Did the European Union Light a Beacon of Hope in North Africa? Assessing the Effectiveness of EU Democracy Promotion in Tunisia. EU Diplomacy Paper 6/2017

This analysis addresses the European Union’s (EU) democracy promotion policy in Tunisia, aiming at understanding its evolution and at assessing its effectiveness: how did the EU’s approach to democracy promotion evolve overtime? To what extent was it effective in promoting Tunisia’s democratic transition? In order to assess the impact of an external actor in the democratic transition, I opted for a two-folded approach: on the one hand, I analysed the EU’s declaratory policy regarding democracy promotion and its implementation. On the other hand, I identified several domestic key actors and analysed their perception of the EU’s contribution to the transition process. I argue that the EU did not apply a ‘democracy promotion’ policy, as this concept implies preparing the ground for political change by actively promoting democratic values. In Tunisia, the EU rather applied a ‘democracy support’ policy: once the regime collapsed, the EU exploited the new ‘window of opportunity’. However, the EU did not have a substantial impact on the outcome of Tunisia’s democratisation: according to the key players’ perception, the EU positively contributed to the success of the transition, but it did not make the difference: Tunisia would have become a democracy with or without the EU’s political and financial support

Effects of Single-Dose Prucalopride on Intestinal Hypomotility in Horses: Preliminary Observations

Abnormalities of gastrointestinal motility are often a challenge in horses; however, the use of prokinetic drugs in such conditions must be firmly established yet. For this reason we carried out a preliminary study on the effects of prucalopride on intestinal motor activity of horses with gut hypomotility. The effect of prucalopride per os by oral dose syringe (2 mg/100 kg body weight) was assessed by abdominal ultrasound (evaluating duodenal, cecal, and colonic motor activity) in six horses with gut hypomotility. After administration of prucalopride, a significant increase of contractile activity was found in the duodenum at 30 minutes (p = 0.0005), 60 minutes (p = 0.01) and 90 minutes (p = 0.01), whereas in the cecum and in the left colon the increase was only present at 60 minutes (p = 0.03, and p = 0.02, respectively). No changes from baseline heart and respiratory rate or behavior side effects were observed after administration of the drug and throughout the observation period. Prucalopride may be a useful adjunct to the therapeutic armamentary for treating hypomotile upper gut conditions of horses. Dosing information is however needed to establish its actual clinical efficacy and its proper effects on the large bowel in these animals

Allergic contact dermatitis is a frequent disease in the dermatological practice : Patch Test is used to make the diagnosis of this disease

La dermatitis alérgica de contacto (DAC) es una enfermedad frecuente en la consulta dermatológica. Para su diagnóstico contamos con una herramienta muy útil como es el test del parche. Objetivos: Determinar características epidemiológicas de nuestra población y prevalencia de alérgenos en los pacientes atendidos en el Hospital LC Lagomaggiore de Mendoza a través del test del parche. Materiales y métodos: Estudio descriptivo observacional transversal. Se seleccionaron pacientes con antecedentes de eczema crónico evaluados en el Servicio de Dermatología desde marzo 2017 hasta junio 2017. Los mismos fueron estudiados mediante la aplicación de pruebas epicutáneas (test del parche) y utilizándose la batería estándar latinoamericana de alérgenos recomendada por el consenso de la Sociedad Argentina de Dermatología. LA-1000 Chemotechnique (Suecia). Resultados: Se estudiaron un total de 21 pacientes, 16 fueron mujeres (76%) y 5 varones (24%). Del total, 11 pacientes (52%) obtuvieron un resultado positivo al menos a un alérgeno. El níquel (21%, 7 pacientes) fue el alérgeno más frecuente. Las manos fueron el sitio con mayor afectación (18%, 16 pacientes). Conclusión: El test del parche es una prueba segura y una herramienta fundamental en el diagnóstico de la DAC. Permite hallar el o los alérgenos involucrados y así poder evitar la exposición a los mismos como parte fundamental de la terapéutica.Allergic contact dermatitis is a frequent disease in the dermatological practice. Patch test is used to make the diagnosis of this disease. Objectives: To determine the epidemiological characteristics and prevalence of allergens in patients of the Hospital LC Lagomaggiore´s in Mendoza. Materials and methods: Transversal observational descriptive study. Patients with a history of chronic eczema were evaluated at Dermatology Unit since March 2017 to June 2017. Patients were studied by applying epicutaneous tests (Patch test) and using the standard Latin American allergen battery recommended by the Argentinian Dermatology Society. Results: A total of 21 patients were studied, 16 were women (76%) and 5 men (24%). Of the total, 11 patients (52%) obtained a positive result at least to one allergen. Nickel (21%, 7 patients) was the most frequent allergen. The hands were the most affected site (18%, 16 patients). Conclusion: The patch test is a safe test and a fundamental tool in the diagnosis of allergic contact dermatitis. It allows to find the allergen involved and thus avoid its exposure as a fundamental part of the therapy.Fil: Cheseé, Clara. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Abaca, María Celeste. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Bassotti, Adriana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Parra, Viviana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Influence of genetics on tumoral pathologies: The example of the adenocarcinoma arising in Barrett's esophagus

Barrett's esophagus (BE) refers to an abnormal change (metaplasia) in the cells of the inferior portion of the esophagus. About 10% of patients with symptomatic gastroesophageal reflux disease (GERD) have BE. In some cases, BE develops as an advanced stage of erosive esophagitis. The risk of esophageal cancer appears to be increased in patients with BE. The only way to diagnose BE is by endoscopy and histology. Some studies suggest that intensive treatment of Barrett's esophagus with effective acid suppression can reduce the amount of abnormal lining in the esophagus. It is not clear whether such treatment also prevents esophageal cancer. Generally, the cancer starts out as carcinoma of the esophagus on the surface, and then invades the surrounding tissue. Surgery offers the best chance of long-term survival. There are many events that occur in Barrett's esophagus that lead to the development of cancer and most of them appear to occur early, before high-grade dysplasia or cancer develops. No one knows what the late events are and how cells acquire the ability to leave their normal growth boundaries. It is now widely accepted that the development of most cancers is due to something called genomic or genetic instability. The aim of this review is to show BE pathology in its progression to cancer looking for new biomarkers to distinguish between BE-dysplasia (low grade and high grade)- adenocarcinoma (ADC) and to characterize the ADC, giving more hope for its treatment

Modelli di organizzazione ex d.lgs. 231/2001 e prevenzione dei rischi

A tredici anni esatti dall’ingresso nel nostro ordinamento della cosiddetta Responsabilità Amministrativa degli Enti per opera del noto D. Lgs. 8 giugno 2001, n. 231, sembra, a parere di chi scrive, che tale tema non sia destinato, almeno per i prossimi anni, a non far parlare di sé. Il compito di questo studio sarà quello di tradurre in chiave giuridica quella prassi imprenditoriale che oggi è nota con il nome di Risk Management. Per cercare di raggiungere un così alto obbiettivo si ricostruirà l’iter legislativo che ha portato all’introduzione dei Modelli di Organizzazione e gestione dei Rischi. La comparazione con gli ordinamenti di common law, unita alle pressioni dei nostri “cugini” europei, ci permetterà di capire come le prassi internazionali ci abbiano aiutato a superare il vincolo dettato dal brocardo latino del Societas delinquere non potest. Ripercorso tale iter, a cui si deve l’emanazione della legge delega n. 300 del 2000, si passerà attraverso i principi cardine di questo “microcodice” che è stato racchiuso nel corpo del D. lgs. n. 231/2001 agli articoli 1), 2), 3) e 4). Tale analisi ha permesso di arricchire l’elaborato con i contributi espressi dalla dottrina in questi anni. Non mancheranno critiche alle scelte espresse dal legislatore delegato, soprattutto, si dirà, sotto il profilo del nomen iuris scelto. Superata questa fase di inquadramento a livello di diritto sostanziale, ci si è posti l’obiettivo di circoscrivere l’ambito di applicazione della disciplina della responsabilità degli enti. In questo caso, i limiti espressi dal delegato sono stati recepiti positivamente, distinguendosi tra criteri oggettivi di attribuzione e criteri soggettivi. Tra i primi, si può denotare l’evolversi dei concetti di Interesse e Vantaggio che l’ente ricava dal verificarsi del reato presupposto. Invece, sotto il profilo soggettivo, o meglio, sotto il profilo di qualifica all’interno dell’ente del soggetto cui è imputabile il reato da cui viene fatta risalire anche la responsabilità dell’ente, apprezzeremo la definizione di Soggetti Apicali e Sottoposti. Bisogna ricordare, infatti, che tale disciplina nasce per mitigare i crimini dei cosiddetti Colletti Bianchi. Proseguendo con la trattazione, facendo riferimento agli articoli 24 e 25 del D.lgs. 231/2001, vedremo come da un’ipotesi iniziale ristretta, in cui venivano ascritti all’ente a titolo di responsabilità solo poche fattispecie, si è rapidamente passati ad un corposo ampliamento di tali ipotesi, sino all’inserimento dell’articolo 25 duodecies operato dal legislatore con il D. Lgs. del 16 luglio 2012, n. 109. Da questo modus operandi si evidenzierà come il legislatore scelse non avvalersi dei poteri collegati alla legge delega, bensì ha consacrato le nuove fattispecie a seguito di puntuali ed autonomi interventi legislativi. Tra questi interventi successivi al D. Lgs. n. 231/2001, abbiamo scelto di posizionare il nostro focus, non potendo trattare tutte le fattispecie in tal sede, sull’articolo 25 undecies che disciplina il caso di connessione della responsabilità degli enti all’ampia gamma dei reati ambientali. Tale inserimento, resosi necessario per rispettare gli impegni sanciti dalla Direttiva n. 2008/99/CE e la connessa Direttiva n. 2009/123/CE (che modificava la Direttiva 2005/35/CE) si è concretizzato con l’emanazione del D. Lgs. n. 121/2011. In particolare, la prima direttiva sopra richiamata risultò molto importante per l’aver imposto agli Stati membri di approntare sanzioni penali efficaci, proporzionate e dissuasive in relazione a condotte offensive dell’ambiente. Rispetto a tutte le altre ipotesi presenti nel decreto, il caso dei reati ambientali è stato scelto, non tanto per le sue complessità di diritto sostanziale in tema penale, bensì per il sistema di Risk management che deve essere attivato da tutti gli enti che potrebbero avere ripercussioni sull’ambiente in virtù della propria attività. Proprio sullo slancio della responsabilità ex articolo 25 undecies, si procederà all’individuazione dell’ultimo punto d’interesse di questo studio. Infatti, per raggiungere l’obiettivo che ci si era posti, non si poteva che giungere alla “porta d’accesso” al Diritto del Rischio. Il fascino per questa materia che, a parere di chi scrive, racchiude in sé i principi propri dell’Analisi Giuridica dell’Economia mutandoli e piegandoli al proprio specifico campo d’analisi, ci ha permesso di considerare la responsabilità amministrativa degli enti come una “tecnica anticipativa del rischio”, intesa come risposta diretta alle esigenze di prevenzione e quindi ad un’anticipazione della tutela, di cui, come si dirà, i Modelli organizzativi ex D.lgs. n. 231/2001 costituiscono una delle più efficaci espressioni. In tutta la trattazione il vero fil rouge sarà rinvenuto nell’analisi dei profili di rischio che viene espressa dagli enti con la creazione dei modelli organizzativi e di gestione dei rischi, il tutto sotto la lente di un legislatore sempre più attento alla prevenzione dei reati che potrebbero essere scongiurati grazie ad una gestione sempre più efficace, nonché necessaria, da parte degli enti

Despedida a mi maestro Prof. Cristóbal Parra

Fil: Bassotti, Adriana. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Departamento de Medicina Intern

Blue-green endoscopy in a dog presenting chronic vomiting-regurgitation

A 2-year-old male Maremma sheepdog presenting with chronic vomiting-regurgitation was examined at the University Veterinary Teaching Hospital, Camerino University. An oesophagogastroscopy with a single blue + green (BG) filter restricting wavelengths from 400 to 550 nm was carried out. A conventional white light endoscopy showed a dilated oesophagus with mildly diffuse erythematous mucosa (more accentuated proximal to the cardia); some portions of the gastric mucosa were covered with fluids and appeared only slightly erythematous. A blue green endoscopy highlighted the oesophageal lesions in dark blue, which made them appear more clearly defined from the remaining mucosa. In the gastric antrum, a small, slightly darker blue roundish area was visible. This area did not show up under the white light endoscopy. A histopathological assessment of biopsy specimens from the distal oesophagus, antrum (including the area highlighted only by BG endoscopy) and gastric body showed chronic-active hyperplastic esophagitis and superficial squamous epithelial dysplasia, while gastric samples showed severe diffuse hyperaemic gastritis of the antrum and superficial diffuse atrophy of the gastric body. The authors believe that the use of a BG endoscopy could be useful in veterinary medicine to increase the diagnostic potential of endoscopic assessment in animals

Irritable bowel syndrome and gluten-related disorders

Background: Irritable bowel syndrome (IBS) is frequently associated with celiac disease (CD) and nonceliac gluten/wheat sensitivity (NCGS/NCWS), but epidemiological and pathophysiological aspects are still unclear. Furthermore, a gluten-free diet (GFD) can positively influence IBS symptoms. Methods: A comprehensive online search for IBS related to CD, NCGS and GFD was made using the Pubmed, Medline and Cochrane databases. Results: Although a systematic screening for CD in IBS is not recommended, CD prevalence can be increased in diarrhea-predominant IBS patients. On the other hand, IBS symptoms can be persistent in treated CD patients, and their prevalence tends to decrease on a GFD. IBS symptoms may overlap and be similar to those associated to nonceliac gluten and/or wheat sensitivity. Increased gut permeability could explain the gluten/wheat effects in IBS patients. Finally, a GFD could improve symptoms in a subgroup of IBS patients. Conclusions: The possible interplay between IBS and gluten-related disorders represents a scientifically and clinically challenging issue. Further studies are needed to confirm these data and better clarify the involved pathophysiological mechanisms

Non Celiac Gluten Sensitivity and Diagnostic Challenges

Non-celiac gluten sensitivity (NCGS), also referred to as non-celiac wheat sensitivity (NCWS), is a clinical syndrome characterized by both intestinal and extra-intestinal symptoms responsive to the withdrawal of gluten-containing food from the diet. The aim of this review is to summarize recent advances in research and provide a brief overview of the history of the condition for the benefit of professionals working in gastroenterology. Academic databases such as PubMed and Google Scholar were searched using key words such as ”non-celiac gluten sensitivity”, “gluten related disorders”, and the studies outlined in reference page were selected and analysed. Most of the analysed studiers agree that NCGS would need to be diagnosed only after exclusion of celiac disease and wheat allergy, and that a reliable serological marker is not available presently. The mechanisms causing symptoms in NCGS after gluten ingestion are largely unknown, but recent advances have begun to offer novel insights. The estimated prevalence of NCGS, at present, varies between 0.6 and 6%. There is an overlap between irritable bowel syndrome and NCGS with regard to the similarity of gastrointestinal symptoms. The histologic characteristics of NCGS are still under investigation, ranging from normal histology to slight increase in the number of T lymphocytes in the superficial epithelium of villi. Positive response to gluten free diet for a limited period (e.g., 6 weeks), followed by the reappearance of symptoms after gluten challenge appears, at this moment, to be the best approach for confirming diagnosis. The Salerno expert criteria may help to diagnose NCGS accurately in particular for research purposes but it has limited applicability in clinical practice

avoiding biopsy in iron deficiency anemia is not a cost effective approach

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