Dio è morto? Il fattore religioso nel diritto internazionale penale.

La seguente tesi intende esporre in modo sistematico le tutele offerte al fenomeno religioso dal diritto internazionale penale. Ricomponendo le fasi essenziali che conducono all'odierno diritto internazionale penale e operando una selezione tra le fonti a disposizione, si intraprende l’analisi puntuale delle fattispecie incriminatrici elaborate dal legislatore sovranazionale, rivolte alla salvaguardia dei diritti di interesse religioso. Da ciò emerge l’esigenza di preservare il sentimento religioso, a maggior ragione nei casi in cui venga oltraggiato. Mediante una breve ricostruzione storica, si evidenzia dapprima il forte impatto che la religione ha esercitato sulla cultura e l’identità dei popoli. A tal proposito vengono prese in considerazione le forme di manifestazione artistiche che meglio esprimono nella pratica l’essenza dei principi a cui si ispirano. Segue la descrizione di come tali eventi vengano trattati in ambito internazionale, per il perfezionamento della stessa civiltà giuridica. Da ultimo, si presentano casi materiali nei quali sia possibile rintracciare l’ applicazione più o meno fedele della normativa illustrata

LA GESTIONE CHIRURGICA DELLA TORSIONE OVARICA E TUBARICA IN ETÀ PEDIATRICA: UPDATE E REVISIONE DELLA LETTERATURA

RIASSUNTO La torsione degli annessi uterini è un’emergenza chirurgica definita come la rotazione parziale o totale dell’ovaio, della tuba uterina o di entrambi intorno al proprio asse vascolare con conseguente compromissione del flusso sanguigno a loro afferente. Generalmente coinvolge entrambe le strutture, ma tale fenomeno può interessare il solo ovaio e più raramente la sola tuba. L’espressione “torsione isolata della tuba” (isolated tubal torsion, ITT) è utilizzata quando la torsione tubarica non è associata alla torsione dell’ovaio. La torsione , quale che sia la struttura interessata, richiede un immediato riconoscimento e trattamento al fine di preservare il potenziale riproduttivo futuro, specialmente nelle bambine. Ad oggi il trattamento conservativo è considerato la migliore procedura chirurgica da attuare in caso di torsione per il mantenimento della funzione ovarica. Scopo della tesi è illustrare sistematicamente l’approccio più adeguato da seguire in caso di sospetta torsione degli annessi uterini nei soggetti in età pediatrica. Il lavoro si basa sulla valutazione degli ultimi aggiornamenti in ambito clinico, laboratoristico e strumentale ottenuti dalla letteratura più recente (2013-2015), fino a considerare il trattamento chirurgico più adeguato, elaborato e maturato nel corso dell’esperienza chirurgica al Dipartimento di Chirurgia Pediatrica dell’Università di Pisa e dell’Ospedale Meyer, Università di Firenze. Particolare attenzione è posta all’outcome chirurgico e alle prospettive di trattamento future, ad oggi formulate solo in via sperimentale, che potrebbero migliorare ulteriormente l’approccio conservativo alla patologia e la prognosi delle pazienti

An Unusual Evolution of Krukenberg Tumour: A Case Report

Krukenberg tumours are rare metastatic tumours of the ovaries characterized by the presence of mucin-producing neoplastic Signet Ring Cell Carcinoma (SRCC). At first glance, this tumour may be confused with a primary ovarian tumour. Surgery and chemotherapy combination have led to improvement in prognosis, but it still remains severe. We report the case of a 60-year-old woman with a Krukenberg tumour rising from a low differentiated gastric adenocarcinoma. The patient was clinically stable for 26 months after surgery until she experienced a prompt decline and died of cerebral haemorrhage within two weeks. The aim of this article was to give an overview of the Krukenberg tumour starting from our case report and comparing it with clinicopathological characteristics of this pathology derived from a review of recent literatur

Hollow Fiber and Nanofiber Membranes in Bioartificial Liver and Neuronal Tissue Engineering.

To date, the creation of biomimetic devices for the regeneration and repair of injured or diseased tissues and organs remains a crucial challenge in tissue engineering. Membrane technology offers advanced approaches to realize multifunctional tools with permissive environments well-controlled at molecular level for the development of functional tissues and organs. Membranes in fiber configuration with precisely controlled, tunable topography, and physical, biochemical, and mechanical cues, can direct and control the function of different kinds of cells toward the recovery from disorders and injuries. At the same time, fiber tools also provide the potential to model diseases in vitro for investigating specific biological phenomena as well as for drug testing. The purpose of this review is to present an overview of the literature concerning the development of hollow fibers and electrospun fiber membranes used in bioartificial organs, tissue engineered constructs, and in vitro bioreactors. With the aim to highlight the main biomedical applications of fiber-based systems, the first part reviews the fibers for bioartificial liver and liver tissue engineering with special attention to their multifunctional role in the long-term maintenance of specific liver functions and in driving hepatocyte differentiation. The second part reports the fiber-based systems used for neuronal tissue applications including advanced approaches for the creation of novel nerve conduits and in vitro models of brain tissue. Besides presenting recent advances and achievements, this work also delineates existing limitations and highlights emerging possibilities and future prospects in this field

Habitual Joint Dislocations and Recurrent Multiple Hernias: An Unusual Connective Tissue Disease?

Purpose: Joint laxity and hernia defects are two well-defined conditions that are rarely described in association in literature. The purpose of this study is to describe a peculiar case of connective tissue disorder, not yet defined, whose features are habitual joint dislocations associated with recurrent and multiple hernias. Methods: This is an unusual case regarding a 22 years old male adult, who presented shoulder, patellar, mandibular habitual joint dislocations associated with groin, femoral, epigastric, umbilical, spigelian and lumbar hernias. His phenotype, consisting of tall stature and joint laxity, recalls a similar-marfanoid habitus. Results: Marfan Syndrome, Ehlers-Danlos syndrome, MEN-2B were excluded by specific assessments. The aspecific clinical features of the patient do not consent the identification of an exact diagnosis. Conclusion: This medical case, characterized by joint hypermobility and multiple recurrent hernias, probably consists in an unacknowledged peculiar case of connective tissue disorder. Further investigations and identification of subjects with similar features could be surely useful to diagnostic research and definitive characterization of patient’s disease

Publication Preview Source It's [not] just the English: Issues in the pre-departure academic orientation of international Masters and research students

This paper reports on research that examined the academic resources and language materials a group of mainly Indonesian international Non Native English Speaking Background Masters and Research Higher Degrees students received prior to the commencement of their degrees in Australia. Contrary to the researchers' expectations, expectations which are also often emphasized in the literature pertaining to this issue, the data pertaining to post-commencement reflections suggest that academic English language competency was not always or mainly identified by respondents as the main challenge these students faced in transition. In terms of academic orientation, for many of the respondents, issues linked to their transition that related as much to navigating a new culture of inquiry as it did to a new language of inquiry were as much if not more significant than the issue of (academic) English

Heart rate reduction with esmolol is associated with improved arterial elastance in patients with septic shock: a prospective observational study

PURPOSE: Ventricular–arterial (V–A) decoupling decreases myocardial efficiency and is exacerbated by tachycardia that increases static arterial elastance (Ea). We thus investigated the effects of heart rate (HR) reduction on Ea in septic shock patients using the beta-blocker esmolol. We hypothesized that esmolol improves Ea by positively affecting the tone of arterial vessels and their responsiveness to HR-related changes in stroke volume (SV). METHODS: After at least 24 h of hemodynamic optimization, 45 septic shock patients, with an HR ≥95 bpm and requiring norepinephrine to maintain mean arterial pressure (MAP) ≥65 mmHg, received a titrated esmolol infusion to maintain HR between 80 and 94 bpm. Ea was calculated as MAP/SV. All measurements, including data from right heart catheterization, echocardiography, arterial waveform analysis, and norepinephrine requirements, were obtained at baseline and at 4 h after commencing esmolol. RESULTS: Esmolol reduced HR in all patients and this was associated with a decrease in Ea (2.19 ± 0.77 vs. 1.72 ± 0.52 mmHg l−1), arterial dP/dtmax (1.08 ± 0.32 vs. 0.89 ± 0.29 mmHg ms−1), and a parallel increase in SV (48 ± 14 vs. 59 ± 18 ml), all p < 0.05. Cardiac output and ejection fraction remained unchanged, whereas norepinephrine requirements were reduced (0.7 ± 0.7 to 0.58 ± 0.5 µg kg−1 min−1, p < 0.05). CONCLUSIONS: HR reduction with esmolol effectively improved Ea while allowing adequate systemic perfusion in patients with severe septic shock who remained tachycardic despite standard volume resuscitation. As Ea is a major determinant of V–A coupling, its reduction may contribute to improving cardiovascular efficiency in septic shock

Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Background Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO. Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited

Overstimulation of glutamate signaling in hamster hippocampal neurons: what’s new?

It is known that ischemic complications arise from neuronal and glial dysfunctions occurring in almost all brain areas. Within some neuronal networks, an early excitatory/inhibitory circuit imbalance tends to account for premature neuronal damages especially during the initial stages of perinatal development. Interestingly, cellular conditions reported in ischemia were also detected during the different phases of hibernation cycle and above all arousal state. Hibernating animals are able to survive under these conditions without neurological damage, so their neuronal circuits present an opportunity to investigate molecular strategies involved in mammalian cell survival under unfavorable conditions. We reported a contextual alterations of both ionotropic and metabotropic Glutamatergic systems in perinatal hippocampal neurons in response to ischemic-like condition, according to their early activation during neuronal development (Giusi et al., 2009; Di Vito et a.l, 2012). In addition, an altered expression was also reported for specific PSD scaffold proteins, which regulate Glutamate receptors targeting (Al-Hallaq et al., 2007). From our preliminary results, we can suggest that specific alterations of glutamatergic receptors, which differ significantly from those reported in other rodent, could play a major role toward the correction of neuronal development aberrations linked to clinical disorders