Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
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Prolactin secreting pituitary neuroendocrine tumors treated by dopamine agonists: predictors of response
Get PDFPurpose: To date, no specific criteria have been clearly established to predict the response to dopamine agonists (DA), and a universally accepted definition of DA resistance remains lacking. This study aimed to analyze the clinical, hormonal, and radiological characteristics of patients with prolactin (PRL)-secreting PitNETs, also known as pituitary adenomas, treated with DA, in order to identify potential predictive factors of hormonal and radiological response to medical therapy. Methods: This retrospective cohort study included 62 patients consecutively admitted to our institution over a 20-year period (2004 – 2024). Seven patients underwent transsphenoidal surgery as first-line treatment before starting DA therapy. Demographic, clinical, hormonal, and radiological data were collected at diagnosis and during follow-up (6, 12, and 24 months, and at the last visit). DA resistance was defined as the failure to normalize PRL levels and to achieve at least a 50% reduction in the tumor’s major diameter or volume. Results: The median age at diagnosis was 37 years (IQR 26.5 – 45.3), with a male-to-female ratio of 1:1.7. Microprolactinomas were observed in 48.4% of patients. All patients were treated with cabergoline (median dose 1.0 mg/week) and followed for a median of 84 months (IQR 35.3 – 114.0). Macroprolactinomas were more frequent in males, who also showed higher baseline PRL levels. Early PRL response to DA treatment was a significant predictor of long-term hormonal response, independent of sex, age, and DA dosage (OR = 11.29; 95% CI 1.10 – 60.74). Tumor response assessment revealed low agreement between classifications based on diameter versus volume reduction. Diameter-based evaluation was more effective in identifying clinical responders at 6 months and at final follow-up, while volumetric measurements provided greater accuracy at 12 and 24 months. Conclusion: Normalization of PRL levels is a practical and reliable predictor of treatment response. A combined radiological assessment using both tumor diameter and volume is advisable: diameter offers greater insight in the early stages, while volume becomes more informative in the mid- to long-term follow-up. In patients with persistently elevated PRL levels and lack of radiological response, alternative management strategies—including surgical resection—should be considered, especially in light of recent evidence supporting the cost-effectiveness of surgery in enclosed prolactinomas
Conformational and Intermolecular Interaction Analysis of Tiaprofenic Acid: A X-Ray Powder Diffraction and First Principle Modeling Analysis
No full textDeglutition preservation after swallowing (SWOARs)-sparing IMRT in head and neck cancers: definitive results of a multicenter prospective study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)
No full textBackground: To investigate changes of objective instrumental measures and correlate with patient reported outcomes (PROs) of radiation-induced dysphagia (RID) after swallowing organs at risk (SWOARs)-sparing IMRT. Methods: Patients (pts) underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Videofluoroscopy (VFS) and M.D. Anderson Dysphagia Inventory (MDADI) questionnaire at baseline, 6 and 12 months after treatment. They were categorized in two groups: MDADI-C ≥ 80 and MDADI-C < 80. Pharyngeal residue (PR) and penetration (P) or aspiration (A) were considered as surrogate of RID. Results: Between 2016 and 2022 we enrolled 75 pts, 40 (53 %) MDADI-C ≥ 80 and 35 (47 %) MDADI-C < 80 at baseline. Among MDADI-C ≥ 80 the mean baseline PR score at FEES was 0,42 rising to 1,36 at 6 months (p = 0,001) and stabilizing to 1,15 at 12 months (p = 0,21); indeed, the mean baseline PR score at VFS was 0,55 rising to 1 at 6 months (p = 0,069) and slightly dropping to 0,7 at 12 months (p = 0,069). Among MDADI-C < 80 the mean baseline PR score at FEES was 0,56 rising to 1,07 at 6 months (p = 0,012) and stabilizing to 1,07 at 12 months (p = 0,99); indeed the mean baseline PR score at VFS was 0,67 rising to 1,19 at 6 months (p = 0,04) and dropping to 0,78 at 12 months (p = 0,04). No correlation was found between PROs and objective measures. Conclusion: Our results show optimal acceptable deglutition preservation from major complications after SWOARs-sparing IMRT by means of low objective scores in both MDADI-C groups. Lack of correlation between PROs and objective measures suggest that referred RID is likely associated to persistence of SWOARs inflammation rather than to a real impairment of function
I nuovi (labili) confini della responsabilita` dei sindaci, e i revisori?
No full textIl provvedimento del Tribunale Bari 24 aprile 2025 in commento offre l’occasione per soffermarsi sulle nuove regole in materia di responsabilita` dei sindaci e di guardare – anche in prospettiva – alla analoga disciplina che concerne i revisori
A systematic review of the predictive factors for the recurrence of acute pancreatitis
No full textPurpose: Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased risk of death. Analyzing the risk factors that may contribute to the recurrence of Biliary and Alcoholic Pancreatitis (BAP and AAP), future research can be driven toward new solutions for preventing and treating this pancreatic disease. Methods: A systematic review was conducted selecting studies from BiomedCentral, PubMed, Scopus and Web of Science by two independent reviewers. Publications were considered only if written in English in the time interval between January 2000 and June 2024 and investigated the risk factors for the recurrence of BAP and AAP. At the end of the selection, a quality assessment phase was conducted using the PROBAST tool. Results: In this systematic review, 8 articles were selected out of 6.945, involving a total sample of 11.271 patients of which 38.77% developed recurrence episodes. 37.5% of the included studies focus on recurrent acute biliary pancreatitis (RBAP), while 62.5% are dedicated to recurrent acute alcoholic pancreatitis (RAAP). The risk factors for the recurrence of AP showed a clear differentiation between the alcoholic and biliary etiology. Most of the considered studies adopted a retrospective design, characterized by a susceptibility to potential methodological biases. However, the trend indicated a more recent increase in prospective studies, together with a greater focus on identifying and understanding the possible risk factors associated with the recurrence of acute pancreatitis (RAP). This result highlighted the progress in the scientific approach toward a more rigorous and systematic assessment of the causes and dynamics that influence the recurrence of the disease. Conclusion: Studies highlighted the importance of lifestyle factors, clinical complications, and surgical interventions that can impact the risk of biliary or alcoholic recurrent acute pancreatitis. Increased and systematic adoption of artificial intelligence-based tools could significantly impact future knowledge relating to the risks of recurrence and relative possibilities of prevention
Hermansky-Pudlak Syndrome: From Molecular Pathogenesis to Targeted Therapies
No full text: Hermansky-Pudlak syndrome (HPS) is a rare inherited disorder caused by defects in lysosome-related organelles (LROs) in various tissues, including platelets, melanocytes, and endothelial cells. Key features of HPS include oculocutaneous albinism, bleeding tendency, and, in some cases, pulmonary fibrosis, granulomatous colitis, and immunodeficiency. The condition is linked to mutations in 11 genes involved in the formation of LROs. Currently, treatment options for HPS are limited and often ineffective. Though cell and gene therapies have been explored for melanosomes and epithelial cells, there is limited knowledge about their application to platelets and endothelial cells. Understanding the detailed mechanisms of HPS pathogenesis is crucial, and using induced pluripotent stem cell (iPSC) models may provide valuable insights into the disease's molecular processes, aiding the development of new treatments. In this review, we will focus on the genetics and molecular mechanisms of HPS, on its clinical manifestations and current therapeutic approaches, highlighting the need for further research into the disease mechanisms and potential innovative therapies
Recenti novità normative in materia di “made in” e prodotti tipici
No full textL’articolo analizza le novità normative europee e italiane in tema di tutela del “made in” e delle indicazioni geografiche (IG). I regolamenti UE 2023/2411 e 2024/1143 unificano e ampliano la protezione delle IG per prodotti agroalimentari, artigianali e industriali, rafforzando coerenza e sostenibilità. Critica la legge italiana 206/2023, potenzialmente in conflitto con l’armonizzazione UE, e sottolinea l’importanza della cooperazione tra livelli normativi per garantire effi- cacia e certezza giuridica.
This article analyzes recent European and Italian legal developments on the protection of “Made in” and geographical indications (GIs). EU Regulations 2023/2411 and 2024/1143 unify and expand the protection of GIs for agri-food, artisanal, and industrial products, strengthening coherence and sustainability. It criticizes Italian Law 206/2023, which may conflict with EU harmonization, and highlights the importance of coordination between legal levels to ensure effectiveness and legal certainty
A Systematic Review of MicroRNAs in Nasal NK/T-Cell Lymphoma: Diagnostic, Prognostic, and Therapeutic Perspectives
Get PDFNasal NK/T-cell lymphoma (NKTCL) is a highly aggressive malignancy with significant predominance with Epstein-Barr virus infection. MicroRNAs (miRNAs) have been found to be key regulators in cancer biology that influence tumorigenesis, disease progression, and immune evasion. This systematic review examines the role of miRNAs in diagnostics, prognosis, and treatment of NKTCL. PubMed and SCOPUS databases were systematically searched using the keywords “miRNAs” and “nasal lymphoma.” Duplicate removal and selection based on the inclusion criteria produced 15 studies for final inclusion. Study design, specific miRNAs under study, and their relevance to NKTCL have been extracted for this narrative synthesis. PRISMA guidelines were followed, and results were narratively synthesized. In the selected studies, miRNAs showed their utility as potential diagnostic markers. Downregulated miRNAs, including miR-15a, miR-101, and miR-342-3p, differentiated NKTCL from normal tissue, while EBV-encoded miRNAs, including miR-BART20-5p and miR-BART8, were identified as potential circulating biomarkers. Prognostically, miRNAs such as miR-223 and miR-342-3p were associated with poor survival and aggressive disease features. Therapeutically, miRNA-based interventions targeting EBV miRNAs, such as miR-BART20-5p and miR-BART9, were emphasized for their ability to modulate immune pathways and oncogenic signaling. Despite these promising reports, heterogeneity in study designs and geographic settings limits their generalization. miRNAs are emerging as key players in the treatment of NKTCL, with application in diagnosis, prognosis, and therapy. Larger, heterogeneous cohorts and the progression of miRNA-based therapeutic research should further validate such studies. This review highlights the potential of miRNA in translation into better outcomes in NKTCL patients
BV formalism and partition functions
No full textThe BV formalism is a well-established method for analyzing symmetries and quantizing field theories. In this paper, we use BV formalism to derive partition functions and the space of gauge invariant operators implementing the equations of motions and their redundancies for selected theories. We discuss various interpretations of the results, some dualities, and relation to the first quantized models