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Background: Ascites is one of the most frequent severe complications in patients with liver cirrhosis. The treatment of this chronic disease usually requires the prolonged use of albumin, frequently continued even after patients' discharge from the hospital., Aims: Aim of the study was to define a consensus among Italian physicians with regard to the use of albumin in patients with decompensated cirrhosis and ascites., Methods: The study adopted the Delphi technique to conduct the consensus activities. All controversial issues related to the use of albumin were identified by the experts' board and proposed to the 68 participating hepatology centres through two subsequent questionnaires. The questionnaires, returned by the specialists involved, were collected and the answers classified to verify the elements on which a consensus was reached., Results: The home use of albumin can help to improve the patient's general conditions and well-being. About 77% of the experts involved considered likely that albumin administration could shorten hospital stays or could reduce the number of hospital admissions. The results of the study, along with a socioeconomic analysis, were presented to the Italian Drug Commission, which subsequently removed the specific hypoalbuminemia level as a prerequisite for having the drug reimbursed by the National Health Service., Conclusions: For an outpatient prescription, the hypoalbuminemia limit of 2.5 g/dl or less is not sufficient, while the decision whether to administer the drug requires the evaluation of patient's overall clinical conditions as an essential criterion for the prescription of a home treatment with albumin.

The risk of sexual transmission of hepatitis C virus (HCV) infection was evaluated among 895 monogamous heterosexual partners of HCV chronically infected individuals in a long-term prospective study, which provided a follow-up period of 8,060 person-years. Seven hundred and seventy-six (86.7%) spouses were followed for 10 yr, corresponding to 7,760 person-years of observation. One hundred and nineteen (13.3%) spouses (69 whose infected partners cleared the virus following treatment and 50 who ended their relationship or were lost at follow-up) contributed an additional 300 person-years. All couples denied practicing anal intercourse or sex during menstruation, as well as condom use. The average weekly rate of sexual intercourse was 1.8. Three HCV infections were observed during follow-up corresponding to an incidence rate of 0.37 per 1,000 person-years. However, the infecting HCV genotype in one spouse (2a) was different from that of the partner (1b), clearly excluding sexual transmission. The remaining two couples had concordant genotypes, but sequence analysis of the NS5b region of the HCV genome, coupled with phylogenetic analysis showed that the corresponding partners carried different viral isolates, again excluding the possibility of intraspousal transmission of HCV. Our data indicate that the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null. No general recommendations for condom use seem required for individuals in monogamous partnerships with HCV-infected partners.

Background and Objective: High-velocity low-amplitude thrust spinal manipulation (SM) is a recommended and commonly used manual therapy intervention in physiotherapy. Beliefs surrounding the safety and effectiveness of SM have challenged its use, and even advocated for its abandonment. Our study aimed to investigate the knowledge and beliefs surrounding SM by Italian physiotherapists compared with similar practitioners in other countries. Methods: An online survey with 41 questions was adapted from previous surveys and was distributed via a mailing list of the Italian Physiotherapists Association (March 22–26, 2020). The questionnaire was divided into 4 sections to capture information on participant demographics, utilization, potential barriers, and knowledge about SM. Questions were differentiated between spinal regions. Attitudes towards different spinal regions, attributes associated with beliefs, and the influence of previous educational background were each evaluated. Results: Of the 7398 registered physiotherapists, 575 (7.8%) completed the survey and were included for analysis. The majority of respondents perceived SM as safe and effective when applied to the thoracic (74.1%) and lumbar (72.2%) spines; whereas, a smaller proportion viewed SM to the upper cervical spine (56.8%) as safe and effective. Respondents reported they were less likely to provide and feel comfortable with upper cervical SM (respectively, 27.5% and 48.5%) compared to the thoracic (respectively, 52.2% and 74.8%) and lumbar spines (respectively, 46.3% and 74.3%). Most physiotherapists (70.4%) agreed they would perform additional screening prior to upper cervical SM compared to other spinal regions. Respondents who were aware of clinical prediction rules were more likely to report being comfortable with SM (OR 2.38–3.69) and to perceive it as safe (OR 1.75–3.12). Finally, physiotherapists without musculoskeletal specialization, especially those with a traditional manual therapy background, were more likely to perform additional screening prior to SM, use SM less frequently, report being less comfortable performing SM, and report upper cervical SM as less safe (p < 0.001). Discussion: The beliefs and attitudes of physiotherapists surrounding the use of SM are significantly different when comparing the upper cervical spine to other spinal regions. An educational background in traditional manual therapy significantly influences beliefs and attitudes. We propose an updated framework on evidence-based SM. [ABSTRACT FROM AUTHOR]

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The funeral oration in memory of Daniel O'Connell was delivered on the 28th and 30th June 1847 in the Roman basilica of Sant'Andrea della Valle. O'Connell had died in Genoa some days before. The Theatine Gioacchino Ventura, a distinguished man at that time, was asked to preach the oration. In the funeral oration Father Ventura indicated O'Connell as a role model. The former maintained that Christians had to imitate the latter by looking for freedom through passiveresistance and active obedience and by keeping within the law. The passive acceptance of an oppressive regime, especially in religious matters, was not a Christian value. Violent rebellion was also wrong. Father Ventura also affirmed that not only did O'Connell fight for freedom through religion, but he also promoted religion by using freedom. According to Father Ventura, this fact proved that the Church did not need protection from absolute monarchies; on the contrary, it could preserve itself under democratic regimes, too. Father Ventura's oration caused great controversy. Many people hoped for a reconciliation between their political expectations and their religious feelings, so Ventura's speech seemed to pave the way for it. Actually O'Connell was one of the first people who combined Catholicism with liberalism and democracy. Ventura could openly claim those opinions because Pope Pius IX, who had just been elected, at the beginning of his pontificate appeared as a reformist open to new ideas. He personally designated Ventura to preach the oration. At the end of 1848 the situation changed, Pius IX started to appear more conservative, so he had to escape from Rome to Gaeta. The “Roman Republic" was proclaimed in Rome. The Theatine escaped from Rome to France before the restoration of the papal power. There, after having declared his submission to the Church (who had condemned one of Ventura's speeches about the revolts in Vienna), he could remain a priest. When some years later Venura started to speak about political matters again, he had deeply changed his ideas. He approved the Napoleon III government, but requested he recognise the supremacy of spiritual power. Ventura died in 1861. During his life he had often changed his political opinion, but not his basic principles, remaining a Catholic priest until his death. In the 20th century the Democrazia Cristiana, the Italian Catholic Christian Democratic party, has occasionally looked to him as a precursor. Father Luigi Sturzo, particularly, was deeply influenced by the thought of the Theatine. [ABSTRACT FROM AUTHOR]

Background: Diet plays a key role in the treatment of type 1 diabetes (T1D). Dietary habits changed rapidly in the last decades and few data are available on recent dietary changes in children and adolescents with T1D., Objective: To test the hypothesis that diet composition changed in a 10-year period in children and adolescents with T1D., Methods: Two hundred and twenty-nine T1D subjects (M/F:121/108) aged 6 to 16 years were recruited: 114 (group A) enrolled in 2009, not using CGM and/or CSII, and 115 (group B) enrolled in 2019. Anthropometric biochemical (HbA1c, lipid profile), diet, and insulin therapy parameters were compared between the two groups. Multivariate logistic regression analysis was performed with HbA1c as dependent variable (HbA1c > 58 mmol/mol = 1) and nutritional variables and technology use as independent ones., Results: Energy intake of group A was not statistically different from that of group B. Group B had a significantly (P < 0.001) higher protein and lipids intake and lower total carbohydrate and fiber intake than group A. HbA1c was significantly (P < 0.01) lower in group B than in group A. Logistic regression analysis showed that MUFA (OR 0.83, 95%CI:0.693-0.998), fiber intake (OR 0.82, 95%CI:0.699-0.0969), and technology use (OR 0.15, 95%CI:0.031-0.685), adjusted for age, gender, BMI, energy intake and diabetes duration, were associated with a HbA1c higher than 58 mmol/mol) (R 2 = 0.27, P < 0.05)., Conclusions: In a 10-year period, diet composition of children and adolescents with T1D changed and glucometabolic control improved. Fiber and MUFA intake showed a positive effect on HbA1c, independent from technology use, supporting the importance of educating children with T1D and families to maintain healthy eating habits., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The article deals with the place of religion in the Risorgimento moderates’ theorizing. It is contended that ultramontanism should be viewed as the proper starting point of moderatism. If the political divorce between the two patterns of thought was sharp, the cultural one was nuanced. The chief element of continuity was a ‘theocratic’ argument: the course of history is governed by divine laws. This argument featured not only in the 1840s, when a current of ‘liberal Catholicism’ first developed, but also in secularizing Piedmont in the 1850s. Therefore liberty was not rooted in the interplay of social interests – as Benjamin Constant for example had argued – but resulted from a transcendental philosophy of history interpreting divine Providence. This approach had a series of ‘illiberal’ implications, such as a failure to accept pluralism, in both the political and the religious spheres, and a shaky appreciation of individual rights. The article also shows that Taparelli d’Azeglio’s version of ultramontanism accommodated important elements of economic and political modernity. [ABSTRACT FROM PUBLISHER]

Objectives: Lipomas of the internal auditory canal (IAC) and cerebellopontine angle (CPA) are exceedingly rare lesions. The purpose of this report was to describe our experience with lipomas of the IAC and CPA and perform a review of the literature. Methods: We report 8 cases of lipomas involving the IAC and/or the CPA that were managed at Gruppo Otologico between April 1987 and October 2012. Results: Four cases of entirely intracanalicular lipomas were radiologically misinterpreted as vestibular schwannomas and underwent tumor removal by a translabyrinthine approach. Two of these patients experienced postoperative facial nerve palsy. Lipomas were suspected in 4 patients on the basis of imaging findings and were managed conservatively. Of these 4 cases, 3 did not show any growth after an average period of 28 months, and 1 case demonstrated tumor growth on follow-up imaging. Conclusions: Neuroimaging represents an extremely important tool for this diagnosis. Attempts to achieve complete resection may result in severe neurologic sequelae, especially in large lesions. Observation with repeated imaging in order to detect growth of the lesion is usually recommended. Debulking of the tumor, mainly aimed at brain stem and cranial nerve decompression, should be considered in cases of disabling and uncontrolled neurologic symptoms and signs. [ABSTRACT FROM AUTHOR]

The article focuses on the publication of the "New Italian Epic," or NIE, a memorandum written by Roberto Bui under the pen name of the collective author Wu Ming. It states that NIE serves as Bui's interpretation of an Italian literary movement that flourished in 1993. It also adds that NIE lists and analyses works under Italian literature while focusing on the essential features of the said works. The memorandum also argues that art and literature must serve its audience by means of attrition.

Describes the final phase of the decoration of S. Maria church in Vallicella in Rome, Italy done by Oratorian priest Sebastiano Resta. Background on Resta; Artworks of Resta; Details of the progress of the project.