Trabectedin for patients with advanced soft tissue sarcoma: A non-interventional, retrospective, multicenter study of the italian sarcoma group

The Italian Sarcoma Group performed this retrospective analysis of patients with advanced soft tissue sarcoma, pretreated with ≥1 anthracycline-based treatment, and treated with trabectedin every three weeks. Primary endpoint was to describe real-life use of trabectedin across Italy. Secondary endpoints included objective response rate (ORR) and safety. Overall, 512 patients from 20 Italian centers were evaluated. Leiomyosarcoma (37.7%)/liposarcoma (30.3%) were the most prevalent histological types (abbreviated as L-sarcoma). Patients received a median of four trabectedin cycles (range: 1–40), mostly as a second-line treatment (~60% of patients). The ORR was 13.7% superior (p < 0.0001) in patients with L-sarcoma compared with patients with non-L-sarcoma (16.6% vs. 9.0%). Median progression-free survival (PFS) was 5.1 months, whereas median overall survival (OS) was 21.6 months. Significantly better PFS and OS were observed in patients with L-sarcoma, those with objective responses and/or disease stabilization, treated in an early line and treated with reduced dose. Bone marrow toxicity (61.4%) and transaminase increases (21.9%) were the most common grade 3/4 adverse events. The results of this real-life study suggest that trabectedin is an active treatment, which is mostly given as a second-line treatment to patients with a good performance status and high-grade, metastatic L-sarcoma (clinical trial information: NCT02793050)

Osteopathy students profile in Italy: A cross sectional census

Introduction: The Osteopathy Students Analysis (OSA) aims to profile osteopathy students in Italy as a target population in terms of sociodemographic characteristics, geographical distribution, health status, and previous and ongoing education specifications. Materials and methods: The OSA used a cross-sectional design. A Web-based survey was distributed to the Italian Osteopathic Education Institutions (OEIs). The OSA survey was composed of items organised into four sections: 1. Sociodemographic characteristics (11 items); 2. Geographical distribution (5 items); 3. Health status (3 items); 4. Previous and ongoing education specifications (16 items). A descriptive sample population analysis was performed. Dichotomous and categorical variables were presented as frequencies and percentages, and continuous variables were displayed as means and standard deviations. Some variables were analysed using a pentenary distribution. Results: 49 out of the 61 OEIs identified matched the inclusion criteria, and among these, 22 accepted to propose the enrolment of their students into the study. The survey was administered to 4,720 students from all the participant OEIs. A total of 3,762 students responded to the survey, accounting for an estimated response rate of 53.7%. The majority of respondents were men (54%), with an average age of 26.9 ± 6.5 years. Almost the totality of the sample was composed of the European ethnic group (99.1%). Respondents were predominantly born in Italy (97.2%). The majority of the sample reported being in good (49.5%) to excellent (38.6%) health. To date, osteopathy students are almost evenly distributed between the two types of curricula (T1 = 46.6%; T2 = 53.4%). Conclusions: The OSA is the first study that aims to profile Italian osteopathy students as a target population in terms of sociodemographic characteristics, geographical distribution, health status, and previous and ongoing education specifications. Future studies should focus on investigating the correlation between the sociodemographic characteristics of students and their academic performance

Qualità dell’inclusione e didattica cooperativa. Una R-A in una scuola secondaria di secondo grado pugliese.

The paper describes an action research carried out in an Apulian high school. The research aspires to promote a reflection about the quality of school inclusion aimed to make an improvement in teacher’s professionalism, educational and teaching activities. The study describes the planning, realization and evaluation of inclusive plans, from observation of the functioning of students with special educational need, according to the ICF model, to experimentation of cooperative methodologies in the classroom. The results explain the importance of a careful planning skills in the dimensions of relationships and learning, able to integrate in a systemic view the school’s quality. The research also confirms that the active participation of teachers and students, in the promotion of better coexistence in school, is a fundamental strategy to make the class (and the school) an open and welcoming context, within which inclusion is understood not only as the involvement of all, but also as the enhancement of each.Il presente contributo descrive un percorso di ricerca-azione realizzato in una scuola secondaria di secondo grado pugliese. La ricerca intende avviare una riflessione circa la qualità dell’inclusione scolastica, con il fine di apportare un miglioramento della professionalità docente e delle pratiche educative e didattiche. Lo studio descrive il processo di progettazione, realizzazione e valutazione di strategie inclusive, dall’osservazione del funzionamento degli studenti con bisogni educativi speciali secondo il modello ICF, alla sperimentazione di metodologie cooperative in classe. I risultati raggiunti mostrano l’importanza di una progettualità attenta sia al piano delle relazioni e sia a quello degli apprendimenti, in grado di integrarsi in una visione sistemica della qualità della scuola. La ricerca conferma inoltre come la partecipazione attiva di docenti e studenti nella promozione di una migliore convivenza scolastica risulti essere uno strumento fondamentale per rendere la classe (e la scuola) uno spazio aperto e accogliente, all’interno del quale l’inclusione sia intesa non solo come coinvolgimento di tutti, ma anche come valorizzazione di ciascuno

Osteopathic manipulation as a complementary treatment for the prevention of cardiac complications: 12-Months follow-up of intima media and blood pressure on a cohort affected by hypertension.

BACKGROUND: Aim of the present study was to investigate the association between osteopathic treatment and hypertension. METHODS: The design was a non-randomized trial including consecutive subjects affected by hypertension and vascular alterations, using pre-post differences in intima-media thickness, systolic and diastolic blood pressure as primary endpoints. Statistical analysis was based on univariate t tests and multivariate linear regression. RESULTS: A total of N = 31 out of N = 63 eligible subjects followed by a single cardiologist received osteopathic treatment in addition to routine care. Clinical measurements were recorded at baseline and after 12 months. Univariate analysis found that osteopathic treatment was significantly associated to an improvement in all primary endpoints. Multivariate linear regression showed that, after adjusting for all potential confounders, osteopathic treatment was performing significantly better for intima-media thickness (delta between pre-post differences in treated and control groups: -0.517; 95% c.i.: -0.680, -0.353) and systolic blood pressure (-4.523; -6.291, -2.755), but not for diastolic blood pressure. CONCLUSION: Our study shows that, among patients affected by cardiovascular disorders, osteopathic treatment is significantly associated to an improvement in intima-media and systolic blood pressure after one year. Multicentric randomized trials of adequate sample size are needed to evaluate the efficacy of OMT in the treatment of hypertension

Osteopathic manipulation as a complementary treatment for the prevention of cardiac complications: 12-Months follow-up of intima media and blood pressure on a cohort affected by hypertension.

BACKGROUND: Aim of the present study was to investigate the association between osteopathic treatment and hypertension. METHODS: The design was a non-randomized trial including consecutive subjects affected by hypertension and vascular alterations, using pre-post differences in intima-media thickness, systolic and diastolic blood pressure as primary endpoints. Statistical analysis was based on univariate t tests and multivariate linear regression. RESULTS: A total of N = 31 out of N = 63 eligible subjects followed by a single cardiologist received osteopathic treatment in addition to routine care. Clinical measurements were recorded at baseline and after 12 months. Univariate analysis found that osteopathic treatment was significantly associated to an improvement in all primary endpoints. Multivariate linear regression showed that, after adjusting for all potential confounders, osteopathic treatment was performing significantly better for intima-media thickness (delta between pre-post differences in treated and control groups: -0.517; 95% c.i.: -0.680, -0.353) and systolic blood pressure (-4.523; -6.291, -2.755), but not for diastolic blood pressure. CONCLUSION: Our study shows that, among patients affected by cardiovascular disorders, osteopathic treatment is significantly associated to an improvement in intima-media and systolic blood pressure after one year. Multicentric randomized trials of adequate sample size are needed to evaluate the efficacy of OMT in the treatment of hypertension

Current status of targeted therapies in advanced gastric cancer

Introduction: In metastatic gastric cancer, chemotherapy is the standard treatment because it prolongs survival when compared to best supportive care alone. However, even after the use of more effective regimens, the overall survival remains disappointing, justifying the need for new treatment options.Areas covered: Areas covered in this review include the most common molecular pathways, which have provided novel targets in gastric cancer therapy. These therapeutic strategies include EGFR inhibitors, anti-angiogenic agents, cell cycle inhibitors and apoptosis promoters.Expert opinion: Several mAbs and kinase inhibitors, especially those targeting EGFR and VEGF/VEGFR, have already demonstrated promising activity in gastric cancer. The Phase III ToGA trial reported an increase in overall survival for patients with human EGF receptor (HER)2-positive gastric cancer treated with chemotherapy and trastuzumab compared to chemotherapy alone. This means that accurate HER2 testing in gastric cancer is necessary. Final data of ongoing trials with novel agents will be critical to further progress with this cancer

Effect of osteopathic manipulative treatment on gastrointestinal function and length of stay of preterm infants: an exploratory study.

BACKGROUND: Organizational improvement of neonatal intensive care units requires strict monitoring of preterm infants, including routine assessment of physiological functions of the gastrointestinal system and optimized procedures for the definition of appropriate discharge timing. METHODS: We conducted a prospective study on the effect of osteopathic manipulative treatment in a cohort of N = 350 consecutive premature infants admitted to a neonatal intensive care unit without any major complication between 2005 and 2008. In addition to ordinary care, N = 162 subjects received osteopathic treatment. Endpoints of the study were differences between study and control groups in terms of excessive length of stay and gastrointestinal symptoms, defined as the upper quartiles in the distribution of the overall population. Statistical analysis was based on crude and adjusted odds ratios from multivariate logistic regression. RESULTS: Baseline characteristics were evenly distributed across treated/control groups, except for the rate of infants unable to be oral fed at admission, significantly higher among those undergoing osteopathic care (p = .03). Osteopathic treatment was significantly associated with a reduced risk of an average daily occurrence of gut symptoms per subject above .44 (OR = 0.45; 0.26-0.74). Gestational age lower or equal to 32 weeks, birth weight lower or equal to 1700 grams and no milk consumption at admission were associated with higher rates of length of stay in the unit of at least 28 days, while osteopathic treatment significantly reduced such risk (OR = 0.22;0.09-0.51). CONCLUSIONS: In a population of premature infants, osteopathic manipulative treatment showed to reduce a high occurrence of gastrointestinal symptoms and an excessive length of stay in the NICU. Randomized control studies are needed to generalize these results to a broad population of high risk newborns