Ma che cosa è questo Atlantico? Un modernista di fronte alla storiografia delle buone intenzioni

The author first establishes his pedigree as an early Atlanticist; then describes the geographical and chronological features of the so-called “new Atlantic history”. The success of Atlantic history is undeni-able. During the past twenty-five years or so, books and articles that identify themselves as “Atlantic” have multiplied, so much that few historians, especially among the younger ones, dare distance themselves from the new obligatory gospel. The author attributes two main features to the new Atlantic history. The first is mainly ethical, in that it assumes that certain moral categories, such as inclusion, diversity, multiethnicity, and multiculturalism, are intrinsecally good and as such must be applied to society as well as to the study of history. The second feature is epistemological. It assumes that by examining the Atlantic communities as a whole we improve the knowledge of their history. By examining this second feature, however, the author shows that the gap between the unattainable promises of the new Atlantic history and their practical realisa-tions in terms of new knowledge is striking. Probably the only subfield of study that has really profited from this new Atlantic perspective is that of African-Atlantic history. There are, of course, a good number of good Atlantic historians. One wonders, however, whether the novelty represented by their works derives more from their originality as scholars rather than from their adherence to the new Atlantic canon. This article is based on a thorough examination of “Atlantic history” books and articles published between 1922 and 2016, that are listed in the Bibliography in chronological order

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients