413 resultados para Nirico, Gaetano.
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BACKGROUND Although different prognostic factors for patients with renal cell carcinoma (RCC) and vena cava tumor thrombus (TT) have been studied, the prognostic value of histologic subtype in these patients remains unclear. OBJECTIVE We analyzed the impact of histologic subtype on cancer-specific survival (CSS). DESIGN, SETTINGS, AND PARTICIPANTS We retrospectively analyzed the records of 1774 patients with RCC and TT who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 US and European centers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Multivariable ordered logistic and Cox regression models were used to quantify the impact of tumor histology on CSS. RESULTS AND LIMITATIONS Overall 5-yr CSS was 53.4% (confidence interval [CI], 50.5-56.2) in the entire group. TT level (according to the Mayo classification of macroscopic venous invasion in RCC) was I in 38.5% of patients, II in 30.6%, III in 17.3%, and IV in 13.5%. Histologic subtypes were clear cell renal cell carcinoma (cRCC) in 89.9% of patients, papillary renal cell carcinoma (pRCC) in 8.5%, and chromophobe RCC in 1.6%. In univariable analysis, pRCC was associated with a significantly worse CSS (p<0.001) compared with cRCC. In multivariable analysis, the presence of pRCC was independently associated with CSS (hazard ratio: 1.62; CI, 1.01-2.61; p<0.05). Higher TT level, positive lymph node status, distant metastasis, and fat invasion were also independently associated with CSS. CONCLUSIONS In our multi-institutional series, we found that patients with pRCC and vena cava TT who underwent radical nephrectomy and tumor thrombectomy had significantly worse cancer-specific outcomes when compared with patients with other histologic subtypes of RCC. We confirmed that higher TT level and fat invasion were independently associated with reduced CSS.
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PURPOSE The impact of cardiopulmonary bypass in level III-IV tumor thrombectomy on surgical and oncologic outcomes is unknown. We determine the impact of cardiopulmonary bypass on overall and cancer specific survival, as well as surgical complication rates and immediate outcomes in patients undergoing nephrectomy and level III-IV tumor thrombectomy with or without cardiopulmonary bypass. MATERIALS AND METHODS We retrospectively analyzed 362 patients with renal cell cancer and with level III or IV tumor thrombus from 1992 to 2012 at 22 U.S. and European centers. Cox proportional hazards models were used to compare overall and cancer specific survival between patients with and without cardiopulmonary bypass. Perioperative mortality and complication rates were assessed using logistic regression analyses. RESULTS Median overall survival was 24.6 months in noncardiopulmonary bypass cases and 26.6 months in cardiopulmonary bypass cases. Overall survival and cancer specific survival did not differ significantly in both groups on univariate analysis or when adjusting for known risk factors. On multivariate analysis no significant differences were seen in hospital length of stay, Clavien 1-4 complication rate, intraoperative or 30-day mortality and cancer specific survival. Limitations include the retrospective nature of the study. CONCLUSIONS In our multi-institutional analysis the use of cardiopulmonary bypass did not significantly impact cancer specific survival or overall survival in patients undergoing nephrectomy and level III or IV tumor thrombectomy. Neither approach was independently associated with increased mortality on multivariate analysis. Greater surgical complications were not independently associated with the use of cardiopulmonary bypass.
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Spreading the PSF over a quite large amount of pixels is an increasingly used observing technique in order to reach extremely precise photometry, such as in the case of exoplanets searching and characterization via transits observations. A PSF top-hat profile helps to minimize the errors contribution due to the uncertainty on the knowledge of the detector flat field. This work has been carried out during the recent design study in the framework of the ESA small mission CHEOPS. Because of lack of perfect flat-fielding information, in the CHEOPS optics it is required to spread the light of a source into a well defined angular area, in a manner as uniform as possible. Furthermore this should be accomplished still retaining the features of a true focal plane onto the detector. In this way, for instance, the angular displacement on the focal plane is fully retained and in case of several stars in a field these look as separated as their distance is larger than the spreading size. An obvious way is to apply a defocus, while the presence of an intermediate pupil plane in the Back End Optics makes attractive to introduce here an optical device that is able to spread the light in a well defined manner, still retaining the direction of the chief ray hitting it. This can be accomplished through an holographic diffuser or through a lenslet array. Both techniques implement the concept of segmenting the pupil into several sub-zones where light is spread to a well defined angle. We present experimental results on how to deliver such PSF profile by mean of holographic diffuser and lenslet array. Both the devices are located in an intermediate pupil plane of a properly scaled laboratory setup mimicking the CHEOPS optical design configuration. © (2014) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
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BACKGROUND Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time. METHODS Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.7 mg/dL and proteinuria <1 g/day or g/g creatinine despite at least 1 year without any immunosuppressive drug) and 'almost tolerant' patients (minimally immunosuppressed patients (MIS) receiving low-dose steroids) as possible. We reported their number and the total number of kidney transplants performed at each centre to calculate their frequency. RESULTS One hundred and forty-seven questionnaires were returned and we identified 66 TOL (61 with complete data) and 34 MIS patients. Of the 61 TOL patients, 26 were previously described by the Nantes group and 35 new patients are presented here. Most of them were noncompliant patients. At data collection, 31/35 patients were alive and 22/31 still TOL. For the remaining 9/31, 2 were restarted on immunosuppressive drugs and 7 had rising creatinine of whom 3 resumed dialysis. Considering all patients, 10-year death-censored graft survival post-immunosuppression weaning reached 85% in TOL patients and 100% in MIS patients. With 218 913 kidney recipients surveyed, cumulative incidences of operational tolerance and almost tolerance were estimated at 3 and 1.5 per 10 000 kidney recipients, respectively. CONCLUSIONS In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival.
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Herein we provide a detailed molecular analysis of the spatial heterogeneity of clinically localized, multifocal prostate cancer to delineate new oncogenes or tumor suppressors. We initially determined the copy number aberration (CNA) profiles of 74 patients with index tumors of Gleason score 7. Of these, 5 patients were subjected to whole-genome sequencing using DNA quantities achievable in diagnostic biopsies, with detailed spatial sampling of 23 distinct tumor regions to assess intraprostatic heterogeneity in focal genomics. Multifocal tumors are highly heterogeneous for single-nucleotide variants (SNVs), CNAs and genomic rearrangements. We identified and validated a new recurrent amplification of MYCL, which is associated with TP53 deletion and unique profiles of DNA damage and transcriptional dysregulation. Moreover, we demonstrate divergent tumor evolution in multifocal cancer and, in some cases, tumors of independent clonal origin. These data represent the first systematic relation of intraprostatic genomic heterogeneity to predicted clinical outcome and inform the development of novel biomarkers that reflect individual prognosis.
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OBJECTIVE To give a comprehensive overview of the phenotypic and genetic spectrum of STXBP1 encephalopathy (STXBP1-E) by systematically reviewing newly diagnosed and previously reported patients. METHODS We recruited newly diagnosed patients with STXBP1 mutations through an international network of clinicians and geneticists. Furthermore, we performed a systematic literature search to review the phenotypes of all previously reported patients. RESULTS We describe the phenotypic features of 147 patients with STXBP1-E including 45 previously unreported patients with 33 novel STXBP1 mutations. All patients have intellectual disability (ID), which is mostly severe to profound (88%). Ninety-five percent of patients have epilepsy. While one-third of patients presented with Ohtahara syndrome (21%) or West syndrome (9.5%), the majority has a nonsyndromic early-onset epilepsy and encephalopathy (53%) with epileptic spasms or tonic seizures as main seizure type. We found no correlation between severity of seizures and severity of ID or between mutation type and seizure characteristics or cognitive outcome. Neurologic comorbidities including autistic features and movement disorders are frequent. We also report 2 previously unreported adult patients with prominent extrapyramidal features. CONCLUSION De novo STXBP1 mutations are among the most frequent causes of epilepsy and encephalopathy. Most patients have severe to profound ID with little correlation among seizure onset, seizure severity, and the degree of ID. Accordingly, we hypothesize that seizure severity and ID present 2 independent dimensions of the STXBP1-E phenotype. STXBP1-E may be conceptualized as a complex neurodevelopmental disorder rather than a primary epileptic encephalopathy.
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Plaza Navona representa una de las visitas obligadas de Roma, pero solo algunos advertirán en ella la presencia española en la sala de exposiciones del Instituto Cervantes o en la inmediata Libreria Española. Todavía serán menos los que se percatarán de la huella española dejada en aquella iglesia de fachada anónima situada, en el extremo sur de la plaza: la antigua iglesia de Santiago de los Españoles. La presente tesis pretende, utilizando el dibujo como guía, herramienta y fin del proceso de análisis y estudio, reconstruir el proceso de conformación y construcción de la que fue iglesia española principal, cuya fundación hace patente el destacado papel jugado por la “nación” castellana en Roma durante la Edad Media; y en torno a la que se aglutinaron las actividades religiosas, diplomáticas y financieras de los castellanos que vivieron en la actual capital italiana. Se intentará recrear en el tiempo la que es hoy la iglesia de Nuestra Señora del Sagrado Corazón, sometiéndola a una restitución gráfica disciplinada, homogénea y objetiva en la medida de lo posible de las varias etapas que la han caracterizadas, desde su fundación hasta cuando en 1878 España se deshizo de ella, ya en ruina, vendiéndola. Como nos comenta Gaetano Moroni, de todas las comunidades nacionales que se encontraban en Roma la española parece ser efectivamente una de las más rica y prestigiosa. Aunque lo que no cuenta Moroni no haya sido todavía demostrado, dicho enunciado resulta de todas formas interesante puesto que pone el acento sobre el hecho de que ya desde el siglo X parece ser habitual de ocupar y reutilizar antiguas ruinas, usándolas como base para la construcción de hospitales para los peregrinos. Esta operación se hizo particularmente frecuente sobre todo antes del Gran Jubileo de 1450: de hecho desde la primera mitad del Quattrocento se fundan distintas iglesias y hospitales nacionales para acoger y prestar una adecuada asistencia y socorro a los innumerables peregrinos que llegaban a la ciudad, edificios que se van construyendo sobre los restos de antiguos edificios de época romana. Prueba de ello es en efecto la fundación originaria de la iglesia y hospital de los Españoles que, parte del conjunto de edificios que compone la Plaza Navona, situada en el corazón de Campo Marzio y cuya posición y forma corresponden a la del antiguo Estadio de Domiciano, y que ahora es en sus dimensiones, en su imagen arquitectónica y en su consistencia material, el resultado de la definición proyectual y de las transformaciones que se llevaron a cabo sobre lo que quedaba del antiguo templo español del siglo XV, entre finales del ‘800 y los años 30 del siglo XX . Transformaciones devastadoras, huellas grabadas o canceladas que encuentran una justificación en los acontecimientos históricos reflejados en el patrimonio urbano. El análisis de todas las fuentes permite trazar, si no la totalidad, buena parte de las modificaciones que la antigua iglesia de Santiago ha sufrido. La construcción del templo se puede dividir en tres momentos decisivos: una primera etapa de fundación en 1450-1478 en la que la iglesia tenía fachada y entrada en via de la Sapienza, hoy Corso Rinascimento; una segunda de significativa ampliación hacia Plaza Navona con una nueva fachada monumental hacia ese espacio público en 1496-1500; y una última importante ampliación entre 1525-1526, llevada a cabo por el arquitecto Antonio da Sangallo el Joven. Tras la intensa vida del templo, en el siglo XVIII, éste cae en ruina y finalmente es vendido en 1878 a la orden de los misioneros franceses de Nuestra Señora del Sagrado Corazón que la reconvierten en iglesia reformando totalmente el conjunto en 1881, según proyecto de Luca Carimini. En 1936, en plena fase de rectificación de trazados urbanos por obra del régimen fascista, según proyecto de Arnaldo Foschini, se mutila su extremidad hacia vía de la Sapienza dejando su estado tal y como se contempla en la actualidad. ABSTRACT The objective of this thesis is the reconstruction of the design and edification process -using drawings and sketches as a guide, tool and the end of the analytical process- of a church which was once the preeminent Spanish church in medieval Rome, known today as Nostra Signora del Sacro Cuore (Our Lady of the Sacred Heart). The founding of this church illustrates the important role held by the Castillian “nation” in Rome during the Middle Ages. It was the focal point of all the religious, diplomatic and economic activities of the Castillian community residing in today’s Italian capital. The aim of this proyect is a recreation the church in time by submitting it to a disciplined, homogenous and objective graphic restitution of the various stages most characteristic the temple, starting from its foundation until 1878 when, in a state of ruins, the church was finally sold off by Spain. Gaetano Moroni once commented that of all the international communities found in Rome, the Spanish community seemed to be one of the wealthiest and most prestigious. Such a statement proves interesting as it emphasizes that starting in the 10th century we see there was a widespread custom of occupying and reusing old ruins for use as the bases of new constructions of hospitals for pilgrims. This custom became especially frequent just before the Jubilee Year of 1450: in fact, in the first half of the Quattrocento we see the founding of many different national churches and hospitals which provided shelter and care to the countless pilgrims arriving in the city, buildings which were constructed on top of the ruins of ancient buildings left over from Roman times. Proof of this is the original foundation of the Spanish church and hospital forming part of the Piazza Navona, built upon and following the outline of the Stadium of Domitian, in the heart of Campo Marzio. Now, in its dimensions, its architectural image and its material substance, it represents the predominant result of the planning definitions and the transformations which affected the old 15th-century Spanish temple. Ocurring between the end of the 19th century and the 1930s, the transformations were devastating, erasing original peculiarities and engraving new ones, transformations made justifiable by the historical events reflected in its urban environs. Analyzing all sources allows us to trace, even if not in entirety, still a sizeable portion of the modifications undergone by the old Church of Saint James. The construction of the temple can be divided into three decisive moments: its foundation, from 1450 to 1478, when the church’s façade and main door looked out on to the Via della Sapienza, today’s central avenue of Corso del Rinascimento; the second stage being a major expansion towards the Piazza Navona (1496-1500) with a new, monumental façade facing the public space; and the third was the last significant expansion, carried out from 1525 to 1526 by the architect Antonio da Sangallo the Younger. Despite an intense and bustling life during the Modern Age, in the 18th century the church began to fall into ruin and was finally sold in 1878 to the order of French missionaries of Our Lady of the Sacred Heart, who reconverted it into a church and completely renovated the structure in 1881 in a project supervised by Luca Carimini. In 1936, the corrective urban redesign of Rome carried out by the fascist regime and implemented by Arnaldo Foschini mutilated the part bordering Via della Sapienza, leaving it as we see it today.
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Caracteres góticos
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Para representarse en el teatro de la ciudad de Valencia el año 1834
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En portada : que se ha de representar en el teatro de esta ciudad
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Representada en el teatro de Valencia en mayo de 1844
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Adaptación de la obra de Voltaire
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En la p. 5 : Música del maestro D. Cayetano Donizetti
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Representado en el Teatro de la ciudad de Valencia en julio de 1841