Search

International audience; BACKGROUND:FOLFIRINOX (leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin) is an option for fit patients with metastatic (MPC) and locally advanced unresectable (LAPC) pancreatic cancer. However, no criteria reliably identify patients with better outcomes.PATIENTS AND METHODS:We investigated putative prognostic factors among 137 MPC/LAPC patients treated with triplet chemotherapy. Association with 6-month survival status (primary endpoint) was assessed by multivariate logistic regression models. A nomogram predicting the risk of death at 6 months was built by assigning a numeric score to each identified variable, weighted on its level of association with survival. External validation was performed in an independent data set of 206 patients. The study was registered at ClinicalTrials.gov (NCT03590275).RESULTS:Four variables (performance status, liver metastases, baseline carbohydrate antigen 19-9 level, and neutrophil-to-lymphocyte ratio) were found to be associated with 6-month survival by multivariate analysis or had sufficient clinical plausibility to be included in the nomogram. Accuracy was confirmed in the validation cohort (C index = 0.762; 95% confidence interval, 0.713-0.825). After grouping all cases, 4 subsets with different outcomes were identified by 0, 1, 2, or > 2 poor prognostic features (P < .0001).CONCLUSION:The nomogram we constructed accurately predicts the risk of death in the first 6 months after initiation of FOLFIRINOX in MPC/LAPC patients. This tool could be useful to guide communication about prognosis, and to inform the design and interpretation of clinical trials.

The conservation of artworks requires a profound knowledge about pictorial materials, their chemical and physical properties and their interaction and/or degradation processes. For this reason, pictorial materials databases are widely used to study and investigate cultural heritage. At Centre for Conservation and Restoration La Venaria Reale, we prepared a set of about 1200 mock-ups with 173 different pigments and/or dyes, used across all the historical times or as products for conservation, four binders, two varnishes and four different materials for underdrawings. In collaboration with the Laboratorio Analisi Scientifiche of Regione Autonoma Valle d’Aosta, the National Institute of Metrological Research and the Department of Architecture and Design of the Polytechnic of Turin, we created a scientific database that is now available online ( http://www.centrorestaurovenaria.it/en/areas/diagnostic/pictorial-materials-database ) designed as a tool for heritage science and conservation. Here, we present a focus on materials for pictorial retouching where the hyperspectral imaging application, conducted with a prototype of new technology, allowed to provide a list of pigments that could be more suitable for conservation treatments and pictorial retouching. Then we present the case study of the industrial painting Notte Barbara (1962) by Pinot Gallizio where the use of the database including modern and contemporary art materials showed to be very useful and where the fibre optics reflectance spectroscopy technique was decisive for pigment identification purpose. Later in this research, the mock-ups will be exploited to study degradation processes, e.g., the lightfastness, or the possible formation of interaction products, e.g., metal carboxylates.

Within the neu_ART project, funded by Regione Piemonte (Italy), a team of specialists in different scientific fields coming from Istituto Nazionale di Fisica Nucleare (INFN), Physics Department of University of Torino and Centro Conservazione e Restauro (CCR) “La Venaria Reale” has developed a new digital X-ray apparatus expressly designed for painted canvas and panels up to about 3 m × 4 m. Compared to all other systems scanning time is faster, the procedure to obtain the whole radiography is easier and images are available in real time. This apparatus has been widely tested on artworks restored at CCR “La Venaria Reale”, allowing to study and optimize the operating parameters and to evaluate its performance, thanks to the feedback provided by professionals involved in the activities of conservation. Supported by the results presented in this work, restorers had the possibility to investigate the materials characteristics and to plan the operating strategy in advance: indeed, radiographs revealed areas with losses of paint, repainted areas, canvas damages, hidden pictures, writings and previous restorations. The X-Ray system for Digital Radiography is integrated in a more complex apparatus that can be used also for computed tomography of voluminous objects up to 2.5 m in height and 2 m in width, making the apparatus developed in the neu_ART project a unique and comprehensive tool at conservators' disposal.

We investigated Lp(a) levels and apo(a) polymorphism in relation to the severity of coronary artery disease, expressed both by the number of coronary arteries stenosed and three different coronary scoring systems. In a sample of 267 patients with coronary artery disease, a Mono-, Bi- or Multi-vessel coronary stenosis was documented by angiography. Twenty-five apo(a) isoforms were detected by a high resolution phenotyping method. Lp(a) levels did not show any differences among subgroups of patients. Both the percentage of apo(a) isoforms of low molecular weight (

To investigate plasma concentrations of lipoprotein(a) [Lp(a)] and apolipoprotein(a) [apo(a)] polymorphism in relation to the presence of microvascular and neurological complications in type 1 diabetes mellitus, 118 young diabetic patients and 127 age-matched controls were recruited. Lp(a) levels were higher in patients than in controls, but the apo(a) isoforms distribution did not differ between the two groups [higher prevalence of isoforms of high relative molecular mass (RMM) in both groups]. Microalbuminuric patients had Lp(a) levels significantly greater than normoalbuminuric patients, and normoalbuminuric patients showed higher Lp(a) levels than controls. Patients with retinopathy or neuropathy showed similar Lp(a) levels to those without retinopathy or neuropathy. No differences in apo(a) isoforms frequencies were observed between subgroups with and without complications (higher prevalence of isoforms of high RMM in every subgroup). However, among patients with retinopathy, those with proliferative retinopathy had higher Lp(a) levels and a different apo(a) isoforms distribution (higher prevalence of isoforms of low RMM) than those with non-proliferative and background retinopathy (higher prevalence of isoforms of high RMM). Our data suggest that young type 1 diabetic patients without microalbuminuria have Lp(a) levels higher than healthy subjects of the same age. Lp(a) levels are further increased in microalbuminuric patients. High Lp(a) levels and apo(a) isoforms of low RMM seem to be associated with the presence of proliferative retinopathy, but have no relation to neuropathy.

AIM The purpose of the study was to investigate lipoprotein (a) (Lp(a)) levels and apolipoprotein (a) (apo(a)) phenotypes, and their relationship with a family history of coronary heart disease (CHD) in patients with essential hypertension (EH). METHODS One hundred and eight newly diagnosed patients with mild to moderate EH and 159 controls were studied. Lp(a) levels were determined with an ELISA method. Apo(a) isoforms were identified by a capillary immunoblotting technique. RESULTS Lp(a) levels and frequency distribution of apo(a) isoforms did not show significant differences between patients and controls. Lp(a) levels in hypertensives with a family history of CHD were significantly higher than in those without a family history of CHD (P < 0.01). Hypertensives with a family history of CHD showed significantly different frequencies of apo(a) isoforms to those without a family history of CHD (P < 0.05). In EH patients with a family history of CHD, apo(a) isoforms of low molecular weight (MW) had a higher prevalence (62.6%), while in hypertensives without a family history of CHD, apo(a) isoforms of high MW were prevalent (81.6%); the difference between the two subgroups was significant (P < 0.001). Multivariate analysis showed that both Lp(a) levels and apo(a) isoforms of low MW are significant variables in distinguishing between the subgroups. CONCLUSIONS Lp(a) levels and apo(a) phenotypes do not differ between hypertensives and controls. High Lp(a) levels and apo(a) isoforms of low MW are strongly associated with a family history of CHD in hypertensives. The quantification of Lp(a) levels and the characterization of apo(a) phenotypes may be used for assessment of familial predisposition to CHD in hypertensives.

The neu_ART project aims at developing state of the art transmission imaging and computed tomography techniques, applied to art objects, by using neutrons as well as more conventional X-rays. In this paper a facility for digital X-ray radiography of large area paintings on canvas or wooden panels and for the X-ray tomography of large size wooden artifacts, recently installed in a protected area, is presented. The results of a K-edge radiography facility that will soon be installed in the same area are also shown.

Aims and background. Malignant pericardial effusion and cardiac tamponade are known complications of many advanced malignancies such as breast cancer, lung cancer,lymphomasandleukemias.Overallsurvivalislow,duetoothermetastaticlo calizations. The present study evaluated the clinical outcome and prognosis in pa tients with advanced cancer with pericardial effusion. Methods. We studied 7 patients, 4 men and 3 women, with malignant pericardial ef fusion, affected by breast cancer (2 patients), lung cancer (adenocarcinoma in 3 pa tients, microcytoma in 1 patient), and B-cell non-Hodgkin lymphoma (1 patient). All patients underwent pericardiocentesis; 3 patients underwent an instillation of thiotepa. Results. One terminal patient treated with pericardiocentesis died after only a few hours.Alltheremainingpatientsexperiencedimmediatesymptomaticimprovement and no operative complications. At the end of the study period, 2 patients were alive at59and33months,respectively,and4diedofdiseaseprogressionat1to32months (mean, 10.5). Conclusions .Pericardiocentesisisanactivenecessaryapproach,and intrapericardial treatment with thiotepa was able to reduce pericardial effusion and to prevent its reaccumulation.The standard treatment of malignant effusion and cardiac tampon ade has not yet been defined. Physicians should consider the status and the progno sis of each case. Free full text available at www.tumorionline.it

Objectives. The purpose of this study was to investigate lipoprotein(a) [Lp(a)] levels and apolipoprotein(a) [apo(a)] phenotypes in relation to age of onset of coronary heart disease (CHD).Background. Although Lp(a) levels have been extensively analyzed in relation to age of CHD, apo(a) phenotypes have not.Methods. Three hundred and thirty-five consecutive CHD patients were enrolled and grouped according to their age of CHD onset (

BACKGROUND Besides hypertension, several cardiovascular risk factors can play a role in the development of coronary heart disease (CHD) in hypertensive patients. Lipoprotein(a) [Lp(a)] is an important and independent cardiovascular risk factor, but its role in the development of CHD in hypertensives has not been studied. OBJECTIVE To investigate whether or not Lp(a) levels and isoforms of apolipoprotein(a) [apo(a)] are predictors of CHD in patients with essential hypertension. METHODS Lp(a) levels and apo(a) polymorphism were evaluated in 249 patients with essential hypertension, in 142 non-hypertensive patients with CHD and in 264 healthy controls. RESULTS Hypertensives with CHD (n = 61) had Lp(a) levels [19 (range 0.5-73.5) versus 7 mg/dl (range 0-83.5), P < 0.001] and a percentage of apo(a) isoforms of low (< 655 kDa) relative molecular mass (RMM, 59.2 versus 25.9%, P < 0.001) higher than did those without CHD (n = 188). Moreover, there were more subjects with at least one apo(a) isoform of low RMM in the subgroup of patients with CHD than there were in that of those without CHD (80.3 versus 30.8%, P< 0.001). Lp(a) levels and apo(a) polymorphism did not differ significantly between hypertensive and non-hypertensive patients with CHD. Stepwise regression analysis indicated that high Lp(a) levels (P= 0.002073) and particularly the presence of at least one apo(a) isoform of low RMM (P < 0.000001) are strong predictors of CHD in hypertensive patients. CONCLUSIONS Our data show that high Lp(a) levels and the presence of at least one apo(a) isoform of low RMM are strong and independent genetic risk factors for CHD in hypertensive patients. These findings suggest that Lp(a) and apo(a) isoforms should be assessed together with other cardiovascular risk factors to establish the overall CHD risk status of each hypertensive patient