Levonorgestrel. The day-after pill

Only making use of Levonorgestrel as a post intercourse anti-conceptive method has proven to be more effective than prior methods and is the object under study in this report. This post intercourse anti-conceptive consists of a set of methods which, employed after at risk sexual intercourse and within a maximum period of time, avoid pregnancy. This post intercourse anti-conceptive is not considered to be an abortion method but it should not be used as a habitual anti-conceptive method due to its adverse effects and its numerous interactions with other pharmaceutical products. Its use shall be limited to emergency situations. Special emphasis must be given as part of health education to females who employ this technique. As health professionals, we need to know this topic in depth so that we can best advise those persons in need of information. The authors propose to provide general information about aspects related to this pharmaceutical product.     

Chimeric antigen receptors in cancer immuno-gene therapy: current status and future directions

The concept of chimeric antigen receptors (CARs) as molecules able to redirect T lymphocytes toward tumor cells is currently being exploited in the field of cancer immunotherapy. Despite promising preliminary results, some clinical trials evidenced limitations for this technology that must be overcome for more extensive application of CARs in tumor immunotherapy. We describe here the fundaments of these molecules in terms of structure, function, possible targets and pre-clinical and clinical applications. We also discuss strategies that can potentially overcome the limitations seen so far, paving the road to a wider application of this exciting new technology.     

The assessment of empathy in adolescence: A contribution to the Italian validation of the "Basic Empathy Scale"

The present study examined the validity of the Basic Empathy Scale (BES) [Jolliffe, D., & Farrington, D. P. (2006a). Development and validation of the Basic Empathy Scale. Journal of Adolescence, 29, 589-611; Jolliffe, D., & Farrington, D. P. (2006b). Examining the relationship between low empathy and bullying. Aggressive Behavior, 32(6), 540-550.] and found further evidence for the scale's good psychometric properties. The BES was administered to a sample of 655 Italian adolescents to examine the generalizability and reliability of its factor structure. The results of the confirmatory factor analysis showed a reasonable data fit with the two hypothesized BES domains of Cognitive Empathy and Affective Empathy. Scale reliability was also satisfactory, showing good internal consistency. Lastly, BES scores were significantly associated with other empathy questionnaire scores (the Interpersonal Reactivity Index and Balanced Emotional Empathy Scale) and with a scale measuring prosocial behavior. Research and practice implications are discussed.     

Lead arthropathy: radiographic, CT and MRI findings

Objective Lead arthropathy is a well-known complication of gunshot injuries with retained intra-articular bullets. Although several previous reports have discussed the radiological findings of this entity, computed tomography (CT) and magnetic resonance imaging (MRI) findings have never been described before in this setting. Materials and methods In this paper the authors review the imaging findings of 11 patients with lead arthropathy (1 of whom had clinical signs of lead poisoning as well), all of them studied by means of radiographs. In addition, non-enhanced CT scans were obtained in 3 patients and gadolinium-enhanced MRI in 1. Results Classic findings of intra-articular speckled lead deposits (occasionally with a “lead arthrogram” appearance), joint space narrowing and preserved bone density were found at radiographs in the great majority of cases. Furthermore, extension of intra-articular lead to adjacent tendon sheaths was observed in almost half of the patients, an observation rarely reported in the literature. CT scans and MRI, in their turn, were superior with regard to soft tissue abnormalities, accurately depicting joint effusion and the thickened synovium with lead particles embedded in it. Conclusion Post-gadolinium MRI had the advantage of showing the enhancement pattern of the inflamed synovium and associated bone marrow edema pattern. Although it is not possible to establish the role of axial imaging in lead arthropathy from the small number of cases studied, this initial experience shows that both methods hold promise in this setting and may be useful, at least in selected cases.     

A missense mutation in the sodium phosphate co-transporter Slc34a1 impairs phosphate homeostasis

The sodium phosphate co-transporters Npt2a and Npt2c play important roles in the regulation of phosphate homeostasis. Slc34a1, the gene encoding Npt2a, resides downstream of the gene encoding coagulation factor XII (f12) and was inadvertently modified while generating f12(-/-) mice. In this report, the renal consequences of this modification are described. The combined single allelic mutant Slc34a1m contains two point mutations in exon 13: A499V is located in intracellular loop 5, and V528M is located in transmembrane domain 11. In addition to the expected coagulopathy of the f12(-/-) phenotype, mice homozygous for the double allelic modification (f12(-/-)/slc34a1(m/m)) displayed hypophosphatemia, hypercalcemia, elevated levels of alkaline phosphatase, urolithiasis, and hydronephrosis. Strategic cross-breedings demonstrated that the kidney-related pathology was associated only with autosomal recessive transmission of the slc34a1(m) gene and was not influenced by the simultaneous inactivation of f12. Npt2a[V528M] could be properly expressed in opossum kidney cells, but Npt2a[A499V] could not. These results suggest that a single amino acid substitution in Npt2a can lead to improper translocation of the protein to the cell membrane, disturbance of phosphate homeostasis, and renal calcification. Whether point mutations in the SLC34A1 gene can lead to hypophosphatemia and nephrolithiasis in humans remains unknown.     

Arsenic trioxide/ascorbic acid therapy in patients with refractory metastatic colorectal carcinoma: a clinical experience

Arsenic trioxide (As₂O₃) has demonstrated effectiveness in treating acute promyelocytic leukemia (APL). Therefore the FDA has approved it to treat APL. In patients with refractory metastatic colorectal carcinoma (CRC), we assessed the efficacy and toxicity of As₂O₃/AA (ascorbic acid) as the outcome of this trial. Five patients with refractory metastatic CRC who failed all previous standard chemotherapy were enrolled in this study. They were treated with 0.25 mg/kg body weight/day As₂O₃ and 1000 mg/day of ascorbic acid for 5 days a week for 5 weeks. Each treatment cycle extended for 7 weeks with 5 weeks of treatment and 2 weeks of rest. All the patients developed moderate to severe toxic side effects to arsenic trioxide/AA therapy and therefore the study was discontinued. No CR (complete remission) or PR (partial remission) was observed. CT scans demonstrated stable or progressive disease. Three of the five patients died within 2 to 5 months after cessation of the therapy. None of the deaths could be related to this clinical trial. Two years of follow-up study showed that two patients were alive with stable disease. Under the current treatment regimen all patients developed moderate to severe side effects with no clinically measurable activity. As an alternate, efforts may be made to reduce the dose and arsenic trioxide may be combined with other standard regimen in reversing the chemo resistance.