Acute Cholecystitis: Diagnostic Pitfall and Timing of Treatment

Objective: Cholelithiasis represents a very frequent health problem with higher prevalence in developed countries. The aim of this chapter is to underline, also by submitting our surgical experience, some diagnostic deceptions and the timing of treatment

Current Approaches in the Minimally Invasive Surgical Treatment of Adrenal Tumors

The use of imaging modalities and minimally invasive surgery plays an important role in the current management of adrenal tumors. Ultrasonography frequently allows for the incidental diagnosis of adrenal masses. The most frequent adrenal pathologies encountered are hypercortisolism (Cushing’s syndrome), primary hyperaldosteronism (Conn’s syndrome), and pheochromocytomas. Clinical presentation of these adrenal tumors can often be non-specific, or such lesions may present as “incidentalomas” in patients who undergo imaging for clinical reasons unrelated to the adrenal glands. Adrenal malignancy is suggested by morphologic characteristics found on imaging studies: increased size, irregular borders, local invasion, and large necrotic areas. The risk of malignancy increases for larger adrenal masses. Minimally invasive surgery has become the initial choice for the treatment of adrenal tumors with retroperitoneal and transperitoneal approaches. This chapter describes the surgical indications and compares the various minimally invasive surgical approaches for the therapeutic management of adrenal masses

A Secondary-Side Controlled Electric Vehicle Wireless Charger

In this paper, the design procedure of an electric vehicle (EV) wireless charger is presented. Unlike most of the systems available in the literature, the proposed charging system is regulated from the vehicle side. The on-board electrical circuit automatically adapts the resonant compensation to guarantee compatibility with the primary inverter characteristics and achieve high transmission efficiency without communication between sides. Moreover, the proposed control strategy, used to regulate the secondary full active rectifier (FAR), allows the supply of the the EV battery, maximizing the efficiency during the whole charging process

Aflibercept Plus FOLFIRI in the Real-life Setting: Safety and Quality of Life Data From the Italian Patient Cohort of the Aflibercept Safety and Quality-of-Life Program Study

Abstract Background Aflibercept combined with FOLFIRI (folinic acid, 5-fluorouracil, irinotecan) as second-line treatment of metastatic colorectal cancer (mCRC) significantly improved survival compared with FOLFIRI alone in the pivotal VELOUR (aflibercept vs. placebo in combination with irinotecan and 5-fluorouracil in the treatment of patients with metastatic colorectal cancer after failure of an oxaliplatin-based regimen) trial. No quality-of-life assessment was performed in VELOUR; therefore, the ASQoP (Aflibercept Safety and Quality-of-Life Program) trial was designed to capture the safety and health-related quality of life (HRQL). Patients and Methods ASQoP was an international, open-label, single-arm trial evaluating the safety and HRQL of aflibercept combined with FOLFIRI administered in a real-life setting to 781 patients with mCRC, pretreated with an oxaliplatin-based regimen with or without bevacizumab. The Italian subset of ASQoP enrolled 200 patients from 28 institutions. The primary endpoint was safety; HRQL was a secondary endpoint, assessed by validated questionnaires (European quality of life 5-dimension instrument 3-level; European Organization for Research and Treatment for Cancer Quality of Life Questionnaire Core 30, version 3; and EORTC-CR29) at baseline, during treatment, and at the end of treatment. Results The median age of the Italian ASQoP population was 63 years; the median number of aflibercept and FOLFIRI cycles was 7. Treatment-emergent adverse events were reported in 97.5% of patients. Hypertension (28.5%), neutropenia (27.5%; from laboratory data), asthenic conditions (20.0%), diarrhea (17.0%), and stomatitis (13.0%) were the most frequent (incidence, ≥ 5%) grade 3/4 toxicities. One toxic death occurred during the study period due to sepsis, without neutropenic complications. No significant worsening of HRQL was shown during treatment. Conclusion Aflibercept combined with FOLFIRI was well tolerated when administered as second-line treatment for patients with mCRC in a real-life setting. It did not affect HRQL and showed similar rates of treatment-emergent adverse events as those observed in the VELOUR trial. No new safety signals were identified

Discontinuation of first-line bevacizumab in metastatic colorectal cancer: the BEAWARE Italian Observational Study

BEAWARE investigated the pattern of first-line bevacizumab early interruption in the Italian real-world setting of metastatic colorectal cancer

Medium-Term Culture of Primary Oral Squamous Cell Carcinoma in a Three-Dimensional Model: Effects on Cell Survival Following Topical 5-Fluororacile Delivery by Drug-Loaded Matrix Tablets

Since the activity of several conventional anticancer drugs is restricted by resistance mechanisms and dose-limiting side-effects, the design of formulations for local application on malignant lesions seems to be an efficient and promising drug delivery approach. In this study, the effect of locally applied 5-FU on cell death was evaluated both in a SCC4/HEK001 model and in a newly proposed 3D outgrowth model of oral squamous cell carcinoma (OSCC). Initially, the optimal drug dose was established by delivery of solutions containing different amounts of 5-FU. The solution containing 1% (w/v) of 5-FU resulted effective in inducing cell death with complete eradication of cell colonies. Buccal tablets were designed to deliver 5-FU locoregionally to the cancer lesions of the oral cavity. Tablets were prepared using a drug loaded matrix of acrylic/methacrylic acid copolymer containing 1% (w/w) of 5-FU and applied on 3D outgrowths. The drug release from tablets appeared to be sufficient to induce cell death as confirmed by transmission electron microscopy and enzymatic assay (TUNEL). After 120 h of treatment, when about 90% of the drug had been discharged from the tablets into the culture environment, 5-FU caused loss of cell-cell communications and apoptotic cell death. After 192 h, a complete disaggregation of the 3D oral outgrowths and the death of all the cells was observed. Buccal matrix tablets could be considered a promising new approach to the locoregional treatment of OSCC. Risks of systemic toxicity are avoided since very low drug doses are delivered

La sinistra extraparlamentare italiana e il terzomondismo (1969-1974)

Tesi di Laurea in Storia contemporanea discussa all'Università "La Sapienza" di Roma il 15/12/2012. Sulla base di un'analisi di giornali e fonti a stampa pubblicate dai maggiori gruppi della sinistra extraparlamentare italiana nel periodo indicato, si è tentato di descrivere e problematizzare il rapporto che questa aveva con il cosidetto Terzo Mondo, i suoi governi e i suoi movimenti. Le ispirazioni e le critiche, i miti e le realtà. Il modo in cui questi rapporti pesavano nell'elaborazione della linea politica interna e internazionale dei gruppi italiani. ENG: 1st level degree-Degree/Bachelor thesis in Contemporary history discussed at "La Sapienza" Univesity of Rome on 15/12/2012. Based on an analysis of newspapers and printed sources published by the major groups of italian extra-parliamentary left in the early 1970s, this work attempt to describe and problematize the relationship that these forces had with the so-called Third world, its governments and its movements. The inspirations and criticisms, the myths and realities. The way in which this relathionships weighed in drawing the line of domestic and international policies of the italian groups

La "maggioranza silenziosa" nel decennio '70 fra anticomunismo e antipolitica

Un lavoro di ricerca tra fonti d'archivio, a stampa e memoriali per ricostruire la breve ma intensa vita di questo movimento degli anni Settanta; individuandone le idee portanti, l'organizzazione e le mire politiche per il futuro. Questo attraverso un'analisi che esplorando anche a livello teorico i due elementi portanti del discorso politico del movimento (anticomunismo e antipolitica) ne rivela i collegamenti con altri fenomeni occorsi nell'Italia repubblicana. ENG: 2nd cycle degree-Master thesis in Contemporary history discussed at "La Sapienza" Universiy of Rome on 21/1/2015. A research work in archival sources, printed sources and personal memories to rebuild short but intense life of this italian movement of the 1970s; identifying the main ideas, the organization and the political aims for the future. This through an analysis that exploring also at theorical level the two pillars of the political discourse of the movement (anti-communism and anti-politics) reveals his connections with other phenomena occurred in republican Italy