Tumour sublines with different metastatic capacity induce similar blood coagulation changes in the host.

This paper is aimed at investigating how metastatic tumour growth influenced the haemostatic system of the host. Blood platelet count, blood fibrinogen level, the activated partial thromboplastin time (APTT) and the prothrombin time (PT) were determined at various intervals during growth and metastasis of a murine fibrosarcoma (mFS6) or one of its sublines with different metastatic capacity. Progressive thrombocytopenia and increase in fibrinogen level were observed during development of the tumour in all the animal groups studied, irrespective of the metastatic potential of the various sublines. No significant changes were observed in the PT or APTT values. These data support the concept that primary rather than metastatic growth influences the haemostatic system of tumour-bearing animals

Rate of primary refractory disease in B and T-cell non-Hodgkin's lymphoma: correlation with long-term survival

BACKGROUND: Primary refractory disease is a main challenge in the management of non-Hodgkin's Lymphoma (NHL). This survey was performed to define the rate of refractory disease to first-line therapy in B and T-cell NHL subtypes and the long-term survival of primary refractory compared to primary responsive patients. METHODS: Medical records were reviewed of 3,106 patients who had undergone primary treatment for NHL between 1982 and 2012, at the Hematology Centers of Torino and Bergamo, Italy. Primary treatment included CHOP or CHOP-like regimens (63.2%), intensive therapy with autograft (16.9%), or other therapies (19.9%). Among B-cell NHL, 1,356 (47.8%) received first-line chemotherapy with rituximab. Refractory disease was defined as stable/progressive disease, or transient response with disease progression within six months. RESULTS: Overall, 690 (22.2%) patients showed primary refractory disease, with a higher incidence amongst T-cell compared to B-cell NHL (41.9% vs. 20.5%, respectively, p<0.001). Several other clinico-pathological factors at presentation were variably associated with refractory disease, including histological aggressive disease, unfavorable clinical presentation, Bone Marrow involvement, low lymphocyte/monocyte ration and male gender. Amongst B-cell NHL, the addition of rituximab was associated with a marked reduction of refractory disease (13.6% vs. 26.7% for non-supplemented chemotherapy, p<0.001). Overall, primary responsive patients had a median survival of 19.8 years, compared to 1.3 yr. for refractory patients. A prolonged survival was consistently observed in all primary responsive patients regardless of the histology. The long life expectancy of primary responsive patients was documented in both series managed before and after 2.000. Response to first line therapy resulted by far the most predictive factor for long-term outcome (HR for primary refractory disease: 16.52, p<0.001). CONCLUSION: Chemosensitivity to primary treatment is crucial for the long-term survival in NHL. This supports the necessity of studies aimed to early identify refractory disease and to develop different treatment strategies for responsive and refractory patients

Azithromycin may reduce cholestasis in primary sclerosing cholangitis: a case report and serendipitous observation.

The newer macrolides have been shown to exert additional anti-inflammatory effects. We report the possible effect of azithromycin on primary sclerosing cholangitis in a patient treated with the drug for severe asthma. A 45-year-old woman with Crohn?s disease and primary sclerosing cholangitis, also suffering from severe asthma, was treated with azithromycin 500 mg OD for 3 consecutive days a week because of the clinical suspicion of bronchiectasis and the severity of her asthma. When the therapy was discontinued, her urine again became darker, pruritus reappeared with the usual severity and laboratory parameters, evaluated after 6 weeks without azithromycin, also worsened. For these reasons macrolide treatment was re-established. Cholestasis-related symptoms and the dark colour of the urine were again reduced 6 weeks later and laboratory parameters were again reversed. We are therefore tempted to speculate that azithromycin may have an effect on primary sclerosing cholangitis on the basis of its anti-inflammatory properties

[Medical therapy of chronic idiopathic constipation]

The medical care of the idiopathic constipation requires the correct patient identification based on precise classification items and on physiopathological considerations. The laxative abuse is often the most difficult problem to be solved and it has to be dealt with the consideration of different clinical aspects (wrong diet, psychological profile, concomitant diseases, drug therapy, etc.). The first step exactly consists in the identification and correction of the wrong convictions, of the behavioural attitudes and of the unbalanced dietary habits. Adding bran is the second widely accepted therapeutic step based on both physiopathological and epidemiological considerations. Even if the mechanism of action is still not completely understood, the fibre addition per se leads to an improvement of the constipation in quite a relevant percentage of patients, although it is often poorly tolerated. Nevertheless there are peculiar conditions not responsive to the bran addition such as the so-called "anismus". For these situations different therapeutic approaches have been proposed with variable results. Among these we can mention the re-educational programmes of the modalities of the defecation using biofeedback techniques. The chronic idiopathic constipation not respondent to the conventional medical therapy appears anyway a problematic and very difficult condition both from the investigational viewpoint and the therapeutic options. Finally it can be stated that the laxatives have a certain role in those clinical conditions most probably leading to the constipation. For each therapeutic drug class it is, of course, of great importance to know its mode of action as well as its adverse event profile

Azithromycin may reduce cholestasis in primary sclerosing cholangitis: a case report and serendipitous observation.

The newer macrolides have been shown to exert additional anti-inflammatory effects. We report the possible effect of azithromycin on primary sclerosing cholangitis in a patient treated with the drug for severe asthma. A 45-year-old woman with Crohn?s disease and primary sclerosing cholangitis, also suffering from severe asthma, was treated with azithromycin 500 mg OD for 3 consecutive days a week because of the clinical suspicion of bronchiectasis and the severity of her asthma. When the therapy was discontinued, her urine again became darker, pruritus reappeared with the usual severity and laboratory parameters, evaluated after 6 weeks without azithromycin, also worsened. For these reasons macrolide treatment was re-established. Cholestasis-related symptoms and the dark colour of the urine were again reduced 6 weeks later and laboratory parameters were again reversed. We are therefore tempted to speculate that azithromycin may have an effect on primary sclerosing cholangitis on the basis of its anti-inflammatory properties

A think tank of the Italian Society of Colorectal Surgery (SICCR) on the surgical treatment of inflammatory bowel disease using the Delphi method: ulcerative colitis

The majority of patients suffering from ulcerative colitis (UC) are managed successfully with medical treatment, but a relevant number of them will still need surgery at some point in their life. Medical treatments and surgical techniques have changed dramatically in recent years, and available guidelines from relevant societies are rapidly evolving, providing UC experts with updated and valid practical recommendations. However, some aspects of the management of UC patients are still debated, and the application of guidelines in clinical practice may be suboptimal. The Italian Society of Colorectal Surgery (SICCR) sponsored the think tank in order to identify critical aspects of the surgical management of UC in Italy. The present paper reports the results of a think tank of Italian colorectal surgeons concerning surgery for UC and was not developed as an alternative to authoritative guidelines currently available. Members of the SICCR voted on several items proposed by the writing committee, based on evidence from the literature. The results are presented, focusing on points to be implemented. UC management relies on evaluations that need to be individualized, but points of major disagreement reported in this paper should be considered in order to develop strategies to improve the quality of the evidence and the application of guidelines in a clinical setting

Studio etnolinguistico ed antropogenetico di una popolazione residuale dell\u2019Asia Centrale: gli Yaghnobi del Tajikistan. Studio preliminare

International audienceThe French review Cahiers du Sud, based in the great southern port of Marseilles, in an editorial epic that began in 1924 under the review’s courageous editor, Jean Ballard, devoted a significant proportion of its pages to Spanish literature – and culture – in the 1920s-1930s. During this period, the abundance of European literatures, particularly from the North, left little space for that South that always had to fight harder than the other geographical areas for the attention of the public and the critics, or even for them to simply have access to its cultural and artistic productions. In this article, we study how the cosmopolitanism of a French and Mediterranean review functioned alongside the literary production of another Mediterranean country such as Spain, before the Civil War of 1936 spelt the end of numerous innovative artistic projects on the other side of the Pyrenees.La revista francesa Cahiers du Sud, afincada en la gran ciudad sureña y portuaria de Marsella, en una epopeya editorial empezada en 1924 por el valiente director de la revista Jean Ballard, dedicó buena parte de sus páginas a la literatura —y a la cultura— española en una época, los años 20 y 30, en que la abundancia de las literaturas europeas, especialmente en el Norte, dejaba poco espacio a este Sur que siempre tuvo que luchar más que otras áreas geográficas para que el público y los críticos se interesaran por él o simplemente tuvieran acceso a sus producciones culturales y artísticas. Estudiamos en nuestro artículo cómo funcionó el cosmopolitismo de una revista francesa y mediterránea respecto a la producción literaria de otro país mediterráneo como España, antes de que la Guerra Civil de 1936 viera el fin de muchos proyectos artísticos innovadores del otro lado del Pirineo

A think tank of the Italian society of colorectal surgery (SICCR) on the surgical treatment of inflammatory bowel disease using the Delphi method: Crohn's disease

The management of Crohn's disease (CD) requires extensive expertise. Many treatment options are available, and surgery still plays a crucial role. In recent years, many medical societies have provided surgeons and gastroenterologists dealing with CD with authoritative guidelines. However, a certain degree of variation can be observed in these papers, and application of guidelines in clinical practice should be improved. The Italian society of colorectal surgery (SICCR) promoted the project reported here, which consists of a think tank of Italian colorectal surgeons to address the surgical aspects of CD management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of CD. The management of CD is, by necessity, patient-tailored, and it is based on clinical data and surgeon's preference, but the committee was able to identify some points of major disagreement and suggested strategies to improve quality of available data and acceptance of guidelines.The management of Crohn’s disease (CD) requires extensive expertise. Many treatment options are available, and surgery still plays a crucial role. In recent years, many medical societies have provided surgeons and gastroenterologists dealing with CD with authoritative guidelines. However, a certain degree of variation can be observed in these papers, and application of guidelines in clinical practice should be improved. The Italian society of colorectal surgery (SICCR) promoted the project reported here, which consists of a think tank of Italian colorectal surgeons to address the surgical aspects of CD management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of CD. The management of CD is, by necessity, patient-tailored, and it is based on clinical data and surgeon’s preference, but the committee was able to identify some points of major disagreement and suggested strategies to improve quality of available data and acceptance of guidelines