BeppoSAX Observations of the TeV Blazar Mkn 421

The blazar Mkn 421 has been observed, as part of the AO1 Core Program, five times from 2 to 7 May 1997. In the LECS+MECS energy band the spectrum shows convex curvature, well represented by a broken power--law. Flux variability (more than a factor 2) has been detected over the entire 0.1--10 keV range, accompanying which the spectrum steepens with the decrease in intensity. Mkn 421 has also been detected with the PDS instrument. Our preliminary analysis indicates that the PDS spectrum lies significantly above the extrapolation from the MECS, suggesting a contribution from a flatter high energy component.Comment: 4 pages, 4 Postscript figures, uses espcrc2.sty and psfig.sty (both included). To appear in "The Active X-ray Sky: Results from BeppoSAX and Rossi-XTE", Rome, Italy, 21-24 October, 1997. Eds.: L. Scarsi, H. Bradt, P. Giommi and F. Fior

BeppoSAX observations of PKS 0528+134

We report on the BeppoSAX observations of the gamma-ray blazar PKS 0528+134 performed in Feb and Mar 1997, during a multiwavelength campaign involving EGRET and ground based telescopes. The source was in a faint and hard state, with energy spectral index alpha=0.48+-0.04 between 0.1 and 10 keV, and [2-10] keV flux of 2.7E-12 erg/cm2/s. No significant variability was observed. The source was detected in the 20-120 keV band by the PDS, with a flux lying slightly above the extrapolation from lower X-ray energies. Comparing this low state with previous higher states of the source, there is an indication that the X-ray spectrum hardens and the gamma-ray spectrum steepens when the source is fainter.Comment: 4 pages, LateX, 5 figures (included). Uses espcrc2.sty and epsf.sty (included). To appear in The Active X-ray Sky: Results from BeppoSAX and Rossi-XTE, Rome, Italy, 21-24 October, 1997. Eds.: L. Scarsi, H. Bradt, P. Giommi and F. Fior

Investigating the EGRET-radio galaxies link with INTEGRAL: the case of 3EG J1621+8203 and NGC 6251

The analysis of an INTEGRAL AO2 observation of the error contours of the EGRET source 3EG J1621+8203 is presented. The only source found inside the error contours for energies between 20 and 30 keV at 5 sigma detection significance is the FR I radio galaxy NGC 6251. This supports the identification of NGC 6251 with 3EG J1621+8203. The observed flux is higher and softer than observed in the past, but consistent with a variable blazar-like spectral energy distribution.Comment: 5 pages, 2 figures. Accepted for publication on A&A Main Journa

À la recherche de Sainte-Sophie : Gaspare et Giuseppe Fossati

Palumbo Fossati Casa Isabella. À la recherche de Sainte-Sophie : Gaspare et Giuseppe Fossati. In: Comptes rendus des séances de l'Académie des Inscriptions et Belles-Lettres, 154e année, N. 1, 2010. pp. 293-299

Preoperative frailty predicts adverse short-term postoperative outcomes in patients treated with radical prostatectomy

Background: To investigate the effect of frailty on short-term postoperative outcomes in patients with prostate cancer treated with radical prostatectomy (RP). Methods: Within the National Inpatient Sample database, we identified 91,618 RP patients treated between 2008 and 2015. The Johns Hopkins Adjusted Clinical Groups frailty-defining indicator was applied, and we examined the rates of frailty over time, as well as its effect on overall complications, major complications, nonhome-based discharge, length of stay (LOS), and total hospital charges (THCs). Time trends and multivariable logistic, Poisson and linear regression models were applied. Results: Overall, 12,185 (13.3%) patients were frail. Rates of frail patients increased over time (from 10.3 to 18.2%; p < 0.001). Frail patients had higher rates of overall complications (16.6 vs. 8.6%), major complications (4.9 vs. 2.6%), nonhome-based discharge (5.9 vs. 5%), longer LOS (2 vs. 1), and higher THCs ($37,186 vs.$35,241) (all p < 0.001). Moreover, frailty was an independent predictor of overall complications (OR: 1.95), major complications (OR: 1.76), nonhome-based discharge (OR: 1.20), longer LOS (RR: 1.19), and higher THCs (RR: $3160) (all p < 0.001). Of frail patients, 10,418 (85.5%) neither exhibited body mass index ≥ 30 nor Charlson comorbidity index ≥ 2. Conclusions: On average, every seventh RP patient is frail and that proportion is on the rise. Frail individuals are at higher risk of adverse short-term postoperative outcomes, that cannot be predicted by other risk factors, such as obesity or comorbidities

Temporal trends and social barriers for inpatient palliative care delivery in metastatic prostate cancer patients receiving critical care therapies

Background: Use of inpatient palliative care (IPC) in advanced cancer patients represents a well-established guideline recommendation. A recent analysis demonstrated that genitourinary (GU) cancer patients benefited of IPC at the second lowest rate within the four examined primaries, namely lung, breast, colorectal, and GU. Based on this observation, we examined temporal trends and predictors of IPC use in metastatic prostate cancer patients receiving critical care therapies (CCT). Materials and methods: We identified mPCa patients receiving CCT within the Nationwide Inpatient Sample database (2004–2015). IPC use rates were evaluated using univariable estimated annual percentage changes analyses. Multivariable logistic regression (MLR) models were used after adjustment for clustering at hospital level. Results: Of 4168 mPCa patients receiving CCT, 449 (11.3%) received IPC. IPC use increased from 1.2 to 22.3% (EAPC: +19.6%, p < 0.001). After stratification according to regions, race, and teaching status, the highest increase of IPC use was recorded in the South (from 0 to 25.4 %, EAPC: +27.6%), in Caucasians (from 1.5 to 24.4 %, EAPC: +19.8%; p < 0.001) and in teaching hospitals (from 0.9 to 26.2 %, EAPC: +19.6%; p < 0.001). In MLR models, teaching status (Odds ratio [OR]: 1.74, p < 0.001) and contemporary year interval (OR: 4.63, p < 0.001) were associated with higher IPC rates. Conversely, African American race (OR: 0.66, p < 0.001) and primary diagnosis of GU disorders (OR: 0.49, p < 0.001) and gastrointestinal (GI) disorders at admission (OR: 0.61, p = 0.02) were associated with lower IPC rates. Conclusions: IPC use rate in mPCa patients receiving CCT sharply increased between 2004 and 2015. The highest increase of IPC use across time was recorded in the South, in Caucasian race, and in teaching hospitals. African-American race and nonteaching status were identified as independent predictors of lower IPC use and represent targets for efforts aimed at improving IPC delivery in mPCa patients receiving CCT

Radical cystectomy plus chemotherapy in patients with pure squamous cell bladder carcinoma: a population-based study

Purpose: To test the effect of perioperative chemotherapy (CHT) on overall mortality (OM) and cancer-specific mortality (CSM) in patients with locally advanced or metastatic squamous cell carcinoma of the urinary bladder (SCC UB). Methods: Within the Surveillance, Epidemiology and End Results database (1988–2016), we identified 1,018 SCC UB patients (664 T3–4aN0M0, 197 TanyN1–3M0 and 156 T4bN0–3 or M1), who underwent radical cystectomy with or without perioperative chemotherapy administration. Inverse probability of treatment-weighting (IPTW), Kaplan–Meier plots and Cox-regression models (CRMs) were used. Results: CHT was administrated in 116 (17.5%) T3–4aN0M0, 77 (39.1%) TanyN1–3M0 and 47 (30.1%) T4bN0–3 or M1 patients. IPTW-adjusted 2-year cancer-specific survival (CSS) was 66.5 vs. 71.5% (p = 0.19), 60.9 vs. 29.5% (p < 0.001) and IPTW-adjusted 1-year CSS was 46.2 vs. 31.1% (p = 0.03) for CHT vs. no CHT administration in T3–4aN0M0, TanyN1–3M0 and T4bN0–3 or M1, respectively. In multivariable IPTW-adjusted CRMs, chemotherapy was an independent predictor of lower CSM in TanyN1–3M0 (HR 0.44) and in T4bN0–3 or M1 (HR 0.60), but not in T3–4aN0M0 (p = 0.6) patients. Virtually the same results were obtained on OM, as well as without IPTW-adjustment and after stratification according to age and gender. Conclusions: The use of perioperative CHT in patients with SCC UB confers survival benefit in the presence of T4b disease, lymph node or distant metastases. Conversely, patients with locally advanced disease but negative lymph node invasion do not benefit from its use. Pending higher quality data from prospective trials, these data should encourage the use of perioperative CHT in those high-risk patient groups