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Testi e materiali iconografici della Mostra "Cantiere Periferie. Alla ricerca d'una città normale. Il ruolo dei quartieri di edilizia pubblica nell'espansione urbana degli ultimi cinquant'anni in Italia", organizzata dal MIBACT e tenuta a Roma, Archivio Centrale di Stato da aprile a giugno 2016. Curatore della sezione SUD.

Negli ultimi anni, la valutazione del sonno ha acquisito una notevole attenzione e rilievo tra i medici e i ricercatori. L'obiettivo di ottenere i dati del sonno in studi su larga scala è stato quasi raggiunto nel corso degli ultimi anni. Questi studi dimostrano che è possibile identificare i disturbi del sonno per mezzo di una cronistoria del sonno, tra cui i tempi e la regolarità di andare a dormire, i risvegli notturni, il tempo di sveglia della mattina etc. I disturbi del sonno nei pazienti anziani possono essere classificati in due gruppi: disturbi del sonno primari e secondari. I disturbi del sonno primari includono sleep disordered breathing (SDB), REM sleep behavior disorder (RBD), restless leg syndrome (RLS), and periodic limb movement in sleep (PLMS). I disturbi del sonno secondari sono causa di malattie con dolore cronico e disagio, tra questi l'urinazione frequente durante la notte, dispnea e farmaci che interferisce con il sonno etc [1].

Introduction: A rare tumour of the lung (RTL) is defined as neoplasm whose incidence is lower than 2% of all pulmonary tumours. Such group includes different benign and malignant lesions with variable occurrence rate. Aim of this study was to retrospectively analyze a single centre surgical experience and com- pare it with the literature. Patients and Methods: From February 2002 to April 2009 twenty-four patients underwent resection for RTL. Different procedures were utilized, including operative rigid bronchoscopy, wedge resection, lobectomy, pneumonectomy, and bronchoplastic procedures. All patients entered a follow-up program (median 22, range1-79 months). Results: According to the 2004 WHO classification 6 patients had benign (Group A) and 18 malignant (Group B) RTL. Group A: endobronchial hamartoma (n=1) endobronchial lipoma (n=1), endobronchial fibroepithelial polyp (n=1), benign fibrous hystiocitoma (n=1) and sclerosing hemangioma (n=2). Group B: pulmonary blastoma (B1, n=1), mucoepidermoid carcinoma (B2, n=1), adenoid cystic carcinoma (B3, n=3), inflammatory myofi- broblastic tumour (B4, n=1), pulmonary synovial sarcoma (B5, n=3), dendritic follicular cells sarcoma (B6, n=1), pleomorphic carcinoma (B7, n=2) spindle cell carcinoma (B8, n=2), and carcinosarcoma (B9, n=4). Symptoms were present mostly in centrally- located neoplasms (10/24, n=3 Group A and n=7 Group B). Two patients were lost at follow-up. Three patients with B9 died of the disease (median 14 months, range 4-15), one B8 immunocompromised patient had progressive disease after 3 months, the remaining are present alive without evidence of disease. Conclusions: Our results substantially reflect the literature data. A multicentre study would add to the knowledge of this heterogeneous group of tumours.

Introduction: Talc is currently the most common agent used for pleurodesis. Despite its role acknowledged as an effective bed side strategy primarily in neoplastic pleural effusion, recently it has been introduced in the treatment of benign diseases such as spontaneous pneumothorax. Aim of this study is to investigate side effects and results of different concentrations of talc pleurod- esis (TP) in rabbits. Materials and Methods: Twenty-six New Zealand rabbits were randomly injected intrapleurally with saline (n=6) or talc slurry at usual dosage 40mg/kg (T40, n=10) and 200mg/kg (T200, n=10). Chest tube was opened at day1 post-operative and removed in day4. Clinical signs and symptoms, fluid lactate dehydrogenase and protein levels were measured daily after the injection until drainage removal, then on day7 and before sacrifice. All groups were equally divided in two endpoints: day14 and day28. At post- mortem examination, pleurodesis was graded, according to Light criteria, from 1(none) to 8(>50% symphysis), by two observers blinded to treatment groups. Results: Adverse reactions were discovered with fever and weight loss in T200 group at 14 and 28 days. Pleurodesis score in the control Saline was negative while it did not differ significantly between T200 (4.0±1.4 at 14 days, 4.2±1.6 at 28 days) and T40 (2.8±2.0 at 14 days, 3.6±1.9 at 28 days) at days 14 and 28 (p=0.25 and p=0.56 respectively). Microscopically several granulomas, moderate localized pleural thickness, few areas of neoangiogen- esis and mediastinal lymphathic tissue infiltration were present in both study groups. Conclusions: TP at usual clinical dosage is well tolerated with acceptable clinical results. By increasing the concentration we observed severe side-effects with only mild improvement of pleurodesis.

Introduction: Uterine leiomyomas belong to a heterogeneous family of tumors with peculiar biological behaviour. Pulmonary metastases may originate from frankly malignant leiomyomas (sarcomas) as well as from so called benign metastasizing leiomyomas. Latency between hysterectomy and metastatic disease may vary from few months to several years. We report two cases with an exceptionally long latent period. Methods: Two cases of apparently primary giant lung tumor were observed. Both presenting clinical history of fever and malaise. Chest x-ray showed in both cases a left pulmonary opacity. Preoperative work-up yielded the diagnosis respectively of epithelial and mesenchymal tumor without extrapulmonary localization (CT and PET-CT). Results: Case N 1: 68 year-old (Z.A.), the giant lobulated tumor, invading the hilar structures, required a left pneumonectomy. Histology revealed a metastatic uterine leiomyoma. She had under- gone hysterectomy for multiple leiomyomas 21 years previously. Case N 2: 66 year-old (M.M), was submitted to left pneumonectomy for a giant tumor extended to both lobes. Also in this case metastasis from uterine leiomyoma was diagnosed and confirmed by comparison with histology from hysterectomy (performed 16 years previously). There was no peri-operative mortality. Both the patients are alive without evidence of disease 6 and 3 months after surgery. Discussion: These cases suggest that the diagnosis of primary pulmonary sarcoma needs careful pathological assessment and follow-up of the patients submitted to hysterectomy for leiomyoma should be protracted.

Introduction: Different etiologies are responsible for a wide spectrum of tracheal injuries. Some of these, such as cicatricial laryngo-tracheal stenosis and tracheoesophageal fistula (T-E) not rarely represent a challenge in tracheal surgery. Aim of this study is to retrospectively review the pattern of post-intubation lesions, extension of surgery and long term results in 49 patients. Methods: From December 1987 to February 2007, 49 patients (23 males and 26 females), mean age 50 (range 15–78), were submit- ted to surgical treatment: cicatricial tracheal stenosis (Group A), T-E fistula (Group B), and tracheal tear (Group C). All patients were symptomatic. Results: No post-operative deaths. In Group A (n = 34) the stricture was considered moderate (residual lumen:30–50%) in 27 patients, and severe (

La realizzazione di una Smart City è un processo molto complesso e di lungo periodo: è necessaria una profonda conoscenza della realtà locale, dei bisogni della collettività e dei singoli individui, delle criticità e dei servizi che devono essere gestiti e garantiti. I servizi di e-health sono un tassello fondamentale verso la realizzazione di una smart city dal punto di vista socio-sanitario. In questo contesto, il progetto e-SHS, non solo si occupa di servizi e-ealth, in particolare per soggetti fragili, ma propone strumenti innovativi per la loro inclusione sociale e l'incremento della solidarietà sociale. L'obiettivo principale di e-SHS è la realizzazione di un primo nucleo di una piattaforma per lo sviluppo di servizi personali e personalizzati basati sull'uso di tecnologie ICT innovative e non invasive nel settore della salute e della solidarietà sociale. Il centro del sistema è rappresentato dall'utente-paziente verso il quale sono definiti e sviluppati servizi di monitoraggio e supporto costante nella gestione della propria salute e del proprio stile di vita, al fine di migliorarne la qualità della vita ed aumentarne l'autonomia e l'indipendenza nelle attività quotidiane, sia in ambiente domestico che in ambienti esterni. Gli utenti verso i quali questo progetto si indirizza sono persone anziane, con problemi di riabilitazione motoria, con parametri vitali da tenere sotto controllo e con disturbi del sonno. Per la sperimentazione saranno coinvolti soggetti volontari. In particolare, e-SHS include servizi per: 1) il monitoraggio di parametri vitali degli utenti 2) il supporto all'esecuzione di attività riabilitative in ambiente domestico; 3) un supporto per monitorare le interazioni sociali degli utenti e migliorarne l'inclusione sociale nelle attività quotidiane; 4) lo sviluppo di reti di supporto sociale che coinvolgono pazienti, familiari, assistenti (i.e., caregivers), allo scopo di promuovere la continuità di assistenza socio-sanitaria in diversi ambienti. Le competenze presenti nel settore "ICT for health, care and well-being" negli 11 istituti del CNR partecipanti al progetto vanno ben oltre quelle che saranno utilizzate in questo progetto. In questo documento si intende presentare le principali attività di ricerca svolte nei singoli istituti ed attinenti al progetto e-SHS, cercando di evidenziare il filo conduttore che porterà alla definizione di un'unica architettura di sistema.

Il progetto sottende il tentativo di costruire un percorso metodologico capace di prefigurare una “Venezia possibile”. L’obiettivo di fondo è quello della costruzione di una nuova centralità lungo il Canal Grande e all’interno del tessuto della città. L’area con più ampio grado di trasformabilità, almeno in potenza, è quella del campo San Vidal con la relazione tra la chiesa ed il convento della Carità che, per la sua interna ripetibilità contenuta nel progetto Palladiano, rimanda fino alle Zattere.

The bronchial tree represents the most frequent site of origin of carcinoids (around 25% of the total). The spectrum of differentiation of lung neuroendocrine tumors ranges from low-malignancy (carcinoids) to highly aggressive forms (small cell lung carcinoma) Diagnostic and therapeutic strategies therefore vary greatly. In well differentiated tumors (carcinoids) signs and symptoms are related to the airways obstruction in central forms, while peripheral forms are mostly discovered accidentally if asymptomatic. Clinical or subclinical paraneoplastic syndromes are associated in a minority of cases. Diagnostic work-up includes CT multislice, bronchial endoscopy and Octreoscan with chest Single Photon Emission Computed Tomography (SPECT). Further contribute may be added by the (68), Ga-DOTA-D-Phe(1)-Tyr(3)-ocreotide (DOTATOC) and 5-hydroxytryptophan (5-HTP) PET-CT, at present available only in a few centres, and by endobronchial ultrasound (EBUS), fluorescence bronchoscopy and virtual bronchoscopy. Surgery is the treatment of choice, while medical therapy is useful to treat the hypersecretion in paraneoplastic syndromes and to control tumor proliferation in metastatic or/and inoperable disease.