bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective Analysis of Ploidy in Primary Osseous and Extraosseous Ewing Family Tumors in Children
Authors: Perotti Daniela , Corletto Valentina , Giardini Roberto , Parafioriti Antonina , Fossati-Bellani Franca , Luksch Roberto 
Published: April 2018

Aims To restrospectively study the DNA content in a series of childhood Ewing Family Tumors (EFT), and to investigate its prognostic value. Methods The study was performed on a series of 27 EFTs (osseous Ewing's sarcoma, 18 cases; extraos-sous Ewing's sarcoma, 2; peripheral neuroepithelioma, 4; Askin Rosai tumors, 3). Ploidy was investigated using both flow cytometry (FCM) and image cytometry (ICM) on tumor cell suspensions from formalin-fixed paraffin-embedded specimens or fresh frozen tissue obtained from the primary tumor at diagnosis. Results Ploidy was evaluable by FCM in all cases, and by ICM in 23/27. When fresh frozen tissue and paraffin-embedded samples from the same tumor were available for analysis, they yielded equal results. The rate of agreement between FCM and ICM was 82%. The majority of cases were diploid, and in the present series aneuploidy seemed to be associated with a poor outcome. Conclusions These results suggest that aneuploidy could be an indicator of a bad prognosis in EFT; however, the small number of cases precludes any conclusion of statistical value. Larger restrospective studies on ploidy using archival material could be performed and their reliability is supported by the concordance of results from fresh and formalin-fixed tissue.
Neoplastic and Non-neoplastic Thyroid Lesions in Autopsy Material: Historical Review of Six Decades in São Paulo, Brazil
Authors: Bisi Hélio , Ruggeri Gláucia Berreta , Filho Adhemar Longatto , Asato de Camargo Rosalinda Y. , Fernandes Vilma S.O. , Abdo Anete H. 
Published: April 2018

Aims and background The aim of the study was to report and discuss a historical series of neoplastic and non-neoplastic lesions of the thyroid gland obtained at autopsy that were examined between 1931 and 1989 at the Pathology Department of the Medical School of the University of SaTo Paulo. Methods Records of 145,043 cases were reviewed to select those affecting the thyroid gland. The slides of these selected cases were analyzed and classified according to the current terminology. Results Non-neoplastic lesions comprised 91.62% of the cases (n=4647), and most of them were adenomatous goiter (n=3014). Neoplastic lesions were divided into two groups: primary and metastatic. Of the 282 primary tumors, 135 were benign and 147 were malignant. Among the malignant neoplasms, the most frequent types were follicular, papillary and undifferentiated (n=39, 36 and 29, respectively). The most frequent tumor types among the metastatic neoplasms were lymphoproliferative processes and carcinomas (n=67 and 34, respectively). Conclusions We conclude that, because of the high frequency of neoplastic lesions (8.38%), 68.24% of which were malignant, detailed examination of the thyroid by pathological methods should be carefully and systematically performed for the accurate detection of thyroid lesions, especially carcinomas.
Littoral Cell Angioma of the Spleen: An Additional Report of Four Cases with Emphasis on the Association with Visceral Organ Cancers
Authors: Bisceglia Michele , Sickel Joshua Z. , Giangaspero Felice , Gomes Vito , Amini Mostafà , Michal Michal 
Published: April 2018

Aims and background Littoral cell angioma (LCA) is an uncommon vascular tumor of the spleen recently described and interpreted as the tumoral counterpart of the normally present littoral cells lining the splenic sinus channels of red pulp. The diagnosis of LCA is suggested by a quite characteristic morphology and confirmed by the demonstration of a hybrid endothelial/histiocytic phenotype. Methods Four original and previously unreported cases of LCA are presented. All four splenic vascular tumors were investigated by light microscopy and immunohistochemistry for endothelial and histiocytic markers. Results All four cases were associated with visceral epithelial malignancies (colorectal adenocarcinoma in two cases, renal and pancreatic adenocarcinoma in one case each). One case was also associated with an intracranial tentorial meningioma. Conclusions We consider our findings as a novelty and signal the possible existence of a clinical syndrome. Five of a total of 21 previously reported cases in the literature were also described as being associated with other cancers (non-Hodgkin's lymphoma in two cases, two not further specified tumors of the liver and brain, an epithelial ovarian cancer, and a non-small cell lung cancer in one case each). Close follow-up and careful investigation in search of a second visceral neoplasm are strongly recommended in cases of LCA, but further clinical observations and more in-depth genetic and molecular studies are needed before any valid conclusions can be drawn.
Brachytherapy for Isolated Vaginal Recurrences from Endometrial Carcinoma
Authors: Colombo Alessandro , Cormio Gennaro , Placa Franco , Landoni Fabio , Ardizzoia Antonio , Gabriele Antonio , Lissoni Andrea 
Published: April 2018

Aims and background Isolated vaginal recurrences of endometrial carcinoma are rare, and prognostic factors that predict treatment outcome are still not well defined. The aim of the present study was to evaluate the results of brachytherapy in isolated vaginal recurrences from endometrial carcinoma. Methods Thirty-five patients with isolated vaginal recurrences were treated with brachytherapy with intravaginal ovoids or cylinders that were calculated to deliver 6000 to 7000 cGy at the surface. Patients were assessed for size and location of recurrence at presentation, response and complications from therapy. Results Treatment was well tolerated by most patients. Grade 2 toxicity occurred in 4 patients (3 cases of partial vaginal stenosis and one proctitis). Complete response to radiation was observed in all patients, and an overall 9 failures were observed (4 local, 4 distant and 1 local plus distant). Twenty patients (57%) were alive without evidence of disease at 3 to 11 years following treatment. Site of vaginal recurrence (upper third versus others) and long (more than 12 months versus less than 12 months) interval from hysterectomy were the only factors significantly related to local failures. Conclusions Isolated vaginal recurrences following hysterectomy for endometrial carcinoma can be treated with brachytherapy with a low rate of severe toxicity.
Activity and Tolerability of Courses of Intra-Arterial Chemotherapy Followed by Chemoembolization in Unresectable Hepatocellular Carcinoma
Authors: Colleoni Marco , Vicario Giovanni , Manente Paolo , De Braud Filippo , Fazio Nicola , Liessi Guido 
Published: April 2018

Aims and Background We previously reported encouraging response rates and survival with combined intraarterial (i.a.) chemotherapy and chemoembolization in unresectable hepatocellular carcinoma. We therefore evaluated a new program combining three courses of i.a. chemotherapy with chemoembolization administered every 28 days. Patients and methods The treatment regimen consisted of L-Ieucovorin (100 mg/m2 i.v.), fluorouracil (800 mg/m2 i.a.), and carboplatin (250 mg/m2 i.a.). Chemoembolization with mitoxantrone (10 mg/m2) plus ethiodized oil and gelatin sponge was performed immediately after. The same treatment was given every 28 days for 3 times. Results Twenty-eight patients entered the study and were assessable for response and side effects. There were 24 males and 4 females (median age, 68 yrs; range, 42-75). TNM stage was II-III in 20 and IVA in 8; 17 were Child's A and 11 Child's B. Baseline α-fetoprotein was elevated in 15, and there was cirrhosis in 23. Twelve patients had a partial response (43%; 95% confidence interval, 24-63%), 13 had stabilization, and 3 progressive disease. Median survival was 16.6 months (range, 2-24). Sixteen patients had grade I-II pain and 14 grade I-II fever. Conclusions Our results indicate that the regimen is safe and well tolerated. Despite 43% objective remissions, our results do not seem better than those obtained with less intensive regimens.
L'ecografia Del Carcinoma Pancreatico
Authors: Innocenti Paolo , Falchini Massimo , Stecco Alessandro 
Published: April 2018

Pancreatic tumors are the fourth cause of death in Occident: the 5-year-survival rate is less than 5% because of diagnostic difficulties, low clinical expression at early stage, and complexity of the surgical treatment. The role of ultrasound (US) is in early diagnosis, because also in early cancer there could be lymphatic spread or peritoneal involvement. There are multiple modalities to study the pancreas with US: abdominal US, “contact” US (endosonography and intra-op-erative or laparoscopic US). The first is not invasive, cheap but limited by extrinsic and intrinsic factors, the latter are respectively characterized by high cost, and need of endoscopic specialists for endosonography, the complementarity to laparoscopy or surgery for the laparoscopic/intraoperative US. Abdominal US is the first diagnostic step for the pancreas, but it is not affordable in 15-25% of patients, because of me-teorism. In all the other cases, it represents the pancreas with a good contrast between the normal parenchyma and tumoral tissues. Abdominal US, together with biopsy, can define the resectability. Ecoendoscopy is actually dedicated to small tumors staging, but recent studies demonstrate the same results achieved by spiral TC. Laparoscopic US is a second step imaging in patients already selected for surgery. The first finality in US evaluation of tumor masses is early diagnosis of pancreatic cancer; it can give to some of these patients the opportunity of undergoing to surgical treatment. This could be achieved by a proper use of the moltitude of ultrasonic abdominal explorations that are requested in daily practice. US, together with CT and MR, can define the resectability of the tumor, with further supplementar evaluation by mean of laparoscopic US. Intraoperative US is now indicated for planning and guiding the surgeon in resection of the pancreatic cancer.
La Chemioterapia Adiuvante Concomitante Del Carcinoma Pancreatico
Authors: Turci Daniele , Cariello Anna , De Giorgi Ugo , Marangolo Maurizio 
Published: April 2018

Pancreatic cancer is a leading cause of cancer death. Despite improvement in diagnosis and treatment in the last 15 years, mortality rates essentially equal the incidence of the disease. Combination treatment with chemoradiation yields up to now better results than chemotherapy or radiotherapy given alone in consideration of substantial radio and chemoresistance of the cancer cells. This study will review the most important literature data about combination adjuvant treatment and preoperative (primary) chemoradiation in pancreatic cancer. Some other reports will be given on locoregional chemotherapy and finally a brief view on a possible perspective for promising future treatments coming from data of molecular pathology. Adjuvant chemoradiation after surgery has been shown to be superior to operation alone in potentially resectable pancreatic cancer in many studies, in terms both of local control and median overall survival. Unfortunately, a consistent percentage of patients cannot receive adjuvant treatment since late recovery after surgery or postoperative morbidity. Owing to this last reason, many authors prefer primary chemoradiation in potentially resectable pancreatic cancer; neoadjuvant treatment find out its background in other relevant biological and clinical evaluations. Some studies report encouraging results with primary chemoradiation using 5-fluorouracil. Other experiences with relatively new drugs, with potent radiosensiting effect, such as gemcitabine or taxol are going on; many of these are phase I studies. Clinical research in the field of preoperative treatment is up to now emerging in some importants Oncological Institutions. The principal actual aim seems to be that of forsee periods of treatment which will be brief and use the dose of chemotherapy that is active, giving acceptable toxicity. Ongoing trials will give, in the next years, the answer about the improvement of efficacy of treatments largely expected by all researchers.
Continuous Monitoring of Urea and Inorganic Phosphate during Hemodialysis: II. Clinical Trials
Authors: Klein E. , Montalvo J.G. 
Published: April 2018

Ion-selective electrodes have been used to monitor urea and inorganic phosphate removal during dialysis. The dialysate outflow concentrations from a single pass bedside controller were used to compute instantaneous serum concentrations. The urea data are in agreement with a single pool reservoir model; the inorganic phosphate removal was not log-linear, indicating rate limiting intracompartmental transfer. The procedure can be applied to the computation of urea generation rates and thus provide information on the protein catabolism rates of the patient; in addition, the monitor provides continuous checks on the dialyzer performance.
Management of Hypertension in Dialysis
Authors: Zucchelli P. , Zuccalà A. , Santoro A. , Sturani A. , Esposti E. Degli , Ligabue A. , Chiarini C. 
Published: April 2018

Arterial hypertension is a highly frequent symptom in end-stage renal failure. This study was designed to evaluate the importance of total exchangeable sodium (NaE), plasma renin activity (PRA) and the adrenergic nervous system in the pathogenesis of high blood pressure. 86 patients were studied (26 with end-stage kidney disease and under conservative treatment and 60 on maintenance haemodialysis). Under conservative treatment a simple linear regression analysis gave a correlation coefficient of 0.794 for NaE × log. PRA against mean arterial pressure (MAP). This data suggests that before the start of the haemodialytic treatment NaE and PRA are important determinants of hypertension. In patients undergoing chronic heamodialysis the correlation between MAP and the product of NaE × log. PRA was lost. In hypertensive patients we have found indication of an increased adrenergic activity. In fact resting heart rate and two hours walking plasma catecholamines were significantly higher in hypertensive compared with normotensive patients on dialysis. A significant positive correlation was found between basal plasma noradrenaline levels and MAP in 34 patients treated with periodic haemodialysis when hypothyroid patients were excluded. Arterial hypertension is a highly frequent symptom in end-stage renal failure and occurs in over 80% of all case histories (1, 2, 3, 4, 5). This paper is a review of our experience concerned with the pathogenesis and management of hypertension in patients with chronic renal failure.
Composite Materials for Biomedical Applications
Authors: Migliaresi C. , Nicolais L. 
Published: April 2018

The concepts of composite mechanics have been used to design two materials for potential prosthesis of biomedical interest. They attain specific physical properties and use polymers which show a high degree of biocompatibility. The materials used were a poly (2-hydroxyethyl-methacrylate) as matrix and polyesther resin as reinforcing fibers. The mechanical performance of a uniaxially oriented composite has been adjusted to match the behaviour of a human tendon. A laminate composite has been modelled for use in plastic surgery.
Restoration of Ultrafiltration Capacity of Peritoneal Membrane in Patients on CAPD
Authors: Bazzato G. , Coli U. , Landini S. , Lucatello S. , Fracasso A. , Righetto F. , Scanferla F. , Morachiello P. 
Published: April 2018

Among 55 uremic patients who entered our CAPD program, 7 of them showed a reduction or loss of the ultrafiltration capacity (UF) of the peritoneal membrane (PM). They have been treated with high dose of Furosemide (F) to force residual urine output. Four appeared «responders» to drug administration with a significant increase in urine volume, Na excretion and, within a week period gained their dry body weight (BW). In the remaining 3 patients drug therapy resulted ineffective, and fluid removal was obtained by hemofiltration (HF). In both groups we noted an increase in the UF capacity of PM when their dry BW was obtained either by pharmacological or technical approach. These results support the assumption that the overhydration status of the PM plays a major role in maintaining the UF process.
Serum Aluminum Levels and Peritoneal Dialysis
Authors: Gilli P. , Fagioli F. , Malacarne F. , Bedani P.L. , Buoncristiani U. , Carobi C. , Locatelli F. , Farinelli A. 
Published: April 2018

Serum aluminum levels, significantly higher in dialysis patients than in normal subjects, were also found to be significantly higher in patients on PD than in those on HD. This could be related to a higher Al transport rate across membrane during PD than during HD. The easier contamination of PD dialysates and their acidic pH could account for this trend to a positive Al balance in PD. On the basis of our observations, however, the significance of the serum aluminum level could be very low, since aluminemia does not seem to reflect the cumulative amount of Al ingested and might not readily help predict the risk of Al intoxication.
Modelling of Plasma-Separation through Microporous Membranes
Authors: Gupta B.B. , Jaffrin M.Y. , Ding L.H. 
Published: April 2018

Available mathematical models of ultrafiltration have been used to predict changes in maximum plasma filtration rate with wall shear rate for given filters and blood properties. We have done many plasmapheresis experiments in vitro, using hollow-fiber filters (500–1000 cm2) and fresh bovine blood collected on ACD or heparin. The comparison between predicted and experimentally obtained filtration rates was good for models based on the concentration polarization theory and lift velocity theory. In other experiments with pulsatile inlet flow we found that plasma filtration rate increased by 20 to 50% compared to nonpulsatile conditions. These results are in good agreement with the modified model of ultrafiltration incorporating pulsating flow. This paper presents relationships between plasma filtration velocity (steady and pulsating flow) and hemolysis limit as a function of wall shear rate and filter size.
Overview of Plasmapheresis in Italy
Authors: Tomasini I. 
Published: April 2018

The national law, concerning Blood Transfusion and Blood derivatives in Italy, aims at achieving self-sufficiency and assuring safety of blood, plasma and plasma derivatives, according to EEC ((EE-Directive 89/381) and to the Council of Europe (R-88/4)). According to this law it is the task of the Central National Authority, (ie Istituto Superiore di Sanità (ISS)), to coordinate the transfusion system nationwide. The adoption and the transmission to the ISS of Regional Blood Registers containing information about the local use of blood and blood derivatives is in progress. Up to now the data are collected from a network among Blood Centers by Società italiana di lm-munoematologia e Trasfusione del Sangue - Associazione Italiana Centri Trasfusionali (SIITS - AICT) and these results show that in Italy the incorrect use of plasma and albumin and the insufficient practice of plasmapheresis are the major obstacles to the achievement of self-sufficiency.
Plasma Exchange in Systemic Lupus Erythematosus. Experience in Thirty-seven Patients
Authors: Lombardo R. , Cepparrone F. , Di Pietro G. , Franco C. , Graziani G. , Avanzi G. 
Published: April 2018

Thirty-seven (37) SLE patients submitted to therapeutic plasmapheresis were examined. The results were good in the active stage of the disease. Various types of antibody, anti-DNA, anti nucleus, anti-cardiolipine, I.C. (Clq and C3d) were removed. The values of IgG, coagulation factors, creatinine and proteinuria were assessed. Close collaboration with the clinicians is urged, with the aim of applying immunosuppressive therapy immediately after P.E. to consolidate the results obtained.
Validation of the MedUseQ: A Self-Administered Screener for Older Adults to Assess Medication Use Problems
Authors: Berman Rebecca L. , Iris Madelyn , Conrad Kendon J. , Robinson Carrie 
Published: April 2018

Background: Older adults taking multiple prescription and nonprescription drugs are at risk for medication use problems, yet there are few brief, self-administered screening tools designed specifically for them. Objective: The study objective was to develop and validate a patient-centered screener for community-dwelling older adults. Methods: In phase 1, a convenience sample of 57 stakeholders (older adults, pharmacists, nurses, and physicians) participated in concept mapping, using Concept System® Global MAXTM, to identify items for a questionnaire. In phase 2, a 40-item questionnaire was tested with a convenience sample of 377 adults and a 24-item version was tested with 306 older adults, aged 55 and older, using Rasch methodology. In phase 3, stakeholder focus groups provided feedback on the format of questionnaire materials and recommended strategies for addressing problems. Results: The concept map contained 72 statements organized into 6 conceptual clusters or domains. The 24-item screener was unidimensional. Cronbach's alpha was .87, person reliability was acceptable (.74), and item reliability was high (.96). Conclusion: The MedUseQ is a validated, patient-centered tool targeting older adults that can be used to assess a wide range of medication use problems in clinical and community settings and to identify areas for education, intervention, or further assessment.
Phenomenon of moral distress through the aspect of interpretive interactionism
Authors: Ko Hsun-Kuei , Chin Chi-Chun , Hsu Min-Tao , Lee Shu-Li 
Published: April 2018

Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung Medical University Hospital. Findings: Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress. Discussion: The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care. Conclusion: The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses.