Utilizzo di sensori inerziali indossabili nella valutazione motoria del paziente affetto da malattia di Parkinson: una Scoping Review

Background: la malattia di Parkinson è un disturbo neurodegenerativo che implica sia sintomi motori che non motori, invalidanti per la vita del paziente. Per ridurre l’impatto dei sintomi sulla qualità di vita è richiesta una complessa gestione della terapia, che si basa su un’accurata valutazione. Gli strumenti di valutazione sono molteplici, la necessità è quella di individuare metodi validi, accurati e rapidi. Obbiettivo: l’obbiettivo della presente scoping review è quello di indagare l’utilizzo di sensori inerziali indossabili nella valutazione dei sintomi motori di pazienti affetti da Malattia di Parkinson. Metodi: la ricerca è stata condotta sulle principali banche dati PubMed, PEDro, Cochrane Library. Gli studi integrati sono stati scelti sulla base di specifici criteri di inclusione ed esclusione. Non sono state applicate restrizioni riguardo alla tipologia delle pubblicazioni. Sono stati applicati limiti di lingua. Risultati: tramite il processo di identificazione degli studi sono stati individuati 1124 risultati. Gli studi inseriti nell’elaborato sono 25, pubblicati in un arco temporale compreso tra il 2012 e il 2023. Conclusioni: gli articoli presi in considerazione reputano i sensori inerziali indossabili come un valido strumento di valutazione dei sintomi motori. La limitazione nel numero di campioni e la scarsa diffusione nella pratica clinica li rendono parte di un campo di studi ancora in fase di sviluppo

Plasma Androgen Receptor and Docetaxel for Metastatic Castration-resistant Prostate Cancer

Càncer de pròstata; Receptor d'andrògens; DocetaxelCáncer de próstata; Receptor de andrógenos; DocetaxelProstate cancer; Androgen receptor; DocetaxelPlasma androgen receptor (AR) gain identifies metastatic castration-resistant prostate cancer (mCRPC) patients with worse outcome on abiraterone/enzalutamide, but its relevance in the context of taxane chemotherapy is unknown. We aimed to evaluate whether docetaxel is active regardless of plasma AR and to perform an exploratory analysis to compare docetaxel with abiraterone/enzalutamide. This multi-institutional study was a pooled analysis of AR status, determined by droplet digital polymerase chain reaction, on pretreatment plasma samples. We evaluated associations between plasma AR and overall/progression-free survival (OS/PFS) and prostate-specific antigen (PSA) response rate in 163 docetaxel-treated patients. OS was significantly shorter in case of AR gain (hazard ratio [HR]=1.61, 95% confidence interval [CI]=1.08-2.39, p=0.018), but not PFS (HR=1.04, 95% CI 0.74-1.46, p=0.8) or PSA response (odds ratio=1.14, 95% CI=0.65-1.99, p=0.7). We investigated the interaction between plasma AR and treatment type after incorporating updated data from our prior study of 73 chemotherapy-naïve, abiraterone/enzalutamide-treated patients, with data from 115 first-line docetaxel patients. In an exploratory analysis of mCRPC patients receiving first-line therapies, a significant interaction was observed between plasma AR and docetaxel versus abiraterone/enzalutamide for OS (HR=0.16, 95% CI=0.06-0.46, p<0.001) and PFS (HR=0.31, 95% CI=0.12-0.80, p=0.02). Specifically, we reported a significant difference for OS favoring abiraterone/enzalutamide for AR-normal patients (HR=1.93, 95% CI=1.19-3.12, p=0.008) and a suggestion favoring docetaxel for AR-gained patients (HR=0.53, 95% CI=0.24-1.16, p=0.11). These data suggest that AR-normal patients should receive abiraterone/enzalutamide and AR-gained could benefit from docetaxel. This treatment selection merits prospective evaluation in a randomized trial. PATIENT SUMMARY: We investigated whether plasma androgen receptor (AR) predicted outcome in metastatic castration-resistant prostate cancer (mCRPC) patients treated with docetaxel, and we performed an exploratory analysis in patients treated with docetaxel or AR-directed drugs as first-line mCRPC therapy. We showed that plasma AR normal favored hormonal treatment, whilst plasma AR-gained patients may have had a longer response to docetaxel, suggesting that plasma AR status could be a useful treatment selection biomarker.Funding/Support and role of the sponsor: V. Conteduca was funded by a European Society of Medical Oncology Translational Clinical Research Fellowship. A. Jayaram is supported by a grant from the Medical Research Council (MR/P002072/1). G. Attard is supported by a Cancer Research UK Advanced Clinician Scientist Grant (A22744). This work was funded in part by Prostate Cancer UK (PG12-49), the “Instituto de Salud Carlos III” (ISCII) PI16/01565 grant. E. Gonzalez-Billalabeitia was funded by a grant from the “Instituto de Salud Carlos III” (ISCIII) PI15/01499. N. RomeroLaorden was funded by a grant from the “Instituto de Salud Carlos III” (CM14-00200). E. Castro is supported by a Prostate Cancer Foundation Young Investigator Award (2017). E. Castro and D. Olmos are supported by grants from the Ministerio de Economía, Industria y Competitividad (JCI-2014-19129 to E.C., RYC-2015-18625 to D.O.). B. Mellado and M. Marin-Aguilera work were supported by the Instituto de Salud Carlos IIISubdirección General de Evaluación y Fomento de la Investigación (PI12/ 01226 and PI15/676) and co-funded by the European Regional Development Fund. Funding from CERCA Programme/Generalitat de Catalunya is gratefully acknowledged. During the conduct of the study, E. Castro was supported by a grant from the Ministerio de Educación, Cultura y Deportes (CAS17/00182). The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding authors had full access to all data and had the final responsibility for the decision to submit for publication

乳兒に於ける化膿性骨髄炎の統計的觀察

Additional file 3: Figure S1. Methylation percentages of the two genes (CASP8 and SCGB3A1) in P, C and PCa samples that were differentially methylated in C and P samples in the training set. The figure highlights a higher methylation percentage for PCa than for healthy samples, but also a higher methylation percentage for P than for C samples in both genes

Impact of the time interval between primary or interval surgery and adjuvant chemotherapy in ovarian cancer patients

IntroductionPrimary debulking surgery (PDS), interval debulking surgery (IDS), and platinum-based chemotherapy are the current standard treatments for advanced ovarian cancer (OC). The time to initiation of adjuvant chemotherapy (TTC) could influence patient outcomes.MethodsWe conducted a multicenter retrospective cohort study of advanced (International Federation of Gynecology and Obstetrics (FIGO) stage III or IV) OC treated between 2014 and 2018 to assess progression-free survival (PFS) and overall survival (OS) in relation to TTC. All patients underwent a germline multigene panel for BRCA1/2 evaluation.ResultsAmong the 83 patients who underwent PDS, a TTC ≥ 60 days was associated with a shorter PFS (hazard ratio (HR) 2.02, 95% confidence interval (CI) 1.04–3.93, p = 0.038), although this association lost statistical significance when adjusting for residual disease (HR 1.52, 95% CI 0.75–3.06, p = 0.244, for TTC and HR 2.73, 95% CI 1.50–4.96, p = 0.001, for residual disease). Among 52 IDS patients, we found no evidence of an association between TTC and clinical outcomes. Ascites, type of chemotherapy, or germline BRCA1/2 mutational status did not influence TTC and were not associated with clinical outcomes in PDS or IDS patients.DiscussionIn conclusion, longer TTC seems to negatively affect prognosis in patients undergoing PDS, especially those with residual disease

Clinical Impact of Next-Generation Sequencing Multi-Gene Panel Highlighting the Landscape of Germline Alterations in Ovarian Cancer Patients

BRCA1 and BRCA2 are the most frequently mutated genes in ovarian cancer (OC) crucial both for the identification of cancer predisposition and therapeutic choices. However, germline variants in other genes could be involved in OC susceptibility. We characterized OC patients to detect mutations in genes other than BRCA1/2 that could be associated with a high risk of developing OC and permit patients to enter the most appropriate treatment and surveillance program. Next-generation sequencing analysis with a 94-gene panel was performed on germline DNA of 219 OC patients. We identified 34 pathogenic/likely pathogenic variants in BRCA1/2 and 38 in other 21 genes. The patients with pathogenic/likely pathogenic variants in the non-BRCA1/2 genes mainly developed OC alone compared to the other groups that also developed breast cancer or other tumors (p = 0.001). Clinical correlation analysis showed that the low-risk patients were significantly associated with platinum sensitivity (p &lt; 0.001). Regarding PARP inhibitors (PARPi) response, the patients with pathogenic mutations in the non-BRCA1/2 genes had worse PFS and OS. Moreover, a statistically significantly worse PFS was found for every increase of one thousand platelets before PARPi treatment. To conclude, knowledge about molecular alterations in genes beyond BRCA1/2 in OC could allow for more personalized diagnostic, predictive, prognostic, and therapeutic strategies for OC patients

Prognostic assessment in IPF

Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal form of fibrotic interstitial lung disease (ILDs). The clinical profile and natural history are extremely heterogeneous, some patients progress rapidly, while others slowly. A proportion of patients experience acute exacerbations of IPF, an accelerated lung function decline of unknown cause that to date is still unpredictable. Moreover the natural course of IPF is influenced by different comorbidities. The intrinsic complexity of this entity makes very challenging to find reliable and standardized methods of prognostic assessment. Multidimensional indices and staging systems have been recently proposed. The advantage of multidimensional indices is that they are more accurate in predicting IPF prognosis compared to single prognostic clinical factors. Currently both functional variables and multidimensional indices are used in clinical practice to discuss prognosis with patients and to guide both treatment and monitoring decisions. Despite these recent progresses we are still unable to predict the rate of disease progression, the risk of acute exacerbations and the most frequent and lethal comorbidities, such as pulmonary hypertension and lung cancer, that may swerve disease course. Future research in the field of genotyping and biomolecular profiling of this heterogeneous entity, will hopefully allow important steps on the complex pathway of IPF prognostic assessment

Primary Mediastinal and Testicular Germ Cell Tumors in Adolescents and Adults: A Comparison of Genomic Alterations and Clinical Implications

Mediastinal germ cell tumors (MGCTs) share histologic, molecular and biomarkers features with testicular GCTs; however, nonseminomatous MGCTs are usually more aggressive and have poorer prognosis than nonseminomatous TGCTs. Most nonseminomatous MGCT cases show early resistance to platinum-based therapies and seldom have been associated with the onset of one or more concomitant somatic malignancies, in particular myeloid neoplasms with recent findings supporting a common, shared genetic precursor with the primary MGCT. Genomic, transcriptomic and epigenetic features of testicular GCTs have been extensively studied, allowing for the understanding of GCT development and transformation of seminomatous and nonseminomatous histologies. However, MGCTs are still lacking proper multi-omics analysis and only few data are reported in the literature. Understanding of the mechanism involved in the development, in the progression and in their higher resistance to common therapies is still poorly understood. With this review, we aim to collect all molecular findings reported in this rare disease, resuming the similarities and disparities with the gonadal counterparts

Carcinosarcoma of the prostate: case report with molecular and histological characterization

We report a case of prostatic carcinosarcoma, a rare variant of prostatic cancer, which is composed of a mixture of epithelial and mesenchymal components with a generally poor outcome

Immune System and DNA Repair Defects in Ovarian Cancer: Implications for Locoregional Approaches

In the last few years, substantial progress has been made in the treatment of ovarian cancer, with increased knowledge about the biology of the disease. Ovarian cancer is a neoplasm strongly linked to defects in DNA repair mechanisms, where deficiency in the homologous recombination (HR) system results in a better response of ovarian cancers to therapy, whether platinum-based chemotherapy, anthracyclines, or poly (ADP-ribose) polymerase (PARP) inhibitors. More recently, it has been demonstrated that different ovarian cancer histotypes may have different immunogenicity. Interestingly, defects in HR systems are associated more frequently with higher tumor infiltrating lymphocytes, providing a rationale for developing combination therapy with immune-modulating agents and PARP inhibitors. Again, locoregional therapies combining heat shock and chemotherapy delivery have been shown to induce an anticancer immune response in vitro. Thus, the potential for locoregional therapeutic approaches that may impact the immune system, perhaps in combination with immune-modulating agents or PARP inhibitors, needs to be further explored. With this premise, we reviewed the main biological and clinical data demonstrating a strict interplay between the immune system, DNA repair mechanisms, and intraperitoneal therapies in ovarian cancer, with a focus on potential future therapeutic implications