DENDRITIC CELL DIFFERENTIATION BLOCKED BY PRIMARY EFFUSION LYMPHOMA-RELEASED FACTORS IS PARTIALLY RESTORED BY INHIBITION OF P38 MAPK

To better understand the molecular mechanisms underlying the dendritic cell (DC) defects in cancer, we analyzed which signaling pathway is implicated in the abnormal monocyte differentiation into DC determined by the presence of Primary effusion lymphoma (PEL) released factors. Our results indicate that the DC, obtained in this condition, together with phenotypic abnormalities and reduced allostimulatory function, showed hyperphosphorylation of signal transducer and activator of transcription 3 (STAT3) and p38 mitogen-activated protein kinase (MAPK) molecules, in comparison to the DC differentiated in the absence of PEL-released factors. The inhibition of p38 MAPK but not of STAT3 phosphorylation, with specific inhibitors, was able to revert the effect of the PEL-released factors on the DC phenotype. This study suggests that p38 MAPK signaling pathway is an important contributor to the abnormal differentiation of DC in PEL

Strategies for Retaining Employees for Call Centers

Voluntary employee turnover has several adverse consequences for call center managers, including lowered productivity and decreased profitability. The purpose of this descriptive multiple case study was to explore strategies used to reduced voluntary employee turnover among 2 call center managers in the southern United States. These managers had been recommended by the human resource directors of the organizations because of their implementation of strategies to reduce voluntary employee turnover. The conceptual framework for this study was Herzberg\u27s motivation-hygiene theory. Data were collected from semistructured face-to-face interviews and employee handbooks. The data analysis consisted of compiling the data, disassembling the data into common codes, reassembling the data into themes, interpreting the meaning, and reporting the themes. The use of member checking and methodological triangulation increased the trustworthiness of the study. Themes that emerged were job satisfaction, employee compensation, opportunity and advancement, reward and recognition, and employee engagement. Recommendations for action include selecting strategies for reducing voluntary employee turnover and using the strategies to improve the commitment of the workers. The findings from this study may contribute to social change by providing strategies that call center managers can use to reduce voluntary employee turnover, thereby positively improving the standard of living for families, and strengthening community wealth and well-being

Liver nodular regenerative hyperplasia after bone marrow transplant.

We report an unusual liver disease which may occur after bone marrow transplantation, i.e. the collapse of hepatic lobuli followed by regenerative islets: the resulting clinical picture may mimic GvHD or a viral disease, but histology is diagnostic, showing nodular regeneration in the absence of inflammation or fibrosis

Incidenza della mutazione rs12979860 del gene di IL28 in un gruppo di soggetti HCV positivi dell’U.O.C. di Malattie infettive del P.O. Civico di Palermo

L'infezione cronica da HCV colpisce 170 milioni di persone in tutto il mondo;su 100 persone infettate dal virus HCV il 15% non sviluppa alcuna patologia cronica ed elimina il virus, il restante 85% sviluppa forme croniche della malattia con evoluzione in cirrosi epatica e in carcinoma epato-cellulare.Il trattamento dell'epatite C cronica, che offre i maggiori vantaggi, è rappresentato da un ciclo di 24-48 settimane di PEG-Interferone-alfa-2a e Ribavirina. Il suo esito è influenzato da una serie di fattori tra cui il genotipo virale ed alcuni polimorfismi genetici dell’ospite I pazienti infetti da HCV di genotipo 2 o 3 hanno probabilità 2-3 volte maggiore di rispondere alla terapia rispetto a coloro che sono infettati dal genotipo 1.Nell’ospite le variazioni geniche dell' IL28 sono associate alla risposta virale al trattamento dell’HCV con PEG-Interferone-alfa-2a e Ribavirina. La presenza del polimorfismo SNP “rs 12979860” determina una sostituzione C/T nella sequenza del promotore a monte del gene umano che codifica per la citochina “IL28” localizzato sul cromosoma 19 la cui espressione è indotta ed attivata dalle infezioni virali. Il polimorfismo IL28 B non solo influenza direttamente la risposta del paziente al trattamento ma ne determina il dosaggio terapeutico in funzione del genotipo stesso. E' stato dimostrato come infatti vi siano genotipi favorevoli al trattamento (C-C) e genotipi meno favorevoli (C-T e T-T). Nel nostro studio abbiamo valutato l’espressione delle mutazioni su un gruppo di 40 pazienti afferenti all’U.O.C. di Malattie infettive del P.O. Civico , affetti da infezione da HCV e candidati a terapia con IFN e RBV .La ricerca è stata effettuata con tecnica in real-time ed ha fornito i seguenti risultati : 12 pazienti postivi (30% ) per genotipo CC suscettibili a terapia e 28 (70%) con genotipo meno favorevole ( CT o TT ) per i quali si dovrà valutare il potenziale impiego dei farmaci antivirali emergenti

LA FARMACOGENOMICA NELLA VALUTAZIONE DEL RISCHIO DA CHEMIOTERAPIA: POLIMORFISMI GENICI E 5-FLUOROURACILE NEL TRATTAMENTO DEL CARCINOMA DEL COLON-RETTO

Introduzione: Il 5-fluorouracile (5-FU) ed il suo profarmaco capecitabina, attivo per via orale, è usato nel trattamento di numerosi tumori solidi, tra cui carcinomi mammari, colo-rettali e della regione testa-collo. Nonostante la sua efficacia, a suo carico sono stati associati fenomeni di grave tossicità correlati all’enzima diidropirimidina deidrogenasi (DPD), responsabile del suo metabolismo,la cui carenza determina un profondo ritardo nell’eliminazione dell’agente chemioterapico.Pertanto la presenza di polimorfismi nella regione codificante del gene DPYD può determinare lo sviluppo di gravi tossicità di III-IV grado, come: nausea, vomito, diarrea, stomatiti, leucopenia, neutropenia, piastrinopenia, anemia e sindrome mano-piede

Pseudocisti pancreatiche infette: Note di tecnica

Introduction. Starting from the observation of 9 cases of giant infected pancreatic cysts, which occurred from 1994 to 2004 at the Department of Oncological and Surgical Studies, the Authors' aim has been to evaluate whether a more thorough necrosectomy, carried-out under videoendoscopic control, associated with a nose-gastro-cavity tube, which ensures a continuous cleansing of the newly-formed cavity, and an appropriate positioning of the drainages, could reduce the morbility and allow a shorter recovery of the infected psuodocysts. Patients and methods. Of 73 cases of acute pancreatitis, observed from 1994 to 2004, 9 showed severe and acute pancreatitis, which included giant pseudocysts, as revealed by the abdomen angio-TC. Our nine septic patients underwent cysto-gastro-anastomosis, necrosectomy, intraoperative cleansing of the cavity with an antibiotic solution and positioning of multiple drainages. Three of these patients also underwent a thorough and targeted nectrosectomy, assisted by a trans-anastomotic videoendoscopy. A nose-gastro-cavity tube has been placed in all the patients. Results. The disappearance of the septic state in our three patients who underwent a targeted video-assisted necrosectomy occurred after three days of treatment; moreover, the abdomen angio-TC on the 5th postoperative day showed the disappearance of the necrotic areas. The recovery of these three patients was significantly shorter, compared to those undergoing traditional treatment (cysto-gastro-anastomosis, standard necrosectomy and positioning of abdominal drainages). Conclusions. Our surgical video-assisted technique demonstrated that, with a slight increase in the operative time, a better control over sepsis may be accomplished, as well as a reduction of he post-operative morbidity, which leads to shorter hospitalisation of patients with infected pancreatic pseudocysts

Adherence issues related to sublingual immunotherapy as perceived by allergists

Objectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers. © 2010 Scurati et al, publisher and licensee Dove Medical Press Ltd