Foreign Banks, Corporate Strategy and Financial Stability: Lessons from the River Plate *

Abstract This paper analyzes the risk taking of branches and subsidiaries of international bank holding institutions from the perspective of host country regulators in two Latin American financial systems: Argentina and Uruguay. Using both theory and empirics, we analyze differences in the risk attitudes of these institutions in the run up to the major financial crises of 2001-02. The empirical part of this paper is based on a rich bank-level dataset on corporate structures, balance sheets, and ownership of banks. We find that foreign banks' branches have taken on fewer risks than subsidiaries and relate this to differences in the legal responsibility of parent banks. This research not only shows original results concerning banks corporate strategies in the face of country risk, but also contributes to the debate on appropriate banking regulation. * We would like to than

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Electronic structure of the Ge/Si(105) hetero-interface: an ARPES and DFT study

We present a joint experimental and theoretical study of the electronic properties of the rebonded-step reconstructed Ge/Si(1 0 5) surface which is the main strained face found on Ge/Si(0 0 1) quantum dots and is considered a prototypical model system for surface strain relaxation in heteroepitaxial growth. Using a vicinal surface as a model system for obtaining a stable single-domain film structure with large terraces and rebonded-step surface termination, we realized an extended and ordered Ge/Si planar hetero-junction suitable for direct study with angle-resolved photoemission spectroscopy. At the coverage of four Ge monolayers photoemission spectroscopy reveals the presence of 2D surface and film bands displaying energy-momentum dispersion compatible with the 5 × 4 periodicity of the system. The good agreement between experiment and first-principles electronic structure calculations confirms the validity of the rebonded-step structural model. The direct observation of surface features within 1 eV below the valence band maximum corroborates previously reported analysis of the electronic and optical behavior of the Ge/Si hetero-interface

Medullary-like hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most frequent primary hepatic cancer. Pathological features can define the biological behavior and prognosis. Medullary-like HCC is a very rare variant that has been described only twice in literature. In the present study, we report the case of a non-cirrhotic 72-year-old man, who presented two HCC lesions on routine screening for hepatitis C virus liver disease. Radiological imaging and biopsy showed two different subtypes: one classic HCC, which was treated with chemoembolization, and a second PET/CT-positive carcinoma with a PET/CT-positive metastatic coeliac lymph node, which was resected laparoscopically with a left lateral sectionectomy and extended lymphadenectomy. Histopathology revealed a medullary-like HCC; lymph node analysis confirmed the metastatic nature of the PET/CT-positive coeliac node and showed an incidental B-cell lymphoma in the hepatic pedicle lymph nodes. To the best of our knowledge this is the third case of medullary-like HCC described in the literature, and the first associated to a concomitant typical HCC

Intensified CHOP (ICHOP) +/− Rituximab in Primary Mediastinal Diffuse Large B Cell Lymphoma (PMBCL): The Role of Doxorubicin/Cyclophosphamide Dose-Intensity

Abstract Background PMBCL is a clinical/biological distinct entity, sharing some characteristics with both classical DLBCL and Hodgkin’s lymphoma. MACOP B is considered the treatment of choice. Methods Starting from 1997, we treated PMBCL with an ICHOP regimen including cyclophosphamide 1750 mg/mq with MESNA uroprotection, doxorubicin 75 mg/mq, vincristine 1.4 mg/mq with 2 mg cap, and prednisone 100 mg d 1–5 of each 14-day courses, GCSF from day 7 to day 12. Rituximab (R) 375mg/mq/course was added to ICHOP (R-ICHOP) from 2002. Treatment plan included five courses of ICHOP±R. Cases with unfavourable prognosis according to age-adjusted International Prognostic Index (aaIPI2–3) were submitted to high dose chemotherapy (HDT) and peripheral stem cell rescue. Radiotherapy on involved sites was then delivered to all patients if at least partial remission (PR) was reached. Clinical response was evaluated through CT +/− Gallium scan (14 pts) up to 2002, and thorough CT + PET scan (16 pts) thereafter, according to Cheson criteria. Results: up to 2006, 30 pts were treated, with the following characteristics: M/F 10/20, median age 34 years (range 22–53), Ann Arbor stage I: 4, II –IIE:19, III: 1, IV: 6; bulky disease: 29; B symptoms: 14; aa IPI 0–1: 24, 2–3: 6; RICHOP/ICHOP 21/9. After ICHOP±R 15 patients achieved complete (CR) or unconfirmed complete remission (CRU), 14 PR, 1 stable disease. At the end of the whole program 29/30 pts reached CR and one progressed. Seven pts received HDT, six following ICHOP±R and one after II line chemotherapy for refractory disease. After a median observation time of 60 months 1 patient progressed and 1 patient relapsed, respectively. Both died of lymphoma. One patient with stage IIE IPI 0 relapsed 18 months after completion of ICHOP and RT and died after further 5 treatment lines including alloBMT. The other patient with stage II EB IPI 1, progressed shortly after R-ICHOP and RT and died five months later. Five-yr failure free survival and overall survival are 93.2 and 92.8, respectively. ICHOP±R was well tolerated, with neither toxic death or life-threatening toxicity. No patient interrupted the planned treatment because of toxicity. Hospitalization was required in seven cases due to febrile neutropenia (6), hemorrhagic cystitis (3 cases), and pneumonia (1). Five episodes of grade III–IV mucositis were observed in 4 patients. Of 147 delivered cycles, 25 were delayed (13 pts). Conclusion: in PMBCL, the results obtained with the ICHOP protocol are better than standard CHOP and comparable to MACOP-B, emphasizing the role of doxorubicin and cyclophosphamide dose-intensity. In this limited series, the impact of adding rituximab is not clear. R-ICHOP ICHOP Tot. Patients (N°) 21 9 30 * IPI 0; ^ IPI 1 IPI 0–1 16 8 24 IPI 2–3 5 1 6 Response to CT (N°) Complete Remission 10 5 15 Partial Remission 11 3 14 Induction Failure 0 1* 1* Response CT +RT+/− HDT (N°) Complete Remission 20 9 29 Partial Remission 0 0 0 Induction Failure 1 0 1 Relapse (N°) 0 1^ 1^ 5-yr FFP 95.2 88.9 93.2 5-yr OS 95.2 88.9 92.8 Median follow up (range) 52 months 104 months 60 months</jats:p

Result of FDG PET Imaging After Chemotherapy +/− Immunotherapy Is a Significant and Independent Prognostic Indicator of Outcome for Patients with Follicular Lymphoma: Survey From a Single Institution

Abstract Abstract 2674 Aim FDG positron emission tomography (PET) is the mainstay of response evaluation in some lymphoma subgroups such as DLBCL or HL according to Cheson criteria 2007. Due to its indolent behaviour, PET restaging has been poorly explored in Follicular Lymphoma (FL) Methods: The analysis was retrospectively conducted in pts with FL who underwent whole-body 18F-FDG-PET as part of response evaluation at the end of first line or savage treatment program at our institution from August 2001 to June 2010. Results: Seventy five patients were identified. Main clinical characteristics: median age 58 (range 26– 78); male 37 pts; B symptoms 6 pts; bulky disease 5 pts; stage IV 42 pts; bone marrow involvement 32 pts. Fifty-five pts were evaluated after first line treatment program, while 20 pts after salvage therapy program. Main chemotherapy regimen: CHOP or CHOP-like 38, CVP 11, polichemotherapy containing high-dose cytosine-arabinoside 11, fludarabine containing regimens 4. Furthermore, 19 pts underwent autologous peripheral stem-cell transplantation after either first line or salvage therapy. Eleven pts also received consolidation radiotherapy. Forty-two pts received Rituximab during chemotherapy. At the end of treatment, 54 pts reached complete remission as confirmed by PET. With a median follow-up of 53 months, a significantly lower actuarial 4yr PFS was observed in post-treatment PET+ versus. PET- patients: 35.1% vs. 74.8% (log rank p&lt;0.01). Among all other prognostic factors analyzed (B-symptoms, bulky disease, chemotherapy regimens, chemotherapy vs chemoimmunotherapy, first line therapy vs salvage chemotherapy), only stage IV showed a correlation with PFS. In a multivariate Cox model including all patients, post-treatment PET+ (HR 2.20; C.I. 95%: 1.02–4.76 p&lt;0.04) and Stage IV (HR 3.08; C.I. 95%: 1.23–7.73 p&lt;0.01) were unfavorable predictors for PFS. Conclusion: This retrospective study demonstrates that post-treatment negative PET is a powerful predictor for PFS. Patients who are PET- can expect a prolonged PFS either in first line or successive lines of treatment. Future clinical trials are needed to evaluate a PET oriented approach focused on improving outcomes according to PET response. Disclosures: No relevant conflicts of interest to declare. </jats:sec

Therapeutic and Mobilizing Activity of a Vinorelbine, Ifosfamide and Cytarabine Regimen (VIHA) as Salvage Regimen In Resistant/Relapse Non Hodgkin Lymphoma (NHL)

Abstract Abstract 1761 Background: The identification of active regimens sharing clinical and mobilizing activity are warranted NHL patients (pts) at high risk at onset or at relapse, as induction therapy before peripheral blood stem cell transplantation (PBSCT). Vinorelbine (VNR), ifosfamide (IFX), and cytarabine (ARA-C) are of proved efficacy in this setting. Methods: From November 1999 to September 2008, 115 pts underwent the VIHA regimen: VNR 25 mg/mq day 3, IFX 2500 mg/mq days 1–3, and ARA-C 2 gm/mq bid days 2–3. Pts older than 60 years, were given the same regimen at 75% of doses. A total of 4 cycles was repeated every 21 days with G-CSF support from day 7 to day 12 or up to the apheresis. Mobilization was performed from the 3rd cycle, in patients withat least partial remission (PR), achieved after cycle 2. All cases with at least stable disease (SD) at the end of VIHA induction and with a CD34+ cell collection of &gt; 1.5 × 10&lt;6/Kg were then candidated to PBSCT. Results: Main clinical characteristics: median age 47 (range 28–73) with 36 pts older 60 years, aggressive histology 73, indolent histology 42, primary refractory disease 44, relapsed disease 71, stage III or IV 42, bone marrow involvement 20, sIPI &gt; 2 13. Seventy-seven pts had received at least two lines of chemotherapy before VIHA. Sixty-seven patients (59%) obtained an objective response (OR) with 48 (42%) of these obtained complete remission (CR) according to CT-scan criteria. Seventy-four patients entered PBSCT and 41 did not for the following reasons: 15 due to unplanned PBSCT, 13 pts failed mobilization, one for toxic deaths, and the others for disease progression. With a median follow-up of 47 months, 4-year progression free survival (PFS) and overall survival (OS) are 30% and 39%, respectively. In univariate analysis, only the histologic category (aggressive vs indolent) was a predictive factor of response (p.001) and survival (p&lt;.0001). In multivariate analysis, only elevated IPI at relapsed (&gt; 2) was a significant negative predictor. Interestingly, there was no difference in OR, PFS and OS between patients treated with full dose or reduced dose VIHA. As concerns stem cell mobilization, in 80 mobilized pts, median number of CD34+ cells collected was 7.1 × 106/Kg (range 1.5–45) after a median of 2 (1-3) apheretic procedures. Among more than 240 VIHA cycles analyzed for haematological toxicity 86% of full dose VIHA required platelet transfusions and 50% RBC transfusions, as compared to 46% (p&lt;.0001), and 34% (p0.03), of reduced dose VIHA, respectively. Febrile neutropenia complicated 27% of all cycles and there were 19 documented infections. Thirty-five per cent required Hospitalization for documented infections or febrile neutropenia was necessary in 35% of full-dose VIHA cycles and in 16% of reduced VIHA cycles, (p.01). There was only one death-related therapy. Conclusions: VIHA shows clinical and mobilizing activity comparable to better known salvage chemotherapy regimens; otherwise our data suggest to use as well the reduced dose regimen, which shares clinical activity and lower toxicity profile. The high CD34 mobilizing activity is notheworthy. Disclosures: No relevant conflicts of interest to declare. </jats:sec