Global responsibility and strategic risk management

The emergence of a global business risk, caused by a more intense companies’ strategic and organizational complexity, leads both the researchers and the enterprises to a concept of a global responsibility as a paradigm for effective relationships with all stakeholders. This global concept of responsibility must include the areas of legal, economic, social and environmental commitment and suggests an integrated approach to risk management. The aim of this article is to propose a theoretical framework about the relations among stakeholders’ expectations, responsibility areas and risk management. By means of a qualitative analysis, the authors intend to suggest some reflections about the approach of some meaningful global companies towards their potential risks and the relationships with their stakeholders

Testicular cancer and sperm DNA damage: short- and long-term effects of antineoplastic treatment

The aim of this study was to investigate sperm DNA damage induced by chemo- and radiotherapy in patients with testicular cancer to provide data on the extent and persistence of nuclear damage that might affect individual reproductive potential. We evaluated pre- and post-antineoplastic treatment sperm DNA integrity, expressed as DNA Fragmentation Index (DFI), in a large caseload of testicular cancer patients by sperm chromatin structure assay. The mean total DFI for all patients at T0 was 18.0 ± 12.5%. Sperm chromatin profile was markedly impaired at T3 (27.7 ± 17.4%) and T6 (23.2 ± 15.3%), improving considerably at T12 and T24 (14.0 ± 8.9% and 14.4 ± 10.3%). After chemotherapy, we found a marked increase in DFI at T3 and T6 and a significant reduction at T12 and T24 in comparison with the baseline. In contrast, DFI increased at T3 and T6 after radiotherapy but the subsequent reduction was far less marked, reaching baseline values at T12 and T24. Finally, post-treatment DNA damage was not age or histotype dependent, but was more marked in the advanced stage of cancer. In this study, we showed that the chromatin profile may be affected in the months immediately following the end of the treatment, improving after 12-24 months. Our results thus indicate that post-treatment DNA damage is influenced both by the type and intensity of the therapy and by the pathological and clinical stage of the disease. © 2014 American Society of Andrology and European Academy of Andrology

Intraluminal recanalization of long infrainguinal chronic total occlusions using the Crosser system

Purpose: To assess the safety and efficacy of a device for vibrational angioplasty in the percutaneous intraluminal recanalization of long infrainguinal chronic total occlusions (CTO). Technique: The Crosser CTO Recanalization System is a mechanical recanalization device that uses high-frequency vibrational energy to disrupt and channel through fibrocalcific plaque without harming the vessel wall, thus assisting in the recanalization of an occluded artery. In 12 diabetic patients (7 men; median age 71 years, range 58–80) with critical limb ischemia owing to long (median length 26 cm, range 21–32) infrainguinal CTOs resistant to conventional guidewire techniques, the Crosser CTO Recanalization System was successful in intraluminally crossing the occlusion in 9 (75%) patients in ,5 minutes (mean 4:03 minutes). The safety endpoint (distal lumen guidewire position with no vessel perforation or dissection) was achieved in all successful cases. Conclusion: In our preliminary experience, the Crosser CTO Recanalization Catheter decreased crossing time, was safe, and achieved a high rate of intraluminal recanalization of long infrainguinal CTOs. J Endovasc Ther. 2009;16:23–27 Key words: critical limb ischemia, chronic total occlusion, percutaneous interventions, infrainguinal occlusion, intraluminal recanalization, vibrational energ