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Search Results: 1 - 10 of 585 matches for " Emiliano Giostra "
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A capillary blood ammonia bedside test following glutamine load to improve the diagnosis of hepatic encephalopathy in cirrhosis
Saskia Ditisheim, Emiliano Giostra, Pierre R Burkhard, Nicolas Goossens, Gilles Mentha, Antoine Hadengue, Laurent Spahr
BMC Gastroenterology , 2011, DOI: 10.1186/1471-230x-11-134
Abstract: To make a diagnosis of HE, we explored the value of ammonia in capillary blood, an equivalent to arterial blood, measured at bedside following an oral glutamine challenge.We included 57 patients (age 56 yrs; M/F: 37/20) with cirrhosis (alcoholic = 42; MELD score 13.8 [7-29], esophageal varices = 38) and previous episodes of HE (n = 19), but without neurological deficits at time of examination, and 13 healthy controls (age 54 yrs). After psychometric tests and capillary (ear lobe) blood ammonia measurements, 20 gr of glutamine was administered orally. Tests were repeated at 60 minutes (+ blood ammonia at 30'). Minimal HE was diagnosed if values were > 1.5 SD in at least 2 psychometric tests. Follow-up lasted 12 months.The test was well tolerated (nausea = 1; dizziness = 1). Patients showed higher values of capillary blood ammonia over time as compared to controls (0'-30'-60 minutes: 75, 117, 169 versus 52, 59, 78 umol/L, p < 0.05). At baseline, 25 patients (44%) had minimal HE, while 38 patients (67%) met the criteria for HE at 60 minutes (chi2: p < 0.01). For the diagnosis of minimal HE, using the ROC curve analysis, baseline capillary blood ammonia showed an AUC of 0.541 (CI: 0.38-0.7, p = 0.6), while at 60 minutes the AUC was 0.727 (CI: 0.58-0.87, p < 0.006). During follow-up, 18 patients (31%) developed clinical episodes of HE. At multivariate analysis, the MELD score (1.12 [1.018-1.236]), previous episodes of HE (3.2[1.069-9.58]), but not capillary blood ammonia, were independent predictors of event.In patients with cirrhosis and normal neurological examination, bedside determination of ammonia in capillary blood following oral glutamine load is well tolerated and achieves a better diagnostic performance for minimal HE than basal capillary ammonia levels. However, capillary blood ammonia is a poor predictor of development of clinically overt HE.Hepatic encephalopathy (HE) is a common complication of cirrhosis that affects quality of life, increases the risk of a
Early liver biopsy, intraparenchymal cholestasis, and prognosis in patients with alcoholic steatohepatitis
Laurent Spahr, Laura Rubbia-Brandt, Muriel Genevay, Antoine Hadengue, Emiliano Giostra
BMC Gastroenterology , 2011, DOI: 10.1186/1471-230x-11-115
Abstract: We studied 163 patients (age 55 yrs [35-78], male/female 102/61) with recent, heavy (> 80 gr/day) alcohol intake, histologically-proven ASH (97% with underlying cirrhosis, Maddrey's score 39 [13-200], no sepsis), who had a liver biopsy performed 3 days [0-10] after hospital admission for clinical decompensation. A semi-quantitative evaluation of steatosis, hepatocellular damage, neutrophilic infiltration, periportal ductular reaction, intraparenchymal cholestasis, and iron deposits was performed by two pathologists. All patients with a Maddrey's score ≥ 32 received steroids. The outcome at 3 months was determined. Statistical analysis was performed using the Wilcoxon and Fisher's exact tests, Kaplan-Meier method, and the Cox proportional hazard model.43 patients died after 31 days [5-85] following biopsy. The 3-month survival rate was 74%. Mean kappa value for histological assessment by the two pathologists was excellent (0.92). Univariate analysis identified age, the Maddrey's score, the Pugh's score, the MELD score and parenchymal cholestasis, but not other histological features, as factors associated with 3-month mortality. At multivariate analysis, age (p = 0.029, OR 2.83 [1.11-7.2], intraparenchymal cholestasis (p = 0.001, OR 3.9 [1.96-7.8], and the Maddrey's score (p = 0.027, OR 3.93 [1.17-13.23] were independent predictors of outcome. Intraparenchymal cholestasis was more frequent in non survivors compared to survivors (70% versus 25%, p < 0.001). Serum bilirubin was higher in patients with severe compared to those with no or mild intraparenchymal cholestasis (238 [27-636] versus 69 [22-640] umol/l, p < 0.001).In this large cohort of patients with histologically documented ASH early after admission and no sepsis, liver biopsy identified marked intraparenchymal cholestasis as an independent predictor of poor short term outcome together with age and the Maddrey's score. It may be hypothesized that incorporation of this particular variable into existing disease
Hyperimmune anti-HBs plasma as alternative to commercial immunoglobulins for prevention of HBV recurrence after liver transplantation
Florian Bihl, Stefan Russmann, Vanina Gurtner, Loriana Di Giammarino, Loredana Pizzi-Bosman, Martine Michel, Andreas Cerny, Antoine Hadengue, Pietro Majno, Emiliano Giostra, Damiano Castelli, Gilles Mentha
BMC Gastroenterology , 2010, DOI: 10.1186/1471-230x-10-71
Abstract: Fresh frozen plasma obtained from blood donors with high anti-HBs levels (hyperimmune plasma, HIP) containing at least 4,500 IU anti-HBs was used as alternative treatment for HBV recurrence prophylaxis post-LT.Twenty-one HBV-related LT recipients received HIP starting at transplantation, followed by long-term combination treatment with NA. Mean follow-up time was 4.5 years (range 0.5-12.6) and each patient received on average 8.2 HIP per year (range 5.8-11.4). Anti-HBs terminal elimination kinetic after HIP administration was 20.6 days (range 13.8-30.9), which is comparable to values reported for commercial HBIG products. All 21 patients remained free of HBV recurrence during follow-up and no transfusion-transmitted infection or other serious complication was observed. Seven patients developed reversible mild transfusion reactions. The cost for one HIP unit was US$140; average yearly HBIG treatment cost was US$1,148 per patient, as compared to US$25,000-100,000 for treatment with commercial HBIG.The results of this study suggest that the use of HIP may be a useful and economical approach for the prevention of HBV recurrence post-LT if used in combination with NA. Additional prospective controlled studies in larger populations are needed to confirm these results.Without prophylactic treatment up to 80% of HBV-related liver transplantation (LT) recipients develop recurrent HBV infection after LT leading to graft damage, organ failure and increased morbidity and mortality [1-4]. Passive immunoprophylaxis with hepatitis B immune globulins (HBIG) in combination with nucleos(t)ide analogues (NA), such as lamivudine or adefovir, is highly effective for the prevention of HBV reinfection with reported HBV recurrence in only 0-10% of patients during long-term follow up after LT [5-7].However, the costs of HBV reinfection prophylaxis with intravenous HBIG are extremely high and economic aspects become an important issue in the long-term care of these patients. The estimated co
Simulacros: arte, subjetividad y resistencia
Discusiones Filosóficas , 2010,
Abstract: in this paper i intend to show how it is possible starting with a rupture with the platonic model of thought to give rise to a consideration of aesthetics and subjectivity as fields of politic experimentation. such field of experimentation can be considered in the very core of platonic work, out of the dispute that this maintains with the artist and that leads him to expel them from the polis. in this expulsion of pretense plato intends to secure the good order of the city, to enclose art within the limits of mimesis and representation. this paper suggests to think about art and politics beyond representation because only overcoming plato's condemnation, art opens the field of resistance by which it introduces what is not presentable: the new.
Ecólogos y mega-minería, reflexiones sobre por qué y cómo involucrarse en el conflicto minero-ambiental
Ecolog?-a austral , 2009,
Abstract: the number of large scale mining operations has been increasing greatly in argentina during the last decade. because large scale mining demands the surrender of large natural areas and the extensive use of toxic substances (e.g., cyanide), it has resulted in social and environmental conflicts of diverse magnitude. an array of different social subjects has publicly stated their support or opposition to mining activities. conversely, professional societies (i.e., asociación argentina de ecología [asae] and sociedad argentina para el estudio de los mamíferos [sarem]) with active participation of ecologists have been absent from the debate. here i argue that both asae and sarem should become publicly involved the mining-environmental conflict not only to fulfill their foundational objectives (contributing to the protection and conservation of argentina's natural heritage) but also because of the scientific-technical character assumed by the documents developed and presented by mining companies (e.g., environmental impact assessments [eia], monitoring plans and reports). potential mechanisms for involvement include: active participation in the evaluation of documents produced by mining companies, public dissemination of these evaluations, collaboration with state agents responsible for evaluating eias and monitoring programs, planning and implementation of legal action against those professionals and public officers who endorse low quality technical documents, and promotion of ethical behavior within the field of ecology.
Racionalización y comunización en la esfera económica. Los matices del individualismo en la teoría de la modernidad weberiana
Emiliano Torterola
Papeles del CEIC , 2010,
Abstract: La lectura de textos clave de la teoría de la modernidad en Weber –como La ética protestante y el espíritu del capitalismo e Historia económica general- podría llevarnos a afirmar que la racionalización de la esfera económica conduce a una constante impersonalización y formalización de las relaciones societales. Sin embargo, tal teoría presenta ciertos matices, tanto desde una perspectiva histórico-cultural como a la luz de algunas categorías sociológicas weberianas. El presente artículo, tiene por objeto complejizar las interpretaciones más usuales de la teoría sociológica de comienzos del siglo XX –incluyendo la de Weber- en torno a la formación del individualismo económico moderno como epicentro del pasaje de los cálidos lazos comunitarios a los instrumentalizados vínculos asociativos. / By reading Weber’s main texts about the theory of modernity – such as The Protestant Ethic and the Spirit of Capitalism and General Economic History- the con-clusion could be reached that the rationalization of the economic sphere leads to an ongoing depersonal-ization and to the formalization of societal relationships. However, his theory does have certain shades to it, both from a historical-cultural perspective as under the light of some main Weberian sociological categories. The aim of this article is to discuss the complexities concealed by the most usual interpretations of the sociological theory at the beginnings of the 20th Cen-tury –including that of Weber– concerning the development of the modern economic individual as epicenter of the passage from the warm communal bonds to the instrumental associative relationships.
Love of Machines. Antynomies of Machine in Polish Modernism Mi o maszyn. Antynomie maszyny w polskim modernizmie
Emiliano Ranocchi
Studi Slavistici , 2012,
Abstract: Also for Polish modernism the machine comes to be a synecdoche of modernity as a whole. In contrast to the fetishistic approach to machines that characterized Italian futurism and to the economic utilitarian attitude of Russian futurism, which saw machines as an instrument of proletarian emancipation, in 1923 the leader and chief theoretician of Polish futurism, Bruno Jasieński, introduced (in Polish Futurism: a balance) the vision of the machine as a prosthesis, a continuation of the human body. This essay starts from Jasieński’s proposition and, by means of an aware?? anachronism, makes use of the 20th century categories of cyborgs to try to describe and interpret an extensive passage of the unique novel of a forgotten Polish writer from the period between the two World wars, Jerzy Sosnkowski. The novel in question is called A Car, You and Me (Love of Machines) and was published in 1925. Chapter VIII of the novel describes the main character’s dystopian dream about machines taking control over the world dooming the human race to extinction. Among 20th century cyborg categories, the ones that appear to be especially useful are those that cross the confines between human and machine and between human and animal. In this case we are dealing with machines described as huge animals. Although the machines theriomorphous shape seems to bypass man, they retain certain key features in common with us, such as sexual desire. Besides the cyborgs, another category (usually applied to man-machine resemblance) proved effective in trying to analyze Sosnkowski’s animal machines, an aesthetic and psychoanalytical one, that of the Uncanny. Although the dystopian character of the dream is due to the fact that machines have no feelings, hence their effectiveness and superiority over men, Sosnkowski seems to have had a foreboding of another possibility: an intelligent machine (in the novel represented by the main character’s car), which empathetically understands and realizes what the man is thinking and feeling. This intuition, which predicts current research into contemporary robotics, makes this text worth remembering. Also for Polish modernism the machine comes to be a synecdoche of modernity as a whole. In contrast to the fetishistic approach to machines that characterized Italian futurism and to the economic utilitarian attitude of Russian futurism, which saw machines as an instrument of proletarian emancipation, in 1923 the leader and chief theoretician of Polish futurism, Bruno Jasieński, introduced (in Polish Futurism: a balance) the vision of the machine as a pros
I contratti a contenuto patrimoniale nel diritto canonico
Emiliano Nicolini
Stato, Chiese e Pluralismo Confessionale , 2011,
Abstract: Il contributo è stato segnalato dal Prof. Vittorio Parlato, già ordinario di Diritto ecclesiastico nella Facoltà di Scienze politiche dell’Università degli Studi di Urbino “Carlo Bo”. SOMMARIO: 1. Il tema - 2. Il contratto di alienazione e la canonizzazione del diritto civile territoriale – 2.1. Gli atti di alienazione come atti di straordinaria amministrazione – 2.2. Tipi di rinvio al diritto civile territoriale, in specie italiano, e limiti - 2.3. I contratti in genere - 2.3.1. Criteri di collegamento con il diritto civile territoriale - 2.4. – I criteri di collegamento con il diritto civile territoriale nei contratti ‘in specie’ - 3. Le condizioni di validità e liceità della fattispecie alienatoria – 3.1. L’alienazione canonicamente invalida - 3.2. L’applicazione del limite del diritto divino - 4. La prescrizione.
Registro faunístico Pleistoceno Antiguo de Atapuerca (Burgos)
Aguirre, Emiliano
Trabajos de Prehistoria , 1995,
Abstract: Faunal lists are presented of the successive beds, either excavated or sampled, in four different sections of the localities at Atapuerca and lbeas de Juarros, Burgos. Considerations follow on the climate and other ecological conditions which may have influenced fossil preservation and the paleofaunal composition of each bed. Correlations are considered between the different sections of Atapuerca and European local fauna. Lower beds of Gran Dolina (TD.3-6) and Penal (TP.3-7) yield abundant remains of a known faunal association lasting with little change from late Early Pleistocene (after Jaramillo) to the West-Runton Freshwater Beds (Cromer Forest Beds). The upper beds of Atapuerca in Gran Dolina (TD.10-11) and the 'Tres Simas' complex (CTS3) are correlated on the ground of their faunal assemblages with those of the mid-upper Middle Pleistocene of Europe, La Fage, Bilzingsleben, Swanscombe, Steinheim 2, Castel di Guido, Malagrotta, Ehringsdorf, which may be correlated to OIS episode 9, or 7. The intermediate beds of Gran Dolina (TD.7-8) have not yet been excavated; the excavation of the intermediate unit of the Tres Simas Complex (CTS.2) was started on/y recently, so that the present author only knows its faunal content from early sampling.It can be predicted that these assemblages, when recovered, will resemble those known from Mauer, L'Escale, Belle-Roche, Cava Pompi, Arago, Lunel-Viel, Westbury 2, which represent major faunal changes in Europe over 500 kaBP and about 400 kaBP. The fossil humans and associated remains in Sima de los Huesos probably correspond to that median part of the Middle Pleistocene. Additional considerations deal with ecological factors that may have influenced the European faunal associations over that time span, with archaeological remains related lo them. Changes are shown, and questions posed for future research. Se presentan listas paleofaunísticas provisionales de cortes distintos en las localidades de Atapuerca e Ibeas de Juarros (Burgos). Los niveles inferiores de Gran Dolina (TD.3-6) contienen constantes restos de la asociación faunística conocida desde el final del Pleistoceno Inferior (post-Jaramillo) hasta las Freshwater Beds de West Runton (Cromer). Las capas superiores en Gran Dolina (TD.1O-11) y en el complejo Tres Simas (CTS.3) se correlacionan por sus conjuntos faunísticos con los de Europa del Pleistoceno Medio medio-alto, como La Fage, Swanscombe, Steinheim 2, Bilzingsleben, Castel di Guido (c.300 kaBP), Ehringsdorf. Los fósiles humanos y restos asociados de Ursus deningeri en Sima de los Huesos" correspond
La industria ósea primitiva de Torralba
Emiliano Aguirre
Munibe Antropologia-Arkeologia , 2005,
Abstract: La observación repetida de ciertos estigmas no explicables por agentes o procesos naturales en fragmentosm óseos de elefantes y otros mamíferos del yacimiento mesopleistoceno de Torralba del Moral (Soria), con repeticiones también insólitas en tama os y formas, fueron interpretadas por F.C. Howell, P. Biberson y E. Aguirre como producto de una industria de artefactos de huesos, cuerno y dientes. Su elaboración aparecía menos compleja que la industria paleolítica y se vino a referir como "industria ósea poco elaborada". No se ha comparado con l a"osteodontoquerática" de R. Dart. En 1964, Biberson y Aguirre rompieron huesos de elefante africano actual como contraste experimental de su interpretación. Luego dise aron un estudio descriptivo y analítico que empezaron a aplicar a más de 200 piezas que consideraban sospechosas. Una revisión corta de esta discusión con varios ejemplos de estigmas, primeros productos de fragmentación verosímilmente intencional, trazas de configuración secundaria, de atrubutos o estructuras útiles, y de algunos que pueden clasificarse como "tipos" o modelos repetidos de utensilios óseos, hallados en dichos yacimientos, es lo que presento, con Munibe, a nuestro amigo y colega Jesus Altuna y a cuantos tambien aprecian su persona y su extensa labor científica.
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