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[English]: This volume proposes a rich corpus of papers about the ‘Other City’, a subject only few times dealt with, but worthy of all our attention: it imposes itself on the scene of international modern and contemporary historiography for its undeniable topicality. Throughout history, the city has always had to deal with social ‘otherness’, i.e. with class privileges and, consequently, with discrimination and marginalization of minorities, of the less well-off, of foreigners, in short, with the differences in status, culture, religion. So that the urban fabric has ended up structuring itself also in function of those inequalities, as well as of the strategic places for the exercise of power, of the political, military or social control, of the spaces for imprisonment, for the sanitary isolation or for the ‘temporary’ remedy to the catastrophes. From the first portraits of cities, made and diffused at the beginning of the fifteenth century for political exaltation purposes or for religious propaganda and for devotional purposes, which often, through increasingly refined graphic techniques, distort or even deny the true urban image, we reach, at the dawn of contemporary history, the new meaning given by scientific topography and new methods of representation; these latter aimed at revealing the structure and the urban landscape in their objectivity, often unexpected for who had known the city through the filter of ‘regime’ iconography. The representation of the urban image still shows the contradictions of a community that sometimes includes and even exalts the diversities, other times rejects them, showing the unease of a difficult integration / [Italiano]: Questo volume propone un ricco corpus di contributi sulla ‘Città Altra’, un tema sinora poco battuto ma degno di tutta la nostra attenzione, che s’impone sulla scena della storiografia internazionale, moderna e contemporanea, per la sua innegabile attualità. Nel corso della storia, la città ha dovuto sempre fare i conti con le ‘alterità’ sociali, ossia con i privilegi di classe e, conseguentemente, con la discriminazione e l’emarginazione delle minoranze, dei meno abbienti, degli stranieri, insomma con le diversità di status, di cultura, di religione. Sicché il tessuto urbano ha finito per strutturarsi anche in funzione di quelle diseguaglianze, oltre che dei luoghi strategici per l’esercizio del potere, del controllo politico, militare o sociale, degli spazi per la reclusione, per l’isolamento sanitario o per il rimedio ‘temporaneo’ alle catastrofi. Dai primi ritratti di città elaborati e diffusi sul principio del Quattrocento per fini di esaltazione politica o per la propaganda religiosa e per scopi devozionali, che spesso, attraverso tecniche grafiche sempre più raffinate, falsano o addirittura negano la vera immagine urbana, si giunge, all’alba della storia contemporanea, al nuovo significato dato dalla topografia scientifica e dai nuovi metodi di rappresentazione, atti a svelare la struttura e il paesaggio urbano nella loro oggettività, spesso cruda e inaspettata per quanti, prima di allora, avessero conosciuto la città attraverso il filtro dell’iconografia ‘di regime’. La rappresentazione dell’immagine urbana mostra ancora oggi le contraddizioni di una comunità che a volte include, e persino esalta, le diversità, altre volte le respinge, tradendo il malessere di una difficile integrazione.

Sin dalla sua costruzione, avvenuta nel 1540, l'opera pia di San Giacomo degli Spagnoli di Napoli fu realizzata con il preciso obiettivo di rappresentare la potenza economico-militare della nazione ispanica. Concepito come un sistema di pluriattività si affermò fin dalla sua nascita come ammortizzatore sociale per rispondere ai bisogni della popolazione ispanica castigliana e catalana residente o di passaggio (militari, poveri e pellegrini), e al contempo come operatore finanziario attento alle opportunità d'investimento offerte dal mercato mobiliare e immobiliare. Ma è il suo inserimento nel 1597 nel circuito creditizio/bancario vero e proprio a evidenziarne l'importanza e la specificità rispetto a quanto fu fatto da altre comunità di stranieri come quella dei ricchi mercanti e banchieri genovesi che oltre alla loggia, simbolo degli affari e degli interessi propriamente economico-finanziari, edificarono cappelle, chiese e monasteri , o anche di lucchesi, fiorentini, greci, albanesi, lombardi, che avevano anch'essi provveduto a creare organismi destinati alla protezione e alla tutela dei connazionali. Attraverso l'iconografia e i documenti contabili conservati presso l'Archivio Storico del Banco di Napoli tra la fine del Cinquecento e il primo ventennio del Seicento s'intende dare voce a quella comunità ispanica che frequentò l'opera pia.

[English]:The city as a destination of the journey in his long evolution throughout history: a basic human need, an event aimed at knowledge, to education, to business and trade, military and religious conquests, but also related to redundancies for the achievement of mere physical or spiritual salvation. In the frame of one of the world's most celebrated historical city, the cradle of Greek antiquity, myth and beauty, travel timeless destination for culture and leisure, and today, more than ever, strongly tending to the conservation and development of their own identity, this collection of essays aims to provide, in the tradition of AISU studies, a further opportunity for reflection and exchange between the various disciplines related to urban history./ [Italiano]:La città come meta del viaggio nella sua lunga evoluzione nel corso della storia: un bisogno primario dell'uomo, un evento finalizzato alla conoscenza, all'istruzione, agli affari e agli scambi commerciali, alle conquiste militari o religiose, ma anche legato agli esodi per il conseguimento della mera salvezza fisica o spirituale. Nella cornice di una delle città storiche più celebrate al mondo, culla dell'antichità greca, del mito e della bellezza, meta intramontabile di viaggi di cultura e di piacere, e oggi, più che mai, fortemente protesa alla conservazione e alla valorizzazione della propria identità, questa raccolta di saggi intende offrire, nel solco della tradizione di studi dell'AISU, un'ulteriore occasione di riflessione e di confronto tra i più svariati ambiti disciplinari attinenti alla storia urbana.

[English]:Starting from one of the most significant chapters of Leonardo's Libro di Pittura, we hwant to focus on the media - namely on the narrative, descriptive and graphics methodologies together with the techniques adopting during the modern and contemporary age as 'diffusers' of the landscape image - and on the deriving potential models for the enhancement of the historical landscape heritage./ [Italiano]: Partendo dal titolo di uno dei capitoli più significativi del Libro di Pittura di Leonardo, si vuole porre l'attenzione sui media, ossia sulle metodologie e sulle tecniche narrative, descrittive e grafiche adottate, nella storia moderna e contemporanea, quali 'diffusori' dell'immagine del paesaggio, e sui potenziali modelli che ne derivano ai fini della valorizzazione del patrimonio storico paesaggistico.

Nel vasto panorama in cui si inquadra il lavoro di ricerca volto allo studio dell’iconografia della città svolge un ruolo significativo la rappresentazione, la disciplina in grado di conservare le immagini e di produrne di sempre più adeguate alle odierne visioni. Rendendosi necessario a tale studio sia l’utilizzo di diversi strumenti di indagine, che il confronto con varie scale di riferimento, che l’apporto di varie discipline, si giunge, attraverso i contributi presenti nel primo numero della rivista, ad esplicitare un metodo di approccio all’immagine della città in cui la visione si configura come linguaggio privilegiato., Eikonocity. Storia e Iconografia delle Città e dei Siti Europei - History and Iconography of European Cities and Sites, Vol 1, No 1 (2016)

Il repertorio iconografico campano a soggetto architettonico rappresenta di certo un corpus di immagini particolarmente significativo, sia perché molto cospicuo e sostanzialmente integro, sia perché decisamente singolare in termini di contenuti figurativi, in quanto espressione ante litteram di una realtà virtuale che simula spazi illusori, in molti casi pensati e progettati fin nei minimi dettagli. Per quanto abbastanza noto e studiato si tratta, tuttavia, di un ambito di ricerca che necessita ancora di approfondimenti specifici, volti alla divulgazione e alla valorizzazione di un patrimonio spesso trascurato nonostante la sua importanza storica, artistica e culturale. Con tale obiettivo appare innanzitutto opportuno predisporre una rigorosa metodologia che – con l’ausilio di tutte le tecniche e le procedure infografiche ritenute utili – possa condurre, per passaggi successivi, alla completa acquisizione e gestione delle informazioni relative agli affreschi parietali a soggetto architettonico che connotano il costruito storico della Campania. In particolare, con riferimento ad alcuni tra i più significativi episodi antichi – grazie all’impiego di tecniche di rappresentazione e di archiviazione dati mediante sistemi digitali – ci si propone di definire un modello di repertorio iconografico organizzato su più livelli, distinti ma interconnessi. Ciò al fine di raccogliere e diffondere informazioni di varia natura (storiche, costruttive, tipologiche), ma fornendo al tempo stesso una preziosa documentazione grafico-descrittiva, onde permettere una corretta fruizione di tale patrimonio e, di conseguenza, una più efficace conservazione e valorizzazione. Si ritiene infatti che la creazione di un database così concepito possa innanzitutto contribuire a fornire un apparato documentale prezioso sia in termini divulgativi – se indirizzato ad una fruizione di tipo turistico – sia in termini tecnico-scientifici, in quanto aperto alla consultazione e potenzialmente alla implementazione da parte di soggetti a vario titolo coinvolti nel processo di conoscenza e di tutela del patrimonio iconografico in oggetto. Un sistema informativo, dunque, che attraverso specifiche indagini trasposte in elaborazioni infografiche, espliciti e visualizzi con una certa immediatezza, le caratteristiche estrinseche e intrinseche dei soggetti analizzati. Ovvero che non si limiti a fornire informazioni quantitative ma, travalicando la funzione di semplice inventario, pervenga ad una descrizione più profonda di questo patrimonio.

The determination of sediment toxicity is challenging due to site-specific factors affecting pollutants distribution and bioavailability, especially when contamination levels are close to expected non-effect concentrations. Different lines of evidence and sensitive tools are necessary for a proper toxicity risk assessment. We examined the case study of the Toce River (Northern Italy), where past industrial activities determined Hg, DDT and As enrichment in sediments. A triad approach comprising chemical, ecotoxicological and ecological analyses (benthic invertebrates) was carried out for risk assessment of residual contamination in river sediments. A “blank” site upstream from the industrial site was selected to compare the other sites downstream. Sediment, water and benthic invertebrate samplings were carried out following standard protocols. Results emphasized that despite the emissions of the industrial site ceased about 20 years ago, sediments in the downstream section of the river remain contaminated by Hg, DDT and As with concentrations exceeding Threshold Effect Concentrations. A chronic whole-sediment test with Chironomus riparius showed decreased development rate and a lower number of eggs per mass in the contaminated sediments. Benthic community was analyzed with the calculation of integrated (STAR_ICMi) and stressor-specific metrics (SPEAR pesticide and mean sensitivity to Hg), but no significant differences were found between upstream and downstream sites. On the other hand, multivariate analysis (partial Redundancy Analysis and variation partitioning) emphasized a slight impact on invertebrate community, accounting for 5% variation in taxa composition. Results show that legacy contaminants in sediments, even at low concentrations, may be bioavailable and possibly toxic for benthic invertebrates. At low concentration levels, sensitive and site-specific tools need to be developed for a proper risk analysis.

Background. Amyand’s hernia (AH) is an inguinal hernia containing the vermiform appendix, with an incidence between 0.4% and 1% of all inguinal hernias. Acute or perforated appendicitis can complicate AH. Case Presentation. A 75-year-old Caucasian man presented with incarceration of vermiform appendix in inguinal hernia sac. Diagnosis was posed preoperatively with computed tomography (CT) scan. Patient underwent urgent surgery and simultaneous appendectomy and hernia repair by Bassini’s technique were performed. Conclusions. Preoperative diagnosis of AH is rare; however it could be useful for surgeon to choose operative approach. Treatment of AH depends on grade of appendix inflammation and/or perforation. The technique utilized to repair hernia depends largely on surgeon’s preferences; the presence of inflamed or perforated appendix is not an absolute contraindication for using a prosthetic mesh.

Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4% (n = 2515) underwent surgery for malignancy and 11.7% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8% (n = 3041) of patients, which was handsewn in 38.9% (n = 1183) and stapled in 61.1% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe.

Aim Accurate preoperative discrimination between extra-and intraperitoneal rectal cancer has important treatmentimplications. Our main objective was to compare thediagnostic performance of MRI with rigid rectoscopy(RRS) in assessing the location of rectal cancers above orbelow the peritoneal reflection (PR), using the findingsobtained during abdominal surgery for treatment of thecancer as the reference standard. We also compared theaccuracy of MRI and RRS in assessing the level of thelower border of the tumour from the anal verge.Method Patients with rectal carcinoma awaiting surgeryunderwent MRI and RRS. The MRI images werereviewed by two abdominal radiologists who determinedthe location of the inferior border of the tumour in rela-tion to the PR. Receiver–operating characteristics (ROC)curve analysis was performed to determine the diagnosticperformance of RRS at different cut-off values.Results The sensitivity and specificity were 98.15% and100%, respectively, for MRI, and 100% and 76.92%,respectively, for RRS at a cut-off value of < 10 cm. Themean level of the lower border of the tumour from theanal verge was 68 44.3 mm on RRS and73.5 42.4 mm on MRI (P = 0.25), with a trendtowards overestimation with MRI.Conclusion RRS is still the main means of assessing thelevel of a rectal tumour from the anal verge, but MRIhas value in determining the level of the tumour in rela-tion to the PR, which cannot be seen on endoscopy.Keywords Rectal cancer, rectoscopy, MRI, perito-neum, surgeryWhat does this paper add to the literature?To our knowledge, this is the first study focusing onthe comparison between the diagnostic performance ofMRI and rigid rectoscopy in assessing the location ofrectal cancer with respect to the anal verge and perito-neal reflection.

Essential element of architectural design in the villa of Oplontis, the wall decoration is characterized by the research of daring perspectives tending to dilate the surfaces of the interior environments: these are paintings in II and III style that depict architectural perspectives according to a marked taste for the theatrical stage design applied to painted decoration; it’s aimed to determine the illusion of environments that you happen endlessly in a game of feints architectures, often processed with extreme wisdom. The working method is related to the establishing the relationship between the container and the space created by the perspective illusion and has its starting point in rigorous photogrammetric survey technique and rendering; then it move on to examine the specialties of roman painting, analyzing both the general characteristics and specific aspects. This study also uses of a philological analysis with reference to vitruvian rules and to greek-romans typologies in order to reconstruct the painted space; finally the painted space, in 3d model, is recomposed with real space, thin to land to representations more effective than they allow to gather better still the experience of a quite new space, in a reconstruction of the architecture integrated by the illusion, as if it were real In this simulation of virtual spaces, the digital graphics helps to lead the experimentation that is developing, as part of the PRIN 2010-2011 research (Architectural Perspective: digital preservation, content access and analytics, scientific coordinator Riccardo Migliari), by the Salerno Unit, with the annexed unities (University of Naples ‘Federico II’, Second University of Naples, University of Basilicata). Of this research, which puts particular attention to the architectural, archaeological and iconographical heritage in Campania, are presented here only part of the achieved outcomes.

Naples has an infinite hypogeum and steeped in history, a city under the city where the events followed have left their indelible imprint from five millennia ago. In the complex of tunnels and cavities excavated in the tuff and placed in the subsoil of the city are many especially the environments and the classic architectures, of greek and roman time: they began as a tuff resource to allow the greeks walls and the temples of the city of Neapolis that was gradually spreading and, at the same time, many areas were dug to create a series of hypogea. The survey of the greek hollow, in Poggioreale area, adds an important wedge to the mosaic outlined so far the Naples’ subsoil with the more ambitious goal of designing a total plan underground city; also the space survey has shown that the tuff was mined continuously according to an innovative technique, by inserting wooden poles inside natural crevices, so blocks of tuff were extracted more easily without damaging the structure of the quarry. After that the boulders were branded and on the walls of the greek hollow in Poggioreale you can see graffiti and symbols dating back to the IV century BC representatives probably, according to the archaeologists, the precise membership quarry.

The use of biomarkers to evaluate the biological effects of chemical pollutants in marine organisms represents a recent tool in the monitoring field responding to the need to detect and assess the effects of chemical contaminants on the biota. The aim of the present work was the field application of the integrated use of acetylcholinesterase (AChE) and antioxidant enzymes (Catalase, CAT, and Glutathione peroxidase, Glut-perox), for detecting the possible exposure/effect induced by chemical pollutants in native marine organisms from a coastal marine area, represented by Salento Peninsula (Italy), that shows a coastline of high environmental value, but under constant urban pressure, including agriculture activities, widely diffused in the whole hinterland. Eight sampling stations were chosen: four not urbanized areas considered “uncontaminated” controls and four clearly exposed to anthropogenic impact. The bioindicator species studied were a sessile invertebrate, Mytilus galloprovincialis, and a benthic teleost fish, Mullus barbatus. AChE activity in M. galloprovincialis revealed significant differences among places; the minimum values observed (3.9  1.8 nmol min-1 mg-1) was about 50% reduced with respect to the maximum found (11.4  0.9 nmol min-1 mg-1). The reduction in AChE activity observed in two control stations could be explained by the leaching of pesticides into the sea from the agricultural lands. Moreover, the inhibition of AChE activity by heavy metals besides pesticides, can also explain the reduction of the enzymatic activity observed in an industrialized and harbour area. In M. galloprovincialis AChE activity showed a significant inverse correlation with catalase activity but not with glutathione peroxidase that did not significantly change in animals sampled from the eight stations. Also in M. barbatus AChE activity showed significant differences among places; it was inversely correlated with liver GSH-Px activity, but not with catalase activity, that did not show any significantly variation in animals sampled in the different stations. In conclusion, the integrated use of AChE and antioxidant enzymes (catalase or glutathione peroxidase) in M. galloprovincialis and M. barbatus, two species living in different compartment of marine coastal ecosystem, can find a useful application within the framework of marine coastal environment monitoring programs for detecting the possible exposure/effect induced by chemical pollutants, including pesticides, on living marine organisms.

The thematic session focuses on the graphic analysis of iconographic sources with an emphasis on the critical reading of the project of an “image construction” - of an architectural, urban and landscape setting. In this perspective, topography, cartography and landscape painting are the main fields of study, investigation and application for this thematic session. In particular, the graphic analysis will be studied in the cultural context which generated the image itself, in reference to the scientific foundations of representation, with the resulting critical choice of the representation, geometric and pictorial methods and techniques for the iconography. Current literature on this topic confirms how construction, as well as the resulting analysis of the initial data, give critical occasion to transfer potential communicative differences. Particular interest will be given to the graphical analysis and verification of the represented places with real ones, using innovative digital representation and image techniques of de-construction.

As far as we know, the construction of the world starts from the worlds that we already have; the construction is a reconstruction. However, how the real worlds that we recognize as such really are, is an entirely different matter? Even under very restrictive assumptions, it is possible to find innumerable interpretations, all equally legitimate???. In Nelson Goodman???s definition, relativism appears as a theoretical concept, in which a single object can be viewed from different perspectives, all resulting from the cognitive orientation of the individual yet considered equally valid. The activity of analysis or the project of urban architecture is influenced by both a myriad of aspects of life of spatial, political and socioeconomic nature, as also by their impact on the perception that the individual has of the constructed environment. As a subject of study, Naples can be related through an indefinite number of perceptions that are evidently equal in the level of volatility and conflictuality of the city, ever changing. Often alternative visions of the urban environment and its elements are the starting point for analysis, survey and representation of the space: from many points of view the city relates, represents and subdivides. The continuing transformation represented by the collective structure of the city to which is entrusted the vision of urban form and an invariant design primarily connected to strategic locations, capable of providing the framework on which to prefigure images of themes and actions at all scales.

Nell???ambito della sperimentazione delle nuove tecnologie di rilievo, un momento interessante è consistito nell???acquisizione tramite rilievo laser scanner delle metope presenti alla base del campanile di Nola. Il campanile, adiacente all???edificio del Duomo di Nola, nella evoluzione storica dell???insula episcopalis di cui fa parte, ha avuto una fase costruttiva basata sul riutilizzo dei materiali provenienti dalle preesistenze della Nola romana. In tal modo l???intero basamento risulta decorato da un fregio probabilmente proveniente dall???antico foro romano e mantiene ancora in parte intatta la sequenza di metope e triglifi che costituivano la decorazione originaria. Nel corso dei secoli gli edifici circostanti si sono evoluti al punto da determinare l???occlusione della base del campanile, costringendola in uno spazio angusto di adiacenze tra edifici. La posizione di tale apparato decorativo è risultata pertanto particolarmente difficoltosa sia ad una normale fruizione che ad una corretta rappresentazione dello stesso, non potendo essere ripreso con le normali tecniche di presa fotografica.

La porzione di territorio meridionale che attualmente costituisce la regione Campania dispiega un numero di episodi e siti archeologici noti a livello mondiale. Essi, con la loro collocazione e configurazione, solo in parte compiutamente messa in luce, raccontano le vicende, spesso devastanti, che hanno contribuito a segnare e ridisegnare questi luoghi. Un possibile modello di analisi delle prospettive architettoniche, risalenti in particolare all’età romana, può essere improntato secondo un approccio multiscalare: dal contesto naturale e infrastrutturale, all’organismo architettonico ed alle sue partizioni L’analisi di tali opere conferma l’esigenza di un ricchissimo spettro di informazioni, diversificate per cronologia e tipologia (disegni, fotografie, modelli digitali, ecc.) che sollecitano la definizione di un necessario strumento di gestione, efficace e durevole, che risulti idoneo anche a supportare uno studio flessibile sulla rappresentazione delle relazioni spazio-temporali che si dispiegano tra reale e virtuale. vanificano illusoriamente la consistenza costruttiva.

The technological development in survey techniques and the specific connection to the valorization of cultural heritage, define the framework in which the investigation is described. The case study is represented by the ancient compound of Stabiae, a site not yet completely disclosed and less enhanced, especially the complex of villa San Marco. About these architectures, the authors describe the fact-finding steps, starting to the further transformations since to the surveying investigations, finalized to the analysis of decorative elements.

Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by complement-mediated intravascular hemolysis due to the lack of CD55 and CD59 on affected erythrocytes. The anti-C5 antibody eculizumab has proven clinically effective, but uncontrolled C3 activation due to CD55 absence may result in opsonization of erythrocytes, possibly leading to clinically meaningful extravascular hemolysis. We investigated the effect of the peptidic C3 inhibitor, compstatin Cp40, and its long-acting form (polyethylene glycol [PEG]-Cp40) on hemolysis and opsonization of PNH erythrocytes in an established in vitro system. Both compounds demonstrated dose-dependent inhibition of hemolysis with IC50 ∼4 µM and full inhibition at 6 µM. Protective levels of either Cp40 or PEG-Cp40 also efficiently prevented deposition of C3 fragments on PNH erythrocytes. We further explored the potential of both inhibitors for systemic administration and performed pharmacokinetic evaluation in nonhuman primates. A single intravenous injection of PEG-Cp40 resulted in a prolonged elimination half-life of >5 days but may potentially affect the plasma levels of C3. Despite faster elimination kinetics, saturating inhibitor concentration could be reached with unmodified Cp40 through repetitive subcutaneous administration. In conclusion, peptide inhibitors of C3 activation effectively prevent hemolysis and C3 opsonization of PNH erythrocytes, and are excellent, and potentially cost-effective, candidates for further clinical investigation.

Hyaluronic acid (HA) treatment has been successfully performed in patients with recurrent upper airway infections or rhinitis. The aim of this study was to assess the efficacy and safety of the topical nasal administration of an HA-based compound by investigating its effects in children with recurrent or chronic middle ear inflammations and chronic adenoiditis. A prospective, single-blind, 1:1 randomised controlled study was performed to compare otoscopy, tympanometry and pure-tone audiometry in children which received the daily topical administration of normal 0.9% sodium chloride saline solution (control group) or 9 mg of sodium hyaluronate in 3 mL of a 0.9% sodium saline solution. The final analysis was based on 116 children (49.1% boys; mean age, 62.9 ± 17.9 months): 58 in the control group and 58 in the study group. At the end of follow-up, the prevalence of patients with impaired otoscopy was significantly lower in the study group ( P value = 0.024) compared to baseline but not in the control group. In comparison with baseline, the prevalence of patients with impaired tympanometry at the end of the follow-up period was significantly lower in the study group ( P value = 0.047) but not in the control group. The reduction in the prevalence of patients with conductive hearing loss (CHL) ( P value = 0.008) and those with moderate CHL ( P value = 0.048) was significant in the study group, but not in the control group. The mean auditory threshold had also significantly improved by the end of treatment in the study group ( P value = 0.004) but not in the control group. Our findings confirm the safety of intermittent treatment with a topical nasal sodium hyaluronate solution and are the first to document its beneficial effect on clinical and audiological outcomes in children with recurrent or chronic middle ear inflammations associated with chronic adenoiditis.

Background We investigated which factors are significantly associated with long-term quality of life after laparoscopic total fundoplication in the treatment of gastroesophageal reflux disease. Methods Patients (n = 144) were given a standardized frequency-intensity symptoms questionnaire and the Short-Form 36 Health Survey for quality-of-life evaluation before and after laparoscopic total fundoplication. Results At follow-up evaluation (n = 102), patients had a significant reduction in their symptoms score and no deterioration in quality of life. A significant association with postoperative dysphagia for solids and/or liquids was found in the physical component summary score of the Short-Form 36 administered to patients postoperatively ( P = .003). Conclusions In this study, laparoscopic total fundoplication was a safe and effective surgical treatment for gastroesophageal reflux disease, generally offering an improved long-term quality of life, with the exception of a minority of patients (6 of 102 patients; 5.8%) who experienced persistent severe dysphagia.

Franchignoni F, Giordano A, Sartorio F, Vercelli S, Pascariello B, Ferriero G. Suggestions for refinement of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH): a factor analysis and Rasch validation study. Objective To perform a comprehensive psychometric analysis of Disabilities of the Arm, Shoulder and Hand (DASH) to examine its properties and provide insights for an improved version. Design Methodologic research on cross-sectional data from a convenience sample. Setting A free-standing rehabilitation center. Participants Outpatients and inpatients (N=238; 56% men; mean age, 52.2y) with upper-extremity musculoskeletal disorders. Main Outcome Measure The official Italian version of DASH was analyzed by factor (both explorative and confirmatory) and Rasch analysis for evaluating dimensionality, functioning of rating scale categories, item fit, hierarchy of item difficulties, and reliability indices. Interventions Not applicable. Results Factor analysis established the presence of 3 underlying constructs related to manual functioning (items 1–5, 7–11, 16–18, 20, 21), shoulder range of motion (items 6, 12–15, 19), and symptoms and consequences (items 22–30). Rating scale diagnostics showed category malfunctioning. The fit to the Rasch model was good for all items except 4 (items 20, 21, 25, 26). Ten item pairs had high residual correlations after subtraction of the Rasch dimension (local dependency). A test model based on the 3 subscales suggested by factor analysis and corrected categories still showed misfitting in items 21 ("Sexual Activities") and 26 ("Tingling") and the presence of some dependent items. Conclusions Unidimensionality and the key domains identified by the original developers as the theoretic framework of DASH were not confirmed by our analyses. The response categories showed misfunctioning. "Sexual Activities" and "Tingling" misfit the Rasch model. Further detailed investigations of DASH are warranted, both to confirm these results in different health conditions and cultures, and to reanalyze in-depth content validity issues regarding the questionnaire.

The evolution of web technologies seems to characterize a new scenario for biomedical researchers who take advantage from sophisticated on to logies offered by scientific portals. This paper introduces the concept of BioContext, a software environment which combines services for the fully exploitation of several ontologies whose knowledge is captured, and managed in a local repository. We illustrate our ideas pragmatically by presenting BCnotes, a BioContext which enables the functional annotation of biomedical texts in order to discover important relationships among genes.