ABSTRACT
Non-small cell lung carcinoma harbouring epidermal growth factor receptor (EGFR) mutation, usually progress after an initial response to tyrosine-kinase inhibitors (TKI). Liquid biopsy enables with a simple blood draw the accurate detection of EGFR p.T790M mutation, the most common resistance mechanism, avoiding the more invasive tissue re-biopsy. However, in a subset of cases, resistance mechanisms are more complex featuring both genetic and morphological changes. Here we report the case of a 67 years-old woman, affected by an EGFR mutated lung adenocarcinoma and treated by TKI. At disease progression, the patient developed a morphological transition to squamous cell carcinoma in association to the arising of a PIK3CA p.E542K mutant subclone. This case illustrates that, even in the "liquid biopsy" era, cytology can have still a role by providing an overall assessment of both morphology and genetic TKI resistance mechanisms.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Squamous Cell/drug therapy , Drug Resistance, Neoplasm , Lung Neoplasms/drug therapy , Protein Kinase Inhibitors/therapeutic use , Adenocarcinoma/enzymology , Adenocarcinoma/genetics , Adenocarcinoma/pathology , Adenocarcinoma of Lung , Aged , Antineoplastic Agents/adverse effects , Biomarkers, Tumor/antagonists & inhibitors , Biomarkers, Tumor/blood , Biomarkers, Tumor/genetics , Biopsy , Carcinoma, Non-Small-Cell Lung/enzymology , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Squamous Cell/enzymology , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , Class I Phosphatidylinositol 3-Kinases/genetics , DNA Mutational Analysis , Disease Progression , Drug Resistance, Neoplasm/genetics , ErbB Receptors/antagonists & inhibitors , ErbB Receptors/blood , ErbB Receptors/genetics , Female , Humans , Lung Neoplasms/enzymology , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Molecular Targeted Therapy , Predictive Value of Tests , Protein Kinase Inhibitors/adverse effects , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , UltrasonographyABSTRACT
Referring to the discussion recently promoted by the Sub-Technical Committee n°4 "Ergonomics and design for sustainability", in this paper will be shown the early results of a theoretical and methodological study on Ergonomic design for sustainability. In particular, the research is based on the comparison between the common thematic structure characterizing Ergonomics, with the principles of Sustainable Development and with criteria adopted from other disciplines already oriented toward Sustainability. The paper identifies an early logical-interpretative model and describes possible and relevant Strategies of Ergonomic design for sustainability, which are connected in a series of specific Sustainable Arguments.
Subject(s)
Conservation of Natural Resources/methods , Ergonomics/methods , Models, Theoretical , Humans , Research DesignABSTRACT
Starting from the results of a theoretical and methodological study on Ergonomic design for sustainability previously developed from the authors, this paper shows the early results of a study that tries to apply them to actual operational and conceptual apparatuses of Ergonomics. In particular, the research aims to verify the possibility for Ergonomics to initiate an update of its current theoretical and procedural tools, towards new design solutions of "sustainable well-being", trying to look for new declinations of its several fields of application. The paper identifies new paradigms and definitions for one of the central themes of ergonomic design, as well as one among the most established and investigated: the usability of products and services.
Subject(s)
Conservation of Natural Resources/methods , Ergonomics/methods , Humans , Interdisciplinary CommunicationABSTRACT
Gallbladder torsion is a rare cause of acute acalculous cholecystitis. Preoperative diagnosis is difficult. The treatment of choice remains immediate cholecystectomy. We present four cases of gallbladder torsion and review the literature.
