The use of the platelet-leukocyte membrane in the treatment of rotator cuff tears improved repair integrity compared with repair without membrane. However, the improvement in repair integrity was not associated with greater improvement in the functional outcome. In fact, the Constant scores of the two groups would have been similar if the shoulder pain component (which had differed preoperatively) had been excluded.

Purpose: NGR-hTNF exploits the tumor-homing peptide asparagine-glycine-arginine (NGR) for selectively targeting TNF-a to an aminopeptidase N overexpressed on cancer endothelial cells. Preclinical synergism with cisplatin was displayed even at low doses. This study primarily aimed to explore the safety of low-dose NGR-hTNF combined with cisplatin in resistant/refractory malignancies. Secondary aims included pharmacokinetics (PKs), pharmacodynamics, and activity.Experimental Design: NGR-hTNF was escalated using a doubling-dose scheme (0.2-0.4-0.8-1.6 mg/m 2 ) in combination with fixed-dose of cisplatin (80 mg/m 2 ), both given intravenously once every three weeks. PKs and circulating TNF-receptors (sTNF-Rs) were assessed over the first three cycles.Results: Globally, 22 patients (12 pretreated with platinum) received a range of one to ten cycles. Consistently with the low-dose range tested, maximum-tolerated dose was not reached. No dose-limiting toxicities (DLTs) were observed at 0.2 (n ¼ 4) and 0.4 mg/m 2 (n ¼ 3). One DLT (grade 3 infusion-related reaction) was observed at 0.8 mg/m 2 . This dose cohort was expanded to six patients without further DLTs.No DLTs were noted also at 1.6 mg/m 2 (n ¼ 3). NGR-hTNF exposure increased dose-proportionally without apparent PK interactions with cisplatin. No shedding of sTNF-Rs was detected up to 0.8 mg/m 2 . At the dose level of 0.8 mg/m 2 , expanded to 12 patients for activity assessment, a platinum-pretreated lung cancer patient achieved a partial response lasting more than six months and five patients maintained stable disease for a median time of 5.9 months.Conclusions: The combination of NGR-hTNF 0.8 mg/m 2 with cisplatin 80 mg/m 2 showed favorable toxicity profile and promising antitumor activity.

Waiting can increase discomfort. The goal of this study was to identify moods and fears of cancer patients while in a waiting room and to capture their concrete suggestions for an anthropocentric transformation of waiting itself. A 15-item questionnaire was given to 355 patients who came to our Out-patient Oncology Clinic. Eighty-three percent of patients felt that waiting has an emotional cost, 35% were upset by talking about their condition with others while waiting, and 26% suffered a major emotional impact seeing other sick people and witnessing their clinical decline. Eighty-nine percent of patients suggested that alternative activities, such as meetings with professionals, doctors, and psychologists, be organized during the waiting period; 65% suggested fun activities (music therapy, drawing courses, library, TV). Most patients asked to have the freedom to leave the waiting room. This option, feasibly by means of IMs/"beepers," would limit their sense of having a lack of freedom or being robbed of their time. This study highlighted the complexity and heterogeneity of emotional implications that waiting causes in patients with cancer and collected many patients' suggestions about how to create a constructive, free, and personalized waiting period, overcoming the boredom, distress, and psychological suffering it causes.

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