[Long term survival in patient with metastatic breast cancer treated with sacituzmab govitecan.].

The clinical case presented refers to a woman suffering from metastatic breast cancer treated with sacituzumab govitecan (SG) who has a long progression-free survival. The case is characterized by the extreme aggressiveness of the neoplastic disease that relapses during adjuvant hormonal treatment with a metastatic disease that presents immunohistochemical characteristics different from the primary tumor. After first-line therapy with nabpaclitaxel and atezolizumab and the subsequent one with carboplatin and gemcitabine, both characterized by short PFS, the third line with SG is characterized by obtaining a complete response and a prolonged PFS as well as extreme tolerability that continues to this day after 15 months of treatment.

Lenvatinib versus Sorafenib Second-Line Therapy in Patients with Hepatocellular Carcinoma Progressed to Atezolizumab plus Bevacizumab: A Retrospective Real-World Study.

Introduction: The most frequently used first-line treatment in patients with advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab. Upon progression after this treatment, the standard of care in many countries is sorafenib, due to the lack of reimbursement for other drugs. Several randomized trials are currently underway to clarify the best second-line therapy in patients with HCC.

Lung-Protective Mechanical Ventilation in Patients with Severe Acute Brain Injury: A Multicenter Randomized Clinical Trial (PROLABI).

Lung-protective strategies using low Vt and moderate positive end-expiratory pressure (PEEP) are considered best practice in critical care, but interventional trials have never been conducted in patients with acute brain injuries because of concerns about carbon dioxide control and the effect of PEEP on cerebral hemodynamics. To test the hypothesis that ventilation with lower VT and higher PEEP compared to conventional ventilation would improve clinical outcomes in patients with acute brain injury. In this multicenter, open-label, controlled clinical trial, 190 adult patients with acute brain injury were assigned to receive either a lung-protective or a conventional ventilatory strategy.

Bickerstaff encephalitis in childhood: a review of 74 cases in the literature from 1951 to today.

Bickerstaff brainstem encephalitis (BBE) is a rare autoimmune disease characterized by the subacute onset of bilateral external ophthalmoplegia, ataxia, and decreased level of consciousness. BBE is part of a group of rare autoimmune diseases in children that can affect the nervous system at any level. The onset of neurological deficits is often sudden and nonspecific.

Postoperative cognitive worsening in seniors with an age above life expectancy: a prospective longitudinal study.

Background: The growing number of elderly patients in hospitals is a challenge for healthcare systems. The main objective is to measure the postoperative change in the cognitive status at hospital discharge and one year after discharge in elderly patients undergoing planned or deferrable surgery.

Methods: We planned a prospective longitudinal study, single-center study: secondary care level hospital, enrolment from September 2018 to May 2019.

Serum LDH levels may predict poor neurological outcome after aneurysmal subarachnoid hemorrhage.

Introduction: Serum lactate dehydrogenase (LDH) levels are often elevated in cardiovascular diseases. Their prognostic role after subarachnoid hemorrhage (SAH) remains poorly evaluated.

Methods: This is a retrospective single-center study of patients with non-traumatic SAH admitted to the intensive care unit (ICU) of an University Hospital from 2007 to 2022.

Mechanical ventilation in patients with acute brain injury: a systematic review with meta-analysis.

Objective: To describe the potential effects of ventilatory strategies on the outcome of acute brain-injured patients undergoing invasive mechanical ventilation.

Design: Systematic review with an individual data meta-analysis.

Setting: Observational and interventional (before/after) studies published up to August 22nd, 2022, were considered for inclusion.

Occurrence of secondary insults during endovascular treatment of acute ischemic stroke and impact on outcome: the SIR-STROKE prospective observational study.

Background: Neurological outcome after endovascular treatment (EVT) of acute ischemic stroke (AIS) may depend on both patient-specific and procedural factors. We hypothesized that altered systemic homeostasis might be frequent and affect outcome in these patients. The aim of this study was to analyze secondary insults during EVT of AIS and its association with outcome and anesthesiologic regimen.

The Increasing Role of CT-Guided Cryoablation for the Treatment of Liver Cancer: A Single-Center Report.

Purpose: Cryoablation (CrA) is a minimally invasive treatment that can be used in primary and metastatic liver cancer. The purpose of this study was to assess the effectiveness of CrA in patients with hepatocellular carcinoma (HCC) and liver metastases. Methods: We retrospectively evaluated the patients who had CrA for HCC or liver metastases between 2015 and 2020.

Management of the Potential Lung Donor.

The use of donor management protocols has significantly improved recovery rates; however, the inherent instability of lungs after death results in low utilization rates of potential donor lungs. Donor lungs are susceptible to direct trauma, aspiration, neurogenic edema, ventilator-associated barotrauma, and ventilator-associated pneumonia. After irreversible brain injury and determination of futility of care, the goal of medical management of the donor shifts to maintaining hemodynamic stability and maximizing the likelihood of successful organ recovery.

Neuropsychological Outcome of Critically Ill Patients with Severe Infection.

Sepsis and septic shock represent important burdens of disease around the world. Sepsis-associated neurological consequences have a great impact on patients, both in the acute phase and in the long term. Sepsis-associated encephalopathy (SAE) is a severe brain dysfunction that may contribute to long-term cognitive impairment.

Synergistic Effect of Static Compliance and D-dimers to Predict Outcome of Patients with COVID-19-ARDS: A Prospective Multicenter Study.

The synergic combination of D-dimer (as proxy of thrombotic/vascular injury) and static compliance (as proxy of parenchymal injury) in predicting mortality in COVID-19-ARDS has not been systematically evaluated. The objective is to determine whether the combination of elevated D-dimer and low static compliance can predict mortality in patients with COVID-19-ARDS. A "training sample" (March-June 2020) and a "testing sample" (September 2020-January 2021) of adult patients invasively ventilated for COVID-19-ARDS were collected in nine hospitals.

An In-Vitro Evaluation of the Characteristics of Zein-Based Films for the Release of Lactobionic Acid and the Effects of Oleic Acid.

Lactobionic acid (LBA) is widely used in different industrial sectors owing to its biocompatibility characteristics as well as antioxidant and antimicrobial properties. In this study, mixtures of the protein zein with LBA and with the addition of oleic acid (OA) as a ternary system were investigated as drug delivery films for the release of LBA. The chosen combinations exploit the vast difference in water solubility between LBA and the other two components (zein and OA).

Effect of SiO Particles on the Relaxation Dynamics of Epoxidized Natural Rubber (ENR) in the Melt State by Time-Resolved Mechanical Spectroscopy.

The rheological behavior of an epoxidized natural rubber (ENR) nanocomposite containing 10 wt.% of silica particles was examined by time-resolved mechanical spectroscopy (TRMS), exploiting the unique capability of this technique for monitoring the time-dependent characteristics of unstable polymer melts. The resulting storage modulus curve has revealed a progressive evolution of the elastic component of the composite, associated with slower relaxations of the ENR macromolecular chains.

Mechanical ventilation in patients with acute brain injury: recommendations of the European Society of Intensive Care Medicine consensus.

Purpose: To provide clinical practice recommendations and generate a research agenda on mechanical ventilation and respiratory support in patients with acute brain injury (ABI).

Methods: An international consensus panel was convened including 29 clinician-scientists in intensive care medicine with expertise in acute respiratory failure, neurointensive care, or both, and two non-voting methodologists. The panel was divided into seven subgroups, each addressing a predefined clinical practice domain relevant to patients admitted to the intensive care unit (ICU) with ABI, defined as acute traumatic brain or cerebrovascular injury.

Occurrence of ventilator associated pneumonia using a tracheostomy tube with subglottic secretion drainage.

Background: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality in critically ill patients who require mechanical ventilation (MV). Subglottic secretions above the endotracheal cuff are associated with bacteria colonization of lower respiratory tract, causing VAP. A preventive strategy to avoid subglottic secretion progression is the drainage with special tracheal tubes effective in preventing both early onset and late onset VAP.

Antiplasticization of Polymer Materials: Structural Aspects and Effects on Mechanical and Diffusion-Controlled Properties.

Antiplasticization of glassy polymers, arising from the addition of small amounts of plasticizer, was examined to highlight the developments that have taken place over the last few decades, aiming to fill gaps of knowledge in the large number of disjointed publications. The analysis includes the role of polymer/plasticizer molecular interactions and the conditions leading to the cross-over from antiplasticization to plasticization. This was based on molecular dynamics considerations of thermal transitions and related relaxation spectra, alongside the deviation of free volumes from the additivity rule.

Structure Evolution of Epoxidized Natural Rubber (ENR) in the Melt State by Time-Resolved Mechanical Spectroscopy.

In this work, time-resolved mechanical spectroscopy (TRMS) was used to accurately characterize the rheological behavior of an epoxidized natural rubber (ENR) containing 25 mol% of epoxy groups. Conventional rheological tests are not suitable to characterize with accuracy the frequency-dependent linear viscoelastic behavior of materials, such as ENR, in a transient configurational state. For this reason, TRMS was used to determine the true rheological behavior of ENR, as well as to gain some insights into the changes of its macromolecular architecture under the dynamic conditions experienced during the measurements.

Experimental Cold-Cured Nanostructured Epoxy-Based Hybrid Formulations: Properties and Durability Performance.

Different hybrid epoxy formulations were produced and cold-cured, monitoring the properties development during low temperature curing and aging. All systems were based on silane functionalized bis-phenol A (DGEBA) resins (Part A), cured at ambient temperature with two amine hardeners (Part B). The different components of the formulations were selected on their potential capability to bring about enhancements in the glass transition temperature.

Impact of imipenem concentration in lung perfusate and tissue biopsy during clinical ex-vivo lung perfusion of high-risk lung donors.

Background: Normothermic ex-vivo lung perfusion (EVLP) limits organ donor shortage by potentially using high-risk donor lungs. Microbial burden reduction has been demonstrated after EVLP using antibiotic prophylaxis with imipenem. However, no data have been published on the clinical consequences of the potential residual bacterial burden.