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Molecular testing; Ovarian cancer Proves moleculars; Càncer d'ovaris Pruebas moleculares; Cáncer de ovarios Background The detection of homologous recombination deficiency (HRD) can identify patients who are more responsive to platinum and poly ADP ribose polymerase inhibitors (PARPi). MyChoice CDx (Myriad) is the most used HRD test in ovarian cancer (OC). However, some limitations of commercial tests exist, because of the high rate of inconclusive results, costs, and the impossibility of evaluating functional resistance mechanisms. Patients and methods Two academic genomic tests and a functional assay, the RAD51 foci, were evaluated to detect HRD. One hundred patients with high-grade OC enrolled in the MITO16A/MaNGO-OV2 trial and treated with first-line therapy with carboplatin, paclitaxel, and bevacizumab were analyzed. Results The failure rate of the two genomic assays was 2%. The sensitivity in detecting HRD when compared with Myriad was 98.1% and 90.6%, respectively. The agreement rate with Myriad was 0.92 and 0.87, with a Cohen’s κ coefficient corresponding to 0.84 and 0.74, respectively. For the RAD51 foci assay, the failure rate was 30%. When the test was successful, discordant results for deficient and proficient tumors were observed, and additional HRD patients were identified compared to Myriad; sensitivity was 82.9%, agreement rate was 0.65, and Cohen’s κ coefficient was 0.18. The HRD detected by genomic assays and residual tumor at primary surgery and stage was correlated with progression-free survival at multivariate analysis. Conclusions Results suggest the feasibility of academic tests for assessing HRD status that show robust concordance with Myriad and correlation with clinical outcome. The contribution of the functional information related to the RAD51 foci test to the genomic data needs further investigation. This work was supported by funding from the AIRC [grant numbers IG 2016 – ID. 18921 and IG 2021 – ID. 25932 projects – P.I. SP and CO-2018-12367051 (Ministero della Salute) P.I SP]; Ricerca Corrente grant M2/7 from Ministero della Salute to DC, Ricerca Corrente from Ministero della Salute to SP. SM is supported by the Italian Association for Cancer Research [grant number IG-2017 n: IG19997]. MITO16A/MaNGO-OV2 trial was partially supported by Roche. AL is a recipient of a grant from the Asociación Española contra el Cáncer (AECC) [grant number INVES20095LLOP]. VS is a recipient of a grant from the Instituto de Salud Carlos III [grant number CPII19/00033] and a European grant for personalized medicine [grant number ERAPERMED 2019-215]. BP is a recipient of a grant from GOIRC. BP was supported by ESMO with a Clinical Translational Fellowship aid supported by Roche. Any views, opinions, findings, conclusions, or recommendations expressed in this material are those solely of the authors and do not necessarily reflect those of ESMO or Roche. NC has received funding from AstraZeneca (to the institution). FP has received funding from Roche, AstraZeneca, Pfizer, Merck Sharp & Dome, Bayer, Incyte, Taiho Oncology, Janssen Cilag, Exelixis, Aileron, and Daiichi Sankyo (grants to the institution for clinical trial activities).

Background Various therapeutic advances have led to a paradigm shift in the clinical management of patients with Inflammatory Bowel Diseases (IBD). Recently vedolizumab and other biologic agents have been introduced as a second choice to anti-TNF-alpha and in whom an anti-TNF-alpha cannot be used. Moreover, leukocytapheresis (LA) is a recognized potential option for the treatment for these IBD patients. The aim of this study is to assess if leukocytapheresis can still have a use in selected Ulcerative Colitis (UC) patients comparing it with vedolizumab. Methods From February 2019 to November 2021, 15 patients with UC were evaluated: 8 patients treated with leukocytapheresis (5 weekly apheresis session) (group 1) and 7 with vedolizumab (group 2). All patients had contraindications to anti-TNF-alpha use. The choice of treatment was driven by disease severity, presence of recognized optimal indications for leukocytapheresis and patient’s choice. We evaluated patients by clinical disease activity indexes and blood parameters levels at the beginning of therapy, then after 3 and 12 months. Results In group 1 after 12 months of follow up (FU) 5 patients achieved clinical remission with 3 patients receiving monthly maintenance therapy. During the FU 3 patients lost response and started biological therapy (vedolizumab). In group 2 after 12 months 3 patients achieved clinical remission with no treatment failure. In table 1 is shown the clinical disease activity for each patient according to Mayo partial score (MPS). The development of the blood parameters is similar in the two groups, with a general reduction of inflammatory parameters after 12 months. In group 1: leukocyte from 6,1 to 5,8 103/mm3; erythrocyte sedimentation rate (ESR) from 21,1 to 15,6 mm/h; platelets (PLT) from 286,6 to 269,5 103/mm3, faecal calprotectin (FC) from 579,1 to 208,5 mg/kg. In group 2: leukocyte from 8,7 to 7,7; ESR from 42,2 to 45,5; PLT from 320,8 to 266,3; FC from 586,2 to 257,2. Conclusion There is an indication overlap between leukocytapheresis and vedolizumab, with a trend in research favouring new biologics. From this clinical experience apheresis appears to be effective as second-choice biological drugs. This type of therapy should not be abandoned but should be investigated further with other comparative study to select patients for the best therapy in terms of efficacy, security and compliance. Moreover, a synergistic approach between these therapies could also be evaluated in the future.

Background Italy was among the first countries hit by the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The application of strict lockdown measures disproportionately affected both cancer patient care as well as basic and translational cancer research. Materials and methods The Italian Cancer Society (SIC) conducted a survey on the effect of lockdown on laboratories involved in cancer research in Italy. The survey was completed by 570 researchers at different stages of their career, working in cancer centers, research institutes and universities from 19 Italian regions. Results During the lockdown period, the impact of the COVID-19 pandemic emergency on face-to-face research activities was high, with a complete (47.7%) or partial (36.1%) shutdown of the laboratories. In the post-lockdown period, research activities were resumed in most of the respondents’ institutions (80.4%), though with some restrictions (77.2%). COVID-19 testing was offered to research personnel only in ~50% of research institutions. Overall, the response to the pandemic was fragmented as in many cases institutions adopted different strategies often aimed at limiting possible infections without a clearly defined contingency plan. Nevertheless, research was able to provide the first answers and possible ways out of the pandemic, also with the contribution of many cancer researchers that sacrificed their research programs to help overcome the pandemic by offering their knowledge and technologies. Conclusions Given the current persistence of an emergency situation in many European countries, a more adequate organization of research centers will be urgent and necessary to ensure the continuity of laboratory activities in a safe environment., Highlights • The SIC conducted a survey on the effect of COVID-19 lockdown on cancer research laboratories in Italy. • The impact of the lockdown on research activities was high, with complete or partial shutdown of >80% of the laboratories. • Response to the pandemic was fragmented with different strategies adopted without a clearly defined contingency plan. • An adequate organization of research centers is urgently needed to ensure laboratory activities in a safe environment.

Background: the lack of standardized pathways for patients with gastrointestinal bleeding may have led to differences in their management and inequity to medical care access. The "Hub & Spoke" model was adopted to fill this gap in many disciplines, but, to our knowledge, no data exist on its efficacy on mortality in GI bleeding. We aimed to evaluate if the "Hub & Spoke" organizational model has an impact on mortality risk from UGIB. Methods: from January 2014 to December 2015, 3324 consecutive patients admitted for UGIB in 50 Italian hospitals were enrolled (1977 patients in hospitals within the "Hub & Spoke" network for digestive hemorrhagic emergency and 1347 in hospitals outside the "Hub & Spoke" network). Clinical, endoscopic and organizational data were recorded. Results: we observed no differences in mortality between patients admitted to hospitals included or not included in the "Hub & Spoke" network (5.2% vs 6.1%, p = 0.3). On multivariate analysis, admission in gastroenterology wards (OR 0.61, p = 0.001) or an academic hospital (OR 0.65, p < 0.056) were independent protective factors while being in "Hub & Spoke" organization system did not affect mortality (OR 1.09, p = 0.57). Conclusion: the "Hub & Spoke" model per sé does not impact on mortality while being treated in academic hospital or gastroenterology wards improved survival.

Faragola and Canusium potters used Ca-rich clays—widely available nearby—for the production of building materials. The clayey materials were used as received, before being fired in the local kilns at temperatures between 600 and ~1000 ° C. No technological distinctions were made in relation to the type of object to be produced (tile, brick, etc). The investigated productions are compositionally distinguishable from both coarse wares for cooking and fine table ware produced in the same archaeological sites. A fine clayey material, very similar to that used for table ware, was supplied for the production of these building materials, which are chemically, mineralogically and petrographically very similar among themselves. Hence, the Faragola and Canusium bricks and tiles cannot be easily discriminated but the presence/absence of volcanites and volcanic glass represents an effective discriminating factor, able to indicate areas of different supplies within two main deposits: the Pleistocene marine and alluvial terraced deposits, typical of northern Apulia.

Background. State anxiety can result from a variety of life situations. This type of anxiety can disrupt occupational engagement and performance, thereby affecting rehabilitation and recovery. Occupational therapists need to address the connection between mind-body-spirit and its relationship to performance and engagement in meaningful occupations. Yoga, when used as an adjunct to therapy, has the potential to address state anxiety. Purpose. The aim was to systematically review the evidence concerning the effectiveness of yoga as a treatment approach for state anxiety. Methods. Six electronic databases, the authors’ own files, and the references of included studies from 1990 to July 2011 were searched. Findings. A total of 25 unique studies represented by 26 publications made up the sample: two systematic reviews; 16 randomized controlled trials, and seven prospective, controlled, non-randomized studies. Evidence suggests yoga can be a viable therapeutic option for reducing state anxiety in certain situations. Implications. In making the determination to recommend yoga as an intervention, occupational therapists should consider the client’s circumstances and values as well as the type and intensity of the yoga program.

L’envasement du barrage Siliana est estime a travers l’etude quantitative des phenomenes erosifs tres actifs dans son bassin versant qui couvre une surface de 1036 km2. Celui-ci est compose de depots alluvionnaires du Quaternaire. Le relief est assez plat et domine par la presence des montagnes. Le climat dominant est de type semi aride. L’estimation de l’erodibilite des terrains est obtenue a travers l’application de deux modeles; l’Analyse Geomorphologique Quantitative (AGQ) et le modele Previsioni dell’Interimento nei Serbatoi Artificiali (PISA) utilisant des facteurs physiques et climatiques du bassin versant de Siliana et du sous-bassin Lakhmess. La confrontation de resultats fournis par ces deux modeles avec ceux issus des leves bathymetriques des fonds des barrages etudies, qui permettent la quantification effective de l’envasement, a permis de valider d’une part l’AGQ comme un outil d’estimation de l’erosion au sein du sous bassin Lakhmess et d’autre part de proposer le modele PISA comme un modele d’estimation de l’envasement du barrage Siliana.

We provide data on fetal growth pattern on the molecular subtypes of Beckwith-Wiedemann syndrome (BWS): IC1 gain of methylation (IC1-GoM), IC2 loss of methylation (IC2-LoM), 11p15.5 paternal uniparental disomy (UPD), and CDKN1C mutation. In this observational study, gestational ages and neonatal growth parameters of 247 BWS patients were compared by calculating gestational age-corrected standard deviation scores (SDS) and proportionality indexes to search for differences among IC1-GoM (n = 21), UPD (n = 87), IC2-LoM (n = 147), and CDKN1C mutation (n = 11) patients. In IC1-GoM subgroup, weight and length are higher than in other subgroups. Body proportionality indexes display the following pattern: highest in IC1-GoM patients, lowest in IC2-LoM/CDKN1C patients, intermediate in UPD ones. Prematurity was significantly more prevalent in the CDKN1C (64%) and IC2-LoM subgroups (37%). Fetal growth patterns are different in the four molecular subtypes of BWS and remarkably consistent with altered gene expression primed by the respective molecular mechanisms. IC1-GoM cases show extreme macrosomia and severe disproportion between weight and length excess. In IC2-LoM/CDKN1C patients, macrosomia is less common and associated with more proportionate weight/length ratios with excess of preterm birth. UPD patients show growth patterns closer to those of IC2-LoM, but manifest a body mass disproportion rather similar to that seen in IC1-GoM cases.

Among the atmospheric emission sources, wildfires are episodic events characterized by large spatial and temporal variability. Therefore, accurate information on gaseous and aerosol emissions from fires for specific regions and seasons is critical for air quality forecasts. The Spinning Enhanced Visible and Infrared Imager (SEVIRI) in geostationary orbit provides fire observations over Africa and the Mediterranean with a temporal resolution of 15 min. It thus resolves the complete fire life cycle and captures the fires' peak intensities, which is not possible in Moderate Resolution Imaging Spectroradiometer (MODIS) fire emission inventories like the Global Fire Assimilation System (GFAS). We evaluate two different operational fire radiative power (FRP) products derived from SEVIRI, by studying a large forest fire in Antalya, Turkey, in July-August 2008. The EUMETSAT Land Surface Analysis Satellite Applications Facility (LSA SAF) has higher FRP values during the fire episode than the Wildfire Automated Biomass Burning Algorithm (WF-ABBA). It is also in better agreement with the co-located, gridded MODIS FRP. Both products miss small fires that frequently occur in the region and are detected by MODIS. Emissions are derived from the FRP products. They are used along-side GFAS emissions in smoke plume simulations with the Weather Research and Forecasting (WRF) model and the Community Multiscale Air Quality (CMAQ) model. In comparisons with MODIS aerosol optical thickness (AOT) and Infrared Atmospheric Sounding Interferometer (IASI), CO and NH3 observations show that including the diurnal variability of fire emissions improves the spatial distribution and peak concentrations of the simulated smoke plumes associated with this large fire. They also show a large discrepancy between the currently available operational FRP products, with the LSA SAF being the most appropriate., SCOPUS: ar.j, info:eu-repo/semantics/published

Among the atmospheric emission sources, wildfires are episodic events characterized by large spatial and temporal variability. Therefore, accurate information on fire gaseous and aerosol emissions for specific regions and seasons is critical for air quality forecasts. The Spinning Enhanced Visible and Infrared Imager (SEVIRI) in geostationary orbit provides fire observations over Africa and the Mediterranean with a unique temporal resolution of 15min. It thus resolves the complete fire life cycle and captures the fires' peak intensities, which is not possible in MODIS-based fire emission inventories like GFAS. We evaluate two different operational Fire Radiative Power (FRP) products derived from SEVIRI, by studying the case of a large forest fire in Antalya, Turkey, in July-August 2008. The EUMETSAT LSA SAF product has higher FRP values during the fire episode than the WF-ABBA product. It is also in better agreement with the colocated, gridded MODIS FRP. Both products miss small fires that frequently occur in the region and are detected by MODIS. Emissions are derived from the FRP products. They are used along-side GFAS emissions in smoke plume simulations with WRF and the Community Multiscale Air Quality model (CMAQ). Comparisons with MODIS AOT and IASI CO and NH3 observations show that including the diurnal variability of fire emissions improves the spatial distribution and peak concentrations of the simulated smoke plumes associated to the large fire. They also show a large discrepancy between the currently available operational FRP products, with the LSA SAF one being the most appropriate., SCOPUS: re.j, info:eu-repo/semantics/published

High levels of serum lipoprotein(a) [Lp(a)] have been associated with increased risk of coronary artery disease (CAD), but this association apparently is not confirmed in elderly people. We evaluated the interactions of Lp(a) with lipid and nonlipid CAD risk factors in a sample of subjects enrolled in the prevalence survey (1992 to 1993) of the Italian Longitudinal Study on Aging (ILSA). The entire population consisted of 5,632 elderly people, aged 65 to 84 years, randomly selected in 8 Italian municipalities. The present cross-sectional study included 400 free-living elderly subjects (74 +/- 6 years) from the randomized cohort of Casamassima (Bari, Southern Italy) (n = 704). The results showed that in the elderly population, high serum Lp(a) is a CAD risk factor dependent on type 2 diabetes mellitus and elevated low-density lipoprotein (LDL) cholesterol levels. In particular, the combined effect of high Lp(a) (or =20 mg/dl) and high LDL cholesterol (or =3.63 mmol/L [or =140 mg/dl]), increases coronary risk by 2.75 (95% confidence interval 7.70 to 0.99); finally, the effect of Lp(a)or =20 mg/dl and LDL cholesterolor =3.63 mmol/L (or =140 mg/dl), combined with type 2 diabetes mellitus, increases risk of CAD by 6.65 (95% confidence interval 35.40 to 1.25). In the elderly, elevated Lp(a) levels appear not to be an independent predictor of CAD, but this lipoprotein is a risk factor only in subjects with type 2 diabetes mellitus and elevated LDL cholesterol.

This work proposes a method by which radium salt concentrations in rocks are determined. It also relates to radon amounts and emissions produced by these salts released into the environment, and, consequently, the affects on man by inhalation. Much of this can be ascribed to materials used in the building industry. On the basis of experimental results, the risk of this is expressed in the light of rules provided about radio-protection.

The Neotectonic evolution of Albania, from the Middle Pleistocene to the present day, is characterised by a general uplift that began after the Pliocene. Subsidence took place locally and led to the formation of graben-shaped Quaternary lakes and plains. During this period, graben lakes were formed at Shkodra, Ohrid, Prespa and Butrinti, whereas at Korca, Elbasani, Zadrima, Tirana, Myzeqe, etc., graben and graben-like plains were created. The Quaternary subsidence structures can be classified into two groups: graben structures created by local or regional extension and graben-like structures formed under a compressional regime. Some case studies are presented to illustrate the formation of these structures and their main engineering geological and hydrogeological characteristics.

Gastrectomy might be a risk factor for cholelithiasis and gallbladder stasis might play a major role. We studied fasting and postprandial gallbladder motility with 600 mg oral erythromycin or placebo in gastrectomized patients (with and without gallstones) and controls.Seventeen patients operated on for gastric cancer (subtotal gastrectomy: n = 10, total gastrectomy: n = 7) were compared with 20 sex- and body-size matched healthy controls. Subjects randomly received erythromycin or placebo 30 min before the ingestion of a standard 200 ml liquid test meal. Gallbladder volume was estimated by ultrasonography until 120 min after test meal. A visual analog scale monitored GI perception of appetite, satiety, nausea, abdominal fullness and epigastric pain.Gastrectomized patients had increased fasting gallbladder volume (35.9 +/- 3.4 ml versus 21.0 +/- 1.4 ml, p = 0.0005) with faster postmeal emptying (T/2 14.8 +/- 1.1 min versus 23.5 +/- 1.5 min, p = 0.00019) than controls. Six patients developed small and asymptomatic gallstones, which did not influence gallbladder motility. In these patients, fasting gallbladder volume increased with time after surgery (r = +0.82, p = 0.047). Perception of satiety, abdominal fullness, and epigastric pain after ingestion of the test meal were all significantly greater in patients than in controls. Erythromycin significantly enhanced gallbladder emptying during fasting (p = 0.001) and postprandially in both patients and controls (0.002p0.017) and significantly reduced postmeal satiety and epigastric discomfort in gastrectomized patients.Increased fasting volume might be a form of stasis, predisposing patients to gallstone formation. Erythromycin improves fasting and postprandial gallbladder emptying and decreases upper GI symptoms in gastrectomized patients.

In this paper a limestone variety belonging to the Butrinti district (Southern Albania) was studied. It is a good quality quarried rock which is utilised for construction and ornamental purposes. Physical and mechanical features were determined in order to classify and evaluate the technical performances of these rocks above all in terms of thermophysical properties.

MIcrozonazione sismica di livello 1 dei centri abitati delle Province di Bari, Andria-Barletta-Trani e Taranto

Gallbladder (GB) volume was monitored by real-time sonography in diabetics (n = 21) and healthy volunteers (n = 55) after a test meal. Seventeen controls and seven diabetics were obese; six patients had both autonomous and somatic neuropathy, and four had somatic neuropathy. Fasting GB volume was similar in controls and diabetics with and without autonomic neuropathy; it was correlated with body mass index (controls, r = 0.43, P less than 0.002; diabetics, r = 0.46, P less than 0.04), and was increased in obese subjects. Post-prandial GB emptying was decreased in diabetics. Those with autonomous neuropathy exhibited larger residual volumes than controls (P less than 0.03). Post-prandial GB emptying was slower and less complete in (non-diabetic) obese subjects and deteriorated further in diabetic obese subjects. GB fasting tone was normal, but GB kinetics were impaired in diabetics; obesity and autonomous neuropathy were correlated with GB hypomotility.

Acute movement disorders associated with bilateral lesions in the basal ganglia are increasingly described in patients affected by diabetes and uremia. Pathophysiology has not been utterly understood yet, but it is likely to be multifactorial, with both ischemic/microvascular and metabolic/toxic factors determining the lesions and symptoms. We have studied a uremic diabetic patient who was admitted in emergency after presenting choreic movements, in which CT and MR, including diffusion-weighted imaging and spectroscopy, showed bilateral symmetric basal ganglia lesions with regression at follow-up. This is the first report in the literature describing spectroscopic findings in this condition.

Electronic thermal packaging design continues to look for novel solutions for enhancing the performance of microelectronic cooling solutions. Driven by increasing thermal performance requirements, particularly in densely packaged militarized electronic systems and other high density or extreme use products, thermal designers are showing that to achieve the necessary cooling, combinations of existing technologies may offer further enhancement than has already been demonstrated. This paper discusses the performance characteristics of a single phase, pumped liquid cooling system (LCS) employed in cooling microprocessors and considers the effects of including solid state cooling (a.k.a thermoelectric cooling) in conjunction with the pumped liquid system. The thermal performance of a baseline LCS without TEC is compared to the performance of a LCS with a TEC combined with two alternative "flux transformer" heat spreaders. The two alternative flux transformers included a solid copper plate and vapor chamber heat pipe. Each "flux transformer" was sandwiched between the concentrated thermal load of the microprocessor and the TEC. The paper discusses the predicted thermal performance for the various systems as well as presenting experimental results. In demonstration, the experimental results show that the addition of TEC's coupled with the vapor chamber heat pipe "flux transformer" provided the most favorable improvement in system performance over the power dissipation range tested. As the TEC electrical power was increased, the temperature gradient across the TEC's increased reducing their coefficient of performance. Eventually, the combined TEC and vapor chamber heat pipe flux transformer solution matched, and then exceeded the heat sink temperature achievable with a conventional single phase pumped liquid cooling system. For microprocessor and ASIC heat dissipations of up to 175 watts, this particular pumped liquid system incorporating TEC's coupled with a vapor chamber heat pipe flux transformer can significantly reduce processor temperatures.

Objective: To estimate the impact of alcohol consumption on the incidence of mild cognitive impairment and its progression to dementia. Methods: We evaluated the incidence of mild cognitive impairment in 1,445 non–cognitively impaired individuals and its progression to dementia in 121 patients with mild cognitive impairment, aged 65 to 84 years, participating in the Italian Longitudinal Study on Aging, with a 3.5-year follow-up. The level of alcohol consumption was ascertained in the year before the survey. Dementia and mild cognitive impairment were classified using current clinical criteria. Results: Patients with mild cognitive impairment who were moderate drinkers, i.e., those who consumed less than 1 drink/day (approximately 15 g of alcohol), had a lower rate of progression to dementia than abstainers (hazard ratio [HR] 0.15; 95% CI 0.03 to 0.78). Furthermore, moderate drinkers with mild cognitive impairment who consumed less than 1 drink/day of wine showed a significantly lower rate of progression to dementia than abstainers (HR 0.15; 95% CI 0.03 to 0.77). Finally, there was no significant association between higher levels of drinking (≥1 drink/day) and rate of progression to dementia in patients with mild cognitive impairment vs abstainers. No significant associations were found between any levels of drinking and the incidence of mild cognitive impairment in non–cognitively impaired individuals vs abstainers. Conclusions: In patients with mild cognitive impairment, up to 1 drink/day of alcohol or wine may decrease the rate of progression to dementia.

Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern Italy.One hundred IBS patients (F:M=73:27, age 48+/-2 years, mean+/-SE) fulfilling ROME II criteria matched with 100 healthy subjects (F:M=70:30, 45+/-2 years). Dyspepsia, bowel habit, alexithymia, psycho-affective profile and quality of life were assessed using specific questionnaires. Basally and postprandially, changes in gallbladder volumes and antral areas after liquid meal and orocaecal transit time (OCTT) were measured respectively by ultrasonography and H(2)-breath test. Appetite, satiety, fullness, nausea, and epigastric pain/discomfort were monitored using visual-analogue scales.Compared with controls, IBS patients had increased dyspepsia (score 12.6+/-0.7 vs 5.1+/-0.2, P0.0001), weekly bowel movements (12.3+/-0.4 vs 5.5+/-0.2, P0.00001, comparable stool shape), alexithymia (score 59.1+/-1.1 vs 40.5+/-1.0, P=0.001), poor quality of life and psycho-affective profile. IBS patients had normal gallbladder emptying, but delayed gastric emptying (T50: 35.5+/-1.0 vs 26.1+/-0.6 min, P=0.00001) and OCTT (163.0+/-5.4 vs 96.6+/-1.8 min, P=0.00001). Fullness, nausea, and epigastric pain/discomfort were greater in IBS than in controls.ROME II IBS patients have a pan-enteric dysmotility with frequent dyspepsia, associated with psychological morbidity and greatly impaired quality of life. The presence of alexithymia, a stable trait, is a novel finding of potential interest to detect subgroups of IBS patients with different patterns recovered after therapy.

There is clear clinical evidence that a drastic lowering of plasma LDL-Cholesterol (LDL) concentrations significantly reduces the rate of total and coronary mortality as well as the incidence of cardiovascular events in high risk hypercholesterolemic patients. We describe the case of a 51-year-old woman with coronary heart disease (CHD) who presented with increasing angina on exertion in 1995, at the age of 45. She suffered from a heterozygous familial hypercholesterolemia and in 1985 her total cholesterol (TCHO) was 328 +/- 62 mg/dl (mean value of ten analysis). After ten years of statins her mean values (20 analysis, 2 per year) were: TCHO 259 +/- 71, LDL 209 +/- 47, HDL 35 +/- 7 mg/dl. Coronary angiography (CA) performed in 1995 disclosed three vessel coronary heart disease with significant stenoses of the distal right coronary artery, multiple calcifications of the interventricularis artery and multiple plaques with significant stenoses in the ramus circumflexus. The woman underwent coronary by-pass surgery. Thereafter the patient was treated for six years with HELP in biweekly intervals, in combination with statins. TCHO, LDL, HDL and fibrinogen (fb) levels were measured before and after each treatment. Their mean values for an amount of 120 sessions were: TCHO pre 216 +/- 23, post 111 +/- 18 LDL pre 152 +/- 16 post 67 +/- 18, HDL pre 42 +/- 5 post 35 +/- 4 fb pre 306 +/- 48 post 125 +/- 31. In 2001 a new CA was performed. Calcifications disappeared and stenoses were identical to the previous CA or reduced. There were no further clinical manifestations of CHD. We trust that the clinical benefit of the HELP procedure will be substantial for those patients who have problems in clearing LDL from their plasma pool and who are at the same time sensitive to elevated LDL levels by the development of premature coronary sclerosis.

The fragile histidine triad (FHIT) gene is a tumor suppressor gene that is altered by deletion in a large fraction of human tumors, including pancreatic cancer. To evaluate the potential of FHIT gene therapy, we developed recombinant adenoviral and adenoassociated viral (AAV) FHIT vectors and tested these vectors in vitro and in vivo for activity against human pancreatic cancer cells. Our data show that viral FHIT gene delivery results in apoptosis by activation of the caspase pathway. Furthermore, Fhit overexpression enhances the susceptibility of pancreatic cancer cells to exogenous inducers of apoptosis. In vivo results show that FHIT gene transfer delays tumor growth and prolongs survival in a murine model mimicking human disease.