Selective splenic artery embolization (SSAE) is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other ...embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP) and warm auto-immune hemolytic anemia (AIHA) both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy.
Summary
Since 2000, we have investigated 67 consecutive patients with stage I/II follicular lymphoma (FL) for the presence of BCL2/IGH rearrangements by polymerase chain reaction (PCR), real time ...quantitative PCR (RQ‐PCR) and digital droplet PCR (ddPCR). All patients were treated with involved‐field radiotherapy (IF‐RT) (24–30 Gy). From 2005, patients with minimal residual disease (MRD) after IF‐RT received rituximab (R) (375 mg/m2, 4 weekly administrations). The median follow‐up is 82 months (17–196). At diagnosis, 72% of patients were BCL2/IGH+. Progression‐free survival (PFS) was significantly better in patients with undetectable/low levels (<10−5) of circulating BCL2/IGH+ cells at diagnosis and in those who were persistently MRD− during follow‐up (P = 0·0038). IF‐RT induced an MRD− status in 50% of cases; 16/19 (84%) MRD+ patients after IF‐RT became MRD− after R treatment. A significantly longer PFS was observed in MRD+ patients treated with R compared to untreated MRD+ patients (P = 0·049). In early stage FL, both circulating levels of BCL2/IGH+ cells at diagnosis and MRD status during follow‐up bear prognostic implications. Standard IF‐RT fails to induce an MRD‐negative status in half of patients. Most patients become MRD− following treatment with R and this is associated with a significantly better PFS.
Summary
We investigated the current role of interferon‐alpha (IFNα) in hairy cell leukaemia (HCL) in a retrospective analysis of patients with HCL. A cohort of 74 patients with HCL was divided in to ...three groups: (A) patients aged >65 years with first‐line treatment; (B) patients with comorbidities with first‐line treatment; (C) patients who were purine analogues resistant. In total, 94% achieved a response, with a complete response rate of 24%. After a median (range) follow‐up of 60 (7–236) months, 55 patients (78%) are still responding. The 5‐year progression‐free survival was 95%, 68%, and 96% in groups A, B and C respectively. A proportion of patients were monitored through their B‐Raf proto‐oncogene, serine/threonine kinase (BRAF)‐V600E status. IFNα remains a possible option in select patients with HCL, where minimal residual disease negativity is achievable.
Abstract
Background
Involvement in research activities is complex in pediatric nursing and allied health professionals (AHPs). It is important to understand which individual factors are associated ...with it to inform policy makers in promoting research.
Methods
A cross-sectional observational study was conducted to describe the level of participation in research activities over the last ten years of nurses and AHPs working in a tertiary pediatric hospital. A large sample of nurses and AHPs working in an Italian academic tertiary pediatric hospital completed an online self-report questionnaire between June and December 2018. Three multivariate logistic regression analyses were performed to predict participation in research projects, speaking at conferences, and writing scientific articles.
Results
Overall, data from 921 health professionals were analyzed (response rate = 66%), of which about 21% (
n
= 196) reported participating in a research project, while 33% (
n
= 297) had attended a scientific conference as a speaker, and 11% (
n
= 94) had written at least one scientific paper. Having a Master or a Regional Advanced Course, working as an AHP or a ward manager, as well as regularly reading scientific journals and participation in an internal hospital research group or attendance in a specific course about research in the hospital, significantly predicted participation in research projects, speaking at conferences and writing scientific papers. It is important to foster research interest and competencies among health professionals to improve participation in research projects, speaking at conferences, and writing scientific papers.
Conclusions
Overall, we found a good level of attendance at conferences as speakers (33%), a moderate level of participation in research (21%), and low levels for writing scientific papers (11%). Our study highlighted the need to support participation in research activities among nurses and AHPs. Policymakers should identify strategies to promote research among nurses and AHPs, such as protected rewarded time for research, specific education, strengthened collaboration with academics, and financial support. Moreover, hospital managers should promote the development of research culture among health professionals, to improve their research competencies and evidence-based practice.
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