Intracranial Subdural Hematoma after Spinal Anesthesia for Cesarean Section

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of the cases, the first clinical symptom associated with intracranial subdural bleeding is severe headache, but the clinical course may have different presentations. In this report, we describe the case of a 38-year-old woman with an acute intracranial subdural hematoma shortly after spinal anesthesia for cesarean section. Early recognition of symptoms of neurologic impairment led to an emergency craniotomy for hematoma evacuation with good recovery of neurologic functions. The possibility of subdural hematoma should be considered in any patient complaining of severe persistent headache following regional anesthesia, unrelieved by conservative measures. Only early diagnosis and an appropriate treatment may avoid death or irreversible neurologic damage

Sex and Gender in Ageing and Longevity: Highlights from an International Course

Gender medicine is a multidisciplinary science and represents an important perspective for pathophysiological and clinical studies in the third millennium. Here, it is provided an overview of the topics discussed in a recent course on the Role of Sex and Gender in Ageing and Longevity. The paper highlights three themes discussed in the course, i.e., the interaction of gender/sex with, i) the pathophysiology of age-related diseases; ii), the role of genetics and epigenetics in ageing and longevity and, iii) the immune responses of older people to pathogens, vaccines, autoantigens, and allergens. Although largely unexplored, it is clear that sex and gender are modulators of disease biology and treatment outcomes. It is becoming evident that men and women should no longer be considered as subgroups, but as biologically distinct groups of patients deserving consideration for specific therapeutic approaches

The Virgo 3 km interferometer for gravitational wave detection

Virgo, designed, constructed and developed by the French-Italian VIRGO collaboration located in Cascina (Pisa, Italy) and aiming to detect gravitational waves, is a ground-based power recycled Michelson interferometer, with 3 km long suspended Fabry-Perot cavities. The first Virgo scientific data-taking started in mid-May 2007, in coincidence with the corresponding LIGO detectors. The optical scheme of the interferometer and the various optical techniques used in the experiment, such as the laser source, control, alignment, stabilization and detection strategies are outlined. The future upgrades that are planned for Virgo from the optical point of view, especially concerning the evolution of the Virgo laser, are presented. Finally, the next generation of the gravitational wave detector (advanced Virgo) is introduced from the point of view of the laser system

Tyrosine-protein kinase inhibition in human erythrocytes by polyphosphoinositides (PIP and PIP2)

In human erythrocytes Ser/Thr- and Tyr-phosphorylations of cytoplasmic domain of band 3 are catalyzed by casein kinase I and Tyr-protein kinase respectively, both distributed between cytosol and membrane structures. The results reported here show that purified cytosolic Tyr-protein kinase activity, assayed on added substrates such as poly(Glu,Tyr)4:1 and isolated chymotryptic fragments of band 3 cytoplasmic domain (cdb3), is potently inhibited by PIP and even more by PIP2. Similar inhibitory effects are displayed by these polyphosphoinositides also on the endogenous Tyr-phosphorylation of band 3, when they are added to the isolated native membranes, thus suggesting their involvement in regulating in-vivo Tyr-phosphorylation of membrane proteins

Relationship Between Membrane-protein Phosphorylation and Intracellular Translocation of Casein Kinase In Human Erythrocytes

The present paper shows that an increased phosphorylation of the membrane proteins, promoted by the okadaic acid (strong inhibitor of P-Ser/Thr-protein phosphatase(s)), is accompanied by a release of casein kinase from the membrane into cytosol. Such an intracellular translocation might provide a feedback mechanism for the regulation of the casein kinase catalyzed phosphorylation of membrane proteins in the human erythrocytes. (C) 1994 Academic Press, Inc

Is Neck Dissection Necessary After Induction Plus Concurrent Chemoradiotherapy in Complete Responder Head and Neck Cancer Patients with Pretherapy Advanced Nodal Disease?

Abstract BACKGROUND: The aim of the present study was to assess, in the setting of a single-institution prospective clinical trial, the necessity of planned neck dissection (PND) in physically and radiologically complete responders with pretherapy advanced nodal disease. METHODS: Between January 2000 and July 2007 a total of 139 patients were enrolled to receive a regimen of platinum-based multidrug induction-concurrent chemoradiotherapy (IC/CCRT). A total of 75 of the enrolled patients with advanced nodal disease were included in this retrospective study. Between 8 and 12 weeks from the end of treatment, the response to IC/CCRT was evaluated by fiber-optic endoscopy and head and neck contrast-enhanced computed tomography or magnetic resonance imaging. RESULTS: The complete clinical response (cCR) rate was 68 %. Among the 51 patients who achieved locoregional cCR at the end of CCRT, 8 underwent PND according to the study recommendation. Of the 43 patients with cCR who did not undergo PND, 2 patients (4.7 %) experienced isolated regional recurrences with the 5-year regional control being 82 %. Patients with cCR did not have a significantly lower regional control compared with patients with cCR who underwent ND (P = .962). Pathological evidence of residual disease was found in 81 % of the patients with less than cCR who underwent ND. CONCLUSIONS: In physically and radiologically complete responders to IC/CCRT, a PND appears not justified. Conversely, PND should be performed in patients clinically suspected of having residual disease in the neck, as a significant proportion have viable tumor cell in post CCRT N

Prognostic significance of LINE-1 hypomethylation in oropharyngeal squamous cell carcinoma

Inclusion of new biomarkers to improve a personalized treatment approach for oropharyngeal squamous cell carcinoma (OPSCC) is urgently needed. Hypomethylation of the Long interspersed nucleotide element-1 (LINE-1) repetitive elements, a widely accepted surrogate of overall genomic DNA methylation content, was found to be associated with a poor prognosis in several cancers. At present, no studies have investigated the influence of LINE-1 methylation levels on OPSCC relapse. The main goal of this study was the evaluation of the prognostic value of LINE-1 methylation status in predicting early tumor relapse in locally advanced OPSCC

Is Neck Dissection Necessary After Induction Plus Concurrent Chemoradiotherapy in Complete Responder Head and Neck Cancer Patients with Pretherapy Advanced Nodal Disease?

Abstract BACKGROUND: The aim of the present study was to assess, in the setting of a single-institution prospective clinical trial, the necessity of planned neck dissection (PND) in physically and radiologically complete responders with pretherapy advanced nodal disease. METHODS: Between January 2000 and July 2007 a total of 139 patients were enrolled to receive a regimen of platinum-based multidrug induction-concurrent chemoradiotherapy (IC/CCRT). A total of 75 of the enrolled patients with advanced nodal disease were included in this retrospective study. Between 8 and 12 weeks from the end of treatment, the response to IC/CCRT was evaluated by fiber-optic endoscopy and head and neck contrast-enhanced computed tomography or magnetic resonance imaging. RESULTS: The complete clinical response (cCR) rate was 68 %. Among the 51 patients who achieved locoregional cCR at the end of CCRT, 8 underwent PND according to the study recommendation. Of the 43 patients with cCR who did not undergo PND, 2 patients (4.7 %) experienced isolated regional recurrences with the 5-year regional control being 82 %. Patients with cCR did not have a significantly lower regional control compared with patients with cCR who underwent ND (P = .962). Pathological evidence of residual disease was found in 81 % of the patients with less than cCR who underwent ND. CONCLUSIONS: In physically and radiologically complete responders to IC/CCRT, a PND appears not justified. Conversely, PND should be performed in patients clinically suspected of having residual disease in the neck, as a significant proportion have viable tumor cell in post CCRT N

Non-endemic locoregionally advanced nasopharyngeal carcinoma: long-term outcome after induction plus concurrent chemoradiotherapy in everyday clinical practice

The aim of this study was to evaluate the longterm outcome in Caucasian population of a non-endemic area treated for locoregionally advanced nasopharyngeal carcinoma (LA-NPC) with multidrug platinum-based induction plus concurrent chemoradiotherapy (IC/CCRT) in everyday clinical practice setting. Between May 1990 and July 2007, 75 patients with newly diagnosed histologically confirmed LA-NPC were given IC/CCRT. All patients were judged suitable to receive conventional fractionated course of radiotherapy to a dose of 70 Gy in 35 fractions (2 Gy per fraction). The intended chemotherapy regimen consisted in one cycle of induction chemotherapy followed by radiotherapy concomitantly with two cycles of chemotherapy. Each cycle of chemotherapy included cis-platinum, 100 mg/m2, and continuous infusion of 5-fluorouracil, 1,000 mg/m2/d for 5 days. The median follow-up in survivors was 122 months. The complete response rate after CCRT was 90.7 %. The main limiting toxicity was grade 3 and 4 pharyngeal mucositis (46.7 %). Five-year cumulative rate of locoregional control (LRC), distant control (DC), overall survival (OS), and event-free survival (EFS) was 80.1, 82.2, 72.0, and 66.7 %, respectively. Ten-year cumulative rate of LRC, DC, OS, and EFS was 73.4, 73.8, 57.1, and 55.2 %, respectively. At multivariate analysis advanced N category and low hemoglobin levels at baseline were found to be independent predictors for both worse OS and EFS. In everyday clinical practice, treating LA-NPC with cisplatin-based IC/CCRT was relatively safe and long-term effective