FDG PET-derived parameters as prognostic tool in progressive malignant pleural mesothelioma treated patients.

PURPOSE: The value of FDG PET-derived parameters in predicting overall survival (OS), local relapse-free survival (LRFS) and distant relapse-free survival (DRFS) in treated patients with malignant pleural mesothelioma (MPM) was evaluated. METHODS: This retrospective evaluation included 55 MPM patients treated between March 2006 and February 2015 with FDG PET/CT-guided salvage helical tomotherapy (HTT) after previous surgery plus chemotherapy. Univariate Cox regression analysis was performed to assess the impact of the following FDG PET-derived parameters: biological target volume (BTV), mean and maximum standardized uptake values (SUVmean/max), metabolic tumour volume (MTV) and total lesion glycolysis (TLG), measured using different uptake thresholds (40%, 50% and 60%). Logistic regression was then performed to identify the best FDG PET-derived parameters for selecting patients with poorer survival. RESULTS: The median OS was 9.1 months (range 0.0 - 69.6 months) after the end of HTT; 54/55 patients were dead at the last follow-up. BTV and TLG40, TLG50 and TLG60 were the most significant predictors of OS (p < 0.005). The median OS was 4.8 months in patients with MTV60 >5 cm3 and TLG40 >334.4, compared with 13.8 months and 16.1 months in patients with smaller values, respectively. The median LRFS and DRFS were 6.2 months (range 1.2 - 39.4 months) and 6.5 months (0.0 - 66.4 months), respectively. TLG40, TLG50 and TLG60 were significantly correlated with LRFS (p < 0.015). Median DRFS was 6.4 months in patients with MTV40 >39.6 cm3 and 6.2 months in patients with TLG40 >334.4, compared with 17 months and 18.8 months in patients with smaller values. BTV, TLG40 and MTV40 were also found to be good predictors in patients with poor OS/LRFS/DRFS (median survival times less than the median values). CONCLUSION: FDG PET-derived parameters effectively discriminated patients with a poor prognosis and may be helpful in the selection of MPM patients for salvage HTT.

Three-dimensional changes of the upper airway in patients with obstructive sleep apnea syndrome after a non-adjustable oral appliance treatment.

The diagnosis, the therapy and the monitoring of the obstructive sleep apnea syndrome (OSAS) are to be considered as critical factors in order to prevent severe systemic complications that can be caused by this pathological condition. This work presents three cases of adult patients affected by OSAS, undergoing therapy with oral appliances (OAs), meant to remove the pharyngeal obstruction caused by mandibular retrusion and tongue collapse in nocturnal supine position. The aim of this work was to evaluate the effect of the OAs both through the comparison of the polysomnographic analysis, in the presence and absence of the appliance in situ, and also through the volumetric measurements of the pharingeal airway thanks to the cone beam computed tomography.

[Changes in blood viscosity after administration of vitamin E in the rabbit]. / Modificazione della viscosita' ematica dopo somministrazione di vitamina E nel coniglio.

Vitamin E is an essential factor to maintain biological membranes stability and its lack may affect membranes structures and reduce erythrocyte life-span. Vitamin E also play a role in the maintenance of a normal platelet aggregation. A.A. studied the effects of a ten days supply of d-1-alpha tocopherol acetate (50 mg/Kg/die) on blood viscosity in 8 rabbits. Results obtained show a significant reduction of blood viscosity on 6th day of treatment in the male rabbits and a progressive reduction of values from the 6th till the 10th day in female rabbits. The most significant decrease of blood viscosity were obtained at the lowest shear-rates, due to an increased red cells deformability to the antioxidative action of vitamin E on the erythrocytes membrane and to a reduced red cells aggregation. Such modifications on the red blood cells caratheristics can be determined by vitamin E through different mechanism: a) inhibiting red cell membrane's polyunsaturable fatty acids oxidation; b) by removal of abnormal lipids from erythrocyte membrane; c) physical and chemical stabilization of membrane's surface.

[Modifications in the feeding behavior of the rat, induced by antimitotic drugs: effects of hydroxyurea]. / Modificazioni del comportamento alimentare del ratto indotte da farmaci antimitotici: effetti dell'idrossiurea.

The effects of Hydroxyurea treatment on food intake and on the self-selection between a protein free diet and a complete one are different from those observed during Cyclophosphamide and Mustine Hydrochloride treatment and appear to be similar to those observed during Methotrexate treatment; these may be referred exclusively to a toxic action of the drug on the liver and on the mucous membranes of digestive apparatus. The urea, a product of Hydroxyurea metabolism, does not seem to induce modifications on food intake both as to the quantitative and qualitative aspect.