24 research outputs found
“Nei mari del sud navigando verso Nord". Gino Nibbi e le isole della Felicità.
No full textA not very well-known and almost unobtainable book, Nelle Isole della Felicità
(1934), and on its author Gino Nibbi (Fermo, Italy 1896-Grottaferrata, Italy 1969) –
a writer, journalist, art expert and voyager who lived in Australia for a long time,
spending three months in the Society Islands.
A rare Italian account on those Polynesian worlds that would otherwise be
the exclusive monopoly of French and American writers, Nibbi’s book stands out
for its refusal to surf the epic of denunciation and condemnation so frequent
among the desecrators of the South Seas. The author manages – in a fairly original
manner for his times – to avoid taking a merely pitying approach to the Tahitians,
wiped out by the missionaries’ evangelization and by the devastating French
rule, or to simply go along the flow of the “no memory people”, the lyric on
“les immémoriaux” sung by Gaugain, Gerbalut, Segalen and the lot. Nibbi rather
chooses a different path, equally distant also from the abundant literature on the
exotic that systematically avoided any reference to the colonial aspect to insist on
the beautiful landscapes, the charming natives, the fertile nature and the marvels
of casual and sensual love. While well-aware of the loss of the ancient traditions
following the so-called “fatal impact”, Nibbi emphasises the contacts and contaminations,
and the Tahitians’ capacity to act upon their impure present of subjugated
colonised people – catching glimpses of persistence, complexity and of an
unchartered vitality. By doing so the book offers an unusual vision of the Islands
of Happiness that deconstructs their stereotypical and reifying representations,
and also reveals a remarkable talent in describing the complex western creatures
living at or passing-by the end of the romantic-Pacific line
“Domattina Tahiti sarà un paese immaginario”. Gino Nibbi e il mito delle isole della felicità
No full textWithin the copious literature on the myth of Tahiti, this essay draws attention to a not very well-known and almost unobtainable book, Nelle Isole della Felicità (1934) , and on its author Gino Nibbi (Fermo, Italy 1896-Grottaferrata, Italy 1969) – a writer, journalist, art expert and voyager who lived in Australia for a long time, spending three months in the Society Islands.
A rare Italian account on those Polynesian worlds that would otherwise be the exclusive monopoly of French and American writers, Nibbi’s book stands out for its refusal to surf the epic of denunciation and condemnation so frequent among the desecrators of the South Seas. The author manages – in a fairly original manner for his times – to avoid taking a merely pitying approach to the Tahitians, wiped out by the missionaries’ evangelization and by the devastating French rule, or to simply go along the flow of the “no memory people”, the lyric on “les immémoriaux” sung by Gaugain, Gerbalut, Segalen and the lot. Nibbi rather chooses a different path, equally distant also from the abundant literature on the exotic that systematically avoided any reference to the colonial aspect to insist on the beautiful landscapes, the charming natives, the fertile nature and the marvels of casual and sensual love. While well-aware of the loss of the ancient traditions following the so-called “fatal impact”, Nibbi emphasises the contacts and contaminations, and the Tahitians’ capacity to act upon their impure present of subjugated colonised people – catching glimpses of persistence, complexity and of an unchartered vitality. By doing so the book offers an unusual vision of the Islands of Happiness that deconstructs their stereotypical and reifying representations, and also reveals a remarkable talent in describing the complex western creatures living at or passing-by the end of the romantic-Pacific line
Recommended from our members
The law of equitable mortgages ::treating of the liens of vendors and purchasers, of the rights and remedies of equitable mortgages by deposit of deeds and other securities ; and particularly with reference to the claims of judgment creditors, the effect of notice with regard to equitable mortgages, and of proceedings on the bankruptcy of equitable mortgagors, with observations on the case of Whitworth v. Gaugain, and an appendix containing forms of equitable deposits, &c. /
No full textRecommended from our members
The law of equitable mortgages ::treating of the liens of vendors and purchasers, of the rights and remedies of equitable mortgages by deposit of deeds and other securities, and particularly with reference to the claims of judgment creditors, the effect of notice with regard to equitable mortgages, and of proceedings on the bankruptcy of equitable mortgagors, with observations on the case of Whitworth v. Gaugain, and an appendix containing forms of equitable deposits, &c. /
No full textRecommended from our members
The law of equitable mortgages ::treating of the liens of vendors and purchasers, of the rights and remedies of equitable mortgages by deposit of deeds and other securities, and particularly with reference to the claims of judgment creditors, the effect of notice with regard to equitable mortgages, and of proceedings on the bankruptcy of equitable mortgagors, with observations on the case of Whitworth v. Gaugain, and an appendix containing forms of equitable deposits, &c. /
No full textEfficacy of Almitrine in the Treatment of Hypoxemia in Sars-Cov-2 Acute Respiratory Distress Syndrome
No full textInternational audienceNo abstract availabl
Association of age with extubation failure in neurocritical intensive care unit patients--Insight from an international prospective study named ENIO
No full textObjective: To assess the association of age with extubation failure in neurocritical care patients. Design: Posthoc analysis of the ‘Extubation strategies in Neuro–Intensive care unit patients and associations with Outcomes (ENIO) study’, an international prospective observational study. Setting: ENIO was conducted in 73 centers in 18 countries from 2018 to 2020. Patients: Neurocritical care patients with a Glasgow Coma Scale score ≤ 12 and receiving ventilation for at least 24 h were included. We categorized patients into four age groups based on age quartiles. Main results: This analysis included 1095 patients with a median age of 53 [35 to 65] years. Younger patients were more likely to be admitted with traumatic brain injury, whereas older patients more often had cerebral hemorrhage, ischemic stroke, central nervous infection, or brain malignancies. Extubation failure occurred in 209 (19 %) patients. In the unadjusted analysis, older patients had a higher risk of extubation failure (odds ratio (OR), 1.012 [95 %–confidence interval (CI) 1.004 to 1.021]; P = 0.006). However, after adjusting for confounding factors, the effect of age on extubation failure was no longer significant (OR, 1.008 [0.997 to 1.019]; P = 0.172). Conclusions: In this international cohort of intubated and ventilated neurocritical care patients, after adjusting for baseline covariates and for previously identified risk factors for extubation failure, age was not associated with extubation failure. Age may not be a factor to consider in extubation decisions for brain–injured patients. Registration: ENIO is registered at clinicaltrials.gov (study identifier NCT 03400904)
Evaluating the Sum of Eye and Motor Components of the Glasgow Coma Score As a Predictor of Extubation Failure in Patients With Acute Brain Injury
No full textObjectives: To evaluate the association between the pre-extubation sum of eye and motor components of the Glasgow Coma Score (GCS-EM) and odds of extubation failure in patients with acute brain injury being liberated from mechanical ventilation. Design: Secondary analysis of a prospective, multicenter observational study (ClinicalTrials.gov identifier NCT03400904). Setting: Sixty-three hospital sites worldwide, with patient recruitment from January 2018 to November 2020. Patients: One thousand one hundred fifty-two critically ill patients with acute brain injury, with a median age of 54 years, of whom 783 (68.0%) were male, 559 (48.5%) had traumatic brain injury, and 905 (78.6%) had a GCS-EM greater than 8 before extubation (scores range from 2 to 10). Interventions: None. Measurements and main results: GCS-EM was computed in intubated patients on the day of extubation. The main outcome was extubation failure, defined as unplanned reintubation within 5 days of extubation. Analyses used multilevel logistic regression with adjustment for patient characteristics and a random intercept for hospital site. In the primary analysis, GCS-EM was not associated with extubation failure (odds ratio, 1.07 per additional point; 95% CI, 0.87-1.31). Findings were consistent in sensitivity analyses that: 1) used different adjustment covariates, 2) included a verbal estimate to derive an overall GCS, 3) accounted for missing data, 4) considered a 2-day time interval to define extubation failure, 5) accounted for competing risks, and 6) used a propensity score-based model. There was no association between GCS-EM and extubation outcome in subgroups defined by brain injury diagnosis or age. Conclusions: In this large, contemporary, multicenter cohort of patients with acute brain injury, we found no association between the GCS-EM and odds of extubation failure. However, few patients had a pre-extubation GCS-EM less than or equal to 8, and the possibility of a true prognostic association in patients with low scores is not excluded
Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial
No full textBackground: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation
Hematological features and alternate diagnoses in critically ill thrombotic antiphospholipid syndrome patients
No full textInternational audienceObjectives: Severe thrombotic antiphospholipid syndrome (APS) frequently affects the kidney, heart, and central nervous system. The precise frequency, clinical picture, differential diagnoses, and outcome of APS-related hematological involvement are lacking, especially in patients requiring ICU admission. This study aimed to describe the hematological manifestations associated with critically ill thrombotic APS patients and catastrophic antiphospholipid syndrome.Methods: This French, national, multicenter, retrospective study, conducted, from January 2000 to September 2018, included all APS patients admitted to 24 participating centers' ICUs with any new thrombotic manifestation. The prevalence of hematological manifestations and their associated outcomes were studied.Results: One hundred and thirty-four patients, female 72%, median [IQR] age 45 [34-56] years, with 152 episodes were included. Anemia was present in 95% of episodes and thrombocytopenia in 93%. The lowest values for hemoglobin and platelets were 7.1 [6.3-8.8] g/dL and 38 [21-60] g/L, respectively. The lowest platelet count below 20 g/L was significantly associated with a higher in-ICU mortality rate (50%, p < 0.0001). A thrombotic microangiopathy syndrome (TMA) syndrome was seen in 16 patients (12%) and was associated with higher in-hospital mortality (p = 0.05). Median ADAMTS-13 levels were 44% [27-74]. Anti-ADAMTS13 antibodies were tested in 11 patients and found negative in all. A suspicion of heparin-induced thrombocytopenia (HIT) was raised in 66 patients but only four patients were classified as definite HIT. Disseminated intravascular coagulation (DIC) was seen in 51% of patients.Conclusion: Thrombocytopenia is very frequent in severe APS patients and may be related to TMA, HIT, or DIC. Deciphering the mechanisms of thrombocytopenia is decisive in CAPS patients.Key Points• Thrombocytopenia is the hallmark laboratory finding in CAPS.• A complete thrombotic microangiopathy pattern is infrequent in CAPS patients.• Alternate diagnoses of CAPS, especially heparin-induced thrombocytopenia, need to be adequately investigated
