Concurrent intra-arterial carboplatin administration and radiation therapy for the treatment of advanced head and neck squamous cell carcinoma: short term results

BACKGROUND: The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin. METHODS: Fifty-six patients with primary head and neck squamous cell carcinoma received 4 cycles of intra-arterial carboplatin (350 mg/m2 per cycle every 2 weeks), with concurrent three-dimensional conformal radiation therapy. RESULTS: Two major and 4 minor complications were observed. Forty-five of the 56 patients (80%) completed the protocol, while 11 (20%) patients had to discontinue the intra-arterial infusions due to the occurrence of severe haematological toxicity, but were able to complete radiotherapy. Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall. After a median 23.55 months (range: 2 to 58 months) of follow-up, 40 patients (71%) are alive and disease-free, 1 (2%) is alive but affected by disease and 15 (27%) have died of the disease or other causes. CONCLUSION: Intra-arterial carboplatin administration with concurrent three-dimensional conformal radiation therapy seems to be a promising alternative to RADPLAT in the treatment of advanced head and neck tumours. Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects

Curative and organ-preserving treatment with intra-arterial carboplatin induction followed by surgery and/or radiotherapy for advanced head and neck cancer: single-center five-year results

BACKGROUND: This study evaluated the feasibility, toxicity, response rate and survival of neoadjuvant superselective intra-arterial infusion of high dose carboplatin in advanced head and neck cancer. METHODS: Forty-six patients with primary head and neck squamous cell carcinoma received 3 cycles of intra-arterial carboplatin (300 to 350 mg/m(2 )per cycle every 2 weeks), followed by radiotherapy or surgery plus radiotherapy. RESULTS: No complications or severe toxicity occurred. Sixteen patients (35%) were complete responders, 20 (43%) partial responders while 10 (22%) did not respond to treatment. After completion of the multimodality treatment, 38/46 patients (83%) were complete responders. After a 5-year follow-up period, 18/46 patients (39%) are alive and disease-free, 3 (6,5%) have died of a second primary tumor and 25 (54,5%) have died of the disease. CONCLUSION: Intra-arterial carboplatin induction chemotherapy is a safe, well-tolerated technique that discriminates between responders and non-responders and so may have prognostic significance in planning further integrated treatments aimed to organ preservation for advanced head and neck carcinomas

Letter: Safety and efficacy issues of tirofiban use in endovascular procedures: What are the actual indications?

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Neuroembolization may expose patients to radiation doses previously linked to tumor induction.

OBJECTIVE: Epidemiological studies indicate a link between low-dose irradiation (<10,000 mGy) to the head and the local occurrence of tumors after decades of delay. Comparable radiation doses can be reached during neuro-endovascular procedures (NEP), but the incidence of similar exposures has not been completely delineated. We compared the levels of radiation to the head measured during NEP to those reported for patients developing radiation-induced cancers. METHODS: In our prospective study we determined the cumulative maximum entrance skin doses (MESD) and the incidence of epilation in 107 consecutive patients submitted to NEP between 2003 and 2007. We also extensively searched the literature and compared our results with the data we found. RESULTS: The cumulative MESD due to NEP was above 3,000 mGy (range 3,101-5,421 mGy) in 18 patients. In 22 we observed partial epilation within 10 weeks from the initial NEP. Sixty cases of epilation after NEP have been previously reported in the literature. The average of the reported MESD was 4,241 mGy (range 2,000-6,640 mGy). CONCLUSION: Physical dosimetry and the incidence of partial epilation indicate that about one fifth of the patients submitted to NEP received radiation doses comparable to those linked to the occurrence of tumors. The potential risks of developing tumors after a long delay, when compared to the immediate benefits of endovascular treatment of aneurysm and arteriovenous malformations (AVM) of the brain, do not counterindicate NEP, but increased awareness of the risk should help physicians and patients to make a fully informed decision when other treatments are available

Fetal neural tube defects in pregnant women previously submitted to bariatric surgery: More attention to a new emerging entity

What's already known about this topic? The pathogenesis of neural tube defects is multifactorial. What does this study add? Although the pathogenesis of neural tube defects is certainly multifactorial, malnutrition after bariatric surgery has to be considered a major risk factor. Women who have undergone bariatric procedure must receive nutritional counselling before and after conception. \ua9 2012 John Wiley & Sons, Ltd

Laurea Magistrale in Didattica e Comunicazione delle Scienze Naturali

Nell’anno accademico 2020-2021 partirà presso l’Università degli Studi di Bologna la Laurea Magistrale “Didattica e Comunicazione delle Scienze Naturali (DiCoSN)”. L’attivazione di questa LM risponde a diverse sollecitazioni del modo culturale e sociale: la spinta all’innovazione scientifica e tecnologica che sta coinvolgendo la didattica negli Atenei italiani; la necessità di dare ai docenti una formazione di qualità, inclusiva e adatta ad ambienti di apprendimento diversificati, l’importanza di diffondere l’informazione sulle scienze naturali a tutta la collettività; l’esigenza di multidisciplinarietà nella vita culturale e sociale. L’obiettivo formativo di DiCoSN è fornire strumenti culturali e competenze necessarie per inserirsi nella ramificata filiera della formazione e dell’educazione nell’ambito delle Scienze Naturali. Verranno, infatti, formati professionisti capaci di innovare meccanismi e modalità di insegnamento/apprendimento dei contenuti scientifici. In particolare, i laureati DiCoSN matureranno i 24 CFU richiesti per accedere a concorsi per l’insegnamento delle Scienze Naturali nelle scuole secondarie di secondo grado

Childhood abuse is associated with structural impairment in the ventrolateral prefrontal cortex and aggressiveness in patients with borderline personality disorder

Volume reduction and functional impairment in areas of the prefrontal cortex (PFC) have been found in borderline personality disorder (BPD), particularly in patients with a history of childhood abuse. These abnormalities may contribute to the expression of emotion dysregulation and aggressiveness. In this study we investigated whether the volume of the PFC is reduced in BPD patients and whether a history of childhood abuse would be associated with greater PFC structural changes. Structural MRI data were obtained from 18 BPD patients and 19 healthy individuals matched for age, sex, handedness, and education and were analyzed using voxel based morphometry. The Child Abuse Scale was used to elicit a past history of abuse; aggression was evaluated using the Buss-Durkee Hostility Inventory (BDHI). The volume of the right ventrolateral PFC (VLPFC) was significantly reduced in BPD subjects with a history of childhood abuse compared to those without this risk factor. Additionally, right VLPFC gray matter volume significantly correlated with the BDHI total score and with BDHI irritability and negativism subscale scores in patients with a history of childhood abuse. Our results suggest that a history of childhood abuse may lead to increased aggression mediated by an impairment of the right VLPFC

Pediatric Moyamoya Disease and Syndrome in Italy: A Multicenter Cohort

none54noBackgroundMoyamoya is a rare progressive cerebral arteriopathy, occurring as an isolated phenomenon (moyamoya disease, MMD) or associated with other conditions (moyamoya syndrome, MMS), responsible for 6-10% of all childhood strokes and transient ischemic attacks (TIAs). MethodsWe conducted a retrospective multicenter study on pediatric-onset MMD/MMS in Italy in order to characterize disease presentation, course, management, neuroradiology, and outcome in a European country. ResultsA total of 65 patients (34/65 women) with MMD (27/65) or MMS (38/65) were included. About 18% (12/65) of patients were asymptomatic and diagnosed incidentally during investigations performed for an underlying condition (incMMS), whereas 82% (53/65) of patients with MMD or MMS were diagnosed due to the presence of neurological symptoms (symptMMD/MMS). Of these latter, before diagnosis, 66% (43/65) of patients suffered from cerebrovascular events with or without other manifestations (ischemic stroke 42%, 27/65; TIA 32%, 21/65; and no hemorrhagic strokes), 18% (12/65) of them reported headache (in 4/12 headache was not associated with any other manifestation), and 26% (17/65) of them experienced multiple phenotypes (&gt;= 2 among: stroke/TIA/seizures/headache/others). Neuroradiology disclosed &gt;= 1 ischemic lesion in 67% (39/58) of patients and posterior circulation involvement in 51% (30/58) of them. About 73% (47/64) of patients underwent surgery, and 69% (45/65) of them received aspirin, but after diagnosis, further stroke events occurred in 20% (12/61) of them, including operated patients (11%, 5/47). Between symptom onset and last follow-up, the overall patient/year incidence of stroke was 10.26% (IC 95% 7.58-13.88%). At last follow-up (median 4 years after diagnosis, range 0.5-15), 43% (26/61) of patients had motor deficits, 31% (19/61) of them had intellectual disability, 13% (8/61) of them had epilepsy, 11% (7/61) of them had behavioral problems, and 25% (13/52) of them had mRS &gt; 2. The proportion of final mRS &gt; 2 was significantly higher in patients with symptMMD/MMS than in patients with incMMS (p = 0.021). Onset age &lt;4 years and stroke before diagnosis were significantly associated with increased risk of intellectual disability (p = 0.0010 and p = 0.0071, respectively) and mRS &gt; 2 at follow-up (p = 0.0106 and p = 0.0009, respectively). ConclusionsMoyamoya is a severe condition that may affect young children and frequently cause cerebrovascular events throughout the disease course, but may also manifest with multiple and non-cerebrovascular clinical phenotypes including headache (isolated or associated with other manifestations), seizures, and movement disorder. Younger onset age and stroke before diagnosis may associate with increased risk of worse outcome (final mRS &gt; 2).openPo', Chiara; Nosadini, Margherita; Zedde, Marialuisa; Pascarella, Rosario; Mirone, Giuseppe; Cicala, Domenico; Rosati, Anna; Cosi, Alessandra; Toldo, Irene; Colombatti, Raffaella; Martelli, Paola; Iodice, Alessandro; Accorsi, Patrizia; Giordano, Lucio; Savasta, Salvatore; Foiadelli, Thomas; Sanfilippo, Giuseppina; Lafe, Elvis; Thyrion, Federico Zappoli; Polonara, Gabriele; Campa, Serena; Raviglione, Federico; Scelsa, Barbara; Bova, Stefania Maria; Greco, Filippo; Cordelli, Duccio Maria; Cirillo, Luigi; Toni, Francesco; Baro, Valentina; Causin, Francesco; Frigo, Anna Chiara; Suppiej, Agnese; Sainati, Laura; Azzolina, Danila; Agostini, Manuela; Cesaroni, Elisabetta; De Carlo, Luigi; Di Rosa, Gabriella; Esposito, Giacomo; Grazian, Luisa; Morini, Giovanna; Nicita, Francesco; Operto, Francesca Felicia; Pruna, Dario; Ragazzi, Paola; Rollo, Massimo; Spalice, Alberto; Striano, Pasquale; Skabar, Aldo; Lanterna, Luigi Alberto; Carai, Andrea; Marras, Carlo Efisio; Manara, Renzo; Sartori, StefanoPo', Chiara; Nosadini, Margherita; Zedde, Marialuisa; Pascarella, Rosario; Mirone, Giuseppe; Cicala, Domenico; Rosati, Anna; Cosi, Alessandra; Toldo, Irene; Colombatti, Raffaella; Martelli, Paola; Iodice, Alessandro; Accorsi, Patrizia; Giordano, Lucio; Savasta, Salvatore; Foiadelli, Thomas; Sanfilippo, Giuseppina; Lafe, Elvis; Thyrion, Federico Zappoli; Polonara, Gabriele; Campa, Serena; Raviglione, Federico; Scelsa, Barbara; Bova, Stefania Maria; Greco, Filippo; Cordelli, Duccio Maria; Cirillo, Luigi; Toni, Francesco; Baro, Valentina; Causin, Francesco; Frigo, Anna Chiara; Suppiej, Agnese; Sainati, Laura; Azzolina, Danila; Agostini, Manuela; Cesaroni, Elisabetta; De Carlo, Luigi; Di Rosa, Gabriella; Esposito, Giacomo; Grazian, Luisa; Morini, Giovanna; Nicita, Francesco; Operto, Francesca Felicia; Pruna, Dario; Ragazzi, Paola; Rollo, Massimo; Spalice, Alberto; Striano, Pasquale; Skabar, Aldo; Lanterna, Luigi Alberto; Carai, Andrea; Marras, Carlo Efisio; Manara, Renzo; Sartori, Stefan