Integrating the care of the complex COPD patient

The European Seminars in Respiratory Medicine has represented an outstanding series updating new science in respiratory disease from the 1990\u2019s up to the early beginning of this 21st century [1,2]. Its aim is to update issues and current science, focusing on the multidisciplinary approach to patients with respiratory disease. As such, it represents a unique opportunity for specialists in Respiratory Medicine involved in Basic and Clinical Research to discuss topical and debated problems in medical care, at a top level forum guided by an expert panel of authors. The structure of the seminar is based on the following pillars: \u2022 Attendance at the Seminars is strictly limited: selection of participants is based, in order of priority, on scientific curriculum, age (younger specialists are privileged), and early receipt of the application form. \u2022 Each topic is allotted considerable time for presentation and discussion. The first section is devoted to a series of presentations (with adequate time allocated for discussion) by an expert panel of researchers and clinicians. In the second section involves discussions of controversial issues, in a smaller audience format encouraging interaction between the panel and audience. \u2022 \u201cMeet the expert\u201d seminars discuss topical subjects in more depth, utilizing an interactive tutorial

Inhalation therapy in the next decade : Determinants of adherence to treatment in asthma and COPD

Peer reviewedPublisher PD

The promher study: An observational Italian study on adjuvant therapy for her2-positive, pT1a-b pN0 breast cancer

Background The management of pT1a-b pN0 HER2-positive breast cancer is controversial and no data about the efficacy of trastuzumab in this setting are available from randomized clinical trials. The aims of this retrospective study were to assess how patients are managed in clinical practice in Italy, which clinical or biological characteristics influenced the choice of adjuvant systemic therapy and the outcome of patients. Methods Data of consecutive patients who underwent surgery from January 2007 to December 2012 for HER2-positive, pT1a-b pN0 M0 breast cancer were retrospectively collected from 28Italian centres. Analysis of contingency tables and multivariate generalized logit models were used to investigate the association between the baseline clinical and biological features and the treatment strategy adopted. Results Among 303 enrolled patients, 204 received adjuvant systemic therapy with trastuzumab, 65 adjuvant systemic therapy without trastuzumab and 34 did not receive adjuvant systemic therapy. At the multivariate analysis age, tumor size, proliferation index and hormone receptor status were significantly associated with the treatment choice. Five-year disease-free survival (DFS) probability was 95%, 94.3% and 69.6% for patients treated with adjuvant systemic therapy and trastuzumab, with adjuvant systemic therapy without trastuzumab and for patients who did not receive adjuvant systemic therapy, respectively (p<0.001). Conclusions The majority of patients (66%) with pT1a-b pN0 HER2-positive breast cancer enrolled in this retrospective study received adjuvant systemic therapy with trastuzumab, whereas only 11% patients did not receive any adjuvant systemic therapy. The choice of treatment type seems to be mainly influenced by tumor size, proliferation index, hormone receptor status and age. The 5-year DFS probability was significantly higher for patients receiving adjuvant systemic therapy with trastuzumab compared with patients not receiving adjuvant systemic therapy or receiving adjuvant systemic therapy without trastuzumab

Local-regional treatments.

<p>AST: adjuvant systemic therapy</p><p>Local-regional treatments.</p

Adjuvant systemic therapies.

<p>AST: adjuvant systemic therapy; CT: chemotherapy; HT: hormone therapy</p><p>Adjuvant systemic therapies.</p

Clinicopathologic characteristics and univariate analysis.

<p>LVI: lymphovascular invasion; HR: hormone receptor; AST: adjuvant systemic therapy; ER: estrogen receptor; PgR: progesteron receptor</p><p>*p-value according to Kruskal-Wallis, Chi square test or Fisher’s exact test, as appropriate</p><p>Clinicopathologic characteristics and univariate analysis.</p

A. Disease-free survival according to treatment group. Fig 1A shows Kaplan Meier’s disease-free survival curves according to treatment group. B. Disease-free survival according to stage. Fig 1B shows Kaplan Meier’s disease-free survival curves according to stage; the analysis was performed on 301 patients, since data on stage were missing for 2 patients.

<p>A. Disease-free survival according to treatment group. Fig 1A shows Kaplan Meier’s disease-free survival curves according to treatment group. B. Disease-free survival according to stage. Fig 1B shows Kaplan Meier’s disease-free survival curves according to stage; the analysis was performed on 301 patients, since data on stage were missing for 2 patients.</p