Commento di Giovanni Gozzini a Un’età contro la storia. Saggio sulla rivoluzione del XXI secolo

Giovanni Gozzini nel suo commento al saggio di Giuseppe Carlo Marino su globalizzazione e crisi del “pensare storico” inquadra i cambiamenti nelle dinamiche economiche e sociali dell’ultimo trentennio in un più ampio mutamento del rapporto fra l’uomo e la realtà globalizzata del nuovo secolo. Gli eventi storici ricordati e i cambiamenti avvenuti sono organicamente relazionati così con le recenti evoluzioni del paradigma dello sviluppo economico e del dibattito culturale dei nostri giorni.In his comment to Giuseppe Carlo Marino’s essay about the globalization and crisis of “historical thought”, Giovanni Gozzini sets the changes in the social and economic dynamics in the last thirty years as a large alteration of the relationship between man and globalized reality of the new century. The mentioned historical events are systematically related with the latest evolutions of the economic model and the nowadays cultural debate

GC-MS Determination and Identification of Eleven Fatty Acids in Triglycerides Isolated from the Seeds of Traditional Kurdish Medicinal Plant Anchusa azurea Mill.

Anchusa azurea Mill. is naturally grown in Iraqi Kurdistan, and it belongs to the Boraginaceae family. The species A. azurea is eaten by Kurdish people and from a phytochemical point of view it has been almost neglected so far and it was thus considered worthy of study. In this investigation the lipids were extracted from seeds and leaves of A. azurea plant with petroleum ether, followed by chloroform and methanol using soxhlet apparatus. The lipid percentage from seeds and leaves were (7.03%) and (1.17%) respectively. Preliminary work on the first extract allowed for the isolation of a mixture of triglycerides, which were submitted to hydrolysis, followed by methylation of free fatty acids. GC-MS analysis showed that the main components were oleic, palmitic, palmitoleic, 11-eicosenoic, erucic and two ω-9 acids. Totally, eleven fatty acids were analyzed from the seeds of the studied plant using GC-MS analysis. The results showed that the plant seeds contain high percentage of elaidic acid (46.42%), palmitic acid (18.9%), linoleic acid (14.59%), and the other main fatty acids (FAs) are erucic acid (6.33%), 11-eicosenoic acid (5.02%), stearic acid (4.55%) and 6,9,12-octadecatrienoic acid (2.43%). The percentage of minor FAs is (0.78%) nervonic acid, (0.46%) myristic acid, (0.38%) palmitoleic acid and (0.14%) for 11-hexadecenoic acid. The total percentages of polyunsaturated (PUFAs), monounsaturated (MUFAs) and saturated fatty acids (SFAs) from the seeds of A. azurea are (17.02, 59.07, 23.91%) respectively. It was found that the percentage and type of fatty acid constituents from A. azurea seeds oil in the present study varied from the same plant in other places and countries

An Unprecedented High Content of the Bioactive Flavone Tricin in Huperzia Medicinal Species Used by the Saraguro in Ecuador.

The flavone tricin (5,7,4′-trihydroxy-3′,5′-dimethoxyflavone) is considered to be a selective potent inhibitor of different cancer cell lines and a potential colorectal cancer chemopreventive agent. In this paper we describe a reliable UHPLC-UV-ESIMS method for the determination of tricin in Huperzia plants used in the traditional medicine of the Saraguro community living in Southern Ecuador. An unusually high amount of tricin was found in H. brevifolia and H. compacta, which exceeded the content of this flavone determined so far in other plants

Italian Physicians' Perceptions about the Role of Asciminib in Later Lines Chronic Myeloid Leukemia in Clinical Practice: A GIMEMA Survey

Unmet needs remain in later lines chronic myeloid leukemia (CML): the response rate and the overall survival of resistant patients in the chronic phase who changed a second-generation TKI in the second line with another TKI with similar action are usually poor, while the off-target toxicities and the potential development of mutations increase. The recent approval of asciminib, a STAMP inhibitor, in the third line, has the potential to soon change the therapeutic algorithm for this subset of patients. Here, we report the results of a GIMEMA survey assessing the number of patients currently treated in the third line in Italy, the current approach in later lines by Italian physicians, and the future role of this drug according to the reason to switch to asciminib (resistance and/or intolerance), as well as the perceptions about the future position of this agent

Genetic Testing and Counselling in Hypertrophic Cardiomyopathy: Frequently Asked Questions

Genetic counselling and genetic testing in hypertrophic cardiomyopathy (HCM) represent an integral part of the diagnostic algorithm to confirm the diagnosis, distinguish it from phenocopies, and suggest tailored therapeutic intervention strategies. Additionally, they enable cascade genetic testing in the family. With the implementation of Next Generation Sequencing technologies (NGS), the interpretation of genetic data has become more complex. In this regard, cardiologists play a central role, aiding geneticists to correctly evaluate the pathogenicity of the identified genetic alterations. In the ideal setting, geneticists and cardiologists must work side by side to diagnose HCM as well as convey the correct information to patients in response to their many questions and concerns. After a brief overview of the role of genetics in the diagnosis of HCM, we present and discuss the frequently asked questions by HCM patients throughout our 20-year genetic counselling experience. Appropriate communication between the team and the families is key to the goal of delivering the full potential of genetic testing to our patients

The new Systematic Coronary Risk Evaluation (SCORE2 and SCORE2-OP) estimates the risk of arterial occlusive events in chronic myeloid leukemia patients treated with nilotinib or ponatinib

Patients with chronic myeloid leukemia (CML) treated with nilotinib or ponatinib may experience arterial occlusive events (AOEs). It is currently recommended to thoroughly assess cardiovascular risk factors before treating CML. We identified 455 consecutive CML adult patients, 335 treated with nilotinib and 120 with ponatinib; 380 patients without previous cardiovascular diseases or diabetes were stratified according to the Systematic Coronary Risk Evaluation (SCORE2) and SCORE2-Older Persons (SCORE2-OP). This updated algorithm from the European Society of Cardiology (ESC) estimates a 10-year risk of fatal and non-fatal cardiovascular diseases. It is based on sex, age, smoking habits, systolic blood pressure, non-high-density lipoprotein cholesterol, and European geographical region of cardiovascular risk. The SCORE2/SCORE2-OP algorithm translated more patients (50.2%) to the high-very high cardiovascular risk category than the previous SCORE (25.3%). Patients with a high to very high SCORE2/SCORE2-OP risk showed a significantly higher incidence rate of AOEs (69.2% vs. 46.5%, p < 0.001). The older SCORE was less specific in estimating AOEs in patients classified as low-intermediate risk (69.8 vs. 54.2%). In multivariate analysis, no associations were found between AOEs and gender, age, and type or dose of tyrosine kinase inhibitor. Only the SCORE2/SCORE2-OP risk was confirmed as a significant predictive factor (p = 0.028; hazard ratio = 2.2; 95% confidence interval = 1.1-4.5). Patients with AOEs required, in most cases, imaging diagnostic tests, additional drugs, and sometimes invasive procedures, increasing access to visits and hospital management. This real-life study suggested that the SCORE2 and SCORE2-OP charts could help identify cardiovascular fragility in CML patients providing them with more attention and a proper TKI selection

Residual peripheral blood CD26+leukemic stem cells in chronic myeloid leukemia patients during TKI therapy and during treatment-free remission

Chronic myeloid leukemia (CML) patients in sustained “deep molecular response” may stop TKI treatment without disease recurrence; however, half of them lose molecular response shortly after TKI withdrawing. Well-defined eligibility criteria to predict a safe discontinuation up-front are still missing. Relapse is probably due to residual quiescent TKI-resistant leukemic stem cells (LSCs) supposedly transcriptionally low/silent and not easily detectable by BCR-ABL1 qRT-PCR. Bone marrow Ph+ CML CD34+/CD38− LSCs were found to specifically co-express CD26 (dipeptidylpeptidase-IV). We explored feasibility of detecting and quantifying CD26+ LSCs by flow cytometry in peripheral blood (PB). Over 400 CML patients (at diagnosis and during/after therapy) entered this cross-sectional study in which CD26 expression was evaluated by a standardized multiparametric flow cytometry analysis on PB CD45+/CD34+/CD38− stem cell population. All 120 CP-CML patients at diagnosis showed measurable PB CD26+ LSCs (median 19.20/μL, range 0.27–698.6). PB CD26+ LSCs were also detectable in 169/236 (71.6%) CP-CML patients in first-line TKI treatment (median 0.014 cells/μL; range 0.0012–0.66) and in 74/112 (66%), additional patients studied on treatment-free remission (TFR) (median 0.015/μL; range 0.006–0.76). Notably, no correlation between BCR-ABL/ABLIS ratio and number of residual LSCs was found both in patients on or off TKIs. This is the first evidence that “circulating” CML LSCs persist in the majority of CML patients in molecular response while on TKI treatment and even after TKI discontinuation. Prospective studies evaluating the dynamics of PB CD26+ LSCs during TKI treatment and the role of a “stem cell response” threshold to achieve and maintain TFR are ongoing

Prognostic Factors for Overall Survival In Chronic Myeloid Leukemia Patients: A Multicentric Cohort Study by the Italian CML GIMEMA Network

An observational prospective study was conducted by the CML Italian network to analyze the role of baseline patient characteristics and first line treatments on overall survival and CML-related mortality in 1206 newly diagnosed CML patients, 608 treated with imatinib (IMA) and 598 with 2nd generation tyrosine kinase inhibitors (2GTKI). IMA-treated patients were much older (median age 69 years, IQR 58-77) than the 2GTKI group (52, IQR 41-63) and had more comorbidities. Estimated 4-year overall survival of the entire cohort was 89% (95%CI 85.9-91.4). Overall, 73 patients (6.1%) died: 17 (2.8%) in the 2GTKI vs 56 (9.2%) in the IMA cohort (adjusted HR=0.50; 95% CI=0.26-0.94), but no differences were detected for CML-related mortality (10 (1.7%) vs 11 (1.8%) in the 2GTKIs vs IMA cohort (sHR=1.61; 0.52-4.96). The ELTS score was associated to CML mortality (high risk vs low, HR=9.67; 95%CI 2.94-31.74; p<0.001), while age (per year, HR=1.03; 95%CI 1.00-1.06; p=0.064), CCI (4-5 vs 2, HR=5.22; 95%CI 2.56-10.65; p<0.001), ELTS score (high risk vs low, HR=3.11; 95%CI 1.52-6.35, p=0.002) and 2GTKI vs IMA (HR=0.26; 95%CI 0.10-0.65, p=0.004) were associated to an increased risk of non-related CML mortality. The ELTS score showed a better discriminant ability than the Sokal score in all comparisons