732 research outputs found
La restituzione virtuale dell’architettura antica come strumento di ricerca e comunicazione dei beni culturali: ricerca estetica e gestione delle fonti
No full textRaffaello Sanzio intuì per primo che il mondo antico, come lo vedevano i suoi occhi, non era che l’eco sbiadita di quella ricchezza che pur doveva caratterizzarne l’esperienza artistica. Oggi la tecnologia permette di realizzare il sogno di Raffaello e di restituire le immagini delle antiche architetture, rivoluzionando la percezione del patrimonio culturale da parte del pubblico moderno. La nostra esperienza decennale nel settore della comunicazione del bene culturale ha consentito di confrontarci con diversi casi: dalla Domus Aurea, all'Ara Pacis; dai filmati divulgativi agli applicativi pensati per le postazioni fisse dei musei, fino alla creazione di software per la gestione dei dati degli scavi archeologici. Sempre ponendo al centro di ogni lavoro i cardini del nostro modo di fare ricerca: l'attenzione al linguaggio, quale strumento di comprensione estetica, e la gestione informatizzata delle fonti, come apparato di studio e metodo di validazione scientifica delle ricostruzioni.[L’impostazione del saggio è comune ai due autori. In particolare, però, Stefano Borghini ha curato il paragrafo “Considerazioni generali”, mentre Raffaele Carlani “Alcune esperienze”]
Results of 12-month rescue treatment with teduglutide in severely active and parenteral nutrition-dependent Crohn's disease
No full textShort bowel syndrome (SBS) is caused by the loss of extensive segments of the small intestine as seen in Crohn’s disease (CD) (1,2) and is characterized by malnutrition; thus, patients with SBS often require parenteral nutrition (PN) (3). Alternatives can maximize the remnant intestinal absorptive capacity, e.g., glucagonlike peptide 2 analog teduglutide. It inhibits gastric acid secretion and motility, stimulates intestinal blood flow, increases the intestinal barrier, and enhances absorption (4). Teduglutide has a safety profile (5), but adverse events are mostly related to hyperplastic and hypertrophic
effects. Thus, patients with SBS having fluctuations in disease activity, e.g., in active CD, have always been excluded from treatment with teduglutide.
For the first time, we report the results of 12-month treatment with teduglutide in a 42-year-old Caucasian woman affected by severely active CD with SBS. Informed consent was obtained.
The patient underwent total colectomy in 1991 because of supposed ulcerative colitis. Then, CD was diagnosed, and since 2010, she underwent many intestinal resections. Many treatments had been unsuccessfully attempted (corticosteroids, infliximab, azathioprine, adalimumab, methotrexate, and certolizumab).
Given her precarious clinical conditions, treatment with 0.05 mg/kg/day teduglutide was started in August 2015. Before treatment, she was in a poor condition.
Nutritional deficiency and electrolyte imbalance were present. PN was initiated 24 h/day and 7 days/week, with a total of 1600 kcal/day per 3000 mL/day. After 12 months, teduglutide played a key role in ameliorating her severe nutritional deficiencies and ensuring her survival with good quality of life. Without teduglutide, her life would have been seriously compromised.
Our patient was unable to totally wean from PN and reduce the number of days of infusion, but the PN volume has been progressively reduced to 2500 mL/day (an almost 20% reduction), with occasional exceptions.
Moreover, total PN calories have been reduced from 1600 to 1400 kcal. An increase was observed in her body weight and BMI (from 17.5 to 24.5 kg/m2). We are confident that more positive goals in PN reduction may be achieved with further therapy.
Crohn’s disease complications and treatment side effects were excluded on close clinical, laboratory, and imaging (US, CT, and MRI) surveillance.
More studies with a larger number of patients and prolonged treatment are necessary to confirm the usefulness and safety of teduglutide in those with severely active CD. Our experience provides elements to support its efficacy and may pave the way for future research on teduglutide, even in other gastrointestinal diseases with fluctuating activities
Culture of gastric biopsies in celiac disease and its relationship with gastritis and Helicobacter pylori infection
No full textBACKGROUND: Celiac disease (CD) is a gluten-related multisystemic disorder. Duodenal biopsy organ culture is a reliable supporting tool for CD diagnosis and can reveal specific immunological activation in many intestinal tracts.
AIM: we investigated the gastric gluten-dependent immunological activation in CD, compared to duodenum. Gastric cultural results were also compared with histology and HP findings.
METHODS: 18 patients with suspected CD and HP infection underwent EGD. Biopsies from duodenum (bulb and second portion) and gastric antrum were collected for histology and organ culture system.
RESULTS: all patients were diagnosed with CD and gastritis. Nine out of 18 (50%) patients were HP-positive. EMA and anti-tTG were positive in 18/18 (100%) cultures from duodenum, as well as in 17/18 (94.4%) gastric cultures. Anti-tTG were higher in duodenal cultures than in gastric ones (p <0.05). Anti-tTG in gastric cultures were similar in HP-positive and HP-negative patients. Nine out of 17 (53%) patients with positive EMA in gastric culture were HP-positive and 8/17 (47%) were HP-negative. No significant difference in EMA gastric culture results was observed between HP-positive and HP-negative patients.
CONCLUSIONS: Our data reveal an involvement also of stomach in CD. HP seems to not affect anti-tTG and EMA results in gastric cultures
Effects of modified wheat gluten aministration in patioents with celiac disease:results of a double-blindgluten-controlled clinical trial
No full textNew insights in IBS-like disorders: Pandora's box has been opened; a review
No full textThe most complained gastrointestinal symptoms are chronic diarrhea, bloating and abdominal pain. Once malignancies and inflammatory bowel diseases are excluded, irritable bowel syndrome (IBS) and the so called "IBS-like disorders" should be taken into account. The relationship between IBS as defined by Rome IV criteria and these clinical conditions is sometimes obscure, since many IBS patients identify food as a possible trigger for their symptoms. Here, we discuss IBS and the most common IBS-like disorders (celiac disease, non-celiac gluten sensitivity, fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), lactose intolerance, small intestinal bacterial overgrowth (SIBO), α-amylase/trypsin inhibitor (ATIs), nickel allergic contact mucositis), focusing on epidemiologic, clinical, diagnostic and therapeutic aspects. Given the lack of specificity of symptoms, clinical investigation will be facilitated by awareness of these disorders as well as new specific diagnostic tools
Robotic colonoscopy: efficacy, tolerability and safety. Preliminary clinical results from a pilot study
No full textBACKGROUND: Robotic colonoscopy (RC) is a pneumatically-driven self-propelling platform (Endotics System®) able to investigate the colon, in order to reduce pain and discomfort. AIMS: (1) to describe the progress in gaining experience and skills of a trainee in RC; (2) to show the clinical outcomes of RC. METHODS: Pilot study. An experienced endoscopist started a training on RC whose progress was assessed comparing the results of 2 consecutive blocks of 27 (Group A) and 28 (Group B) procedures. CIR (Cecal Intubation Rate), CIT (Cecal Intubation Time) and Withdrawal Time (WT) were measured. Polyp Detection Rate (PDR), Adenoma Detection Rate (ADR) and Advanced Neoplasia Detection Rate (ANDR) were calculated. Possible adverse events were recorded. At the end of the procedure all patients completed a visual analog scale (VAS) to measure their perceived pain during RC and reported their willingness to repeat RC. RESULTS: General CIR was 92.7%, reaching 100% in Group B. Comparing the two groups, CIT significantly decreased from 55 to 22 min (p value 0.0007), whereas procedures with CIT ≤ 20 min increased (p value 0.037). WT significatively reduced from 21 to 16 min (p value 0.0186). PDR was 40% (males 62.5%, females 14.3%). ADR was 26.7% (males 27.5%, females 14.3%). Most of patients judged the procedure as mild or no distress, with high willingness-to-repeat the RC (92.7%). CONCLUSIONS: Our results about RC are encouraging as preliminary experience, with clear individual learning progress, accurate diagnosis in a painless or comfortable procedure and with possibility to remove polypoid lesions. Studies with larger populations are needed to confirm obtained results
Onset of suspected ulcerative colitis after treatment with tocilizumab in patient with celiac disease and juvenile idiopathic arthritis
No full textTo the Editors,
Celiac disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD), although their etiopathogenesis appear to be different and there are conflicting data about their association. The humanized anti- interleukin (IL)-6 receptor antibody tocilizumab is used for rheumatoid ar- thritis and sometimes for patients with UC refractory to conventional ther- apies. A few studies have reported that tocilizumab can aggravate pre-existing UC or cause de novo drug-induced IBD, probably because of failure to suppress intestinal IL-6 production.
We report the case of a female pa- tient with a family history of CD and UC
Anti-transglutaminase detection followed by endomysium antibody confirmation test on monkey esophagus is the best strategy to screen for celiac disease
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Corrado Cagli. Transatlantic bridges, 1938-1947
No full textIn the 1930s the young Italian artist, Corrado Cagli was a rising star of the Scuola Romana, supported by the Fascist regime despite being both Jewish and a homosexual. Following the Racial Laws, he fled first to Paris, and then to the USA, where he remained until 1947. Raffaele Bedarida’s new book, Corrado Cagli – La pittura, l’esilio, l’America (1938-1947) Donzelli Editore, 2018 (soon to be translated into English by CPL Editions), focuses on Cagli’s American exile.
While examining Cagli in the context of the artistic and intellectual migration from Europe to the US, Bedarida provides valuable new insight into the specific plight of this Italian Jewish artist, once championed by Fascism and into the complexities of the use of art for cultural diplomacy.
The author combines biography, cultural history, and critical analysis in exploring a decisive period in the life and work of a painter whose complex personality and non-signature style, defy classifications. The book also provides thought-provoking and nuanced arguments on the ideologically based ostracism that Cagli encountered upon returning to Italy in the immediate aftermath of the war. Because of his past as a former regime-endorsed artist, his recent American success, his participation in the liberation of Europe from Nazi-Fascism with the American army, and Jewish exile, Cagli simply did not fit into any of the faction of Italy’s post-war heated cultural disputes.
Based on extensive original research and written with brio, Bedarida’s book is an essential contribution to a growing field of studies that examine how, by welcoming artist and intellectuals in flight from Nazi-Fascism, the United States had been given what Will Norman has called “custodianship for a civilization.
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