9 research outputs found

    Neutrophil-to-lymphocyte ratio may be associated with the outcome in patients with prostate cancer

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    Purpose: Evidences have shown that neutrophil-to-lymphocyte ratio (NLR) has a prognostic value in patients with cancer. We wanted to test the prognostic significance of NLR in prostatic cancer of patients who are candidate to radical prostatectomy. Methods: We have considered 731 patients. Complete demographic data including age, tumor stage, Gleason score, complete blood count and serum biochemical profile were collected. Pre-treatment percentage of neutrophils and NLR were considered, and correlated with patients data and recurrence free survival. Results: 389 patients were evaluated, mean age 65 years, mean follow-up 51.5 months, mean recurrence free survival 51.3 months. Total neutrophil count does not correlate with biochemical recurrence and disease free survival. Patients with a value higher of 60% of neutrophils are more likely to have a recurrence. Patients with a total lymphocyte count <1,500 have a higher rate of relapse. NLR was not correlated with baseline total PSA, with Gleason score and with pathological stage; patients with a NLR >3 has a higher incidence of recurrence. In multivariate analysis including age, total PSA and NLR, NLR is the most important factor able to predict recurrence. There are some limitations to this study; first, this is a retrospective study, and the total number of patients analyzed is relatively small. Conclusions: Our study suggests that pre-treatment NLR may be associated with disease free survival in patients with prostate cancer, and could be introduced in clinical practice. NLR has the advantage of low economic cost and wide availability

    Assessing resilience of mountain communities Hit by the central Italy Earthquakes of 2016.

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    Community resilience is “the ability of a system to recover from the effect of a hazard, preserving its essential structures and functions”. Psychological aspects have a significant influence on the adaptive capacity of populations hit by natural disasters. Among such aspects, place attachment appears to play an important role. The well-being deriving from the identification with a place has been acknowledged in literature; the loss of one's own place has devastating effects on the emotional state of individuals. Studies about natural disasters have largely underlined how such events change the emotional bonds with the territory, but only recently place attachment has been explored as a crucial aspect for maintaining the communities’ resilience; most of the papers concerned climate change resilience, very few earthquake resilience. This chapter aims to contribute to the understanding of the influence of territorial bonds on the social resilience of communities hit by earthquakes. Data were collected through paper questionnaires, in three small mountain communities of central Italy, about one year after the earthquake of August 24th, 2016. Results show that place attachment was a central value for the three-quarters of the interviewees, despite the seismic hazard, in all three areas. Findings encourage further investigations in other areas with different territorial settings and urban size, for a better knowledge of the role of place attachment for earthquake resilience

    Is child walking conditioned by gender? Surface EMG patterns in female and male children

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    EMG-based differences between females and males during walking are generally acknowledged in adults. Aim of the study was the quantification of possible gender differences in myoelectric activity of gastrocnemius lateralis (GL) and tibialis anterior (TA) during walking in school-age children. Gender-related comparison with adults was also provided to get possible novel insight in maturation of gait. To this aim, Statistical gait analysis, a recent methodology performing a statistical characterization of gait by averaging spatial-temporal and surface-EMG-based parameters over hundreds of strides, was performed in100 healthy school-age children (C-group) and in 33 healthy young adults (YA-group). On average, 301±110 consecutive strides were analyzed for each subject. In C-group, no significant differences (p>0.05) were observed between females and males in GL and TA, considering mean onset/offset instants of activation and occurrence frequency. Stratifying the C-group for age, small differences between females and males in occurrence frequency of GL arose in oldest children. In YA-group, females showed a significant propensity for a more complex recruitment of TA and GL (higher number of activations during gait cycle, quantified by occurrence frequency) compared to males. These outcomes suggest that gender-related differences in sEMG parameters do not characterize the recruitment of GL and TA during child walking in early years (6-8 years), start occurring when adolescence is approaching (10-12 years), and are acknowledged in both ankle muscles only in adults. Present findings seem to support previous studies on maturation of gait which indicate adolescence as the time-range where gait is completing its maturation path

    Survival in patients with clear cell renal cell carcinoma is predicted by HIF-1 alpha expression

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    Aim: To investigate hypoxia inducible factor-1α's (HIF-1α) immunohistochemical expression in clear cell renal cell carcinoma (ccRCC) treated with radical nephrectomy. Patients and Methods: One hundred and forty-eight patients were considered from those who underwent radical nephrectomy between 1983 and 1993. Archived materials were retrieved from the Institute of Pathological Anatomy for immunostaining. The features considered on the histological specimens were tumor stage, grade, as well as cellular and vascular HIF-1α expression. All considered parameters were correlated with time to recurrence (TTR) and overall survival (OS). Results: TTR was significantly longer in patients with low cellular HIF-1α expression; patients' survival was higher in those with low HIF-1α expression. Regarding vascular HIF-1α expression, the differences were not statistically significant when considering TTR and OS. On univariate analysis, age, clinical stage and HIF-1α cellular expression showed a significant association with OS. Conclusion: Cellular HIF-1α is an important indicator of prognosis in patients with ccRCC; high HIF-1α expression predicts poor survival

    Survival in Patients with Clear Cell Renal Cell Carcinoma is Predicted by HIF-1α Expression

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    Abstract. Aim: ΀o investigate hypoxia inducible factor-1α’s (HIF-1α) immunohistochemical expression in clear cell renal cell carcinoma (ccRCC) treated with radical nephrectomy. Patients and Methods: One hundred and forty-eight patients were considered from those who underwent radical nephrectomy between 1983 and 1993. Archived materials were retrieved from the Institute of Pathological Anatomy for immunostaining. The features considered on the histological specimens were tumor stage, grade, as well as cellular and vascular HIF-1α expression. All considered parameters were correlated with time to recurrence (TTR) and overall survival (OS). Results: TTR was significantly longer in patients with low cellular HIF-1α expression; patients’ survival was higher in those with low HIF-1α expression. Regarding vascular HIF-1α expression, the differences were not statistically significant when considering TTR and OS. On univariate analysis, age, clinical stage and HIF-1α cellular expression showed a significant association with OS. Conclusion: Cellular HIF-1α is an important indicator of prognosis in patients with ccRCC; high HIF-1α expression predicts poor survival

    Implementation of EHMRG Risk Model in an Italian Population of Elderly Patients with Acute Heart Failure

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    Acute heart failure (AHF) is a cardiac emergency with an increasing incidence, especially among elderly patients. The Emergency Heart failure Mortality Risk Grade (EHMRG) has been validated to assess the 7-days AHF mortality risk, suggesting the management of patients admitted to an emergency department (ED). EHMRG has never been implemented in Italian ED nor among elderly patients. We aimed to assess EHMRG score accuracy in predicting in-hospital death in a retrospective cohort of elderly subjects admitted for AHF from the ED to an Internal Medicine Department. We enrolled, in a 24-months timeframe, all the patients admitted to an Internal Medicine Department from ED for AHF. We calculated the EHMRG score, subdividing patients into six categories, and assessing in-hospital mortality and length of stay. We evaluated EHMRG accuracy with ROC curve analysis and survival with Kaplan–Meier and Cox models. We collected 439 subjects, with 45 in-hospital deaths (10.3%), observing a significant increase of in-hospital death along with EHMRG class, from 0% (class 1) to 7.7% (class 5b; p p 103 (Se: 71.1%; Sp: 72.8%; LR+: 2.62; LR-: 0.40; PPV: 23.0%; NPV: 95.7%), but performed better considering the events in the first seven days of admission (AUC: 0.83; 95%; CI: 0.75–0.91; p < 0.0001). In light of our observations, EHMRG can be useful also for the Italian emergency system to predict the risk of short-term mortality for AHF among elderly patients. EHMRG performance was better in the first seven days but remained acceptable when considering the whole period of hospitalization
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