Objective No-visitor policies adopted to prevent coronavirus disease-19 (COVID-19) spread in hospital wards have deeply impacted communication with patients and their relatives. Whereas in pre-COVID-19 era family-clinician meetings were held in person, during the pandemic interactions often took place over the phone, frequently causing feelings of uncertainty and distress to the close ones at home. The goal of this study was to assess and improve the effectiveness of structured telephone-based communication with hospitalized onco-hematological patients’ relatives in COVID-19 era. Methods After no-visitor policy was adopted in the Onco-Hematological Unit of Modena, inpatients’ relatives were contacted daily for clinical updates. After discharge, a telephone satisfaction survey was administered to all contact people of patients consecutive admitted between December 2020 and January 2021 ( n = 97). Mean score of response and potential statistically significative differences depending on respondents’ characteristics were assessed. Results Most relatives were satisfied with the communication received with a mean total score of 4.69 on a 5-point Likert scale (standard deviation: 0.60). Results showed high satisfaction rate with both the informative (mean ± SD: 4.66 ± 0.64) and emotional (mean ± SD: 4.66 ± 0.58) content, with no significant difference depending on respondents’ demographic characteristics ( p > 0.05). Conclusion A structured telephone-based communication may be a reasonable substitute for face-to-face meetings; especially if regular in time, conducted by the same doctor and integrated with video calls. Our findings might assist health workers in implementing measures to minimize the psychological effects of no-visitor policies during hospitalization. Clinical updates delivery through structured phone calls and video calls could become an opportunity also in post-COVID era.

Introduction: Mixed adenoneuroendocrine carcinoma (MANEC) is an uncommon and aggressive tumor arising throughout the entire gastrointestinal tract. Treatment options are limited, and survival is dismal with conventional therapies. Case description: We present the case of a 66-year-old man who was diagnosed with a locally advanced MANEC of the gastroesophageal junction. He was treated with perioperative chemotherapy and total gastrectomy. After anastomotic tumor recurrence was detected, he underwent three systemic regimens, including chemoradiotherapy. The patient was then tested for mismatch repair (MMR) protein status, revealing defective expression of MLH1 and PMS2 proteins. Treatment with anti–programmed death 1 (PD-1) receptor monoclonal antibody pembrolizumab was started and radiologic response is ongoing after 11 months. Clinical benefit was evident, and no immune therapy–related side effect was detected. Conclusions: To our knowledge, this is the first report of a heavily pretreated and rapidly progressing deficient MMR gastroesophageal MANEC experiencing a durable benefit from anti-PD1 treatment.

Hereditary cancer syndromes are inherited disorders caused by germline pathogenic variants (PVs) that lead to an increased risk of developing certain types of cancer, frequently at an earlier age than in the rest of the population. The germline PVs promote cancer development, growth and survival, and may represent an ideal target for the personalized treatment of hereditary tumors. PARP inhibitors for the treatment of BRCA and PALB2-associated tumors, immune checkpoint inhibitors for tumors associated with the Lynch Syndrome, HIF-2α inhibitor in the VHL-related cancers and, finally, selective RET inhibitors for the treatment of MEN2-associated medullary thyroid cancer are the most successful examples of how a germline PVs can be exploited to develop effective personalized therapies and improve the outcome of these patients. The present review aims to describe and discuss the personalized systemic therapies for inherited cancer syndromes that have been developed and investigated in clinical trials in recent decades.

defined in literature were evaluated in this study. These were: neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR), systemic immune-inflammation index (SII), haemoglobin, lymphocyte, platelet. The patients were divided in two subgroups according to the median values of NLR, PLR, MLR and SII.Results: A total of 105 patients with AGC were included in the study. There was no relationship between survival and anaemia (hgb <12gr / dl), thrombocytopenia (100.000 / mL), leukopenia (<4000 / mL) and lymphopenia (1000 / mL) (P ¼ 0.29, P ¼ 0.49, P ¼ 0.53, P ¼ 0.29, respectively). There was a statistically significant relationship between NLR (P ¼ 0.008), PLR (P ¼ 0.019), MLR (P ¼ 0.06) and overall survival; there was no significant result with SII (P ¼ 0.375). While the median survival was 14.6 months in the patients in the low NLR group, this rate was 7.9 months in the high group. Likewise, in the group with low PLR and MLR, the mean survival of the patients was 12.7 and 14.6 months, respectively. Median survival in patients with high PLR and MLR was 8.2 and 7.9 months, respectively. Multivariate analysis showed that NLR was an independent predictor of overall survival.Conclusions: Through the parameters derived from complete blood count, NLR appears to be a promising prognostic marker in patients with AGC.

BACKGROUND Acute heart failure (AHF) seems to provoke profound derangement of abdominal hemodynamic, which causes symptoms and impacts on renal function. METHODS 27 patients (10 F - age 78 - EF 0.39) admitted for AHF underwent cardiac and abdominal ultrasound at day 1 and 5. Arterial and venous flow within liver, spleen and kidney were recorded. Portal and Splenic Vein flow was described as continuous, pulsatile or reversed, whereas hepatic vein systolic and diastolic ratio was measured. Renal Venous Doppler Profile (VDP) was classified as: continuous, pulsatile, biphasic or monophasic. Arterial Resistive Index (RI) ≥0.7 was considered elevated. OUTCOME At day 1 most patients presented with some degree of deranged VDP and high RI in all examined organs. At day 5, a significant proportion of patients improved their VDP in Liver, Kidney and Spleen, while the percentage of patients with collapsing IVC did not significantly change. On the arterial side, the proportion of patients with high Hepatic RI dropped significantly. CONCLUSIONS Our preliminary data show that most deranged VDP in abdominal organs and Hepatic RI improve after decongestion despite a nonsignificant trend in improvement in IVC profile. RESULTS Classification day 1 day 5 p IVC Collapsing 24% 34% ns Portal Vein Continous 22% 50% Pulsatile 72% 50% Reversed 6% 0% &lt;.05* Hepatic Vein S/D≥1 24% 59% S/D &lt;1 60% 28% Reversed S 16% 14% &lt;.05* Hepatic Artery RI ≥0.7 87% 36% &lt;.05 Splenic Vein Flat 28% 57% Pulsatile 56% 33% Reversed 16% 10% &lt;.05* Splenic Artery RI ≥ 0.7 52% 48% ns Renal Vein Continous 11% 39% Pulsatile/Biphasic 52% 52% Monophasic 37% 9% &lt;.05* Renal Artery RI ≥0.7 63% 65% ns * Refers to normal profile versus all other deranged profiles