Oltre le narrazioni dell\u2019umanitario. Beyond Humanitarian Narratives

Questo numero monografico della rivista \uabSociologia della comunicazione\ubb \ue8 dedicato agli aspetti etici, estetici e politici della \u201cnarrativa umanitaria\u201d, con particolare attenzione alla rappresentazione dei migranti e dei lori Paesi di origine prodotta dai media, dalle agenzie degli aiuti umanitari, dalle ONG (Organizzazioni Non Governative) e dagli altri soggetti della societ\ue0 civile e del terzo settore. L\u2019ipotesi di fondo che ci ha orientato nella scelta del tema e lungo la strutturazione del nostro percorso \ue8 che i flussi migratori irregolari nel Mediterraneo degli ultimi anni siano associabili, in ambito comunicativo, a una dislocazione discorsiva della rappresentazione dello \u201cspettacolo del dolore\u201d a distanza, proposta dai media mainstream e dalle agenzie dell\u2019umanitario, dal contesto dell\u2019aiuto umanitario e della filantropia, al contesto della sicurezza e dell\u2019ordine pubblico nazionale. Un tema di grande rilevanza nel dibattito internazionale, ma che non ha ancora raggiunto un\u2019adeguata conoscenza nel nostro Paese. I contributi contenuti nel volume, pubblicati in lingua italiana o inglese, si collocano all\u2019interno del pi\uf9 aggiornato dibattito internazionale sul tema

[The ISP (Safe Insertion of PICCs) protocol: a bundle of 8 recommendations to minimize the complications related to the peripherally inserted central venous catheters (PICC)]

The ISP (Safe Insertion of PICCs) protocol: a bundle of 8 recommendations to minimize the complications related to the peripherally inserted central venous catheters (PICC)

Uterine smooth muscle tumors of uncertain malignant potential (STUMP): pathology, follow-up and recurrence.

The term smooth uterine muscle of uncertain malignant potential (STUMPs) indicates a group of uterine smooth muscle tumors (SMTs) that cannot be diagnosed unequivocally as benign or malignant. Diagnosis, surgical management, and follow-up of this neoplasm remain controversial, especially in pre-menopausal women with fertility desire, due to the non aggressive behaviour and prolonged survival rate when compared to leiomyosarcomas. However, recurrence is estimated between 8.7% and 11% and may include delayed-recurrences. We reported five cases of uterine masses treated by surgical procedure diagnosed as STUMP on final pathology. Four patients underwent a total abdominal hysterectomy with or without salpingo-oophorectomy. One patient underwent excision of uterine mass and subsequent total abdominal hysterectomy plus bilateral salpingo-oophorectomy after the diagnosis of STUMP. All patients in our study remained recurrence-free to date (with a follow up period ranging from 6 to 81 months). Based on our experience and in consideration of the lack of consensus regarding the malignant potential, diagnostic criteria, gold-standard treatment and follow-up, we believe that close multidisciplinary management is mandatory in the event of STUMP. We suggest that gynaecologist, dedicated pathologist (with high level of expertize in gynaecological pathology) and oncologist should work as a team in the counselling and management of this neoplasm from detection till completion of follow up. Furthermore, we recommend immunohistochemistry to investigate the overexpression of p16 and p53 in order to identify the cohort of patients at increased risk of recurrence who may benefit from more aggressive surgical-oncological strategies

Female Stress Urinary Incontinence: Clinical Efficacy and Satisfaction After Transobturator Adjustable Tape Sling. An Observational Longitudinal Cohort Study.

We performed an observational longitudinal cohort study on patients affected by stress urinary incontinence (SUI) and surgically treated with a transobturator adjustable tape sling (TOA) in order to evaluate this surgical procedure in terms of efficacy, safety, quality of life (QoL) improvement, and patient satisfaction. For all patients, we recorded: general features, preoperative SUI risk factors, obstetrics history, preoperative urodynamic tests, intraoperative/postoperative complications, number of postoperative sling regulations, postmicturition residue, and hospital stay. All patients were asked to complete the validated short version of the Urogenital Distress Inventory (UDI-6) questionnaire 18 months after discharge to evaluate the efficacy of the TOA system. We added 2 adjunctive items to the UDI-6 in order to evaluate patient satisfaction and QoL. All 77 surgical procedures were performed under locoregional anesthesia without complications. Postoperative TOA regulations were performed in 46.8% of patients immediately after the procedure and in 14.3% during hospitalization. Before discharge, postmicturition residue was negative in 67 cases and less than 50 cc in 10 cases. Mean hospital stay was 2.18 days. From the questionnaire evaluation, we found that after the procedure, 90.9% of patients showed a complete regression of urinary symptoms, 1.3% obtained considerable relief from preoperative symptoms, and 6.6% reported poor or absent symptom improvements; 75.3% of patients were totally satisfied and 5.2% totally disappointed. The possibility of modulating postoperative sling tension and reusing the surgical materials in association with short hospitalization as well as high patient satisfaction render TOA a safe, effective, and low-cost technique for the treatment of female SUI

The physiopathologic role of oxidative stress in skeletal muscle.

Muscle senescence is a complex mechanism that is usually associated with a decrease in mass, strength and velocity of contraction. This state, known as sarcopenia, is a multifactorial process and it may be the consequence of several events, including accumulation of oxidative stress. The role of oxidative stress in the physiopathology of skeletal muscle is quite complex. Transiently increased levels of oxidative stress might reflect a potentially health promoting process, while an uncontrolled accumulation might have pathological implication. The physiopathological role of oxidative stress on skeletal muscle, its involvement in aging-induced sarcopenia, and potential countermeasures will be discusse

Muscle-type dependent sarcolemmal NOS1 mislocalization following 91 days exposure to effective microgravity onboard the International Space Station (ISS).

Exposure to eective microgravity (G) causes numerous adaptive changes to skeletal muscle, which usually lead to a pronounced muscle atrophy. This evidence was obtained in animal experiments in short-term space ight missions. However, the eects of long-term exposure to eective G is still unexplored. This contribution presents the analysis of nitric oxide synthase-1 (NOS1) gene expression and subcellular distribution carried out in soleus (SOL) and extensor digitorum longus (EDL) of mice housed for 91 days in a mice drawer system (MDS) onboard the ISS (1). The long-term exposure to G onboard the ISS caused a signicant muscle atrophy to anti-gravity soleus but not to the fast-twitch EDL. Atrophy was associated to the altered expression of diverse genes (1). The present results show that NOS1 expression was highly misregulated in both soleus and EDL of space own mice. Moreover, laser confocal microscope image analysis demonstrates that space ight induced translocation of sarcolemmal NOS1 into the cytosol in soleus but not in EDL. This is in agreement with the sarcolemma-to-cytosol NOS1 mislocalization observed in ground-based microgravity models (2,3). Our results strongly support the hypothesis that preservation of NOS/NO signaling in EDL muscle might represent an adaptive protective process that explains the absence of atrophy even after the prolonged exposure to long-term exposure to microgravity. The MDS project was sponsored by the Italian Space Agency. (1) Sandona et al., PlosOne 2012 in press); (2) Suzuki N, et al. (2007) J Clin Invest 117: 2468-2476; (3) Rudnick J, et al. (2004) FASEB J 18: 1228-1230. Sponsor: DLR 50WB112

Short-, medium- and long-term effects on skeletal muscles in pre-flight tests of MDS mission

The Mouse Drawer System (MDS) is an automated rodent spaceflight payload designed to accommodate mice in individual cages on board the International Space Station. The MDS cage size is smaller than standard laboratory cages and might affect overall mouse activity and muscle properties. Therefore we examined the effects of 20-, 60- and 100-day housing in MDS cages on skeletal muscle properties, as a ground control experiment in view of the scheduled spaceflight mission. In particular, we evaluated muscle morphology and some physiological properties, as well as the expression of different genes, including critical atrophy genes. After 20 days, body weight of MDS mice slightly decreased compared to controls, whereas control and MDS mice showed similar weight in the 60- and 100-day tests. No major differences were observed in the mean fiber cross sectional area of fast (EDL) and slow (soleus) muscles from control and MDS mice. Electrophysiological properties were comparable in control and 60-day MDS mice. Expression of ubiquitin-ligases and autophagic genes was slightly up-regulated in the short-term MDS test only. SDS-PAGE analysis of myosin heavy chain composition demonstrated slight modifications only in the 20-day MDS EDL muscle and the 60-day MDS soleus muscle. In conclusion, our preliminary analyses point to minor adaptive changes in hind limb muscles of mice housed for 20 days in MDS cages, whereas no significant change was observed at later stages, suggesting that the MDS payload is suitable for studies on skeletal muscle in future spaceflight missions

Increased plin2 expression in human skeletal muscle is associated with sarcopenia and muscle weakness

Human aging is associated with a progressive loss of muscle mass and strength and a concomitant fat accumulation in form of inter-muscular adipose tissue, causing skeletal muscle function decline and immobilization. Fat accumulation can also occur as intra-muscular triglycerides (IMTG) deposition in lipid droplets, which are associated with perilipin proteins, such as Perilipin2 (Plin2). It is not known whether Plin2 expression changes with age and if this has consequences on muscle mass and strength. We studied the expression of Plin2 in the vastus lateralis (VL) muscle of both healthy subjects and patients affected by lower limb mobility limitation of different age. We found that Plin2 expression increases with age, this phenomenon being particularly evident in patients. Moreover, Plin2 expression is inversely correlated with quadriceps strength and VL thickness. To investigate the molecular mechanisms underpinning this phenomenon, we focused on IGF-1/p53 network/signalling pathway, involved in muscle physiology. We found that Plin2 expression strongly correlates with increased p53 activation and reduced IGF-1 expression. To confirm these observations made on humans, we studied mice overexpressing muscle-specific IGF-1, which are protected from sarcopenia. These mice resulted almost negative for the expression of Plin2 and p53 at two years of age. We conclude that fat deposition within skeletal muscle in form of Plin2-coated lipid droplets increases with age and is associated with decreased muscle strength and thickness, likely through an IGF-1- and p53-dependent mechanism. The data also suggest that excessive intramuscular fat accumulation could be the initial trigger for p53 activation and consequent loss of muscle mass and strength

Atrophy/hypertrophy cell signaling in muscles of young athletes trained with vibrational-proprioceptive stimulation.

Neurol Res. 2011 Dec;33(10):998-1009. Atrophy/hypertrophy cell signaling in muscles of young athletes trained with vibrational-proprioceptive stimulation. Kern H, Pelosi L, Coletto L, Musar\uf2 A, Sandri M, Vogelauer M, Trimmel L, Cvecka J, Hamar D, Kovarik J, L\uf6fler S, Sarabon N, Protasi F, Adami N, Biral D, Zampieri S, Carraro U. Source Wilhelminenspital, Wien, Austria. Abstract OBJECTIVE: To compare the effects of isokinetic (ISO-K) and vibrational-proprioceptive (VIB) trainings on muscle mass and strength. METHODS: In 29 ISO-K- or VIB-trained young athletes we evaluated: force, muscle fiber morphometry, and gene expression of muscle atrophy/hypertrophy cell signaling. RESULTS: VIB training increased the maximal isometric unilateral leg extension force by 48\ub71%. ISO-K training improved the force by 24\ub78%. Both improvements were statistically significant (P\u2a7f0\ub701). The more functional effectiveness of the VIB training in comparison with the ISO-K training was shown by the statistical significance changes only in VIB group in: rate of force development in time segment 0-50 ms (P<0\ub7001), squat jump (P<0\ub705) and 30-m acceleration running test (P<0\ub705). VIB training induced a highly significant increase of mean diameter of fast fiber (+9%, P<0\ub7001), but not of slow muscle fibers (-3%, not significant). No neural cell adhesion molecule-positive (N-CAM(+)) and embryonic myosin heavy chain-positive (MHC-emb(+)) myofibers were detected. VIB induced a significant twofold increase (P<0\ub705) of the skeletal muscle isoform insulin-like growth factor-1 (IGF-1) Ec mRNA. Atrogin-1 and muscle ring finger-1 (MuRF-1) did not change, but myostatin was strongly downregulated after VIB training (P<0\ub7001). Peroxisome proliferator-activated receptor \u3b3 coactivator-1\u3b1 (PGC-1\u3b1) expression increased in post-training groups, but only in VIB reached statistical significance (+228%, P<0\ub705). DISCUSSION: We demonstrated that both trainings are effective and do not induce muscle damage. Only VIB-trained group showed statistical significance increase of hypertrophy cell signaling pathways (IGF-1Ec and PGC-1\u3b1 upregulation, and myostatin downregulation) leading to hypertrophy of fast twitch muscle fibers. PMID: 22196751 [PubMed - in process

Long-term high-level exercise promotes muscle reinnervation with age.

The histologic features of aging muscle suggest that denervation contributes to atrophy, that immobility accelerates the process, and that routine exercise may protect against loss of motor units and muscle tissue. Here, we compared muscle biopsies from sedentary and physically active seniors and found that seniors with a long history of high-level recreational activity up to the time of muscle biopsy had 1) lower loss of muscle strength versus young men (32% loss in physically active vs 51% loss in sedentary seniors); 2) fewer small angulated (denervated) myofibers; 3) a higher percentage of fiber-type groups (reinnervated muscle fibers) that were almost exclusive of the slow type; and 4) sparse normal-size muscle fibers coexpressing fast and slow myosin heavy chains, which is not compatible with exercise-driven muscle-type transformation. The biopsies from the old physically active seniors varied from sparse fiber-type groupings to almost fully transformed muscle, suggesting that coexpressing fibers appear to fill gaps. Altogether, the data show that long-term physical activity promotes reinnervation of muscle fibers and suggest that decades of high-level exercise allow the body to adapt to age-related denervation by saving otherwise lost muscle fibers through selective recruitment to slow motor units. These effects on size and structure of myofibers may delay functional decline in late aging. Trial registration: ClinicalTrials.gov (NCT01679977)