El valor como problemática discursiva: propuesta de un modelo analítico para el caso de los mercados artísticos

El presente trabajo tiene por objetivo presentar desarrollos parciales en torno a la configuración de un modelo semiótico para el análisis de las relaciones discursivas que operan en la construcción social del valor de las mercancías artísticas. Puesto que el problema del lugar de la discursividad social en la producción del valor económico excede el ámbito de las artes, desarrollaremos en primer lugar una hipótesis general según la cual, en cualquier intercambio económico, la constitución relacional del valor en una cadena de instancias se encuentra siempre sujeta a condiciones de intercambio discursivas que, lejos de “comunicar” entre esas instancias una información económica “objetiva”, son atravesadas por desfasajes meta-argumentativos y meta-narrativos. Así, en virtud de esos desfasajes, esta discursividad que organiza las instancias de oferta y demanda de un bien, por definición, jamás puede ser idéntica en una u otra posición del intercambio. En segundo lugar, y específicamente en relación con casos específicos de mercados artísticos, buscaremos mostrar la centralidad del componente metadiscursivointermediario (publicidades, críticas, comentarios on line, rumores, etc.) en la construcción de colectivos de intercambio que, más que estar predeterminados por categorías económicas, surgen por efecto de funcionamientos estrictamente semióticos

Report of mycobacteria isolated from domestic and wildlife species during 2004-2008

La identificación de la tuberculosis bovina y su diferenciación de las micobacteriosis es fundamental durante el diagnóstico. Es por eso que los laboratorios especializados en micobacterias son de suma importancia en los servicios de salud pública y salud animal. El objetivo de la presente investigación es diferenciar Mycobacterium bovis de micobacterias no tuberculosas en cepas cultivadas a partir de especies domésticas y silvestres de siete provincias de Argentina durante 2004-2008. La diferenciación se basó sobre las pruebas bioquímicas, las características fenotípicas y el “spolygotyping” de M. bovis. Con la identificación bioquímica y fenotípica se detectaron 20 cepas de M. bovis, 18 de las cuales fueron confirmadas mediante “spolygotyping”, y 34 cepas de micobacterias no tuberculosas. Trece especies fueron caracterizadas y todas ellas fueron agrupadas considerando el riesgo biológico y el potencial patógeno notificado en seres humanos y/o animales. En este trabajo se han logrado avances en el diagnóstico de tuberculosis y micobacteriosis en medicina veterinaria. En este área el diagnóstico habitualmente se basa sobre la observación micro y macroscópica de los tubérculos y los resultados de la intradermorreacción. Estos avances son importantes porque la tuberculosis zoonótica aún es un problema de salud pública en América Latina.Detection and identification of bovine tuberculosis and its differentiation from micobacteriosis is fundamental during diagnoses. That is why mycobacteria laboratories improvement becomes essential in public health and veterinary medicine services. The objective of the present research is to differentiate Mycobacterium bovis and nontuberculous mycobacterias in isolates cultured from domestic and wildlife species from seven Argentinean provinces during 2004-2008. Differentiation was based on biochemical tests, phenotypic characteristics and M. bovis spolygotyping. Biochemical and phenotypic identification resulted in 20 M. bovis strains, 18 of them were confirmed by spolygotyping, and 34 nontuberculous mycobacteria strains. Thirteen species were characterized and all of them were grouped considering biological risk and pathogenic potential reported in humans and/or animals. Here we have reached advances in tuberculosis and micobacteriosis diagnoses in veterinary medicine. In this area diagnoses are often based on micro and macroscopic observation of the tubercles and skin test results. These advances are not minor as zoonotic tuberculosis is still a public health problem in Latin America.Facultad de Ciencias Veterinaria

Report of mycobacteria isolated from domestic and wildlife species during 2004-2008

La identificación de la tuberculosis bovina y su diferenciación de las micobacteriosis es fundamental durante el diagnóstico. Es por eso que los laboratorios especializados en micobacterias son de suma importancia en los servicios de salud pública y salud animal. El objetivo de la presente investigación es diferenciar Mycobacterium bovis de micobacterias no tuberculosas en cepas cultivadas a partir de especies domésticas y silvestres de siete provincias de Argentina durante 2004-2008. La diferenciación se basó sobre las pruebas bioquímicas, las características fenotípicas y el “spolygotyping” de M. bovis. Con la identificación bioquímica y fenotípica se detectaron 20 cepas de M. bovis, 18 de las cuales fueron confirmadas mediante “spolygotyping”, y 34 cepas de micobacterias no tuberculosas. Trece especies fueron caracterizadas y todas ellas fueron agrupadas considerando el riesgo biológico y el potencial patógeno notificado en seres humanos y/o animales. En este trabajo se han logrado avances en el diagnóstico de tuberculosis y micobacteriosis en medicina veterinaria. En este área el diagnóstico habitualmente se basa sobre la observación micro y macroscópica de los tubérculos y los resultados de la intradermorreacción. Estos avances son importantes porque la tuberculosis zoonótica aún es un problema de salud pública en América Latina.Detection and identification of bovine tuberculosis and its differentiation from micobacteriosis is fundamental during diagnoses. That is why mycobacteria laboratories improvement becomes essential in public health and veterinary medicine services. The objective of the present research is to differentiate Mycobacterium bovis and nontuberculous mycobacterias in isolates cultured from domestic and wildlife species from seven Argentinean provinces during 2004-2008. Differentiation was based on biochemical tests, phenotypic characteristics and M. bovis spolygotyping. Biochemical and phenotypic identification resulted in 20 M. bovis strains, 18 of them were confirmed by spolygotyping, and 34 nontuberculous mycobacteria strains. Thirteen species were characterized and all of them were grouped considering biological risk and pathogenic potential reported in humans and/or animals. Here we have reached advances in tuberculosis and micobacteriosis diagnoses in veterinary medicine. In this area diagnoses are often based on micro and macroscopic observation of the tubercles and skin test results. These advances are not minor as zoonotic tuberculosis is still a public health problem in Latin America.Facultad de Ciencias Veterinaria

New Copy Number Variations in Schizophrenia

Genome-wide screenings for copy number variations (CNVs) in patients with schizophrenia have demonstrated the presence of several CNVs that increase the risk of developing the disease and a growing number of large rare CNVs; the contribution of these rare CNVs to schizophrenia remains unknown. Using Affymetrix 6.0 arrays, we undertook a systematic search for CNVs in 172 patients with schizophrenia and 160 healthy controls, all of Italian origin, with the aim of confirming previously identified loci and identifying novel schizophrenia susceptibility genes. We found five patients with a CNV occurring in one of the regions most convincingly implicated as risk factors for schizophrenia: NRXN1 and the 16p13.1 regions were found to be deleted in single patients and 15q11.2 in 2 patients, whereas the 15q13.3 region was duplicated in one patient. Furthermore, we found three distinct patients with CNVs in 2q12.2, 3q29 and 17p12 loci, respectively. These loci were previously reported to be deleted or duplicated in patients with schizophrenia but were never formally associated with the disease. We found 5 large CNVs (>900 kb) in 4q32, 5q14.3, 8q23.3, 11q25 and 17q12 in five different patients that could include some new candidate schizophrenia susceptibility genes. In conclusion, the identification of previously reported CNVs and of new, rare, large CNVs further supports a model of schizophrenia that includes the effect of multiple, rare, highly penetrant variants

Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis

We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P < 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD4OL (Spearman's rank correlation coefficient [r(s)], -0.33; P < 0.001), sNox2-dp (r(s), -0.57; P < 0.0001), and urinary excretion of isoprostanes (r(s), -0.48; P < 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2 alpha-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population