients with genetic polymorphism had suffered deep venous thrombosis. Our findings indicate that splenectomy contributes to abnormal platelet aggregation and endothelial cell activation with hypercoagulability.