•Chemotherapy treatment induces in cancer patients a huge number of side effects, such as Peripheral Neuropathy.•Physical exercise is feasible for cancer patients and can counteract the limitations ...due to chemotherapy.•A specific exercise protocol produces significant improvements in cancer patients with Peripheral Neuropathy.
Chemotherapy-induced peripheral neuropathy (CIPN) is the most common neurological and clinically relevant side effect of many commonly used chemotherapeutic agents. Moreover, little effort has been done to investigate the potentially beneficial effects of specific exercises to counteract the CIPN symptoms.
This document aims to summarize and analyze systematically the current body of evidence about the effects of specific exercise protocols on CIPN symptoms, balance control, physical function and quality of life in patients with CIPN.
Specific terms were identified for the literature research in MEDLINE, Scopus, Bandolier, PEDro, and Web of Science.
Five manuscripts were considered eligible for this review. Quality appraisal distinguished two studies as high quality investigations while three with low quality. Results were summarized in the following domains: “CIPN symptoms”, “Static balance control”, “Dynamic balance control”, “Quality of life and Physical function”.
Significant improvements were detected on postural control. Additionally, patients’ quality of life and independence were found ameliorated after exercise sessions. Combined exercise protocols including endurance, strength and sensorimotor training showed larger improvements.
This systematic review comes from a highly selected but small source of data. Nevertheless, specific exercise for cancer patients undergoing chemotherapy with CIPN symptoms should be recommended since these interventions appeared as feasible and have been demonstrated as useful tools to counteract some of the limitations due to chemotherapy.
Eosinophilic, solid and cystic (ESC) renal cell carcinoma (RCC) is characterized by a solid and cystic architecture with cells showing abundant eosinophilic cytoplasm with hobnail arrangement and a ...cytokeratin 7-negative/cytokeratin 20-positive immunophenotype. Recent studies have suggested that bi-allelic events affecting TSC genes might play an important role for such tumors. However, only indirect evidence of the clonal origin of TSC mutation has been gathered so far. Therefore, in this paper we aimed to perform multi-regional tumor sampling molecular analysis in four ESC RCC cases that had been completely embedded, three sporadic and one occurring in a patient with tuberous sclerosis complex (TSC). Histologically, the 4 cases showed cystic and solid architecture and cells with abundant eosinophilic cytoplasm with cytoplasmic stippling and round to oval nuclei. Immunohistochemistry showed at least focal expression of cytokeratin 20 in all tissue samples and negative cytokeratin 7, as well as diffuse positivity for S100A1 and at least focal expression of cathepsin K in three out of four cases. The sporadic cases showed the same somatic TSC1 mutations in all tissue samples analyzed, while the TSC-associated case showed the same TSC1 alteration in both normal tissue and all tumor samples analyzed, proving the germline nature of the alteration. In conclusion, our data demonstrate that clonal TSC loss is a key event in ESC RCC and support considering ESC RCC as an entity given its distinct morphologic, immunophenotypical and molecular characteristics.
Background
Recent papers consider surgery as an option for synchronous liver oligometastatic patients metastatic pancreatic ductal adenocarcinoma (mPDAC). In this study, we present our series of ...resected mPDACs after neoadjuvant chemotherapy (nCT).
Patients and methods
All patients resected after downstaging of mPDAC were included in this study. Downstaging criteria were disappearance of liver metastasis and a decrease in cancer antigen (CA) 19-9. The type and duration of nCT, last nCT surgery interval, histology, morbidity, and mortality were recorded, and overall survival (OS) and disease-free survival (DFS) were analyzed.
Results
Overall, 24 of 535 patients (4.5%) observed with mPDAC were included. These patients received gemcitabine alone (5/24), gemcitabine + nanoparticle albumin-bound (nab)−paclitaxel (3/24), and FOLFIRINOX (16/24). Primary tumor size decreased from 31 to 19 mm (
p
< 0.001), and serum CA19-9 decreased from 596 to 18 U/mL (
p
< 0.001). In 14/24 patients, the tumor was located in the head. Median interval nCT surgery was 2 months, there were no mortalities, and the postoperative course was uneventful in 34% of cases. Grade B/C pancreatic fistula, postoperative bleeding, and sepsis occurred in 17/4, 4, and 12% of cases, respectively, and reoperation rate was 4%. R0 resection was achieved in 88% of cases, with 17% complete pathological response. Positive nodes were found in 9/24 patients with a median node ratio of 0.37, and OS and DFS was 56 and 27 months, respectively.
Conclusions
Patients with mPDAC who were fully responsive to nCT may be cautiously considered for surgery, with potential benefit in survival compared with palliative chemotherapy alone. This is supported by results of our retrospective study, which is the largest ever reported.
Objectives
To evaluate MRI derived whole-tumour histogram analysis parameters in predicting pancreatic neuroendocrine neoplasm (panNEN) grade and aggressiveness.
Methods
Pre-operative MR of 42 ...consecutive patients with panNEN >1 cm were retrospectively analysed. T1-/T2-weighted images and ADC maps were analysed. Histogram-derived parameters were compared to histopathological features using the Mann-Whitney U test. Diagnostic accuracy was assessed by ROC-AUC analysis; sensitivity and specificity were assessed for each histogram parameter.
Results
ADC
entropy
was significantly higher in G2-3 tumours with ROC-AUC 0.757; sensitivity and specificity were 83.3 % (95 % CI: 61.2–94.5) and 61.1 % (95 % CI: 36.1–81.7). ADC
kurtosis
was higher in panNENs with vascular involvement, nodal and hepatic metastases (p= .008, .021 and .008; ROC-AUC= 0.820, 0.709 and 0.820); sensitivity and specificity were: 85.7/74.3 % (95 % CI: 42–99.2 /56.4–86.9), 36.8/96.5 % (95 % CI: 17.2–61.4 /76–99.8) and 100/62.8 % (95 % CI: 56.1–100/44.9–78.1). No significant differences between groups were found for other histogram-derived parameters (
p
>.05).
Conclusions
Whole-tumour histogram analysis of ADC maps may be helpful in predicting tumour grade, vascular involvement, nodal and liver metastases in panNENs. ADC
entropy
and ADC
kurtosis
are the most accurate parameters for identification of panNENs with malignant behaviour.
Key Points
•
Whole-tumour ADC histogram analysis can predict aggressiveness in pancreatic neuroendocrine neoplasms
.
•
ADC entropy and kurtosis are higher in aggressive tumours
.
•
ADC histogram analysis can quantify tumour diffusion heterogeneity
.
•
Non-invasive quantification of tumour heterogeneity can provide adjunctive information for prognostication
.
The surface energy balance algorithm for land (SEBAL) has been demonstrated to provide accurate estimates of crop evapotranspiration (ET) and yield at different spatial scales even under highly ...heterogeneous conditions. However, validation of the SEBAL using in-field direct and indirect measurements of plant water status is a necessary step before deploying the algorithm as an irrigation scheduling tool. To this end, a study was conducted in a maize field located near the Venice Lagoon area in Italy. The experimental area was irrigated using a 274 m long variable rate irrigation (VRI) system with 25-m sections. Three irrigation management zones (IMZs; high, medium and low irrigation requirement zones) were defined combining soil texture and normalized difference vegetation index (NDVI) data. Soil moisture sensors were installed in the different IMZs and used to schedule irrigation. In addition, SEBAL-based actual evapotranspiration (ETr) and biomass estimates were calculated throughout the season. VRI management allowed crop water demand to be matched, saving up to 42 mm (−16%) of water when compared to uniform irrigation rates. The high irrigation amounts applied during the growing season to avoid water stress resulted in no significant differences among the IMZs. SEBAL-based biomass estimates agreed with in-season measurements at 72, 105 and 112 days after planting (DAP; r2 = 0.87). Seasonal ET matched the spatial variability observed in the measured yield map at harvest. Moreover, the SEBAL-derived yield map largely agreed with the measured yield map with relative errors of 0.3% among the IMZs and of 1% (0.21 t ha−1) for the whole field. While the FAO method-based stress coefficient (Ks) never dropped below the optimum condition (Ks = 1) for all the IMZs and the uniform zone, SEBAL Ks was sensitive to changes in water status and remained below 1 during most of the growing season. Using SEBAL to capture the daily spatial variation in crop water needs and growth would enable the definition of transient, dynamic IMZs. This allows farmers to apply proper irrigation amounts increasing water use efficiency.
Insurance agents often provide crop hail damage estimates based on their personal experience and field samples, which are not always representative of the investigated field’s spatial variability. ...For these reasons, farmers and the insurance market ask for a reliable, objective, and less labor-intensive method to determine crop hail losses. Integrating remote sensing and crop modeling provides a unique opportunity for the crop insurance market for a reliable, objective, and less labor-intensive method to estimate hail damage. To this end, a study was conducted on eight distinct maize fields for a total of 90 hectares. Five fields were damaged by the hailstorm that occurred on 13 July 2019 and three were not damaged. Soil and plant samples were collected to characterize the experimental areas. The Surface Energy Balance Algorithm for Land (SEBAL) was deployed to determine the total aboveground biomass and obtainable yield at harvest, using Landsat 7 and 8 satellite images. Modeled hail damages (HDDSSAT1, coupling SEBAL estimates of obtainable yield and DSSAT-based potential yield; HDDSSAT2, coupling yield map at harvest and the Decision Support System for Agrotechnology Transfer (DSSAT)-based potential yield) were calculated and compared to the estimates of the insurance company (HDinsurance). SEBAL-based biomass and yield estimates agreed with in-season measurements (−4% and +0.5%, respectively). While some under and overestimations were observed, HDinsurance and HDDSSAT1 averaged similar values (−4.9% and +3.4%) compared to the reference approach (HDDSSAT2).
Parvalbumin is a cytosolic calcium-binding protein expressed in the distal convoluted tubule of the renal nephron. Among epithelial renal tumors, the reactivity for parvalbumin is observed in ...chromophobe renal cell carcinomas and frequently in oncocytomas. On the other hand, there are no data available on parvalbumin expression in the mesenchymal tumors of the kidney. Therefore, the purpose of this study was to evaluate the expression of parvalbumin in the spectrum of PEC (perivascular epithelioid cells) lesions of the kidney. Sixty-six PEC lesions (37 classic angiomyolipomas, 10 microscopic angiomyolipomas, 7 epithelioid angiomyolipomas/pure epithelioid PEComas, 5 leiomyoma-like angiomyolipomas, 3 lipoma-like angiomyolipomas, 2 intraglomerular lesions, 1 angiomyolipoma with epithelial cysts (AMLEC), and 1 sclerosing angiomyolipoma) were immunohistochemically stained with parvalbumin. Overall, parvalbumin immunostain was found in fifty-six PEC lesions (85%) and absent in the remaining ten cases (15%). Classic angiomyolipomas were positive in almost all cases (97%). Intraglomerular lesions and AMLEC showed parvalbumin immunolabeling as well. None of the 7 epithelioid angiomyolipomas/pure epithelioid PEComas or the only sclerosing angiomyolipoma expressed parvalbumin. In conclusion, we demonstrated the immunolabeling of parvalbumin in almost all PEC lesions of the kidney, but not in the epithelioid angiomyolipoma/pure epithelioid PEComa. This finding could shed light on some biological characteristics observed in the PEC lesions such as the plasticity of their cellular component. Moreover, parvalbumin may be another useful tool in the differential diagnosis among epithelioid angiomyolipoma/pure epithelioid PEComa with other renal eosinophilic tumors, such as oncocytoma and chromophobe renal cell carcinoma.
Purpose
Aerobic exercise capacity is reduced in patients with chronic kidney disease, partly due to alterations at the muscular and microvascular level. This study evaluated oxygen uptake (VO
2
) ...kinetics as indicator of muscular oxidative metabolism in a population of Kidney Transplant Recipients (KTRs).
Methods
Two groups of KTRs enrolled 3 (
n
= 21) and 12 months (
n
= 14) after transplantation and a control group of healthy young adults (
n
= 16) underwent cardiopulmonary exercise testing on cycle-ergometer. The protocol consisted in two subsequent constant, moderate-load exercise phases with a final incremental test until exhaustion.
Results
The time constant of VO
2
kinetics was slower in KTRs at 3 and 12 months after transplantation compared to controls (50.4 ± 13.1 s and 43.8 ± 11.6 s vs 28.9 ± 8.4 s, respectively;
P
< 0.01). Peak VO
2
was lower in KTRs evaluated 3 months after transplantation compared to patients evaluated after 1 year (21.3 ± 4.3 and 26.4 ± 8.0 mL/kg/min;
P
= 0.04). Blood haemoglobin (Hb) concentration was higher in KTRs evaluated at 12 months (12.8 ± 1.7 vs 14.6 ± 1.7 g/dL;
P
< 0.01). Among KTRs, τ showed a moderate negative correlation with Peak VO
2
(ρ = − 0.52) and Oxygen uptake efficiency slope (OUES) (
r
= − 0.57) while no significant correlation with Hb and peak heart rate.
Conclusions
KTRs show slower VO
2
kinetics compared to healthy controls. Hb and peak VO
2
seem to improve during the first year after transplantation. VO
2
kinetics were significantly associated with indices of cardiorespiratory fitness, but less with central determinants of aerobic capacity, thus suggesting a potential usefulness of adding this index of muscular oxidative metabolism to functional evaluation in KTRs.
Cathepsin K is a papain-like cysteine protease with high matrix-degrading activity. Among several cathepsins, cathepsin K is the most potent mammalian collagenase, mainly expressed by osteoclasts. ...This review summarizes most of the recent findings of cathepsin K expression, highlighting its role in renal tumors for diagnostic purposes and as a potential molecular target. Indeed, cathepsin K is a recognized diagnostic tool for the identification of TFE3/TFEB-rearranged renal cell carcinoma, TFEB-amplified renal cell carcinoma, and pure epithelioid PEComa/epithelioid angiomyolipoma. More recently, its expression has been observed in a subgroup of eosinophilic renal neoplasms molecularly characterized by TSC/mTOR gene mutations. Interestingly, both TSC mutations or TFE3 rearrangement have been reported in pure epithelioid PEComa/epithelioid angiomyolipoma. Therefore, cathepsin K seems to be a downstream marker of TFE3/TFEB rearrangement, TFEB amplification, and mTOR pathway activation. Given the established role of mTOR inhibitors as a pharmacological option in renal cancers, cathepsin K could be of use as a predictive marker of therapy response and as a potential target. In the future, uropathologists may implement the use of cathepsin K to establish a diagnosis among renal tumors with clear cells, papillary architecture, and oncocytic features.
Defining the most profitable remote sensing platforms is a difficult decision-making process, as it requires agronomic and economic considerations. In this paper, the price and profitability of three ...levels of remote sensing platforms were evaluated to define a decision-making process. Prices of satellite, plane and UAV-acquired vegetation indices were collected in Italy during 2020 and compared to the economic benefits resulting from variable rate nitrogen application, according to a bibliographic meta-analysis performed on grains. The quality comparison of these three technologies was performed considering the error propagation in the NDVI formula. The errors of the single bands were used to assess the optical properties of the sensors. Results showed that medium-resolution satellite data with good optical properties could be profitably used for variable rate nitrogen applications starting from 2.5 hectares, in case of medium resolution with good optical properties. High-resolution satellites with lower optical quality were profitable starting from 13.2 hectares, while very high-resolution satellites with good optical properties could be profitably used starting from 76.8 hectares. Plane-acquired images, which have good optical properties, were profitable starting from 66.4 hectares. Additionally, a reference model for satellite image price is proposed.
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