Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"
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Paliperidone-Induced Massive Asymptomatic Creatine Kinase Elevation in Youth: From a Case Report to Literature Review
No full textBackground/Objectives: Unlike rhabdomyolysis and neuroleptic malignant syndrome (NMS), massive asymptomatic creatine kinase elevation (MACKE) represents a condition commonly detected during routine screening in patients receiving antipsychotic drugs. In particular, current evidence indicates a greater incidence of this condition in patients without signs of NMS, rhabdomyolysis, or other causes of CK increase during exposure to second-generation antipsychotics (SGAs) than first-generation antipsychotics (FGAs) with a variable onset and duration. Although its pathophysiology is still not fully elucidated, MACKE has usually been recognized as a self-limiting condition, but drug discontinuation might also be required to successfully revert it. Overall, knowledge in this field is mainly extrapolated from adult data, while similar evidence in youths is still limited. As clinicians might often deal with MACKE, its understanding needs to be expanded to avoid misdiagnosis, potentially leading to wasteful healthcare spending and unfavorable patient outcomes. Methods: By reporting the first case of MACKE in an adolescent receiving an SGA, namely paliperidone, we also aimed to provide a comprehensive overview of this medical condition. Conclusions: Making a MACKE diagnosis is essential since its relevant clinical and economic implications are mainly related to unnecessary closer laboratory monitoring or therapeutic changes (e.g., drug discontinuation or switch to another medication)
Numerical Modelling of Groundwater Level and Salinity Evolution in a Low-Lying Coastal Area Under Intensive Agricultural Activity
No full textThe groundwater salinity changes of the coastal unconfined aquifer of the Po Delta (Italy) from 2010 to 2020 were assessed via a density-dependent numerical model implemented with SEAWAT 4.2. The temporal discretization was defined on a monthly basis, allowing for detailed analysis of the evolution of salinity stratification within the aquifer and of the vertical fluxes induced by the reclamation drainage network. The validated model was used to unravel surface-groundwater interaction fluxes and the long-term impacts induced by the ongoing climate change. The simulation highlighted that deeper layers experienced a salinity increase due to the presence of hyper saline low permeability lenses, while shallow layers experienced both increasing and decreasing salinization trends, depending on the temporal and areal distribution of local factors such as recharge and evapotranspiration, the connection between the shallow aquifer and the drainage network, and the presence of a seawater wedge along the coastline. The sensitivity analysis performed on the maximum plant salt uptake due to evapotranspiration revealed a slight variation in the accumulated salinity mass and concentration within the aquifer, resulting in a maximum error of less than 2% at the end of the simulation
Eosinophilic Esophagitis and Cow’s Milk: Mechanisms, Challenges, and Treatment Perspectives
No full textEosinophilic esophagitis is a chronic, antigen-driven, immune-mediated disease characterized by esophageal dysfunction and significant eosinophilic infiltration. Its rising incidence and prevalence over recent decades reflect both increased clinical awareness and the influence of environmental factors such as dietary patterns and allergen exposure. Among food allergens, cow’s milk proteins are the most commonly implicated triggers, contributing to esophageal inflammation through complex immunological pathways involving both IgE-mediated and non-IgE-mediated mechanisms. Dietary elimination of cow’s milk has been shown to induce histologic remission in over 60% of pediatric patients, underscoring its pivotal role in eosinophilic esophagitis management. Despite these promising results, challenges persist, including variability in individual responses, the burden of adherence to restrictive diets, and gaps in understanding the molecular mechanisms driving cow’s milk-induced esophageal inflammation. This review examines the complex relationship between eosinophilic esophagitis and cow’s milk, focusing on its role in disease pathogenesis and management, offering insights into its therapeutic implications. Understanding the interplay between eosinophilic esophagitis and dietary allergens, particularly cow’s milk, may inform the development of targeted interventions and improve clinical outcomes for affected patients
Itiner-e: A high-resolution dataset of roads of the Roman Empire
No full textThe Roman Empire’s road system was critical for structuring the movement of people, goods and ideas, and sustaining imperial control. Yet, it remains incompletely mapped and poorly integrated across sources despite centuries of research. We present Itiner-e, the most detailed and comprehensive
open digital dataset of roads in the entire Roman Empire. It was created by identifying roads from archaeological and historical sources, locating them using modern and historical topographic maps and remote sensing, and digitising them with road segment-level metadata and certainty categories.
The dataset nearly doubles the known length of Roman roads through increased coverage and spatial precision, and reveals that the location of only 2.737% are known with certainty. This resource is transformative for understanding how mobility shaped connectivity, administration, and even disease transmission in the ancient world, and for studies of the millennia-long development of terrestrial mobility in the region
Eredità della Guerra Fredda tra dismissione, salvaguardia e riconversione
No full textMany U.S. chancelleries of the Cold War have been decommissioned, privatised, privatized and adaptively reused. Evidence of a relevant cultural-political program, even if authored by world-famous Modernist architects, is often not adequately protected today. The conservation, reuse and expansion of the Oslo and London buildings are exemplary in this light. Both listed but with differences in limiting their erasing, they reveal some affinities in the treatment of the ‘Ancient‘ matter. Wider was the freedom granted in London in carrying out building innovations, such as gutting wholly the interiors, occupying fully the lot and putting up a massive raising. Even if in Oslo, where the chancellery is worth as national monument, the same type of additions took place ‘invisibly’, the result however preserved a Modernism icon rather than the real building. Jorge Otero-Pailos made here some sculptures by using the steel of the fence, so taken away from the landfill, thus inviting to reason on heritage and conservation as tools of social and cultural criticism, multiplying the associated narratives
From north to south: exploring Italian sun-exposure habits through the “Save your skin” campaign
No full textBackground: Sun exposure is the main external risk factor for skin cancer, affecting melanoma and non-melanoma differently. Although increased awareness of sun-induced skin damage and appropriate photoprotection has helped to reduce melanoma incidence, inadequate sun protection persists, influenced by geographical, social, and cultural factors. Italy’s varying climates —from the colder north to the warmer south— impact sun exposure behaviours. Objectives: This study examined sun protection habits from the 2023 “Save your skin” campaign to identify at-risk groups and support targeted education. Materials & Methods: Participants completed anonymous questionnaires on sun exposure, sunscreen use, and skin cancer history. Results: Among 1,773 participants, 45% spent 2-4 weeks per year in the sun on holiday, 26% experienced occupational sun exposure, and 33% used tanning beds. Despite darker skin types, only 26% tanned easily; severe sunburn rates were consistent across regions. Central and southern participants reported more sun exposure on holiday than northern participants (p < 0.001); work-related sun exposure was more common in the south. Tanning bed use was higher in the north (p < 0.001). Although 62.46% always used sunscreen, only 32.51% applied it correctly. Misconceptions about sunscreen were widespread, and actinic damage was more frequent among those with lower photoprotection awareness. Conclusion: Inadequate sun protection is widespread in Italy, with regional differences in sun exposure and tanning bed use. Misconceptions about sunscreen are common, and the rate of proper application is low. The higher incidence of actinic damage among those with less photoprotection knowledge highlights the need for targeted education to improve sun safety and reduce skin cancer risk
