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In recent years, there has been increased awareness of a concept of medicine based on individual differences taking into consideration genetic variability, environment, characteristics of the microbiome and individual lifestyles. It makes use of genomics, transcriptomics, proteomics and metabolomics techniques, obtaining a large amount of information which enables a more precise characterization of the patient. This model expands to the principles of prediction, prevention, personalization and participation, including all medical specialties. In nephrology, the application of precision medicine could play a central role, thanks to the information available today in multiple fields: for example the impact of alterations in the intestinal microbiota on the progression of chronic renal failure, in polycystic disease, in diabetic nephropathy and in the personalized approach to the transition period before the beginning of hemodialysis therapy., In recent years, there has been increased awareness of a concept of medicine based on individual differences taking into consideration genetic variability, environment, characteristics of the microbiome and individual lifestyles. It makes use of genomics, transcriptomics, proteomics and metabolomics techniques, obtaining a large amount of information which enables a more precise characterization of the patient. This model expands to the principles of prediction, prevention, personalization and participation, including all medical specialties. In nephrology, the application of precision medicine could play a central role, thanks to the information available today in multiple fields: for example the impact of alterations in the intestinal microbiota on the progression of chronic renal failure, in polycystic disease, in diabetic nephropathy and in the personalized approach to the transition period before the beginning of hemodialysis therapy.

Dialysis patients have a wide range of pathologies that contribute to their frailty. Maintaining a good nutritional status is useful to prevent and treat the so-called Protein-Energy Wasting (PEW), a complex clinical-laboratory condition in which a protein-energy depletion occurs. Adherence to a proper nutritional therapy in CKD requires considerable effort from both patients and health personnel (doctors and nurses). In order to slow down the effects of malnutrition and the disasters that complicate PEW, nephrologists can use supplementation products. In our observational, prospective, multicentre study, we administered an intradialytic parenteral nutrition of a three-compartment emulsion for intravenous infusion through an infusion pump connected to the venous line. After 12 weeks of treatment, subjects with severe malnutrition were reduced from 61.1% to 33.3%, serum creatinine increased by 16% (from 6.00 ± 1.48 mg/dL to 6.98 ± 2.46 mg/dL; P < 0.001), total protein and albumin levels respectively by 13% (from 5.46 ± 0.63 g/dL to 6.19 ± 0.66 g/dL; P < 0.001) and 19% (from 2.70 ± 0.48 g/dL to 3.20 ± 0.57 g/dL; P < 0.001), body weight by 3% (from 55.7 ± 13.2 kg to 57.6 ± 13.0 kg; P < 0.001)., Dialysis patients have a wide range of pathologies that contribute to their frailty. Maintaining a good nutritional status is useful to prevent and treat the so-called Protein-Energy Wasting (PEW), a complex clinical-laboratory condition in which a protein-energy depletion occurs. Adherence to a proper nutritional therapy in CKD requires considerable effort from both patients and health personnel (doctors and nurses). In order to slow down the effects of malnutrition and the disasters that complicate PEW, nephrologists can use supplementation products. In our observational, prospective, multicentre study, we administered an intradialytic parenteral nutrition of a three-compartment emulsion for intravenous infusion through an infusion pump connected to the venous line. After 12 weeks of treatment, subjects with severe malnutrition were reduced from 61.1% to 33.3%, serum creatinine increased by 16% (from 6.00 ± 1.48 mg/dL to 6.98 ± 2.46 mg/dL; P < 0.001), total protein and albumin levels respectively by 13% (from 5.46 ± 0.63 g/dL to 6.19 ± 0.66 g/dL; P < 0.001) and 19% (from 2.70 ± 0.48 g/dL to 3.20 ± 0.57 g/dL; P < 0.001), body weight by 3% (from 55.7 ± 13.2 kg to 57.6 ± 13.0 kg; P < 0.001).

The chapter summarizes and analyzes the many issues pertaining to the interpretation and application of the misdemeanor of Destroying or Disfiguring an Habitat within a Protected Site (introduced into the Italian Penal Code in 2011), taking into account its complex relationship with relevant EU and Italian law, including, specifically, other national criminal law provisions pertaining to environment protection.

The chapter summarizes and analyzes the many and most up-to-date issues pertaining to the interpretation and application of the misdemeanor of Damage to the Archaeological, Historical or Artistic Heritage of the Nation, taking into account both academic literature and case law. The relation of art. 733 with other relevant provisions of the Penal Code, as well as with the different system of criminal offences set in the Code of Cultural Heritage (d.lgs. 42/2004) and with the definition of ‘cultural property’ provided therein, is also briefly assessed.

The chapter summarizes and analyzes the many and most up-to-date issues pertaining to the interpretation and application of the misdemeanor of Destroying or Disfiguring Natural Beauty, taking into account both academic literature and case law. The relation of art. 734 with other relevant provisions of the Penal Code and of the Code of Cultural and Landscape Heritage (d.lgs. 42/2004), as well as with the definition of ‘landscape assets’ provided therein, is also briefly assessed.

Commento dottrinale e giurisprudenziale aggiornato agli artt. da 414 a 421 del codice penale