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La chiesa di Santa Maria Maggiore della Pietrasanta fu progettata da Cosimo Fanzago tra il 1653 e il 1667 e sorge sulle rovine di una basilica eretta da Pomponio, vescovo di Napoli, tra il 514 e il 532 nel centro storico di Napoli. La presenza di un'antica pietra sacra, con una croce incisa, ha dato origine alla denominazione più comune di Chiesa della Pietrasanta In questo articolo, gli autori, dopo una descrizione dettagliata delle tecnologie, innovative e tradizionali, per il restauro, illustrano criticamente le tecnologie applicate all'ipogeo, agli stucchi e ai dipinti della Chiesa su tela, evidenziando i risultati raggiunti.

This work reports the result of a research activity conducted in Bolivia in the year 2020, in synergy between Bolivian Polytechnic University School "Josè Maria Nunez del Prado", University of Naples Federico II and Pegaso Telematic University. In particular, the research had as its object the study of a housing unit suitable for coping with the floods that frequently afflict some Bolivian peasant populations. During the research, much attention was initially paid to the historical, political, socio-economic aspects and to the cultural and traditional characteristics of the ethnic groups that make up the population of Bolivia; subsequently, the morphology and hydrography of the Bolivian territory were examined, as well as the climate, the trend of rainfall and the El Niño and La Niña phenomena that often cause floods with serious risks for the populations, especially rural ones. Having completed these first two phases of the research, the authors moved on to the study of the traditional construction characteristics of rural architecture, paying particular attention to the basic construction materials used in the peasant areas of Bolivia, in particular to raw earth and bamboo, as well as the principles and rules that regulate the construction of rural housing in Bolivia. For rural architecture, the traditional Pawichi house and the traditional dwellings of the indigenous Chiquitana population were examined in detail. Only after having acquired all these important aspects, the research became interested in the design of a new rural house which, respecting Bolivian cultural traditions, would be able to cope with floods and reduce the risks associated with them. In the design of this new emergency housing unit, the authors focused their attention not only on the compositional and functional aspects of the housing unit, but also on the constructive aspects by designing new structural elements such as the pillars made with five bamboo canes suitably linked together. with knots of the Andean construction tradition. The composition of the housing unit proposed by the authors is governed by a basic 4x4 module that can be full, or delimited by infill and window frames, or empty, or without surrounding infill elements to allow the creation of the traditional place for socialization, the Punilla. Never as in this case have, I been particularly happy with the invitation formulated by the authors, and in particular by the young researchers, Francesca Volpe and Emanuele La Mantia, to present their work. In fact, I was able to see the procedural quality of the research and the intelligent design procedure that led to the definition of a housing prototype of great interest for the Andean populations.

The gol that the authors have set themselves, through the recovery of the Dogana at Ponte della Maddalena, a historical building in total abandonment, is to create a structure that, together with other buildings already present in the Neapolitan territory, from a "welcome network and hospitality" for the many tourist who arrive in Naples.

Le cause di aggressione dovute all’ambiente possono essere formalmente suddivise in chimiche, fisiche, meccaniche e biologiche (tabella 4.1). In realtà, difficilmente in un processo di degradazione esiste un solo fenomeno aggressivo, spesso sono più cause che concorrono al deterioramento del materiale; tuttavia però esiste sempre quella che può essere definita la causa fondamentale che innesca il processo degradante. Per garantire la durabilità delle strutture in calcestruzzo armato ordinario o precompresso, esposte all’azione dell’ambiente, si devono adottare i provvedimenti atti a limitare gli effetti di degrado indotti dall’attacco chimico, fisico e derivante dalla corrosione delle armature e dai cicli di gelo e disgelo, in relazione alla norma europea UNI-EN 206-1. In accordo con la norma UNI-EN 206-1 e con quella italiana UNI 11104 il livello di rischio per una determinata opera dipende dall’ambiente cui la stessa è esposta. The causes of aggression due to the environment can be formally divided into chemical, physical, mechanical and biological (table 4.1). In reality, in a degradation process there is hardly a single aggressive phenomenon, often there are several causes that contribute to the deterioration of the material; however, there is always what can be defined as the fundamental cause that triggers the degrading process. To ensure the durability of ordinary or pre-stressed reinforced concrete structures exposed to the action of the environment, measures must be taken to limit the effects of degradation induced by chemical and physical attack and resulting from the corrosion of the reinforcements and cycles of freeze and thaw, in relation to the European standard UNI-EN 206-1. In accordance with the UNI-EN 206-1 standard and the Italian UNI 11104 standard, the level of risk for a given work depends on the environment to which it is exposed.

Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients ( F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) ( χ 2 10.4; p < 0.001 ), neutrophil-to-lymphocyte (NL) ratio ( χ 2 7.6; p = 0.006 ), and platelet count ( χ 2 5.39; p = 0.02 ), along with age ( χ 2 87.6; p < 0.001 ) and gender ( χ 2 17.3; p < 0.001 ), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL ratio > 4.68 was characterized by an odds ratio for in-hospital mortality OR = 3.40 (2.40-4.82), while the OR for a RDW > 13.7 % was 4.09 (2.87-5.83); a platelet count > 166,000 /μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.

In this paper it is presented a search for architectural restoration and urban redevelopment of the Market Square in Naples. What is common to the Anjou, the Masaniello revolution and Ferdinand IV of Borbone with the architect Francesco Sicuro? A square, Piazza Mercato, which for many centuries was a beat-ing heart of Naples and Neapolitans. This great City shopping center, opened in 1270 by Charles I of Anjou, after the first post-war period has been affected by a slow decline that brought the wonderful square to become a huge parking lot and saw the eitht-century fountains that adorn subjected to constant vandalism. To-day in the Market Square, as in many other places and here perhaps more than others, it is spectacularly photographed the historical stratification: there coexist the speculation of the fif-ties and sixties and the survival of quality architecture. A set, therefore, of great historical, urban, architectural and social that today is in a state of disrepair and has largely lost its ancient and vibrant shopping destination and trade. In this arrangement it becomes import the disproportionate volume of Palazzo Ottieri that if one side has denied the sea, on the other hand has strengthened the market castrum character. The research is divided into three phases: 1 “History”, which is conducted in-depth historical analysis of the sites; 2 “The existing Town Planning Tools”, which is studied either both the urban layout of the place or the set of existing planning instruments; 3 “The Project”, in which we propose a hypothesis building restoration of the facades and regeneration hypothesis of places to return to the square its former main function, that of “THE MARKET”

The engineering approach in the design of fire prevention allows the engineer to study fire pre-vention solutions that do not meet the requirements of the Rules provided that they ensure the same level of fire safety. To design interventions appropriate to ensure the fire resistance of structures, and in particular for the steel structures, the performance approach of the Rules requires the adoption of prede-fined solutions as a function only of the structural material and the required fire resistance. The performance approach of the Norms, therefore, does not take into account the loads acting on the structural element and the critical temperature, which is the temperature at which the load that can be worn in hot equals the exercise load. Often, during the design phase, some of the requirements of rules are difficult, if not impossible to meet. A practical example is that of a restoration project of a historic building, for which interventions are required non-invasive, reversible and compatible. In this paper it is presented a study that enables you to design interventions appropriate to en-sure the fire resistance of structural elements with an analytical method and, therefore, with an engineering approach. In particular, according to the fire scenario adopted, the analytical method proposed allows to determine the critical temperature of the structural element under study, depending on the working load, the resistant section and solicitation of project. Subsequently, depending on the critical temperature and the required fire resistance, it is possible to design the appropriate fire-fighting interventions.

In this paper it is presented a research for the enhancement, the reuse and the architectural recovery of the holy monument Annunziata, located in Cava de 'Tirreni (SA). The Annunziata resort is one of the oldest farmhouses: it’s located on the south-eastern slope of Mount Castello and it’s a destination for tourists and pilgrims from all over Italy who visit the "Little Lourdes", that is a faithful reproduction of the famous French cave. The large architectural complex, dating to 1506, is characterized by multiple layering, alterations and extensions and it includes the church of the Annunziata with its pertaining premises, the sacristy, the bell tower, the baroque St. Andrea’s chapel and the imposing structure of the former monastery with various venues, the cloister, the oratory, the pertaining spaces open. Due to its architectural value and the amplitude of its built-up volumes, it has an important urban role in the context. Starting from a thorough historical analysis of the monument and analyzing the technological and constructive systems used, it is expected to intervene by first defining a restoration project aimed at enhancing in particular the interior environments, the structural elements and finishes of the church and its pertaining premises, in full respect of the constraints of the Superintendence for the Cultural Heritage and Activities of the Campania Region, to which the building organization is subject. A second intervention is then aimed at the retraining and reuse of the former monastery, including the cloister, the oratory, the perpetual areas and the open spaces, attributing the building to a new destination, that is compatible with both the typological features originated and the capacity of the structural elements, in full respect of architectural constraints.

OBJECTIVES: This study evaluated the virological efficacy of dolutegravir 50 mg twice daily in 190 HIV-1 failing antiretroviral-experienced patients with previous exposure to first-generation integrase strand transfer inhibitor (INSTI) over a 5 year follow-up using data from clinical practice. PATIENTS AND METHODS: This analysis included HIV-1-infected patients who were ≥18 years of age, treatment experienced, had HIV-1 RNA >50 copies/mL, with INSTI-resistant virus, who started dolutegravir 50 mg twice daily plus optimized background therapy (OBT), recorded in the national prospective database PRESTIGIO (www.progettoprestigio.it). Follow-up accrued from the start of dolutegravir 50 mg twice daily + OBT until virological failure (VF) or dolutegravir discontinuation for any reason or the last treatment visit on dolutegravir 50 mg twice daily treatment. VF was defined by the lack of achievement of HIV-1 RNA 100000 copies/mL (adjusted HR = 4.73, 95% CI = 1.33-16.78, P = 0.016) and with ≥1 INSTI mutations plus Q148H/K/R/N and the G140S/A/C as compared with other subjects (adjusted HR = 4.18, 95% CI = 1.32-13.23, P = 0.015). CONCLUSIONS: Our data showed a favourable long-term efficacy of dolutegravir 50 mg twice daily in association with OBT in treatment-experienced failing subjects, with INSTI-resistant virus, in the real world. A close monitoring of adherence is crucial for maintenance of virological response in this fragile subgroup of subjects.

Knowledge of the pathogenic mechanisms of severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2) is certainly a priority for the scientific community. Two main elements are involved in the biology of the most severe forms of coronavirus disease 2019 (COVID-19): the direct cytopathic effect of the virus against the host tissues, and a dysfunction of the immune system, characterized by the exhaustion of T lymphocytes. The exhaustion of T cells in COVID-19 is poorly understand, but some data could suggest a possible role of PD-1/PD-L1 axis. The aim of this study was to evaluate the possible role of PD-L1 expression in the pulmonary tissue in subjects affected by COVID-19. The presence of SARS-CoV-2 in the pulmonary tissue, and its exact location, was indagated by in situ hybridization; the expression of PD-L1 and CD8 in the same tissue was indagated by immunohistochemistry. Overall, PD-L1 resulted diffusely expressed in 70% of the cases, and an intense expression was observed in 43.5% of cases. Diffuse and intense presence of SARS-CoV-2 by in situ hybridization significantly correlated with an intense PD-L1 expression, and with expression of PD-L1 by pneumocytes. PD-L1 is overexpressed in the pulmonary tissue of subjects died from COVID-19, and mainly in subjects with a high viral load. These data suggest a possible role of PD-L1 in the immune system exhaustion at the basis of the severe forms of the disease.

Post-mortem examination plays a pivotal role in understanding the pathobiology of the SARS-CoV-2; thus, the optimization of virus detection on the post-mortem formalin-fixed paraffin-embedded (FFPE) tissue is needed. Different techniques are available for the identification of the SARS-CoV-2, including reverse transcription polymerase chain reaction (RT-PCR), immunohistochemistry (IHC), in situ hybridization (ISH), and electron microscopy. The main goal of this study is to compare ISH versus RT-PCR to detect SARS-CoV-2 on post-mortem lung samples of positive deceased subjects. A total of 27 samples were analyzed by RT-PCR targeting different viral RNA sequences of SARS-CoV-2, including envelope (E), nucleocapsid (N), spike (S), and open reading frame (ORF1ab) genes and ISH targeting S and Orf1ab. All 27 cases showed the N gene amplification, 22 out of 27 the E gene amplification, 26 out of 27 the S gene amplification, and only 6 the ORF1ab gene amplification. The S ISH was positive only in 12 out of 26 cases positive by RT-PCR. The S ISH positive cases with strong and diffuse staining showed a correlation with low values of the number of the amplification cycles by S RT-PCR suggesting that ISH is a sensitive assay mainly in cases carrying high levels of S RNA. In conclusion, our findings demonstrated that ISH assay has lower sensitivity to detect SARS-CoV-2 in FFPE compared to RT-PCR; however, it is able to localize the virus in the cellular context since it preserves the morphology. Supplementary Information The online version contains supplementary material available at 10.1007/s00428-021-03262-8.

Confrontando la manutenzione dell’ambiente costruito con la stessa attività riferita, in genere, ai prodotti manifatturieri, importanti caratteristiche specifiche emergono, sia nelle tecnologie di processo che di prodotto. Infatti, per le costruzioni lo stretto legame tra manutenzione e qualità acquisisce, in più, notevoli implicazioni di ordine sociale e collettivo, sia se applicata a edifici e spazi pubblici, sia se riferita all’edilizia residenziale privata. Nonostante ciò, tenendo conto della tendenza al “constructuring” che sembra indirizzare il futuro dell’edilizia sotto gli influssi della digitalizzazione, è ugualmente utile tener presente gli avanzamenti nel campo della manutenzione nella produzione manifatturiera, fra tradizione, consumismo, sostenibilità e digitalizzazione. Dopo aver sviluppato alcune questioni di ordine generale, il contributo approfondisce il tema focalizzando lo scenario italiano. Gli approfondimenti scientifici e gli sviluppi normativi sulla manutenzione edilizia vengono sintetizzati, evidenziando lo iato con la realtà operativa, caratterizzata da ostacoli socio-economico e culturali. La netta predominanza del calcestruzzo di cemento armato nelle costruzioni italiane dell’ultimo secolo porta a argomentare che esisterà una profonda differenza: da un lato, le future costruzioni ex novo, in cui una cultura tecnica ormai orientata sulla qualità potrà agevolare l’attuazione di efficaci interventi manutentivi; dall’altro le costruzioni ereditate dal recente passato, per le quali una manutenzione sostitutiva, che accompagni graduali processi realistici di rinnovo, rimpiazzerà gli abituali interventi manutentivi, non più sufficienti. Mentre ci si chiede quanto resta della notte perché una diffusa qualità dell’ambiente costruito possa rendere bastevoli processi di mantenimento, la sentinella biblica ci suggerisce una risposta (“se volete domandare, domandate” [Is 21,11]), indicando la strada - irta ma irrinunciabile - di un generale ripensamento sulla cultura della costruzione, condiviso in chiave olistica. Comparing the maintenance of the built environment with the same activity applied to the generality of manufacturing products, important specific characteristics emerge, both in process and product technologies. In fact, the close link between maintenance and quality for the built environment acquires, plus, more significant implications of a social and collective nature, both if applied to buildings and public spaces, and if it refers to private residential constructions. Despite this, taking into account the trend towards “constructuring” that seems to direct the future of construction under the influence of the digitalization, it is equally useful to keep in mind the advances in the field of maintenance in manufacturing production, between tradition, consumerism, sustainability and digitization. After having developed some general issues, the contribution explores the theme by focusing on the Italian scenario. The scientific insights and regulatory developments on building maintenance are summarized, highlighting the hiatus with the operational reality, characterized by socio-economic and cultural obstacles. The clear predominance of reinforced concrete in Italian constructions of the last century leads to the argument that there will be a profound difference: on the one hand, future constructions ex novo, in which a technical culture now oriented towards quality can facilitate the implementation of effective maintenance interventions; on the other hand, the buildings inherited from the recent past, for which a replacement maintenance, which accompanies gradual realistic renewal processes, will replace the usual maintenance interventions, which are no longer sufficient. While one wonders what is left of the night what of the night so that a widespread quality of the built environment can make maintenance processes sufficient, the biblical watchman suggests an answer («If you would ask, then ask; and come back yet again» [Is 21:11]), indicating the way - steep but indispensable - of a general rethinking on the culture of construction, shared in a holistic key.

The Mediterranean civilisation, in its millenary history, has also expressed itself through particular artefacts that have strongly characterised the territory. Knowledge of the artefacts that "qualify" a territory, both in historical and material terms, is a necessary prerequisite for tackling the planning and management problems relating to their protection and conservation. The architecture of the "vernacular" is linked to domestic life, customs, the "dialects" of places and the essence of the Genius Loci. The building heritage of the islands surrounding Sicily features special building techniques and systems that exploit natural resources to generate original artefacts and extremely functional building technologies that can be re-evaluated in terms of eco- sustainability. To speak of architecture on the island of Pantelleria is to discover the ancient links between materials, techniques and landscape. The island is well known for its dammusi, interesting artefacts both for their morphological characteristics and their technological-constructive profile. These artefacts are important traces of an ancient building tradition where the domestic space was created in direct relation to the natural environment and developed in relation to daily needs. The study intends to describe the evolution of this building typology and to highlight the presence of the 'palazzetto' in the Pantelleria area, which from the typological and technological-constructive research carried out can be considered a derivative of the dammuso itself. This study is the result of a research that, starting from the identification of the artefacts (often integrated and sometimes made unrecognisable by the expansion building) and from the survey of the factory, comes to the classification of building types and construction techniques.

Unfinished constructions represent a contemporary unresolved problem, especially in the Italian scenario. Despite the different type, original intended use and location, the reinforced concrete used as structural material denotes a common distinctive feature of these constructions. In recent decades, this phenomenon has been the object of scandal campaigns, mostly referred to public Administrations. By contrast, various publications and exhibitions have extensively investigated the potentials of unfinished constructions, arousing the interest of academics and designers. Nevertheless, on an operational level the issue still appears unsolved. Indeed, the incomplete constructions bring up technical and methodological problems finding no confirmation at the regulatory and legislative level, to the present day. The proposed article is part of a research line that has already explored the phenomenon of unfinished constructions from a theoretical point of view. It aims at developing the subject, precisely referring to the reinforced concrete as the main building material. In addition to the diagnosis problems and the restoration of the damaged structures, often characterized by advanced states of decay due to the condition of incompleteness, the article provides ideas and tools maintenance- oriented.

Introduction Molar pregnancies belong to a group of diseases classified as gestational trophoblastic diseases, which result from an altered fertilization. Partial molar pregnancy with a live fetus is a very rare condition, occurring in 0.005 to 0.01% of all pregnancies; it presents a challenging diagnosis, especially when clinical signs are almost completely absent. Case presentation Here we report a rare case of partial molar pregnancy in which a normal-appearing male fetus with diploid karyotype was delivered at 31 weeks gestation by a 37-year-old white woman. The pregnancy was characterized by an episode of threatened abortion in the first trimester and an ultrasonographic diagnosis of intrauterine growth restriction. Our patient did not report any suspicious symptoms for trophoblastic disease. Due to impaired umbilical artery velocimetry with an absence of the diastolic phase, she underwent an emergency caesarean section at 31 weeks and delivered an 880 g male baby. The male baby was normal without any complications at 3-month and 12-month follow-up and the mother had no evidence of recurrence after 3 and 12 months of follow-up. Pathological examination of the placenta showed changes of partial hydatidiform mole. Conclusion Partial molar pregnancy with a live fetus is a very rare condition that presents a challenging diagnosis. Recognizing it is of primary importance for patient care and the placenta should always be investigated at birth, especially in a newborn with intrauterine growth restriction.

Papillary thyroid carcinomas (PTCs) have an excellent prognosis, but a fraction of them show aggressive behavior, becoming radioiodine (RAI)-resistant and/or metastatic. AXL (Anexelekto) is a tyrosine kinase receptor regulating viability, invasiveness and chemoresistance in various human cancers, including PTCs. Here, we analyze the role of AXL in PTC prognosis and as a marker of RAI refractoriness. Immunohistochemistry was used to assess AXL positivity in a cohort of human PTC samples. Normal and cancerous thyroid cell lines were used in vitro for signaling, survival and RAI uptake evaluations. 38.2% of human PTCs displayed high expression of AXL that positively correlated with RAI-refractoriness and disease persistence or recurrence, especially when combined with v-raf murine sarcoma viral oncogene homolog B(BRAF) V600E mutation. In human PTC samples, AXL expression correlated with V-akt murine thymoma viral oncogene homolog 1 (AKT1) and p65 nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) activation levels. Consistently, AXL stimulation with its ligand growth arrest-specific gene 6 (GAS6) increased AKT1- and p65 NF-kB-phosphorylation and promoted survival of thyroid cancer cell lines in culture. Enforced expression or activation of AXL in normal rat thyroid cells significantly reduced the expression of the sodium/iodide symporter (NIS) and the radioiodine uptake. These data indicate that AXL expression levels could be used as predictor of RAI refractoriness and as a possible novel therapeutic target of RAI resistant PTCs. Papillary thyroid carcinomas (PTCs) have an excellent prognosis, but a fraction of them show aggressive behavior, becoming radioiodine (RAI)-resistant and/or metastatic. AXL (Anexelekto) is a tyrosine kinase receptor regulating viability, invasiveness and chemoresistance in various human cancers, including PTCs. Here, we analyze the role of AXL in PTC prognosis and as a marker of RAI refractoriness. Immunohistochemistry was used to assess AXL positivity in a cohort of human PTC samples. Normal and cancerous thyroid cell lines were used in vitro for signaling, survival and RAI uptake evaluations. 38.2% of human PTCs displayed high expression of AXL that positively correlated with RAI-refractoriness and disease persistence or recurrence, especially when combined with v-raf murine sarcoma viral oncogene homolog B(BRAF) V600E mutation. In human PTC samples, AXL expression correlated with V-akt murine thymoma viral oncogene homolog 1 (AKT1) and p65 nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) activation levels. Consistently, AXL stimulation with its ligand growth arrest-specific gene 6 (GAS6) increased AKT1- and p65 NF-kB-phosphorylation and promoted survival of thyroid cancer cell lines in culture. Enforced expression or activation of AXL in normal rat thyroid cells significantly reduced the expression of the sodium/iodide symporter (NIS) and the radioiodine uptake. These data indicate that AXL expression levels could be used as predictor of RAI refractoriness and as a possible novel therapeutic target of RAI resistant PTCs.

Background: Purpose of this study was to evaluate the contribution of the Extracellular-regulated protein kinase (ERK)-1/2 pathway to oncogenic signaling elicited by the tyrosine kinase receptor HER2 in Non-Small Cell Lung Cancer (NSCLC) and to assess the prognostic value of these oncoproteins in NSCLC patients. Methods: Immunohistochemistry was performed to determine expression and activation of HER2 and ERK1/2 (detected by phosphorylation of Y1248 and T202/Y204, respectively) using Tissue Micro Arrays (TMA) containing matched normal and neoplastic tissues from 132 NSCLC patients. Survival analysis was carried out using the Kaplan-Meier method. Univariate and multivariate analysis were used to evaluate the prognostic value of pERK1/2, pHER2 and a combination thereof with clinical-pathological parameters such as age, lymph node status (N), size (T), stage (TNM) and grade. Results: We found that HER2 was overexpressed in 33/120 (27%) and activated in 41/114 (36%) cases; ERK1/2 was activated in 44/102 (43%) cases. A direct association was found between pERK1/2 and pHER2 (23/41; p=0.038). In addition, patients positive for pERK1/2 and for both pHER2 and pERK1/2 showed significantly worse overall survival (OS) and disease-free survival (DFS) compared with negative patients. Univariate and multivariate analysis of patients' survival revealed that positivity for pHER2-pERK1/2 and for pERK1/2 alone were independent prognostic factors of poor survival in NSCLC patients. In particular, this association was significantly important for DFS in stage I+II patients. Conclusion: This study provides evidence that activated ERK1/2 and/or the combined activation of HER2 and ERK1/2 are good indicators of poor prognosis in NSCLC patients, not only in unselected patients but also in early stage disease.

Urinary bladder cancer is a common malignancy in industrialized countries. More than 90% of bladder cancer originates in the transitional cells. Bladder transitional cancer prognosis is, according to the most recent definition related to the level of tumor infiltration, characterized by two main phenotypes, Non Muscle Invasive Bladder Transitional Cancer (NMIBC) and Muscle Invasive Bladder Transitional Cancer (MIBC). Either the genetic profile and the clinical course of the two subtypes are completely different, however among NMIBC the prognosis is not completely predictable, since 20% of the cases experience a relapse, even in the form of MIBC. It has recently been reported that the chromosomal region 12q13-15, containing crucial cancer genes such as MDM2, CDK4, GLI and an entire cluster of HOX genes, is amplified in bladder cancer. Moreover, it was also described the strong involvement of HOX B13 in particular in several tumors of urogenital system. HOX genes codify for transcriptionl factor, involved in embryonal development and cancer progression, with main nuclear expression. Particularly it was also described the strong involvement of HOX B13 in several tumors of urogenital system. In this study we have been investigated, by immunohistochemisty and quantitative Real Time PCR, the HOX B13 expression in bladder cancer evolution and progression, evaluating its ability to discriminate between NMIBC and MBCI phenotypes. Cytoplasmic HOX B13 delocalization significantly relates with muscle invasion (p 0.004) . In addition in the series of NMIBC nuclear HOX B13 expression loss is significantly associated to shorter disease free survival (p-value=0.038) defining a potential prognostic role. Overexpression of HOX B13 in more aggressive phenotype is also demonstrate at gene level by quantitative RT-PCR. The de-regulation and delocalization of HOX B13 in urinary bladder cancer supports again the important role of HOX genes in tumor evolution and represents a starting point to establish an integrated analysis, in which HOX genes represent important prognostic and predictive markers for bladder cancer.

In 2012, we conducted a retrospective cross-sectional study to assess the number of people living with HIV linked to care and, among these, the number of people on antiretroviral therapy. The health authority in each of the 20 Italian Regions provided the list of Public Infectious Diseases Clinics providing antiretroviral therapy and monitoring people with HIV infection. We asked every Public Infectious Diseases Clinic to report the number of HIV-positive people diagnosed and linked to care and the number of those on antiretroviral therapy during 2012. In 2012, 94,146 people diagnosed with HIV and linked to care were reported. The majority were males (70.1%), Italians (84.4%), and aged between 25 and 49 years (63.4%); the probable route of transmission was heterosexual contact in 37.5% of cases, injecting drug use in 28.1%, and male-to-male contact in 27.9%. Among people in care, 20.1% had less than 350 CD4 cells/μl, 87.6% received antiretroviral therapy, and among these, 62.4% had a CD4 cell count higher than 350 cells/μl. The overall estimated prevalence of individuals diagnosed and linked to care in 2012 in Italy was 0.16 per 100 residents (all ages). Adding the estimated proportion of undiagnosed people, the estimated HIV prevalence would range between 0.19 and 0.26 per 100 residents. In Italy, the majority of people diagnosed and linked to care receive antiretroviral therapy. A higher prevalence of individuals diagnosed and linked to care was observed in Northern Italy and among males. More information for developing the HIV care continuum is necessary to improve the entire engagement in care, focusing on test-and-treat strategies to substantially reduce the proportion of people still undiagnosed or with a detectable viral load.

Neoplasms in the testis and in the testicular adnexa of elderly patients are completely different from those observed in younger patients. Indeed, although conventional seminomas and nonseminomas are mainly observed in the age range of 20-45 years, spermatocytic seminoma, malignant Leydig tumors, and lymphomas in the testis and sarcomas in the paratesticular region are encountered in individuals older than 60 years of age. Here, we discuss the testis and paratesticular region neoplasm more commonly diagnosed in elderly men.

Primary breast mucosa-associated lymphoid tissue (MALT) lymphomas are uncommon and restricted diagnostic criteria should be used to exclude breast involvement by systemic lymphomas. The molecular pathogenesis of primary breast MALT lymphomas is not clear because of the rarity of the disease. Generally the molecular studies of MALT lymphoma in extranodal sites have shown the presence of different chromosomal aberrations, mutually exclusive with substantial differences in their frequency relatively to topographic localization. Few cases of breast MALT lymphomas in the literature have been assessed for MALT lymphoma-associated translocations and BCL10 expression, underlying their rarity in primary breast MALT lymphomas. In our study, we analyzed a series of nine cases of primary breast MALT lymphomas. FISH results showed evidence of MALT1 gene rearrangements in four primary breast lymphomas, in particular three cases with t(11;18)(q21;q21) and one case with t(14;18)(q32;q21). In addition, BCL10 gene rearrangement was not observed. There was no evidence of BCL10 gene translocation in any of the neoplasms assessed. Our data indicate that MALT1 gene rearrangements are not rare in primary breast MALT lymphoma in contrast with results of previous series. Finally, t(11;18) has been observed to be significantly associated with high intensity cytoplasmic BCL10 expression underlying cross-talk between MALT1 and BCL10 pathways in the pathogenesis of MALT lymphomas.

Introduction Breast involvement by non-Hodgkin lymphoma is particularly rare in men. We describe the case of a patient with a rapidly growing, painless gynecomastia-like nodule in the left breast. On ultrasonography, the nodule was suspicious for breast carcinoma. Case presentation A breast biopsy from a 54-year-old Caucasian man showed the morphoimmunophenotypical features of grade 3 follicular lymphoma. Moreover, fluorescence in situ hybridization analysis showed a t(14,18) translocation suggesting breast involvement by a systemic lymphoma rather than a primary breast lymphoma. The histological diagnosis was subsequently confirmed after nodule excision. Mediastinal and abdominal node involvement was then identified on computed tomography and positron emission tomography scans during staging examinations. Our patient was treated with chemotherapy. After three years our patient experienced a right retro-areolar relapse. He then received two further cycles of chemotherapy but developed a myeloid acute leukemia and, as a result of this, he subsequently died. Conclusions The rarity of breast lymphomas, especially in men, and the problems related to the therapeutic choices with these tumors require molecular techniques in association with classical histological diagnosis.