Giant acquired tracheocele in a syndromic child: Case report and review of the literature

We report a case of acquired tracheocele in a child with multiple congenital anomalies of the face, limbs, kidneys, and heart, to share our experience with international scientific community, considering the rarity of the disease especially in the pediatric population. Patientâs history reported a tracheotomy at one month of life that was closed at 3 years old. Ten years later, the patient come to us for an anterior cervical mass swelling during respiratory effort and chronic productive cough. The diagnosis was made by high resolution Computed Tomography scan of the neck and chest and an elective surgical resection of the lesion under general anesthesia was done

Overview of the first HyMeX Special Observation Period over Italy: Observations and model results

The Special Observation Period (SOP1), part of the HyMeX campaign (Hydrological cycle in the Mediter- ranean Experiments, 5 September–6 November 2012), was dedicated to heavy precipitation events and flash floods in the western Mediterranean, and three Italian hydro- meteorological monitoring sites were identified: Liguria– Tuscany, northeastern Italy and central Italy. The extraordi- nary deployment of advanced instrumentation, including in- strumented aircrafts, and the use of several different opera- tional weather forecast models, including hydrological mod- els and marine models, allowed an unprecedented monitoring and analysis of high-impact weather events around the Italian hydro-meteorological sites. This activity has seen strong collaboration between the Italian scientific and operational communities. In this paper an overview of the Italian organization during SOP1 is provided, and selected Intensive Observation Periods (IOPs) are described. A significant event for each Italian target area is chosen for this analysis: IOP2 (12–13 September 2012) in northeastern Italy, IOP13 (15– 16 October 2012) in central Italy and IOP19 (3–5 Novem- ber 2012) in Liguria and Tuscany. For each IOP the mete- orological characteristics, together with special observations and weather forecasts, are analyzed with the aim of high- lighting strengths and weaknesses of the forecast modeling systems, including the hydrological impacts. The usefulness of having different weather forecast operational chains cha acterized by different numerical weather prediction models and/or different model set up or initial conditions is finally shown for one of the events (IOP19)

Overview of the first HyMeX Special Observation Period over Italy: observations and model results

Abstract. The Special Observation Period (SOP1), part of the HyMeX campaign (Hydrological cycle in the Mediterranean Experiments, 5 September–6 November 2012), was dedicated to heavy precipitation events and flash floods in the western Mediterranean, and three Italian hydro-meteorological monitoring sites were identified: Liguria–Tuscany, northeastern Italy and central Italy. The extraordinary deployment of advanced instrumentation, including instrumented aircrafts, and the use of several different operational weather forecast models, including hydrological models and marine models, allowed an unprecedented monitoring and analysis of high-impact weather events around the Italian hydro-meteorological sites. This activity has seen strong collaboration between the Italian scientific and operational communities. In this paper an overview of the Italian organization during SOP1 is provided, and selected Intensive Observation Periods (IOPs) are described. A significant event for each Italian target area is chosen for this analysis: IOP2 (12–13 September 2012) in northeastern Italy, IOP13 (15–16 October 2012) in central Italy and IOP19 (3–5 November 2012) in Liguria and Tuscany. For each IOP the meteorological characteristics, together with special observations and weather forecasts, are analyzed with the aim of highlighting strengths and weaknesses of the forecast modeling systems, including the hydrological impacts. The usefulness of having different weather forecast operational chains characterized by different numerical weather prediction models and/or different model set up or initial conditions is finally shown for one of the events (IOP19)

Choice of Frontline Tyrosine-Kinase Inhibitor and Early Events in Very Elderly Patients With Chronic Myeloid Leukemia in Chronic Phase: A "Campus CML" Study

Objectives: The study aimed to evaluate the utilization of frontline TKI therapy in a large cohort of elderly CP-CML patients. Methods: A retrospective analysis was conducted on 332 CP-CML patients aged 75 years or older among 1929 diagnosed from January 2012 to December 2019 followed at 36 participating Hematology Centers involved in the "Campus CML" project. Results: Among the patients analyzed, 85.8% received imatinib (IM) while 14.2% received second-generation TKIs (2G-TKI), 59.5% dasatinib, and 40.5% nilotinib. Most patients initiated IM at standard dose (67.3%) while 32.7% at reduced dose. A similar trend was observed with 2G-TKIs. The cumulative incidence of permanent TKI discontinuation at 12 months was 28.4%, primarily due to primary resistance (10.1%) and extra-hematologic toxicity (9.5%), with no significant difference between IM and 2G-TKI groups. Following the introduction of generic IM in Italy in 2018, IM usage increased significantly compared with 2G-TKIs. Conclusions: IM was in our Centers the preferred frontline therapy for older CP-CML patients, with increasing utilization after the introduction of generic formulations. However, 2G-TKIs are still used in a substantial proportion of patients, suggesting individualized physician assessments regarding patient suitability and expectations. Further investigation is needed to assess efficacy and safety of reduced TKI doses in this patient population

Choice of Frontline Tyrosine-Kinase Inhibitor and Early Events in Very Elderly Patients With Chronic Myeloid Leukemia in Chronic Phase: A “Campus CML” Study

Objectives: The study aimed to evaluate the utilization of frontline TKI therapy in a large cohort of elderly CP-CML patients. Methods: A retrospective analysis was conducted on 332 CP-CML patients aged 75 years or older among 1929 diagnosed from January 2012 to December 2019 followed at 36 participating Hematology Centers involved in the “Campus CML” project. Results: Among the patients analyzed, 85.8% received imatinib (IM) while 14.2% received second-generation TKIs (2G-TKI), 59.5% dasatinib, and 40.5% nilotinib. Most patients initiated IM at standard dose (67.3%) while 32.7% at reduced dose. A similar trend was observed with 2G-TKIs. The cumulative incidence of permanent TKI discontinuation at 12 months was 28.4%, primarily due to primary resistance (10.1%) and extra-hematologic toxicity (9.5%), with no significant difference between IM and 2G-TKI groups. Following the introduction of generic IM in Italy in 2018, IM usage increased significantly compared with 2G-TKIs. Conclusions: IM was in our Centers the preferred frontline therapy for older CP-CML patients, with increasing utilization after the introduction of generic formulations. However, 2G-TKIs are still used in a substantial proportion of patients, suggesting individualized physician assessments regarding patient suitability and expectations. Further investigation is needed to assess efficacy and safety of reduced TKI doses in this patient population

Determinants of frontline tyrosine kinase inhibitor choice for patients with chronic-phase chronic myeloid leukemia: A study from the Registro Italiano LMC and Campus CML

BackgroundImatinib, dasatinib, and nilotinib are tyrosine kinase inhibitors (TKIs) approved in Italy for frontline treatment of chronic-phase chronic myeloid leukemia (CP-CML). The choice of TKI is based on a combined evaluation of the patient's and the disease characteristics. The aim of this study was to analyze the use of frontline TKI therapy in an unselected cohort of Italian patients with CP-CML to correlate the choice with the patient's features. MethodsA total of 1967 patients with CP-CML diagnosed between 2012 and 2019 at 36 centers throughout Italy were retrospectively evaluated; 1089 patients (55.4%) received imatinib and 878 patients (44.6%) received a second-generation (2G) TKI. ResultsSecond-generation TKIs were chosen for most patients aged <45 years (69.2%), whereas imatinib was used in 76.7% of patients aged >65 years (p < .001). There was a predominant use of imatinib in intermediate/high European long-term survival risk patients (60.0%/66.0% vs. 49.7% in low-risk patients) and a limited use of 2G-TKIs in patients with comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, previous neoplasms, ischemic heart disease, or stroke and in those with >3 concomitant drugs. We observed a greater use of imatinib (61.1%) in patients diagnosed in 2018-2019 compared to 2012-2017 (53.2%; p = .002). In multivariable analysis, factors correlated with imatinib use were age > 65 years, spleen size, the presence of comorbidities, and & GE;3 concomitant medications. ConclusionsThis observational study of almost 2000 cases of CML shows that imatinib is the frontline drug of choice in 55% of Italian patients with CP-CML, with 2G-TKIs prevalently used in younger patients and in those with no concomitant clinical conditions. Introduction of the generic formulation in 2018 seems to have fostered imatinib use

Analyzing Microblogging Posts for Tracking Collective Emotional Trajectories

The technologies of communication, such as forums and instant messaging, available in the social media platforms open to the possibility to convey and express emotions and feelings, besides to facilitate interaction. Emotions and social relationships are often connected, indeed, emotions and feelings can make the users favorable or reluctant to socialize, as well, experiences of socialization can influence the behaviors. Being personal, emotions and feelings can be crucial in the dynamics of social communities, perhaps more than other elements, such as events and multimedia items, because the individuals tend to interact with the users with who have particular affinity or with who share sensations. In this paper we introduce the problem of tracking users who share emotional behavior with other users. The proposed method relies on a cyberspace based on emotional words extracted from social media posts. It builds emotional trajectories as sequences of points of the cyberspace characterized by highly similar emotions. We show the viability of the method on Twitter data and provide a quantitative evaluation and qualitative considerations

Influence of time to complete remission and duration of all-trans retinoic acid therapy on the relapse risk in patients with acute promyelocytic leukemia receiving AIDA protocols

Despite the impressive results obtained with standard chemotherapy, approximately 20% of acute promyelocytic leukemia (APL) patients undergo disease relapse thereby requiring salvage therapy. Few data is available on long-term prognosis in relation to time to complete remission (CR): we reviewed 142 patients treated with AIDA protocols and we found that 42 out of 142 (29.6%) patients achieved CR after 35 days (median time, 42 days). No significant differences in presenting features, including FAB subtype, type of PML/RARA transcript and relapse risk at presentation between the two patient groups achieving CR > or <35 days were revealed, except for male sex and older age that were significantly associated with delayed CR. Rate of relapse was 31% in patients with delayed CR compared to 17% in the group of patients who achieved CR<35 days (p=0.001), with a 5-year CIR of 29.6% compared to 12% (p=0.03). APL patients with delayed CR should be more closely monitored during follow-up for early identification of relapse and prompt administration of pre-emptive salvage therapy