Hypersensitivity reactions (HSRs) to platinum are an important issue in the treatment of patients (pts) with ovarian cancer (OC). Germline BRCA mutations have been proposed as a risk factor. We aimed ...at evaluating the incidence and severity of HSRs to platinum in OC pts. with known BRCA status.
We retrospectively analyzed 432 pts. from 5 Italian Centers. In addition, we performed a systematic review and meta-analysis of published series.
Four hundred nine pts. received at least one prior platinum-based treatment line: 314 were BRCA wild type (77%) and 95 were BRCA mutated (23%). There was no statistical difference in exposure to platinum. Incidence of any grade HSRs was higher among BRCA mutated pts. 9% vs 18%, p = 0.019 and the time-to-HSRs curves show that the risk increases with the duration of platinum exposure, in BRCA mutated pts. more than in BRCA wild type. A multivariable analysis showed that harboring a germline BRCA mutation was related to a higher incidence of HSRs (HR: 1.84, 95% CI 1.00–3.99, p = 0.05) while having received pegylated liposomal doxorubicin (PLD) was related to a lower incidence of HSRs (HR: 0.03 95% CI 0.004–0.22, p = 0.001). The systematic review confirmed the higher incidence of HSRs in BRCA mutated pts., though heterogeneity among series was significant.
In OC pts. with BRCA mutations, there is a significantly higher incidence of HSRs to carboplatin, not justified by longer drug exposure. On the other hand, PLD exerted a protective role in our series.
•Hypersensitivity reactions (HSRs) to carboplatin are frequent in pretreated ovarian cancer (OC) patients (pts).•The role of BRCA mutations (mut) as a risk factor has been suggested.•We demonstrate that BRCAmut pts. have an increased risk of HSRs which is not justified by longer drug exposure only.•Receiving pegylated liposomal doxorubicin was a protective factor in our series.•The meta-analysis of literature, though results are heterogeneous, confirms the role of BRCAmut in increasing HSRs risk.
Accurate follow-up after diagnostic and therapeutic injections is extremely important in orthopedic surgery. We describe a simple, inexpensive, and convenient method of obtaining such follow-up in a ...precise and easy-to-interpret way. A case example is given in which this information was useful to the physician and patient.
The Fine Wire Technique for Flexor Tenolysis Rosenblum, Matthew K; Baltodano, Pablo A; Weinberg, Maxene H ...
Plastic and reconstructive surgery. Global open,
2017-November, Letnik:
5, Številka:
11
Journal Article
Recenzirano
Odprti dostop
BACKGROUND:Flexor tenolysis surgery for flexor digitorum profundus and superficialis adhesions is a common procedure performed by hand surgeons. Releasing these adhered tendons can greatly improve ...hand function and improve quality of life. Recent evidence, however, has shown that the outcomes of tenolysis surgeries are often suboptimal and can result in relapsing adhesions or even tendon ruptures.
METHODS:This article describes a new technique with potential for reduced complication ratesThe Fine Wire Technique for Flexor Tenolysis (FWT).
RESULTS:Following FWT, the patient detailed in this article had an excellent recovery of function and no complicationsincluding tendon rupture, infection, hematomas, or any other complications. She reported a major improvement from her preoperative functionality and continues to have this level of success. The wire’s thinness allows for a swift tenolysis.
CONCLUSIONS:The FWT is a new option available to the hand surgeon associated with good functional results. The wire is readily available to the clinician and is also inexpensive.
The primary objective of this paper is to analyze the main characteristics of recent tourism policies in Rome by describing the local modalities through which the neoliberal approach to urban ...strategies has been implemented. The first section highlights some general features of the city of Rome and its tourism, which are particularly useful for understanding the specificities of neoliberal tourism policies. The paper then proceeds to describe the most clearly defined neoliberal period of the city from 1993 to 2008, when the new Master Plan was drawn up to establish new policies and projects for tourism. The period that followed 2008 was marked by the gradual withdrawal of public action, which on the other hand has left ample freedom to the forces of tourism and globalization.
After defining the concept of resilience and its application to the regional context, the paper presents a preliminary evaluation of regional economic resilience in the case of the Italian regions. ...In doing so, we follow the approach by Martin (J Econ Geogr 12:1–32,
2012)
and Martin and Sunley (
2015
) who identify three different dimensions to regional economic resilience: (a) resistance, i.e., the degree of sensitivity or depth of reaction of a regional economy to a recessionary shock; (b) recovery, i.e., the speed and magnitude of the recovery; (c) reorientation and renewal, i.e., the ability of a region to adapt in response to the shock and renew its growth path. The analysis is conducted at the local labor systems (LLS) geographical level and focuses, at this stage, only on the first two dimensions of resilience, i.e., resistance and recovery. The recessionary shock (2009–2010) is defined following the Italian National Statistical Institute approach for which a recession implies a decrease in GDP for three consecutive trimesters. The pre-recessionary period is 2007–2008 and the recovery period 2011 (as a new recession started again in Italy at the end of 2011). The results clearly point at very heterogeneous resilience for the Italian LLS.
This paper examines the role of biophysical and anthropogenic factors as potential drivers of land degradation in a large Mediterranean urban region. The sensitivity of land to degradation is ...examined in relation to the territorial disparities observed within Rome's metropolitan area (Italy), and to the changes in its spatial organisation resulting from urban shrinkage. We derive a composite index of land sensitivity to degradation using the Environmentally Sensitive Areas Index (ESAI) at the municipal level. The observed regional disparities in ESAI scores are analysed diachronically for the period 1990–2008, based on elevation, distance from the coast and population density. The results indicate that spatial disparities in ESAI recorded in 1990 had decreased by 2008, although the degree of land sensitivity had increased throughout the urban region. We subsequently relate these changes to different models of urban organisation (i.e. 'compact growth' vs 'sprawl') observed in Rome since the 1990s. In 1990, the highest degree of land sensitivity was on the urban fringe of Rome, whereas by 2008 the greatest increase in land sensitivity was observed within suburban municipalities. This sensitivity progressively spread further away from the main urban centre during the study period. The results suggest the need to reconsider the polycentric spatial framework as an environmentally sustainable model for Rome and other urban regions in the Mediterranean.
SARS coronavirus 2 (SARS-CoV-2) infects human angiotensin-converting enzyme 2 (hACE2)-expressing lung epithelial cells through its spike (S) protein. The S protein is highly glycosylated and could be ...a target for lectins. Surfactant protein A (SP-A) is a collagen-containing C-type lectin, expressed by mucosal epithelial cells and mediates its antiviral activities by binding to viral glycoproteins.
This study examined the mechanistic role of human SP-A in SARS-CoV-2 infectivity and lung injury
and
.
Human SP-A can bind both SARS-CoV-2 S protein and hACE2 in a dose-dependent manner (p<0.01). Pre-incubation of SARS-CoV-2 (Delta) with human SP-A inhibited virus binding and entry and reduced viral load in human lung epithelial cells, evidenced by the dose-dependent decrease in viral RNA, nucleocapsid protein (NP), and titer (p<0.01). We observed significant weight loss, increased viral burden, and mortality rate, and more severe lung injury in SARS-CoV-2 infected hACE2/SP-A KO mice (SP-A deficient mice with hACE2 transgene) compared to infected hACE2/mSP-A (K18) and hACE2/hSP-A1 (6A
) mice (with both hACE2 and human SP-A1 transgenes) 6 Days Post-infection (DPI). Furthermore, increased SP-A level was observed in the saliva of COVID-19 patients compared to healthy controls (p<0.05), but severe COVID-19 patients had relatively lower SP-A levels than moderate COVID-19 patients (p<0.05).
Collectively, human SP-A attenuates SARS-CoV-2-induced acute lung injury (ALI) by directly binding to the S protein and hACE2, and inhibiting its infectivity; and SP-A level in the saliva of COVID-19 patients might serve as a biomarker for COVID-19 severity.
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