COGNITION: a prospective precision oncology trial for patients with early breast cancer at high risk following neoadjuvant chemotherapy.

BACKGROUND: COGNITION (Comprehensive assessment of clinical features, genomics and further molecular markers to identify patients with early breast cancer for enrolment on marker driven trials) is a diagnostic registry trial that employs genomic and transcriptomic profiling to identify biomarkers in patients with early breast cancer with a high risk for relapse after standard neoadjuvant chemotherapy (NACT) to guide genomics-driven targeted post-neoadjuvant therapy. PATIENTS AND METHODS: At National Center for Tumor Diseases Heidelberg patients were biopsied before starting NACT, and for patients with residual tumors after NACT additional biopsy material was collected. Whole-genome/exome and transcriptome sequencing were applied on tumor and corresponding blood samples. RESULTS: In the pilot phase 255 patients were enrolled, among which 213 were assessable: thereof 48.8% were identified to be at a high risk for relapse following NACT; 86.4% of 81 patients discussed in the molecular tumor board were eligible for a targeted therapy within the interventional multiarm phase II trial COGNITION-GUIDE (Genomics-guided targeted post neoadjuvant therapy in patients with early breast cancer) starting enrolment in Q4/2022. An in-depth longitudinal analysis at baseline and in residual tumor tissue of 16 patients revealed some cases with clonal evolution but largely stable genetic alterations, suggesting restricted selective pressure of broad-acting cytotoxic neoadjuvant chemotherapies. CONCLUSIONS: While most precision oncology initiatives focus on metastatic disease, the presented concept offers the opportunity to empower novel therapy options for patients with high-risk early breast cancer in the post-neoadjuvant setting within a biomarker-driven trial and provides the basis to test the value of precision oncology in a curative setting with the overarching goal to increase cure rates.

General health & psychological distress in children with temporomandibular disorder.

INTRODUCTION: Temporomandibular disorders (TMD) are an heterogeneous group of disorders affecting temporomandibular joints (TMJ), masticatory muscles, or both. The aim of this study is to evaluate the relationship between general health and psychological distress variables and the clinical diagnosis of TMD in children between 8 - 13 years old. Moreover, it will be underlined the different perception of psychological distress existing between patients and their parents. MATERIALS AND METHODS: Patients were divided in two groups: the "case group", which includes patients with TMD, and the "control group", which included patients asymptomatic for TMD. The "case group" is composed by 29 patients, while the "control group" is composed by 22 patients. The patients were asked to fill in a questionnaire called Child Health Questionnaire (CHQ), to evaluate general health and psychological condition and, eventually, the presence of symptoms of stress, anxiety and/or depression. The CHQ is 87 - item questionnaire developed in USA specifically for children. RESULT: As widely reported during the present work, the link between TMD and psychological distress is existing and quite strong, because of lack of number of patients many aspects worth of attentions have not been analyzed as they deserved. CONCLUSION: That's way the conclusion must lead to the proposal of going on with the present study following, possibly, some aspects of research as an increase of the number of patients involved in the study; Individuate possible elements, internal and external, that could strongly influence differences between patient's results and parent's results, etc.

Effects of time and temperature on the viability of Toxoplasma gondii tissue cysts in enhanced pork loin.

Enhanced or pumped pork products represent a significant proportion (40 to 50%) of the commercially available pork cuts available to consumers at the retail level. In a previous study, pork loins containing viable Toxoplasma gondii tissue cysts were pumped with solutions containing 2% sodium chloride or 1.4% or higher potassium or sodium lactate and stored at 4 degrees C for 7 days. This treatment prevented transmission of T. gondii to cats. In the present study, enhanced pork loins were stored for 0, 8, 16, 24, 32, or 40 h at 4 degrees C and then fed to T. gondii-seronegative cats to determine how quickly the loss of tissue cyst viability occurred. In a second experiment, pork loins collected from pigs experimentally infected with T. gondii were stored at temperatures found in retail meat cases and then fed to T. gondii-seronegative cats to determine the effect of typical meat case storage temperatures on tissue cyst viability. In both experiments, cat feces were examined for 14 days after the infected meat meal to assess oocyst shedding. The results indicate that solutions containing 2% sodium chloride or 1.4% potassium or sodium lactate are effective within 8 h of injection for killing T. gondii tissue cysts in pork loins and that storage at meat case temperatures at or below 0 degrees C (32 degrees F) for 7 days also killed T. gondii tissue cysts in pork loins.

Prevalencia de obesidad y sobrepeso en población escolar / Prevalence of obesity and overweight in school children population

Objetivos: 1-Determinar la prevalencia de obesidad y sobrepeso en niños que cursan 5° año de la EGB en establecimientos escolares de la ciudad de Venado Tuerto. 2-Determinar si existe relación entre el estado nutricional y la actividad física en los niños. Matriales y métodos: se encuestaron 444 niños de 5to. año EGB en 23 establecimientos escolares de la ciudad de Venado Tuerto. Las encuestas realizadas constaron de 14 preguntas y un registro de las comidas que el niño realizó durante un día. Las mismas fueron entregadas en mano y se las retiró después de 1 semana. Los niños fueron previamente evaluados según su índice de masa corporal en relación de su edad. Las categorías asignadas fueron: desnutridos (D), peso normal(PN), sobrepeso (S), obesidad (O). Como punto de corte se utilizó para S (entre los percentilos 85 y 95) y para los O (> percentilo 95) según las curvas del Instituto Nacional d Estadísticas en Salud (NCHS)...

Impact of interventions designed to increase market share and prescribing of fexofenadine at HMOs.

The impact of interventions designed to shift prescribing from loratadine to fexofenadine at HMOs was studied. Pharmacy claims data for a six-month preintervention period at four HMOs were analyzed to identify all new and refill prescriptions for loratadine, fexofenadine, astemizole, and cetirizine. The interventions consisted of a mandatory lockout of loratadine in favor of fexofenadine (at HMO A), a voluntary switch to fexofenadine promoted through letters to both physicians and members (HMO B), and a voluntary switch promoted through letters to physicians only (HMO C). There was no intervention at HMO D. Pharmacy claims data for the six months after each intervention program was implemented were analyzed to determine changes in the market share and prescribing of the study drugs. After the intervention programs were implemented, the market share of fexofenadine increased from 18.9% to 65.2% at HMO A, from 14.8% to 21.0% at HMO B, and from 20.7% to 23.8% at HMO C. Loratadine's market share decreased from 62.3% to 8.7% at HMO A, from 67.5% to 58.6% at HMO B, and from 70.5% to 65.3% at HMO C. HMOs A, B, and C each had greater shifts in market share for fexofenadine and loratadine than the control HMO. Changes in prescribing followed a similar pattern for the 25 physicians at each HMO who had most frequently prescribed loratadine during the preintervention period. The average cost per antihistamine prescription decreased 22.3% at HMO A. Prescription costs continued to rise at HMOs B, C, and D. Mandating the use of fexofenadine produced a significant increase in its market share, reduced the cost of nonsedating antihistamines, and successfully influenced prescribing behavior. Voluntary programs had a more modest impact on market share and did not stop increases in prescription costs.

Quinidine versus propafenone for conversion of atrial fibrillation to sinus rhythm.

The efficacy and safety of quinidine, as a rapid oral loading therapy, and propafenone in the conversion of atrial fibrillation of <6 months duration to sinus rhythm were compared. Quinidine was more efficacious and as well tolerated as propafenone.

[Femoral arterio-venous fistula. A rare complication of right heart catheterization]. / La fistola artero-venosa femorale. Una rara complicanza del cateterismo cardiaco destro.

Percutaneous central venous catheterization through the femoral vein is frequently used in the Coronary Care Unit. Complications such as thrombophlebitis, thromboembolism and femoral artery puncture are rare. We describe a case of arteriovenous fistula due to femoral vein catheterization in a 61 year old man who was admitted because of advanced atrioventricular block. Auscultation revealed a systodiastolic murmur. Two dimensional and color Doppler flow imaging demonstrated an arteriovenous communication between the superficial femoral artery and common femoral vein without hemodinamic consequences. Two months later, on physical examination and Doppler investigation, the fistula had disappeared.

Dynamics of optically switched bistable laser diodes in the injection-locked state.

The dynamical properties of dispersive optical bistability in a semiconductor laser biased from below to above threshold are investigated both experimentally and theoretically. The optical bistability switch-off time is found to decrease continuously from below to above threshold. A fast switch-off in less than 100 ps has been observed when the laser operates in the injection-locked condition.

Molecular characterization of hemoglobin C in Sicily.

Analysis of polymorphisms of the beta-globin gene cluster was performed on 12 families and on one unrelated individual of Sicilian origin who carried hemoglobin C (Hb C). Two different haplotypes were found in association with beta c Sicilian alleles, corresponding to haplotypes I and II previously described in American blacks. In our population, the more frequent one (haplotype I) was linked to the lack of a polymorphic HpaI site 3' to the beta gene (13.0-kb fragment), similarly to haplotype I in blacks, while the less frequent one was linked to a 7.0-kb HpaI fragment attributable to a site that had never been previously described in linkage with beta c alleles. In Italy, these two haplotypes have been found in rare cases in association with beta A alleles. These findings provide new insights into the origin of Hb C present in Sicily, suggesting that (1) the beta c mutation detected in Sicily derived from African black chromosomes and does not represent a new mutation; and (2) Hb C may have originated either by multiple mutational events on separate chromosomes or by mutation in the HpaI site 3' to the beta gene in a pre-existing beta c chromosome.

[Ambulatory electrocardiography in aged patients with syncope]. / L'elettrocardiografia dinamica nei pazienti anziani affetti da sincope.

3600 dynamic ecg recordings were carried out over a period of about seven years. In 408 cases (11.3%), indication for the investigation consisted of syncopal or equivalent minor episodes. 37 patients (9%) presented symptoms during the recording; in 12 cases (2.9%), the symptoms corresponded to an arrhythmia. An increase in atrial and ventricular arrhythmias with advancing age was also observed. Owing to the high incidence of arrhythmias in the elderly, and the poor correlation between symptoms and significant arrhythmias, dynamic ecg is therefore of little diagnostic value in syncope patients.

[Atrial myxoma in the aged. Apropos of 2 clinical cases]. / Il mixoma atriale nell'anziano. A proposito di due casi clinici.

Cardiac myxoma are a diagnostic dilemma, simulating a variety of cardiac and non cardiac diseases. Echocardiography is a powerful technique for diagnosing primary tumors of the heart. We report two cases of elderly patients, with atrial myxomas, for which operation was safely performed on the basis of echocardiography alone without preoperative catheterization.

[Carcinoid cardiopathy]. / La cardiopatia da carcinoide.

A series of 5 males and 2 females aged 23-73 yr with carcinoid cardiopathy is presented, all of them with clinical and instrumental signs of liver metastasis. The main clinical signs were dyspnoea and asthenia rendered ingravescent by effort, and, in the later stage, a frank picture of congestive cardiac decompensation. All subjected presented stethoscopic evidence of tricuspid valvulopathy, combined with pulmonary stenosis in 2 cases. The ECG picture displayed a constant reduction in cardiac potentials, together with right branch bundle block in 3 cases. In cases where an echocardiogram was taken, this confirmed tricuspid involvement. The disease progressed in all cases, and four patients died as a result of terminal liver failure.