Impact of combination chemotherapy on toxicity in ovarian cancer: Systematic revision of literature and meta-analysis

The purpose of this statistical analysis is to demonstrate the real advantages in terms of cost-benefit of combination chemotherapy compared with single-agent chemotherapy. The trials, which are used in this meta-analysis, have been searched on PubMed database and they are phase II or randomized phase III studies with only chemotherapy regimens. In this meta-analysis were evaluated adverse effects with odds ratio (OR), which is expressed in 95% confidence intervals (95% CI). Only 4 studies contained all the set selection criteria and they were selected. The data, which were obtained, were analyzed using MedCalc Application. The combination therapy was more strongly linked to certain adverse events than to chemotherapy with a single agent: thrombocytopenia, anemia, neutropenia and nausea. The data obtained for leukopenia, for vomiting and for stomatitis are not statistically significant, as well as those of antitumor activity. Obtained data allow us to state that the overall combination therapy is more closely related to adverse effects such as thrombocytopenia, anemia, neutropenia and nausea compared tosingle-agent chemotherapy

Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study

Objectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment. Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analogue scale (VAS), Health Assessment Questionnaire (HAQ) modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI) score, the 28-joint Disease Activity Score (DAS 28), and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3) for synovial proliferation (SP), joint effusion (SE), bone erosions (BE), and PD. Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated. Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA

Quantification of fibrosis by collagen proportionate area predicts hepatic decompensation in hepatitis C cirrhosis

Background It is unclear whether the course of cirrhosis and its prognosis are related to the amount of collagen in the liver. Aim To determine whether fibrosis, assessed by collagen proportionate area (CPA) in patients with compensated cirrhosis, is associated with the presence of oesophageal varices, and predict disease decompensation during the follow-up period. Methods We prospectively evaluated 118 consecutive patients with compensated cirrhosis to correlate fibrosis, assessed by CPA in liver biopsies, with the presence of oesophageal varices (OV) and with the rate of liver decompensation (LD) development during a median follow-up of 72 months. Results At baseline 38 (32.2%) patients had OV and during the follow-up (median 72 months, IQR 47–91), 17 patients (14.4%) developed LD. The mean CPA value was different in patients with and without OV (14.8 5.9% vs. 21.6 9.5%, P < 0.001). The best CPA cut-off for OV by area under the receiver operating characteristic (AUROC) was ≥14% and with multivariate logistic analysis CPA was the only variable associated with OV (OR: 28.32, 95% CI: 6.30–127.28; P < 0.001). By AUROC analysis the best CPA cut-off to predict LD was 18.0%. By Cox regression multivariate analysis CPA ≥18% (HR: 3.99, 95% CI: 1.04–11.45; P = 0.036), albumin (HR: 0.12, 95% CI: 0.04–0.43; P = 0.001) and presence of OV (HR: 8.15, 95% CI: 2.31– 28.78; P = 0.001) were independently associated with LD. Conclusion Quantification of fibrosis by collagen proportionate area allows identification of patients with compensated HCV cirrhosis with a higher likelihood of clinically relevant portal hypertension and a higher risk of decompensation

Comparison of Histochemical Stainings in Evaluation of Liver Fibrosis and Correlation with Transient Elastography in Chronic Hepatitis

Background and Aim. The best staining to evaluate liver fibrosis in liver hepatitis is still a debated topic. This study aimed to compare Masson's trichrome (MT), Sirius Red (SR), and orcein stainings in evaluating liver fibrosis in chronic HCV hepatitis (CHC) with semiquantitative and quantitative methods (Collagen Proportionate Area (CPA) by Digital Image Analysis (DIA)) and correlate them with transient elastography (TE). Methods. Liver stiffness evaluation of 111 consecutive patients with CHC was performed by TE. Semiquantitative staging by Metavir score system and CPA by DIA were assessed on liver biopsy stained with MT, SR, and orcein. Results. MT, SR, and orcein staining showed concordant results in 89.6% of cases in staging CHC, without significant difference in both semiquantitative and quantitative evaluations of fibrosis. TE values were concordant with orcein levels in 86.5% of the cases and with MT/RS in 77.5% (P < 0.001). No significant correlation between the grade of necroinflammatory activity and TE values was found. Conclusion. In CHC, SR/MT and orcein stainings are almost concordant and when discordant, orcein staining is better related to TE values than MT/RS. This suggests that elastic fibers play a more important role than reticular or collagenous ones in determining stiffness values in CHC

Trends in chronic hepatitis B virus infection in Italy over a 10-year period: Clues from the nationwide PITER and MASTER cohorts toward elimination

Objectives: The study measures trends in the profile of patients with chronic hepatitis B virus linked to care in Italy. Methods: A cross-sectional, multicenter, observational cohort (PITER cohort) of consecutive patients with hepatitis B surface antigen (HBsAg) over the period 2019-2021 from 46 centers was evaluated. The reference was the MASTER cohort collected over the years 2012-2015. Standard statistical methods were used. Results: The PITER cohort enrolled 4583 patients, of whom 21.8% were non-Italian natives. Compared with those in MASTER, the patients were older and more often female. The prevalence of hepatitis B e antigen (HBeAg) declined (7.2% vs 12.3; P &lt;0.0001) and that of anti-hepatitis D virus (HDV) remained stable (9.3% vs 8.3%). In both cohorts, about 25% of the patients had cirrhosis, and those in the PITER cohort were older. HBeAg-positive was 5.0% vs 12.6% (P &lt;0.0001) and anti-HDV positive 24.8% vs 17.5% (P &lt;0.0017). In the logistic model, the variables associated with cirrhosis were anti-HDV-positive (odds ratio = 10.08; confidence interval 7.63-13.43), age, sex, and body mass index; the likelihood of cirrhosis was reduced by 40% in the PITER cohort. Among non-Italians, 12.3% were HBeAg-positive (vs 23.4% in the MASTER cohort; P &lt;0.0001), and 12.3% were anti-HDV-positive (vs 11.1%). Overall, the adherence to the European Association for the Study of the Liver recommendations for antiviral treatment increased over time. Conclusion: Chronic hepatitis B virus infection appears to be in the process of becoming under control in Italy; however, HDV infection is still a health concern in patients with cirrhosis and in migrants

I know people who can and who cannot: A measure of the perception of economic inequality in everyday life

Versión preprintThis paper describes the development of the Perceived Economic Inequality in Everyday Life (PEIEL) scale. It is written and validated in Spanish. We first carried out an exploratory study, using a sample of 205 participants (52.2% men and 47.8% women; age: M = 24.69, SD = 8.95). We then conducted a confirmatory study with a sample size of 215 individuals (43.7% men and 56.3% women; age: M = 23.83, SD = 6.46). Results showed that the PEIEL scale is a valid and reliable unidimensional instrument. This scale negatively predicted tolerance of economic inequality over and above perceived inequality measured by wage gap estimates. In addition, perceived economic inequality in everyday life was negatively associated with tolerance of inequality, particularly in individuals with right-wing political ideology.Universidad de Costa Rica/[OAICE-006-2017]/UCR/Costa RicaUCR::Sedes Regionales::Sede de Occident

Freedom and the Pursuit of Happiness: An Economic and Political Perspective

This book is about the relationship between different concepts of freedom and happiness. The book's authors distinguish three concepts for which an empirical measure exists: opportunity to choose (negative freedom), capability to choose (positive freedom), and autonomy to choose (autonomy freedom). They also provide a comprehensive account of the relationship between freedom and well-being by comparing channels through which freedoms affect quality of life. The book also explores whether the different conceptions of freedom complement or replace each other in the determination of the level of well-being. In so doing, the authors make freedoms a tool for policy making and are able to say which conception is the most effective for well-being, as circumstances change. The results have implications for a justification of a free society: maximizing freedoms is good for its favorable consequences upon individual well-being, a fundamental value for the judgment of human advantage