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espanolEn espanol, los afijos flexivos solamente se ligan al nucleo morfologico y semantico de los compuestos de dos sustantivos (N-N), lo cual implica que el plural de casa cuna o de hombre lobo es casaS cuna y hombreS lobo respectivamente mientras que *casa cunaS y *hombre loboS son agramaticales porque el afijo flexivo esta ligado al modificador. Sin embargo, en el caso de los sufijos derivativos y, en concreto, del sufijo evaluativo diminutivo -ito, parece existir mas flexibilidad ya que, para algunos hablantes, el sufijo puede tener abarque sobre todo el compuesto tanto si esta ligado al nucleo (casITA cuna / hombrecITO lobo) como si esta ligado al modificador (casa cunITA / hombre lobITO). A partir de una Tarea de Interpretacion de Imagenes y de una Tarea de Juicios de Aceptabilidad que se administraron a un grupo de hablantes de espanol peninsular y de portugues brasileno, se constata que el sufijo derivativo -ito se acepta con un grado significativamente mayor cuando va ligado al nucleo tal como sucede con el sufijo flexivo -s. EnglishIn Spanish, inflectional affixes attach to the morphological and semantic head of NounNoun (N-N) compounds, which implies that the plural of casa cuna or hombre lobo is casaS cuna and hombreS lobo respectively, while *casa cunaS and *hombre loboS are ungrammatical because the inflectional affix is attached to the modifier. However, there seems to be more flexibility in the case of derivational affixes, specifically evaluative diminutive affixes such as -ito, as for some native speakers, this suffix can have scope over the entire compound whether it is attached to the head (casITA cuna / hombrecITO lobo) or to the modifier (casa cunITA / hombre lobITO). In this article, data elicited via a Picture Interpretation Task and an Acceptability Judgment Task that were administered to a group of Peninsular Spanish speakers and to a group of Brazilian Portuguese speakers, show that derivative affix -ito is significantly more acceptable when attached to the head of the N-N compound, as is the case with inflectional affix -s.

Glotopolítica latinoamericana: tendencias y perspectivas recoge el resultado de presentaciones y deliberaciones del IV Congreso Latinoamericano de Glotopolítica, realizado en la Universidad de San Pablo (Brasil) en septiembre de 2019, que convocó a numerosos y destacados especialistas en el área. Su inscripción en una serie (los anteriores se realizaron en Chile, Colombia y Alemania) nos permite apreciar los grandes ejes de los que da cuenta el cuidadoso e inteligente armado del libro decidido por los editores, y fundamentado en la Presentación. El tramo que hemos recorrido como especialistas, en el cual los eventos internacionales son hitos significativos, ha ido mostrando la amplitud de un campo que se construye apelando a tradiciones académicas variadas, que insiste en su carácter interdisciplinario y crítico y que no deja de tener una dimensión militante que se expone en las reflexiones teóricas, las investigaciones empíricas y las prácticas institucionales.

IX Congresso Brasileiro de Hispanistas realizado nos dias 22 a 25 agosto 2016 Ainda que a formação das construções relativas seja semelhante no espanhol (E) e no português brasileiro (PB), o uso das relativas restritivas não estândar parece ser diferente. No E, por um lado, é bastante comum a relativa com pronome resumptivo (Brucart, 1999), (Es una chica que ya te he dicho que ayer hablamos con ella), sobretudo quando o antecedente é indefinido e está distante da cláusula relativa; por outro, não são comuns ou aceitas as construções oblíquas com um complementizador (Rivero, 1982, apud Liceras, 1986, p. 47) e a preposição elidida (?Este es el libro que he hablado muchas veces). Já em PB a formação preferida é a com complementizador e sem preposição –segundo Tarallo (1983) uma cortadora (A moça que eu falei ontem está aqui)– frente à construção com resumptivo (A moça que eu falei com ela ontem está aqui), atualmente estigmatizada.Com o objetivo de investigar o grau de aceitabilidade das relativas especificativas no E por falantes do PB e determinar em que medida se produz transferência da L1, aplicamos um teste de Juízo de Aceitabilidade a 30 falantes de ELE cuja língua materna é o PB e a um grupo de controle de 30 hispanofalantes. Os resultados mostraram que o grau de aceitação das construções cortadoras é mais alto que o grau de aceitabilidade das relativas com resumptivo. Os hispano- falantes vão em direção oposta: as construções de resumptivo apresentaram um grau mais alto de aceitabilidade que as cortadoras, o que permite concluir que os falantes do PB transferem suas preferências ao E, tal como podíamos predizer a partir das propostas dos linguistas UNILA­-UNIOESTE

IX Congresso Brasileiro de Hispanistas realizado nos dias 22 a 25 agosto 2016 El portugués brasileño (PB) se considera una lengua de núcleo a la izquierda, como vemos en (1b) frente a (1c). Si bien Zwicky (1985) mantiene que la direccionalidad del núcleo es la misma en la morfología flexiva que en la derivativa, la relación entre la direccionalidad del núcleo y el afijo diminutivo no es tan clara como en el caso de la flexión. Al igual que la flexión de plural, (2b) inho tiene abarque sobre todo el compuesto y, por lo tanto, la representación de (2b) es la versión reducida de (2a). Sin embargo, cuando inho se une al modificador como en (2c), la interpretación no queda clara. (1a) uma mulher polvo (1b) duas mulherES polvo (1c) *duas mulher polvoS (2a) homem lobo (2b) homenzINHO lobo (2c) homem lobINHO En este estudio 30 hablantes de inglés L1 – PBL2 y 30 de PBL1 participaron en dos experimentos: una Tarea con Imágenes (TI) que mostraba compuestos NN con afijo diminutivo (inho/inha) y una tarea de Juicios de Aceptabilidad (TJA) con afijo diminutivo y afijo plural (s). Los resultados de la TI muestran que los hablantes de PBL1 no interpretan que inho en el modificador tenga abarque sobre todo el compuesto y los hablantes de PBL2 diferencian entre los casos en que inho se sitúa en el núcleo o en el modificador. Los resultados de la TJA revelan que, tanto para los hablantes de PBL1 como para los de PBL2, la aceptabilidad de los afijos flexivos y derivativos en el modificador es siempre significativamente más baja que la de esos afijos en el núcleo. Esto explica que la direccionalidad del núcleo para los afijos flexivos y para la derivación está mejor establecida en la gramática del PBL1 que en la gramática PBL2 UNILA­-UNIOESTE

From the theoretical point of view, antiproteolytic therapy would seem to be the rationale for acute pancreatitis management. Unfortunately, clinical human trials studying the role of antiproteases in the treatment of acute pancreatitis differ in several respects in terms of their basic design. As a consequence, any form of homogeneous analysis of the reported data as a whole is impossible. Considering the data emerging from a meta-analysis of five trials a rational use of antiproteases may result in a reduction of complications requiring surgery and of patient management costs only in selected cases, meaning by that severe and necrotic forms. As regards presumptive applications, over 400 patients were prospectively tested versus placebo in a double-blind trial with the aim of preventing acute pancreatitis after ERCP. The complication incidence was significantly lower among the pretreated patients; anyway, also in this field of protease inhibitor clinical application it is necessary to identify the patients with the greatest risk to develop post-ERCP acute pancreatitis. In conclusion, antiproteases can still play a role when given prophylactically or when used in the very early phases of the disease; moreover a ‘multiple drugs approach’ (including, for example, suitable antibiotics) seems to represent nowadays the most modern and rational treatment of acute pancreatitis.

Background. Total parenteral nutrition and somatostatin or analogues represent a consolidated therapeutic approach for external fistulas, a frequent complication of major pancreatic surgery. Aims. To establish the effects of the somatostatin analogue lanreotide on exocrine pancreatic secretion. Methods. Eight patients, undergoing pancreaticoduodenectomy for malignancy, were enrolled in the trial. The volume and composition of pancreatic secretion were evaluated after one single subcutaneous injection of lanreotide 0.5 mg or placebo in a randomised, double-blind cross-over trial. Results. In the seven patients completing the study, the 24-h output volume was 208.6±41.3 and 253.9±72.4 ml after lanreotide and placebo, respectively. During the first 6 hours values were 48.1±14.7 and 77.6±21.4 ml (p=0.02). No significant difference between treatments was detected in the qualitative composition of 24-h pancreatic secretion, although bicarbonate secretion remained lower after the active drug at all the observation intervals. Peak lanreotide levels were detected 15–30 min after drug injection. Clinical and laboratory tolerability was good. Conclusions. Lanreotide induced a statistically significant reduction in the output volume with respect to placebo in the first 6 hours after administration, but not thereafter. The present results encourage a new study to be undertaken in a larger sample and with a multiple dosing scheme of treatment.

External pancreatic fistulas resistant to medical treatment are an indication for surgery. Over the period from May 1986 to March 1999, we operated on 17 patients suffering from a stabilized external pancreatic fistula as a result of surgical treatment for severe acute pancreatitis in 12 cases, chronic pancreatitis in 3, duodenopancreatectomy in 1, and islet cell tumor enucleation in 1. The surgical repair consisted of precise identification of the fistula tract around the drainage tube and its anastomosis with a Roux-en-Y jejunal loop (fistulojejunostomy). The surgical mortality was nil, and the postoperative outcome was uneventful in 12 patients. Four patients experienced surgical complications, all of which were treated conservatively. After a median follow-up of 93 months, 14 patients are still alive and healthy, 1 had died of neoplastic cachexia, and 2 were lost to follow-up. In our experience, fistulojejunostomy appears to be safe, easy to perform, and curative.

Quality of life (Qol) assessment is a mandatory endpoint of cancer clinical trials. Little research has been conducted on pancreatic cancer (Pc) and no disease specific Qol questionnaire exists. We report on the development of the European Organization for Research and Treatment of Cancer (EORTC) Pc Qol module to supplement the core cancer module (QLQ-C30). Literature research and qualitative interviews with 6 specialists and 34 patients in the UK were followed by construction of a questionnaire, a peer review by international specialists and EORTC. Administration of the QLQ-C 30, a provisional Pc module and a qualitative debriefing interview was performed on 78 patients in 8 countries stratified into groups by disease stage and treatment intention. Pretesting identified that 23/26 questions had an adequate internal reliability (Cronbach's alpha0.7) and construct validity (Pearson's r 0.4-0.6). The median time of completion was 12 mins. Qualitative analysis indicates that the module is easy to complete and cross culturally applicable. The EORTC QLO-PAN 26 includes 26 items covering symptoms, body image, sexuality and the emotional and social consequences of Pc. It is intended for use in patients undergoing clinical trials for pancreatic cancer including surgery, chemotherapy and radiotherapy and will allow the detection of small but clinically meaningful differences in clinical trials for Pc.

Surgery still plays an important role even in advanced endocrine tumours of the pancreas, owing to their biological behaviour. Sometimes it is possible to attempt a radical approach, but more often only cytoreduction is feasible. In fact, when the malignancy is not completely resectable on account of vessel involvement or extensive liver metastases, surgical reduction of the tumour burden (debulking) can be proposed, aimed at improving the clinical conditions and survival of these patients. Forty-one patients suffering from advanced endocrine tumour of the pancreas were observed from 1985 to 1996. In 13 patients, the disease was locally advanced as far as concerns lymph node metastases and/or vessel involvement, while the other 28 patients presented liver metastases. In the former group, we performed 6 radical resections, in the latter we submitted 2 patients to radical resection and 12 patients to cytoreductive surgery, with complete removal of the pancreatic malignancy. The overall survival of the resected patients was 87% (7/8). Three patients (37.5%) are alive and free of disease, while the other 4 have subsequently developed liver metastases. One patient died with hepatic recurrence. Half the patients (6/12) undergoing cytoreductive surgery are alive, 3 with stable and 3 with progressive disease. The other 6 patients have died due to liver progression of the disease. As data in the literature concerning the role of debulking as regards the survival are conflicting, we have modified our surgical approach in patients with advanced disease. We perform cytoreductive surgery whenever complete removal of the pancreatic tumour is feasible. The rationale of this approach is to leave only a liver with residual disease, with a view to giving targeted adjuvant treatment.

From the theoretical point of view, antiproteolytic therapy would seem to be the rationale for acute pancreatitis management. Unfortunately, clinical human trials studying the role of antiproteases in the treatment of acute pancreatitis differ in several respects in terms of their basic design. As a consequence, any form of homogeneous analysis of the reported data as a whole is impossible. Considering the data emerging from a meta-analysis of five trials a rational use of antiproteases may result in a reduction of complications requiring surgery and of patient management costs only in selected cases, meaning by that severe and necrotic forms. As regards presumptive applications, over 400 patients were prospectively tested versus placebo in a double-blind trial with the aim of preventing acute pancreatitis after ERCP. The complication incidence was significantly lower among the pretreated patients; anyway, also in this field of protease inhibitor clinical application it is necessary to identify the patients with the greatest risk to develop post-ERCP acute pancreatitis. In conclusion, antiproteases can still play a role when given prophylactically or when used in the very early phases of the disease; moreover a 'multiple drugs approach' (including, for example, suitable antibiotics) seems to represent nowadays the most modern and rational treatment of acute pancreatitis.

The surgeon was the only figure involved in the management of chronic pancreatitis patients unresponsive to medical treatment, until a few years ago. Nowadays, because of less invasive, endoscopy offers a seductive alternative to surgery. Up to now no clinical prospective and randomized data comparing the results of the two different approaches are available. Surgery seems to be the only solution for chronic pancreatitis with duodenal stenosis and the last chance of eliminating diagnostic uncertainty. Also in the case of biliary tract involvement surgery should be regarded as the procedure of choice, inasmuch as the stenosis is benign and generally long-lasting, and endoscopic treatment would have to be repeated several times; endoscopy, in this indication, should be reserved only for patients who present contraindicating surgery conditions (such as severe jaundice, colangitis etc.); the endoscopist should assess whether to insert a stent or a naso-biliary drainage tube referring the patient back to the surgeon once good clinical conditions have been restored. Endoscopy and surgery should be regarded not as adversaries in the management of chronic pancreatitis and its complications, but as complementary procedures in an integrated approach. The maximum degree of complementarity should be achieved in the management of pseudocysts and in cases presenting severe, incapacitating pain. In selected cases endoscopy can play a definitive role. The generally good surgical outcomes, moreover, should convince endoscopists not to insist with repeated, hazardous manoeuvres in cases of failure. Particularly interesting is the possibility of performing endoscopic sphincterotomy combined with extracorporeal shock-wave lithotripsy prior to surgical treatment in cases of chronic calcifying calcific pancreatitis. The crushing of the calculi and partial clearance of the duct have simplified surgery and complete clearance of the duct in those patients receiving such treatment in our experience.