Head–neck melanoma. clinical, histopathological and prognostic features of an italian multicentric study

Background: Primitive location of melanoma could be a relevant prognostic factor. As regards the scalp, some studies indicate a particularly aggressive biological behaviour for this anatomical localisation. Objectives: In this multicentric study, data regarding head–neck melanoma (HNM) have been revised. Methods: The design of the study included two main phases. In this retrospective study, data regarding HNM have been collected and analysed. Results: In summary, our data suggest that the posterior neck is the area most affected by thicker melanomas. Cheeks and neck melanoma are associated with reduced disease-free years of life and overall survival compared with all other sites of HNM. Conclusions: This study provides useful information in defining the clinical features of HNM, thus improving diagnosis and treatment strategies

Methodological study to evaluate the psychometric properties of FACIT-CD in a sample of Brazilian women with cervical intraepithelial neoplasia

Background: The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. The aim of this study was to evaluate the psychometric properties of the FACIT-CD questionnaire in Brazilian women diagnosed with CIN. Methods: The properties of the FACIT-CD questionnaire were tested on a sample of 439 women seen at the Department of Prevention of Barretos Cancer Hospital, including 329 patients who were diagnosed with CIN and 110 women who were not diagnosed with the disease. The analysed parameters included internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient), structural validity, convergent validity (correlation with the SF-12 and EORTC QLQ-CX24 questionnaires), discriminant validity (according to disease status, and self-rating of health), sensitivity, and responsiveness. Results: The Cronbach alpha values of the FACIT-CD scales were higher than 0.70 with the exception of the relationship scale (0.66). The FACIT-CD reproducibility was satisfactory, with variation in the intraclass correlation coefficients ranging between 0.50 and 0.83, although the 95% confidence interval (CI) was lower than 0.40 (0.33-0.64) on the treatment satisfaction scale. Regarding structural validity, only one item on the physical well-being scale was not kept in the original domain. The expected correlations between the FACIT-CD and SF-12 were not confirmed, whereas the correlations between the FACIT-CD and EORTC QLQ-CX24 were confirmed. The questionnaire was able to discriminate the groups according to disease status and self-rating of health. The sensitivity was low for the relationship scale and moderate for the other scales. The responsiveness of the FACIT-CD questionnaire varied between the groups that denominate the self-perception of health as no change, improvement or worsening. Conclusion: Our results are encouraging and indicate that the FACIT-CD questionnaire is a promising tool for the analysis of the quality of life of women with CIN.The postdoctoral fellowship was supported by Sao Paulo Research Foundation (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo - FAPESP, Sao Paulo, Brazil). Process number: FAPESP 2014/10158-3. The funding body had no role in the design of the study and collection, analysis and interpretation of data and in writing the manuscript.info:eu-repo/semantics/publishedVersio

Secukinumab shows high efficacy irrespective of HLA-Cw6 status in patients with moderate-to-severe plaque-type psoriasis: SUPREME study

Background: Understanding genetic variations is important in predicting treatment response and forms the basis for identifying new pharmacogenetic and pharmacogenomic targets for psoriasis treatment. There are limited data on the efficacy of secukinumab in relation to genetic markers. Objectives: To evaluate the efficacy and safety of secukinumab 300 mg in HLA-Cw6-positive (Cw6-POS) and HLA-Cw6-negative (Cw6-NEG) patients with moderate-to-severe chronic plaque-type psoriasis. Methods: SUPREME was a 24-week, phase IIIb study with an extension period up to 72 weeks. Primary end point was Psoriasis Area Severity Index (PASI) 90 response rate after 16 weeks. Results: In total, 434 patients were recruited: 185 (42\ub76%) were Cw6-POS and 246 (56\ub77%) were Cw6-NEG (three not assessed). Mean \ub1 SD age was 45\ub72 \ub1 13\ub72 years (Cw6-POS 42\ub77 \ub1 13\ub71; Cw6-NEG 47\ub72 \ub1 12\ub79). The baseline PASI score was comparable between the cohorts [Cw6-POS 20\ub77 \ub1 8\ub799; Cw6-NEG 21\ub75 \ub1 9\ub799 (P = 0\ub7777)]. At week 16, PASI 90 was achieved in 80\ub74% of Cw6-POS and 79\ub77% of Cw6-NEG patients (difference 0\ub776; 95% confidence interval 127\ub704 to 8\ub723). No differences in absolute PASI at week 16 (Cw6-POS 1\ub736 \ub1 3\ub758; Cw6-NEG 1\ub718 \ub1 2\ub729) were observed. The overall safety profile of secukinumab was consistent with that previously reported. No statistically significant difference was detected in the rate of treatment-emergent adverse events [Cw6-POS 42\ub77%; Cw6-NEG 49\ub76% (P = 0\ub7295)]. A high PASI 90 response was achieved with secukinumab with a fast reduction in absolute PASI. Conclusions: Determination of HLA-Cw6 status for secukinumab therapy is unnecessary, as it is highly effective regardless of HLA-Cw6 status

SEDIMENTARY PROCESSES AND BIOFACIES OF LATE CRETACEOUS LOW-ENERGY CARBONATE RAMP SYSTEMS (SOUTHERN ITALY)

This paper characterizes a low-energy, open-shelf setting by focusing on the sedimentary processes and biofacies of a Late Cretaceous, temperate-type open shelf in the southern Apennine nappes of Italy. The facies evolution of the related rudist-rich limestones takes into account the macrofossil characteristics and the microfaunal assemblages.The open-shelf depositional setting is interpreted by facies analysis. The facies are gradually transitional and the facies belts are broad, but wave-resistant biogenic frameworks are absent. Presumably the sea floor was characterized by a low bathymetric slope on which the wave energy was dissipated across a wide shelf, resulting in low-energy environments. Storm waves were damped by the wide, shallow bottom, and the fine fraction was not winnowed. Many rudists are in growth position, and those reworked are well preserved and commonly articulated. Different bathymetries and hydrodynamic conditions in two study areas, the Sorrento Peninsula and the northern Cilento, resulted in different biofacies and stratal geometries. In the Cilento area, high-energy currents such as tidal currents created a network of small channel-like depressions. Different rudist species colonized these channels and their margins. Rudists in growth position are rare, although reworked bivalves are commonly conjoined and the shells are pristine. In this subtidal facies key foraminifer species vary in abundance. The presence of marine open-shelf agglutinate forms supports the interpretation of a marine, high-energy shelf.In the Sorrento area, ephemeral subaerial exposure surfaces and pedogenic deposits indicate intertidal conditions and rudist facies indicate subtidal sandy shelf. The rudists formed monospecific to paucispecific assemblages. The foraminiferal assemblages are much more diversified than those in the Cilento successions, indicating small but meaningful oscillations in sub-environments.The rudist shell beds exhibit great taphonomic variability. The foraminiferal assemblages are characterized by distinct taxa such as abundant conical and discoidal agglutinate forms (Cuneolina and Dicyclina), thick-shelled evoluted Soritidae (Murgella, Scandonea, and Pseudorhapydionina), and larger, thicker ovoidal or subspherical Rotaliidae that indicate well-lit depositional environments with open water circulation and normal salinity, characterized by medium values of the hydrodynamic energy with scarce or no evidence of traction currents