La classificazione di Lauren può essere considerata un parametro indipendente per la valutazione prognostica di pazienti operati per cancro gastrico? Analisi di una casistica

Gli Autori valutano l’efficacia della classificazione secondo Lauren in 28 pazienti operati per cancro gastrico con intento di radicalità chi - rurgica. Tale classificazione risulta infatti più aderente all’effettiva evo - luzione della storia naturale di questa patologia e quindi consente una valutazione prognostica assai più aderente all’andamento clinico di questi pazienti. Altre metodiche classificative o stadiative attualmente in uso, soprattutto ove strutturate su parametri isto-morfologici, appaio - no infatti insoddisfacenti e predispongono spesso a sovra- o sottostadia - z i o n i . Dei 28 casi osservati, il 64,28% tra quelli considerati di tipo inte - stinale secondo Lauren sopravvive dopo una mediana di follow-up di 4 anni, contro il 42,85% dei casi valutati del tipo diffuso. Vengono da ultimo discusse le recenti acquisizioni circa la biologia molecolare del cancro gastrico

Le malformazioni vascolari: necessità di un trattamento multidisciplinare. Considerazioni su di un caso clinico.

Abstract The case reported here is a paradigm of a complex vascular malformation with a therapeutic approach which involved both vascular radiology and surgery. The case came to our attention in 1999 and consisted in a tumefaction of the left gluteal region in a 14-year-old female coming from the south of Italy. The lesion had previously been evaluated by ultrasonography and magnetic resonance imaging. The lesion was described as a dysplastic malformation with a high vascular factor. After angiography, a surgical option was not considered as a first choice, beacisae of the wide excision it would have required. We decided to embolize the mass under angiographic guidance with fibrin spirals. After a first unsuccessfull attempt to reduce the mass, a second embolization also yielded no result, and therefore we decided to remove the dysplasia surgically. A wide excision was undertaken, extended to the muscles but sparing as much skin as possible to avoid reconstruction problems. The dysplasia, however, recurred after one year and was finally resolved only in 2001 after a third embolization. Because of the multiple types of symptoms, a multidisciplinary approach is required to obtain both a correct classification and treatment of the vascular malformations. The relevant literature is discussed

Cronache della città di Fermo pubblicate per la prima volta ed illustrate dal cav. Gaetano de Menicis;

University of Illinois Library bookplate: "From the library of Conte Antonio Cavagna Sangiuliani di Gualdana Lazelada di Bereguardo, purchased 1921".Cronaca fermana di Antonio di Niccolò, dall'anno 1176 all'anno 1447.--Annotazioni e giunte alla medesima.--Annali della città di Fermo di Giovan Paolo Montani, dall'anno 1445 al 1557.--Annali di Fermo di Autore Anonimo, dall'anno 1445 al 1557.--Annotazioni e giunte agli Annali del Montani e dell'Anonimo.--Sommario Cronologico di carte Fermane anteriori al secolo XIV, con alcuni Documenti riferiti per esteso.--Appendice di documenti al suddetto Sommario.--Indice delle cronache.--Indice dei documenti.Mode of access: Internet

Lenvatinib Is Highly Effective in Patients with Hepatocellular Carcinoma Related to Both Metabolic Dysfunction-Associated Steatohepatitis and Alcoholic Etiology: A Propensity Score Analysis

Background and aims: Metabolic dysfunction-associated steatotic liver disease (MASLD)-related hepatocellular carcinoma (HCC) may have distinct biological characteristics influencing systemic treatment response. However, the prognostic impact of MASLD vs. alcohol-related HCC in patients receiving lenvatinib remains unclear. This study aimed to assess lenvatinib’s effectiveness and safety in these populations. Methods: A multicenter cohort of 378 HCC patients treated with lenvatinib (2019–2024) was analyzed. Propensity score matching was performed based on age, sex, tumoral stage, alpha-fetoprotein levels and Child–Pugh class. Survival was estimated using Kaplan–Meier analysis and compared with the log-rank test. Results were expressed as HR and 95% CI. Results: After matching, 115 patients per group were compared. Median OS was 21 months (95% CI: 20–23) in the group with metabolic dysfunction-associated steatohepatitis (MASH) and 19 months (95% CI: 18–21) in the group with alcohol etiology (p = 0.18). In multivariate analysis, only Child–Pugh class (HR 2.67, 95% CI: 1.84–5.41) and tumor stage (HR 2.18, 95% CI: 1.57–6.93) resulted as significant predictors of OS. Median PFS was 9 months (95% CI: 8–9) in patients with MASH and 9 months (95% CI: 7–10) in patients with alcohol etiology (p = 0.33). Only the Child–Pugh class was a significant predictor of PFS in univariate analysis (HR 1.56, 95% CI: 1.15–3.41; p = 0.03). No difference in terms of adverse event rate was observed between the two groups. Conclusions: Lenvatinib is effective in patients with both MASH- and alcohol-related HCC, with no difference in oncological outcomes between the two groups

Design and Implementation of an Integrated Reconfigurable Silicon Photonics Switch Matrix in IRIS Project

This paper aims to present the design and the achieved results on a CMOS electronic and photonic integrated device for low cost, low power, transparent, mass-manufacturable optical switching. An unprecedented number of integrated photonic components (more than 1000), each individually electronically controlled, allows for the realization of a transponder aggregator device which interconnects up to eight transponders to a four direction colorless-directionless-contentionless ROADM. Each direction supports 12 200-GHz spaced wavelengths, which can be independently added or dropped from the network. An electronic ASIC, 3-D integrated on top of the photonic chip, controls the switch fabrics to allow a complete and microsecond fast reconfigurability

Waiting list mortality and 5-year transplant survival benefit of patients with MASLD: an Italian liver transplant registry study

Background & aims: International consensus has recently introduced a new definition of metabolic dysfunction-associated steatotic liver disease (MASLD). We sought to analyse epidemiological trends, prognostic features, and transplant survival benefits of patients with MASLD and without MASLD waiting for liver transplantation (LT) in Italy. Methods: Using the Italian Liver Transplant Registry database, we analysed data from adult patients listed for primary LT attributable to end-stage chronic liver disease between January 2012 and December 2022. Independent multivariable waiting lists and post-transplant survival models were developed for patients with and without hepatocellular carcinoma (HCC). A Monte Carlo simulation was used to create 5-year transplant benefit distributions based on the presence of MASLD, HCC, and model for end-stage liver disease (MELD)-sodium values. Results: A total sample of 1,941 patients with MASLD and 11,201 patients without MASLD was considered. A significant increase in the prevalence of MASLD as an indication for LT was observed from 2012 to 2022, for both cohorts with HCC (from 17.7 to 30%) and without HCC (from 9.5 to 11.8%) cohorts. Projections suggest that, as early as next year, MASLD will overcome HCV as the second most common indication for transplantation after alcoholic liver disease in Italy. According to univariate and multivariate analyses, MASLD was not an independent predictive factor for patient survival after transplantation. However, it increased the risk of death for patients on the waiting list without HCC (hazard ratio 1.62, p <0.001). At the same MELD-sodium, the 5-year transplant benefit was higher in patients with non-HCC MASLD, followed by patients with HCC, whereas it was lower in patients without HCC and without MASLD. Conclusions: Patients with non-HCC MASLD had an increased waitlist mortality and 5-year transplant survival benefit compared with other candidates. Impact and implications: The present research addresses the critical need to understand the evolving landscape of liver transplantation indications, mainly focusing on metabolic dysfunction-associated steatotic liver disease (MASLD) in Italy. Given the significant rise in MASLD cases, these findings highlight that patients with non-HCC MASLD face increased waitlist mortality and benefit more from liver transplantation within 5 years compared with other candidates. The significance of these results lies in their emphasis on the necessity of focusing on patients with MASLD on waiting lists to improve outcomes. By tailoring transplant eligibility criteria and resource allocation, the study provides actionable insights to improve patient survival and optimise liver transplantation practices