Cartografie antropologiche: sui “profughi del tempo”

Focusing on the figure of cyborg, being an important concentration of fantasy and reality, could represent a good starting point when trying to think more deeply on the relationship between man and machine, which is an essential theme of the 20th century philosophy. The article suggest how cartographies of the overall reality of contemporary subjectivities can be developed and how the latest can hope with the transformation of their modalities based upon the introduction of the machine within 'living bodies'

Anders e l'incompleto

This contribution aims at highlighting some fundamental motifs (reasons) of that particular philosophical anthropology which can be found in the works of G. Anders, who sets at the center of the analysis, with strong clarity, the figure of man as human being, who comes into the world as “incomplete” and “undetermined”: according to Anders this concretizes itself through the critical confrontation with the philosophical anthropology which becomes philosophy of the tekhne in A. Gehlen and with the Kafkian representation of an existence radically incomplete

Continued efforts to translate diabetes cardiovascular outcome trials into clinical practice

Diabetic patients suffer from a high rate of cardiovascular events and such risk increases with HbA1c. However, lowering HbA1c does not appear to yield the same benefit on macrovascular endpoints, as observed for microvascular endpoints. As the number of glucose-lowering medications increases, clinicians have to consider several open questions in the management of type 2 diabetes, one of which is the cardiovascular risk profile of each regimen. Recent placebo-controlled cardiovascular outcome trials (CVOTs) have responded to some of these questions, but careful interpretation is needed. After general disappointment around CVOTs assessing safety of DPP-4 inhibitors (SAVOR, TECOS, EXAMINE) and the GLP-1 receptor agonist lixisenatide (ELIXA), the EMPA-REG Outcome trial and the LEADER trial have shown superiority of the SGLT2-I empagliflozin and the GLP-1RA liraglutide, respectively, on the 3-point MACE outcome (cardiovascular death, non-fatal myocardial infarction or stroke) and cardiovascular, as well as all-cause mortality. While available mechanistic studies largely support a cardioprotective effect of GLP-1, the ability of SGLT2 inhibitor(s) to prevent cardiovascular death was unexpected and deserves future investigation. We herein review the results of completed CVOTs of glucose-lowering medications and suggest a possible treatment algorithm based on cardiac and renal co-morbidities to translate CVOT findings into clinical practice

Su un avantesto di «Se questo è un uomo» (con una nuova edizione del «Rapporto» sul Lager di Monowitz del 1946)

Primo Levi scrisse con Leonardo De Benedetti il “Rapporto sulla organizzazione igienico-sanitaria del Campo di concentramento per Ebrei di Monowitz (Auschwitz - Alta Slesia)”, uscito nel 1946 sulla “Minerva Medica”. Il “Rapporto” è stato ripubblicato nel 1993 negli atti di un convegno e ristampato nel 1997 nelle Opere di Levi. Le ripubblicazioni hanno introdotto numerosi errori nel testo del “Rapporto” che modificano il senso di alcuni passi. L'articolo ricostruisce la storia editoriale del “Rapporto” e delle due traduzioni in lingua straniera esistenti, mettendo in relazione il testo del 1946 con “Se questo è un uomo”. L'analisi testuale dimostra che il “Rapporto” sia da considerare un avantesto di “Se questo è un uomo”. L'articolo propone infine una edizione critica del “Rapporto”

Use and effectiveness of dapagliflozin in routine clinical practice. An Italian multicenter retrospective study

In randomized controlled trials (RCTs), sodium-glucose co-transporter-2 (SGLT2) inhibitors have been shown to confer glycaemic and extra-glycaemic benefits. The DARWIN-T2D (DApagliflozin Real World evIdeNce in Type 2 Diabetes) study was a multicentre retrospective study designed to evaluate the baseline characteristics of patients receiving dapagliflozin vs those receiving selected comparators (dipeptidyl peptidase-4 inhibitors, gliclazide, or glucagon-like peptide-1 receptor agonists), and drug effectiveness in routine clinical practice. From a population of 281 217, the analysis included 17 285 patients initiating dapagliflozin or comparator glucose-lowering medications (GLMs), 6751 of whom had a follow-up examination. At baseline, participants starting dapagliflozin were younger, had a longer disease duration, higher glycated haemoglobin (HbA1c) concentration, and a more complex history of previous GLM use, but the clinical profile of patients receiving dapagliflozin changed during the study period. Dapagliflozin reduced HbA1c by 0.7%, body weight by 2.7 kg, and systolic blood pressure by 3.0 mm Hg. Effects of comparator GLMs were also within the expected range, based on RCTs. This real-world study shows an initial channelling of dapagliflozin to difficult-to-treat patients. Nonetheless, dapagliflozin provided significant benefits with regard to glucose control, body weight and blood pressure that were in line with findings from RCTs

Simvastatin Rapidly and Reversibly Inhibits Insulin Secretion in Intact Single-Islet Cultures

open10Epidemiological studies suggest that statins may promote the development or exacerbation of diabetes, but whether this occurs through inhibition of insulin secretion is unclear. This lack of understanding is partly due to the cellular models used to explore this phenomenon (cell lines or pooled islets), which are non-physiologic and have limited clinical transferability.openScattolini, Valentina; Luni, Camilla; Zambon, Alessandro; Galvanin, Silvia; Gagliano, Onelia; Ciubotaru, Catalin Dacian; Avogaro, Angelo; Mammano, Fabio; Elvassore, Nicola; Fadini, Gian PaoloScattolini, Valentina; Luni, Camilla; Zambon, Alessandro; Galvanin, Silvia; Gagliano, Onelia; Ciubotaru, CATALIN DACIAN; Avogaro, Angelo; Mammano, Fabio; Elvassore, Nicola; Fadini, GIAN PAOL

Comparative Effectiveness of DPP-4 Inhibitors Versus Sulfonylurea for the Treatment of Type 2 Diabetes in Routine Clinical Practice: A Retrospective Multicenter Real-World Study

Introduction: DPP-4 inhibitors (DPP4i) and sulfonylureas are popular second-line therapies for type 2 diabetes (T2D), but there is a paucity of real-world studies comparing their effectiveness in routine clinical practice. Methods: This was a multicenter retrospective study on diabetes outpatient clinics comparing the effectiveness of DPP4i versus gliclazide extended release. The primary endpoint was change from baseline in HbA1c. Secondary endpoints were changes in fasting plasma glucose, body weight, and systolic blood pressure. Automated software extracted data from the same clinical electronic chart system at all centers. Propensity score matching (PSM) was used to generate comparable cohorts to perform outcome analysis. Results: We included data on 2410 patients starting DPP4i and 1590 patients starting gliclazide (mainly 30–60 mg/day). At baseline, the two groups differed in disease duration, body weight, blood pressure, HbA1c, fasting glucose, HDL cholesterol, triglycerides, liver enzymes, eGFR, prevalence of microangiopathy, and use of metformin. Among DPP4i molecules, no difference in glycemic effectiveness was detected. In matched cohorts (n = 1316/group), patients starting DPP4i, as compared with patients starting gliclazide, experienced greater reductions in HbA1c (− 0.6% versus − 0.4%; p < 0.001), fasting glucose (− 14.1 mg/dl versus − 8.8 mg/dl; p = 0.007), and body weight (− 0.4 kg versus − 0.1 kg; p = 0.006) after an average 6 months follow-up. DPP4i improved glucose control more than gliclazide, especially in patients who had failed with other glucose-lowering medications or were on basal insulin. Conclusions: This large retrospective real-world study shows that, in routine clinical practice, starting a DPP4i allows better glycemic control than starting low-dose gliclazide. Funding: The Italian Diabetes Society, with external support from AstraZeneca

Introdução de novos acessos no banco in vitro do gênero Ananas

A conservação in vitro é uma estratégia que deve ser considerada para a criação de cópias de segurança de importantes coleções de germoplasma. Além de apresentar vantagens sobre a conservação em campo, permite a disponibilização de acessos para uso e intercâmbio de forma rápida e segura. A Embrapa possui uma coleção de germoplasma de abacaxi com 624 acessos do gênero Ananas e espécies afins, em condições de campo. UPDF. 61

Ampliação do banco in vitro do gênero Ananas.

A conservação in vitro é uma estratégia que deve ser considerada para a criação de cópias de segurança de importantes coleções de germoplasma. Além de apresentar vantagens sobre a conservação em campo, permite a disponibilização de acessos para uso e intercâmbio de forma rápida e segura. A Embrapa possui uma coleção de germoplasma de abacaxi com 624 acessos do gênero Ananas e espécies afins, em condições de campo. Uma duplicata de segurança in vitro vem sendo introduzida desde 2003, com aproximadamente 200 acessos já estabelecidos.PDF. 097_11

Vasculogenesis and Diabetic Erectile Dysfunction: How Relevant Is Glycemic Control?

Erectile dysfunction (ED) is a complication of diabetes, condition responsible for causing endothelial dysfunction (EDys) and hampering repair mechanisms. However, scarce information is available linking vasculogenesis mediated by Endothelial Progenitor Cells (EPCs) and diabetes-associated ED. Furthermore, it remains to be elucidated if glycemic control plays a role on EPCs functions, EPCs modulators, and penile vascular health. We evaluated the effects of diabetes and insulin therapy on bone marrow (BM) and circulating EPCs, testosterone, and systemic/penile Stromal Derived Factor-1 alpha (SDF-1) expression. Male Wistar rats were divided into groups: age-matched controls, 8-weeks streptozotocin-induced type 1 diabetics, and insulin-treated 8-weeks diabetics. EPCs were identified by flow cytometry for CD34/CD133/VEGFR2/CXCR4 antigens. Systemic SDF-1 and testosterone levels were evaluated by ELISA. Penile SDF-1 protein expression was assessed, in experimental and human diabetic cavernosal samples, by immunohistochemical techniques. Diabetic animals presented a reduction of BM-derived EPCs and an increase in putative circulating endothelial cells (CECs) sloughed from vessels wall. These alterations were rescued by insulin therapy. In addition, glycemic control promoted an increase in systemic testosterone and SDF-1 levels, which were significantly decreased in animals with diabetes. SDF-1 protein expression was reduced in experimental and human cavernosal diabetic samples, an effect prevented by insulin in treated animals. Insulin administration rescued the effects of diabetes on BM function, CECs levels, testosterone, and plasmatic/penile SDF-1 protein expression. This emphasizes the importance of glycemic control in the prevention of diabetes-induced systemic and penile EDys, by the amelioration of endothelial damage, and increase in protective pathways.European Society for Sexual Medicine (ESSM Award for Medical Research 2011), and by the Portuguese Society of Andrology (Professor Alexandre Moreira Award “Research in Sexual Medicine 2013”)info:eu-repo/semantics/publishedVersio