management of one patient with oligoprogressive thyroid cancer during treatment with lenvatinib

Recent thyroid cancer guidelines found it reasonable to use local therapies during treatment with tyrosine kinase inhibitors (TKIs) in selected patients with oligoprogressive disease, namely, in the presence of a single progressing lesion in an otherwise TKI-responsive metastatic cancer. However, there is a lack of experience in the management of oligoprogressive thyroid cancers. This report illustrates the case of one patient with oligoprogressive thyroid cancer during therapy with lenvatinib. We found that the application of local ablative therapy in oligoprogressive disease prolonged the progression-free survival and thus extended the time to therapy interruption. However, the optimal care for TKI-treated oligoprogressive cancers remains unclear and needs to be investigated in prospective trials

Verbano

L’obiettivo del progetto è la soluzione del problema Verbano tramite la scelta di una nuova regolazione e di oppurtuni interventi strutturali. Tale soluzione deve tendere a minimizzare i danni causati da eventi alluvionali tanto a monte quanto a valle, i danni indotti dalla mancata fornitura idrica agli utenti irrigui ed idroelettrici di valle e quelli subiti dalla navigazione e dal turismo quando si deprimono eccessivamente i livelli lacuali, senza trascurare, nel contempo, il mantenimento di un deflusso minimo nel Ticino, a valle dello sbarramento del Panperduto. In tale ricerca si dovranno ovviamente tener conto dei vincoli posti dalla capacità di smaltimento delle portate all’incile del lago e dalla necessità di mantenere attiva la sua naturale funzione di laminazione in occasione di eventi alluvionali che interessino anche il Po

Ten year survival after excision of squamous cell cancer in Zenker's diverticulum: report of a case

BACKGROUND: Zenker's diverticulum (ZD) has been increasingly recognized as a site of primary epithelial malignancy. Pitt in 1896 described the first case. METHODS: Between 1990 and 2005, 30 patients affected of esophageal diverticulum were referred to our Department. RESULTS: The pathological results revealed one case of squamous cell carcinoma. On follow-up 10 years after diverticulectomy alone, the patient was alive and well without evidence of recurrence. CONCLUSION: Our case reported provides additional data on clinical decision when the tumor is well localized without full-thickness penetration or extension to the line of resection. In this patient, long-term survival and apparent disease control have been effected by diverticulectomy alone. A case of such long survival is very rare

Morphometric anatomical and CT study of the human adult sacroiliac region.

To identify and describe the morphometry and CT features of the articular and extra-articular portions of the sacroiliac region. The resulting knowledge might help to avoid complications in sacroiliac joint (SIJ) fusion. We analyzed 102 dry hemi-sacra, 80 ilia, and 10 intact pelves and assessed the pelvic computerized tomography (CT) scans of 90 patients, who underwent the examination for conditions not involving the pelvis. We assessed both the posterior aspect of sacrum with regard to the depressions located externally to the lateral sacral crest at the level of the proximal three sacral vertebrae and the posteroinferior aspect of ilium. Coronal and axial CT scans of the SIJ of patients were obtained and the joint space was measured. On each side, the sacrum exhibits three bone depressions, not described in anatomic textbooks or studies, facing the medial aspect of the posteroinferior ilium, not yet described in detail. Both structures are extra-articular portions situated posteriorly to the SIJ. Coronal CT scans of patients showing the first three sacral foramens and the interval between sacrum and ilium as a continuous space display only the S1 and S3 portions of SIJ, the intermediate portion being extra-articular. The S2 portion is visible on the most anterior coronal scan. Axial scans show articular and extra-articular portions and features improperly described as anatomic variations. Extra-articular portions of the sacroiliac region, not yet described exhaustively, have often been confused with SIJ. Coronal CT scans through the middle part of sacrum, the most used to evaluate degenerative and inflammatory conditions of SIJ, show articular and extra-articular portions of the region

President Obama’s Humble Face: An Authentic or a Socially Desirable Posturing? A Study on Reactions to Obama’s Autobiographical Self-Disclosures

Referring to the mainstream studies based on the personalization’s hypothesis, which positively evaluates signals of dominance shown by leaders, the analysis of Obama’s rhetoric stays a relevant exception. His risky recall, during his political talks, of his social difficulties as a child of a mixed couple was in fact one of the more surprising aspects of his success. Nevertheless, reactions to his autobiographical sharing were scarcely explored. Based on the idea that these self-disclosures signal his responsivity toward the audience of low social condition and can, therefore, be defined as a sign of humility, this research aims to test if coherence between Obama’s words and his facial expressions of contempt, due to the seriousness of social injustices endured in his childhood, may influence the receivers’ perception of such unexpected communication. Before reading a brief autobiographical sharing taken from a “Back-to-school” speech, a highly ritualized monolog the US President addresses each year to students, 175 Italian participants were presented with a photo of Obama displaying either an expression of contempt (taken from the video of the speech) or a neutral expression. Comparisons between self-assessments of perceptions and reactions of participants assigned to the two experimental conditions show that a facial expression of contempt, coherent with words describing his school difficulties, has been crucial for perceiving this humble political discourse as authentic and not as a simple socially desirable posturing. More studies seem to be needed, however, to understand how humble speech could enhance the positive face of leaders or backfire against them

Drug addicted mothers and their empathic reactivity to painful cues.

Introduction: Mother-infant relationship is crucial for offspring\u2019s development. Substance-abuse has been shown to affect adults\u2019 ability to care for their children, in particular in the affective- relational aspects of parenting, such as the attachment bond and the ability to provide protection. Surprisingly, no previous study has explored neural responses associated with empathy towards children\u2019s pain in mothers with such history. Empathy is a more general construct than parenting and deficits in neural empathic responses may better explain failures in caring of addicted mothers. Aims of the study: This study was aimed at investigating the empathic response to pain inflicted by a dangerous tool to hands of kids when compared to neutral situations in a sample of mothers with history of drug-abuse. We used Event-Related Potentials (ERPs) technique to explore the time-course of neural empathic responses to pain by virtue of its excellent time resolution. In particular, we asked whether empathic responses to pain of children would differ in drug-addicted mothers compared to control group, during a relatively automatic early stage of processing or during a more controlled delayed one involving mentalizing. Material and methods: Event-related potentials (ERPs) have been recorded from drug-addicted mothers (i.e., clinical) and control groups to track neural activity in a pain decision task. Stimuli were pictures showing one infant hand in painful (harmful object applied to the hand) and neutral situations (harmful object located close to the hand). Results: Neural empathic responses towards children in pain differed between the two groups such that ERPs diverged between the painful and neutral stimulation at delayed stages of processing only for the clinical group. Conclusions: We interpreted these results as indicating that the control group implicitly judged also the neutral situations involving children as potentially painful supporting a lack of mentalizing abilities in the clinical group when compared with controls

ERP evidence for ultra-fast semantic processing in the picture-word interference paradigm

International audienceWe used the event-related potential (ERP) approach combined with a subtraction technique to explore the timecourse of activation of semantic and phonological representations in the picture–word interference paradigm. Subjects were exposed to to-be-named pictures superimposed on to-be-ignored semantically related, phonologically related, or unrelated words, and distinct ERP waveforms were generated time-locked to these different classes of stimuli. Difference ERP waveforms were generated in the semantic condition and in the phonological condition by subtracting ERP activity associated with unrelated picture–word stimuli from ERP activity associated with related picture–word stimuli. We measured both latency and amplitude of these difference ERP waveforms in a pre-articulatory time-window. The behavioral results showed standard interference effects in the semantic condition, and facilitatory effects in the phonological condition. The ERP results indicated a bimodal distribution of semantic effects, characterized by the extremely rapid onset (at about 100 ms) of a primary component followed by a later, distinct, component. Phonological effects in ERPs were characterized by components with later onsets and distinct scalp topography of ERP sources relative to semantic ERP components. Regression analyses revealed a covariation between semantic and phonological behavioral effect sizes and ERP component amplitudes, and no covariation between the behavioral effects and ERP component latency. The early effect of semantic distractors is thought to reflect very fast access to semantic representations from picture stimuli modulating on-going orthographic processing of distractor words

CAESAR II Tool: Complementary Analyses for Emergency Planning Based on Seismic Risks Impact Evaluations

Italy is a country with high seismic hazard, however since the delay in the seismic classification of the national territory, most of the existing building heritage does not comply with the current technical standards for buildings. The seismic events that have hit different Italian regions in recent years have highlighted the complexity of the challenge for the public bodies both in the emergency management and post‐event reconstruction and in the planning of effective risk prevention and mitigation measures to be implemented in ‘peacetime’. These difficulties concern, in particular, the capacity to properly manage the financial and technical resources available and to identify the intervention priorities throughout the entire emergency cycle. For correct management, the priority is to quantify and localize, through simulations, the quantification of probable damages and to evaluate in terms of cost‐benefits the possible alternative strategies for mitigation, also taking into account the potential, in terms of cost‐effectiveness, of integrated measures for seismic and energy retrofitting. In this framework, the project CAESAR II (Complementary Analyses for Emergency planning based on Seismic Risks impact evaluations) has been developed as a Decision Support System for Public Authorities in charge of developing Disaster Risk Reduction plans, with the possibility of programming mid to long‐term investments for public and private properties, as well as defining custom financial support mechanisms and tax incentives

Hepatitis B Surface Antigen Seropositive Men in Serodiscordant Couples: Effects on the Assisted Reproductive Outcomes

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KRAS Codons 12 and 13 Mutation Analysis: A Comparative Study between Direct Sequencing and a New Sensitive Real-Time PCR Assay

KRAS somatic mutations are found in 30–40% of colorectal cancer (CRC). Seven mutations in codons 12 and 13 of KRAS (95% of the observed human mutations) preclude the efficacy of anti-EGFR therapy for the treatment of CRC. Assessment of KRAS mutational status has become a standard procedure in the management of patients with CRC. Technically, KRAS mutation testing can be performed with different methods, characterized by distinct sensitivities and specificities. The present study analyzed KRAS in 182 CRC histological samples by using direct sequencing and a new kit based on a Real-Time Sequence-Specific Primers-PCR technology. The kit allowed to recover as positive 17 samples that were negative or unclear by sequencing, with a recovery rate equal to 13.82%. This study proposes a fast, sensitive, and high-throughput system to identify such seven described mutations of KRAS gene in CRC samples