Predicting lymphoma development in patients with Sjögren's syndrome

ABSTRACTIntroduction: The issue of predicting lymphoma in primary Sjogren's syndrome (pSS) starts from its clinical and biologic essence, i.e., an autoimmune exocrinopathy with sicca syndrome, infl..

MicroRNA deregulation in thyroid cancer

In cancer microRNAs are often dysregulated with their expression patterns being correlated with clinically relevant tumor characteristics. Recently, microRNAs were shown to be directly involved in cancer initiation and progression. Despite the large amount of data showing strong correlations between cancer phenotype and microRNAs aberrant expression, very little is known about the molecular mechanisms inducing such deregulation. Thyroid carcinomas comprise a heterogeneous group of neoplasms with distinctive clinical and pathological characteristics. Activating mutations in Ras genes are frequently found in poorly differentiated and in anaplastic thyroid carcinomas. We have recently shown that oncogenic activation of Ras is able to change the expression of several microRNAs in thyroid epithelial cells. One of the top aberrantly expressed ones is miR-21, a microRNA prevoiusly reported overexpressed in a wide variety of cancers and causally linked to cellular proliferation, survival and migration. By using an inducible Ras oncogene we demonstrated that constitutively active Ras induce overexpression of miR-21 at very early times after its activation, and that such overexpression is maintained at later times as well as in chronically Ras-transformed cells. Analysis of a panel of thyroid tumors with different hystotypes revealed that miR-21 is overexpressed mainly in anaplastic carcinomas, thus correlating with the most aggressive phenotype. Interestingly, this induction seems to be cell-type specific, since the inducible Ras oncogene is unable to increase miR-21 levels in cultured fibroblasts. Moreover, our data show that at least two different Ras downstream pathways are necessary to induce miR-21 expression. We then asked if the ability of Ras in inducing miR-21 overexpression is verified in vivo. To answer this question we analyzed the expression of this microRNA in a mouse model of Ras-induced lung tumorigenesis, showing that Ras constitutive activation is able to increase miR-21 levels in normal lung and that the Ras-initiated lung cancer progression is accompained by a further increase in miR-21 expression. Taken together, our data strongly suggest that the oncogenic activation of Ras could be responsible for the increased expression of miR-21 frequently observed in human cancers

Maintenance bevacizumab beyond first-line paclitaxel plus bevacizumab in patients with Her2-negative hormone receptor-positive metastatic breast cancer. Efficacy in combination with hormonal therapy

Background: Data on efficacy of bevacizumab (B) beyond first-line taxane -including regimen (BT) as first-line treatment are lacking. Although preclinical results that anti-angiogenic agents combined with hormonal therapy (HT) could be active, no clinical data exist about combination of maintenance Bevacizumab (mBev) with HT.Methods: Thirty-five patients who experienced a response after first-line BT, were given mBev at the dose of 15 mg/kg every 3 weeks. Among 30 pts with hormonal receptor-positive metastatic breast cancer (MBC), 20 (66.6%) received HT with mBev (mHTBev). Objective of the study was the outcome and safety of mBev and in two groups of patients receiving HT or not.Results: Complete response and partial response was achieved/maintained in 4 (11.4%) and 13 (37.1%) patients, respectively (overall response rate: 48.5%). Clinical benefit was obtained on 23 patients (65.7%). Median of mBev PFS and clinical benefit were 6.8 months (95% CI: 0.8-12.7) and 17.1 months (95% CI :12.2-21.9), respectively. Median PFS of patients who received mHTBev was longer than mBev without HT (13 months and 4.1 months, respectively, p = 0.05). The most common severe toxicities were proteinuria (11.4%) and hypertension (8.5%). No additional toxicity was observed with HTBev.Conclusion: Maintenance bevacizumab with or without anti-hormonal therapy in patients with hormone receptor positive breast cancer is tolerable and associated with long-term clinical outcome; these results encourage the strategy of prolonging bevacizumab until progression in combination with anti-hormonal agents

Langerhans' cell histiocytosis of the vulva: The use of photodynamic therapy

Background: The evaluation of possible efficacy of Photodynamic Therapy (PDT) in a rare condition of vulvar Langerhans' cell histiocytosis (LCH), in a 43-years-old women with one year history of pruritic vulvar lesions. Main observations: After a cycle of 5 sessions of PDT, with aminolevulinic acid (ALA) in low percentage (5%), the patient reported an improvement of lesions, and an high improvement of local symptoms, with a significant reduction of itch and pain. Conclusions: Our case confirms this single experience of literature for the treatment of vulvar LCH by PDT, with an improvement of disease's symptoms, and can suggest the use of PDT for this rare and untreated disease

On the relationship between the approximate number system (ANS) and mathematics in first grade children

An increasing number of studies have investigated the cognitive components that contribute to the development of mathematical skills. The Approximate Number System (ANS) is a non-verbal, primitive, noisy and imprecise cognitive system of magnitude representation for making quantitative judgments and decisions. It allows discrimination of large numerosities without using counting or numerical symbols. The ANS has been considered one of the foundational-specific skills that underlie the development of mathematical abilities. However, the relationship between the ANS and mathematical abilities in preschool children is still matter of debate as it has been evidenced in some studies but not in others. Therefore, it remains controversial whether the ANS serves as a foundation for mathematical abilities. The present study investigated the relationship between ANS performance and mathematics in 110 first grade children. We measured ANS abilities, verbal intelligence and different aspects of numerical competence. Correlational analyses indicated that performance in the approximate addition ANS task was associated with mathematical abilities, even when age and verbal IQ were controlled for. Moreover, it was found that the subgroup of children with higher ANS performance showed better mathematical abilities than the subgroup of children with lower ANS performance. Longitudinal and training studies are needed to identify the direction of the link between ANS and mathematical ability

Prospective study on nanoparticle albumin-bound paclitaxel in advanced breast cancer. Clinical results and biological observations in taxane-pretreated patients

Background: There is a deep need to improve the care of metastatic breast cancer (MBC) patients, since even today it remains an incurable disease. Taxanes are considered the most effective cytotoxic drugs for the treatment of MBC, both in monotherapy and in combined schedules, but the need for synthetic solvents contributes to the severe toxicities and may have a negative impact on the efficacy. Nanoparticle albumin-bound paclitaxel (Nab-paclitaxel) is a colloidal suspension of paclitaxel and human serum albumin initially developed to avoid the toxicities associated with conventional taxanes. Patients and methods: The aim of this prospective, single-center open-label, noncomparative study was to evaluate the efficacy and safety of nab-paclitaxel in MBC patients pretreated with taxanes. The patients were treated with nab-paclitaxel as a single agent, 260 mg/m2 on day 1 of each 3-week cycle or 125 mg/m2 weekly. The primary endpoint was the overall response rate (ORR). Secondary objectives were duration of response, clinical benefit rate, progression-free survival (PFS), overall survival, and safety. Results: A total of 42 patients (median age 48 years, median Eastern Cooperative Oncology Group performance status 0, triple-negative MBC 19%, all pretreated with a taxane-based therapy, mainly in advanced disease) were enrolled in the study. The ORR was 23.8%, including one complete response (2.4%) and nine partial responses (21.4%); the disease control rate was 50%. The median duration of response was 7.2 months. After a median follow-up of 9 months, the median PFS was 4.6 months. ORR and PFS were similar irrespective of the previous chemotherapy lines, metastatic sites, and biomolecular expression. Nab-paclitaxel was well tolerated, and the most frequent treatment-related toxicities were mild to moderate (grades 1–2). Conclusion: This real-life study shows that nab-paclitaxel has a significant antitumor activity and a manageable safety profile in patients pretreated with taxanes and experiencing a treatment failure after at least one line of chemotherapy

Acne Scars: Pathogenesis, Classification and Treatment

Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%–14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options