Primary mediastinal lymphoma: diagnosis and treatment options.

Primary mediastinal large B-cell lymphoma (PMBCL) is a unique B-cell lymphoma variant that arises from a putative thymic medulla B cell. It constitutes 2-4% of non-Hodgkin lymphomas and occurs most frequently in young females. PMBCL is characterized by a diffuse proliferation of medium-to-large B cells associated with sclerosis. Molecular analysis shows that PMBCL is a distinct entity compared to other types of diffuse large B-cell lymphomas. PMBCL is characterized by a locally invasive anterior mediastinal bulky mass. The combination of rituximab with CHOP/CHOP-like regimens followed by mediastinal radiation therapy (RT) is associated with a 5-year progression-free survival of 75-85%. However, the role of consolidation RT still remains uncertain. More intensive regimens, such as DA-EPOCH-R without mediastinal RT, have shown very promising results. The conclusive role of PET-CT scan requires prospective studies and there is hope that this may allow to de-escalate RT and accordingly yield reliable prognostic information

Epirubicin. A new entry in the list of fetal cardiotoxic drugs? Intrauterine death of one fetus in a twin pregnancy. Case report and review of literature

BACKGROUND: Current knowledge indicate that epirubicin administration in late pregnancy is almost devoid of any fetal cardiotoxicity. We report a twin pregnancy complicated by breast cancer in which epirubicin administration was causatively linked to the death of one twin who was small for gestational age (SGA) and in a condition of oligohydramnios and determined the onset of a transient cardiotoxicity of the surviving fetus/newborn. CASE PRESENTATION: A 38-year-old caucasic woman with a dichorionic twin pregnancy was referred to our center at 20 and 1/7 weeks for a suspected breast cancer, later confirmed by the histopathology report. At 31 and 3/7 weeks, after the second chemotherapy cycle, ultrasound examination evidenced the demise of one twin while cardiac examination revealed a monophasic diastolic ventricular filling, i.e. a diastolic dysfunction of the surviving fetus who was delivered the following day due to the occurrence of grade II placental abruption. The role of epirubicin cardiotoxicity in the death of the first twin was supported by post-mortem cardiac and placental examination and by the absence of structural or genomic abnormalities that may indicate an alternative etiology of fetal demise. The occurrence of epirubicin cardiotoxicity in the surviving newborn was confirmed by the report of high levels of troponin and transient left ventricular septal hypokinesia. CONCLUSION: Based on our findings we suggest that epirubicin administration in pregnancy should be preceded by the screening of some fetal conditions like SGA and oligohydramnios that may increase its cardiotoxicity and that, during treatment, the diastolic function of the fetal right ventricle should be specifically monitored by a pediatric cardiologist; also, epirubicin and desamethasone for lung maturation should not be closely administered since placental effects of glucocorticoids may increase epirubicin toxicity

Contingency tables with structural zeros and discrete copulas

In this work, we analyze the connection between contingency table analysis and copulas in a discrete framework. We focus on the impact of structural zeros on the general theory presented by Geenens (2020) based on a new idea of copula models for discrete variables. Through examples, we investigate the pros and cons of applying the theory developed by Geenens (2020) and discuss some open questions for future researc

Multi-way contingency tables with uniform margins

We study the problem of transforming a multi-way contingency table into an equivalent table with uniform margins and same dependence structure. Such a problem relates to recent developments in copula modeling for discrete random vectors. Here, we focus on three-way binary tables and show that, even in such a simple case, the situation is quite different than for two-way tables. Many more constraints are needed to ensure a unique solution to the problem. Therefore, the uniqueness of the transformed table is subject to arbitrary choices of the practitioner. We illustrate the theory through some examples, and conclude with a discussion on the topic and future research directions

Il «buon costume» come limite ai diritti: prospettive e problematiche

This doctoral thesis concerns the concept of «good mores» as a limitation to constitutional rights. The goal of this research is to devise a definition of this concept that a secularized and pluralist society can accept. In the first part of the thesis I have examined the «good mores» within Italian legal system. I have singled out the legal sources that refer to «good mores», or to similar notions, and I have studied how these concepts live in the jurisprudence and in doctrinal opinions. In the second part of the thesis I have analyzed the «good mores» in a transnational context, and I took into account this clause in the European dimension and, in a comparative perspective, in a foreign legal system, namely that of U.S.A. In the last part of the work I attempted a definition of the «good mores». Since this concept has a content that belongs to the sphere of ethics and values, I held that the source of shared values in a liberal-democratic society might be its Constitution, and, within a pluralist Constitution, there might be an overlapping consensus on the value of human dignity. Therefore, I examined the possibility to link the «good mores» to human dignity, and I explored the consequences of that interpretive solution with regard to fundamental rights of the individual.

Thirty-Five Years of the 1988 Brazilian Constitution: Rights, Promises and Democratic Resilience

This article provides a historical perspective on the moments anticipating the formation of Brazil’s 1988 Constitution, as well as a reflection on the future of Brazilian democracy. It is divided into four parts. Part I recounts the historical circumstances prior to the convening of the Constituent Assembly, which led to the 1988 Constitution. Part II analyzes the changes brought about by the new Constitution, especially regarding the three branches of government, as well as the evolutions in Brazilian constitutional theory over the period. Part III evaluates some of the critical moments experienced during its thirty-five years in force. The article concludes with a final note on the challenges that Brazil faces in the near future: the fight against poverty, the emergence of new technologies, and environmental protection. Despite some moments of fright and frustrations, there are good reasons to celebrate the thirty-fifth anniversary of the 1988 Constitution and the consolidation of constitutional democracy in Brazil. Nevertheless, there remains a long journey ahead