Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge.
Giovane attrice già famosa, destinata a divenire la prima grande diva del teatro italiano in Europa come nelle Americhe, Adelaide Ristori. Donna appassionata, brillante e inquieta quanto amante della poesia e dell’arte, Lauretta Cipriani Parra, attiva fin dalla giovinezza nell’opposizione politica, compagna e poi moglie del tanto più giovane ‘triunviro’ del Governo provvisorio toscano, Giuseppe Montanelli. Adelaide, impegnata in incessanti tournée e corteggiata dalla società internazionale, è alla ricerca di una diversa idea dell’interprete drammatica, che considera il vero fulcro di ogni realizzazione scenica, e domanderà alle capacità letterarie di Montanelli, in esilio a Parigi dopo la Restaurazione granducale toscana, un testo chiave per i futuri successi. E se Lauretta sembra accettare ruoli subalterni e inusuali per amore del marito, persegue invece precise architetture per farlo emergere nei fasti del Secondo Impero e spianare la via politica per un prossimo, trionfante, ritorno nella Penisola.
Riassunto: Laura Orvieto (Milano 1876-Firenze 1953, scrittrice per l'infanzia, ha sempre amato raccontare storie. Chiedeva a tutti di raccontarne a lei e, se non trovava nessuno disponibile, ne raccontava lei ai bambini più piccoli: erano storie ispirate ai molti libri che leggeva, o alle favole che vecchie donne le avevano raccontato. In età adulta, diventata scrittrice, le sue opere di maggior successo si ispireranno ai miti dell'antichità classica e alle piccole avventure dei figli. Ma nella seconda metà degli anni Trenta molte cose cambiano, per una famiglia della borghesia ebraica fiorentina: l'emarginazione razziale ormai incalza. Laura, intorno al 1936, decide di abbandonare i temi abituali, di guardare alle origini e di narrare la propria storia, quella del marito Angiolo e delle rispettive famiglie. La Storia di Angiolo e Laura si propone con uno stile semplice e diretto, molto vicino a quello delle altre opere della Orvieto; ma nelle pagine finali invece lascerà spazio a dichiarazioni che illustrano la dolorosa presa di coscienza della scrittrice. Oggi possiamo chiederci fino a che punto quelle pagine rispondano a un percorso biografico reale: altre fonti integrano, confermano o smentiscono le vicende e gli stati d'animo espressi nel libro. La lettura parallela di alcuni capitoli e di altri documenti rivela aspetti meno noti della vita, del pensiero e degli stati d'animo di Laura e della sua famiglia e ne illustra i metodi di lavoro.Parole chiave: Laura Orvieto; Scrittrici ebree del Novecento; Letteratura autobiografica femminile; Emancipazione ebraica; Leggi razziali; Scrittrici per l'infanzia.abstRact: Laura Orvieto (Milan 1876 -Florence 1953), children's writer, always loved telling stories. She asked everyone to tell her stories and, if she couldn't find anyone available, she told stories to younger children. These stories were inspired by the many books she read and by the fairy tales told by old women. As an adult, once a writer, her most successful work was inspired by classical mythology and the small adventures of her own children. But in the second half of the 1930s many things changed for a family from the Florentine Jewish middle classes, with the increasing pressure of racial marginalization. In around 1936 Laura decided to abandon her usual themes, and instead to turn to her origins and tell her own story, and that of her husband Angiolo and their respective families. The Storia di Angiolo e Laura is written in a simple and direct style, close to Orvieto's other work. But in the final pages she allows space for statements that illustrate her painful crisis of conscience. Today we can ask to what extent these pages reflect a real biographical journey: other sources complete, confirm or deny the events and states of mind expressed in the book. A parallel reading of a few chapters and other documents reveals less well-known aspects of the thinking and frame of mind of Laura and her family and illustrates her working methods.
The contribution offers an overview of the archives of the movements preserved in Tuscany and of the critical issues of their conservation and enhancement.
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