Sistemi di produzione di raggi X per diagnostica medica: possibili sviluppi

Scopo di questo elaborato è esplorare alternative alla tecnologia dei tubi a raggi X per uso medico che nella forma attuale risale al 1913, con particolare riguardo alle radiografie dentali; individuate le quantità in gioco e i loro ordini dei grandezza si analizzerà la fattibilità di una modifica a tali tecniche, la sostituzione dell'anodo degli apparati con un anodo fine, stimando nuovamente le grandezze sensibili e discutendo pro e contro della tecnica. Saranno inoltre prese in considerazione altre possibilità di produzione di raggi X.ope

Biomarkers in Breast Cancer

Breast cancer is the most common cancer in women and its incidence experienced an important increase, thanks to the introduction of a systematic screening. The increased incidence of early breast cancer has led to debates on its over-treatment, which may cause unnecessary harm to patients with favorable prognosis. Therefore, modern research is in the quest of finding the perfect prognostic marker to avoid overtreatment in patients with a favorable prognosis. In this perspective, many molecular markers have been studied in the last decades in order to provide both a useful prognostic tool, able to determine whether the cancer is likely to be indolent or aggressive, and a possible therapeutic target. In this chapter, we review the current knowledge about the principal biomarkers, which are usually immunohistochemically tested on breast surgical specimens, including ER and PR, Mib1/Ki-67 and HER2/neu expression. Furthermore, we will analyze other possible prognostic markers which may have in the future a key role in breast cancer management, such as several multigene panels (OncotypeDX, Mammaprint, NanoString Prosigma). Finally, we will discuss the role of genetic tests for some know genetic mutations associated with higher breast cancer susceptibility (BRCA1 and 2 genes)

Risk-Reducing Breast and Gynecological Surgery for BRCA Mutation Carriers: A Narrative Review

This narrative review aims to clarify the role of breast and gynecological risk-reduction surgery in BRCA mutation carriers. We examine the indications, contraindications, complications, technical aspects, timing, economic impact, ethical issues, and prognostic benefits of the most common prophylactic surgical options from the perspectives of a breast surgeon and a gynecologist. A comprehensive literature review was conducted using the PubMed/Medline, Scopus, and EMBASE databases. The databases were explored from their inceptions to August 2022. Three independent reviewers screened the items and selected those most relevant to this review’s scope. BRCA1/2 mutation carriers are significantly more likely to develop breast, ovarian, and serous endometrial cancer. Because of the Angelina effect, there has been a significant increase in bilateral risk-reducing mastectomy (BRRM) since 2013. BRRM and risk-reducing salpingo-oophorectomy (RRSO) significantly reduce the risk of developing breast and ovarian cancer. RRSO has significant side effects, including an impact on fertility and early menopause (i.e., vasomotor symptoms, cardiovascular disease, osteoporosis, cognitive impairment, and sexual dysfunction). Hormonal therapy can help with these symptoms. Because of the lower risk of developing breast cancer in the residual mammary gland tissue after BRRM, estrogen-only treatments have an advantage over an estrogen/progesterone combined treatment. Risk-reducing hysterectomy allows for estrogen-only treatments and lowers the risk of endometrial cancer. Although prophylactic surgery reduces the cancer risk, it has disadvantages associated with early menopause. A multidisciplinary team must carefully inform the woman who chooses this path of the broad spectrum of implications, from cancer risk reduction to hormonal therapies

Breast and Axilla Treatment in Ductal Carcinoma In Situ

Ductal carcinoma in situ (DCIS) represents a challenge for the breast unit team, beginning from its difficult radiological detection and continuing with its controversial multimodal treatment and management. With the introduction of the mammographic screening, DCIS has become a common diagnosis. In fact, today DCIS is mostly identified by mammography or magnetic resonance imaging (MRI). The increased prevalence of DCIS diagnosis, in the past, raised the problem of the therapeutic management. In this chapter, the breast and axillary surgery in case of DCIS and the most controversial aspects regarding DCIS management are reviewed based on international guidelines and on the current literature

High quality factor photonic cavity for dark matter axion searches

Searches for dark matter axion involve the use of microwave resonant cavities operating in a strong magnetic field. Detector sensitivity is directly related to the cavity quality factor, which is limited, however, by the presence of the external magnetic field. In this paper we present a cavity of novel design whose quality factor is not affected by a magnetic field. It is based on a photonic structure by the use of sapphire rods. The quality factor at cryogenic temperature is in excess of $5 \times 10^5$ for a selected mode.Comment: 6 pages, 7 figure

Search for galactic axions with a high-Q dielectric cavity

A haloscope of the QUAX--$a\gamma$ experiment, composed of an high-Q resonant cavity immersed in a 8 T magnet and cooled to $\sim 4.5$~K is operated to search for galactic axion with mass $m_a\simeq42.8~\mu\text{eV}$. The design of the cavity with hollow dielectric cylinders concentrically inserted in a OFHC Cu cavity, allowed us to maintain a loaded quality-factor Q $\sim 300000$ during the measurements in presence of magnetic field. Through the cavity tuning mechanism it was possible to modulate the resonance frequency of the haloscope in the region $10.35337-10.35345$~GHz and thus acquire different dataset at different resonance frequencies. Acquiring each dataset for about 50 minutes, combining them and correcting for the axion's signal estimation-efficiency we set a limit on the axion-photon coupling $g_{a\gamma\gamma}< 0.731\times10^{-13}$ GeV$^{-1}$ with the confidence level set at $90\%$

Galactic axions search with a superconducting resonant cavity

To account for the dark matter content in our Universe, post-inflationary scenarios predict for the QCD axion a mass in the range (10-10^3)\,\mu\mbox{eV}. Searches with haloscope experiments in this mass range require the monitoring of resonant cavity modes with frequency above 5\,GHz, where several experimental limitations occur due to linear amplifiers, small volumes, and low quality factors of Cu resonant cavities. In this paper we deal with the last issue, presenting the result of a search for galactic axions using a haloscope based on a 36\,\mbox{cm}^3 NbTi superconducting cavity. The cavity worked at T=4\,\mbox{K} in a 2\,T magnetic field and exhibited a quality factor $Q_0= 4.5\times10^5$ for the TM010 mode at 9\,GHz. With such values of $Q$ the axion signal is significantly increased with respect to copper cavity haloscopes. Operating this setup we set the limit g_{a\gamma\gamma}<1.03\times10^{-12}\,\mbox{GeV}^{-1} on the axion photon coupling for a mass of about 37\,$\mu$eV. A comprehensive study of the NbTi cavity at different magnetic fields, temperatures, and frequencies is also presented

Hypersensitivity to Pegylated E.coli asparaginase as first-line treatment in contemporary paediatric acute lymphoblastic leukaemia protocols: a meta-analysis of the Ponte di Legno Toxicity working group

Background: Hypersensitivity reactions to asparaginase challenge its use and occur frequently (30-75%) after native Escherichia Coli (E.coli) asparaginase. Comparison of inci-dence of allergic reactions to pegylated E.coli asparaginase (PEGasparaginase) across contem-porary paediatric acute lymphoblastic leukaemia (ALL) protocols is lacking. Method and patients: Questionnaires were sent to all members of the international ALL Ponte di Legno Toxicity Working Group. Meta-analyses were conducted to estimate the incidence of three types of hypersensitivity (allergy, allergic-like reaction and silent inactivation). Informa-tion on protocol level regarding PEGasparaginase dosing regimen, administration route and use of therapeutic drug monitoring was collected for risk analysis. Results: Newly diagnosed patients with ALL (n Z 5880), aged 1-24 years old, were enrolled in seven different upfront ALL protocols using PEGasparaginase as first-line treatment. The incidence of allergic reactions (sum of allergies and allergic-like reactions) [95% confidence in-terval] was 2% [1%; 3%] during induction and 8% [5%; 11%] during postinduction. Route of administration, number of doses, dosage and number of PEGasparaginase-free weeks did not significantly influence risk of hypersensitivity. Multivariate meta-regression analysis suggests that initiation of PEGasparaginase in postinduction and higher number of PEGasparaginase-free intervals increased the risk for allergic reactions. 9-16% and 23-29% of all hypersensitivities were allergic-like reactions and silent inactivation, respectively. Conclusion: The incidence of allergic reactions is lower in protocols using PEGasparaginase as first-line treatment compared with that reported for E.coli asparaginase or PEGasparaginase after E.coli asparaginase. Postinduction phase, a higher number of PEGasparaginase-free intervals, and initiation of PEGasparaginase in postinduction phase are risk factors for allergic reactions. These results are important for planning of PEGasparaginase administrations in future frontline therapy. Analysis and Stochastic

Histopathological Characterization of Tail Injury and Traumatic Neuroma Development after Tail Docking in Piglets

SummaryTail docking of neonatal pigs is widely used as a measure to reduce the incidence of tail biting, a complex management problem in the pig industry. Concerns exist over the long-term consequences of tail docking for possible tail stump pain sensitivity due to the development of traumatic neuromas in injured peripheral nerves. Tail stumps were obtained post mortem from four female pigs at each of 1, 4, 8 and 16 weeks following tail amputation (approximately two-thirds removed) by a gas-heated docking iron on post natal day 3. Tissues were processed routinely for histopathological examination. Non-neural inflammatory and reparative epidermal and dermal changes associated with tissue thickening and healing were observed 1 to 4 months after docking. Mild neutrophilic inflammation was present in some cases, although this and other degenerative and non-neural reparative changes are not likely to have caused pain. Traumatic neuroma and neuromatous tissue development was not observed 1 week after tail docking, but was evident 1 month after tail docking. Over time there was marked nerve sheath and axonal proliferation leading to the formation of neuromata, which were either localized and circumscribed or comprised of multiple axons dispersed within granulation tissue. Four months after tail resection, neuroma formation was still incomplete, with possible implications for sensitivity of the tail stump