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Una donna di 30 anni si presenta all’osservazione degli autori presso il Settore di Medicina Orale (Università degli Studi di Palermo) per la comparsa di una neoformazione gengivale a livello del V sestante. In anamnesi patologica remota non risultano patologie sistemiche attuali o pregresse, la paziente è in apparenti buone condizioni di salute, riferisce di non assumere farmaci e non ha subito in passato interventi chirurgici. La paziente, non fumatrice, non riferisce dolore nella sede interessata ma progressivo accrescimento della lesione. All’esame obiettivo extra-orale non si apprezzano linfoadenopatie latero-cervicali o altre anomalie. All’esame obiettivo intra-orale si rileva una neoformazione, localizzata nel V sestante su mucosa masticatoria e alveolare tra gli elementi 4.1 e 4.3, del diametro di circa 1 cm, che si presenta di colorito roseo, rivestita da mucosa di aspetto fisiologico e integro e non mobile rispetto ai piani sottostanti. Alla palpazione è possibile apprezzare una consistenza dura-elastica. La paziente non è portatrice di protesi mobili, non sono rilevabili fattori traumatici associabili alla presenza di tale condizione; si rileva la presenza di affollamento dentario e tartaro diffuso. In considerazione della crescita della lesione e dell’aspetto clinico, si prescrive alla paziente una TC Cone-Beam

The increase in patients' average age, the enhancement of anticoagulation therapy and the growth of vascular interventions represent the perfect conditions for the onset of atheroembolic renal disease. AERD is observed in patients with diffuse atherosclerosis, generally after a triggering event such as surgery on the aorta, invasive procedures (angiography, catheterization of the left ventricle, coronary angioplasty) and anticoagulant or fibrinolytic therapy. The clinical signs are heterogeneous, a consequence of the occlusion of downstream small arterial vessels by cholesterol emboli coming from atheromatous plaques of the aorta, or one of its main branches. The proximity of the kidneys to the abdominal aorta, and the high flow of blood they receive, make them a major target organ. For this reason, AERD represents a pathological condition that always needs to be taken into account in the nephropathic patient, although its systemic nature makes the diagnosis difficult. This manuscript presents a review of the existing literature on this pathology, to provide an updated summary of the state of the art: risk factors, diagnostics, histology and therapeutic approaches.

The paper illustrates the strategies set up for the communication of the documentary heritage of the Museum of Representation (Mu.Ra.), Department of Civil Engineering and Architecture, University of Catania. Mu.Ra. houses and exhibits the collections of architectural projects (Francesco Fichera Archive) and chalcographies (including the collection of G.B. Piranesi). The mission of the museum is to preserve, protect and make available to the scientific as well as to a wider community, the results of the Department research, education and dissemination activities.This has inspired a new way of thinking, valuing and using the heritage possessed. Focusing on the enhancement of the collections and merging research and educational purposes, an innovative participatory approach has been investigated and experimented.Indeed the students of the drawing courses and interns at the museum have been involved in their dual role of future designers and potential visitors of the museum developing strategies for new target users. Specifically, the experimentation was carried out on the projects by Francesco Fichera and was focused on the development of a communication strategy addressed to the reading and understanding of the architectural project. The aim was to actively involve the visitor in the learning process, making the visit a cognitive and emotional experience through new forms of representation. To achieve this goal the students worked both on architectures existing in Catania and on the unrealized projects, with the aim of recreating, using 3D modeling, virtual environments and reality, the visual and perceptive sensations of the unfinished architectural space.DOI: https://doi.org/10.20365/disegnarecon.23.2019.8

The Firenze 2016 Committee was established in 2013 on the impetus of the Rec- tor of the University of Florence Alberto Tesi, who suggested that Florence Council, the Tuscan Region and scientific and cultural institutions collaborate in the prepara- tion of the fiftieth anniversary of the 1966 Florence Flood. All main Institutions both political and cultural have participated in the Commit- tee, as well as very numerous national and international Public and Private Associa- tions. A complete list of the over 100 participants of the Committee can be found on the Project’s website . In the period 2013-2014, the Committee was presided over by Mario Primicerio, former mayor of the Florence Muncipality and from 2014 by the Mayor of Florence, Dario Nardella. As from 2015, the President of the Tuscan Region, Enrico Rossi, has taken on the charge of co-President. The Committee Secretary is prof. Giorgio Valentino Federici of the University of Florence. Since the foundation of the Committee, we have established an International Technical and Scientific Committee (ITSC) for an independent evaluation of what had been and what could still be done to reduce the flood risk for Florence. I wish to emphasize the importance and the innovative character of this initiative for our Country where the practice of accountability, common in the Anglo-Saxon world, seems to be considerably less present. It is indeed the case that, to help solve Venice’s problems, an international scientific committee was set up. This, however, operated under the aegis of the Consortium of companies responsible for the planning and re- alisation of the works, and therefore followed procedures which cannot be seen as an example of ‘accountability’. It is also important to observe that, with regard to Ven- ice’s problem, the Italian Government adopted, even amongst a thousand difficulties, quite a different strategy from that adopted for Florence. The special law for Venice has allowed the city of Venice to enjoy enormous funding for its defence and the safe- guarding of the lagoon, funding of an order of magnitude higher than that allocated to the defence of the city of Florence. How was such a different treatment possible? The flood risk “has been removed”, as we say in Florence. Many people believe that the risk still remains. For this reason, about three years ago, together with Mario Primicerio, former Mayor of Florence, we decided to set up the institution of an International Scientific Committee (ITSC). We were aware that a Fellow of the Accademia dei Lincei, prof. Giovanni Seminara, was an expert of water engineering very much involved in the scientific problems related to the safeguard of Venice and its lagoon. He had never been professionally involved in the management of the Arno flood risk but, together with his high qualifications, he was the ideal candidate for the ITSC. So we asked him to extend the efforts he had devoted to protecting Venice to supporting the equally important aim of protecting Florence from the flooding of the Arno River. With his help, we then identified a possible composition of the Committee, inspired by the strict principle of independence that had guided us from the beginning. The choice of Gerry Galloway as Chair of the ITSC is also in line with the objective of seeking a guide of great authority and, at the same time, of total independence. And so the ITSC experience began. We wish to extend many thanks, also on be- half of the co -chairs of the Firenze 2016 Committee, Dario Nardella the Mayor of Florence and Enrico Rossi President of the Tuscany Region, to the members of the ITSC, and in particular to Gerry Galloway and to Giovanni Seminara, for their gen- erous and hard-working commitment. Note that the principle of accountability was also applied to ITSC. Indeed, the final Report was sent for review to two anonymous referees, who wished their identities to be disclosed, namely Prof. Murugesu Sivapa- lan (University of Illinois at Urbana-Champaign) and Prof. Demetris Koutsoyiannis (Technical University of Athens). The manuscript was also submitted for comments to the three former Secretaries of the Arno Basin Authorities, Prof. Angelo Nardi, Prof. Giovanni Menduni and Dr. Gaia Checcucci. Finally, let us thank the Rector of the University of Florence, Luigi Dei, for sup- porting the publication of this report printed by the FUP – Firenze University Press.

According to many studies, extracorporeal dialysis with convective methods is associated with better clinical outcomes and a survival benefit compared to diffusive techniques. However, there is no full agreement on the actual superiority of this kind of renal replacement therapy on hard end-points such as mortality. We performed a retrospective epidemiological cohort study to provide "real-world" evidence on the impact of convective and non-convective dialysis techniques on all-cause and cardiac mortality and biochemical outcomes among dialysis patients in Sicily, the southernmost region of Italy. Data of all incident adult patients (N = 6529) who have started chronic extracorporeal dialysis over the period 2009-2015 were retrieved from the Sicilian Registry of Nephrology, Dialysis and Transplantation. There were 1558 patients receiving convective techniques (23.86%). Overall mortality rate was 45.21% with a significant difference between convective (31.39%) and non-convective (49.55%) groups (P 0.0001). After adjustment for potential confounders in multiple Cox regression models of increasing complexity, the mortality risk remained significantly lower for patients treated with convective methods (HR, 0.581; 95%CI, 0.525 to 0.643; P 0.0001). Moreover, the convective group had a better blood chemistry profile, improved dialysis efficacy, and reduced mortality rate from cardiac diseases compared to the non-convective group. As a sensitivity analysis, patients were categorized according to propensity score quartiles and the hazard ratio for both all-cause and cardiac mortality was significantly lower for the convective group in each quartile. In conclusion, despite the observational and retrospective design, the results of the present study further support the use of convective therapies for the treatment of end-stage renal disease.

Objective To develop a new composite disease activity score for gout and provide its first validation. Methods Disease activity has been defined as the ongoing presence of urate deposits that lead to acute arthritis and joint damage. Every measure for each Outcome Measures in Rheumatology core domain was considered. A 3-step approach (factor analysis, linear discriminant analysis, and linear regression) was applied to derive the Gout Activity Score (GAS). Decision to change treatment or 6-month flare count were used as the surrogate criteria of high disease activity. Baseline and 12-month followup data of 446 patients included in the Kick-Off of the Italian Network for Gout cohort were used. Construct- and criterion-related validity were tested. External validation on an independent sample is reported. Results Factor analysis identified 5 factors: patient-reported outcomes, joint examination, flares, tophi, and serum uric acid (sUA). Discriminant function analysis resulted in a correct classification of 79%. Linear regression analysis identified a first candidate GAS including 12-month flare count, sUA, visual analog scale (VAS) of pain, VAS global activity assessment, swollen and tender joint counts, and a cumulative measure of tophi. Alternative scores were also developed. The developed GAS demonstrated a good correlation with functional disability (criterion validity) and discrimination between patient- and physician-reported measures of active disease (construct validity). The results were reproduced in the external sample. Conclusion This study developed and validated a composite measure of disease activity in gout. Further testing is required to confirm its generalizability, responsiveness, and usefulness in assisting with clinical decisions.