Author name: aventino

Following the full-scale Russian invasion of Ukraine, psychoanalysts across Europe organized volunteer initiatives to support colleagues, patients, and families affected by the war. One such initiative was an online mothers’ group facilitated by the author. This article brings together excerpts from the testimonies of two Ukrainian psychoanalytic psychotherapists and mothers who participated in the group. The excerpts have been edited and rearranged while preserving the authors’ original words. The full version of this article is published in ‘Child and Adolescent Psychoanalysis in Times of Crisis War, Pandemic and Climate Change’, edited by Kristin. Fiorella and published by Routledge in 2025. Mary Cassatt (1844–1926), The Child’s Bath, 1893. Olio su tela. The Beginning KATERYNA Before the war started, I lived comfortably in my country and had a private psychotherapy practice. Together with my beloved husband, we were raising our son, had bought a house and were planning to renovate it in preparation for the arrival of our daughter. I never planned to emigrate when I was eight months pregnant. I could not even imagine in my worst nightmares that I would give birth under the explosions of enemy rockets and that our first days with our daughter would take place in a bomb shelter. I could not imagine that my fear of death would become so real that it would manifest itself in a desire to hold my daughter constantly, even when there was no need or threat. TETIANA The war took us by surprise. But I was already familiar with the first powerful explosions I heard at five in the morning on 24 February. My heart was pounding, and tears were streaming down my face. I felt a sticky, hot déjà vu from the summer of 2014 in Donetsk. For a moment I was immersed in memories of a wonderful family and peaceful life. Then, with the Russian invasion, I lost everything at once. I could not believe that the situation was repeating itself. My heart cried out in denial, but reality broke into my consciousness with terrible explosions from all sides. In the first days of the war, when I was full of despair and fear, my six-month-old son did not seem to react at all to the events around him. He remained as cheerful and lively as ever. One moment stands out in my memory. Almost at midnight, a powerful bombardment began and everything around us exploded loudly. We took the children to the stairwell next to the lift and just stood there, trembling from the sound of the deadly shells. I held the baby in my arms and tried to talk to him, and he babbled back, looked into my eyes and smiled. At that moment, a wild fear for my children’s lives overwhelmed me. At the same time, I was relieved that my baby was fine and did not seem frightened at all. Birth KATERYNA The war caught me at the beginning of my eighth month of pregnancy. I refused to even think about giving birth in a cellar or a bomb shelter. Photographs of the first women giving birth in underground and metro shelters horrified me. I could not believe in this reality or that I would have to face it directly. I dreamed that my child would be born in my hometown, accompanied by a doctor I trusted and in partnership with my husband. I imagined that we would return home with our daughter to our son and gradually get used to our new family member. I felt that all the conditions were in place to give this child a basic sense of security and safety in the world I would be bringing her into. A woman enters the maternity ward with one identity and leaves with another. But in the harsh reality of war, with constant sirens and being in a bomb shelter with a newborn in my arms, this space was transformed into something damaged, further increasing my regression and fears. I was lucky. Our first meeting with my daughter was in the delivery room, not the bomb shelter, and we managed to enjoy the silence in each other’s strong embrace for the first hour and a half. But soon the chaos began and the siren went off. Shortly afterwards we heard that two cruise missiles had fallen near the maternity hospital. That day, my daughter and I spent time in the corridor and in the bomb shelter. Tears streamed uncontrollably down my face. Inside me and around me echoed the question: “When will this nightmare end?” TETIANA Almost a year later, after we had reached safety, the neighbors started setting off fireworks. Suddenly my son started screaming, grabbed his clothes and pulled me down the stairs. It struck me that he seemed to be experiencing the same thing I had experienced when I held him to my heart to the sound of cannon fire. When he slept, he would cling to my neck as if to prevent me from falling if I suddenly had to run somewhere. I also felt much calmer having him close. In this way I felt I could protect him better, shielding him with my body in case of danger. Käthe Kollwitz (1867–1945), Die Mütter (Le Madri), 1921–1922. Xilografia. Leaving TETIANA I had fled Donetsk under fire with two children, and now I had a newborn with winter outside. For the first few days I was in a state of utter shock and helplessness, with an almost animal fear for my children’s lives. Somewhere around the fifth day, after another terrifying night in a cold basement with a screaming baby, I realized that I had to secure a safe place for all of us. If something happened to me, who would look after them? My emotions ranged from helplessness to inner strength and determination. The fear of danger on the road for my baby was extremely heavy for me, but staying was much more dangerous. We were very lucky to reach the station, board a train

Small bites, major discomfort Article prepared by the specialists of Aventino Medical Group.Scientific review: Dr Megon Bresciani, Specialist in Allergology; Dr Paola Groff, Specialist in Paediatrics. Mosquito bites For many people, mosquitoes are simply a summer nuisance. In fact, they are the insects that most frequently come into contact with humans during the warmer months, causing millions of bites every year. In recent decades, the Asian tiger mosquito (Aedes albopictus) has spread throughout much of Italy alongside the common mosquito. It is easily recognisable by the distinctive black-and-white stripes on its legs and body. Where are they found? Mosquitoes need water to reproduce and can breed in even very small amounts of it. They are frequently found: The common mosquito is particularly active from dusk until dawn, whereas the Asian tiger mosquito mainly bites during the daytime, with peaks in activity during the early morning and late afternoon. How does a mosquito bite? Only female mosquitoes bite, as they use blood as a source of nutrients for the development of their eggs. When biting, the mosquito injects a small amount of saliva containing anticoagulant substances into the skin. It is this saliva that triggers the inflammatory reaction responsible for the itching. What symptoms do mosquito bites cause? In most cases, the following symptoms appear: Children and people who are allergic or particularly sensitive may experience more pronounced reactions, with extensive and persistent swelling. Children with atopic conditions, for example, may develop particularly noticeable local reactions, with red and swollen areas that can reach several centimetres in diameter and persist for a few days. What about horseflies? A horsefly does not sting: it bites, superficially tearing the skin in order to feed on blood. This is why a horsefly bite is often more painful than a mosquito bite. It may cause immediate pain, redness, swelling, itching, and sometimes a small superficial wound. In most cases, it causes an unpleasant but harmless local reaction. More rarely, extensive swelling or allergic reactions may occur and require medical assessment. Why are some people bitten more than others? Many people feel that they are mosquitoes’ “favourite victims”, and this is partly true. Mosquitoes are attracted by: For this reason, some people are bitten much more frequently than others, even when they are in the same environment. When should you be concerned? In most cases, mosquito bites are harmless. It is advisable to consult a doctor if: 🦟 Can mosquitoes in Italy transmit diseases? For most people in Italy, mosquito bites remain nothing more than a minor local nuisance. However, the Asian tiger mosquito is closely monitored by public health authorities because it can transmit certain viruses, including chikungunya, dengue, and Zika, after biting an infected person and subsequently biting other people. The disease most frequently associated with the Asian tiger mosquito in Italy is chikungunya. The name of this viral disease literally means “that which bends”, referring to the severe joint pain that can characterise it. Its main symptoms include: In most cases, people recover spontaneously, although joint pain may persist for several weeks or, more rarely, for several months. Fortunately, the risk for people living or spending a holiday in Italy remains low and should not cause alarm. However, it is advisable to consult a doctor if high fever, severe joint pain, or unusual symptoms develop after numerous mosquito bites or following a trip to a tropical or subtropical country. 💡 Good to know: the presence of the Asian tiger mosquito is one of the reasons why mosquito-control programmes and the elimination of stagnant water are considered important public health measures. What should you do after a mosquito bite? ✅ Applying a cold compress can quickly reduce itching and swelling. The following may be helpful: The most important rule, however, is to avoid scratching, as scratching encourages inflammation and secondary infections. How can mosquito bites be prevented? Prevention is the most effective strategy. 🧴 Use suitable insect repellents on the skin. 👕 Wear lightweight clothing that covers the skin during the times of day when mosquitoes are most active. 🪟 Install mosquito screens in the home. 💧 Remove stagnant water from plant saucers, watering cans, and outdoor containers. 👶 For young children, it is preferable to use mosquito netting over pushchairs and cots rather than relying exclusively on insect repellents. Did you know…? Only female mosquitoes bite. They need the proteins found in blood to support the maturation of their eggs. A mosquito can detect a person from dozens of metres away. Carbon dioxide, body heat, and skin odours help it locate its target. In summary 📍 Where? Gardens, parks, terraces, balconies, and areas with stagnant water. 📍 When? From spring to autumn. 📍 Main symptom? Itching and localised swelling. 📍 Main risk? Inflammatory reactions and, rarely, the transmission of viruses such as chikungunya. 📍 First aid? Cold compresses and soothing creams. 📍 Prevention? Insect repellents, mosquito screens, and the elimination of stagnant water. Concerns after an insect bite? Book an appointment with one of the Aventino Medical Group specialists directly online.

Small, silent, and often underestimated Article prepared by the specialists of Aventino Medical Group.Scientific review: Dr Guido Castelli Gattinara, Specialist in Infectious Diseases; Dr Luigi Cornacchia, Specialist in Dermatology; Dr Paola Groff, Specialist in Paediatrics. Unlike mosquitoes, ticks do not bite in self-defence, but in order to feed. Once attached to the skin, a tick may remain unnoticed for many hours or even several days. The bite is generally painless, which is why many people only notice the tick while showering or changing their clothes after a walk. Where are ticks found? Contrary to popular belief, ticks do not live in trees and do not jump onto people. They are mainly found: They are particularly active from spring to autumn. In Italy, they are most commonly found at altitudes below 1,400 metres, although they may also be present at higher elevations in some mountainous areas. How does a tick bite occur? Ticks position themselves on grass or low-growing shrubs and attach themselves to animals or people as they pass by. Once they reach the skin, they look for a warm, concealed area in which to attach, such as: Because tick saliva contains anaesthetic substances, the bite often goes unnoticed. What should you do if you find a tick? ✅ Early removal is the most important measure. Use fine-tipped tweezers: Whenever possible, note the date of the bite to help with any subsequent medical assessment. What should you not do? ❌ Do not crush the tick with your fingers. ❌ Do not use oil, alcohol, acetone, petroleum jelly, or other substances in an attempt to “suffocate” it. ❌ Do not burn it with a match or cigarette. These methods may increase the risk of transmission of infectious agents. Why do tick bites require attention? The main concern is not the bite itself, but the possibility that some ticks may transmit infections. The best known is Lyme disease, caused by a bacterium transmitted through the bite of certain tick species. In some parts of Europe, ticks may also transmit TBE, or tick-borne encephalitis, a viral infection for which an effective vaccine is available. The risk of transmission increases the longer the tick remains attached to the skin. What symptoms may develop? In most cases, a tick bite causes no consequences. However, after a tick bite, it is advisable to monitor the skin and your general health for approximately one month and watch for the possible appearance of: Erythema migrans is one of the most characteristic signs of Lyme disease. How can tick bites be prevented? Prevention is particularly important during hikes and outdoor activities. 🧴 Apply repellents containing DEET, or diethyltoluamide, to exposed skin. 👖 Treat clothing with permethrin-based products, which are particularly useful during hikes and activities in high-risk areas. 🥾 Wear closed shoes and long trousers. 👖 Tuck the bottoms of your trousers into your socks when hiking in high-risk areas. 🚿 Check your skin carefully when you return and take a shower as soon as possible. 🐕 Check pets as well, as they may carry ticks into the home. When should you consult a doctor? It is advisable to consult a doctor if: Did you know…? The sooner a tick is removed, the lower the risk of transmission of certain infections. This is why it is important to check the skin after hikes and walks in natural areas. A tick can be as small as a sesame seed. During its immature stages, it may be so small that it can easily go unnoticed. In summary 📍 Where? Meadows, woodlands, countryside, and walking trails. 📍 When? From spring to autumn. 📍 Main symptom of the bite? Often none. 📍 Main risk? Transmission of infections such as Lyme disease. 📍 First aid? Correct and prompt removal of the tick. 📍 Prevention? Appropriate clothing, repellents, and checking the skin after outdoor activities. Concerns after a tick bite? In most cases, no specific treatment is required. However, if the tick remained attached for a long time, if unusual symptoms develop, or if you are unsure whether it was removed correctly, a medical assessment may be helpful. The Dermatology, Infectious Diseases, Internal Medicine, and Paediatrics specialists at Aventino Medical Group can assist adults and children with the management and monitoring of tick bites. At Aventino Medical Group, you can also receive advice on the prevention of tick-borne diseases and, when indicated, be vaccinated against TBE, or tick-borne encephalitis.

One of the most feared animals, yet rarely aggressive Article prepared by the specialists at Aventino Medical Group.Scientific review: Dr Alessandro Cristaudo, Specialist in Internal Medicine; Dr Paola Groff, Specialist in Paediatrics. Few creatures cause as much concern as the viper. Yet despite its bad reputation, this snake generally tries to avoid contact with humans and bites almost exclusively when it feels threatened or is accidentally stepped on. In Italy, vipers are found in many regions, particularly in hilly and mountainous areas. Encounters may occur during hikes, but bites remain relatively rare events. Where are vipers found? Vipers prefer quiet, sunny environments with plenty of hiding places. They are more commonly encountered: They are particularly active from spring through autumn. During the hottest hours of the day, they may be seen basking in the sun on rocks, trails or stone walls. How can you recognise a viper? Some features are fairly typical: However, confidently distinguishing a viper from other harmless snakes can be difficult, even for experienced people. For this reason, it is always best to keep your distance and avoid trying to identify it at close range, capture it or kill it. How does the bite occur? A viper does not attack humans in order to hunt them. Bites generally occur when: Many hikers do not see the animal until the moment of contact. What symptoms can it cause? The bite is generally painful from the outset. The most common symptoms are: Two small, closely spaced puncture marks left by the venomous fangs are often visible, although their absence does not completely rule out a bite. In more significant cases, the following may occur: Severity depends on several factors: Viper bite: what happens over the following hours? A viper bite is not always equally severe. In some cases, it may be a “dry bite”, meaning that no significant amount of venom has been injected. In other cases, however, the venom causes local and systemic symptoms that may develop over the following hours. During the first few minutes, the following usually appear: Over the following hours, the swelling may increase and spread upwards along the limb. The following may occur: Significant symptoms often appear within the first few hours, but medical observation is necessary because the condition may worsen progressively. Are children at greater risk? Yes. For the same amount of venom, a child receives a proportionally larger dose than an adult. For this reason, every suspected viper bite in a child requires urgent medical assessment. Particular caution is also required in older people, pregnant women and people with chronic medical conditions. 🐍 Do vipers really chase people? No. This is one of the most widespread and least substantiated beliefs. A viper tends to move away when it detects vibrations or noise and prefers to avoid contact with humans. Most bites occur because the animal is accidentally stepped on or because someone tries to approach it too closely. 💡 Good to know: many people who have been bitten report that they did not see the viper before the incident. What should you do after a bite? ✅ Stay calm.✅ Move away from the animal.✅ Keep the person still, preferably lying down.✅ Immobilise the affected limb as much as possible.✅ Remove rings, bracelets, tight shoes or restrictive clothing, as swelling may increase rapidly.✅ Call 112 or reach an Emergency Department as quickly as possible.✅ If possible, use a pen to mark the edge of the swelling and write down the time, to help doctors assess its progression. If the snake is still visible, it may be useful to remember what it looked like or photograph it from a distance, without exposing yourself to further risk. What should you do if you are far from a medical facility? The most important thing is to minimise movement. Walking, running or becoming agitated may promote the spread of the venom. If you are on a trail, in the mountains or in an isolated area, it is better to stop and arrange for emergency assistance. If possible: ✅ call 112 immediately;✅ keep the person calm and lying down;✅ immobilise the affected limb with an improvised splint or simply keep it still;✅ prevent the person from walking;✅ protect the person from heat or cold while waiting for help;✅ monitor their general condition, breathing and level of consciousness. If transport is unavoidable, the person who has been bitten should exert as little effort as possible. What should you NOT do? ❌ Do not cut the wound.❌ Do not suck out the venom.❌ Do not apply a tourniquet.❌ Do not tighten the limb with improvised compression bandages.❌ Do not apply ice directly to the wound.❌ Do not give alcohol.❌ Do not run to seek help.❌ Do not attempt to capture or kill the snake. These practices, although once widespread, are ineffective and may worsen the situation. Is there any medication you should carry with you? No. Carrying viper antivenom is neither useful nor recommended. Antivenom must only be administered in hospital, following medical assessment and under monitoring, because it can cause serious reactions and is not indicated in every case. What does make sense to carry during a hike is a small, practical kit containing: After a suspected viper bite, it is prudent to avoid aspirin and anti-inflammatory medicines such as ibuprofen or ketoprofen, unless otherwise advised by a doctor, because they may interfere with bleeding or blood clotting. Treatment in hospital In the Emergency Department, the patient is monitored through: Antivenom is not always administered. It is reserved for cases involving signs of significant envenomation, systemic symptoms or marked worsening of the local condition. The decision is made by the doctor, often in consultation with a Poison Control Centre. How can bites be prevented? Prevention is simple and highly effective. 🥾 Wear hiking boots or closed shoes during walks and hikes.👖 Choose long trousers on trails with tall vegetation.👀 Watch where you place your hands and feet.🪵 Take care when moving stones or piles of firewood.🚶

The danger hidden beneath the sand Article prepared by the specialists at Aventino Medical Group.Scientific review: Dr Alessandro Cristaudo, Specialist in Internal Medicine; Dr Luigi Cornacchia, Specialist in Dermatology. Many tourists have never heard of it, yet the weever fish, also known as the greater weever or spider fish, is probably responsible for some of the most painful stings occurring on Italian beaches every summer. Where does it hide? This small fish lives on sandy seabeds and spends much of the day partially buried in the sand, with only its eyes and venomous dorsal spines protruding. It is most commonly found: How does the sting occur? The sting is almost always accidental. While walking through shallow water, a person may step on the fish hidden beneath the sand. To defend itself, the weever fish raises its dorsal spines, which penetrate the skin and inject venom. What symptoms can it cause? ⚠️ Pain begins immediately and is often extremely intense, sometimes described as a burning sensation or an electric shock. Within a few minutes, the following may develop: More sensitive individuals may also experience: What should you do? ✅ Weever fish venom is heat-sensitive, meaning that it is inactivated by heat. For this reason, the most effective treatment is to immerse the affected area in very warm water at a temperature of approximately 40–45°C for at least 30 minutes, taking care not to cause burns. How can stings be prevented? Prevention is simple: 👟 Wear water shoes or protective beach footwear when walking through shallow water. Another useful precaution is to shuffle the feet gently along the sandy seabed. The vibrations tend to make the fish move away before contact occurs. Did you know? The weever fish spends much of the day hidden beneath the sand. Although it is often only 10–30 centimetres long, it can be almost invisible to beachgoers walking through shallow water. Even a dead weever fish can still sting Its venomous spines remain dangerous and the fish should always be handled with care. In summary 📍 Where? Sandy seabeds and shallow water.📍 When? Mainly during the summer and when the sea is calm.📍 Main symptom? Immediate and extremely intense pain.📍 First aid? Warm water for at least 30 minutes.📍 Prevention? Water shoes and caution when walking over sandy seabeds. Concerns after a sting or bite? If the pain is severe, your symptoms worsen, or you develop difficulty breathing, feel generally unwell, or experience other significant symptoms, go to the nearest Emergency Department. For non-urgent concerns, you can book an appointment at Aventino Medical Group.

The housemate that prefers not to be seen Article prepared by the specialists at Aventino Medical Group.Scientific review: Dr Guido Castelli Gattinara, Specialist in Infectious Diseases; Dr Alessandro Cristaudo, Specialist in Internal Medicine. Few animals cause as much fear as spiders. Yet the good news is that most spiders found in Italy are completely harmless to humans. Two species, however, regularly attract media attention and raise many questions: the violin spider and the Mediterranean black widow, known in Italian as the malmignatta. The reality is less alarming than it is often portrayed online, but it is still worth learning about these animals, knowing where they are found and recognising the situations that require medical assessment. Violin spider: the housemate that prefers not to be seen The violin spider (Loxosceles rufescens) is found across much of Italy, particularly in the central and southern regions. Its name comes from a distinctive dark marking on the cephalothorax that vaguely resembles the shape of a violin. It is not always easy to see with the naked eye, but this marking is the origin of the common name “violin spider”. Contrary to popular belief, it does not mainly live in forests or gardens. It prefers dry, dark and undisturbed places such as: It is a shy animal and is mainly active at night. How does the bite occur? The violin spider is not aggressive and does not attack humans. Bites almost always occur accidentally: Can it really bite while you are sleeping? Yes, it can happen, but not because the spider actively seeks out humans. The violin spider is not aggressive and generally prefers to hide. Because it is nocturnal, a bite may occur if the spider is accidentally trapped and crushed between the skin and the bed sheets, or between the skin and an item of clothing. Even in these cases, the bite is therefore caused by accidental contact, not by an attack. What symptoms can it cause? This is where many misunderstandings begin. In most cases, the bite causes: Many people do not even realise that they have been bitten. In a minority of cases, a more significant lesion may develop and worsen over the following hours or days, causing: The lesion may become relatively large and may take several weeks to heal. An important clarification 🕷️ Not all skin lesions attributed to the violin spider are actually caused by this spider. Many bacterial infections, bites or stings from other insects, and small infected wounds are mistakenly identified as violin spider bites. For this reason, a definite diagnosis is often difficult. When should you consult a doctor? Medical assessment is advisable if: Mediterranean black widow: the black widow of the Mediterranean The Mediterranean black widow (Latrodectus tredecimguttatus), known in Italian as the malmignatta, belongs to the same family as the black widow spiders found in other parts of the world. It is a shiny black spider, often characterised by red spots on its abdomen. Fortunately, it is much less common than the violin spider. Where is it found? It prefers: It is mainly encountered in the central and southern regions of Italy. How does the bite occur? The Mediterranean black widow is also not particularly aggressive. Bites generally occur: What symptoms can it cause? Unlike the violin spider, the Mediterranean black widow mainly causes systemic symptoms. After a bite, the following may occur: The symptoms can be very alarming but, in most cases, they resolve favourably with appropriate treatment. 🕷️ Spider bites: when should you really be concerned? Most spider bites observed in Italy do not require urgent treatment. Prompt medical attention is recommended if any of the following symptoms occur: Young children, older people and medically vulnerable individuals always require particular attention. What should you do after a suspected spider bite? ✅ Wash the area with soap and water.✅ Apply a cold compress.✅ Monitor the lesion over the following hours.✅ Taking photographs of the lesion may be useful for documenting how it changes over time. If the spider can be observed without taking any risks, a photograph may help the doctor identify it. How can bites be prevented? Prevention is simple and highly effective. 🧤 Wear gloves when handling boxes, firewood or materials that have been left undisturbed for a long time.👟 Check shoes and clothing that have been left outdoors or in a garage.📦 Take care when clearing out cellars, attics or storage areas.🌾 Wear gloves and suitable clothing when carrying out agricultural or gardening work. Did you know? Many spiders are useful in homes and gardens. They help to naturally control mosquitoes, flies and other small insects. The violin spider does not build the classic geometric spider webs. It prefers to hide in quiet, rarely disturbed places, where it produces irregular and barely visible strands of silk. In summary 📍 Where? The violin spider is mainly found in indoor environments; the Mediterranean black widow is found in the countryside and rural areas.📍 When? More frequently during the warmer months.📍 Main symptom of a violin spider bite? A skin lesion that may worsen over time.📍 Main symptom of a Mediterranean black widow bite? Muscle cramps and systemic symptoms.📍 First aid? Washing, cold compresses and observation.📍 Prevention? Gloves and caution around shoes, boxes, firewood and rarely used environments. Concerns after a sting or bite? If you experience severe pain, worsening of the lesion, fever, or feel generally unwell, seek prompt medical attention or go to the nearest Emergency Department. For non-urgent concerns, you can book an appointment at Aventino Medical Group.

The caterpillar you should never touch Article prepared by the specialists at Aventino Medical Group.Scientific review: Dr Megon Bresciani, Specialist in Allergology; Dr Paola Groff, Specialist in Paediatrics. The pine processionary is a caterpillar known for its distinctive way of moving: the caterpillars often travel in a line, one behind the other, forming a true “procession”. It is important to recognise this caterpillar because, although it does not sting or bite, it is covered with urticating hairs that can cause severe irritation to the skin, eyes and respiratory tract. Where is it found? The pine processionary caterpillar is mainly found near pine trees, where it builds clearly visible whitish, cotton-like nests among the branches. It may be encountered: The caterpillars descend from the trees and move across the ground, often in a line, especially from late winter through spring. However, the risk of exposure to their urticating hairs may persist during the following months. Why is it dangerous? The problem is not a bite, but contact with the urticating hairs. These hairs are extremely small, invisible to the naked eye and equipped with tiny hooks that allow them to cling easily to the skin and mucous membranes. They can: For this reason, direct contact with the caterpillar is not necessary for a reaction to occur. What symptoms can it cause? Contact with the urticating hairs may cause: Children may be particularly curious about the caterpillars moving in a line and are therefore at greater risk of directly touching them with their hands or coming into contact with them on the face and around the eyes. 🌲 What happens after exposure to pine processionary caterpillars? Once they penetrate the tissues, the urticating hairs release irritating substances that can trigger a sometimes very intense inflammatory reaction. Skin contact The most common reaction is irritant dermatitis characterised by: Symptoms may appear within a few minutes or several hours later. They mainly affect exposed areas such as the arms, legs, neck and face. In children, the itching may be particularly intense and lead to scratching, increasing the risk of a secondary skin infection. Eye contact If the hairs enter the eyes, they may cause: In these cases, it is important not to rub the eyes and to seek medical advice, as the hairs may remain trapped in the conjunctiva. Inhalation of urticating hairs When carried by the wind, the hairs may be inhaled. Symptoms may include: People with asthma or respiratory allergies may develop more pronounced symptoms. Contact with the mouth and mucous membranes More rarely, particularly in young children, the hairs may enter the mouth. In this case, they may cause: Can allergic reactions occur? Yes, although they are uncommon. In predisposed individuals, exposure may cause: If any of these symptoms occur, immediate assessment at an Emergency Department is necessary. 💡 Good to know: many people believe that there is a risk only when the caterpillar is touched. In reality, on windy days symptoms may develop even without direct contact, simply by spending time near infested trees. Be careful with pets Dogs and cats, especially dogs, are particularly at risk because they may sniff or lick the caterpillars. In dogs, exposure may cause: In these cases, a veterinarian should be contacted immediately. What should you do after exposure? ✅ Move away from the affected area.✅ Avoid scratching or rubbing the skin.✅ Remove contaminated clothing and wash it.✅ Rinse the skin thoroughly with plenty of water.✅ If the eyes are affected, rinse them with sterile saline solution.✅ Consult a doctor if the symptoms are severe or if the eyes, mouth or respiratory tract are involved. What should you NOT do? ❌ Do not touch the caterpillars.❌ Do not crush pine processionary caterpillars.❌ Do not handle their nests.❌ Do not scratch irritated skin.❌ Do not allow children or pets to approach them. The nests must be removed by specialised professionals. How can exposure be prevented? Prevention mainly involves recognising the risk. 🌲 Look for white nests in pine trees.🚸 Supervise children in parks and pine forests.🐕 Keep dogs on a lead in areas where there may be a risk.👀 Avoid areas where infestations have been reported.🏡 Report nests found in public spaces or shared residential areas. Did you know? Even when pine processionary caterpillars are no longer visible, their urticating hairs may remain in the environment. During the summer, exposure may occur through residues left on abandoned nests, tree bark, the ground or pine needles. For this reason, nests or suspicious material found beneath pine trees should never be touched. The pine processionary spends almost its entire life as a caterpillar and only a few days as an adult moth. After the eggs hatch, the caterpillar lives on pine trees for approximately seven to nine months. It then burrows into the ground and develops into a pupa, a stage that may last from several weeks to several months. The adult moth emerges during the summer and generally lives for less than a week, just long enough to mate and lay its eggs. In summary 📍 Where? Pine forests, parks, gardens and areas with pine trees.📍 When? Mainly from late winter through spring, although the urticating hairs may persist in the environment.📍 Main symptoms? Itching, dermatitis and irritation of the eyes or respiratory tract.📍 Main risk? Contact with the skin, eyes or mouth, or inhalation of the urticating hairs.📍 First aid? Wash the affected area, do not rub it and remove contaminated clothing.📍 Prevention? Do not touch caterpillars or nests, and supervise children and pets. Concerns after a sting or bite? Book an appointment with one of the specialists at Aventino Medical Group directly online.

The Mediterranean Sea’s Most Common Marine Encounter Article prepared by the specialists of Aventino Medical Group.Scientific review: Dr. Megon Bresciani, Specialist in Allergology; Dr. Paola Groff, Specialist in Pediatrics. A refreshing swim in crystal-clear waters, a calm summer day at the beach, and suddenly an intense burning sensation on your skin: jellyfish stings are among the most common summer hazards along the Italian coastline. Fortunately, in most cases they are not serious. However, understanding how jellyfish behave and knowing the correct first-aid measures can significantly reduce pain and help prevent complications. Where are jellyfish found? Jellyfish are a natural part of the Mediterranean marine ecosystem and can be found along all Italian coastlines. They are more commonly encountered: Some species are carried close to the shore by winds or sea currents, increasing the likelihood of contact with swimmers. Even a jellyfish that appears dead after being washed ashore may still have active stinging cells for several hours. How does a jellyfish sting occur? Contrary to popular belief, jellyfish do not intentionally sting people. When the skin comes into contact with their tentacles, thousands of microscopic stinging cells called nematocysts are triggered, releasing irritating substances into the skin. The severity of the reaction depends on several factors: What symptoms does it cause? Symptoms usually appear immediately after contact. The most common signs include: The skin lesion often resembles the mark left by a whip, following the path of the tentacle. In the following days, some symptoms may persist, including: When should you seek medical advice? In most cases, the reaction remains limited to the affected area. However, you should consult a doctor if: 🌊 Are Mediterranean jellyfish dangerous? Most jellyfish species found in Italian waters cause mainly pain, burning sensations and skin irritation. Serious complications are uncommon. However, some individuals may develop more significant reactions, including: The risk increases after extensive contact with the tentacles or in particularly sensitive individuals. 💡 Good to know: Most jellyfish stings occurring on Italian beaches do not cause permanent damage and resolve completely within a few days. What should you do after a jellyfish sting? ✅ Leave the water calmly. ✅ Rinse the affected area only with seawater. ✅ Carefully remove any visible tentacle fragments using a rigid object (such as the edge of a card) or fine tweezers. ✅ Apply cold compresses wrapped in a cloth. If necessary, a doctor may recommend specific creams or medications to relieve pain and reduce inflammation. What should you NOT do? ❌ Do not rinse the affected area with fresh water. ❌ Do not rub the skin with sand or towels. ❌ Do not scratch the lesion. ❌ Do not apply improvised home remedies unless recommended by a healthcare professional. These actions may trigger additional nematocysts to discharge, worsening the skin reaction and increasing discomfort. How can you prevent jellyfish stings? Although prevention is not always possible, a few simple precautions can significantly reduce the risk. 🏖️ Check sea conditions before entering the water. 👀 Pay attention to lifeguard warnings and beach safety notices. 🤿 Wear a protective swim shirt or a lightweight wetsuit during prolonged swimming or water sports. 🌊 Avoid touching jellyfish, whether they are floating in the water or washed up on the beach. 👶 Closely supervise children in areas where jellyfish have been reported. Did you know? Jellyfish existed long before dinosaurs. They have inhabited the world’s oceans for hundreds of millions of years and are among the oldest living organisms still found on Earth today. Jellyfish have no brain, no heart and no bones. Yet they are still able to move, orient themselves and respond to changes in their marine environment. In summary 📍 Where? Open sea, sheltered bays and coastal waters. 📍 When? Most commonly during the summer months and on calm sea days. 📍 Main symptom? Immediate burning sensation with redness of the skin. 📍 Main risk? Severe pain, extensive skin irritation and allergic reactions in susceptible individuals. 📍 First aid? Rinse with seawater, remove any remaining tentacles and apply cold compresses. 📍 Prevention? Pay attention to beach warnings, avoid contact with jellyfish and wear protective clothing during water activities. Concerned after a sting or bite? If the pain is severe, your symptoms worsen, or you develop difficulty breathing, feel generally unwell, or experience other significant symptoms, go to the nearest Emergency Department. For non-urgent concerns, you can book an appointment at Aventino Medical Group.

Pain, swelling or allergy? Article prepared by the specialists of Aventino Medical Group.Scientific review: Dr Megon Bresciani, Allergy Specialist; Dr Alessandro Cristaudo, Internal Medicine Specialist. A sugary drink left on the table, an ice cream eaten on the beach or a picnic in the countryside: bees, wasps and hornets are part of the Italian summer and, in most cases, coexist peacefully with people. Stings are very common during the warmer months and generally cause only localised pain and swelling. In some situations, however, they can become a genuine medical emergency. Where are they found? Bees, wasps and hornets are found throughout much of Italy. They are frequently encountered: Wasps and hornets are particularly attracted to: What is the difference between a bee, a wasp and a hornet? 🐝 A bee tends to sting only in self-defence. After stinging, it leaves its stinger in the skin and generally dies. 🐝 A wasp is more aggressive and can sting repeatedly without losing its stinger. 🐝 A hornet is larger than a wasp and often causes concern because of its size, but it is not necessarily more aggressive. Its sting can, however, be particularly painful. How does a sting occur? Stinging is a defensive mechanism used by the insect. It may occur: During the sting, venom is injected into the skin, causing an immediate inflammatory reaction. What symptoms do they cause? In most cases, the following symptoms occur: Symptoms tend to improve within a few hours or days. In children, the swelling may appear particularly noticeable, especially when the sting affects the hands, feet or face. When should you be concerned? Certain situations require particular attention. ⚠️ Multiple stings Receiving numerous stings at the same time increases the amount of venom injected and may cause general symptoms even in people who are not allergic. ⚠️ Stings inside the mouth or throat These can cause swelling that obstructs the airway and require urgent medical assessment. ⚠️ Allergic reactions In sensitised individuals, even a single sting may cause a severe allergic reaction known as anaphylaxis. Particular concern is required when breathing symptoms or a feeling of faintness occur in addition to swelling at the site of the sting. 🚑 When does a sting become an emergency? Emergency services must be called immediately, or the person must go to the Emergency Department, if any of the following occur: These symptoms may develop within a few minutes of the sting and require immediate treatment. 💡 Good to know: people who have previously experienced a serious allergic reaction should always carry the adrenaline auto-injector prescribed by their doctor. What should you do after a sting? ✅ If a stinger is present, as may occur after a bee sting, it should be removed as quickly as possible. It should be removed gently, taking care not to squeeze the venom sac further. The following measures may be helpful: Ice should not be applied directly to the skin but wrapped in a cloth. In the event of a serious allergic reaction, difficulty breathing, facial swelling or general symptoms, do not wait for medication taken at home to work. Call the emergency services immediately or go to the Emergency Department. How can stings be prevented? Prevention is particularly important during outdoor activities. 🥤 Always check glasses and cans before drinking. 👟 Avoid walking barefoot on grass. 🍉 Cover food and drinks during outdoor meals. 👕 Choose neutral-coloured clothing and avoid particularly strong perfumes during hikes or picnics. 🚗 When driving, keep the windows closed in areas where bees, wasps and hornets are particularly common. 🤲 When bees or wasps are nearby, avoid sudden movements and do not try to crush them. Did you know? Only bees almost always leave their stinger in the skin.Wasps and hornets can sting several times without losing their stinger. An allergic reaction can develop even after years of stings without any previous problems.Breathing difficulties, facial swelling or widespread hives should therefore never be underestimated. Unsure what to do after a sting? In most cases, pain and swelling resolve spontaneously. However, if significant symptoms, extensive reactions or doubts about the nature of the reaction occur, a medical assessment can help distinguish a normal inflammatory response from an allergic reaction. The Allergy, Internal Medicine, Dermatology and Paediatrics specialists at Aventino Medical Group are available to assess and manage insect stings in adults and children. In summary 📍 Where? Gardens, countryside, parks and areas where food is eaten outdoors.📍 When? Mainly from late spring to early autumn.📍 Main symptom? Immediate pain with redness and swelling.📍 Main risk? Allergic reactions and stings in critical areas such as the mouth or throat.📍 First aid? Remove the stinger, apply a cold compress and monitor the symptoms.📍 Prevention? Pay attention to food and drinks, avoid sudden movements and do not walk barefoot. Unsure what to do after a sting or bite? If you experience difficulty breathing, widespread swelling, or any other signs of a severe allergic reaction, call the emergency services (112/118) or go to the nearest Emergency Department immediately. For non-urgent concerns, you can book an appointment at Aventino Medical Group.

Small Summer Encounters, Big Questions About Your Skin Article prepared by the doctors of Aventino Medical Group: Luigi Cornacchia, Dermatology Specialist; Megon Bresciani, Allergy Specialist; Guido Castelli Gattinara, Infectious Diseases Specialist; Paola Groff, Paediatrics Specialist; Alessandro Cristaudo, Internal Medicine Specialist. Summer in Italy is synonymous with holidays, walks in nature, days at the seaside and outdoor activities. However, it is precisely in the most beautiful places of the season that people may come into contact with insects, marine animals or other organisms capable of causing stings, bites or skin irritation. In most cases, these are unpleasant but harmless episodes that resolve spontaneously within a few days. In some situations, however, it is important to recognise quickly the warning signs that require medical assessment. How can you tell whether it is a simple mosquito bite or something that deserves greater attention? Which mistakes should be avoided? And when is it necessary to consult a doctor? This guide provides an overview of the main risks associated with summer in Italy and will help you understand quickly what to do. At a glance: what might have stung or bitten you?  If you notice… It could be… What to do immediately An itchy raised bump Mosquito Apply something cold and avoid scratching A tick attached to the skin Tick Remove it correctly Severe pain and immediate swelling Bee, wasp or hornet Apply ice and monitor the symptoms Red streaks and burning after swimming Jellyfish Rinse with seawater Very severe pain in the foot while in the sea Weever fish Immerse the foot in hot water Two small puncture marks with increasing swelling Viper Keep the affected area still and go to the Emergency Department Itching and dermatitis after contact with caterpillars or pine trees Pine processionary caterpillar Wash the affected area thoroughly A skin lesion that worsens over the following days Possible Mediterranean recluse spider bite Seek medical assessment The Most Common Insect Stings and Bites Insect stings and bites are undoubtedly the most common summer problem. Mosquitoes generally cause itching and small areas of localised swelling, whereas bees, wasps and hornets cause immediate pain and a more noticeable inflammatory reaction. For most people, the problem remains limited to the affected area. However, some individuals may develop severe allergic reactions requiring urgent medical treatment. 👉 Learn more: Mosquito Bites and Tiger Mosquitoes: Remedies, Prevention and When to Consult a Doctor 👉 Learn more: Wasp, Bee or Hornet Sting: What to Do Immediately, Allergy Symptoms and When to Go to the Emergency Department Ticks: Small but Not to Be Underestimated Ticks are particularly common during hikes, walks in woodland areas or activities in the countryside. Their bite is generally painless and often goes unnoticed. The reason they require attention is their ability to transmit certain infections, including Lyme disease, which must be treated with antibiotics. Early and correct removal of the tick is the most important measure. 👉 Learn more: Tick Bite: What to Do, How to Remove a Tick and Symptoms of Lyme Disease Hazards at Sea: Jellyfish and Weever Fish The Mediterranean Sea offers wonderful opportunities for leisure, but it can also hold a few surprises. Jellyfish are responsible for many episodes of burning and skin irritation during the summer. Fortunately, in most cases they cause only local symptoms. The weever fish is less well known, but it can cause extremely severe pain when accidentally stepped on in shallow sandy waters. 👉 Learn more: Jellyfish Sting: What to Do Immediately, Effective Remedies and Mistakes to Avoid 👉 Learn more: Weever Fish Sting: What to Do Immediately, Symptoms and Remedies for Pain The Animals That Cause the Most Fear When people think about summer bites, vipers and spiders are probably the animals that cause the greatest concern. In reality, both the Mediterranean recluse spider and the viper tend to avoid contact with humans, and accidents are relatively uncommon. This does not mean that they should be underestimated: knowing the symptoms and understanding how to respond can make an important difference. 👉 Learn more: Viper Bite: Symptoms, What to Do Immediately and When to Go to the Emergency Department 👉 Learn more: Mediterranean Recluse Spider and Black Widow Spider Bites: Symptoms, Pictures, What to Do and When to Worry Pine Processionary Caterpillars: A Risk Many People Do Not Know About The pine processionary caterpillar does not sting or bite, but it has tiny irritating hairs that can cause inflammation of the skin, eyes and respiratory tract. Children and pets are particularly exposed because they may be attracted by the distinctive caterpillars moving in a line. 👉 Learn more: Pine Processionary Caterpillars: Symptoms Affecting the Skin, Eyes and Respiratory Tract and What to Do After Contact When Should You Seek Medical Advice Quickly? Regardless of the animal involved, certain symptoms should always be taken seriously. A medical assessment is advisable if any of the following occur: A Small Useful Kit to Take on Holiday When spending a great deal of time outdoors, it may be useful to carry: People with severe allergies to insect stings should always carry the medication prescribed by their specialist. Frequently Asked Questions About Summer Stings and Bites How can you tell whether a sting or bite is dangerous? It is advisable to consult a doctor if there is difficulty breathing, swelling of the face, fever, significant pain or progressive worsening of the lesion. Which bites or stings can transmit diseases? In Italy, ticks represent the main infectious risk, while some mosquitoes may occasionally transmit viral diseases. When should you go to the Emergency Department? In the event of a severe allergic reaction, breathing difficulties, a viper bite, multiple stings or general symptoms such as dizziness and fainting. Are children at greater risk? Children spend more time outdoors and may notice stings or bites only after some time. It is therefore useful to check their skin after hikes, days at the seaside or activities in parks. Which animals most frequently cause problems during the summer? Mosquitoes, ticks, bees, wasps, hornets, jellyfish,