El derecho al hijo deseado y programado. Estudio ético-antropológico de las nuevas formas de procreación humana a partir de las intuiciones de Marcel Gauchet y Emmanuel Lévinas

Este trabajo examina las razones antropológicas y las implicaciones éticojurídicas relacionadas con las transformaciones introducidas por el progreso biotecnológico en el acontecimiento generativo humano. El objetivo central es demostrar cómo las Técnicas de Reproducción Asistida ―especialmente en su forma heteróloga y subrogada― configuran una procreación desencarnada en la que el hijo es reducido al mero producto de una elección y selección. En la primera parte se analizan los nuevos paradigmas procreativos en relación al problema de la reificación de la vida humana. La segunda se centra en la filiación descifrada como derecho de la autodeterminación reproductiva de la personalidad adulta. Se constata así la superación de un tipo de filiación como relación indisponible ―al menos hasta la fecundación, origen de la responsabilidad genitorial― a otro tipo de filiación entendida como negocio jurídico en el que la condición de ser hijo sucede como efecto legal de la voluntad de un adulto de asumir el rol de padre o madre con la fuerza de la ley ―e incluso con la aportación genética de terceros―. En la última parte se presenta a la paternidad como lugar antropológico privilegiado donde poder anclar la filiación libre de toda manipulación técnicocientificista y de cualquier deseo adulto-céntrico. La investigación clausura destacando la importancia de la finitud ontológica del haber-nacido y la inevitable trama relacional del generar humano. Toda la tesis se apoya en las teorías formuladas sobre el tema por Marcel Gauchet y Emmanuel Lévinas.Questo lavoro esamina le ragioni antropologiche e le implicazioni eticogiuridiche legate alle trasformazioni introdotte dal progresso biotecnologico nell’evento generativo umano. L’obiettivo centrale è dimostrare come le Tecniche di Riproduzione Assistita ―specialmente nella loro forma eterologa e surrogata― configurano una procreazione disincarnata in cui il figlio è ridotto a mero prodotto di una scelta e selezione. Nella prima parte si analizzano i nuovi paradigmi procrativi in relazione al problema della reificazione della vita umana. La seconda si focalizza sulla filiazione decifrata come diritto dell’autodeterminazione riproduttiva della personalità adulta. Si constata così il superamento di un tipo di filiazione come relazione indisponibile ―almeno fino alla fecondazione, origine della responsabilità genitoriale― ad un altro tipo di filiazione intesa come negozio giuridico in cui la condizione di figlio avviene come conseguenza legale della volontà di un adulto di assumere il ruolo di padre o di madre con la forza della legge ―e persino con il contributo genetico di terzi―. Nell’ultima parte si presenta la paternità come luogo antropologico privilegiato in cui poter ancorare la filiazione libera da ogni manipolazione tecnico-scientista e da qualsiasi desiderio adultocentrico. La ricerca si chiude sottolineando l’importanza della finitezza ontologica dell’essere-nati e l’inevitabile trama relazionale del generare umano. Tutta la tesi si basa sulle teorie formulate in materia da Marcel Gauchet ed Emmanuel LévinasFilosofíaPrograma de Doctorado en los Retos de las Ciencias Sociales y Humanas en la Sociedad del Siglo XX

Pyogenic vertebral osteomyelitis complicating abdominal penetrating injury : case report and review of the literature

Pyogenic vertebral osteomyelitis is a rare condition usually associated with endocarditis or spinal surgery. However, it may also occur following abdominal penetrating trauma with associated gastrointestinal perforation. Diagnosis might be challenging and appropriate treatment is essential to ensure a positive outcome. In trans-abdominal trauma, 48 hours of broad-spectrum antibiotics is generally recommended for prophylaxis of secondary infections. A case report of vertebral osteomyelitis complicating trans-colonic injury to the retroperitoneum is presented and clinical management is discussed in the light of literature review

Synchronous adenocarcinoma and carcinoid tumor of the terminal ileum in a Crohn's disease patient

BACKGROUND: Several malignancies have been described in association with inflammatory bowel diseases, the most common being adenocarcinoma. Carcinoid tumor and Crohn disease has also been previously reported, however the coexistence of both neoplasms is quite rare and the clinical diagnosis is very difficult. Here we report what we believe to be the fourth case of a mixed adenocarcinoid tumor coexisting with Crohn's disease. CASE REPORT: The patient presented with clinical and radiological features of intestinal obstruction. Laparotomy showed a stricturing lesion in the last 6 cm of the terminal ileum with proximal dilation. Only the histology of the resected surgical specimen proved the presence of a mixed adenocarcinoid tumor involving the terminal ileum. CONCLUSION: Carcinoid tumor should be suspected in elderly patients with Crohn's disease presenting with intestinal obstruction and laparotomy should be considered to exclude malignancy

Confocal laser endomicroscopy for the detection of mucosal changes in ileal pouch after restorative proctocolectomy

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Effects of chronic inflammatory bowel diseases on left ventricular structure and function: a study protocol

BACKGROUND: Experimental evidences suggest an increased collagen deposition in inflammatory bowel diseases (IBD). In particular, large amounts of collagen type I, III and V have been described and correlated to the development of intestinal fibrotic lesions. No information has been available until now about the possible increased collagen deposition far from the main target organ. In the hypothesis that chronic inflammation and increased collagen metabolism are reflected also in the systemic circulation, we aimed this study to evaluate the effects on left ventricular wall structure by assessing splancnic and systemic collagen metabolism (procollagen III assay), deposition (ultrasonic tissue characterization), and cardiac function (echocardiography) in patients with different long standing history of IBD, before and after surgery. METHODS: Thirty patients affected by active IBD, 15 with Crohn and 15 with Ulcerative Colitis, submitted to surgery will be enrolled in the study in a double blind fashion. They will be studied before the surgical operation and 6, 12 months after surgery. A control group of 15 healthy age and gender-matched subjects will also be studied. At each interval blood samples will be collected in order to assess the collagen metabolism; a transthoracic echocardiogram will be recorded for the subsequent determination of cardiac function and collagen deposition. DISCUSSION: From this study protocol we expect additional information about the association between IBD and cardiovascular disorders; in particular to address the question if chronic inflammation, through the altered collagen metabolism, could affect left ventricular structure and function in a manner directly related to the estimated duration of the disease

Elevated serum procollagen type III peptide in splanchnic and peripheral circulation of patients with inflammatory bowel disease submitted to surgery

BACKGROUND: In the hypothesis that the increased collagen metabolism in the intestinal wall of patients affected by inflammatory bowel disease (IBD) is reflected in the systemic circulation, we aimed the study to evaluate serum level of procollagen III peptide (PIIIP) in peripheral and splanchnic circulation by a commercial radioimmunoassay of patients with different histories of disease. METHODS: Twenty-seven patients, 17 with Crohn and 10 with ulcerative colitis submitted to surgery were studied. Blood samples were obtained before surgery from a peripheral vein and during surgery from the mesenteric vein draining the affected intestinal segment. Fifteen healthy age and sex matched subjects were studied to determine normal range for peripheral PIIIP. RESULTS: In IBD patients peripheral PIIIP level was significantly higher if compared with controls (5.0 ± 1.9 vs 2.7 ± 0.7 μg/l; p = 0.0001); splanchnic PIIIP level was 5.5 ± 2.6 μg/l showing a positive gradient between splanchnic and peripheral concentrations of PIIIP. No significant differences between groups nor correlations with patients' age and duration of disease were found. CONCLUSIONS: We provide evidence that the increased local collagen metabolism in active IBD is reflected also in the systemic circulation irrespective of the history of the disease, suggesting that PIIIP should be considered more appropiately as a marker of the activity phases of IBD