28 research outputs found
Estimated glomerular filtration rate is an easy predictor of venous thromboembolism in cancer patients undergoing platinum-based chemotherapy
No full textBackground. Reduced estimated glomerular filtration rate (eGFR) has been associated with increased venous thromboembolism (VTE) risk in the general population. VTE incidence significantly increases in cancer patients, especially those undergoing chemotherapy. Despite the evidence that a substantial number of cancer patients have unrecognized renal impairment, as indicated by reduced eGFR in the presence of serum creatinine levels within the reference value, chemotherapy dosage is routinely adjusted for serum creatinine values. Among chemotherapies, platinum-based regimens are associated with the highest rates of VTE. A cohort study was designed to assess the value of pretreatment eGFR in the risk prediction of a first VTE episode in cancer outpatients without previous history of VTE who were scheduled for platinum-based chemotherapy. Methods. Serum creatinine and eGFR were evaluated before the start of standard platinum-based chemotherapy in a cohort of 322 consecutive patients with primary or relapsing/recurrent solid cancers, representative of a general practice population. Results. Patients who experienced a first VTE episode in the course of chemotherapy had lower mean eGFR values compared with patients who remained VTE free. Multivariate Cox analysis demonstrated that eGFR had an independent value for risk prediction of a first VTE episode during treatment, with a 3.15 hazard ratio. Indeed, 14% of patients with reduced eGFR had VTE over 1-year follow-up compared with 6% of patients with normal eGFR values. Conclusion. The results suggest that reductions in eGFR, even in the presence of normal serum creatinine, are associated with an increased VTE risk in cancer outpatients undergoing platinum-based chemotherapy regimens. Determining eGFR before chemotherapy could represent a simple predictor of VTE, at no additional cost to health care systems. © AlphaMed Press 2014
Ketogenic diet and other dietary intervention strategies in the treatment of cancer
No full textPre-clinical and clinical studies have investigated the role of a dysregulated metabolism in the sustainability of tumor initiation and progression. One of the most familiar metabolic alterations encountered in several types of cancers is the upregulation of glycolysis, which is also maintained in conditions of normal oxygen tension (aerobic glycolysis, Warburg effect) while oxidative phosphorylation is apparently reduced. As a result, cancer cells convert most incoming glucose to lactate. Although more rapid, adenosine triphosphate (ATP) production by glycolysis is less efficient in terms of ATP generated per unit of glucose consumed than oxidative phosphorylation. The consequence is that tumor cells require an abnormally higher rate of glucose compared to the normal counterpart. New evidence shows that other metabolic substrates such as glutamine may also have an important role in cancer metabolism. Ketogenic diet (KD) replaces all but non-starchy vegetable carbohydrates with low to moderate amounts of protein and high amounts of monounsaturated and polyunsaturated fats. The rationale of KD is valid both because it lowers carbohydrate uptake possibly leading to cancer cell starvation and apoptosis and, at the same time, increases the levels of ketone bodies available for energy production in normal cells but not in cancer cells which have an allegedly downregulated oxidative phosphorylation. For this reason, several authors speculate on the possibility to evaluate KD as a novel approach in the treatment of cancer. In this review we will assess the data supporting the use of such alimentary regimen and its impact on tumor development and progression
Un nuovo volgarizzamento del «Chronicon maius» di Isidoro di Siviglia (Firenze, BNC, Magl. XXXVIII 127).
No full textUn manoscritto del XIV secolo, oggi conservato alla Biblioteca Nazionale Centrale di Firenze, conserva un volgarizzamento inedito del Chronicon di Isidoro di Siviglia, di area toscana. Il manoscritto fa parte di un nutrito gruppo di codici vergati dal copista del ms. Panciatichiano 32, il più antico testimone del Novellino. Il saggio si propone di approfondire in particolare le dinamiche di interazione fra testo originale e traduzione e di collocare il volgarizzamento nell’ambito della tradizione volgare del Chronicon.A manuscript kept in the the Biblioteca Nazionale Centrale of Florence contains, among other texts, a vernacularization of Isidore of Seville’s Chronicon from Tuscany till now unpublished. This manuscript was copied by the scribe who assembles the oldest witness of the italian Novellino. Furthermore, the essay explores the interactions between text and translation; at the same time, it aims to place the vernacularization within Chronicon’s manuscript tradition.
Impact of chemotherapy on activated protein C-dependent thrombin generation--association with VTE occurrence
No full textChemotherapy has been associated with an increased risk of venous thromboembolism (VTE). However, the prevalence of coagulation abnormalities or VTE occurrence as a consequence of different anti-cancer agents or treatment schemes is largely uncharacterized. Thus, this study was aimed at analyzing the impact of different anticancer drugs on the prothrombotic status of cancer out-patients scheduled for chemotherapy. To this purpose, a mono-institutional study was prospectively conducted to monitor serial changes of activated protein C (APC) function in 505 consecutive cancer out-patients with primary or relapsing solid cancer at the start of a new chemotherapy regimen. The results obtained showed that age >65 years (p = 0.01), ECOG performance status (p = 0.01), platinum-based (p = 0.035) and fluoropyrimidine-based regimens (p = 0.008) were independent predictors of an acquired APC resistance during the first chemotherapy cycle. Multivariate model of Cox proportional hazards survival analysis demonstrated that a decline in APC functionality (HR = 2.4; p = 0.013) and platinum-based regimens (HR = 2.2; p = 0.042) were both capable of predicting the occurrence of a first VTE episode during chemotherapy. Indeed, 14% of patients with platinum-associated APC impairment had VTE over a 1-year follow-up, compared to 3% of patients treated with other regimens and in whom APC functionality remained stable (HR = 1.5; p = 0.003). We may, thus, conclude that use of platinum-based regimens is responsible for induction of an acquired thrombophilic condition and represents a predictor for VTE even after adjustment for other risk factors
Increased risk of chemotherapy-associated venous thromboembolism in elderly patients with cancer
No full textData on the relationship between aging, chemotherapy, and risk for venous thromboembolism (VTE) are controversial. We sought to evaluate the risk of chemotherapy-associated VTE in young to middle-aged (YMA) and elderly cancer patients and to analyze the VTE-free survival time in both groups. Patients with histologically confirmed diagnosis of solid malignancy receiving any type of systemic chemotherapy, no clinical diagnosis of VTE before chemotherapy initiation, and Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤2 were enrolled in this study. Of the 486 consecutive patients included in the study, 380 (78%) were classified as YMA (≤70 years of age) and 106 (22%) as elderly (>70 years of age). At a median follow-up of 1 year, the incidence of VTE events was almost two-fold greater in elderly than in YMA (11% vs. 6%). Age (≤70 years vs. >70 years (hazard ratio [HR], 2.42; 95% confidence interval [CI] 1.15-5.06; p=0.020), ECOG-PS (HR, 6.54; 95% CI 3.10-13.8; p<0.0001), and platinum-based chemotherapy (HR, 2.46; 95% CI 1.06-5.69; p=0.035) were independent risk factors for VTE. In the elderly subset, a trend toward an increased risk of VTE in patients receiving a platinum-based chemotherapy when compared with a non-platinum-containing regimen was observed (15% vs. 9.1%). The Kaplan-Meier analysis showed that elderly patients had a significantly shorter VTE-free survival time compared with younger cancer patients (log-rank test=2.0; p=0.045). Our study reports an increase incidence of VTE in elderly cancer patients treated with chemotherapy compared with the younger group, suggesting that aging is one of the most important risk factors for VTE. On the basis of the results of this study, we believe that a validated predictive model including age, ECOG-PS, and type of chemotherapy (platinum- vs. non-platinum containing regimen) would enable clinicians to target thromboprophylaxis to those patients considered to be at greatest risk
Nuova luce sulla figura di Lucrezia Borgia dalla corrispondenza decifrata
No full textSommario: Il ritorno alle fonti documentarie, come metodo generale per rivedere giudizi storici faziosi e rimuovere conseguenti incrostazioni astoriche improprie, si applica in modo esemplare alla vicenda dei Borgia e di Lucrezia in particolare. Lo svelamento della corrispondenza cifrata, nella fattispecie due lettere intercorse tra la duchessa di Ferrara, Modena e Reggio, e il marito Alfonso I d’Este, contribuisce in modo significativo a far luce sulla natura autentica della donna più calunniata della storia moderna. Il modo in cui venne vissuto dai due coniugi un drammatico momento bellico del 1510 è rimasto per mezzo millennio misteriosamente nascosto “sotto ‘l velame de li versi strani”, vale a dire i segni di un alfabeto alternativo utilizzato per proteggere informazioni riservate nella corrispondenza diplomatica e tra principi rinascimentali. Un ruolo decisivo per rivalutare la figura di Lucrezia Borgia riveste il contenuto di due missive scambiate col marito duca, ed è emerso esattamente due anni fa, quando è stato da noi individuato e ricostruito il protocollo segreto tramite il quale i due testi erano stati vergati. Emerge la figura di una donna di trent’anni equilibrata e fedele, che gestisce la famiglia e il ducato mentre il marito è impegnato sul fronte bellico: tutto questo traspare da due lettere riservate e quindi verosimilmente sincere. Averne scoperto e divulgato il contenuto può servire a ristabilire la verità storica e ad ottemperare a un dovere di giustizia nei loro confronti. Abstract: The return to the documentary sources, as a general method to review biased historical judgments and to remove resulting improper anti-historical encrustations, perfectly fits Borgia’s events, Lucrezia’s especially. Revealing the ciphered correspondence, namely two mail exchanged between the duchess of Ferrara, Modena and Reggio, and the husband Alfonso I d’Este, is of paramount importance to show the real character of the most defamed woman in the modern history. The way they lived a dramatic moment in 1510 has been concealed for half a millennium under symbols of an unconventional alphabet used to protect classified information in the communications between diplomats and princes of the Renaissance. The content of two letters exchanged with her husband and duke plays a crucial role in reconsidering Lucrezia Borgia’s position, and it came out exactly two years ago, when we identified and reconstructed the secret protocol used to encrypt the two texts. It emerges the figure of a sensible and faithful thirty-year-old woman, who manages the family and the duchy while her husband is engaged on the war front: all this appears from two confidential and, as such, likely sincere letters. The discovery and disclosure of their contents can be useful to re-establish the historical truth and to comply with a duty of justice towards the two consorts.
Image et rituel : à propos des peintures bouddhiques népalaises
No full textThe article describes Nepalese Buddhist paintings which depict the celebration of the ritual of initiation performed for men and women when they reach the age of seventy-seven years, seven months and seven days (Sanskrit bhimaratha or Newari bura jyanko). On this occasion both paintings and bronzes are commissioned and all surviving examples of such paintings are Buddhist. This ritual was depicted in Nepalese paintings from the 15th up to the 19th century. The author gives a detailed description of a painting dated 1433, which was restored in 1666, illustrating the celebration of this ritual in Kathmandu, by a family of Buddhist traders. From an iconographic point of view, the author shows the link between the goddess Usnisavijaya and the stupa of Svayambhu, the monument most popular among the Newar Buddhists and the main object of cult. Besides their exceptional aesthetic qualities, the Nepalese paintings of the Malla period described in this article are cultural and historical documents.L'article décrit les peintures népalaises bouddhiques qui illustrent la célébration du rituel d'initiation accompli pour les hommes et les femmes néwar qui ont atteint l'âge de soixante-dix-sept ans, sept mois et sept jours (sanskrit bhimaratha ou néwari bura jyanko). Ce rituel a été représenté dans les peintures népalaises à partir du XVe siècle jusqu'à la fin du XIXe siècle. L'auteur donne une description détaillée de la plus ancienne peinture datée 1433, refaite en 1666, illustrant la célébration de ce rituel à Kathmandu par une famille de marchands. Du point de vue iconographique, on met en évidence le lien entre la déesse Usnasavijaya et le stupa de Svayambhu, le monument le plus populaire parmi les bouddhistes néwar et le principal objet de culte. En dehors de leurs qualités esthétiques exceptionnelles, les peintures népalaises de l'époque Malla présentées dans cet article sont des documents à la fois historiques et culturels.Vergati Anne. Image et rituel : à propos des peintures bouddhiques népalaises. In: Arts asiatiques, tome 54, 1999. pp. 33-43
The Consequence of Immune Suppressive Cells in the Use of Therapeutic Cancer Vaccines and Their Importance in Immune Monitoring
No full textEvaluating the number, phenotypic characteristics, and function of immunosuppressive cells in the tumor microenvironment and peripheral blood could elucidate the antitumor immune response and provide information to evaluate the efficacy of cancer vaccines. Further studies are needed to evaluate the correlation between changes in immunosuppressive cells and clinical outcomes of patients in cancer vaccine clinical trials. This paper focuses on the role of T-regulatory cells, myeloid-derived suppressor cells, and tumor-associated macrophages in cancer and cancer immunotherapy and their role in immune monitoring.</jats:p
Una nuova scheda per Giusto de' Conti tesoriere della Marca
No full textIl profilo biografico dell’autore della Bella mano solo di recente si è arricchito di dati e informazioni, soprattutto relative alla sua attività politico-diplomatica al servizio di papa Eugenio IV. In questo saggio si riesamina l’insieme dei documenti da lui vergati in qualità di tesoriere pontificio, alla luce del ritrovamento di un un’ordinanza con firma autografa finora sconosciuta.The biography of Giusto de’ Conti, the "Bella Mano" author, has only recently been enriched by data and information, especially relating to his political-diplomatic activity at the service of Pope Eugene IV. In this essay we publish a new "ordinanza" with an unknown handwritten signature and we review all the documents he has written as papal treasurer
Strategies for Cancer Vaccine Development
No full textTreating cancer with vaccines has been a challenging field of investigation since the 1950s. Over the years, the lack of effective active immunotherapies has led to the development of numerous novel strategies. However, the use of therapeutic cancer vaccines may be on the verge of becoming an effective modality. Recent phase II/III clinical trials have achieved hopeful results in terms of overall survival. Yet despite these encouraging successes, in general, very little is known about the basic immunological mechanisms involved in vaccine immunotherapy. Gaining a better understanding of the mechanisms that govern the specific immune responses (i.e., cytotoxic T lymphocytes, CD4 T helper cells, T regulatory cells, cells of innate immunity, tumor escape mechanisms) elicited by each of the various vaccine platforms should be a concern of cancer vaccine clinical trials, along with clinical benefits. This review focuses on current strategies employed by recent clinical trials of therapeutic cancer vaccines and analyzes them both clinically and immunologically.</jats:p
