Dose-escalated pelvic radiotherapy for prostate cancer in definitive or postoperative setting

Purpose Given the absence of standardized planning approach for clinically node-positive (cN1) prostate cancer (PCa), we collected data about the use of prophylactic pelvic irradiation and nodal boost. The aim of the present series is to retrospectively assess clinical outcomes after this approach to compare different multimodal treatment strategies in this scenario. Methods Data from clinical records of patients affected by cN1 PCa and treated in six different Italian institutes with prophylactic pelvic irradiation and boost on pathologic pelvic lymph nodes detected with CT, MRI or choline PET/CT were retrospectively reviewed and collected. Clinical outcomes in terms of overall survival (OS) and biochemical relapse-free survival (b-RFS) were explored. The correlation between outcomes and baseline features (International Society of Urological Pathology-ISUP pattern, total dose to positive pelvic nodes 60 Gy, sequential or simultaneous integrated boost (SIB) administration and definitive vs postoperative treatment) was explored. Results ISUP pattern < 2 was a significant predictor of improved b-RFS (HR = 0.3, 95% CI 0.1220-0.7647, P = 0.0113), while total dose < 60 Gy to positive pelvic nodes was associated with worse b-RFS (HR = 3.59, 95% CI 1.3245-9.741, P = 0.01). Conversely, treatment setting (postoperative vs definitive) and treatment delivery technique (SIB vs sequential boost) were not associated with significant differences in terms of b-RFS (HR = 0.85, 95% CI 0.338-2.169, P = 0.743, and HR = 2.39, 95% CI 0.93-6.111, P = 0.067, respectively). Conclusion Results from the current analysis are in keeping with data from literature showing that pelvic irradiation and boost on positive nodes are effective approaches. Upfront surgical approach was not associated with better clinical outcomes

“Gli aspetti innovativi dell’informativa finanziaria nelle “entità” del settore pubblico: gli IPSAS 5, 15, 18, 19 e 21”

Per il citato lavoro, che rappresenta un contributo alla ricerca della Scuola Superiore della Pubblica Amministrazione “Principi e metodi di contabilità economico-patrimoniale per lo Stato e le Pubbliche Amministrazioni nel quadro teorico ed operativo internazionale” (coordinatore Prof. L. Anselmi, anni 2007/2008), sono stati assolti gli obblighi di pubblicazione direttamente dall’autore, ai sensi della Legge 15.4.2006 n. 106 e del D.P.R. 03.05.2006, n. 252

Prolonged and biphasic acute hepatitis A in hepatitis B virus carrier

Acute hepatitis A is generally a self-limited disease in healthy subjects within few weeks, but an uncommon type of prolonged and biphasic acute course of hepatitis A infection has been also described. This type of presentation is observed in about 6-10% of patients, but a small number of reports, concerning this topic, are available in literature. In addition, hepatitis A virus (HAV) infection in hepatitis B virus (HBV) carriers has rarely been discussed. A 41-year-old Italian man, already known to our Department for HBV infection as an inactive carrier HBsAg(+)ve, experienced a prolonged and biphasic course of acute hepatitis A, lasting about 7 months. In this patient possible factors, causing the second flare of transaminases, were excluded (in particular autoimmunity). Liver biopsy as well HAV RNA search in blood/stools were not performed. In conclusion, the hepatologist should take into account this type of atypical course in patients with HAV-related hepatitis and should promote HAV vaccination in subjects with HBV-chronic hepatitis, to prevent possible life-threatening acute exacerbation of hepatic damage, mainly in HBV-carriers with more severe forms of liver diseases

Efficacy of dual therapy in patients >65 years old with alanine transaminase flare during chronic hepatitis C genotype 2

Hepatitis C virus (HCV)-related chronic hepatitis is characterized by different clinical outcomes as well as by distinct biochemical and virological patterns. According to guidelines concerning dual therapy, high rates of sustained virological response (or HCV-RNA undetectable 24 weeks after the end of antiviral treatment) has been obtained in patients with persistent HCV infection, caused by genotype 2 (CHC G2). Dual therapy (pegylated interferon plus ribavirin) might be an useful strategy not only in the treatment of younger patients (≤65 years old, that is generally considered as age limit for the beginning of the antiviral treatment) but also of older patients (&gt;65 years old) experiencing an alanine aminotransferase (ALT) flare (with value of ALT-alanine transaminase ≥400 U/L). In fact the progress of fibrosis can advance quicker exactly during the transaminase breakthrough. We report our experience in the treatment of two Italian patients with CHC G2, one of them was a never treated (naive) woman, whereas the other was a previously treated man with several co-morbidities. Both patients presented an excellent virological response to dual therapy despite unfavorable predictive factors, such as old age (&gt;65 years), ALT flare and possible moderate hepatic fibrosis

Fever and erythema: exclude all and then… think of Still’s disease!

Adult-onset Still’s disease is a rare disease. Diagnosis of Still’s disease is often difficult to achieve. Herein, we describe our diagnostic approach in a case report regarding an adult patient who presented with fever, erythema, lymphadenopathy and arthralgia

Pressurised Chemical Looping Combustion (PCLC): air reactor design

6 figures, 2 tables.-- ATI Annual Congress (ATI 2022) 11/09/2022 - 14/09/2022 Bari, Italy.Bioenergy combustion with Carbon Capture and Storage (BECCS) is a key technology to achieve carbon negative emissions power generation. This can be achieved by coupling the biofuels combustion with CO2 capture and storage (CCS). The lowest cost for CCS corresponds at the moment to the Chemical Looping Combustion (CLC) process. This can use biofuels which can be gaseous (biomethane, biogas or syngas etc.), liquid (biodiesel, bioethanol, biobutanol and pyrolysis oils etc.) or solids (wood dust, charcoal dust, wood chips, wood pellets etc.) While plant design with gaseous and liquid biofuels would be simpler, plants using solid biofuels and based on two couple fluidisd beds would need the use of a third reactor named carbon stripper. In the specific case if we plan to couple a CLC plant with a turbo expander (to achieve the high efficiencies of a combined cycle power plant) we have to work with pressurized reactors. However, there are some technical barriers to the coupling of a chemical looping combustor with a turbo expander, such as: the operation of the combustor in pressurised conditions; the inventory balance among reactors; elutriated particles reaching the turbo expander. This explaind why there is no commercial plant at the moment capable to do this. The aim of this paper is to present a model for the dimensioning of an air reactor to be coupled to a turbo expander of the power of about 12 MWe. Based on this, the air mass flow can be obtained and the geometric parameters can be calculated, to have an air velocity which is needed to achieve the fast fluidization regime and to ensure a high conversion rate as well as particles and heat exchage among air and fuel reactor.This work has been funded by the GTCLC-NEG project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodow-ska-Curie grant agreement No. 101018756.Peer reviewe