El signo transformador de Michele Taruffo en la cultura (también procesal)

El ensayo trata de la influencia de Michele Taruffo en la cultura jurídica, esto en relación con las características de su formación erudita y sobre todo de su personalidad humana. Gran intelectual polifacético, Taruffo sentía sobre todo curiosidad por todas las elaboraciones culturales avanzadas que tenían un carácter un tanto filosófico. De ahí una complejidad de intereses que se refleja bellamente en muchas de sus obras eruditas

Responsibilities of Judges and Advocates in Civil and Common Law: Some Lingering Misconceptions Concerning Civil Lawsuits

In a period in which an event as interesting and important as the formulationof Principles and Rules of Transnational Civil Procedure by theAmerican Law Institute and the International Institute for the Unificationof Private Law (UNIDROIT) is sternly advancing to accommodate basicprocedural concepts for both the civil and common law systems, a centralproblem faced in such conciliation seems to be that of clarifying the actualroles and responsibilities of judges and lawyers in the conduct of a civildispute. To do so will essentially mean scrutinizing the value and validityof settled conceptions of the inherent features of civil and common lawsystems, including the notion that these systems are basically opposite eachother. In other words, we will attempt to evaluate the correctness and reliability of this assertion, as well as to the unavoidable opposition itincurs

Associations between serum gamma-globulin concentration, enzyme activities, growth and survival in preweaning Alpine goat kids

Colostral immunity is crucial for young ruminants, but the individual factors that may affect passive transfer status and its effects on preweaning growth performance have not been widely investigated in goats. The methods to quantify immunoglobulins G can be expensive. Colostrum enzymes, though, pass the intestinal barrier and might be suitable as markers of passive transfer status, as demonstrated in other ruminant species. This study aimed to investigate the effect of sex, litter size, dam parity, and birth body weight on passive transfer status and the relationship between gamma-globulin concentration (GG) and pre-weaning growth performance in Alpine goat kids. The association between serum GG, serum total protein concentration and serum activity of colostrum enzymes including γ-glutamyltransferase (GGT), alkaline phosphatase (ALP), aspartate aminotrans- ferase (AST), and lactate dehydrogenase (LDH) was examined for their use as predictors of passive transfer status in neonatal goat kids. Sixty-six Alpine goat kids (39 males, 27 females), born to 28 does at one dairy goat farm during two delivery seasons, were enrolled. Kids nursed their dams in group housing until weaned at 50 days of age. Blood samples were collected 24 h after birth. Body weights (BW) were taken at birth and weaning. Serum enzyme activities and total protein concentration were measured using a clinical biochemical analyser. Serum GG was determined by gel electrophoresis. Statistical analysis was performed using GraphPad Prism (v. 8.2.1). No significant differences in serum GG between males and females, singlets and twins, multiparous’ and pri- miparous’ kids were found. No association was detected between birth BW and GG. Serum GG was strongly and significantly associated with TP (R2 =0.85; p 0.0001) and moderately associated with GGT (R2 =0.47; p 0.0001). No correlation was found with ALP, AST, and LDH. Although partial failure of passive transfer (FPT) was diagnosed in 23% of kids, no effects on morbidity (3%), mortality (0%) and pre-weaning growth performance were observed. Our results confirm that serum total proteins can be used to indirectly estimate immunoglobulin concentration. Contrarily, passive transfer status can be predicted with little success by measuring the activity of serum GGT. It is not advisable to use ALP, AST and LDH as indicators of passive transfer status. Finally, FTP is not necessarily associated with the health and preweaning growth performance of Alpine goat kids reared in non- intensive breeding systems that follow good farming practices

Electron Spin Resonance dosimetry using organic compounds (alanine and ammonium tartrate) for mixed neutron-gamma fields

Alongside with the development of Neutron Capture Therapy (NCT) and the use of thermal neutrons for radiotherapeutic purposes, many efforts have been devoted to the characterization of the beam in order to optimize therapy procedures. Reliable dose measurements should be able to determine the various (neutrons and photonic) components of the mixed beam usually employed for therapy. This paper studies the effect of additives such as boric and gadolinium nuclei on the sensitivity of neutron organic (alanine and ammonium tartrate) dosimeters analyzed through Electron Spin Resonance (ESR) technique (Marrale, 2014). These dosimeters were exposed to a mixed (neutron-gamma) field mainly composed of thermal neutrons. The choice of 10B and 64Gd as nuclei additives is due to their very high capture cross section for thermal neutrons. Also, after the nuclear reaction with thermal neutrons are emitted particles, which in turn release their energy in the vicinity of the reaction site (Marrale, 2008). The irradiation with mixed field (neutron-gamma) were performed within the thermal column of the TRIGA reactor, University of Pavia. Dosimeters readout was performed through the Electron Spin Resonance spectrometer Bruker ECS106 located at the Laboratory of Dosimetry ESR / TL of the Department of Physics and Chemistry - University of Palermo. We found that the addition of Gadolinium allows to largely increase the sensitivity of the dosimeters for thermal neutrons. In particular, a low concentration (5% by weight) of gadolinium oxide leads to an improvement of the sensitivity of neutrons more than 10 times. In addition, for this low content of gadolinium the photon tissue equivalence is not heavily reduced. This experimental analyses are compared with computational analyses carried out by means of Monte Carlo simulations performed with the MCNP (Monte Carlo N-Particle) transport code. A good agreement was observed for alanine dosimeters

R-CVP versus R-CHOP versus R-FM for the initial treatment of patients with advanced-stage follicular lmphoma: results of the FOLL05 trial conducted by the Fondazione Italiana Linfomi

PURPOSE Although rituximab (R) is commonly used for patients with advanced follicular lymphoma (FL) requiring treatment, the optimal associated chemotherapy regimen has yet to be clarified. PATIENTS AND METHODS We conducted an open-label, multicenter, randomized trial among adult patients with previously untreated stages II to IV FL to compare efficacy of eight doses of R associated with eight cycles of cyclophosphamide, vincristine, and prednisone (CVP) or six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or six cycles of fludarabine and mitoxantrone (FM). The principal end point of the study was time to treatment failure (TTF). Results There were 534 patients enrolled onto the study. Overall response rates were 88%, 93%, and 91% for R-CVP, R-CHOP, and R-FM, respectively (P=.247). After a median follow-up of 34 months, 3-year TTFs were 46%, 62%, and 59% for the respective treatment groups (R-CHOP v R-CVP, P=.003; R-FM v R-CVP, P=.006; R-FM v R-CHOP, P=.763). Three-year progression-free survival (PFS) rates were 52%, 68%, and 63% (overall P=.011), respectively, and 3-year overall survival was 95% for the whole series. R-FM resulted in higher rates of grade 3 to 4 neutropenia (64%) compared with R-CVP (28%) and R-CHOP (50%; P< .001). Overall, 23 second malignancies were registered during follow-up: four in R-CVP, five in R-CHOP, and 14 in R-FM. CONCLUSION In this study, R-CHOP and R-FM were superior to R-CVP in terms of 3-year TTF and PFS. In addition, R-CHOP had a better risk-benefit ratio compared with R-FM

Integrated clinicopathologic and molecular analysis of endometrial carcinoma: Prognostic impact of the new ESGO-ESTRO-ESP endometrial cancer risk classification and proposal of histopathologic algorithm for its implementation in clinical practice

IntroductionThe European Society of Gynecologic Oncology/European Society of Radiation Therapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) committee recently proposed a new risk stratification system for endometrial carcinoma (EC) patients that incorporates clinicopathologic and molecular features. The aim of the study is to compare the new ESGO/ESTRO/ESP risk classification system with the previous 2016 recommendations, evaluating the impact of molecular classification and defining a new algorithm for selecting cases for molecular analysis to assign the appropriate risk class.MethodsThe cohort included 211 consecutive EC patients. Immunohistochemistry and next-generation sequencing were used to assign molecular subgroups of EC: POLE mutant (POLE), mismatch repair deficient (MMRd), p53 mutant (p53abn), and no specific molecular profile (NSMP).ResultsImmuno-molecular analysis was successful in all cases, identifying the four molecular subgroups: 7.6% POLE, 32.2% MMRd, 20.9% p53abn, and 39.3% NSMP. The recent 2020 guidelines showed a 32.7% risk group change compared with the previous 2016 classification system: the reassignment is due to POLE mutations, abnormal p53 expression, and a better definition of lymphovascular space invasion. The 2020 system assigns more patients to lower-risk groups (42.2%) than the 2016 recommendation (25.6%). Considering the 2020 risk classification system that includes the difference between “unknown molecular classification” and “known,” the integration of molecular subgroups allowed 6.6% of patients to be recategorized into a different risk class. In addition, the use of the proposed algorithm based on histopathologic parameters would have resulted in a 62.6% reduction in molecular analysis, compared to applying molecular classification to all patients.ConclusionApplication of the new 2020 risk classification integrating clinicopathologic and molecular parameters provided more accurate identification of low-and high-risk patients, potentially allowing a more specific selection of patients for post-operative adjuvant therapy. The proposed histopathologic algorithm significantly decreases the number of tests needed and could be a promising tool for cost reduction without compromising prognostic stratification

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

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

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 &lt; 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