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Objectives: Cisplatin is essential in the curative treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) patients. The assessment of risk factors to predict an early cisplatin-induced nephrotoxicity could help in better managing one of the most relevant cisplatin-related dose-limiting factors., Material and Methods: We retrospectively collected data of LA-HNSCC patients treated at our Institution from 2008 to 2019. Patients received cisplatin in a curative setting concurrently with radiation. Acute Kidney Injury (AKI) was assessed as a dichotomous variable (CreaIncr) based on pre-treatment values, and values recorded at days 6-20 post-first cycle of cisplatin. Univariable logistic regression models were performed to investigate associations between CreaIncr and clinical characteristics. A multivariable logistic model on a priori selected putative covariates was performed., Results: Of the 350 LA-HNSCC treated patients, 204 were analyzed. Ninety (44 %) suffered from any grade AKI (grade I 51.1 %): out of them, 84.4 % received high-dose cisplatin (100 mg/m2 q21). On the univariable logistic regression model, male sex, age, serum uric acid, creatinine, concomitant drugs, and cisplatin schedule were significantly associated with a higher rate of AKI. At multivariable model, age (p = 0.034), baseline creatinine (p = 0.027), concomitant drugs (p = 0.043), and cisplatin schedule (one-day bolus or fractionated high-dose vs. weekly; p = 0.001) maintained their significant association., Conclusions: Identifying pre-treatment risk factors in LA-HNSCC patients may improve decision-making in a setting where cisplatin has a curative significance. A strict monitoring of AKI could avoid cisplatin dose adjustments, interruptions, and treatment delays, thus limiting a negative impact on outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Pork loins were cooked with 5 different polyphenol-rich vegetable extracts: Polygonum cuspidatum, oregano extract, rosemary extract, white grape extract and green tea extract. These extracts were added to brine, taking into account their solubility, for subsequent injection and cooking. Loins with added vegetable extracts exhibited higher antioxidant effect compared to controls, as shown by the oxidized/reduced ascorbate ratio, the potential of reduction and the fat oxidation rate. However, some effects were observed in terms of taste, colour changes and, in some cases (green tea and oregano), presence of blots on meat slices. Poor diffusion of the brine through the muscle fibres and insolubility of the extracts in localized spots are weaknesses of these products. A significant amount of polyphenols was lost or destroyed during the cooking phase of the process. Sensory tests show that only Polygonum cuspidatum and rosemary extract result in an acceptable product. In this case the contribution of active molecules in the final product is rather limited., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Plastics are the most common material of marine litter and have become a global pollution concern. They are persistent in the environment where they gradually degrade into increasingly smaller particles-microplastics (MP). Our study presents results of sea-surface monitoring for MP in the Slovenian part of the Trieste Bay in the Northern Adriatic Sea. In 17 trawls conducted over a 20-month period we found a high average concentration of 406×10 3 MPparticles/km 2 . Over 80% of the particles were identified as polyethylene. The significant variability of MP concentrations obtained on different sampling dates is explained by use of surface current maps and a recently developed Markov chain marine litter distribution model for the Adriatic Sea., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

In recent years, formulations of the Italian cold cut mortadella have changed to meet evolving tastes and nutritional trends. The aim of the present study was to analyze the physical, chemical, and sensory characteristics of currently produced mortadella. Representative samples of Italian mortadella (13 brands, 3 samples/brand) were analyzed. Three groups of products were identified according to their chemical compositions. The median cluster was composed of 54.80% moisture, 26.19% fat, and 15.02% protein, whereas the other two clusters were characterized by a higher percentage of moisture or fat. These results indicate that, on average, the current products are characterized by less fat (-5%) and salt (-10%) content compared to products 20 years ago., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The evaluation of the efficiency with which the reactions involving nitrite proceed in mortadella and of the effect exercised on their kinetics by some variables (ingoing amount of sodium nitrite and temperature) is the purpose of this work. Kinetics parameters were calculated at each level of nitrite added (40, 70, 100 and 150 mg/kg) and at five temperature (55°, 60°, 65°, 70° and 72 °C). While the colour formation reaction is favoured by low activation energy, it becomes crucial to enable nitrite to proceed according to direct reduction thus preventing an increase in nitrate concentration as well as an excess of nitric oxide in the product. Kinetics data suggest that this scope is performed when the product achieves the temperature of 65 °C as fast as possible with an ingoing amount of sodium nitrite of 70 mg/kg., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Fractures of the humerus in patients with total shoulder replacement are rare and difficult to treat. The treatment of periprosthetic humeral fractures depends on the location of the fracture in relation to the humeral stem and the stability of the stem/bone interface. We wished to determine the treatment outcomes in a series of patients managed in our institution with periprosthetic humeral fractures. We also carried out a review of the literature. Over a 5 year period, out of 10 patients, 7 were available at the final follow up with a mean age of 72 years (range 68-75). A fall from standing height was the most common mechanism of injury. All patients were found to have stable prosthesis in situ and were treated with angular stable plates and cerclage wiring. The mean time from the total shoulder replacement to injury (fracture) was 11.2 months (range 8-21). All fractures united without complications at a mean time of 5.1 months (range 4-6). The literature review revealed a limited number of publications reporting on the management of approximately 40 patients. The outcome noted in these patients is also presented., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Tumor human papillomavirus (HPV) status strongly affects overall survival (OS) of oropharyngeal cancer (OPC) patients. Recently, three groups with different outcomes were identified based on HPV status, smoking history and tumor stage. Our objective was to validate this model using a single-institutional retrospective database., Patients and Methods: Patients (n=120) diagnosed with OPC at our institution, treated with concomitant cisplatin plus radiotherapy (RT) (n=64), induction chemotherapy followed by concomitant chemoradiation (n=39) or RT alone (n=17), were stratified in three groups with respect to the risk of death (low 26, intermediate 46 and high 49 patients) according to tumor p16 expression as surrogate of HPV status, pack-years of tobacco smoking and nodal/tumor stage. Group-stratified Kaplan-Meier OS curves were estimated and compared using the log-rank test., Results: The 2-year OS estimates were 100%, 86% and 70%, respectively. The difference between the survival curves was statistically significant (P=0.009). The Harrell's concordance index was 0.70. The calibration plot showed a good concordance between our results and those observed in the original study., Conclusions: This study validates the risk grouping previously identified. Risk-driven clinical decision making and trial designs will help in better defining the most appropriate treatment in OPC patients.

Background: This monocentric study evaluates the activity and tolerability of docetaxel (Taxotere), cisplatin and 5-fluorouracil (5-FU) (TPF) induction chemotherapy followed by intensity-modulated radiotherapy (IMRT) concurrent with high-dose cisplatin in Epstein-Barr virus -related locally advanced undifferentiated nasopharyngeal cancer., Patients and Methods: We retrospectively reviewed the records of patients who received induction docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2) on day 1, and 5-FU 750 mg/m(2)/day (96-h continuous infusion). Following induction, patients received full doses of IMRT concurrently with cisplatin 100 mg/m(2) every 21 days for three cycles., Results: Thirty patients received three TPF cycles (median). Induction was well tolerated; the main toxicity was neutropenia (33%, grade 3-4). During chemoradiotherapy, neutropenia (40%) and mucositis (43%) were the most frequent grade 3-4 adverse events. Mean dose of IMRT was 68.8 Gy. Worst late toxicity was xerostomia. Complete response rate was 93%. At 35 months, two patients had locoregional recurrence, three had distant metastases, and one had both. Three-year progression-free survival and overall survival were 79% [95% confidence interval (CI) 64% to 94%] and 87% (95% CI 74%- to 100%), respectively., Conclusions: In this high-stage nonendemic cancer population, TPF followed by high-dose cisplatin IMRT was promising; this treatment approach deserves evaluation in randomized trials.

Background: Extravasation of erythrocytes (erythrodiapedesis [ED]) is currently included among causes of skin damage in legs with chronic venous disorders (CVD) and ascribed to venular hypertension. ED is followed by erythrocyte disruption, degradation of hemoglobin, and storing of ferric iron into hemosiderin. The aim of this study was to evaluate the occurrence of ED in the skin of legs with different clinical stages of CVD., Methods: One hundred eighteen skin biopsies from legs with CVD underwent histologic evaluation for ED and hemosiderin deposition (HD)., Results: ED was found in only 21/118 specimens. In particular, it was found in ulcer samples, in tissues surrounding varicophlebitis and, finally, in acute eczematous skin. ED was found in only 15/30 samples showing HD., Conclusion: Our findings confirm the occurrence of ED during CVD. However, it was found only in concomitance of severe dermal inflammation. Hemosiderin deposition in the absence of actual ED could be explained with previous healed episodes of skin inflammation. However, ED is not likely the only cause of skin iron overload, which could also occur by a molecular mechanism. Further studies are needed to define the mechanism of iron deposition in the skin of legs afflicted with CVD., (Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.)

This report describes an ischemic stroke following endovenous laser treatment of the great saphenous vein in a patient with a patent foramen ovale. No thrombophilic conditions or other possible sources of emboli could be demonstrated., (Copyright 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.)

Background: Chronic Venous Insufficiency (CVI) provokes skin pigmentation commonly seen in the gaiter region of the leg. The exact nature and pathogenesis of this are poorly understood., Objective: To evaluate the presence of melanin and haemosiderin in histological sections of the skin of limbs with primary varicose veins., Methods: Histological investigations were performed in 49 biopsies from pigmented and non-pigmented skin of limbs with varicose veins and control limbs., Results: All samples from pigmented skin showed a higher content of melanin than controls. In contrast, haemosiderin was found in only a few biopsies taken from the more severely pigmented skin in areas of lipodermatosclerosis. Erythrocyte diapedesis was observed only where an intense inflammatory process was also present., Conclusions: Our findings suggest that in the initial phases of skin changes due to venous disease, pigmentation is attributable to melanin. Haemosiderin seems to play a role in the evolution of skin changes toward lipodermatosclerosis and ulceration. Erythrocyte diapedesis is likely to occur only during acute phases of the inflammatory process. Further investigations are needed to explain the cause and the exact cellular and molecular mechanisms responsible for hypermelanisation occurring in early phases of skin changes in CVI.

Background: Primary varicose veins are commonly considered a progressive disease starting from the saphenous junctions and extending to tributaries in a retrograde fashion along the saphenous trunks. This theory has been criticized by studies indicating different patterns of development and progression of varicose veins. To contribute to the understanding of the pathogenesis of the disease, the anatomy of the venous bed was comparatively evaluated by duplex sonography in patients with varicose veins with a marked difference in age., Methods: The study included 100 varicose limbs in 82 patients aged < 30 years and 238 limbs in 183 patients aged > 60 years. Veins were designated as saphenous veins (SVs), tributaries of the SVs (STVs), and veins not connected with the SVs (NSVs). Four main anatomic patterns were comparatively evaluated: (1) varicose changes only along SVs, (2) varicose changes along SVs and STVs, (3) varicose changes only in STVs, and (4) varicose changes only in NSVs., Results: SVs were normal in 44% of varicose limbs. In most limbs from young subjects, varicose changes afflicted only SVTs (25%) and NSVs (36%). Varicose SVs were more frequent in the older group (62%) than in younger one (39%) owing to a higher prevalence of limbs with combined SV and STV varicosities (respectively, 59% and 37%). In the older group, varicosities in the STVs were more frequently observed in association with incompetence of the SV trunks., Conclusion: The frequent occurrence of normal SVs in varicose limbs of all patients does not support the crucial role commonly credited to SVs in the pathogenesis of primary varicosities. Moreover, the SV trunks were normal in most varicose limbs from young patients. These findings suggest that varicose disease may progressively extend in an antegrade fashion, spreading from the STVs to the SVs. This hypothesis suggests that the saphenous trunks could be spared in the treatment of a relevant number of varicose legs. Prospective longitudinal studies with serial duplex evaluations of large series of extremities are necessary to confirm this hypothesis.

Background/aims: The role of coffee in the development of hepatocellular carcinoma (HCC) is debated. The aim of this study was to investigate the role of coffee in HCC, taking the main risk factors into account., Methods: A hospital-based case-control study was conducted in an area of northern Italy. We recruited 250 HCC cases and 500 controls hospitalized for any reasons other than neoplasms, and liver and alcohol-related diseases. Subjects were interviewed on their lifetime history of coffee consumption using a standardized questionnaire., Results: Coffee consumption in the decade before the interview was associated with a decreasing risk of HCC with a clear dose-effect relation. With respect to non-drinking subjects, the odds ratios (ORs) were: 0.8, (95% CI 0.4-1.3) for 1-2 cups/day, 0.4 (95% CI 0.2-0.8) for 3-4 cups/day and 0.3 (95% CI 0.1-0.7) for 5 or more cups/day. The ORs for HCC decreased for drinking >2, compared to 0-2 cups/day of coffee, for an alcohol intake >80 g/day (OR from 5.7 to 3.3), for presence of hepatitis B virus infection (OR from 16.4 to 7.3) or hepatitis C virus infection (OR from 38.2 to 9.0)., Conclusions: Coffee drinking was inversely associated with HCC regardless of its aetiology.

To ascertain whether fatigue perception is linked to exertion dyspnea and/or to an impaired cardiorespiratory response during walk, 11 patients (8 females, age range 21-46 years) with multiple sclerosis (MS) and mild disability underwent the 6-min walk test. Ten healthy subjects (7 females, age range 25-49 years) were studied, as a control group. Patients did not differ from controls in spirometry, lung volumes and respiratory muscle strength. There was a significant difference in walk distance between patients and controls (P<0.001), but not in dyspnea perception. In patients, the walk distance significantly related to disability score (P<0.01), but not to fatigue. Compared to controls, patients had a significant decrease in oxygen pulse during walk (P<0.05) and a significant increase in the ventilatory equivalent of CO2 both at baseline and during walk (P<0.05). The relative contribution of both the tidal volume and of the ratio of inspiratory to total breathing cycle duration to the increase in minute ventilation during walk was significantly less in patients, as compared to controls (P<0.05). We conclude that in MS patients with mild disability, fatigue and exertion dyspnea are different sensations without any link and a peripheral limitation during walk can occur.