18 research outputs found
The cardio-renal-metabolic connection: a review of the evidence
No full textAbstract Type 2 diabetes (T2D), cardiovascular disease (CVD) and chronic kidney disease (CKD), are recognized among the most disruptive public health issues of the current century. A large body of evidence from epidemiological and clinical research supports the existence of a strong interconnection between these conditions, such that the unifying term cardio-metabolic-renal (CMR) disease has been defined. This coexistence has remarkable epidemiological, pathophysiologic, and prognostic implications. The mechanisms of hyperglycemia-induced damage to the cardio-renal system are well validated, as are those that tie cardiac and renal disease together. Yet, it remains controversial how and to what extent CVD and CKD can promote metabolic dysregulation. The aim of this review is to recapitulate the epidemiology of the CMR connections; to discuss the well-established, as well as the putative and emerging mechanisms implicated in the interplay among these three entities; and to provide a pathophysiological background for an integrated therapeutic intervention aiming at interrupting this vicious crosstalks
The Elusive Nature of ABCC8-related Maturity-Onset Diabetes of the Young (ABCC8-MODY). A Review of the Literature and Case Discussion
No full textPurpose of Review: Maturity-onset diabetes of the young (MODY) are monogenic forms of diabetes resulting from genetic defects, usually transmitted in an autosomal dominant fashion, leading to β-cell dysfunction. Due to the lack of homogeneous clinical features and univocal diagnostic criteria, MODY is often misdiagnosed as type 1 or type 2 diabetes, hence its diagnosis relies mostly on genetic testing. Fourteen subtypes of MODY have been described to date. Here, we review ABCC8-MODY pathophysiology, genetic and clinical features, and current therapeutic options. Recent Findings: ABCC8-MODY is caused by mutations in the adenosine triphosphate (ATP)-binding cassette transporter subfamily C member 8 (ABCC8) gene, involved in the regulation of insulin secretion. The complexity of ABCC8-MODY genetic picture is mirrored by a variety of clinical manifestations, encompassing a wide spectrum of disease severity. Such inconsistency of genotype-phenotype correlation has not been fully understood. A correct diagnosis is crucial for the choice of adequate treatment and outcome improvement. By targeting the defective gene product, sulfonylureas are the preferred medications in ABCC8-MODY, although efficacy vary substantially. We illustrate three case reports in whom a diagnosis of ABCC8-MODY was suspected after the identification of novel ABCC8 variants that turned out to be of unknown significance. We discuss that careful interpretation of genetic testing is needed even on the background of a suggestive clinical context. Summary: We highlight the need for further research to unravel ABCC8-MODY disease mechanisms, as well as to clarify the pathogenicity of identified ABCC8 variants and their influence on clinical presentation and response to therapy
Francesco Sansovino e la prudenza
No full textL’articolo tratta del singolare Dialogo della pratica della ragione, scritto fra il 1538 e il 1542 da Francesco Sansovino, per formazione giurista ma dedicatosi poi all’attività di «poligrafo». In particolare l’autore si sofferma sulla nozione di prudenza che emerge dal Dialogo, la quale si rende emblema, probabilmente ad insaputa di Sansovino stesso, di un importante passaggio sia teorico che storico avvenuto alle soglie dell’età moderna. Rintracciando la genesi della prudentia nella phronesis aristotelica e nella sua successiva stabilizzazione teorica nella teologia morale di Tommaso, l’autore mostra come nel Dialogo essa torni a rivestire, grazie anche all’accostamento con le dottrine, di per sé assai distanti, di Bartolo e Machiavelli, il ruolo pratico di habito attivo con ragione. Tale virtù diviene altresì espressione di quel sapere tipico dell’umanesimo civile che saprà coniugare vita mondana e riflessione intellettuale.This article is about the peculiar work Dialogo della pratica della ragione, written between 1538 and 1542 by Francesco Sansovino, who was educated as a jurist but then became a «polygraph». The author is particularly focused on the concept of prudence, which arises from the Dialogo. It is likely that Sansovino himself ignored that such concept became the symbol of an important theoretical and historical transition at the beginning of the modern age. The author traces the genesis of the prudentia in the Aristotelian phronesis and in its subsequent stabilization within Thomas Aquinas’ moral theology. He shows that in the Diagolo, also because of the combination with the rather different theories of Bartolo and Machiavelli, such concept is back in its practical role of habito attivo con ragione. Such virtue also becomes the expression of that typical knowledge of civil humanism, where social life and intellectual knowledge are strictly combined
Prefazione
No full textViene presentata un'opera dedicata al tema del "sentire" analizzato attraverso l'opera di D. von Hildebrand, M. Scheler e E. Stein. Al centro della fenomenologia del sentire, l'autrice colloca il sentimento dell'amore come tratto distintivo dell'identità umana.This work is dedicated to the theme of “feeling”, analyzed through the works of D. von Hildebrand, M. Scheler and E. Stein. The author states that love is the centre of the phenomenology of feeling, and it is also the distinctive trait of human identity
Una sillaba non si divide. A proposito della sillaba «Schmerz»
No full textIl confronto tra Celan e Heidegger impegna poesia e filosofia in un dialogo profondo. Entrambi gli autori si attendono dall’altro una parola risolutiva: da una parte il riconoscimento di una colpa, dall’altra la richiesta di una assoluzione. Alla fine l’intento non viene raggiunto, le differenze restano tali e soprattutto si riconosce che il dolore non è condivisibile, inchioda alla responsabilità personale, alla solitudine, al colloquio interrotto.The contrast between Celan and Heidegger engages poetry and philosophy in a deep dialogue. Each author expects from the other a definitive statement: on one side, the acknowledgement of a fault, on the other the claim for an absolution. The ends never meet, differences remain the same and, moreover, it becomes clear that the pain cannot be shared, that there is an inescapable responsibility, a loneliness, an interrupted conversation
La post-modernità e il soggetto del racconto
No full textLa modernità ha elaborato nozioni forti di soggettività esposte in vari modelli, dal razionalismo all’idealismo, in grado di confrontarsi con il mutare delle epoche e delle culture. Il postmoderno si caratterizza invece come l’epoca che mette in crisi il soggetto moderno e che non crede più nella capacità della storia di conferire un senso all’esistenza e un orientamento alle azioni. In particolare il postmoderno ha costretto a ripensare la nozione di persona, non più concepibile come unità di sostanza, uguaglianza o convenzione. In tale contesto si inserisce la proposta di Ricoeur di ripensare la nozione di identità tenendo conto delle sue formulazioni storiche e anche delle critiche a cui il postmoderno ha sottoposto ogni classica nozione di soggetto. Viene quindi indicata una nozione di identità narrativa che rimane fissata nelle storie personali e nelle loro relazioni all’interno di una storia comune, diventando una categoria di ontologia della prassi. L’identità umana si esprime perciò come permanenza nel tempo, fedeltà alla parola data, partecipazione a una origine comune che permette esperienze e scelte responsabili nei racconti che è in grado di generare e condividere.Various models of strong notions of subjectivity have been elaborated throughout modernity, from rationalism to idealism, and these notions were able to face the changing of cultures and ages. On the other hand, postmodern seems to be the age that calls into question the modern notion of subject and the possibility throughout history to give life a meaning and to give actions an orientation. In particular, postmodern has led to rethinking the notion of person, which can be no longer considered as unity of substance, equality or convention. This is the context where Ricoeur’s proposal is set. The author suggests that the notion of identity must be reconsidered, starting from its historical formulations and from the criticism that postmodern has moved to every classical notion of subject. Ricoeur then indicates a notion of narrative identity, which is engraved in personal stories and in their relations within a common history. This becomes a category of ontology of praxis. Human identity expresses itself as permanence in time, faithfulness to a promise, participation in a common origin, which allows experiences and responsible choices in the narrations, that it is able to generate and share
An Insight into the Foundations of Eco-Phenomenology
No full textThe transformation of phenomenology that Anna-Teresa Tymieniecka carried out is centred on two major themes. The first is the theme of phenomenological vision, which allows philosophy to go beyond Descartes’ dualism; the second is the concept of transcendental subjectivity: reality may appear only to a constituent ego, which can perceive it. These two themes are her important legacy, which Tymieniecka received from Husserl but which she took one step further. This author thinks that the contemporary world is determined by the power of technology, which has enslaved people. This is the ideological structure of our times. If philosophy wants to achieve the manifestation of the logos of life, it has to address the great topics of life, the world, nature, and the cosmos. This is the mission of
phenomenology today
Hyperglycemia, circulating stem cells and long-term outcome of COVID-19
No full textopenIperglicemia, cellule staminali circolanti e outcome a lungo termine di COVID-19Hyperglycemia, circulating stem cells and long-term outcome of COVID-1
Sex differences in the weight response to GLP-1RA in people with type 2 diabetes. A long-term longitudinal real-world study
No full textSex differences may influence pathophysiology, treatment response, and outcomes of type 2 diabetes (T2D). We assessed whether sex affected clinical response to GLP-1 receptor agonists (GLP-1RA) in a large real-world cohort. Thus, we conducted a multicentre, retrospective, longitudinal study of 7847 individuals with T2D initiating GLP-1RA therapy across 18 Italian diabetes centres. Participants were stratified by self-reported sex. The primary outcome was change in body weight over time; secondary outcomes included changes in HbA1c, renal function, and lipid profile. Analyses were performed using a mixed model for repeated measures, adjusting for baseline imbalances.Participants were 60 % male, with similar age, diabetes duration, and HbA1c (mean 8.0 %). Females had higher BMI but fewer micro- and macrovascular complications. Over a median 4-year follow-up, females experienced significantly greater weight reduction than males (adjusted mean difference: −1.1 kg; p < 0.001), with more females achieving a weight loss of ≥ 5 % (66.5 % vs. 58.0 %, p < 0.001) or ≥ 10 % (40.0 % vs 30.7 %, p < 0.001). This sex difference in weight loss remained unchanged after progressive adjustment for variables that differed between males and females, across GLP-1RA molecules, and after accounting for weight-adjusted drug doses. Instead, HbA1c reductions were comparable between men and women (mean difference 0.4 mmol/mol; p = 0.21).In conclusion, in this real-world cohort, women achieved greater weight loss than men after GLP-1RA initiation, independently of dosing. These findings highlight sex as a potential predictor of GLP-1RA response and support individualized T2D management. Further investigation is needed to clarify the biological mechanisms underlying this sex-specific response
Arsenio Frugoni: l’incontro con Dante
No full textThe essay analyzes medieval historian Arsenio Frugoni's studies on Dante, highlighting how his encounter with the author of The Comedy is based on his previous studies on Rome in the Middle Ages, the cardinals, and the Jubilee of 1300. In Dante Frugoni sees his own spiritual tension toward a Church that in his view fails to translate the original Gospel inspiration into institutional and legal terms
