Histological changes in odontogenic parakeratinized keratocysts treated with marsupialization followed by enucleation

The purpose of this study was to evaluate whether marsupialization treatment induces changes in the histology of odontogenic keratocyst epithelium and to compare our experience with the literature. A retrospective revision of histological samples was performed. 5 patients with odontogenic keratocyst treated with marsupialization follow by enucleation were selected. Histologic evaluation analyzed the changes in the keratocyst epithelium after marsupialization in terms of type of keratinization, thickness of the epithelium and connective tissue, the presence of acanthosis, the presence and grade of fibrosis, the type and grade of inflammation and the presence and number of mitotic figures and daughter cysts. In our case series, a variation of para-keratinized into ortho-keratinized keratocyst was found in one case, and no significant increases were observed in the epithelium and capsule thickness, or even in the level of inflammation. However, we observed an increase in fibrosis and qualitative changes in inflammation type. Minor and major histological changes were associated with reduction in cyst volume, which resulted in a simpler and less invasive cystic enucleation after marsupialization

Responsabilità del medico e regolazione della successione di leggi di qualificazione

La Corte di cassazione statuisce la non retroattività delle norme sostanziali delle leggi del 2012 e del 2017 che qualificano la responsabilità del medico come extracontrattuale facendo leva sul legittimo affidamento riposto nell’applicazione, ai fatti anteriori, del regime della responsabilità contrattuale «da contatto sociale». Gli Autori ragionano sulla possibilità di riconoscere natura interpretativa (e dunque retroattiva) alle norme in esame nonché sul raccordo tra queste ultime e il potere pur sempre sussistente in capo al giudice di qualificare il diritto risarcitorio

First-Line Treatment of Older Patients with CLL: A New Approach in the Chemo-Free Era

Simple Summary The modern treatment of chronic lymphocytic leukemia (CLL) has dramatically changed thanks to the development of effective mechanism-based drugs, which have proven to be superior to chemoimmunotherapy in all age groups. Because the choice of treatment for older patients largely depends on fitness status rather than chronological age, we aimed to discuss and put into perspective (i) the definition of an older patient, (ii) the efficacy of targeted agents in this patient population, and (iii) the cost-effectiveness of targeted therapy in high-income countries. Bruton tyrosine kinase inhibitors (BTKi) and the BCL2 inhibitor venetoclax, with or without the anti-CD20 monoclonal antibody Obinutuzumab, represent the preferred options for the first-line therapy of CLL because they are more effective and may improve quality of life. However, patient inclusion criteria are heterogeneous across trials designed for older patients, and the identification of CLL-specific parameters identifying unfit patients at risk of developing drug-specific adverse events is required to guide treatment choice. Due to inclusion/exclusion criteria in trials, higher discontinuation rates with BTKi were reported in real-world studies, and registry analyses provided useful information on factors predicting earlier discontinuation in a real-world setting. Though targeted agents were shown to be cost-effective treatments in high-income countries, the out-of-pocket expenses may limit accessibility to these drugs, and the overall expenditure for new drugs in CLL is projected to increase substantially, posing an issue for sustainability. This being said, the choice of a finite-duration treatment based on venetoclax-containing regimens or treatment until progression with BTKi is today possible in high-income countries, and the therapy choice drivers are represented by coexisting medical conditions rather than age, patient expectations, logistics, and sustainability

Commento agli articoli 75-81 c.p.c., Delle parti, in Codice di procedura civile. Commentario diretto da Claudio Consolo. Vol. 1

Commento sistematico agli articoli da 75 a 81 del c.p.c. alla luce delle interpretazioni dottrinali e degli orientamenti giurisprudenzial

Commento agli articoli 267-272 c.p.c., Dell’intervento di terzi

Commento sistematico agli articoli da 267-272 del c.p.c. alla luce delle interpretazioni dottrinali e degli orientamenti giurisprudenzial

Commento agli articoli 90-98 c.p.c., Delle responsabilità delle parti per le spese e per i danni processuali

Commento sistematico agli articoli da 90 a 98 del c.p.c. alla luce delle interpretazioni dottrinali e degli orientamenti giurisprudenzial

Commento agli articoli 88-89 c.p.c., Dei doveri delle parti e dei difensori,

Commento sistematico agli articoli 88 e 89 del c.p.c. alla luce delle interpretazioni dottrinali e degli orientamenti giurisprudenzial

Codice di procedura civile. Commentario diretto da Claudio Consolo, VI ed., IPSOA - gruppo Wolters Kluwer, Tomo I

Commento sistematico agli articoli da 82 a 87 del c.p.c. alla luce delle interpretazioni dottrinali e degli orientamenti giurisprudenzial