Search

The "asbestos problem" arises from the fact that asbestos is still abundant in many buildings and represents a hazard for human health. Current strategies adopted by law aiming at mitigating this hazard are far from being ideal. A smarter solution would be an energy sustainable detoxification treatment followed by recycling. If adopted, it would preserve the environment from pollution, natural resources from depletion and human health from hazard. Asbestos -cement slates were thermally deactivated through a sustainable process and reused in mortar for plaster applications. We found that the addition up to 7 wt% of the deactivated product does not affect significantly the water demand; does not affect thixotropy, stickiness and spreadability of the plastic mixture; slightly increases the strength of the mortar; does not compromise mechanical properties after aging. Considering the huge amount of traditional mortar employed worldwide, a rapid end of the "asbestos problem" is envisaged.

Deactivated (detoxified) asbestos-cement (DAC), i.e. asbestos-cement slates thermally treated at 1100 °C in order to convert the harmful asbestos fibers into non harmful mineral phases, has been successfully mixed with 74.6 wt% quartz sand and up to 63.2 wt% basalt sand, to produce stone wool with mechanical properties and composition competitive with commercial stone wool. The sample with 50 % DAC and 50 % basalt provided the best comparison with commercial stone wool in terms of liquidus temperature (lower than for the other mixtures) and Young's modulus (higher). Through further composition optimization and utilization of multiple components, we estimate that future batches could utilize 70–75 % of DAC. These promising results and expectations highlight a feasible reuse of DAC as secondary raw material for stone wool production and a possible route to the elimination of a toxic waste from the environment and the preservation of primary raw materials.

The recycling of cement asbestos slates (CASs) thermally treated in air at 1100 °C as secondary raw material in the production of Vitreous China (VC) sanitary wares has been investigated. Deactivated cement asbestos powder (DCAP) has been used in individual substitutions (5 wt%) of quartz and feldspar. The single raw materials, the ceramic technological properties before and after firing, and the phases and microstructure evolution during firing have been investigated with a variety of techniques, including those commonly used for production quality checks and instrumental methods for mineralogical analyses. DCAP acts as flux rather than as inert in the firing process, promoting greification. Although the substituted samples have some critical aspects that need to be addressed before processing, such as the presence of sulphate salts that increase the dispersant demand and the colour of the fired ceramic body, the overall technological properties are comparable to those of normal production, suggesting the possible reuse of DCAP powder in the production of sanitary wares.

The products of cement–asbestos treated in air at 1100 °C were characterized by a multi-methodological approach to determine: (i) the effective deactivation of harmful asbestos fibers; (ii) the mineralogy and microstructure of the inert product and its possible use as a secondary raw material (SRM); and (iii) any potential health hazard of the SRM. For this purpose, energy-dispersive X-ray fluorescence spectrometry (EDXRF), X-ray powder diffraction (XRPD), scanning, and transmission electron microscopy (SEM and TEM) analyses were performed. The powdered SRM was also analyzed by dynamic laser scattering and solution leaching experiments, to determine grain size distribution and possible elements release. Our results confirm the deactivation of crocidolite and chrysotile asbestos fibers, but at the same time evidence a significant fraction of nanoparticles in the SRM and some critical releases of SO42–, F– and Cr6+ in solution. Both the nanoparticle fraction and the critical elemental release may pose human health concern and adversely affect potential applications of the SRM. Strategies to control the grain size distribution through adjusted thermal treatment conditions and microwave-assisted grinding operations are discussed. Possible routes to safely reuse the SRM are indicated.

Cement asbestos slates, commonly known as Eternit® and still abundant in private and public buildings, were deactivated through a thermal process. The resulting deactivated cement asbestos powder (DCAP), a mixture of Ca-Mg-Al silicates and glass, was compounded with Pavatekno Gold 200 (PT) and Pavafloor H200/E (PF), two different epoxy resins (bisphenol A epichlorohydrin) for flooring applications. The addition of the DCAP filler to the PF samples causes a slight but acceptable decrease in the relevant mechanical properties (compressive, tensile, and flexural strengths) upon increasing DCAP content. The addition of the DCAP filler to pure epoxy (PT resin) causes a slight decrease in the tensile and flexural strengths with increasing DCAP content, while the compressive strength is almost unaffected, and the Shore hardness increases. The main mechanical properties of the PT samples are significantly better than those of the filler-bearing sample of normal production. Overall, these results suggest that DCAP can be advantageously used as filler in addition to, or in substitution for, commercial barite. In particular, the sample with 20 wt% of DCAP is the best performing in terms of compressive, tensile, and flexural strengths, whereas the sample with 30 wt% of DCAP shows the highest Shore hardness, which is an important property to be considered in flooring applications.

Design and anthropology represent two intertwined disciplines, which historically have found fruitful opportunities for comparison and elements of contact; in light of the social changes that are strongly influencing also the design field, today more than ever these two disciplines are called to question themselves again, with a critical and future-oriented approach, to renew their fields of investigation by enhancing each other's interferences, strategies of collaboration and possible common challenges. In particular, the paper aims to adopt a projective perspective, investigating the present as a time open to the future, a moving "edge". In fact, more and more frequently we wonder what the perspective is for "the anthropology of the future" (Bryant and Knight, 2019), taking a position similar to those design-oriented approaches promoting "the uncertain and the possibility" (Akama et al., 2018) as well as "fragilisms" as vectors of innovation. The analysis will focus on the role of public anthropology as a privileged interlocutor to those engaged in design; on the enhancement of suburbs as a territory of "residual authenticity" and creative "indiscipline" (Vattimo 1988, p. XI); on the centrality of a micro approach to urban regeneration, as well as on the examples of widespread and inclusive regeneration that see the inhabitants as co-authors, where individuals are not mere bearers of culture and values, but also creators of new culture and projects. The goal is to outline a synergy that looks to the future of action-research on the peripheries starting from margins, diversities, hybrids, creativity and the informal. Furthermore, we will analyze the prospects of urban regeneration in a post-anthropocentric era. The paper, starting from some recent case studies that mainly involved the Milan area, thus intends to underline and enhance the disciplinary links between anthropology and design, but also their "exchanges, entanglements and frictions" (Bargna and Santanera

Quali azioni per un orientamento sistemico? Presentazione dei lavori di Ricerca cooperativa sulle pratiche di orientamento e la professionalità orientante nel passaggio tra primo grado e secondo grado della Scuola Secondaria realizzati con i docenti della Rete generale del sistema pubblico di istruzione, Ambito subprovinciale Milano 3. Racconto delle esperienze vissute e dei cambiamenti introdotti dalle scuole nelle pratiche di orientamento grazie al progetto O.S.A. ‒ Orientarsi in un Sistema che Apprende.

The presence of an angiitis process in the central nervous system (CNS) characterizes different groups of conditions: from idiopathic pachymeningitis to lymphoproliferative disorders. In absence of specific infections, inflammatory and neoplastic diseases, the term "PACNS" (Primary Angiitis of the CNS) was proposed to indicate a peculiar vascular inflammation of unknown origin of meningeal vessels extending to the brain or spinal cord parenchyma. We report two cases of PACNS with peculiar and atypical features: the first one with a possible Epstein Barr Virus (EBV) relationship, the second one with spinal cord involvement only, treated surgically. We also hypothesize a correlation between EBV chronic infection and possible subtypes of PACNS stressing the importance of EBER (EBV-encoded RNA) test in the routine examination of brain biopsies suspicious for PACNS.

PURPOSE: A major stroke after carotid endareterectomy (CEA) is an event that should be managed according to a planned strategy. Literature data on this issue are not definitive. We reviewed our series in the attempt to define an algorithm of treatment if this complication occurs. METHODS: A consecutive series of 413 CEAs in 390 patients was considered. All operations were performed under general anaesthesia and EEG monitoring. An indwelling shunt was inserted only according to EEG changes. Direct closure of the arteriotomy was performed in all cases. Intraoperative ultrasound was not routinely employed before 2004. Patients who suffered from the new onset of an ischaemic hemispheric deficit or the worsening of a pre-existing deficit within 72 h after surgery were included in the present study. RESULTS: Sixteen patients (3.9%) suffered from perioperative stroke. Seven patients presented neurological deficits that rapidly and spontaneously resolved. In nine cases (2.2%) a major stroke occurred. Acute occlusion of the internal carotid artery (ICA), with or without embolic blocking of the omolateral M1 segment, occurred in eight cases; in one case a patent ICA was associated with the occlusion of two frontal branches of the omolateral middle cerebral artery. Seven cases were reoperated on. The ICA was reopened in all these cases except one. Among these seven cases, three (42%) had a good outcome. CONCLUSIONS: A major stroke after CEA is caused, in most of cases, by the acute ICA occlusion with or without intracerebral embolic occlusion. Reopening of the occluded ICA gives good results when intracerebral vessels are patent and when the occluded ICA is satisfactorily reopened. An algorithm of planned reactions in case of perioperative stroke is finally proposed.

Background: Subthalamic deep brain stimulation has proved significant efficacy in the treatment of Parkinson disease. Adverse events, due to surgical and hardware-related complications, must be clearly addressed to properly balance the cost-effectiveness of the therapy. In addition, limited data exists about medical adverse events after surgery. Methods: One hundred forty-one patients undergoing subthalamic deep brain stimulation for Parkinson disease from 1998 to 2007 were considered. Medical records, operative notes, clinical findings at follow-up and final outcome were accurately recorded to identify surgical- and hardware-related complications, infections and delayed adverse medical events. Results: Five hundred twenty-two surgical procedures were performed, including electrodes positioning and impulse programmable generators implantation and substitutions. Mean follow-up of the patients was 4.6 years (9 months10 years). Surgical complications were observed in 5.6% of patients, including two hemorrhages (1.4%) and three (2.1%) inabilities to complete the surgical procedure. Medical delayed adverse events affected 1.4% of patients, with a patient having a fatal aspiration pneumonia. Infections were seen in 5.6% of patients; removal of the hardware was necessary in 3.6%. Hardware-adverse events were observed in 7% of patients, generally requiring minor surgery. Direct surgical mortality was 0%; overall mortality was 0.7% and permanent surgical morbidity was 0.7%. Conclusions: Deep brain stimulation can be regarded as a safe procedure. Mortality and permanent morbidity are very low, and surgical complications are relatively rare. Nevertheless, minor complications are not infrequent; hence the importance of continuous monitoring of the patients during the follow-up period. © 2010 Elsevier Inc.

Phosphaturic mesenchymal tumors that cause the paraneoplastic syndrome known as oncogenic osteomalacia are rare. The authors report on the case of a 57-year-old man with a history of osteomalacia and in whom was diagnosed a thoracic spine tumor at the T-4 level. Complete tumor resection was accomplished. The histological diagnosis was phosphaturic mesenchymal tumor (mixed connective tissue variant). After lesion removal, the paraneoplastic syndrome resolved. At the 24-month follow-up, no recurrence of the disease was observed. The clinical presentation, surgical technique, and follow-up in this case were reviewed in detail.

AIM: The purpose of this work is to evaluate if the asymmetry of venous outflow between the two hemispheres is a reliable criterion of impairment of the cerebral vascular reserve among symptomatic patients harbouring a spontaneous atherosclerotic occlusion of internal carotid artery. METHODS: From January 1995 to December 2007, 7 symptomatic patients, affected from occlusion of internal carotid artery, were submitted to a low-flow by-pass between the superficial temporal artery and the middle cerebral artery owing to the presence of an impairment of cerebral vascular reserve diagnosed by TC-Doppler, SPECT or perfusion-CT with acetazolamide challenge. Conventional angiography was always performed. Angiographic studies of these patients were reviewed in order to find out the presence of asymmetry of the venous outflow. In the same period 35 patients harbouring an occlusion of the carotid artery in the neck and a normal cerebral reserve underwent cerebral angiography in our departments in Monza. Angiographic studies, of this latter group of patients, were also retrospectively analyzed with the same purpose. RESULTS: All patients, with a poor cerebral reserve, showed an asymmetry of venous outflow >3 s omolateral at the carotid occlusion. Patients, with a normal cerebral reserve, showed an asymmetry of venous outflow <2 s. CONCLUSIONS: Asymmetry of venous outflow were correlated to an impaired cerebral reserve also in chronic conditions as atherosclerotic spontaneous occlusion of internal carotid artery. Our data are a further support to the reliability of this criterion in case of therapeutic sacrifice of internal carotid artery

BACKGROUND: High-frequency stimulation of the subthalamic nucleus (STN-DBS) improves motor symptoms in advanced Parkinson's disease (PD), but the mechanisms are still unclear. Functional imaging evidenced pathological overactivity in motor cortical areas in advanced PD that can be normalized by effective therapies. PATIENTS AND METHODS: We studied resting state cerebral blood flow pre-operatively and 12 months after surgery in 40 patients with advanced PD using ECD-SPECT. SPECT scans were also acquired 1 year apart in 21 matched PD controls who did not undergo surgery. Statistical analysis was performed using statistical parametric mapping (SPM2) software. In addition, we correlated brain perfusion changes after surgery with clinical improvement, assessed using the unified PD rating scale motor score (UPDRS-III). RESULTS: Patients showed marked motor improvement and medication reduction after surgery. Stimulated PD patients revealed bilateral rCBF decrements in motor cortical areas and prefrontal cortex bilaterally compared to pre-surgical condition as well as versus PD controls (p<.01 FDR corrected). Perfusion increases were found in cerebellum, temporal and occipital lobes. Clinical improvement was associated with perfusion decrements in primary motor and premotor cortices. CONCLUSIONS: Effective STN-DBS is associated with neuronal activity changes in brain regions implicated in movement programming and performance. We hypothesize that clinical benefit might be associated with stimulation-induced normalization of the abnormal overactivity within the cortico-basal ganglia-thalamo-cortical motor loop in advanced PD.

Extradural motor cortex stimulation (EMCS) has been proposed as alternative to deep brain stimulation (DBS) in the treatment of Parkinson's disease (PD). Its mechanisms of action are still unclear. Neuroimaging evidenced motor cortical dysfunction in PD that can be reversed by therapy. We performed left hemisphere EMCS surgery in six advanced PD patients fulfilling CAPSIT criteria for DBS with the exception of age >70 years. After 6 months, we measured regional cerebral blood flow (rCBF) at rest with SPECT and Tc-99m cysteinate dimer bicisate off-medication with stimulator off and on. Clinical assessment included Unified Parkinson's Disease Rating Scale part II and III, Abnormal Involuntary Movement Scale and mean dopaminergic medication dosage. We used statistical parametric mapping for imaging data analysis. Clinically we observed no mean changes in motor scales, although blinded evaluation revealed some benefit in individual patients. We found significant rCBF decrements in the pre-central gyrus, pre-motor cortex and caudate nucleus bilaterally, left prefrontal areas and right thalamus. Perfusion increments were found in cerebellum bilaterally. EMCS determined significant modulation of neuronal activity within the cortico-basal ganglia-thalamo-cortical motor loop in our cohort of advanced PD patients. However, these effects were paralleled by mild and variable clinical efficacy.

Esthesioneuroblastoma is a rare malignant neoplasm arising in the nasal cavity. Huge esthesioneuroblastomas, extending into the ethmoid roof and the cribriform plate, or invading the anterior cranial fossa, have traditionally been treated by craniofacial resection. Because of the invasiveness and potentially disfiguring results of a transfacial approach, a new technique has been proposed, combining endoscopic nasal and anterior craniotomy resection. We describe the case of a young male presenting with a large esthesioneuroblastoma involving the nasal cavity and the anterior cranial fossa, causing a huge skull base destruction. A combined transcranial and endoscopic nasal resection resulted in a macroscopically total removal of the tumor. The operative technique is reviewed in detail, along with the method used for the reconstruction of the anterior skull base defect.

BACKGROUND: Subthalamic Deep Brain Stimulation is a valid surgical procedure for the treatment of idiopathic PD, although its precise mechanism of action is still unclear; moreover, there are no conclusive data about the functional anatomy of the human subthalamic region. Identifying the location of active contacts for StnDBS can yield interesting insights on the mechanisms of action of DBS and the different role played by the anatomical structures of the subthalamic region. METHODS: Twenty-five patients operated on for bilateral StnDBS were considered. During the surgical procedure, a complete intraoperative neurophysiological study was obtained by means of semimicrorecordings and stimulations. After surgery, an MRI study confirmed the position of the electrodes; MR images were subsequently superimposed onto a stereotactic atlas by using a dedicated workstation. The coordinates relative to the tip of the electrodes and active contacts were then calculated. RESULTS: Most of the electrode tips are located inside the subthalamus or immediately ventrally to it. Of the active contacts used for chronic stimulation, 96.5% are located in a well-defined anatomical region, which includes subthalamus, zona incerta, and FF. CONCLUSIONS: Our findings seem to suggest that other structures beyond the subthalamus itself play a clinical role in symptoms control after DBS for PD.

This report describes a malignant neoplasia of the pineal region in a 65-year-old woman who presented with symptoms of intracranial hypertension and dissemination to CSF with radiologically documented lumbar intradural localizations. The histological examination of the lesion showed fragments of a cystic malignant neoplasia with epithelial elements resembling squamous cell carcinoma. We excluded the possibility of a cerebral metastasis from a squamous cell carcinoma arising in the genital or gastrointestinal tract, lung and skin. We propose this unique report for cyto-histological correlation and, as suggested in the American and Japanese literature, we discuss the hypothesis of the development of a squamous cell carcinoma arising from the malignant degeneration of a cerebral epidermoid cyst and we show by cytological examination of the CSF the exceptional presence of malignant cells and by lumbar MRI their intradural localizations.

Extradural motor cortex stimulation (EMCS) is a surgical procedure proposed for patients with advanced Parkinson's disease (PD) who cannot undergo deep brain stimulation (DBS). Five PD patients with motor fluctuations and dyskinesia underwent EMCS of the left hemisphere. All fulfilled CAPSIT criteria for DBS, with the exception of age >70 years. Patients were assessed preoperatively and 6 months after surgery on and off medications, with stimulator on, and 2 weeks later with stimulator off. Outcome measures included changes in mean medication dosage (levodopa and dopamine agonists), Unified Parkinson's Disease Rating Scale (UPDRS Parts H-HI and Item 39), and dyskinesias (Abnormal Involuntary Movements Scale [AIMS]). We found no significant mean changes following EMCS. However, there was a trend for a reduction of mean daily medication intake (-30%) and AIMS (-19%). There were 3 patients who reported reduced OFF time (UPDRS Item 39) and 4 of 5 who felt a subjective benefit in stability and gait. In our PD cohort, EMCS induced no objective benefit, although some subjective improvement was reported mostly on axial symptoms. (C) 2006 Movement Disorder Society.

A decline in verbal fluency is the most consistent neuropsychological sequela of deep brain stimulation (DBS) for Parkinson's disease. We assessed clinical correlates and switching and clustering subcomponents in 26 parkinsonians undergoing subthalamic DBS. Post-surgical motor improvement was accompanied by worsening at both letter and category fluency tasks. Total number of words and switches decreased, while average cluster size was unchanged. Worsening tended to be prominent in patients with baseline poorer cognitive status and more depressed mood. Impairment of shifting suggests prefrontal dysfunction, possibly due to disruption of fronto-striatal circuits along the surgical trajectory and/or to high frequency stimulation itself.

OBJECTIVE: Subthalamic (Stn) deep brain stimulation (DBS) is a valid surgical therapy for the treatment of severe Parkinson's disease. In recent years, StnDBS has been proposed for patients who previously received other surgical treatments, such as thalamotomy and pallidotomy. Nonetheless, there is no consensus about the indications of DBS in patients who previously underwent surgery. To the best of our knowledge this is the first reported case of a patient treated with DBS after previous thalamotomy and adrenal grafting. CLINICAL PRESENTATION: A 62-year-old man with a long history (more than 30 yr) of Parkinson's disease received unilateral thalamotomy and autologous adrenal graft on two independent occasions. Thalamotomy led to a significant improvement, although limited to the control of contralateral tremor. The autologous adrenal graft was of no benefit. For the subsequent occurrence of L-dopa related dyskinesias and severe "off" periods, the patient was referred to our center for StnDBS. INTERVENTION: The patient underwent bilateral StnDBS, obtaining a satisfactory improvement of rigidity and bradykinesia on both sides. The 1-year follow-up evaluation showed a 46% improvement in the Unified Parkinson's Disease Rating Scale motor section, along with a noticeable reduction in antiparkinsonian therapy (81%). CONCLUSION: This case is consistent with previous reports from the literature, suggesting that StnDBS is feasible and safe, even in patients who previously received other surgical treatments for Parkinson's disease, such as thalamotomy or cell grafting