33 research outputs found

    Clinicopathologic idiosyncrasies of nasopharyngeal cancer in a moderate-risk Mediterranean region

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    Il carcinoma del rinofaringe presenta una notevole eterogeneità per quanto riguarda le caratteristiche epidemiologiche, patogenetiche, cliniche e prognostiche sulla base dellarea geografica considerata. Lincidenza registrata nel Mediterraneo per tale patologia si colloca fra quella delle forme epidemiche e sporadiche registrate rispettivamente nel Sud Est Asiatico e nel Nord America. Il presente studio descrive le caratteristiche di questa patologia per quanto riguarda lovest della Grecia. Sono stati analizzati i dati relativi a 70 pazienti affetti da carcinoma del rinofaringe la cui diagnosi è stata posta presso un singolo centro fra il 1994 e il 2014. Il trattamento primario si è basato sulla radioterapia con o senza chemioterapia associata. Sono stati raccolti ai fini dellanalisi statistica i dati demografici, i fattori di rischio, le caratteristiche della neoplasia, la presentazione clinica e loutcome. Sono state calcolate sia la sopravvivenza globale (OS) che la sopravvivenza specifica per malattia (DSS) a 5 anni. Tutti i fattori potenzialmente predittori di sopravvivenza sono stati testati a unanalisi univariata e multivariata. La variante maggiormente diagnosticata allanalisi istopatologica è stato il tipo 3 secondo la WHO (74,3%) che si è associato in modo significativo con sintomatologia nasale alla presentazione (p = 0,050), linfoadenopatie metastatiche (p = 0,028), stage clinico avanzato (p = 0,009) e risposta completa al trattamento iniziale (p = 0,018). Lanalisi univariata ha evidenziato un impatto negativo in termini prognostici per letà avanzata (OS p = 0,029, DSS p = 0,041), la mancata risposta ai trattamenti (OS & DSS p < 0,001) e la recidiva di malattia (OS p = 0,003, DSS p = 0,001). A unanalisi multivariata la recidiva di malattia ha mantenuto un impatto prognostico negativo (HR 7,442, 95% IC 2,199-25,187, p = 0,001). In conclusione, fra i carcinomi nasofaringei diagnosticati nellovest della Grecia, il linfoepitelioma mostra caratteristiche peculiari sotto il profilo clinico, tali per cui la sua inclusione assieme alle neoplasie tipo 2 secondo la WHO nel gruppo di carcinomi rinofaringei non cheratinizzanti potrebbe risultare inappropriata. Infine, la recidiva di malattia, indipendentemente dagli altri fattori in gioco, appare essere un evento gravemente avverso

    Utilization of mechanical power and associations with clinical outcomes in brain injured patients. a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

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    BackgroundThere is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes.MethodsIn this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale &lt;= 12 before intubation) who required mechanical ventilation (MV) &gt;= 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS).ResultsWe included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22).ConclusionsExposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

    Sponsorship of sport mega events: a conceptual approach for creating shared value

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    Sport mega events represent an important platform that sponsors can use to communicate with prospective consumers. Although literature exists on value creation within sport (e.g. Woratschek, Horbel, & Popp, 2014), little attention has been afforded as to how sponsor brands and hosts may create value for consumers and other stakeholder groups within this important context. Therefore, this study aims to conceptualise the Creation of Shared Value (CSV) in sport mega events

    Brand orientation: Conceptual extension, scale development and validation

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    Creating powerful brands that stand out from competition, deliver on their promise, and strengthen over time is among the greatest challenges managers face. Building on prior relevant work, this study re-conceptualizes brand orientation and provides a broader operationalization to capture the main organizational behaviors manifested by strategically brand-oriented companies. Following established measurement theory guidelines and scaling procedures, this article reports a series of five complementary studies that collectively present the development of a new brand orientation scale to measure an organization&apos;s holistic approach to branding. The new scale comprises four dimensions (brand importance, brand consistency, brand differentiation, and brand intelligence) and demonstrates satisfactory psychometric properties of reliability and validity. The findings suggest that brand orientation (1) is stronger in companies in which the power of the marketing department in organizational decision making is high and (2) serially mediates the effects of marketing department power and market orientation on financial performance. © 2021 Elsevier Inc

    The interplay of strategic and internal green marketing orientation on competitive advantage

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    This paper seeks to clarify and refine the relationship between strategic and internal green marketing and firm competitiveness. Despite the significance of corporate environmental strategy to firms adopting a triple-bottom line performance evaluation, there is insufficient focus on strategic green marketing and its impact on a firm&apos;s competitiveness. This study fills the gap by providing a comprehensive view of strategic green marketing and its impact on competitive advantage. Findings also reveal the moderating role of internal green marketing actions towards the development of a sustained competitive advantage. Specifically, the findings build on contemporary green marketing literature suggesting that a significant interplay between strategy and people exists which enhances the creation of competitive advantage. This in turn increases financial performance. Finally, this research uses an updated approach to build on current literature concerning the drivers and outcomes of strategic green marketing. This provides managers with nuanced insights about environmentally-driven competitive advantage. © 2018 Elsevier Inc

    Expression des Retinoid-X-Rezeptors während der Entstehung und Progression laryngealer Tumoren

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