Careful breakthrough cancer pain treatment through rapid-onset transmucosal fentanyl improves the quality of life in cancer patients: results from the best multicenter study

Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Stable chronic background pain (numeric rating scale, NRS <= 4) during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). RESULTS: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (linear p-value = 0.1) and dyspnea (Linear p-value = 0.05). The ESAS and PSQI questionnaires confirmed these positive results (p < 0.0001 and p = 0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance

Covid-19 And Rheumatic Autoimmune Systemic Diseases: Role of Pre-Existing Lung Involvement and Ongoing Treatments

The Covid-19 pandemic may have a deleterious impact on patients with autoimmune systemic diseases (ASD) due to their deep immune-system alterations

Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis

We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P < 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD4OL (Spearman's rank correlation coefficient [r(s)], -0.33; P < 0.001), sNox2-dp (r(s), -0.57; P < 0.0001), and urinary excretion of isoprostanes (r(s), -0.48; P < 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2 alpha-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)

Relationship between cognitive impairment and behavioural disturbances in Alzheimer's disease patients

Abstract. Background and aims: Alzheimer's disease (AD) is a neurodegenerative disorder in which the patients can exhibit some behavioural disturbances in addition to cognitive impairment. The aims of the present study were to investigate the relationship between severity and rate of decline of the cognitive and behavioural impairment in patient with AD. Methods: 54 AD patients were assessed at baseline and after 12 months with the Mental Deterioration Battery (MDB), the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) and the Neuropsychiatric Inventory (NPI-10). Results: MDB was more accurate than ADAS-Cog in the early diagnosis of AD. Conversely, ADAS-Cog was more sensitive at revealing the progression of cognitive decline. Depression, Apathy and Anxiety are the most frequent and severe behavioural disturbances at baseline. At follow-up Delusions and Irritability increased significantly. Significant correlations were observed between severity of cognitive impairment and behavioural disorders both at baseline and in the progression rate passing from T0 to T12. Conclusions: Severity and progression rate of behavioural and cognitive alterations in patients with AD are significantly associated

Overview on Lead-Cooled Fast Reactor Design and Related Technologies Development in ENEA

none20noThe next generation of nuclear energy systems, also known as Generation-IV reactors are being developed to meet the highest targets of safety and reliability, sustainability, economics, proliferation resistance and physical protection, with improved performances with respect to plants currently operating or presently being built. Among the proposed technologies, Lead-cooled Fast Reactors (LFRs) have been identified by nuclear industries, western Counties and developing Countries among the optimal Generation IV candidates. Since 2000, ENEA, the Italian National Agency for New Technologies, Energy and Sustainable Economic Development is supporting the core design, safety assessment and technological development of innovative nuclear systems cooled by heavy liquid metals (HLM), and most recently fully oriented on LFRs, developing world-recognized skills in the fast spectrum core design and one of the largest European fleets of experimental facilities aiming at investigating HLM thermal-hydraulics, coolant chemistry control, corrosion behavior for structural materials and material properties in HLM environment, as well as at developing corrosion-protective coatings, components, instrumentation and innovative systems, supported by experiments and numerical tools. Efforts are also devoted in developing and validating numerical tools for the specific application to HLM systems, ranging from neutronics codes, system and core thermal-hydraulic codes, computational fluid dynamics (CFD) and fuel pin performance codes, including their coupling. The present work aims at highlighting the capabilities and competencies developed by ENEA so far in the framework of liquid metal technologies for GEN-IV LFRs. In particular, an overview on the ongoing R&D experimental program will be depicted considering the actual fleet of facilities: CIRCE, NACIE-UP, LIFUS5, LECOR, BID-1, HELENA, RACHEL and Mechanical Labs. An overview on the numerical activities performed so far and presently ongoing is also reported. Finally, an overview of the ENEA contribution to the ALFRED Project in the frame of the FALCON international consortium is reported, mainly addressing the activity ongoing in terms of core design, technology development and auxiliary systems design.mixedTarantino, Mariano; Angiolini, Massimo; Bassini, Serena; Cataldo, Sebastiano; Ciantelli, Chiara; Cristalli, Carlo; Del Nevo, Alessandro; Di Piazza, Ivan; Diamanti, Dario; Eboli, Marica; Fiore, Angela; Grasso, Giacomo; Lodi, Francesco; Lorusso, Pierdomenico; Marinari, Ranieri; Martelli, Daniele; Papa, Francesca; Sartorio, Camillo; Utili, Marco; Venturini, AlessandroTarantino, Mariano; Angiolini, Massimo; Bassini, Serena; Cataldo, Sebastiano; Ciantelli, Chiara; Cristalli, Carlo; Del Nevo, Alessandro; Di Piazza, Ivan; Diamanti, Dario; Eboli, Marica; Fiore, Angela; Grasso, Giacomo; Lodi, Francesco; Lorusso, Pierdomenico; Marinari, Ranieri; Martelli, Daniele; Papa, Francesca; Sartorio, Camillo; Utili, Marco; Venturini, Alessandr

Maturation of critical technologies for the DEMO balance of plant systems

The Pre-Concept Design (PCD) of the Balance of Plant (BoP) systems of the EU-DEMO power plant is described in this paper for both breeding blanket (BB) concepts under assessment, namely the Water Cooled Lithium Lead (WCLL) BB and the Helium Cooled Pebble Bed (HCPB) BB. Moreover, the results of a preliminary evaluation of a number of BoP variants are discussed. This paper outlines the steps of the BoP design development, highlighting the project objectives and the strategy for their achievement under the very challenging requirements which include, among others, the intermittent nature of the DEMO plasma heat source. The main achievements during the PCD Phase will be reported together with the development plan for the Concept Design (CD) Phase to reach a mature (feasible) BoP concept for DEMO.peer-reviewe

Inflammatory rheumatic diseases with onset after SARS-CoV-2 infection or COVID-19 vaccination: a report of 267 cases from the COVID-19 and ASD group

Objectives To better define the spectrum of new-onset post-COVID-19 and post-COVID-19 vaccine inflammatory rheumatic diseases (IRD) from a large multicentric observational study.Methods Consecutive cases of IRD encountered during a 12-month period and satisfying one of the following inclusion criteria: (a) onset of the rheumatic manifestations within 4 weeks from SARS-CoV-2 infection or (b) onset of the rheumatic manifestations within 4 weeks from the administration of one of the COVID-19 vaccines ws recruited.Results The final analysis cohort comprised 267 patients, of which 122 (45.2%) in the post-COVID-19 and 145 (54.8%) in the postvaccine cohort. Distribution of IRD categories differed between the two cohorts: the post-COVID-19 cohort had a higher percentage of patients classified as having inflammatory joint diseases (IJD, 52.5% vs 37.2%, p=0.013) while the post-vaccine cohort had a higher prevalence of patients classified as polymyalgia rheumatica (PMR, 33.1% vs 21.3%, p=0.032). No differences were detected in the percentage of patients diagnosed with connective tissue diseases (CTD 19.7% vs 20.7%, p=0.837) or vasculitis (6.6% vs 9.0%, p=0.467). Despite the short follow-up period, IJD and PMR patients’ response to first-line therapy was favourable, with both groups achieving a drop in baseline disease activity scores of ~30% and ~70% respectively.Conclusion Our article reports the largest cohort published to date of new-onset IRD following SARS-CoV-2 infection or COVID-19 vaccines. Although causality cannot be ascertained, the spectrum of possible clinical manifestations is broad and includes IJD, PMR, CTD and vasculitis