Efficacy and safety of dolutegravir and doravirine dual therapy in the context of antiretroviral therapy switch: 48 weeks analysis.

Dual therapy in HIV represents an attractive opportunity for HIV infected people in virologic suppression Dual therapy regimens should achieve and maintain viral suppression and immunologic control while minimizing short and long term AEs, improve adherence and convenience and reduce drug drug interactions and costs To date, there are few clinical data to support a dual regimen with dolutegravir and doravirine 1 The individual efficacy of both doravirine and dolutegravir suggests that concomitant administration of these two molecules as part of an NRTI sparing regimen could be a viable option, although to date there are no studies in the HIV infected population The aim of our study is to investigate whether a dual therapy regimen containing dolutegravir and doravirine is effective and saf

Use of Laparoscopic and Laparotomic J-Plasma Handpiece in Gynecological Malignancies: Results From A Pilot Study in A Tertiary Care Center

Introduction: The J-Plasma has recently been introduced into the surgical community with different intrinsic characteristics aimed to further reduce the thermal effect and enhance precision when compared to standard radiofrequency. This study aimed to investigate the role of this new technology in different conditions of gynecological carcinomatosis characterized by the indication for regional peritonectomy and/or ablation, either in laparotomy (LPT) or in laparoscopy (LPS), in the context of a modern personalized approach to the surgical management of gynecological malignancies. Material and Methods: From January 2019 to April 2019, 12 patients were selected for this prospective pilot study at the Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome. In this single surgeon experience, the inclusion criteria were: histologically proven advanced ovarian/endometrial cancer, primary or interval debulking surgery, and intraoperative indication for regional peritonectomy. Six patients were treated by LPS (Group 1) and 6 by LPT (Group 2). Results: In Group 1 the indication for debulking surgery was in 4 cases an interval debulking surgery and 2 advanced endometrial cancer. All patients in Group 2 underwent primary debulking surgery for advanced ovarian cancer. The whole cohort achieved a complete tumor excision after surgery. The median OT and median EBL were 195 min and 100 ml in Group 1, and 420 min and 500 ml in Group 2. The median hospital stay was 4 days in Group 1 and 13 days in Group 2, respectively. No intra and postoperative complications were registered within 60 days after surgery. Conclusions: J-Plasma allows to approach delicate maneuvers on viscera, mesentery, and blood vessels with a high degree of safety and precision thanks to its limited vertical and lateral thermal spread, favoring the surgeon to push ever higher the cytoreduction/morbidity tradeoff. The use of J-Plasma in cytoreductive surgery could also increase the range of possible minimally invasive procedures, narrowing the technical distance with the open technique and thus contributing to designing a personalized surgical strategy for each patient in different scenarios of peritoneal carcinomatosis

Fogli 609-596, Termini Imerese-Capo Plaia

Il Servizio Geologico Nazionale ha unificato i Fogli 609 "Termini Imerese" e 596 "Capo Plaia" in un unico Foglio denominato 609/596 "Termini Imerese-Capo Plaia" allo scopo di uniformare i rilievi e raccoglierne la descrizione in un unico volume delle Note Illustrative. Il Foglio 609/596 "Termini Imerese-Capo Plaia" della Carta Geologica d’Italia in scala 1:50.000 è stato realizzato nell’ambito del Progetto CARG con i fondi della Legge 67/88 - Legge 226/99 con una convenzione tra Servizio Geologico Nazionale ora ISPRA) e Regione Siciliana. Le aree ricadono interamente nella Provincia di Palermo, comprendono la fascia marina del Golfo di Termini Imerese fino al promontorio di Capo Plaia, la regione dei Monti di Termini Imerese e Trabia ad ovest e il settore occidentale del gruppo montuoso delle Madonie ad est. Tra questi rilievi si sviluppa un’ampio settore collinare inciso dai fiumi Torto e Imera settentrionale (o Fiume Grande)

Spider bite mimicking pyoderma gangrenosum in sJIA: a case report

Introduction: Several paediatric patients manifest conditions commonly misdiagnosed as spider bites, which however, can include other arthropods bites; bacterial, viral, and mycotic infections; vasculitis; dermatological diseases; miscellaneous conditions as drug reactions, chemical injuries. Objectives: In Italy, spiders which are likely to be associated with severe toxin mediated tissue damage are uncommon, especially in urban zones. However, a minor trauma may be a precipitating factor for pyoderma gangrenosum particularly over the legs, in association with inflammatory bowel disease, haematologic diseases and Juvenile Idiopathic Arthritis (JIA)

Sentinel Lymph Node in Aged Endometrial Cancer Patients "The SAGE Study": A Multicenter Experience

OBJECTIVE: The incidence of endometrial cancer is increasing in elderly people. Considering that aging progressively affects lymphatic draining function, we aimed to define its impact on IGC uptake during SLN mapping. METHODS: A multicenter retrospective cohort of endometrial cancer patients with apparently early-stage endometrial cancer undergoing complete surgical staging with SLN dissection was identified in four referral cancer centers from May 2015 to March 2021. Patients were classified in Group 1 (<65 years old) and Group 2 (≥65 years old). The primary endpoint was the assessment of the overall, bilateral, and unsuccessful SLN mapping in the two groups. Secondary outcomes were the evaluation of SLN anatomical distribution and the identification of predictors for mapping failure applying a logistic regression. RESULTS: A total of 844 patients were enrolled in the study (499 in Group 1 and 395 in Group 2). The overall detection rate, the successful bilateral mapping, and the mapping failure rate of the SLN were 93.8% vs. 87.6% (p = 0.002), 77.1% vs. 66.8% (p = 0.001), and 22.9% vs. 33.2% (p = 0.001), respectively, in Group 1 vs. Group 2. The advanced age affects the anatomical distribution of the SLN leading to a stepwise reduction of “unexpected” mapping sites (left hemipelvis: p < 0.001; right hemipelvis: p = 0.058). At multivariate analysis age ≥ 65 (OR: 1.495, 95% CI: 1.095–2.042, p = 0.011), BMI (OR: 1.023, 95% CI: 1.000–1.046, p = 0.047), non-endometrioid histotype (OR: 1.619, 95% CI: 1.067–2.458, p = 0.024), and LVSI (OR: 1.407, 95% CI: 1.010–1.961, p = 0.044) represent independent predictors of unsuccessful mapping. Applying binomial logistic regression analysis, there was a 1.280-fold increase in the risk of failed mapping for every 10-year-old increase in age (OR: 1.280, 95% CI: 1.108–1.479, p = 0.001). A higher rate of surgical under-staging (0.9% vs. 3.3%, p = 0.012) and adjuvant undertreatment (p = 0.018) was reported in Group 2. CONCLUSIONS: Old age represents a risk factor for SLN mapping failure both intrinsically and in relation to the greater incidence of other independent risk factors such as LVSI, non-endometrioid histotype, and BMI. Surgeons should target the usual uptake along UPP during the SLN dissection in this subgroup of patients to minimize mapping failure and the consequent risk of surgical under-staging and adjuvant undertreatment