Inducers of epithelial mesenchymal transition and cancer stem cells in malignant pleural effusions

The Epithelial to Mesenchymal Transition (EMT) plays a role not only in tumor metastasis but also in tumor recurrence. This process is believed to be tightly linked to the presence of Cancer Stem Cells (CSCs) however, it is still not clear which factors could induce EMT and how it could be a source for CSCs. It has been demonstrated that Malignant Pleural Effusion (MPEs) may represent an excellent source to identify markers and molecular mechanisms involved in EMT and CSCs development. Growth factors, cell differentiation markers and molecular adhesion are involved in some of the crucial neoplastic cell events such as proliferation, metastasis, resistance to chemotherapy and EMT. In this review, we summarize the current understanding of which molecular markers can orchestrate EMT and CSCs in MPEs

La rappresentazione del rapporto tra utenti e sistema sanitario: I modelli culturali dei medici di medicina generale - The representation of the relationship between users and healthcare system: Cultural models of general practitioners

The present research study explores the emotional and symbolic representation of the Italian healthcare system and specifically of general medical services reported by a group of Italian general practitioners. General medicine is recently affected by a structural change which could be sustained also by a cultural revolution, however this revolution seems to be oriented to expected values without a clear methodology which promotes and accompanies this cultural change. The present study deals with the lack of practices due to these unrealized expected values and assumes that for intervening it is necessary knowing the existing culture before thinking to change it. Interviews to 36 general practitioners were analyzed by Emotional Text Analysis (AET). Results highlight a factorial space characterized by five clusters. According to respondents’ perspective, healthcare problems refer to two large issues characterized by powerlessness of general practitioners to intervene. On the one hand, there is health emergency, dealt with by first aid and emergency medicine. On the other hand, there is chronicity, especially affecting the elderly, which is dealt with by other workers (nurses, private family assistants, social workers) who care patients at home and replace physicians. The general practitioners’ work is difficult because of many different reasons; but the central theme is the lack of absolute power – based on morality and consciousness – which leads to the perception of catastrophic consequences for medical profession and the physician-patient relationship. Often, general practitioners are in their offices and are not able to go to patients’ home, therefore they cannot create care relationships based on trust and dependence which allow useful and trustworthy interventions. In sum, the core theme emerging from data refers to the general practitioners’ perceived lack of personal and trust-based relationships with patients

La relazione che organizza il contesto sanitario: domanda dell’utenza e risposta dei servizi sanitari, nel territorio e nell’ospedale - The relationship which organizes the healthcare context: users’ demand and response of healthcare services, in the territory and the hospital

Our intent is to present citizens’ demand of health care services in Italy through a research structured in three studies. We used the Emotional Text Analysis (ETA) to lead the three s tudies: the first study regarded the citizens’expectations of the healthcare services, the second study regarded the point of view of the hospital personnel (medical doctors and nurses), the third regarded the point of view of the General Practitioners onthe health care services. These three studies are briefly presented. Data and outcome of an Assumed Similarity Test applied to all experimental subjects of the three studies in order to make a comparison among them, are also presented. The findings of the Emotional Text Analysis show that citizens, potential users of health services, center their requests on their individual subjectivity, and seek answers both to their suffering and to the feeling of alienation that characterizes the being sick feeling that makes them go to a medical doctor. For their part, general practitioners and hospital doctors immediately transform this subjective feeling in an objective medical diagnosis. Here a first gap emerges between patient’s demand and medical response, leavingthe possibility of an alliance on the diagnosis in order to jointly fight the disease. It has long been in place though a change that has expelled the patient also from sharing the diagnostic process, increasingly taken from self-centered dynamics within the healthcare system. This widens the gap between the request of the citizens and the response of the health services, that contributes to that conflictual growth to which defensive medicine gives a dysfunctional answer. The Assumed Similarity Test contributes to the interpretation of the health care dynamic identified in the Emotional Text Analysis; particularly in regard to the unfolding conflict, given by the hypothesis emerging from the data analysis, that a feeling of closeness for the hospital personnel goes along with an emotional stance of overpowering the othe

The relationship between health care users’ demand and the health care system’s response: a research on change observed in the health care system, in the hospital and in the territory

The present research study aims at exploring the representation of the health service within a group of hospital physicians and nurses. The objective is to identify how the symbolic dynamic of hospital workers shapes their own praxis. The texts of interviews with 25 hospital workers have been subjected to Emotional Text Analysis (ETA). Five clusters emerge from the analysis where the topic of giving life and avoiding death is central and where the hospital assumes a thaumaturgical and basically omnipotent role. This is in conflict with recognizing the limitations of therapy. Only in the background the culture of curing the patients appears, characterized by aggressive reactivity towards the crisis which leads patients to emergency intervention because crises are ascribed to deviances frommedical prescription. Emergency intervention is ultimately the kind of intervention which the hospital believes it is capable to provide. Another problem is the lack of filters provided by bureaucratized general practitioners, whose cooperation would be essential, but who are supposed to have no longer the necessary relationship with their patients

Rapid on-site evaluation (ROSE) in pancreatic cancer diagnosis. doing more with less

Rapid on-site evaluation (ROSE) in pancreatic cancer diagnosis: Doing more with les

Clinical-pathological features of an occult mixed mucinous male breast cancer. a case report

Mucinous carcinoma of the male breast is an uncommon malignant breast neoplasm and its diagnoses remain difficult. It is probably due to such a low rate of breast cancer cases that men tend to be diagnosed at an older age than women and with a later stage of the disease. We describe a case of a 69-year-old male who displayed a palpable lump in his right axilla several years ago, showing signs of cutaneous adnexal mucinous adenocarcinoma after biopsy. After six years and several clinical examination and systemic investigation without results, the patient underwent to fine needle aspiration cytology and subsequently a biopsy of a mass with irregular margins in the retroareolar region of his right breast. The final diagnosis was of a mixed mucinous breast cancer with neuroendocrine differentiation. The tumor cells phenotype showed Synaptophisin (+), CEA (+/-), CK-20 (-), CK-7 (+), TTF-1 (-), estrogen receptor (-), progesterone (-) and HER 2 (++). These results were unusual for a mucinous male breast carcinoma. In the presence of a lesion in the axillary area with no specific primary origin, breast cancer should never be ruled out, even in the absence of clinical evidence and with an immunohistochemical pattern not indicative of mammary origin

L’Islam e la sua rappresentazione nella cultura italiana

Different groups of citizens from Latium region, distributed by gender and age, and belonging to the medium-high socio-economic-cultural class, were asked in 2002, 2004 and 2005 to express what was coming to their mind, their associations and fantasies about Islam and islamic populations. The data were processed with the Emotional Text Analysis. The results of these three research studies are presented, which show a progressive accentuation of the pejorative stereotypes towards the islamic populations

Diagnostic and therapeutic path of breast cancer: Effectiveness, appropriateness, and costs â Results from the DOCMa study

none8noopenGiovagnoli, Maria Rosaria; Bonifacino, Adriana; Neglia, Cosimo; Benvenuto, Marco; Sambati, Francesco Vincenzo; Giolli, Lorenzo; Giovagnoli, Alessandra; Piscitelli, PriscoGiovagnoli, Maria Rosaria; Bonifacino, Adriana; Neglia, Cosimo; Benvenuto, Marco; Sambati, Francesco Vincenzo; Giolli, Lorenzo; Giovagnoli, Alessandra; Piscitelli, Prisc

La valutazione della genitorialità. una ricerca esplorativa, per capire come venga vissuta da un gruppo di cittadini romani

This paper reports the data of an exploratory research conducted with a group of Roman citizens who were asked what they thought about the possibility of assessing the parenting of families considered at risk over the parental expertise. Citizens were interviewed and the interviews were submitted to AET, Emotional Analysis of the Text. Assessing parenting often involves families with internal conflicts. We think the conflict is not only there. Conflicts also cross the theoretical, legal, and political hypotheses, which base the opportunity to intervene within the issues involved in parental evaluation. They are also found in the relationship between families and services. Legal and sociological literature advise the presence of these conflicts and discuss the issues; whereas the psychological and psychiatric one is focused on the application of techniques, whether they are evaluation, psychotherapy, re-education. This perspective does not consider the conflicting complexity which founds the parental evaluation, but it is focused only on the family. We were interested in analysing, in this context, what is the citizens’ perception of the evaluation of parenting, who are their potential customers and users; in particular, if and how these conflictual dynamics are perceived by them. After the analysis of the interview, the data outline three cultures. One proposes the traditional Italian family, the feminised family and designated to the care of members in difficulty within the home wall; family today in a strong crisis within processes of change. Another proposes the centrality of the court and the legal culture, founded on evaluations and resolving actions that often can result in child custody actions. These two cultures contrast: when the traditional family is missing, the court appears. There is no counseling which concerns the changes of the family. Psychological and neuropsychiatric counseling agencies do not appear in the data, except for social services, in any case subordinated to the court. A third culture proposes an “ideal” adult, who with balance and reflection skills, has to face a fearful context, but it is an isolated individual, without a relational context of reference. This culture seems to opposite the dissolution of relational contexts – state, organizations, family – to the idealized individual, self-determined and alone. The development of psychological function in the assessment of parenting concerns two aspects: the importance of studying the complexity of the social mandate and the intervention with the conflicting relationships of the family and of all the other actors involved

Emotional textual analysis

Emotional Textual Analysis (ETA) analyzes the symbolic level of texts as a part of applied research and interventions. The method is based on the study of the association of dense words, words that convey most of the emotional components of texts. In this approach, language is thought of as an organizer of the relationship between the individual contributor of the text and his or her context, rather than as a detector of the individual’s emotions. A case example shows the use of ETA, with the assistance of specific software, in analyzing the interviews of the inhabitants of a city suburb with respect to their expectations of fulfillment and development in relation to perceived local opportunities