bluuebunny/crossref_metadata_2025 huggingface dataset:
Vers des dispositifs intégrés en réponse aux situations de jeunes à difficultés multiples ?
Authors: Barreyre Jean-Yves
Published: December 2015

Cet article propose une réflexion, à partir d’études réalisées par le cedias-creai et d’une formation-action conduite par le creai -Nord-Pas-de Calais avec unifaf , sur la nécessité de dépasser les frontières sectorielles des interventions sanitaires et sociales en direction de la jeunesse « en difficulté ». Il faut considérer aujourd’hui que cette jeunesse se trouve dans une situation de vulnérabilité généralisée. Abandonner la notion de « jeunesse sectorisée » dans des dispositifs spécifiques au regard de politiques publiques ou de secteurs d’activités devient une urgence. L’idée est de développer une stratégie globale d’intervention autour d’une politique générale en direction de la jeunesse. Et d’inscrire la « protection de l’enfance » dans cette politique de la jeunesse. Des articulations, une coopération entre les politiques, entre les secteurs, entre les professionnels doivent garantir la prise en compte du parcours de vie des jeunes de la protection de l’enfance et la cohérence de celui-ci.
Être adulte en sortant de structures d’Aide sociale à l’enfance, le capital social au cœur de la définition de l’autonomie
Authors: Kerivel Aude
Published: December 2015

Alors que le passage de l’âge de jeunesse à l’âge adulte n’est plus aujourd’hui marqué par un âge délimité, en revanche pour les jeunes de la protection de l’enfance, celui-ci correspond au départ du lieu de placement. La sortie de dispositif d’Aide sociale à l’enfance est cruciale. Il s’agit pour les professionnels de préparer les jeunes à la sortie et donc de les « accompagner vers l’autonomie ». L’article décrypte les facteurs qui impactent ce moment de la sortie, et parfois la suite de la trajectoire. Notamment, il aborde cette « injonction à l’autonomie » à un âge relativement jeune au regard des autres jeunesses et ses conséquences. On ne leur permet pas le temps des expériences, on ne leur permet pas de vivre une jeunesse. Et de plus, ces jeunes et leurs familles sont fréquemment dépourvus de capital social. Comment les professionnels peuvent alors réaliser cet accompagnement : c’est ce que dévoile l’article.
Nostalgia and Tourism: Narratives of Yucatán’s Tangible Heritage
Authors: Fernández Repetto Francisco Javier
Published: December 2015

Tourism in Mexico plays an important role in the country’s economy. It represents almost a third of the foreign currency that is invested in the country (Banco de México, 2014). Remarkable pre-Hispanic sites, colonial cities that flourished during the colonial period, as well as those that did during the 19th century, are key to understanding the diverse touristy attractions that can be found all over Mexico. Two major and related events, in terms of strategy for touristic promotion are analyzed here. Firstly, the controversy about the recently built monument of the founding fathers of Merida, Francisco de Montejo el Adelantado and Francisco de Montejo el Mozo. Secondly, Merida’s historical downtown Centro Histórico’s development and the related project Haciendas del Mundo Maya derived from it. As I will argue, all these events are part of a an anachronic perspective that links Yucatán’s modernity to its glorious past, which have as their main goal the portrayal of Yucatán as being modern, yet anchored in its past and from this, the search to promote the State, both for tourists and locals, appealing to a sense of nostalgia as the main element of attraction.
Cultural heritage and memory: untangling the ties that bind
Authors: Viejo-Rose Dacia
Published: December 2015

Today in heritage studies memory looms larger than ever, there are memory parks, memory politics, and memory wars, there is discussion of ‘dissonant’, ‘dark’, and ‘difficult’ heritage linked to memories of traumatic past events. But what to we mean when we use the word ‘memory’ in the field of heritage? How is the divide between its social and individual realms bridged? This article theorizes the intimate relationship between heritage and memory by focusing on three areas. First, it maps out the vocabulary that has emerged from the heritage-memory dyad including how notions of collective memory and lieux de mémoire have been used, and occasionally misused, as well as the metaphors employed in the process. Second, the emergence of memory studies is considered, providing a brief overview of its foundations as well as assessing how it differs from, overlaps with, and contributes to heritage research. A third section offers a brief review of recent developments in cognitive psychology, neuroscience, and evolutionary biology relating to memory and how this might inform heritage studies. The concluding discussion provides a synthesis of the theoretical and empirical contribution of memory research to furthering out understanding of cultural heritage and proposes directions for future work on the area of confluence between the two.
L’« exceptionnalité » d’Ebola et les « réticences » populaires en Guinée-Conakry. Réflexions à partir d’une approche d’anthropologie symétrique
Authors: Faye Sylvain Landry
Published: December 2015

Cet article discute de l’exceptionnalité de l’épidémie Ebola telle que vécue en Guinée-Conakry et analyse les rationalités à l’œuvre dans les rumeurs et les attitudes à l’égard des activités et des équipes de la « Riposte », qualifiées de « réticences » par l’OMS. Il adopte une perspective d’anthropologie symétrique, qui consiste à questionner aussi bien le contexte socioculturel et historico-politique que les aspects techniques de ce dispositif de lutte sans concéder de privilège épistémologique à l’un des deux aspects. Si la Riposte a justifié l’imposition de normes de biosécurité par le caractère exceptionnel de l’épidémie d’Ebola, les populations, elles, ne la vivent pas toujours comme un événement « hors normes ». Leurs discours et leurs comportements à son égard sont nourris par une longue histoire socioculturelle et prennent corps dans une économie politique locale et nationale faite de méfiances et de clivages ethniques. Plus spécifiquement, les attitudes face aux enterrements dignes et sécurisés expriment une critique d’un dispositif technique centré sur la biosécurité, qui retire aux familles leurs droits et nie leur capacité de gestion sécuritaire de l’espace mortuaire. Finalement, les attitudes dites réticentes témoignent d’une réaction à une violence structurelle produite par la Riposte et correspondent à des formes de mobilisation pour revendiquer une meilleure reconnaissance du rôle des communautés dans la gestion de l’épidémie. Cet article souhaite prouver qu’une lecture critique et symétrique par l’anthropologie du dispositif de lutte n’est pas purement négative. Au contraire, elle fournit les moyens et les arguments d’une approche plus collaborative et plus respectueuse des droits et des devoirs des communautés, en éclairant les enjeux sociopolitiques et contextuels de l’épidémie.
Ebola vu de loin : les agents de la santé face au risque et à l'incertitude dans les campagnes du Burkina Faso
Authors: Østergaard Lise Rosendal
Published: December 2015

Bien que la maladie à virus Ebola ait épargné le Burkina Faso pendant l’épidémie qui a frappé l’Afrique de l’Ouest, elle a tout de même suscité chez les travailleurs de la santé publique un certain nombre de craintes et d’interrogations, notamment sur les questions de sécurité et d’équité. Issu d’une enquête ethnographique dans trois Centres de Santé et de Promotion Sociale (CSPS) dans la Province du Boulgou au Burkina Faso, sur les moyens pratiques et technologiques accessibles pour maintenir un niveau minimal de sécurité sanitaire, cet article aborde la question des aléas et du risque professionnels. Les réflexions des travailleurs de la santé prenaient souvent un tour moral sur la déontologie du métier et sur les responsabilités du gouvernement. La conscience accrue de la menace d’Ebola a exacerbé des tensions existantes entre ces travailleurs et le gouvernement, au point que les premiers ont plus que jamais mis en doute le sens de la justice du second.
Ebola, entre science et fiction
Authors: Keck Frédéric
Published: December 2015

Cet article examine les modalités d’entrée de la fiction dans la gestion des maladies infectieuses émergentes comme Ebola. Deux modalités sont distinguées, expliquant que la fiction soit utilisée pour se préparer à des épidémies catastrophiques dont la probabilité ne peut pas être calculée. Dans un imaginaire du virus mutant, la fiction représente des espaces impurs à partir desquels commence un récit de contagion, qu’elle vise à contenir. Dans un imaginaire du virus ennemi, la fiction représente des interactions entre des êtres dotés d’intentions sur des échelles différentes et permet de penser l’incertitude de ces interactions. En s’appuyant sur l’anthropologie de la figuration, l’article montre que ces deux modalités peuvent être décrites à travers l’opposition entre une ontologie analogiste, ancrée dans des pratiques pastorales, et une ontologie animiste, ancrée dans des pratiques cynégétiques. Il interroge ainsi le rôle des images de « chasseurs de virus » dans la gestion contemporaine des épidémies.
Un « alien » dans le cerveau. Expérience sociale de la maladie mentale et idiome naturaliste des neurosciences
Authors: Moutaud Baptiste
Published: December 2015

Dans cet article, j’interroge les enjeux anthropologiques soulevés par la diffusion du discours naturaliste des neurosciences dans les sociétés contemporaines et l’idée qu’il offrirait aux individus une nouvelle manière de se penser et de se définir selon le cerveau et son fonctionnement. Pour cela, je décris les logiques selon lesquelles des personnes souffrant d’un trouble obsessionnel compulsif s’approprient des explications cognitives ou biologiques pour rendre compte de leur expérience de la maladie. J’avance l’idée que ces explications sont un idiome que les personnes mobilisent pour les registres d’action qu’il leur offre afin de reprendre le contrôle de leur trajectoire, d’agir sur leur environnement et de négocier les contraintes de la maladie. Plus que la construction d’une forme de vie fondée sur le biologique, ce langage s’inscrit dans des dispositifs qui le diffusent en écho des idéaux politiques et éthiques de la démocratie sanitaire et de l’empowerment. L’ensemble participe à construire la figure d’un individu souffrant d’un trouble psychiatrique qui pourrait agir sur son cerveau pour redevenir acteur de sa santé et rejoindre la communauté des citoyens.
Le virus Ebola : un révélateur d’inégalités biomédicales et une intervention internationale hétérogène
Authors: Patterson Donna A.
Published: December 2015

L’épidémie d’Ebola qui a frappé l’Afrique de l’Ouest en 2014 diffère considérablement des précédentes épidémies par son ampleur et la rapidité de sa progression. L’article adopte une approche historique et ethnographique du contexte de sa survenue. À bien des égards, l’épidémie a été sans précédent mais le Sénégal et le Nigeria ont été capables, grâce à des services de santé publique plus performants, de réagir plus rapidement et plus efficacement que les pays foyers de l’épidémie : le Liberia, la Sierra Leone et la Guinée. L’article analyse la source des disparités relevées au niveau des infrastructures biomédicales et des réponses politiques et sociales à la menace virale, et propose des recommandations pour l’avenir.
L’anthropologie au défi de l’Ebola
Authors: Moulin Anne Marie
Published: December 2015

Phénomène sans précédent, les anthropologues ont été immédiatement associés à la mobilisation internationale lors de la survenue de l’épidémie de 2014 due au virus Ebola. Jusque-là cantonnée à des régions reculées de l’Afrique centrale, elle s’est étendue en Afrique de l’Ouest, y compris dans des zones urbaines, et a fait souffler la crainte d’une pandémie. La rupture semblait être consommée avec le passé de lutte contre les grandes épidémies, marqué par une certaine violence structurelle, la panique des populations et la circulation de rumeurs hostiles aux interventions médicales. Ce numéro spécial d’Anthropologie & Santé présente un historique récent de l’épidémie, aborde les rapports entre science et fiction, et rapporte plusieurs observations de terrain, dans les pays de l’épicentre et aux alentours. L’anthropologie montre les tensions subsistant néanmoins entre éthique et science, même sous leur forme la plus contemporaine, et sa capacité à résoudre les contradictions tout en tenant compte des avancées de l’une et de l’autre. Le numéro se conclut sur l’inscription d’une épidémie singulière dans une série d’événements et la contribution de l’anthropologie, au-delà de son apport dans l’urgence, à la preparedness ou à l’effort de rationalisation dans la durée.
International Student Mobility Trends between Developed and Developing Countries
Authors: Liu Xuezhi , Li Chun
Published: December 2015

The authors offer international student mobility trends between developed and developing countries. Global outflow, inflow, and net inflow trends are described to display an overall and dynamic landscape of international student mobility. International student mobility trends between developed and developing countries are compared from perspectives of absolute and relative quantities. Relationships between mobility trends and economic growth are explored using regression analysis with applicable variables such as global outflow number and global GDP, outflow number and GDP in developing countries, inflow number and GDP in developed countries, etc.
Outbound Mobility and Students' Decision Making Process
Authors: Wadhwa Rashim
Published: December 2015

The author explores the decision making process of Indian students and factors influencing the decision of going abroad from the lens of prospective students. The study involves a sample of 362 prospective students from India. The author used a questionnaire and semi-structured interviews to collect data. The findings revealed that Indian students' decision making process involves four stages and differs according to the type and level of education. This study also provides insights into international student recruiters related to potential clients' choices and usage of different marketing strategies.
Drifting Houses, Shifting Anchors
Authors: Cho Hyunyoung , Haines David W. , Rosenblum Karen E.
Published: December 2015

Based on a new American college campus in Korea's Incheon Free Economic Zone, the authors in this chapter examine the experience of a set of students who challenge the traditional categorizations of “international” students and are often not counted in standard statistics on transnational student mobility. The authors discuss the changing nature and value of English-language education in this international setting, the increasing number of these students who already have international experience, and how these students themselves navigate a range of national and international identities. The authors also identify challenges these new international students pose for academic faculty and staff, particularly how to reconcile the different claims that students, staff, and faculty make about the meaning of being international.
Choosing the Right Pathway
Authors: Velliaris Donna M.
Published: December 2015

The Eynesbury Institute of Business and Technology (EIBT) is a pre-university pathway institution to the University of Adelaide or the University of South Australia. This chapter contributes to improving the understanding of the various factors that underpinned EIBT students' decision with regards to choosing Australia, and more specifically Adelaide and EIBT, as their study destination. International student applicants are located within a complex matrix of influences that can be effectively represented by overlapping spheres of push (operating in the home country) and pull (operating in the host country) factors. As evidenced in the qualitative data collected from a mandatory online questionnaire targeted at newly enrolled EIBT students, international mobility not only contributes to the internationalisation of Higher Education Institutions (HEIs), but also impacts on the outlooks, subsequent lifestyles and future careers of the students themselves. Pathway institutions offer valuable partnerships for HEIs and this study contributes to that rather shallow body of knowledge.
A Review of Literature on Adjustment Issues of International Students
Authors: Hwang Eunjin , Martirosyan Nara M. , Moore George W.
Published: December 2015

There is a scarcity of studies wherein a critical review or synthesis exists on the adjustment of international students with a few exceptional works. Therefore, through critical analyses of recent studies from various disciplines, the authors examine conceptual applications of existing models or typologies incorporated in previous studies, and redefine the nature of problems encountered by international students with a synthesis of study results on their adjustment issues: psychological, socio-cultural, and academic adjustment. Furthermore, suggestions for both practitioners and researchers are elaborated in the chapter. These suggestions include creating a new conceptual/theoretical model, emphasizing a critical role played by the host university, and tailoring support services to satisfy specific needs of diverse groups of international students within the specific campus context.
Discovering and Analysing Ontological Models From Big RDF Data
Authors: Rivero Carlos R. , Hernández Inma , Ruiz David , Cochuelo Rafael
Published: December 2015

We are witnessing an increasing popularity of the Web of Data, which exposes a large variety of web sources that provide their data using RDF. Ontological models are used as the schema to organize this data. These models are usually shared by several communities and, to devise them, there is usually an agreement amongst those communities. As a result, it is common to have more than one ontological model to understand some RDF data; therefore, there might be a gap between the ontological models and the RDF data, which is not negligible in practice. In this article, the authors present a technique to automatically discover ontological models from raw RDF data. It is based on the intensive usage of a set of SPARQL 1.1 structural queries that are generic and independent from the RDF data. The final result of the authors' technique is an ontological model that is derived from the RDF data, and includes types and properties, subtypes, domains and ranges of properties and subproperties. The authors have conducted experiments with millions of triples that prove that their technique is suitable to deal with Big RDF Data. As far as they know, this is the first technique to discover such ontological models in the context of RDF data and the Web of Data.
Imaging sketch of bedside ultrasonography to improve the diagnosis of rupture of splenic artery aneurysm
Authors: Barakat Bahjat , Pezzilli Raffaele
Published: December 2015

Not available.
The effect of age, anatomical site and bone structure on osteogenesis in New Zealand White rabbit
Authors: Ravanetti Francesca , Scarpa Edoardo , Farina Vittorio , Zedda Marco , Galli Carlo , Borghetti Paolo , Cacchioli Antonio
Published: December 2015

Among animal models, rabbits are widely used in medical research, as they fill the gap between smaller models, commonly employed in basic science, and larger ones, which are better suited for preclinical trials. Given their rapid growth, rabbits provide a valuable system for the evaluation of bone implants for tissue regeneration. By means of a histomorphometric analysis, here we quantified the mineral apposition rates (MARs) in osteonic, periosteum and endosteum osteogenic fronts, of skeletal elements within femur, tibia, radius, ulna, frontal and parietal bones in New Zealand White rabbits aged 6, 7 and 8 months. Our hypothesis is that the MAR varies according to the skeletal maturity of the animal, and also within the skeletal elements and the osteogenic fronts considered. In the present study we show that the MAR in both femur and tibia is significantly higher than in ulna and radius. We also demonstrate that the MAR in parietal bones is significantly higher compared to the MAR of both frontal and forelimb bones. Contrary to what was expected, the MARs of all the skeletal elements considered were not decreased following full skeletal maturity. Finally, the MAR of the osteonic-osteogenic front is the lowest in all of the skeletal elements considered. In conclusion, these results provide new important insights for the evaluation of bone implants, casting a light on the role of both age and osteogenic fronts on the bone MAR, and providing valuable information on the physiological bone turnover in New Zealand White rabbits.
Clinical and therapeutic value of carotid intima-media thickness
Authors: Vassallo Enrico , Musella Francesca , Mosca Susanna , Casaretti Laura , Formisano Roberto , Mattiello Giacomo , Bologna Ada , Fabiani Irma , Gambardella Francesco , Petraglia Laura , Rengo Giuseppe , Leosco Dario , Perrone-Filardi Pasquale
Published: December 2015

Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain.
Coronary artery anomalies and their clinical relevance
Authors: Misuraca Leonardo , Benedetti Giovanni , Petronio Anna Sonia , De Carlo Marco , Chella Piersilvio , Pieroni Andrea , Balbarini Alberto
Published: December 2015

Coronary artery anomalies (CAAs) represent one of the most confusing topic in cardiology and affect approximately 1% of the general population. Altough some anomalies seem to be only anatomical curiosities, others may sometimes have fatal consequences. This review describes the anatomical characteristics of main CAAs and focuses on the pathophysiological mechanisms by which CAAs may cause a pathological state. The last section describes these therapeutical options of this congenital disorders.
Preventive Cardiology: comparisons of European and Italian projects with the Cardiac Units from Emilia Romagna region. A workshop of IACPR/GICR - Emilia Romagna
Authors: Piepoli Massimo F. , Brambilla Antonio , Brambilla Lorenzo , Ceconi Claudio , Coruzzi Paolo , Corvi Ursula , Diaco Tommaso , Di Pasquale Giuseppe , Malagoli Alessandro , Miserotti Giuseppe , Pozzati Andrea , Semprini Pier Luigi , Sverzellati Enrico , Urbinati Stefano , Villani Giovanni Q.
Published: December 2015

A workshop endorsed by the Italian Association of Cardiovascular Prevention and Rehabilitation – Emilia Romagna Section – held in Piacenza in May 2011, gave the opportunity to discuss the emerging role of Preventive Cardiology in the modern era. From the new documents recently published by the European and Italian Scientific Associations, the barriers in their implementation, and the contribution of the health care providers, physicians, nurses, both in primary and secondary prevention were discussed. The local initiatives of cardiac prevention in different areas were presented and compared. A new project of secondary prevention in the follow-up and management of patients with dilated cardiomyopathy and heart failure promoted by the Emilia Romagna Region Health Authority was presented.
Remember of William B. Kannel
Authors: Scardi Sabino
Published: December 2015

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Selection criteria for referral to cardiac rehabilitation centers
Authors: Greco Cesare , Cacciatore Giuseppe , Gulizia Michele , Martinelli Luigi , Oliva Fabrizio , Olivari Zoran , Seccareccia Fulvia , Temporelli Pier Luigi , Urbinati Stefano
Published: December 2015

Current guidelines state that cardiac rehabilitation is indicated after the acute phase of major cardiovascular diseases and interventions; on the other hand implementation of these indications is difficult because of several barriers, i.e. the number of patients per year with an indication exceeds by far the accommodation offer of cardiac rehabilitation centers; the demand for access to cardiac rehabilitation from acute cardiac care hospitals is low because the attention is focused on the acute phase of cardiac diseases. The present Consensus Document describes the changes in clinical epidemiology of the main cardiovascular diseases, showing that complications are increasingly more frequent in the postacute phase, especially in the setting of myocardial infarction. The Joint ANMCO/IACPR-GICR Committee defines priority criteria based on clinical risk for admission to cardiac rehabilitation centers as inpatients. This Consensus Document represents, therefore, an important step forward in the search for continuity of care in high-risk patients during the post-acute phase.
Analysis of the vital exhaustion construct in a female population during cardiac rehabilitation
Authors: Balestroni Gianluigi , Giannuzzi Pantaleo , Omarini Giovanna , Omarini Pierangela
Published: December 2015

Background: Vital Exhaustion (VE) is a psychological construct that has been shown to be predictive for cardiac morbidity and mortality. There are not sufficient data which clarify whether the female population express this construct differentely comparing to males. This study aims to analyze the construct of Vital Exhaustion in a population of women admitted to a cardiac rehabilitation program. Material and Method: The selected sample consisted of 854 women with an average age of 58 years (SD ± 10.2). All patients were at their first hospitalization for a cardiac rehabilitation program. The tool used to analyze the construct of Vital Exhaustion was the B scale of the Cognitive Behavioural Assessment Hospital form (CBA-H). The study also analyzed the answers to the D scale of the CBA-H concerning aspects of lifestyle and behavioral habits. Results: The percentage of women with considerable value of Vital Exhaustion was very high (67.7%). Moreover, the group of women with higher Vital Exhaustion showed more dysfunctional habits (smoking, poor physical activity, incorrect diet) and more referred psychological problems as well as job and/or family distress and insomnia. 207 women (24.2%) of the sample belonged to economically active population; 136 (69%) of these women presented a high value of VE and 61 (31%) a low one. Among the employed women, 24% of the group with high VE value reported to be unsatisfied, while the same condition lowered at 9.6% in the group with low VE value (p=.004); moreover, 41.7% versus 18.5% (p=.000) described their working life as a source of tension. Conclusions: Considering a sample of female cardiac patients, this study shows that the construct of Vital Exhaustion is particularly present. It also appears that the construct of Vital Exhaustion can be interpreted as an indicator of lifestyle problems in women, helping health-professionals in selecting efficient educational and/or psychological interventions.
Total occlusion of the abdominal aorta in a patient with renal failure and refractory hypertension: a case report
Authors: Perrino Cinzia , Scudiero Laura , Petretta Maria Piera , Schiattarella Gabriele Giacomo , De Laurentis Mario , Ilardi Federica , Magliulo Fabio , Carotenuto Giuseppe , Esposito Giovanni
Published: December 2015

Total occlusion of the abdominal aorta is unusual, and potentially catastrophic. It occurs in patients with advanced atherosclerotic occlusive disease, and can cause severe ischemic manifestations, depending on the site of obstruction. Prompt and appropriate diagnostic and therapeutic approaches are important whenever this condition is suspected, in order to avoid a fatal outcome. The development of a complex network of collaterals may prevent the manifestation of acute ischemic phenomena, and cause a delay in diagnosis and treatment. Here we report the clinical case of a 59-year-old man who was referred to our Department for evaluation of renal failure and refractory hypertension. Ultrasonography and 99mTc-DTPA scintigraphy showed a shrunken, non-functioning left kidney, while CT angiography and aortography showed the complete occlusion of the aorta from below the right renal artery down to the bifurcation of both common iliac arteries, with a critical stenosis of the origin of the right renal artery, an occlusion of the left renal artery as well as of the origin of the inferior mesenteric artery. The patient was referred to the surgery department for aorto-bifemoral bypass surgery and re-implantation of the right renal artery.
The effect of antituberculosis treatment on interferon-γ release assay results
Authors: Bugiani M. , Bonora S. , Carosso A. , Piccioni P. , Cavallero M. , Mondo A. , Ghisetti V.
Published: December 2015

Background and Aim. Monitoring the efficacy of antituberculosis therapy is crucial. The aim of this work is to investigate the effect of tuberculosis treatment on interferon- γ response using Quanti-FERON©-TB Gold in tube (QFT-GIT). Methods. A total of 216 new pulmonary tuberculosis (TB) cases were tested with QFT-GIT at the start of the treatment and, randomly, once or twice between 90 and 180 days afterwards. Data was analysed using the random effect regression model analysis. Results. 63.4% of patients were positive at the QFTGIT (>.35 UI cut-off). TB cases showed a significant loglinear increase in interferon-γ (IFN-γ) concentration, over time of treatment: IFN-γ concentration increased by 78% after 6 months of treatment in acid-fast bacilli positive (A) and culture negative cases in culture confirmed cases the increase was 43% if A+ and 20% in A-. Conclusions. Effective therapy seems to restore cellular responses to Mycobacterium tuberculosis antigens. The potential use of interferon gamma release assay (IGRA) in monitoring response to TB treatment is hampered by the presence of active mycobacterial replication at baseline and needs further evaluation.
Adult cystic fibrosis care in the 21st century
Authors: Garattini E. , Bilton D. , Cremona G. , Hodson M.
Published: December 2015

Cystic fibrosis (CF) is the most common autosomal recessive inherited disease of Caucasian populations. As a result of a variety of diagnostic and therapeutic strategies there has been a dramatic increase in the life expectancy of patients with CF in the last decades and 50% of patients are now adults. This review will focus on the disease in adults and the provision of appropriate care. The complex care required to improve the survival and quality of life in the adult patients can best be provided in a dedicated adult cystic fibrosis unit. These units currently exist in many European countries, but more are needed in Italy.
Are Italian Pulmonologists aware of the Guidelines for asthma management and do they know how to apply them?
Authors: Bacci E. , Melosini L. , Novelli F. , Marinaro S. , Pala A.P. , Angino A. , Dente F.L. , Paggiaro P.
Published: December 2015

Background. Since 1995 GINA (Global Initiative on Asthma) guidelines for asthma management have been updated annually and published in order to promote better management of asthma in real life situations. The aim of our study was to assess the level of implementation of GINA Guidelines among Italian Pulmonary Specialists (PSs). Methods. A detailed questionnaire was sent to 296 Respiratory Units (RUs) in Italy in order to collect information about personnel involved in the management of asthma patients, availability and use of diagnostic tools, recommended treatment according to the degree of asthma severity, educational activity. Data were analysed by using the SPSS programme. Results. 74 (25%) questionnaires were returned and analysed. Most RUs (70%) do not have a dedicated asthma clinic; however, spirometry is available in more than 90% of RUs, although it is performed in no more than 50% of patients in most RUs. Asthma treatment concurs with GINA recommendations in most RUs. Educational activity is performed by almost all RUs, usually in informal manner, during clinical visits, whereas only few RUs arrange individual educational sessions or “asthma school”. Conclusions. GINA guidelines for asthma management are applied by most Italian RUs included in this study in regard to educational activity and, to a lesser extent, to treatment. Surprisingly, many RUs perform spirometry in a relatively small number of patients despite its availability.
Malignant melanoma presenting as an isolated pleural effusion
Authors: Shameem M. , Akhtar J. , Baneen U. , Ahmad Khan N. , Bhargava R. , Ahmed Z. , Shahid M. , Azfar Siddiqui M.
Published: December 2015

Isolated pleural effusion is a very rare presentation of malignant melanoma. A 46 year-old male patient presented to us with complaints of shortness of breath during the previous month. A contrast enhanced computed tomography (CECT) imaging scan of his thorax showed right-sided pleural effusion with the absence of any mass lesion or mediastinal lymphadenopathy. Cytology of his pleural fluid showed pigmented cells suggestive of malignant melanoma. Staining of the pleural fluid cells with immunohistological markers for melanoma (HMB 45 and S 100) were positive. An examination of his skin did not reveal any pigmented lesion, nor was there a past history of malignant melanoma for this patient. The patient responded well to therapy for malignant melanoma and has remained asymptomatic for the last year. This patient was diagnosed with a rare case of primary malignant melanoma of the pleura presenting as isolated pleural effusion.
Prolonged hospitalisation for immigrants and high risk patients with positive smear pulmonary tuberculosis
Authors: Luzzati R. , Confalonieri M. , Cazzadori A. , Della Loggia P. , Cifaldi R. , Fabris C. , Biolo M. , Borelli M. , Longo C. , Concia E.
Published: December 2015

Background and objective. Tuberculosis (TB) occurring in immigrants and resistance to drugs are major problems for TB control in Western countries. Directly observed therapy (DOT) reduces disease transmission, but this approach may have poor results among illegal immigrants. Our aim was to evaluate a prolonged hospitalisation programme to improve early outcome of TB treatment in high risk patients. Methods. All the consecutive adult patients with sputum smear-positive pulmonary TB admitted to 2 Italian referral TB Centres were evaluated. Hospital-based DOT was provided to high risk patients up-to smear conversion. Demographic, microbiological and clinical conditions, as potential factors associated with confirmed smear conversion at 60 and 90 days of anti-tuberculous therapy were evaluated. Results. 122 patients were studied, 45.9% of them were immigrants (20% illegal) from high-prevalence TB countries. HIV testing was negative in all cases. Twelve patients had M. tuberculosis resistant to ≥ 1 first-line anti-tuberculous agents. The rate of defaulting from TB treatment was 7.3%. Sputum smear became negative in 84.4% cases after 60 days and 93.3% cases after 90 days. At such time, smear conversion rates were similar among different high risk subgroups such as illegal immigrants (95.9%), legal foreign-born (92.5%) and Italian persons (94.8%). Persistent sputum smear positivity was independently correlated with the extent of pulmonary lesions at 60 (p<0.0001) and 90 days (p=0.038) of hospital-based DOT. Conclusions. These findings suggest that prolonged hospitalisation for illegal immigrants and high risk TB patients, may positively influence the early outcome of TB treatment despite of drug resistance and legal status.
Organization of an Endoscopic Division
Authors: Legorini C.E. , Milani G.F. , Calabro S.
Published: December 2015

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Bronchoscopy Report: format and filing, images and exam correlation
Authors: Corbetta L. , Mereu C.
Published: December 2015

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Bronchoalveolar Lavage. Technical Notes
Authors: Poletti V. , Casoni G. , Ravaglia C. , Romagnoli M. , Tomassetti S.
Published: December 2015

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Autofluorescence Bronchoscopy and Endobronchial Ultrasound
Authors: Falcone F. , Majori M. , Grosso D. , Fois F. , Trisolini R.
Published: December 2015

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Lung Transplantation and Endoscopic Issues
Authors: Callegari G. , Fracchia C.
Published: December 2015

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Palliative Therapy
Authors: Milani G.F. , Simonassi C. , Salio M.
Published: December 2015

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Bronchoscopic Curative Therapy
Authors: Patelli M. , Paioli D. , Trisolini R.
Published: December 2015

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Percutaneous Approach in Pneumology
Authors: Aliprandi P.L. , Basile F.P. , Tassi G.F.
Published: December 2015

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Therapeutic approach beyond conventional temozolomide for newly diagnosed glioblastoma: Review of the present evidence and future direction
Authors: Mallick Supriya , Gandhi Ajeet Kumar , Rath Goura Kishor
Published: December 2015

Glioblastoma multiforme (GBM) is the most aggressive form of primary brain tumor. Maximal safe surgical resection followed by adjuvant partial brain radiation with concurrent and adjuvant temozolomide (TMZ) (oral alkylating agent) is the standard of care. Five years survival in TMZ treated patient reaches 9.8%. We aimed to summarize the changes in the management of GBM beyond conventional temozolomide based adjuvant treatment. We searched the PUBMED with the following key words: Glioblastoma, phase III trial, Phase II trial, adjuvant treatment in GBM. Clinical research has found a wide range of molecular aberrations in GBM and attempts are being made to further improve survival with the addition of different classes of drugs. Angiogenesis inhibitors, oncolytic vaccines, dose dense TMZ, and anti-epidermal growth factor receptor monoclonal antibody in phase III trials have failed to improve survival. Recent studies have also shown that the management strategies might be different and needs to be customized as per the age of patients such as pediatric and elderly patients. In addition, treatments should be personalized depending on the molecular aberrations. We reviewed all published phase III trials for newly diagnosed GBM as well as also looked into possible future directions in this review. Limited progress has happed beyond conventional TMZ in the adjuvant treatment of GBM. Newer insights are emerging about treatment intensification and introduction of newer molecular targeted drugs with more information about molecular aberrations.
Maintenance pemetrexed in nonsmall cell lung carcinoma: Outcome analysis from a tertiary care center
Authors: Pandey Avinash Vijaykumar , Phillip Deepa Susan , Noronha Vanita , Joshi Amit , Janu Amit , Jambekar Nirmala , Kaushal Rajesh , Mahajan Abhishek , Prabhash Kumar
Published: December 2015

Background: Maintenance pemetrexed is a standard treatment option for selected non squamous nonsmall cell lung carcinoma patients having a response to platin based doublet. We conducted a clinical audit of such selected patients and report the outcome among the Indian population. Aim: To evaluate the outcomes with maintenance pemetrexed in the patients with locally advanced and metastatic adenocarcinoma lung. Objectives: To calculate the progression free survival (PFS), overall survival (OS), and factors affecting the outcome. Materials and Methods: Data of patients with locally advanced and metastatic adenocarcinoma lung were retrieved from prospectively maintained lung cancer database registered between June 2011 and March 2014. The patients who achieved partial response (n = 87) or stable disease (n = 101) after 6 cycles of pemetrexed platin based doublet and received the maintenance pemetrexed were selected for final analysis (n = 188). Kaplan-Meir survival analysis was used for PFS and OS. Log rank test was used to evaluate the factors affecting the outcome. Results: Median follow-up is 14 months. The median number of maintenance pemetrexed cycles received is 6 (1-38). Common reason for the discontinuation are disease progression (n = 127), renal toxicity (n = 4), and social/financial (n = 7). Median PFS and OS are 8 months and 20 months, respectively. The patients with baseline pleural effusion had better PFS (9 months vs. 7 months, P = 0.02) and OS (26 months vs. 18 months, P = 0.05). The patients receiving more than 6 cycles of maintenance had improved PFS (12 vs. 7 months, P = 0.002) and OS (26 vs. 16 months, P = 0.05). Conclusion: Maintenance pemetrexed is feasible and well tolerated by the majority of Indian patients who achieved the response after platin based doublet. The patients with baseline pleural effusion benefit more with maintenance pemetrexed.
Early Human Papilloma Virus (HPV) Oncogenic Influences in Breast Cancer
Authors: Ngan Christopher , Lawson James S. , Clay Rosemary , Delprado Warick , Whitaker Noel J. , Glenn Wendy K.
Published: December 2015

Background

Human papilloma viruses (HPVs) may act early in breast oncogenesis (“hit-and-run” phenomena).

Methods

The authors used immunohistochemistry for the identification of HPV E7 oncogenic protein expression in 32 sets of benign and subsequent breast cancer specimens from the same Australian patients.

Results

HPV E7 oncoprotein was clearly expressed in the nuclei of 23 (72%) of the 32 benign specimens and 20 (62.5%) of the subsequent 32 breast cancer specimens in the same patients. There was no HPV E7 protein expression in seven (30%) of the 23 breast cancer specimens that had prior HPV E7 protein-positive benign breast biopsies in the same patients.

Conclusions

This observation suggests that HPV oncogenic influences occur early in some breast cancers. This finding confirms the previous observations. This early influence of HPVs may be the reason why there is no increase in the prevalence of HPV-associated breast cancer in immunocompromised patients as compared to HPV-associated cervical cancer.
Agents zoonotiques vectorisés étudiés à l’Institut Hospitalo-Universitaire Méditerranée Infection
Authors: Laroche Maureen , Alméras Lionel , Bérenger Jean-Michel , Raoult Didier , Parola Philippe
Published: December 2015

L’entomologie médicale est l’étude des arthropodes vecteurs d’agents pathogènes responsables de maladies humaines, dont de nombreuses zoonoses émergentes ces dernières années. Nous présentons ici quelques axes de recherche développés par l’équipe d’Entomologie Médicale de l’Institut Hospitalo-Universitaire Méditerranée Infection, illustrés par des études récentes ou emblématiques : l’innovation technologique pour identifier les arthropodes, l’utilisation des arthropodes comme outil épidémiologique ou diagnostique, les enquêtes autour de cas cliniques et les modèles expérimentaux pour comprendre les interactions entre les arthropodes, l’homme et les microorganismes.

Résumé
The intradiscal failure pressure on porcine lumbar intervertebral discs: an experimental approach
Authors: Araújo A. R. G. , Peixinho N. , Pinho A. , Claro J. C. P.
Published: December 2015

Abstract. The intervertebral disc is submitted to complex loading during its normal daily activities which are responsible for variations of the hydrostatic pressure in its structure. Thus, the determination of the magnitude of failure hydrostatic pressure is essential as a potential for the evaluation of the mechanisms that promote the weakening and the disruption of the annular fibers, commonly linked to herniation process on the spine column. However, few studies include the determination of the failure pressure on discs and the results are widely contradictory. Therefore, the objective of the present work is to determine the values of IDP that promotes the disc disruption. To achieve this goal, the tests were performed using a hydraulic cylinder that inflates the intervertebral disc. The results revealed a mean pressure failure of 0.62 ± 0.08 MPa for lumbar porcine samples (n = 6). From this approach it can be concluded that (1) the potential for disc injury may exist at low pressures for lumbar porcine discs when compared several animal and human ones; (2) the rupture of human cervical and porcine lumbar annular fibers could occur for values of intradiscal pressure that are within the physiological range.
Rejoinder to Michelle Marder Kamhi: Family Feud
Authors: Seddon Fred
Published: December 2015

The author responds to Michelle Marder Kamhi’s reply to his review of her book, Who Says That’s Art? He takes her to task on a few issues, but largely sees this as a mere skirmish between two colleagues who agree on many fundamentals.
Solidarity Forever: The Historical Background of John Steinbeck's In Dubious Battle
Authors: Dawson Jon Falsarella
Published: December 2015

This article examines the strikes that provided the basis for In Dubious Battle. Building on the work of Jackson J. Benson and Anne Loftis, I analyze how Steinbeck utilized episodes from the Tagus Ranch peach strike in August of 1933 and a cotton strike throughout the San Joaquin Valley that October. Through the use of periodical accounts, I examine how Steinbeck deviated from the particulars of these labor disputes to clarify the central themes of the novel. Further, the article brings these events to bear on the representation of Mac and Jim Nolan, whose motives and methods have been the subjects of significant critical scrutiny. While Steinbeck does not necessarily present these characters in a favorable manner, In Dubious Battle indicates that the primary responsibility for human suffering rests on the growers since they preside over an economic framework that limits the opportunities available to the working class.
“A room of experience into which I cannot enter”: John Steinbeck on Race
Authors: Lynn Shane
Published: December 2015

In her seminal study on intellectuals and the civil rights struggle, Carol Polsgrove castigated “white intellectuals, in the North and South” for their reticence. After Brown v. Board of Education “opened the door to change,” she argues, America's leading intellectuals simply “milled about outside the door, debating amongst themselves how fast America ought to go through it.” Yet what of John Steinbeck? How did the compassionate advocate of social justice in the thirties respond to the racial upheaval of the fifties and sixties, a time when his winning of the Nobel Prize in Literature made him once more a highly visible public intellectual? This paper applies a historical perspective in examining Steinbeck's contributions (or lack thereof) to America's race issue, with a particular emphasis on his nonfiction and personal correspondence. It is argued that Steinbeck was typically uncomfortable airing his support for the civil rights movement and deliberately avoided presenting himself as a spokesman on the issue. While in his fiction he tended to indulge in stereotyping, he did so with no perceptible intent to denigrate his nonwhite characters. His preoccupation, even when addressing the race issue directly, was always with the danger of moral decline in American society at large. Steinbeck's African American was presented as a dignified and courageous foil to the materialistic white American, who was “trapped and entangled” in avaricious individualism.