Nab-paclitaxel in pretreated metastatic breast cancer: evaluation of activity, safety, and quality of life

Objective: Metastatic breast cancer (MBC) is an incurable disease; the treatment of this disease prolongs survival, improving the quality of life (QoL) with a balance between efficacy and toxicity of the treatment. In recent years, treatment with nab-paclitaxel has improved the already known antitumor activity of conventional paclitaxel, in terms of increased efficacy and better tolerability. The aim of this study was to evaluate nab-paclitaxel in Italian patients with MBC. Methods: We conducted a retrospective analysis of 90 patients with histologically confirmed diagnosis of MBC. To evaluate the efficacy of nab-paclitaxel, overall survival (OS), progression-free survival (PFS), and overall response rate were the primary endpoints, whereas carbohydrate antigen 15.3 (Ca15.3) reduction, QoL, and tolerability were secondary endpoints. Results: The median OS was 10.4 months, the median PFS was 6.8 months. A considerable difference Ca15.3 before and after treatment was observed. Descriptive and regression analyses were done to examine the associations between Ca15.3 response and OS, demonstrating good correlation, revealing that Ca15.3 reduction is an important predictor of OS. Conclusion: Nab-paclitaxel is an effective and well-tolerated treatment of patients affected by MBC. The drug showed an improved tolerability profile. With all the limitations of the observational nature of our results, nab-paclitaxel has proven to be an effective and safe therapeutic option in patients with MBC

Terminal or truncal ligation of the inferior thyroid artery during thyroidectomy? A prospective randomized trial

INTRODUCTION: Thyroidectomy is a common procedure in general and endocrine surgery. The technique of ligation of inferior thyroid artery (ITA) has been invoked as a possible cause of appearance of postoperative hypocalcemia. METHODS: We performed a prospective randomized study involving 184 patients undergoing total thyroidectomy to evaluate the differences of truncal ligation versus distal ligation of ITA in terms of postoperative hypocalcemia, vocal fold palsy, voice and swallowing impairment. The patients were divided into group A (trunk ligation of ITA) and group B (terminal branches ligation of ITA). RESULTS: We evaluated postoperative PTH and calcemia (immediate, 6 and 12 months after thyroidectomy), postoperative day of discontinuation of calcium and vitamin D supplementation, voice and swallowing complaints, evaluated by mean of two specific tests available in literature, day of hospital discharge. CONCLUSION: The only significant differences between the two groups were a higher immediate postoperative calcemia and a greater number of patients discharged without calcium and vitamin-D supplementation in the group B. In conclusion, no substantial differences were found between the two groups. The choice depends on the experience of the surgeon

Bronchial epithelial damage after a half-marathon in nonasthmatic amateur runners

Am J Physiol Lung Cell Mol Physiol. 2010 Jun;298(6):L857-62. Epub 2010 Apr 2. Bronchial epithelial damage after a half-marathon in nonasthmatic amateur runners. Chimenti L, Morici G, Paternò A, Santagata R, Bonanno A, Profita M, Riccobono L, Bellia V, Bonsignore MR. SourceDept. Biomedico Di Medicina Interna & Specialistica, Section of Pneumology, Univ. of Palermo, Via Trabucco 180, 90146 Palermo, Italy. [email protected] Abstract High neutrophil counts in induced sputum have been found in nonasthmatic amateur runners at rest and after a marathon, but the pathogenesis of airway neutrophilia in athletes is still poorly understood. Bronchial epithelial damage may occur during intense exercise, as suggested by investigations conducted in endurance-trained mice and competitive human athletes studied under resting conditions. To gain further information on airway changes acutely induced by exercise, airway cell composition, apoptosis, IL-8 concentration in induced sputum, and serum CC-16 level were measured in 15 male amateur runners at rest (baseline) and shortly after a half-marathon. Different from results obtained after a marathon, neutrophil absolute counts were unchanged, whereas bronchial epithelial cell absolute counts and their apoptosis increased significantly (P < 0.01). IL-8 in induced sputum supernatants almost doubled postrace compared with baseline (P < 0.01) and correlated positively with bronchial epithelial cell absolute counts (R(2) = 0.373, P < 0.01). Serum CC-16 significantly increased after all races (P < 0.01). These data show mild bronchial epithelial cell injury acutely induced by intense endurance exercise in humans, extending to large airways the data obtained in peripheral airways of endurance-trained mice. Therefore, neutrophil influx into the airways of athletes may be secondary to bronchial epithelial damage associated with intense exercise. PMID:20363849[PubMed - indexed for MEDLINE

Dove è finito il gruppo?

Gli autori affrontano la questione della “sparizione” nella contemporaneità dei gruppi e della gruppalità in differenti contesti dove tradizionalmente il “fare gruppi” era diventato una consuetudine: ambito clinico, terapeutico, istituzionale. Ci si interroga se la difficoltà riscontrata dai professionisti della salute mentale e del benessere psicosociale, esperti in gruppi, di avviare e mantenere setting collettivi, sia una delle numerose manifestazioni della deriva neoliberista che investe le vite di tutti, le relazioni, la concezione del mondo e della vita.The authors deal with the question of the "disappearance" of groups and of groupality in the contemporary world in different contexts where traditionally "making groups" had become a habit: clinical, therapeutic, institutional sphere. The question arises whether the difficulty encountered by professionals in mental health and psychosocial well-being, experts in groups, to initiate and maintain collective settings, is one of the numerous manifestations of the neoliberal drift that affects everyone's lives, relationships, the conception of the world and life

La trasmissione tra le generazioni

La trasmissione psichica e culturale tra generazioni è un processo essenziale che presenta sfide specifiche nel tempo attuale. Mentre la trasmissione tradizionale avveniva attraverso la parola e la presenza fisica, in spazi e tempi definiti, oggi essa si realizza attraverso sistemi digitali che annullano lo spazio pubblico e offrono un'infinita fonte virtuale di informazioni, ma priva di connessione generazionale. La memoria e il calcolo vengono sostituiti dall'informazione immediatamente disponibile, facendo sì che la formazione si riduca a un accumulo di notizie e tecniche, privo di approfondimento e personalizzazione. Questo processo sembra interrompere la trasmissione autentica, sostituendola con un enorme manuale d'uso virtuale. Le istituzioni accademiche tendono a privilegiare saperi oggettivi e impersonali, escludendo l'aspetto relazionale delle esperienze. La razionalità attuale si concentra sull'efficienza immediata a scapito dell'autonomia e dell'identità dell'operatore. La trasmissione richiede cura e fiducia, e, per essere efficace e autentica, richiede tempo, fiducia e relazioni profonde.The psychic and cultural transmission between generations is an essential process that faces specific challenges in the present time. While traditional transmission occurred through spoken word and physical presence, in defined spaces and times, today it takes place through digital systems that eliminate public space and offer an infinite virtual source of information, but lack generational connection. Memory and calculation are replaced by immediately available information, reducing education to a mere accumulation of facts and techniques, devoid of depth and personalization. This process seems to interrupt authentic transmission, replacing it with a massive virtual user manual. Academic institutions tend to prioritize objective and impersonal knowledge, excluding the relational aspect of experiences. Current rationality focuses on immediate efficiency at the expense of the autonomy and identity of the operator. Transmission requires care and trust, and to be effective and authentic, it necessitates time, trust, and deep relationships

Role of chronic exsposure to cigarette smoke on endoglin/CD105 expression in airway epithelium.

Dysregulation of airway epithelial cell function related to cigarette smoke exposure plays an important role in the pathophysiology of COPD and is associated to tissue damage and disease severity. CD105 is a component of the receptor complex of TGF-β, a pleiotropic cytokine involved in cellular proliferation, differentiation and migration. CD105 regulates the expression of different components of the extracellular matrix suggesting a role of CD105 in cellular transmigration and remodeling processes. The aim of the present study was to investigate the expression of endoglin/CD105 in airway epithelium of COPD patients and its involvement in tissue remodeling and progression of COPD. We evaluated the immunoreactivity for CD105 expression in bronchial biopsies isolated from COPD patients and healthy controls (HC). The analysis of metaplastic epithelium was performed in bronchial biopsies by Image Analysis software (Leica Quantimet system). Finally, we investigated the expression of CD105 protein receptor in human bronchial epithelial cells (16HBE cells) exposed to 5% Cigarette Smoke Extract (CSE) for 12 days by western blot. We found that the CD105 immunoreactivity was significantly higher in bronchial epithelium of COPD than HC. Morphometric analysis of bioptic samples of COPD showed an increase of the immunoreactivity for CD105 in the area of metaplastic than in not metaplastic epithelium. Long term exposure to CSE significantly up-regulated CD105 expression in 16HBE. Chronic inflammation due to cigarette smoke might play a critic role on the alteration of CD105 protein expression in COPD, promoting tissue remodeling, angiogenesis and dysregulation of physiological reparative mechanisms, leading to squamous metaplasia

Airway cell composition at rest and after an all-out test in competitive rowers

Med Sci Sports Exerc. 2004 Oct;36(10):1723-9. Airway cell composition at rest and after an all-out test in competitive rowers. Morici G, Bonsignore MR, Zangla D, Riccobono L, Profita M, Bonanno A, Paternò A, Di Giorgi R, Mirabella F, Chimenti L, Benigno A, Vignola AM, Bellia V, Amato G, Bonsignore G. SourceDepartment of Experimental Medicine Italian National Research Council (CNR), Palermo, Italy. Abstract PURPOSES: This study was designed to assess: a) whether rowing affects airway cell composition, and b) the possible relationship between the degree of ventilation during exercise and airway cells. SUBJECTS AND METHODS: In nine young, nonasthmatic competitive rowers (mean age +/- SD: 16.2 +/- 1.0 yr), induced sputum samples were obtained at rest and shortly after an all-out rowing test over 1000 m (mean duration: 200 +/- 14 s), during which ventilatory and metabolic variables were recorded breath-by-breath (Cosmed K4b, Italy). RESULTS: At rest, induced sputum showed prevalence of neutrophils (60%) over macrophages (40%); after exercise, total cell and bronchial epithelial cell (BEC) counts tended to increase. In the last minute of exercise, mean VE was 158.0 +/- 41.5 L x min(-1), and VO2 x kg(-1) 62 +/- 11 mL x min(-1). Exercise VE correlated directly with postexercise total cell (Spearman rho: 0.75, P < 0.05) an dmacrophage (rho: 0.82, P < 0.05) counts. A similar trend was observed for exercise VE and changes in BEC counts from baseline to postexercise (rho: 0.64, P = 0.11). Exercise VE did not correlate with airway neutrophil counts at rest or after exercise. Expression of adhesion molecules by airway neutrophils, macrophages, and eosinophils decreased after the all-out test. CONCLUSION: Similar to endurance athletes, nonasthmatic competitive rowers showed increased neutrophils in induced sputum compared with values found in sedentary subjects. The trend toward increased BEC postexercise possibly reflected the effects of high airflows on airway epithelium. Airway macrophages postexercise were highest in rowers showing tile most intense exercise hyperpnea, suggesting early involvement of these cells during exercise. However, the low expression of adhesion molecules by all airway cell types suggests that intense short-lived exercise may be associated with a blunted response of airway cells in nonasthmatic well-trained rowers. PMID:15595293[PubMed - indexed for MEDLINE

The life of relationship in globalized financial economic devices. Evidences from the experience of a group-analytic transcultural workshop.

Summary The present contribution - starting from the experience of the EATGA Workshop 2011 that took place in Palermo, whose theme was “Intersubjective bonds in a globalized economy”- invites reflection on the quality of the life of relationships and intersubjective connectedness in the social contemporary world. One of the characterizing cultural phenomena influencing contemporary reality is made up of the dominant and pervasive presence of the logic and language of the financial markets in policies and activities that organize and articulate daily life. The theoretical hypothesis driving our research is that the structures of subjectivity, the meaning and the way of being in a relationship are characteristics (cultural themes) that emerge within a historically defined cultural system/device. In such a theoretical perspective, the cultural themes (i.e. gift, market,) are incorporated or interiorized by men belonging to a shared cultural system and so become elements of the shared subjectivity and of the meanings given to intersubjective exchanges and bonds. From the workshop experience some meanings emerge concerning the role of the economical-financial system in promoting codes and symbols that define the shape and the sense of relationships. The cultural codes of the market have come out of the economic circle in which they have originated and are offered as organizers of affections and of relationships. This denotes and marks the current critical historical moment, in which the values and the cultural codes organized on trust, on reciprocity, on community participation and solidarity seem to be interdicted