29 research outputs found

    In the eye of the storm : the Italian economy and the eurozone crisis

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    The eurozone crisis had a more significant and longer-lasting impact on Italy than on virtually any other member state, with the effects still visible a decade after. The extent of the shock was surprising in view of progress Italy had apparently made in the 1990s in terms of enhancing its capacity to meet the demands of European Monetary Union. The explanation for this traumatic economic experience lies in Italy’s deep, long-term, structural tensions which were placed under severe pressure during the 1990s and which were cracked open by the 2011 sovereign debt crisis. These have had long-standing economic effects as well as political ramifications in terms of a significant change in the Italy–EU relationship

    Phase II study of rituximab after priming with IFN in patients with relapsed LG/F B-cell lymphoma

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    Rituximab mechanism of action includes CDC, ADCC and induction of apoptosis. The administration of IFN-a before and during Rituximab treatment could be effective in increasing antigen surface expression; further the immuno modulators effect of IFN-a, including stimulation of T-cell cytotoxicity and natural killer cell activity, might sinergize with the mechenism of action of Rituximab in inducing neoplastic clone suppression. In an ongoing open, non comparative, multicenter, Phase II Italian study, 63 relapsed LG/F NHL patiens, enrolled between May 97 and June 99, were treated with IFN+Rituximab. Treatment started with IFN-a, 1.5MU/day sc for the first week and then at 3 MU during second week. At day 15 patients received the first Rituximab injection at 375mg/sq, that was repeated at day 22, 29 an 36. IFN-a dose was maintained at 3 MU during the third week and than increased to 6 MU during fourth and fifth week. Patient characteristics included: median age 52 years (range 31-70 yr); male 30%; IWF: A 11%, B 27%, C 45%, D 17%; 80% stages III an IV; 53%, 29%, 18% of patients in 1st, 2nd and 3rd relapses, respectively. All patients had progressive disease, requiring therapy. By intent to treat analysis, the 58 patients evaluable for response obtained: CR 29%, PR 43% SD 14%, PD 4%, and dropouts 10%. Six out of the 17 patients who obtained CR are relapsed after 5, 12, 13, 15 and 16 months, respectively. The other 11 are still in CR after 2+ ® 24+ months of observation. Of the 25 PR patients, 4 were immediately treated with radiotherapy and/or chemotherapy and they are not evaluable for duration remission. Five out of the remaining 21 patients are relapsed after 1, 5, 8, 9, 12 months, respectively. The other 16 patients are still in PR after 2+ ® 22+ months. AEs, occurred in the 47 patients evaluable for toxicity, were primarily grade I and II, occurring with first Rituximab infusion. Nineteen patients required dose reduction of IFN. The most frequent treatment related AEs were: fever, neutropenia, transaminases increase, nausea, chills, hypertension, thrombocytopenia and vomiting. Ten patients (21%) had grade III and 3 (6%) grade IV AEs. This interim analysis suggests that combination immunotherapy with IFN-a and Rituximab is more effective than Rituximab alone, but the AEs rate increases (72% ORR versus 48% and 27% grade III and IV AEs versus 15%, observed in the pivotal study)

    Monitoring of minimal residual disease after CHOP and rituximab in previously untreated patients with follicular lymphoma.

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    Minimal residual disease (MRD) following sequential administration of CHOP and rituximab was studied in previously untreated patients with follicular lymphoma. At diagnosis, the presence of Bcl-2/IgH-positive cells in the peripheral blood (PB) and/or bone marrow (BM) was demonstrated in all patients (n = 128) by polymerase chain reaction (PCR) analysis. Patients who achieved a clinical response following CHOP but remained PCR-positive were eligible for rituximab (375 mg/m(2) intravenously, weekly for 4 weeks). After CHOP, 57% achieved a complete response (CR), 37% a partial response (PR), and 6% were nonresponders (NR). At this stage, patients proving PCR-negative (n = 41) or failing to achieve a clinical response (n = 8) were excluded from rituximab treatment. Seventy-seven patients received rituximab and entered a scheduled MRD follow-up program. At the first molecular follow-up (+12 weeks), 59% had converted to PCR negativity in the BM and PB, with a further increase documented at the second control (+28 weeks) with 74% PCR negative. At the last molecular follow-up (+44 weeks), 63% of the patients remained PCR negative. At 3 years, the estimated overall survival of all patients is 95% (95% confidence interval [CI], 86-98). For patients achieving PCR-negative status following CHOP and therefore excluded from rituximab treatment, freedom from recurrence (FFR) was 52% (95% CI, 28-71). For patients treated with rituximab, a durable PCR-negative status was associated with a better clinical outcome since FFR was 57% (95% CI, 23-81) compared with 20% (95% CI, 4-46) in patients who never achieved or lost the molecular negativity (P <.001)

    Monitoring of minimal residual disease after CHOP and rituximab in previously untreated patients with follicular lymphoma

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    Minimal residual disease (MRD) following sequential administration of CHOP and rituximab was studied in previously untreated patients with follicular lymphoma. At diagnosis, the presence of Bcl-2/IgH-positive cells in the peripheral blood (PB) and/or bone marrow (BM) was demonstrated in all patients (n = 128) by polymerase chain reaction (PCR) analysis. Patients who achieved a clinical response following CHOP but remained PCR-positive were eligible for rituximab (375 mg/m(2) intravenously, weekly for 4 weeks). After CHOP, 57% achieved a complete response (CR), 37% a partial response (PR), and 6% were nonresponders (NR). At this stage, patients proving PCR-negative (n = 41) or failing to achieve a clinical response (n = 8) were excluded from rituximab treatment. Seventy-seven patients received rituximab and entered a scheduled MRD follow-up program. At the first molecular follow-up (+12 weeks), 59% had converted to PCR negativity in the BM and PB, with a further increase documented at the second control (+28 weeks) with 74% PCR negative. At the last molecular follow-up (+44 weeks), 63% of the patients remained PCR negative. At 3 years, the estimated overall survival of all patients is 95% (95% confidence interval [CI], 86-98). For patients achieving PCR-negative status following CHOP and therefore excluded from rituximab treatment, freedom from recurrence (FFR) was 52% (95% CI, 28-71). For patients treated with rituximab, a durable PCR-negative status was associated with a better clinical outcome since FFR was 57% (95% CI, 23-81) compared with 20% (95% CI, 4-46) in patients who never achieved or lost the molecular negativity (P <.001)

    I movimenti per l'unitĂ  europea 1970-1986

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    L'opera raccoglie numerosi contributi che cercano di ricostruire l'attività dei movimenti e delle personalità che vi agirono per l'unità europea tra il 1970 e il 1986 cioè tra la fase di rilancio del processo di costruzione europea degli anni Settanta che pur in un contesto di profonda crisi vedono il lancio di politiche europee e di innovazioni istituzionali e la fase immediatamente precedente all'Atto Unico, anche questa caratterizzata da crisi e conflitti fra i vari membri della CE

    Sharing Patient and Clinician Experiences of Moderate-to-Severe Psoriasis: A Nationwide Italian Survey and Expert Opinion to Explore Barriers Impacting upon Patient Wellbeing

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    A nationwide survey was conducted in adult patients with psoriasis (PsO) across Italy to obtain their real-world perspective of the impact of PsO on their wellbeing. Patients completed a 26-question survey (based on the patient benefit index; PBI, The Dermatology Life Quality Index; DLQI and the World Health Organization-five; WHO-5 wellbeing index) and workshop discussion sessions were undertaken by dermatologists to interpret results from the survey. 392 patients with PsO completed the survey. Analysis of results was restricted to patients who had moderate-to-severe plaque psoriasis (assessed by patients; n = 252; 64.3%). Dermatologists (n = 32) completed one question from the survey related to wellbeing and rated social, physical and mental domains as contributing to a similar extent, with comparable scores also observed by patients. For treatment, biologics yielded higher scores on average, whereas little difference was observed between topical and conventional systemic treatments. Only 23.8% of patients felt that their dermatologist was taking into consideration their wellbeing and 32.6% of the patients considered their therapy as inadequate in improving signs and symptoms of the disease. This survey identified key factors contributing to barriers impacting on patient wellbeing. Simple, but comprehensive questionnaires can provide important insight to patients’ needs that may significantly increase clinician awareness during visits leading to tailored treatment
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