Novel schedule for treatment of inflammatory breast cancer

Inflammatory breast cancer (IBC) is the most aggressive form of this tumor, with the clinical and biological characteristics of a rapidly proliferating disease. This tumor is always diagnosed at advanced stages, atleast stage IIIB (locally advanced), so its management requires an integrated multidisciplinary approach with a systemic therapy followed by surgery and radiation therapy. Patients with IBC usually have a worse prognosis but the achievement of a pathologic complete response after neoadjuvant chemotherapy may have good rates of overall survival. We present the case of a 47 year old women with IBC, luminal B and with high proliferative index; she was successfully treated with a sequential schedule of chemotherapy (anthracyclines dose-dense/carboplatin+ taxane/Cyclophosphamide Methotrexate Fluorouracil), hormone-therapy, complementary radiotherapy and finally surgery until the achievement of a complete clinical and pathological response. Luminal B inflammatory breast cancer with high proliferation index can benefit from sequential schedules of neoadjuvant chemotherapy and hormonal treatment and this can result in pathological complete response

CHRONIC CONSTIPATION IS A RISK FACTOR FOR METABOLIC SYNDROME

Background and aim: A recent epidemiologic survey in the U.S. provides indirect evidence that constipation is a risk factor for cardiovascular disease in postmenopausal females. To characterize the related factors involved in and to further analyse if this assumption also applies to an Italian population, we studied the impact of chronic constipation on ischemic cardiopathy and predisposing risk factors in a large population of female patients in a primary care setting. Material and methods: We retrospectively evaluated 754 female patients (mean age 46±20 years) on data file of a primary care setting. All subjects requiring medical referral for constipation were screened and presence of chronic constipation was confirmed by standardized questionnaires. The presence of clinical and/or instrumental diagnosis of ischemic cardiopathy, metabolic syndrome, diabetes and blood hypertension was scored in patients with and without chronic constipation. In all patients the consumption of drugs potentially delaying colonic transit (calcium channel blockers and beta blockers) was recorded. Patients on opioid or analgesic treatment were excluded. Results: The overall prevalence of chronic constipation was 9.4% (71/754) with the age being similar in patients with and without constipation (46±19 vs. 51±22, p=NS). The prevalence of metabolic syndrome was significantly higher in subjects with chronic constipation (5/66 vs 16/667, OR=3.1, 95% CI 1.1–8.9, p=0.03). Conversely, prevalence of diabetes, blood hypertension, ischemic cardiopathy was similar in patients with and without constipation (59/624 vs 10/61; 204/478 vs 28/43; 46/637 vs 6/65, respectively p= all NS). No significant difference was also observed as far as calcium channel blockers (64/619 vs 9/62) and beta blockers (81/602 vs 9/62) consumption in patients with or without constipation respectively. Conclusions: We showed that chronic constipation is a risk factor for metabolic syndrome in female patients. Although we did not find any significant association between chronic constipation and ischemic cardiopathy, our findings support the hypothesis that constipation may act as cardiovascular risk factor. Whether this association is dependent on dietary or hormonal factors deserves further investigation

INTRA-DUODENAL RELEASE OF A BITTER COMPOUND DECREASES CALORIC INTAKE IN HEALTHY VOLUNTEERS

Background and aim: α-gustducin and bitter taste receptors (T2R) are expressed both in the oral cavity and in the gastrointestinal (GI) tract. Experimental data showed that bitter tastants induce the release of gut hormones from enteroendocrine cells in the gut, suggesting a possible role of bitter taste receptors in the control of food intake and GI functions. We aimed to test the effects of a bitter taste receptor agonist on food intake and GI feelings. Material and methods: We enrolled 19 healthy subjects (9 males, age 27±7, BMI 24±6) in a double-blind placebo controlled study. Each subject randomly received an acid-resistant capsule containing placebo or 18 mg of quinine HCl. 60 minutes after capsule administration, the subjects underwent to an ad libitum test, until the maximum satiation. Meal test was composed by white bread, cheese and meat cream (89 kcal/portion: 50% carbohydrate, 31% fat, 19% protein). Caloric intake, meal duration and satiation levels, scored on a Visual Analogue Scale (VAS) were calculated at the end of the meal test. A questionnaire assessing GI sensations (bloating, fullness, nausea, epigastric discomfort and hunger) was administered before and at the end of the test. Data (mean ± SD) were compared by using paired t test. Results: No oral bitter sensation or side effects was observed both with quinine HCland placebo. No significant differences in terms of GI sensations and hunger feelings were observed between the two sessions of the study. The amount of calories ingested was significantly lower when subjects received quinine HCl than placebo (564±262 vs 667±278 kcal; p=0.02). Conversely, quinine HCl did not affect the meal duration (14.4±4.2 vs 16.6±4.6 min; p=NS) and the satiationintensity (82 vs 82 mm; p=NS). Conclusions: The intra-duodenal release of a bitter compound significantly decreases caloric intake in an ad libitum test meal without affecting GI sensations and hunger feeling. As the bitter compound does not influence meal duration, we hypothesize that quinine HCl decreases the caloric intake by affecting the rate of meal portions consumption. Evaluation of gut hormones kinetics and studies with other bitter taste receptor agonist are needed to establish the role of gastrointestinal bitter taste receptor in the control of food intak

ACHALASIA TREATMENT IMPROVES SPECIFIC SYMPTOMS AND QUALITY OF LIFE: VALIDATION OF AN ACHALASIA SPECIFIC QUALITY OF LIFE QUESTIONNAIRE

Background and aim: Therapies for achalasia aim to patients’ symptom relief, but they affect patient’s quality of life (QoL), too. An ad hoc question- naire evaluating both achalasia-related symptoms and disease related QoL is lacking. Aim: To validate a disease specific QoL questionnaire in perspectively evaluated Italian achalasia patients. Material and methods: 22 consecutive achalasia patients (4 men, age range 19–86 years) were included in the study. At baseline a structured question- naire was used to evaluate both esophageal symptoms and disease specific QoL. Questionnaire graded achalasia-related symptoms severity (dysphagia for solids and liquids, food regurgitation, chest pain, nocturnal cough) from 0 to 3, based on their impact on daily activities. Also a disease specific QoL was evaluated by a self administred questionnaire, the AE-18, that investigated four domains (physical, psychological and social functioning, and sleep dis- turbance). Scores for each item range from 1 (“always”) to 5 (“never”); higher scores corresponding to better quality of life. All patients were questioned before, 1 and 6 months after a specific t reatment regimen, that according to patients clinical status consisted in pneumatic dilation, botulinum toxin injection or surgical myotomy. Results: Patients within each specific treatment groups were the following (3/22 surgical myotomy, 14/22 pneumatic dilation and 5/22 Botox injections, respectively. In the table are reported the baseline demographics and achalasia- related symptoms’ severity and QoL (data are expressed as mean ± SD) within each treatments group. Table 1 Surgery group Dilation group Botox group p Age at diagnosis 42.3 ± 6.5 42.3 ± 13 81.8 ± 4.8 < 0.001 Age at onset of symptoms 39.3 ± 7.5 40.3 ± 12.4 80.8 ± 5.6 < 0.001 Dysphagia for solids 2.7 ± 0.6 2.2 ± 0.7 2.2 ± 0.5 0.5 Dysphagia for liquids 2.0 ± 1.0 2.1 ± 0.7 2.2 ± 0.5 0.9 Regurgitation of undigested food 1.0 ± 1.7 0.7 ± 0.8 0.6 ± 1.3 0.8 Chest pain 0.7 ± 1.1 1.1 ± 1.1 1.0 ± 1.4 0.8 Nocturnal cough 1.3 ± 1.5 1.3 ± 1.2 1.0 ± 1.4 0.9 AE-18 total score 54 ± 14 53 ± 12 53 ± 11 0.9 At both 1 and 6 months of the follow-up, the severity mean scores of dysphagia achalasia-related symptoms severity were significantly reduced compared to baseline (p < 0.05). Similarly, the AE-18 total score was significantly improved (p < 0.001). Conclusions: We showed that therapy-induced improvement of achalasia- related symptoms correlate with a significant improvement of patients quality of life as assessed by a specific questionnaire

CORRELATES TO ABDOMINAL PAIN IN CONSTIPATION PREVALENT IBS PATIENTS

Background and aim: Symptoms of irritable bowel syndrome (IBS) have been associated to altered motility and sensation. In constipated prevalent-IBS patients, a clear association between bowel habit and abdominal pain remains to be established, and it is not known whether factors related to patients daily life may play a role in symptoms generation. Our aim was to evaluate the association between abdominal pain, bowel habit, demographic factors, alimentary/voluptuary habits and colonic transit in constipated-IBS patients. Material and methods: 68 patients complaining of chronic constipation were selected on the basis of the Rome 3 criteria for IBS. Colonic transit time (CTT) was studied and alimentary attitudes and smoking habit were recorded. Presence of mild or severe abdominal pain was scored, as well as the prevalent pain characteristics, defined as diffuse or localized, chronic or acute, with cramps or gradually distending. Data were analysed by univariate and stepwise multiple logistic regression analysis was also used to verify the risk association between pain and all other variables. Results: 40 patients were classified as constipated and 28 had alternating evacuation. Constipated patients had a lower scholar degree, consumed more laxatives, had a longer transit time in the right colon and scored more chronic pain than alternating ones, but it was not confirmed by multivariate analysis. When severity of abdominal pain was used as discriminating factor, a significant number of subjects reporting severe pain were males (16/30 vs 4/38, p<0.01) and smokers (20/30 vs 4/38, p<0.001). Multivariate analysis confirmed that only smoking was an independent factor associated with severe abdominal pain (OR 14.3, CI 2–99, p= 0.007). Conclusions: Abdominal pain is similarly reported by constipated or alternating IBS patients and it is not associated with colonic transit time or demographics. Smoking is the only factor constantly and independently associated to severe abdominal pain. As smoking does not seem likely to affect colonic transit time we suggest that smoking may act on the visceral perception in IBS-constipated patients

Can Humans Discriminate Horse ‘Fear’ Chemosignals from Control Chemosignals? Comment on Sabiniewicz et al. A Preliminary Investigation of Interspecific Chemosensory Communication of Emotions: Can Humans (Homo sapiens) Recognise Fear- and Non-Fear Body Odour from Horses (Equus ferus caballus). Animals 2021, 11, 3499

We illustrate the problematic nature of different assumptions guiding the examination of whether humans can detect the source of fear chemosignals (i.e., body odors) emitted by horses—a research question examined in an article recently published in Animals. A central issue is that the formulation of the question itself contains the answer to it. In this paper, we parse the problematic assumptions on which the analysis and methodology rely, leading to conclusions that are difficult to support. These assumptions constitute examples of methodological problems that should be avoided in research with animals and odors. The unique aspect of this paper is that it is a collaborative product, including the original contributor, in the pursuit of transparency in science.info:eu-repo/semantics/publishedVersio

Situation identification in smart wearable computing systems based on machine learning and Context Space Theory

Wearable devices and smart sensors are increasingly adopted to monitor the behaviors of human and artificial agents. Many applications rely on the capability of such devices to recognize daily life activities performed by the monitored users in order to tailor their behaviors with respect to the occurring situations. Despite the constant evolution of smart sensing technologies and the numerous research in this field, an accurate recognition of in-the-wild situations still represents an open research challenge. This work proposes a novel approach for situation identification capable of recognizing the activities and the situations in which they occur in different environments and behavioral contexts, processing data acquired by wearable and environmental sensors. An architecture of a situation-aware wearable computing system is proposed, inspired by Endsley's situation-awareness model, consisting of a two-step approach for situation identification. The approach first identifies the daily life activities via a learning-based technique. Simultaneously, the context in which the activities are performed is recognized using Context Space Theory. Finally, the fusion between the context state and the activities allows identifying the complex situations in which the user is acting. The knowledge regarding the situations forms the basis on which novel and smarter applications can be realized. The approach has been evaluated on the ExtraSensory public dataset and compared with state-of-the-art techniques, achieving an accuracy of 96% for the recognition of situations and with significantly low computational time, demonstrating the efficacy of the two-step situation identification approach

Sex differences in the behavioral responses of dogs exposed to human chemosignals of fear and happiness

This research focuses on sex differences in the behavioral patterns of dogs when they are exposed to human chemosignals (sweat) produced in happy and fear contexts. No age, breed or apparatus-directed behavior differences were found. However, when exposed to fear chemosignals, dogs' behavior towards their owners, and their stress signals lasted longer when compared to being exposed to happiness as well as control chemosignals. In the happy odor condition, females, in contrast to males, displayed a significantly higher interest to the stranger compared to their owner. In the fear condition, dogs spent more time with their owner compared to the stranger. Behaviors directed towards the door, indicative of exit interest, had a longer duration in the fear condition than the other two conditions. Female dogs revealed a significantly longer door-directed behavior in the fear condition compared to the control condition. Overall the data shows that the effect of exposure to human emotional chemosignals is not sex dependent for behaviors related to the apparatus, the owner or the stress behaviors; however, in the happiness condition, females showed a stronger tendency to interact with the stranger.info:eu-repo/semantics/publishedVersio

Puppies in the problem-solving paradigm: quick males and social females

We report an observational, double-blind study that examined puppies’ behaviors while engaged in solving an experimental food retrieval task (food retrieval task instrument: FRTI). The experimental setting included passive social distractors (i.e., the dog’s owner and a stranger). The focus was on how the social and physical environment shapes puppies’ behaviors according to sex. The dependent variables were the number of tasks solved on an apparatus (Performance Index) and the time required to solve the frst task (Speed). Sex and Stress were set as explanatory factors, and Social Interest, FRTI interactions, other behavior, and age as covariates. The main fndings were that male puppies solved the frst task faster than females. On the other hand, females displayed signifcantly more social interest and did so more rapidly than males. Males showed delayed task resolution. This study demonstrates sex diferences in a problem-solving task in dog puppies for the frst time, thus highlighting that sexually dimorphic behavioral diferences in problem-solving strategies develop early on during ontogenesis.info:eu-repo/semantics/publishedVersio

Low glycemic index diet in children and young adults with refractory epilepsy: first Italian experience.

This is the report on the first Italian experience with the low glycemic index diet (LGIT) in a group of children, adolescents and young adults with refractory epileptic encephalopathies. A retrospective chart review was performed on patients initiating the LGIT in an outpatient setting from 2005 to 2010. Demographic and clinical information including seizure type, baseline seizure frequency, medications, blood chemistry, side effects, and anthropometrics were collected. Patients were educated and followed by a dietician to restrict foods with high glycemic index and to limit total daily carbohydrates to 40-60g. Change in seizure frequency was assessed at each 3-month follow-up intervals in the first year and then at each 6-month intervals. Fifteen consecutive patients (13 males and 2 females, aged between 11.3 years and 22 years), almost all affected by generalized cryptogenic or symptomatic refractory epilepsy, were enrolled in the study. After a mean follow-up period of 14.5±6.5 months (median 12.0; range 1-60 months), 6 patients (40%) had a 75-90% seizure reduction, while seizures decreased by 50% in other 2 (13.3%) and were unchanged in 7 (46.7%). The diet was discontinued in 4 patients within the first 5 months. No adverse events occurred during the diet. In conclusion, this initial experience confirms that some refractory patients may improve on the LGIT, even as first dietary option