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In recent years, part of the scientific community has focused its attention on the involvement of the epithelial-mesenchymal trophic unit (EMTU) in mucosa remodeling, monitoring its role in chronic inflammatory lung diseases. The term EMTU is used to describe the anatomic and functional relationship between the attenuated fibroblast sheath and epithelial tissue, i.e. the signaling between epithelial cells and the underlying fibroblasts, which are in close indirect physical contact with the former. These interactions are important for many airway functions, such as differentiation during lung growth, repair of damaged tissue and regulation of inflammatory response. Several studies have indicated a key role for the EMTU in the processes that influence mucosae remodelling. These processes can be observed in different pathologies, such as asthma or chronic obstructive pulmonary disease (COPD). This review focuses on the primary role of the EMTU in mucosa remodeling, aiming to give a contribution to an issue that, if deepened may lead to more efficient treatments for the handling of chronic respiratory diseases. The close correlation between the reactivation of the EMTU in adult age and the onset of chronic diseases of the respiratory system is now widely accepted by the scientific community. It is therefore of fundamental importance to enhance our knowledge on its reactivation and the processes that lead to tissue remodeling. Pinpointing the key molecular pathways would provide new therapeutic targets for limiting the remodeling processes typical of subjects suffering from different types of airway pathologies.

The study investigated the correlation between the perception of sibling relationship to cope an adverse occurrence – the partial collapse of a primary school – and the indicators related to the traumatic impact set off by the event, by soliciting the child’s reminiscence of the catastrophic experience. One hundred trauma-exposed children were recruited from a Sicilian primary school and were administered the following research instruments: the Trauma Symptom Checklist for Children (TSCC-A), to investigate the traumatized response that can be triggered in the children involved; the Brother as a Resource Questionnaire (BRQ), to delve into the perception of sibling relationship as a resource. The outcomes showed statistically significant negative correlations between the Anxiety scale of the TSCC-A and the Scaffolding factors (r = −.260, p

BACKGROUND: Everolimus is a mammalian target of rapamycin inhibitor approved for the treatment of metastatic renal cell carcinoma (mRCC). We aimed to assess the association between pre-treatment neutrophil-to-lymphocyte ratio (NLR) and the outcome of patients treated with everolimus for mRCC.METHODS: Ninety-seven patients with mRCC were treated with everolimus till April 2013 in our institutions. Patients were stratified in two groups with NLR >3 (Group A) vs

Background. The limitations imposed by governments for containing the spread of COVID-19 have affected familial relationships, especially those of families dealing with children with special needs or chronic illness conditions. The current study aims to better understand what pathological/disability condition has impacted parental resources, sense of competence, and perception of children’s executive functioning the most. Methods. A sample of 648 parents was asked to answer a survey assessing children’s condition (typical development, specific learning disorder, autism spectrum syndrome, chronic illness), parental resources, parenting sense of competence (distinguished into parental satisfaction and self-efficacy), and parents’ perception of their children’s executive functioning. A MANOVA model was performed to assess differences in parental resources, sense of competence, and perception of the children’s executive functions according to their condition. A path analysis model was performed to examine the impact of sense of competence and children’s condition on parental resources and children’s executive functions. Results. Parents with children with specific learning disorder reported lower scores of parental resources in terms of total scores, common antecedents, and specific antecedents compared to parents with typically developed children (total scores: MD = 56.45, p < 0.001; common antecedents: MD = 22.28, p < 0.00; specific antecedents: MD = 34.17, p < 0.001), parents with autistic children (total scores: MD = 62.79, p = 0.01; common antecedents: MD = 24.03, p = 0.01; specific antecedents: MD = 38.76, p = 0.02) and parents of children with chronic illness (total scores: MD = 37.42, p = 0.04; common antecedents: MD = 16.59, p = 0.01). The path analysis model shows a direct effect of parental satisfaction (β = 0.26) and pathology/disability (β = −0.10) on parental resources that, in turn, influence parents’ perception of their children’s executive functioning (β = 0.24). Conclusion. Although no data about the prepandemic situation is available, the current study highlights that parental stress influence children’s cognition. Moreover, parents of children with special needs seemed to be challenged during COVID-19, especially parents of children with specific learning disorders, that are already stressed out by their children’s condition. Therefore, academic services should undertake preventive measures to preserve parental well-being and to provide a supportive environment for children, especially for those with atypical development.

Background: A growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy. Materials and methods: We carried out a retrospective analysis of prospectively collected data from consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population. Results: One hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS [hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268] and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed. Conclusions: The present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC.

This is the second of two papers concerning our study into an integrated approach to psychotic disorders conducted at the University Psychiatry Unit of Palermo's Polyclinic over approximately 15 years; this paper concentrates on the clinical phenomena. The study aimed to find the best possible treatment and to improve the prognosis of this patient group. We have explored the efficacy of a range of psycho-therapeutic (cognitive-behavioural, systemic-relational, psychodynamic, group and others), psycho-pharmaceutical, psychiatric rehabilitative and psycho-educational treatments, with a hermeneutic approach instead of a systematic one. The study's conclusions, described in the paper, are that all psychotic functions start with a nuclear psychic issue connected to emotional development. We describe how the most significant symptoms of acute psychotic manifestations (delusions and misperceptions) make use of an encrypted psychological meaning that can be decoded through the patient's symbolic language. This language is a key element in diagnosis and in the choice of treatment. The paper describes how we revised our understanding of psychosis from being a brain disease to being a process aimed at the rearrangement of psychic functioning. Our significant results are described.Ceci est le deuxième d’une série de deux articles consacré à notre étude d’une approche intégrée des troubles psychotiques, conduite sur une quinzaine d’années à l’Université de Palerme, dans le service de Polyclinique en Psychiatrie. Cet article se concentre sur les phénomènes cliniques. L’étude visait à trouver le meilleur traitement possible et à améliorer le pronostic pour ce groupe de patients. Nous avons exploré l’efficacité d’un éventail de traitements: psychothérapeutiques (cognitif-behaviouriste, systémique-relationnel, psychodynamique, de groupe, etc), psychopharmacologiques, de réadaptation psychiatrique, et les traitements psychopédagogiques. Notre approche est herméneutique et non pas systématique. Les conclusions de l’étude, décrites dans cet article, sont que tout fonctionnement psychotique commence avec un problème psychique central en lien avec le développement émotionnel. Nous décrivons comment les symptômes les plus significatifs de manifestations psychotiques aigues (délires et perceptions erronées) emploient un sens psychologique encrypté, qui peut être décodé par le biais du langage symbolique du patient. Ce langage est un élément clé dans le diagnostic et dans le choix du traitement. Cet article décrit comment nous avons révisé notre compréhension de la psychose, la considérant au départ comme une maladie du cerveau, puis finalement comme un processus visant le réaménagement du fonctionnement psychique. Nous décrivons ici nos importants résultats.Dies ist der zweite von zwei Beiträgen unsere Studie einen integrierten Ansatz bei psychotischen Störungen betreffend, die über einen Zeitraum von ungefähr 15 Jahren an der Universitätspsychiatrie der Poliklinik in Palermo durchgeführt wurde. Dieser Teil konzentriert sich auf die klinischen Phänomene. Ziel der Studie war es, die bestmögliche Behandlung zu finden und die Prognose dieser Patientengruppe zu verbessern. Wir haben die Wirksamkeit einer Reihe von psychotherapeutischen (kognitiv-verhaltenstherapeutischen, systemisch-relationalen, psychodynamischen, gruppentherapeutischen und anderen), psychopharmazeutischen, psychiatrischen Rehabilitations- und psychopädagogischen Behandlungen mit einem hermeneutischen Ansatz anstelle eines systematischen untersucht. Die in dieser Arbeit beschriebenen Schlußfolgerungen der Studie lauten, daß alle psychotischen Funktionen mit einem nuklearpsychischen Problem beginnen, das mit der emotionalen Entwicklung verbunden ist. Wir beschreiben, wie die wichtigsten Symptome akuter psychotischer Manifestationen (Wahnvorstellungen und Fehlwahrnehmungen) eine verschlüsselte psychologische Bedeutung nutzen, die durch die Symbolsprache des Patienten entschlüsselt werden kann. Diese Sprache ist ein Schlüsselelement bei der Diagnose und bei der Wahl der Behandlung. Der Beitrag beschreibt, wie wir unser Verständnis von Psychose von einer Gehirnkrankheit zu einem Prozeß überarbeitet haben, der auf die Neuordnung der psychischen Funktionen abzielt. Unsere signifikanten Ergebnisse werden beschrieben.Questo secondo articolo si concentra maggiormente sull’aspetto clinico del fenomeno psicotico, in relazione ai nostri studi condotti presso l’Unità Operativa di Psichiatria del Policlinico Universitario di Palermo per circa quindici anni. Lo studio è finalizzato a realizzare il miglior trattamento possibile ed a migliorare la prognosi di questo tipo di pazienti. Nel corso degli anni abbiamo valutato l’efficacia di diversi approcci psicoterapeutici (cognitivo comportamentale, sistemico-relazionale, psicodinamico individuale, di gruppo ed altro ancora), psicofarmacologici, psichiatrico-riabilitativi e psicoeducazionale, con un approccio ermeneutico più che sistematico. Le nostre valutazioni ci hanno portato alla convinzione che l’approccio di J.W. Perry sia la migliore forma di trattamento che abbiamo avuto modo di sperimentare e che è possibile adattarlo a differenti contesti di cura. La nostra esperienza ci ha condotti alla convinzione che, alla base del funzionamento psicotico, esista una problematica psichica nucleare riguardante lo sviluppo affettivo. Inoltre, abbiamo avuto modo di constatare come i sintomi più significativi della manifestazione psicotica acuta (deliri e dispercezioni) siano dotati di un significato psicologico criptato che può essere decodificato attraverso il linguaggio simbolico; tale significato simbolico rappresenta un elemento fondamentale per la diagnosi e per orientare il trattamento. Gli aspetti clinici della nostra esperienza sono riportati nelle prossime pagine.Это вторая из двух статей, в которых описано наше исследование интегрированного подхода к психотическим расстройствам. Исследование проводилось в университете Палермо в отделении психиатрии в течение 15 лет. В статье поставлен акцент на клинических феноменах. Исследование было направлено на поиск наилучшего возможного лечения и на улучшение прогноза для этой группы пациентов. Мы изучили эффективность различных психотерапевтических (когнитивно-бихевиорального, системно-реляционного, психодинамического, группового и других), психофармакологического, психообразовательного подходов и реабилатационной психиатрии. Мы пришли к выводу, что все психотические функции начинаются с ядерной психической проблемы, связанной с эмоциональным развитием. Мы описываем, как наиболее значимые симптомы острых психотических проявлений (бред, ложное восприятие) содержат зашифрованный психологический смысл, который может быть расшифрован с помощью символического языка пациента. Этот язык оказывается ключевым элементом в постановке диагноза и выборе лечения. Статья описывает пересмотр нашего понимания психоза: мы перешли от взглядов на психоз как на заболевание головного мозга к его пониманию как процесса, нацеленного на перестройку психического функционирования. Представлены наши значимые результаты.Este es el segundo de dos ensayos acerca de nuestro estudio sobre un abordaje integrado de los trastornos psicóticos, conducido en la Unidad Policlínica Psiquiátrica de la Universidad de Palermo durante aproximadamente 15 años. El presente trabajo da cuenta del fenómeno clínico. El estudio está orientado a encontrar el mejor tratamiento posible y a mejorar la prognosis de este grupo de pacientes. Hemos explorado la eficacia de un espectro de psicoterapias (cognitivo-conductual, sistémica-relacional, psicodinámica, de grupo, y otras), psico-farmacología, rehabilitación psiquiátrica, y tratamientos psico-educacionales, con un abordaje hermenéutico en lugar de uno sistemático. Las conclusiones del estudio descripto en el trabajo, dan cuenta que todas las funciones psicóticas comienzan con un problema psíquico nuclear conectado al desarrollo emocional. Describimos como los síntomas más significativos de las manifestaciones psicóticas agudas (delirios y percepciones erróneas) hacen uso de un sentido psicológico encriptado que puede ser decodificado a través del lenguaje simbólico del paciente. Este lenguaje es un elemento clave para el diagnóstico y elección del tratamiento. El artículo describe el modo en que hemos revisado nuestra comprensión de la psicosis, desde ser considerada una enfermedad cerebral hasta ser un proceso destinado a la reorganización del funcionamiento psíquico. Se describen nuestros resultados significativos.精神病, 象征, 易感性2-治疗精神紊乱的另一个视角 这是两篇论文的第二篇, 涉及我们在巴勒莫大学精神病学联合诊所15年以来, 关于精神紊乱的整合取向研究。这篇文章关注临床现象。研究目的是寻找最佳治疗方法, 以及提高病人群体的预后。我们以解释学的视角, 而非系统的视角探索了一系列治疗的效力, 包括一系列心理治疗 (认知行为, 系统关系, 心理动力, 团体及其它), 及精神药物, 精神病复原, 心理教育治疗。研究结果在文中显示, 所有精神功能都开始于与情绪发展相关的核精神议题。我们将描述严重精神病中最重要的症状 (妄想与知觉异常)如何将心理意义进行了机密的编码, 以及我们如何用病人象征的语言来对它进行解码。这一语言是诊断和治疗选择的关键元素。文章描述了我们如何从把精神病看作大脑的疾病, 转变为认识到这是一个心理功能重置到尝试过程。文章描述了我们最重要的研究结果。.

The epithelial–mesenchymal trophic unit (EMTU) is a morphofunctional entity involved in the maintenance of the homeostasis of airways as well as in the pathogenesis of several diseases, including asthma and chronic obstructive pulmonary disease (COPD). The “muco-microbiotic layer” (MML) is the innermost layer of airways made by microbiota elements (bacteria, viruses, archaea and fungi) and the surrounding mucous matrix. The MML homeostasis is also crucial for maintaining the healthy status of organs and its alteration is at the basis of airway disorders. Nanovesicles produced by EMTU and MML elements are probably the most important tool of communication among the different cell types, including inflammatory ones. How nanovesicles produced by EMTU and MML may affect the airway integrity, leading to the onset of asthma and COPD, as well as their putative use in therapy will be discussed here.

The study was conducted with 104 mothers (average age 32.5 years, SD 6.1) of preterm infants (very and moderately preterm but still healthy) to monitor the perceived maternal role competence from the time of hospitalisation to post-discharge, in order to define an intervention program to support mothers during this transition. A targeted Q-Sort tool (Maternal Competence Q-Sort in preterm birth) was applied at two different times as a self-observation tool for parenting competence in neonatology. A tendency towards dysregulation of the maternal role competence was detected, mainly in terms of low self-assessment and was found to worsen during post-discharge, particularly with regard to caregiving ability. This study suggests the importance of accompanying parenting competence in preterm birth conditions, not only during hospitalisation in the Neonatal Intensive Care Unit (NICU) but also following discharge in order to promote the development of premature infants. This paper reports in the last part a specific integrated psychoeducational intervention program (psychologist and nurses), which we defined precisely in light of the suggestions offered by the study data on perceived maternal competence created with the Q-sort.

A few reports suggest that molecular mimicry can have a role in determining the more severe and deadly forms of COVID-19, inducing endothelial damage, disseminated intravascular coagulation, and multiorgan failure. Heat shock proteins/molecular chaperones can be involved in these molecular mimicry phenomena. However, tumor cells can display on their surface heat shock proteins/molecular chaperones that are mimicked by SARS-CoV-2 molecules (including the Spike protein), similarly to what happens in other bacterial or viral infections. Since molecular mimicry between SARS-CoV-2 and tumoral proteins can elicit an immune reaction in which antibodies or cytotoxic cells produced against the virus cross-react with the tumor cells, we want to prompt clinical studies to evaluate the impact of SARS-CoV-2 infection on prognosis and follow up of various forms of tumors. These topics, including a brief historical overview, are discussed in this paper.

Background: Stomach diseases are an important sector of gastroenterology, including proliferative benign, premalignant, and malignant pathologies of the gastric mucosa, such as gastritis, hyperplastic polyps, metaplasia, dysplasia, and adenocarcinoma. There are data showing quantitative changes in chaperone system (CS) components in inflammatory pathologies and tumorigenesis, but their roles are poorly understood, and information pertaining to the stomach is scarce. Here, we report our findings on one CS component, the chaperone Hsp60, which we studied first considering its essential functions inside and outside mitochondria. Methods: We performed immunohistochemical experiments for Hsp60 in different samples of gastric mucosa. Results: The data obtained by quantitative analysis showed that the average percentages of Hsp60 were of 32.8 in normal mucosa, 33.5 in mild-to-moderate gastritis, 51.8 in severe gastritis, 58.5 in hyperplastic polyps, 67.0 in intestinal metaplasia, 89.4 in gastric dysplasia, and 92.5 in adenocarcinomas. Noteworthy were: (i) the difference between dysplasia and adenocarcinoma with the other pathologies, (ii) the progressive increase in Hsp60 from gastritis to hyperplastic polyp, gastric dysplasia, and gastric carcinoma, and (iii) the correlation of Hsp60 levels with histological patterns of cell proliferation and, especially, with tissue malignancy grades. Conclusions: This trend likely reflects the mounting need for cells for Hsp60 as they progress toward malignancy and is a useful indicator in differential diagnosis, as well as the call for research on the mechanisms underpinning the increase in Hsp60 and its possible roles in carcinogenesis.

This study has explored the valence of sibship that may empower the self-esteem of children with asthma at the interpersonal, environmental control competence, emotionality management, and body-image levels. It has been assumed that the relationship between siblings may have a moderating effect on the negative impact that asthma has on child’s development. Seventy children suffering from chronic asthma have been involved: 40 children with siblings (experimental group) and 30 sibling-free children (control group). The children with asthma have exhibited higher levels of self-esteem in comparison with the sibling-free children. The results of the study, at the clinical significance level, highlight how meaningful could be the involvement of healthy siblings to support the development, and to ease the compliance of children suffering from asthma. The outcomes have confirmed the supportive valence of sibship for the self-esteem of the children with asthma.

Il saggio analizza ruoli e funzioni del mediatore interculturale, individuando conoscenze e competenze professionali specifiche e ipotizzando percorsi formativi adeguati. In particolare si sofferma sulle competenze relative alle capacità di ascolto, di empatia, di entrare in relazione attraverso il canale verbale e non verbale e sulla necessità di un percorso centrato anche sullo sviluppo della consapevolezza di sé per potere entrare in contatto con l'altro.

Acute lymphoblastic leukemia (ALL) is a very distressing experience for children and requires a special effort of adjustment. Therefore, it seems to be crucial to explore coping resources for the experienced risk condition. In this sense, the study focuses on coping strategies and locus of control in children with ALL during the treatment phase, and on their possible relation. The correlation between children and maternal coping strategies is also investigated. The participants involved were an experimental group of 40 children with ALL and their mothers, and 30 healthy children as the control group. The tools used were: the Child Behavioral Style Scale and the Monitor-Blunter Style Scale to assess the coping strategies of children and mothers; the locus of Control Scale for Children to analyze the children’s perception of controlling the events. Both children with ALL and their mothers resorted to monitoring coping strategies with a statistically significant rate of occurrence (children: M=17.8, SD=3.8; mothers: M=10.48, SD=3.4). The data concerning the locus of control show this tendency towards internal causes (M=53.1, SD=4.7). There were statistically significant correlations between monitoring coping strategies and external locus of control (r=0.400, P

Background Measures of prognosis for cancer patients are typically evaluated at the time of diagnosis. However, this study assessed the changes in 2-year CS rates after first-line chemotherapy for metastatic UC. Patients and Methods Conditional overall survival and CPFS probability were estimated using the Kaplan-Meier method. Adjusted survival functions were stratified according to age groups (< 70 years vs. ≥ 70 years), sex, Eastern Cooperative Oncology Group (ECOG) performance status (PS; ECOG PSA ≤ 2 vs. ECOG PS > 2), pretreatment Hb levels (< 12 mg/dL vs. ≥ 12 mg/dL) and pretreatment NLR (< 3 vs. ≥ 3). Pairs of CS curves were compared using the Mantel-Haenszel log-rank test. Results Two hundred ninety-eight patients were included in this analysis, 233 were male, and their median age was 69 years. First-line median overall survival and progression-free survival were 10.7 months (95% confidence interval [CI], 9.6-12.6) and 6.0 months (95% CI, 5.5-7.1), respectively. CPFS and COS showed an increasing trend in the population considered (b = 0.35; P

Background: Increased neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation, is associated with poor outcome for various types of cancers. We assessed the role on outcome prediction of NLR at baseline and persistent during first-line chemotherapy in patients with advanced urothelial cancer. Methods: We retrospectively reviewed 292 patients with unresectable or metastatic urothelial cancer treated with first-line chemotherapy between January 2003 and December 2012. The cutoff values of NLR (>3 vs.12g/dL), pretherapy NLR (>3 vs.3 vs.≤3). Results: Patients with pre- and follow-up NLR of>3 had a median progression-free survival of 3.2months and a median overall survival of 5.7months. In multivariate analysis, visceral metastases, pretherapy hemoglobin, and follow-up NLR were significant predictors of progression-free survival [hazard ratio (HR) 1.75, P=0.0001; HR 1.57, P=0.0015; HR 2.77, P&nbsp

Oggetto di analisi è il territorio compreso tra Reno e Panaro, considerato attraverso la valutazione delle testimonianze archeologiche che ha restituito. Tra queste particolare attenzione è rivolta alle testimonianze di scultura e in particolare agli interessanti segnacoli funerari di età orientalizzante restituiti da questo comparto territoriale.

Analisi di un capitello frammentario conservato nel museo, che è la sola testimonianza superstite dell'antica chiesa di Santo Stefano della Rocca di Bazzano.

Dai rilevamenti condotti sul territorio collinare e montano bolognese nel 1972/75 è stato ricavato un ampio repertorio, in gran parte inedito, di edifici storici appartenenti ai tipi d'area geomateriale litica e mista. Questo patrimonio viene studiato all'interno di ricerche universitare, e analizzato nelle sue componenti costitutive, ai fini di corretti riuso e riqualificazione funzionale. In questo capitolo si evincono i caratteri formali, costruttivi e materici dell'edilizia storica rurale della Valle del Torrente Samoggia.

Si prendono in considerazione i diversi apporti di fonti scritte e materiali per lo studio di un territorio medievale.