Articoli di riviste: "863/.64 b"

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Yacoubi, Loubna, Soumia Farih, Noussaiba Benhamza, Abderazzak Seddari e Adil maleb. "Health vigilance concerning Acinetobacter baumannii bacteremia at the mohammed VI university hospital of oujda (morocco): epidemiological profile and antibiotic resistance". E3S Web of Conferences 319 (2021): 01003. http://dx.doi.org/10.1051/e3sconf/202131901003.

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The objective of this work is to determine the epidemiological profile of Acinetobacter b aumannii (A.baumannii ) bacteremia in the microbiology laboratory of CHU Mohammed VI of Oujda and its antibiotic resistance rates. This is a retrospective and descriptive study of 27 months from June 24, 2016to September 19, 2018 including all positive blood cultures processed in the microbiology laboratory in accordance with REMIC (reference in medical microbiology)and EUCAST(European Committee on Antimicrobial Susceptibility Testing). Contaminated blood cultures were excluded. As results we collected 863 positive blood cultures, A. baumannii accounted for 7.41% (n = 64). 67% (n =43) of the strains were isolated from patients hospitalized in intensive care (adults, children and newborns). The two main risk factors described in patients with our series were wearing of intravascular device in 55% (n=35) Immunosuppression in 22% n=14). A. baumannii bacteremia was associated with care in 37.5% (n=24). 75% (n=48) of A. baumannii isolates were resistant to carbapenems. No strain of A. baumannii was resistant to colistin. In light of these results strengthening the control and prevention measures for healthcare associated infections would be the most reliable way to limit the spread of A. baumannii in our establishment.

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Duvic, M., A. Forero-Torres, F. Foss, E. Olsen, L. Pinter-Brown e Y. Kim. "Long-term treatment of CTCL with the oral PNP inhibitor, forodesine". Journal of Clinical Oncology 27, n. 15_suppl (20 maggio 2009): 8552. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.8552.

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8552 Background: Forodesine is a potent inhibitor of purine nucleoside phosphorylase (PNP) that leads to T-cell selective intracellular accumulation of dGTP, resulting in apoptosis. Methods: An open-label dose escalation study of oral forodesine (40–320 mg/m2 daily) for 4 wks with extended therapy was performed to determine the maximum tolerated and/or optimal biologic dose (OBD). Additional subjects were accrued at an OBD (80 mg/m2) to further assess safety and clinical efficacy. Subjects with refractory CTCL, stages IB-IV were eligible. The primary efficacy endpoint (objective response rate [ORR]) was defined as ≥ 50% improvement by a severity-weighted assessment tool (mSWAT). Results: The overall intent to treat response rate was 17 of 64 (27%) subjects or 14 of 36 (39%) at the OBD. As of October 2008, nine of 64 subjects (14%) have received forodesine treatment for >12 months. This cohort of 9 subjects is further examined. Six discontinued treatment (median time on treatment 440 days): 4 for progressive disease, 1 withdrew consent, and 1 due to an adverse event (Diffuse Large B-cell Lymphoma). Three are continuing on therapy for 416, 710, and 863 days. Median age was 68 years (range 42, 81), and all but one was ≥ stage III. They had received a median of 3 prior systemic therapies including 8 of 9 with prior bexarotene. Five of 9 subjects had a response (2 with complete response, 3 with partial response, and 4 with stable disease). Related AEs were experienced by 7 of 9 subjects. The most frequent were nausea (44%), fatigue, peripheral edema, dyspnea, and urinary casts (all 22%). Grade 3 or higher related AEs were experienced by 2 of 9 subjects (Diffuse Large B-Cell Lymphoma as previously mentioned and peripheral edema). There were no hematologic or infection AEs related to forodesine. Grade 3 lymphopenia and CD4 count < 200 were noted in 8 of 9 and 4 of 9 subjects respectively. The risk of any infection AE regardless of cause in these 9 subjects was 15 per 100 person-months of forodesine exposure compared to 59 in all other subjects (n=55). Conclusions: Forodesine has an acceptable safety profile and efficacy in these CTCL subjects treated for 12 months or longer. [Table: see text]

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Matsuda, Shinichiro, Ritsuro Suzuki, Masaya Inoue, Ritsuko Seki, Koji Nagafuji, Hiroaki Miyoshi, Koichi Ohshima e Junji Suzumiya. "Clinical and Prognostic Significance of Epstein-Barr Virus in Diffuse Large B-Cell Lymphoma". Blood 128, n. 22 (2 dicembre 2016): 108. http://dx.doi.org/10.1182/blood.v128.22.108.108.

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Abstract Introduction: Diffuse large B-cell lymphoma (DLBCL) is the largest subtype of lymphoma, but consists of heterogeneous groups with different prognosis. Many studies conducted to determine prognosis factors of DLBCL. Recently, several studies have been reported that the elderly Epstein-Barr virus (EBV)-positive DLBCL patients showed worse prognosis than the elderly EBV-negative DLBCL. (Oyama T et al. Clin Cancer Res 2007;13:5024-5032). On the other hand, other studies reported that EBV-positivity is not a prognosis factor in young-adult DLBCL patients (Hong JY et al. Annals of Oncology 2015;26:548-555, Nicolae A et al. BLOOD 2015;126:863-872). In the present study, retrospective analyses were carried out for patients with DLBCL diagnosed between 1990 and 2007 to analyze the clinical and prognostic significance of EBV. Patients: Those who met the following criteria were included in the study: (i) pathology confirmed de novo DLBCL, according to the WHO classification; (ii) adequate amount and quality of paraffin-embedded biopsy specimens or unstained slides for EBV-encoded RNA in situ hybridization. Statistical methods: Intergroup comparisons were carried out with Fisher's exact test for categorical variables and the Mann-Whitney test for age. For survival analysis, we carried out Kaplan-Meier and multivariate proportional hazard (Cox) analyses. Statistical analyses were carried out using the software Stata SE version 14.0. Results: A total of 456 patients were included. The median follow up duration of survivor was 100 months (range, 1.9-363). There were 236 male (51.75%) and 220 female patients (48.25%) with a median age of 67 (range, 22-94) years. 246 patients (54.0%) were in advanced (III/IV) stage, 134 (29.4%) presented with poor Eastern Cooperative Oncology Group Performance Status (ECOG-PS), 275 (60.3%) with elevated lactate dehydrogenase (LDH) level, 263 (57.7%) with extranodal involvement of 1 or more sites, and 64 (14.0%) with bulky mass. As a consequence, 211 patients (46.3%) were in high/high-intermediate International Prognostic Index (IPI) categories. 5 years overall survival (OS) was 66.2%, in total. EBV was detected in samples from 47 patients (10.3 %). The positivity was 10.6% (15 / 142) in patients of 60 years or younger, and 10.2 % (32 / 314) in those older than 60 years (p = 0.51). No differences in back ground date were found between EBV - positive and negative DLBCLs regarding age (median 66.5 vs. 64.8, P = 0.17), male sex (88.1% vs. 11.9%, P = 0.16), advanced stage (88.2% vs. 11.8%, P = 0.17), poor ECOG-PS (90.3% vs. 9.7%, P = 0.47), elevated LDH (89.5% vs. 10.6%, P = 0.48), extranodal sites of one or more (90.5% vs. 9.5%, P = 0.31), bulky mass (92.2% vs. 7.8%, P = 0.33), and higher IPI categories (88.6% vs. 11.4%, P = 0.29). The prognosis was also not different between EBV-positive and negative DLBCLs. The 5 years OS was 42.6% for EBV-positive DLBCLs, and 56.4% for EBV-negative DLBCLs (P = 0.11). The same results were found for the younger (53.3% vs. 66.9%, P = 0.30) and the elderly patients (42.9% vs. 51.8%, P = 0.18). Conclusion: In this practice based, uncontrolled study, EBV-positively wad not different in younger and elderly DLBCLs. Although EBV-positive DLBCL showed worse trend of prognosis, the difference was not statistically significant. The significance of EBV in DLBCL should be reconsidered in unbiased, large-scale patient date. Figure Figure. Disclosures Suzuki: Chugai: Honoraria; Bristol-Myers Squibb: Honoraria; Kyowa Hakko kirin: Honoraria. Suzumiya:Chugai: Research Funding, Speakers Bureau; Astellas: Research Funding; Toyama Chemical: Research Funding; Eizai: Research Funding; Takeda: Speakers Bureau; Kyowa Hakko Kirin: Research Funding.

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LU, X., X. ZHAO, C. BAI, C. ZHAO, G. LU e G. XU. "Corrigendum to “LC–MS-based metabonomics analysis” [J. Chromatogr. B 866 (2008) 64]". Journal of Chromatography B 874, n. 1-2 (15 ottobre 2008): 125. http://dx.doi.org/10.1016/j.jchromb.2008.09.001.

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Howarth, David E., Jayne L. Kennedy, Andrew M. Will, Trevor F. Carr e Wynn Robert. "Does the Use of Different Factor VIII Products Influence Inhibitor Formation in Patients with Haemaphilia A." Blood 106, n. 11 (16 novembre 2005): 4029. http://dx.doi.org/10.1182/blood.v106.11.4029.4029.

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Abstract This retrospective study looked at all patients with Haemophilia A who attended Manchester Pendlebury Childrens Hospital for their first and subsequent Factor replacement therapy between January 1980 and May 2005. The aim was to determine :- Does an increased number of different products used influence inhibitor formation. Does using a B domain deleted factor (Refacto) concentrate influence inhibitor formation. Does changing from plasma derived to recombinant factor influence inhibitor formation. A total of 107 patients who received a cumulative total of 65,102 trearment days were identified and the following information was recorded for each patient :-severity of haemophilia (mild, moderate or severe) and baseline factor VIII level, date and age of first product, all types of products used, number of treatment days used of each product, detection of inhibitor and if present date of ocurrence and age of patient. The policy of the unit was to test for inhibitors every six months, pre operatively or when clinically indicated. Thirteen different products were in use during the period of the study :- AHFC(anti haemophilic factor concentrate), Cryoprecipitate, 8Y, 8SM, Alphanate, Replenate, Monoclate P, Helixate, Refacto, Recombinate, Hemophil M, Advate and Haemate P. Only 4 patients out of 107 developed inhibitors and all were exposed to less than 4 products. Inhibitor patient demographics Haemophilia type and baseline factor VIII Number of treatment days before inhibitor Products used with respective treatment days Severe (<1%) 249 Cryoprecipitate (128) 8Y(121) Severe (1%) 75 Alphanate(34) 8SM(34) Replinate(7) Moderate (2%) 39 Alphanate(30) Helixate(9) Moderate (2%) 18 Refacto(2) Helixate(16) A total of 37 patients received 6 or greater factor products. The mean number of treatment days was 1224 (median 1285, SDV 863) and the mean number of factor products used was 6.8 (median 7, SDV 0.81). In severe patients (baseline factor VIII of 2% or less) a total of 31 patients received 4 or greater factor products. The mean number of treatment days was 1512 (median 1501, SDV 776) and the mean number of factor products used was 6.45 (median 6, SDV 1.31). A total of 23 patients received 6 or greater factor products. The mean number of treatment days was 1664 (median 1525, SDV 776) and the mean number of products used was 7.04 (median 7, SDV 0.93). There were 10443 exposure days of Refacto in those patients that did not develop an inhibitor. 69 out of 103 patients were exposed to the product with a mean number of treatment days of 151 (median 43, SDV 237). In the same population 29 out of 43 severe patients (baseline factor VIII of 2% or less) were exposed to the product with a total number of exposure days of 6464 with a mean number of treatment days of 222 (median 241, SDV 241). There were only 2 exposure days of ReFacto in just one of the inhibitor patients. 64 patient changed from using plasma to recombinant products. Only one of these patients developed an inhibitor. In this study the number of different factors used, use of a B deleted domain factor and change from plasma derived to recombinant factors did not appear to be factors in the formation of inhibitors.

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Novak, Anne J., Takashi Akasaka, Michelle Manske, Tammy Price-Troska, Mamta Gupta, Thomas E. Witzig, Martin JS Dyer, Ahmet Dogan e Stephen M. Ansell. "Elevated Expression of GPR34 in Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma and Its Association with Increased Cell Growth, Erk Activation, and AP-1 and CRE-Mediated Transcription." Blood 114, n. 22 (20 novembre 2009): 3927. http://dx.doi.org/10.1182/blood.v114.22.3927.3927.

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Abstract Abstract 3927 Poster Board III-863 In previous studies we characterized the t(X;14)(p11.4;q32) translocation in a patient with MALT lymphoma and found that GPR34, an orphan G-protein coupled receptor (GPCR), was highly expressed due to its juxtaposition to the IGHSA2 switch region. As part of a larger MALT gene expression-profiling project, we have now acquired gene expression analysis on the patient carrying the t(X;14)(p11;q32) translocation and have confirmed overexpression of GPR34. We then measured GPR34 mRNA expression in a panel of MALT lymphomas (n=17) and found that GPR34 was expressed at levels higher than that seen in normal B cells (mean, 11.3 fold; median, 5.5; range, 1.4-64 fold). When analyzed separately, 70% (12/17) had an expression level greater than 3-fold over normal B cells. Of note, in a gastric MALT lymphoma specimen, we found a 64 fold increase in GPR34 mRNA expression. FISH studies performed on this specimen showed an extra intact GPR34 signal but no translocation involving IGH or GPR34, suggesting that other mechanisms, including gene dosage effect, can upregulate GPR34. Elevated expression of GPR34 mRNA was also detected in other histologic types of NHL, but not to the extent seen in MALT lymphoma. Taken together, these data suggest that GPR34 is commonly overexpressed in MALT lymphoma and that deregulation of GPR34 expression can occur independent of a t(X;14)(p11.4;q32) translocation. The receptor encoded by GPR34 is most similar to the PY2 receptor subfamily of GPCR and GPR34 mRNA transcripts are abundant in mast cells while lower levels were detected in other immune cells including B cells. Signals from GPR34 have been briefly described and the results to date suggest that overexpression of GPR34 results in an accumulation of inositol phosphates. To further characterize the impact of GPR34 overexpression on cell signaling, HeLa cells were transduced with a retroviral expression plasmid (pBMN-GFP) that expresses GPR34 and GFP. GFP expressing cells were isolated and overexpression of GPR34 mRNA was confirmed by PCR and GPR34 protein expression was detected by flow cytometry. When normalized to the isotype control, pBMN-GPR34 cells expressed 17-fold more GPR34 on their cell surface compared to the pBMN-vector control cells. To determine which signaling pathways were affected by GPR34 overexpression, pBMN-GPR34 or pBMN-vector control cells were transfected with an AP-1, CRE, NF-κB, E2F, SRE, NFAT, or ISRE- luciferase reporter plasmid. Upon normalization with renilla, pBMN-GPR34 expressing cells had increased luciferase activity (n=3) driven by AP-1 (5.35-fold), CRE (4.7), NF-κB (2.8-fold), and E2F (2.13) when compared to pBMN-vector control cells. ISRE, NFAT, and SRE mediated luciferase expression was similar in the GPR34 and control cells. AP-1 and CRE have been implicated in a large variety of cellular processes, including transformation, and both AP-1 and CRE activity is induced upon activation of MAP kinases. To determine if MAPK activity was also upregulated in GPR34 expressing cells, we analyzed the phosphorylation status of Erk1/2 in pBMN-GPR34 cells by western blot and found that Erk1/2 was constitutively phosphorylated in GRP34 expressing cells (1.8 fold increase) compared to vector control cells. Increased phosphorylation of PKC-α/β was also detected in pBMN-GPR34 cells (3.5 fold increase compared to control cells). To determine the biologic impact of GRP34 overexpression on cell growth, the proliferation rates of pBMN-control and pBMN-GPR34 cells were compared and it was found that proliferation of GPR34 expressing cells was 2.2 times higher than that seen in control cells. Because the MAPK kinase pathway was found to be active in the pBMN-GPR34 cells, we tested the effect of the MEK inhibitor PD98059 on proliferation and saw a dose dependent decrease in proliferation of GPR34 expressing cells. These results suggest that GPR34-mediated proliferation is Erk-dependent. In summary, these data suggest that deregulation of GPR34 is commonly found in MALT lymphoma and that overexpression of GPR34 results in activation of Erk1/2, phosphorylation of PKC, and results is AP-1 and CRE mediated transcription. Additionally, our data suggest that overexpression of GPR34 results in increased cell growth that is MAPK-dependent. Taken together, this studies indicate that overexpression of a GPCR, GPR34, may be a novel mechanism by which MALT, lymphoma, and potentially other subtypes of NHL, develop. Disclosures: No relevant conflicts of interest to declare.

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Sanchez-Bilbao, L., M. J. García-García, D. Martínez-López, M. Rivero-Tirado, B. Castro, I. González-Mazón, J. Crespo, M. A. González-Gay e R. Blanco. "POS1376 UVEITIS IN 1449 PATIENTS WITH INFLAMMATORY BOWEL DISEASE. STUDY FROM A SINGLE UNIVERSITY CENTER". Annals of the Rheumatic Diseases 80, Suppl 1 (19 maggio 2021): 970.1–970. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3610.

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Background:Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD), and Ulcerative colitis (UC) are related to Spondyloarthritis (SpA). Ocular manifestations (OM) are well-stablished in axial SpA but not in IBD. It has been classically reported that whereas uveitis with axial SpA is predominantly anterior, unilateral, acute, and non-recurrent; in IBD it is bilateral, posterior, insidious, and chronic (1).Objectives:In a large unselected series of IBD, our aim was to assess a) epidemiology and clinical features of uveitis associated to IBD, b) to compare patients who developed uveitis and those who did not, and c) its relationship with biological treatment used in IBD.Methods:Study of all consecutive patients from a single University Hospital during the last 40 years with: a) IBD (CD and UC), and b) uveitis according to Standarization Uveitis Nomenclature (SUN) Working Group. Demographic features, clinical findings, occurrence of other extraintestinal manifestations and treatment were recorded.Results:We studied 1449 (714 women/735 men) patients with IBD, mean age of 55.2±15.9 years.Uveitis was present in 23 (1.6 %) (38 eyes) of 1448 IBD patients. The most common pattern of uveitis was typically anterior (n=18; 78.3%), unilateral (n=19; 82.6%), acute (n=19; 82.6%), and non-recurrent (n=12; 52.2%).The comparative study between patients with and without uveitis showed a significant predominance of women (Table 1) in patients with uveitis, as well as erythema nodosum, hidradenitis suppurativa and joint involvement.Regarding IBD severity, in terms of surgical interventions, and conventional and biological immunosuppressive treatments, there were no significant differences.Conclusion:Although uveitis is more infrequent in IBD than in axial SpA, it is also anterior, unilateral, acute, and non-recurrent in contrast with published data from selected series. Patients with uveitis do not seem to represent more severe phenotype of IBD.References:[1]Lyons & Rosenbaum JT. Arch Ophthalmol 1997; 115:61-4.Table 1.General features of 1448 patients with IBD with and without uveitis.Overall(n=1449)Uveitis(n=23)Non uveitis(n=1426)pMain general featuresAge, years, mean±SD55.2±15.949.1±14.655.2±15.90.8Sex, women/men, n, (% of women)714 / 735 (49.3)17 / 6 (73.9)697 / 729 (48.9)0.02*IBD duration, years, mean±SD13.2 ± 9.717.4 ± 10.213.1 ± 8.90.08IBD SeveritySurgical Interventions, n (%)289 (19.9)2 (8.7)284 (19.9)0.7Conventional Immunosuppressive drugs, n (%)878 (60.6)14 (60.9)863 (60.5)0.5Biological Therapy, n (%)384 (26.5)7 (30.4)378 (26.5))0.9TNFi monoclonal antibodies384 (26.5)7 (30.4)378 (26.5)0.9Ustekinumab27 (1.9)1 (4.3)27 (1.9)0.5Other23 (1.6)1 (4.3)22 (1.6)0.3Extraintestinal manifestationsCutaneous manifestations, n (%) (TOTAL)125 (8.6)9 (39.1)121 (8.7)0.1Erythema nodosum, n (%)26 (1.8)6 (26.1)24 (1.7)0.009*Pyoderma gangrenosum, n (%)13 (0.9)1 (4.3)13 (0.9)0.7Hidradenitis suppurativa, n (%)2 (0.1)1 (4.3)1 (0.1)0.0001*Joint involvement, n (%) (TOTAL)131 (9)10 (43.5)121 (8.5)0.0001*Axial pattern, n (%)65 (4.5)4 (17.4)58 (4.1)0.0001*Peripheral pattern, n (%)64 (4.4)4 (17.4)63 (4.4)0.9Disclosure of Interests:Lara Sanchez-Bilbao: None declared, María José García-García: None declared, David Martínez-López: None declared, Montserrat Rivero-Tirado: None declared, Beatriz Castro: None declared, Iñigo González-Mazón: None declared, Javier Crespo: None declared, Miguel A González-Gay Speakers bureau: AbbVie, Pfizer, Roche, Sanofi, Celgene and MSD., Grant/research support from: AbbVie, MSD, Jansen and Roche,, Ricardo Blanco Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD., Grant/research support from: AbbVie, MSD and Roche

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Bradwell, Arthur R., Neil D. Evans, Mike J. Chappell, Paul Cockwell, Steven D. Reid, John Harrison, Colin Hutchison e Graham P. Mead. "Rapid Removal of Free Light Chains from Serum by Hemodialysis for Patients with Myeloma Kidney." Blood 106, n. 11 (16 novembre 2005): 3482. http://dx.doi.org/10.1182/blood.v106.11.3482.3482.

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Abstract Introduction. Acute renal failure (ARF) develops in 10–15% of patients with multiple myeloma (MM). Typically, complexes of serum free light chains (sFLC) and Tamm-Horsfall protein form casts in the distal tubules that block urine flow. Many patients, subsequently, require long-term hemodialysis (HD) and may have reduced survival. In an attempt to minimise renal damage, plasma exchange (PE) has been used to reduce the pre-renal load of sFLC. Zucchelli et al., (Kidney Int1988; 33:1175–1180) showed that PE reduced HD requirements but subsequent controlled trials showed no benefit (Johnson WJ et al., Arch Intern Med1990; 150:863–869: Clarke WF et al., Haematologica2005; 90(s1) p117). The availability of sFLC immunoassays now allows an informed evaluation of the role of PE and/or HD in treating these patients. Methods. sFLC were measured in 1: 100 patients with chronic renal failure (CRF), GFR< 15ml/min and not on dialysis; 2: 38 at the beginning and end of HD (dialyzer A) and 3: 25 on chronic ambulatory peritoneal dialysis (CAPD). sFLC hemofiltration efficiency was assessed, in-vitro, for three different dialyzers, using standard pump pressures and flow rates. Sera containing approximately 1,000 mg/L of monoclonal kappa (κ ) (NR < 20mg/L) and lambda (λ ) FLC (NR < 27mg/L) were recycled for ~45 minutes through the dialyzers and clearance rates assessed. A two-compartment, mathematical model was constructed to assess sFLC removal by HD and PE from hypothetical patients. The following parameters were considered:- sFLC concentrations in MM at clinical presentation; monomeric κ or dimeric λ clearance differences; partition of sFLC between vascular and extravascular compartments; flow of FLC between compartments; half-life of sFLC in ARF; sFLC production and tumour killing rates with chemotherapy. The model was interrogated for various dialysis times, different dialyzers and a PE protocol of 3L, x6 over 2 weeks. Results. Mean sFLC concentrations in severe CRF were: κ 93 mg/L (range 43–207); λ 64 mg/L (range 43–134). Mean sFLC before and after HD: κ 130 mg/L (range 40–567) to 49 (range 20–234); λ 100 mg/L (range 31–225) to 61 (range 24–159). Mean sFLC in CAPD patients: κ 118 mg/L (range 31–266); λ 114 mg/L (range 36–263). Clearances of sFLC by the 3 dialyzers were: A: BBraun high flux polyethersulfone 1.8sqm (HI PeS) (the dialyzer in routine use); κ 46%: λ 39%, B: Idmesa high flux polyethersulphone 2.0sqm (200MHP); κ 67%: λ 59%, C: Asahi high flux polysulphone 2.1sqm (APS 1050); κ 71%: λ 65%. Model calculations showed that sFLC reduced from a starting value of 14g/L (typical of light chain MM) to less than 0.5g/L in 14 days using PE. Membrane A, used for four hours, x3/week, was approximately 20% more efficient than PE and reduced κ sFLC approximately 50% faster than the natural clearance rate of patients in ARF. Dialyzers B and C were approximately twice as efficient. Performing initial, 16-hour dialyses daily for 3 days, with dialyzer C reduced sFLC to less than 0.5g/L in 2–3 days with ~95% of the sFLC being removed. Dimeric λ sFLC were removed ~50% more slowly. Conclusion. PE was less efficient at removing sFLC than routine HD. Prolonged HD with high-flux dialyzers removed monoclonal sFLC quickly and should be assessed in a clinical trial for patients with acute myeloma kidney. CAPD was inefficient at removing sFLC.

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Mirza, A., Z. Win Naing, P. Khonsari, H. Khan, P. Rezai, A. K. Abbas e M. Nisar. "POS1421 AROMATASE INHIBITORS AND SKELETAL HEALTH – NATURAL HISTORY AND INTERVENTIONAL EPIDEMIOLOGY". Annals of the Rheumatic Diseases 81, Suppl 1 (23 maggio 2022): 1054.1–1054. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2165.

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BackgroundBreast cancer remains the most common cancer diagnosed in women worldwide. Aromatase inhibitors (AI) are employed for hormone sensitive disease in mainly postmenopausal women. AI related bone loss (AIBL) is a known complication; although data regarding the natural history in the real-world, long-term outcomes and the role of bone active therapy in fracture prevention is sparse.ObjectivesOur aim was to determine the real-world impact of AIBL and whether bone sparing therapy utilising standard risk stratification model is sufficient for fracture prevention.MethodsWe undertook a longitudinal study of patients prescribed AI for breast cancer over a seven-year period at our university teaching hospital. All the data was recorded electronically with full access to demographics, disease parameters, investigations and drug management. DEXA scans performed prior to initiation of AI were compared with subsequent imaging over a mean follow up of 3 years. Outcome data for cancer and all fractures was collected. Statistical analysis was done to investigate significant relationships amongst the variables of interest.Results1001 women were identified during the study period. The mean age of the cohort was 64 years (range 29-93). 929 (93%) were Caucasian, 57 (6%) were Asian and 15 (1%) were Afro-Caribbean. 723 women (72%) were diagnosed with invasive ductal carcinoma and 863 women (86%) were postmenopausal. At diagnosis, 428 women (43%) had node positive disease and 35 women (4%) had metastases. 91 women (9%) had sustained fractures prior to their breast cancer diagnosis.All women had a baseline DEXA: 496 (49.6%) had osteopenia, 151 (15%) had osteoporosis and 354 (35.4%) had a normal result. 478 (48%) of women had a repeat scan available. Overall, there was a decline (from a mean of 0.888 g/cm2 to 0.858 g/cm2, p<0.0001) in left neck of femur (LNOF) bone mineral density (BMD) over time (mean of 3 years, with a range of 1-6).334 (33%) were prescribed bone active therapy with 276 women (83%) given oral bisphosphonates. This group had an improvement in BMD by 0.4% (LNOF mean BMD of 0.785 g/cm2 at baseline compared to LNOF mean BMD of 0.788 at repeat DEXA, p=0.82).Women who were not offered any treatment (n=667, 66%), showed a significant decline in bone density with the decline being -5%. (LNOF mean BMD of 0.939 g/cm2 at baseline compared to LNOF mean BMD of 0.888 g/cm2 at repeat DEXA, p< 0.0001).The rate of fractures remained the same between the treatment (19 fractures, 5.67%) and non-treatment group (38 fractures, 5.70%)ConclusionOur study provides long term data for AIBL and confirms a significant decline in BMD over seven years. It confirms that bone sparing therapy is effective in reducing the pace of decline in BMD. However standard risk stratification model such as FRAX based intervention thresholds in mainly those with WHO defined osteoporosis (T ≤-2.5) is ineffective in fracture prevention in keeping with prior literature. Since our study period overlaps with publication of newer guidelines recommending different T score-based risk model, further studies are required to confirm their utility.References[1]https://www.wcrf.org/dietandcancer/worldwide-cancer-data/. Date accessed: 26.01.2022[2]R. Coleman, J.J. Body, M. Aapro, et al., Bone health in cancer patients: ESMO clinical practice guidelines, Ann. Oncol. 25 (Suppl 3) (2014) iii124–iii137.[3]E. Amir, B. Seruga, S. Niraula, et al., Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis, J. Natl. Cancer Inst. 103 (2011) 1299–1309.Disclosure of InterestsNone declared

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Pho, Nguyen Van, Pham Tich Xuan e Pham Thanh Dang. "Occurrence of supergene nickel ores in the Ha Tri Massive, Hoa An District, Cao Bang Province". VIETNAM JOURNAL OF EARTH SCIENCES 40, n. 2 (19 gennaio 2018): 154–65. http://dx.doi.org/10.15625/0866-7187/40/2/11676.

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Nickel (Ni) laterites are regolith materials derived from ultramafic rocks and play an important role in the world's Ni production. Ni-laterite deposits are the supergene enrichment of Ni formed from the intense chemical and mechanical weathering of ultramafic parental rocks. In Vietnam, the weathering profile containing Ni laterite was first discovered in the Ha Tri massive (Cao Bang). This profile develops on the Ha Tri serpentinized peridotite rocks classified to the Cao Bang mafic-ultramafic complex (North Vietnam) and exhibits thick weathered zone (10 - 15m). This work carried out a detailed study of the weathering profile at the center of Ha Tri massive. Samples from different horizons of the profile were collected and analyzed in detail by XRF, XRD and SEM-EDX methods to establish the relationship between the Ni-rich supergene products and the parental peridotites (lherzolite) rocks in Ha Tri massive. The results show that the saprolite horizon is most Ni-rich in the weathering profile in Ha Tri. In this horizon, Ni-silicate minerals of garnierite group such as pimelite, nepouite and other Mg-Ni silicates have been found. The appearance of minerals of garnierite group is due to the exchange of Mg by Ni during weathering of peridotite minerals, especially olivine, which leads to the enrichment of the supergene Ni. The occurrence of Ni silicates suggests the existence of the supergene Ni ore in the weathering profile of the Ha Tri massive.References Bosio N.J., Hurst J.V., Smith R.L., 1975. Nickelliferousnontronite, a 15 Å garnierite, at Niquelandia, Goias Brazil. Clays Clay Miner., 23, 400-403. Brand N.W., Butt C.R.M., Elias M., 1998. Nickel Laterites: Classification and features. AGSO Journal of Australian Geology & Geophysics, 17(4), 81-88. Bricker O.P., Nesbitt H.W. and Gunter W.D., 1973. The stability of talc. American Mineralogist, 58, 64-72. Brindley G.W. and Hang P.T., 1973. The nature of garnierites. Structures, chemical composition and color characteristics. Clay and Clay Minerals, 21, 27-40. Brindley G.W. and Maksimovic Z., 1974. The nature and nomenclature of hydrous nickel-containing silicates. Clay Minerals, 10, 271-277. Brindley G.W. and Wan H.M., 1975. Composition structures and thermal behavior of nickel containing minerals in thelizardite-ne´pouite series. American Mineralogist, 60, 863-871. Brindley G.W., Bish D.L. and Wan H.M., 1979. Compositions, structures and properties of nickel containing minerals in the kerolite-pimelite series. American Mineralogist, 64, 615-625. Cluzel D. and Vigier B., 2008. Syntectonic mobility of supergene nickel ores from New Caledonia (Southwest Pacific). Evidence from faulted regolith and garnierite veins. Resource Geology, 58, 161-170. Colin F., Nahon D., Trescases J.J., Melfi A.J., 1990. Lateritic weathering of pyroxenites at Niquelandia, Goais, Brazil: The supergene behavior ofnickel: Economic Geology, 85, 1010-1023. Das S.K., Sahoo R.K., Muralidhar J., Nayak B.K., 1999. Mineralogy and geochemistry of profilesthrough lateritic nickel deposits at Kansa,Sukinda, Orissa. Joural of Geoogical. SocietyIndia, 53, 649-668. Decarreau A., Colin F., Herbillon A., Manceau A., Nahon D., Paquet H., Trauth-Badaud D.,Trescases J.J., 1987. Domain segregation in NiFe-Mg-Smectites. Clay Minerals, 35, 1-10. Freyssinet P., Butt C.R.M. and Morris R.C., 2005. Oreforming processes related to lateritic weathering. Economic Geology, 100th aniversary volume, 681-722.Garnier J., Quantin C., Martins E.S., Becquer T., 2006. Solid speciation and availability of chromium in ultramafic soils from Niquelandia, Brazil. Journal of Geochemical Exploration, 88, 206-209. Garnier J., Quantin C., Guimarães E., Becquer T., 2008. Can chromite weathering be a source of Cr in soils? Mineralogy Magazine, 72, 49-53. Gleeson S.A., Butt C.R. and Elias M., 2003. Nickel laterites: A review. SEG Newsletter, 54, 11-18. Gleeson S.A., Butt C.R., Wlias M., 2003. Nickellaterites: a review. SEG Newsletter, Society of Economic Geology, 54. Available from www.segweb.org. Golightly J.P., 1981. Nickeliferous laterite deposits. Economic Geology, 75th Anniversary volume, 710-735. Golightly J.P., 2010. Progress in understanding the evolution of nickel laterite. Society of Economic Geology, In Special Publication, 15, 451-485. Manceau A. and Calas G., 1985. Heterogeneous distribution of nickel in hydrous silicates from New Caledonia ore deposits. American Mineralogist, 70, 549-558. Nguyen Van Pho, 2013. Tropic weathering in Vietnam (in Vietnamese). Pubisher Science and Technology, 365p.Ngo Xuan Thanh, Tran Thanh Hai, Nguyen Hoang, Vu Quang Lan, S. Kwon, Tetsumaru Itaya, M. Santosh, 2014. Backarc mafic-ultramafic magmatism in Northeastern Vietnam and its regional tectonic significance. Journal of Asian Earth Sciences, 90, 45-60.Pelletier B., 1983. Localisation du nickel dans les minerais ‘‘garnieritiques’’ de Nouvelle-Caledonie. Sciences Ge´ologique: Me´moires, 73, 173-183.Pelletier B., 1996. Serpentines in nickel silicate ores from New Caledonia. In Grimsey E.J., and Neuss I. (eds): Nickel ’96, Australasian Institute of Miningand Metallurgy, Melbourne, Publication Series 6(9), 197-205. Proenza J.A., Lewis J.F., Galı´ S., Tauler E., Labrador M., Melgarejo J.C., Longo F. and Bloise G., 2008. Garnierite mineralization from Falcondo Ni-laterite deposit (Dominican Republic). Macla, 9, 197-198. Soler J.M., Cama J., Galı´ S., Mele´ndez W., Ramı´rez, A., andEstanga, J., 2008. Composition and dissolution kinetics ofgarnierite from the Loma de Hierro Ni-laterite deposit,Venezuela. Chemical Geology, 249, 191-202. Springer G., 1974. Compositional and structural variations ingarnierites. The Canadian Mineralogist, 12, 381-388. Springer G., 1976. Falcondoite, nickel analogue of sepiolite. The Canadian Mineralogist, 14, 407-409.Svetlitskaya T.V., Tolstykh N.D., Izokh A.E., Phuong Ngo Thi, 2015. PGE geochemical constraints on the origin of the Ni-Cu-PGE sulfide mineralization in the Suoi Cun intrusion, Cao Bang province, Northeastern Vietnam. Miner Petrol, 109, 161-180.Tran Trong Hoa, Izokh A.E., Polyakov G.V., Borisenko A.S., Tran Tuan Anh, Balykin P.A., Ngo Thi Phuong, Rudnev S.N., Vu Van Van, Bui An Nien, 2008. Permo-Triassic magmatism and metallogeny of Northern Vietnam in relation to the Emeishan plume. Russ. Geol. Geophys., 49, 480-491.Trescases J.J., 1975. L'évolution supergene des roches ultrabasiques en zone tropicale: Formation de gisements nikelifères de Nouvelle Caledonie. Editions ORSTOM, Paris, 259p.Tri T.V., Khuc V. (eds), 2011. Geology and Earth Resources of Vietnam. Publishing House for Science and Technology, 645p (in English). Villanova-de-Benavent C., Proenza J.A., GalíS., Tauler E., Lewis J.F. and Longo F., 2011. Talc- and serpentine-like ‘‘garnierites’’ in the Falcondo Ni-laterite deposit, Dominican Republic. ‘Let’s talk ore deposits’, 11th Biennial Meeting SGA 2011, Antofagasta, Chile, 3p.Wells M.A., 2003. Goronickel laterite deposit. New Caledonia. CRC LEME, p.3.

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Hering, Dagmara, Brad S. Hubbard, Michael A. Weber e Richard R. Heuser. "Impact of Renal Pelvic Denervation on Systemic Hemodynamics and Neurohumoral Changes in a Porcine Model". American Journal of Nephrology 52, n. 5 (2021): 429–34. http://dx.doi.org/10.1159/000516186.

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Introduction: The blood pressure (BP) response to arterial renal denervation (RDN) is variable. Methods: This study examined the effectiveness of renal pelvic denervation (RPD) on BP, heart rate (HR), norepinephrine (NE), and histopathology in 42 swine. NE levels were measured immediately, 7, 14, 30, and 90 days after RPD. Intra-arterial BP and HR were measured throughout RPD and after 14 days in 5 swine. Results: During the procedure, RPD immediately reduced systolic BP (−20.6 ± 18.3 mm Hg), diastolic BP (−6.0 ± 8.3 mm Hg), and HR (−5.4 ± 5.6 bpm), which remained decreased at follow-up. The porcine kidneys had a mean NE reduction of 76% directly post procedure and 60% after 7 days, 64% after 14 days, 57% after 30 days, and 65% after 90 days. Histopathological examination confirmed nerve ablation. Conclusions: These preliminary findings suggest that the renal pelvis nerve ablation is an encouraging target for RDN. Clinical trials are required to test the feasibility of RPD in human hypertension.

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Bousahba, A., e F. Bereksi-Reguig. "Gemcitabin (G) plus cisplatin (P) versus etoposid (E) plus cisplatin in advanced/metastatic non-small cell lung cancer (NSCLC): Preliminary results of a randomized monocentric study". Journal of Clinical Oncology 25, n. 18_suppl (20 giugno 2007): 18155. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.18155.

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18155 Background: we performed a randomized monocentric study to compare the treatment response of two chemotherapy doublets EP versus GP. Survival rates and toxicity are the secondary endpoints. Methods: from December 2003 to October 2006, patients with non-operable stage IIIB /IV histological or cytological proven NSCLC, ECOG PS = 2, were randomized to: (A) gemcitabin 1250 mg/m2 on d 1, 8 plus cisplatin 80 mg/m2 on d1 q3w for 6 cycles or (B) cisplatin at same dose followed by etoposid 100 mg / m2 on d1, 2, 3 q3w. The sample size was estimated at 64 patients per treatment arm to provide a power of 0.80 to detect a 20% difference in response rate between the two groups at the 5% level. Results: one hundred thirteen chemonaïve patients were enrolled (A: 57, B: 56), median age 61 years (arm A) and 57.5 years (arm B), stage IIIB (42.1% A vs 41.1% B), two or more metastatic sites (34% A, 39% B), PS 1 (68.4% A, 69.6% B). 360 cycles were administered 187 (A) and 173 (B) with a median of 3 cycles per patient in each group. Two patients were excluded from analysis. One hundred one patients were evaluable for toxicity, 90 for response. 47 pts were evaluable in A and 43 pts in B with treatment response in intent to treat principle respectively: complete response (1.8% - 0%), partial responses (29.1% and 20.7%). The objective response rate was 30.9% (95% CI 18.8%-43.2%) in A, 20.7% (95% CI 9.8%-31.6%) in B, no change (36.4% and 37.7%) and progressive disease (18.2% and 22.6%). Median duration of objective response 8.2 months (A) and 8.3 months (B), median time to progression : 8.0 months (A) and 7.5 months (B). Incidences of grade 3–4 toxicities were respectively in arms A and B: nausea-vomiting (37%-12.5%), leucopenia (5.6%-14.6%), neutropenia (13%-37.5%), thrombopenia (0–2.1%), anemia (13%-6.3%). Febril neutropenia occurred in 1.9% (A) and 8.3% (B). One toxic death occurred in arm B. Conclusions: preliminary analysis indicates that GP had a more favourable toxicity profile and a higher activity is suggested for the GP regimen. The enrolment is continued. No significant financial relationships to disclose.

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Trushkova, N. V., e G. Zelano. "IntelligenceGym — is an effective tool to improve cognitive functions in the elderly". Russian Journal of Geriatric Medicine, n. 1 (19 aprile 2021): 60–64. http://dx.doi.org/10.37586/2686-8636-1-2021-60-64.

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Aim. The aim of our study was to verify the effectiveness of the innovative IntelligenceGym training in improving cognitive abilities in the elderly.Material and methods. We developed an original training method that requires interaction between motor and cognitive functions. In our study 123 women and 89 men, aged 68–76 were examined. The inclusion criteria were Mini-Mental State Examination (MMSE) scores of 23 to 25 at inclusion, autonomy in walking, medical certification to participate in light physical activity. We have proposed to the participants to attend IntelligenceGym training one hour twice a week for 24 weeks. Cognitive performance was assessed before and after intervention included MMSE, Forward and Backward Digit Span Test, Rey’s Auditory Verbal Learning test (RAVLT), TMT-A, TMT-B. Moreover, motor performance was tested by using the Time Up and Go (TUG) test.Results.The cognitive assessment after IntelligenceGym training showed statistically significant improvement in all the scores tested (t-test performed). The results showed that participants of the IntelligenceGym training had particularly improved performance in Digit Span, MMSE and TMT-B tests and also improvements in motor TUG test.Conclusion. These findings indicate that the IntelligenceGym training is an efficient tool to improve cognitive performance in older adults with borderline or mild cognitive deficiency.

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Raftopoulos, Christian, Pierre Mathurin, Dutcho Boscherini, Rudolf F. Billa, Michel Van Boven e Philippe Hantson. "Prospective analysis of aneurysm treatment in a series of 103 consecutive patients when endovascular embolization is considered the first option". Journal of Neurosurgery 93, n. 2 (agosto 2000): 175–82. http://dx.doi.org/10.3171/jns.2000.93.2.0175.

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Object. The aim of this study was to evaluate prospectively the results of treating cerebral aneurysms with coil embolization (CE) or with surgical clipping when CE was considered the first option.Methods. Whenever an aneurysm was to be treated, CE was first considered by our neurovascular team. Surgical clipping was reserved for cases excluded from CE or cases in which CE failed. The study consisted of 103 consecutive patients with 132 aneurysms, of which 127 were treated. Coil embolization was performed using Guglielmi detachable coils, and surgery was performed using Zeppelin clips. Three groups were defined: Group A consisted of 64 aneurysms that were treated by CE (neck/sac ratio < 1:3); Group B, 63 aneurysms that were surgically clipped; and Group C, 12 aneurysms that failed to be satisfactorily (≥ 95%) embolized and were subsequently clipped. The percentages of residual aneurysm were 31.2% in Group A, 1.6% in Group B, and 0% in Group C. The percentages of patients with poor Glasgow Outcome Scale (GOS) scores (GOS Scores 1–3) were 13.3% in Group A, 6.1% in Group B, and 8.3% in Group C. The percentages of poor outcome (GOS Scores 1–3) in patients with good clinical status before treatment were 10.7% in Group A, 0% in Group B, and 8.3% in Group C.Conclusions. Even with preselection, CE remains associated with a significant number of treatment failures and poor outcomes, even in patients with good preoperative clinical status. Surgical clipping can offer better results than CE, even for more complex aneurysms of the anterior circulation, especially for those involving the middle cerebral artery cases. However, because CE can be effective and causes less stress and invasiveness for the patient, it should be considered first in aneurysms strictly selected by a neurovascular team.

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Doria-Medina, Roberto, Ulrich Hubbe, Christoph Scholz, Ronen Sircar, Johannes Brönner, Herbert Hoedlmoser e Jan-Helge Klingler. "Free-Hand MIS TLIF without 3D Navigation—How to Achieve Low Radiation Exposure for Both Surgeon and Patient". Journal of Clinical Medicine 12, n. 15 (4 agosto 2023): 5125. http://dx.doi.org/10.3390/jcm12155125.

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Background: Transforaminal lumbar interbody fusion (TLIF) is one of the most frequently performed spinal fusion techniques, and this minimally invasive (MIS) approach has advantages over the traditional open approach. A drawback is the higher radiation exposure for the surgeon when conventional fluoroscopy (2D-fluoroscopy) is used. While computer-assisted navigation (CAN) reduce the surgeon’s radiation exposure, the patient’s exposure is higher. When we investigated 2D-fluoroscopically guided and 3D-navigated MIS TLIF in a randomized controlled trial, we detected low radiation doses for both the surgeon and the patient in the 2D-fluoroscopy group. Therefore, we extended the dataset, and herein, we report the radiation-sparing surgical technique of 2D-fluoroscopy-guided MIS TLIF. Methods: Monosegmental and bisegmental MIS TLIF was performed on 24 patients in adherence to advanced radiation protection principles and a radiation-sparing surgical protocol. Dedicated dosemeters recorded patient and surgeon radiation exposure. For safety assessment, pedicle screw accuracy was graded according to the Gertzbein–Robbins classification. Results: In total, 99 of 102 (97.1%) pedicle screws were correctly positioned (Gertzbein grade A/B). No breach caused neurological symptoms or necessitated revision surgery. The effective radiation dose to the surgeon was 41 ± 12 µSv per segment. Fluoroscopy time was 64 ± 34 s and 75 ± 43 radiographic images per segment were performed. Patient radiation doses at the neck, chest, and umbilical area were 65 ± 40, 123 ± 116, and 823 ± 862 µSv per segment, respectively. Conclusions: Using a dedicated radiation-sparing free-hand technique, 2D-fluoroscopy-guided MIS TLIF is successfully achievable with low radiation exposure to both the surgeon and the patient. With this technique, the maximum annual radiation exposure to the surgeon will not be exceeded, even with workday use.

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Chughtai, Umer Javed. "To Determine the Efficacy of Antibiotic Prophylaxis in patients Undergoing Flexible Cystoscopy". Pakistan Journal of Medical and Health Sciences 16, n. 5 (26 maggio 2022): 24–25. http://dx.doi.org/10.53350/pjmhs2216524.

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Background: Flexible cystoscopy is a commonly performed intervention in urology practice. It has both diagnostic and therapeutic value and has an added advantage of being used as an outpatient procedure. However one of the common complication associated with it, is the development of Urinary tract infection (UTI) because of its minimally invasive nature. Aim: To determine the efficacy of antibiotic prophylaxis in patients undergoing flexible cystoscopy. Methods: A randomized control study was performed in total 144 patients selected for flexible cystoscopy. Patients were divided into Group A (Antibiotic group) and Control Group B. Group A received a single dose of Levofloxacin 500mg one hour before procedure, while no antibiotic prophylaxis was given to Group B. Primary outcome was development of UTI, which was assessed by subjective symptoms of UTI, results of urine culture and routine urine examination at 1st week after the procedure Results: After 1 week of procedure, 5 patients (6.9%) in Group A and 7 patients (9.7%) in Group B developed UTI. 3 patients (4.1%) in Group A and 6 patients (8.3%) in Group B developed asymptomatic bacteriuria after 1 week. 64 patients (88.9%) in Group A and 59 patients (81.9%) in Group B did not develop UTI after 1 week of procedure Conclusion: Prophylactic use of antibiotics before flexible cystoscopy has no effect in reducing the frequency of post procedure urinary tract infections Keywords: Urinary Tract Infection UTI), Cystoscopy, Antibiotic prophylaxis

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Holmberg, M., S. McGill, C. Ehrenborg, L. Wesslén, E. Hjelm, J. Darelid, L. Blad, L. Engstrand, R. Regnery e G. Friman. "Evaluation of Human Seroreactivity to BartonellaSpecies in Sweden". Journal of Clinical Microbiology 37, n. 5 (1999): 1381–84. http://dx.doi.org/10.1128/jcm.37.5.1381-1384.1999.

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Among the species that compose the expanding genusBartonella, thus far only B. henselae andB. quintana have reportedly been isolated from humans in Europe. To evaluate the prevalence of Bartonella infection in Sweden, we conducted a retrospective serological examination of 126 human serum samples. These samples were analyzed for antibodies toB. henselae, B. quintana, and B. elizabethae. Serum samples from 100 blood donors, who spanned the ages of 20 to 60 and had no apparent clinical signs of illness, were also studied as a control group. An immunoglobulin G indirect fluorescence antibody assay revealed 4 and 8.3% Bartonellapositivity rates for the blood donor and patient group, respectively, when a cutoff titer of ≥64 was chosen. Among the blood donors, four were seropositive to B. elizabethae; one of these also had concordant positive titer to B. henselae. In the patient group, 14 serum samples were positive against Bartonellaspp. These serum specimens represented nine patients. In three of these seropositive patients, paired serum samples displayed a fourfold increase in antibody titer to at least one of the three antigens. These three patients are discussed. In this report we also present a case study of a 60-year-old Swedish male with fatal myocarditis. Postmortem serological analysis revealed a high titer against B. elizabethae. PCR and nucleotide sequencing of the myocardial tissue from this patient, and of liver tissue from one of the other three patients, showed sequences similar to B. quintana. The age, geographical origin, animal contacts, and serological response pattern to the different Bartonella antigens differed among the four patients. This study substantiates the presence ofBartonella spp. in Sweden, documents the seroreactivity to three Bartonella antigens in Swedish patients, and reports the first two cases of B. quintana-like infections in Sweden.

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Carles, Joan, Enrique Gallardo Diaz, Montserrat Domenech, Albert Font, Joaquim Bellmunt, Begoña Mellado, Cristina Suárez et al. "A phase IIb trial of docetaxel concurrent with radiotherapy plus hormotherapy versus radio hormonotherapy in high-risk localized prostate cancer (QRT SOGUG trial): Preliminary report for design, tolerance, and toxicity." Journal of Clinical Oncology 33, n. 7_suppl (1 marzo 2015): 15. http://dx.doi.org/10.1200/jco.2015.33.7_suppl.15.

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15 Background: Docetaxel improves survival in patients (pts) with metastatic hormonosensitive prostate cancer (PC) and castration-resistant prostate cancer. The objective of this phase IIb trial was to assess the activity of low dose docetaxel concurrent with radiotherapy plus standard hormonal treatment in pts with high risk localized CaP. Methods: High-risk localized CaP was defined by ≥ 1 of the following criteria: T3-T4, Gleason score (GS) ≥ 8, PSA > 20 ng/mL, pN+. Pts were randomly assigned to either arm A (LH-RH analogs every 3 months for 3 years and radiotherapy 73.8 Gy [1.8 Gy x 41 fractions] or 74 Gy [2Gy x 37 fractions]) or arm B (LH-RH analogs every 3 months for 3 years, radiotherapy and concurrent weekly docetaxel at 20 mg/m2 for 9 weeks). Chemotherapy was started one week before of radiotherapy. Primary endpoint was PSA relapse according to the Phoenix definition. The planned number of pts was 130 to detect a 15% difference with a power of 80% and an alpha of 0.05 (two-sided). Results: From 12/2008 to 9/2012, 130 pts were accrued (Arm A: 64, Arm B: 66). Median age was 68 years (61-73). Patients had T3-T4 (82.6%), GS ≥ 8 (76.3%), PSA > 20 ng/mL (26.9%) and pN+ (18.9%). All characteristics were well-balanced between arms. Median dose of radiotherapy was 74 Gy (72–74.8) in arm A, and 73.8 Gy ( 72-75.6) in arm B. 75.7% of pts received the planned 9 treatments of docetaxel and median number of cycles delivered per patient was 9. After a median follow-up of 29.6 months (9.6-40.2), most common grade 1/2 toxicities (arm A and arm B) were: cystitis ( 12.5% vs 8.3%), diarrhea (35.9% vs 70%), proctitis (12.5% vs 13.3%), rectal tenesmus (3.1% vs 23.3%), asthenia (23.4% vs 61.6%) and dysuria ( 28.1% vs 30.0%). Toxicity G3/G4 diarrhea was reported in 8.3% of pts in arm B and 0% in arm A. G3/G4 lymphopenia occurred less often in arm A than in arm B (3.1% vs 23.3%). %). There was no toxicity-related death. Conclusions: The QRT SOGUG phase IIb trial met its accrual target and shows that concurrent weekly docetaxel can be administered with standard doses of radiotherapy and without increasing toxicity profile. Clinical trial information: 2008-003554-14.

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Kouabla Liliane Siransy, Amah Patricia Victorine Goran-Kouacou, e Adjoumanvoulé Honoré Adou. "Screening and Titration of Anti-A and Anti-B Haemolysins in Blood Donors: An Essential Test for Transfusion Immunosafety of Packed Red Blood Cells". Sumerianz Journal of Medical and Healthcare, n. 63 (20 dicembre 2023): 20–27. http://dx.doi.org/10.47752/sjmh.62.20-27.

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The study aimed to examine the presence of anti-A and anti-B haemolysins in the serum of blood donors. Methods: A retrospective cross-sectional survey was conducted at the National Blood Transfusion Centre (CNTS) in Abidjan-Treichville, involving 1350 voluntary blood donors aged 18 to 65, belonging to blood groups A, B, and O. The immuno-haematology unit of the CNTS laboratory performed all biological analyses. Data collection forms from the CNTS Côte d’Ivoire computer system were used to collect socio-demographic data and haemolysin test results. Haemolysins were detected using a manual technique of direct haemagglutination of serum with A1 and B test red blood cells treated with papain, with titration performed through dilution series. Statistical analysis employed the Chi-square and Fisher tests at a 5% significance level. Results: Male donors constituted 86.3%, with a mean age of 31.8 ± 5.2 years, primarily in the 25-34 age group. The prevalence of haemolysins was 20.2%, with higher frequencies observed in males (73.3%, p=0.005), blood group O ((82.7%, p=0.000), and the 25-44 age group (49.8%, p<0.0001). Anti-B IgG was the most common haemolysin type (49.1%, p=0.0000). Anti-A IgG levels were notably higher in group O compared to group B (p=0.001) and in males compared to females (p=0.012), while anti-B IgG levels were higher in group O compared to group A (p<0.0001). Titration analysis indicated a prevalence of titration 2, with no high titres (≥ 64) detected. Conclusion: The study underscores that blood group O donors exhibited a higher likelihood of haemolysins. Despite generally low haemolysin titres, caution is advised during transfusions involving blood with these irregular antibodies due to their potential to cause severe complications in the recipient.

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Luceri, Francesco, Davide Cucchi, Enrico Rosagrata, Carlo Eugenio Zaolino, Alessandra Menon, Mattia Radici, Andrea Zagarella et al. "Novel Radiographic Indexes for Elbow Stability Assessment: Part B—Preliminary Clinical Study". Indian Journal of Orthopaedics 55, S2 (28 aprile 2021): 347–58. http://dx.doi.org/10.1007/s43465-021-00399-1.

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Abstract Introduction The coronoid process plays a key-role in preserving elbow stability. Currently, there are no radiographic indexes conceived to assess the intrinsic elbow stability and the joint congruency. The aim of this study is to present new radiological parameters, which will help assess the intrinsic stability of the ulnohumeral joint and to define normal values of these indexes in a normal, healthy population. Methods Four independent observers (two orthopaedic surgeons and two radiologists) selected lateral view X-rays of subjects with no history of upper limb disease or surgery. The following radiographic indexes were defined: trochlear depth index (TDI); anterior coverage index (ACI); posterior coverage index (PCI); olecranon–coronoid angle (OCA); radiographic coverage angle (RCA). Inter-observer and intra-observer reproducibility were assessed for each index. Results 126 subjects were included. Standardized lateral elbow radiographs (62 left and 64 right elbows) were obtained and analysed. The mean TDI was 0.46 ± 0.06 (0.3–1.6), the mean ACI was 2.0 ± 0.2 (1.6–3.1) and the mean PCI was 1.3 ± 0.1 (1.0–1.9). The mean RCA was 179.6 ± 8.3° (normalized RCA: 49.9 ± 2.3%) and the mean OCA was 24.6 ± 3.7°. The indexes had a high-grade of inter-observer and intra-observer reliability for each of the four observers. Significantly higher values were found for males for TDI, ACI, PCI and RCA. Conclusion The novel radiological parameters described are simple, reliable and easily reproducible. These features make them a promising tool for radiographic evaluation both for orthopaedic surgeons and for radiologists in the emergency department setting or during outpatient services. Level of evidence Basic Science Study (Case Series). Clinical relevance The novel radiological parameters described are reliable, easily reproducible and become handy for orthopaedic surgeons as well as radiologists in daily clinical practice.

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Chen, Weiyi, Adam Olsen, Seeta Chaganti, Jeff Halaas, Andrew D. Zelenetz, Julie Feldstein, Jane Houldsworth e Raju S. K. Chaganti. "Clinical Outcome Correlations of Genomic Gains and Losses in Diffuse Large B-Cell Lymphoma by Array-CGH." Blood 104, n. 11 (16 novembre 2004): 30. http://dx.doi.org/10.1182/blood.v104.11.30.30.

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Abstract Conventional karyotype and chromosomal comparative genomic hybridization (CGH) studies of diffuse large B-cell lymphoma (DLBCL) have revealed few chromosomal abnormalities associated with outcome. In order to evaluate the association between genomic copy number changes in DLBCL and clinical outcome at a higher resolution, we assayed a panel of 64 newly-diagnosed DLBCL specimens by array-CGH. For each specimen, the respective patient had a known response to anthracycline-based therapy, and the median follow-up was 5-years. Forward and reverse hybridizations were performed for all specimens to avoid dye-bias, using BAC/PAC arrays with 1-4 Mb resolution coverage of the genome (Spectral Genomics). After customized normalization, the circular binary segmentation (CBS) algorithm was used to identify regional copy number changes along each chromosome in each specimen. Of the 64 specimens, 59 (92%) displayed regional copy number changes. The frequency of gain/loss of each clone for all 64 specimens was then calculated based on the CBS results, and, additionally, based on singleton clone changes if they were outside of CBS-defined regions. Clones displaying change ≥ in 10% of specimens for at least two contiguous clones were further considered as recurrent sites for clinical correlations. 27 sites of recurrent gain and 25 sites of recurrent loss were identified. Association between loss or gain of sites and International Prognostic Index (IPI) were evaluated using Fisher’s exact test, and associations between loss or gain of sites and time to treatment failure (TTF) and overall survival (OS) were tested using the log-rank test. Table 1 lists the sites as independent markers that were significant at p < 0.05. Of these sites, five (with asterisk) were found to significantly predict outcome after stratifying by IPI using the stratified log-rank test. It is noted that 6 of the sites were 5 Mb or less in size, facilitating the identification of target genes. Losses of chromosome 7 (8–13 Mb) and chromosome 13 (56.7–63 Mb) were found to contribute to IPI prediction of outcome, but were not significantly associated with clinical features as independent markers. In summary, array-CGH has lead to the identification of several genetic markers with prognostic significance in DLBCL, which in some cases are of a size amenable for target gene identification. Significant Genetic Markers Associated with Clinical Outcome Chrom. Start (Mb) End (MB) Change # of cases IPI TTF OS 1 78.2 79.1 Loss 19 Better 2 2.4 4.1 Loss 8 Worse* 3 0.2 72.3 Gain 14 Better Better 3 101.3 136 Gain 18 Low Better 3 154.7 188.7 Gain 18 Low Better Better 6 62.2 170.5 Loss 32 Low Better Better 7 18.8 19.2 Loss 11 Better* 9 8.3 13 Loss 13 Better 9 83.9 96.3 Gain 9 Better 9 122.1 132.8 Gain 12 Better Better* 12 0 133.3 Gain 31 High 16 0.1 4.7 Gain 13 Better 16 33.8 35.6 Loss 7 Worse* Worse* 19 43.1 63.7 Gain 13 Better Better

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Ma, Yuxiang, Guohai Dong e Xiaozhou Ma. "SEPARATION OF LOW-FREQUENCY WAVES BY AN ANALYTICAL METHOD". Coastal Engineering Proceedings 1, n. 32 (31 gennaio 2011): 64. http://dx.doi.org/10.9753/icce.v32.waves.64.

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A new method for separating low-frequency waves in time domain is proposed by constructing the analytical signals of the measured waves. Using three simultaneous wave records, the time series of incident bound, free and reflected low-frequency waves can be obtained by the present method. This method is only suitable for separating monochromatic low-frequency waves. The applicability of the method is examined by numerical tests. The results show that the present method can give accurate results over sloping beaches when water depth (kh) is larger than 0.2. Then, the present method is used to study an experiment of low-frequency waves over a mild slope beach. References Bakkenes, H.J. 2002. Observation and separation of bound and free low-frequency waves in the nearshore zone, in Faculty of Civil Engineering and Geosciences. Delft University of Technology: Delft. Baldock, T.E., D.A., Huntley, P.A.D., Bird, T.O., Hare, and G.N., Bullock. 2000. Breakpoint generated surf beat induced by bichromatic wave groups. Coastal Engineering. 30 (2-4): 213-242. http://dx.doi.org/10.1016/S0378-3839(99)00061-7 Battjes, J.A., Bakkenes, H.J., Janssen, T.T., van Dongeren, A.R. 2004. Shoaling of subharmonic gravity waves. J. Geophys. Res., 109(C2): C02009. http://dx.doi.org/10.1029/2003JC001863 Bowers, E.C. 1977. Harbour resonance due to set-down beneath wave groups. Journal of Fluid Mechanics. 79: 71-92. http://dx.doi.org/10.1017/S0022112077000044 Cohen, L. 1995. Time Frequency Analysis: Theory and Applications. Prentice Hall Englewood Cliffs, New Jersey. Dong, G.H., X.Z., Ma, M., Perlin, Y.X., Ma, B., Yu, and G., Wang. 2009. Experimental Study of long wave generation on sloping bottoms. Coastal Engineering, 56(1), 82-89. http://dx.doi.org/10.1016/j.coastaleng.2008.10.002 Kamphuis, J.W. 2000. Designing for low frequency waves. Proceedings of 27th International Conference on Coastal Engineering. Sydney, Australian. 1434-1447. Kostense, J.K. 1984. Measurements of surf beat and set-down beneath wave groups. Proceedings of 19th International Conference on Coastal Engineering. Houston, USA. 724-740. Longuet-Higgins, M.S. and R.W., Stewart. 1962. Radiation stress and mass transport in gravity waves with application to 'surfbeat'. Journal of Fluid Mechanics. 13: 481-504 http://dx.doi.org/10.1017/S0022112062000877 Mallat, S. 1999. A Wavelet Tour of Signal Processing. Academic Press. PMCid:407895 Nagai, T., N., Hashimoto, T., Asai, et al. 1994. Relationship of a moored vessel in a harbor and a long wave caused by wave groups. Proceedings of 17th International Conference on Coastal Engineering. Kobe, Japan. 847-861. Schäffer, H.A. 1993. Second-orderwavemaker theory for irregularwaves.Ocean Engineering. 23 (1), 47–88. http://dx.doi.org/10.1016/0029-8018(95)00013-B Symonds, G.D.A., D.A., Huntley, and A.J., Bowen. 1982. Two-dimensional surf beat-long-wave generation by a time-varying breakpoint. Journal of Geophysical Research. 87(C1): 492-498. http://dx.doi.org/10.1029/JC087iC01p00492 Yu, J. and C.C., Mei. 2000. Formation of sand bars under surface waves. Journal of Fluid Mechanics. 416: 315-348. http://dx.doi.org/10.1017/S0022112000001063

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Seyferth, Anne V., Meghan N. Cichocki, Chien-Wei Wang, Yun-Ju Huang, Yi-Wei Huang, Jung-Sheng Chen, Chang-Fu Kuo e Kevin C. Chung. "Factors Associated With Quality Care Among Adults With Rheumatoid Arthritis". JAMA Network Open 5, n. 12 (12 dicembre 2022): e2246299. http://dx.doi.org/10.1001/jamanetworkopen.2022.46299.

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ImportanceAlthough quality care markers exist for patients with rheumatoid arthritis (RA), the predictors of meeting these markers are unclear.ObjectiveTo explore factors associated with quality care among patients with RA.Design, Setting, and ParticipantsA retrospective cohort study using insurance claims from 2009 to 2017 was conducted, and 6 sequential logistic regression models were built to evaluate quality care markers. Quality care markers were measured at 1 year post-RA diagnosis for each patient. The MarketScan Research Database, which contains commercial and Medicare Advantage administrative claims data from more than 100 million individuals in the US, was used to identify patients aged 18 to 64 years with a diagnosis claim for RA. Patients with conditions presenting similar to RA and missing demographic characteristics were excluded. Data analysis occurred between February 18 and May 5, 2022.ExposuresSuccess or failure to meet selected RA quality care markers within 1 year after RA diagnosis.Main Outcomes and MeasuresPrevalence of meeting successive quality care markers for RA.ResultsAmong 581 770 patients, 430 843 (74.1%) were women and the mean (SD) age was 48.9 (11.3) years. Most patients (236 285 [40.6%]) resided in the South and had an income less than or equal to $45 200 (490 366 [84.3%]). Of the total study population, 399 862 individuals (68.7%) met at least 1 quality care marker and 181 908 (31.3%) met 0 markers. Most commonly, patients met annual laboratory testing (299 323 [51.5%]) and referral to a rheumatologist (256 765 [44.1%]) markers. The least met marker was receiving hepatitis B screening prior to initiation of disease-modifying antirheumatic drug (DMARD) therapy (18 548 [3.2%]). Women were most likely to meet all quality care markers except receiving DMARDs with hepatitis B screening (odds ratio, 1.14; 95% CI, 1.12-1.16). Individuals with lower median household income had lower odds of receiving a rheumatologist referral, an annual physical examination, or annual laboratory testing, but greater odds of receiving the other quality care markers. Patients with Medicare and those with comorbidities were generally less likely to meet quality care markers.Conclusions and RelevanceIn this cohort study of patients with RA, findings indicated downstream associations with rheumatologist referral and receiving DMARDs and varied associations between meeting quality care markers and patient characteristics. These findings suggest that prioritizing early care, especially for vulnerable patients, will ensure that quality care continues.

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Ravaud, Alain, Carlos H. Barrios, Boris Y. Alekseev, Miah Hiang Tay, Sanjiv S. Agarwala, Suayib Yalcin, Chia-Chi Lin et al. "Randomized phase II study of first-line everolimus plus bevacizumab (E+B) versus interferon α-2a plus bevacizumab (I+B) in patients (pts) with metastatic renal cell carcinoma (mRCC): Record-2 final overall survival (OS) and safety results." Journal of Clinical Oncology 31, n. 15_suppl (20 maggio 2013): 4576. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.4576.

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4576 Background: RECORD-2 (NCT00719264) primary analysis demonstrated similar median progression-free survival (PFS) for pts with mRCC treated with E+B and I+B (Dec 2011 cut-off). The primary objective was not met; median PFS in E+B/I+B was 9.3/10.0 mo (HRIFN/EVE, 0.91; 95% CI, 0.69-1.19; P=0.485) and probability of success (PoS) of a subsequent phase III trial was 5.1%. Here we present final OS and safety/exposure results (Aug 2012 cut-off). Methods: Untreated pts with clear cell mRCC and previous nephrectomy were randomized 1:1 to B 10 mg/kg every 2 weeks and either E 10 mg/day or I (9 MIU 3 times/week). The primary objective was treatment effect on PFS per central review based on an estimation of PoS (≥50%) of a subsequent phase III study. Secondary objectives included OS and safety. Results: In E+B (n=182) and I+B (n=183) arms, median age was 60/60 years and 76/72% of pts were men, respectively. In both arms, most pts (93%) were of favorable/intermediate MSKCC risk. Median follow-up was 33 mo. In E+B and I+B arms, 51/52% of pts died, respectively. Median OS (95% CI) was 27.1 mo (19.9-35.3) in the E+B arm and 27.1 mo (20.4-30.8) in the I+B arm. After discontinuing study treatment, 64/60% of pts in E+B and I+B arms, respectively, received antineoplastic therapy. Median exposure duration in E+B and I+B arms was 8.5/8.3 mo, respectively; AEs resulted in treatment discontinuation for 23/25% of pts, respectively. The most frequent AEs (%) were stomatitis (63), proteinuria (50), diarrhea (40), hypertension (38), and epistaxis (35) in the E+B arm and decreased appetite (45), fatigue (42), proteinuria (38), asthenia (35), and pyrexia (35) in the I+B arm. The most frequent grade 3/4 AEs (%) were proteinuria (24), stomatitis (11), and anemia (11) for E+B and fatigue (17), asthenia (14), and proteinuria (10) for I+B. Conclusions: OS of E+B and I+B was similar. OS results are consistent with PFS primary analysis. First-line treatment with mTOR inhibitor-based therapy did not impair chance of survival relative to standard therapy. No new safety issues were identified and E+B remained generally well tolerated. Clinical trial information: NCT00719264.

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Giommoni, Elisa, Evaristo Maiello, Vanja Vaccaro, Ermanno Rondini, Caterina Vivaldi, Giampaolo Tortora, Laura Toppo et al. "Activity and safety of Nab-FOLFIRI and Nab-FOLFOX as first-line treatment for metastatic pancreatic cancer (phase II NabucCO study)." Journal of Clinical Oncology 36, n. 4_suppl (1 febbraio 2018): 351. http://dx.doi.org/10.1200/jco.2018.36.4_suppl.351.

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351 Background: FOLFIRINOX is an approved regimen for metastatic pancreatic cancer (mPC). We performed a modification in FOLFIRINOX schedule, using nab-paclitaxel (nab-p) to obtain two regimens that could be as effective and less toxic than the original triplet. NabucCO study was a randomized phase II trial to assess activity and toxicity of nab-p instead of either oxaliplatin (Nab-FOLFIRI) or irinotecan (Nab-FOLFOX) in first line setting. Previous dose–finding NabucCO study defined that maximum tolerated dose of nab-p with FOLFIRI is 120 mg/m2, and with FOLFOX is 160 mg/m2. Methods: The study was a 1:1 parallel arm, open label, not comparative one to assess overall response rate (ORR) of Nab-FOLFIRI and Nab-FOLFOX as primary end-point. Patients (pts) with PS 0-1, untreated for mPC were randomized to receive leucovorin 400 mg/m2, 5FU bolus 400 mg/m2, 5FU 48h ci 2400 mg/m2, irinotecan 180 mg/m2 plus nab-p 120 mg/m2 (arm A) or leucovorin 400 mg/m2, 5FU bolus 400 mg/m2, 5FU 48h ci 2400 mg/m2 and oxaliplatin 85 mg/m2 iv plus nab-p 160 mg/m2 (arm B) every 2 weeks for up to 12 cycles. Secondary end points were clinical benefit rate (CBR), progression free survival (PFS), overall survival (OS), and safety. Results: From November 2015 to January 2017, 84 pts were treated (42 for each arm). Median age was 60 years (29-65) in arm A and 64 years (47-64) in arm B. The ORR was 31 % for both schedules, with a CBR of 69% and 71%, respectively. At a median follow-up of 11.4 months for arm A and 14.5 months for arm B (censored on august, 31th 2017), 1-year survival is 41% and 50%, respectively. For Nab-FOLFIRI PFS and mOS were 6 months (90% CI: 4.9-8.0) and 13.2 months (90% CI: 8.3-14.8), while in Nab-FOLFOX were 5.6 months (90% CI:4.9-7.2) and 10.8 months (90% CI: 8.4-12.8). Grade ≥3 toxicities in arm A were neutropenia (19%) and febrile neutropenia (12%). In arm B, main grade ≥3 toxicities were neutropenia (29%), fatigue (14%), peripheral neuropathy (7%). No toxic death were registered. Conclusions: Nab-FOLFIRI and Nab–FOLFOX demonstrated a similar activity to FOLFIRINOX, with better safety profile in terms of neutropenia, fatigue and neuropathy. These results could justify a future phase III evaluation. Clinical trial information: NCT02109341.

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Soto-Sanfiel, María Teresa, Laura Aymerich Franch e Xavier Ribes Guàrdia. "Interactividad y contenido como factores de disfrute en las ficciones interactivas". Revista Latina de Comunicación Social, n. 64 (26 febbraio 2009): 668–81. http://dx.doi.org/10.4185/10.4185/rlcs-64-2009-853-668-681.

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Se reportan las conclusiones obtenidas de una investigación experimental que tiene por objetivos: 1.- explorar la relación entre interactividad, contenido y disfrute en la recepción de ficciones interactivas; 2.- observar el vínculo del disfrute con los conceptos de entretenimiento, agrado y gratificación, y 3.- indagar sobre la relación entre disfrute e intención manifiesta de consumo posterior, voluntad de pago por visión o predicción de éxito de las ficciones interactivas en televisión. 310 participantes fueron sometidos a cuatro situaciones experimentales derivadas de la combinación entre las variables modalidad de la ficción (interactiva o no interactiva) y contenido (final feliz o trágico). Los resultados señalan que: a.- el contenido ejerce superior impacto en el disfrute de la narrativa que la interactividad; b.- los conceptos de disfrute, entretenimiento y gratificación, aunque relacionados, describen distintos aspectos de la experiencia de consumo, y 3.- el disfrute se vincula con la voluntad de consumo posterior.

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Bagley, Stephen, Jacob Shabason, Divij Mathew, Shawn Kothari, Derek Oldridge, Arati Desai, Robert Lustig et al. "CTIM-35. A PHASE II STUDY OF GITR AGONIST INCAGN01876 AND PD-1 INHIBITOR RETIFANLIMAB IN COMBINATION WITH STEREOTACTIC RADIOTHERAPY IN PATIENTS WITH RECURRENT GLIOBLASTOMA". Neuro-Oncology 24, Supplement_7 (1 novembre 2022): vii69. http://dx.doi.org/10.1093/neuonc/noac209.267.

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Abstract BACKGROUND We evaluated the combination of retifanlimab, INCAGN01876, and FSRT in patients with recurrent GBM. METHODS Phase II, single-center, 2 cohort study (A: single-arm non-surgical cohort; B, two-arm neoadjuvant/surgical cohort). Cohort A patients received pre-FSRT one-time doses of retifanlimab (500mg) and INCAGN01876 (300mg), FSRT (8 Gy x 3 fractions), and post-FSRT 28-day treatment cycles (retifanlimab, day 1; INCAGN01876, days 1, 15). Cohort B patients received pre-surgery doses of retifanlimab + INCAGN01876; subsequently, patients either went directly to resection (Sub-Arm 1) or to FSRT followed by resection (Sub-Arm 2). All patients resumed immunotherapy post-operatively. Primary endpoint: ORR in Cohort A. Data cut-off for this analysis was June 30, 2022. RESULTS Thirty-two evaluable patients: Cohort A, n=16; Cohort B, n=16 (Sub-Arm 1, n=8, Sub-Arm 2, n=8). Median follow-up time: Cohort A, 13.6 months; Cohort B, 8.8 months. Forty-four percent women, median age 64 (IQR, 55–65), 56% MGMT unmethylated. Most common grade 3/4 treatment-related AEs included cerebral edema (25%), lymphopenia (16%), and cognitive disturbance (13%). Efficacy in Cohort A: no objective responses observed, best response of stable disease achieved in 9/16 patients (56%), median PFS 3.9 months (95% CI 2.1 – 6.2 months), median OS 9.8 months (95% CI 8.3 months – not reached [NR]). Efficacy in Cohort B: median PFS NR, median OS 15.1 months (95% CI 8.5 months – NR). Median PFS and OS are longer in Cohort B Sub-Arm 2 compared to Cohort B Sub-Arm 1 (PFS, NR vs. 2.2 months, p = 0.009; OS, NR vs. 8.5 months, p=0.026). Results of tissue and blood-based immune correlative analyses will be presented. CONCLUSIONS The combination of retifanlimab, INCAGN01876, and FSRT is generally well-tolerated in patients with recurrent GBM when administered with or without surgical resection. Survival outcomes in the neoadjuvant cohort are encouraging, largely driven by patients that received neoadjuvant FSRT.

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Patil, Kamal, SS Singla e MB Nagmoti. "Group B Streptococci Colonization in Pregnant Women: Is Screening Necessary?" Journal of South Asian Federation of Obstetrics and Gynaecology 5, n. 2 (2013): 64–67. http://dx.doi.org/10.5005/jp-journals-10006-1226.

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ABSTRACT Objectives Group B Streptococcus (GBS) has been recognized as the leading cause of serious neonatal infections through mother—fetal vertical transmission in the west, however, in India, its spectrum is largely under estimated. The present study was carried out to find the incidence of rectovaginal carriage of GBS in parturient women, association with risk factors in mother and to study the neonatal outcome. Materials and methods A one year cross-sectional prospective study was carried out in 905 parturient women admitted at a tertiary care center meeting the selection criteria over a period of one year from June 2007 to May 2008. The inclusion criteria were all pregnant women admitted to the labor room after 35 ± 1 week of gestation. Rectal and vaginal swabs were taken and cultured on selective Todd-Hewitt broth medium followed by sub culture on blood agar and confirmation by Latex agglutination test from all the women meeting the inclusion criteria. The outcomes measured were the incidence, antenatal risk factors in mother and the neonatal outcome. Analysis was done using paired ‘t’ test, chi-square test and a p-value of <0.05 was taken as statistically significant. Results Incidence of group B Streptococcus (GBS) was 12.15% and detection rate was increased by 4.6% with the inclusion of rectal swabs for culture. GBS carriage was significantly increased with preterm birth (OR 8.3, 95% CI,1.1- 15.5), premature rupture of membranes (OR 7.5, 95% CI, 1.1- 13.4), prolonged duration of ruptured membranes more than 10 hours (OR 21, 95% CI,15.2-34.2) and intrapartum temperature more than 38°C(OR 3.1, 95% CI, 0.43-6.66). Birth weight less than 2.5 kg and neonatal intensive care admissions were significantly more (35.45%) in infants of GBS positive women. Conclusion GBS colonization was more frequent in women with risk factors. GBS pick up rate was increased by the inclusion of both rectal and vaginal swabs. How to cite this article Patil KP, Singla SS, Nagmoti MB, Swamy MK. Group B Streptococci Colonization in Pregnant Women: Is Screening Necessary? J South Asian Feder Obst Gynae 2013;5(2):64-67.

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Duarte, M., J. Sousa Morais, R. Faria, B. Guerra Leal, A. Marinho, J. Correia, F. Farinha, P. Pinho Costa, B. Martins Da Silva e C. Vasconcelos. "AB1026 INFLAMMATORY MANIFESTATIONS IN PATIENTS WITH HUMAN LEUKOCYTE ANTIGEN-B*51 POSITIVE AND WITHOUT BEHÇET’S DISEASE". Annals of the Rheumatic Diseases 79, Suppl 1 (giugno 2020): 1805.2–1806. http://dx.doi.org/10.1136/annrheumdis-2020-eular.6572.

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Background:Human leukocyte antigen (HLA) B*51 allele is the most important genetic factor in susceptibility to Behçet’s disease (BD), an immune-mediated systemic disorder of unknown etiology, characterized by recurrent episodes of inflammatory manifestations. In fact there is a considerable clinical overlap of BD with autoinflammatory syndromes. As it’s known, the majority of HLA-B*51 positive individuals do not develop BD. But do these individuals also present inflammatory manifestations?Objectives:Characterize the group of individuals in our hospital with positive HLA-B*51, without BD diagnosis and review whether inflammatory manifestations are present in these individuals.Methods:A retrospective study of HLA-B*51 positive patients between 2000 and 2019. Genomic DNA was obtained from peripheral blood and HLA genotyping was performed using a PCR with Sequence Specific Primers (PCR–SSP) methodology. From the group of 289 B*51 positive patients, BD diagnosis were excluded. Demographic and clinical data were collected by review of clinical files in December 2019.Results:176 patients, mean age of 48.5 ± 16.5 years (5 to 84 years). Most were female (68%). The HLA study was motivated by multiple diagnostic suspicions: spondyloarthritis (SpA, 25.0%), BD (22.7%) and systemic sclerosis (SSc, 10.8%). The mean time elapsed since the immunogenetic study was 8.3 years, with 12 deaths recorded. 69 (39.2%) subjects had no diagnosis for immune-mediated disease (IMD). Of the other 107 patients, the majority had 1 IMD (64.5%), and the rest were diagnosed with 2 to 4 IMD. The most frequent IMD were SpA (20.8%), psoriasis (10.4%), psoriatic arthritis (9.7%), SSc (9.7%) and rheumatoid arthritis (7.1%). Autoantibodies were detected in 94 individuals (53.4%): antinuclear antibodies (64 patients), rheumatoid factor (26 patients) and CCP antibodies (11 patients). In 55 individuals no inflammatory manifestation was identified but the 68.8% of them presented between 1 to 7 manifestations:System involvedClinical manifestationFrequencyEars, nose and throatChronic rhinitis32 (13.2%)∑ = 76 (31.4%)Recurrent tonsillitis20 (8.3%)Other24 (9.9%)Cutaneous, mucous and serousRecurrent oral aphtous ulcers34 (14.0%)∑ = 57 (23.6%)Serositis10 (4.1%)Other13 (5.4%)NeurologicalChronic headache34 (14.0%)∑ = 36 (14.9%)Asseptic meningitis2 (0.8%)OcularOcular inflammation31 (12.8%)∑ = 31 (12.8%)UrinaryRecurrent cystitis15 (6.2%)∑ = 15 (6.2%)VascularVenous thromboembolism7 (2.9%)∑ = 14 (5.8%)Aneurysm6 (2.5%)Spontaneous coronary dissection1 (0.4%)RheumaticArthromyalgia6 (2.5%)∑ = 9 (3.7%)Gout3 (1.2%)ConstitutionalRecurrent fever syndrome1 (0.4%)∑ = 1 (0.4%)DigestiveRecurrent abdominal pain1 (0.4%)∑ = 1 (0.4%)LymphaticAxillary and inguinal adenopathies1 (0.4%)∑ = 1 (0.4%)PulmonaryChronic pulmonary infiltrate1 (0.4%)∑ = 1 (0.4%)Conclusion:Inflammatory manifestations are common in HLA-B*51 positive individuals, even in those without BD diagnosis. Further research is needed, considering other HLA alleles associated with increased risk of BD and including control groups.References:[1]Burillo-Sanz S, Montes-Cano M, García-Lozano J,et al. Behçet´s disease and genetic interactions between HLA-B*51 and variants in genes of autoinflammatory syndromes.Sci Rep2019;9:2777.[2]McGonagle D, McDermott MF. A Proposed Classification on the Immunological Diseases.PLoS Med2006;3(8):e297.[3]Tong B, Liu X, Xiao J, Su G. Immunopathogenesis of Behcet´s Disease.Front. Immunol2019;10:665.Disclosure of Interests:None declared

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Cheng, Isaac, Ho So, Carson CY Yip, Ying Ying Leung, Kichul Shin, Muhammad Ahmed Saeed, Praveena Chiowchanwisawakit et al. "Abstract 16 — Are We Treating-to-Target on Spondyloarthritis (SpA)? A One-Year Analysis from the Asia Pacific League of Associations for Rheumatology (APLAR) SpA Registry". Journal of Clinical Rheumatology and Immunology 23, Supp01 (novembre 2023): 38–40. http://dx.doi.org/10.1142/s2661341723740322.

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Background This analysis aimed to evaluate the extent of treat-to-target (T2T) achievement after 1-year intensive treatment in patients enrolled to the APLAR SpA registry. Methods Patients who fulfilled the CASPAR2006 for psoriatic arthritis (PsA), and 2009ASAS criteria for axial spondylitis (AxSpA) were recruited. Current analysis included the first 143 patients reaching the 1-year timepoint across 7 Asia-Pacific regions (Hong Kong, Singapore, Korea, India, Pakistan, Qatar and Thailand). Results 79 patients with PsA(age: 52±13 years, 43(55%) male, disease duration: 8.0±8.3 years) and 64 patients with AxSpA (age:41±16 years, 48(75%) male, disease duration: 4.8±7.2 years) were included. There were significant improvement in Disease Activity in Psoriatic Arthritis (DAPSA) (22.1±14.4 at baseline vs 11.5±10.0 at 1-year, p<0.001) while Ankylosing Spondylitis Disease Activity Score (ASDAS) remained stable. Other characteristics are listed in Table 1. Concerning the medication use, there was an increase in the number of patients receiving biologic/target synthetic disease-modifying drug (b/tsDMARDS, 29% at baseline to 61% at 1-year for PsA, and 52% at baseline to 64% at 1-year for AxSpA) (Fig. 1). Regarding T2T, 62% and 45% of PsA patient achieved DAPSA-low disease activity (DAPSA-LDA) and minimal disease activity (MDA) respectively, while 53% of patients with Axial SpA achieved ASDAS-LDA. The use of b/tsDMARDs was significantly higher in patient who achieved MDA when compared to those who did not (Fig. 1). The MDA/ASDAS-LDA achievement rate were comparable to that of the tight control arm of TICOPA cohort (41%) or TICOSPA study (60%) respectively. Treatment was escalated in 86% of visits when treatment target was not met. The reason for non-escalation of drug included: patients’choice (42%), mild symptoms only and physician decides to keep current regime (27%), adverse events (19%), no viable alternatives (8%) and others (4%). Conclusions Implementing the T2T strategy in patient with SpA was feasible in selected centres from the APLAR region, with similar target achievement rate compared to T2T studies conducted in Europe.

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Prasad, Durga, Anshu Srivastava, Anil Tambe, Surender Kumar Yachha, Moinak Sen Sarma e Ujjal Poddar. "Clinical Profile, Response to Therapy, and Outcome of Children with Primary Intestinal Lymphangiectasia". Digestive Diseases 37, n. 6 (2019): 458–66. http://dx.doi.org/10.1159/000499450.

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Objective: Intestinal lymphangiectasia (IL; primary or secondary) is an important cause of protein-losing enteropathy. We evaluated the clinicolaboratory profile, response to therapy, complications, and outcome of children with primary IL (PIL). Methods: Consecutive children (≤18 years) diagnosed with PIL (clinical setting, typical small bowel histopathology, and exclusion of secondary causes) from 2007 to 2017 were evaluated. Results: Twenty-eight children with PIL (16 boys, age at symptom onset-12 [1–192] months and at diagnosis 8 [1–18] years) were studied. Pedal edema (93%), chronic diarrhea (78.6%), and recurrent anasarca (64%) were the common presentations. Ascites, pleural, and pericardial effusion were seen in 64 (n-18; chylous-5, non-chylous-13), 18, and 18% cases, respectively. Hypoproteinemia, hypoalbuminemia, hypocalcemia, and lymphopenia were present in 82, 82, 75 and 39% cases, respectively. Duodenal biopsy established the diagnosis in 86% cases, while 14% required distal small bowel biopsies. Dietary therapy was given in all and 6 cases required additional therapy (octreotide-6, tranexamic acid-3, and total parenteral nutrition-1). Lymphedema (3/5 vs. 1/23), pleural effusion (4/5 vs. 1/23), and the need for additional therapy (4/5 vs. 2/23) were significantly more in patients with chylous ascites (n = 5) than those without chylous ascites (n = 23). Twenty-four cases in follow-up (39 [6–120] months) showed improvement; however, 8 required readmission (symptom recurrence-6 [25%], complication-2 [8.3%], Budd Chiari Syndrome-1, and abdominal B cell lymphoma-1). Conclusion: Presence of chylous ascites suggests severe disease in children with PIL. Majority of PIL children respond to dietary therapy; only 20% need additional therapy. Long-term follow-up is essential to monitor for symptoms relapse and complications.

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Navarrete, José E., David C. Tong, Jason Cobb, Frederic F. Rahbari-Oskoui, Darya Hosein, Sheryl C. Caberto, Janice P. Lea e Harold A. Franch. "Epidemiology of COVID-19 Infection in Hospitalized End-Stage Kidney Disease Patients in a Predominantly African-American Population". American Journal of Nephrology 52, n. 3 (2021): 190–98. http://dx.doi.org/10.1159/000514752.

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Background: End-stage kidney disease patients on dialysis are particularly susceptible to COVID-19 infection due to comorbidities, age, and logistic constraints of dialysis making social distancing difficult. We describe our experience with hospitalized dialysis patients with COVID-19 and factors associated with mortality. Methods: From March 1, 2020, to May 31, 2020, all dialysis patients admitted to 4 Emory Hospitals and tested for COVID-19 were identified. Sociodemographic information and clinical and laboratory data were obtained from the medical record. Death was defined as an in-hospital death or transfer to hospice for end-of-life care. Patients were followed until discharge or death. Results: Sixty-four dialysis patients with COVID-19 were identified. Eighty-four percent were African-American. The median age was 64 years, and 59% were males. Four patients were on peritoneal dialysis, and 60 were on hemodialysis for a median time of 3.8 years, while 31% were obese. Fever (72%), cough (61%), and diarrhea (22%) were the most common symptoms at presentation. Thirty-three percent required admission to intensive care unit, and 23% required mechanical ventilation. The median length of stay was 10 days, while 11 patients (17%) died during hospitalization and 17% were discharged to a temporary rehabilitation facility. Age >65 years (RR 13.7, CI: 1.9–100.7), C-reactive protein >100 mg/dL (RR 8.3, CI: 1.1–60.4), peak D-dimer >3,000 ng/mL (RR 4.3, CI: 1.03–18.2), bilirubin >1 mg/dL (RR 3.9, CI: 1.5–10.4), and history of peripheral vascular disease (RR 3.2, CI: 1.2–9.1) were associated with mortality. Dialysis COVID-19-infected patients were more likely to develop thromboembolic complications than those without COVID-19 (RR 3.7, CI: 1.3–10.1). Conclusion: In a predominantly African-American population, the mortality of end-stage kidney disease patients admitted with COVID-19 infection was 17%. Age, C-reactive protein, D-dimer, bilirubin, and history of peripheral vascular disease were associated with worse survival.

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Weil, Matthias. "The Mixed-valent Mercury(I/II) Compounds Hg3(HAsO4)2 and Hg6As2O10". Zeitschrift für Naturforschung B 69, n. 6 (1 giugno 2014): 665–73. http://dx.doi.org/10.5560/znb.2014-4063.

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The mixed-valent mercury compounds Hg3(HAsO4)2 (= HgIIHgI 2(HAsO4)2) and Hg6As2O10 (= HgI 2HgII 2(AsO4)2·2HgIIO) were obtained from the reaction of (Hg3)3(AsO4)4 with arsenic acid (60 wt-%) carried out at 65 ºC and as a by-product under hydrothermal conditions, respectively. The crystal structure of Hg3(HAsO4)2 (Z = 2, C2/c, a = 13:010(3), b = 8:149(2), c = 9:496(3) Å, b = 126:864(4)º, 1427 structure factors, 64 parameters, R[F2 > 2 s(F2)] = 0:0272; wR (all F2) = 0.0490) contains a centrosymmetric O-Hg-Hg-O unit (d(Hg-Hg) = 2.5226(8) Å, d(Hg-O) = 2.141(5) Å), ∠(Hg-Hg-O) = 167:68(13)º) and an Hg2+ cation that is located on a twofold rotation axis showing an almost linear coordination to two O atoms (d(Hg-O) = 2.059(5) Å; ∠(O-Hg-O) = 177:3(2)º). The O-Hg-Hg-O and O-Hg-O units are linked by AsO3OH tetrahedra resulting in the formation of chains extending parallel to [102]. Strong hydrogen bonding (d(O···O) = 2.523(6) Å) between AsO3OH tetrahedra of neighbouring chains is observed. The crystal structure of Hg6As2O10 (Z = 2, P21=n, a = 6:94750(10), b = 8:9837(2), c = 8:9966(2) Å, b = 98:1630(10)º, 4842 structure factors, 83 parameters, R [F2 > 2 s(F2)] = 0:0269, wR (all F2) = 0.0577) contains an O-Hg-Hg-O unit (d(Hg-Hg) = 2.5337(3) Å, d(Hg-O) = 2.181(3) Å, ∠(Hg-Hg-O) = 168:05(10)º) and two O- Hg-O units (d(Hg-O) = 2.048(3), 2.072(3) Å, ∠(O-Hg-O) = 168:78(15)º; 2.149(4), 2.150(3) Å, 166:65(12)º) that are linked into a three-dimensional framework structure with As atoms of the AsO4 tetrahedra in the voids. An alternative structural description of Hg6As2O10 is presented under consideration of oxygen-centred [OHg4] tetrahedra.

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van Prehn, Joffrey, Koen L. Vincken, Bart E. Muhs, Gijsbrecht K. W. Barwegen, Lambertus W. Bartels, Mathias Prokop, Frans L. Moll e Hence J. M. Verhagen. "Toward Endografting of the Ascending Aorta: Insight into Dynamics Using Dynamic Cine-CTA". Journal of Endovascular Therapy 14, n. 4 (agosto 2007): 551–60. http://dx.doi.org/10.1177/152660280701400418.

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Purpose: To evaluate pulsatility and movement along the ascending thoracic aorta using dynamic electrocardiographically-gated 64-slice cine computed tomographic angiography (CTA). Methods: Diameter and area change and center of mass (COM) movement of the ascending thoracic aorta was determined per cardiac cycle in 15 patients at surgically relevant anatomical levels: (A) 5 mm distal to the coronary arteries, (B) 5 mm proximal to the innominate artery, and (C) halfway up the ascending aorta. Additionally, COM movement was determined 1 cm (level P) and 2 cm (level Q) distal from the origins of the innominate, left carotid, and left subclavian arteries. Eight gated datasets covering the cardiac cycle were used to reconstruct images at each level perpendicular to the aortic lumen. The distance between important anatomical landmarks was determined. Results: All levels showed significant cardiac cycle—induced diameter and area changes (p<0.001), with the largest pulsatility 5 mm distal to the coronary arteries. Mean maximum diameter changes were (A) 17.4%±4.8% (range 7.5%–27.5%), (B) 13.9%±3.5% (range 10.6%–25.0%), and (C) 12.9%±3.4% (8.3%–19.6%). Mean area changes were (A) 12.7%±5.5% (range 4.3%–21.8%), (B) 7.5%±2.0% (range 4.1%–11.0%), and (C) 5.6%±2.2% (range 1.9%–11.4%). Mean maximum COM movements were (A) 6.1±2.0 mm (range 2.7–9.0), (B) 2.3±1.1 mm (range 1.1–5.6), and (C) 3.6±1.5 mm (range 1.4–6.5). Mean COM movements of the innominate, left carotid, and left subclavian arteries, respectively, were (P) 1.960.7 mm (range 0.9–3.7), 2.4±0.6 mm (range 1.4–3.3), and 1.9±0.6 mm (range 0.8–2.8), and (Q) 1.8±0.7 mm (range 0.8–3.5), 1.8±0.6 mm (range 0.8–2.7), 1.9±0.6 mm (range 1.1–3.4). Conclusion: The dynamics of the ascending thoracic aorta and the arch vessels are impressive, showing a wide range of 3-dimensional motions. Future ascending arch branched and fenestrated thoracic endograft designs must consider this active local environment, as it may have implications for durability, sealing, and ultimate clinical success.

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Pereira, Karla de Castro, Eliane Dias Quintela, Vinicius A. do Nascimento, Daniel José da Silva, Dannilo V. M. Rocha, José Francisco A. Silva, Steven P. Arthurs, Moacir Rossi Forim, Fabiano Guimarães Silva e Cristiane de Melo Cazal. "Characterization of Zanthoxylum rhoifolium (Sapindales: Rutaceae) Essential Oil Nanospheres and Insecticidal Effects to Bemisia tabaci (Sternorrhyncha: Aleyrodidae)". Plants 11, n. 9 (22 aprile 2022): 1135. http://dx.doi.org/10.3390/plants11091135.

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Encapsulation via nanotechnology offers a potential method to overcome limited thermal and photo-stability of botanical pesticides. In this study, nanospheres of essential oils (NSEO) derived from Zanthoxylum rhoifolium Lam. fruit were characterized and evaluated for their photostability and insecticidal activity against Bemisia tabaci. Three major compounds of Z. rhoifolium fruits were detected by CG-MS: β-phellandrene (76.8%), β-myrcene (9.6%), and germacrene D (8.3%). The nanoprecipitation method was used to obtain homogeneous spherical NSEO, with ≥98% encapsulation efficiency. Tests with UV/Vis spectrophotometry showed significantly reduced photodegradation from exposed NSEO samples when compared with essential oil (EO) controls. Whitefly screenhouses bioassays with bean plants treated with 0.25, 0.5, 1 and 1.5% suspensions showed EO treatments in both free and nanoencapsulated forms reduced adult whitefly oviposition by up to 71%. In further tests, applications at 1.5% caused ≥64% mortality of second instar nymphs. When the test was conducted under high temperature and light radiation conditions, the insecticidal effect of NSEO treatments was improved (i.e., 84.3% mortality) when compared to the free form (64.8%). Our results indicate the insecticidal potential of EO-derived from Z. rhoifolium fruits with further formulation as nanospheres providing greater photostability and enhanced insecticidal activity against B. tabaci under adverse environmental conditions.

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Faqah, Anadil, Summaiya Asif, Suleyman Yasin Goksu e Hassan S. Sheikh. "Real-World Data (RWD) on the 3-Year Follow-Up Outcomes of Different CNS Prophylaxis Strategies Across CNS-IPI Risk Groups in Patients With Diffuse Large B-Cell Non-Hodgkin Lymphoma". JCO Global Oncology, n. 7 (aprile 2021): 486–94. http://dx.doi.org/10.1200/go.20.00422.

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PURPOSE CNS relapse in patients with diffuse large B-cell lymphoma (DLBCL) is associated with poor prognosis with a median survival of about 2.5 months. Data demonstrating best prophylactic strategy remain controversial and need further definition. PATIENTS AND METHODS We present data of 110 patients with DLBCL treated with standard systemic therapy divided into four groups based on primary CNS prophylaxis strategy and CNS International Prognostic Index (IPI) risk categories. We compared their 3-year CNS relapse rate and overall survival in each group. RESULTS The CNS prophylaxis strategy consisted of intrathecal (IT) methotrexate (MTX) in group 1, high-dose (HD) MTX in group 2, combination IT and HD MTX in group 3, and IT and/or HD MTX with intensive chemotherapy in group 4. At 3 years, CNS relapse rate was 8.6% (4/46), 8.3% (1/12), 4.8% (2/42), and 18% (2/11) in groups 1-4 ( P = .64), respectively. According to CNS IPI, the CNS relapse rate was 16.6%, 10.1%, and 0% in high-, intermediate-, and low-risk groups, respectively. The 3-year overall survival rate was 69%, 75%, 80%, and 45% in groups 1-4 ( P = .71), respectively. CONCLUSION Our study while did not find statistical significance did indicate a lower incidence of CNS relapse with the addition of systemic HD MTX to IT MTX in the high-risk DLBCL population.

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Nastoupil, Loretta J., Michael D. Jain, Lei Feng, Jay Y. Spiegel, Armin Ghobadi, Yi Lin, Saurabh Dahiya et al. "Standard-of-Care Axicabtagene Ciloleucel for Relapsed or Refractory Large B-Cell Lymphoma: Results From the US Lymphoma CAR T Consortium". Journal of Clinical Oncology 38, n. 27 (20 settembre 2020): 3119–28. http://dx.doi.org/10.1200/jco.19.02104.

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PURPOSE Axicabtagene ciloleucel (axi-cel) is an autologous CD19-directed chimeric antigen receptor (CAR) T-cell therapy approved for relapsed/refractory large B-cell lymphoma (LBCL) on the basis of the single-arm phase II ZUMA-1 trial, which showed best overall and complete response rates in infused patients of 83% and 58%, respectively. We report clinical outcomes with axi-cel in the standard-of-care (SOC) setting for the approved indication. PATIENTS AND METHODS Data were collected retrospectively from all patients with relapsed/refractory LBCL who underwent leukapheresis as of September 30, 2018, at 17 US institutions with the intent to receive SOC axi-cel. Toxicities were graded and managed according to each institution’s guidelines. Responses were assessed as per Lugano 2014 classification. RESULTS Of 298 patients who underwent leukapheresis, 275 (92%) received axi-cel therapy. Compared with the registrational ZUMA-1 trial, 129 patients (43%) in this SOC study would not have met ZUMA-1 eligibility criteria because of comorbidities at the time of leukapheresis. Among the axi-cel–treated patients, grade ≥ 3 cytokine release syndrome and neurotoxicity occurred in 7% and 31%, respectively. Nonrelapse mortality was 4.4%. Best overall and complete response rates in infused patients were 82% (95% CI, 77% to 86%) and 64% (95% CI, 58% to 69%), respectively. At a median follow-up of 12.9 months from the time of CAR T-cell infusion, median progression-free survival was 8.3 months (95% CI, 6.0 to15.1 months), and median overall survival was not reached. Patients with poor Eastern Cooperative Oncology Group performance status of 2-4 and elevated lactate dehydrogenase had shorter progression-free and overall survival on univariable and multivariable analysis. CONCLUSION The safety and efficacy of axi-cel in the SOC setting in patients with relapsed/refractory LBCL was comparable to the registrational ZUMA-1 trial.

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Perry, Ashley M., Tao Zou, Andrew M. Brunner, Donna S. Neuberg e Amir T. Fathi. "The Impact of Insurance Status at Diagnosis on Overall Survival in Chronic Myeloid Leukemia: A Population-Based Analysis". Blood 126, n. 23 (3 dicembre 2015): 631. http://dx.doi.org/10.1182/blood.v126.23.631.631.

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Abstract Introduction: Survival among patients diagnosed with chronic myeloid leukemia (CML) has markedly improved with the advent of tyrosine kinase inhibitors. Nonetheless, access to care, including medication cost and adherence, may be barriers to therapeutic effectiveness. We performed a population-based analysis to determine if insurance status at the time of CML diagnosis influenced patient outcomes. Methods: We used the Surveillance, Epidemiology, and End Results Program (SEER) database (November 2014 submission) to identify patients age 15 or older, diagnosed with CML between 2007 and 2012 (SEER ICD-O3 recodes 9863 and 9875). We included patients with documented insurance status at diagnosis and categorized them as either private insurance, Medicaid coverage, or uninsured. We excluded patients with unknown insurance status at diagnosis. The primary outcome was overall survival according to insurance status. We performed a stratified analysis looking at patients age 15-64 and patients 65 or older; we did not include uninsured patients over age 65 in the analysis (n=16) due to Medicare eligibility. Covariates of interest in multivariable analysis included age at diagnosis, race, ethnicity, sex, and marital status at diagnosis. Overall survival was compared by log-rank test and estimated by the method of Kaplan and Meier. P-values were significant to the 2-sided 0.05 level. Results: 5784 patientswere diagnosed with CML between 2007 and 2012 and had insurance status documented at diagnosis. Of patients age 15-64, uninsured and Medicaid patients were younger, more often non-white race and Hispanic ethnicity, and less often married (Table 1). Over age 65, Medicaid patients were more often female, non-white race and Hispanic ethnicity, and less often married. Median follow up was 32 months. Among patients age 15 to 64, being uninsured or having Medicaid was associated with worse survival compared to insured patients (5-year OS uninsured 72.7%, Medicaid 73.1%, insured 86.6%, p<0.0001) (Figure 1A). For patients over age 65, there was no difference in 5-year OS between patients with Medicaid and those with other insurance (40.2% vs. 43.4%, p=0.0802). In multivariable analysis of patients age 15-64, compared to insured patients, there was increased mortality among patients who were uninsured (HR 2.156, p<0.0001) or on Medicaid (HR 1.972, p<0.0001). There was worse survival with increased age (HR 1.046 per year, p<0.0001), male sex (HR 1.282, p=0.0279) and, compared to married persons, being single (HR 1.883, p<0.0001). For patients over age 65 at diagnosis, only age was associated with increased mortality (HR 1.078 per year, p<0.0001). Conclusions: CML patients under age 65 without insurance or with Medicaid had significantly worse survival compared to patients with insurance. This difference was not noted with patients over age 65; whose survival was relatively poorer regardless of insurance status, as previously described (Cancer 2013;119:2620). Marital status and race/ethnicity also impacted survival. Despite highly effective therapies currently available for CML, these findings suggest that many patients may not have access to or receive appropriate care, in part related to insurance coverage. Table 1. Patient Demographics Age 15-64 p-value Age 65+ p-value (3626 patients) (2142 patients) Uninsured Medicaid Insured Medicaid Insured Total, n (%) 321 (8.9%) 595 (16.4%) 2710 (74.7%) 190 (8.9%) 1952 (91.1%) Age, median (range) 44 (18-64) 45 (15-64) 50 (15-64) <0.0001 75 (65-97) 76 (65-102) 0.5388 Gender, n (%) 0.0482 0.0074 Male 203 (63%) 328 (55%) 1603 (59%) 86 (45%) 1087 (56%) Female 118 (37%) 267 (45%) 1107 (41%) 105 (55%) 865 (44%) Race, n (%) <0.0001 <0.0001 White 231 (72%) 402 (68%) 2112 (78%) 131 (69%) 1724 (89%) Black 68 (21%) 114 (19%) 313 (12%) 26 (14%) 144 (7%) American Indian 2 (1%) 25 (4%) 13 (0.5%) 2 (1%) 7 (0.4%) Asian, Pacific Islander 15 (5%) 48 (8%) 215 (8%) 30 (16%) 65 (3%) Unknown 5 (2%) 6 (1%) 57 (2%) 1 (0.5%) 12 (0.6%) Hispanic Ethnicity, n (%) <0.0001 <0.0001 Non- 234 (73%) 420 (71%) 2341 (86%) 151 (79%) 1813 (93%) Hispanic Hispanic 87 (27%) 175 (29%) 369 (14%) 39 (21%) 139 (7%) Marital Status, n (%) <0.0001 <0.0001 Single 141 (46%) 281 (50%) 588 (23%) 41 (23%) 153 (9%) Married/partner 123 (40%) 194 (34%) 1652 (65%) 67 (37%) 1069 (59%) Divorced/separated/widowed 45 (15%) 90 (16%) 288 (11%) 72 (40%) 578 (32%) Figure 1. Survival of patients (A) age 15-64 and (B) age 65+ by insurance status at diagnosis. Figure 1. Survival of patients (A) age 15-64 and (B) age 65+ by insurance status at diagnosis. Disclosures Fathi: Seattle Genetics: Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda Pharmaceuticals International Co.: Research Funding; Ariad: Consultancy; Exelexis: Research Funding; Agios: Membership on an entity's Board of Directors or advisory committees; Merck: Membership on an entity's Board of Directors or advisory committees.

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de Paula Nogueira Cruz, Felipe, Ailton Ferreira de Paula, Camila Tita Nogueira, Paulo Henrique Marques de Andrade, Leonardo Maurici Borges, Paulo Teixeira Lacava, Ilana L. B. C. Camargo, Fernanda de Freitas Aníbal e Cristina Paiva de Sousa. "Discovery of a Novel Lineage Burkholderia cepacia ST 1870 Endophytically Isolated from Medicinal Polygala paniculata Which Shows Potent In Vitro Antileishmanial and Antimicrobial Effects". International Journal of Microbiology 2021 (17 febbraio 2021): 1–17. http://dx.doi.org/10.1155/2021/6618559.

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In this study, we report the isolation and identification of an endophytic strain of Burkholderia cepacia (COPS strain) associated with Polygala paniculata roots. Polygala plants are rich sources of promising microbiomes, of which the literature reports several pharmacological effects, such as trypanocidal, antinociceptive, anesthetic, anxiolytics, and anticonvulsant activities. B. cepacia COPS belongs to a new sequence type (ST 1870) and harbors a genome estimated in 8.3 Mbp which exhibits the aminoglycosides and beta-lactams resistance genes aph(3′)-IIa and blaTEM-116, respectively. Analysis performed using MLST, average nucleotide identity, and digital DNA-DNA hybridization support its species-level identification and reveals its novel housekeeping genes alleles gyrB, lepA, and phaC. The root endophyte B. cepacia COPS drew our attention from a group of 14 bacterial isolates during the primary screening for being potentially active against Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212, Micrococcus luteus ATCC 9341, Escherichia coli ATCC 25922, and Candida albicans ATCC 10231 and exhibited the broad-spectrum activity against phytopathogenic fungi. In addition, COPS strain showed production of protease, lipase, and esterase in solid media, and its natural product extract showed potent inhibition against fungal plant pathogens, such as Moniliophthora perniciosa, whose antagonism index (89.32%) exceeded the positive control (74.17%), whereas Sclerotinia sclerotiorum and Ceratocystis paradoxa showed high percentages of inhibition (85.53% and 82.69%, respectively). COPS crude extract also significantly inhibited S. epidermidis ATCC 35984, E. faecium ATCC 700221 (MIC values of 32 μg/mL for both), E. faecalis ATCC 29212 (64 μg/mL), and S. aureus ATCC 25923 (128 μg/mL). We observed moderate antagonistic activity against A. baumannii ATCC 19606 and E. coli ATCC 25922 (both at 512 μg/mL), as well as potent cytotoxic effects on Leishmania infantum and Leishmania major promastigote forms with 78.25% and 57.30% inhibition. In conclusion, this study presents for the first time the isolation of an endophytic B. cepacia strain associated with P. paniculata and enough evidence that these plants may be considered a rich source of microbes for the fight against neglected diseases.

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Vangelov, Damian, Milena Aleksova, Yana Todorova, Radoslava Emilova, Nikol Kapincheva, Nina Yancheva, Vesselina Koleva e Maria Nikolova. "IMMUNE RESPONSE TO SARS-COV-2 IN PATIENTS WITH CHRONIC HIV INFECTION". PROBLEMS of Infectious and Parasitic Diseases 51, n. 1 (14 agosto 2023): 11–18. http://dx.doi.org/10.58395/jww92v65.

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Introduction. Data for the long-term effects of SARS-CoV-2/HIV co-infection on immune restoration, as well as the level of post-exposure and post-vaccination immunity at the current stage of SARS-CoV-2 pandemic in HIV+ individuals is still scarce. We assessed SARS-CoV-2-specific immune responses, and the effects of SARS-CoV-2 infection on the immune recovery in HIV+cART+ patients with different exposure history. Materials and methods. HIV+cART+ patients 9 (2-18) months after mild/moderate COVID-19 and completed immunization with anti-SARS-CoV-2 vaccine (n=13, group A), convalescent, not immunized (n=11, group B), or with no history of exposure to SARS-CoV-2 (n=11, group C) were included in the study. CD4AC and CD4/CD8 ratio were determined before and after the documented/probable contact with SARS-CoV-2 by 4-color flow cytometry (TRUCount, MultiTest, FACSCanto II). Virus-specific immunity was characterized by the SARS-CoV-2 specific IFNγ production (SARS-CoV-2 IGRA, Euroimmun) and the levels of RBD-IgG ((Euroimmun ELISA). Results. SARS-CoV-2 specific T-cell and IgG responses were highly correlated and present, respectively, in 92% and 100%; 64% and 54%, 36% and 50% from group A, B and C patients. SARS-CoV-2 specific IFNy+T cells and RDB-IgG were significantly higher in the group with hybrid exposure (A) as compared to convalescent (B) and asymptomatic (C) patients. No significant difference existed between background and actual CD4AC (mean 836 vs 799 cells/µl, p>0.05, Mann-Whitney), and the CD4/CD8 ratio significantly increased in the group with hybrid exposure (0.92 vs 1.07, p<0.01, paired T-test). Conclusion. Over 80% of tested HIV+ individuals have mounted a SARS-CoV-2 specific immune response. Immunization and hybrid exposure provide a durable and significantly stronger SARS-CoV-2-specific immune response as compared to mild/ asymptomatic infection, without affecting the long-term immune recovery.

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Rhee, Sung-Min, GunWoo Nam, Joo Hyun Park, Hyeon Jang Jeong, TAE-YON RHIE, Suk-Hee Park e Joo Han Oh. "The Direct Effect of Nanofiber-based Vitamin D Sheet Engineered with 3D Printing for Tendon-to-bone Healing and Muscle Regeneration after Repair in a Chronic Rotator Cuff Tear Model of Rabbit (217)". Orthopaedic Journal of Sports Medicine 9, n. 10_suppl5 (1 ottobre 2021): 2325967121S0032. http://dx.doi.org/10.1177/2325967121s00325.

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Objectives: To compare the efficacy between the direct effect of nanofiber-based vitamin D sheet engineered with 3D printing (VTD sheet) and vitamin D supplementation (VTDS) as diet on tendon-to-bone healing and muscle regeneration after repair in a chronic rotator cuff tear model of rabbit. Methods: A total of 64 rabbits were randomly allocated into two groups (n=32), then each groups was allocated into four small groups (Group A, A’: VTDS only, Group B, B’: Normal diet + sheet without vitamin D, Group C, C’: Normal diet + VTD sheet, Group D, D’: VTDS + VTD sheet, n=8 each). The supraspinatus tendons which were detached and left for 6 weeks were repaired in a transosseous manner with the sheet only for groups B and B’, and VTD sheet for groups C, C’, D and D’ (Figure 1). Groups A, B, C, and D were extracted at 4weeks after repair, while groups A’, B’, C’, and D’ were extracted at 12 weeks after repair. Serum 25-OH vitamin D level was checked at the time of making tear, repair, and extraction. Regarding tendon-to-bone healing, the expression (relative ratio to control) of genes including type 1 collagen (COL1), type 3 collagen (COL3), bone morphogenic protein-2 (BMP-2), scleraxis (SCX), SOX9, and aggrecan (ACAN) was assessed at 4 weeks (Groups A, B, C, and D), and at 12 weeks (Groups A’, B’, C’, and D’) after repair. The histological and biomechanical evaluations of tendon-to-bone healing were done at 12 weeks after repair. Regarding muscle regeneration, rotator cuff muscle cross-sectional areas were measured at 4 and 12 weeks after repair. Enzyme-linked immunosorbent assay (ELISA) was done to calculate vitamin D level in muscle at 12 weeks after repair. Results: Serum vitamin D level of group D and D’ was highest among groups at the time of repair and extraction (p < 0.001). At 4 weeks after repair, mRNA expression of COL1 in group D was highest among groups (A, B, C, D; 0.86 ± 0.25, 0.90 ± 0.27, 0.93 ± 0.19, and 1.06 ± 0.25, respectively, p = 0.046). At 12 weeks after repair, group D’ showed most dense collagen density (p = 0.037) and had highest load to failure among groups (A’, B’, C’, D’; 102.3 ± 12.6 N, 99.5 ± 8.3 N, 102.3 ± 18.5 N, and 139.6 ± 25.3, respectively, p = 0.024). Regarding muscle regeneration, the cross-sectional area of muscle fiber was largest in group D and D’ at 4 and 12 weeks after repair (p < 0.05, figure 4) with highest vitamin D level of muscle by ELISA at 12 weeks after repair (p = 0.003). Conclusions: The use of nanofiber-based vitamin D sheet engineered with 3D printing may promote tendon-to-bone healing and regenerate rotator cuff muscle after repair in a chronic rabbit rotator cuff tear model.

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Qvist, A. H., M. T. Væsel, C. M. Jensen e S. L. Jensen. "Plate fixation compared with nonoperative treatment of displaced midshaft clavicular fractures: a randomized clinical trial". Bone & Joint Journal 100-B, n. 10 (ottobre 2018): 1385–91. http://dx.doi.org/10.1302/0301-620x.100b10.bjj-2017-1137.r3.

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AimsRecent studies of nonoperatively treated displaced midshaft clavicular fractures have shown a high incidence of nonunion and unsatisfactory functional outcome. Some studies have shown superior functional results and higher rates of healing following operative treatment. The aim of this study was to compare the outcome in these patients after nonoperative management with those treated with fixation.Patients and MethodsIn a multicentre, parallel randomized controlled trial, 146 adult patients with an acute displaced fracture of the midthird of the clavicle were randomized to either nonoperative treatment with a sling (71, 55 men and 16 women with a mean age of 39 years, 18 to 60) or fixation with a pre-contoured plate and locking screws (75, 64 men and 11 women with a mean age of 40 years, 18 to 60). Outcome was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) Score, the Constant Score, and radiographical evidence of union. Patients were followed for one year.ResultsA total of 60 patients in the nonoperative group and 64 in the operative group completed one-year follow-up. At three months’ follow-up, both the median DASH (1.7 vs 8.3) and median Constant scores (97 vs 90) were significantly better in the operated group (both p = 0.02). After six months and one year, there was no difference in the median DASH or Constant scores. The rate of nonunion was lower in the operative group (2 vs 11 patients, p < 0.02). Nine patients in the nonoperative group underwent surgery for nonunion. The plate was subsequently removed in 16 patients (25%). One patient had a new fracture after removal of the plate and one underwent revision surgery for failure of fixation.ConclusionFixation of a displaced midshaft clavicular fracture using a pre-contoured plate and locking screws results in faster functional recovery and a higher rate of union compared with nonoperative management, but the function of the shoulder is equal after six months and at one year. Cite this article: Bone Joint J 2018;100-B:1385–91.

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Manz, Christopher, William Ferrell, Joelle Williamson, Emily Schriver, Jonathan Wakim, Neda Khan, Michael Kopinsky et al. "Remote patient-reported symptoms and passive activity monitoring to improve patient-clinician communication regarding symptoms and functional status: A randomized controlled trial (PROStep)." Journal of Clinical Oncology 40, n. 16_suppl (1 giugno 2022): 1506. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.1506.

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1506 Background: Oncologists suboptimally assess patient symptoms and functional status, possibly leading to poor symptom management or over-treatment. Remote patient-reported symptoms and passive activity monitoring may provide objective measures of symptoms and functional status to improve patient-clinician communication and symptom understanding. We assessed the impact of a clinician-centered dashboard of longitudinal patient-reported symptoms and step counts on patient-clinician communication regarding symptoms and functional status. Methods: This randomized trial enrolled 108 patients with incurable GI or lung cancers treated with chemotherapy at a large academic health center. Patients were randomized to either of Arms A) control, B) weekly patient-reported symptoms via text message + step tracking from a wearable activity monitor, with summary dashboards given to clinicians at each visit, or C) arm B plus text message-based prompts to patients encouraging discussion of symptoms and functional status prior to each visit. We used Kruskal Wallis tests to compare co-primary outcomes (patient-reported perceptions of clinician symptom and functional status understanding at 6 months after enrollment) between control (A) and intervention (B+C) arms on a 5-point scale (1 = Not at all; 2 = Slightly; 3 = Moderately; 4 = Considerably; 5 = Completely). Results: 33, 37, and 38 patients were enrolled in arms A, B, and C, respectively. Patients were 54.6% male, mean age was 58.9 years, 77% had GI cancer, and 23% had lung cancer. At six months, there was no difference between control and intervention arms in patient perception of clinician understanding of symptoms (Arm A: 4.5, Arm B/C: 4.5, p = 0.85) or functional status (Arm A: 4.5, Arm B/C: 4.3, p = 0.59). Patients reported that their oncology team seldom discussed PROstep data during appointments (mean 2.3 on 5-point scale where 2 = seldom). Hospitalization rates were 42% and 45% for Arms A and B/C (p = 0.8), respectively, and new palliative care referrals were 9% and 10% (p = 0.8), respectively. Mean adherence to weekly patient reports and Fitbit data (at least 4 of 7 days in a week) was 64% and 53%, respectively. Net promoter score was 8.3 on a 10-point scale. Conclusions: Clinician and patient-directed dashboards based on patient-generated health data did not lead to higher patient-perceived clinician understanding of symptoms and functional status, although this was limited by moderate adherence to remote symptom and step count collection and low frequency of clinician discussion of PROStep data with patients, highlighting challenges to clinical application of these data sources. Further efforts are needed to improve patient-clinician communication about symptoms and functional status. Clinical trial information: NCT04616768.

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Kindler, H. L., D. Niedzwiecki, D. Hollis, E. Oraefo, D. Schrag, H. Hurwitz, H. L. McLeod, M. F. Mulcahy, R. L. Schilsky e R. M. Goldberg. "A double-blind, placebo-controlled, randomized phase III trial of gemcitabine (G) plus bevacizumab (B) versus gemcitabine plus placebo (P) in patients (pts) with advanced pancreatic cancer (PC): A preliminary analysis of Cancer and Leukemia Group B (CALGB". Journal of Clinical Oncology 25, n. 18_suppl (20 giugno 2007): 4508. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.4508.

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4508 Background: In a phase II trial in 52 PC pts, GB yielded a 21% response rate and a median survival of 8.8 months (mo) (Kindler, JCO 2005). These data led CALGB to conduct a phase III trial of GB vs. GP in advanced PC pts. Methods: This randomized trial was double-blind, placebo-controlled. Eligible pts had no prior therapy for advanced disease, PS 0–2, no tumor invasion of adjacent organs, no increased bleeding risk. Primary endpoint: overall survival (OS). Stratification: PS (0/1 or 2), disease extent (locally advanced or metastatic), prior radiation (RT) (yes/no). Statistics: 90% power to detect a difference in median OS of 6 vs. 8.1 mo. Treatment: Pts received G 1,000 mg/m2 over 30 minutes days (D) 1, 8, 15 Q28D; B 10 mg/kg or P D 1, 15 Q28D. CT scans: Q2 cycles. Results: 602 pts enrolled 6/30/04–4/14/06. Based on a protocol-specified interim analysis with 64% of information on OS, the CALGB Data Safety Monitoring Board released study data in 6/06 because a futility boundary was crossed. Pts on treatment were notified and unblinded. Pt characteristics (302GB/300GP): male 58%/51%; median age 63.8/65.0; PS 2 9%/9%; stage IV 85%/84%; prior RT 11%/11%. Median follow-up: 11.3/11.7 mo. As of 12/22/06, 436 pts (224/212) have died (93% of total expected deaths at planned final analysis). Median OS 5.7/6.0 mo (95% CI: 4.9, 6.5/5.0, 6.9). Median failure-free survival 4.8/4.3 mo (95% CI: 4.3, 5.7/3.8, 5.6). Response (includes unconfirmed responses): complete (CR) 1.9%/3.0%; partial (PR) 11.2%/8.3%, stable disease (SD) 40.7%/35.7%. Disease control rate (CR/PR/SD) 54%/47%. 525 pts (268/257) are currently evaluable for toxicity. Median cycles 3.5/3.1 (p=0.09). Total mg/m2 G received 9095/8334 (p=0.22). Grade ¾ toxicity (%pts GB/GP): neutropenia 33%/30%; anemia 5%/8%; thrombocytopenia 12%/12%; hypertension 8%/2%; perforation 0.4%/0%; GI bleed 3%/2%; CVA 2%/2%; proteinuria 4%/1%; venous thrombosis 9%/9%. Conclusion: The addition of B to G does not improve survival in advanced PC. [Table: see text]

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Savic, Zeljka, Vladimir Vracaric, Ljiljana Hadnadjev, Zora Petrovic e Dragomir Damjanov. "Experience in the treatment of some complications of portal hypertension in alcoholic liver cirrhosis". Vojnosanitetski pregled 68, n. 11 (2011): 917–22. http://dx.doi.org/10.2298/vsp1111917s.

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Background/Aim. Portal hypertension (PH) is hemodynamical abnormality associated with the most serious complications of alcoholic liver cirrhosis (ALC): ascites, varices and variceal bleeding. The aim of this study was to determine characteristics of portal hypertension, especially of upper gastrointestinal bleedings in patients with alcoholic liver cirrhosis (ALC). Methods. A total of 237 patients with ALC were observed in a 3-year period. Results. A total of 161 patients (68%) were hospitalized because of PH elements: 86 (36.3%) had upper gastrointestinal bleeding, 75 (31.7%) were decompensated. Only 76 (32%) of the patients had icterus. General mortality was 85 (36%). According to the source of bleeding, 61 (71%) patients bled from varices, and 25 (29%) from other sources with existing varices but non-incriminated for bleeding in 16 (64%) of those patients. Active bleeding or stigmata of recent bleeding were found in 63 (73%) cases. Endoscopic treatment of variceal bleeding along with octreotide applied in 20 (32.78%) patients, just octreotide in 32 (52.46%), and octreotid plus balloon tamponade in 9 (14.75%). According to Child-Pugh classification, 25 (29%) of the bleeding patients were in class A, score 5.4; 43 (50%) in class B, score 7.8; and 18 (21%) in class C, score 10.9. Average hemoglobin level was 93 g/L, hematocrit 0.27, AST 71.52 U/L (normal to 37 U/L), ALT 37.74 U/L (normal to 40 U/L). Until this bleeding episode, 41 (47%) of the patients already bled. In the decompensated patients 3 (4%) were in Child Pugh class A, score 6; 42 (56%) in class B, score 8.3; and 30 (40%) in class C, score 10.6. Until this decompensation episode, 7 (9.3%) patients already bled. Conclusion. Patients with ALC need early detection of varices, primary and secondary profilaxis of variceal bleeding and adequate therapy of ascites. When bleeding occurs, patients need urgent upper endoscopy and intensive treatment.

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Effendy, John D. Kildea e Allan H. White. "Lewis-Base Adducts of Group 11 Metal(I) Compounds. LXVIII Synthesis and Structural Systematics of Some 1 : 3 Adducts of Silver(I) Compounds with Triphenylstibine, [(Ph3Sb)3AgX], X = Cl, I, SCN, NCS, CN, ONO2". Australian Journal of Chemistry 50, n. 6 (1997): 587. http://dx.doi.org/10.1071/c96035.

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The syntheses and room-temperature single-crystal X-ray structural characterization of 1 : 3 adducts formed between silver(I) (pseudo-) halides, AgX, and triphenylstibine, SbPh3, are described for X = Cl, I, SCN, NCS, CN, NO3 (1)-(6). The chloride, as its methanol solvate (1a), is isomorphous with the arsine analogue: triclinic, P-1, a 13·373(4), b 14·48(6), c 14·702(3) Å, α 83·49(3), β 87·76(2), γ 76·45(3)°; Z = 2, conventional R on F being 0·046 for No 5514 independent ‘observed’ reflections (I > 3σ(I )). A new form (1b) of the chloride has also been authenticated: monoclinic, P 21/c, a 12·832(2), b 54·24(1), c 18·519(8) Å, β 129·68(3)°; Z = 8 (R 0·065 for No 5672). No bromide has been obtained; the iodide (2) is described as monoclinic, P 21/n, a 19·611(4), b 14·473(6), c 17·74(1) Å, β 98·28(3)°; Z = 4 (R 0·036 for No 6769). The thiocyanate crystallizes from acetonitrile or pyridine as an S-bonded form (3) isomorphous with the arsine analogue: monoclinic, P 21/n, a 19·143(7), b 14·288(5), c 18·694(6) Å, β 98·81(2)°; Z = 4 (R 0·037 for No 4482). From 2-methylpyridine, remarkably, a solvate is obtained in which the thiocyanate is N-bonded (4): triclinic, P-1, a 27·261(5), b 14·767(3), c 13·319(1) Å, α 91·53(1), β 101·58(1), γ 92·29(2)°; Z = 4 (R 0·045 for No 6900). The cyanide is also monoclinic, P 21/n, a 19·442(7), b 14·267(3), c 17·741(6) Å, β 97·63(3)°, z = 4; R 0·057 for No 2487. The unsolvated 1 : 3 nitrate complex (6a) is monoclinic, P 21/n, a 19·602(5), b 14·455(1), c 17·727(2) Å, β 97·19(2)°, Z = 4; R was 0·034 for No 6522. The complex is isomorphous with the arsenic and phosphorus analogues, being mononuclear [(Ph3Sb)3Ag(O2NO)]. The ethanol solvate (6b) is triclinic, P-1, a 13·352(5), b 14·548(9), c 14·701(4) Å, α 81·64(4), β 84·45(3), γ 75·32(4)°, Z = 2; R was 0·058 for No 4702. Ag-Sb range between 2·6980(8) and 2·843(3) Å in the precise determinations; Ag-X are 2·481(4) and 2·52(1) Å (the two chlorides), 2·757(1) (I), 2·533(3) (SCN), 2·21(1) (NCS), 2· 09(3) (CN), 2·377(7) Å (unidentate ONO2)

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Guo, FengPing. "Bioinformatics Analysis of JAZF1 Gene in Broilers with Ascites Syndrome". Pakistan Veterinary Journal 41, n. 01 (1 marzo 2021): 19–24. http://dx.doi.org/10.29261/pakvetj/2020.072.

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Pulmonary vascular remodeling (PVR) is the main characteristic lesion of ascites syndrome (AS) in broilers. JAZF1 plays an important role in PVR, but there is no study on its protein function and structure. In this study, the physical and chemical properties, hydrophilicity/hydrophobicity and transmembrane domain, phosphorylation site and glycosylation site, subcellular localization and signal peptide, secondary and tertiary structure, antigen peptide and conserved domain and phylogenetic relationship of JAZF1 protein were predicted online by bioinformatics tools. The results showed that the number of amino acids of JAZF1 was 243aa, the theoretical isoelectric point was 8.63, the instability index was 58.1, and the average coefficient of hydrophilicity was -0.674. It was found to be a hydrophilic protein having 35 phosphorylation sites and a N-glycosylation site with no transmembrane domain. The protein is expressed in the nucleus, there is no signal peptide distribution in the whole sequence and the secondary structure is mainly composed of random coil and α- helix. There were 7 B cell epitopes, 7 conserved domains and compared with other birds, JAZF1 is 95.61% similar. In summary, from the analysis we came to conclude that the amino acid sequence 64-80aa, 91-108aa, 136-151aa and 179-187aa can be selected as antigen sites and among which 136-151aa may be the best. This study lays a good foundation for follow-up experiments, which then provides powerful conditions for pathological detection of pulmonary vascular remodeling and gene drug therapy of ascites syndrome in broilers.

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Афолабі Олусегун Еммануель. "A Developmental Perspective to Attention-Deficit Hyperactivity Disorder (ADHD) in Children". East European Journal of Psycholinguistics 3, n. 1 (12 agosto 2016): 8–22. http://dx.doi.org/10.29038/eejpl.2016.3.1.olu.

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The debate about diagnoses and treatment of attention deficit hyperactive disorder (ADHD) in children continue to range on between the developmental and biological perspectives. While there is increasing evidence that support the biological susceptibility of the disorder, a number of researches also emphasized the significant effect of environment on the syndrome. This study used developmental perspectives to evaluate and bring together various bio-psychosocial factors that impact on children diagnosed with ADHD. The study explored and integrated the existing and advancing study on ADHD to a more refined pattern that embraced developmental perspectives. The study also discussed how the linkage in childhood ADHD fits within the developmental psychopathology perspective. The study revealed that ADHD as a developmental disorder is influenced by prenatal, biological and psychosocial environmental risk factors, and suggested that better understanding of genomic susceptibilities, family environment and parental characteristics would transform the pathway for development of ADHD in children. References American Psychiatric Association.(2000). Diagnostic and StatisticalManual of MentalDisorders. 4th ed. Washington, DC: American Psychiatric Association. American Psychiatric Association.(2013). Diagnostic and StatisticalManual of MentalDisorders.5th ed. Washington, DC: American Psychiatric Association. Arnsten, A.F, (2007). Catecholamine and second messenger influenceson prefrontalcortical networks of “representational knowledge”:a rational bridge between genetics andthe symptoms of mental illness. Cerebral Cortex, 17, i6–i15. Arnsten, A.F, & Pliszka, S.R. (2011). Catecholamine influences on prefrontalcorticalfunction: relevance to treatment of attentiondeficit/hyperactivity disorder and relateddisorders. Pharmacology, Biochemistry and Behavior, 99, 211–216. Atladóttir H.O, Parner E.T, & Schendel D. (2007). Variation in incidence ofneurodevelopmental disorders with season of birth. Epidemiology, 18, 240–245. Barkley, R. A. (2006). Attention deficit/hyperactivity disorder: A handbook for diagnosisand treatment (3rd ed.). New York: Guilford Baumeister A.A, Hawkins M.F (2001). Incoherence of neuroimaging studies of attentiondeficit/ hyperactivity disorder. Clinical Neuropharmacology, 24, 2–10. Berger I. (2011). Diagnosis of attention deficit hyperactivity disorder: much ado aboutsomething. Israeli Medical Association Journal, 13, 571–574. Berger, A., Posner, M. I. (2000). Pathologies of brain attentionalnetworks. Neuroscienceand Biobehavioral Reviews, 24, 3–5. Biederman J, Faraone S.V, Keenan K, Knee D, &Tsuang M.T (1990): Familygenetic andpsychosocial risk factors in DSM-III attention deficit disorder. Journal of AmericanAcademy of Child and Adolescent Psychiatry, 29, 526 –533. Biederman J, Faraone SV, Keenan K, Tsuang MT (1991b): Evidence of familialassociationbetween attention deficit disorder and major affective disorders. Archives of GeneralPsychiatry, 48, 633–642. Biederman, J, Faraone, S.V, Keenan K, Benjamin, J, Krifcher, B. &Moore C. et al (1992).Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder.Patterns of comorbidity in probands and relativesin psychiatrically and pediatricallyreferred samples. Archives of General Psychiatry, 49, 728 –738. Biederman, J., Milberger, S., Faraone, S. V., Kiely, K., Guite, J.,Mick, E., Ablon, S., Warburton, R., & Reed, E. (1995). Family environment risk factors for attention deficithyperactivity disorder: A test of Rutter’s indicators of adversity. Archives of GeneralPsychiatry, 52, 464–470. Biederman, J., Faraone, S.V., Mick, E., Spencer,T.,Wilens,T., Kiely,K., Guite, J., Ablon, J.S., Reed, E., & Warburton, R. (1995). High risk for attention deficit hyperactivity disorderamong children of parents with childhood onset of the disorder: A pilot study. Journal ofAmerican Psychiatry, 152, 431–435. Biederman J, Faraone S.V, Monuteaux M, Spencer T, Wilens T, Bober M, et al (2004).Gender effects of attention deficit hyperactivity disorder inadults, revisited. BiologicalPsychiatry, 55, 692–700. Brookes, K.,Mill, J.,&Guindalini,C., et al (2006). Acommon haplotype of the dopaminetransporter geneassociated with attention-deficit/hyperactivity disorderand interactingwithmaternal use of alcohol duringpregnancy. Archives of General Psychiatry, 63, 74–81. Brophy, K., Hawi, Z., Kirley, A., Fitzgerald, M., & Gill, M. (2002). Synaptosomalassociated protein 25 (SNAP-25) and attention deficit hyperactivity disorder (ADHD):Evidence of linkage and association in the Irish population. Molecular Psychiatry, 7 , 913–917 Campbell, S. B. (2000). Attention-Deficit/Hyperactivity Disorder: A developmental view.In: Handbook of Developmental Psychopathology. (pp. 383–401). A. J. Sameroff, M.Lewis, & S. Miller (Eds.). New York: Kluwer Academic/Plenum. Carlson, E. A., Jacobvitz, D., & Sroufe, L. A. (1995). A developmental investigation ofinattentiveness and hyperactivity. Child Development, 66, 37–54. Childress, A.C, Berry, S.A (2012). Pharmacotherapy of attention-deficit hyperactivitydisorder in adolescents. Drugs, 72, 309–325. Cortese, S (2012). The neurobiology and genetics of attention-deficit/hyperactivitydisorder (ADHD): what every clinician shouldknow. European Journal of PaediatricNeurology, 16, 422–433. Dopheide, J.A (2005). ASHP therapeutic position statement on theappropriate use ofmedications in the treatment of attention deficit/hyperactivity disorder in paediatricpatients. American Journal of Health System Pharmacy, 62, 1502– 1509. Coghill, D., Nigg, J., Rothenberger, A., Sonuga-Barke, E., & Tannock, R. (2005). Withercausal models in the neuroscience of ADHD? Developmental Science, 8, 105–114. Cummings, E. M., Davies, P., & Campbell, S. B. (2000). Developmental Psychopathologyand Family Process: Research, Theory, and Clinical Implications. New York: Guilford. Faraone, S. V., Perlis, R. H., Doyle, A. E., Smoller, J. W., Goralnick, J. J., Holmgren, M.A., et al. (2005). Molecular genetics of attention-defi cit/hyperactivity disorder. BiologicalPsychiatry, 57 , 1313–1323. Faraone, S, Biederman, J, Krifcher Lehman, B, Keenan, K, Norman, D, Seidman, L. et al.(1993). 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Nature, nuture, and attentiondeficit hyperactivitydisorder. Developmental Review, 20, 568–581. Faraone S.V, Perlis R.H, Doyle A.E, Smoller J.W, Goralnick J, &Holmgren M.A, et al.(2005). Molecular genetics of attention deficit hyperactivity disorder. BiologicalPsychiatry, 57, 1313–1323. Gray, J. A., Feldon, J., Rawlins, J. N. P., Hemsley, D. R., & Smith, A. D. (1991) Theneuropsychology of schizophrenia. Behavioral and Brain Sciences, 14, 1–84. Gray, J. A. (1982). The neumpsychology of anxiety. New York: Oxford University Press. Halperin, J. M., & Healey, D. M. (2011). The infl uences of environmental enrichment,cognitive enhancement,and physical exercise on brain development: Can we alter thedevelopmental trajectory of ADHD? Neuroscience and Biobehavioral Reviews, 35 , 621–634. Hauschild K.M, Mouridsen S.E, & Nielsen S. (2005). Season of birth inDanish childrenwith language disorder born in the 1958–1976 period. Neuropsychobiology; 51, 93–99. Hudziak J.J, Rudiger L.P, Neale M.C, Heath A.C, & Todd R.D (2000). A twin study ofinattentive,aggressive, and anxious/depressed behaviors. Journal of the American Academyof Child and Adolescent Psychiatry, 39, 469 –476. Kahn, R. S., Khoury, J. & Nichols,W.C., et al (2003). Role of dopamine transportergenotype and maternal prenatal smoking in childhood hyperactive-impulsive,inattentive,and oppositional behaviors. Journal of Pediatrics, 143, 104–110. Kesner R.P, & Churchwell J.C (2011). An analysis of rat prefrontal cortexin mediatingexecutive function. Neurobiology of Learning and Memory, 96, 417–431. Kuntsi, J.,& Stevenson, J. (2000). Hyperactivity in children:Afocuson genetic research andpsychological theories. Clinical Child and Family Psychology Review, 3, 1–24. Langley, K., Rice, F., & van den Bree, M. B., et al (2005). Maternal smoking duringpregnancy as an environmental risk factor for attention deficit hyperactivity disorderbehaviour. A Review. Minerva Pediatrica, 57, 359–371. Manshadi M, Lippmann S, O’Daniel R, & Blackman A (1983): Alcohol abuse andattention deficit disorder. Journal of Clinical Psychiatry, 44, 379 –380 Martin N, Scourfield J, McGuffin P (2002).Observer effects and heritability ofchildhoodattention-deficit hyperactivity disorder symptoms. British Journal of Psychiatry, 80, 260 –265. Neale, B. M., Medland, S. E., Ripke, S., Asherson, P., Franke, B., Lesch, K. P., et al.(2010). Meta-analysis of genome-wide association studies of attention-defi cit/hyperactivity disorder. Journal of the American Academy of Child and AdolescentPsychiatry, 49 , 884–897. Nigg J, Nikolas M, & Burt S. A(2010). Measured gene-by-environment interaction inrelation to attention-deficit/hyperactivity disorder. Journal of the American Academy ofChild and Adolescent Psychiatry, 49, 863–73. Oades, R. D., Lasky-Su, J., Christiansen, H., Faraone, S.V., Sonuga-Barke, E. J., Banaschewski, T., et al. (2008). The influence of serotonin- and other genes onimpulsivebehavioral aggression and cognitive impulsivity in children with attentiondeficit/hyperactivity. A Developmental Perspective on ADHD disorder (ADHD): Findingsfrom a family-based association test (FBAT) analysis. Behavioral and Brain Functions, 4,4–48. Pastor P. N & Reuben C.A. (2008). Diagnosed attention deficit hyperactivity disorder andlearning disability: United States, 2004–2006. Vital Health Statistics, 10, 1–14. Quay, H. C. (1988a). Attention deficit disorder and the behavioral inhibitionsystem: Therelvance of the neuropsychological theory of Jeffrey A. Gray. In: Attention deficitdisorder: Criteria, cognition, intervention (pp. 117–126). L. M. Bloomingdale & J.Sergeant (Eds.). NewYork: Pergamon. Quay, H. C. (1988b). The behavioral reward and inhibition systems inchildhood behaviordisorder. In: Attentiondeficit disorder W; New research in treatment, psychopharnmcology,and attention (pp. 176–186). L. M. Bloomingdale (Ed.). NA: Pergamon. Quay, H. C. (1996, January). Gray'sbehavioral inhibition in ADHD:An update. Paperpresented at the annual meeting of the InternationalSociety for Research in Child andAdolescent Psychopathology, Los Angeles, CA. Rader, R, McCauley L,& Callen, E.C. (2009). Current strategies in thediagnosis andtreatment of childhood attention-deficit/hyperactivity disorder. American FamilyPhysician, 79, 657–665. Robbins, T. W. (2003). Dopamine and cognition. Currpin Neurol,16, (2), S1–S2. Rutter, M, Cox, A, Tupling, C, Berger, M, &Yule, W. (1975). Attainment and adjustmentin two geographical areas. 1—The prevalence of psychiatric disorders. British Journal ofPsychiatry, 126, 493–509. Rutter, M., &Sroufe, L. A. (2000). Developmental psychopathology: Concepts andchallenges. Development and Psychopathology, 12, 265–296. Sergeant, J. (2000). The cognitive-energetic model: An empiricalapproach to attentiondeficit hyperactivity disorder. Neuroscienceand Biobehavioral Reviews, 24, 7–12. Sherman D, McGue M, &Iacono W (1997). Twin concordance for attention deficithyperactivity disorder: A comparison of teachers’ and mothers’reports. American Journalof Psychiatry, 154, 532–535. Sonuga-Barke, E. J., Auerbach, J., Campbell, S. B., Daley, D., & Thompson, M. (2005).Preschool varieties of hyperactive and dysregulated behaviour: Multiple pathways betweenrisk and disorder. Developmental Science, 8 , 141–150. Sonuga-Barke, E. J., Bitsakou, P., & Thompson, M. (2010). Beyond the dual pathwaymodel: Evidence for the dissociation of timing, inhibitory, and delayrelated impairments inattention-defi cit/hyperactivity disorder. Journal of the American Academy of Child andAdolescent Psychiatry, 49 , 345–355. Sonuga-Barke, E. J., & Halperin, J. (2010). Developmental phenotypes and causalpathways in attention deficit/hyperactivity disorder: Potential targets for earlyintervention? Journal of Child Psychology and Psychiatry, 51, 368–398. Sprich-Buckminster S, Biederman J, Milberger S, Faraone S, &Krifcher LehmanB (1993):Are perinatal complications relevant to the manifestation ofADD? Issues of comorbidityand familiality. Journal of American Academy of Child and Adolescent Psychiatry,32,1032–1037 Swanson, J. M., Sunohara, G. A., Kennedy, J. L., Regino,R., Fineberg, E.,Wigal, T.,Lerner, M.,Williams, L., LaHoste,G. J.,&Wigal, S. (1998). Association of the dopaminereceptorD4 (DRD4) gene with a refined phenotype of attention deficithyperactivitydisorder (ADHD): A family–based approach.Molecular Psychiatry, 3, 38–41. Taylor, E. (1999). Developmental neuropsychopathology of attentiondeficit and impulsiveness. Development and Psychopathology, 11, 607–628. Thapar, A.,O’Donovan,M., &Owen,M. J. (2005b). The genetics of attention deficithyperactivity disorder. Human Molecular Genetics, 14, 275–282. Thapar, A., Langley, K.,O’Donovan,M. (2006). 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Barrientos, Jacqueline Claudia, Richard R. Furman, John Leonard, Ian Flinn, Kanti Roop Rai, Sven De Vos, Marshall T. Schreeder et al. "Update on a phase I study of the selective PI3Kδ inhibitor idelalisib (GS-1101) in combination with rituximab and/or bendamustine in patients with relapsed or refractory CLL." Journal of Clinical Oncology 31, n. 15_suppl (20 maggio 2013): 7017. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.7017.

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7017 Background: PI3K-delta signaling is critical for proliferation, survival, homing and tissue retention of malignant B cells. Idelalisib is a first-in-class, selective, oral inhibitor of PI3Kδ that has shown considerable monotherapy activity in pts with heavily pretreated CLL. Methods: This phase I study evaluated idelalisib continuously given at 150 mg BID in combination with rituximab (R, 375 mg/m2 every wk x 8), bendamustine (B, 70 or 90 mg/m2 x 2, every 4 wks x 6) or BR (every 4 wks x 6) for relapsed/refractory CLL. Pts still on treatment after 48 weeks were eligible to continue idelalisib on an extension study. Clinical response was evaluated according to published criteria (Hallek 2008; Cheson 2012). Results: 52 pts (23F/29M) with a median (range) age of 64 (41-87) years were enrolled. Adverse disease characteristics included bulky lymphadenopathy (62%), refractory disease (50%), multiple prior therapies (median 3, range: 1-14) with 96% receiving prior R and 44% receiving prior B. As of 14 Jan 2013, the median (range) treatment duration was 18 (1-33) months. 31/52 (60%) pts enrolled into the extension study; of those, 24/52 (46%) pts are continuing idelalisib treatment on the extension study. The ORR was 81%, with 1 CR, and a median (range) time to response of 1.9 (1.5-8.3) months. The 2-year PFS and OS were 62% and 85%, respectively. At 2 years follow up, 71% of responses were still enduring. There was no difference in outcomes for pts with <3 prior treatments (n=21) vs ≥3 prior treatments (n=31). The most common TEAEs (any Grade/≥Gr 3, independent of causality) included pyrexia (44%/6%), diarrhea (40%/14%), cough (31%/2%), fatigue (29%/2%), nausea (29%/0%). Pneumonia (any Gr/≥Gr 3) occurred in 15%/12% and rash was seen in 15%/0%. 10% of patients experienced ≥Gr 3 ALT/AST elevation based on laboratory values. Conclusions: A lack of overlapping toxicities allowed idelalisib to be co-administered with R, B, or BR, and all 3 combination regimens were highly active, resulting in durable tumor control in pts with heavily pretreated relapsed/refractory CLL. Phase III trials evaluating the efficacy of idelalisib in combination with R or BR are ongoing. Clinical trial information: NCT01088048.

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50

Garibaldi, A., D. Bertetti, P. Pensa e M. L. Gullino. "First Report of Botrytis Blight Caused by Botrytis cinerea on Gaura lindheimeri in Italy". Plant Disease 93, n. 1 (gennaio 2009): 107. http://dx.doi.org/10.1094/pdis-93-1-0107c.

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Gaura lindheimeri (wand flower) is a perennial plant belonging to the Onagraceae family that is used for perennial borders in xeric and mesic landscapes. It produces flowers floating above the plant like small, dancing butterflies. This plant is becoming popular in the Albenga Region (northern Italy) where white and rose varieties are grown as potted plants. In January of 2008, 5-month-old ‘Whirling Butterflies’ plants grown in plastic pots (14 cm in diameter) in the open field started showing symptoms of a previously unknown blight. When the disease developed, temperatures ranged between 3 and 17°C (average 9°C) and average relative humidity was 64%. Small, brown spots appeared on the basal portion of leaves first, eventually spreading to cover entire leaves. Subsequently, the pathogen developed abundant, soft gray mycelium on affected leaf tissue. Severely infected leaves eventually became completely rotten and desiccated. Sixty percent of plants were affected by the disease. Tissues were excised from diseased leaves, immersed in a solution containing 1% sodium hypochlorite for 10 s, and then cultured on potato dextrose agar (PDA) medium. The fungus produced abundant mycelium on PDA medium when incubated under constant fluorescent light at 22 ± 1°C. The conidia were smooth, hyaline, globoid, measuring 11.8 to 9.4 × 8.3 to 6.6 (average 10.7 × 7.4) μm, and are similar to those described for Botrytis cinerea. The identity of the pathogen was also confirmed by the production of numerous sclerotia on PDA plates incubated for 20 days at 8 ± 1°C. Sclerotia were dark, irregular, and measured 3 to 4 × 2 to 3 mm. The fungus was identified as B. cinerea on the basis of these characters (1). Pathogenicity tests were performed by spraying leaves of healthy, potted 8-month-old G. lindheimeri ‘Whirling Butterflies’ plants with a 105 conidia/ml suspension. Plants sprayed with water only served as controls. Five plants per treatment were used. Plants were covered with plastic bags for 6 days after inoculation and maintained in a growth chamber at 20 ± 1°C. The first foliar lesions developed on leaves 5 days after inoculation, whereas control plants remained healthy. B. cinerea was consistently reisolated from these lesions. The pathogenicity test was completed twice. To our knowledge, this is the first report of the presence of B. cinerea on G. lindheimeri in Italy. The economic importance of this disease will increase with the increased cultivation of this species. Reference: (1) H. L. Barnett and B. B. Hunter. Illustrated Genera of Imperfect Fungi. Burgess Publishing Company, Minneapolis, MN, 1972.

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