Outcome of HIV-infected patients with hepatocellular carcinoma: a comparison with HIV negative controls

Background and rationale for the study. This study investigated whether human immunodeficiency virus (HIV) infection adversely affects the prognosis of patients diagnosed with hepatocellular carcinoma (HCC).Thirty-four HIV-positive patients with chronic liver disease, consecutively diagnosed with HCC from 1998 to 2007 were one-to-one matched with 34 HIV negative controls for: sex, liver function (Child-Turcotte-Pugh class [CTP]), cancer stage (BCLC model) and, whenever possible, age, etiology of liver disease and modality of cancer diagnosis. Survival in the two groups and independent prognostic predictors were assessed. Results. Among HIV patients 88% were receiving HAART. HIV-RNA was undetectable in 65% of cases; median lymphocyte CD4+ count was 368.5/mmc. Etiology of liver disease was mostly related to HCV infection. CTP class was: A in 38%, B in 41%, C in 21% of cases. BCLC cancer stage was: early in 50%, intermediate in 23.5%, advanced in 5.9%, end-stage in 20.6% of cases. HCC treatments and death causes did not differ between the two groups. Median survival did not differ, being 16 months (95% CI: 6-26) in HIV positive and 23 months (95% CI: 5-41) in HIV negative patients (P=0.391). BCLC cancer stage and HCC treatment proved to be independent predictors of survival both in the whole population and in HIV patients. Conclusions. Survival of HIV infected patients receiving antiretroviral therapy and diagnosed with HCC is similar to that of HIV negative patients bearing this tumor. Prognosis is determined by the cancer bulk and its treatment.

L'Occidente di Elisée Reclus: l'invenzione dell'Europa nella Nouvelle Géographie Universelle (1876-1894)

La Nouvelle Géographie Universelle di Élisée Reclus relativizza e problematizza il ruolo dell’Europa e il suo peso nello scacchiere mondiale, restando tuttavia in equilibrio fra, da una parte, la critica delle pratiche coloniali e dall’altra la fiducia nei confronti della tradizione culturale proveniente dall’antica Grecia e dal secolo de Lumi destinata, nella visione evoluzionista dell’autore, a spargere negli altri continenti i germi del pensiero socialista e anarchico. In questo lavoro si cerca di chiarire questa rappresentazione dei concetti di Europa e Occidente in tre passaggi successivi. Dapprima, la ricostruzione della genealogia, della teoria e del contesto storico del concetto di geografia universale all’epoca. Poi, la ricostruzione dalle fonti di archivio delle reti scientifiche di respiro europeo che sono state alla base di quest’opera, indispensabile per poterne comprendere il significato politico nel contesto dell’epoca. Infine, l’indagine sul testo per ricostruire ruolo, caratteri e suddivisione dell’Europa, che si rivela, nonostante la serrata critica del suo ruolo colonizzatore, come il privilegiato laboratorio individuato dai “geografi anarchici” per lo sviluppo delle lotte sociali e per la costruzione, su basi anche geografiche, di una proposta politica federalista e libertaria.

"Mi bèl pawòl, mi!" Rappresentazione delle lingue e della parola nella narrativa di Patrick Chamoiseau e Raphael Confiant (1986-1994)

From 1986 to 1994, Patrick Chamoiseau and Raphaël Confiant published a series of fictional and non-fictional writings focusing on language issues. Interest in these themes can certainly in part be explained by the "surconscience linguistique" that Lise Gauvin attributes to Francophone authors: a linguistic over-awareness which, in the case of these two Martiniquais writers, may be attributed to their Creole-French diglossia. Although we might believe that the idea of Gauvin is right, it doesn't seem enough to explain why the linguistic theme plays such a central role in Chamoiseau's and Confiant's works. Deeply influenced by Glissant's theories on Creole popular culture and Antillean literature (Le discours antillais), they conceived a "Créolité" poetics based on a primarly identity-based and geopolitical discourse. Declaring the need to build an authentically Creole literary discourse, one that finally expresses the Martiniquais reality, Chamoiseau and Confiant (as well as Bernabé, third and last author of Éloge de la créolité) found the «foundations of [their] being» in orality and its poetics in the Creole language. This belief was maily translated into their works in two ways: by representing the (diglossic) relationships occurring between their first languages (Creole and French) and by representing the Creole parole (orality) and its function. An analysis of our authors' literary and theoretical writings will enable us to show how two works that develop around the same themes and thesis have in fact produced very divergent results, which were perhaps already perceivable in the main ambiguities of their common manifestos.