CCNU, vinblastine, procarbazine and prednisone (CVPP) with extended-field radiotherapy in the treatment of early unfavorable Hodgkin's disease - A prospective study on behalf of the Gruppo Italiano per lo Studio dei Linfomi (GISL)

Purpose. To test the adequacy of the CVPP four-drug regimen as ancillary chemotherapy associated with extended-field radiotherapy in the treatment of early, unfavorable, clinically staged Hodgkin's disease. Patients and Methods. The population of this prospective, multicenter study consisted of 49 patients with stage I-II disease, associated with bulky involvement or unfavorable histology (lymphocyte-depleted nodular sclerosis or lymphocyte depletion), systemic symptoms or extranodal involvement, or presenting with stage III A favorable-histology disease, with or without extranodal involvement. Results. Complete remission was achieved in 39 patients, partial remission in 2, while 8 patients did not respond. Four patients have relapsed so far (median follow-up: 43 months), all of whom were subsequently rescued with different salvage treatments. Dose intensity (mean+/-SD: 0.83+/-0.12) and hematological toxicity (including 2 deaths from infection) were higher when RT followed CT than when it was interposed in the middle of the 6 cycles. No growth factors were used. Nonhematological toxicity was very low and fully tolerable. Conclusions. Results confirmed the mild neurological and gastroenteric side effects of CVPP that make it an interesting MOPP-variant regimen. This combination seems most indicated when a regimen devoid of cardiac and pulmonary toxicity is required for association with full-dosage mediastinal radiotherapy, as is often the case in early, unfavorable Hodgkin's disease. The optimal sequence consists of radiotherapy administered after completion of the chemotherapy program. The use of growth factors for correction (or prevention) of marked leukopenia seems appropriate

Search for hydrogen peroxide in the Martian atmosphere by the Planetary Fourier Spectrometer onboard Mars Express

We searched for hydrogen peroxide (H2O2) in the Martian atmosphere using data measured by the Planetary Fourier Spectrometer (PFS) onboard Mars Express during five martian years (MY27-31). It is well known that H2O2 plays a key role in the oxidizing capacity of the Martian atmosphere. However, only a few studies based on ground-based observations can be found in the literature. Here, we performed the first analysis of H2O2 using long-term measurements by a spacecraft-borne instrument. We used the ν4 band of H2O2 in the spectral range between 359 cm-1 and 382 cm-1 where strong features of H2O2 are present around 362 cm-1 and 379 cm-1. Since the features were expected to be very weak even at the strong band, sensitive data calibrations were performed and a large number of spectra were selected and averaged. We made three averaged spectra for different seasons over relatively low latitudes (50°S-50°N). We found features of H2O2 at 379 cm-1, whereas no clear features were detected at 362 cm-1 due to large amounts of uncertainty in the data. The derived mixing ratios of H2O2 were close to the detection limits: 16 ± 19 ppb at Ls = 0-120°, 35 ± 32 ppb at Ls = 120-240°, and 41 ± 28 ppb at Ls = 240-360°. The retrieved value showed the detection of H2O2 only for the third seasonal period, and the values in the other periods provided the upper limits. These long-term averaged abundances derived by the PFS generally agreed with the ones reported by ground-based observations. From our derived mixing ratio of H2O2, the lifetime of CH4 in the Martian atmosphere is estimated to be several decades in the shortest case. Our results and sporadic detections of CH4 suggest the presence of strong CH4 sinks not subject to atmospheric oxidation. <P /

12 years of atmospheric monitoring by the Planetary Fourier Spectrometer onboard Mars Express

We use thermal-infrared spectra returned by the Mars Express Planetary Fourier Spectrometer (PFS-MEx) to retrieve atmospheric and surface temperature, and dust and water ice aerosol optical depth. More than 2,500,000 spectra have been used to build this new dataset, covering the full range of season, latitude, longitude, and local time. The data presented here span more than six Martian years (from MY26, Ls = 331°, 10 January 2004 to MY 33, Ls = 78°, 6 December 2015). We successfully retrieved atmospheric temperatures and aerosols opacity in the polar regions, including the polar nights. By exploiting PFS/MEx capability to perform observations at different local times (LT), this dataset allows investigation of the daily cycles of suspended dust and ice. We present an overview of the seasonal and latitudinal dependence of atmospheric quantities during the relevant period, as well as an assessment of the interannual variability in the current Martian climate, including spatial, daily (LT), seasonal, and interannual variations of the aphelion equatorial cloud belt. With unprecedented spatial and temporal coverage and details revealed, this dataset offers new challenges to the GCMs and, at the same time, a new reference for the MYs complementary to those observed by MGS-TES

Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population

Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25–79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008–2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake

Independent confirmation of a methane spike on Mars and a source region east of Gale Crater

Reports of methane detection in the Martian atmosphere have been intensely debated. The presence of methane could enhance habitability and may even be a signature of life. However, no detection has been confirmed with independent measurements. Here, we report a firm detection of 15.5 ± 2.5 ppb by volume of methane in the Martian atmosphere above Gale Crater on 16 June 2013, by the Planetary Fourier Spectrometer onboard Mars Express, one day after the in situ observation of a methane spike by the Curiosity rover. Methane was not detected in other orbital passages. The detection uses improved observational geometry, as well as more sophisticated data treatment and analysis, and constitutes a contemporaneous, independent detection of methane. We perform ensemble simulations of the Martian atmosphere, using stochastic gas release scenarios to identify a potential source region east of Gale Crater. Our independent geological analysis also points to a source in this region, where faults of Aeolis Mensae may extend into proposed shallow ice of the Medusae Fossae Formation and episodically release gas trapped below or within the ice. Our identification of a probable release location will provide focus for future investigations into the origin of methane on Mars

Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape

What is the role of the placebo effect for pain relief in neurorehabilitation? Clinical implications from the Italian consensus conference on pain in neurorehabilitation

Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy

PFS Scientific Results and Statistics for the First 100 Orbits of the Mars Express Mission.

International audienc

PFS Scientific Results and Statistics for the First 100 Orbits of the Mars Express Mission.

International audienc