272 research outputs found
Androgen deprivation therapy for prostate cancer
No full textIn the contemporary scene, less than 5% of men with newly diagnosed prostate cancer (PC) have metastases at first presentation, compared to 20–25%, more than 20Â years ago. Nonetheless, the use of androgen deprivation therapy (ADT) has increased over the years, suggesting that patients in Europe and United States may receive ADT in cases of lower disease burden, and not always according to evidence based indications. Nonetheless, PC remains the second most common cause of cancer death after lung cancer in American men. Thus, there is a need for more effective, specific and well tolerated agents which can provide a longer and good quality of life while avoiding the side effects related to disease and treatment morbidity. After mentioning the current knowledge on the endocrinology of androgens and androgen receptor, relevant to PC development, as well as the possible events occurring during PC initiation, we will compare different hormonal compounds available for the treatment of PC, both from a pharmacological standpoint, and in terms of contemporary clinical indications
Correlation between human epidermal growth factor receptor 2 (HER2) status and central nervous system (CNS) involvement in metastatic castration-resistant prostate cancer (mCRPC).
No full text 210 Background: The incidence of CNS metastasesin prostate cancer is very low. Recent data suggest that HER-2/neu is involved in progression of prostate cancer. Docetaxel-based chemotherapy has provided a survival advantage for mCRPC. The purpose of this retrospective study was to evaluate the relation between HER-2 status and risk of CNS metastases in pts with mCRPC treated with docetaxel. Methods: From 2003 to 2010, 130 pts with mCRPC were treated with 3wk docetaxel 75 mg/mq. 72/130 pts were retreated with the same regimen on disease progression. 50 out of these 72 pts received second docetaxel retreatment. All pts had bone metastases. Pts underwent total body CT scan before starting docetaxel chemotherapy and every 6 months during treatment. The median age was 66 (41–88), median baseline PSA: 110 ng/ml (range 5–1100), median ECOG Performance Status: 1 (range 0–2). The data on 130 pts, who underwent diagnostic biopsy or potentially curative resection , were reviewed. Tissue blocks from primary prostate cancer tissues were obtained. Grade 3 of the HER-2 by IHC staining was defined as a positive result or gene amplification by FISH. 10 out of these 50 pts receiving second docetaxel retreatment were diagnosed with CNS metastases. Results: CNS metastases were observed in HER-2 positive pts. 6/10 pts presented parenchymal metastases: 4 pts were asymptomatic, 3 pts underwent metastasectomy and all of them received palliative whole-brain RT. 4/10 pts presented leptomeningeal metastases with neurological symptoms and 2 of them received palliative whole-brain RT. The median time from prostate cancer diagnosis to the date of diagnosis of CNS metastases was 6 years (1–8). The median time from first cycle of docetaxel to the date of diagnosis of CNS metastases was 3 years (1.5–4). Conclusions: These preliminary data demonstrated that HER-2 expression confers an increased risk of CNS metastases in mCRPC and constitutes a therapeutic challenge. The apparent increase of CNS presentation may be related to the effectiveness of systemic therapy. These informations support the further evaluation of neurological symptoms in long-term docetaxel treated pts. </jats:p
Prognostic role of chromogranin A expression for docetaxel response in hormone-refractory metastatic prostate cancer
No full textBackground: The neuroendocrine (NE) cells in prostate cancer are indistinguishable from non-NE cancer cells morphologically and are usually detected by immunohistochemical study for NE markers. We analyzed the expression of Chromogranin A (Chr A) in malignant prostate tissue as prognostic factor for docetaxel response in metastatic HRPC. Methods: From January 2003 to December 2006, 40 patients with metastatic HRPC received a median of 12 cycles (range 2–18) of Docetaxel 75 mg/mq every 21 days and 5 mg of prednisone twice daily as initial therapy. Tissue blocks from primary prostate cancer tissues were obtained and immunostaining for Chr A was performed. The median age was 70 years (range 46–82); median baseline PSA: 310 ng/ml (range 0.15–700); median ECOG Performance Status: 1 (range 0- 2). PSA level was measured every 4 weeks and the treatment was considered effective if a rate of PSA-decline > 50% from baseline was found. TTP was the preliminary end point. Results: Response to Docetaxel was assessed at every 3 cycles of treatment. The Chr A expression was found in 19/40 patients with Gleason = 7, PSA < 20, bone and soft tissue metastasis; 10 of them showed PR (decrease in PSA < 50%), 4 SD and TTP was 9.2 months. Moreover they received second line chemotherapy without significant efficacy. 5/19 patients with Chr A expression showed PD, the PSA level was not correlated with clinical outcome, TTP was 5 months and were chemoresistant to different line treatment. Besides, Chr A was not detected in 21/40 patients with Gleason = 7, PSA > 20 and bone metastasis; 10 of them showed CR (PSA normalized) and 11 PR, TTP was 20 months. Conclusions: NE differentiation do not constituite a different histopathological category of prostate cancer but the NE phenotype can be correlated with poorly differentiated adenocarcinoma. NE differentiation can be considered a factor that influences prognosis and treatment in advanced prostate cancer; cases with Chr A expression did not benefit from Docetaxel and had poor prognosis. These preliminary data indicate that initial therapeutic approach should be different according to Chr A expression
Contrast-enhanced multislice pneumo-CT-cystography in the evaluation of urinary bladder neoplasms
No full textDiagnostic usefulness of BAEPs. A clinical case
No full textWe report the clinical case of a patient operated for a right extracerebral haematoma. In the immediate post-operative period, although no clinical signs were present, a BAEP examination (showing the lack of the V) warned of a pathological condition which was ascertained by CT. A second haematoma was observed, contralateral to the first, and immediately removed. In this case, therapy was based on the neuroelectrophysiological findings
Terremoto e paesaggi costruiti nel progetto dello spazio urbano
No full textGli eventi sismici che si sono abbattuti sui centri minori dell’entroterra della Campania nel corso del Novecento, in particolare quello del 1980, hanno fatto perdere l’identità di interi brani di paesaggi costruiti, decretandone l’abbandono e condannandoli all’oblio. Di contro, la delocalizzazione di interi centri abitati ha contribuito a ridisegnare il paesaggio con interventi alla scala urbana in cui il disegno si configura come strumento di progetto dello spazio a misura d’uomo. Questi luoghi urbani sono, oggi, alla ricerca di un’identità che, più che nascere da un processo di sedimentazione naturale, deve emergere da una crescita rapida, spesso accelerata o addirittura forzata, che necessita di tempi più lunghi per poter misurare la rispondenza degli intenti progettuali come fatto materiale.
La ricostruzione ha umanizzato e urbanizzato il paesaggio con l’obiettivo di riscattarne tutta la materialità di spazio costruito e lasciar maturare nuovi e inattesi significati che non eludano il rispetto del preesistente, ma lo reinterpretino in chiave dinamica. La trasformazione del paesaggio a seguito di eventi cosi impattanti sul territorio, ridisegna lo spazio costruito in base alle interrelazioni umane alla scala dell’intero borgo, configurando spazi urbani che necessitano di essere “interiorizzati” per includere al preesistente il nuovo.
La qualità architettonica non è solo un requisito intrinseco del progetto e del processo edilizio, ma anche un valore aggiunto giorno per giorno finché non si costruisce una memoria storica, e l’uomo non riesce ad appropriarsi dei luoghi e a vivere la trasformazione come momento di riconoscimento culturale. In effetti, il cambiamento che è insito nella modificazione del contesto è energia che nasce dalla conoscenza del contesto stesso e si traduce in spazi costruiti nell’architettura. E questa energia è una risorsa che deve essere trasmessa al contesto umano.
Il tema-luogo del progetto, sperimentato nelle nuove realtà urbane di Bisaccia ed Apice, consente di formulare riflessioni su ciò che è stato fatto, sui come e sui perché della trasformazione e sui tempi necessari per sedimentare
Non-destructive evaluation of impact damage on carbon fiber laminates: Comparison between ESPI and Shearography
No full textThe aim of this paper is to investigate the ability of two different interferometric NDT techniques to detect and evaluate barely visible impact damage on composite laminates. The interferometric techniques allow to investigate large and complex structures. Electronic Speckle Pattern Interferometry (ESPI) works through real-time surface illumination by visible laser (i.e. 532 nm) and the range and the accuracy are related to the wavelength. While the ESPI works with the "classic" holographic configuration, that is reference beam and object beam, the Shearography uses the object image itself as reference: two object images are overlapped creating a shear image. This makes the method much less sensitive to external vibrations and noise but with one difference, it measures the first derivative of the displacement. In this work, different specimens at different impact energies have been investigated by means of both methods. The delaminated areas have been estimated and compared. © 2016 Author(s)
A comparison of end-sewn and stampled w-ileal reservoir for orthotopic bladder replacement
No full textImpact Damage Investigation on Glass Fiber-Reinforced Plate Laminates at Room and Lower Temperatures through Ultrasound Testing and Electronic Speckle Pattern Interferometry
No full textIn this work, the evaluation of damage area due to low-velocity impact tests at different impact energy values and different temperatures on glass fiber-reinforced plate laminates was investigated by two nondestructive evaluation (NDE) techniques, electronic speckle pattern interferometry (ESPI) and ultrasound testing (UT). Composites are characterized by several interacting failure modes such as matrix breakage, fiber failure and delaminations, which can be simultaneously induced by low-velocity impacts and can be different depending on the temperature. It can be complicated to detect by visual inspections of the structures for such phenomena. This paper aims to investigate the dependence of the damaged area with respect to temperature variation on glass fiber composite laminates. GF composite laminates were impacted with three energy levels (5, 10, 20 J) and at different temperatures (room temperature, − 25, − 50 °C) by a drop weight impact machine. The results show that at decreasing temperature, a decrease in the damage extension was observed, which is more evident at increasing impact energy. Moreover, as expected, the results confirm UT and ESPI techniques are able to identify the barely visible low-velocity impact damage. However, some limitations for detection were found in ESPI. Nonetheless, the ESPI technique can be considered as one of the useful NDE methods if the calibration and the post-processing methods are improved. © 2019, ASM International
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