Bladder Sparing Approaches for Muscle-Invasive Bladder Cancers.

OPINION STATEMENT: Organ preservation has been increasingly utilised in the management of muscle-invasive bladder cancer. Multiple bladder preservation options exist, although the approach of maximal TURBT performed along with chemoradiation is the most favoured. Phase III trials have shown superiority of chemoradiotherapy compared to radiotherapy alone. Concurrent chemoradiotherapy gives local control outcomes comparable to those of radical surgery, but seemingly more superior when considering quality of life. Bladder-preserving techniques represent an alternative for patients who are unfit for cystectomy or decline major surgical intervention; however, these patients will need lifelong rigorous surveillance. It is important to emphasise to the patients opting for organ preservation the need for lifelong bladder surveillance as risk of recurrence remains even years after radical chemoradiotherapy treatment. No randomised control trials have yet directly compared radical cystectomy with bladder-preserving chemoradiation, leaving the age-old question of superiority of one modality over another unanswered. Radical cystectomy and chemoradiation, however, must be seen as complimentary treatments rather than competing treatments. Meticulous patient selection is vital in treatment modality selection with the success of recent trials within the field of bladder preservation only being possible through this application of meticulous selection criteria compared to previous decades. A multidisciplinary approach with radiation oncologists, medical oncologists, and urologists is needed to closely monitor patients who undergo bladder preservation in order to optimise outcomes

Un Geodatabase per l'analisi stratigrafico-sequenziale

In questo studio viene presentata una struttura di Banca Dati Geologica in formato ESRI Geodatabase creata seguendo le Linee Guida per l'informatizzazione della Carta Geologica d'Italia alla scala 1:50.000. Il contenuto informativo è stato ampliato da informazioni derivanti al rilevamento stratigrafico sequenziale dell'area interessata (Cilento). Con l'aiuto del GIS i diversi systems tract vengono meglio individuati e separati dai limiti cronostratigrafici rendendo posssibile la costruzione di scenari spazio-temporali per la produzione di una cartografia geologico-tematica basata sulle informazioni stratigrafico-sequenziali.PublishedFiera di Bolzano, Bolzano5.4. TTC - Sistema Informativo Territorialeope

Un Geodatabase per l'analisi stratigrafico-sequenziale

In questo studio viene presentata una struttura di Banca Dati Geologica in formato ESRI Geodatabase creata seguendo le Linee Guida per l'informatizzazione della Carta Geologica d'Italia alla scala 1:50.000. Il contenuto informativo è stato ampliato da informazioni derivanti al rilevamento stratigrafico sequenziale dell'area interessata (Cilento). Con l'aiuto del GIS i diversi systems tract vengono meglio individuati e separati dai limiti cronostratigrafici rendendo posssibile la costruzione di scenari spazio-temporali per la produzione di una cartografia geologico-tematica basata sulle informazioni stratigrafico-sequenziali

Management of advanced prostate cancer: A systematic review of existing guidelines and recommendations

The therapeutic landscape of advanced prostate cancer is continuously changing under the light of new available treatment options and the improved understanding of the molecular characteristics of the disease. The lack of high quality evidence regarding the sequencing of these treatments along with the earlier implementation of these therapeutic approaches during the course of the disease have created issues of dispute regarding the optimal treatment of patients with advanced prostate cancer. Therefore, we conducted a systematic review of the existing guidelines and recent randomized trials not included in these guidelines, and present a comprehensive analysis of the available treatment options in each of the stages of advanced prostate cancer, as well as the supportive treatments available for these patients. © 2018 Elsevier Lt

Unglazed pottery from the masjed-i jom?e of Isfahan (Iran): technology and provenance.

The masjed-i jom’e of Isfahan is one of the earliest mosques of Iran. Since 1970, Italian researchers performed an extensive archaeological investigation uncovering huge amounts of finds. This study aims at investigating the technological features and provenance of the unglazed pottery finds by using a minero-petrographic approach. Twenty-three samples of storage, table and cooking wares were selected based on the recurrence of typologically identifiable fragments and fabrics. Two bricks, seven production indicators (spacers, kiln furniture, slags) and a local clay were analysed for comparison. The production indicators and most of the pottery show high-CaO concentration. Thick-walled wares contain coarse sedimentary/metamorphic inclusions. Samples with thinner walls contain similar but fine/well-sorted inclusions. The mineralogy and microstructure indicate firing temperatures mainly ranging from 850 to 1000 °C. Low-CaO samples contain coarse sedimentary inclusions; in one sample, volcanic lithics are present. Firing temperatures range from about 800 to 950 °C, and the low-CaO character can be related to their specific function for cooking foods. One sample, found in older stratigraphic levels, differs for its peculiar calcitic temper and lower firing temperature. Local production of most samples was constrained by the composition of the inclusions compatible with the sediments of the Isfahan area. High-CaO pottery shows compositional affinity with production indicators, local clay and tiles produced in Isfahan during the Safavid period. Cooking ware usually contains local temper, with the exception of a sample with volcanic inclusions, for which a non-local provenance is supposed. No appropriate information is, however, available regarding the low-CaO clays used in the area

Minimally important differences for the EORTC QLQ-C30 in prostate cancer clinical trials

BACKGROUND The aim of the study was to estimate the minimally important difference (MID) for interpreting group-level change over time, both within a group and between groups, for the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scores in patients with prostate cancer. METHODS We used data from two published EORTC trials. Clinical anchors were selected by strength of correlations with QLQ-C30 scales. In addition, clinicians' input was obtained with regard to plausibility of the selected anchors. The mean change method was applied for interpreting change over time within a group of patients and linear regression models were fitted to estimate MIDs for between-group differences in change over time. Distribution-based estimates were also evaluated. RESULTS Two clinical anchors were eligible for MID estimation; performance status and the CTCAE diarrhoea domain. MIDs were developed for 7 scales (physical functioning, role functioning, social functioning, pain, fatigue, global quality of life, diarrhoea) and varied by scale and direction (improvement vs deterioration). Within-group MIDs ranged from 4 to 14 points for improvement and - 13 to - 5 points for deterioration and MIDs for between-group differences in change scores ranged from 3 to 13 for improvement and - 10 to - 5 for deterioration. CONCLUSIONS Our findings aid the meaningful interpretation of changes on a set of EORTC QLQ-C30 scale scores over time, both within and between groups, and for performing more accurate sample size calculations for clinical trials in prostate cancer