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Il contributo si propone di indagare i meccanismi di automazione nel processo civile nelle procedure concorsuali, attraverso l'analisi della normativa di riferimento sia del processo telematico che del Codice della crisi d’impresa e dell’insolvenza. A tal fine, si prenderà in considerazione il grado di automazione dei procedimenti, evidenziandone le criticità e le funzioni non ancora implementate; si procederà inoltre ad una comparazione con i sistemi processuali di Germania, Francia e Spagna; si tratteggeranno infine le conclusioni in vista di prospettive future utili ad una maggiore armonizzazione tra procedimenti giurisdizionali e tecnologia. The paper aims to investigate the mechanisms of automation in civil and insolvency procedures, through the analysis of the reference legislation of both the telematic process and the New Insolvency Law. To this end, the degree of automation of proceedings will be taken into consideration, highlighting critical issues and functions not yet implemented; a comparison will be made with the procedural systems of Germany, France and Spain; conclusions will be drawn in view of future outlooks useful for a greater harmonisation between judicial proceedings and technology.

Este trabajo se propone analizar la vigencia de la Cuestión Malvinas y de la Cuestión Gibraltar como causas nacionales. A este respecto, se analizará la presencia de la cuestión en la sociedad de los Estados involucrados, considerando las manifestaciones de la comunidad y de sus asociaciones, y en las mediciones de la opinión pública de esos países. Se analizará la construcción de la cuestión en formato de causa asociada a la consolidación de la idea de nación en base a la integralidad territorial perdida, tanto en Argentina como en España, como Estados Reclamantes de Soberanía, señalando como esta caracterización se vincula con la permanencia de la cuestión en los países, lo cual se abordará partiendo de la opinión pública pero incorporando la presencia y valoración por parte de la comunidad en términos amplios, incluyendo a las asociaciones de la sociedad civil como articuladoras de esa valoración.

Introduction: The Health Care Quality System began in 1992 and continues in the complex phenomenon of innovation which is necessary to improve the Health Care System. This study aims to investigate how patients perceive the quality of care provided in the interventional cardiology service and therefore whether they are satisfied with the care received. Materials and Methods: A questionnaire of 19 total items was elaborated and administered on 81 patients with the objective of assessing the importance of the interaction modality of the nursing staff with the patients who undergo the interventional cardiology procedure in the intra and peri- procedural moments. Results: The sample collected was significantly heterogeneous because the male component was more frequent (p

El presente artículo analiza el posicionamiento estratégico de Brasil en relación a su percepción del entorno regional, considerando que la resultante conducta en el ámbito de la defensa producto de dicha apreciación tiene un fuerte impacto en las dinámicas geopolíticas de seguridad de Sudamérica. En este marco, a partir de un análisis sincrónico de los hechos relevantes en materia de defensa y de los documentos oficiales de dicho país, el trabajo identifica un cambio en la política de defensa brasileña a partir del 2016 que da lugar a un viraje de la orientación estratégica de dicha política seguida desde 2003, la cual estaba sustentada en la construcción de autonomía a partir de la diversificación de sus relaciones internacionales y el fomento de la integración sudamericana. En este sentido, se establece que luego de la llegada de Temer al ejecutivo brasileño, la política de defensa de Brasil comenzó a tener una progresiva orientación vinculada a la estrategia de la aquiescencia, argumentando que la misma está evidenciada en su marcado acoplamiento estratégico hacia Estados Unidos de América. El artículo finaliza indicando el impacto que este cambio ha tenido en el nuevo documento de defensa nacional de Brasil y sugiriendo las potenciales implicancias que las nuevas dinámicas geopolíticas de seguridad de Sudamérica tienen para la República Argentina.

These reflections arise from a double teaching: First from those of Ricoeur, and then those of Jervolino. Particularly strong in their interpretation of hermeneutics, and we may say the philosophical practice as a whole, is the urgency of reality – that is, the need to have interpretation, language and praxis converge. From Text to Action and The Words of Praxis are two of the titles that inspire the following thoughts. They indicate a bearing, a direction in which to search. The basic idea is to go "beyond the text", to understand semiotics and hermeneutics as activities rooted in bodily and experiential practice. The impression is that the relationship between classic semiotics and perception is one of disinterest in the best of cases, and in the worst of ill-concealed annoyance. Having developed as a logical-linguistic theory on the one hand, or as a logic of cultures on the other, traditional semiotics did not deal with the subject of perception and experience in a fruitful way, lingering for a long time on a structuralism-based textualism. From this point of view, the meeting between semiotics and phenomenology – which, even before Merleau-Ponty, makes perception the main object of its investigation, and indeed the very field of its own development – has long been deferred. Our attempt to bring semiotics, phenomenology and the philosophy of language together, in a common space to be drawn, leads us to reflect on the way in which the question of perception has been (or not been) approached at the crossroads of these disciplines. Ours obviously will not be a historiographical reread, but rather a critical one, looking to identify some theoretical nodes that allow us to explore the issues that enliven this reflection. As Ricœur would say, we must move “from text to action”.

Il saggio intende indagare la libertà di concorrenza in prospettiva costituzionale. Dapprima le sue radici, così come intese dall’Assemblea costituente, poi l’evoluzione dovuta all’ordinamento europeo, con l’istituzione di autorità nazionali indipendenti, di cui si discuterà la legittimità costituzionale, nonché le complesse relazioni tra pubblici poteri ed ex-monopolisti. / 𝑇ℎ𝑒 𝑒𝑠𝑠𝑎𝑦 𝑎𝑖𝑚𝑠 𝑡𝑜 𝑎𝑛𝑎𝑙𝑦𝑧𝑒 𝑓𝑟𝑒𝑒𝑑𝑜𝑚 𝑜𝑓 𝑐𝑜𝑚𝑝𝑒𝑡𝑖𝑡𝑖𝑜𝑛 𝑏𝑦 𝑎 𝑐𝑜𝑛𝑠𝑡𝑖𝑡𝑢𝑡𝑖𝑜𝑛𝑎𝑙 𝑝𝑜𝑖𝑛𝑡 𝑜𝑓 𝑣𝑖𝑒𝑤. 𝐹𝑖𝑟𝑠𝑡𝑙𝑦, 𝑖𝑡𝑠 𝑜𝑟𝑖𝑔𝑖𝑛 𝑖𝑛 𝑡ℎ𝑒 𝐶𝑜𝑛𝑠𝑡𝑖𝑡𝑢𝑡𝑖𝑜𝑛 𝑜𝑓 1948 𝑤𝑖𝑙𝑙 𝑏𝑒 𝑎𝑛𝑎𝑙𝑦𝑧𝑒𝑑. 𝑆𝑒𝑐𝑜𝑛𝑑𝑙𝑦, 𝑖𝑡𝑠 𝑒𝑣𝑜𝑙𝑢𝑡𝑖𝑜𝑛, 𝑚𝑎𝑖𝑛𝑙𝑦 𝑑𝑢𝑒 𝑡𝑜 𝑡ℎ𝑒 𝐸𝑢𝑟𝑜𝑝𝑒𝑎𝑛 𝑙𝑎𝑤, 𝑤𝑖𝑙𝑙 𝑏𝑒 𝑐ℎ𝑟𝑜𝑛𝑖𝑐𝑙𝑒𝑑. 𝑇ℎ𝑖𝑟𝑑𝑙𝑦, 𝑡ℎ𝑒 𝑙𝑒𝑔𝑎𝑙 𝑖𝑚𝑝𝑙𝑖𝑐𝑎𝑡𝑖𝑜𝑛𝑠 𝑜𝑓 𝑡ℎ𝑒 𝑒𝑠𝑡𝑎𝑏𝑙𝑖𝑠ℎ𝑚𝑒𝑛𝑡 𝑜𝑓 𝑖𝑛𝑑𝑒𝑝𝑒𝑛𝑑𝑒𝑛𝑡 𝑟𝑒𝑔𝑢𝑙𝑎𝑡𝑜𝑟𝑦 𝑎𝑢𝑡ℎ𝑜𝑟𝑖𝑡𝑖𝑒𝑠 𝑤𝑖𝑙𝑙 𝑏𝑒 𝑒𝑣𝑎𝑙𝑢𝑎𝑡𝑒𝑑. 𝐶𝑜𝑛𝑠𝑡𝑖𝑡𝑢𝑡𝑖𝑜𝑛𝑎𝑙 𝑙𝑒𝑔𝑖𝑡𝑖𝑚𝑎𝑐𝑦 𝑜𝑓 𝑡ℎ𝑒𝑠𝑒 𝑎𝑢𝑡ℎ𝑜𝑟𝑖𝑡𝑖𝑒𝑠 𝑎𝑛𝑑 𝑡ℎ𝑒 𝑐𝑜𝑚𝑝𝑙𝑒𝑥 𝑟𝑒𝑙𝑎𝑡𝑖𝑜𝑛𝑠ℎ𝑖𝑝𝑠 𝑏𝑒𝑡𝑤𝑒𝑒𝑛 𝑝𝑢𝑏𝑙𝑖𝑐 𝑖𝑛𝑠𝑡𝑖𝑡𝑢𝑡𝑖𝑜𝑛𝑠 𝑎𝑛𝑑 𝑖𝑛𝑐𝑢𝑚𝑏𝑒𝑛𝑡𝑠 𝑖𝑛 𝑟𝑒𝑔𝑢𝑙𝑎𝑡𝑒𝑑 𝑠𝑒𝑐𝑡𝑜𝑟𝑠 𝑤𝑖𝑙𝑙 𝑎𝑙𝑠𝑜 𝑏𝑒 ℎ𝑖𝑔ℎ𝑙𝑖𝑔ℎ𝑡𝑒𝑑.

To date methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common pathogens causing nosocomial infections(1). In Europe the proportion of MRSA is increasing sharply and the distribution varies from country to country. In recent years there has, in various parts of the world, the emergence of infection with strains of S. aureus methicillin-resistant community-acquired (CA-MRSA) than those circulating in hospitals(2). These strains contain a gene that confers resistance to methicillin (mec A SSC mec IV) which is usually associated with the gene for Leukocidin Panton Valentine (PVL) toxin responsible for necrosis of skin and soft tissue (3). In 2006-2008, at the Laboratory of Bacteriology PolyclinicTor Vergata,were isolated a total of 738 strains of S. aureus from biological samples of different nature (oral, vaginal secretions, wound swab, secreted headset, etc ...) of patients related to our surgeries.The identification and study of drug sensitivity of strains were performed with the automatic VITEK2 (bioMérieux). Of the 738 strains of S. aureus identified 212 (28.7%) were resistant to methicillin (MRSA), with an increasing trend over the years: 46 isolates, respectively, in 2006, 76 in 2007 and 90 in 2008. The highest frequency of MRSA (varying between 85% and 95%) was detected in wound swabs from the dispensary and diabetes (diabetic foot).

Klebsiella pneumoniae carbapenemase (KPC) was detected in two isolates of carbapenem-resistant K. pneumoniae in an italian teaching hospital. This is the first report of a KPC-producing isolates in our country. The first strain was isolated from a urine sample collected from a indwelling urinary catheter in a ICU-patient with subdural haematoma, while the second was from the culture of the central venous catheter (CVC) in a patient affected by Crohn’s disease admitted in gastroenterology ward. Both were resistant to all ß-lactams, susceptible to imipenem and meropenem and resistant to ertapenem.They were resistant to other classes of non-ß-lactams antibiotics such as quinolones, aminoglycosides (with the exception of amikacin), trimethoprim-sulfamethoxazole (TMP-SMX) as well as to nitrofurantoin.The isolates were not associated with travel abroad.They were found to contain the plasmid encoded carbapenemase gene blaKPC and were also positive to the Hodge’s test.The detection of KPC-producing bacteria has important implications in infection control and public health. The K. pneumoniae carbapenemase (KPC) belong to class A ß-lactamases of the functional group 2f. Reported for the first time in U.S. in 2001, these agents were subsequently identified in Europe. KPC strains are typically resistant to penicillins, extended-spectrum cephalosporin and aztreonam and present a peculiar behavior against carbapenems in that MIC is close to the susceptibility value or is borderline (except for ertapenem).This pattern is often associated with resistance to quinolones.The information is conveyed by the resistance plasmids, thus explaining their diffusion and implication in outbreaks of KPC. Despite this, to date there are few reports concerning the isolation of this phenotype in Italy.The purpose of this paper is to present two clinical cases related to the isolation of KPC in our hospital. The KPC-producing strains have been respectively isolated: the first in a patient with Crohn’s disease, and the second in a patient with a subdural haematoma. Nono of these patient had a recent history of travel abroad. The strains were characterized by Vitek 2 and E-test (bioMérieux). The phenotype was confirmed through the execution of the Hodge’s test and by PCR blaKPC. The genetic relationship between isolates was determined by Rep-PCR. Both isolates were resistant to ß-lactams, quinolones and ertapenem, and were susceptible to imipenem, meropenem, tigecycline and colistin. The Hodge’s test was positive and the sequence analysis of the blaKPC gene revealed a KPC gene type 2. The fingerprinting showed that the isolates were clonally related. Both patients were successfully treated with tigecycline. KPC represents a real challenge either for the clinicians, who have limited therapeutic options to treat infections due to this microorganism, and for the laboratory, since their correct identification is necessary to reduce the dissemination of the pathogen.

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Dialysis treatments have allowed 'terminal patients' to live for years and years. However, life expectancy and quality are still consistently reduced in renal dialysis patients. Consequently, all efforts to device alternative treatments to the conventional ones are highly justified. Recently, the Hemo Study showed that neither the use of high flux membranes, nor the increase of the dialysis dose above the conventional, were capable to reduce significantly patient's mortality and morbidity, although 8% reduction of the risk of death was seen in patients treated with high flux vs. patients treated with low-flux dialysis. A relevant question is if convective treatments may offer an overprotection from morbidity and mortality, in comparison with low flux and high flux treatments. Data from the Registro Lombardo di Nefrologia e Trapianto published in 2000 showed a trend toward a better survival (RR= 90) and a significantly better protection from tunnel carpal syndrome (RR= 0.58; p= 0.03) in patients treated with convective treatments (hemofiltration and/or hemodiafiltration) vs. patients treated with diffusive dialysis. Except than a better cardiovascular stability observed on hemofiltration and an higher beta2-microglobuline clearance given by online hemofiltration and hemodiafiltration, evident clinical benefits of convective treatments, over the conventional high flux treatments, are not yet clearly demonstrated. Notwithstanding that, online convective treatments, that are performed with high flux compatible membranes and high technology machines, producing high quality water, offer at the moment the best bases for the improvement of clinical results of dialysis, especially in some category of patients.

Results from recent studies have demonstrated that kidney-transplanted patients have better expectation and quality of life than dialysis patients on a waiting list for kidney transplant. Moreover, the scientific literature has conclusively shown that the survival of the patient and of the kidney graft are better in patients who received a kidney from a living donor, than in patients who received a cadaveric kidney. The main factors that may have a negative influence on the kidney transplant are: the recipient's age, diabetes mellitus, smoking and the time spent on dialysis before the transplant. The shortage of cadaveric kidneys and the small number of living kidney transplant are the main obstacles to a more widespread use of kidney transplantation. Kidney transplant from living donors needs to be implemented because it represents the best treatment for patients with kidney failure and it can decrease or even avoid the need for dialysis before kidney transplantation.

Within recent years important progress has been made in the field of renal transplantation, both in terms of surgery and immunosuppression. At the present time renal transplantation offers a better expectation and quality of life to patients with end stage renal disease, compared with patients in dialysis. The survival of renal transplantation depends on many immunological and non immunological factors. The widespread use of calcineurine inhibitors (cyclosporine and tacrolimus) has improved the actuarial survival of transplanted kidneys at one year, decreasing the number and the severity of acute rejection episodes, but the calcineurine inhibitors did not improve the chronic rejection. The use of the new immunosuppressant drugs (mycophenolate mofetil, rapamicine and RAD, anti CD25 humanized antibodies) has contributed both to a further reduction of the number of rejection episodes and of side-effects of the immunosuppressant drugs, which have been possible thanks to the various combinations of these drugs. moreover these drugs allow the reduction or withdraw of steroids. Further studies will be necessary to ascertain that these new drugs improve the long term survival of transplanted kidneys and to define more precisely problems relating to the immunosuppressive therapy with respect to renal function, rejection, and patients' quality of life.

"In this paper we examine some biometric aspects of women's fertility cycle and we statistically test a hypothesis concerning the effects of hormone interactions on cycle temporal dynamics. The data base has been provided by the Catholic Marriage Advisory Council Centre...and concerns 31,290 cycles (belonging to 1,781 women), classified according to their length, the length of pre and post ovular phases and woman's age. The distributional model of cycle and phase lengths has been estimated by a kernel procedure and interesting statistical cause-effect relationships have been highlighted showing a sort of hormonal balancing action on the physiological process." (SUMMARY IN ENG), (excerpt)

Twenty-seven patients, eighteen females and nine males, with chronic renal failure and secondary hyperparathyroidism, were treated by subtotal parathyroidectomy. Bone pain, in 24 patients, hypercalcemia in 2 and severe pruritus in 1 were the main indications to surgery. Result evaluation was possible in twenty four patients. Bone pain disappeared or was reduced in 20/22 patients. Serum alkaline phosphatase and PTH returned to normal in 21/24 patients. There patients had persistent hyperparathyroidism because of inadequate surgical exploration. Another group of seven patients with secondary hyperparathyroidism recalcitant to medical therapy or relapsing after subtotal parathyroidectomy was treated with calcitriol ev. After nine months of follow-up PTH and alkaline phosphatase serum levels were reduced to normal value in all patients.

Three hundred and sixty-three postmenopausal women received 6 months of cyclic hormone replacement therapy with conjugated estrogens in differing doses (0.625 mg and 1.25 mg) associated in a sequential pattern lasting 12 days with progestagens (medroxyprogesterone acetate or medrogestone) in 16 italian health centres. The results of the multicentre study confirm the efficacy of this conjugated estrogen-progestogen regimen in resolving climacteric syndrome, offering cardiovascular protection and vaginal trophic effect and preventing postmenopausal osteoporosis, as well as confirming its tolerability in relation to blood pressure, body weight, breast, endometrium, blood coagulation and hepato-renal function.

Fourteen patients with chronic renal failure and secondary hyperparathyroidism were treated by subtotal parathyroidectomy. Bone pain and hypercalcemia were the main indications to surgery respectively in 13 and 1 patients. Bone pain disappeared or was significantly reduced in 12/14 patients. Two patients had a persistent hyperparathyroidism. Serum alkaline phosphatase returned to normal in 12 patients and PTH in 11 of 12 patients with pretreatment high levels.