Trasmissione post-natale del citomegalovirus attraverso il latte materno al neonato VLBW

Introduction Postnatal human cytomegalovirus (CMV) infection is usually asymptomatic in term babies, while preterm infants are more susceptible to symptomatic CMV infection. Breastfeeding plays a dominant role in the epidemiology of transmission of postnatal CMV infection, but the risk factors of symptomatic CMV infection in preterm infants are unknown. Patients and Methods Between December 2003 and August 2006, eighty Very Low Birth Weight (VLBW) preterm infants (gestational age ≤ 32 weeks and birth weight < 1500 g), admitted to the Neonatal Intensive Care Unit of St Orsola-Malpighi General Hospital, Bologna were recruited. All of them were breastfed for at least one month. During the first week of life, serological test for CMV was performed on maternal blood. Furthermore, urinary CMV culture was performed in all the infants in order to exclude a congenital CMV infection. Urine samples from each infant were collected and processed for CMV culture once a week. Once every 15 days a blood sample was taken from each infant to evaluate the complete blood count, the hepatic function and the C reactive protein. In addition, samples of fresh breast milk were processed weekly for CMV culture. A genetic analysis of virus variant was performed in the urine of the infected infants and in their mother’s milk to confirm the origin of infection. Results We evaluated 80 VLBW infants and their 68 mothers. Fifty-three mothers (78%) were positive for CMV IgG antibodies, and 15 (22%) were seronegative. In the seronegative group, CMV was never isolated in breast milk, and none of the 18 infants developed viruria; in the seropositive group, CMV was isolated in 21 out of 53 (40%) mother’s milk. CMV was detected in the urine samples of 9 out of 26 (35%) preterm infants, who were born from 21 virolactia positive mothers. Six of these infants had clinically asymptomatic CMV infection, while 3 showed a sepsis-like illness with bradycardia, tachypnea and repeated desaturations. Eight out of nine infants showed abnormal hematologic values. The detection of neutropenia was strictly related to CMV infection (8/9 infected infants vs 17/53 non infected infants, P<.005), such as the detection of an increase in conjugated bilirubin (3/9 infected infants vs 2/53 non infected infants, P<.05). The degree of neutropenia was not different between the two groups (infected/non infected). The use of hemoderivatives (plasma and/or IgM–enriched immunoglobulin) in order to treat a suspected/certain infection in newborn with GE< 28 ws was seen as protective against CMV infection (1/4 infected infants vs 18/20 non infected infants [GE<28 ws]; P<.05). Furthermore, bronchopulmonary dysplasia (defined both as oxygen-dependency at 30 days of life and 36 ws of postmenstrual age) correlated with symptomatic infection (3/3 symptomatic vs 0/6 asymptomatic: P<.05). Conclusion Our data suggest that CMV infection transmitted to preterm newborn through human milk is always asymptomatic when newborns are clinically stable. Otherwise, the infection can worsen a preexisting disease such as bronchopulmonary dysplasia. Human milk offers many nutritional and psychological advantages to preterm newborns: according to our data, there’s no reason to contraindicate it neither to pasteurize the milk of all the mothers of preterm infants who are CMV seropositive.

Rafael Moneo: la complessità del vuoto. Dalle matrici formali dell'opera di Oteiza e Chillida

The experience of void, essential to the production of forms and to make use them, can be considered as the base of the activities that attend to the formative processes. If void and matter constitutes the basic substances of architecture. Their role in the definition of form, the symbolic value and the constructive methods of it defines the quality of the space. This job inquires the character of space in the architecture of Moneo interpreting the meaning of the void in the Basque culture through the reading of the form matrices in the work of Jorge Oteiza and Eduardo Chillida. In the tie with the Basque culture a reading key is characterized by concurring to put in relation some of the theoretical principles expressed by Moneo on the relationship between place and time, in an unique and specific vision of the space. In the analysis of the process that determines the genesis of the architecture of Moneo emerges a trajectory whose direction is constructed on two pivos: on the one hand architecture like instrument of appropriation of the place, gushed from an acquaintance process who leans itself to the reading of the relations that define the place and of the resonances through which measuring it, on the other hand the architecture whose character is able to represent and to extend the time in which he is conceived, through the autonomy that is conferred to them from values. Following the trace characterized from this hypothesis, that is supported on the theories elaborated from Moneo, surveying deepens the reading of the principles that construct the sculptural work of Oteiza and Chillida, features from a search around the topic of the void and to its expression through the form. It is instrumental to the definition of a specific area that concurs to interpret the character of the space subtended to a vision of the place and the time, affine to the sensibility of Moneo and in some way not stranger to its cultural formation. The years of the academic formation, during which Moneo enters in contact with the Basque artistic culture, seem to be an important period in the birth of that knowledge that will leads him to the formulation of theories tied to the relationship between time, place and architecture. The values expressed through the experimental work of Oteiza and Chillida during years '50 are valid bases to the understanding of such relationships. In tracing a profile of the figures of Oteiza and Chillida, without the pretension that it is exhaustive for the reading of the complex historical period in which they are placed, but with the needs to put the work in a context, I want to be evidenced the important role carried out from the two artists from the Basque cultural area within which Moneo moves its first steps. The tie that approaches Moneo to the Basque culture following the personal trajectory of the formative experience interlaces to that one of important figures of the art and the Spanish architecture. One of the more meaningful relationships is born just during the years of his academic formation, from 1958 to the 1961, when he works like student in the professional office of the architect Francisco Sáenz de Oiza, who was teaching architectural design at the ETSAM. In these years many figures of Basque artists alternated at the professional office of Oiza that enjoys the important support of the manufacturer and maecenas Juan Huarte Beaumont, introduced to he from Oteiza. The tie between Huarte and Oteiza is solid and continuous in the years and it realizes in a contribution to many of the initiatives that makes of Oteiza a forwarder of the Basque culture. In the four years of collaboration with Oiza, Moneo has the opportunity to keep in contact with an atmosphere permeated by a constant search in the field of the plastic art and with figures directly connected to such atmosphere. It’s of a period of great intensity as in the production like in the promotion of the Basque art. The collective “Blanco y Negro”, than is held in 1959 at the Galería Darro to Madrid, is only one of the many times of an exhibition of the work of Oteiza and Chillida. The end of the Fifties is a period of international acknowledgment for Chillida that for Oteiza. The decade of the Fifties consecrates the hypotheses of a mythical past of the Basque people through the spread of the studies carried out in the antecedent years. The archaeological discoveries that join to a context already rich of signs of the prehistoric era, consolidate the knowledge of a strong cultural identity. Oteiza, like Chillida and other contemporary artists, believe in a cosmogonist conception belonging to the Basques, connected to their matriarchal mythological past. The void in its meaning of absence, in the Basque culture, thus as in various archaic and oriental religions, is equivalent to the spiritual fullness as essential condition to the revealing of essence. Retracing the archaic origins of the Basque culture emerges the deep meaning that the void assumes as key element in the religious interpretation of the passage from the life to the death. The symbology becomes rich of meaningful characters who derive from the fact that it is a chthonic cult. A representation of earth like place in which divine manifest itself but also like connection between divine and human, and this manipulation of the matter of which the earth it is composed is the tangible projection of the continuous search of the man towards God. The search of equilibrium between empty and full, that characterizes also the development of the form in architecture, in the Basque culture assumes therefore a peculiar value that returns like constant in great part of the plastic expressions, than in this context seem to be privileged regarding the other expressive forms. Oteiza and Chillida develop two original points of view in the representation of the void through the form. Both use of rigorous systems of rules sensitive to the physics principles and the characters of the matter. The last aim of the Oteiza’s construction is the void like limit of the knowledge, like border between known and unknown. It doesn’t means to reduce the sculptural object to an only allusive dimension because the void as physical and spiritual power is an active void, that possesses that value able to reveal the being through the trace of un-being. The void in its transcendental manifestation acts at the same time from universal and from particular, like in the atomic structure of the matter, in which on one side it constitutes the inner structure of every atom and on the other one it is necessary condition to the interaction between all the atoms. The void can be seen therefore as the action field that concurs the relations between the forms but is also the necessary condition to the same existence of the form. In the construction of Chillida the void represents that counterpart structuring the matter, inborn in it, the element in absence of which wouldn’t be variations neither distinctive characters to define the phenomenal variety of the world. The physics laws become the subject of the sculptural representation, the void are the instrument that concurs to catch up the equilibrium. Chillida dedicate himself to experience the space through the senses, to perceive of the qualities, to tell the physics laws which forge the matter in the form and the form arranges the places. From the artistic experience of the two sculptors they can be transposed, to the architectonic work of Moneo, those matrices on which they have constructed their original lyric expressions, where the void is absolute protagonist. An ambit is defined thus within which the matrices form them drafts from the work of Oteiza and Chillida can be traced in the definition of the process of birth and construction of the architecture of Moneo, but also in the relation that the architecture establishes with the place and in the time. The void becomes instrument to read the space constructed in its relationships that determine the proportions, rhythms, and relations. In this way the void concurs to interpret the architectonic space and to read the value of it, the quality of the spaces constructing it. This because it’s like an instrument of the composition, whose role is to maintain to the separation between the elements putting in evidence the field of relations. The void is that instrument that serves to characterize the elements that are with in the composition, related between each other, but distinguished. The meaning of the void therefore pushes the interpretation of the architectonic composition on the game of the relations between the elements that, independent and distinguished, strengthen themselves in their identity. On the one hand if void, as measurable reality, concurs all the dimensional changes quantifying the relationships between the parts, on the other hand its dialectic connotation concurs to search the equilibrium that regulated such variations. Equilibrium that therefore does not represent an obtained state applying criteria setting up from arbitrary rules but that depends from the intimate nature of the matter and its embodiment in the form. The production of a form, or a formal system that can be finalized to the construction of a building, is indissolubly tied to the technique that is based on the acquaintance of the formal vocation of the matter, and what it also can representing, meaning, expresses itself in characterizing the site. For Moneo, in fact, the space defined from the architecture is above all a site, because the essence of the site is based on the construction. When Moneo speaks about “birth of the idea of plan” like essential moment in the construction process of the architecture, it refers to a process whose complexity cannot be born other than from a deepened acquaintance of the site that leads to the comprehension of its specificity. Specificity arise from the infinite sum of relations, than for Moneo is the story of the oneness of a site, of its history, of the cultural identity and of the dimensional characters that that they are tied to it beyond that to the physical characteristics of the site. This vision is leaned to a solid made physical structure of perceptions, of distances, guideline and references that then make that the process is first of all acquaintance, appropriation. Appropriation that however does not happen for directed consequence because does not exist a relationship of cause and effect between place and architecture, thus as an univocal and exclusive way does not exist to arrive to a representation of an idea. An approach that, through the construction of the place where the architecture acquires its being, searches an expression of its sense of the truth. The proposal of a distinction for areas like space, matter, spirit and time, answering to the issues that scan the topics of the planning search of Moneo, concurs a more immediate reading of the systems subtended to the composition principles, through which is related the recurrent architectonic elements in its planning dictionary. From the dialectic between the opposites that is expressed in the duality of the form, through the definition of a complex element that can mediate between inside and outside as a real system of exchange, Moneo experiences the form development of the building deepening the relations that the volume establishes in the site. From time to time the invention of a system used to answer to the needs of the program and to resolve the dual character of the construction in an only gesture, involves a deep acquaintance of the professional practice. The technical aspect is the essential support to which the construction of the system is indissolubly tied. What therefore arouses interest is the search of the criteria and the way to construct that can reveal essential aspects of the being of the things. The constructive process demands, in fact, the acquaintance of the formative properties of the matter. Property from which the reflections gush on the relations that can be born around the architecture through the resonance produced from the forms. The void, in fact, through the form is in a position to constructing the site establishing a reciprocity relation. A reciprocity that is determined in the game between empty and full and of the forms between each other, regarding around, but also with regard to the subjective experience. The construction of a background used to amplify what is arranged on it and to clearly show the relations between the parts and at the same time able to tie itself with around opening the space of the vision, is a system that in the architecture of Moneo has one of its more effective applications in the use of the platform used like architectonic element. The spiritual force of this architectonic gesture is in the ability to define a place whose projecting intention is perceived and shared with who experience and has lived like some instrument to contact the cosmic forces, in a delicate process that lead to the equilibrium with them, but in completely physical way. The principles subtended to the construction of the form taken from the study of the void and the relations that it concurs, lead to express human values in the construction of the site. The validity of these principles however is tested from the time. The time is what Moneo considers as filter that every architecture is subordinate to and the survival of architecture, or any of its formal characters, reveals them the validity of the principles that have determined it. It manifests thus, in the tie between the spatial and spiritual dimension, between the material and the worldly dimension, the state of necessity that leads, in the construction of the architecture, to establish a contact with the forces of the universe and the intimate world, through a process that translate that necessity in elaboration of a formal system.

ROS generate dalle NAD(P)H ossidasi nella segnalazione redox in linee cellulari leucemiche

Discovery of the Nox family has led to the concept that ROS are “intentionally” generated and are biologically functional in various cell types. Over the last decades, ROS have been shown to be involved in several physiological and pathological processes and ROS producing enzymes have been suggested as a target for drug development. The mechanism involved in the prosurvival effect of cytokines on the human acute myeloid leukaemia cell lines M07e and B1647 is investigated. A decrease in intracellular reactive oxygen species (ROS) content, glucose transport activity and cell survival was observed in the presence of inhibitors of plasma membrane ROS sources, such as DPI and apocynin, and by small interference RNA for NOX2 in M07e cells. Furthermore, Nox generated ROS are required to sustain B1647 cell viability and proliferation; in fact, antioxidants such as EUK-134 or Nox inhibitors and siRNA direct cells to apoptotic cell death, suggesting that manipulation of cellular NOX2 and NOX4 could affect survival of leukemic cells. Moreover, hydrogen peroxide has been long thought to be freely diffusible but recent evidence suggest that specific mammalian aquaporin homologues (AQP8) possess the capacity to channel H2O2 across membrane. In this thesis is shown that inhibition of aquaporins diminishes intracellular ROS accumulation either when H2O2 is produced by Nox enzymes or when is added exogenously to the medium. These data suggest that specific inhibition of Nox enzymes and AQP8 could be an interesting novel anti-leukemic strategy.

I drammi per musica di Giacomo Antonio Perti per il teatro della Villa medicea di Pratolino (1700-01; 1707-10)

L’attività nel teatro della Villa medicea di Pratolino, presso Firenze, giunse al culmine nel primo decennio del ’700, quando il principe Ferdinando de’ Medici commissionò e vi fece rappresentare, una per anno, opere in musica di Alessandro Scarlatti e di Giacomo Antonio Perti. Benché le partiture siano perdute, sopravvive un’ingente quantità di materiale documentario, in massima parte inedito, il quale dà un eccezionale resoconto sul mecenatismo del Principe e sul funzionamento della macchina teatrale. La dissertazione si concentra sulle sei opere poste in musica da Perti ("Lucio Vero", 1700, in collaborazione con Martino Bitti; "Astianatte", 1701; "Dionisio re di Portogallo", 1707; "Ginevra principessa di Scozia", 1708; "Berenice regina d’Egitto", 1709; "Rodelinda regina de’ Longobardi", 1710), sui rapporti del compositore col Principe, col librettista Antonio Salvi, col rivale Scarlatti, coi cantanti e con la corte medicea, sullo stile da lui perseguito e – per quanto è dato sapere o lecito ipotizzare – sulla fisionomia dei suoi lavori (strutture e risorse letterarie, teatrali e musicali).

Dalle feste di nozze alle orchestre di stato: Maria Lătărețu e l'invenzione della muzică populară

Le musiche “popolaresche” urbane, in genere trascurate nella letteratura etnomusicologica, sono state quasi completamente ignorate nel caso della Romania. Il presente studio si propone di colmare almeno in parte questa lacuna, indagando questo fenomeno musicale nella Bucarest degli anni Trenta e Quaranta del Novecento. Le musiche esaminate sono tuttavia inserite entro una cornice storica più ampia, che data a partire dalla fine del XVIII secolo, e messe in relazione con alcune produzioni di origine rurale che con queste hanno uno stretto rapporto. Il caso di Maria Lătărețu (1911-1972) si è rivelato particolarmente fecondo in questo senso, dal momento che la cantante apparteneva ad entrambi i versanti musicali, rurale e urbano, e nepadroneggiava con disinvoltura i rispettivi repertori. Dopo il suo trasferimento nella capitale, negli anni Trenta, è diventata una delle figure di maggior spicco di quel fenomeno noto come muzică populară (creazione musicale eminentemente urbana e borghese con radici però nel mondo delle musiche rurali). L’analisi del repertorio (o, per meglio dire, dei due repertori) della Lătărețu, anche nel confronto con repertori limitrofi, ha permesso di comprendere più da vicino alcuni dei meccanismi musicali alla base di questa creazione. Un genere musicale che non nasce dal nulla nel dopo-guerra, ma piuttosto continua una tradizione di musica urbana, caratterizzata in senso locale, ma influenzata dal modello della canzone europea occidentale, che data almeno dagli inizi del Novecento. Attraverso procedimenti in parte già collaudati da compositori colti che sin dal XIX secolo, in Romania come altrove, si erano cimentati con la creazione di melodie in stile popolare o nell’armonizzazione di musiche di provenienza contadina, le melodie rurali nel bagaglio della cantante venivano trasformate in qualcosa di inedito. Una trasformazione che, come viene dimostrato efficacemente nell’ultimo capitolo, non investe solo il livello superficiale, ma coinvolge in modo profondo la sintassi musicale.

Interventi normativi, interni ed uniformi, dettati dalle nuove esigenze e dai nuovi quesiti posti dalla modernizzazione dei traffici, con particolare riferimento al trasporto containerizzato e multimodale

Come si evince dal titolo della tesi, la ricerca effettuata dal presente candidato nel corso del dottorato di ricerca ha avuto ad oggetto lo studio della materia relativa ai trasporti nell’ambito di diversi sistemi giuridici europei, con particolare attenzione ai risvolti di carattere pratico che l’interpretazione delle normative uniformi poteva produrre nell’ambito delle diverse giurisdizioni nonché alle diverse impostazioni e alla variegata gamma di soluzioni interpretative che nell’ambito di problemi simili possono essere adottate a seconda che una stessa questione venga discussa in un ordinamento piuttosto che in un altro. Dall’avvento del trasporto marittimo di containers alla necessità di disciplinare l’intera materia attraverso una normativa multimodale il passo è estremamente breve, posto che, proprio in considerazione delle caratteristiche proprie del trasporto containerizzato, gli aventi diritto al carico sono principalmente interessati al completamente del trasferimento door-to-door inteso nella sua globalità, piuttosto che al buon esito del trasporto sulla singola tratta marittima. Il progetto di revisione delle Regole dell’Aja-Visby adottato dall’United Nations Commission on International Trade Law (Uncitral) e il Comité Maritime International (CMI) costituisce per definizione un progetto limitato ad un trasporto multimodale comprendente necessariamente una tratta marittima, ma rappresenta comunque un interessante banco di prova per valutare la funzionalità di strumenti di recente impiego, come ad esempio i cosiddetti e-documents, concetto peraltro già inserito nel progetto UNCITRAL, anche se con scarsi elementi di reale novità rispetto alla tradizionale disciplina relativa ai documenti cartacei. Proprio la parte relativa ai documenti e titoli di viaggio merita particolare attenzione soprattutto in riferimento alle problematiche connesse al traffico containerizzato, con particolare riferimento al concetto di transhipment, e alla conseguente necessità che la polizza garantisca al legittimo portatore una copertura completa sull’intero viaggio della merce, oltre a dargli la possibilità di individuare agevolmente la propria controparte contrattuale, e cioè il vettore.

La clausola della nazione più favorita dalle convenzioni internazionali all'ordinamento europeo

Il principale obiettivo della tesi è dimostrare come la connessione tra i differenti livelli giuridici che riguardano le relazioni tra Stati membri dell'UE richieda un'interpretazione sistematica delle convenzioni contro le doppie imposizioni intracomunitarie, ed in particolare richieda l'applicazione della clausola della nazione più favorita.

Dalle ambivalenze della Storia alla “cosmopolitical fiction”: la rappresentazione dell'alterità nel romanzo di Anita Desai

Varcare le frontiere della Storia attraverso le storie personali dei suoi personaggi ha sempre affascinato la sensibilità creatrice di Anita Desai, i cui romanzi possono essere considerati un interessante esempio di letteratura di confine, che riesce nel difficile compito di misurarsi, con eleganza e sensibilità, nella rappresentazione delle più feroci forme di marginalizzazione. Proponendo un dialogo tra alterità, che apre alle complessità storico-culturali in maniera del tutto a-ideologica e imparziale, la scrittrice indoinglese procede alla “provincializzazione” dell’India attraverso le numerose ambivalenze prodotte nelle zone frontaliere analizzate. Dalla rappresentazione della frontiera identitaria esterna, ovvero dall’ambivalente rapporto intrattenuto con il colonizzatore/ex-colonizzatore inglese, alla rappresentazione della frontiera identitaria interna, ovvero l’analisi delle contraddittorie relazioni tra le componenti etniche del subcontinente, Desai arriva infine a problematizzare storie di ambivalenti processi di marginalizzazione prodotti da mondi culturali così diversi come la Germania nazista, o gli indiani Huichol del lontano Messico, tracciando geografie culturali inedite della grande ragnatela della Storia. Desai riesce così a recuperare voci liminali spesso trascurate dalla postcolonialità stessa, per riconfigurarle in un’esplorazione profonda del comune destino dell’umanità, voci straniate e stranianti che acquisiscono un vero e proprio status di agency discorsiva, proiettando la sua scrittura verso una dimensione cosmopolitica. L’opera di Desai diventa indubbiamente un’opportunità concreta per scorgere nella differenza l’universalità di una comune umanità, vale a dire un’opportunità per vedere nell’alterità un’identità ribaltata.

Trattamento radioterapico ipofrazionato ad alte dosi del carcinoma prostatico con tecnica ad intensità modulata (IMRT) guidata dalle immagini (IGRT)

Obiettivo: valutare la tossicità ed il controllo di malattia di un trattamento radioterapico ipofrazionato ad alte dosi con tecnica ad intensità modulata (IMRT) guidata dalle immagini (IGRT) in pazienti affetti da carcinoma prostatico a rischio intermedio, alto ed altissimo di recidiva. Materiali e metodi: tutti i pazienti candidati al trattamento sono stati stadiati e sottoposti al posizionamento di tre “markers” fiduciali intraprostatici necessari per l’IGRT. Mediante tecnica SIB – IMRT sono stati erogati alla prostata 67,50 Gy in 25 frazioni (EQD2 = 81 Gy), alle vescichette 56,25 Gy in 25 frazioni (EQD2 = 60,35 Gy) e ai linfonodi pelvici, qualora irradiati, 50 Gy in 25 frazioni. La tossicità gastrointestinale (GI) e genitourinaria (GU) è stata valutata mediante i CTCAE v. 4.03. Per individuare una possibile correlazione tra i potenziali fattori di rischio e la tossicità registrata è stato utilizzato il test esatto di Fisher e la sopravvivenza libera da malattia è stata calcolata mediante il metodo di Kaplan-Meier. Risultati: sono stati arruolati 71 pazienti. Il follow up medio è di 19 mesi (3-35 mesi). Nessun paziente ha dovuto interrompere il trattamento per la tossicità acuta. Il 14% dei pazienti (10 casi) ha presentato una tossicità acuta GI G ≥ 2 e il 15% (11 pazienti) ha riportato una tossicità acuta GU G2. Per quanto riguarda la tossicità tardiva GI e GU G ≥ 2, essa è stata documentata, rispettivamente, nel 14% dei casi (9 pazienti) e nell’11% (7 pazienti). Non è stata riscontrata nessuna tossicità, acuta o cronica, G4. Nessun fattore di rischio correlava con la tossicità. La sopravvivenza libera da malattia a 2 anni è del 94%. Conclusioni: il trattamento radioterapico ipofrazionato ad alte dosi con IMRT-IGRT appare essere sicuro ed efficace. Sono comunque necessari ulteriori studi per confermare questi dati ed i presupposti radiobiologici dell’ipofrazionamento del carcinoma prostatico.