1,720,960 research outputs found
Il trattamento del carcinoma renale avanzato: un aggiornamento [The Treatment of Metastatic Renal Cell Carcinoma: An Update]
No full textIl panorama terapeutico del carcinoma a cellule renali si è modificato drasticamente nel corso degli ultimi anni. In questa revisione della Letteratura offriamo una sintesi delle più recenti evidenze scientifiche nel settore. L’introduzione di uno standard terapeutico nel setting adiuvante, basato sull’immunoterapia con immune checkpoint inhibitors, è stata una delle maggiori novità degli ultimi anni. L’efficacia di tale trattamento, in termini di riduzione del rischio di recidiva, è però variabile in base a molteplici fattori, che devono essere considerati con attenzione dal clinico al momento della scelta terapeutica. Un’altra grande novità riguarda il trattamento di prima linea della malattia metastatica, il cui standard è al momento costituito da combinazioni di due ICI o di un ICI con un VEGFR-TKI). La scelta della migliore opzione tra quelle disponibili nella pratica clinica richiede un’attenta valutazione, al fine di impostare la strategia terapeutica più adatta ad ogni paziente. L’analisi critica dei più recenti studi clinici è uno strumento fondamentale nel delineare una corretta condotta clinica nei due setting sopra menzionati. Infine, questa revisione si focalizza sul ruolo del Nefrologo nella gestione del paziente con RCC, in tutti i setting di malattia considerati.The therapeutic landscape for renal cell carcinoma (RCC) has undergone significant changes in recent years. In this Literature review, we offer a synopsis of the latest scientific evidence in this field. The introduction of a standard of care in the adjuvant setting, based on immune checkpoint inhibitors (ICI), was a breakthrough. The efficacy of this treatment, calculated as the relapse risk reduction, can vary depending on multiple factors, whose knowledge is important for the clinician in the therapeutic choice. Another innovation concerns the first-line therapy for metastatic RCC. In this setting, the new standard is represented by an immune combination, a therapy based either on a doublet of ICIs or on a combination between an ICI and one VEGFR-TKI. Making the best choice between the available options requires careful evaluation, in order to tailor the most appropriate treatment for each patient. The critical analysis of the most recent clinical trials is a fundamental tool to tailor the correct clinical management of localized and advanced RCC. Finally, this review focuses on the role of the nephrologist in the management of RCC patients, across different disease settings
How to deal with renal toxicities from immune-based combination treatments in metastatic renal cell carcinoma. A nephrological consultation for Oncologists
No full textWe are witnessing a revolution in the treatment of metastatic renal cell carcinoma (mRCC). Indeed, several immune -based combinations (ICI [immune checkpoint inhibitor] + ICI, or ICI + antiangiogenic agents) have been approved as first -line therapy for mRCC after demonstrating superior efficacy over the previous standard. Despite all the improvements made, safety remains a critical issue, adverse events (AEs) being the main reason for drug discontinuations or dose reductions, ultimately resulting in an increased risk of losing efficacy. Thus, a good understanding of the AEs associated with the use of immune -based combinations, their prevention, and management, are key in order to maximize therapeutic effectiveness. Among these AEs, renal ones are relatively frequent, but always difficult to be diagnosed, not to take into account that it is often difficult to determine which drug is to blame for such toxicities. Chronic kidney disease (CKD) is a common finding in patients with RCC, either as a pre-existing condition and/or as a consequence of cancer and its treatment; furthermore, CKD, especially in advanced stages and in patients undergoing dialysis, may influence the pharmacokinetics and pharmacodynamics properties of anticancer agents. Finally, managing cancer therapy in kidney transplanted patients is another challenge. In this review, we discuss the therapy management of immune -based combinations in patients with CKD, on dialysis, or transplanted, as well as their renal toxicities, with a focus on their prevention, detection and practical management, taking into account the crucial role of the consulting nephrologist within the multidisciplinary care of these patients
Gestione della chemioterapia in pazienti in trattamento dialitico cronico
No full textL’incidenza dei tumori è aumentata nei pazienti con insufficienza renale cronica e, ancor più, nei pazienti
in dialisi.
La dialisi può influenzare la terapia, così come la prognosi, dei pazienti oncologici, aumentando sia la
mortalità relata al cancro che quella non relata, e rappresenta la causa principale di un uso non ottimale
delle terapie oncologiche.
Nei pazienti con insufficienza renale, il dosaggio di molti chemioterapici dovrebbe essere ridotto ma, a
causa della mancanza di una reale conoscenza delle proprietà farmacocinetiche e farmacodinamiche di
questi farmaci in dialisi, ciò viene spesso fatto empiricamente. Nonostante siano disponibili in letteratura
numerosi lavori riguardanti l’uso della chemioterapia in dialisi, vi è poca uniformità per quanto riguarda
le dosi e i tempi di somministrazione dei farmaci e non esistono linee guida a riguardo per la mancanza di
“evidenze” poiché questi pazienti vengono solitamente esclusi dai trial clinici dei farmaci. È quindi
fondamentale creare degli studi specifici in ambito onconefrologico per decidere come, quando e a che
dose utilizzare la chemioterapia nei pazienti in dialisi e quindi garantire un trattamento ottimale anche a
questi pazienti.The incidence of tumors is increased in patients with chronic renal failure and even more in patients on dialysis. Dialysis can affect both therapy and prognosis of oncological patients. It increases both cancer-related and non-cancer-related mortality rates and is the main cause of a suboptimal use of therapies. In patients with renal impairment, the dosage of many chemotherapies should be reduced but, due to the lack of real knowledge of the pharmacokinetic and pharmacodynamic properties of these drugs in dialysis, dosage adjustments are often done empirically and most often avoided. Although many papers are available in the literature regarding chemotherapy in dialysis, there is a lack of consensus regarding drug dosages and administration schedules. Furthermore, guidelines are absent due to the lack of "evidence" for most of these patients, usually excluded from experimental treatments. Specific onconephrologic trials are therefore mandatory to decide how much, how, and when to use chemotherapy in patients on dialysis and thereby ensure adequate treatment for these patients
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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