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Background: Adult, benign, non-iatrogenic bronchoesophageal fistula (BEF) is a rare condition, which is occasionally described in single case reports. Therefore, little is known about its possible causes, presentation and management. Methods: A systematic search of the literature in MEDLINE, PubMed Central and EMBASE databases between 1990 and 2020 was carried out to identify all cases of BEF. The initial database search identified 19,452 articles, of which 183 (251 individual patient cases) were included in the final analysis. Results: Main causes of BEF were congenital malformations (97/251, 38.7%) and infections (82/251, 32.7%), while 33/251 (13.1%) fistulae were regarded as idiopathic and 39/251 (15.5%) attributed to other causes. Esophagograpy was the most sensitive method of diagnosis (97.4%) compared with esophagoscopy (78.9%), computed tomography (49.6%) and bronchoscopy (46.0%). Definitive treatment was surgical for 176 patients (70%), endoscopic for 25 (10%) and medical for 37 (14.7%). Compared with congenital BEFs, infective BEFs had shorter median symptom duration and were distributed more proximally over the bronchial tree. Definitive treatment was almost only surgical for congenital BEFs, while infective BEFs were treated also endoscopically (12%) and by medical therapy (38%). Morbidity, treatment failure and recurrence rates were higher for infective BEFs. Conclusions: BEFs are rare. Symptoms are non-specific and a high index of suspicion is necessary for diagnosis. Patients with infective BEF tend to have a more severe clinical picture than those with congenital BEF. Surgery is the main treatment for patients affected by congenital BEF, while infective BEFs may heal conservatively. [ABSTRACT FROM AUTHOR]

The essay aims at reconstructing the processes that led to the publication and circulation of Thomas Pynchon’s works in Italy from the mid-1960s to the present day, so as to shed light on the fragmented and distorted reception of Pynchon’s corpus between the 1980s and the 2000s. The first section examines the organization of Bompiani publishing house in the 1960s and 1970s, as Pynchon’s early Italian reception was tied to the publisher’s policies. The second section focuses on the translation of V. by Liana Burgess, which Pynchon himself appreciated. The last section summarizes the subsequent Italian critical reception of Pynchon, conditioned by the general reorganization of the publishing industry affecting both Europe and the United States. [ABSTRACT FROM AUTHOR]

Review of: A Companion to Federico Fellini, Frank Burke, Marguerite Waller and Marita Gubareva (eds) (2020) Hoboken, NJ: Wiley Blackwell, 576 pp., ISBN 978-1-11943-153-4, h/bk, $89.29 [ABSTRACT FROM AUTHOR]

What does Federico Fellini's cinema tell us today, in the 100th anniversary year of its author's birth and 28 years after his death? What remains undiscovered in the critical response to the work of one of the most celebrated Italian filmmakers of the 20th century? What is the influence of that work on contemporary cinema and what methodological approaches are better suited to make meaning of its heterogeneity and not infrequent thorniness on important issues such as sexual and gender politics? These are some of the questions posed by two books published in 2020 (Frank Burke, Fellini's Films and Commercials: From Postwar to Postmodern and A Companion to Federico Fellini. Edited by Frank Burke, Marguerite Waller, and Marita Gubareva) whose goal is to revive a debate that, at least in the Anglo-Saxon world, has been quiet for too long. Taking the two books as a point of departure, this essay focuses on the current state of Fellini studies, addressing matters such as the Fellinian "subject," individualism, authenticity, self-reflexivity, dream, the sociopolitical, and gender in an effort to understand the role played in film history by one of the most influential Italian filmmakers. [ABSTRACT FROM AUTHOR]

Background The prognostic relevance of health-related quality of life (HRQoL) has been scarcely studied in the dialysis population and the prognostic power for mortality of the HRQoL domains is unknown. Methods We tested the prognostic value for mortality of the HRQoL domains included in the 36-item Short Form Health Survey (SF-36) by Cox's regression analysis and by state-of-the-art prognostic techniques {explained variation in mortality [ R 2], calibration, discrimination [Harrell's C], risk reclassification [Net Reclassification Index (NRI)], Integrated Discrimination Index [IDI]} in a cohort of 951 patients on chronic haemodialysis. Results In multivariable Cox models, all but two domains (role limitation due to physical health and due to emotional problems) were independently related with mortality. Physical functioning was the domain adding the highest explanatory power (R 2+5.3%) to a basic model including established risk factors for mortality in the dialysis population. The same domain improved risk calibration and showed the highest Harrell's C (+1.7%) and the highest reclassification power (categorical NRI + 8.7%, continuous NRI +46%, P ≤ 0.006) and the highest IDI (+3.4%, P < 0.001). These results were fully confirmed in analyses testing the additional prognostic power of SF-36 domains when combined to a well-validated risk score in dialysis patients. Conclusions Physical functioning holds the highest prognostic power for mortality among the domains of SF-36. The gain in prognostic ability by this domain is relevant for clinical practice. Physical functioning has the potential for refining the prognosis and for informing exercise programmes in the dialysis population. [ABSTRACT FROM AUTHOR]

Background: In patients submitted to major pulmonary resection, the postoperative length of stay is mainly influenced by the duration of air leaks and chest tube removal. The measurement of air leaks largely relies on traditional chest drainage systems which are prone to subjective interpretation. Difficulty in differentiating between active air leaks and bubbles due to a pleural space effect may also lead to tentative drain clamping and prolonged time for chest drain removal. New digital systems allow continuous monitoring of air leaks, identifying subtle leakage that may be not visible during daily patient evaluation. Moreover, an objective assessment of air leaks may lead to a reduced interobserver variability and to an optimized timing for chest tube removal.Methods: This study is a prospective randomized, interventional, multicenter trial designed to compare an electronic chest drainage system (Drentech™ Palm Evo) with a traditional system (Drentech™ Compact) in a cohort of patients undergoing pulmonary lobectomy through a standard three-port video-assisted thoracic surgery approach for both benign and malignant disease. The study will enroll 382 patients in three Italian centers. The duration of chest drainage and the length of hospital stay will be evaluated in the two groups. Moreover, the study will evaluate whether the use of a digital chest system compared with a traditional system reduces the interobserver variability. Finally, it will evaluate whether the digital drain system may help in distinguishing an active air leak from a pleural space effect, by the digital assessment of intrapleural differential pressure, and in identifying potential predictors of prolonged air leaks.Discussion: To date, few studies have been performed to evaluate the clinical impact of digital drainage systems. The proposed prospective randomized trial will provide new knowledge to this research area by investigating and comparing the difference between digital and traditional chest drain systems. In particular, the objectives of this project are to evaluate the feasibility and usefulness of digital chest drainages and to provide new tools to identify patients at higher risk of developing prolonged air leaks.Trial Registration: ClinicalTrials.gov, NCT03536130. Retrospectively registered on 24 May 2018. [ABSTRACT FROM AUTHOR]

Background/Aims: Fabry disease (FD) is a lysosomal storage disorder characterized by pervasive renal involvement. However, this disease is underdiagnosed in patient with chronic kidney disease (CKD), including those with end stage renal disease (ESRD), so their investigation represents an unexploited opportunity for early diagnosis of the disease and for its identification in relatives of affected patients. Methods: We investigated Fabry disease in a clinical and biological database including ESRD patients of unknown cause in a geographical area with 2 million residents. The study was based on state of art GLA gene sequencing and was extended to relatives of affected ESRD patients. Results: Among ESRD patients qualified for enrollment into this study, a previously undiagnosed young man harboring the mutation p.I91T was identified. The study of the proband's family led to the identification of 8 additional cases. In another ESRD male patient, we identified the functional polymorphism p.D313Y. Furthermore, in 55 ESRD patients (24.2%) we found intronic polymorphisms of uncertain functional relevance in the non-coding regions of the GLA gene. Conclusion: A comprehensive survey of ESRD patients in a geographical area of 2 million residents identified one undiagnosed case of Fabry disease and led to the identification of 8 additional cases among his relatives. Screening protocols starting from the dialysis population and upstream extended to families of affected individuals may be an effective strategy to maximize the early identification of subjects with Fabry disease. [ABSTRACT FROM AUTHOR]

This is a review of the volume Stabat mater. Immagini e sequenze nel moderno, edited by Anna Dolfi. It provides a brief description of the theme of the Stabat mater (in literature, music, art) developed in the twenty-eight essays of the volume. [ABSTRACT FROM AUTHOR]

Background: Snoring, an indicator of sleep-disordered breathing (SDB), associates with all-cause and cardiovascular (CV) mortality in high-risk conditions such as chronic heart failure (HF). Because SDB and HF are exceedingly frequent in end-stage kidney disease (ESKD), we hypothesized that SDB as detected by snoring may impact upon the relationship between chronic HF and all-cause and CV mortality in these patients. Methods: We tested this hypothesis in a cohort of 827 ESKD patients, followed up for 2.3 years. Results: In this population, snoring was a strong modifier of the risk of chronic HF for all-cause and CV death. In fully adjusted Cox models, the hazard ratio (HR) associated to chronic HF for the study outcomes was highest in heavy snorers [all-cause death: HR 2.6 (95% CI 1.6-4.3, p < 0.001); CV death: HR 4.0 (95% CI 2.1-7.6, p < 0.001)], intermediate in moderate snorers [all-cause death: HR 1.6 (95% CI 1.1-2.2, p = 0.01); CV death: HR 1.8 (95% CI 1.2-2.8, p = 0.01)], and lowest and not significant in non-snorers [all-cause death: HR 0.9 (95% CI 0.6-1.6, p = NS); CV death: HR 0.8 (95% CI 0.4-1.6, p = NS)]. Conclusions: Snoring is a strong and independent effect modifier of the relationship between chronic HF and all-cause and CV mortality in ESKD. Since SDB and snoring are in part attributable to reversible pharyngeal oedema, intensified surveillance and treatment of chronic HF snorers on dialysis may translate into better clinical outcomes in this very high-risk population, an issue which remains to be tested in specifically designed clinical trials. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

International investment tribunals considering claims of indirect expropriation have increasingly taken into account the host state’s regulatory purpose in their analysis, alluding to the need for measures to achieve a balance between host state and investor interests. Some tribunals have attempted to employ proportionality analysis in their determination of claims, but their reasoning has been methodologically problematic and characterized by a stringent standard of review, diverging from the approach of other international and supranational for a hearing disputes concerning the exercise of public power affecting individual rights and interests. Investment tribunals should be more deferential in performing proportionality analysis, mindful of host state authorities’ greater democratic legitimacy and proximity to host state communities, and tribunals’ comparatively weak institutional capacity. Such an approach would entail greater deference to host states in evaluating the legitimacy of a measure’s objective, the measure’s suitability and necessity, and the ultimate balance between the interests of the host state and of the investor. An appropriately deferential use of proportionality analysis is a more coherent approach to indirect expropriation that provides greater space for host states to take measures in the public interest, yet provides sufficient scrutiny to control misuse of public power.

The main goal of this paper — originally published in Portuguese in 1993 — is to propose a reflection on a key question often associated with the training of translators: What kind of knowledge should future professionals acquire in order to produce successful translations? As it examines logocentric notions of knowledge and meaning from the perspective of contemporary, post-Nietzschean thought, with special emphasis on Derridean deconstruction, this paper explores similarities between traditional notions of translation and pedagogy, both founded on the possibility of stable meanings that could be objectively separated from the language and the circumstances in which they occur. Such notions and what they imply for the kinds of relationships that define and constitute both translation and pedagogy are also further questioned from the perspective of some key insights from psychoanalytic theory as it undermines the rationalist notion according to which knowledge is something that might be completely grasped or mastered. As a general conclusion, the paper emphasizes the importance of developing a critical apparatus within the classroom that will allow both students and teachers to constantly evaluate their relationship and the power dynamic that create their community as well the roles they play in the production and transference of meaning in such a community, a production which is central to both translation and pedagogy. [ABSTRACT FROM AUTHOR]

The article discusses the 17th century history of Livorno, Italy, with a focus on the records of the Inquisition in Livorno concerning Muslim slaves and trials related to magic practices. Topics discussed include relations between religious and ethnic groups in Livorno, the history of Muslim slaves in the region and the practice of magic, and cultural relations between Livorno and North Africa.

In her essay, Telling stories to create history: slavery in Toni Morrison's fiction, Itala Vivan analyzes the fictional work of the African American writer Toni Morrison and focuses especially on Beloved (1987) and A Mercy (2008), both stories of women slaves. Through individual stories Morrison gives a history of the African American community but also, at the same time, of the whole of America. The writer reveals the consubstantiality of such stories in the creation of modernity whose multiple nature, originally announced by William Edward Burghardt DuBois, is reconfirmed and enriched with elements from the cultural imagery of the American universe. Morrison outlines a history and a story built of unspeakable truths that unveil tragic, multi-layered elements streaming from the veins of America and intertwined with the running blood of slavery. [ABSTRACT FROM AUTHOR]