Formalizzazione del sistema giuridico, retorica forense e didattica. Un esperimento

Il contributo riferisce di una sperimentazione riguardante l’esposizione di argomenti giuridici mediante l’utilizzo di metodiche proprie della teoria dei sistemi e di linguaggi visuali a blocchi in seno ad un corso per la preparazione dell’esame di ammissione all’esercizio della professione forense, e delle riflessioni che ne sono scaturite

A new induction schedule of epoetin alfa 40.000 IU in anemic patients with advanced lung cancer

Background: Non-small cell lung cancer (NSCLC) treatment with new drugs in combination with platinum salts induce anemia G1/2 and G3/4 WHO in about 35 and 10-20% of patients, respectively, with a chemotherapy (CT) dose intensity decrease in 20% of cases. Epoetin alfa, administered at standard dosages has been shown to significantly increase hemoglobin (Hb) levels, decrease transfusion requirements, and improve quality-of-life parameters in patients undergoing chemotherapy. Objective: This open-label, non-randomized study was conducted to evaluate the efficacy and safety of an induction dose of epoetin alfa 40.000 IU in lung cancer patients with moderate or severe anemia who were receiving CT. Patients and methods: Twenty-four patients (8 SCLC and 16 NSCLC) were enrolled in the study to receive single subcutaneous (s.c.) injections of epoetin alfa 40.000 IU on days 1, 4, 7, 10, and 13, followed by standard treatment (10.000 IU t.i.w.) for the further 2 weeks. Nine patients had been previously treated with epoetin alfa 10.000 IU t.i.w. Twenty-two patients were receiving first-tine CT and two patients were receiving docetaxel as second-line CT. Results: After 15 days of treatment, in 21 evaluable patients, Hb was 10.5 +/- 1.3 g/dL (mean +/- S.D.), with a mean increase from baseline of 2.0 g/dL (95% CI: 1.3-2.7). Hb increase was greater than or equal to2 g/dL in 11 patients, 1-1.9 g/dL in 5 patients, and <1 g/dL in 5 patients. After 30 days of treatment, Hb was 11.5 +/- 0.8 g/dL (mean S.D.), with a mean increase from baseline of 2.9 g/dL (95% CI: 2.4-3.4) in 20 evaluable patients. No adverse events possibly related to epoetin alfa treatment were observed. Conclusion: An induction therapy with epoetin alfa. 40.000 IU for 2 weeks followed by standard treatment allows an Hb increase of 2.9 g/dL even in advanced lung cancer patients with a moderate/severe anemia, without RBC transfusion requirements. A randomized study of the proposed induction dose of epoetin alfa 40.000 IU is actually ongoing. (C) 2004 Elsevier Ireland Ltd. All rights reserved

How do we treat the broad spectrum of patients with serious mental illness who have committed crimes? The Law 81/2014: limits and problems

In Italia è in corso un processo di deistituzionalizzazione che non ha precedenti al mondo. Si stanno progressivamente svuotando gli Ospedali Psichiatrici Giudiziari che non sono mai stati riformati negli ultimi 80 anni. Questo processo sta venendo attuato tramite una stratificazione di norme senza una progettualità diversa dalla rapida chiusura di queste fatiscenti strutture. Ai Dipartimenti di Salute Mentale (DSM) sono richieste una molteplicità di compiti nuovi e fortemente specialistici, e una estensione del loro potere di controllo, senza che queste strutture siano organizzate in tale senso. Alcune delle norme recentemente varate, come la Legge 81 del 2014, per risolvere alcuni problemi derivanti dalle difficoltà di deistituzionalizzazione complicano, a nostro parere, diversi aspetti gestionali di questa popolazione di gravi pazienti psichiatrici, che comunque non è assimilabile alla normale utenza dei DSM.Vi è necessità di un intervento legislativo coordinato e pensato su una prospettiva a lungo termineIn Italy an ongoing process of deinstitutionalization unprecedented in the world is been enacted.The Judicial Psychiatric Hospitals, that were never reformed in the past 80 years, are now on the edge of their closure.This process is being implemented through a layering of rules that had no purpose other than the rapid closure of these structures.The Mental Health Departments have now the responsibility of a multiplicity of new and highly specialized tasks, and an extension of their power to control.There is no previous organization for these tasks in the Mental Health System. Some of the recently enacted laws,such as the Law 81 of 2014, are intented to solve some problems, althought issues of deinstitutionalization are getting worse.In our opinion several management aspects of this population of severe psychiatric patients are unfit with the present organization of the Mental Health Services.There is need for legislative action coordinated and based on a long-term perspective

Prevalence and time course of post-stroke pain: A multicenter prospective hospital-based study

OBJECTIVE: Pain prevalence data for patients at various stages after stroke. DESIGN: Repeated cross-sectional, observational epidemiological study. SETTING: Hospital-based multicenter study. SUBJECTS: Four hundred forty-three prospectively enrolled stroke survivors. METHODS: All patients underwent bedside clinical examination. The different types of post-stroke pain (central post-stroke pain, musculoskeletal pains, shoulder pain, spasticity-related pain, and headache) were diagnosed with widely accepted criteria during the acute, subacute, and chronic stroke stages. Differences among the three stages were analyzed with χ(2)-tests. RESULTS: The mean overall prevalence of pain was 29.56% (14.06% in the acute, 42.73% in the subacute, and 31.90% in the chronic post-stroke stage). Time course differed significantly according to the various pain types (P < 0.001). The prevalence of musculoskeletal and shoulder pain was higher in the subacute and chronic than in the acute stages after stroke; the prevalence of spasticity-related pain peaked in the chronic stage. Conversely, headache manifested in the acute post-stroke stage. The prevalence of central post-stroke pain was higher in the subacute and chronic than in the acute post-stroke stage. Fewer than 25% of the patients with central post-stroke pain received drug treatment. CONCLUSIONS: Pain after stroke is more frequent in the subacute and chronic phase than in the acute phase, but it is still largely undertreated

The Undoing Effect of Positive Emotions

Positive emotions are hypothesized to undo the cardiovascular aftereffects of negative emotions. Study 1 tests this undoing effect. Participants (n = 170) experiencing anxiety-induced cardiovascular reactivity viewed a film that elicited (a) contentment, (b) amusement, (c) neutrality, or (d) sadness. Contentment-eliciting and amusing films produced faster cardiovascular recovery than neutral or sad films did. Participants in Study 2 (n = 185) viewed these same films following a neutral state. Results disconfirm the alternative explanation that the undoing effect reflects a simple replacement process. Findings are contextualized by Fredrickson's broaden-and-build theory of positive emotions (B. L. Fredrickson, 1998).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45369/1/11031_2004_Article_292902.pd

Vitamin D Deficiency and Risk Factors Related to Acute Psychiatric Relapses in Patients with Severe Mental Disorders: A Preliminary Study

Previous studies have indicated that vitamin (Vit) D deficiency is frequent in psychiatric patients, regardless of diagnostic category. We aimed to assess whether acute psychiatric relapses in inpatients was associated with Vit D deficiency compared to stabilized outpatients. The cohort (152 total patients, 75 males and 77 females) had a mean age of 47.3 ± 14.4 years at admission and was grouped according to psychiatric diagnosis. Psychopathological symptom severity was assessed by the Brief Psychiatric Rating Scale (BPRS), a multidimensional symptom inventory. Total calcium serum levels were measured using standard laboratory methods, while plasma levels of 25-OH-Vit D and parathyroid hormone (PTH) were measured by automated chemiluminescence immunoassays. The psychiatric inpatient subgroup showed a significant difference in serum levels of 25-OH-Vit D and PTH (p &lt; 0.001). Correlation analysis between serum levels of 25-OH-Vit D and BPRS total and subitem scores indicated a significantly negative relationship. In addition, linear regression analysis evidenced that the inpatient condition might predict low PTH and 25-OH-Vit D serum levels. Hospitalized psychiatric patients are at increased risk for Vit D deficiency regardless of their diagnostic categories. The mechanism underlying the association between acute psychiatric relapses and Vit D deficiency remains unclear. Therefore, screening for Vit D deficiency should pertain to the health assessment of patients with major psychiatric disorders

Aromatic and proteomic analyses corroborate the distinction between Mediterranean landraces and modern varieties of durum wheat

In this paper volatile organic compounds (VOCs) from durum wheat cultivars and landraces were analyzed using PTR-TOF-MS. The aim was to characterize the VOC's profile of the wholemeal flour and of the kernel to find out if any VOCs were specific to varieties and sample matrices. The VOC data is accompanied by SDS-PAGE analyses of the storage proteins (gliadins and glutenins). Statistical analyses was carried out both on the signals obtained by MS and on the protein profiles. The difference between the VOC profile of two cultivars or two preparations of the same sample - matrices, in this case kernel vs wholemeal flour - can be very subtle; the high resolution of PTR-TOF-MS - down to levels as low as pptv - made it possible to recognize these differences. The effects of grinding on the VOC profiles were analyzed using SIMPER and Tanglegram statistical methods. Our results show that it is possible describe samples using VOC profiles and protein data

Aromatic and proteomic analyses corroborate the distinction between Mediterranean landraces and modern varieties of durum wheat

In this paper volatile organic compounds (VOCs) from durum wheat cultivars and landraces were analyzed using PTR-TOF-MS. The aim was to characterize the VOC’s profile of the wholemeal flour and of the kernel to find out if any VOCs were specific to varieties and sample matrices. The VOC data is accompanied by SDS-PAGE analyses of the storage proteins (gliadins and glutenins). Statistical analyses was carried out both on the signals obtained by MS and on the protein profiles. The difference between the VOC profile of two cultivars or two preparations of the same sample - matrices, in this case kernel vs wholemeal flour - can be very subtle; the high resolution of PTR-TOF-MS - down to levels as low as pptv - made it possible to recognize these differences. The effects of grinding on the VOC profiles were analyzed using SIMPER and Tanglegram statistical methods. Our results show that it is possible describe samples using VOC profiles and protein data