Sentimental Identity, History and Politics in Daniel Cortezón’s "A vila sulagada"

The novels of Daniel Cortezón, which have not attracted as much critical attention as his theatrical productions, are of contemporary interest as they develop his ideas on identity, history and politics. The purpose of this article is to show, through an analysis of the complex arrangement of the above three concepts, how A vila Sulagada is a metaphor for the historical failure of Galicia.

Exchange protein directly activated by cyclic AMP (EPAC) activation reverses neutrophil dysfunction induced by β2-agonists, corticosteroids, and critical illness

Background Neutrophils play a role in the pathogenesis of asthma, chronic obstructive pulmonary disease, and pulmonary infection. Impaired neutrophil phagocytosis predicts hospital-acquired infection. Despite this, remarkably few neutrophil-specific treatments exist. 

Objectives We sought to identify novel pathways for the restoration of effective neutrophil phagocytosis and to activate such pathways effectively in neutrophils from patients with impaired neutrophil phagocytosis. 

Methods Blood neutrophils were isolated from healthy volunteers and patients with impaired neutrophil function. In healthy neutrophils phagocytic impairment was induced experimentally by using β₂-agonists. Inhibitors and activators of cyclic AMP (cAMP)-dependent pathways were used to assess the influence on neutrophil phagocytosis in vitro. 

Results β₂-Agonists and corticosteroids inhibited neutrophil phagocytosis. Impairment of neutrophil phagocytosis by β₂-agonists was associated with significantly reduced RhoA activity. Inhibition of protein kinase A (PKA) restored phagocytosis and RhoA activity, suggesting that cAMP signals through PKA to drive phagocytic impairment. However, cAMP can signal through effectors other than PKA, such as exchange protein directly activated by cyclic AMP (EPAC). An EPAC-activating analog of cAMP (8CPT-2Me-cAMP) reversed neutrophil dysfunction induced by β₂-agonists or corticosteroids but did not increase RhoA activity. 8CPT-2Me-cAMP reversed phagocytic impairment induced by Rho kinase inhibition but was ineffective in the presence of Rap-1 GTPase inhibitors. 8CPT-2Me-cAMP restored function to neutrophils from patients with known acquired impairment of neutrophil phagocytosis. 

Conclusions EPAC activation consistently reverses clinical and experimental impairment of neutrophil phagocytosis. EPAC signals through Rap-1 and bypasses RhoA. EPAC activation represents a novel potential means by which to reverse impaired neutrophil phagocytosis.

Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU):A randomised, double-blind, placebo-controlled trial

Background: Delirium is frequently diagnosed in critically ill patients and is associated with poor clinical outcomes. Haloperidol is the most commonly used drug for delirium despite little evidence of its effectiveness. The aim of this study was to establish whether early treatment with haloperidol would decrease the time that survivors of critical illness spent in delirium or coma. Methods: We did this double-blind, placebo-controlled randomised trial in a general adult intensive care unit (ICU). Critically ill patients (≥18 years) needing mechanical ventilation within 72 h of admission were enrolled. Patients were randomised (by an independent nurse, in 1:1 ratio, with permuted block size of four and six, using a centralised, secure web-based randomisation service) to receive haloperidol 2·5 mg or 0·9% saline placebo intravenously every 8 h, irrespective of coma or delirium status. Study drug was discontinued on ICU discharge, once delirium-free and coma-free for 2 consecutive days, or after a maximum of 14 days of treatment, whichever came first. Delirium was assessed using the confusion assessment method for the ICU (CAM-ICU). The primary outcome was delirium-free and coma-free days, defined as the number of days in the first 14 days after randomisation during which the patient was alive without delirium and not in coma from any cause. Patients who died within the 14 day study period were recorded as having 0 days free of delirium and coma. ICU clinical and research staff and patients were masked to treatment throughout the study. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Registry, number ISRCTN83567338. Findings: 142 patients were randomised, 141 were included in the final analysis (71 haloperidol, 70 placebo). Patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median 5 days [IQR 0-10] vs 6 days [0-11] days; p=0·53). The most common adverse events were oversedation (11 patients in the haloperidol group vs six in the placebo group) and QTc prolongation (seven patients in the haloperidol group vs six in the placebo group). No patient had a serious adverse event related to the study drug. Interpretation: These results do not support the hypothesis that haloperidol modifies duration of delirium in critically ill patients. Although haloperidol can be used safely in this population of patients, pending the results of trials in progress, the use of intravenous haloperidol should be reserved for short-term management of acute agitation. Funding: National Institute for Health Research. © 2013 Elsevier Ltd.

Levosimendan for the Prevention of Acute Organ Dysfunction in Sepsis

BACKGROUND Levosimendan is a calcium-sensitizing drug with inotropic and other properties that may improve outcomes in patients with sepsis. 
METHODS We conducted a double-blind, randomized clinical trial to investigate whether levosimendan reduces the severity of organ dysfunction in adults with sepsis. Patients were randomly assigned to receive a blinded infusion of levosimendan (at a dose of 0.05 to 0.2 μg per kilogram of body weight per minute) for 24 hours or placebo in addition to standard care. The primary outcome was the mean daily Sequential Organ Failure Assessment (SOFA) score in the intensive care unit up to day 28 (scores for each of five systems range from 0 to 4, with higher scores indicating more severe dysfunction; maximum score, 20). Secondary outcomes included 28-day mortality, time to weaning from mechanical ventilation, and adverse events. 
RESULTS The trial recruited 516 patients; 259 were assigned to receive levosimendan and 257 to receive placebo. There was no significant difference in the mean (±SD) SOFA score between the levosimendan group and the placebo group (6.68±3.96 vs. 6.06±3.89; mean difference, 0.61; 95% confidence interval [CI], −0.07 to 1.29; P=0.053). Mortality at 28 days was 34.5% in the levosimendan group and 30.9% in the placebo group (absolute difference, 3.6 percentage points; 95% CI, −4.5 to 11.7; P=0.43). Among patients requiring ventilation at baseline, those in the levosimendan group were less likely than those in the placebo group to be successfully weaned from mechanical ventilation over the period of 28 days (hazard ratio, 0.77; 95% CI, 0.60 to 0.97; P=0.03). More patients in the levosimendan group than in the placebo group had supraventricular tachyarrhythmia (3.1% vs. 0.4%; absolute difference, 2.7 percentage points; 95% CI, 0.1 to 5.3; P=0.04). 
CONCLUSIONS The addition of levosimendan to standard treatment in adults with sepsis was not associated with less severe organ dysfunction or lower mortality. Levosimendan was associated with a lower likelihood of successful weaning from mechanical ventilation and a higher risk of supraventricular tachyarrhythmia. (Funded by the NIHR Efficacy and Mechanism Evaluation Programme and others; LeoPARDS Current Controlled Trials number, ISRCTN12776039.)

Étude du livre de Daniel Lerner "The passing of traditional society: modernizing the Middle East" et de sa réception par la communauté scientifique

Cette étude a pour but de mettre en contexte la thèse de la modernisation psychique de Daniel Lerner, de faire une analyse interne de l’ouvrage et d’étudier sa réception par les sociologues de l’époque. Comme démarche de recherche, dans un premier temps, nous replacerons l’ouvrage dans la situation historique des deux premières décennies de la guerre froide (les années 50 et 60). Ce faisant, nous tenterons de comprendre la logique de la politique de développement des États-Unis à l’endroit des pays en voie de développement et la place des recherches universitaires dans la politique coloniale américaine. L’approche du développement exogène a largement inspiré les politiques étrangères des pays occidentaux et leurs efforts pour lancer le développement des pays plus nécessiteux. C’est pour cela que Lerner se concentre sur l’effet des médias américains, et surtout du Voice of America, pour analyser le rôle que ceux-ci jouent dans le processus de transformation de la personnalité. Pour aborder cette étape de la recherche, nous devrons comprendre davantage le contexte de l’ouvrage et mieux analyser la relation entre les facteurs externes et les éléments internes qui ont influencé la formation de l’ouvrage. Dans un deuxième temps, nous étudierons l’ouvrage de Lerner et nous discuterons des différents aspects relatifs aux changements sociaux que l’ouvrage a examinés. Dans notre analyse de l’ouvrage, nous critiquerons divers aspects de la pensée sociologique de Lerner et sa manière d’interpréter les faits sociaux et les statistiques. Dans un troisième temps, nous réviserons la réception de l’ouvrage par la communauté scientifique de son époque pour obtenir une large vision de la place de l’oeuvre dans l’histoire de la pensée sociologique américaine du développement. Nous établirons une catégorisation des recensions de l’ouvrage portant sur l’approche sociologique de Lerner et nous mettrons ces recensions dans l’éclairage des champs de recherches universitaires américaines. Nous nous concentrerons sur la réception de cette théorie chez les sociologues de l’époque pour comprendre la dialectique entre la thèse qui y est défendue et la société. Ce faisant, nous éviterons de nous éloigner de la sociologie comme étant la discipline de l’étude des liens sociaux et des interactions symboliques et nous éviterons de réduire notre démarche sociologique à une simple étude historique des idées. En gros, nous discuterons de la vision sociologique de l’auteur, de la façon dont son ouvrage a été formé au fil du temps et comment il a été influencé par l’esprit de son époque. De plus, nous verrons comment l’écrivain s’est nourri des théories sociologiques et à quel point il a influencé la pensée sociologique de son temps. Tout cela, en parallèle à l’analyse interne de l’ouvrage, nous permettra de saisir la place de «The Passing of Traditional Society» dans la pensée sociologique américaine. Cette recherche nous aidera à mieux comprendre la vision américaine de l’empathie en tant qu’un élément modernisateur, par rapport à la question du développement dans le contexte historique de l’époque. Cette compréhension nous mènera à approfondir notre analyse des programmes de développement des États-Unis dans le monde en voie du développement. Cette étude nous amènera aussi à élargir notre vision quant aux idées construites et formées dans leur contexte historique (en général) et à découvrir comment la communauté scientifique reste toujours en parti prisonnière de son contexte historique. Cette étude nous permettra de mieux voir les idées (le texte) en relation avec la société, ce qui est vital pour ne pas tomber dans la réduction des idées seulement au texte ou seulement au contexte. En outre, elle nous aidera à comprendre davantage la façon dont la société intervient dans la formation des idées et comment en retour les idées influencent la société.

Poema en prosa y mundos especulativos : en torno a Les chasseurs du temps de Daniel Walther

The prose poem has traditionally been considered above all a lyrical genre. Nevertheless, there are short fictions showing the main features of the prose poem, such as brevity, intensity, autonomy, importance of connotation, visionary character and, above all, the dominance of description. The fictional prose poem gives shape to an imaginary world which is poetically described, rather than narrated. The fictional character of this kind of prose poem is especially clear when what is described is a future reality, as it is the case in Stéphane Mallarmé’s «Le Phénomène futur» and in later series of prose poems which create prospective universes. Among them, the series collected by Daniel Walther in 2010 under the title of Les Chasseurs du temps stands out for its mysterious force, its fictional coherence and the beauty of its ima¬ges.

Fritz-Peter Hager/Daniel Tröhler (Hrsg.): Neue Pestalozzi-Studien. Bd. 1: Anna Pestalozzis Tagebuch - Käte Silber: Anna Pestalozzi und der Frauenkreis um Pestalozzi. Bern/Stuttgart: Haupt 1993 [Rezension]

Rezension von: Fritz-Peter Hager/Daniel Tröhler (Hrsg.): Neue Pestalozzi-Studien. Bd. 1: Anna Pestalozzis Tagebuch - Käte Silber: Anna Pestalozzi und der Frauenkreis um Pestalozzi. Bern/Stuttgart: Haupt 1993, 242 S.