A precise new KLOE measurement of ∣Fπ∣2|F_\pi|^2 with ISR events and determination of ππ\pi\pi contribution to aμa_\mu for 0.592<Mππ<0.9750.592 < M_{\pi\pi} < 0.975 GeV

The KLOE experiment at the DA$\Phi$NE $\phi$-factory has performed a new precise measurement of the pion form factor using Initial State Radiation events, with photons emitted at small polar angle. Results based on an integrated luminosity of 240 pb$^{-1}$ and extraction of the $\pi\pi$ contribution to $a_\mu$ in the mass range $0.35< M^2_{\pi\pi}<0.95$ GeV$^2$ are presented. The new value of $a^{\pi\pi}_\mu$ has smaller (30%) statistical and systematic error and is consistent with the KLOE published value (confirming the current disagreement between the standard model prediction for $a_\mu$ and the measured value).Comment: 5 pages, proceedings for the CIPANP 2009 conferenc

Incoherent pion photoproduction on the deuteron in the first resonance region

Incoherent pion photoproduction on the deuteron is studied in the first resonance region. The unpolarized cross section, the beam asymmetry, and the vector and tensor target asymmetries are calculated in the framework of a diagrammatic approach. Pole diagrams and one-loop diagrams with $NN$ scattering in the final state are taken into account. An elementary operator for pion photoproduction on the nucleon is taken in various on-shell forms and calculated using the SAID and MAID multipole analyses. Model dependence of the obtained results is discussed in some detail. A comparison with predictions of other works is given. Although a reasonable description of many available experimental data on the unpolarized total and differential cross sections and photon asymmetry has been achieved, in some cases a significant disagreement between the theory and experiment has been found. Invoking known information on the reactions $\gamma d\to\pi^0 d$ and $\gamma d\to np$ we predict the total photoabsorption cross section for deuterium. We find that our values strongly overestimate experimental data in the vicinity of the $\Delta$ peak.Comment: 22 pages, 23 figure

Relationship between Bispectral Index, electroencephalographic state entropy and effect-site EC 50 for propofol at different clinical endpoints

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Relationship between Bispectral Index, electroencephalographic state entropy and effect-site EC 50 for propofol at different clinical endpoints

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Comparison of two rocuronium bromide doses in adult and elderly patients who underwent laparoscopic surgery

Background The aim of our study was to evaluate the effects of two different doses of rocuronium bromide (0.5 mg/kg and 0.9 mg/kg) on the length of neuromuscular block, on the haemodynamic stability and on the side effects in patients of different ages. Methods We recruited 80 patients who underwent laparoscopic surgery (cholecystectomy, appendicectomy, varicocelectomy) belonging to ASA I–II classes and divided them into four groups:• 20 adults (A0.5) who received rocuronium bromide 0.5 mg/kg• 20 elderly patients (E0.5) who received rocuronium bromide 0.5 mg/kg• 20 adults (A0.9) who received rocuronium bromide 0.9 mg/kg• 20 elderly patients (E0.9) who received rocuronium bromide 0.9 mg/kgIntubation conditions, continuous monitoring of HR, NIBP, SpO2, EtCO2 were recorded. Onset time, REC 25%, TOF-ratio 0.70 were analysed by TOF-WATCH.Nerve-evoked muscle tension and neuromuscular paralysis extension were expressed by strength of contraction of adductor pollicis, in response to a direct stimulation of the ulnar nerve (TOF). Results The results showed that in elderly patients the effect of rocuronium bromide, at two different doses, was similar. Significant differences regarding the onset time was found among the groups showing that with the same dose of rocuronium bromide, the onset time was prolonged in elderly patients compared to adult patients. Moreover, increasing the dose, the onset time was reduced in both groups (p < 0.05). Forty per cent of adult group A0.5 showed excellent intubation conditions versus 60% of A0.9 (p < 0.05); elderly patients did not show any significant difference in the intubation procedure after different doses of rocuronium bromide.ConclusionsThe results from the four groups showed that in elderly patients 0.5 mg/kg of rocuronium bromide resulted in a good recovery, while 0.9 mg/kg increased the recovery time. Moreover, in adults the high dose was more effective because it reduced the number of injections and post-operative recovery time

Comparison of two rocuronium bromide doses in adult and elderly patients who underwent laparoscopic surgery

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Quasifree pion photoproduction on the deuteron in the Δ\Delta region

Photo production of pions on the deuteron is studied in the spectator nucleon model. The Born terms of the elementary production amplitude are determined in pseudovector $\pi$N coupling and supplied with a form factor. The $\Delta$ resonance is considered both in the $s$ and the $u$ channel. The parameters of the $\Delta$ resonance and the cutoff of the form factors are fixed on the leading photoproduction multipoles. Results for total and differential cross sections are compared with experimental data. Particular attention is paid to the role of Pauli correlations of the final state nucleons in the quasifree case. The results are compared with those for pion photoproduction on the nucleon.Comment: 17 pages LateX2e including 5 postscript figure

A rare case of pituitary melanoma metastasis: a dramatic and prolonged response to dabrafenib-trametinib therapy

Introduction: Pituitary metastases (PM) are rare events and to date only very few cases of melanoma PM have been described in literature up to now. Case Presentation: We describe the clinical history of a 33-year-old male patient who underwent surgical excision of an inter-scapular melanoma in 2008. The subsequent follow-up was negative for ~10 years. In September 2018, due to the onset of a severe headache, the patient underwent a brain magnetic resonance imaging, which showed an expansive mass in the saddle and suprasellar region with a maximum diameter of 17 mm. Pituitary function tests and visual field were normal. Worsening of the headache and the appearance of a left eye ptosis led the patient to surgical removal of the lesion in October 2018. The histological examination unexpectedly showed metastasis of the melanoma. Post-operative hormonal assessment showed secondary hypothyroidism and hypoadrenalism, which were both promptly treated, and a mild hypogonadism. Three months after surgery, a sellar MRI showed a persistent, increased pituitary mass (3 cm of diameter); fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) detected an increased radiopharmaceutical uptake in the sellar region. Due to the persistence of the disease and the evidence of a BRAF V600E mutation, in February 2019, the patient underwent a combined treatment with dabrafenib (a BRAF inhibitor) and trametinib (mitogen-activated extracellular signal-regulate kinase inhibitor). Sellar MRI performed 6 months later showed no evidence of mass in the sellar region. The patient was in a good clinical condition and did not complain of headaches or other symptoms; there were no significant side-effects from the anticancer therapy. After 13 months of treatment, the patient showed no recurrence of the disease on morphological imaging. Anticancer therapy was confirmed, replacement therapies with hydrocortisone and levothyroxine continued and the pituitary-gonadal axis was restored. Conclusion: This is a very interesting case, both for the rarity of the pituitary melanoma metastasis and for the singular therapeutic course carried out by the patient. This is the first case of a pituitary melanoma metastasis with BRAF mutation, successfully treated with the combination of dabrafenib and trametinib after incomplete surgical removal

Specific and non-specific biomarkers in neuroendocrine gastroenteropancreatic tumors

The diagnosis of neuroendocrine tumors (NETs) is a challenging task: Symptoms are rarely specific, and clinical manifestations are often evident only when metastases are already present. However, several bioactive substances secreted by NETs can be included for diagnostic, prognostic, and predictive purposes. Expression of these substances differs between different NETs according to the tumor hormone production. Gastroenteropancreatic (GEP) NETs originate from the diffuse neuroendocrine system of the gastrointestinal tract and pancreatic islets cells: These tumors may produce many non-specific and specific substances, such as chromogranin A, insulin, gastrin, glucagon, and serotonin, which shape the clinical manifestations of the NETs. To provide an up-to-date reference concerning the different biomarkers, as well as their main limitations, we reviewed and summarized existing literature

Case Report: Ipilimumab-Induced Panhypophysitis: An Infrequent Occurrence and Literature Review

BackgroundImmune checkpoint inhibitors (ICIs), by unleashing the anticancer response of the immune system, can improve survival of patients affected by several malignancies, but may trigger a broad spectrum of adverse events, including autoimmune hypophysitis. ICI-related hypophysitis mainly manifests with anterior hypopituitarism, while the simultaneous involvement of both anterior and posterior pituitary (i.e., panhypophysitis) has rarely been described.Case PresentationIn June 2015, a 64-year-old man affected by liver metastases of a uveal melanoma was referred to us due to polyuria and polydipsia. Two months prior, he had started ipilimumab therapy (3 mg/kg iv every 21 days). The treatment was well-tolerated (only mild asthenia and diarrhea were reported). A few days before the fourth cycle, the patient complained of intense headaches, profound fatigue, nocturia, polyuria (up to 10 L urine/daily), and polydipsia. Laboratory tests were consistent with adrenal insufficiency, hypothyroidism, and transient central diabetes insipidus. The pituitary MRI showed an enlarged gland with microinfarcts, while the hypophyseal stalk was normal, and the neurohypophyseal 'bright signal' in T1 sequences was not detected. The treatment included dexamethasone (then cortisone acetate at replacement dose), desmopressin, and levothyroxine. Within the next five days, the symptoms resolved, and blood pressure, electrolytes, glucose, and urinalysis were stable within the normal ranges; desmopressin was discontinued while cortisone acetate and levothyroxine were maintained. The fourth ipilimumab dose was entirely administered in the absence of further side effects.ConclusionAs ICIs are increasingly used as anticancer agents, the damage to anterior and/or posterior pituitary can be progressively encountered by oncologists and endocrinologists in their clinical practice. Patients on ICIs and their caregivers should be informed about that risk and be empowered to alert the referring specialists early, at the onset of panhypopituitarism symptoms, including polyuria/polydipsia