Rare and complicated forms of infantile hemangiomas: new therapeutic outlooks

Infantile hemangiomas (IHs) are the most common benign neoplastic pathology of childhood; their natural history generally involves three phases: after the onset, which usually occurs in the first weeks of life, there is the proliferation phase where the IH reaches its maximum development and it is followed by the spontaneous involution which leads to the IH regression. The duration and the extent of these phases may vary widely even though in most of the cases the involution process begins around twelve months of life and the regression, complete or partial, is completed around seventh-ninth year of life. The majority of the IHs does not require any treatment. However, 10%-20% is likely to develop serious complications, functional impairments or aesthetic alterations and entail a timely treatment. Although there is no treatment protocol currently shared, therapies usually used in cases with a complication risk consist in: systemic or intralesional steroids as a first choice; interferon α, vincristine and/or bleomicin as second or third choice and/or surgical treatment. Propranolol, a non-selective beta-blocker, has been used for cardiovascular diseases even in childhood for decades. Since 2008 it has been widely used in the IHs treatment, although it is still "off-label". In literature there are hundreds of cases and some clinical studies that show the effectiveness and safety of this drug for this indication. Thanks to a multidisciplinary team (Dermatologists, Cardiologists, Paediatricians, and Radiologists) of S. Orsola-Malpighi Hospital, a clinical study, which has been previously approved by the ethics committee, is carried out in order to evaluate the efficacy and safety of systemic propranolol in the treatment of IHs in paediatric age. At the end of 2012, 78 patients underwent this treatment: the results we have obtained so far show a good efficacy and safety profile in agreement with the data provided by the literature.

Il contributo della psicopatologia ansiosa materna prenatale sul temperamento infantile e la relazione precoce madre-bambino

La sintomatologia ansiosa materna nel periodo prenatale risulta influire negativamente non sullo stato materno ma anche sul successivo sviluppo infantile, Tuttavia, sono limitati gli studi che hanno considerato lo specifico contributo dei disturbi d’ansia nel periodo prenatale. L’obiettivo generale dello studio è quello di indagare nel primo periodo post partum la relazione tra psicopatologia ansiosa materna e: temperamento e sviluppo neonatale, qualità del caregiving materno e dei pattern interattivi madre-bambino. 138 donne sono state intervistate utilizzando SCID-I (First et al., 1997) durante il terzo trimestre di gravidanza. 31 donne (22,5%) presentano disturbo d’ansia nel periodo prenatale. A 1 mese post partum il comportamento del neonato è stato valutato mediante NBAS (Brazelton, Nugent, 1995), mentre le madri hanno compilato MBAS (Brazelton, Nugent, 1995). A 3 mesi postpartum, una sequenza interattiva madre-bambino è stata videoregistrata e codificata utilizzando GRS (Murray et al., 1996). La procedura dello Stranger Episode (Murray et al., 2007) è stata utilizzata per osservare i pattern interattivi materni e infantili nell’interazione con una persona estranea. I neonati di madri con disturbo d’ansia manifestano alle NBAS minori capacità a livello di organizzazione di stati comportamentali, minori capacità attentive e di autoregolazione. Le madri ansiose si percepiscono significativamente meno sicure nell’occuparsi di loro, valutando i propri figli maggiormente instabili e irregolari. Nell’interazione face to face, esse mostrano comportamenti significativamente meno sensibilI, risultando meno coinvolte attivamente con il proprio bambino. Durante lo Stranger Episode, le madri con fobia sociale presentano maggiori livelli di ansia e incoraggiando in modo significativamente inferiore l’interazione del bambino con l’estraneo. I risultati sottolineano l’importanza di valutare in epoca prenatale la psicopatologia ansiosa materna. Le evidenze confermano la rilevanza che può assumere un modello multifattoriale di rischio in cui i disturbi d’ansia prenatali e la qualità del caregiving materno possono agire in modo sinergico nell’influire sugli esiti infantili.

Studies on the dual in Mycenaean, in the Homeric poetry and in the Attic Theatre of the 5th century — morphological, dialectal and stylistical variations

The present dissertation focuses on the dual number in Ancient Greek in a diachronical lapse stretching from the Mycenaean age to the Attic Drama and Comedy of the 5th century BC. In the first chapter morphological issues are addressed, chiefly in a comparative perspective. The Indo European evidence on the dual is hence gathered in order to sketch patterns of grammaticalisation and paradigmatisation of specific grams, growing increasingly functional within the Greek domain. In the second chapter syntactical problems are tackled. After a survey of scholarly literature on the Greek dual, we engage in a functional and typological approach, in order to disentangle some biased assessments on the dual, namely its alleged lack of regularity and intermittent agreement. Some recent frameworks in General Linguistics provide useful grounds for casting new light on the subject. Internal Reconstruction, for instance, supports the facultativity of the dual in each and every stage of its development; Typology and the Animacy Hierarcy add precious cross linguistical insight on the behaviour of the dual toward agreement. Glaring differences also arise as to the adoption — or avoidance — of the dual by different authors. Idiolectal varieties prove in fact conditioned by stylistical and register necessity. By means of a comparison among Epics, Tragedy and Comedy it is possible to enhance differences in the evaluation of the dual, which led sometimes to forms of ‘censure’ — thus triggering the onset of competing strategies to express duality. The last two chapters delve into the tantalising variety of the Homeric evidence, first of all in an account of the notorious issue of the Embassy of Iliad IX, and last in a commentary of all significant Homeric duals — mostly represented by archaisms, formulae, and ad hoc coinages.

The Bible in Medieval Love Lyrics: A Fundamental Element of European Poetry Books

The focus of this study is the relationship among three different manuscripts (Modena, Bibl. Estense, MS α.R.4.4; Firenze, Bibl. Laurenziana MS Rediano 9; and London, BL, MS Harley, 2253) and the poetry they transmit. The aim of this research is to show the ways that the Bible was used in the transmission of the lyric poetry in the three literatures that they represent: Occitan (primarily through Marcabru’s songs), Italian (through the love poetry of Guittone d’Arezzo), and Middle English (through the Harley love lyrics and the MS.’s primary scribe), in a medieval European context.