Risk of misclassification during diagnosis of malnutrition in retroperitoneal sarcoma patients.

BACKGROUND: Retroperitoneal sarcoma (RPS) is a rare tumour that can reach exceptionally large size at diagnosis and affects body weight with its volume. We investigated the risk of nutritional status misclassification based on the Global Leadership Initiative on Malnutrition (GLIM) criteria in RPS patients. METHODS: We retrospectively analyzed the baseline data of patients with primary RPS including anthropometry, Malnutrition Universal Screening Tool (MUST) score and skeletal muscle index (SMI) calculated on preoperative CT scan. Phenotypic GLIM criteria considered were non-volitional weight loss, low-BMI and low muscle mass. MUST score, being inclusive of weight loss, was chosen as its surrogate. Reduced muscle mass was defined with SMI cut-offs <38.5-52.4 cm2/m2 for female and male respectively. RESULTS: From 2018 to 2020, 100 consecutive patients (male/female: 48/52) were included. Median age was 61 (48-68) years, median BMI 24.6 (21.5-27.4) kg/m2. Seven patients (7%) reported MUST score ≥2 and 80 (80%) score 0. Five patients (5%) were underweight, 44 (44%) overweight and obese. Sixty patients (60%) presented low SMI, of those 56 (93%) were normal or overweight, and 46 (77%) not at nutritional risk according to the MUST score. Both underweight BMI and MUST score ≥2 were not correlated with low SMI (p = 0.406, p = 0.612, respectively). No relevant discrepancy was found in the postoperative course of patients with low or normal muscle mass, although SMI was able to better characterize nutritional risk in the proportion of patents with high-grade liposarcoma and predicted worst overall survival. CONCLUSION: GLIM criteria are a useful tool for diagnosis of malnutrition. However, our analysis suggests that phenotypic criteria are not interchangeable with each other. An altered body composition is often hidden in patients with retroperitoneal sarcoma and the use of weight-based classification does not seem to be appropriate, enhancing the role of mass muscle measurement to prevent misdetections of malnourished patient.

Mixture of Graphene Oxide/Phosphoric Acid/Melamine as Coating for Improved Fire Protective Performance and Enhancement of Surface Electrical Properties on Wood Chipboard.

Looking for multifunctional materials, an assessment of the performances both as fire retardant and generator of electrically conductive surfaces for a three component mixture of graphene oxide, phosphoric acid and melamine applied on wood chipboard was performed. A simple approach was used to investigate the intumescent char formation and quantify the loss mass during vertical burning tests, in which the prepared samples were exposed for a certain time interval to a flame generated by an ethanol lamp in ambient conditions. Moreover, mass loss evolution and structural changes that occur during the burning process were more comprehensive investigated by differential thermal and thermogravimetric (DTA/TGA) techniques. By comparing the performances between the wood chipboard samples without any coverage and those covered with one or multiple component mixture, an increase of protection against the fire action was noticed when the three component mixture was used. Also, an improvement of the electrical properties was observed, after flame exposure of the samples covered with multiple layers (i.e., two and three), when the three component mixture was used. Morphological and structural investigations by microscopy (optical and electronic-SEMEDX), X-ray diffraction (XRD) and spectral (Raman, FTIR) methods are described. An assessment of market potential is also discussed.

3-Aminopropyl-Triethoxysilane Functionalized Graphene Oxide for Silane-Based Consolidation Treatments to Increase Mortar Performances.

The influence of chemically converted GO (graphene oxide) functionalized with APTES (3-aminopropyl-triethoxysilane) and unfunctionalized GO, dispersed in ethanolic solution of TEOS (tetraethyl orthosilicate), on the performances of the mortar samples, such as capillary water absorption and compressive strength was evaluated. The effect of the GO based nanomaterials (GO and GO functionalized with APTES) on the mortar microstructure was investigated by Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), Raman spectroscopy and scanning electron microscopy (SEM). The multifunctionality of the mortar brushed with GO based nanomaterials consolidation suspension was proved by the results (i) of the mechanical tests which show an improvement of the compressive strength and (ii) the capillary water absorption results which indicate the decreasing of the water penetration speed. For the mortar samples brushed with GO consolidation suspension, an increase value for the compressive strength of approximately twice compared to the untreated control samples and a decreased value for the capillary absorption water coefficient with one order of magnitude in comparison with the untreated control samples were obtained.

New fabrication method for producing reduced graphene oxide flexible electrodes by using a low-power visible laser diode engraving system.

The fabrication of bendable electronic devices is a scientific-technological area of very rapid advance in which new materials and fabrication techniques are being continuously developed. In these kinds of devices, the fabrication of flexible conductive electrodes adherent to the substrate is a key factor. Further, eco-friendliness, low cost and fast production are essential requirements for the successful progress of new technologies. In this work, a novel method for obtaining graphene-based flexible electrodes is presented. Conductive films were obtained by means of the visible laser irradiation of graphene oxide layers deposited on polyethylene terephthalate substrates and self-standing membranes sandwiched between glass slides. Despite the low power of the laser system, the numerical simulations indicate the development of temperatures over 1000 K throughout the irradiated material. The laser-induced spatially confined heating leads to the reduction of the graphene oxide material, whereas the glass-based sandwich assembly avoids reoxidation from the surrounding air. By scanning and pixelated modes, reduced graphene oxide electrodes, up to 100 µm in thickness, and with a resistivity as low as 6 × 10-4 Ωm, were obtained in an easy and versatile way. Proof-of-concept microsupercapacitors and electrochemical sensors were fabricated with this technique, showing promising performance.

Rituximab, alkylating agents or combination therapy for gastric mucosa-associated lymphoid tissue lymphoma: a monocentric non-randomised observational study.

BACKGROUND: There is no consensus on the standard treatment of gastric mucosa-associated lymphoid tissue (MALT) lymphoma for Helicobacter pylori-negative patients and for patients with persistent disease despite H. pylori eradication. AIM: To evaluate the comparative efficacy and safety of alkylating agents and rituximab alone or in combination. METHODS: In this monocentric retrospective study, which included 106 patients who had not been previously treated with anti-cancer agents, we evaluated the efficacy and safety of oral alkylating agents monotherapy (n = 48), rituximab monotherapy (n = 28) and the therapy combining both drugs (n = 30). Evaluations were performed at weeks 6 (W6), 25 (W25), and 52 (W52) and after 2 years (W104). RESULTS: After a median follow-up period of 4.9 years (range 0.4-17.2 years), complete remission and overall response were significantly higher in patients in the combination therapy group at W104 (92% and 100% respectively) compared with patients treated with alkylating agents alone (66% and 68%) and rituximab alone (64% and 73%). The 5-year progression-free survival probabilities were 68%, 70% and 89% in patients treated with alkylating agents alone, rituximab alone and combination therapy respectively. Haematological adverse events were reported in 32 (30%) patients (mostly grade 1) and were more frequent in the two groups receiving alkylating agents (P = 0.05 and P < 0.001). No toxicity-related death was reported. CONCLUSIONS: The use of anti-cancer systemic therapy is safe and efficient in gastric MALT lymphoma. In this retrospective study, the combination of rituximab plus chlorambucil seems more efficient than rituximab or alkylating agents alone. Rituximab has a better safety profile than regimens containing alkylating agents.

Diffuse large B-cell lymphoma of Waldeyer's ring has distinct clinicopathologic features: a GELA study.

BACKGROUND: Diffuse large B-cell lymphomas (DLBCLs) arising in specific extranodal sites have peculiar clinicopathologic features. PATIENTS AND METHODS: We analyzed a cohort of 187 primary Waldeyer's ring (WR) DLBCLs retrieved from GELA protocols using anthracyclin-based polychemotherapy. RESULTS: Most patients (92%) had stage I-II disease. A germinal center B-cell-like (GCB) immunophenotype was observed in 61%, and BCL2 expression in 55%, of WR DLBCLs. BCL2, BCL6, IRF4 and MYC breakpoints were observed in, respectively, 3 of 42 (7%), 9 of 36 (25%), 2 of 26 (8%) and 4 of 40 (10%) contributive cases. A variable follicular pattern was evidenced in 30 of 68 (44%) large biopsy specimens. The 5-year progression-free survival (PFS) and the overall survival (OS) of 153 WR DLBCL patients with survival information were 69.5% and 77.8%, respectively. The GCB immunophenotype correlated with a better OS (P = 0.0015), while BCL2 expression predicted a worse OS (P = 0.037), an effect overcome by the GCB/non-GCB classification. Compared with matched nodal DLBCLs, WR DLBCLs with no age-adjusted international prognostic index factor disclosed a better 5-year PFS rate (77.5% versus 70.7%; P = 0.03). CONCLUSIONS: WR DLBCLs display distinct clinicopathologic features compared with conventional DLBCLs, with usual localized-stage disease, common follicular features and a high frequency of GCB immunophenotype contrasting with a low rate of BCL2 rearrangements. In addition, they seem to be associated with a better outcome than their nodal counterpart.

Follicular lymphoma cell niche: identification of a preeminent IL-4-dependent T(FH)-B cell axis.

Follicular lymphoma (FL) B cells contract tight connections with their microenvironment, which governs the pathogenesis and progression of the disease. Indeed, specific immune response gene signatures, obtained from whole biopsy samples, have been associated with patient survival. In this study, we performed gene expression profiling of purified B cell and non-B cell compartments obtained from FL and reactive lymph nodes. We identified 677 non-redundant genes defining the FL interface and involving 26 FL-specific functional networks. This approach highlighted an interleukin-4 (IL-4)-centered pathway associated with an activation of signal transducer and activator of transcription 6 (STAT6), which favors overexpression of IL-4-target genes. In addition, FL microenvironment was characterized by a strong enrichment in follicular helper T cells (T(FH)), as demonstrated through transcriptomic and flow cytometry analyses. The majority of phospho-STAT6(pos) B cells were located at the vicinity of cells expressing the programmed death 1 (PD-1) T(FH) marker. Moreover, purified FL-derived T(FH), expressed IL4 at very high levels compared with purified tonsil-derived T(FH) or non-T(FH) microenvironment. Altogether, our study demonstrated that tumor-infiltrating T(FH) specifically express functional IL-4 in FL, creating an IL-4-dependent T(FH)-B cell axis. This cross talk could sustain FL pathogenesis and represent a new potential therapeutic target.

The novel immunosuppressive enzyme IL4I1 is expressed by neoplastic cells of several B-cell lymphomas and by tumor-associated macrophages.

We previously reported a strong IL4I1 gene expression in primary mediastinal B-cell lymphoma (PMBL) and recently identified the protein as a secreted L-phenylalanine oxidase, physiologically expressed by myeloid cells, which inhibits T-cell proliferation in vitro. Here, we analyzed the pattern of IL4I1 protein expression in 315 human lymphoid and non-lymphoid malignancies. Besides PMBL, IL4I1 expression in tumors was very frequent. IL4I1 was detected in tumor-associated macrophages from most of the tumors and in neoplastic cells from follicular lymphoma, classic and nodular lymphocyte predominant Hodgkin lymphomas and small lymphocytic lymphoma, three of which are germinal center derived. IL4I1-positive tumor cells were also detected in rare cases of solid cancers, mainly mesothelioma. The enzymatic activity paralleled protein expression, suggesting that IL4I1 is functional in vivo. Depending on the tumor type, IL4I1 may impact on different infiltrating lymphocyte populations with consequences on tumor evolution. In the particular case of follicular lymphoma cells, which are susceptible to antitumor cytotoxic T cells killing but depend on interactions with local T helper cells for survival, a high level of IL4I1 expression seems associated with the absence of bone marrow involvement and a better outcome. These findings plead for an evaluation of IL4I1 as a prognosis factor.

Gold films deposited over regular arrays of polystyrene nanospheres as highly effective SERS substrates from visible to NIR.

Gold nanostructured films of various thicknesses (15, 30, and 60 nm) are deposited over regular arrays of polystyrene nanospheres in an attempt to evaluate their potential as SERS-active substrates. Atomic force microscopy is used to topographically characterize the substrates as well as to ensure the thickness of the deposited gold films. The optical response of the prepared substrates recommends their use in SERS experiments with multiple laser lines from visible and NIR spectral domains. The assessment of the substrates' SERS activity is performed by using the 532, 633, and 830 nm excitation lines and different average enhancement factor (EF) values are obtained depending on the film thickness and employed laser line. The 60 nm gold nanostructured film generates the greatest local electromagnetic field confinement under NIR excitation and consequently gives rise to maximum SERS enhancement. The large tunability of surface plasmon excitation combined with the advantage of relatively high exhibited average EF values obtained under NIR excitation recommends these substrates as outstanding candidates for upcoming investigations of biological relevant molecules.

A Raman spectroscopic study of the diclofenac sodium-beta-cyclodextrin interaction.

The inclusion complex of diclofenac sodium (DCFNa) and beta-cyclodextrin (betaCD) was prepared and analyzed by using Raman and SERS spectroscopy. The interaction between DCFNa and betaCD molecules was evidenced by monitoring the change in the peak positions and the widths of some guest molecule bands relative to those observed in the spectra of the free compound and 1:1 DCFNa-betaCD physical mixture. Raman data have shown that the interaction between the guest and host molecules in the 1:1 DCFNa-betaCD complex is maintained both through the dichlorophenyl ring and the phenylacetate group. SER spectra revealed that depending on the pH value of the solution different isomeric forms of the 1:1 guest-host complex are preferentially adsorbed on the silver surface via the nonbonding electrons of the oxygen atom. The orientation of the adsorbed species with respect to the metal surface was also elucidated.

[How extensively should irritable bowel syndrome be investigated? Expensive bowel sounds in the abdomen]. / Wie gründlich muss das Reizdarmsyndrom abgeklärt werden? Teures Rumoren im Bauch.

Its high prevalence, chronic course, sometimes very troubling symptoms and rather limited therapeutic options, make the irritable bowel syndrome (IBS) one of the most common conditions seen by the family doctor, internist and gastroenterologist. IBS is characterized by abdominal pain accompanied by altered bowel movements and a facultative association with abdominal distension. IBS runs a chronic recurrent course punctuated by relatively symptom-free phases, and an overall good prognosis for survival (quoad vitam). Visceral hypersensitivity, altered gastrointestinal motility, psychosocial factors, and neurotransmitter imbalance are under discussion as underlying pathophysiology. An orienting medical history, clinical examination and exclusion of such alarm symptoms as weight loss, general debility and rectal bleeding, must be followed by a rational choice of further diagnostic measures.

[Proper patient counseling, recommended nutrition, specific medication. The basics of irritable bowel syndrome therapy]. / Gute Patientenführung, richtige Ernährung, gezielte Medikation. Das sind die Trümpfe in der Reizdarmtherapie.

In the treatment of the irritable bowel syndrome, it is important to qualify unrealistic expectations with regard to treatment, at an early stage. The therapeutic spectrum encompasses establishment of good rapport between physician and patient, modification of life style, provision of good patient information, reassurance, coping strategies, and temporal restraints on medication. Depending on the leading symptoms, the latter may range from laxatives to probiotics, anticholinergics or spasmolytics, prokinetic and anti-diarrheal agents, to 5-HT3/HT4 receptor antagonists. In individual patients with frequently recurrent or permanent pain, the use of tricyclic antidepressants may be considered. Painkillers should be reserved for patients in whom other therapeutic strategies have failed.