The CAP-CR study: direct medical costs in Italian metastatic colorectal cancer patients on first-line infusional 5-fluorouracil or oral capecitabine.

AIM: To describe the healthcare resource consumption of metastatic colorectal cancer (MCRC) patients in the Italian healthcare setting. METHODS: A retrospective chart analysis estimating direct medical costs of first-line infusional 5-Fluorouracil (5-FU) or oral Capecitabine (CAP), associated or not with other chemotherapies, from the Italian Healthcare Service (IHCS) and Hospital (H) perspectives. RESULTS: 202 subjects were analysed. CAP patients (N=66) were older, with a more compromised clinical status and received less chemotherapy agents in association than 5-FU patients (N=136). From the IHCS perspective, mean total costs per patient were 12,029 euro and 5,781 euro in the 5-FU and CAP arms respectively; 7,338 euro and 4,688 euro from the H perspective. The infusional administration route of 5-FU was a cost driver from both perspectives. Sensitivity analyses found the results to be robust to variations in base case parameters. CONCLUSIONS: Management of MCRC by oral chemotherapies may be an economically advantageous option to both IHCS and hospitals.

[Transient pseudohypoaldosteronism secondary to congenital malformation pathology of the urinary tract (valves of the posterior urethra): a report of a case with elements of a physiopathological nature]. / Pseudoipoaldosteronismo transitorio secondario a patologia congenita malformativa delle vie urinarie (valvole dell'uretra posteriore): descrizione di un caso ed elementi di ordine fisio-patologico.

A case of secondary transient pseudohypoaldosteronism (PHA) in a three-month-old infant who had arrived in emergency conditions is reported. Clinically the patient presented dehydration associated with salt loss, metabolic acidosis, severe hyperkalemia, markedly elevated levels both of plasma renin activity and aldosterone concentration. Biochemical and instrumental tests and clinical evolution have given reason to consider it as a case of transient PHA, secondary to an obstructive uropathy (PUV) with urinary infection. Secondary forms of PHA have frequently been documented in young infants with urinary tract infection associated with both obstructive and non obstructive uropathy. After medical or surgical therapy the abnormalities quickly disappear. This reported case suggests that the pediatrician-neonatologist dealing with a young infant with obstructive uropathy should not only consider the surgical treatment but also the medical one, in the light of the associated physiopathological aspects.

[A case report of reversible biliary pseudolithiasis caused by ceftriaxone in childhood: does the problem deserve greater attention?]. / Descrizione di un caso di pseudolitiasi biliare reversibile da ceftriaxone in età pediatrica: è opportuna una maggiore attenzione al problema?

The authors report the case of a nine-year-old girl admitted to hospital with signs of meningeal irritation during the course of hyperpyretic phlogosis of the upper airways who presented, after 6 days' treatment with CFTX, at a dose of 50 mg/kg/day (1.5 g/day), therefore at the maximum recommended dose for the antibiotic in question, symptomatic cholecystic "pseudolithiasis" which resolved two weeks after the suspension of the drug. This case appears to concord with recent reports of "pseudolithiasis" in childhood that appeared with doses not regarded as being at risk, and it draws attention to the etiopathogenetic importance of other factors, including familial recurrence. The authors recommend a reasonable use of CFTX and the need to be "vigilant" both in relation to the onset and evolution of the clinical condition described above.

Platelet subpopulations in adult and geriatric males.

In this study, the authors wanted to investigate the volume, density, and percentage of three platelet subpopulations present in adult and geriatric males. Ninety subjects, between the ages of 20 and 40, were chosen for the adult group and 50 subjects, all older than age 70, were used for the geriatric group. The platelet subpopulations were separated with discontinuous gradients of Percoll. The results obtained from the three platelet subpopulations--low, intermediate, and high density--show different volumes and percentages in both the groups studied. From the information that larger platelets can be expected to have a longer life span, it was possible to hypothesize that platelets found in geriatric males have a reduced average life span. It is also clear that platelets exist that have similar volumes but different densities.

[Platelet aggregation induced by adenosine diphosphate, collagen and adrenaline in human platelet subpopulations]. / Aggregazione piastrinica indotta da adenosin difosfato, collagene ed adrenalina nelle sottopopolazioni piastriniche umane.

The study of platelet aggregation is normally carried out with the use of "Platelet Rich Plasma" (PRP) in which is grouped the overall platelets population. We have divided this population in three defined subclasses by gradients with discontinuous density, so as to test their own functional response towards three aggregant agents: adenosine diphosphate, epinephrine and collagen. The obtained results have been compared by an Aggregation Index, calculated as a ratio between the maximum percentage of aggregation and platelets mass. In this way it is pointed out a discriminating behaviour in three groups of thrombocytes relative to a functional different attitude towards different inducers and associated to an activation of heterogeneous way.

[Effects of dihydrostreptomycin and gentamycin on platelet membrane Na+-K+ATPase]. / Azione della diidrostreptomicina e della gentamicina sulla Na+-K+ATPasi di membrana piastrinica.

The use of aminoglycosides is characterised by a bound linkage between therapeutic and toxical levels. The aim of our study was to define the influence of diidrostreptomicin and gentamicin over Na+-K+ATPase of membranes of platelets. In this study, Bounting's and Caravaggio's method has been used, while ATPase activity was expressed in n mol of hydrolized ATP/min/mg of proteins. The data so obtained showed that the antibiotics were able to block up ATPase activity.

[Circadian rhythm of platelet aggregation induced by adrenaline and collagen in man]. / Variazione circadiana dell'aggegazione piastrinica indotta da adrenalina e collagene nell'uomo.

In five, healthy, male subjects the circadian variation of adrenaline and collagen induced platelets aggregation has been studied. Blood samples were carried out every four hours for a 24 hours period, platelets aggregation was evaluated on the P.P.P. by Elvi-Logos aggregometer adding adrenaline (1 mM/ml) or collagen (80 mg/ml). Cosinor test was used to detect circadian rhythms. A statistically significant circadian rhythm with peak in the morning has been demonstrated using both collagen or adrenaline. It is concluded that the adrenaline and collagen induced platelets aggregation "in vitro" shows a maximum of activity in the morning.