Leucomelanoderma in blacks

A recent epidemic of leucomelanoderma in Blacks is described. A total of 347 patients was seen in two hospitals during the survey period. The ratio of females to males was 7:1. A striking pattern af patchy depigmentation and mottled hypermelanosis occurred predominantly on the face and neck, but sometimes extended to other areas. Most but not all cases later showed repigmentation. The cause of the dyschromia appeared to be monobenzone, a bleaching agent recently included in certain overnight creams packed in wide-mouthed jars.S. Afr. Med. J., 48, 1555 (1974)

Using the automated HYPERNETS hyperspectral system for multi-mission satellite ocean colour validation in the Río de la Plata, accounting for different spatial resolutions

Validation of water reflectance using in situ data is essential to ensure the quality of ocean colour satellite-derived products useful for water quality monitoring, like turbidity and chlorophyll-a concentration. Since December 2021, the HYPERNETS automated hyperspectral system has been collecting data in the optically complex and highly turbid waters of the Río de la Plata, an ideal scenario for testing atmospheric correction algorithms’ performance. The site, located 60 km south of Buenos Aires (Argentina), is described in relation to the water reflectance spectral features and variability using high spatial resolution imagery and a methodology is proposed to objectively select a sensor-specific location of a reference pixel for satellite validation. Six months of data is used to evaluate surface water reflectance operational products from multi-spectral systems like Landsat 8&9/OLI (L89/OLI), Sentinel-2/MSI (S2/MSI) & Sentinel-3/OLCI (S3/OLCI), and PlanetScope SuperDoves (PS/SD), and also non standard products for Aqua/MODIS (Aqua/MODIS) and SNPP&JPSS1/VIIRS (SJ/VIIRS) missions. Moreover, the standard surface water reflectance product from the hyperspectral PRISMA mission could also be evaluated. The matchups show general good results when in situ measurements are compared to L2 standard products of high spatial resolution sensors that use land-based atmospheric correction approach, if sun glint contamination is avoided. Low mean relative percentage difference was found for S2/MSI (2.45%) and L89/OLI (−3.52%), but higher for PS/SD (30.7%). In turn, S3/OLCI medium resolution also showed low mean relative differences (2.31%), while SJ/VIIRS and Aqua/MODIS showed larger and negative differences (−16.35 for SJ/VIIRS and −35.6% for Aqua/MODIS) which showed a clear increase towards the shortest blue bands. The results show the great potential of the HYPERNETS automated system to provide high quality and quantity of data for validation of satellite data at all visible and near infrared (VNIR, 400–900 nm) wavelengths in a multi-mission perspective

Validation of satellite water products based on HYPERNETS in situ data using a Match-up Database (MDB) file structure

A Match-up Database (MDB) file structure and tools were developed to ease the validation analysis of satellite water products and to improve the exchange and processing of match-up data from different sites, missions and atmospheric correction processors. In situ remote sensing reflectance (Rrs) measurements were available from the HYPSTAR® (HYperspectral Pointable System for Terrestrial and Aquatic Radiometry), a new automated hyperspectral radiometer. An MDB file is a NetCDF file containing all the potential match-ups between satellite and in situ data on a specific site and within a given time window. These files are generated and manipulated with three modules developed in Python to implement the validation protocols: extract satellite data, associate each extract with co-located in situ radiometry data, and then perform the validation analysis. This work provides details on the implementation of the open-source MDB file structure and tools. The approach is demonstrated by a multi-site matchup comparison based on satellite data from the Sentinel-2 MSI and Sentinel-3 OLCI sensors, and HYPSTAR® data acquired over six water sites with diverse optical regimes from February 2021 to March 2023.The analysis of Sentinel-3 OLCI matchups across the six sites shows consistency with previous comparisons based on AERONET-OC data over extended reflectance range. We evaluated Sentinel-2 MSI reflectance data corrected with two atmospheric correction processors (ACOLITE and C2RCC) over four sites with clear to highly turbid waters. Results showed that the performance of the processors depends on the optical regime of the sites. Overall, we proved the suitability of the open-source MDB-based approach to implement validation protocols and generate automated matchup analyses for different missions, processors and sites

Real life use of bendamustine in elderly patients with lymphoid neoplasia

Background. Bendamustine is a cytotoxic alkylating drug with a broad range of indications as a single agent or in combination therapy in lymphoid neoplasia patients. However, its tolerability in elderly patients is still debated. Methods: An observational, retrospective study was carried out; patients with chronic lymphocytic leukemia (CLL) or lymphoma, aged ≥ 65 years old, treated with bendamustine-based regimens in first or subsequent lines between 2010 and 2020 were considered eligible. Results: Overall, 179 patients aged ≥ 65 years were enrolled, 53% between 71 and 79 years old. Cumulative Illness Rating Scale (CIRS) comorbidity score was ≥6 in 54% patients. Overall survival (OS) at 12 months was 95% (95% confidence interval [CI]: 90–97%); after a median follow up of 50 months, median OS was 84 months. The overall response rate was 87%, with 56% complete responses; the median time to progression (TTP) was 61 months. The baseline factors affecting OS by multivariable analysis were sex, histological diagnosis, renal function, and planned bendamustine dose, while only type of lymphoma and bendamustine dose impacted on TTP. Main adverse events were neutropenia (grade ≥ 3: 43%) and infections (any grade: 36%), with 17% of patients requiring hospital admission. Conclusions: The responses to bendamustine, as well as survival, are relevant even in advanced age patients, with a manageable incidence of acute toxicity

Distribution and ecology of <i>Pseudo-nitzschia</i> species (Bacillariophyceae) in surface waters of the Weddell Sea (Antarctica)

The distribution of six Pseudo-nitzschia species and their relationship with environmental conditions were studied for the first time in a vast zone of the Weddell Sea (∼61–77°S, Antarctica). Both qualitative and quantitative phytoplankton samples, collected during summer 2004, were examined using light and scanning electron microscopy. Phytoplankton abundance and composition showed great variability along our study area. Diatoms were the most conspicuous phytoplankton group in the northern area while small flagellates were generally dominant in the southern stations. The genus Pseudo-nitzschia was broadly distributed and significantly contributed to total diatom densities. A marked contrast in Pseudo-nitzschia species distribution was observed in three main zones divided by the Weddell Front (WF) and the Antarctic Slope Front (ASF). P. subcurvata and P. turgiduloides were the most abundant species in the neritic Weddell Sea zone, south of the ASF, mainly near the ice-edge in shallower waters and in conditions of long photoperiod. In contrast, P. prolongatoides and P. lineola dominated north of the ASF; the first was associated with deeper and nutrient-rich waters whereas the latter showed a weak relation with environmental variables examined. Finally, P. turgidula and P. heimii were mostly observed in the Weddell–Scotia Confluence Zone in the warmest and far from ice covered waters, north of the WF. A brief morphological Pseudo-nitzschia species description is given in the Appendix, including morphometrics and pictures.Facultad de Ciencias Naturales y Muse

Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5-12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss &gt;10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II-III-IV NLPHL

Observational study of chronic myeloid leukemia italian patients who discontinued tyrosine kinase inhibitors in clinical practice

It is judged safe to discontinue treatment with tyrosine kinase inhibitors (TKI) for chronic myeloid leukemia (CML) in experimental trials on treatment-free remission (TFR). We collected a total of 293 Italian patients with chronic phase CML who discontinued TKI in deep molecular response. Seventy-two percent of patients were on treatment with imatinib, and 28% with second generation TKI at the time of discontinuation. Median duration of treatment with the last TKI was 77 months [Interquartile Range (IQR) 54;111], median duration of deep molecular response was 46 months (IQR 31;74). Duration of treatment with TKI and duration of deep molecular response were shorter with second generation TKI than with imatinib (P&lt;0.001). Eighty-eight percent of patients discontinued as per clinical practice, and reasons for stopping treatment were: toxicity (20%), pregnancy (6%), and shared decision between treating physician and patient (62%). After a median follow up of 34 months (range, 12-161) overall estimated TFR was 62% (95%CI: 56;68). At 12 months, TFR was 68% (95%CI: 62;74) for imatinib, 73% (95%CI: 64;83) for second generation TKI. Overall median time to restart treatment was six months (IQR 4;11). No progressions occurred. Although our study has the limitation of a retrospective study, our experience within the Italian population confirms that discontinuation of imatinib and second generation TKI is feasible and safe in clinical practice

Paclitaxel, vinorelbine and 5-fluorouracil in breast cancer patients pretreated with adjuvant anthracyclines

We investigated the activity and toxicity of a combination of vinorelbine (VNB), paclitaxel (PTX) and 5-fluorouracil (5-FU) continuous infusion administered as first-line chemotherapy in metastatic breast cancer patients pretreated with adjuvant anthracyclines. A total of 61 patients received a regimen consisting of VNB 25 mg m−2 on days 1 and 15, PTX 60 mg m−2 on days 1, 8 and 15 and continuous infusion of 5-FU at 200 mg m−2 every day. Cycles were repeated every 28 days. Disease response was evaluated by both RECIST and World Health Organization (WHO) criteria. Objective responses were recorded in 39 of 61 patients (64.0%) assessed by WHO and in 36 of 50 patients (72.0%) assessable by RECIST criteria. Complete remission occurred in 15 (24.6%) and 14 patients (28.0%), respectively. The median time to progression and overall survival of entire population was 10.6 and 27.3 months, respectively, and median duration of complete response was 14.8 months. The dose-limiting toxicity was myelosuppression (leucopenia grade 3/4 in 52.5% of patients). Grade 3/4 nonhaematologic toxicities included mucositis/diarrhoea in 13.1%, skin in 3.3% and cardiac in 1.6% of patients. Grade 2/3 neurotoxicity was observed in five patients (7.2%). The VNB, PTX and 5-FU continuous infusion combination regimen was active and manageable. Complete responses were frequent and durable