Search

Il contributo analizza il rapporto poliedrico della provincia storica di terra di lavoro con la Nazione dall'unificazione al fascismo, momento di dissoluzione della provincia storica .

Insulin-like growth factor-1 (IGF-1) plays an important role in exercise physiology. We aimed the present study at assessing whether IGF-1 system and its changes with exercise are related to walking capacity in intermittent claudication (IC).In 45 IC patients, blood samples for the measurement of IGF-1, IGF binding protein-3 (IGFBP-3), and acid labile subunit (ALS) were taken at rest and immediately after a treadmill exercise performed until initial claudication distance (ICD), i.e. until the occurrence of claudication pain in the affected limb. Control group consisted of 45 age- and sex-matched subjects without previous myocardial infarction or stroke.When IC patients were divided into two groups according to ICD value, ANOVA showed significant group differences for IGFBP-3 and ALS. Indeed, resting levels of IGFBP-3 were 3537+/-109 microg/L in controls, moderately lower (3399+/-204 microg/L) in IC patients with ICDor= median, and markedly lower (2580+/-196 microg/L) in those with ICDmedian. ANOVA showed a significant difference between the three groups (F=9.42, P=0.001). Corresponding values for ALS were 13.4+/-0.9 mg/L, 10.0+/-1.2 mg/L, and 5.9+/-0.7 mg/L (F=14.21, P=0.001). A similar trend was observed for IGF-1 (F=2.85, P=0.063). Also the subdivision of the IC population according to ankle/brachial index median value showed that values of IGFBP-3 and ALS resulted progressively lower as the severity of the disease increased (F=4.71, P=0.011 for IGFBP-3, and F=12.04, P=0.001, for ALS). Exercise significantly increased serum levels of the three components of the IGF-1 system. Furthermore, ICD showed a direct correlation with exercise-induced changes in serum levels of IGF-1 (r=0.465, P0.001), and ALS (r=0.624, P0.001). At multivariate analysis, ICD remained associated with both IGF-1 (beta-coefficient=0.513, P0.001), and ALS (beta-coefficient=0.645, P0.001), after correction for confounding factors.Impaired IGF-1 system is implicated in the complex mechanism responsible for reduced exercise tolerance in IC. Furthermore, this finding suggests that affected individuals could represent a target population for interventions to rise IGF-1 levels.

The present review addresses the history of intermittent claudication in terms of pathogenetic and therapeutic approach. The reduced blood supply to the affected limb was initially explained by ‘vasospasm theory’, and vasodilators were the first drugs to be used. However, the demonstration that they induce the blood steal phenomenon led to the demise of vasodilating therapy. The 1970s marked the shift in interest from ‘vessel’ to ‘blood’, and drugs that improve blood rheology were introduced. In the 1990s, research focused on the metabolic regulation of the ischaemic muscle, and the ‘metabolic therapy’ has emerged as a new approach with which to improve walking capacity in claudicant patients. (Eur Heart J Supplements 2002; 4 (Suppl B): B2‐B7)

Adhesion molecules play a relevant role in the pathogenesis of vascular diseases. In 21 patients with intermittent claudication and 18 sex- and age-matched control subjects, we measured plasma levels of the circulating form of the adhesion molecules E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) alongside von Willebrand factor (vWF), at rest, at maximally tolerated exercise and 5, 15 and 30 min after exercise. In controls, plasma sICAM-1 levels did not change with exercise, while in claudicants they increased from 285+/-15 to 317+/-16 ng/ml (p0.01). Also for sVCAM-1 exercise did not modify plasma levels of sVCAM-1 in controls but increased it in claudicants from 671+/-45 to 751+/-47 ng/ml (p0.05). Similarly, vWF did not change with exercise in controls, but increased in claudicants from 100+/-9% to 111+/-8% of value for pooled normal plasma (p0.05). Exercise-induced changes in sICAM-1 negatively correlated with the maximal tolerated walking time, which is an index of disease severity. These findings indicate that, in claudicants, exercise is associated with increase in plasma levels of sICAM-1 and sVCAM-1.

Quality of life assessment is becoming increasingly relevant for evaluating the impact of disease and treatments and for deciding priorities when allocating resources. This is especially true in intermittent claudication where the goal of therapy is not the cure of the disease but rather to alleviate its symptoms and improve the patient's functional capabilities. At present, however, no generic scale fits all criteria for the ideal quality of life measuring in intermittent claudication.We developed a questionnaire aimed at evaluating the specific limitations encountered by claudicants in the physical activity and in the social and emotional functioning. The present study evaluated the questionnaire for validity, reliability, and sensitivity to change, attributes considered to be essential for a questionnaire to be useful.In 30 patients with intermittent claudication, the scores of the four sections of the questionnaire significantly correlated with the scores of the corresponding sections of the Nottingham Health Profile. This indicates that the questionnaire is valid. For each of the four subscales, the intraclass correlation coefficient was0.75, thus showing a high test re-test reliability. Also the internal consistency is strong with alpha coefficient ranging from 0.79 to 0.89. Finally, the questionnaire was administered to 9 patients before and 4 weeks after percutaneous transluminal angioplasty for claudication. After the intervention, the improvement in walking performance paralleled the improvement in quality of life. This indicates that the questionnaire is sensitive to change.Our questionnaire appears to be a valid and reliable quality of life measure in intermittent claudication.

It is now clear that different pathophysiologic mechanisms have a profound influence on the extent of the functional impairment in intermittent claudication. In particular, metabolic derangements, including impaired oxygen delivery and/or extraction, reduced nitric oxide synthesis, reduced glucose oxidation, accumulation of toxic metabolites and reduction in carnitine availability are correlated with disease severity. Therefore, metabolic interventions aimed at counteracting these alterations may represent a valid therapeutic approach to the treatment of this condition. To date, verapamil and L-arginine efficacy has been proven in few patients; a large scale clinical trial, conversely, reports that propionyl-L-carnitine appears to be an effective and well tolerated drug for the treatment of intermittent claudication.

In 5 patients with frequent premature ventricular ectopic beats, refractory to other antiarrhythmic treatments, amiodarone, given orally at the dose of 200 mg once a day for 4 weeks, reduced beta-adrenoceptor density from 202.9 +/- 62 to 101.1 +/- 33 fmol/mg protein (p0.01). Similarly, kd decreased from 21.0 +/- 6 to 3.9 +/- 1 (p0.05). Changes in beta-adrenoceptor population were accompanied by a marked reduction in mean premature ventricular complexes (PVC) frequency from the control value of 428.9 +/- 150.3 to 13.4 +/- 10.7 PVC/h (p0.05) and by a decrease in heart rate, from 83.8 +/- 4 to 73.9 +/- 4 b/min (p0.01). On the contrary, mean arterial pressure remained unchanged. Patients did not show side effects during treatment. Therefore, low dose oral amiodarone has important pharmacologic and therapeutic effects. It significantly reduces lymphocyte beta-adrenoceptor density and is effective in treatment of ventricular arrhythmias. Additional studies were performed in vitro exposing lymphocytes to increasing concentrations of amiodarone. The analysis of variance for repeated measures showed that amiodarone-induced reduction in lymphocyte beta-adrenoceptor density is a dose-depending phenomenon. Accordingly, treatment with doses of amiodarone higher than that used in the present study may induce a major reduction in lymphocyte beta-receptor density and exert a depressant cardiac effect.

The risk of cardiac arrhythmias during exercise and the recovery period may be enhanced by sympathetic activity. Accordingly, lymphocyte beta-adrenoceptor density was measured in 5 healthy men, aged between 25 and 32 years, at rest, at peak exercise and during the recovery period. Exercise increased 3H-dihydroalprenolol binding from 125 +/- 58 to 234 +/- 70 fmol/mg protein (p less than 0.02). During recovery, beta-adrenoceptor density was still higher than at rest, being 192 +/- 36 fmol/mg protein (p less than 0.02). No significant difference was found between exercise and recovery values (Tab. I). Results did not change when binding data were standardized to lymphocyte number, thus demonstrating that increases in binding were independent of exercise-induced lymphocytosis. Kd did not change significantly during the study. Since lymphocytic beta-adrenoceptor density may parallel myocardial beta-adrenoceptor density, this study suggests the myocardium may be more sensitive to the arrhythmogenic properties of catecholamines during exercise.

Nota su alcuni prodotti di toreutica provenienti dall'area picena in epoca tardo-orientalizzante ed arcaica

Oltre a chiarire diversi aspetti relativi all’acquisto, nel 1747, del seicentesco palazzo della famiglia Marciano nella strada di Costantinopoli da parte di Tommaso Francesco Spinelli, marchese di Fuscaldo, un’inedita documentazione custodita nel fondo notarile dell’Archivio di Stato di Napoli permette di far luce sulla cessione, nello stesso anno, di un suolo adiacente appartenente alle religiose della chiesa di S. Giovanni Battista delle Monache, primo passo verso l’ampliamento e la definitiva configurazione dell’edificio. Solo dopo la realizzazione di una nuova ala sarà infatti avviata la radicale riorganizzazione degli accessi agli appartamenti superiori attraverso una scalinata intervallata da due ballatoi affacciati sulla strada di Costantinopoli attraverso ampi finestroni che ancora oggi si inframmezzano tra la facciata del palazzo e quella della chiesa, fulcro di un organico riammodernamento del palazzo culminato intorno al 1790 con gli affreschi sulla volta del salone delle feste e, poco più tardi, con le pitture di gusto neoclassico della loggia.

Saggio su un dipinto praticamente inedito di Ignazio Stern.

I periodici illustrati editi in Italia dagli anni Trenta dell’Ottocento, e che di grande fortuna godranno per almeno un quarto di secolo, rappresentano una straordinaria ma ancora inesplorata fonte per lo studio delle Due Sicilie e, nello specifico, di Terra di Lavoro. Un occhio finalmente ‘moderno’, esito del rinnovamento della storiografia locale e tanto lontano dagli stereotipati schemi descrittivo-figurativi tardo settecenteschi, costituisce in questo senso il filo conduttore di saggi, resoconti di viaggio o semplici osservazioni su di una provincia tanto vasta e popolosa quanto, in fondo, ancora poco conosciuta, ma che in quegli stessi anni era oggetto di profonde trasformazioni urbane e territoriali. Con l’indispensabile ausilio dell’illustrazione, ecco così riemergere dalle pagine del Cosmorama Pittorico, del Teatro Universale, dell’Album e, soprattutto, dei napoletani Poliorama e Omnibus Pittoresco, città e monumenti antichi e moderni, paesaggi agrari o scorci naturali, frammenti di territorio ancora «privi di storia» perché riscoperti dopo secoli di oblio, perché lontani dai consueti itinerari di viaggio o perché permeati di quell’inedito «spirito delle industrie» in anni decisivi nella complessiva modernizzazione del Regno.

Mai sufficientemente affrontato sino a ora, il rapporto del pittore tedesco Wilhelm Tischbein con i sovrani di Napoli offre diversi spunti di riflessione sulle commissioni di corte, sulla produzione di ritratti e, persino, sul significato esoterico di alcune opere. Attraverso le memorie dell’artista, nuove attribuzioni e inedite letture iconologiche, si ricostruirà in particolare il legame con la regina Maria Carolina, sullo sfondo di un secolo che volge al termine e che travolgerà il Regno con la breve Rivoluzione del 1799.

L’interesse sui rapporti tra Napoli e Vienna nell’ambito della storiografia del Mezzogiorno d’Italia non è stato fortunato: sul viceregno austriaco ha pesato il giudizio sull’eccessivo fiscalismo e sulla scarsa capacità di realizzazione di progetti rinnovatori; sull’epoca di Maria Carolina il ruolo della regina nella repressione dei movimenti rivoluzionari. Per le due epoche gli studi sono stati lungamente concentrati sulle correnti riformistiche. È negli ultimi due decenni che si assiste a una crescita di interesse per temi interdisciplinari legati alla cultura, all’arte, alla musica e al teatro, dai quali emerge la connessione del Regno con le altre realtà europee. The interest on the relations between Naples and Vienna in the context of the historiography of the Southern Italy was not fortunate: on the Austrian vice-kingdom had an impact the judgment on the excessive fiscalism and the lack of capacity to carry out renewing projects; on the age of Maria Carolina, the role of the queen in the repression of revolutionary movements. For these two epochs, studies have been long concentrated on reformist currents. The last two decades have seen an increase in interest in interdisciplinary themes related to culture, art, music and theatre, from which emerges the connection of the Kingdom with other European realities.

A paradox marks the cinematographic presence of Caserta and its Province. On the one hand, the famous Royal Palace, chosen as a set for dozens of Italian and international films from the 1930s to the present day, is actually a closed place, not linked to the territory and, moreover, used largely to represent and evoke other spaces of power. On the other hand, in the course of the twentieth century, the presence on the big screen of the Caserta Province was sporadic. Only at the beginning of the new millennium did this territory become the privileged setting for stories with a strong realism and aimed at telling facts and episodes largely related to the crime news. This intervention therefore aims to focus on the film production of the last fifteen years in order to identify, together with the aspects that characterize it, the places most used and thus offer a critical reading of the interpretations suggested by the films.

Il rapporto che la dinastia dei Borbone ebbe nell’Ottocento con la provincia e soprattutto la città di Caserta fu più stretto di quanto fosse stato nel secolo precedente. Ferdinando II e soprattutto sua moglie Maria Teresa preferirono soggiornare lungamente nel grande palazzo casertano, facendo però, tuttavia, vita ritirata. I cerimoniali di corte che qui si svolgevano, coinvolgendo la partecipazione soprattutto di ambienti elitari ma difficilmente della cittadina, evidenziano le difficoltà di adattamento della dinastia tra vecchio e nuovo. The relationship that the Bourbon dynasty had in the nineteenth century with the province and especially the city of Caserta was closer than it had been in the previous century. Ferdinand II and especially his wife Maria Teresa preferred to stay for a long time in the great royal palace, but they made a retreat. The court ceremonies that took place here, involving the participation above all of elitist environments but hardly of the town, highlight the difficulties of adaptation of the dynasty between the old and the new.