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Nuzzolese E.,Bari
Journal of Forensic Odonto-Stomatology | Year: 2014

Trafficking in human beings is a modern form of slavery and is a well-known phenomenon throughout the European Union and beyond. After drug dealing and the weapons industry, human trafficking is the second largest criminal activity in the world today and it is a growing crime. The aim of governmental and non-governmental agencies, which are either directly or indirectly involved in combating trafficking in human beings, is the identification and referral of victims of trafficking and also to encourage self-referrals. Identification is the most important step to provide protection and assistance to victims of trafficking. Victims often have a variety of physical and mental health needs, including psychological trauma, injuries from violence, head and neck trauma, sexually transmitted infections and other gynaecological problems, dental/oral problems and have poor nutrition. The author’s experience in the field of community dentistry in presented within. Volunteer dental services are offered to non-European Union patients held in a centre for asylum seekers in Bari (Italy). Dental professionals can, in fact, contribute to the identification, assistance and protection of trafficked persons, as well as offering forensic services to assist the police investigation in order to identify crimes and find the criminal organizations behind them. As for domestic violence and child abuse cases, there are ethical concerns involved in the identification and protection of the trafficked persons, as well as the need for interdisciplinary work and awareness. Adequate training in behavioural science and intercultural learning is paramount in order to avoid misunderstandings and increase sensitivity. © 2014, International Organisation for Forensic Odonto-Stomatology. All rights reserved.

Vennari C.,Bari | Vennari C.,University of Naples Federico II | Gariano S.L.,Perugia | Gariano S.L.,University of Perugia | And 4 more authors.
Bulletin of Engineering Geology and the Environment | Year: 2015

The occurrence of sinkholes not directly related to karst has been determined in several areas worldwide in recent years. These phenomena may be particularly dangerous to humans and infrastructure due to their subtle origin and need to be carefully examined. In this work, we describe five sinkholes recently identified in a hilly setting of Southern Italy characterized by Pliocene conglomerate and sand, and variously dislocated by tectonic structures. The sinkholes were examined by different methods (interpretation of multi-temporal aerial photos, geological, geomorphological and geophysical surveys). An historical analysis was performed to collect and critically evaluate information regarding the age of the phenomena. Based on this information, it can be conjectured that two of the five sinkholes developed during the 2000–2001 winter; two of the remaining probably originated during the 70s; the last one opened sometime between February 2001 and November 2007. Based on such chronology, attempts have been performed to identify the likely triggers, through hydrological and seismic analyses. In both cases, no immediate correlation could be found. The origin of the studied phenomena remains uncertain, and may be related to sub-cutaneous erosion, in an area that is renowned to be rich in groundwater. Local changes in the water table, related to climate and/or man-induced activities, may have triggered the development of the cover suffusion-type sinkholes. The present work highlights the potential for this type of phenomena to occur in geological settings without the direct presence of soluble rocks at the surface, a condition quite common in Southern Italy, and the need to carry out further studies in order to better comprehend their mechanisms of origin and successive evolution, and to properly evaluate the related hazard. © 2015 Springer-Verlag Berlin Heidelberg

Mastrofilippo D.,Bari | De Marzo N.,University of Bari
Psychiatria Danubina | Year: 2014

The tango brings out the true essence of the individuals, it removes every mask and stops the lies you tells yourself, forcingthe contact with yourself even before with the others. This is the essence on which we relied to propose a course of psychotherapy with basic elements of tango, as a peculiar mode of experiencing oneself. In this paper we analyze how Tango could become an interesting instrument for the cure and the prevention of psychological and physical problems. © Medicinska naklada - Zagreb, Croatia

Montilla S.,Italian Medicines Agency AIFA | Marchesini G.,S. Orsola Malpighi University Hospital | Sammarco A.,Italian Medicines Agency AIFA | Trotta M.P.,Italian Medicines Agency AIFA | And 17 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2014

Background and aims: In Italy, the reimbursed use of incretin mimetics and incretin enhancers was subject to enrollment of patients into a web-based system recording the general demographic and clinical data of patients. We report the utilization data of glucagon-like peptide 1 (GLP1) receptor agonists and dipeptidylpeptidase-4 (DPP4) inhibitors in clinical practice as recorded by the Italian Medicines Agency (AIFA) Monitoring Registry. Methods and results: From February 2008 to August 2010, 75,283 patients with type 2 diabetes were entered into the registry and treated with exenatide, sitagliptin, or vildagliptin. The treatment was administered to patients in a wide range of ages (≥75 years, n=6125 cases), body mass index (BMI) (≥35kg/m2, n=22,015), and metabolic control (HbA1c≥11% ((96mmol/mol), n=3151). Overall, 1116 suspected adverse drug reactions were registered, including 12 cases of acute pancreatitis (six on exenatide). Hypoglycemic episodes mainly occurred in combination with sulfonylureas. Treatment discontinuation for the three drugs (logistic regression analysis) was negatively associated with the male gender and positively with baseline HbA1c, diabetes duration, and, limitedly to DPP-4 inhibitors, with BMI. Treatment discontinuation (including loss to follow-up, accounting for 21-26%) was frequent. Discontinuation for treatment failure occurred in 7.7% of cases (exenatide), 3.8% (sitagliptin), and 4.1% (vildagliptin), respectively, corresponding to 27-40% of all discontinuations, after excluding lost to follow-up. HbA1c decreased on average by 0.9-1.0% (9mmol/mol). Body weight decreased by 3.5% with exenatide and by 1.0-1.5% with DPP-4 inhibitors. Conclusions: In the real world of Italian diabetes centers, prescriptions of incretins have been made in many cases outside the regulatory limits. Nevertheless, when appropriately utilized, incretins may grant results at least in line with pivotal trials. © 2014 Elsevier B.V.

Mussini C.,University of Modena and Reggio Emilia | Lorenzini P.,National Institute for Infectious Diseases | Cozzi-Lepri A.,University College London | Lapadula G.,University of Milan Bicocca | And 96 more authors.
The Lancet HIV | Year: 2015

Background: In patients with HIV, immune reconstitution after antiretroviral therapy (ART) is often incomplete. We assessed the probability of patients reaching a CD4/CD8 ratio of 1 or more after the start of ART and its association with the onset of non-AIDS-defining events and death. Methods: We did an analysis of the ICONA cohort, which recruited treatment-naive patients with HIV in Italy. We included participants in the cohort who started ART, reached an undetectable viral load (≤80 copies per mL), and had a CD4/CD8 ratio of less than 0·8 at the time of an undetectable viral load. We defined ratio normalisation in patients as two consecutive values of 1 or more. We used Kaplan-Meier curves to estimate the cumulative probability of ratio normalisation. We then used Poisson regression models to identify factors independently associated with normalisation and with progression to non-AIDS-defining events or death. Findings: We included 3236 participants, enrolled between Jan 22, 1997, and Feb 25, 2013. At the start of ART, median CD4/CD8 ratio in our population was 0·39 (IQR 0·26-0·55). 458 (14%) patients reached a CD4/CD8 ratio of 1 or more; the estimated probability of normalisation was 4·4% (95% CI 3·7-5·2) by 1 year from baseline, 11·5% (10·2-13·0) by 2 years, and 29·4% (26·7-32·4) by 5 years. Factors associated with normalisation were high pre-ART CD4 cell counts, a high CD4/CD8 ratio at baseline, and negative cytomegalovirus serological findings. The incidence rate of non-AIDS-defining events for patients with a CD4/CD8 ratio of less than 0·30 (4·2 per 100 patient-years, 95% CI 3·4-5·3) was double that for those with a ratio of 0·30-0·45 (2·3, 2·1-2·5) or more than 0·45 (2·2, 1·7-2·9). A ratio of less than 0·30 was independently associated with an increased risk of non-AIDS-defining events or death compared with one of more than 0·45. Interpretation: Few patients had normalised CD4/CD8 ratios, even though they had viral suppression. Low ratios were associated with increased risk of serious events and deaths. The CD4/CD8 ratio could be used by clinicians to identity patients at risk of non-AIDS-related events. Funding: AbbVie, Bristol-Myers Squibb, Gilead, Janssen, Merck Sharp & Dohme, ViiV Italy. © 2015 Elsevier Ltd.

Parise M.,Bari | Closson D.,Royal Military Academy | Gutierrez F.,University of Zaragoza | Stevanovic Z.,University of Belgrade
Environmental Earth Sciences | Year: 2015

Karst environments are characterized by distinctive landforms and a peculiar hydrologic behavior dominated by subsurface drainage. Karst systems can be extremely complex, heterogeneous, and unpredictable due to the wide range of geological and hydrological controlling factors. The great variability results in serious problems for engineers, and in difficulties to characterize the karstified rock masses, and in designing the engineering works to be performed. The design and development of engineering projects in karst environments require specific approaches aimed at minimizing the detrimental effects of hazardous processes and environmental problems. Further, karst aquifers (that provide approximately 20–25 % of the world’s drinking water) are extremely vulnerable to pollution, due to the direct connection between the surface and the subsurface drainage, the rapidity of the water flow in conduit networks, and the very low depuration capability. Sinkholes are the main source of engineering problems in karst environments, and may cause severe damage in any human structure. The strategies and solutions that may be applied to mitigate sinkhole problems are highly variable and largely depend on the kind of engineering structure, the karst setting, and the typology and size of the sinkholes. A sound geological model, properly considering the peculiarities of karst and its interactions with the human environment, is essential for the design of cost-effective and successful risk reduction programs. Due to the unique direct interaction between surface and subsurface environments, and the frequent ground instability problems related to underground karstification, management of karst environments is a very delicate matter. Disregarding such circumstances in land-use planning and development inevitably results in severe problems with high economic impacts. Karst environments require specific investigation methods in order to properly manage and safeguard the sensitive geo-ecosystems and natural resources associated with them. © 2015 Springer-Verlag Berlin Heidelberg

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