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Chondrosarcoma (ChS), a malignant cartilage-producing tumor, is the second most frequently diagnosed osseous sarcoma after osteosarcoma. It represents a very heterogeneous group of malignant chemo- and radiation-resistant neoplasms, accounting for approximately 20% of all bone sarcomas. The majority of ChS patients have a good prognosis after a complete surgical resection, as these tumors grow slowly and rarely metastasize. Conversely, patients with inoperable disease, due to the tumor location, size, or metastases, represent a great clinical challenge. Despite several genetic and epigenetic alterations that have been described in distinct ChS subtypes, very few therapeutic options are currently available for ChS patients. Therefore, new prognostic factors for tumor progression as well as new treatment options have to be explored, especially for patients with unresectable or metastatic disease. Recent studies have shown that a correlation between immune infiltrate composition, tumor aggressiveness, and survival does exist in ChS patients. In addition, the intra-tumor microvessel density has been proven to be associated with aggressive clinical behavior and a high metastatic potential in ChS. This review will provide an insight into the ChS microenvironment, since immunotherapy and antiangiogenic agents are emerging as interesting therapeutic options for ChS patients. [ABSTRACT FROM AUTHOR]

In 1997 the Organisation for Economic Co-operation and Development (OECD) launched the OECD Programme for International Student Assessment (PISA) for collecting information about 15-year-old students in participating countries. Our study analyses the PISA 2006 cognitive test for evaluating the Italian student performance in mathematics, reading and science comparing the results of different local governments. For this purpose the most proper statistic methodology is Item Response Theory--IRT--that collects several models, the simplest is Rasch Model--RM (1960). As the items used in the analysis are both dichotomous and polytomous, we apply Partial Credit Model (PCM). (Contains 7 figures and 8 tables.)

Vein grafts are the most used conduits in coronary artery bypass grafting (CABG), even though many studies have suggested their lower patency compared to arterial alternatives. We have reviewed the techniques and technologies that have been investigated over the years with the aim of improving the quality of these conduits. We found that preoperative and postoperative optimal medical therapy and no-touch harvesting techniques have the strongest evidence for optimizing vein graft patency. On the other hand, the use of venous external support, endoscopic harvesting, vein preservation solution and anastomosis, and graft configuration need further investigation. We have also analyzed strategies to treat vein graft failure: when feasible, re-doing the CABG and native vessel primary coronary intervention (PCI) are the best options, followed by percutaneous procedures targeting the failed grafts. [ABSTRACT FROM AUTHOR]

The north-eastern border of CA represents the accretionary system developed during its continuous collision with Apulian block. The tardive oblique tectonic component is highlighted by pervasive NW-SE crustal transpressive left-lateral strike slip faults developed from the Upper Miocene to Quaternary tectonic stages. The seismotectonic and landslides Main Map represents the update of the main faults, the style of their arrangement and kinematics, the seismotectonic features and landslide area distribution with risk implications. Seismotectonics allows us to recognise a vertical crustal zonation with the distribution of earthquakes and their focal mechanism solution. The prevalent modality of ruptures depicts a mainly transcurrent and compressive solution in mid-lower crust portions respectively. This data, together with the historical seismicity analysis of the area, lead to consider the NW-SE strike-slip faults improved on the Main Map, as recent and tectonically active. The areal distribution of landslide and susceptibility of the area is due to the interaction between seismotectonic peculiarity, lithological typologies and fault zone architectures. Landslides and flood phenomena of this sector involve many municipalities, major and minor infrastructures and economic and social activities. The landslides and the faults have been identified, mapped and classified, originally at detail scale and, then, represented at 1:50,000 scale in the Main Map, included as supplementary material. The geo-structural and geomorphological data were analysed in a geographic information system allowing data management and implementation. The work presents an updated knowledge framework of risk conditions of the study zone, available to plan and reduce the fundamental elements that determine the landslide and seismic risks in this region. [ABSTRACT FROM AUTHOR]

Background: The quality of a myocardial protection of a single-dose del Nido cardioplegia versus multiple dose blood-based cardioplegia on myocardial injury, outcomes and operative times in patients undergoing minimally invasive aortic valve replacement is basically unreported. Methods and Results: Preoperative and post-operative data, as well as technical details from isolated minimally invasive aortic valve replacements, performed using single-dose or multiple-dose cardioplegia were prospectively collected and retrospectively analysed. A total of 110 patients undergoing minimally invasive valve replacements at our institution composed two groups: 55 patients in the blood cardioplegia group (BloCa) and 55 in the del Nido group (DeNiCa). The two-matched groups were comparable in terms of preoperative variables. In the DeNiCa group, there was a statistically significant less need for cardiac defibrillation after aortic cross-clamp release (p < 0.001). Moreover, the BloCa group received intraoperatively more blood transfusions (p = 0.001) and more insulin administration for higher glucose levels (p < 0.001). The BloCa group showed higher intraoperative lactate levels (p = 0.01). Need for post-operative inotropic and vasoactive support, Creatine Kinase-MB levels after 6 and 12 h, onset of post-operative atrial fibrillation and length of stay were similar. No deaths occurred in neither groups. Conclusion: Single-dose del Nido cardioplegia in the setting of minimally invasive aortic surgery seems to offer adequate myocardial protection, comparable to multiple dose hematic cardioplegia. It has been documented a lower peri-operative need of defibrillation after cross-clamp release, lactate- and glucose peak values, as well as less blood transfusions compared to blood cardioplegic strategy. [ABSTRACT FROM AUTHOR]