Introduction
An ongoing national multicenter survey Italian Oncologic Pain multiSetting Multicentric Survey (IOPS-MS) is evaluating the characteristics of breakthrough cancer pain (BTP) in different ...clinical settings. Preliminary data from the first 1500 cancer patients with BTP enrolled in this study are presented here.
Methods
Thirty-two clinical centers are involved in the survey. A diagnosis of BTP was performed by a standard algorithm. Epidemiological data, Karnofsky index, stage of disease, presence and sites of metastases, ongoing oncologic treatment, and characteristics of background pain and BTP and their treatments were recorded. Background pain and BTP intensity were measured. Patients were also questioned about BTP predictability, BTP onset (≤10 or >10 min), BTP duration, background and BTP medications and their doses, time to meaningful pain relief after BTP medication, and satisfaction with BTP medication. The occurrence of adverse reactions was also assessed, as well as mucosal toxicity.
Results
Background pain was well controlled with opioid treatment (numerical rating scale 3.0 ± 1.1). Patients reported 2.5 ± 1.6 BTP episodes/day with a mean intensity of 7.5 ± 1.4 and duration of 43 ± 40 min; 977 patients (65.1%) reported non-predictable BTP, and 1076 patients (71.7%) reported a rapid onset of BTP (≤10 min). Higher patient satisfaction was reported by patients treated with fast onset opioids.
Conclusions
These preliminary data underline that the standard algorithm used is a valid tool for a proper diagnosis of BTP in cancer patients. Moreover, rapid relief of pain is crucial for patients’ satisfaction. The final IOPS-MS data are necessary to understand relationships between BTP characteristics and other clinical variables in oncologic patients.
Funding
Molteni Farmaceutici, Italy.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Low Factor XIII (FXIII) activity has been reported in the blood of patients with chronic venous leg ulcer (CVU). In vivo studies have described increased wound healing in CVU patients treated with ...FXIII concentrate, and in vitro studies have shown increased regenerative capacity in FXIII‐treated fibroblasts. In addition, a common G‐to‐T polymorphism in the FXIIIA‐subunit gene (V34L) significantly increases the activity and modifies the cross‐linking properties of the FXIII molecule and this variant has been investigated as a protective factor against thrombosis, a recognized risk factor for CVU establishment. Therefore, the role of FXIII levels, FXIII V34L, FVR506Q, and FIIG20210A, common gene polymorphisms in the pathogenesis of CVU was investigated. Ninety‐one patients with CVU and 195 healthy controls (91 of them sex‐ and age‐matched) were PCR‐genotyped for the FXIIIV34L, FVR506Q, and FIIG20210A substitutions and FXIIIA‐subunit levels were determined by immuno‐electrophoresis. The extent of the venous ulcer surface in patients was measured by computer software. The allele frequency and the genotype distribution of the FXIII polymorphism did not show significant differences between the whole group of cases and controls as well as prothrombin variants did. On the contrary, the FVR506Q variant (FV Leiden) allele was more frequent in patients, yielding a significant OR value of 5.93 (95 percent CI, 1.83–19.17; p= 0.003). Considering only CVU cases secondary to a post–thrombotic syndrome (n= 24), FV Leiden yielded a greater OR value of 16.08 (95 percent CI, 4.33‐59.6; p < 0.0001). When the CVU cases were stratified by the three possible FXIII genotypes, a significant trend toward a lower mean value of the ulcerated area was clearly evident as the number of the polymorphic alleles (L34) increased in the genotype of patients (VV = 11.9 cm2,± 23.6; VL = 6.1 cm2,± 6.9; LL = 4.1 cm2,± 2.8; p= 0.01). On the other hand, FXIIIA antigen levels were similar between CVU cases and matched controls, but 11 percent of cases had FXIII deficiency (FXIIIA ≤ 0.65 U/ml; p= 0.003) and they showed a greater mean extension of the lesion if compared with the remaining cases without FXIIIA deficiency (14.5 cm2, ± 20.2 vs. 9.0 cm2, ± 6.3; p= 0.08). We conclude that FXIII antigen levels and FXIII V34L polymorphism may play a crucial role in the complex cascade of CVU pathophysiology, being significantly related to the CVU progression and extension because of the direct effects they have on the FXIII molecular activity.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
This paper examines in depth the determinants of repartnering in Italy. With data from a national survey conducted in 2003, the effects of socio-economic, demographic and contextual characteristics ...on second-union formation among separated women are examined. The analysis is of particular interest in a country such as Italy, which is undergoing a transition from traditional to modern family behaviours. In addition, it allows us to verify the hypothesis that the importance of demographic factors in the repartnering process decreases as marital instability becomes more common. Results of event history analysis models confirm the basic hypothesis and show some unexpected effects.
The present investigation addresses the mechanisms of inorganic phases precipitation from detergency solutions of low polyphosphate formulation. In washing machine systems the main precipitation ...agent is Na4P2O7·10H2O that constitutes up to 10 wt % commercial Na5P3O10·5H2O. The solid incrustation on the heating coil is mainly formed by amorphous calcium pyrophosphate, subsequently transforming first into amorphous calcium orthophosphate and then into low crystallinity hydroxylapatite. The tripolyphosphate eventually present in the precipitates hydrolyzes as well at the working temperature present at the surface of the washing machine coil (100 °C). The pyrophosphate presence strongly inhibits the crystallization of hydroxylapatite in the washing system; thus, thermal treatment of amorphous calcium–pyrophosphate is a viable mechanism to produce hydroxylapatite with controlled crystallinity. A range of analytical techniques including X-ray diffraction, IR spectroscopy, and liquid- and solid-state NMR were employed to quantify the speciation kinetics in solution, to characterize the nature of the precipitates, and to monitor the phase transformations in the solid.
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IJS, KILJ, NUK, PNG, UL, UM
Union dissolution is a constantly increasing phenomenon across Europe - even in Italy where the prevalence of divorce has always been among the lowest. This poses several questions on the potential ...consequences of such an event on the families involved. Many studies show that women usually experience the worst financial consequences, although there are few analyses on Italy, given the relatively low levels of union instability. In this work we study the impact of separation on the economic well-being of men and women using data from the European Community Household Panel (ECHP), analyzed using both objective and subjective measures. By means of a matching method, we also estimate the effect of union dissolution, taking account of possible variations according to the different living arrangements adopted by ex-partners after separation. Results confirm that women experience worse economic distress than men. However, there is also a significant drop in economic well-being among non-custodial fathers who live alone after separation. In addition, it is found that income-based measures do not encapsulate all the dimensions of well-being, and therefore need to be complemented with other measures. //ABSTRACT IN FRENCH: Les ruptures d'union sont en hausse constante en Europe-même en Italie où la fréquence des divorces est parmi les plus basses. Cette tendance soulève différentes questions sur les conséquences des ruptures sur les familles concernées. De nombreuses études ont montré que c'étaient les femmes qui subissaient les conséquences financières les plus défavorables, mais la situation est mal connue en Italie, du fait de la rareté relative du phénomène. Nous analysons l'impact de la séparation sur le bien-être économique des hommes et des femmes à partir des données du Panel Européen des Ménages (ECHP), en nous appuyant à la fois sur des mesures objectives et subjectives. A l'aide d'appariements, les effets des ruptures d'unions sont estimés, en considérant une variation possible suivant le type de ménage dans lequel les anciens conjoints s'installent après la séparation. Les résultats confirment l'existence de plus grandes difficultés économiques chez les femmes. Toutefois, il y a également une chute significative de bien-être économique parmi les pères qui n'ont pas la garde des enfants et vivent seuls après la séparation. En outre, il apparaît que les mesures basées sur le revenu ne reflètent pas toutes les dimensions du bien-être, et doivent par conséquent être complétées par d'autres mesures. Reprinted by permission of Springer
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BFBNIB, CEKLJ, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, NMLJ, NUK, ODKLJ, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UL, UM, UPUK, VKSCE, ZAGLJ
Union dissolution is a constantly increasing phenomenon across Europe—even in Italy where the prevalence of divorce has always been among the lowest. This poses several questions on the potential ...consequences of such an event on the families involved. Many studies show that women usually experience the worst financial consequences, although there are few analyses on Italy, given the relatively low levels of union instability. In this work we study the impact of separation on the economic well-being of men and women using data from the European Community Household Panel (ECHP), analyzed using both objective and subjective measures. By means of a matching method, we also estimate the effect of union dissolution, taking account of possible variations according to the different living arrangements adopted by ex-partners after separation. Results confirm that women experience worse economic distress than men. However, there is also a significant drop in economic well-being among non-custodial fathers who live alone after separation. In addition, it is found that income-based measures do not encapsulate all the dimensions of well-being, and therefore need to be complemented with other measures. /// Les ruptures ď union sont en hausse constante en Europe-même en Italie où la fréquence des divorces est parmi les plus basses. Cette tendance soulève différentes questions sur les conséquences des ruptures sur les families concernées. De nombreuses études ont montré que c'étaient les femmes qui subissaient les conséquences financières les plus défavorables, mais la situation est mal connue en Italie, du fait de la rareté relative du phénomène. Nous analysons l'impact de la séparation sur le bien-être économique des hommes et des femmes à partir des données du Panel Européen des Ménages (ECHP), en nous appuyant à la fois sur des mesures objectives et subjectives. A l'aide d'appariements, les effets des ruptures ď unions sont estimés, en considérant une variation possible suivant le type de menage dans lequel les anciens conjoints s'installent après la separation. Les résultats confìrment l'existence de plus grandes diffìcultés économiques chez les femmes. Toutefois, il y a également une chute significative de bien-être économique parmi les pères qui n'ont pas la garde des enfants et vivent seuls après la séparation. En outre, il apparaît que les mesures basées sur le revenu ne reflètent pas toutes les dimensions du bien-être, et doivent par consequent être complétées par d'autres mesures.
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BFBNIB, CEKLJ, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, NMLJ, NUK, ODKLJ, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UL, UM, UPUK, VKSCE, ZAGLJ
Matrix metalloproteinases (MMPs) are overexpressed in venous leg ulcers, determining a breakdown of the main extracellular matrix (ECM) components owing mainly to collagenase activities, and so ...playing a crucial role in ulcer pathogenesis. The authors studied the effects of coagulation factor XIII (FXIII), which cross-links collagen and other ECM components, in human fibroblast cultured cells in the presence and in the absence of matrix metalloproteinases from Clostridium histolyticum collagenase. Clostridium collagenase at concentrations of 2.0, 1.0, and 0.5 mg/mL was added to normal human dermal fibroblasts cultured in the presence of 0.0, 1.0, and 5.0 U/mL of FXIII concentrate (Fibrogammin P, Aventis Behring). Cell counting and metabolically active fibroblast evaluation in the cultures were monitored for 72 hours, by means of trypan-blue dye and MTT test, respectively. The MTT test showed that at the highest collagenase concentration (2.0 mg/mL), the cell number decreased more than 95% in 72 hours of treatment and no significant differences were observed regardless of the FXIII concentrations utilized. At lower collagenase concentration (1.0 mg/mL), in absence or in presence of FXIII (1.0 U/mL), the cell number decreased by about 80% in 72 hours. In contrast, in the presence of higher FXIII levels (5.0 U/mL), cells suffered globally significantly less collagenase effects (p=0.011) and the gain was appreciable at each time tested. Finally, at 0.5 mg/mL of collagenase concentration, in the absence of FXIII, the cell number decreased by about 60% in 72 hours, whereas in presence of FXIII 1.0 U/mL and 5.0 U/mL, cells decreased significantly less, by about 35% and 20%, respectively (p<0.025 and p<0.01, respectively). These data were also confirmed by direct cell counting utilizing the trypan-blue test. Factor XIII contrasts effectively the detrimental action of Clostridium collagenases in human fibroblast cultured cells. These results support several in vivo reports about the effectiveness of its topical application in order to enhance the venous ulcer healing processes.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Using a sample of Italian women interviewed in 2003 in the survey “Family and Social Subject,” this paper investigates two issues: (1) how a woman’s family life-course (union status and parity/ages ...of children born in the first marriage) influences the risk of a post-dissolution birth among separated women; and (2) how the experience of a marital disruption affects a woman’s cumulated fertility. Given that in Italy marital instability is relatively recent and still barely socially accepted, our main assumption is that separated women engage in more prudent reproductive behaviour than their counterparts living in countries with a longer experience of the phenomenon. With respect to the first point, our results show that: (i) not only remarriage, but also cohabitation, are strongly associated with the likelihood of post-dissolution childbearing; (ii) significant differences in the risk of having a child following the dissolution of a marriage are present only between separated women with no children and separated women with children; thus, separated women with one child have the same probability of experiencing a post-dissolution birth as those with two or more children, and the age of children is irrelevant. With respect to the second point, we find that women who underwent a marital dissolution have lower fertility than those who remained continuously married, and that repartnering enables this group of women to recapture some—but not all—of the fertility lost with the dissolution of the first marriage.
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