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Radium-223 has improved overall survival (OS) and reduced symptomatic skeletal events (SSE) in patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastases (ALSYMPCA trial). Our aim was to assess clinical and biochemical factors related to survival, safety and survival outcomes of Radium-223 in a clinical practice setting. We retrospectively analysed 32 mCRPC patients treated with Radium-223, assessing bone scan, pain reduction, alkaline phosphatase (ALP) and prostate-specific antigen (PSA) response (≥30% reduction). At scintigraphic assessment, 41% had partial response with a disease control rate of 91%; 56% had ALP response and 25% had PSA response; 41% had pain reduction with pain control of 72%. Scintigraphic response and stability were correlated with longer median progression-free survival (mPFS) (13 and 12 vs. 6 months; P=0.002) and mOS (16 and 12 vs. 6 months; P=0.003). ALP response was associated with longer mPFS (13 vs. 12 months; P=0.2) and mOS (16 vs. 12 months; P=0.2). PSA response was associated with longer mPFS (13 vs. 12 months; P=0.02), whereas mOS could not be computed. Pain response and stability were associated with survival benefit according to mPFS (13 and 12 vs. 9 months) and mOS (both 16 vs. 12 months) without statistical significance. Baseline ALP <220 UI/l, Eastern Cooperative Oncology Group (ECOG) performance status 0 and absence of previous chemotherapy correlated with statistically significantly longer survival outcomes. Skeletal-related events (SRE) occurred in three patients and median time to first SRE was 9.5 months, mPFS was 12 months and mOS 14 months. G3-G4 toxicities developed in 16% of patients. Our results are in line with those reported in the pivotal trial and in other retrospective studies. In conclusion, Radium-223 was associated with high scintigraphic, biochemical and pain response rates and was tolerated well by most patients. Response to Radium-223 and better baseline factors correlated to longer survival in clinical practice experience as in the clinical trial setting. [ABSTRACT FROM AUTHOR]

One of the most relevant problems in principal component analysis and factor analysis is the interpretation of the components/factors. In this paper, disjoint principal component analysis model is extended in a maximum-likelihood framework to allow for inference on the model parameters. A coordinate ascent algorithm is proposed to estimate the model parameters. The performance of the methodology is evaluated on simulated and real data sets. [ABSTRACT FROM AUTHOR]

Fotemustine (FTM) is a treatment option in recurrent malignant gliomas (MGs) after first-line Stupp treatment. The efficacy and the safety of fractionated FTM schedule proposed by Addeo et al was analysed in the present study in recurrent MGs patients. A retrospective analysis on 40 recurrent MGs patients and second-line fractionated FTM chemotherapy was performed. Response evaluation was assessed using RANO criteria and safety was assessed using CTCAE v.4.03. Subgroup analyses based on MGMT methylation, resurgery and reirradiation were performed. A review of the literature was also performed. The results revealed 5 partial responses (13%) and 19 stable diseases (47%) with a disease-control rate of 60%. Median progression-free survival (PFS) was 4 months, with a PFS of 33% at 6 months and 13% at 1 year. The median overall survival (OS) was 9 months and OS at 6 months was of 55% and at 1 year of 30%. Methylated patients experienced longer mPFS (6 vs. 3 months; p=0.004) and mOS (10 vs. 4 months; p<0.0001) compared with unmethylated patients. Patients treated with reirradiation experienced longer mPFS (5 vs. 3.5 months; p=0.48) and mOS (10 vs. 5 months; p=0.11). No survival benefit with resurgery was observed. Furthermore, the fractioned schedule was well tolerated, only 15% of patients developed severe myelotoxicities. Considering the present findings, fractionated FTM schedule is an efficient second-line option for MGs associated with an acceptable myelotoxicity profile. Additionally, MGMT methylation is associated with improved survival outcomes. However, this study highlights the requirement for further prospective randomized studies on resurgery and reirradiation. [ABSTRACT FROM AUTHOR]

The therapeutic management of recurrent malignant gliomas (MGs) is not determined. Therefore, the efficacy of a multimodal approach and a combination systemic therapy was investigated. A retrospective analysis of 26 MGs patients at first relapse treated with multimodal therapy (chemotherapy plus surgery and/or reirradiation) or chemotherapy alone was performed. Second-line chemotherapy consisted of fotemustine (FTM) in combination with bevacizumab (BEV) (cFTM/BEV) or followed by third-line BEV (sFTM/BEV). Subgroup analyses were performed. Multimodal therapy provided a higher overall response rate (ORR) (73 vs. 47%), disease control rate (DCR) (82 vs. 67%), median progression-free survival (mPFS) (11 vs. 7 months; P=0.08) and median overall survival (mOS) (13 vs. 8 months; P=0.04) compared with chemotherapy. Concomitant FTM/BEV resulted in higher ORR (84 vs. 36%), DCR (92 vs. 57%), mPFS (10 vs. 5 months; P=0.22) and mOS (11 vs. 5.2 months; P=0.15) compared with sFTM/BEV. Methylated patients did not experience additional survival benefits with multimodality treatment but had higher mPFS (10 vs 7.1 months; P=0.33) and mOS (11 vs. 8 months; P=0.33) with cFTM/BEV. Unmethylated patients experienced the greatest survival benefit with the multimodal approach (mPFS: 10 vs. 5 months; mOS 11 vs 6 months; both P=0.02) and cFTM/BEV (mPFS: 5 vs. 2 months; mOS 6 vs. 3.2 months; both P=0.01). In conclusion, in recurrent MGs, multimodal therapy and cFTM/BEV provide survival and response benefits. Methylated patients benefit from a cFTM/BEV but not from a multimodal approach. Notably, unmethylated patients had the highest survival benefit with the two strategies. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1DM) ethiopathogenesis is still being studied, since the role of environmental factors , especially viruses, is not yet clear. This study was conducted on 31 paediatric patients with T1DM at onset. We analysed: Coxsackieviruses A (CoxA), Coxsackieviruses B (CoxB), Echoviruses (Echo); Influenzavirus A and B (IV-A and IV-B); Adenovirus (AdV); Parainfluenza viruses 1-2 and 3 (PiV 1-2-3); Cytomegalovirus (CMV) and Respiratory Syncytial Virus (RSV). Enteroviruses, especially CoxB and Echo, are most represented. Unexpectedly, Parainfluenza viruses were detected in seasonal subgroups, with peaks in autumn and spring, and spread homogeneously in different age groups.

Objective: The study intends to include the evaluation of family styles while the patients are admitted at a hospital dedicated to the emergency (SPDC)., Methods: The sample of the study involved patients of a SPDC and their families. The clinical assessment has been conducted through the use of ICD-IX, DSM-5 and BPRS. During the stabilization phase, both patients and families have been administered a socio-demographic report and the FACES IV. The FACES Questionnaire assesses the family through eight scales (two scales indicating health-oriented functioning: Balanced Cohesion, Balanced Flexibility; four scales indicating problematic functioning: Disengagement, Hyper-involvement, Rigidity, Disorganization; a scale for Family Communication; a scale for Family Satisfaction)., Results: 35,7% has shown to be health-oriented in the sample. Patients have shown a significantly higher problematic perception of their family, compared to their parents, being more involved in the relationship. The patients have a disengaged-disorganized family style, parents have an average-unbalanced style. The age of patients over 30 correlates significantly with a dysfunctional view of their family relationships., Conclusions: Faced with an event that requires hospitalization, families have a greater tendency toward dysfunctionality, with a more painful perception than their children, partially counterbalanced by a greater functionality of the parents. The temporal element, the age of the patients and the duration of the illness seem significant elements in favor of a greater family problematic.