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Cyclophosphamide "metronomic" chemotherapy for palliative treatment of a young patient with advanced epithelial ovarian cancer
Riccardo Samaritani, Giacomo Corrado, Enrico Vizza, Carlo Sbiroli
BMC Cancer , 2007, DOI: 10.1186/1471-2407-7-65
Abstract: We tried palliative chemotherapy with daily low dose oral cyclophosphamide with a patient suffering from stage IIIC ovarian cancer that responded to daily cyclophosphamide (CTX) after no response to chemotherapy with paclitaxel and carboplatin as first line and progression after second line with topotecan.The progression-free survival time on daily low dose oral cyclophosphamide treatment was 65 months without side effects. She was well during the chemotherapy and lived a normal working and social life.We think that use of low dose of oral CTX should be investigated further as a strategy against tumour progression after standard chemotherapy in patients who are platinum resistant with poor performance status.Ovarian cancer remains the most common cause of death from a gynaecologic malignancy. In 2005, it is estimated that over 22,000 women will develop ovarian cancer and 16,210 will die as a result [1].Current treatment of ovarian cancer entails a combination of surgery and chemotherapy. Currently, 1st-line chemotherapy consists of a combination of carboplatin and paclitaxel to which approximately 80% of women respond [2].However, despite aggressive surgery and chemotherapy, more than 80% of patients will relapse and will then be treated with second line chemotherapy with objective responses in about 20% of patients and even lower percentages of complete responses. This is why the main goal of second and third line chemotherapy is palliative care with the aim to prolong time to progression and to improve quality of life.Several chemotherapeutic regimens have been used as single agents in phase II trials with patients previously treated with cisplatin including paclitaxel, topotecan, liposomal doxorubicin, gemcitabine and oxaliplatin, showing objective response rates ranging from 10–50% and different toxicity profiles [3].Many factors play a role when choosing a drug, such as patient compliance, toxicity of previous treatments and treatment costs. Because, at present
Human Papilloma Virus prevalence and type-specific relative contribution in invasive cervical cancer specimens from Italy
Luciano Mariani, Núria Monfulleda, Laia Alemany, Enrico Vizza, Ferdinando Marandino, Amina Vocaturo, Maria Benevolo, Beatriz Quirós, Belén Lloveras, Jo Klaustermeier, Wim Quint, Silvia de Sanjosé, F Xavier Bosch
BMC Cancer , 2010, DOI: 10.1186/1471-2407-10-259
Abstract: To describe the prevalence of HPV and the HPV type-specific distribution in ICC cases identified in Rome, Italy.140 paraffin embedded tissue blocks of primary ICC diagnosed between 2001 and 2006 were identified at the Regina Elena Cancer Institute in Rome (Italy). HPV was detected through amplification of HPV DNA using SPF-10 HPV broad-spectrum primers followed by DEIA and then genotyping by LiPA25 (version 1).134 cases were considered suitable for HPV DNA detection after histological evaluation; and overall, 90.3% (121/134) HPV prevalence was detected. 111 cases had a single HPV type, 4 cases had an uncharacterized type (HPVX) and 6 cases had multiple HPV infections. The five most common single HPV types among positive cases were: HPV16 (71/121; 58.7%), HPV18 (12/121; 9.9%), HPV31, HPV45 and HPV58 (5/121; 4.1% each). 2 (1.5%) of the single infections and 2 (1.5%) of the multiple infections contained low risk types. Statistically significant differences in the relative contribution of HPV18 were found when comparing squamous cell carcinomas with adenocarcinomas.HPV16 and HPV18 accounted for almost 70% of all the HPV positive ICC cases. The study provides baseline information for further evaluation on the impact of recently introduced HPV vaccines in Italy.Cervical cancer is a serious public health problem representing the 2nd most common cancer diagnosed among women worldwide. Around 493,000 new cases and 274,000 deaths from this disease were estimated in 2002 [1]. In this study we analyse and present data regarding Human Papillomavirus (HPV) in invasive cervical cancer (ICC) specimens from Italy, a country whose population consist of 25.94 million [2] women at risk of developing ICC (15 y.o. or older). The age-standardized incidence rate of cervical cancer in Italy has been estimated at 8.1 new cases per 100,000 women annually [1]. Current estimates indicate that 3,418 women are diagnosed with ICC every year and 1,186 die from the disease, ranking the 10th most fre
A multicenter prospective phase II randomized trial of epirubicin/vinorelbine versus pegylated liposomal doxorubicin/vinorelbine as first-line treatment in advanced breast cancer. A GOIM study
Patrizia Vici, Giuseppe Colucci, Francesco Giotta, Domenico Sergi, Gianfranco Filippelli, Pasquale Perri, Claudio Botti, Enrico Vizza, Armando Carpino, Laura Pizzuti, Agnese Latorre, Diana Giannarelli, Massimo Lopez, Luigi Di Lauro
Journal of Experimental & Clinical Cancer Research , 2011, DOI: 10.1186/1756-9966-30-39
Abstract: Patients with relapsed breast cancer not previously treated with adjuvant anthracyclines were randomly assigned to epirubicin/vinorelbine (arm A: EPI/VNB, EPI 90 mg/m2 on day 1, VNB 25 mg/m2 on days 1,5 plus G-CSF subcutaneously on days 7-12, with cycles repeated every 21 days), or to pegylated liposomal doxorubicin/VNB (arm B: PLD/VNB, PLD 40 mg/m2 on day 1, VNB 30 mg/m2 on days 1, 15, with cycles repeated every 4 weeks). Primary objective was to evaluate the efficacy of the two regimens in terms of response rate, secondarily toxicity, progression free survival and overall survival.One hundred and four patients have been enrolled (arm A 54, arm B 50): characteristics were well balanced between the 2 arms. Responses were as follows: arm A, 3 (5.6%) CR, 20 (37%) PR, (ORR 42.6%, 95%CI 29.3%-55.9%); arm B, 8 (16%) CR, 18 (36%) PR, (ORR 52%, 95%CI 38.2%-65.8%). Median progression free survival was 10.7 months in arm A (95% CI, 8.7-12.6), and 8.8 months in arm B (95% CI, 7.1-10.5). Median overall survival was 34.6 months in arm A (95%CI, 19.5-49.8) and 24.8 months in arm B (95%CI, 15.7-33.9). As toxicity concerns, both treatment regimens were well tolerated; myelosuppression was the dose-limiting toxicity, with G3-4 neutropenia occurring in 18.5% and 22% of the patients of arm A and B, respectively. No relevant differences in main toxic effects have been observed between the two arms, except for alopecia, more common in arm A, and cutaneous toxicity, observed only in arm B. No clinical congestive heart failures have been observed, one case of tachyarrhythmia was reported after the last EPI/VNB cycle, and two reversible ≥ 20% LVEF decreases have been observed in arm A.Both anthracycline- containing regimens evaluated in the present study seem to be active and with a satisfactory tolerability in anthracycline-na?ve relapsed breast cancer patients.Anthracyclines are among the most active drugs in advanced breast cancer, with response rates as single agents of approximately
Geostatistical Modeling of Uncertainty for the Risk Analysis of a Contaminated Site  [PDF]
Enrico Guastaldi
Journal of Water Resource and Protection (JWARP) , 2011, DOI: 10.4236/jwarp.2011.38066
Abstract: This work is a study of multivariate simulations of pollutants to assess the sampling uncertainty for the risk analysis of a contaminated site. The study started from data collected for a remediation project of a steel- works in northern Italy. The soil samples were taken from boreholes excavated a few years ago and analyzed by a chemical laboratory. The data set comprises concentrations of several pollutants, from which a subset of ten organic and inorganic compounds were selected. The first part of study is a univariate and bivariate sta- tistical analysis of the data. All data were spatially analyzed and transformed to the Gaussian space so as to reduce the effects of extreme high values due to contaminant hot spots and the requirements of Gaussian simulation procedures. The variography analysis quantified spatial correlation and cross-correlations, which led to a hypothesized linear model of coregionalization for all variables. Geostatistical simulation methods were applied to assess the uncertainty. Two types of simulations were performed: correlation correction of univariate sequential Gaussian simulations (SGS), and sequential Gaussian co-simulations (SGCOS). The outputs from the correlation correction simulations and SGCOS were analyzed and grade-tonnage curves were produced to assess basic environmental risk.
Perturbation of Hydrogen Degenerate Levels and SO(4)  [PDF]
Enrico Onofri
Journal of Modern Physics (JMP) , 2014, DOI: 10.4236/jmp.2014.512106

We present a short note about the perturbative correction to Rydberg energies under a perturbation cosθ/rμ and discuss the role of SO(4) symmetry.

Unusual presentation for a patent ductus arteriosus
C. D. Vizza,R. Badagliacca,R. Poscia,C. Gambardella
European Respiratory Review , 2009,
Abstract: A 63-yr-old black female, with a 1-yr history of hepatitis C and ascites was referred to an expert centre with suspicion of portopulmonary hypertension (PPHTN). Her poor condition made a rapid diagnosis imperative and precluded a normal diagnostic work-up. Echocardiography confirmed severe pulmonary hypertension (PH). A hepatic scintigraphy and an abdominal echo-Doppler study excluded liver cirrhosis and portal hypertension. Cardiac magnetic resonance imaging showed marked dilation of the right ventricle with significant hypertrophy of the free wall, a finding that is uncommon in idiopathic pulmonary arterial hypertension or PPHTN. Right heart catheterisation demonstrated severe pre-capillary PH without response to acute vasodilator testing. Finally the patient underwent computed tomography angiography, which showed marked dilation of the pulmonary artery without thromboembolic disease and, unexpectedly, a partially calcified large patent ductus arteriosus. The correct diagnosis of the underlying cause of pulmonary arterial hypertension is essential. Patients with underlying heart defects may have an atypical presentation and be referred to expert centres with an incorrect diagnosis. A full investigation is necessary; careful examination of right ventricular anatomy can provide clues about the aetiology of PH, and it is important to exclude intra- and extracardiac shunts during haemodynamic studies.
Measuring Salinity within Shallow Piezometers:Comparison of Two Field Methods  [PDF]
Enrico Balugani, Marco Antonellini
Journal of Water Resource and Protection (JWARP) , 2010, DOI: 10.4236/jwarp.2010.23029
Abstract: The objective of this study is to understand the validity of salinity vertical profiles collected from shallow piezometers that are not previously flushed. This study shows that salinity data collected from boreholes are only an average value along the entire screened section of the piezometer. In order to collect data that is rep-resentative for the salinity of the adjacent aquifer, a new monitoring strategy has been developed. This strat-egy includes measurement of the salinity at the top of the watertable in an auger hole which is a shallow boreholes made with an handheld drill. This should be combined with measurements in piezometers that are first flushed to take out stagnant water. From the piezometers on can measure the average salinity of the screened part and the salinity at the bottom of the aquifer. By using this monitoring strategy it is also possi-ble to define where the piezometers screens are located if this is not known beforehand.
Energy and Sustainability in Museums. The Plant Refurbishment of the Medieval Building of Palagio di Parte Guelfa in Florence  [PDF]
Carla Balocco, Enrico Marmonti
Open Journal of Energy Efficiency (OJEE) , 2012, DOI: 10.4236/ojee.2012.13004
Abstract: This paper presents a performance-based design of a HVAC plant and controller system of the “Palagio di Parte Guelfa” Palace, a medieval building converted into a museum in the city of Firenze. Transient simulations to evaluate the internal microclimate conditions during the year for the building and the different system plant were carried out. A comparison between the indoor microclimatic parameters obtained and the values suggested by the standards on protection and conservation of historical works of art, suggested a non-invasive and reversible plant system solution. The MuseumofHistorical Footballbuilding portion is the case study. The proposed plant, a constant air flow system coupled with radiant panels dry mounted above the existing flooring, was simulated throughout the year under transient conditions to evaluate its energy performance. This solution ensures indoor temperature and humidity values suitable for the conservation of works of art and visitor comfort. It is an example of a possible course of action for a plant refurbishment in a historic building converted into a museum, located in climatic regions characterized by high thermal and solar loads. The present paper concerns the study of an integrated and reversible architectural-plant solution proposed: reversibility of the proposed system is understood as the possibility for the present conditions being easily restored.
Hierarchical Modeling by Recursive Unsupervised Spectral Clustering and Network Extended Importance Measures to Analyze the Reliability Characteristics of Complex Network Systems  [PDF]
Yiping Fang, Enrico Zio
American Journal of Operations Research (AJOR) , 2013, DOI: 10.4236/ajor.2013.31A010

The complexity of large-scale network systems made of a large number of nonlinearly interconnected components is a restrictive facet for their modeling and analysis. In this paper, we propose a framework of hierarchical modeling of a complex network system, based on a recursive unsupervised spectral clustering method. The hierarchical model serves the purpose of facilitating the management of complexity in the analysis of real-world critical infrastructures. We exemplify this by referring to the reliability analysis of the 380 kV Italian Power Transmission Network (IPTN). In this work of analysis, the classical component Importance Measures (IMs) of reliability theory have been extended to render them compatible and applicable to a complex distributed network system. By utilizing these extended IMs, the reliability properties of the IPTN system can be evaluated in the framework of the hierarchical system model, with the aim of providing risk managers with information on the risk/safety significance of system structures and components.

Bilinear Mappings and the Frame Operator  [PDF]
Enrico Au-Yeung
Advances in Pure Mathematics (APM) , 2013, DOI: 10.4236/apm.2013.34062

The theory of frames has been actively developed by many authors over the past two decades, both for its applications to signal processing, and for its deep connections to other areas of mathematics such as operator theory. Central to the study of frames is the frame operator. We initiate an investigation that extends the frame operator to the bilinear setting.

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