Clinical outcome and biological characteristics of Chronic Myeloid Leukemia patients treated with nilotinib front-line

The present work reports the outcome of the GIMEMA CML WP study CML0811, an independent trial investigating nilotinib as front-line treatment in chronic phase chronic myeloid leukemia (CML). Moreover, the results of the proteomic analysis of the CD34+ cells collected at CML diagnosis, compared to the counterpart from healthy donors, are reported. Our study confirmed that nilotinib is highly effective in the prevention of the progression to accelerated/blast phase, a condition that today is still associated with high mortality rates. Despite the relatively short follow-up, cardiovascular issues, particularly atherosclerotic adverse events (AE), have emerged, and the frequency of these AEs may counterbalance the anti-leukemic efficacy. The deep molecular response rates in our study compare favorably to those obtained with imatinib, in historic cohorts, and confirm the findings of the Company-sponsored ENESTnd study. Considering the increasing rates of deep MR over time we observed, a significant proportion of patients will be candidate to treatment discontinuation in the next years, with higher probability of remaining disease-free in the long term. The presence of the additional and complex changes we found at the proteomic level in CML CD34+ cells should be taken into account for the investigation on novel targeted therapies, aimed at the eradication of the disease.

Studio della risposta temporale di fotorivelatori con diversi accoppiamenti a scintillatori e diversa elettronica di front end e di read out

Lo scopo di questa tesi è lo studio, mediante misure sperimentali con un telescopio per raggi cosmici, della risposta temporale di rivelatori a scintillazione accoppiati a diversi tipi di fotorivelatori. In particolare sono stati studiati due tipi di fotorivelatori: i fotomoltiplicatori al silicio (SiPM) ed i rivelatori MicroChannel Plate (MCP); entrambi i sensori presentano ottime caratteristiche per ciò che concerne la risposta temporale. Per una migliore caratterizzazione dei fotorivelatori e per una maggiore completezza dello studio sono stati analizzati anche diversi modelli di accoppiamento tra gli scintillatori ed i sensori, sia a diretto contatto che tramite fibre ottiche. Per cercare di sfruttare al meglio le eccellenti proprietà temporali, sono state utilizzate anche diverse schede di front end veloce e diversa elettronica di read out. In particolare in questa tesi, per la prima volta, è stata usata, per lo studio di questi nuovi fotorivelatori, l’elettronica di front end e read out realizzata per il rivelatore TOF dell’esperimento ALICE a LHC. I risultati di questa tesi rappresentano un punto di partenza per la realizzazione di rivelatori con ottima risoluzione temporale in esperimenti di fisica nucleare ed subnucleare (definizione del trigger, misure di tempo di volo, calorimetria). Altre interessanti applicazioni sono possibili in ambito medico, in particolare strumenti di diagnostica avanzata quali ad esempio la PET.

Intracranial pressure pulse amplitude during changes in head elevation: a new parameter for determining optimum cerebral perfusion pressure?

During short-term postural changes, the factors determining the amplitude of intracranial pulse pressure (ICPPA) remain constant, except for cerebrovascular resistance (CVR). Therefore, it may be possible to draw conclusions from the ICPPA onto the cerebrovascular resistance (CVR) and thus the relative change in cerebral perfusion pressure (CPP).

Pulse or hyaline ring granuloma. Review of the literature on etiopathogenesis of oral and extraoral lesions

Since the late 1950s, reports on an unusual giant-cell granulomatous lesion affecting the jaws, lungs, stomach and intestines have been published. Histopathologically, the lesions showed the presence of structureless hyaline rings with multinucleated giant cells. The aim of this review was to summarize the literature on the etiopathogenesis of the so-called oral and extraoral pulse or hyaline ring granuloma. Literature was searched using PubMed and Medline. In addition, hand search was performed. Search words were oral and extraoral hyaline ring granuloma, giant-cell hyaline angiopathy, pulse granuloma and chronic periostitis. Numerous terms for hyaline ring granuloma have been introduced over time (1971-2008). One hundred seventy-three cases of oral hyaline ring granuloma have been retrieved from the literature. In the mandible, 72.3% occurred . Two theories for etiopathogenesis have been proposed: (1) the origin of the hyaline rings is due to a foreign material (pulse and legumes) having penetrated the oral mucosa or gastrointestinal tract and lungs (exogenous theory) and (2) the rings are due to hyaline degenerative changes in walls of blood vessels (endogenous theory). Experimental production of oral and extraoral hyaline ring granulomas is consistent with the exogenous origin. Particles or remains of leguminous cells having been implanted or aspirated into human tissues whether located to the oral cavity or throughout the entire digestive tract and respiratory system are thought to be causative. Pulse or hyaline ring granulomas are rare but are well-defined oral and extraoral lesions due to implantation of the cellulose moiety of plant foods in contrast to the starch components.

Pulse-pressure variation and hemodynamic response in patients with elevated pulmonary artery pressure: a clinical study

Pulse-pressure variation (PPV) due to increased right ventricular afterload and dysfunction may misleadingly suggest volume responsiveness. We aimed to assess prediction of volume responsiveness with PPV in patients with increased pulmonary artery pressure.

Pulse pressure variation and volume responsiveness during acutely increased pulmonary artery pressure: an experimental study

We found that pulse pressure variation (PPV) did not predict volume responsiveness in patients with increased pulmonary artery pressure. This study tests the hypothesis that PPV does not predict fluid responsiveness during an endotoxin-induced acute increase in pulmonary artery pressure and right ventricular loading.

Comparison of non-calibrated pulse-contour analysis with continuous thermodilution for cardiac output assessment in patients with induced hypothermia after cardiac arrest

Induced mild hypothermia after cardiac arrest interferes with clinical assessment of the cardiovascular status of patients. In this situation, non-invasive cardiac output measurement could be useful. Unfortunately, arterial pulse contour is altered by temperature, and the performance of devices using arterial blood pressure contour analysis to derive cardiac output may be insufficient.

Chest pulse-wave velocity: a novel approach to assess arterial stiffness

Pulse-wave velocity (PWV) is considered as the gold-standard method to assess arterial stiffness, an independent predictor of cardiovascular morbidity and mortality. Current available devices that measure PWV need to be operated by skilled medical staff, thus, reducing the potential use of PWV in the ambulatory setting. In this paper, we present a new technique allowing continuous, unsupervised measurements of pulse transit times (PTT) in central arteries by means of a chest sensor. This technique relies on measuring the propagation time of pressure pulses from their genesis in the left ventricle to their later arrival at the cutaneous vasculature on the sternum. Combined thoracic impedance cardiography and phonocardiography are used to detect the opening of the aortic valve, from which a pre-ejection period (PEP) value is estimated. Multichannel reflective photoplethysmography at the sternum is used to detect the distal pulse-arrival time (PAT). A PTT value is then calculated as PTT = PAT - PEP. After optimizing the parameters of the chest PTT calculation algorithm on a nine-subject cohort, a prospective validation study involving 31 normo- and hypertensive subjects was performed. 1/chest PTT correlated very well with the COMPLIOR carotid to femoral PWV (r = 0.88, p < 10 (-9)). Finally, an empirical method to map chest PTT values onto chest PWV values is explored.

The ocular pulse amplitude at different intraocular pressure: a prospective study

To investigate changes in ocular pulse amplitude (OPA) during a short-term increase in intraocular pressure (IOP) and to assess possible influences of biometrical properties of the eye, including central corneal thickness (CCT) and axial length.

Invariant barriers to reactive front propagation in fluid flows

We present theory and experiments on the dynamics of reaction fronts in two-dimensional, vortex-dominated flows, for both time-independent and periodically driven cases. We find that the front propagation process is controlled by one-sided barriers that are either fixed in the laboratory frame (time-independent flows) or oscillate periodically (periodically driven flows). We call these barriers burning invariant manifolds (BIMs), since their role in front propagation is analogous to that of invariant manifolds in the transport and mixing of passive impurities under advection. Theoretically, the BIMs emerge from a dynamical systems approach when the advection-reaction-diffusion dynamics is recast as an ODE for front element dynamics. Experimentally, we measure the location of BIMs for several laboratory flows and confirm their role as barriers to front propagation.

Barriers to front propagation in ordered and disordered vortex flows

We present experiments on reactive front propagation in a two-dimensional (2D) vortex chain flow (both time-independent and time-periodic) and a 2D spatially disordered (time-independent) vortex-dominated flow. The flows are generated using magnetohydrodynamic forcing techniques, and the fronts are produced using the excitable, ferroin-catalyzed Belousov-Zhabotinsky chemical reaction. In both of these flows, front propagation is dominated by the presence of burning invariant manifolds (BIMs) that act as barriers, similar to invariant manifolds that dominate the transport of passive impurities. Convergence of the fronts onto these BIMs is shown experimentally for all of the flows studied. The BIMs are also shown to collapse onto the invariant manifolds for passive transport in the limit of large flow velocities. For the disordered flow, the measured BIMs are compared to those predicted using a measured velocity field and a three-dimensional set of ordinary differential equations that describe the dynamics of front propagation in advection-reaction-diffusion systems.

Effect of Pulse Depletion in a Brillouin Optical Time-Domain Analysis System

Energy transfer between the interacting waves in a distributed Brillouin sensor can result in a distorted measurement of the local Brillouin gain spectrum, leading to systematic errors. It is demonstrated that this depletion effect can be precisely modelled. This has been validated by experimental tests in an excellent quantitative agreement. Strict guidelines can be enunciated from the model to make the impact of depletion negligible, for any type and any length of fiber. (C) 2013 Optical Society of America