Evaluating the Correlation between Overjet and Skeletal Parameters Using DVT

Aim. To evaluate the degree of correlation between a dental parameter of immediate clinical relevance (overjet) with skeletal (ANB angle) and dentoskeletal parameters such as the IMPA angle and upper incisor-bispinal angle. Materials and Methods. A sample of 42 subjects, all in complete permanent dentition and without a history of orthodontic treatment or systemic pathologies, was subdivided into 2 groups: group 1 consisted of 25 subjects with ANB angle 0°–4° (skeletal class I), and group 2 was made up of 17 subjects with ANB angle >4° (skeletal class II). Each subject underwent cone-beam computed tomography (CBCT). For each right and left CBCT, the following parameters were measured: (1) ANB, (2) OJ (overjet), (3) IMPA angle, and (4) upper incisor-bispinal angle (U1/ANS-PNS). Results. Analysis of the entire sample revealed that both right and left overjets were correlated in a statistically significant fashion (<0.001) with ANB. No correlation between overjet and IMPA emerged, while a weak correlation between overjet and the left U1-bispinal plane was ascertained. Conclusions. Overjet may be a reliable predictor of ANB, and to a lesser extent the U1-bispinal plane, particularly in skeletal class II

Implications of metabolism-driven myeloid dysfunctions in cancer therapy

Immune homeostasis is maintained by an adequate balance of myeloid and lymphoid responses. In chronic inflammatory states, including cancer, this balance is lost due to dramatic expansion of myeloid progenitors that fail to mature to functional inflammatory neutrophils, macrophages, and dendritic cells (DCs), thus giving rise to a decline in the antitumor effector lymphoid response. Cancer-related inflammation orchestrates the production of hematopoietic growth factors and cytokines that perpetuate recruitment and activation of myeloid precursors, resulting in unresolved and chronic inflammation. This pathologic inflammation creates profound alterations in the intrinsic cellular metabolism of the myeloid progenitor pool, which is amplified by competition for essential nutrients and by hypoxia-induced metabolic rewiring at the tumor site. Therefore, persistent myelopoiesis and metabolic dysfunctions contribute to the development of cancer, as well as to the severity of a broad range of diseases, including metabolic syndrome and autoimmune and infectious diseases. The aims of this review are to (1) define the metabolic networks implicated in aberrant myelopoiesis observed in cancer patients, (2) discuss the mechanisms underlying these clinical manifestations and the impact of metabolic perturbations on clinical outcomes, and (3) explore new biomarkers and therapeutic strategies to restore immunometabolism and differentiation of myeloid cells towards an effector phenotype to increase host antitumor immunity. We propose that the profound metabolic alterations and associated transcriptional changes triggered by chronic and overactivated immune responses in myeloid cells represent critical factors influencing the balance between therapeutic efficacy and immune-related adverse effects (irAEs) for current therapeutic strategies, including immune checkpoint inhibitor (ICI) therapy

LOWER RESPONSE TO INTRAVESICAL ADJUVANT THERAPY IN HIGH-RISK BLADDER CANCER COULD BE RELATED TO THE UROTHELIAL EXPRESSION OF EGFR

LOWER RESPONSE TO INTRAVESICAL ADJUVANT THERAPY IN HIGH-RISK BLADDER CANCER COULD BE RELATED TO THE UROTHELIAL EXPRESSION OF EGFR Cristina Scalici Gesolfo1, Sebastiano Billone1, Alessio Guarneri1, Marco Vella1, Alessandro Perez2, Graziella Cangemi2, Antonio Russo2, Alchiede Simonato1,Vincenzo Serretta1 and GSTU Foundation3 1Section of Urology, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Palermo, Italy; 2Section of Medical Oncology, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy; 3Palermo, Italy Introduction: Studies on the role of EGFR in non-muscleinvasive bladder cancer (non-MIBC) are lacking. EGFR expression has been determined mainly in tissue specimens of MIBC and its overexpression has been associated with worse prognosis and shorter survival. Urothelial EGFR status after transurethral resection (TUR) of non-MIBC could indicate the risk of recurrence and progression. We investigated the feasibility of EGFR measurement in bladder washings of patients undergoing intravesical adjuvant therapy for non-MIBC and its usefulness in identifying risk subgroups. Patients and Methods: Our prospective study included patients after TUR of non-MIBC and healthy controls. Samples of bladder washings were centrifuged at 4˚C for 10 minutes at 1500 rpm, washed in cold phosphate buffer saline solution and centrifuged again obtaining a cellular pellet stored at −80˚C until RNA extraction was performed by miRNeasy Mini Kit (QiagenR). A Nanodrop ND-2000 spectrophotometer was used to check for good quality of RNA. RNA criteria to proceed with reverse transcription to cDNA: minimum 500 ng/ml, protein (260/280) solvents and organic compounds (260/230), contamination ratio 1.7-2.5. The cDNA obtained from RNA by High Capacity cDNA Reverse Transcription Kit (Life TechnologiesR) was used to perform a gene expression analysis by a real-time PCR, according to the method of the comparative quantification (ΔΔCt) with an endogenous control (cyclophilin). Every reaction was set in triplicate as a further guarantee of quality. The patients were grouped for EAU risk class and maintained in follow-up. EGFR expressions were statistically analyzed according to EAU risk groups and to patients’ outcomes. EGFR gene expression values were expressed in folds of change compared to healthy controls (EGFR=1). Results: Fifty-eight patients and 21 healthy age-matched controls were entered. An adequate cellular pellet was obtained in 50 patients (86.2%) showing a median EGFR expression of 2.0-fold (IQR=0.6-4.3-fold, p=0.0004). The median level of EGFR varied considerably among the EAU risk classes. After TUR and adjuvant intravesical therapy, in 22 (55%) out of 40 high-risk patients, EGFR decreased to 1.3-fold (IQR=0.9-1.5-fold), while 18 (45%) showed elevated EGFR, median=4.7-fold (IQR=4.1-11.6-fold). At 25 months median follow-up (IQR=19.0-34.8 months), 20 (40%) patients experienced recurrence and six (12%) progression. Among patients with and those without EGFR gene increase, disease in nine (22.5%) and five (12.5%) recurred and in five (12.5%) and one (2.5%) progressed, respectively. Conclusion: In our experience EGFR expression measurement was feasible in more than 85% of patients and was related to EAU risk classes for recurrence and progression, showing different behavior during intravesical therapy. It was possible to identify a subgroup of high-risk patients overexpressing EGFR in spite of intravesical adjuvant therapy. EGFR evaluation in bladder washing could represent a repeatable and useful tool to identify a subgroup of patients at risk for progression predicted as not being responsive to intravesical adjuvant therapy and candidates for early radical cystectomy. We wish to thank GSTU Foundation for data and statistical management

The vaccinaTion & Hpv Knowledge (THinK) questionnaire: a reliability and validity study on a sample of women living in Sicily (southern-Italy)

Objective The aim of this study was to introduce the VaccinaTion & Hpv Knowledge (THinK) questionnaire to assess knowledge about human papillomavirus (HPV) and attitude to HPV-vaccination. Its reliability and validity was demonstrated in a sample of women living in Sicily (southern Italy). Methods A cross-sectional survey was conducted on a sample of 220 women at the “Paolo Giaccone” University Hospital in Palermo (Sicily), aged 18–61. Data were analyzed through Cronbach’s alpha and exploratory factor analysis, followed by a structural equation model with measurement component. The two-level data structure was explicitly considered. Results Three dimensions were found: “knowledge of HPV infection (kHPV), “Attitude to be vaccinated against HPV (aHPV)” and “Knowledge about vaccines (KV)” (97% overall explained variance). Internal consistency was good for the whole questionnaire (0.82) and the first dimension (0.88) and acceptable for the second (0.78) and the third dimension (0.73). 23% of women showed no or little knowledge of HPV and 44.3% of women had no or little knowledge about HPV induced lesions. Discussion The use of a validated questionnaire may serve as a useful measure to assess general knowledge about HPV and attitude towards vaccination against HPV in the primary prevention setting

Everolimus plus aromatase inhibitors vs aromatase inhibitors as maintenance therapy after first-line chemotherapy in HR+/HER2- metastatic breast cancer: Final results of the phase III randomized MAIN-A trial

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Validation of the American Joint Committee on Cancer new prognostic stage groups for HER2-positive breast cancer patients treated with adjuvant chemotherapy and trastuzumab in the prospective ShortHER trial

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Well-being among Italian medical oncologists: An exploratory study

Background: Recently, attention has been focused on physicians' stress and quality-of-life improvement. Due to their relationship with patients, oncologists in particular are overloaded physically, emotionally and psychologically. Previous studies showed that training of communication skills improves the satisfaction and well-being of physicians and patients. Aims: Our research investigates the relationship between work stress and engagement and personal well-being in physicians working in Italian hospitals. Materials and Methods: 176 physicians were included. Doctors filled out self-report questionnaires to evaluate work stress and coping strategies, personal well-being, work engagement and two purpose-built scales to measure the degree of perceived organizational support and the level of specific training of social and relational skills. Descriptive statistics were used to analyze data, as well as correlation analysis (Pearson's r), hierarchical regression analysis (enter step) and analysis of variance (one-way ANOVA). Result: Positive and significant correlations were found between variables. Moreover, physicians who obtained higher levels of specific training on social and relational skills reported lower levels of stress. Oncologists experienced greater stress than other physicians in terms of maladaptive coping and lack of additional training. Conclusions: The study suggests that physicians' well-being is mediated by professional aspects, such as social skills in relationships with patients.M