69 research outputs found
Il mare è maschio, la terra è femmina. Cosmogonie biamontiane
No’m sai quora mais la veyrai,que tan son nostras terras lonh. Jaufré Rudel Il mio contributo vuole esplorare l’abitudine di Biamonti a declinare in numerose varianti un’equazione manichea, che stringe a sistema i personaggi maschili dei suoi romanzi e il mare, e i personaggi femminili e la terra, in un paesaggio di corrispondenze che ammette poche deviazioni dal modello. L’apparente scontatezza della scelta che, come ovvio ricalca un cliché tassonomico quasi universale, non deve trarre in in..
Macchie di crescita
L’article problématise la méthaphore de la « lecture » du paysage. Au niveau anthropologique, cette opération précede l’usage de l’écriture et implique une schématisation mentale de l’objet représenté-interprété. De ce point de vue, la réflexion met en évidence la verticalité temporelle, biologique et culturelle, du paysage. Sa perception individuelle et collective passe par la reconnaissance de figures rythmiques qui activent la mémoire d’un schéma psychique et permettent à l’homo sapiens de se voir dans le monde
L’île partagée. Géographies de la différence dans Passavamo sulla terra leggeri de Sergio Atzeni
“These are the colors of Africa”, he said. The blood that flowed from the zebra’s mouth was dark red and clotted.J. Kilgo, Colors of Africa. Pour les chercheurs qui ont étudié le genre épique et les multiples dynamiques de l’oralité chez des peuples qui sont loin de notre « anthropologie de la modernité », parler de tonalité épique dans la littérature contemporaine a peu de sens ou, s’il en a, c’est plutôt dans une acception métaphorique et méta-littéraire. À la rigueur, l’épopée se tient à d..
La femme et la mer dans Il silenzio de Francesco Biamonti : au-delà de la séduction
La nature est un temple où de vivants piliersLaissent parfois sortir de confuses paroles.Baudelaire Du nouveau roman qu’avait commencé à écrire Francesco Biamonti, il ne nous reste que vingt-neuf pages dactylographiées, de nombreuses variantes, un titre hypothétique, et deux brefs entretiens, qui exposent les grandes lignes de l’inspiration et la trame de l’œuvre. C’est avec une certaine perplexité philologique, qu’à présent nous pouvons lire cette ébauche de récit dans une petite édition pos..
Is It Possible to Eradicate Carbapenem-Resistant Acinetobacter baumannii (CRAB) from Endemic Hospitals?
Despite the global efforts to antagonize carbapenem-resistant Acinetobacter baumannii (CRAB) spreading, it remains an emerging threat with a related mortality exceeding 40% among critically ill patients. The purpose of this review is to provide evidence concerning the best infection prevention and control (IPC) strategies to fight CRAB spreading in endemic hospitals
A Fatal Case of Pseudomonas aeruginosa Community-Acquired Pneumonia in an Immunocompetent Patient: Clinical and Molecular Characterization and Literature Review
Rare cases of Pseudomonas aeruginosa community-acquired pneumonia (PA-CAP) were
reported in non-immunocompromised patients. We describe a case of Pseudomonas aeruginosa
(PA) necrotizing cavitary CAP with a fatal outcome in a 53-year-old man previously infected with
SARS-CoV-2, who was admitted for dyspnea, fever, cough, hemoptysis, acute respiratory failure
and a right upper lobe opacification. Six hours after admission, despite effective antibiotic therapy,
he experienced multi-organ failure and died. Autopsy confirmed necrotizing pneumonia with
alveolar hemorrhage. Blood and bronchoalveolar lavage cultures were positive for PA serotype
O:9 belonging to ST1184. The strain shares the same virulence factor profile with reference genome
PA01. With the aim to better investigate the clinical and molecular characteristics of PA-CAP, we
considered the literature of the last 13 years concerning this topic. The prevalence of hospitalized
PA-CAP is about 4% and has a mortality rate of 33–66%. Smoking, alcohol abuse and contaminated
fluid exposure were the recognized risk factors; most cases presented the same symptoms described
above and needed intensive care. Co-infection of PA-influenza A is described, which is possibly
caused by influenza-inducing respiratory epithelial cell dysfunction: the same pathophysiological
mechanism could be assumed with SARS-CoV-2 infection. Considering the high rate of fatal
outcomes, additional studies are needed to identify sources of infections and new risk factors, along
with genetic and immunological features. Current CAP guidelines should be revised in light of
these results
A proof-of-concept study on the genomic evolution of Sars-Cov-2 in molnupiravir-treated, paxlovid-treated and drug-naĂŻve patients
Little is known about SARS-CoV-2 evolution under Molnupiravir and Paxlovid, the only antivirals approved for COVID-19 treatment. By investigating SARS-CoV-2 variability in 8 Molnupiravir-treated, 7 Paxlovid-treated and 5 drug-naive individuals at 4 time-points (Days 0-2-5-7), a higher genetic distance is found under Molnupiravir pressure compared to Paxlovid and no-drug pressure (nucleotide-substitutions/site mean & PLUSMN;Standard error: 18.7 x 10(-4) & PLUSMN; 2.1 x 10(-4) vs. 3.3 x 10(-4) & PLUSMN; 0.8 x 10(-4) vs. 3.1 x 10(-4) & PLUSMN; 0.8 x 10(-4), P = 0.0003), peaking between Day 2 and 5. Molnupiravir drives the emergence of more G-A and C-T transitions than other mutations (P = 0.031). SARS-CoV-2 selective evolution under Molnupiravir pressure does not differ from that under Paxlovid or no-drug pressure, except for orf8 (dN > dS, P = 0.001); few amino acid mutations are enriched at specific sites. No RNA-dependent RNA polymerase (RdRp) or main proteases (Mpro) mutations conferring resistance to Molnupiravir or Paxlovid are found. This proof-of-concept study defines the SARS-CoV-2 within-host evolution during antiviral treatment, confirming higher in vivo variability induced by Molnupiravir compared to Paxlovid and drug-naive, albeit not resulting in apparent mutation selection
Do all critically ill patients with COVID-19 disease benefit from adding tocilizumab to glucocorticoids? A retrospective cohort study.
Background: Treatment guidelines recommend the tocilizumab use in patients with a CRP of >7.5 mg/dL. We aimed to estimate the causal effect of glucocorticoids + tocilizumab on mortality overall and after stratification for PaO2/FiO2 ratio and CRP levels. Methods: This was an observational cohort study of patients with severe COVID-19 pneumonia. The primary endpoint was day 28 mortality. Survival analysis was conducted to estimate the conditional and average causal effect of glucocorticoids + tocilizumab vs. glucocorticoids alone using Kaplan–Meier curves and Cox regression models with a time-varying variable for the intervention. The hypothesis of the existence of effect measure modification by CRP and PaO2/FiO2 ratio was tested by including an interaction term in the model. Results: In total, 992 patients, median age 69 years, 72.9% males, 597 (60.2%) treated with monotherapy, and 395 (31.8%), adding tocilizumab upon respiratory deterioration, were included. At BL, the two groups differed for median values of CRP (6 vs. 7 mg/dL; p 7.5 mg/dL prior to treatment initiation and the largest effect for a CRP > 15 mg/dL. Large randomized studies are needed to establish an exact cut-off for clinical use
COVID-19-associated vasculitis and thrombotic complications: from pathological findings to multidisciplinary discussion
Neutrophilic arterial vasculitis in COVID-19 represents a novel finding and could be responsible for thrombotic complications
Ceftolozane/Tazobactam for Treatment of Severe ESBL-Producing Enterobacterales Infections: A Multicenter Nationwide Clinical Experience (CEFTABUSE II Study)
Background. Few data are reported in the literature about the outcome of patients with severe extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) infections treated with ceftolozane/tazobactam (C/T), in empiric or definitive therapy.Methods. A multicenter retrospective study was performed in Italy (June 2016-June 2019). Successful clinical outcome was defined as complete resolution of clinical signs/symptoms related to ESBL-E infection and lack of microbiological evidence of infection. The primary end point was to identify predictors of clinical failure of C/T therapy.Results. C/T treatment was documented in 153 patients: pneumonia was the most common diagnosis (n = 46, 30%), followed by 34 cases of complicated urinary tract infections (22.2%). Septic shock was observed in 42 (27.5%) patients. C/T was used as empiric therapy in 46 (30%) patients and as monotherapy in 127 (83%) patients. Favorable clinical outcome was observed in 128 (83.7%) patients; 25 patients were considered to have failed C/T therapy. Overall, 30-day mortality was reported for 15 (9.8%) patients. At multivariate analysis, Charlson comorbidity index >4 (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.9-3.5; P = .02), septic shock (OR, 6.2; 95% CI, 3.8-7.9; P < .001), and continuous renal replacement therapy (OR, 3.1; 95% CI, 1.9-5.3; P = .001) were independently associated with clinical failure, whereas empiric therapy displaying in vitro activity (OR, 0.12; 95% CI, 0.01-0.34; P < .001) and adequate source control of infection (OR, 0.42; 95% CI, 0.14-0.55; P < .001) were associated with clinical success.Conclusions. Data show that C/T could be a valid option in empiric and/or targeted therapy in patients with severe infections caused by ESBL-producing Enterobacterales. Clinicians should be aware of the risk of clinical failure with standard-dose C/T therapy in septic patients receiving CRRT
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