Aspects of Land Take in the Metropolitan Area of Naples

Land take is a phenomenon of great concern nowadays because of the large number of its negative impacts regarding biological, economic and social balance. In Italy, the development of urban and other artificial land has been irreversibly transforming a nonrenewable resource such as soil, regardless the almost constant population rate, with different speed depending of the region considered. The aim of this paper is to analyze the phenomenon in the metropolitan area of Naples, which is an area highly affected by territorial aggression of human matrix. The data used are both by the Institute for Environmental Protection and Research (ISPRA) Report 2015 on the usage of the land and by ISTAT relating to the resident population up to the 1st of January 2015 and the extension of land for agricultural use (Census 2010). The mathematical combination of this data creates a new indicator that can be referred to as “residual land”; this residual area is of great extension with many different characteristics and it could represent the area where the phenomenon of land take most occurs. The identification, measurement and analysis of “residual land” provide new insights on the evolution of land take and this new indicator can represent a critical element to work on to prevent future land transformation and protect natural and agricultural areas within the Italian context.

Stapled haemorrhoidopexy vs. Milligan-Morgan haemorrhoidectomy for grade III haemorrhoids: a randomized clinical trial

The aim of this double blind randomized clinical trial was to compare the short-term and long-term outcomes of stapled haemorrhoidopexy (SH group) performed using a circular stapler with that of the Milligan-Morgan haemorrhoidectomy (MMH group). A total of 79 consecutive patients with grade III haemorrhoids were randomized into two groups treated with SH (n. 39) and MMH (n. 40). The outcomes of the procedures were evaluated postoperatively and over a follow-up period of minimum 2 years. Patients undergoing the SH procedure showed greater short term advantages than MMH group with reduced pain, shorter length of hospital stay, earlier return to work and high patient satisfaction. Long-term follow-up has indicated more favourable results in MMH group in terms of resumption of symptoms with absence of residual prolapse and risk of recurrence of prolapse. At two years follow-up recurrent prolapse was confirmed in six patients of SH group (13%) whereas in none of the MMH group. At six months follow-up there weren’t significant difference in the mean satisfaction score for the two groups. At two years the mean satisfaction score was higher in the MMH group vs SH group. Seven patients in the SH group needed a reoperation whereas none in MMH group. From January 2009, in our Surgery Unit the patients are always informed about a higher recurrence rate of SH and we perform this technique only when the patient choices to accept this risk to take advantage of the short-term benefits of this procedure.