Analytical Criticalities Associated to Different Immunological Methods for Serum Free Light Chain Detection in Plasma Cell Dyscrasias: A Description of Particular Clinical Cases.

Current criteria for differential diagnosis of multiple myeloma (MM), Monoclonal gammopathy of undetermined significance (MGUS), and smoldering multiple myeloma (SMM) are included in the 2003 guidelines by the International Myeloma Working Group (IMWG). An updated version was then published in 2014, highlighting the importance of serum free light chain (sFLC) detection, as well as the κ/λ ratio as excellent indicators of clonality. At present, two commercial assays for sFLC quantification are available: the Freelite™ assay and the N-Latex assay. The first was developed by The Binding Site based on a mixture of polyclonal antibodies directed against a variety of FLC epitopes. It may be run on a wide range of nephelometers, as well as on turbidimeters. The second method was developed by Siemens and runs exclusively on Siemens instruments. It employs a probe mixture of mouse monoclonal antibodies. The aim of our study was to evaluate sFLC measurement and calculated κ/λ ratio in 85 patients with monoclonal gammopathies (MGs) in order to compare methods. We demonstrated that there is only a moderate concordance between the two FLC assays. In particular, in one case, we observed no qualitative alterations of the serum protein pattern, and in the absence of a Freelite™ assay, sFLC measurement would not have been possible to highlight the increase of λ FLC.

Quality of Life in Women Diagnosed with Breast Cancer after a 12-Month Treatment of Lifestyle Modifications.

Healthy lifestyles are associated with better health-related quality of life (HRQoL), favorable prognosis and lower mortality in breast cancer (BC) survivors. We investigated changes in HRQoL after a 12-month lifestyle modification program in 227 BC survivors participating in DEDiCa trial (Mediterranean diet, exercise, vitamin D). HRQoL was evaluated through validated questionnaires: EQ-5D-3L, EORTC-QLQ-C30 and EORTC QLQ-BR23. Baseline changes were tested using analysis of variance. Multiple regression analyses were performed to assess treatment effects on HRQoL. Increases were observed in global health status (p < 0.001), physical (p = 0.003), role (p = 0.002) and social functioning (p < 0.001), body image (p < 0.001), future perspective (p < 0.001), well-being (p = 0.001), and reductions in fatigue (p < 0.001), nausea and vomiting (p = 0.015), dyspnea (p = 0.001), constipation (p = 0.049), financial problems (p = 0.012), sexual functioning (p = 0.025), systematic therapy side effects (p < 0.001) and breast symptoms (p = 0.004). Multiple regression analyses found inverse associations between changes in BMI and global health status (p = 0.048) and between serum 25(OH)D levels and breast symptoms (p = 0.002). A healthy lifestyle treatment of traditional Mediterranean diet and exercise may impact positively on HRQoL in BC survivors possibly through reductions in body weight while vitamin D sufficiency may improve BC-related symptoms. These findings are relevant to BC survivors whose lower HRQoL negatively affects treatment compliance and disease outcomes.

Submarine wastewater discharges: dispersion modelling in the Northern Adriatic Sea.

BACKGROUND, AIM AND SCOPE: Opposite interests must coexist in coastal areas: the presence of significant cities and urban centres, of touristic and recreational areas, and of extensive shellfish farming. To avoid local pollution caused by treated wastewaters along the Northern Adriatic coast (Friuli Venezia-Giulia and Veneto regions), marine outfall systems have been constructed. In this study, the application of a numerical dispersion model is used to support the traditional monitoring methods in order to link information concerning the hydrodynamic circulation and the microbiological features, to evaluate possible health risks associated with recreational and coastal shellfish farming activities. The study is a preliminary analysis of the environmental impact of wastewater treatment plants (WWTPs) with submarine discharge outfalls. It also could be useful for the water profile definition according to the Directive 2006/7/EC on the quality of bathing water and for the integrated areal analysis (Ostoich et al. 2006), to define the area of influence of each submarine discharge point. MATERIALS AND METHODS: Historical data on discharges of the considered WWTPs were recovered and evaluated. Data on discharges' control for Veneto region (WWTPs of Lido and Cavallino) were produced by the WWTPs' manager Veritas Laboratory service, while data for the WWTPs of Friuli Venezia-Giulia region were produced by the regional environmental protection agency in the institutional control activity following official methods. The hydrodynamic model used in this work is the three-dimensional version of the finite element model SHYFEM, developed at ISMAR-CNR (Marine Science Institute of the Italian National Research Council) in Venice (Umgiesser et al. J Mar Syst 51:123-145, 2008). RESULTS AND DISCUSSION: Numerical simulations have been carried out with the 3D version of the finite element model SHYFEM for 3 months during autumn 2007 to evaluate the bacterial pollution dispersion along the coasts of Veneto and Friuli Venezia-Giulia regions, prescribing meteo-marine forcings and concentration values at the points corresponding to the positions of the submarine outfalls. Model results show that during autumn 2007 the discharges of the submarine outfalls of the Venice province seem to have no impact on the surface water quality, while there are some visible effects in the Gulf of Trieste. This reflects the behaviour of the experimental data collected by ARPAV and ARPA FVG and monitoring campaigns both on water and shellfish quality. Further results have been elaborated to identify the area of influence of each discharge point; scenarios were developed with imposed concentrations. The results seem to highlight that the two discharges of the Veneto region are not noticeable, while the discharges of the Gulf of Trieste (in particular the Servola and Barcola ones) are perceptible. CONCLUSIONS: This study represents a new step towards the study of the microbiological pollution dispersion and impact due to the discharges of the submarine outfalls of the Veneto and Friuli Venezia-Giulia regions (nine considered discharge points). With the 3D version of the finite element model SHYFEM, the information obtained from the hydrodynamic circulation has been linked to the classical methods of analysis, to assess possible risks connected to the microbiological parameter Escherichia coli. RECOMMENDATIONS AND PERSPECTIVES: In future studies the time scale for microbiological parameters' decay could be linked to various environmental parameters such as light climate, temperature, and salinity. Interesting information would come from the study of new scenarios with different configurations of the discharge of the pipelines and/or the treatment plants and in particular from the improvements of the 3D version of the SHYFEM model, to take the stratification process into account which occurs during spring-summer, since the Northern Adriatic Sea is a very complex ecosystem, both as physical and ecological processes.