Valutazione del rapporto urinario proteine totali/creatinina e albumina/creatinina in cani affetti da iperadrenocorticismo e da diabete mellito

INTRODUCTION – In human medicine, diabetes mellitus (DM), hypertension, proteinuria and nephropathy are often associated although it is still not clear whether hypertension is the consequence or the cause of nephropathy and albuminuria. Microalbuminuria, in humans, is an early and sensitive marker which permits timely and effective therapy in the early phase of renal damage. Conversely, in dogs, these relationships were not fully investigated, even though hypertension has been associated with many diseases (Bodey and Michell, 1996). In a previous study, 20% of diabetic dogs were found proteinuric based on a U:P/C > 1 and 46% were hypertensive; this latter finding is similar to the prevalence of hypertension in diabetic people (40-80%) (Struble et al., 1998). In the same canine study, hypertension was also positively correlated with the duration of the disease, as is the case in human beings. Hypertension was also found to be a common complication of hypercortisolism (HC) in dogs, with a prevalence which varies from 50 (Goy-Thollot et al., 2002) to 80% (Danese and Aron, 1994).The aim of our study was to evaluate the urinary albumin to creatinine ratio (U:A/C) in dogs affected by Diabetes Mellitus and HC in order to ascertain if, as in human beings, it could represent an early and more sensitive marker of renal damage than U:P/C. Furthermore, the relationship between proteinuria and hypertension in DM and HC was also investigated. MATERIALS AND METHODS – Twenty dogs with DM, 14 with HC and 21 healthy dogs (control group) were included in the prospective case-control study. Inclusion criteria were hyperglycaemia, glicosuria and serum fructosamine above the reference range for DM dogs and a positive ACTH stimulation test and/or low-dose dexamethasone test and consistent findings of HC on abdominal ultrasonography in HC dogs. Dogs were excluded if affected by urinary tract infections and if the serum creatinine or urea values were above the reference range. At the moment of inclusion, an appropriate therapy had already been instituted less than 1 month earlier in 12 diabetic dogs. The control dogs were considered healthy based on clinical exam and clinicopathological findings. All dogs underwent urine sample collection by cystocentesis and systemic blood pressure measurement by means of either an oscillometric device (BP-88 Next, Colin Corporation, Japan) or by Doppler ultrasonic traducer (Minidop ES-100VX, Hadeco, Japan). The choice of method depended on the dog’s body weight: Doppler ultrasonography was employed in dogs < 20 kg of body weight and the oscillometric method in the other subjects. Dogs were considered hypertensive whenever systemic blood pressure was found ≥ 160 mmHg. The urine was assayed for U:P/C and U:A/C (Gentilini et al., 2005). The data between groups were compared using the Mann-Whitney U test. The reference ranges for U:P/C and U:A/C had already been established by our laboratory as 0.6 and 0.05, respectively. U:P/C and U:A/C findings were correlated to systemic blood pressure and Spearman R correlation coefficients were calculated. In all cases, p < 0.05 was considered statistically significant. RESULTS – The mean ± sd urinary albumin concentration in the three groups was 1.79 mg/dl ± 2.18; 20.02 mg/dl ± 43.25; 52.02 mg/dl ± 98.27, in healthy, diabetic and hypercortisolemic dogs, respectively. The urine albumin concentration differed significantly between healthy and diabetic dogs (p = 0.008) and between healthy and HC dogs (p = 0.011). U:A/C values ranged from 0.00 to 0.34 (mean ± sd 0.02 ± 0.07), 0.00 to 6.72 (mean ± sd 0.62 ± 1.52) and 0.00 to 5.52 (mean ± sd 1.27 ± 1.70) in the control, DM and HC groups, respectively; U:P/C values ranged from 0.1 to 0.6 (mean ± sd 0.17 ± 0.15) 0.1 to 6.6 (mean ± sd 0.93 ± 1.15) and 0.2 to 7.1 (mean ± sd 1.90 ± 2.11) in the control, DM and HC groups, respectively. In diabetic dogs, U:A/C was above the reference range in 11 out of 20 dogs (55%). Among these, 5/20 (25%) showed an increase only in the U:A/C ratio while, in 6/20 (30%), both the U:P/C and the U:A/C were abnormal. Among the latter, 4 dogs had already undergone therapy. In subjects affected with HC, U:P/C and U:A/C were both increased in 10/14 (71%) while in 2/14 (14%) only U:A/C was above the reference range. Overall, by comparing U:P/C and U:A/C in the various groups, a significant increase in protein excretion in disease-affected animals compared to healthy dogs was found. Blood pressure (BP) in diabetic subjects ranged from 88 to 203 mmHg (mean ± sd 143 ± 33 mmHg) and 7/20 (35%) dogs were found to be hypertensive. In HC dogs, BP ranged from 116 to 200 mmHg (mean ± sd 167 ± 26 mmHg) and 9/14 (64%) dogs were hypertensive. Blood pressure and proteinuria were not significantly correlated. Furthermore, in the DM group, U:P/C and U:A/C were both increased in 3 hypertensive dogs and 2 normotensive dogs while the only increase of U:A/C was observed in 2 hypertensive and 3 normotensive dogs. In the HC group, the U:P/C and the U:A/C were both increased in 6 hypertensive and 2 normotensive dogs; the U:A/C was the sole increased parameter in 1 hypertensive dog and in 1 dog with normal pressure. DISCUSSION AND CONCLUSION- The findings of this study suggest that, in dogs affected by DM and HC, an increase in U:P/C, U:A/C and systemic hypertension is frequently present. Remarkably, some dogs affected by both DM and HC showed an U:A/C but not U:P/C above the reference range. In diabetic dogs, albuminuria was observed in 25% of the subjects, suggesting the possibility that this parameter could be employed for detecting renal damage at an early phase when common semiquantiative tests and even U:P/C fall inside the reference range. In HC dogs, a higher number of subjects with overt proteinuria was found while only 14% presented an increase only in the U:A/C. This fact, associated with a greater number of hypertensive dogs having HC rather than DM, could suggest a greater influence on renal function by the mechanisms involved in hypertension secondary to hypercortisolemia. Furthermore, it is possible that, in HC dogs, the diagnosis was more delayed than in DM dogs. However, the lack of a statistically significant correlation between hypertension and increased protein excretion as well as the apparently random distribution of proteinuric subjects in normotensive and hypertensive cases, imply that other factors besides hypertension are involved in causing proteinuria. Longitudinal studies are needed to further investigate the relationship between hypertension and proteinuria.

Aspetti innovativi per la valutazione e la misura della porosità nei materiali dell'edilizia antica e moderna. La geometria frattale della porosità

New concepts on porosity appraisal in ancient and modern construction materials. The role of Fractal Geometry on porosity characterization and transport phenomena. This work studied the potential of Fractal Geometry to the characterization of porous materials. Besides the descriptive aspects of the pore size distribution, the fractal dimensions have led to the development of rational relations for the prediction of permeability coefficients to fluid and heat transfer. The research considered natural materials used in historical buildings (rock and earth) as well as currently employed materials as hydraulic cement and technologically advanced materials such as silicon carbide or YSZ ceramics. The experimental results of porosity derived from the techniques of mercury intrusion and from the image analysis. Data elaboration was carried out according to established procedures of Fractal Geometry. It was found that certain classes of materials are clearly fractal and respond to simple patterns such as Sierpinski and Menger models. In several cases, however, the fractal character is not recognised because the microstructure of the material is based on different phases at different dimensional scales, and in consequence the “fractal dimensions” calculated from porosimetric data do not come within the standard range (less than 3). Using different type and numbers of fractal units is possible, however, to obtain “virtual” microstructures that have the fraction of voids and pore size distribution equivalent with the experimental ones for almost any material. Thus it was possible to take the expressions for the permeability and the thermal conduction which does not require empirical “constants”, these expressions have also provided values that are generally in agreement with the experimental available data. More problematic has been the fractal discussion of the geometry of the rupture of the material subjected to mechanical stress both external and internal applied. The results achieved on these issues are qualitative and prone to future studies. Keywords: Materials, Microstructure, Porosity, Fractal Geometry, Permeability, Thermal conduction, Mechanical strength.

Atto di disposizione, expressio causae e dichiarazione di scienza

A far data dalla pubblicazione di un importante ed illustre contributo scientifico (GIORGIANNI, voce Causa (dir. priv.), in Enc. dir., VI, Milano, 1960), e dalla proposta, in esso contenuta, di restituire spazio a fattispecie attributive di diritti giustificate, sotto il profilo causale, dal solo riferimento espresso al rapporto fondamentale che ne costituisca fondamento (le c.d. ), un serrato dibattito ha visto contrapporsi nel tempo fautori di soluzioni possibiliste e sostenitori di una più uniforme descrizione del sistema della circolazione dei diritti e dei rimedi connessi alla mancanza di causa negli atti di disposizione, per quanto avulsi dal contratto cui essi intendano dare compiuta attuazione. La ricerca ha cercato di dimostrare, attraverso una compiuta analisi di ciò che la formula expressio causae davvero significhi, come la presenza o assenza di questa non sia in grado di giustificare un effetto tanto pregnante come la sottrazione della vicenda traslativa alle conseguenze derivanti dalla mancanza di causa, per tale intendendosi il rapporto fondamentale che ne costituisce l’antecedente logico. Allo scrivente è parso che il vero nodo teorico da sciogliere non sia costituito dal concetto di causa che questi Autori assumono a fondamento, quanto piuttosto da una impropria valutazione dell’expressio causae. Tale valutazione conduce ad attribuire al momento ricognitivo, di cui l’enunciazione della causa consiste, una valenza sostanzialmente astratta che non si rinviene nemmeno nelle più estreme ricostruzioni delle fattispecie contemplate all’art. 1988 c.c. e che, in materia di accertamento negoziale, è senza eccezioni rifiutata. Ciò che sembra decisivo, infatti, è che la natura dell'expressio causae, in primo luogo ricognitiva del rapporto cui si dà esecuzione, ben lungi dal rappresentare elemento sufficiente per una autonoma considerazione della causa dell'atto (sussistente) e della causa dell'attribuzione (la cui conservazione è decisa dalle sorti del Rechtsgrund), non pare idonea a suffragare – seppur in via provvisoria, ma con una divergente considerazione dell’avente causa rispetto ai terzi ulteriori acquirenti – una soluzione compiutamente esaustiva del problema della giustificazione dell'effetto, rimandando a modelli – quello della dichiarazione di scienza, innanzitutto – rispetto ai quali una astrazione più che processuale sembra del tutto preclusa, anche per considerazioni storiche che si è cercato di descrivere. Del resto, l’analisi delle ipotesi in cui la ricognizione di un rapporto fondamentale, o la promessa di quanto già dovuto in forza di un rapporto fondamentale (art. 1988 c.c.) mostra come, indipendentemente dalla soluzione che si ritenga pertinente circa la natura di tali figure (meramente dichiarativa del vincolo o addirittura costitutiva), un effetto di astrazione materiale, per quanto relativa, è da escludersi. Trasposta nell’ambito delle prestazioni isolate, questa consapevolezza significa impossibilità di rendere invece materialmente astratta l’attribuzione (efficace immediatamente, e solo soggetta ad essere da un atto di segno contrario dall’avente causa al dante causa, oggetto di una pretesa giudiziale personale). La dichiarazione del rapporto fondamentale, che è intimamente connessa ed insopprimibile in ogni fenomeno di imputazione soggettiva (si deve infatti enunciare ciò cui si dà esecuzione), appare sicuramente sussumibile nello schema della dichiarazione di scienza, nell’effetto in senso lato ricognitivo. Ritenere che essa possa di fatto rendere irrilevante, ai fini della conservazione dell’efficacia della prestazione isolata cui si collega, la reale situazione del rapporto fondamentale (in ipotesi mai esistito, o successivamente venuto meno) significa introdurre surrettiziamente una ipotesi di riconoscimento costitutivo e astratto. Ma tale ultima soluzione non può trovare spazio in alcuna delle opzioni interpretative proposte in materia di riconoscimento e, nemmeno, in quella più estrema che ravvisa nel riconoscimento del debito titolato una forma di accertamento unilaterale. In conclusione, la dottrina delle prestazioni isolate nel fare dell’expressio causae l’elemento capace di decidere in via definitiva del verificarsi dell’effetto traslativo – effetto che va, giova ripeterlo, solo rimosso con un atto uguale e contrario assolutamente diverso da quanto nel nostro sistema appare essere, oggi, la ripetizione di indebito – determina una supervalutazione del momento ricognitivo, insito in ogni fenomeno di imputazione/esecuzione. Detto esito costituisce non tanto la recezione del Trennungsprinzip vigente in Germania, ammissibile nella misura in cui si reputi dispositiva la norma di cui all’art. 1376 c.c., quanto piuttosto la silenziosa riproposizione del modello della Schuldanerkenntnis (§781 B.G.B.), la cui totale estraneità rispetto alla tradizione giuridica delle codificazioni franco-italiane (Code civil, c.c. del 1865, c.c. del 1942) si crede di avere sufficientemente dimostrato.

Abbandono del territorio e dissesto idrogeologico in Appennino bolognese: analisi delle dinamiche e degli interventi di gestione idraulico-forestale

The abandonment of less productive fields and agro-forest activities has occured in the last decades, interesting large mountain areas in all mediterranean basin. Until the fifties, agricultural practices dealt mainly with soil surface and surface runoff control systems. However, the apparent sustainability of soil use results often in contrast with historical documents, witnessing heavy hydrogeological instability, in naturally fragile areas. The research focused on the dynamics and effects of post-coltural land abandonment in a critical mountain area of the Reno River. The Reno River rappresents a typical Tuscan-Emilian Apennines Watershed where soil erosion occurs under very different conditions depending on interactions between land use, climate, geomorphology and lithology. Landslides are largely rappresented, due to the diffusion of clay hill slopes. Recent researches suggest that climatic variability will increase as a consequence of global climate change, resulting in greater frequency and intensity of extreme weather events, which could increase rates of erosion, landslides reactivations and diffusion of calanchive basins. As far as hill slopes are concerned, instability is today basically due to intrinsic factors, as the Apennine range is a rather young formation, in geological terms, and is mainly formed by sedimentary rocks with high occurrence of clays. Therefore landslides and rockfalls are very frequent, while surface soil erosion is generally low and anyway concentrated in the low Apennine, where intensive farming is still economically worth. The study, supported by GIS use, analyses the main fisical characteristics of the area and the historical changes of land use, and focalizes the dynamics of spontaneous reafforestation. Futhermore, the research studies the results of soil bioengineering and surface water control solutions for the restablishment of landslides occured in the last period. Infact soil bioengineering has been recently used in different situations in order to consolidate slopes and hillsides and prevent erosion; when applied, it gave good results, both in terms of engineering efficiency and vegetational development, expecially if combined with a good hydraulic control, thus proving to be an actual alternative to other techniques with heavier environmental impacts. Research into the specific site features and the use of proper plant species is vital to the success of bioengineering works.

Sviluppo di tecniche di analisi ifenate per la quantificazione di biomarcatori di esposizione a tossici ambientali: gli acidi mercapturici

Human biomonitoring (HBM) is an ideal tool for evaluating toxicant exposure in health risk assessment. Chemical substances or their metabolites related to environmental pollutants can be detected as biomarkers of exposure using a wide variety of biological fluids. Individual exposure to aromatic hydrocarbon compounds (benzene, toluene, and o-xylene –“BTX”) were analysed with a liquid chromatography coupled to electrospray ionisation-mass spectrometry (μHPLC-ESI-MS/MS) method for the simultaneous quantitative detection of the BTX exposure biomarker SPMA, SBMA and o-MBMA in human urine. Urinary S-phenylmercapturic acid (SPMA) is a biomarker proposed by the American Conference of Governmental Industrial Hygienists (ACGIH) for assessing occupational exposure to benzene (Biological Exposure Index of 25 microg/g creatinine). Urinary S-benzylmercapturic (SBMA) and o-methyl S-benzyl mercapturic acid (o-MBMA) are specific toluene and o-xylene metabolites of glutathione detoxicant pathways, proposed as reliable biomarkers of exposure. To this aim a pre-treatment of the urine with solid phase extraction (SPE) and an evaporation step were necessary to concentrate the mercapturic acids before instrumental analysis. A liquid chromatography separation was carried out with a reversed phase capillary column (Synergi 4u Max-RP) using a binary gradient composed of an acquous solution of formic acid 0.07% v/v and methanol. The mercapturic acids were determinated by negative-ion-mass spectrometry and the data were corrected using isotope-labelled analogs as internal standards. The analytical method follows U.S. Food and Drug Administration guidance and was applied to assess exposure to BTX in a group of 396 traffic wardens. The association between biomarker results and individual factors, such as age, sex and tobacco smoke were also investigated. The present work also included improvements in the methods used by modifying various chromatographic parameters and experimental procedures. A partial validation was conducted to evaluate LOD, precision, accuracy, recovery as well as matrix effects. Higher sensitivity will be possible in future biological monitoring programmes, allowing evaluation of very low level of BTX human exposure. Keywords: Human biomonitoring, aromatic hydrocarbons, biomarker of exposure, HPLC-MS/MS.

La comunicazione della cooperazione allo sviluppo: gli Enti Pubblici. Analisi discorsive dei Siti Web

Our research takes place in the context of a discipline kwown as Communication for Development, sited inside the field of Communication for Social Change, characterized by the use of interpersonal ad mass communication theories and tools, applyied to international development cooperation. Our study aims at pointing out a change of paradigm in this field: our object is Public Administration’s communication, therefore, what we suggest is a shift from Communication for Development, to Development Communication. The object of our study, hence, becomes the discourse itself, in its double action of representation and construction of reality. In particular, we are interested in the discourse’s tribute to the creation of a collective immagination, wich is the perspective towards which we have oriented the analysis, through a structuralist semoitics-based methodology integrated with a socio-semiotic approach. Taking into consideartion the fact that in our contemporary society (that is to say a ‘Western’ and ‘First World’ society), the internet is a crucial public space for the mediation and the management of collective immagination, we chose the web sites of Public Bodies which are dedicated to International Cooperation has our analysis corpus. This, due to their symbolic and ideologic significance, as well as for the actual political responsibility we think these web sites should have. The result of our analysis allows us to suggest some discoursive strategies used in the web sites of Public Bodies. In these sites, there is a tendency to shift the discourses around international cooperation from the ideological axis - avoiding in so doing to explicit a political statement about the causes of injustices and un-balances which lead to the necessity of a support in development (i.e. avoiding to mention values such as social justice and democracy while acknowledging socio-economical institutions which contribute to foster underdevelopment on a global scale) -, to the ethical axis, hence referring to moral values concerning the private sphere (human solidarity and charity), which is delegated mainly to non governamental associations.

Innovazione organizzativa e istituzionale della pubblica amministrazione. Un approccio interpretativo e l'analisi di un dispositivo partecipativo nel settore della cultura

The thesis aims at inquiring into the issue of innovation and organizational and institutional change in the public administration with regard to the increasingly massive adoption of participatory devices and practices in various arenas of public policies. The field of reference regards transformations of the types of public actions and regulation systems, concerning governance. Together with the crisis of the public function and of the role played by the insitutions what is emerging are different levels of governement, both towards an over national and a local direction, and a plurality of social interlocutors, followed by a post-bureaucratic pattern of the public administration that is opening itself in the direction of environment and citizens. The public adminstration is no longer considered an inert object within the bureaucratic paradigm but as a series of communicative processes, choices, cultures and practices that actively builds itself and the environment it interacts with. Therefore, the output of the public administration isn’t the simple service being supplied but the relationship enacted with the citizen, relationship that becomes the constituent basis of adminstrative processes. The intention of thesis is to take into consideration the relation between innovation of the public administration and participatory experimentations and implementations regarded as exchanges in which citizens and the public administration hold talks and debates. The issue of the organizational change of the public administration as output and effect of inclusive deliberative practices has been analysed starting from an institutionalist approach, in other words examining the constituent features of institutions, “rediscovering” them with regard to their public nature, their ability to elaborate collective values and meanings, the social definition of problems and solutions. The participatory device employed by the Forlì city council that involved enterprises and cultural associations of the area in order to build a participatory Table, has been studied through a qualitative methodology (participant observation and semi-strutctured interviews). The analysis inquired into the public nature both of the participatory device and the administrative action itself as well as into elements pertaining the deliberative setting, the regulative reference framework and the actors which took part in the process.

Analisi critico-comparativa delle traduzioni italiane di Un amour de Swann di Marcel Proust

Affrontare l’analisi critica delle traduzioni italiane di Un amour de Swann di Marcel Proust implica necessariamente un attento esame dello stile esemplare di un autore, che ha modificato, in larga misura, la concezione del romanzo e della scrittura stessa; in secondo luogo significa considerare l’altrettanto complesso lavorio intellettuale rappresentato dalla traduzione, in qualità di atto critico fondamentale. Prenderemo in esame nel capitolo primo la genesi del TP, le sue specificità narratologiche e la ricezione critica francese e italiana, per comprendere appieno l’originalità di Proust rispetto al panorama letterario dell’epoca. Nella seconda parte del primo capitolo delineeremo un excursus lungo la storia di tutte le traduzioni italiane del romanzo, accordando particolare attenzione alla figura di ogni traduttore: Natalia Ginzburg (1946), Bruno Schacherl (1946), Armando Landini (1946), Oreste Del Buono (1965), Giovanni Raboni (1978), Maria Teresa Nessi Somaini (1981), Gianna Tornabuoni (1988), Eurialo De Michelis (1990) e il traduttore, rimasto anonimo, della casa editrice La Spiga Languages (1995). Nel secondo capitolo analizzeremo la peculiarità stilistica più nota dell’autore, la sintassi. I lunghi periodi complicati da un intreccio di subordinate e sciolti solo con il ricorso a vari nessi sintattici contribuiscono a rendere la sintassi proustiana una delle sfide maggiori in sede traduttiva. Nel capitolo successivo accorderemo attenzione all’eteroglossia enunciativa, espressa nei diversi idioletti del romanzo. In sede contrastiva affronteremo la questione della trasposizione dei niveaux de langue, per poter valutare le scelte intraprese dai traduttori in un ambito altamente complesso, a causa della diversità diafasica intrinseca dei due codici. All’interno del medesimo capitolo apriremo una parentesi sulla specificità di una traduzione, quella di Giacomo Debenedetti, effettuata seguendo una personale esegesi dello stile musicale e armonico di Proust. Riserveremo al capitolo quarto lo studio del linguaggio figurato, soffermandoci sull’analisi delle espressioni idiomatiche, che vengono impiegate frequentemente da alcuni personaggi. Rivolgeremo uno sguardo d’insieme alle strategie messe in atto dai traduttori, per cercare un equivalente idiomatico o per ricreare il medesimo impatto nel lettore, qualora vi siano casi di anisomorfismo. Analizzeremo nel quinto capitolo la terminologia della moda, confrontando il lessico impiegato nel TP con le soluzioni adottate nei TA, e aprendo, inevitabilmente, una parentesi sulla terminologia storica del settore. A compimento del lavoro presenteremo la nostra proposta traduttiva di un capitolo tratto dal saggio Proust et le style di Jean Milly, per mettere in luce, tramite la sua parola autorevole, la genialità e la complessità della scrittura proustiana e, conseguentemente, il compito ardimentoso e ammirevole che è stato richiesto ai traduttori italiani.

Analisi spaziale dei dati entomologici in ambiente GIS: prospettive di utilizzo nell'agricoltura di precisione

Scopo della ricerca è stato definire le dinamiche spazio-temporali degli insetti studiati mediante l’impiego di tecniche geostatistiche. La ricerca è stata condotta su due casi studio, il primo riguardante tre specie di Elateridi di elevata importanza economica su scala aziendale, il secondo inerente al monitoraggio di Diabrotica virgifera virgifera (diabrotica del mais) su scala regionale. Gli scopi specifici dei due casi studio sono stati: Caso studio 1 a) Monitorare l’entità della popolazione di Elateridi su scala aziendale mediante approccio geostatistico. b) Elaborazione di mappe di distribuzione spaziale interfacciabili all’ambiente GIS. c) Individuare i fattori predisponenti l’infestazione. d) Verificare la necessità dell’impiego di mezzi chimici per il controllo delle specie dannose. e) Proporre strategie alternative volte alla riduzione dell’impiego di trattamenti geodisinfestanti. Caso studio 2 a) Studiare la distribuzione spaziale su scala regionale la popolazione del fitofago D. virgifera virgifera. b) Applicare a livello regionale una griglia di monitoraggio efficace per studiarne la diffusione. c) Individuare le aree a rischio e studiare i fattori predisponenti l’infestazione e diffusione. d) Ottimizzare ed economizzare il piano di monitoraggio.

L'impiego del modello di Rash per la valutazione della soddisfazione del paziente nell'ambito delle strutture sanitarie di ricovero

Hospitals and health service providers are use to collect data about patient’s opinion to improve patient health status and communication with them and to upgrade the management and the organization of the health service provided. A lot of survey are carry out for this purpose and several questionnaire are built to measure patient satisfaction. In particular patient satisfaction is a way to describe and assess the level of hospital service from the patient’s point of view. It is a cognitive and an emotional response to the hospital experience. Methodologically patient satisfaction is defined as a multidimensional latent variable. To assess patient satisfaction Item Response Theory has greater advantages compared to Classical Test Theory. Rasch model is a one-parameter model which belongs to Item Response Theory. Rasch model yield objective measure of the construct that are independent of the set of people interviewed and of set of items used. Rasch estimates are continuous and can be useful to “calibrate” the scale of the latent trait. This research attempt to investigate the questionnaire currently adopted to measure patient satisfaction in an Italian hospital, completed by a large sample of 3390 patients. We verify the multidimensional nature of the variable, the properties of the instrument and the level of satisfaction in the hospital. Successively we used Rasch estimates to describe the most satisfied and the less satisfied patients.