Celiac crisis as the life-threatening onset of celiac disease in children. a case report

Celiac disease (CD) is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. In rare cases, CD may occur with a severe potential life-threatening manifestation known as a celiac crisis (CC). This may be a consequence of a delayed diagnosis and expose patients to possible fatal complications. We report the case of a 22-month-old child admitted to our hospital for a CC characterized by weight loss, vomiting, and diarrhea associated with a malnutrition state. Early identification of symptoms of CC is essential to provide a prompt diagnosis and management

Innovación de la administración pública: nuevo sentido en la gestión

La administración pública se encuentra en un proceso de transición entre un modelo de gestión de control jerárquico y un modelo flexible de eficiencia, racionalización y modernización. Dicha transición está motivada por dos tendencias que se persiguen desde el Estado: (i) Las doctrinas económicas neoliberales y su influencia en el tipo de intervención del Estado, la descentralización y la participación ciudadana y, (ii) las aspiraciones democráticas y de Estado de derecho del pueblo colombiano

Le Origini delle compagnie barracellari e gli ordinamenti di polizia rurale nella Sardegna moderna

Sommario: 1 La tradizione storiografica e il «Tractatus de barracellis». – 2. Il problema delle origini del barracellato. – 3. La contrastata affermazione del barracellato nelle terre infeudate. – 4. Il barracellato tra giurisdizione regia e giurisdizioni territoriali

The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the "Delirium Day 2015"

Backround: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. Aim: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. Methods: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score ≥ 4: possible delirium; scores 1-3: possible cognitive impairment). Results: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score ≥ 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. Discussion: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. Conclusion: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence

Do "novo sindicalismo" à "concertação social": ascensão (e crise) do sindicalismo no Brasil (1978-1998)

A trajetória do sindicalismo no Brasil de 1978 a 1998 aparece como uma passagem, no plano da estratégia sindical, da confrontação à cooperação conflitiva, ou ainda, da luta de classes na produção para uma "convergência antagônica", ou um sindicalismo de participação ou de "concertação social", que é, nada mais, nada menos, que um defensivismo de novo tipo, de cariz neocorporativo. O que procuramos caracterizar aqui é a prevalência progressiva na prática sindical hegemônica da CUT nos anos 90 desse neocorporativismo operário, que tende a debilitar a perspectiva de classe que caracterizou a luta política e sindical no Brasil dos anos 80. Abstract The trajectory of syndicalism in Brazil from 1978 to 1998 appears to be a passage, at the level of syndicalist strategy, from confrontation to conflictive cooperation, or still, from class struggle in production towards a "antagonistic convergence" or a participative syndicalism, which is, nothing more, nothing less, than a defense of a newer type, of neo corporative aspect. What it is aimed to characterize here is the progressive prevalence, in the hegemonic syndicate practice of CUT in the 1990's, of this workers' neo corporatism, which tends to debilitate the class perspective that characterized political and syndicate struggle in Brazil in the 1980's. Résumé La trajectoire du syndicalisme au Brésil de 1978 à 1998 se présente comme un passage, sur le plan de la stratégie syndicale, de la confrontation à la coopération conflictuelle, ou encore, de la lutte des classes dans la production vers une «convergence antagonique», ou un syndicalisme de participation ou de «concertation sociale», qui s'avère précisement un défensivisme nouveau, d'apparence néo-corporative. Ce que nous cherchons à caractériser ici est l'importance progressive dans la pratique syndicaliste prépondérante de la CUT dans les années 90 du nouveau corporatisme ouvrier, qui a tendance à affaiblir la perspective de classe qui a caractérisé la lutte politique et syndicale au Brésil dans les années 80

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Identidade, tradição e legitimidade nas religiões afro-brasileiras

Este artigo se debruça sobre o discurso da tradição e a forma como este é empregado na busca por legitimidade e prestígio dentro do campo religioso afro-brasileiro nas cidades de Recife e João Pessoa. Ultimamente as religiões afro-brasileiras têm passado por mudanças importantes relacionadas à emergência de um novo contexto no campo das relações raciais e, também, no mercado religioso brasileiro. Com relação ao primeiro aspecto, dois fenômenos se destacam: (1) a postura presente em vários segmentos dos movimentos negros que tendem a encarar as religiões afro-brasileiras como “espaços de resistência cultural” e componente indispensável da construção/afirmação da identidade negra, e (2) a atuação do Estado que passou a desenvolver políticas públicas voltadas para estas religiões. Outra fonte de legitimidade advém do mercado religioso e suas tendências atuais, nas quais as religiões que valorizam o simbólico, o mágico e o corpo, tendem a atrair um número significativo de adeptos e simpatizantes. No centro das negociações e reposicionamentos envolvidos, encontra-se a referência e a reivindicação de continuidade com “a tradição africana original”. Esta tradição, sempre em processo de invenção e reinvenção, constitui a uma das fontes de legitimação a partir da qual as denominações religiosas afro-brasileiras, especialmente o candomblé, têm buscado assegurar o seu reconhecimento, não apenas dentro do campo religioso afro-brasileiro, mas também junto à sociedade englobante

Identificación de los objetivos del desarrollo sostenible-ODS- desde el planteamiento estratégico de las empresas que cotizan en la bolsa de valores de Colombia

This paper, based on the content analysis of the corporate strategic approach (vision, mission, values, objectives and strategies of the company), identifes which Sustainable Development Goals -SDGs- have been prioritized by 23 representative corporations listed on Colombia´s Stock Exchange. It is presumed that corporations are committed to the SDGs from their strategic approach. This project found that decent work and economic growth; and industry, innovation and infrastructure, are the objectives that appear explicit in these approaches so that greater corporate concern is assumed. On the other hand, underwater life does not appear in the interest of the corporate approachEste artículo identifca a partir del análisis de contenido del planteamiento estratégico corporativo (visión, misión, valores, objetivos y estrategias de la empresa), cuáles Objetivos de Desarrollo Sostenible —ODS— han sido priorizados por 23 empresas representativas que cotizan en la Bolsa de Valores de Colombia. Se presume que las corporaciones están comprometidas con los ODS desde su planteamiento estratégico. Como resultado se encuentra que el trabajo decente y crecimiento económico, e industria, innovación e infraestructura, son los objetivos que aparecen explícitos en dichos planteamientos, por lo que se asume mayor preocupación corporativa. A su vez, la vida submarina no aparece en el interés del planteamiento corporativo

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Los Bronces antropomorfos sardos de la Cerdeña nurágica

Il proposito di questo lavoro è quello di fornire un quadro d’insieme delle società sarde e del loro percorso storico nei primi secoli del primo millennio a.C. attraverso lo studio della piccola plastica antropomorfa il cui repertorio figurativo, insieme alle altre categorie di oggetti di bronzo destinato ad essere accolte nei luoghi di culto, costituisce una fonte di informazione di grande importanza relativamente al modo in cui gli antichi abitanti dell’isola rappresentavano il loro sistema di valori, gli equilibri tra le differenti componenti sociali ed il rapporto con il mondo degli esseri supremi e degli antenati. Il catalogo dei reperti integra il corpus dei bronzetti pubblicato nel 1966 da Lilliu con esemplari di recente acquisizione alcuni dei quali ancora inediti