Search

We report on the outcome of 114 COVID-19-associated acute respiratory distress syndrome (ARDS) survivors evaluated at 3, 6 and 12 months after intensive care unit discharge with assessment of physical, mental and cognitive impairments. Critical illness polyneuromyopathy was diagnosed in 23 patients (39%). Handgrip dynamometry was 70% predicted at 3 months and significantly improved over time, whereas the 6 min walk test (80% predicted) and severe fatigue (27% of patients) did not. Independence in activities of daily living (ADL) was achieved by 98% at 3 months. Cognitive impairment (28% at 3 months) improved over time, whereas depression, anxiety and post-traumatic stress disorder symptoms, present in 9%, 10% and 4% at 3 months, did not. Normalised health-related quality of life was good. COVID-19-associated ARDS leads to persisting impairment in performance-based measures of physical function, while ADL, cognitive and mental health status, and health-related quality of life may be less impaired. Trial registration number NCT04608994., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The DigniCap System is an effective scalp cooling device for the prevention of chemotherapy-induced alopecia in early breast cancer patients., Aim: This prospective study was designed to confirm the efficacy and tolerability of the device, to explore potential factors associated with its efficacy and to collect data on patient perceptions and satisfaction., Methods: Between January 2016 and June 2018, 163 early breast cancer patients eligible for adjuvant chemotherapy were enrolled. Hair loss was assessed using the Dean scale, where a score of 0-2 (hair loss ≤50%) was defined as successful., Results: Hair preservation was successful in 57% of patients in the overall series. The proportion was even higher (81%) in the patient subgroup treated with a paclitaxel and trastuzumab regimen. Side effects (feeling cold, headache, head heaviness, scalp and cervical pain) were mild to moderate and did not correlate with the rate of hair loss. Lifestyle, anthropometric factors and hair characteristics failed to be associated with device efficacy., Conclusions: The DigniCap System was well tolerated and found to be effective in preventing alopecia in early breast cancer patients. Our study failed to identify factors other than type of chemotherapy regimen associated with hair preservation., (© 2020 John Wiley & Sons Australia, Ltd.)

Thermally-activated delayed fluorescence (TADF) emitters-just like phosphorescent ones-can in principle allow for 100% internal quantum efficiency of organic light-emitting diodes (OLEDs), because the initially formed electron-hole pairs in the non-emissive triplet state can be efficiently converted into emissive singlets by reverse intersystem crossing. However, as compared to phosphorescent emitter complexes with their bulky-often close to spherical-molecular structures, TADF emitters offer the advantage to align them such that their optical transition dipole moments (TDMs) lie preferentially in the film plane. In this report, we address the question which factors control the orientation of TADF emitters. Specifically, we discuss how guest-host interactions may be used to influence this parameter and propose an interplay of different factors being responsible. We infer that emitter orientation is mainly governed by the molecular shape of the TADF molecule itself and by the physical properties of the host-foremost, its glass transition temperature T g and its tendency for alignment being expressed, e.g., as birefringence or the formation of a giant surface potential of the host. Electrostatic dipole-dipole interactions between host and emitter are not found to play an important role., (Copyright © 2020 Naqvi, Schmid, Crovini, Sahay, Naujoks, Rodella, Zhang, Strohriegl, Bräse, Zysman-Colman and Brütting.)

The synthesis of stable blue TADF emitters and the corresponding matrix materials is one of the biggest challenges in the development of novel OLED materials. We present six bipolar host materials based on triazine as an acceptor and two types of donors, namely, carbazole, and acridine. Using a tool box approach, the chemical structure of the materials is changed in a systematic way. Both the carbazole and acridine donor are connected to the triazine acceptor via a para- or a meta-linked phenyl ring or are linked directly to each other. The photophysics of the materials has been investigated in detail by absorption-, fluorescence-, and phosphorescence spectroscopy in solution. In addition, a number of DFT calculations have been made which result in a deeper understanding of the photophysics. The presence of a phenyl bridge between donor and acceptor cores leads to a considerable decrease of the triplet energy due to extension of the overlap electron and hole orbitals over the triazine-phenyl core of the molecule. This decrease is more pronounced for the para-phenylene than for the meta-phenylene linker. Only direct connection of the donor group to the triazine core provides a high energy of the triplet state of 2.97 eV for the carbazole derivative CTRZ and 3.07 eV for the acridine ATRZ . This is a major requirement for the use of the materials as a host for blue TADF emitters., (Copyright © 2020 Rodella, Bagnich, Duda, Meier, Kahle, Athanasopoulos, Köhler and Strohriegl.)

Importance: Aromatase inhibitors induce a profound depletion in serum estrogen levels. Postmenopausal obese women receiving aromatase inhibitor therapy may be at increased risk of bone fractures owing to the detrimental association of adiposity with bone quality and the loss of the protective effect of estrogens on bone mineral density., Objective: To determine whether fat body mass (FBM), as measured by dual-energy x-ray absorptiometry, is associated with vertebral fracture prevalence in postmenopausal women undergoing adjuvant aromatase inhibitor therapy for breast cancer., Design, Setting, and Participants: In this single-center, cross-sectional study, 556 postmenopausal women with early-stage breast cancer were consecutively enrolled from October 15, 2013, to June 30, 2018, and stratified according to whether they were aromatase inhibitor-naive or aromatase inhibitor-treated for at least 2 years. The database was locked on December 31, 2018, and data analysis was completed on February 28, 2019. Eligible patients in both groups had normal renal function, no metabolic diseases, and no previous or current treatment with antiosteoporotic drugs or glucocorticoids. Previous chemotherapy, but not tamoxifen, was permitted. Data were gathered once, at baseline., Main Outcomes and Measures: Vertebral fracture prevalence associated with FBM in aromatase inhibitor-naive and aromatase inhibitor-treated patients., Results: Of the 556 women enrolled, the mean age was 63.0 years (95% CI, 62.2-63.8 years). The 195 aromatase inhibitor-treated patients were older than the 361 aromatase inhibitor-naive patients (mean age, 66.1 vs 61.3 years; P < .001), had a higher body mass index (mean, 26.4 vs 25.3; P = .009), were less likely to engage in physical activity (65.3% vs 73.7%; P = .03), and were less likely to consume alcoholic beverages (68.4% vs 80.9%; P = .001). Among the aromatase inhibitor-naive patients, the vertebral fracture prevalence was higher in the subgroup with FBM below the median value than in those with high FBM, but the difference was not statistically significant (19.2% vs 13.3%; P = .13). Conversely, the proportion of vertebral fractures in the aromatase inhibitor-treated group was 20.0% in patients with low FBM vs 33.3% in patients with high FBM (P = .04). An opposite trend in the association of FBM with vertebral fracture prevalence according to aromatase inhibitor group was shown by multivariable analysis in the propensity score-matched sample: odds ratio, 0.38 (95% CI, 0.12-1.19) and 1.94 (95% CI, 0.67-5.64) in the aromatase inhibitor-naive and aromatase inhibitor-treated groups, respectively (odds ratio for the interaction, 5.77 [95% CI, 1.08-30.81]; P for interaction term = .03)., Conclusions and Relevance: Fat body mass may be associated with fragility-related fractures in patients with breast cancer who undergo aromatase inhibitor therapy. If these data are confirmed, obesity could be included in the algorithm for assessing fracture risk and selecting patients to receive bone resorption inhibitors.

Objectives: The aim of this study was to investigate efficacy and safety of eribulin in heavily pretreated patients with advanced breast cancer (BC) in a real-life setting., Methods: This retrospective monocentric study included patients with HER-2-negative metastatic BC, pretreated with anthracyclines and taxanes, who were referred to the Oncology Department of Spedali Civili of Brescia from May 2012 to April 2017. Patients received the same dose of eribulin as that used in the EMBRACE trial: 1.4 mg/m2 on days 1 and 8 every 21 days., Results: In a total of 53 patients, 32% obtained a partial response, 11% a stable disease, and 43% a clinical benefit (CB). After a median follow-up of 36 months, median progression-free survival (PFS) was 4.7 months and median overall survival (OS) 13.53 months. Median PFS was significantly longer in patients who reported a CB compared to those with no CB, while survival outcomes (PFS and OS) were better in patients who received > 6 cycles of eribulin. Eribulin showed a good tolerability profile with acceptable toxicities, similar to those reported in EMBRACE., Conclusions: Our experience in a real-world setting confirms the activity, efficacy, and good tolerability profile of eribulin in heavily pretreated BC patients., (© 2018 S. Karger AG, Basel.)

Background: The impact of long-term adjuvant therapy with aromatase inhibitors (AIs) on vertebral fracture (VF) risk is still unclear., Objective: In this cross-sectional study, we explored the prevalence and determinants of VFs in breast cancer (BC) patients before and during AI therapy. Each woman underwent a dual-energy X-ray absorptiometry (DXA) to evaluate bone mineral density (BMD) and identify VFs by a quantitative morphometric approach. Blood samples were collected to measure serum hormone and calcium levels., Results: We consecutively included 263 postmenopausal women with hormone receptor-positive early BC. One-hundred-sixty-nine women were AI-naïve, and 94 were AI-treated. AI-treated patients had lower BMD at total hip (p=0.01) and lumbar spine (p=0.03), higher serum vitamin D (p<0.001) and parathyroid hormone (p=0.006) values as compared to AI-naïve patients. The prevalence of VFs was 18.9% in AI-naïve patients, and 31.2% in those assessed during AI therapy (odds ratio 1.90, 95% CI 1.1-3.5, p=0.03). In AI-naïve patients, VFs were associated with older age (p=0.002) and lower BMD values at femoral neck (p=0.04) and total hip (p=0.007), whereas VFs occurred without association with any parameter analyzed in AI-treated patients. In AI-treated group, the prevalence of VFs was not significantly different between patients with osteoporosis and those with normal BMD (36.7% vs. 20.0%; p=0.31)., Conclusions: In women with early BC, AI therapy is associated with high prevalence of radiological VFs, which were shown to be independent of BMD values during the adjuvant treatment. These findings may be clinically relevant since they may lead to a change in management of AI-induced skeletal fragility. Specifically, the results of this study provide a rationale for performing a morphometric evaluation of VFs in all women undergoing treatment with AIs., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Prisoners in Nazi concentration camps lived through extreme situations that included starvation. We test our hypothesis that there is a greater lifetime presence of binge eating among survivors from concentration camps than in a control group., Methods: The subjects were 51 political prisoners who survived Nazi concentration camps and 47 ex-partisans of similar age and sex. A clinical interview investigated the lifetime occurrence of binge eating. The Eating Attitudes Test was also administered., Results: The mean reported loss of weight among survivors was 27-3 kg. Thirty-three per cent of them and 4% of the ex-partisans reported going on eating binges at some time in their lives (P < 0.0007). There was no significant difference in the Eating Attitudes Test scores of survivors and ex-partisans, but, among survivors, the Bulimia subscale significantly discriminated subjects who reported current binge eating., Conclusions: Our study confirms that subjects who have survived a period of extreme food deprivation are more likely to develop binge eating behaviour.

Background: The study aimed to assess the current and lifetime rates of post-traumatic stress disorder (PTSD) and major depression (MDD) among Nazi concentration camps survivors., Methods: We investigated 51 Italian political deportees and 47 Resistance Movement veterans who reported traumatic experiences during active service. The Structured Clinical Interview for DSM-IV was used to assess the presence of PTSD and MDD. The Dissociative Experiences Scale and the shorter version of the Hopkins Symptoms Checklist were also administered., Results: The lifetime rates of PTSD and MDD were 35.3% and 45.1% respectively among deportees and 4.3% and 6.4% among former partisans. The current rates for PTSD and MDD were 25.5% and 33.3% among deportees and 4.3% and 4.3% among former partisans. Dissociative symptoms were more severe among deportees than among Resistance movement veterans., Conclusions: Concentration camp internment, even for political reasons, appears to have severe long-term psychiatric consequences.