Tailored treatment including radical prostatectomy and radiation therapy + androgen deprivation therapy versus exclusive radical prostatectomy in high-risk prostate cancer patients: results from a prospective study

Purpose To evaluate outcomes of patients with high risk prostate cancer (PCa) who underwent radical prostatectomy (RP) in a context of a multidisciplinary approach including adjuvant radiation (RT) + androgen deprivation therapy (ADT). Matherials and Methods 244 consecutive patients with high risk localized PCa underwent RP and bilateral extended pelvic lymph node dissection at our institution. Adjuvant RT + 24 months ADT was carried out in subjects with pathological stage ≥ T3N0 and/or positive surgical margins or in patients with local relapse. Results After a median follow-up was 54.17 months (range 5.4-117.16), 13 (5.3%) subjects had biochemical progression, 21 (8.6%) had clinical progression, 7 (2.9%) died due to prostate cancer and 15 (6.1%) died due to other causes. 136 (55.7%) patients did not receive any adjuvant treatment while 108 (44.3%) received respectively adjuvant or salvage RT+ADT. Multivariate Cox proportional hazard analysis showed that pre-operative PSA value at diagnosis is a significant predictive factor for BCR (HR: 1.04, p < 0.05) and that Gleason Score 8-10 (HR: 2.4; p<0.05) and PSMs (HR: 2.01; p < 0.01) were significant predictors for clinical progression. Radical prostatectomy group was associated with BPFS, CPFS, CSS and OS at 5-years of 97%, 90%, 95% and 86% respectively, while adjuvant radiation + androgen deprivation therapy group was associated with a BPFS, CPFS and CSS at 5-years of 91%, 83%, 95% and 88%, without any statistical difference. Conclusions Multimodality tailored treatment based on RP and adjuvant therapy with RT+ADT achieve similar results in terms of OS after 5-years of follow-up

Natalizumab, Fingolimod and Dimethyl Fumarate Use and Pregnancy-Related Relapse and Disability in Women With Multiple Sclerosis

To investigate pregnancy-related disease activity in a contemporary multiple sclerosis (MS) cohort

The 10B(p,α)7Be S(E)-factor from 5 keV to 1.5 MeV using the Trojan Horse Method

The 10 B(p, α ) 7 Be reaction is the main responsible for the 10 B destruction in stellar interior [1]. In such environments this p-capture process occurs at a Gamow energy of 10 keV and takes places mainly through a resonant state (Ex = 8.701 MeV) of the compound 11 C nucleus. Thus a resonance right in the region of the Gamow peak is expected to significantly influence the behavior of the astrophysical S(E)-factor. The 10 B(p, α ) 7 Be reaction was studied via the Trojan Horse Method (THM) applied to the 2 H( 10 B, α 7 Be)n in order to extract the astrophysical S(E)-factor in a wide energy range from 5 keV to 1.5 MeV

Tailored treatment including radical prostatectomy and radiation therapy + androgen deprivation therapy versus exclusive radical prostatectomy in high-risk prostate cancer patients: results from a prospective study

Purpose To evaluate outcomes of patients with high risk prostate cancer (PCa) who underwent radical prostatectomy (RP) in a context of a multidisciplinary approach including adjuvant radiation (RT) + androgen deprivation therapy (ADT). Matherials and Methods 244 consecutive patients with high risk localized PCa underwent RP and bilateral extended pelvic lymph node dissection at our institution. Adjuvant RT + 24 months ADT was carried out in subjects with pathological stage ≥ T3N0 and/or positive surgical margins or in patients with local relapse. Results After a median follow-up was 54.17 months (range 5.4-117.16), 13 (5.3%) subjects had biochemical progression, 21 (8.6%) had clinical progression, 7 (2.9%) died due to prostate cancer and 15 (6.1%) died due to other causes. 136 (55.7%) patients did not receive any adjuvant treatment while 108 (44.3%) received respectively adjuvant or salvage RT+ADT. Multivariate Cox proportional hazard analysis showed that pre-operative PSA value at diagnosis is a significant predictive factor for BCR (HR: 1.04, p < 0.05) and that Gleason Score 8-10 (HR: 2.4; p<0.05) and PSMs (HR: 2.01; p < 0.01) were significant predictors for clinical progression. Radical prostatectomy group was associated with BPFS, CPFS, CSS and OS at 5-years of 97%, 90%, 95% and 86% respectively, while adjuvant radiation + androgen deprivation therapy group was associated with a BPFS, CPFS and CSS at 5-years of 91%, 83%, 95% and 88%, without any statistical difference. Conclusions Multimodality tailored treatment based on RP and adjuvant therapy with RT+ADT achieve similar results in terms of OS after 5-years of follow-up

Apathy as a herald of cognitive changes in multiple sclerosis: A 2-year follow-up study

Background: Behavioral symptoms, such as apathy and depression, are common in multiple sclerosis (MS) but their relationship with cognitive and clinical characteristics often remains underinvestigated and not monitored over time. Objective: The aim of this study was to assess the evolution of cognitive profile of patients affected by MS in relation to apathy and depression using a 2-year follow-up study. Methods: Two years after the first assessment, 100 of 125 MS patients were re-evaluated on a comprehensive neuropsychological battery, and on specific scales for assessment of apathy (Apathy Evaluation Scale—Self-reported) and depression (Hamilton Depression Rating Scale). Results: After 2 years (T1), we found a relatively consistent prevalence of apathy (about 40%) and a reduction in prevalence of depression (from 44% to 30%). Higher level of apathy at baseline predicted the progressive cognitive changes at follow-up; and patients with apathy without depression (“pure” apathy) than patients without apathy had poorer performance on the interference task of the Stroop test assessing inhibitory control. Conclusion: The present results suggested that apathy in MS was associated with more severe executive dysfunctions (in particular cognitive control). Apathy rather than depression predicted cognitive impairment in MS over time

Diritto dell\u2019Unione Europea. Sistema Istituzionale, ordinamento, tutela giurisdizionale, competenze [7 ed.]

Tra la precedente e questa settima edizione del manuale sono passati soltanto due anni e mezzo. In questo breve periodo, l\u2019edificio dell\u2019Unione e del suo ordinamento hanno vissuto tante importanti novit\ue0. Da un lato, l\u2019Unione ha conosciuto episodi molto gravi e inediti per la sua non breve vita: l\u2019uscita definitiva del Regno Unito, con la conclusione dell\u2019Accordo sulle condizioni del recesso ai sensi dell\u2019art. 50 TUE; la necessit\ue0 per le istituzioni di sfruttare tutti gli strumenti offerti dai Trattati per evitare che alcuni Stati membri violassero il principio dello Stato di diritto, valore fondante dell\u2019Unione ai sensi dell\u2019art. 2 TUE; lo scoppio della crisi sanitaria ed economica provocata dalla pandemia del COVID-19, con la conseguente introduzione di ampie deroghe alle regole comuni a favore degli Stati membri e la messa in cantiere di innovative soluzioni di sostegno da parte della stessa Unione. D\u2019altro lato, i due anni e mezzo coperti da questa nuova edizione hanno visto il riproporsi di conflitti e frizioni gi\ue0 emersi in passato ma che, lungi dal risolversi col tempo, hanno assunto, in questi ultimissimi anni, connotati ancora pi\uf9 drammatici del passato. Bench\ue9 preannunciata da una serie di pronunce precedenti, l\u2019ordinanza del Bundesverfassungsgericht sul programma PSPP rappresenta una sfida inedita, tanto nei toni, quanto nel merito, all'indipendenza della BCE e, soprattutto, al monopolio della Corte di giustizia circa l\u2019interpretazione e il sindacato di validit\ue0 del diritto dell\u2019Unione. Sotto questo profilo, anche l\u2019atteggiamento di altre Corti costituzionali o supreme, compreso quello emerso nel celebre obiter dictum della sentenza n. 269/17 della Corte italiana e non abbandonato del tutto in sentenza successive, solleva pesanti interrogativi sul se il dialogo tra Corti sia davvero capace di porre rimedio al quesito ineludibile: a chi spetta l\u2019ultima parola? Di questi e di molti altri temi si d\ue0 conto nella nuova edizione, utilizzando, come per il passato, soprattutto la giurisprudenza e i casi di volta in volta esaminati. Sono oltre 80 le nuove sentenze della Corte di giustizia richiamate, senza contare quelle di altre giurisdizioni. L\u2019aggiornamento della settima edizione \ue8 stata curato da Giacomo Biagioni (Parti I e II), Stefano Amadeo (Parti III e IV), Cristina Schepisi (Parte V) e Fabio Spitaleri (Parte VI). Luigi Daniele si \ue8 occupato dell\u2019aggiornamento dell\u2019Introduzione nonch\ue9 del coordinamento e della revisione dell\u2019intera opera. La nota bibliografica \ue8 stata curata da Sarah Lattanzi che ha anche coordinato gli indici