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Neoadjuvant-intensified treatment for rectal cancer:Time to change?

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World Journal of Gastroenterology 2013年第20期19卷 3052-3061页

作者： Daniela Musio Francesca De Felice Nadia Bulzonetti Roberta Guarnaccia rossella Caiazzo Caterina Bangrazi Nicola Raffetto Vincenzo Tombolini Department of Radiotherapy Policlinico Umberto I University of Rome "Sapienza"00161 RomeItaly

AIM:To investigate whether neoadjuvant-intensified radiochemotherapy improved overall and disease-free survival in patients with locally advanced rectal ***:Between January 2007 and December 2011,80 patients with histologically confirmed rectal adenocarcinoma were *** were clinically classified as either T3 or T4 and by the N stage based on the presence or absence of positive regional lymph *** received intensified combined modality treatment,consisting of neoadjuvant radiation therapy(50.4-54.0 Gy) and infusional chemotherapy(oxaliplatin 50 mg/m 2) on the first day of each week,plus five daily continuous infusions of fluorouracil(200 mg/m 2 per die) from the first day of radiation therapy until radiotherapy *** received five or six cycles of oxaliplatin based on performance status,clinical lymph node involvement,and potential risk of a non-sphincter-conserving surgical *** was planned 7 to 9 wk after the end of radiochemotherapy treatment;adjuvant chemotherapy treatment was left to the oncologist's discretion and was recommended in patients with positive lymph *** treatment,all patients were monitored every three months for the first year and every six months for the subsequent ***:Of the 80 patients enrolled,75 patients completed the programmed neoadjuvant radiochemotherapy *** patients received the radiotherapy prescribed total dose;five patients suspended chemotherapy indefinitely because of chemotherapyrelated *** least five cycles of oxaliplatin were administered to 73 *** was well tolerated with high compliance and a good level of *** of the acute toxic effects observed were classified as grades *** grade 2 was the most common symptom(63.75%) and the earliest manifestation of acute *** toxicity grades 3-4 was reported in 30% of patients and grade 3 or 4 diarrhoea reported in just three patients(3.75%).Seventy-seven

关键词： Rectal cancer Neoadjuvant treatment Intensified radiochemotherapy Oxaliplatin Fluorouracil

Negative capsule endoscopy in patients with obscure gastrointestinal bleeding reliable: Recurrence of bleeding on long-term follow-up

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World Journal of Gastroenterology 2013年第28期19卷 4520-4525页

作者： Maria Elena Riccioni Riccardo Urgesi rossella Cianci Gianluca Rizzo Luca D'Angelo Riccardo Marmo Guido Costamagna Digestive Endoscopy Unit Catholic University of Rome 00168 Rome Italy Gastroenterology and Digestive Endoscopy Unit Ospedale Belcolle 01100 Viterbo Italy Department of Internal Medicine Catholic University of Rome 00168 Rome Italy Department of Surgery Catholic University of Rome 00168 Rome Italy Department of Neurosurgery Ospedale Belcolle 01100 Viterbo Italy Gastroenterology Unit Ospedale di Polla 84035 Polla Salerno Italy

AIM: To assess the rate of recurrent bleeding of the small bowel in patients with obscure bleeding already undergone capsule endoscopy (CE) with negative results. METHODS: We reviewed the medical records related to 696 consecutive CE performed from December 2002 to January 2011, focusing our attention on patients with recurrence of obscure bleeding and negative CE. Evaluating the patient follow-up, we analyzed the recurrence rate of obscure bleeding in patient with a negative CE. Actuarial rates of rebleeding during follow-up were calculated, and factors associated with rebleeding were assessed through an univariate and multivariate analysis. A P value of less than 0.05 was regarded as statistically significant. The sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of negative CE were calculated. RESULTS: Two hundred and seven out of 696 (29.7%) CE studies resulted negative in patient with obscure/overt gastrointestinal bleeding. Overall, 489 CE (70.2%) were positive studies. The median follow-up was 24 mo (range 12-36 mo). During follow-up, recurrence of obscure bleeding was observed only in 34 out of 207 negative CE patients (16.4%); 26 out of 34 with obscure overt bleeding and 8 out of 34 with obscure occult bleeding. The younger age (< 65 years) and the onset of bleeding such as melena are independent risk factors of rebleeding after a negative CE (OR = 2.6703, 95%CI: 1.1651-6.1202, P = 0.0203; OR 4.7718, 95%CI: 1.9739-11.5350, P = 0.0005). The rebleeding rate (CE+ vs CE-) was 16.4% vs 45.1% (χ 2 test, P = 0.00001). The sensitivity, specificity, and PPV and NPV were 93.8%, 100%, 100%, 80.1%, respectively. CONCLUSION: Patients with obscure gastrointestinal bleeding and negative CE had a significantly lower rebleeding rate, and further invasive investigations can be deferred.

关键词： Capsule endoscopy Enteroscopy Anemia Obscure gastrointestinal bleeding Rebleeding

Free electron lasers driven by plasma accelerators:status and near-term prospects

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High Power Laser Science and Engineering 2021年第4期9卷 112-126页

作者： C.Emma J.Van Tilborg R.Assmann S.Barber A.cianchi S.Corde M.E.Couprie R.D'Arcy M.Ferrario A.F.Habib B.Hidding M.J.Hogan C.B.Schroeder A.Marinelli M.Labat R.Li J.Liu A.Loulergue J.Osterhoff A.R.Maier B.W.J.Mc Neil W.Wang SLAC National Accelerator Laboratory Menlo ParkCA 94025USA BELLA Center Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA Deutsches Elektronen-Synchrotron DESY 22607 HamburgGermany INFN-LNF 00044 FrascatiItaly LOA ENSTA ParisCNRSEcole PolytechniqueInstitut Polytechnique de Paris91762 PalaiseauFrance Synchrotron SOLEIL L'Orme des MerisiersSaint-Aubin91192 Gif-sur-YvetteFrance Scottish Centre for the Application of Plasma-Based Accelerators SCAPA Department of PhysicsUniversity of StrathclydeScottish Universities Physics Alliance SUPAGlasgow G11XQUK Shanghai Institute of Optics and Fine Mechanics Chinese Academy of SciencesShanghai 201800China Department of Physics University of StrathclydeScottish Universities Physics Alliance SUPAGlasgow G1IXQUK Cockcroft Institute Warrington WA44ADUK

Owing to their ultra-high accelerating gradients,combined with injection inside micrometer-scale accelerating wakefield buckets,plasma-based accelerators hold great potential to drive a new generation of free-electron lasers(FELs).Indeed,the first demonstration of plasma-driven FEL gain was reported recently,representing a major milestone for the *** groups around the world are pursuing these novel light sources,with methodology varying in the use of wakefield driver(laser-driven or beam-driven),plasma structure,phase-space manipulation,beamline design,and undulator technology,among *** paper presents our best attempt to provide a comprehensive overview of the global community efforts towards plasma-based FEL research and development.

关键词： plasma accelerators free electron lasers novel light sources

Predictability and Management of OARs Toxicity in Patients with Prostate Cancer Treated with High-Dose Radiotherapy

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Journal of Cancer Therapy 2013年第10期4卷 1452-1458页

作者： Vincenzo Ravo Domenico Borrelli Sara Falivene rossella Di Franco Matteo Muto Angela Argenone Valentina Borzillo Fabrizio Cammarota Paolo Muto Radiotherapy Emicenter Naples Italy Radiotherapy of Second University of Naples Naples Italy Radiotherapy Unit Istituto Nazionale per lo Studio e la Cura dei Tumori “Fondazione Giovanni Pascale”—IRCCS Naples Italy

Aim: To evaluate the predictability of toxicity analyzing the dose-volume histograms (DVHs) and to verify the effectiveness of preventive measures limiting side toxicity considering the evolution of the radiation techniques for prostate cancer treatment. Materials and Methods: 208 patients with localized prostate cancer were treated with exclusive radiotherapy until 73.8 Gy (group A) or 79.2 Gy (group B) with the dose escalation technique. Preventive measures to minimize the side effects were recommended in group B. Results: The assessment of genitourinary toxicity was similar while gastrointestinal toxicity was better in group B. Valuating the treatment plans, we found that most of the patients developing toxicity had “borderline” DVHs. Conclusion: Our analysis led to the establishment of a protocol for the management of patients with “border-line” DVH.

关键词： Toxicity Radiotherapy Prostate Cancer Prevention

Body Image and Personality in Aesthetic Plastic Surgery: A Case-Control Study

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Open Journal of Medical Psychology 2015年第2期4卷 35-44页

作者： Valentina Elisabetta Di Mattei Elena Pagani Bagliacca Luca Lavezzari rossella Di Pierro Letizia Carnelli Paola Zucchi Franz Baruffaldi Preis Lucio Sarno San Raffaele Hospital Milan Italy University Vita-Salute San Raffaele Milan Italy Department of Psychology University of Milano Bicocca Milan Italy Orthopaedic Institute Galeazzi Milan Italy

Introduction: The amount of research on the relationship between plastic surgery and psychological features, such as personality disorders and indexes of body image dissatisfaction, has increased significantly in the last years. Aim: The aim of the present study was to examine these psychological features among Italian patients who underwent aesthetic plastic surgery, testing the mediating role of the mass media influence on the relationship between them and the choice of aesthetic plastic surgery. The Personality Diagnostic Questionnaire 4+ (PDQ-4+) and the Body Uneasiness Test (BUT) were administered to patients who underwent aesthetic plastic surgery (N = 111) and participants who had no history of aesthetic plastic surgical procedures (N = 149). Results: Results showed that aesthetic patients reported higher indexes of body image disturbance than controls. No significant differences between aesthetic participants and controls were found in all three cluster B personality disorders. Moreover, the effect of body image dissatisfaction on the choice to undergo aesthetic plastic surgery was partially mediated by the influence of mass media. Conclusions: In conclusion, the present study confirmed the importance of body dissatisfaction as a predictor of the choice to undergo aesthetic surgery and highlighted the influence of media messages regarding physical appearance.

关键词： Body Image Dissatisfaction Plastic Surgery Personality Disorders Mass Media

Challenges of Improving Intensive Care Medicine in Eritrea: Impact of an Italian Cooperative Project of Educational and Clinical Support

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Open Journal of Anesthesiology 2013年第7期3卷 315-319页

作者： Valentina Anichini Giovanni Zagli Hagos Goitom Giovanni cianchi Andrea Cecchi Lucia Perretta Emanuele Bigazzi Barbara Gazzini Simone Proietti Alessandro Di Filippo Simone Toccafondi Gianfranco Gensini Giancarlo Berni Adriano Peris Anesthesia and Intensive Care Unit of Emergency Department Careggi Teaching Hospital Florence Italy Anesthesia and Intensive Care Faculty of Medicine University of Florence Florence Italy Department Intensive Care Unit Orotta National Referral Hospital Asmara Eritrea Department of Critical Care Medicine and Surgery Careggi Teaching Hospital Florence Italy First Aid of Emergency Department Careggi Teaching Hospital Florence Italy Tuscany Region Sanitary System Florence Italy.

Intensive care in Africa is available only in teaching or referral hospitals. Here we report the experience of a multidisciplinary collaboration between physicians and nurses of the Emergency Department (First Aid and Intensive Care Unit) of a tertiary referral hospital (Careggi Teaching Hospital, Florence, IT) and physicians and nurses of Orotta National referral Hospital in Asmara, Eritrea. The project was aimed at performing clinical assistance and training on the job to the local staff to improve the standard of care in the local Emergency Department. The duration of the project was initially planned to be 30 months, but unfortunately it was interrupted after 18 months because of lack of funds. The Italian staff was composed of two physicians and two nurses per period. To monitor local ICU activity, a retrospective survey of 36 months was performed. During the 36 months of data collection, 1169 patients were admitted to the ICU. Intra-ICU mortality rate resulted comparable before, during, and after Italian presence. On the contrary, the 28-day mortality resulted significantly lower bo th during and after the Italian stay. After project interruption, the Italian staff maintained contact with the Eritrean ICU personnel, who were invited to attend the Italian ICU for one month per year, and collected information about Orotta ICU activities.

关键词： Intensive Care Unit Developing Countries MEWS

Intra-hepatic and extra-hepatic cholangiocarcinoma:New insight into epidemiology and risk factors

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World Journal of Gastrointestinal Oncology 2010年第11期2卷 407-416页

作者： Vincenzo Cardinale rossella Semeraro Alessia Torrice Manuela Gatto Cristina Napoli Maria Consiglia Bragazzi Raffaele Gentile Domenico Alvaro Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche Sapienza University of Rome00185 RomeItaly

Cholangiocarcinoma(CCA) is a malignant tumour that arises from biliary epithelium at any portion of the biliary *** is currently classified as intra-hepatic or extra-hepatic CCA(EH-CCA).Recent evidences suggest that intra-hepatic CCA(IH-CCA) and EH-CCA are biologically different cancers,giving further support to a number of recent epidemiological studies showing large differences in terms of incidence,mortality and risk *** purpose of this manuscript is to review recent literature dealing with the descriptive epidemiology and risk factors of CCA with a special effort to compare IH-with EH-CCA.

关键词： Liver flukes Viral hepatitis Liver stem cells Peribiliary glands Epidemiology Extra-hepatic cholangiocarcinoma Risk factors Primary sclerosing cholangitis Intra-hepatic cholangiocarcinoma Liver cirrhosis

Prevention and Treatment of Radiation Induced Skin Damage in Breast Cancer

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Journal of Cosmetics, Dermatological Sciences and Applications 2014年第1期4卷 16-23页

作者： rossella Di Franco Vincenzo Ravo Sara Falivene Angela Argenone Valentina Borzillo Francesca Maria Giugliano Elena Sammarco Matteo Muto Salvatore Cappabianca Paolo Muto Radiation Oncology Istituto Nazionale per lo Studio e la Cura dei Tumori-Fondazione “Giovanni Pascale” IRCCS Naples Italy Radiation Oncology Muto-Onlus Foundation of Naples Casavatore Naples Italy Radiation Oncology Second University of Naples Naples Italy U.O.S. of Dermatology P.O. Ascalesi Naples Italy

Introduction: Skin toxicity is a frequent side effect of radio and chemo-treatments in patients treated for breast cancer after conservative surgery. The aim of this paper is to report our experience in the management of skin toxicity evaluating radiotherapy planning and using preventive local aids. Materials and Methods: We have observed 300 patients undergoing radiotherapy. All received the prescription of a prophylactic moisturizing cream. Skin toxicity was valuated according to Acute Radiation Morbidity Scoring Criteria of the RTOG. Moreover, in a subgroup of 100 patients, we correlated the study of breast volume and features of treatment plans, with the addition of topic prophylactic treatment, using an oral therapy based on Resveratrol, Lycopene, Vitamin C and Anthocyanins (Ixor?). In another subgroup, 100 patients were subjected to corneometry assessing numerically skin hydration before, during and after radiotherapy. Results: In all patients, we related skin toxicity and the type of cream used. All patients completed the radiotherapy treatment, and G4 cutaneous toxicity was not observed in any of them. In patients treated with topic treatment and therapy based on Resveratrol, Lycopene, Vitamin C and Anthocyanins (Ixor?), the protective effect of (Ixor?) is more detected in patients with PTV (Planning Target Volume) <500 ml, when Dmax reaches values lower or equal to 107%, but not exceeding 110% of the prescribed dose, and in patients undergoing adjuvant chemotherapy with anthracyclines and taxanes. The values of corneometry allow us to evaluate the moisturizing effect for products used, and identify cases of skin toxicity in a first phase. Conclusions: Our study confirms the value of moisturizers in the prevention and resolution of radiotherapy-induced skin damage. An instrumental assessment of skin hydration with corneometry can help the radiation oncologist to use strategies that prevent the onset of toxicity of high degree.

关键词： Skin Toxicity Prevention and Treatment Radiotherapy

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激光诱导动力学磷光法直接检测痕量铀

国外铀金地质 1993年第3期10卷 270-278页

作者： rossella Brina Allan G.Miller 钟妙兰核工业北京地质研究院 100029

动力学磷光法提供了一种直接测定水溶液中从ng/L—mg/L级范围内铀的快速。灵敏、准确方法。其检出限达1ng/L。铀的特性曲线从检出限到1mg/L呈线性关系。些技术能校正存在于基体熄灭作用的磷光数据。因此,绝大多数实际样品能直接地或经... 详细信息

动力学磷光法提供了一种直接测定水溶液中从ng/L—mg/L级范围内铀的快速。灵敏、准确方法。其检出限达1ng/L。铀的特性曲线从检出限到1mg/L呈线性关系。些技术能校正存在于基体熄灭作用的磷光数据。因此,绝大多数实际样品能直接地或经有限的样品预处理后进行分析。本技术对环境、地质、生物样品的例行分析很容易且有效。铀的浓度高于0.1μg/L的样品,给出的相对标准偏差(RSD)低于5％。其基体熄灭效应采用铀酰离子磷光的动力学分析方法消除。

关键词：铀磷光法激光诱导动力学