Prognostic value of normal sodium levels in patients with metastatic renal cell carcinoma receiving tyrosine kinase inhibitors

Background: Although serum sodium concentration, particularly hyponatremia, has been shown to be a prognostic marker of survival in metastatic renal cell carcinoma (mRCC), the impact of normal sodium levels has not been investigated. Herein, we investigate the influence of normonatremia in mRCC patients treated with tyrosine kinase inhibitors (TKIs). Materials and methods: For this retrospective study, the clinical and biochemical data of patients treated with first-line TKIs for mRCC were available from seven Italian cancer centers. We collected natremia levels at baseline and first evaluation after treatment excluding patients with sodium levels outside the normal range (<135 or >145 mEq/L). The remaining patients were subdivided into two groups according to the median sodium value: natremia patients with <140 mEq/L (n = 132) and baseline natremia patients with ≥140 mEq/L (n = 185). Subsequently, we analyzed the impact of sodium levels on response rate (RR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). PFS and OS were estimated through the Kaplan–Meier method, and differences between groups were examined by the log-rank test. Univariate and multivariate Cox regression analyses were applied to evaluate the prognostic factors for PFS and OS. Results: Of the 368 patients, 317 were included in the analysis, 73.1% were men, and the median age was 67 years (range 36–89). When comparing patients with baseline natremia ≥140 mEq/L (n = 185) to patients with natremia <140 mEq/L (n = 132), the PFS was 15 vs. 10 months (p < 0.01) and the OS was 63 vs. 36 months, respectively (p = 0.02). On the first evaluation, patients with serum sodium ≥140 mEq/L had longer PFS (15 vs. 10 months, p < 0.01) and OS (70 vs. 32 months, p < 0.01) than patients with levels <140 mEq/L. Moreover, clinical outcomes showed a significant improvement in patients with natremia ≥140 mEq/L compared with patients with levels <140 mEq/L both at baseline and first evaluation: PFS was 19 vs. 11 months (p < 0.01) and OS was 70 vs. 36 months (p < 0.01), respectively. Conclusions: To the best of our knowledge, this is the first study to investigate the impact of normonatremia in mRCC. We found that serum sodium levels <140 mEq/L at baseline and first assessment are independently associated with worse PFS and OS in mRCC patients treated with TKIs in the first-line setting

Helicobacter pylori cag Pathogenicity Island Is Associated with Reduced Expression of Interleukin-4 (IL-4) mRNA and Modulation of the IL-4δ2 mRNA Isoform in Human Gastric Mucosa

Interleukin-4 (IL-4) and IL-4δ2 mRNA gastric expression was evaluated in healthy subjects and patients who did not have ulcers but were infected with Helicobacter pylori with or without the cag pathogenicity island (cag PAI). IL-4 mRNA was physiologically expressed by gastric epithelium and negatively influenced by H. pylori. Also, nonepithelial cells in the lamina propria of H. pylori-infected patients expressed IL-4 mRNA, whereas IL-4δ2 mRNA was found only in cag PAI-negative patients. Thus, gastric IL-4 takes part in the local immune response to H. pylori

Four α\alpha-particles as a final state of 16^{16}O* Quasi Projectile decay

International audienceFour α-particles as a final state of 16O* quasi-projectile decayproduced in peripheral 16O+12C reactions at 130 MeV is thoroughly studied. The differentdecay channels leading to the four α-particles final state are reconstructed by carrying out an event-by-event analysis of α correlations in the population of intermediate 8Be and 12C. Although small, a non negligible contribution due to 8Begs evaporation is found.A comparison between predictions of an accurate Hauser-Feshbach decay code and branching ratios of the different decay channels is performed. Significant deviations are observed, among these the Hoyle state population which is considerably lower than the one predicted according to the statistical model, thus suggesting possible structure effects in the Coulomb barrier and/or in the transmission coefficients

Four α-particles as a final state of 16O* Quasi Projectile decay

Four α-particles as a final state of 16O* quasi-projectile decayproduced in peripheral 16O+12C reactions at 130 MeV is thoroughly studied. The differentdecay channels leading to the four α-particles final state are reconstructed by carrying out an event-by-event analysis of α correlations in the population of intermediate 8Be and 12C. Although small, a non negligible contribution due to 8Begs evaporation is found.A comparison between predictions of an accurate Hauser-Feshbach decay code and branching ratios of the different decay channels is performed. Significant deviations are observed, among these the Hoyle state population which is considerably lower than the one predicted according to the statistical model, thus suggesting possible structure effects in the Coulomb barrier and/or in the transmission coefficients

Studying the Decay of 46^{46}Ti*: Does Different Partner Structure Influence the Competing Mechanisms and the Following Compound Nucleus Decay?

International audienceA useful tool to underline possible structure effects on the competition between different reaction mechanisms, which may change the expected decay chain probability, is the exclusive study of light charged particles emission from hot light composite systems. In particular, the influence of projectile structure may be evidenced by studying the competition between fast and thermal emissions. In this framework, the four reactions ^16O+^30Si, ^18O+^28Si, ^19F+^27Al at 7 MeV/u and ^16O+^30Si at 8 MeV/u have been carried out using the GARFIELD+RCo array at Legnaro National Laboratories. Some anomalies in the α-particle emission channels have been evidenced in the measurements reported above, showing in an exclusive way the observed effects related to the entrance channels. The experimental results are compared to statistical model predictions, for which the same filtering and complete event selection have been applied

Comparative study of four reactions at onset of pre-equilibrium emission

The study of the emitted particles, comparing pre-equilibrium and thermal components, is a useful tool to examine the nuclear structure of emitters. Possible clustering effects, which may change the expected decay chain probability, could be highlighted on the competition between different reaction mechanisms. The NUCL-EX collaboration (INFN, Italy) has carried out an extensive research campaign on pre-equilibrium emission of light charged particles from hot nuclei. In this framework, the reactions 16O+30Si, 18O+28Si, 19F+27Al at 7 AMeV and 16O+30Si at 8 AMeV have been carried out using the GARFIELD+RCo array at Legnaro National Laboratories. Some anomalies in the α-particle emission channels have been evidenced in the measurement reported above, showing in an exclusive way the observed effects related to the entrance channels. The experimental results are compared to model prediction, for which the same filtering and complete event selection have been applied

Shape coexistence in 94Zr studied via Coulomb excitation

In recent years, a number of both theoretical and experimental investigations have been performed focusing on the zirconium isotopic chain. In particular, state-of-the-art Monte Carlo shell-model calculations predict shape coexistence in these isotopes. In this context, the 94Zr nucleus, which is believed to possess a nearly spherical ground state, is particularly interesting since the purported deformed structure is basedon the low-lying 02+ state, making it amenable for detailed study. In order to provide definitive conclusionson the shapes of the low-lying states, two complementary experiments to study 94Zr by means of low-energy Coulomb excitation were performed. This data will allow the quadrupole moments of the 21,2+ levels to be extracted as well as for the deformation parameters of the 01,2+ states to be determined and, thus, definitive conclusions to be drawn on the role of shape coexistence in this nucleus for the first time. The first experiment was performed at the INFN Legnaro National Laboratory with the GALILEO-SPIDER setup, which, for the first time, was coupled with 6 lanthanum bromide scintillators (LaBr3:Ce) in order to maximize the γ-ray detection effciency. The second experiment was performed at the Maier-Leibnitz Laboratory (MLL) in Munich and used a Q3D magnetic spectrograph to detect the scattered 12C ions following Coulomb excitation of 94Zr targets

Shape coexistence in

In recent years, a number of both theoretical and experimental investigations have been performed focusing on the zirconium isotopic chain. In particular, state-of-the-art Monte Carlo shell-model calculations predict shape coexistence in these isotopes. In this context, the 94Zr nucleus, which is believed to possess a nearly spherical ground state, is particularly interesting since the purported deformed structure is basedon the low-lying 02+ state, making it amenable for detailed study. In order to provide definitive conclusionson the shapes of the low-lying states, two complementary experiments to study 94Zr by means of low-energy Coulomb excitation were performed. This data will allow the quadrupole moments of the 21,2+ levels to be extracted as well as for the deformation parameters of the 01,2+ states to be determined and, thus, definitive conclusions to be drawn on the role of shape coexistence in this nucleus for the first time. The first experiment was performed at the INFN Legnaro National Laboratory with the GALILEO-SPIDER setup, which, for the first time, was coupled with 6 lanthanum bromide scintillators (LaBr3:Ce) in order to maximize the γ-ray detection effciency. The second experiment was performed at the Maier-Leibnitz Laboratory (MLL) in Munich and used a Q3D magnetic spectrograph to detect the scattered 12C ions following Coulomb excitation of 94Zr targets