Studio del comportamento meccanico di smalti porcellanati per substrati metallici

Composite porcelain enamels are inorganic coatings for metallic components based on a special ceramic-vitreous matrix in which specific additives are randomly dispersed. The ceramic-vitreous matrix is made by a mixture of various raw materials and elements and in particular it is based on boron-silicate glass added with metal oxides(1) of titanium, zinc, tin, zirconia, alumina, ecc. These additions are often used to improve and enhance some important performances such as corrosion(2) and wear resistance, mechanical strength, fracture toughness and also aesthetic functions. The coating process, called enamelling, depends on the nature of the surface, but also on the kind of the used porcelain enamel. For metal sheets coatings two industrial processes are actually used: one based on a wet porcelain enamel and another based on a dry-silicone porcelain enamel. During the firing process, that is performed at about 870°C in the case of a steel substrate, the enamel raw material melts and interacts with the metal substrate so enabling the formation of a continuous varying structure. The interface domain between the substrate and the external layer is made of a complex material system where the ceramic vitreous and the metal constituents are mixed. In particular four main regions can be identified, (i) the pure metal region, (ii) the region where the metal constituents are dominant compared with the ceramic vitreous components, (iii) the region where the ceramic vitreous constituents are dominant compared with the metal ones, and the fourth region (iv) composed by the pure ceramic vitreous material. It has also to be noticed the presence of metallic dendrites that hinder the substrate and the external layer passing through the interphase region. Each region of the final composite structure plays a specific role: the metal substrate has mainly the structural function, the interphase region and the embedded dendrites guarantee the adhesion of the external vitreous layer to the substrate and the external vitreous layer is characterized by an high tribological, corrosion and thermal shock resistance. Such material, due to its internal composition, functionalization and architecture can be considered as a functionally graded composite material. The knowledge of the mechanical, tribological and chemical behavior of such composites is not well established and the research is still in progress. In particular the mechanical performances data about the composite coating are not jet established. In the present work the Residual Stresses, the Young modulus and the First Crack Failure of the composite porcelain enamel coating are studied. Due to the differences of the porcelain composite enamel and steel thermal properties the enamelled steel sheets have residual stresses: compressive residual stress acts on the coating and tensile residual stress acts on the steel sheet. The residual stresses estimation has been performed by measuring the curvature of rectangular one-side coated specimens. The Young modulus and the First Crack Failure (FCF) of the coating have been estimated by four point bending tests (3-7) monitored by means of the Acoustic Emission (AE) technique(5,6). In particular the AE information has been used to identify, during the bending tests, the displacement domain over which no coating failure occurs (Free Failure Zone, FFZ). In the FFZ domain, the Young modulus has been estimated according to ASTM D6272-02. The FCF has been calculated as the ratio between the displacement at the first crack of the coating and the coating thickness on the cracked side. The mechanical performances of the tested coated specimens have also been related and discussed to respective microstructure and surface characteristics by double entry charts.

Criteri di valutazione medico-legale della narcolessia

Impairment due to narcolepsy strongly limits job performance, but there are no standard criteria to assess disability in people with narcolepsy and a scale of disease severity is still lacking. We explored: 1. the interobserver reliability among Italian Medical Commissions making disability and handicap benefit decisions for people with narcolepsy, searching for correlations between the recognized disability degree and patients’ features; 2. the willingness to report patients to the driving licence authority; 3. possible sources of variance in judgement. Fifteen narcoleptic patients were examined by four Medical Commissions in simulated sessions. Raw agreement and interobserver reliability among Commissions were calculated for disability and handicap benefit decisions and for driving licence decisions. Levels of judgement differed on percentage of disability (p<0.001), severity of handicap (p=0.0007) and the need to inform the driving licence authority (p=0.032). Interobserver reliability ranged from Kappa = - 0.10 to Kappa = 0.35 for disability benefit decision and from Kappa = - 0.26 to Kappa = 0.36 for handicap benefit decision. The raw agreement on driving licence decision ranged from 73% to 100% (Kappa not calculable). Spearman’s correlation between percentages of disability and patients’ features showed correlations with age, daytime naps, sleepiness, cataplexy and quality of life. This first interobserver reliability study on social benefit decisions for narcolepsy shows the difficulty of reaching an agreement in this field, mainly due to variance in interpretation of the assessment criteria. The minimum set of indicators of disease severity correlating with patients’ self assessments encourages a disability classification of narcolepsy.

PTA e stenting carotideo: valutazione morfologica ed evolutiva, a breve e medio termine

In un periodo di tre anni è stato svolto un lavoro mirato alla valutazione delle complicanze correlate all’utilizzo dello stenting carotideo. Dopo la preparazione di un protocollo con definizione di tutti i fattori di rischio sono stati individuati i criteri di inclusione ed esclusione attraverso i quali arruolare i pazienti. Da Luglio 2004 a Marzo 2007 sono stati inclusi 298 pazienti e sono state valutate le caratteristiche della placca carotidea, con particolare riferimento alla presenza di ulcerazione e/o di stenosi serrata, la tortuosità dei vasi e il tipo di arco aortico oltre a tutti i fattori di rischio demografici e metabolici. E’ stato valutato quanto e se questi fattori di rischio incrementino la percentuale di complicanze della procedura di stenting carotideo. I pazienti arruolati sono stati suddivisi in due gruppi a seconda della morfologia della placca: placca complicata (placca con ulcera del diametro > di 2 mm e placca con stenosi sub occlusiva 99%) e placca non complicata. I due gruppi sono stati comparati in termini di epidemiologia, sintomatologia neurologica preoperatoria, tipo di arco, presenza di stenosi o ostruzione della carotide controlaterale, tipo di stent e di protezione cerebrale utilizzati, evoluzione clinica e risultati tecnici. I dati sono stati valutati mediante analisi statistica di regressione logistica multipla per evidenziare le variabili correlate con l’insuccesso. Dei 298 pazienti consecutivi sottoposti a stenting, 77 hanno mostrato una placca complicata (25,8%) e 221 una placca non complicata (74,2%). I due gruppi non hanno avuto sostanziali differenze epidemiologiche o di sintomatologia preoperatoria. Il successo tecnico si è avuto in 272 casi (91,2%) e sintomi neurologici post-operatosi si sono verificati in 23 casi (23.3%). Tutti i sintomi sono stati temporanei. Non si sono avute differenze statisticamente significative tra i due gruppi in relazione alle complicanze neurologiche e ai fallimenti tecnici. L’età avanzata è correlata ad un incremento dei fallimenti tecnici. I risultati dello studio portano alla conclusione che la morfologia della placca non porta ad un incremento significativo dei rischi correlati alla procedura di stenting carotideo e che l’indicazione alla CAS può essere posta indipendentemente dalla caratteristica della placca.

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.

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.

Influenza delle caratteristiche quali-quantitative della luce da fonti artificiali sulla fisio-morfologia di piante verdi per interior landscaping

La conoscenza delle esigenze luminose (intensità, spettro, durata minima, massima ed ottimale del fotoperiodo di illuminazione) e della tolleranza alle condizioni degli interni delle piante ad uso decorativo, è di fondamentale importanza per una giusta tecnica di progettazione (dimensionamento e dislocazione dei punti luce) dell’indoor plantscaping. Il lungo periodo di condizionamento al quale queste piante vengono sottoposte, caratterizzato principalmente dalla scarsa disponibilità di luce naturale e dagli alti livelli di concentrazione di CO2 determina una forte influenza sui processi morfo-fisiologici. Il presente studio analizza il fattore luminoso ed è articolato su più punti quali; • caratterizzazione della riposta fotosintetica all’intensità luminosa di 21 delle principali specie a fogliame decorativo comunemente utilizzate nella realizzazione degli spazi verdi indoor, per stabilire quali siano i minimi ed ottimali livelli di PAR tali da garantire una fotosintesi netta positiva e nel complesso le condizioni di maggior benessere per le piante; • quantificazione dell’incremento fotosintetico netto dovuto ad una maggior concentrazione di CO2 negli interni rispetto alla concentrazione CO2 atmosferica esterna, all’aumentare dell’ intensità luminosa artificiale sulle precedenti specie; • monitoraggio dell’andamento delle attività fotosintetiche durante il periodo di illuminazione di 8 ore comunemente utilizzato in un interno ad uso lavorativo, a PAR costante e variabile in Ficus elastica e Dieffenbachia picta, al fine di stabilire quali possano essere le durate e le modalità di somministrazione della luce per rendere massima la fotosintesi netta riducendo al minimo i consumi energetici dovuti all’accensione delle lampade; • valutazione della risposta morfo-fisiologica e fotosintetica a modificazioni dello spettro luminoso mediante l’uso di LED monocromatici colorati ad emissione nel bianco, blu e rosso in Ficus benjamina e Iresine herbistii al fine di stabilire se questo tipo di lampade possano essere utilizzate come fonte integrativa e/o sostitutiva nella realizzazione degli spazi verdi interni. Vengono analizzati il punto si compensazione alla luce (g), il punto di saturazione alla luce (s), l’efficienza quantica (AQE), il punto di respirazione al buio (Rd) e la fotosintesi netta massima (A max) per (Aglaonema commutatum, Asplenium nidus, Anthurium andreanum, Begonia rex, Calathea luoise, Calathea veitchiana, Calathea rufibarba, Calathea zebrina, Codiaeum variegatum, Cthenanthe oppenheimiana, Dieffenbakia picta, Ficus benjamina, Ficus elatica, Ficus longifolia, Fittonia verschaffeltii, Iresine herbistii, Philodendron erubescens, Philodendron pertusum, Potos aureus, Spathiphillum wallisi, Syngonium podophillum ) e classificate le specie in funzione di Amax in quattro categorie; A max < 2 µmol CO2 m-2 s-1, A max compresa tra 2 e 4 µmol CO2 m-2 s-1, Amax cpmpresa tra 4 e 6 µmol CO2 m-2 s-1, Amax > 6 µmol CO2 m-2 s-1, al fine di mettere in risalto la potenzialità fotosintetiche di ogni singola specie. I valori di PAR compresi tra (g) ed (s) forniscono le indicazioni sulle quali basarsi per scegliere una giusta lampada o dimensionare un punto luce per ogni singola specie e/o composizione. È stimata l’influenza di due livelli di concentrazione di CO2 ambientale (400 e 800 ppm) all’incrementare dell’intensità luminosa sul processo fotosintetico delle specie precedenti. Per quasi tutte le specie 800 ppm di CO2 non favoriscono nessun incremento all’attività fotosintetica ad eccezione di Ficus benjamina, Ficus elatica e Syngonium podophillum se non accompagnati da una disponibilità luminosa superiore alle 10 µmol m-2 s-1. Viene monitorato l’andamento dell’attività fotosintetica a PAR costante e variabile (intervallando periodi di 8 minuti a PAR 40 e 80) durante 8 ore di illuminazione su Ficus elastica e Dieffenbachia picta al fine di stabilire la miglior modalità di somministrazione della luce. La fotosintesi netta cumulativa per l’intera durata di illuminazione a PAR costante mostra un calo dopo alcune ore dall’attivazione in Dieffenbackia, e un andamento oscillatorio in Ficus. L’illuminazione alternata consente di raggiungere i quantitativi di CO2 organicata a 80 µmol m-2 s-1 di PAR, dopo 5 ore e mezza sia in Ficus che Dieffenbackia sebbene le potenzialità fotosintetiche delle due piante siano molto differenti. È stato valutato l’effetto dell’illuminazione artificiale mediante LED (15W) a luce bianca, blu e rossa monocromatica in rapporto alla luce neon(36W) bianca tradizionale (con differenti abbinamenti tra le lampade) sui principali parametri morfologici e fisiologici, in Ficus benjamin ‘Variegata’ e Iresine herbistii per verificare se tali fonti possono rappresentare una valida alternativa nella sostituzione o integrazione di altre lampade per gli spazi verdi indoor. Tutte le combinazioni LED indagate possono rappresentare un’alternativa di sostituzione alla coltivazione con neon ed un risparmio energetico di oltre il 50%. Una PAR di 20,6 µmol m-2 s-1 della singola lampada LED bianco è sufficiente per mantenere la pianta in condizioni di sopravvivenza con un consumo di 15W a fronte dei 36W necessari per il funzionamento di ogni neon. La combinazione LED bianco + LED blu monocromatico favorisce il contenimento della taglia della pianta, caratteristica gradita nella fase di utilizzo indoor, una maggior produzione di sostanza secca e un’attività fotosintetica più elevata.

Ricerca, mediante tecniche di proteomica, di biomarcatori proteici utili nella valutazione della qualità degli alimenti di origine animale

In the last decades, the increase of industrial activities and of the request for the world food requirement, the intensification of natural resources exploitation, directly connected to pollution, have aroused an increasing interest of the public opinion towards initiatives linked to the regulation of food production, as well to the institution of a modern legislation for the consumer guardianship. This work was planned taking into account some important thematics related to marine environment, collecting and showing the data obtained from the studies made on different marine species of commercial interest (Chamelea gallina, Mytilus edulis, Ostrea edulis, Crassostrea gigas, Salmo salar, Gadus morhua). These studies have evaluated the effects of important physic and chemical parameters variations (temperature, xenobiotics like drugs, hydrocarbons and pesticides) on cells involved in the immune defence (haemocytes) and on some important enzymatic systems involved in xenobiotic biotransformation processes (cytochrome P450 complex) and in the related antioxidant defence processes (Superoxide dismutase, Catalase, Heat Shock Protein), from a biochemical and bimolecular point of view. Oxygen is essential in the biological answer of a living organism. Its consume in the normal cellular breathing physiological processes and foreign substances biotransformation, leads to reactive oxygen species (ROS) formation, potentially toxic and responsible of biological macromolecules damages with consequent pathologies worsening. Such processes can bring to a qualitative alteration of the derived products, but also to a general state of suffering that in the most serious cases can provoke the death of the organism, with important repercussions in economic field, in the output of the breedings, of fishing and of aquaculture. In this study it seemed interesting to apply also alternative methodologies currently in use in the medical field (cytofluorimetry) and in proteomic studies (bidimensional electrophoresis, mass spectrometry) with the aim of identify new biomarkers to place beside the traditional methods for the control of the animal origin food quality. From the results it’s possible to point out some relevant aspects from each experiment: 1. The cytofluorimetric techniques applied to O. edulis and C. gigas could bring to important developments in the search of alternative methods that quickly allows to identify with precision the origin of a specific sample, contributing to oppose possible alimentary frauds, in this case for example related to presence of a different species, also under a qualitative profile, but morpholgically similar. A concrete perspective for the application in the inspective field of this method has to be confirmed by further laboratory tests that take also in account in vivo experiments to evaluate the effect in the whole organism of the factors evaluated only on haemocytes in vitro. These elements suggest therefore the possibility to suit the cytofluorimetric methods for the study of animal organisms of food interest, still before these enter the phase of industrial working processes, giving useful information about the possible presence of contaminants sources that can induce an increase of the immune defence and an alteration of normal cellular parameter values. 2. C. gallina immune system has shown an interesting answer to benzo[a]pyrene (B[a]P) exposure, dose and time dependent, with a significant decrease of the expression and of the activity of one of the most important enzymes involved in the antioxidant defence in haemocytes and haemolymph. The data obtained are confirmed by several measurements of physiological parameters, that together with the decrease of the activity of 7-etossi-resourifine-O-deetilase (EROD linked to xenobiotic biotransformation processes) during exposure, underline the major effects of B[a]P action. The identification of basal levels of EROD supports the possible presence of CYP1A subfamily in the invertebrates, still today controversial, never identified previously in C. gallina and never isolated in the immune cells, as confirmed instead in this study with the identification of CYP1A-immunopositive protein (CYP1A-IPP). This protein could reveal a good biomarker at the base of a simple and quick method that could give clear information about specific pollutants presence, even at low concentrations in the environment where usually these organisms are fished before being commercialized. 3. In this experiment it has been evaluated the effect of the antibiotic chloramphenicol (CA) in an important species of commercial interest, Chamelea gallina. Chloramphenicol is a drug still used in some developing countries, also in veterinary field. Controls to evaluate its presence in the alimentary products of animal origin, can reveal ineffective whereas the concentration results to be below the limit of sensitivity of the instruments usually used in this type of analysis. Negative effects of CA towards the CYP1A- IPP proteins, underlined in this work, seem to be due to the attack of free radicals resultant from the action of the antibiotic. This brings to a meaningful alteration of the biotransformation mechanisms through the free radicals. It seems particularly interesting to pay attention to the narrow relationships in C. gallina, between SOD/CAT and CYP450 system, actively involved in detoxification mechanism, especially if compared with the few similar works today present about mollusc, a group that is composed by numerous species that enter in the food field and on which constant controls are necessary to evaluate in a rapid and effective way the presence of possible contaminations. 4. The investigations on fishes (Gadus morhua, and Salmo salar) and on a bivalve mollusc (Mytilus edulis) have allowed to evaluate different aspects related to the possibility to identify a biomarker for the evaluation of the health of organisms of food interest and consequently for the quality of the final product through 2DE methodologies. In the seafood field these techniques are currently used with a discreet success only for vertebrates (fishes), while in the study of the invertebrates (molluscs) there are a lot of difficulties. The results obtained in this work have underline several problems in the correct identification of the isolated proteins in animal organisms of which doesn’t currently exist a complete genomic sequence. This brings to attribute some identities on the base of the comparison with similar proteins in other animal groups, incurring in the possibility to obtain inaccurate data and above all discordant with those obtained on the same animals by other authors. Nevertheless the data obtained in this work after MALDI-ToF analysis, result however objective and the spectra collected could be again analyzed in the future after the update of genomic database related to the species studied. 4-A. The investigation about the presence of HSP70 isoforms directly induced by different phenomena of stress like B[a]P presence, has used bidimensional electrophoresis methods in C. gallina, that have allowed to isolate numerous protein on 2DE gels, allowing the collection of several spots currently in phase of analysis with MALDI-ToF-MS. The present preliminary work has allowed therefore to acquire and to improve important methodologies in the study of cellular parameters and in the proteomic field, that is not only revealed of great potentiality in the application in medical and veterinary field, but also in the field of the inspection of the foods with connections to the toxicology and the environmental pollution. Such study contributes therefore to the search of rapid and new methodologies, that can increase the inspective strategies, integrating themselves with those existing, but improving at the same time the general background of information related to the state of health of the considered animal organism, with the possibility, still hypothetical, to replace in particular cases the employment of the traditional techniques in the alimentary field.

L'Azienda USL di Bologna: analisi dell'impatto della fusione delle tre precedenti Aziende sugli assetti organizzativi

L’Azienda USL di Bologna è la più grande della regione ed è una delle più grandi in Italia: serve una popolazione di 836.697 abitanti ed è distribuita su 50 comuni. E’ stata istituita il 1° gennaio 2004 con la Legge della Regione Emilia Romagna n. 21 del 20/10/2003 che ha unificato i Comuni di tre Aziende USL: “Città di Bologna”, “Bologna Sud” e “Bologna Nord” (ad eccezione del Comune di Medicina che dall’Area Nord è entrato a far parte dell’Azienda USL di Imola che ha mantenuto un’autonoma configurazione giuridica). Il territorio dell’Azienda USL di Bologna si estende per 2915,4 Kmq ed è caratterizzato dalla particolare ubicazione geografica dei suoi distretti. Al Distretto prettamente urbano, quale quello di Bologna Città si affiancano nell’Area Nord i Distretti di pianura quali Pianura Est e Pianura Ovest, mentre nell’Area Sud si collocano i Distretti con territorio più collinare, quali quelli di Casalecchio di Reno e San Lazzaro di Savena ed il Distretto di Porretta Terme che si caratterizza per l’alta percentuale di territorio montuoso. L’unificazione di territori diversi per caratteristiche orografiche, demografiche e socioeconomiche, ha comportato una maggiore complessità rispetto al passato in termini di governo delle condizioni di equità. La rimodulazione istituzionale ed organizzativa dell’offerta dei sevizi sanitari ha comportato il gravoso compito di razionalizzarne la distribuzione, tenendo conto delle peculiarità del contesto. Alcuni studi di fattibilità precedenti l’unificazione, avevano rilevato come attraverso la costituzione di un’Azienda USL unica si sarebbero potuti più agevolmente perseguire gli obiettivi collegati alle prospettive di sviluppo e di ulteriore qualificazione del sistema dei servizi delle Aziende USL dell’area bolognese, con benefici per il complessivo servizio sanitario regionale. Le tre Aziende precedentemente operanti nell’area bolognese erano percepite come inadeguate, per dimensioni, a supportare uno sviluppo dei servizi ritenuto indispensabile per la popolazione ma, che, se singolarmente realizzato, avrebbe condotto ad una inutile duplicazione di servizi già presenti. Attraverso l’integrazione delle attività di acquisizione dei fattori produttivi e di gestione dei servizi delle tre Aziende, si sarebbero potute ragionevolmente conseguire economie più consistenti rispetto a quanto in precedenza ottenuto attraverso il coordinamento volontario di tali processi da parte delle tre Direzioni. L’istituzione della nuova Azienda unica, conformemente al Piano sanitario regionale si proponeva di: o accelerare i processi di integrazione e di redistribuzione dell’offerta dei servizi territoriali, tenendo conto della progressiva divaricazione fra i cambiamenti demografici, che segnavano un crescente deflusso dal centro storico verso le periferie, ed i flussi legati alle attività lavorative, che si muovevano in senso contrario; o riorganizzare i servizi sanitari in una logica di rete e di sistema, condizione necessaria per assicurare l’equità di accesso ai servizi e alle cure, in stretta interlocuzione con gli Enti Locali titolari dei servizi sociali; o favorire il raggiungimento dell’equilibrio finanziario dell’Azienda e contribuire in modo significativo alla sostenibilità finanziaria dell’intero sistema sanitario regionale. L’entità delle risorse impegnate nell’Area bolognese e le dimensioni del bilancio della nuova Azienda unificata offrivano la possibilità di realizzare economie di scala e di scopo, attraverso la concentrazione e/o la creazione di sinergie fra funzioni e attività, sia in ambito ospedaliero, sia territoriale, con un chiaro effetto sull’equilibrio del bilancio dell’intero Servizio sanitario regionale. A cinque anni dalla sua costituzione, l’Azienda USL di Bologna, ha completato una significativa fase del complessivo processo riorganizzativo superando le principali difficoltà dovute alla fusione di tre Aziende diverse, non solo per collocazione geografica e sistemi di gestione, ma anche per la cultura dei propri componenti. La tesi affronta il tema dell’analisi dell’impatto della fusione sugli assetti organizzativi aziendali attraverso uno sviluppo così articolato: o la sistematizzazione delle principali teorie e modelli organizzativi con particolare attenzione alla loro contestualizzazione nella realtà delle organizzazioni professionali di tipo sanitario; o l’analisi principali aspetti della complessità del sistema tecnico, sociale, culturale e valoriale delle organizzazioni sanitarie; o l’esame dello sviluppo organizzativo dell’Azienda USL di Bologna attraverso la lettura combinata dell’Atto e del Regolamento Organizzativo Aziendali esaminati alla luce della normativa vigente, con particolare attenzione all’articolazione distrettuale e all’organizzazione Dipartimentale per cogliere gli aspetti di specificità che hanno caratterizzano il disegno organizzativo globalmente declinato. o l’esposizione degli esiti di un questionario progettato, in accordo con la Direzione Sanitaria Aziendale, allo scopo di raccogliere significativi elementi per valutare l’impatto della riorganizzazione dipartimentale rispetto ai tre ruoli designati in “staff “alle Direzioni degli otto Dipartimenti Ospedalieri dell’AUSL di Bologna, a tre anni dalla loro formale istituzione. La raccolta dei dati è stata attuata tramite la somministrazione diretta, ai soggetti indagati, di un questionario costituito da numerosi quesiti a risposta chiusa, integrati da domande aperte finalizzate all’approfondimento delle dimensioni di ruolo che più frequentemente possono presentare aspetti di criticità. Il progetto ha previsto la rielaborazione aggregata dei dati e la diffusione degli esiti della ricerca: alla Direzione Sanitaria Aziendale, alle Direzioni Dipartimentali ospedaliere ed a tutti i soggetti coinvolti nell’indagine stessa per poi riesaminare in una discussione allargata i temi di maggiore interesse e le criticità emersi. Gli esiti sono esposti in una serie di tabelle con i principali indicatori e vengono adeguatamente illustrati.