Intra-and extra-hospitalization monitoring of vital signs. Two sides of the same coin. Perspectives from Lims and Greenline study operators

Background: In recent years, due to the epidemiological transition, the burden of very complex patients in hospital wards has increased. Telemedicine usage appears to be a potential high-impact factor in helping with patient management, allowing hospital personnel to assess conditions in out-of-hospital scenarios. Methods: To investigate the management of chronic patients during both hospitalization for disease and discharge, randomized studies (LIMS and Greenline-HT) are ongoing in the Internal Medicine Unit at ASL Roma 6 Castelli Hospital. The study endpoints are clinical outcomes (from a patient’s perspective). In this perspective paper, the main findings of these studies, from the operators’ point of view, are reported. Operator opinions were collected from structured and unstructured surveys conducted among the staff involved, and their main themes are reported in a narrative manner. Results: Telemonitoring appears to be linked to a reduction in side-events and side-effects, which represent some of most commons risk factors for re-hospitalization and for delayed discharge during hospitalization. The main perceived advantages are increased patient safety and the quick response in case of emergency. The main disadvantages are believed to be related to low patient compliance and an infrastructural lack of optimization. Conclusions: The evidence of wireless monitoring studies, combined with the analysis of activity data, suggests the need for a model of patient management that envisages an increase in the territory of structures capable of offering patients subacute care (the possibility of antibiotic treatments, blood transfusions, infusion support, and pain therapy) for the timely management of chronic patients in the terminal phase, for which treatment in acute wards must be guaranteed only for a limited time for the management of the acute phase of their diseases

A case series of low dose bevacizumab and chemotherapy in heavily pretreated patients with epithelial ovarian cancer

Abstract Background The addition of bevacizumab to standard chemotherapy prolongs progression free survival in the first line treatment of epithelial ovarian cancer (EOC), but its cost/effectiveness is debated. We assessed the safety and activity of a lower dose of bevacizumab in pretreated advanced stage EOC. Methods We treated 15 patients, mostly with platinum resistant EOC, who had received a median of four prior cytotoxic regimens, with bevacizumab 5–7.5 mg/kg q21 days in combination with either carboplatin (n = 8), oral cyclofosfamide (n = 5) or weekly paclitaxel (n = 2). Bevacizumab was administered until disease progression. Tumor response was assessed by CA125 and fusion 18 F-FDG PET/contrast enhanced CT. Results The median number of bevacizumab cycles was 21 (range 3–59). The median baseline CA125 was 272 U/ml and decreased to 15.2 U/ml at nadir. Tumor response was 4 complete response (CR) (26.7%) and 7 partial response (PR) (46.7%) by chemotherapy (CT), with an overall response rate of 73.4% (95% CI, 51.0 – 95.8) according to Response Evaluation Criteria In Solid Tumors (RECIST), and 6 CR (40%) and 4 PR (26.7%) by PET, for an overall metabolic response rate of 67% (95%CI, 42.8 – 90.6) according to PET Response Criteria in Solid Tumors (PERCIST). Median progression free survival (PFS) was 21 months and median overall survival (OS) was 24 months. Grade 3 adverse events related to bevacizumab were hypertension (n = 2), proteinuria (n = 1) and epistaxis (n = 5). Treatment was delayed in five patients for nasal bleeding or uncontrolled hypertension. Conclusions Low-dose bevacizumab and chemotherapy was well tolerated and active in a heavily pretreated population of advanced EOC. Further studies should assess the activity of low dose bevacizumab in EOC.</p

Mapa Universal de 1506 [Material cartográfico] / Giovanni M. Contarini, Francisco Rosselli ; reproducción y comentarios publicados por Carlos Sanz.

Ed. facs.Primer MapaMundi impreso y fechado ; representa la superficie de la Tierra después de los descubrimientos españolesReprod. facs. de la Ed. : Venecia o Florencia, 150

Complete resolution of primary sclerosing peritonitis (“abdominal cocoon”) following long term therapy for Tropheryma whipplei: a case report and review of literature

A 53-year-old man was admitted to our internal medicine unit with intestinal obstruction and signs of systemic inflammatory disease. Clinical history was unremarkable until a few months earlier, when he began suffering from Achilles tendonitis. Diagnostic procedures, including laparotomy, revealed diffuse thickening of the peritoneum resembling sclerosing encapsulating peritonitis. Biopsies showed reactive fibrosis. No known secondary causes were found and surgery was technically not feasible. Clinical conditions worsened daily until, on the basis of the overall spectrum of clinical and radiological findings, Whipple’s disease was hypothesised and specific therapy administered, with prompt clinical improvement. Complete disappearance of the cocoon was demonstrated at 1 year clinical/ultrasound/computed tomography follow-up

Publishing (and Forgetting) the Small or Medium-sized Scholarly Edition or Cultural Heritage Collection as Linked Open Data: Using Zenodo and Github to Publish the Visionary Cross Project

Abstract of paper 0432 presented at the Digital Humanities Conference 2019 (DH2019), Utrecht , the Netherlands 9-12 July, 2019

A novel spleen‐dedicated stiffness measurement by FibroScan® improves the screening of high‐risk oesophageal varices

International audienc

The level of manganese superoxide dismutase content is an independent prognostic factor for glioblastoma. Biological mechanisms and clinical implications.

We address the issue of the role of manganese superoxide dismutase in tumorigenesis by studying a relatively homogeneous group of tumours for the correlation between amount of this anti-oxidant enzyme and prognosis. The clinical outcome of 30 patients affected by glioblastomas whose manganese superoxide dismutase content had been established at the time of first diagnosis is compared. When the survival of patients is stratified according to manganese superoxide dismutase level in the tumour, a link of these levels and prognosis can be observed. Patients with high levels of manganese superoxide dismutase show a median survival time of 6.11 months, while patients whose tumours display a low amount of MnSOD have a median survival time of 12.17 months. To assess the upstream mechanisms that sustain the increase in manganese superoxide dismutase content in brain neuroepithelial tumours, we also studied the expression of p53 in a series of 17 astrocytomas of various grading. In all tested astrocytomas, high manganese superoxide dismutase content is associated with cytoplasmic accumulation of p53. Thus glioblastomas can be divided into two distinct groups on the basis of their content of manganese superoxide dismutase, having 'better' or 'worse' prognosis, respectively. The use of this protein as a marker may help to define therapeutic strategies in the clinical management of glioblastoma