Search Our Scientific Publications & Authors

Proc (Bayl Univ Med Cent) 2019 Jan 14;32(1):90-92. Epub 2019 Jan 14.

Texas A&M College of Medicine, College StationTexas.

Bullous pemphigoid (BP) is a blistering dermatosis characterized by an autoimmune response to two hemidesmosomal proteins, BP180 and BP230. We describe a case of an 80-year-old man diagnosed with BP by clinical features, histopathology, and immunosorbent assay who developed milia within resolving BP lesions. Milia formation during recovery is common in cases of mucous membrane pemphigoid and epidermolysis bullosa acquisita but has rarely been reported in cases of BP. Read More

Actas Dermosifiliogr 2019 Mar 26. Epub 2019 Mar 26.

Departamento de Dermatología, Universidad de Tor Vergata, Roma, Lazio, Italia.

Background: Seborrheic keratoses (SK) are easily recognizable by clinical and dermoscopic approach, nevertheless, some lesions act as a simulator of different skin conditions lacking typical clinical and dermoscopic criteria.

Objective: The aim of our study was to find specific dermoscopic features or a global pattern to improve diagnostic skills for challenging SK.

Materials And Methods: We examined 72 atypical SK excised from September 2014 up to September 2017 by using the 2-step algorithm modified by Malvehy (2002) and Argenziano (2003). Read More

J Allergy Clin Immunol Pract 2019 Mar 15. Epub 2019 Mar 15.

Dermatology Department, Clinica Dermatologica Internacional, Marques de Villamagna 8, Madrid, Spain.

West J Emerg Med 2019 Mar 6;20(2):228-231. Epub 2019 Feb 6.

Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, Wisconsin.

Video review for quality and education purposes has been a valued tool for decades. However, the use of this process dropped significantly after the development of the Health Insurance Portability and Accountability Act in the 1990s. Video review was recently reestablished at our institution. Read More

J Med Virol 2019 Feb 22. Epub 2019 Feb 22.

Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy.

Chronic hepatitis delta (CHD) is the most severe chronic hepatitis, with no satisfactory treatment options and severe clinical outcomes. This infection is frequent in the migrant subjects from endemic areas, especially from Africa and East-Europe. The pegylated (PEG)-interferon α (IFN) is limited by side effects and poor response. Read More

Ig Sanita Pubbl 2018 Jul-Aug;74(4):377-387

UO Igiene Ospedaliera, Fondazione Policlinico Gemelli, Roma, Italia.

The management of healthcare facilities has become increasingly complex in recent years, leading to a greater demand for public health physicians in Italy. Public Health physicians are responsible for evaluating community needs, with particular attention to health determinants and, at the same time, to final user feedback. During their training, they must acquire the competencies to manage a wide range of problems. Read More

J Thorac Oncol 2019 Feb 6. Epub 2019 Feb 6.

Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Department of Multidisciplinary Oncology and Therapeutic Innovations. Marseille, France; Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm UMR1068, CNRS UMR7258, Marseille, France.

Introduction: KRAS mutation is the most frequent molecular alteration found in advanced NSCLC; it is associated with a poor prognosis without available targeted therapy. Treatment options for NSCLC have been recently enriched by the development of immune checkpoint inhibitors (ICIs), and data about its efficacy in patients with KRAS-mutant NSCLC are discordant. This study assessed the routine efficacy of ICIs in advanced KRAS-mutant NSCLC. Read More

JAAD Case Rep 2019 Feb 29;5(2):167-169. Epub 2019 Jan 29.

Department of Pathology, Chengdu Second People's Hospital, Sichuan, China.

Eur J Cancer 2019 Mar 24;109:28-35. Epub 2019 Jan 24.

Department of Medicine, Division of Solid Tumor Oncology, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address:

Introduction: HER2 mutations occur in 1-3% of lung adenocarcinomas. With increasing use of next-generation sequencing at diagnosis, more patients with HER2-mutant tumours present for treatment. Few data are available to describe the clinical course and outcomes of these patients when treated with afatinib, a pan-HER inhibitor. Read More

J Trauma Acute Care Surg 2019 Apr;86(4):557-564

From the Division of Trauma, Critical Care, and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Background: As more pneumothoraxes (PTX) are being identified on chest computed tomography (CT), the empiric trigger for tube thoracostomy (TT) versus observation remains unclear. We hypothesized that PTX measuring 35 mm or less on chest CT can be safely observed in both penetrating and blunt trauma mechanisms.

Methods: A retrospective review was conducted of all patients diagnosed with PTX by chest CT between January 2011 and December 2016. Read More

J Nephrol 2019 Jan 10. Epub 2019 Jan 10.

Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy.

Background: The clinical benefits of on-line hemodiafiltration (HDF) versus high-flux membranes hemodialysis (hf-HD) are still debated. In fact, although a superiority of one treatment over the other, especially in terms of mortality, did not emerge from the analysis of clinical trials, improved intradialytic vascular stability and cardiovascular mortality have been observed in patients undergoing HDF rather than hf-HD; the lower removal of sodium (Na) during HDF seems to play a major role. The plasma concentration of Na is the major determinant of plasma tonicity, which, by determining the flow of water between the intracellular and the extracellular compartment, contributes to the vascular refilling process and the maintenance of blood pressure during the hemodialysis treatment. Read More

Front Physiol 2018 4;9:1736. Epub 2018 Dec 4.

Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil.

Blood flow restriction training (BFRT) has been proposed to induce muscle hypertrophy, but its safety remains controversial as it may increase mean arterial pressure (MAP) due to muscle metaboreflex activation. However, BFR training also causes metabolite accumulation that may desensitize type III and IV nerve endings, which trigger muscle metaboreflex. Then, we hypothesized that a period of BFR training would result in blunted hemodynamic activation during muscle metaboreflex. Read More

Korean J Intern Med 2018 Dec 31. Epub 2018 Dec 31.

Division of Rheumatology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea.

J Nephrol 2019 Jan 2. Epub 2019 Jan 2.

Division of Nephrology, Department of Scienze Mediche e Chirurgiche Avanzate, University of Campania "Luigi Vanvitelli", Via M. Longo 50, 80138, Naples, Italy.

Background: Incremental dialysis may preserve residual renal function and improve survival in comparison with full-dose dialysis; however, available evidence is limited. We therefore compared all-cause mortality and residual kidney function (RKF) loss in incremental and full-dose dialysis and time to full-dose dialysis in incremental hemodialysis (IHD) and incremental peritoneal dialysis (IPD).

Methods: We performed a systematic review and meta-analysis of cohort studies of adults with ESRD starting IHD and IPD. Read More

J Dermatol 2019 Feb 14;46(2):158-160. Epub 2018 Dec 14.

Department of Dermatology, No. 1 Hospital of China Medical University, Shenyang, China.

We report a 21-year-old man with recurrent bullous eruptions and severe itching on the lower legs and feet since 5 years of age. Dry, dirty brown, tile-like scales covered his lower legs with dystrophic toenails. Nodular prurigo-like lesions, scarring papules and milia remitted after the bullous eruptions. Read More

J Appl Physiol (1985) 2019 Feb 13;126(2):444-453. Epub 2018 Dec 13.

Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy.

Metaboreflex is a reflex triggered during exercise or postexercise muscle ischemia (PEMI) by metaboreceptor stimulation. Typical features of metaboreflex are increased cardiac output (CO) and blood pressure. Patients suffering from metabolic syndrome display hemodynamic abnormalities, with an exaggerated systemic vascular resistance (SVR) and reduced CO response during PEMI-induced metaboreflex. Read More

Ann Emerg Med 2018 Nov 14. Epub 2018 Nov 14.

Department of Emergency Medicine, University of Texas Health Science Center at Houston, Houston, TX.

Study Objective: The transfusion of older packed RBCs may be harmful in critically ill patients. We seek to determine the association between packed RBC age and mortality among trauma patients requiring massive packed RBC transfusion.

Methods: We analyzed data from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios trial. Read More

Ann Plast Surg 2018 Dec;81(6):657-661

From the Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA.

Background: The prepuce is an excellent donor site for skin grafts with minimal donor site morbidity. Full-thickness grafts are often required for correction of congenital syndactyly and in burn contractures.

Methods: Preputial skin was used for grafting in 18 children: 5 with burn contractures and 13 with congenital syndactyly. Read More

Ann Ig 2018 Sep-Oct;30(5 Supple 2):15-21

Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.

Background: Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Read More

J Dtsch Dermatol Ges 2018 Oct;16(10):1289-1295

Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology and Diabetology, Saarland University Medical Center, Homburg, Germany.

With an incidence of 1 in 700 births, Down syndrome (DS) is not an uncommon condition. It is associated with various disorders of different organ systems. Serious disorders include cardiac defects and leukemia. Read More

J Dtsch Dermatol Ges 2018 Oct;16(10):1289-1296

Universität des Saarlandes, Kliniken für Kinder- und Jugendmedizin, Sektion Pädiatrische Endokrinologie und Diabetologie, Homburg.

Das Down-Syndrom (DS) ist mit einer Inzidenz von 1 : 700 aller Geburten nicht selten und mit diversen Erkrankungen unterschiedlicher Organsysteme assoziiert. Zu den schwerwiegenden Erkrankungen zählen Herzfehler und Leukämie. Letztere zeigt sich im Neugeborenenalter und geht nicht immer in eine klassische myeloische Leukämie über (transiente myeloproliferative Erkrankung). Read More

Am J Med Genet A 2018 Nov 5;176(11):2451-2455. Epub 2018 Oct 5.

Division of Dermatology, Children's National Health System, Washington, District of Columbia.

Basan syndrome is an autosomal dominant ectodermal dysplasia (ED) with congenital adermatoglyphia, transient neonatal acral bullae, and congenital facial milia. Autosomal dominant adermatoglyphia (ADG) is characterized as adermatoglyphia with hypohidrosis. Recently mutations in the skin-specific isoform of the gene SMARCAD1 have been found in both syndromes. Read More

Ann Agric Environ Med 2018 Sep 9;25(3):421-427. Epub 2018 Apr 9.

1st Faculty of Medicine, Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic.

Introduction And Objective: Polychlorinated biphenyls (PCBs) have been used commercially since 1929 as dielectric and insulating non-flammable substances, additives for paints, etc. In Slovakia, 60 chemical production workers highly exposed to PCBs (mainly to Delor 103) were studied with duration of exposure ranging from 3 months to 19 years.

Material And Methods: Clinical examinations of skin, skin histology and laboratory tests concerning lipid metabolism, iron metabolism and levels of copper provided comparisons with a control group of healthy individuals and/or the upper limits of normal values. Read More

J Am Coll Surg 2018 Dec 21;227(6):587-595. Epub 2018 Sep 21.

Center for Translational Injury Research, University of Texas Health Science Center, Houston, TX; Department of Surgery, McGovern Medical School, University of Texas Health Science Center, Houston, TX.

Background: Endotheliopathy of trauma is characterized by breakdown of the endothelial glycocalyx. Elevated biomarkers of endotheliopathy, such as serum syndecan-1 (Synd-1) ≥ 40 ng/mL, have been associated with increased need for transfusions, complications, and mortality. We hypothesized that severely injured trauma patients who exhibit elevated Synd-1 levels shortly after admission have an increased likelihood of developing sepsis. Read More

Forensic Sci Int 2018 Oct 31;291:207-215. Epub 2018 Aug 31.

Forensic Toxicology Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, Florence, Italy; U.R.I.To.N-Unit of Research of University of Florence, Florence, Italy.

In case of drug-facilitated sexual assault (DFSA), the evidence is frequently anecdotal, with few investigations based on scientific evidences being carried out and thus most cases are diagnosed as an acute drug or alcohol intoxication. The reason may lay in the lack of specific knowledge by the victim on the possibility to retrospectively study the allegedly events and to the absence of standardized and shared protocols among health, forensic and police subjects. On this basis, in 2015 the Unit of Forensic Toxicology of University of Florence and the Sexual Assaults Centre in Hospital Careggi have fixed a common protocol to be applied in case of DFSA. Read More

Rev Mal Respir 2018 Dec 10;35(10):1028-1038. Epub 2018 Sep 10.

Service de pneumologie, hôpital Larrey, centre hospitalier universitaire, université Paul-Sabatier, 31059 Toulouse, France. Electronic address:

Introduction: Anti-tumoral immunotherapy is currently the basis of a profound modification of therapeutic concepts in oncology, in particular since the arrival of immune checkpoint inhibitors (ICI). In addition to their efficacy profile, these immune-targeted agents also generate adverse events. With the increasing use of ICI for a growing number of tumor types, awareness of immunotherapy-related adverse events is essential to ensure prompt diagnosis and effective management of these potentially serious adverse events. Read More

J Dermatol 2019 Apr 8;46(4):e136-e137. Epub 2018 Sep 8.

Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan.

Dermatol Surg 2019 01;45(1):83-89

All authors are affiliated with the Department of Dermatology, Aesthetic Surgery, and Intervention Dermatology, Aura Skin Institute, Chandigarh, India.

Background: Noncultured epidermal cell suspension transplantation is a very popular surgical modality for treating vitiligo. However, the procedure can be modified to improve results.

Objective: To study the extent of repigmentation with noncultured trypsinized fragmented epidermal suspension using platelet-rich plasma (PRP) as a suspending agent and pixel erbium yttrium aluminium garnet laser for ablation of recipient area in patients with stable vitiligo. Read More

Int J Occup Med Environ Health 2018 Dec 3;31(6):753-761. Epub 2018 Aug 3.

National Institute of Health, Roma, Italy.

Objectives: The aging of the workforce is an issue that calls for concrete measures to promote the health of older workers. This study reports on the results of the European "ProHealth65+" research project interventions conducted in Poland in relation to workplace health promotion for older workers (WHPOW) and the institutions involved in these programs.

Material And Methods: A three-stage search of peer-reviewed and grey literature on the WHPOW in Poland. Read More

G Ital Nefrol 2018 Jul;35(4)

Divisione di Nefrologia, Dialisi Azienda Ospedaliero Universitaria Policlinico di Modena, Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con Interesse Trapiantologico, Oncologico e di Medicina Rigenerativa. Università di Modena e Reggio Emilia, Modena, Italia.

The Autosomal Dominant Polycystic Kidney Disease(ADPKD) is the most frequent renal genetic condition and involves 7 to 10% of subjects undergoing renal replacement therapy. It is estimated that between 24,000 and 34,000 subjects in Italy are affected by this condition. For an illness that has long been neglected due to a lack of treatment options, an attractive treatment possibility is now available: tolvaptan has shown clinical efficacy regarding disease progression in two clinical trials (ADPKD patients with mild renal failure and ADPKD patients with advanced renal failure). Read More

Colloids Surf B Biointerfaces 2018 Nov 11;171:115-122. Epub 2018 Jul 11.

Dept. of Scienze della Vita e dell'Ambiente, Drug Science Division, University of Cagliari, 09124 Cagliari, Italy.

The aim of the work was to extract, characterize, and formulate Thymus capitatus (Tymbra capitata) essential oil in phospholipid vesicles: liposomes, glycerosomes and Penetration Enhancer-containing Vesicles (PEVs). The steam-distilled essential oil was mainly composed of carvacrol. The oil was mixed with lecithin and water to produce liposomes, or different ratios of water/glycerol or water/propylene glycol (PG) to produce glycerosomes and PG-PEVs, respectively. Read More

J Thorac Oncol 2018 Oct 11;13(10):1595-1601. Epub 2018 Jul 11.

Department of Medicine, Cantonal Hospital Lucerne, Luzern, Switzerland.

Introduction: In ret proto-oncogene (RET)-rearranged lung cancers, data on the frequency of brain metastases and, in particular, the outcomes of multikinase inhibitor therapy in patients with intracranial disease are not well characterized.

Methods: A global, multi-institutional registry (cohort A, n = 114) and a bi-institutional data set (cohort B, n = 71) of RET-rearranged lung cancer patients were analyzed. Patients were eligible if they had stage IV lung cancers harboring a RET rearrangement by local testing. Read More

Indian J Med Res 2018 04;147(4):361-368

Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi, India.

Background & Objectives: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer mortality. The objective of this study was to find out the differential expression of apolipoproteins (ApoAI and ApoAIV) in HCC and cases of liver cirrhosis and chronic hepatitis (controls) without HCC and to compare ApoAI and ApoAIV expression with alpha-foetoprotein (AFP), the conventional marker in HCC.

Methods: Fifty patients with HCC and 50 controls comprising patients with liver cirrhosis (n=25) and chronic hepatitis (n=25) without HCC were included in this study. Read More

J Nephrol 2019 Apr 5;32(2):231-239. Epub 2018 Jul 5.

Department of Nephrology, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80037, Naples, Italy.

Achievement of sodium and fluid balance is considered a major determinant of dialysis adequacy in peritoneal dialysis (PD). However, the contribution of different PD modalities to dialytic sodium removal (DSR) remains ill-defined. We performed a systematic review and meta-analysis to compare DSR by manual (continuous ambulatory PD, CAPD) versus automated PD (APD). Read More

Biochemistry 2018 07 5;57(28):4206-4213. Epub 2018 Jul 5.

Department of Chemical Sciences , Tata Institute of Fundamental Research , Homi Bhabha Road , Colaba, Mumbai 400005 , India.

Structure-based "rational" drug design strategies fail for diseases associated with intrinsically disordered proteins (IDPs). However, structural disorder allows large-amplitude spontaneous intramolecular dynamics in a protein. We demonstrate a method that exploits this dynamics to provide quantitative information about the degree of interaction of an IDP with other molecules. Read More

J Cutan Med Surg 2018 May/Jun;22(3):356-358

2 Division of Dermatology and Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Epidermolysis bullosa acquisita (EBA) is a rare acquired type of mechanobullous disease affecting the dermal-epidermal junction (DEJ) of trauma prone acral surfaces. It manifests as tense vesicles, bullae, and milia and typically heals as atrophic hypo- or hyperpigmented scars. Classic noninflammatory mechanobullous EBA typically presents at a mean age of 48 years. Read More

Lett Appl Microbiol 2018 Sep 17;67(3):244-253. Epub 2018 Jul 17.

Division of Veterinary Microbiology & Immunology, FVSc & A.H., Shuhama (Aulesteng), SKUAST-K, Shalimar, India.

Currently used alum precipitated and oil adjuvant vaccines against HS caused by Pasteurella multocida B:2, have side effects and short-lived immunity, leading to regular catastrophic outbreaks in bovines in Asian subcontinent. The need for the development of an improved vaccine with longer immunity and the ability to differentiate between vaccinated and infected is essential. Pasteurella phage isolated in present study belongs to family Siphoviridae. Read More

J Cosmet Dermatol 2019 Feb 28;18(1):301-302. Epub 2018 May 28.

Skin Disease Centre, Nashik, India.

Pigmented transverse nasal band (PTNB) is an interesting morphological entity mainly of cosmetic concern. It is believed to be related to a defect in the development of the nasal cartilages and bones from childhood to adolescence. Some patients may have genetic predisposition. Read More

Int J Dermatol 2018 Sep 28;57(9):1102-1106. Epub 2018 May 28.

Consultant Dermatologist, Salmaniya Medical Complex, Manama, Bahrain.

Bazex-Dupré-Christol syndrome is a rare genodermatosis that manifests with the classical triad of basal cell carcinoma, follicular atrophoderma, and hypotrichosis; yet it may be accompanied by milia, ichthyosis, neurological symptoms, and visceral malignancies. Symptom onset is nonsimultaneous, and hence the diagnosis is often made late and the opportunity of counseling and following up is missed. This article aims toward providing a comprehensive review of the clinical perspective of Bazex-Dupré-Christol syndrome, highlighting the major clinical variants to facilitate reaching a prompt diagnosis. Read More

CMAJ 2018 May;190(20):E623

Faculty of Medicine, University of Ottawa, Ottawa, Ont.

Nephrol Dial Transplant 2018 Nov;33(11):1896-1904

Department of Nephrology and Dialysis, Alessandro Manzoni Hospital ASST Lecco, Lecco, Italy.

Despite the technological and pharmacological advancements in the last 30 years, morbidity and mortality of dialysis patients are still astonishingly high. Today, convective treatments, such as high-flux haemodialysis (hf-HD) and haemodiafiltration (HDF), are established techniques; the online production of fresh pure dialysate has provided clinical and economic advantages. Nevertheless, the actual benefits of HDF, even with high-convective-volume treatments, are still debatable. Read More

Neuron 2018 Mar;97(6):1268-1283.e6

Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01605, USA. Electronic address:

To identify novel genes associated with ALS, we undertook two lines of investigation. We carried out a genome-wide association study comparing 20,806 ALS cases and 59,804 controls. Independently, we performed a rare variant burden analysis comparing 1,138 index familial ALS cases and 19,494 controls. Read More

Actas Dermosifiliogr 2019 Jan - Feb;110(1):71-74. Epub 2018 Mar 13.

Servicio de Dermatología, Hospital de la Sant Creu i Sant Pau, Barcelona, España.

Niger J Clin Pract 2018 Mar;21(3):395-396

Dermatology Unit, Department of Medicine, Barau Dikko Teaching Hospital, Kaduna, Nigeria.

Milia are multiple, small, benign keratin-filled superficial epidermoid cysts which are classified as primary when they occur spontaneously or secondary when they result from skin trauma or disease. Multiple eruptive milia (MEM) refer to a condition characterized by a sudden eruption of a large number of milia. MEM may be familial, occur as part of a genodermatosis, or occur spontaneously when they are termed idiopathic. Read More

G Ital Dermatol Venereol 2018 Mar 6. Epub 2018 Mar 6.

Dermatology Unit "Daniele Innocenzi", Dept of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy -

Rev Gastroenterol Peru 2017 Oct-Dec;37(4):394-398

Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú.

The present case is a 56 year old male who present hyperpigmented and hypopigmented scars in both hands, associated with the presence of milia cysts. It was studied the metabolism of porphyrins and skin biopsy of the lesions which were compatible with porphyria cutanea tarda. In the initial laboratory, elevated transaminases values were found and subsequently identified chronic infection of hepatitis C virus. Read More

J Clin Virol 2018 04 31;101:18-22. Epub 2018 Jan 31.

Laboratory of Microbiology and Virology, Amedeo di Savoia Hospital, Turin, Italy.

Background: Zika virus (ZIKV) remains a public health concern due to its association with fetal malformation and neurologic disease.

Objective: To report a reference centre experience on ZIKA virus (ZIKV) infection in travelers from epidemic countries from January 1 to September, 30, 2016 in Italy North-West (a geographic area covering 4.424 million inhabitants, corresponding to almost 73% of Italy North-West area). Read More