Negative symptoms as key features of depression among cannabis users: a preliminary report.

OBJECTIVE: Cannabis use is frequent among depressed patients and may lead to the so-called "amotivational syndrome", which combines symptoms of affective flattening and loss of emotional reactivity (i.e. the so-called "negative" symptomatology). The aim of this study was to investigate the negative symptomatology in depressed patients with concomitant cannabis use disorders (CUDs) in comparison with depressed patients without CUDs. PATIENTS AND METHODS: Fifty-one patients with a diagnosis of Major Depressive Disorder (MDD) and concomitant CUD and fifty-one MDD patients were enrolled in the study. The 21-Item Hamilton Depression Rating Scale (HDRS) and the negative symptoms subscales of the Positive and Negative Syndrome Scale (PANSS) were used to assess depressive and negative symptomatology. RESULTS: Patients with cannabis use disorders presented significantly more severe negative symptoms in comparison with patients without cannabis use (15.18 ± 2.25 vs 13.75 ± 2.44; t100 = 3.25 p = 0.002). DISCUSSION: A deeper knowledge of the "negative" psychopathological profile of MDD patients who use cannabis may lead to novel etiopathogenetic models of MDD and to more appropriate treatment approaches

5-fluorouracil modulated by leucovorin, methotrexate and mitomycin: highly effective, low-cost chemotherapy for advanced colorectal cancer

We have reported that an alternating regimen of bolus and continuous infusion 5-fluorouracil (FU) was superior to bolus FU in terms of response rate and progression-free survival in advanced colorectal cancer. Biochemical modulation was an essential part of this regimen and it was selective for the schedule of FU administration: bolus FU was in fact modulated by methotrexate (MTX) while continuous infusion FU was potentiated by 6-s-leucovorin (LV). Considering the low cost and the favourable report on the activity of mitomycin C (mito) added to CI FU, we have incorporated this agent in the infusional part of our treatment programme. 105 patients with untreated, advanced, measurable colorectal cancer were accrued from 13 Italian centres and treated with the following regimen. 2 biweekly cycles of FU bolus (600 mg/m2), modulated by MTX (24 h earlier, 200 mg/m2) were alternated with a 3-week continuous infusion of FU (200 mg/m2daily), modulated by LV (20 mg/m2weekly bolus). Mito, 7 mg/m2, was given on the first day of the infusional period. After a 1 week rest, the whole cycle (8 weeks) was repeated, if indicated. 5 complete and 34 partial responses were obtained (response rate, 37% on the intention to treat basis; 95% confidence limits, 28–46%). After a median follow-up time of 26 months, 37 patients are still alive. The median progression-free survival is 7.7 months with an overall survival of 18.8 months and a 2-year survival rate of 30%. The regimen was very well tolerated with fewer than 13% of patients experiencing WHO grade III–IV toxicity. These results are consistent with those obtained by our group in 3 previous trials of schedule specific biochemical modulation of FU. They also indicate a highly active, little toxic, inexpensive regimen of old drugs to be used (a) as an alternative to the more expensive combinations including CPT-11 or oxaliplatin or (b) as the basis for combination programmes with these agents. © 2001 Cancer Research Campaign http://www.bjcancer.co

Sicurezza e Resilienza delle Infrastrutture

Negli ultimi anni si sono manifestati eventi calamitosi che hanno causato collassi, completi o parziali nelle reti infrastrutturali in numerose aree nel mondo. A fronteggiare tali calamità intervengono la pubblica amministrazione e/o i gestori della rete che, collaborando a volte anche con associazioni e organizzazioni private e di volontariato, operano per ripristinare le prestazioni originarie del sistema. In particolar modo le infrastrutture critiche, cioè quei sistemi legati ai servizi di comunicazione, distribuzione dell’energia, sanità, tecnologia dell’informazione, sistemi finanziari/bancari, trasporti e sistemi idrici che forniscono i servizi essenziali per l’economia, la sicurezza e la stabilità di una Nazione, devono essere salvaguardate dai disastri. Il sistema di trasporto è essenziale per il benessere delle comunità, specialmente in condizioni avverse in quanto fornisce la possibilità di evacuazione, delle operazioni di salvataggio e facilita il ripristino dei servizi per la comunità, data la sua vasta interconnessione con tutte le altre infrastrutture critiche. Le caratteristiche e la capacità di un determinato territorio atte a fronteggiare gli eventi calamitosi dipendono da numerosi aspetti che possono essere riassunti nei concetti di sostenibilità, vulnerabilità e resilienza. Gli approcci definiti come disaster risk, climate change e quello basato sulla resilienza sono gli strumenti di valutazione maggiormente utilizzati e innovativi. La recente introduzione di questi concetti e degli approcci citati comporta un ventaglio di definizioni non univoche nella letteratura tecnica. Il presente lavoro ha lo scopo di: 1) Fornire una revisione critica e comparata della letteratura tecnica sull’argomento; 2) Analizzare gli attuali approcci che mirano ad incrementare la resilienza di una infrastruttura legata al trasporto, in particolar modo nei confronti di eventi rari (es. alluvioni, frane, ecc.); 3) Individuare i fattori e le azioni che influiscono sul ripristino delle performance del sistema; 4) Elaborare un metodo di valutazione della resilienza di tipo gerarchico

[Clinical evaluation of the tolerability of imipenem in the treatment of postoperative infections in oncologic surgery].

Fifteen neoplastic patients were examined in a pilot study to evaluate side effects and efficacy of imipenem (three doses of 500 mg/die, e.v.) as monochemotherapy of post-operative septic complications. These infections included: two wound infections, nine lung infections, one case of mixed infection (spread purulent peritonitis associated with lung infection), one case of urinary tract infection, one chronic suppurative malleolar ulcer in a patient with Kaposi's sarcoma, and one case of mediastinitis due to oesophageal perforation during endoscopic dilatation. Antibiotic treatment was successful in 14 patients, apyrexia being reached within 2nd to 13th day of treatment (median: 4th day) with negative microbiologic and radiologic assessment; only in the patient with chronic suppurative malleolar ulcer, notwithstanding apyrexia, microbiologic culture indicated the persistence of a pre-treatment pathogen (P. mirabilis). Side effects included only a slight and transient increase of serum transaminases in one patient