In the last few years, non-small cell lung cancer (NSCLC) treatment has totally revolutionized by the improvement in molecular diagnostics and the introduction of targeted therapies, becoming the ...standard of care in patients with actionable alterations. Mostly, genomic mutations are mutually exclusive although some cases of co-occurring actionable alterations could be discovered, especially with the recent introduction of genomic sequencing by next generation sequencing (NGS). Few data are available in the treatment of these particular cases. The co-occurring RAS G12C mutation seems to be a poor prognostic factor in patients with ALK rearranged NSCLC. We report two cases of women with diagnosis of advanced adenocarcinoma oncogene addicted with ALK rearrangement and KRAS G12C mutation. In both cases the PD-L1 status was high (> 50 %). Although both received Alectinib as ALK inhibitor, the lesion rapidly progressed. The patients had benefit only by treatments with chemotherapy, while anti PD-1/PD-L1 axis inhibitors seemed to be inefficient. Precise diagnostic techniques allow the detection of concomitant driver alterations; therefore, oncologists should consider these rare double mutations in NSCLC patients. Further prospective study is still warranted to investigate the role of co-occurring driver alterations and the relevant treatment paradigm
Cadmium telluride (CdTe) thin films have been deposited on glass/conducting glass (FTO) substrates using low-cost two electrode system and aqueous electrodeposition method. The glass/FTO substrates ...were used to grow the CdTe layers at different deposition voltages. The structural, electrical, optical and morphological properties of the resulting films have been characterized using X-ray diffraction (XRD), Photoelectrochemical (PEC) cell measurements, optical absorption spectroscopy and Scanning Electron Microscopy (SEM). The XRD results indicate that at voltages less than or higher than 1.576 V, crystallinity is poor due to presence of two phases. When CdTe is grown at 1.576 V, the composition is stoichiometric, and the (111) peak has the highest intensity in the XRD diffractogram indicating a high degree of crystallinity. SEM studies showed that all layers had pin-holes and gaps between the grains. These openings seem to be more common in the samples grown at voltages away from the stoichiometric voltage (1.576 V). The linear I–V curves of glass/FTO/CdS/CdTe/Au structures fabricated using stoichiometric CdTe showed efficiency of 10.1 % under AM 1.5 illumination.
Electrodeposition of
n
-type and
p
-type thin-film layers of ZnS was carried out using a simple two-electrode system and aqueous solutions of ZnCl
2
and (NH
4
)
2
S
2
O
3
with different Zn
2+
...concentrations. X-ray diffraction measurements show that the ZnS layers deposited from both solutions are amorphous. Optical absorption measurements show low absorbance of the layers with energy bandgap in the range of 3.68 eV to 3.78 eV after postdeposition annealing. Photoelectrochemical cell measurements show that both
n
-type and
p
-type ZnS thin layers can be electrodeposited by simply changing the concentrations of the deposition solutions. With higher Zn
2+
concentration in the bath,
n
-type ZnS films were deposited, while
p
-type ZnS films were deposited with lower Zn
2+
concentration. The estimated resistivity of layers from both solutions using
I
–
V
measurements were 3.0 × 10
4
Ω cm and 2.0 × 10
4
Ω cm, respectively, for
n
-ZnS and
p
-ZnS. Scanning electron microscopy shows that the deposited films consist of particles with good surface coverage of the glass/fluorine-doped tin oxide substrate.
Lung transplantation (LT) is a viable option for a select group of patients with end-stage lung disease. However, infections are a major complication after LT, accounting for significant morbidity ...and mortality. Several germs may be responsible; multidrug-resistant Gram-negative (MDR-GN) bacteria are emerging. Colistin is widely used in the treatment of these infections and is administered by inhalation and/or parenterally. At our institution, in patients with tracheostomy, colistin is administered by direct instillation in the airway during bronchoscopy. We reviewed a series of patients who underwent LT complicated by postoperative MDR-GN bacterial pulmonary infection.
From January 2015 to May 2017, 26 lung transplants were performed. In the postoperative course, 14 (54%) developed MDR-GN bacterial infection; respiratory specimen culture, blood tests, and chest X-ray were considered. Colistin was the only antibiotic usable. Thirteen patients received intravenous (IV) colistin; in the subgroup of patients with tracheostomy, colistin was instilled directly in the airway, and 6 patients received inhaled colistin.
Seven patients needed tracheostomy. Pseudomonas aeruginosa was the predominant infection (86%), with Acinetobacter baumanii seen in 2 cases (14%). An early clinical-laboratory response was observed in 9 patients (64%). White blood cell count and C-reactive protein values improved (P = .02 and P = .001, respectively). A significant reduction in bacterial load was observed on microbiologic bronchoalveolar lavage specimens.
Colistin instilled directly in the airway did not show side effects. The combination of IV and inhaled/instilled colistin could be a useful treatment option for MDR-GN infections after LT.
•Lung transplantation patients require careful management.•MDR-GN bacteria infections are emerging not only among hospitalized patients, but also among solid-organ transplantation patients.•Colistin is useful to treat these infections.•Instillation of colistin in the airways of transplanted patients improves transplanted lung outcomes, but much more frequently among solid-organ transplant patients.
Abstract Background Lung transplantation (LT) is only therapeutic option for patients affected by chronic respiratory failure. Chronic rejection, also known as bronchiolitis obliterans syndrome ...(BOS), is still the main cause of death and the most important factor that influences post-transplantation quality of life. Currently available therapies have not been proven to result in significant benefit in the prevention or treatment of BOS. Extracorporeal photopheresis (ECP) seems to reduce the rate of lung function decline in transplant recipients with progressive BOS. Methods From 1991 until now, 239 LTs were performed at our center. Fifty-four patients (22.5%) developed BOS; 15 of these (27.7%) were treated with ECP. At the beginning of the treatment, all patients showed a mean decline of forced expiratory volume in 1 second (FEV1 ) from baseline values of 45.8% ± 17.2%; 2 patients were in long-term oxygen therapy. Results Mean follow-up from November 2013 to June 2016 was 11.6 ± 7 months. Twelve patients (80%) showed lung function stabilization with an FEV1 range after treatment between −6% to +8% from the pre-treatment values. We did not report any adverse effects or increase of infections incidence. Discussion ECP seems to be an effective and well-tolerated therapeutic option for LT patients with BOS in terms of stabilization of lung function and increased survival.
Photocatalytic TiO2 coatings on limestone Licciulli, A.; Calia, A.; Lettieri, M. ...
Journal of sol-gel science and technology,
12/2011, Letnik:
60, Številka:
3
Journal Article
Recenzirano
The application of photocatalytic coatings on stone has been investigated for providing surface protection and self-cleaning properties. Sol–Gel and hydrothermal processes were used to synthesise TiO
...2
colloidal suspensions and coatings with enhanced photocatalytic activity without any thermal curing of the coated stone. The stone was a porous limestone (apulian sedimentary carbonatic, calcite stone). Films and powders prepared from TiO
2
sols were studied using X-ray diffraction to evaluate the microstructure and identify rutile and anatase phases. A morphological and physical characterisation was carried out on coated and uncoated stone to establish the changes of appearance, colour, water absorption by capillarity and water vapour permeability. The photocatalytic activity of the coated surface was evaluated under UV irradiation through NO
x
and organics degradation tests. The performances of the synthesised TiO
2
sols were compared with commercial TiO
2
suspension. Since the coating doesn’t need temperature treatments for activating the photocatalytic properties, the nano-crystalline hydrothermal TiO
2
sols seem good candidate for coating applications on stone that cannot be annealed after the coating application.
Rare-earth oxide materials emit thermal radiation in a narrow spectral region, and can be used for a variety of different high-temperature applications, such as the generation of electricity by ...thermophotovoltaic conversion of thermal radiation. However, because a detailed understanding of the mechanism of selective emission from rare-earth atoms has so far been missing, attempts to engineer selective emitters have relied mainly on empirical approaches. In this work, we present a new quantum thermodynamic model to describe the mechanisms of thermal pumping and radiative de-excitation in rare-earth oxide materials. By evaluating the effects of the local crystal-field symmetry around a rare-earth ion, this model clearly explains how and why only some of the room-temperature absorption peaks give rise to highly efficient emission bands at high temperature (1,000-1,500 degrees C). High-temperature emissivity measurements along with photoluminescence and cathodoluminescence results confirm the predictions of the theory.
Abstract Lung transplantation is a well-established treatment for selected patients with advanced chronic respiratory insufficiency. Recognizing those patients with end-stage lung disease who might ...benefit from lung transplantation is a crucial task. Considering the presence of inadequate evidence-based practice, international and national scientific societies provided consensus opinions regarding the appropriate timing of listing. The Study Group for Thoracic Organs Transplantation (branch of the Italian Society for Organs Transplantation) promoted and realized a Delphi conference among the Italian lung transplantation centers to provide guidance to clinical practice based on international recommendations. The experts from the nine Italian centers completed two rounds of standardized questionnaires (answer rate, 100%): 42 statements received a consensus ≥80%. The selected statements presented in this article are intended to assist Italian clinicians in selecting patients for lung transplantation.
Abstract Background Acute kidney injury and chronic kidney failure are serious complications after lung transplantation. Glomerular filtration rate (GFR) is the primary indicator of renal function. ...Several equations have been proposed to evaluate the estimated GFR (eGFR). We compared three different equations to determine which has the better correlation with the development of acute and chronic renal failure in lung recipients. Methods Twenty-two patients with a mean age of 54.4 ± 8.5 years underwent lung transplantation from 2010 to 2015. Thirteen (59%) had pulmonary fibrosis, 7 (32%) emphysema, 1 (4.5%) bronchiectasis, and 1 (4.5%) lymphangioleiomyomatosis. In all patients, eGFR was measured preoperatively using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Levey's Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. In 20 patients (90%) eGFR was calculated at 1, 3, and 6 months. Results According to CKD-EPI and MDRD, eight patients (36.3%) had preoperative reduction in eGFR, whereas 6 patients (27.2%) had preoperative reduction according to the CG ( P = .04). The mean values were higher for the CG (103.2 vs. 102 vs. 94.4). Five patients (22.7%) developed perioperative acute renal failure requesting a dialysis treatment; four of these showed a preoperative eGFR to the highest CG ( P = .05). At 1 and 6 months after lung transplantation, the CG, MDRD and CKD-EPI eGFR values were, respectively, 86.6, 84.1 and 76.6 mL/min/1.73m2 and 75.8, 72.7, and 72.3 mL/min/1.73m2 . CKD-EPI eGFR values are more predictable than the other equations of AKI. Conclusions Preoperative assessment of eGFR using the MDRD and CKD-EPI seems to correlate better than the CG to the prediction of acute renal failure, whereas for the chronic form the three equations seem equivalent.
Abstract Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial pneumonia of unknown etiology, which is associated with the histopathologic pattern of usual interstitial ...pneumonia (UIP) and leads to a progressive decrease of respiratory function. The present article describes a case of a 62-year-old ex-smoker referred to our hospital because of IPF. After 2 years of follow-up, the subject experienced a significant worsening of pulmonary function and was enrolled in a lung transplantation program. Afterward, a pharmacological treatment with pirfenidone was started, achieving a stabilization of respiratory function. The patient underwent a single lung transplantation by means of a normothermic ex vivo lung perfusion (EVLP) approach according to the Toronto model. At 20-month evaluation the subject's respiratory function was significantly improved, and quality of life was considerably ameliorated. We believe that an integrated multidisciplinary approach should be considered a key option for the treatment of individuals with IPF.
PDF
