Quality of life in patients treated by organ preservation surgery for early laryngeal carcinoma

Eugenia Allegra, Teresa Franco, Serena Trapasso, Teodoro Aragona, Rossana Domanico, Aldo GarozzoDepartment of Otolaryngology, Head and Neck Surgery, University of Catanzaro, Catanzaro, ItalyBackground and objective: Supracricoid partial laryngectomy (SCL) was introduced as an organ preservation procedure for treating selected early laryngeal cancer. However, the recovery of the voice after SCL may result in different degrees of dysphonia. To improve the functional recovery and quality of the voice, we realized a modified supracricoid laryngectomy (MSCL) using sternohyoid muscles for neoglottic reconstruction in selected patients affected by T1b–T2 laryngeal cancer. In this study, we evaluate the quality of life (QoL) in patients treated by SCL and MSCL.Methods: The quality of life (QoL) evaluation was undertaken using the Italian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.Results: The overall QoL, assessed with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, was better in patients treated with MSCL than in those treated with SCL. The better QoL correlates with the highest response scores to the questions on the relative global functioning scales in patients treated with MSCL.Conclusion: The new surgical technique has improved the QoL of patients with early laryngeal cancer, with improved communication ability achieved. Reconstruction of neocords in MSCL improves speech function in comparison to SCL, and patients experience less discomfort and achieve an almost normal communication performance.Keywords: supracricoid laryngectomy, quality of life, laryngeal carcinoma, EORTC QL

Assessments of the environmental performance of global companies need to account for company size

While the awareness of the corporate world toward sustainability is growing, how to assess corporate environmental performance objectively and efficiently remains an open question. Here we estimate the relationship between company size and four environmental indicators to understand the environmental performance of nearly 6500 companies, building on the concept of allometric scaling and using Thomson Reuters EIKON data for the year 2018. We highlight that carbon dioxide emissions, energy use, water and waste production scale with the size according to a power law. This can be used as a benchmark to assess unambiguously a company’s environmental performance. We find that the adopted Environmental, Social & Governance rating is uncorrelated with the environmental performance. Our results suggest that a fair and effective environmental policy should consider the nature of the scaling relationship. Scaling laws suggest the existence of a nexus between an underlying network and corporate metabolism, whose understanding would help in discerning the determinants of environmental impacts

Variation in chromogranin A serum levels during intermittent versus continuous androgen deprivation therapy for prostate adenocarcinoma

OBJECTIVES. It has been hypothesized that continuous androgen-suppression therapy produces hyperactivation of neuroendocrine (NE) cells and an increase in chromogranin A (CgA) in prostate carcinoma (PC). The aim of this study was to verify whether the intermittent administration of androgen deprivation (IAD) reduces the risk of CgA increase in PC cases treated with complete androgen deprivation (CAD). MATERIALS AND METHODS. We analyzed changes in serum CgA levels in patients with PC who successfully responded to the first 24 months of IAD versus continuous CAD therapy. Two different populations were analyzed: Type 1 = pT3pN0M0 prostate cancers with biochemical (PSA) progression after RRP; Type 2 = metastatic PC directly submitted to CAD. Cases in Type I and Type 2 population were randomly assigned to IAD versus continuous CAD therapy. Forty cases each in Type 1 and Type 2 population were included in the analysis. At 1, 3, 6,12,18,24 months of IAD versus continuous therapy, serum levels of CgA compared to PSA levels were analyzed. RESULTS. In population Type 1 and Type 2, in the group of cases continuously treated with CAD (Group 2), there was a significant trend to increase for CgA levels from baseline to 24 months of therapy. On the contrary, no significant variations were found in cases treated with IAD (Group 1). Either in population Type 1 or Type 2, at 12- and 24-month follow-up, mean and median serum levels of CgA were significantly (P < 0.005) lower in Group 1 than in Group 2. CONCLUSIONS. The present study represents the first evidence in the literature that the intermittent administration of CAD therapy significantly reduces the increase in serum CgA levels during CAD therapy. (C) 2003 Wiley-Liss, Inc

Associations between Notch-2, Akt-1 and HER2/neu expression in invasive human breast cancer: a tissue microarray immunophenotypic analysis on 98 patients.

Objective: We aimed to investigate the existence of associations between well-established and newly recognized biological and phenotypic features of breast cancer involved in tumor progression and prognosis. Methods: Ninety-eight cases of invasive breast cancer were assessed for the immunohistochemical expression of estrogen and progesterone receptors, Ki-67, HER2, Akt-1, and Notch-2, using the tissue microarray technique. Data regarding tumor histotype, histological grade, tumor size and lymph node status were collected for each patient and included in the analysis. Results: Several significant associations between histological and/or immunophenotypic features came from the analysis of our data. Positive associations were observed between estrogen and progesterone receptors, tumor grade and proliferation index, tumor grade and HER2, Akt-1 and estrogen receptors, and Notch-2 and HER2. Inverse associations were noted between hormone receptors and tumor grade, hormone receptors and HER2, Akt-1 and tumor grade, and Akt-1 and nodal invasion. Conclusions: Our results, showing the existence of a number of estrogen receptor-positive tumors with Akt-1 expression, better degree of differentiation, and no lymph node involvement, along with the presence of HER2- positive tumors with strong Notch-2 expression, support the role of Notch and Akt in breast cancer progression and suggest that they may also represent new appealing therapeutic targets

Magnetic resonance imaging and previous cesarean section in placenta accrete spectrum disorder: Predictor model

Objective: To evaluate objective criteria of Magnetic Resonance Imaging (MRI) of Placenta Accreta Spectrum disorder (PAS) analyzing interobserver agreement and to derive a model including imaging and clinical variables to predict PAS. Methods: A retrospective review including patients submitted to MRI with suspicious findings of PAS on ultrasound. Exclusion criteria were lack of pathology or surgical information and missing or poor-quality MRI. Two radiologists analyzed six MRI features, and significant clinical data were also recorded. PAS confirmed on pathology or during intraoperative findings were considered positive for the primary outcome. Variables were tested through logistic regression models. Results: Final study included 96 patients with a mean age of 33 years and 73.0% of previous C-sections. All MRI features were significantly associated with PAS for both readers. After logistic regression fit, including MRI signs with a moderate or higher interobserver agreement, intraplacental T2 dark band was the most significant radiologic criteria, and ROC analysis resulted in an AUC&nbsp;=&nbsp;0.782. After including the most relevant clinical data (previous C-section) to the model, the ROC analysis improved to an AUC&nbsp;=&nbsp;0.893. Conclusion: Simplified objective criteria on MRI, including intraplacental T2 dark band associated with clinical information of previous C-sections, had the highest accuracy and was used for a predictive model of PAS

Detection and characterization of Plasmodium spp. by semi-nested multiplex PCR both in mosquito vectors and in humans residing in historically endemic areas of Paraguay

Corresponding author at: Department of Tropical Medicine, Research Institute in Health Science (IICS-UNA), National University of Asunción, Campus UNA, San Lorenzo, Paraguay. E-mail addresses: [email protected], [email protected]. (F. del Puerto).In Paraguay, no cases of Malaria have been recorded since 2011. Microscopy and the SnM-PCR technique were implemented to detect and characterize Plasmodium spp. both in mosquitoes and in humans residing in historically endemic areas of Paraguay, to evaluate the possibility of finding asymptomatic cases and/or Plasmodium parasites circulating in anophelines. Between 2013 and 2015, 361 human blood samples were collected on filter paper, and between 2016 and 2017, 938 female Anopheles mosquitoes were captured in 15 Paraguayan localities. All the diagnostic techniques showed negative results. We observed no asymptomatic case or Plasmodium circulating in vectors.Consejo Nacional de Ciencia y TecnologíaPrograma Paraguayo para el Desarrollo de la Ciencia y Tecnología. Proyectos de investigación y desarroll

Modelos de seguridad social en derecho comparado

This research refers to the theoretical framework of various models of social security in the world, namely the English model, German and mixed. The problem that has been raised is: What are the characteristic features that define the social security models: English, German and mixed ?. Target is plotted: determining the characteristic elements that define the models of social security: English, German and mixed. This research is descriptive in nature as it seeks to determine the characteristics and qualities of social security models under study. Currently stand as models conceptually defined mixed English German Model,, and. On the one hand, the German model which is characterized by compulsory social insurance and funding is provided by employers and insurers, with government s u b s i d y. S e c o n d l y, t h e E n g l i s h m o d e l i s characterized by its social security aid-against all tax-financed social needs, a situation that entails solidarity at the national level. And the mixed model, which integrates essential elements of the two models mentioned above. Unable to find a unique and representative model Social Security, since most of the existing models of social security have taken aspects, tools and experiences of others, which is why it is very important to know about its rise and progress.Esta investigación hace referencia al marco teórico de los distintos modelos de seguridad social en el mundo, en concreto el modelo inglés, alemán y el mixto. El problema que se ha planteado es: ¿Cuáles son los elementos característicos que definen los modelos de seguridad social: inglés, alemán y mixto?. Como objetivo se ha trazado: determinar los elementos característicos que definen los modelos de seguridad social: Inglés, Alemán y mixto. Esta investigación es de carácter descriptivo, ya que busca determinar las características y cualidades de los modelos de seguridad social en estudio. Actualmente se destacan como modelos definidos conceptualmente el Modelo alemán, inglés, y mixto. Por una parte, el modelo alemán que se caracteriza por seguros sociales obligatorios y su financiación está a cargo de empleadores y aseguradores, con subvención del Estado. En segundo lugar, el modelo inglés está caracterizado por su seguridad social de tipo asistencial frente a todas las necesidades sociales financiado por impuestos, situación que implica una solidaridad en el plano nacional. Y el modelo mixto, que integra elementos e s e n c i a l e s d e l o s d o s m o d e l o s m e n c i o n a d o s anteriormente. No es posible encontrar un Modelo de Seguridad Social único y representativo, ya que la mayoría de los modelos de seguridad social existentes han tomado aspectos, instrumentos y experiencias de otros, y es por esto que es de gran importancia conocer sobre su surgimiento y avances

Haplotype affinities resolve a major component of goat (<i>Capra hircus</i>) MtDNA D-loop diversity and reveal specific features of the Sardinian stock

Goat mtDNA haplogroup A is a poorly resolved lineage absorbing most of the overall diversity and is found in locations as distant as Eastern Asia and Southern Africa. Its phylogenetic dissection would cast light on an important portion of the spread of goat breeding. The aims of this work were 1) to provide an operational definition of meaningful mtDNA units within haplogroup A, 2) to investigate the mechanisms underlying the maintenance of diversity by considering the modes of selection operated by breeders and 3) to identify the peculiarities of Sardinian mtDNA types. We sequenced the mtDNA D-loop in a large sample of animals (1,591) which represents a non-trivial quota of the entire goat population of Sardinia. We found that Sardinia mirrors a large quota of mtDNA diversity of Western Eurasia in the number of variable sites, their mutational pattern and allele frequency. By using Bayesian analysis, a distance-based tree and a network analysis, we recognized demographically coherent groups of sequences identified by particular subsets of the variable positions. The results showed that this assignment system could be reproduced in other studies, capturing the greatest part of haplotype diversity. We identified haplotype groups overrepresented in Sardinian goats as a result of founder effects. We found that breeders maintain diversity of matrilines most likely through equalization of the reproductive potential. Moreover, the relevant amount of inter-farm mtDNA diversity found does not increase proportionally with distance. Our results illustrate the effects of breeding practices on the composition of maternal gene pool and identify mtDNA types that may be considered in projects aimed at retrieving the maternal component of the oldest breeds of Sardinia.</br

Sedimentary processes in the head of the Cabo Polonio mega slide canyon (southwestern Atlantic margin off Uruguay)

The Southwestern Atlantic margin is characterized by several canyon systems incised on a huge contourite depositional system associated with the interaction of strong Antarctic water masses with the seafloor. So far, however, only one mega slide canyon (Cabo Polonio) has been described in the Uruguayan continental slope. In this work, sedimentary processes dominating the head of this mega slide canyon are described and interpreted based on the analysis of the composition (texture and fossils) and distribution of widespread gravel along its head and thalweg. This information is integrated with acoustic (multibeam and seismic) and hydrological data. Results suggest that the evolution of the head of the canyon presents retrogressive erosion related to debris and turbidity flows. This erosion is ongoing and/or has been active during the recent past and contourite deposits are involved in headwall erosion. The pathway of gravel along the canyon and the thalweg was reconstructed. The strong flow of the South Atlantic Central Water, and its interaction with the Antarctic Intermediate Water, dominates the modern hydrology, promoting highly energetic conditions enhancing headwall erosion. This work contributes to a better understanding of the sedimentary processes connected to an mega slide canyon in the upper slope off Uruguay and located in the northernmost distribution of the South Atlantic Contourite Depositional System