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PURPOSE: To monitor improvements and follow-up of patients with EDs (Eating Disorders), and BED (Binge Eating Disorder) in the Regional Reference Center for the Physiopathology of Nutrition of Teramo, Italy. METHODS: All the access for EDs (diagnosed according to DSM-IV) were recorded at first visit and follow up. The diagnoses and characteristics of patients from the Teramo area, who enjoy easier access to the service were compared to those of patients from other local health authorities. The degree of improvement in BMI between the first and last appointment of patients with AN (anorexia nervosa), and the average time of treatment, were noted. Microsoft Excel was used for data storing and processing. Statistical analysis was performed by the X-Lstat software. RESULTS: Of the 169 patients registered, 90.5% were female. The average age of patients followed by the Centre for eating disorders was 29.3 (60.9% of the cases were in the youth age bracket). In local patients, the AN is corrected with greater success and in less time compared to cases of AN in active mobility. CONCLUSIONS: This study shows that an integrated multidisciplinary outpatient service provides continuity of care and more support to patients coming from the province. The data demonstrate that the ability of the outpatient structure to intercept early cases and offer effective therapeutic itineraries is directly related to its accessibility. These data provide valuable references for a more rational and thoughtful use of available resources and to begin the development of a registry of EDs in Abruzzo’s region in center of Italy.

Background Aromatase inhibitors (AIs) are more effective than tamoxifen as neoadjuvant endocrine therapy (NET) for hormone receptor (HR)-positive breast cancer. Here we report the surgical and long-term outcome of elderly postmenopausal patients with locally advanced, HR-positive breast cancer treated with preoperative AIs. Methods Between January 2003 and December 2012, 144 postmenopausal patients inoperable with breast conservative surgery (BCS) received letrozole, anastrozole, or exemestane as NET. Patients underwent breast surgery and received adjuvant AIs. Adjuvant systemic therapy, chemotherapy and/or trastuzumab, and adjuvant radiotherapy were administered as appropriate, but limited to high-risk patients with few or no comorbidities. Results After a median follow-up of 49 months, 4 (3.0 %) patients had local relapse, 18 (12.5 %) had distant metastases, and 24 (17.0 %) died. BCS was performed in 121 (84.0 %) patients. A tumor size

Aims and background: Erlotinib approval was supported by the positive results of a large multicentric phase III trial (BR.21 study) that included 10% Asiatic patients and the remaining were North-American Caucasian. It is well-known that the efficacy of tyrosine kinase inhibitors is strongly influenced by ethnicity and other genetic factors. It is, therefore, relevant to establish whether the same profile of efficacy is seen in an unselected population and whether the results of BR.21 can be generalized to other patient populations, such as that described here. Methods: In this retrospective, observational, multicentric study, we assessed effectiveness and potentially response predictive factors in 222 unselected Italian patients, with stage IIIB/IV non-small-cell lung cancer, with performance status from 0 to 3, who had received at least one line of chemotherapy, treated with the standard dose of erlotinib (150 mg once daily) until disease progression or unacceptable toxicity. Results: The disease control rate was 60.9% (135 patients). Median progression-free survival and overall survival times were 3.1 months and 7.97 months, respectively. The characteristics of non-smoker, female gender, performance status 0 or 1 were associated with a significantly better prognosis in terms of disease control rate and were also predictive of longer overall survival and progression-free survival. The 1-year survival rate was 38.79%. Even though Italian patients baseline characteristics were strongly different to those reported in pivotal BR.21 trial in terms of age, performance status, line treatment and ethnic group, our study confirms the favorable effectiveness profile in real clinical practice of erlotinib according to results from the pivotal study BR.21. Conclusions: Today, we know that epidermal growth factor receptor (EGFR) status assessment is mandatory before starting first-line therapy and that the presence of only certain clinical characteristics initially associated with sensitivity to EGFR-tyrosine kinase inhibitors, as reported in this study, is not sufficient in selecting patients candidates to such treatments.

Purpose The aim of this study is to evaluate the long-term outcome of patients with locally advanced breast cancer treated with neoadjuvant systemic chemotherapy (NST) in routine clinical practice. Methods Four hundred and nine patients were identified between January 1999 and December 2011. All patients received NST followed by surgery, adjuvant treatments and radiotherapy, as appropriate. Results At Kaplan–Meier analysis, patients with surgical stage III disease were more likely to develop distant metastasis and die from breast cancer (p

Gemcitabine is a commonly used chemotherapeutic agent for a variety of tumors. Although this nucleoside analog antineoplastic agent is similar in structure to cytarabine, central nervous system toxicities have rarely been attributed to gemcitabine. The posterior reversible encephalopathy syndrome (PRES) is a condition characterized by reversible neurological and radiological findings that has been associated with use of chemotherapeutic and more recently novel targeted therapies. We describe one case of a 41-year-old woman with PRES under treatment for leiomyosarcoma because of the probable association with gemcitabine. Our case, to our knowledge, represents the seventh published report of this particular toxicity. Naranjo algorithm, efficacious method for assessing the causality of adverse drug reactions (ADRs) from a case report, suggests a direct casual relationship. PRES is probably a rare complication of gemcitabine, but the oncologist should take it into careful consideration, because PRES is reversible with treatment of current hypertension or removal of the causative agent. However, failure to quickly recognize the syndrome and discontinue the offending agent may result in profound and permanent central nervous system dysfunction or death.

Purpose of this research was to analyse the rare diseases drug supply paths in the Italian region of Campania (Health District 47 of the Local Medical Company Naples 1), with a particular focus on current regulations in this field, and quantify the economic incidence of such pathologies in each quarter of 2007 and 2008. Rare, or orphan, diseases are especially serious and onerous from every point of view. Patients meet significant difficulties in obtaining information and in identifying the most appropriate treatment path within the health care system. Pharmaceutical prescriptions were analysed in order to identify the number of patients for each pathology in each quarter of the years 2007 and 2008, the drugs used, the quantity of each drug, and the costs for treatments. Data show a significant increase of costs during each quarter of the year 2008, as well as from 2007 to 2008. In the absence of specific guidelines for the Campania Region, the Local Medical Company of Naples 1 has established a procedure for patients affected by rare diseases that enables them to receive at no cost products that otherwise would not be distributed for free by the health care system.

Hydroxamate-based histone deacetylase inhibitors (Hb-HDACIs), such as vorinostat, belinostat and panobinostat, have been previously shown to have a wide range of activity in hematologic malignancies such as cutaneous T-cell lymphoma and multiple myeloma. Recent data show that they synergize with a variety of cytotoxic and molecular targeted agents in many different solid tumors, including breast, prostate, pancreatic, lung and ovarian cancer. Hb-HDACIs have a quite good toxicity profile and are now being tested in phase I and II clinical trials in solid tumors with promising results in selected neoplasms, such as hepatocarcinoma. This review will focus on their clinical activity and safety in patients with advanced solid neoplasms.

A combined analytical/numerical approach is proposed to address the problem of the ship roll motion under the combined action of wind and waves. The approach is modular allowing an easy update of the methodology on the basis of new research outcomes. Realistic environmental conditions regarding both wind and waves are considered. The spatial correlation of wind gusts is taken into account by means of an “aerodynamic admittance” function. The proposed analytical procedure allows obtaining approximate statistical averages of the roll motion without necessarily resorting to time consuming Monte Carlo simulations. On the basis of the results obtained, an estimation of the capsize probability can be carried out. It seems that the effect of wind gustiness could be considered negligible when compared to the effect of waves and of mean wind speed if the ship roll period is not too large. Finally, the presented approach moves towards the concept of “performance based analysis”, recently introduced at IMO as the basis for future developments of Intact Stability, in a clear and formal way.

This paper addresses, starting from an extensive series of tests in longitudinal regular waves, the problems connected with the threshold formulation for parametric rolling and its amplitude modelling above threshold. Both head and following waves have been considered, also in view of the greater attention to head sea conditions called during IMO/SLF discussion on the revision of the Intact Stability Code. Particular attention is given to the nonlinear damping, nonlinear restoring and nonlinear parametric excitation terms. The mathematical models so developed are “compared” with experimental results by means of an ad hoc parameter estimation technique. The experimental results show that a preliminary analysis of the possibility of the onset of parametric rolling can be done by using standard hydrostatic packages allowing for the computation in longitudinal waves. The amplitude above threshold needs, however, a nonlinear approach. The subject is discussed in connection with a series of experiments on scale models of naval ships (a frigate and a destroyer) which exhibited large amplitude rolling in head waves in some loading conditions.