A possible role for low-dose cyclosporine in refractory immune thrombocytopenic purpura.

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Cytomegalovirus and ClostridiumDifficile co-infection in severe ulcero-hemorrhagic colitis during inductionchemotherapy for acute lymphoblastic leukemia

Here we describe the first case of a biopsyprovenCytomegalovirus ulcero-hemorrhagic colitis,associated with Clostridium Difficile co-infection,occurring during standard induction chemotherapyfor common B cell acute lymphoblastic leukemia.We discuss the case and focalize clinical managementand diagnostic issues arising from it

Pattern of care and effectiveness of treatment for glioblastoma patients in the real world: Results from a prospective population-based registry. Could survival differ in a high-volume center?

BACKGROUND: As yet, no population-based prospective studies have been conducted to investigate the incidence and clinical outcome of glioblastoma (GBM) or the diffusion and impact of the current standard therapeutic approach in newly diagnosed patients younger than aged 70 years. METHODS: Data on all new cases of primary brain tumors observed from January 1, 2009, to December 31, 2010, in adults residing within the Emilia-Romagna region were recorded in a prospective registry in the Project of Emilia Romagna on Neuro-Oncology (PERNO). Based on the data from this registry, a prospective evaluation was made of the treatment efficacy and outcome in GBM patients. RESULTS: Two hundred sixty-seven GBM patients (median age, 64 y; range, 29-84 y) were enrolled. The median overall survival (OS) was 10.7 months (95% CI, 9.2-12.4). The 139 patients 64aged 70 years who were given standard temozolomide treatment concomitant with and adjuvant to radiotherapy had a median OS of 16.4 months (95% CI, 14.0-18.5). With multivariate analysis, OS correlated significantly with KPS (HR = 0.458; 95% CI, 0.248-0.847; P = .0127), MGMT methylation status (HR = 0.612; 95% CI, 0.388-0.966; P = .0350), and treatment received in a high versus low-volume center (HR = 0.56; 95% CI, 0.328-0.986; P = .0446). CONCLUSIONS: The median OS following standard temozolomide treatment concurrent with and adjuvant to radiotherapy given to (72.8% of) patients aged 6470 years is consistent with findings reported from randomized phase III trials. The volume and expertise of the treatment center should be further investigated as a prognostic factor

The antileukemic potential of natural killer cells

The antileukemic potential of natural killer (NK) cells has over the years raised considerable interest and new immune-based treatment protocols characterized by the infusion of freshly isolated or ex vivo activated and expanded effectors have been designed. Several aspects still need to be addressed, including the optimal timing of NK infusion during the course of the disease, the best preparative regimen, the origin of NK cells and the possible need of ex vivo NK cell manipulation before the infusion. The aims of this review are to discuss the experimental and clinical data available on the role played by NK cells for leukemia patients and to revise the different good manufacturing practice protocols for ex vivo manipulation of these effector cells

Birth after direct intraperitoneal insemination with frozen semen of donor.

For the first time, as least as far we known, a pregnancy and a normal baby obtained with DII with frozen semen of donor are reported. Our experience not only shows DII with frozen semen may be used successfully in AID but that it poses interesting hypotheses, to be verified in future, of its use in association with, or as an alternative to, GIFT and IVF/ET in cases of AID failure and as a first approach to an insemination technique in AID in general

Panoramic diagnostic microhysteroscopy: analysis of results obtained from 976 patients.

Panoramic diagnostic microhysteroscopy was performed in the outpatients department on 976 patients without using any type of anaesthetic. In 889 patients, that is 91%, the examination was successful, while it failed in 87 cases, that is, 9%. In 90% of the patients, the examination caused no pain whatsoever, and none of the patients suffered serious complications, either immediately after the examination of later. Comparison with the definite histological diagnosis showed 100% sensitivity and 86% specificity of microhysteroscopy. We can state that panoramic diagnostic microhysteroscopy performed in the outpatients department has proved to be a reliable examination from a diagnostic point of view, and is moreover safe and without pain for the patients

Simple and practical technique for hysterosalpingography: results obtained in 564 cases.

About 5 years ago, we proposed a new technique for hysterosalpingography in order to make it simpler for the gynecologist and the radiologist and more readily acceptable for the patients. In our opinion, the technique is simple and practical; we have performed ISG's with it and have succeeded in 555 cases, that is, 98.4%; in 9 cases, 1.6%, we did not succeed. In 5 of these 9 cases, the failure was due to an error in the application of the technique. This technique, however, must not be used in patients with suspected didelphic uterus or septum or with an unsuitable portio. In none of the patients was the technique followed by complications

Panoramic diagnostic microhysteroscopy and female sterility: analysis of results in 284 patients.

The results of panoramic diagnostic microhysteroscopy are reported in 284 patients with sterility or infertility problems. In 33.5% of the patients, microhysteroscopy revealed uterine pathology; in the majority of cases they were pathologies which are unanimously recognized as being causes of sterility, while in others there were pathologies whose role infertilities is still unclear. There was a good correlation between microhysteroscopy and histology in cases of endometrial hyperplasia and of endometritis, whereas in cases of endometrial polyps and functional diagnosis of the endometrium, the correlation was less satisfactory. Although it is not possible at present to draw definite conclusions about the real value and advantages of microhysteroscopy in the diagnosis of female infertility, we are convinced that it is of great use and that it should be at the basis of any investigation involving the infertile woman

Usefulness of hysteroscopy in staging of endometrial carcinoma: Analysis of results obtained from 96 patients

Knowledge of the exact clinical stage of cancer of the endometrium is useful to plan therapy and to determine prognosis. Precise staging is impossible at present, but hysteroscopy is a method which can be used to differentiate between stages I and II. We report the results obtained with hysteroscopy in the clinical staging of 96 patients with cancer of the endometrium. We had 11 false negatives and two false positives, giving a sensitivity of 44%, specificity of 97%, negative predictive value of 90%, positive predictive value of 78% and diagnostic accuracy of 89%. The high specificity of hysteroscopy proves its usefulness in the clinical staging of cancer of the endometrium but the sensitivity of the technique is not very high. A combination of hysteroscopy and deep biopsies of cervical tissue may increase the sensitivity of hysteroscopy and increase the reliability of a clinical study of cancer of the endometrium