The course of cancer related fatigue up to ten years in early breast cancer patients. What impact in clinical practice?

Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors. This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress. Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF. Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT. Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue

LISA Pathfinder test-mass charging during galactic cosmic-ray flux short-term variations

none5sìMetal free-floating test masses aboard the future interferometers devoted to gravitational wave detection in space are charged by galactic and solar cosmic rays with energies > 100 MeV/n. This process represents one of the main sources of noise in the lowest frequency band (< 10(-3) Hz) of these experiments. We study here the charging of the LISA Pathfinder (LISA-PF) gold-platinum test masses due to galactic cosmic-ray (GCR) protons and helium nuclei with the Fluka Monte Carlo toolkit. Projections of the energy spectra of GCRs during the LISA-PF operations in 2015 are considered. This work was carried out on the basis of the solar activity level and solar polarity epoch expected for LISA-PF. The effects of GCR short-term variations are evaluated here for the first time. Classical Forbush decreases, GCR variations induced by the Sun rotation, and fluctuations in the LISA-PF frequency bandwidth are discussed.Article Number: 035001openGrimani, Catia; Fabi, M.; Lobo, A.; Mateos, I.; Telloni, D.Grimani, Catia; Fabi, M.; Lobo, A.; Mateos, I.; Telloni, D

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

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

Weekly epirubicin plus lonidamine in advanced breast carcinoma

: Lonidamine has been demonstrated to potentiate the cytotoxic activity of several antineoplastic drugs, for example anthracyclines. Moreover, epirubicin is considered one of the most active drugs in advanced breast cancer, although optimal dose and schedule remains to be defined. In the present study we have treated 51 patients with advanced breast cancer with a combination of lonidamine (450 mg/day orally from day 1 throughout treatment) and epirubicin (25 mg/m2 i.v.) administered according to a weekly schedule for 24 weeks. Objective responses were observed in 29 out of 51 patients (57%; CR 16%, PR 41%). Liver metastases responded in eight out of 12 evaluable patients (67%). Average response duration was 12.4 months and median overall survival was 23 months (range 1-90+). Toxicity was negligible. The combination of weekly epirubicin and lonidamine is feasible and active in advanced breast cancer patients

Dental anomalies : prevalence and associations between them in a large sample of non-orthodontic subjects, a cross-sectional study

Background: To analyze the prevalence and associations between dental anomalies detectable on panoramic radiographs in a sample of non-orthodontic growing subjects. Methods: For this cross-sectional study, digital panoramic radiographs of 5005 subjects were initially screened from a single radiographic center in Rome. Inclusion criteria were: subjects who were aged 8–12 years, Caucasian, and had good diagnostic quality radiographs. Syndromic subjects, those with craniofacial malformation, or orthodontic patients were excluded and this led to a sample of 4706 subjects [mean (SD) age = 9.6 (1.2) years, 2366 males and 2340 females]. Sample was subsequently divided into four subgroups (8, 9, 10, and 11–12 year-old groups). Two operators examined panoramic radiographs to observe the presence of common dental anomalies. The prevalence and associations between dental anomalies were also investigated. Results: The overall prevalence of dental anomalies was 20.9%. Approximately, 17.9% showed only one anomaly, 2.7% two anomalies, while only 0.3% had more than two anomalies. The most frequent anomalies were the displacement of maxillary canine (7.5%), hypodontia (7.1%), impacted teeth (3.9%), tooth ankylosis (2.8%), and tooth transposition (1.4%). The lower right second premolar was the most frequent missing teeth; 3.7% had only one tooth agenesis, and 0.08% had six or more missing tooth (Oligodontia). Mesiodens was the most common type of supernumerary tooth (0.66%). Two subjects had taurodontic tooth (0.04%). Tooth transpositions and displacement of maxillary canine were seen in 1.4 and 7.5%, retrospectively (approximately 69 and 58% were in the 8 and 9 year-old groups, retrospectively). Significant associations were detected between the different dental anomalies (P < .05). Conclusions: The results of our study revealed significant associations among different dental anomalies and provide further evidences to support common etiological factors

A retrospective evaluation of subsurface monopolar radiofrequency for lifting of the face, neck, and Jawline

BACKGROUND Subsurface monopolar radiofrequency (SMRF) has emerged as a new method for reducing skin laxity via the controlled delivery of thermal energy below the skin using a radiofrequency probe. OBJECTIVE To evaluate the overall efficacy of the treatment and satisfaction ratings of subjects who underwent a single SMRF treatment to the face, neck, or jawline (or some combination). MATERIALS AND METHODS A retrospective, single-center study was conducted in which data were obtained via subject follow-ups at 90 and 180 days posttreatment. RESULTS A total of 35 subjects, 6 men and 29 women, underwent a single SMRF treatment. Overall, 77% of subjects reported improvement, and 64% reported satisfaction with the treatment site at Day 180 posttreatment. CONCLUSION Subsurface monopolar radiofrequency represents an effective modality to achieve skin tightening of the face, neck, and jawline. The data suggest that there is an energy delivery threshold, above which a higher percentage of subjects report satisfaction. Analysis of treatments parameters suggests an optimal treatment time and tissue temperature that should be achieved to maximize results. © 2016 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc

Raja asterias population assessment in FAO GFCM GSA17 area

Population structure and distribution of the starry ray, Raja asterias, were described based on data collected during yearly rapido trawl surveys (SoleMon), between 2005 and 2014 in the Northern and Central Adriatic Sea. A total of 306 individuals were caught, sex ratio was 1.04:1 in favor of males and length-weight relationships were obtained for the whole sample. Following the MEDITS scale, maturity was estimated, observing a higher number of immature individuals. Relative abundance significantly increased during the recent period with the highest values recorded at 5-30 m depths. Such increase could be related to the response of R. asterias to climatic change or to the decrease  in fishing pressure in the area. Clear spatial segregation of individuals depending on their life stage was observed, with immature individuals inhabiting the coastal areas and adults more abundant at depths greater than 40 m. The comparison of the result of the present study with MEDITS survey outcomes in terms of  distribution patterns, persistence areas of adults and juveniles and abundances indices, evidences that SoleMon survey seems to be more suitable in defining such features of the stock, likely due to the greater catchability of the rapido trawl in respect to the MEDITS trawl net. However, further investigations are needed to identify factors affecting the increasing abundance of this species, and develop an action plan for spatial management of fishing activities

Silo collapse under granular discharge

We investigate, at a laboratory scale, the collapse of cylindrical shells of radius $R$ and thickness $t$ induced by a granular discharge. We measure the critical filling height for which the structure fails upon discharge. We observe that the silos sustain filling heights significantly above an estimation obtained by coupling standard shell-buckling and granular stress distribution theories. Two effects contribute to stabilize the structure: (i) below the critical filling height, a dynamical stabilization due to granular wall friction prevents the localized shell-buckling modes to grow irreversibly; (ii) above the critical filling height, collapse occurs before the downward sliding motion of the whole granular column sets in, such that only a partial friction mobilization is at play. However, we notice also that the critical filling height is reduced as the grain size, $d$, increases. The importance of grain size contribution is controlled by the ratio $d/\sqrt{R t}$. We rationalize these antagonist effects with a novel fluid/structure theory both accounting for the actual status of granular friction at the wall and the inherent shell imperfections mediated by the grains. This theory yields new scaling predictions which are compared with the experimental results.Comment: Original work, 13 pages and 11 figure