A new schedule of one week on/one week off temozolomide as second-line treatment of advanced neuroendocrine carcinomas (TENEC-TRIAL): a multicenter, open-label, single-arm, phase II trial

BACKGROUND

There is no consensus on the second-line treatment of patients with progressive high-grade neuroendocrine neoplasms (NENs G3) and large-cell lung neuroendocrine carcinoma. These patients generally have poor performance status and low tolerance to combination therapy. In this trial, we aim to evaluate the efficacy and safety of temozolomide given every other week in patients with advanced platinum-pretreated NENs G3.

PATIENTS AND METHODS

This trial is an open-label, non-randomized, phase II trial. Patients with platinum-pretreated metastatic neuroendocrine carcinoma were treated with 75 mg/m2/day of temozolomide for 7 days, followed by 7 days of no treatment (regimen one week on/one week off). The primary endpoint was the overall response rate. Secondary endpoints included progression-free survival (PFS), overall survival (OS), safety and tolerability. This study is registered with ClinicalTrials.gov, NCT04122911.

RESULTS

From 2017 to 2020, 38 patients were enrolled. Among the patients with determined Ki67, 12 out of 36 (33.3%) had a Ki67 index <55% and the remaining 24 out of 36 (66.6%) had an index ≥55%. Overall response rate was 18% (7/38), including one complete response and six partial responses. The median PFS was 5.86 months [95% confidence interval (CI) 4.8 months-not applicable) and the median OS was 12.1 months (95% CI 5.6-20.4 months). The 1-year PFS rate was 37%. No statistically significant difference in median PFS [hazard ratio 1.3 (95% CI 0.6-2.8); P = 0.44] and median OS [hazard ratio 1.1 (95% CI 0.5-2.4); P = 0.77] was observed among patients with Ki67 <55% versus ≥55%. Only G1-G2 adverse events were registered, the most common being G1 nausea, diarrhea and abdominal pain.

CONCLUSION

One week on/one week off temozolomide shows promising activity in patients with poorly differentiated NEN. The good safety profile confirmed the possibility of using this scheme in patients with poor performance status.

Cognitive dysfunction and psychopathology: a cohort study of adults with intellectual developmental disorder

BACKGROUND

Cognitive impairment of intellectual developmental disorders (IDD) is determined by several different combinations of specific cognitive alterations. People with IDD present a rate of mental health problems that is up to 4 times higher than that of the general population. Despite this, the relationship between specific cognitive dysfunctions and co-occurring mental disorders has not been adequately studied. The aim of the present paper is to investigate the association between specific cognitive dysfunctions and specific psychiatric symptoms and syndromes in people with IDD.

METHODS

One hundred and twenty adults with mild to moderate IDD living in residential facilities underwent a clinical and instrumental assessment for specific cognitive and psychopathological features.

RESULTS

Participants with IDD and ASD have significantly lower scores compared to those without respect to who has not the diagnosis on the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) on the WAIS-IV and higher time scores on the TMT A. Moreover, there is a significant association between years of hospitalisation and TMT B and TMT B A time scores; the longer a participant with IDD was hospitalised, the worse their performance on the TMT. Although not statistically significant, many psychopathological clusters showed substantial cognitive profiles.

CONCLUSIONS

Although further research is needed, neuropsychological and IQ tests scores seem to be differently associated to various psychopathological conditions co-occurring with IDD, and with ASD especially. Cognitive assessment seems to support diagnosis and treatment of psychopathological co-occurrences in persons with IDD, also in consideration of indirect implications including a better knowledge of the patient's characteristics beyond IQ deficit.

HPV self-sampling acceptability among women in Italy: preliminary results of a cross-sectional study

Background

Secondary prevention measures have strongly contributed to the reduction of incidence and mortality of cervical cancer (CC) identifying women at high risk of developing it. This cross-sectional study aimed to investigate the acceptability of a home-based self-sampling methodology for Human Papilloma Virus (HPV) testing and the factors that may influence women’s preference.

Methods

A random sample of women over the age of 50 years has been selected in Southern part of Italy. Data was collected through an anonymous self-administered questionnaire and included socio-demographic characteristics, knowledge of HPV infection and prevention measures, and attitudes towards the acceptability of self-collected cervico-vaginal sampling (CVS) and urine sampling (US).

Results

Among the 321 women who completed the survey, more than two-thirds (73.7%) knew that CC is caused by HPV, only 68.9% knew that the HPV screening is useful for an early detection and diagnosis of CC, and 17% never had Pap-test or HPV-DNA test. Of the respondents, 67.9% declared that they preferred self-collected US for future HPV testing compared with clinician-taken cervical samples (CCS). The most common reasons reported for preferring US included that it was easier (54.8%), more convenient (28.7%), and less embarrassing (21.7%). Among those women who showed negative attitude towards self-collected US, 8 out of 10 (77.3%) expressed scepticism about its diagnostic performance. Only 37% of the sample preferred CVS, and this attitude is mainly attributable to the fear of not carrying out a correct self-sampling (71.2%) and to its underrated diagnostic performance (33.7%).

Conclusions

The preliminary results suggest that US is more acceptable than CCS and CVS in Italy. Urinary HPV test presents similar accuracy of the latter tests to detect CC and its supply in the context of population-based screening programmes could improve adherence, reducing the cost and burden on physicians.

Key messages

• Urine self-sampling could represent an innovative early detection approach to increase adherence to cervical cancer screening programmes.

• Further research is needed to assess whether the screening status and the strategy of self-samplers distribution could act as predictors of screening uptake.

Preventing food contamination: preliminary results of a cross-sectional study among food handlers

Background

More than 600 million people around the world get sick every year due to eating contaminated food, which is impressive considering that all foodborne diseases (FDs) are preventable. Contamination during food preparation by food handlers (FHs) is one of the main causes of FDs. The aim of this study is to assess the knowledge and behaviors of FHs related to FDs.

Methods

The cross-sectional study was conducted in two regions (i.e. Calabria and Sicily) of Southern Italy. Data was collected through an anonymous self-administered questionnaire designed to retrieve sociodemographic information, knowledge about food safety, and food-handling behaviors among a randomly selected sample of FHs ≥ 18 years of age.

Results

Findings refer to a sample of 171 respondents with a mean age of 40 years (SD ± 12.7). A vast majority (63.7%) of FHs did not know the correct procedure for hand washing according to Food & Drug Administration (FDA) guidelines and 28.4% of subjects did not wash their hands after touching raw food, which constitutes a major risk of food cross-contamination. One-third of FHs were unknowledgeable that cross-contamination (e.g. using the same utensils for cooked and raw foods) could lead to FDs. Multiple logistic regression analysis showed a positive correlation (p &lt; 0.001) among good knowledge and proper food-handling practices, such as using separate kitchen utensils to prepare cooked and raw foods and storing them in separate areas or fridges. Less than half of the sample (42.1%) reported the need for more information about FDs.

Conclusions

Preliminary results highlight a lack of knowledge about simple rules to avoid food cross-contamination that could negatively impact on food safety and food-handling behaviors. This study add evidence about areas where intervention are needed to reduce the occurrence of FDs.

Key messages

Flu immunization during pregnancy: a cross-sectional study among Italian healthcare providers

Background

Flu vaccination during pregnancy has been proven to be effective in preventing illness and hospitalization in both pregnant women and newborns. However, flu vaccination uptake is still suboptimal. The study aimed to assess if healthcare providers (HCPs) are knowledgeable about flu vaccination recommendation during pregnancy and if they routinely recommend the vaccination.

Methods

The present survey was carried out among obstetricians-gynaecologists (OBs), midwives and primary care physicians (PCPs) in the Southern part of Italy. Data were collected through an anonymous self-administered questionnaire that included professional information, knowledge, perceptions and practices on flu vaccination during pregnancy.

Results

96 participants were hitherto enrolled (36.5% OBs, 35.4% PCPs and 28.1% midwives). Among the responders, 63.5% and 66.7% knew that flu vaccination can be administrated during any trimester of pregnancy and reduces the risk of preterm birth and miscarriage, respectively. Alarmingly, more than a fifth (22.9%) of the sample believed that vaccines during pregnancy are more dangerous than safe and only 67.7% routinely recommend the flu vaccine to all women regardless of their stage in pregnancy. Among HCPs who did not recommend the flu shot, the most frequently reported reasons were that flu vaccine recommendation was outside the scope of their practice (62.5%), that women are more hesitant about vaccines during pregnancy (37.5%) and lack of time (25%).

Conclusions

The preliminary results highlight alarming gaps in knowledge (e.g. immunization timing) and suboptimal routine recommendation of the flu vaccine that represents a missed opportunity. Indeed, it has been demonstrated that when women are offered vaccination, most tend to accept it.

Key messages

• Unmotivated concerns about vaccine safety during pregnancy have to be addressed among HCPs to enhance flu recommendation and, subsequently, immunization coverage in pregnant women.

• Strategies to disseminate evidence-based recommendations to HCPs regarding flu immunization during pregnancy have to be implemented and evaluated in order to improve public health.

Comparison between recommended and mandatory vaccine uptake during adolescence in Italy

Background

Immunization programs are key preventive interventions and have largely contributed to reducing the burden of infectious diseases and decreasing related morbidity, mortality and healthcare costs. The study aimed to investigate coverage regarding diphtheria, tetanus, and acellular pertussis (dTap) - Inactivated Poliomyelitis Vaccine (IPV) and Human Papilloma Virus (HPV) vaccine and attitudes towards vaccinations among undergraduate university students in Southern Italy.

Methods

This cross-sectional study was conducted among 327 students through an anonymous online questionnaire and included socio-demographic characteristics, attitudes towards vaccinations overall and specifically on dTap-IPV and HPV, reasons for having received or not vaccinations and willingness to receive vaccinations.

Results

One third of the students were concerned about serious adverse effects of vaccines and 95% believed that vaccines for uncommon diseases are useless. During adolescence, 89% of the sample received the mandatory dTap-IPV vaccine booster. Among unvaccinated students, 45% were unwilling to get vaccinated against dTap-IPV because they believed not to be at risk of infection (59%) and had lack of recommendation (35.3%). Regarding vaccination against HPV, 67% had received the recommended schedule. Among those who did not receive it, 34% were unwilling to get vaccinated because they did not feel at risk of HPV infection (41%). Interestingly, 16% of the sample disclosed some barriers to access vaccination centers. Moreover, 30% declared that HPV vaccination was discouraged by healthcare professionals (HCPs).

Conclusions

Vaccination uptake is worryingly low and national objective coverage seems not still achieved. Likewise, risk perception of vaccine-preventable diseases was low and it seems negatively impact on the intention to get vaccinated. Improving vaccine confidence among HCPs is crucial as they have been shown to have the potential to influence patient vaccination uptake.

Key messages

Understanding barriers to dTap vaccination recommendations during pregnancy among healthcare workers

Background

Diphtheria, tetanus and pertussis (dTap) vaccination is heavily endorsed during pregnancy. However, maternal dTap immunization rates in Italy remain low. Lack of healthcare workers (HCWs) recommendation to get vaccinated represents one of the main barriers to immunization during pregnancy. Therefore, this study aimed to investigate what HCWs know about dTap vaccination, practices and potential barrier to recommending immunization during pregnancy.

Methods

This cross-sectional study was conducted among obstetricians-gynaecologists (OBs), midwives and general practitioners (GPs) in 2 regions of Southern Italy. An anonymous self-administered questionnaire was used to collect data on professional information, knowledge, risk perceptions and practices regarding dTap vaccination during pregnancy.

Results

Until now 94 HCWs were recruited (36.2% OBs, 35.1% GPs and 28.7% midwives). Overall, 63.8% knew that dTap vaccination has to be administered during the third trimester of gestation and 94.7% that it is able to protect newborns against pertussis before active immunization. One-third of the HCWs believed that vaccines in pregnancy were more dangerous than safe. Seven out of ten HCWs routinely recommended dTap vaccine and provided information about dTap vaccination to all pregnant women. Most frequent reported reasons for not recommending dTap vaccination during pregnancy were that it was outside the scope of their practice (72.4%), that women are more vaccine hesitant during pregnancy (42.9%), lack of time (28.6%), lack of knowledge on the topic (28.6%) and the belief that the vaccine could interfere with the development of the fetus (14,3%).

Conclusions

Lack of knowledge, unsatisfactory recommendation of dTap immunization during pregnancy and uncertainty over their responsibility around vaccination suggest that public health organisations should strengthen dissemination and implementation of evidence-based recommendations.

Key messages

• Barriers to recommending dTap immunization during pregnancy remain among healthcare workers.

• Strategies (e.g. electronic reminders) to facilitate HCWs in recommending and informing on dTap immunization should be implemented and evaluated to improve vaccination coverage in pregnant women.

Patients with resolution of low-lying placenta and placenta previa remain at increased risk of postpartum hemorrhage

OBJECTIVE

To determine whether women who experience resolution of low placentation (low-lying placenta or placenta previa) are at increased risk of postpartum hemorrhage compared to those with normal placentation throughout pregnancy.

METHODS

This was a retrospective cohort study of women who delivered at Mount Sinai Hospital between 2015 and 2019, and who were diagnosed with low-lying placenta or placenta previa on transvaginal ultrasound at the time of the second-trimester anatomical survey, with resolution of low placentation on subsequent ultrasound examination. Women undergoing second-trimester anatomical survey who had normal placentation on transvaginal ultrasound 3 days before or after the cases were randomly identified for comparison. The primary outcome was the rate of postpartum hemorrhage. Secondary outcomes included the need for a blood transfusion, use of additional uterotonic medication, the need for additional procedures to control bleeding, and maternal admission to the intensive care unit. Outcomes were assessed using a multivariable logistic regression model.

RESULTS

A total of 1256 women were identified for analysis, of whom 628 had resolved low placentation and 628 had normal placentation. Women with resolved low placentation, compared to those with normal placentation throughout pregnancy, had significantly higher mean age (33.0 ± 5.4 years vs 31.9 ± 5.5 years; P < 0.01) and lower mean body mass index at delivery (27.9 ± 5.5 kg/m² vs 30.2 ± 5.7 kg/m² ; P < 0.01), and were more likely to have undergone in-vitro fertilization, be of non-Hispanic white race, have posterior placental location (all P < 0.01) and have private/commercial health insurance (P = 0.04). Patients with resolved low placentation vs normal placentation had greater odds of postpartum hemorrhage (adjusted odds ratio (aOR), 3.5 (95% CI, 2.0-6.0); P < 0.01), use of additional uterotonic medication (aOR, 2.2 (95% CI, 1.5-3.1); P < 0.01) and increased rates of additional procedures to control bleeding (aOR, 4.0 (95% CI, 1.3-11.9); P = 0.01).

CONCLUSION

Despite high rates of resolution of low-lying placenta and placenta previa by term, women with resolved low placentation remain at increased risk of postpartum hemorrhage compared to those with normal placentation throughout pregnancy. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

What drives inhaler prescription for asthma patients? Results from a real-life retrospective analysis

BACKGROUND

The choice of inhaler device for asthma patients depends upon multiple attributes. We investigated factors that may drive general practitioners (GPs) and respiratory specialists in the prescription of inhaler devices for asthma patients who initiated inhalation therapy.

METHODS

We retrospectively analysed prescriptions by GPs and respiratory specialists to asthma patients commencing inhaled corticosteroid/long-acting β2-agonist combination therapy available as both pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs). Patient characteristics were compared by device and multivariate analysis was used to model the likelihood of receiving a pMDI as opposed to a DPI in order to identify drivers for prescription. A sample of the respiratory specialists completed an ad-hoc survey of their perceived success in achieving asthma control in their patients and barriers to attaining full control.

RESULTS

Prescription of a particular inhaler device was unrelated to the characteristics of the patients. Multivariate analysis revealed that the main driver for the choice of inhaler device was the medication (Odds Ratio and 95% Confidence Interval, respectively for GPs and specialists: 0.19 [0.16-0.23]; 0.17 [0.08-0.37]). Specialists perceived asthma as being inadequately controlled in 41% of their patients, and considered patients' difficulties in using DPIs and pMDIs as instrumental in this, citing a need for a novel, more effective inhaler technology.

CONCLUSION

Physicians choose inhaler devices according to the prescribed drugs and not to the characteristics of the individual patient. This may reflect a lack of confidence in existing inhaler devices and underlines the need for technologies, which are more reliable and easier to use by patients.

The Island CGH, a new coding scheme: concept and demonstration

Computer generated holograms (CGHs) are powerful optical elements used in many fields, such as wavefront shaping, quality testing of complex optics, and anti-counterfeiting devices. The Lee algorithm is the most used to generate binary amplitude Fourier holograms. Grayscale CGHs are known to give a higher reconstruction quality than binary holograms, but they usually require a cumbersome production process. A very simple and straightforward method of manufacturing rewritable grayscale CGHs is proposed here by taking advantage of two key components: a digital micro-mirror device (DMDs) and a photochromic plate. An innovative algorithm, named Island algorithm, able to generate grayscale amplitude Fourier CGHs, is reported and compared with the standard Lee approach, based on 9 levels. A crucial advantage lies on the fact that the increase or decrease of the quantification does not affect the spatial resolution. In other words, the new coding leads to a higher spatial resolution (for a given CGH size) and a reconstructed image with an order of magnitude higher contrast with respect to the classical Lee-coded hologram. In order to show the huge potential of our approach, a 201 level Island hologram is designed, produced and reconstructed, pushing the contrast to values higher than10⁴. These results reveal the potential of our process as well as our algorithm for generating programmable grayscale CGHs.

A27 Whole genome characterization of influenza D viruses detected in cattle herds in northern Italy between 2015 and 2017

Influenza D virus (IDV) is a new viral genus identified within the Orthomyxoviridae family, showing 50 per cent amino acid identity with human influenza C virus. Similar to human influenza viruses of the C genus, IDV also harbors 7 genomic segments and uses 9-O-acetylated sialic acids as cell receptors. This newly emerged virus exhibits a broad host range and is capable of infecting swine, cattle, sheep, goats, ferrets, and guinea pigs. In Italy, IDV was first detected in archived samples collected between 2014 and 2015 from cattle and swine in the Po Valley area. Here, we report the genetic characterization of IDV viruses detected in an extensive area of northern Italy, namely Veneto, Lombardy, and Piedmont, through passive surveillance between September 2015 and October 2017. A total of 482 samples, including nasal swabs, lungs, and bronchoalveolar lavage fluid, collected from 309 cattle farms were tested. Thirty cattle herds turned out to be positive, for a total of 40 samples positive by Real Time RT-PCR targeting the PB2 gene. Representative IDV positive swabs were sequenced on an Illumina Miseq platform, and phylogenetic analyses were performed for each genome segment. The analyses of the seven gene segments demonstrated that the viruses identified in the north of Italy clearly grouped within a genetic cluster of IDV sequences previously described in Italy and in the USA, thus suggesting a common origin for these viruses. Interestingly, the IDVs identified in Italy presented a low similarity (96.1% to 98.8% for the seven gene segments) to the French IDVs, which is the only other European country where this pathogen has been identified and characterized so far. The wide IDV host range and the ability of this virus to reassort are a matter of concern. Results of this study indicate that IDV is extensively circulating among bovine herds in Northern Italy and suggest a potential role of IDV in the bovine respiratory disease complex, highlighting the need to perform surveillance on an ongoing basis to track its spread and evolution.

The anti-proliferative effects of adiponectin on human lung adenocarcinoma A549 cells and oxidative stress involvement

Adiponectin (Acrp30) plays an important role in energy metabolism and inflammation. Recently, in vivo serum Acrp30 levels have been reported to be correlated to risk of developing several types of cancers such as lung cancer, and in vitro studies have demonstrated a role for Acrp30 in the control of cell proliferation and survival. However, the molecular effects of Acrp30 on lung cancer have not yet been clearly defined. In the present study, we investigated the effects of different concentrations of Acrp30 on the A549 human alveolar epithelial cell line, an in vitro model of lung adenocarcinoma. A549 cells were exposed to various concentrations of Acrp30 and successively, proliferation, apoptosis and oxidative stress were evaluated by MTT test, caspase activity assay, flow-cytometry and western blotting analysis. Our results demonstrated that Acrp30 causes, in a time- and dose-dependent manner, a reduction of cell viability and duplication together with an increase in cell apoptosis rate. In addition, we found that Acrp30 induces an increase of lipid peroxidation evaluated by TBARS assay and a concomitant reduction of nitric oxide release, both markers of cellular oxidative stress. Taken together, our data on A549 cells provides new insight into potential involvement of Acrp30 on physio-pathologic mechanisms of lung diseases through interference with proliferation, apoptosis and oxidative status.

Relationship between velocity and muscular endurance of the upper body

Strength, power and muscular endurance tests have been developed as means of assessing people's physical abilities. However, testing may be expensive or time consuming. A method to reduce the time of physical assessment could be to use predictive algorithms for indirect assessment. The aim of this study will be to determine a relationship between strength, power and muscular endurance in order to identify predictors for an easier and faster assessment. 33 male strength-trained participants (22.8 ± 4.6 years, 172.5 ± 6.7 cm, 68.0 ± 10.6 kg) performed a single pull-up (SPU) and a single push-up (SPH) and a set of pull-ups (EPU) and push-ups (EPH) to exhaustion. The participants were divided into three sub-groups according to their training experience. Force(F), Power(P), Velocity(V) and relative power(R-P), extracted from an accelerometer (500 Hz), were compared between groups (ANOVA) and a subsequent linear regression analysis was performed to identify predictors of the performance measures. The regression models were able to explain 61% of the variance with the EPU as dependent variable and the V of the SPU as independent variable and 68% of the variance with the EPH as dependent variable and EPU as independent variable. In addition, increased performance measures were found according to training experience, in particular regarding muscular endurance of both the EPU and EPH (p < 0.001 and p < 0.01, respectively). A significant effect of training experience was also present for the V of the SPU (p < 0.001). The results indicate that a relation between muscular endurance and velocity is present. The generated equations allow to estimate both the number of EPH and EPU from a SPU. The equations may be helpful to reduce the time of assessment for upper body physical evaluation.

Secondary Leukemia following Treatment for Hodgkin's Disease

Aims and Background

Patients treated for Hodgkin's disease with chemotherapy or with the association of chemotherapy and radiotherapy have an increased risk of secondary leukemia. The aim of this study was to evaluate the leukemogenic risk due to these treatment modalities.

Methods

We performed a case-control study on a population of 1410 patients treated for Hodgkin's disease from 1970 to 1990 in our Institute. Among these patients, we identified 25 cases of secondary leukemia and 3 cases of myelodysplasia, all occurring more than one year after the diagnosis of Hodgkin's disease. Three cases occurred among the patients treated with radiotherapy alone. When we analyzed the risk in relation to the type of treatment (radiotherapy, chemotherapy, or both), the comparisons were relative to patients treated with radiotherapy alone.

Results

We found that chemotherapy alone is associated with a fivefold increased risk (odds ratio = 5.4) compared with radiotherapy alone. When both treatments are used, the risk is not further increased (odds ratio = 4.4). Patients receiving more than 6 courses of chemotherapy have an excess risk (relative risk = 2.5) compared with those treated with 6 courses or less. No increased risk was observed after splenectomy.

Conclusions

This study confirms an increased incidence of secondary leukemia occurring in patients treated for Hodgkin's disease. The increased risk seems to be correlated with the number of courses of alkylating agent therapy, whereas it is unaffected by the addition of radiotherapy.

Role of contrast-enhanced ultrasound to define prognosis and predict response to biotherapy in pancreatic neuroendocrine tumors

PURPOSE

The incidence of neuroendocrine tumors (NETs) is progressively increasing. Most cases arise from the digestive system, where ileum, rectum and pancreas represent the commonest site of origin. Liver metastases are frequently detected at diagnosis or during the follow-up. Contrast-enhanced ultrasound (CEUS) is used in patients with pancreatic NETs (P-NETs) and liver metastases from P-NET but its role has not been standardized. The aim of this retrospective study was to investigate CEUS in patients with P-NETs and liver metastases from P-NET both as prognostic factor and predictor of response to therapy with somatostatin analogues (SSAs).

METHODS

CEUS was performed at the diagnosis of NET and 3, 6 and 12 months after the beginning of SSAs. CEUS pattern was compared with contrast-enhanced computed tomography (CT) pattern.

RESULTS

There was a significant association between CEUS and CT pattern (X ² = 79.0; p < 0.0001). A significant association was found between CEUS pattern and Ki-67 index (X ² = 24.6; p < 0.0001). The hypervascular homogeneous CEUS typical pattern was associated with low tumor grading (G1 or G2) (X ² = 24.0; p < 0.0001). CEUS pattern changed from hypervascular homogeneous in baseline to hypovascular/hypervascular inhomogeneous after SSA therapy, with a significant association between tumor response at CT scan and appearance of hypervascular inhomogeneous pattern at CEUS evaluation (6 months: X ² = 57.0; p < 0.0001; 12 months: X ² = 49.8; p < 0.0001).

CONCLUSIONS

In patients with P-NET, CEUS pattern correlates with tumor grading, being homogeneous in G1-G2 but not in G3 tumors. After therapy with SSAs, CEUS is predictive of response to SSAs. These findings seem to support a role of CEUS as prognostic and predictive factor of response.

Disinfection of water inoculated with Enterococcus faecalis using solar/Fe(III)EDDS-H2O2 or S2O82- process

In this study, the activation of H₂O₂ and persulfate ions induced by solar photolysis of Fe(III)EDDS complex were investigated in water disinfection, applying solar AOPs processes. The use of Fe(III)EDDS complex maintains iron in soluble form until slightly basic pH and so the photolysis is efficient in a large range of pH compatible with natural waters. Moreover, for the first time, the impact of photogenerated hydroxyl and sulfate radicals on the inactivation of Enterococcus faecalis in water was studied. E. faecalis was proposed as alternative model microorganism given its higher resistance than the commonly used E. coli. The reactivity of hydroxyl radicals seems to be more efficient for the inactivation of such strain than the reactivity of sulfate radicals. Moreover, experimental results show that the concentration of Fe(III)EDDS complex is a key parameter for the inactivation of microrganisms. For the direct application in natural waters, the efficiency of the process in the presence of ubiquitous inorganic compounds, such as carbonate (HCO₃^-/CO₃^2-) and chloride ions (Cl^-), was also investigated. Carbonates showed a strong reduction on the E. faecalis inactivation in all cases; meanwhile chloride ions enhanced the inactivation in the presence of persulfate as also shown by using a complementary kinetic modeling approach. A dual role of Fe(III)EDDS complex was established and discussed; essential for the generation of radical species but a trap for the reactivity of these same radicals.

QuIQ (Quick Instrument for Quality of Life): A New Instrument for a Rapid Assessment of Generic Quality of Life

Introduction

Recently, new patient-oriented outcome measures have emerged in mental health research and practice. Among these, generic quality of life (GQoL) has gained a central place and has come to represent a valid endpoint in most settings, from basic care programs to clinical trials, especially for the field of intellectual disability (ID). However, most studies still refer to health-related QoL, and the tools for the assessment of GQoL present many issues related to the structure complexity and administration time.

Aim

The purposes is to evaluate psychometric properties of a new rapid tool for the GQoL assessment named QuIQ (quick instrument for quality of life), originally constructed for use for people with ID.

Methods

Two hundred and ten persons with ID were consecutively administered with the QuIQ. A part of them were also assessed with the BASIQ, the Italian adaptation of the quality of life instrument package. QuIQ has the same conceptual framework and refers to the same areas of the BASIQ, but include a low number of dimensions (only attribution of importance and perception of satisfaction) and a factor way of score attribution such as visual analogue scale and graphic geometrical mean calculation.

Results

QuIQ showed good internal coherence (Cronbach's α = 0.92), inter-rater reliability (Cohen's K > 0.93), and concurrent validity (> 0.8) with BASIQ.

Conclusion

These findings seem to display for the QuIQ good psychometric characteristics. They also suggest that it could be possible to apply rapid QoL assessment to all the range of people with ID. This could have very important implications for future massive use in different settings.

Programmable CGH on photochromic plates coded with DMD generated masks

Computer Generated Holograms (CGHs) are used for wavefront shaping and complex optics testing. Present technology allows for recording binary CGHs. We propose a Digital Micro-mirror Device (DMD) as a reconfigurable mask, to record rewritable binary and grayscale CGHs on a photochromic plate. Opaque at rest, this plate becomes transparent when it is illuminated with visible light of suitable wavelength. We have successfully recorded the very first amplitude grayscale CGH, with a contrast greater than 50, which was reconstructed with a high fidelity in shape, intensity, size and location. These results reveal the high potential of this method for generating programmable/rewritable grayscale CGHs, which combine DMDs and photochromic substrates.

Abstract P2-09-03: Long-term comparison of anastrozole versus tamoxifen: Results from LATTE/ATAC

Background: Previous reports from the Anastrozole Tamoxifen Alone or in Combination (ATAC) trial have shown significantly prolonged disease-free survival, lower rates of recurrence and distant recurrence, and reduced contralateral breast cancer in patients treated with anastrozole compared to tamoxifen (Cuzick et al., Lancet, 2010). Here, we compare the long-term effects of anastrozole versus tamoxifen in patients randomised to either monotherapy arm in the ATAC trial.

Methods: Postmenopausal women with hormone receptor positive breast cancer randomised to anastrozole or tamoxifen in the main ATAC trial were eligible for the LATTE observational study. The primary objective was to compare the long-term effects of tamoxifen and anastrozole on time to recurrence and death beyond 10 years after randomisation. Secondary objectives included time to distant recurrence, cancer-specific survival, new breast primaries, other cancers, fractures, and cardiac/cerebrovascular events. Cox proportional hazard methods were used to compute hazard ratios (95% CI) for recurrence from the time of last publication (10 years median follow-up).

Results: 2452 women from 11 countries were entered into the LATTE study. 40 women withdrew consent and 759 women died or had a recurrence within 10 years, which left 1653 women for analysis (838 anastrozole vs. 815 tamoxifen). A total of 118 breast events (69 anastrozole (8.2%) vs. 49 tamoxifen (6.0%)) were reported. No significant difference between the two treatment arms were observed (HR=1.36 (0.94-1.97), P=0.098). 57 women had a distant recurrence (33 (3.9%) vs. 24 (2.9%)), 41 reported a loco-regional recurrence (23 (2.7%) vs. 18 (2.2%)), and 26 contra-lateral breast cancer were recorded (17 (2.0%) vs. 9 (1.1%)). None of the treatment comparisons were statistically significant. 305 deaths were recorded (147 (17.5%) vs. 158 (19.4%)), of which 31 were due to breast cancer. Significantly fewer gynaecological cancers were recorded with anastrozole (7 vs. 16; OR=0.42 (0.15-1.09), P=0.05), but overall the effect on other cancers was not significant (54 (6.4%) vs. 64 (7.9%). Fractures, cardiovascular, and cerebrovascular events were evenly distributed between the treatment arms.

Conclusions: Although anastrozole was associated with significant fewer recurrences compared to tamoxifen in the first 10 years of follow-up, in this analysis, with limited number of patients, we could not find a significant difference between the two treatment arms.

Citation Format: Cuzick J, Sestak I, Bianco A, Strobbe L, Bergh J, Hanusch C, Neven P, Dowsett M, Forbes JF, Buzdar A, Smith R, Howell A. Long-term comparison of anastrozole versus tamoxifen: Results from LATTE/ATAC [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-09-03.

Imaging of post-surgical treatment and of related complications in spinal trauma

Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation. The neuroradiological evaluation of the postoperative spine requires a general knowledge of the surgical approach to each spinal region and of the normal temporal evolution of expected postoperative changes. The neuroradiologist should evaluate the devices implanted, their related complications and promptly alert the surgeon of acute complications, mainly vascular and infective. During the follow-up, it is mandatory to know and search chronic complications as pseudomeningocele, accelerated degenerative disease, arachnoiditis, peridural fibrosis. Knowledge of specific complications relating to each surgical approach will assist the neuroradiologist in interpretation of postoperative images.

ACTN3/ACE genotypes and mitochondrial genome in professional soccer players’ performance

Two nuclear genes, ACTN3, encoding for the α-actinin skeletal muscle isoform 3, and ACE encoding the angiotensin-converting enzyme, have both been associated with quantitative physical performance traits in the general population. The purpose of our study was to assess the association between the two nuclear gene variants, R577X (rs1815739) in ACTN3 and I/D (rs4340) in ACE, with elite athletes’ performance and the effect of training on the mitochondrial DNA (mtDNA) content in peripheral blood. We evaluated the genotypes and frequencies of ACTN3 R577X and ACE I/D polymorphisms between soccer players (n = 43) and healthy non-athletic controls (n = 128). Total DNA was extracted from peripheral blood samples using the standard procedure. The genotypes were assessed by PCR-RFLP analysis and mtDNA cellular content by RT-PCR. The soccer players showed a tendency to a prevalence of ACTN3RR and ACEDD genotypes both independently and in co-occurrence. The effect of physical training on the mitochondrial DNA content in the athletic population was reflected strikingly in its increase in peripheral blood. Based on our results, we suggest that the analysis of ACTN3 and ACE genotypes could predict talent in the soccer field and that knowledge of the genetic variants could determine types and training times for soccer players. In addition, the novelty of this work, never before described in the sports literature, is that the increase of mitochondrial content can be correlated with the training load, suggesting that the mtDNA copy number may be considered a viable bioenergetics biomarker.

Secondary metabolites from Scrophularia canina L

A re-examination of Scrophularia canina L. confirmed the presence of iridoid glucosides considered as chemotaxonomic markers for the Scrophulariaceae family, like aucubin, harpagide and 8-O-acetylharpagide, besides the further presence of 8-epiloganic acid, which is, indeed, considered the biogenetic precursor of iridoids normally found in Scrophulariaceae, and was recognised here for the first time in the studied species. Also verbascoside and (E)-phytol were evidenced for the first time in S. canina. The former compound is an almost ubiquitous glycosidic phenyl-ethanoid, which attains systematic importance when in co-occurrence with iridoids, and its taxonomical implications were discussed. The latter compound, even though it is omnipresent, is interestingly endowed with several biological activities, which may give an additional reason for the traditional uses of this plant.

Unusual molecular pattern in Ajugoideae subfamily: the case of Ajuga genevensis L. from Dolomites

We analysed the ethanolic extract from Ajuga genevensis L. (Lamiaceae) growing in Dolomites, part of Italian Alps. Three new compounds for this species were identified: rosmarinic acid (1), oleanolic acid (2) and maslinic acid (3), representative of two different classes of chemical compounds (phenylpropanoids and pentacyclic triterpenes). A. genevensis resulted to be a valuable source of these compounds endowed with interesting biological activities (i.e. antioxidant, neuroprotective, anti-inflammatory, antiproliferative). The recognition of compounds (1), (2) and (3) may also confirm the ethnomedicinal uses of this plant. From a chemotaxonomical point of view, it is worth noting that iridoids were not evidenced in this accession. Iridoids are considered chemotaxonomic marker in Lamiales, and, in contrast with a previous study on this species, the presence of aucubin was not confirmed. In addition, the presence of large amounts of rosmarinic acid (1) was unexpected for a species that does not belong to subfamily Nepetoideae.

Scenedesmus dimorphus (Turpin) Kützing growth with digestate from biogas plant in outdoor bag photobioreactors

Digestate coming from an Anaerobic Digestion unit in a Biogas Plant, feeded on cow manure and vegetable waste from markets, has been used. About 8-35 L polyethylene transparent bags have been employed as cultivation container, outdoor. Different aliquots of digestate, alone or mixed with commercial liquid fertiliser, were employed to cultivate in batch Scenedesus dimorphus, a freshwater green microalga, in the ENEA facilities of Casaccia Research Center, near Rome, Italy. The cultivation period was June-July 2013. The average daily yields of dry microalgae biomass varied from 20 mg/L/d to 60 mg/L/d, mean 38.2 mg/L/d. Final dry biomass concentration varied from 0.18 to 1.29 g/L, mean 0.55 g/L. S. dimorphus proved to be very efficient in removing N and P from the culture medium. Another fact emerged from these trials is that S. dimorphus inner composition resulted to be variable in response to the tested different culture conditions.

Effects of mini trampoline exercise on male gymnasts' physiological parameters: a pilot study

AIM

There are limited studies that indicate the effects of trampoline exercise on strength and other physiological parameters. This study aims to determine whether twelve weeks of trampoline exercise would have any effects on the physical and physiological parameters of male gymnasts.

METHODS

A number of 20 intercollegiate competitive male gymnasts (as experimental group) and 20 non-athlete male (as control group) participated voluntarily. Their anthropometric characteristics and the anaerobic power were measured and their back strength, vertical jump, standing long jump and 20 meter sprint performances were measured.

RESULTS

As a result; whereas 12 weeks of trampoline exercise improved standing long jump (before 242.35±3.40 cm; after 251.70±2.95 cm) and also vertical jump, 20 meter sprint speed and anaerobic power of subjects. We did not observe significant changes on back strength performances (before 148.32±5.73 kg; after 148.10±5.71).

CONCLUSION

The trampoline exercise protocol improved significantly speed, jump and anaerobic performances of the experimental group, while did not induced any changes on back strength performances. More studies are necessary to confirm the interesting results coming from this pilot intervention.

Differentially expressed and activated proteins associated with non small cell lung cancer tissues

Background

Lung cancer is a leading cause of mortality. The most common cancer subtype, non small cell lung cancer (NSCLC), accounts for 85-90 % all cases and is mainly caused by environmental and genetic factors. Mechanisms involved in lung carcinogenesis include deregulation of several kinases and molecular pathways affecting cell proliferation, apoptosis and differentiation. Despite advances in lung cancer detection, diagnosis and staging, survival rate still remains poor and novel biomarkers for both diagnosis and therapy need to be identified. In the present study, we have explored the potential of novel specific biomarkers in the diagnosis of NSCLC, and the over-expression/activation of several kinases involved in disease development and progression.

Method

Lung tumor tissue specimens and adjacent cancer-free tissues from 8 NSCLC patients undergoing surgery were collected. The differential activation status of ERK1/2, AKT and IKBα/NF-κβ was analyzed. Subsequently, protein expression profile of NSCLC vs normal surrounding tissue was compared by a proteomic approach using LC-MS MS. Subsequently, MS/MS outputs were analyzed by the Protein Discoverer platform for label-free quantitation analysis. Finally, results were confirmed by western blotting analysis.

Results

This study confirms the involvement of ERK1/2, AKT, IKBα and NF-κβ proteins in NSCLC demonstrating a significant over-activation of all tested proteins. Furthermore, we found significant differential expression of 20 proteins (R_sc ≥ 1.50 or ≤ −1.50) of which 7 are under-expressed and 13 over-expressed in NSCLC lung tissues. Finally, we validated, by western blotting, the two most under-expressed NSCLC tissue proteins, carbonic anhydrase I and II isoforms.

Conclusion

Our data further support the possibility of developing both diagnostic tests and innovative targeted therapy in NSCLC. In addition to selective inhibitors of ERK1/2, AKT, IKBα and NF-κβ, as therapeutic options, our data, for the first time, indicates carbonic anhydrase I and II as attractive targets for development of diagnostic tools enabling selection of patients for a more specific therapy in NSCLC.