Barruel, Bossuet e la democrazia nel 1789

1 In queste pagine esaminerò un articolo dell’ex gesuita Augustin Barruel apparso sul «Journal ecclésiastique» dell’aprile 1789 (pp. 389-433). Non mi occuperò quindi del Barruel più noto, quello dei Mémoires pour servir à l’histoire du jacobinisme (Londres 1797-1798), l’opera a cui Barruel deve la sua fama, ma sulla quale mancano studi soddisfacenti. Studi soddisfacenti mancano su tutte le opere e sulla vita del personaggio. Eppure Barruel merita di essere ricordato non soltanto per i Mémoire..

Les Catéchismes républicains en Italie (1796-1799)

Entre 1796 et 1799 – pendant la période appelée Triennio – plusieurs républiques fleurirent en Italie suite à l’intervention des armées de la Grande nation. Ce fut la première expérience constitutionnelle de l’Italie et, malgré son extrême brièveté et ses graves limites, ce fut une expérience d’une nouveauté et d’une importance extraordinaires. Les républicains italiens savaient qu’ils étaient peu nombreux et isolés au milieu de masses dans la plupart des cas hostiles, méfiantes, indifférente..

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Aspects du débat sur l'Égalité durant le Triennio républicain

Luciano Guerci, Aspects of the debate on equality during the Republican Triennio. During the three-year period 1796-1799, although all Italian Republicans agreed about the abolition of birth privileges and the fact that all citizens were equal before the law, divisions and contrasts emerged concerning the equality of possessions. On the one hand there were those who, while rejecting what was called « actual equality » (or « economic equality »), were in favour of measures that should alleviate the « mons- truous inequality » in wealth distribution. On the other hand this attitude was strongly opposed and even condemned among the Republicans themselves since many considered it to be dangerous and subversive. Those who advocated a fairer distribution of wealth often confined themselves to pointing it out as a goal to be achieved, but did not formulate any specific policy ; however, it should not be forgotten that their criticism of the existing situation was effective and to the point.Luciano Guerci, Aspetti del dibattito sull'eguaglianza ml Triennio repubblicano. Se tra il 1796 e il 1799 tutti i repubblicani italiani si trovarono d'accordo circa Pabolizione dei privilegi legati alia nascita e circa l'eguaglianza dei cittadini di fronte alla legge, divisioni e constrasti si manifestarono circa l'eguaglianza dei beni. Ci furono infatti coloro che, pur rifiutando ciò che veniva chiamata « eguaglianza di fatto » (o « eguaglianza economica »), si dichiararono favorevoli a prowedimenti che attenuassero la « mostruosa ineguaglianza » nelle ricchesse. Forte fu l'opposizione a un simile atteggiamento, che all'intenso stesso del fronte repubblicano fu condamnato da molti come pericolo e sowersivo. I Sostenitori di una più equie ripartizione dei beni si limitarono spesso a indicare una meta da raggiungere sensa formulare programmi precisi, ma occorre sottolineare che le loro critiche alla situazione esistente non mancavano di lucidità ni efficacia.Luciano Guerci, Aspects du débat sur l'Égalité durant le Triennio républicain. Si entre 1796 et 1799 tous les républicains italiens se trouvèrent d'accord sur l'abolition des privilèges liés à la naissance et sur l'égalité des citoyens devant la loi, des divisions et des contrastes très vifs vinrent au premier plan à propos de l'égalité des biens. En effet, il y eut ceux qui, tout en refusant ce qu'on appelait « égalité de fait » (ou « égalité économique »), se prononcèrent pour des mesures capables de diminuer l'« inégalité monstrueuse » des richesses. Ce point de vue fut âprement combattu, et à l'intérieur même du front républicain il fut condamné par beaucoup de gens en tant que dangereux et subversif. Ceux qui étaient favorables à une répartition des biens plus équitable se bornèrent souvent à indiquer un but à atteindre sans élaborer des programmes précis, mais il faut souligner que leurs critiques de la situation existante ne manquèrent ni de lucidité ni d'efficacité.Guerci Luciano. Aspects du débat sur l'Égalité durant le Triennio républicain. In: Annales historiques de la Révolution française, n°313, 1998. L'Italie du Triennio révolutionnaire 1796-1799. pp. 409-430

Il coraggio della ragione. Franco Venturi intellettuale e storico cosmopolita

Studio n. 3

The 2q23.1 microdeletion syndrome: clinical and behavioural phenotype.

Six submicroscopic deletions comprising chromosome band 2q23.1 in patients with severe mental retardation (MR), short stature, microcephaly and epilepsy have been reported, suggesting that haploinsufficiency of one or more genes in the 2q23.1 region might be responsible for the common phenotypic features in these patients. In this study, we report the molecular and clinical characterisation of nine new 2q23.1 deletion patients and a clinical update on two previously reported patients. All patients were mentally retarded with pronounced speech delay and additional abnormalities including short stature, seizures, microcephaly and coarse facies. The majority of cases presented with stereotypic repetitive behaviour, a disturbed sleep pattern and a broad-based gait. These features led to the initial clinical impression of Angelman, Rett or Smith–Magenis syndromes in several patients. The overlapping 2q23.1 deletion region in all 15 patients comprises only one gene, namely, MBD5. Interestingly, MBD5 is a member of the methyl CpG-binding domain protein family, which also comprises MECP2, mutated in Rett’s syndrome. Another gene in the 2q23.1 region, EPC2, was deleted in 12 patients who had a broader phenotype than those with a deletion of MBD5 only. EPC2 is a member of the polycomb protein family, involved in heterochromatin formation and might be involved in causing MR. Patients with a 2q23.1 microdeletion present with a variable phenotype and the diagnosis should be considered in mentally retarded children with coarse facies, seizures, disturbed sleeping patterns and additional specific behavioural problems