Per la storia di Urbs Salvia. Il contributo delle recenti indagini di scavo nell'area forense

Le campagne di scavo condotte dal 1995 nell\u2019area forense di Urbs Salvia dal Dipartimento SASA hanno affrontato alcune delle principali questioni aperte sul piano storico-archeologico: le origini della citt\ue0 in et\ue0 tardo repubblicana, la programmazione urbanistica, la relativa monumentalizzazione nella prima et\ue0 imperiale e le vicende tardo-antiche, fino alle ultime attestazioni di vita. Le indagini hanno potuto apportare testimonianze monumentali e materiali utili a far luce l\ue0 ove poco o niente soccorrono le fonti scritte. Quanto alle origini di Urbs Salvia, i cui abitanti erano denominati Urbe Salvia Pollentini secondo la testimonianza di Plinio il Vecchio ed erano amministrati da pretores, come le colonie di fondazione antica, poteva gi\ue0 ritenersi che la citt\ue0, nata con il nome di Pollentia nel II sec. a.C., lo trasformasse ad un certo momento in quello di Urbs Salvia. Ora i rinvenimenti delle recenti indagini archeologiche permettono di affermare la sicura esistenza nell\u2019area di un insediamento urbano, cui pu\uf2 riconoscersi natura coloniale, gi\ue0 dalla fine del II secolo a.C. Tra le pi\uf9 significative testimonianze materiali rinvenute in profondit\ue0 vanno annoverati i resti di strutture edilizie private e publiche (tra cui un edificio con tutta evidenza adibito a funzioni civili), muri e allestimenti pavimentali, superfici glareate, massicciate, elementi architettonici rinvenuti in condizioni di reimpiego in monumenti pi\uf9 tardi ed altro ancora, la cui definizione cronologica nel tardo II /inizi I sec. a.C. \ue8 assicurata dai relativi depositi stratigrafici. Pertanto si intravedono ancora in chiaroscuro le tracce anche materiali di un insediamento urbano in cui pare ora possibile riconoscere per la prima volta l\u2019immagine dell\u2019antica colonia di fine II sec. a.C., identificabile con Pollentia. L\u2019arrivo dei veterani in et\ue0 triumvirale con conseguente fenomeno di grande crescita edilizia, riguard\uf2 tutte le colonie militari della Regio V, ma anche la citt\ue0 di Urbs Salvia ne fu interessata, con l\u2019avvio di un riassetto urbanistico che oblitera le vecchie strutture per dare luogo ad uno straordinario piano programmatico di sviluppo ed \ue8 in questo periodo che nasce la nuova Urbs Salvia trasformando il vecchio poleonimo nell\u2019 appellativo onomastico della citt\ue0. L\u2019opera di Augusto rappresenta uno snodo significativo tra la fine dell\u2019et\ue0 tardo-repubblicana e la prima et\ue0 imperiale. Nel piano programmatico unitario risultano la cinta muraria, la definizione degli isolati, l\u2019acquedotto e il serbatoio e la riorganizzazione del Foro, e la sistemazione di nuovi quartieri residenziali (si segnalano tra questi gli Edifici \u201cdelle acque\u201d e \u201cdel pozzo\u201d). Ad et\ue0 tiberiano-claudia va attribuito un imponente progetto di riorganizzazione monumentale degli spazi: nel Foro civile si provvede alla costruzione di nuovi portici e di altri edifici pubblici, mentre nell\u2019area cultuale, ad Est della Salaria Gallica, si realizza il monumentale complesso Tempio-Criptoportico, in funzione forense, dedicato alla Salus Augusta Salviensium, e con essa al culto imperiale, portando a compimento anche l\u2019assetto della viabilit\ue0 circostante, rappresentato dal I cardine Est e dalla Strada Sud del Criptoportico. Le indagini di scavo hanno interessato anche un altro piccolo ma importante monumento, il c.d. Tempietto del Foro, per la sua posizione prospiciente la piazza forense, al pari del grandioso Tempio-Criptoportico, dalla singolare planimetria, circondato su tre lati da un portico e con una scalinata di accesso sulla fronte. Quanto ai lati Nord ed Ovest della piazza forense, gli scavi hanno portato in luce rispettivamente un edificio porticato ed un portico che vengono cos\uec a definire ulteriormente la configurazione del Foro civile in et\ue0 tiberiana, in una visione organica nell\u2019ambito del perimetro della cinta muraria e del reticolo stradale gi\ue0 delineato nel piano programmatico di et\ue0 augustea. Una fase di distruzione e conseguente ristrutturazione \ue8 stata individuata negli Edifici \u201cdelle acque \u201c e \u201cdel pozzo\u201d con rifacimenti pavimentali e nuovi adattamenti in esterno ascrivibili alla seconda met\ue0 del III secolo (sull\u2019argomento si veda G.M. FABRINI in G.M. FABRINI, L. SFORZINI, G. MANTELLA, Urbs Salvia (Urbisaglia, MC): pavimenti musivi dell\u2019 Edificio \u201cdelle acque\u201d nell\u2019area forense. Dallo scavo agli interventi di restauro conservativo delle strutture, in Atti XVII Convegno AISCOM, Teramo 2011, in corso di stampa). Allo stesso periodo risalgono anche interventi di rifacimento che hanno interessato anche le sedi stradali

Bevacizumab for the Treatment of Radiation-Induced Cerebral Necrosis: A Systematic Review of the Literature

Radiation necrosis (RN) of brain tissue is a serious late complication of brain irradiation and recently bevacizumab has been suggested as treatment option of RN. There is a lack of data in the literature regarding the effectiveness of bevacizumab for the treatment of RN. The purpose of this review was to perform a comprehensive analysis of all reported cases using bevacizumab for the treatment of brain RN. In September 2016, we performed a comprehensive literature search of the following electronic databases: PubMed, Web of Science, Scopus and Cochrane Library. The research for the review was conducted using a combination of the keywords “radiation necrosis”, “radiotherapy” and “bevacizumab” alongside the fields comprising article title, abstract and keywords. Randomized trials, non-randomized trials, prospective studies, retrospective studies and single case reports were included in the review. Our research generated 21 studies and 125 cases where bevacizumab had been used for the treatment of RN. The median follow-up was 8 months and the most frequent bevacizumab dose used was 7.5 mg/kg for 2 weeks with a median of four cycles. Low-dose bevacizumab resulted in effectiveness with improvement in both clinical and radiographic response. The median decrease in T1 contrast enhancement and in T2/FLAIR signal abnormality was 64% and 60%, respectively. A reduction in steroidal therapy was observed in majority of patients treated. Based on the data of our review, bevacizumab appears to be a promising agent for the treatment of brain RN. Future prospective studies are required to evaluate the role of bevacizumab in RN and to define the optimal scheduling, dosage and duration of therapy

O papel da microbiota intestinal na metabolização do glúten: uma revisão / The role of gut microbiota in gluten metabolization: a review

O presente trabalho teve como objetivo identificar nas literaturas atuais o papel e a importância da microbiota humana na metabolização do glúten, quais famílias bacterianas são envolvidas neste processo assim como seus mecanismos de ação no metabolismo do glúten. O trabalho teve também como objetivo avaliar se existe relação imunoprotetora da microbiota humana perante imunopatologias desencadeadas pela proteína. Para isso, foram selecionados artigos disponíveis nas bases de dados PubMed e Google Scholar. Serão incluídos neste estudo os artigos que apresentam os descritores (Mesh) “Glutens” AND “Microbiota”, assim como (Mesh) “Glutens” AND “Metabolism”. Deste modo, foram adotados como critérios de exclusão os artigos que excediam um tempo de vinte anos de publicação e aqueles que eram compostos por estudos de caso, revisões narrativas e estudos in vitro. Conforme a seleção dos arquivos, foi elaborado um fluxograma pelo método PRISMA, cujo acervo final de dados foi registrado no trabalho. Os resultados categorizaram as informações em cada artigo presente, buscando achados notórios. Assim, conforme os dados analisados, foi observado que o corpo humano é capaz de degradar alguns peptídeos do glúten, sendo assim, a digestão e absorção de peptídeos provenientes do glúten modulada pela própria ingestão da proteína. Compreendeu-se a proteína do glúten como reguladora da diversidade e da quantidade de microrganismos da microbiota do TGI, comprovando a estreita relação da metabolização do glúten com a microbiota humana, sendo ela complexa e crucial. Por fim, acredita-se que a degradação de peptídeos imunogênicos seja de origem simbiótica, sendo a microbiota intestinal a maior responsável pela atividade

The effectiveness of bevacizumab in radionecrosis after radiosurgery of a single brain metastasis

Radionecrosis (RN) of brain tissue is a serious late complication of brain irradiation and historically has been treated with corticosteroid therapy and alternatively surgical decompression. Recently, bevacizumab has been suggested for treatment of cerebral radiation necrosis. We present a case of a 73- years-old women affected by a primary nonsmall cell lung cancer with a single brain metastasis treated with radiosurgery. Two years after radiosurgery the patient referred neurological symptoms and a brain magnetic resonance confirmed the presence of RN. The patient refused surgical decompression so underwent at the treatment with bevacizumab 7.5 mg/kg/2 weeks for a total of 4 cycles. After two months of treatment the patient reported strumental and clinical improvement. Ten months after bevacizumab discontinuation the patient experienced a recurrence of RN with evident clinical manifestation and confirmed by radiological imaging. A new treatment with bevacizumab was not performed due to the systemic progression disease and the worsening of clinical status. Despite limited to only one clinical case, our study suggests the efficacy of bevacizumab to treat RN. Future studies are needed to confirm its mechanism and to properly define the optimal scheduling, dosage and duration of therapy

Non-melanoma skin cancer treated with high-doserate brachytherapy and Valencia applicator in elderly patients: a retrospective case series

Purpose: The incidence of non-melanoma skin cancer (NMSC) has been increasing over the past 30 years. Basal cell carcinoma and squamous cell carcinoma are the two most common subtypes of NMSC. The aim of this study was to estimate tumour control, toxicity, and aesthetic events in elderly patients treated with high-dose-rate (HDR) brachytherapy (BT) using Valencia applicator. Material and methods: From January 2012 to May 2015, 57 lesions in 39 elderly eligible patients were enrolled. All the lesions had a diameter ≤ 25 mm (median: 12.5 mm) and a depth ≤ 4 mm. The appropriate Valencia applicator, 2 or 3 cm in diameter was used. The prescribed dose was 40 Gy in 8 fractions (5 Gy/fraction) in 48 lesions (group A), and 50 Gy in 10 fractions (5 Gy/fraction) in 9 lesions (group B), delivered 2/3 times a week. The biological effective dose (BED) was 60 Gy and 75 Gy, respectively. Results: After median follow-up of 12 months, 96.25% lesions showed a complete response and only two cases presented partial remission. Radiation Therapy Oncology Group – European Organization for Research and Treatment of Cancer (RTOG/EORTC) G 1-2 acute toxicities were observed in 63.2% of the lesions: 56.3% in group A and 77.7% in group B. Late G1-G2 toxicities was observed in 19.3% of the lesions: 18.8% in group A and 22.2% in group B, respectively. No G3 or higher acute or late toxicities occurred. In 86% of the lesions, an excellent cosmetic result was observed (87.5% in group A and 77.8% in group B). Six lesions had a good cosmetic outcome and only 2.3% presented a fair cosmetic impact. Conclusions: The treatment of NMSC with HDR-BT using Valencia surface applicator is effective with excellent and good cosmetics results in elderly patients. The hypofractionated course appears effective and no statistical differences were observed between the two groups analysed

GÊNEROS ORAIS FORMAIS: O QUE É POSSÍVEL E NECESSÁRIO SER ENSINADO NO LIVRO DIDÁTICO DESTINADO A PESSOAS JOVENS, ADULTAS E IDOSAS?

What do textbooks propose when they present a set of strategies for working with formal oral genres in the classroom?This questioning guides this work that investigated the treatment with formal oral genres presented by a collection of textbooks directed to the education of Young, Adult and Elderly people. To achieve this goal we focus on the documentary approach(FLICK, 2009, LOPES e GALVÃO, 2001) to analyze the collection “É Bom Aprender” (PNLD, 2011), acquired by 16 (sixteen) municipalities of public education networks of Mata Norte Pernambucana. To discuss the investigated phenomenon, we submitted the collection to an interpretivist analysis, based on a qualitative approach (BORTONI-RICARDO, 2008).The results indicate the presence of proposals aimed at the use of formal oral, favorable to the understanding of dimensions related to social uses however, it is limited from the point of view of the space of reflection on the various discursive situations and on the approximations between the genres materialized in the oral and written modalities of the language. Faced with this scenario,we reinforce the importance that working with formal oral textual genres in EJAI classes is a primary task for the students' teaching-learning process, since it contributes to the acquisition of an effective social-linguistic development that, therefore, favors the consolidation of subjects' rights.O que propõem os livros didáticos quando apresentam um conjunto de estratégias para trabalhar os gêneros orais formais em sala de aula? Esse questionamento pauta este trabalho que investigou o trato com os gêneros orais formais apresentados por uma coleção de livros didáticos direcionados à educação de pessoas jovens, adultas e idosas. Para alcançar esse objetivo, tomamos como foco a abordagem documental (FLICK, 2009, LOPES e GALVÃO, 2001) para analisar a coleção “É Bom Aprender” (PNLD, 2011), adquirida por 16 (dezesseis) municípios de redes públicas de ensino da Mata Norte Pernambucana. Para a discutir o fenômeno investigado, submetemos a coleção a uma análise interpretativista, com base em uma abordagem qualitativa (BORTONI-RICARDO, 2008). Os resultados sinalizam para a presença de propostas, voltadas para o uso do oral formal, favoráveis à compreensão sobre dimensões relativas aos usos sociais. Contudo, são limitadas do ponto de vista do espaço da reflexão sobre as variadas situações discursivas e sobre as aproximações entre os gêneros materializados nas modalidades oral e escrita da língua. Frente a esse cenário, reforçamos a importância de que trabalhar com os gêneros textuais orais formais nas turmas de EJAI é uma tarefa primordial para o processo de ensino-aprendizagem dos/as educandos/as, uma vez que contribui para a ampliação das práticas linguísticas e sociais, com vista a favorecer a consolidação dos direitos dos sujeitos

A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy

Abstract Background At recurrence the use of nitrosoureas is widely-used as a therapeutic option for glioblastoma (GBM) patients. The efficacy of fotemustine (FTM) has been demonstrated in phase II clinical trials; however, these papers report a wide range of progression-free-survival (PFS-6 m) rates, ranging from 21% to 52%. We investigated whether FTM could have a different response pattern in respect to time to adjuvant temozolomide failure, or whether specific independent risk factors could be responsible for the wide range of response rates observed. Methods Recurrent GBM patients have been treated with fotemustine 75-100 mg/sqm at day 1, 8, 15 and after 4/5 weeks of rest with 100 mg/sqm every 21 days. Patients were stratified in 4 groups according to time to temozolomide failure: before starting (B0), during the first 6 months (B1), after more than 6 months of therapy (B2), and after a treatment-free interval (B3). Primary endpoint was PFS-6 m. A multivariable analysis was performed to identify whether gender, time after radiotherapy, second surgery and number of TMZ cycles could be independent predictors of the clinical benefit to FTM treatment. Results 163 recurrent GBM patients were included in the analysis. PFS-6 m rates for the B0, B1, B2 and B3 groups were 25%, 28%, 31.1% and 43.8%, respectively. The probability of disease control was higher in patients with a longer time after radiotherapy (p = 0.0161) and in those who had undergone a second surgery (p = 0.0306). Conclusions FTM is confirmed as a valuable therapeutic option for patients with recurrent GBM and was active in all study patient groups. Time after the completion of radiotherapy and second surgery are independent treatment-related risk factors that were predictive of clinical benefit.</p

A multimodal approach to the treatment of bilateral choroidal metastases from thyroid carcinoma

A 58-year old man, affected by metastatic thyroid carcinoma, experienced a progressive bilateral visual impairment. Ophthalmic examination revealed the presence of a choroidal mass with an associated exudative retinal detachment in both eyes. Twelve years before, a diagnosis of metastatic thyroid carcinoma had been established and the patient had been subject to several therapeutic procedures

Non-melanoma skin cancer treated with high-dose-rate brachytherapy: a review of literature

Purpose: The incidence of non-melanoma skin cancer (NMSC) has been increasing over the past 30 years. There are different treatment options and surgical excision is the most frequent treatment due to its low rates of recurrence. Radiotherapy is an effective alternative of surgery, and brachytherapy (BT) might be a better therapeutic option due to high radiation dose concentration to the tumor with rapid dose fall-off resulting in normal tissues sparing. The aim of this review was to evaluate the local control, toxicity, and cosmetic outcomes in NMSC treated with high-dose-rate BT (HDR-BT). Material and methods: In May 2016, a systematic search of bibliographic database of PubMed, Web of Science, Scopus, and Cochrane Library with a combination of key words of “skin cancer”, “high dose rate brachytherapy”,“squamous cell carcinoma”, “basal cell carcinoma”, and “non melanoma skin cancer“ was performed. In this systematic review, we included randomized trials, non-randomized trials, prospective and retrospective studies in patients affected by NMSC treated with HDR-BT. Results: Our searches generated a total of 85 results, and through a process of screening, 10 publications were selected for the review. Brachytherapy was well tolerated with acceptable toxicity and high local control rates (median: 97%). Cosmetic outcome was reported in seven study and consisted in an excellent and good cosmetic results in 94.8% of cases. Conclusions: Based on the review data, we can conclude that the treatment of NMSC with HDR-BT is effective with excellent and good cosmetics results, even in elderly patients. The hypofractionated course appears effective with very good local disease control. More data with large-scale randomized controlled trials are needed to assess the efficacy and safety of brachytherapy