Gastric mucosal lesions after Billroth I resection for benign gastric ulcer

Les lésions histologiques prédominent dans la région périanastomotique: importance de la biopsie en cours de gastroscopi

"Genetically modified" spider-like oligothiophenes : electron properties and electropolymerization

Multithiophene-based semiconductors are a virtually boundless class of molecular functional materials with very promising potential applications in a variety of fields, like electronics, energetics, sensoristics. Starting from our previous exhaustive work on \u201cspider-like\u201d branched oligothiophenes, affording a reliable rationalization of the relationships between structure and electronic properties1,2, we have recently developed many structure modifications with respect to the original all-thiophene systems, aiming to achieve finer and wider modulation of both the HOMO and LUMO levels. In particular, the \u201ccore\u201d of our oligothiophene systems has been modified by inserting appropriate building blocks of different electron richness, asymmetrically affecting both the LUMO and HOMO energy levels and localization along the main conjugated backbone, thus achieving one more freedom degree in tuning the electron properties of the molecule. A wide series of \u201cgenetically-modified\u201d spider-like oligothiophenes and their electrodeposited conducting polymers have been investigated by CV and EIS, focusing on the effect of core modification at constant thiophene side chains, and on the effect of increasing length and/or branching in the thiophene side chains at constant modified core. The core modification appears to be much more effective on the HOMO and LUMO energy levels and positions, while effective conjugation in the thiophene side chains is more determining on the oligomerization ability. The exhaustiveness of our investigation affords interpretative and predictive criteria which could usefully exploited in target-oriented molecular design

Relapsing bloodstream infections during treatment of acute leukemia

Acute leukemia (AL) patients may experience more than one episode of bloodstream infection (BSI) caused by the same pathogen during the entire chemotherapy program. In order to identify factors influencing BSI recurrence (R-BSI) during subsequent phases of treatment, we analyzed all BSIs occurring to consecutively treated AL patients during a period of active epidemiologic surveillance at our institution between 2004 and 2011. Two hundred and fifty BSIs were observed in 138 patients receiving more than 1 cycle of chemotherapy. BSI due to the same pathogen recurred in 39/138 (28.3 %) patients. Gram-negative rods (GNRs) accounted for 59.6 % and Gram-positive cocci (GPCs) for 34.4 % of BSI. Four pathogens were involved in R-BSI: Escherichia coli, Pseudomonas aeruginosa, coagulase-negative staphylococci, and Streptococcus viridans. GNRs were significantly more frequent among R-BSI compared to non-relapsing BSI (nR-BSI) [69/94 (73.4 %) vs 70/156 (50.6 %), p < 0.0001]; in particular, E. coli accounted for 67 % of R-BSI vs 32.1 % of nR-BSI (p < 0.0001). Receiving more than four chemotherapy courses and having an extended spectrum β-lactamase (ESBL)-producing E. coli BSI at any time of treatment were significantly associated to R-BSI. A trend toward a higher mortality among R-BSI patients in comparison with nR-BSI was observed (17.9 and 7.1 %, respectively, p = 0.12). Among AL patients, R-BSI is a frequent phenomenon, which may contribute to the shift of epidemiology toward GNR and to a higher mortality. This should significantly impact the strategies of antibiotic prophylaxis and treatment in patients with AL

A randomized comparison of caspofungin versus antifungal prophylaxis according to investigator policy in acute leukaemia patients undergoing induction chemotherapy (PROFIL-C study).

Background: Invasive fungal infections (IFIs) are considered a major problem among patients undergoing acute leukaemia (AL) induction treatment. PROphylaxis of Fungal invasive Infections in Leukaemia-Caspofungin (PROFIL-C) is a multicentre study aiming to assess the comparative yield of using caspofungin versus standard policy (SP) regimens and the overall impact of IFI in routine clinical care conditions. Methods: All AL patients receiving IFI prophylaxis according to local SP were prospectively included in the study by Northern Italy Leukaemia Group (NILG) centres. To allow the comparison of caspofungin versus SP regimens as prophylaxis strategies, caspofungin treatment was assigned via a centralized randomized procedure. The study was registered at http://www.clinicaltrial.gov (NCT00501098). Results: Over a 2 year period, 175 patients were included. The overall incidence of IFI was 32/175 (18.3%) [10/175 (5.7%) probable/proven and 22/175 (12.6%) possible], with no statistically significant differences between caspofungin-based versus SP-based regimens [overall: 15/93 (16.1%) versus 17/82 (20.7%), relative risk (RR) 0.78, 95% confidence interval (CI) 0.42-1.46; probable/proven: 7/93 (7.5%) versus 3/82 (3.7%), RR 2.06, 95% CI 0.55-7.7; possible: 8/93 (8.6%) versus 14/82 (17.1%), RR 0.5, 95% CI 0.22-1.14]. Only one IFI-related death was recorded (10%). Conclusions: The incidence and mortality of IFI were lower than expected in this strictly sequential cohort representative of the routine care in the NILG network. The efficacy and safety of caspofungin were similar to other prophylactic regimens