CT-based tumour response criteria compared after combined treatment for liver metastases of colorectal cancer

open6noPurpose: The aim of this analysis is to compare different tumour response criteria (TRC) after chemotherapy combined with bevacizumab in liver metastases from colorectal cancer (mCRC) to ascertain the best early prognostic indicator of response. Methods and Materials: 103 target liver metastases from 65 mCRC patients treated with chemoterapy plus bevacizumab were examined at the Istituto Oncologico Veneto IOV-IRCSS (March 2008-January 2013). All patients had baseline CT and at least one follow-up scan. Tumour response was retrospectively analyzed by two radiologists using RECIST1.1, modified Choi, and Chun morphologic criteria. Tumour response, classified as good (complete or partial response) or poor (stable or progressive disease), was compared with progression-free survival (PFS) at first follow-up (t1) and time of best response. Interobserver agreement and concordance between TRC were measured. Results: At t1, 32.31% showed a good response according to RECIST1.1 (median PFS 11.1), 84.62% according to Choi (median PFS 10.8). These percentages rose to 49.23% (median PFS 12.1) and 87.69% (median PFS 10.8), respectively, at the time of best response. According to Chun, 67.69% showed a good response at the time of best response (median PFS 10.8). The Choi criteria detected a higher proportion of good responders at t1, showing a better correlation with PFS; all methods correlated with PFS at the time of best response. Conclusion: The Choi criteria proved more consistent in the early detection of response in mCRC treated with chemotherapy plus bevacizumab, underscoring the importance of using these criteria in the early assessment of response to combined treatment.openopenVarotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, F.Varotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, Fabi

Metformin: a modulator of bevacizumab activity in cancer? A case report.

Recurrent type I endometrial cancer ((EC)) has poor prognosis and demands novel therapeutic approaches. Bevacizumab, a VEGF-A neutralizing monoclonal antibody, has shown clinical activity in this setting. To our knowledge, however, although some diabetic cancer patients treated with bevacizumab may also take metformin, whether metformin modulates response to anti-VEGF therapy has not yet been investigated. Here, we report the case of a patient with advanced (EC) treated, among other drugs, with bevacizumab in combination with metformin. The patient affected by relapsed (EC) G3 type 1, presented in march 2010 with liver, lungs and mediastinic metastases. After six cycles of paclitaxel and cisplatin she underwent partial response. Later on, she had disease progression notwithstanding administration of multiple lines of chemotherapy. In march 2013, due to brain metastases with coma, she began steroid therapy with development of secondary diabetes. At this time, administration of Bevacizumab plus Metformin improved her performance status. CT scans performed in this time window showed reduced radiologic density of the lung and mediastinic lesions and of liver disease, suggestive of increased tumor necrosis. Strong F-18-FDG uptake by PET imaging along with high levels of monocarboxylate transporter 4 and lack of liver kinase B1 expression in liver metastasis, highlighted metabolic features previously associated with response to anti-VEGF therapy and phenformin in preclinical models. However, clinical benefit was transitory and was followed by rapid and fatal disease progression. These findingsalbeit limited to a single casesuggest that tumors lacking LKB1 expression and/or endowed with an highly glycolytic phenotype might develop large necrotic areas following combined treatment with metformin plus bevacizumab. As metformin is widely used among diabetes patients as well as in ongoing clinical trials in cancer patients, these results deserve further clinical investigation

Penyuluhan Bahaya Penyalahgunaan Napza Bagi Pelajar dan Remaja

Penyalahgunaan NAPZA (Narkotika, Psikotropika, dan Zat-zat Adiktif) merupakan suatu pola perilaku yang bersifat patologik, dan biasanya dilakukan oleh individu yang mempunyai kepribadian rentan atau mempunyai resiko tinggi, dan jika dilakukan dalam jangka waktu tertentu akan menimbulkan gangguan bio-psiko-sosial-spiritual. NAPZA bersifat psikotropika dan psikoaktif yang mempunyai pengaruh terhadap sistem syaraf dan biasanya digunakan sebagai analgetika (pengurang rasa sakit) dan memberikan pengaruh pada aktifitas mental dan perilaku serta digunakan sebagai terapi gangguan psikiatrik pada dunia kedokteran. Secara farmakologik, yang termasuk NAPZA antara lain ganja, morfin, sabu, ekstasi, marijuana, putau, kokain, pil koplo, dan sebagainya. Obat-obatan ini termasuk dalam daftar obat G yang artinya dalam penggunaannya harus disertai dengan kontrol dosis yang sangat ketat oleh dokter. Pelajar (siswi) adalah istilah bagi peserta didik pada jenjang pendidikan menengah pertama dan menengah atas. Siswa adalah komponen dalam sistem pendidikan, yang selanjutnya menjalani proses pendidikan, sehingga menjadi manusia yang berkualitas sesuai dengan tujuan pendidikan nasional. Penyuluhan ini menempatkan pelajar sebagai suatu komponen ditinjau dari pendekatan sosial, dan psikologis

Coherent Excitonic Coupling in an Asymmetric Double InGaAs Quantum Well Arises from Many-Body Effects

We study an asymmetric double InGaAs quantum well using optical two-dimensional coherent spectroscopy. The collection of zero-quantum, one-quantum, and two-quantum two-dimensional spectra provides a unique and comprehensive picture of the double well coherent optical response. Coherent and incoherent contributions to the coupling between the two quantum well excitons are clearly separated. An excellent agreement with density matrix calculations reveals that coherent interwell coupling originates from many-body interactions

Dynamics of long-range order in an exciton-polariton condensate

We report on time resolved measurements of the first order spatial coherence in an exciton polariton Bose-Einstein condensate. Long range spatial coherence is found to set in right at the onset of stimulated scattering, on a picosecond time scale. The coherence reaches its maximum value after the population and decays slower, staying up to a few hundreds of picoseconds. This behavior can be qualitatively reproduced, using a stochastic classical field model describing interaction between the polariton condensate and the exciton reservoir within a disordered potential.Comment: 7 pages, 4 figure

Omineca Miner, January, 02, 1915

BACKGROUND AND AIMS: Immature platelet fraction (IPF) represents the quote of younger and larger sized circulating platelets, a potential marker of platelet reactivity and major cardiovascular events. We aimed to assess the relationship between IPF levels and the prevalence and extent of coronary artery disease (CAD) in patients undergoing coronary angiography. METHODS: A cohort of consecutive patients undergoing coronary angiography in a single centre were included. Significant CAD was defined as at least 1 vessel stenosis >50%, while severe CAD was defined as left main and/or three-vessel disease. IPF levels were measured at admission by routine blood cells count (A Sysmex XE-2100). RESULTS: We included 1789 patients, divided according to quartiles values of IPF. IPF levels were directly related to active smoke (p = 0.02), and non-acute coronary syndrome as indication to angiography (p < 0.001), higher levels of haemoglobin and uric acid (p < 0.001, respectively) and lower platelet count (p = 0.003). Angiographic features did not significantly differ according to quartiles values of IPF, but for a lower degree of TIMI flow in patients with a higher percentage of reticulated platelets (p = 0.01) and a higher rate of lesions involving bifurcations (p = 0.05). IPF levels did not affect the prevalence of CAD (77% vs. 82.2% vs. 79.1% vs. 75.6%, p = 0.34, adjusted OR [95% CI] = 0.93 [0.82-1.05], p = 0.22), nor of severe left main/three-vessel CAD (28.5% vs. 34.4% vs. 32.2% vs. 33.1%, p = 0.27; adjusted OR [95% CI] = 0.99 [0.90-1.1], p = 0.88). CONCLUSIONS: The present study shows that among patients undergoing coronary angiography, the immature platelet fraction (IPF) is not associated with the prevalence and extent of coronary artery disease, and, therefore, should not be overlooked as a marker of coronary atherosclerosis

Confirming the function of a Final Bronze Age wine processing site in the Nuraghe Genna Maria in Villanovaforru (South Sardinia)

The stone artefact in the hut γ of the NuragheGenna Maria, object of this study, is part of a compound still unpublished today and dated to the Nuragic period. It was found during a 1991 excavation, revealing a situation unchanged since the collapse occurred between the 10th and 9th century B.C., thus preserving the situation at the time of the collapse to this day. The presence of tartaric acid - the marker considered to determinate the presence of wines or products deriving from grapes - has been determined using HPLC-DAD and UHPLC-HQOMS. So the findings under examination, together with the overall evaluation of the archaeological aspects examined, suggests to positively consider the stone artifact as a "laccus" (the latin word for wine presses, still used in the Sardinian language today ) for grape crushing. The internal slope of the floor of the "laccus" allowed the extraction of juice with rapid separation of juice from berry skins. The presence in Sardinia of a large number of "stone wine presses" ("palmenti" in Italian) such as that of the Nuraghe Genna Maria studied in this article, brings a contribution to their dating and confirm the existence of an oenological industry on the island in the Archaic period (9th-10th century B.C.)

Potassium deficiency and drought stress in grapevine cultivars

Potassium availability affects drought responses in plants through several metabolic roles, among which stomatal regulation, cell growth and xylem hydraulics. Vitis vinifera L. is a highly valuable crop and several genotypes have been selected during its millennial cultivation. Varieties show differences in their adaptability to stress conditions, making them more or less suitable to certain climatic and edaphic conditions. The varieties cultivated in Sicily are characterized by high variability. We investigated the response of two Sicilian cultivars (Nero d'Avola and Catarratto) to potassium deficiency and drought stress. Two-year-old grafted plants were grown in agriperlite, with or without potassium in the fertigation solution, and subjected to moderate drought stress by suspending irrigation for 6-8 days. Potassium content of xylem sap, leaf and root tissues were measured with an ion-selective electrode. Changes in stomatal conductance, plant transpiration and hydraulic conductance were compared between genotypes and treatments, in order to gain information for the development of optimal fertigation practices and the selection of the most drought tolerant varieties