Clinical predictive factors of pathologic complete response in locally advanced rectal cancer

Background: Predictive factors of pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) are still not identified. The purpose of this study was to define them. Materials and Methods: Data from consecutive LARC patients treated between January 2008 and June 2014 at our Institution were included in the analysis. All patients were treated with a long course of nCRT. Demographics, initial diagnosis and tumor extension details, as well as treatment modalities characteristics were included in the univariate and logistic regression analysis. Results: In total 99 patients received nCRT, of whom 23 patients (23.2%) achieved pCR. Patients with and without pCR were similar in term of age, sex, comobidities, BMI and tumor characteristics. Multivariate logistic regression indicated that pre-treatment tumor size <= 5 cm was a significant predictor for pCR (p = 0.035), whereas clinical N stage only showed a positive trend (p = 0.084). Conclusions: Tumor size at diagnosis could be used to predict pCR, and thus to individualize therapy in LARC patients management. Validation in other studies is needed

Correlation between onco-suppressors PTEN and NM23 and clinical outcome in patients with T1 breast cancer

The aim of the present work was to evaluate the prognostic significance in patients with T1 breast cancer of tissue expression of the two oncosuppressors phosphatase and tensin homolog (PTEN) and non-metastatic clone 23 (NM23) as detected by immunohistochemistry

Aortic Aneurysm: A Surgical Point of View

Aortic aneurysms are of different types as different ones are the types of treatment available to us. Following the advent of endovascular surgery, perioperative mortality has been significantly reduced, but open surgery remains the first choice under some occurrences. The purpose of this chapter is to try to clarify the dichotomy between open and endovascular aortic aneurysms in the several types of aortic aneurysms, highlighting the indications and complications to guide to the best therapeutic choice

Scintigraphy-based analysis of possible pulmonary lesions after foam sclerotherapy: a pilot study

The aims of this study were to assess extemporaneous in vivo binding between 99mTcO4- and two sclerosant detergents in foam sclerotherapy, and subsequently to control any possible damage in lungs and other organs related to sclerosant foam passage. A prospective comparative pilot study was performed on two male patients (62 and 56 years old) affected by varicose veins; each of them underwent scintigraphy investigations with free radiotracer and a scintigraphy investigation after each of the four sessions of sclerotherapy of varicose tributaries of the lower limbs with labeled sclerosant foam. One of the two patients underwent two further scintigraphic investigations, with free radiotracer and with labeled sclerosant foam, at a later stage. Four mL of 2% polidocanol (POL) foam, or four mL of 1% sodiumtetradecylsulfate (STS) foam for session were injected. The sclerosant foam was labeled with the radioactive tracer technetium pertechnetate, 99mTcO4- (120 MBq per exam). Two scintigraphy assessments for free tracer (basal) and five scintigraphy investigations of bound-tosclerosant tracer uptake/transit were obtained. No relevant variations in time/activity curves of the lungs and other organs were documented between the basal and post-sclerotherapy findings, also at the later stage. Free radiotracer mean region-of-interest data were: 336 counts (heart), 208 counts (lungs) and 371 counts (thyroid). Mean values extrapolated from each curve at each step for labeled CO2O2-based sclerosant foam were respectively: 351 counts (POL) and 328 counts (STS) for heart, 202 counts (POL) and 188 counts (STS) for lungs, 335 (POL) and 263 (STS) for thyroid. No pulmonary damage by sclerosant foam was caused. Neither immediately after treatments, nor at short-term follow-up

Implementation of psychology counseling sufistic for diabetes genetic client in millenial age

Everyone through the millennial age. The researcher assessed that when in the millennial age, the age of approximately 24–35 if a person can successfully lead a career, economic, religious, health, family life, then in his age after millennial, she/he just reaped the success of his/her business at the next millennial age. Method: selected clients have genetic diabetics at the age of 50 years, but one of the health lives that is lived at millennial age is not well regulated, so at the age above the age of age he has genetic diabetics, especially most families also have diabetes and die on average 40 years average. Undergoing the Quran treatment that tells the story of the previous prophet‘s life in the prophet and sufistic counseling psychology is predicted to prepare the client to accept destiny as a person with genetic diabetes and prepå clients to face death. Result: Thus the success of undergoing millennial age in all predicted increases happiness in the age after millennial age. the toughness of someone living life even in severe pain is something that needs to be prepared in the treatment of Sufi counseling psychology. Sufistic counseling formula is someone trying to pray until the maximum problem results are up to God PET = R

Variegated silencing through epigenetic modifications of a large Xq region in a case of balanced X;2 translocation with Incontinentia Pigmenti-like phenotype

Molecular mechanisms underlying aberrant phenotypes in balanced X;autosome translocations are scarcely understood. We report the case of a de novo reciprocal balanced translocation X;2(q23;q33) presenting phenotypic alterations highly suggestive of Incontinentia Pigmenti (IP) syndrome, a genodermatosis with abnormal skin pigmentation and neurological failure, segregating as X-linked dominant disorder. Through molecular studies, we demonstrated that the altered phenotype could not be ascribed to chromosome microdeletions or to XIST-mediated inactivation of Xq24-qter. Interestingly, we found that the Xq24-qter region, which translocated downstream of the heterochromatic band 2q34, undergoes epigenetic silencing mediated by DNA methylation and histone alterations. Among the downregulated genes, we found the inhibitor of kappa light polypeptide gene enhancer in B cells, kinase gamma (IKBKG/NEMO), the causative gene of IP. We hypothesize that a mosaic functional nullisomy of the translocated genes, through a Position Effect Variegation-like heterochromatization, might be responsible for the proband's phenotypic anomalies. Partial silencing of IKBKG may be responsible for the skin anomalies observed, thereby mimicking the IP pathological condition. In addition to its clinical relevance, this paper addresses fundamental issues related to the chromatin status and nuclear localization of a human euchromatic region translocated proximally to heterochromatin. In conclusion, the study provides new insight into long-range gene silencing mechanisms and their direct impact in human disease

Recensioni e letture

Rosi Braidotti, Transpositions: On Nomadic Ethics(Nadia Manzo) – Beïda Chikhi, Assia Djébar: histoires et fantaisies (Mena Marotta) – Juan Goytisolo, Contra las sagradas formas (Paola Chiara Santoro) – Lisa Hopkins, Screen Adaptations. Shakespeare’s The Tempest. The relationship between Text and Film (Maria Izzo) – Paul Skandera (ed.), Phraseology and Culture in English (Paola Attolino) – Yoko Tawada, Sprachpolizei und Spielpolyglotte (Daniela Allocca)Rosi Braidotti, Transpositions: On Nomadic Ethics(Nadia Manzo) – Beïda Chikhi, Assia Djébar: histoires et fantaisies (Mena Marotta) – Juan Goytisolo, Contra las sagradas formas (Paola Chiara Santoro) – Lisa Hopkins, Screen Adaptations. Shakespeare’s The Tempest. The relationship between Text and Film (Maria Izzo) – Paul Skandera (ed.), Phraseology and Culture in English (Paola Attolino) – Yoko Tawada, Sprachpolizei und Spielpolyglotte (Daniela Allocca

Longitudinal Analysis of Functional and Clinical Factors and Falls in Institutionalized Older People with Dementia

Na última fase da demência, torna-se comum a institucionalização devido à dificuldade de relacionamento e cuidado. O objetivo do estudo foi verificar a presença de distúrbios comportamentais, funcionais e cognitivos de idosos institucionalizados com demência e analisar de forma prospectiva os fatores funcionais, a fase da demência e a taxa de óbito e quedas ao longo de 8 meses destes idosos. Trata-se de um estudo longitudinal, que ocorreu em dois momentos de avaliação (inicial e após 8 meses), com idosos institucionalizados com demência. Inicialmente, os participantes foram submetidos a uma avaliação envolvendo fatores comportamentais (expressões faciais, Inventário Neuropsiquiátrico, variáveis cardiovasculares), instrumentos funcionais e cognitivos. Ao longo de 8 meses, uma vez por mês era solicitado à equipe o registro da taxa de quedas. Após 8 meses, os participantes foram submetidos à avaliação funcional e à fase de demência, além do registro de óbitos. Como resultados principais, foi observada presença de baixa variabilidade de frequência cardíaca e distúrbios comportamentais, cognitivos e funcionais. Os idosos apresentaram aumento da taxa de quedas, piora significativa do quadro funcional e aumento do número de idosos classificados com demência avançada. Os resultados acompanham a progressividade característica da demência. Como conclusão, faz-se importante o relato de quedas com intuito de identificar os fatores de risco para e assim poder agir com antecedência.In the last stage of dementia, there is functional dependence and gait disturbance with increasing risk of falls, making institutionalization common due to difficulty of relationship and care. The purpose of this study was to verify presence of behavioral, functional and cognitive disorders in institutionalized older people with dementia and to analyze prospectively functional factors, stage of dementia and rate of death and falls over 8 months in the sample. In this longitudinal study, there were two moments of evaluation, at baseline and after 8 months, with institutionalized older people diagnosed with dementia. The participants were submitted to an assessment involving anamnesis, behavioral factors (facial expressions, Neuropsychiatric Inventory, cardiovascular variables), functional and cognitive tools. For 8 months, once a month the team was asked to record rate of falls. After 8 months, an assessment of functional capacity, dementia phase and rate of falls was done. As results, presence of low heart rate variability and behavioral, cognitive and functional disorders were observed. Over 8 months, the participants showed an increase rate of falls, a significant worsening of functional capacity and an increase number of older people with advanced dementia. The results followed characteristic progression of dementia. As conclusion, it is important to understand falls and risk factors for falls to be able to act in advance