Head and neck cancer radiotherapy amid COVID‐19 pandemic : Report from Milan, Italy

Background: Management of head and neck cancers (HNC) in radiation oncology in the coronavirus disease 2019 (COVID-19) era is challenging. Aim of our work is to report organization strategies at a radiation therapy (RT) department in the first European area experiencing the COVID-19 pandemic. Methods: We focused on (a) dedicated procedures for HNC, (b) RT scheduling, and (c) health care professionals' protection applied during the COVID-19 breakdown (from March 1, 2020 to April 30, 2020). Results: Applied procedures are reported and discussed. Forty-three patients were treated. Image-guided, intensity modulated RT was performed in all cases. Median overall treatment time was 50 (interquartile range: 47-54.25) days. RT was interrupted/delayed in seven patients (16%) for suspected COVID-19 infection. Two health professionals managing HNC patients were proven as COVID-19 positive. Conclusion: Adequate and well-timed organization allowed for the optimization of HNC patients balancing at the best of our possibilities patients' care and personnel's safety

Usefulness of bronchoalveolar lavage in suspect COVID-19 repeatedly negative swab test and interstitial lung disease

The diagnosis of coronavirus disease 2019 (COVID-19) relies on nasopharyngeal swab, which shows a 20–30% risk of false negativity [1]. Bronchoalveolar lavage (BAL) is reported to be useful in patients with pulmonary interstitial infiltrates on high-resolution computed tomography (HRCT). We investigated the usefulness of BAL in symptomatic patients with positive HRCT and a repeatedly negative swab test (‘grey zone’)

Taking one step backward to take two steps forward: The importance of breast tumor phenotype in MRI-based prediction of response

Evaluation of tumor phenotype is currently accepted to guide management of breast cancer and neoadjuvant chemotherapy (NAC). Magnetic resonance imaging (MRI) is a diagnostic imaging tool to evaluate response to NAC, mainly through morphological evaluation (RECIST criteria). It has been suggested that the capability of post-NAC MRI in the detection of complete response is greatly influenced by tumor phenotype; the interplay of the expression of estrogen and progesterone receptors and of human epidermal growth factor-2 affects deeply variable tissue characteristics. The purpose of the present review is to revise current evidence about the differential diagnostic performance of MRI according to breast tumor phenotype, both in the post-NAC setting (detection of complete response) and in the pre-NAC settings (prediction of complete response), in order to advise the radiologist in the cautious interpretation of MRI-derived information. We also discuss the potential role of additional MRI techniques [diffusion-weighted imaging (DWI)] in this context. The conclusions of the present review may be helpful to achieve further personalization of management protocols to individual patients

Cytoskeletal control of B cell responses to antigens.

The actin cytoskeleton is essential for cell mechanics and has increasingly been implicated in the regulation of cell signalling. In B cells, the actin cytoskeleton is extensively coupled to B cell receptor (BCR) signalling pathways, and defects of the actin cytoskeleton can either promote or suppress B cell activation. Recent insights from studies using single-cell imaging and biophysical techniques suggest that actin orchestrates BCR signalling at the plasma membrane through effects on protein diffusion and that it regulates antigen discrimination through the biomechanics of immune synapses. These mechanical functions also have a role in the adaptation of B cell subsets to specialized tasks during antibody responses