La Scuola di Francoforte

La Scuola di Francoforte costituisce, nel panorama filosofico-politico del Novecento, una delle più ricche e interessanti esperienze di declinazione, di riattualizzazione e, per alcuni aspetti, di critica del marxismo. L'articolo presenta una sintetica ricostruzione l’itinerario teorico della prima generazione della Scuola di Francoforte, concentrandosi in particolare sulle opere degli intellettuali più rappresentativi all’interno di essa (Max Horkheimer, Erich Fromm, Theodor W. Adorno, Friedrich Pollock, Herbert Marcuse), con l’obiet- tivo di evidenziare le innovazioni, in chiave di teoria sociale, apportate da questi autori rispetto alla teoria marxiana

Teorie dello Stato e della democrazia

L'articolo presenta una ricostruzione delle principali teorie dello Stato di area marxista: da Ralph Miliband, a Louis Althusser, a Nicos Poulantzas, fino agli approcci di William Domhoff, di Claus Offe e di Juergen Habermas, per finire con la teoria neomarxista di Jacques Bidet

Avventure dell’alienazione: da Marx alle rivisitazioni contemporanee

Sebbene il concetto di alienazione abbia una storia molto lunga, nella qualele tappe fondamentali sono segnate dal pensiero di filosofi di prima grandezzacome Rousseau, Hegel e Feuerbach, in queste pagine ci limiteremo a riprendere laquestione a partireda Marx, tralasciando di riflettere sul rapporto che lo lega aisuoi grandi predecessori; partiremo da Marx perché il paragone con il suo pensieroci servirà a collocare meglio il lavoro di alcuni studiosi contemporanei che hannocercato di conferire al concetto di alienazione una nuova vitalità, e penso inparticolare a Rahel Jaeggi e Harmut Rosa. L’alienazione di cui ci parlano (in modidiversi l’uno dall’altra) questi autori, ha ancora qualche rapporto con quellamarxiana? Comporta una critica delle tesi del pensatore di Treviri o anche, per altriversi, uno sviluppo di esse

Neoadjuvant treatment in pancreatic cance. Evidence-based medicine? A systematic review and meta-analysis

Neoadjuvant treatment in non-metastatic pancreatic cancer (PaC) has the theoretical advantages of downstaging the tumor, sterilizing any present systemic undetectable disease, selecting patients for surgery and administering therapy to each patient. The aim of this systematic review is to analyze the state of the art on neoadjuvant protocols for non-metastatic PaC. A literature search over the last 10 years was conducted, and papers had to be focused on resectable, borderline resectable (BLR) or locally advanced (LA) histo- or cytologically proven PaC; to be prospective studies or prospectively collected databases; to report percentage of protocol achievement and survival data at least in an intention-to-treat (ITT) analysis. Twelve studies were eligible for systematic review. Studies included a total of 624 patients: 248 resectable, 268 BLR, 71 LA and 37 non-specified. All studies were included for meta-analysis. ITT overall survival (OS) was 16.7 months (95% CI 15.16-18.26 months); for resected patients OS was 22.78 months (95% CI 20.42-25.16), and for eventually non-resected patients it was 9.89 months (95% CI 8.84-10.96). Neoadjuvant approaches for resectable, BLR and LA PaC are spreading. Outcomes tend to be better outside an RCT context, but strong evidences are lacking. Actually such treatments should be performed only in a randomized clinical trial setting

The Role of Neoadjuvant Therapy in Surgical Treatment of Pancreatic Cancer

Pancreatic cancer is a leading cause of cancer-related death worldwide, and its burden is destined to increase. Multimodal treatment is crucial to achieve a cure, but standardization is far to come. Borderline resectable disease is the most challenging situation to face. An anatomically resectable disease may hide a biologically aggressive or undiagnosed systemic disease. Whether the patient has to undergo surgery first or after locoregional or systemic therapy is still unknown. Decision-making stands on low-quality evidences since RCTs are lacking. Neoadjuvant treatment may downstage the tumor and treat an early systemic disease, selecting patients for surgery in order to achieve a margin-free resection and avoid early recurrences and useless pancreatectomies. Resectable patients without other worrisome features may benefit from a surgery-first approach, while all other nonmetastatic patients should be enrolled in trials to rule out the outcomes of neoadjuvant treatments

Overall Survival Following Anastomotic Leakage After Surgery for Carcinoma of the Esophagus and Gastroesophageal Junction: A Systematic Review

The effect of anastomotic leakage, in patients who underwent surgery for carcinoma of the esophagus and gastroesophageal junction, on overall survival (OS) is a debated and controversial topic. The aim of this systematic review was to clarify the impact of anastomotic leakage on long-term survival of patients with esophageal cancer undergoing esophagectomy. A systematic literature review was carried out from 2000 to 2022. We chose articles reporting data from patients who underwent surgery for carcinoma of the esophagus and gastroesophageal junction. Data regarding 1-, 3- and 5-year OS were analyzed. Twenty studies met the inclusion criteria, yielding a total of 9,279 patients. Analyzing data from selected studies, anastomotic leakage was found to be associated with decreased OS in 5,456 cases while in the remaining 3,823 it had no impact on long term survival (p<0.05). However, this result did not emerge from the other studies considered in the systematic review. Anastomotic leakage is a severe postoperative complication, which seems to have an impact on overall survival. However, the topic remains debated and not supported by all case series included in this systematic review

Postoperative Pancreatic Fistula. Is Minimally Invasive Surgery Better than Open? A Systematic Review and Meta-analysis

Background/Aim: Minimally invasive pancreatico-duodenectomy (PD) is gaining popularity. The aim of this study was to compare the incidence of postoperative pancreatic fistula (POPF) after minimally invasive versus open procedures. Materials and Methods: Following the PRISMA statement, literature research was conducted focusing on papers comparing the incidence of POPF after open pancreaticoduodenectomy (OPD) versus minimally invasive pancreaticoduodenectomy (MIPD). Results: Twenty-one papers were included in this meta -analysis, for a total of 4,448 patients. A total of 2,456 patients (55.2%) underwent OPD, while 1,992 (44.8%) underwent MIPD. Age, ASA score III patients, incidence of pancreatic ductal adenocarcinoma and duct diameter were significantly lower in the MIPD group. No statistically significant differences were found between the OPD and MIPD regarding the incidence of major complications (15.6% vs. 17.0%, respectively, p=0.55), mortality (3.7% vs. 2.4%, p=0.81), and POPF rate (14.3% vs. 12.9%, p=0.25). Conclusion: MIPD and OPD had comparable rates of postoperative complications, postoperative mortality, and POPF