Evaluation of fatigue in patients with pancreatic cancer receiving chemotherapy treatment: a cross-sectional observational study

Background and aim of the work: Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients (CPs) and negatively affects quality of life. Although CRF is frequently experienced, it is often underreported, underdiagnosed and undertreated. The objectives of this study were to evaluate the level of fatigue in patients with pancreatic cancer undergoing chemotherapy and to analyse its correlation with patients\u2019 demographic and clinical variables. Methods: A cross-sectional observational study was implemented in the Oncology Day Hospital of a Northern Italian hospital. A sample of 48 patients receiving chemotherapy were evaluated through the Brief Fatigue Inventory Italian version (BFI-I) between 1 May and 12 October 2016. Data were statistically analysed. Results: Most of our patients (94%) experienced fatigue. Women as well as patients with an age 6565 years reported more fatigue. Anemia, pain and a weight loss of over 16 kg in the last 6 months were significantly related to the perception of fatigue. Regarding life habits, smoking was related to high global score of BFI-I. Conclusions: In accordance with literature, our study suggests that fatigue is a frequent symptom influenced by many constitutional, clinical and environmental factors. Our results highlight the need for an early and regular evaluation of fatigue among cancer patients, in order to implement all those pharmacological and non-pharmacological interventions with proven efficacy in attenuating this symptom

Allergy in adolescent population (14-18 years) living in campania region (southern Italy). a multicenter study

Adolescents (Ad) constitute a difficult to manage population among individuals suffering from asthma. The aim of our study was to assess the prevalence, clinical characteristics and age of onset of allergic sensitization and clinical symptoms in a sample of atopic Ad living in the Campania region (Southern Italy). Sixteen Allergy units or Centers belonging to the Italian Association of Hospital and Territorial Allergologists (AAIITO, Campania region) participated in this cross-sectional study. A case report form (CRF) was specifically designed for this study and commercial allergen extracts used for screening SPTs were provided by ALK-Abelló Group (Milan, Italy). A total of 443 patients were examined (females, f 220, 49.6 %; males, m 223, 50.3%). Dust mites represent the most common sensitizing agents in allergic Ad living in Campania region (Dermatoph. pteronyssinus 67.4% and Dermatoph. farinae 66.5%), followed by Parietaria (58.9%), grasses (45.8%), Artemisia vulgaris (16.7%), Olea Europaea (32.2%), dog dander (17.1%), cat dander (20.0%), Alternaria alternata (8.1%), Cupressus sempervirens (4.9%), Betula pendula (4.7%), other allergens (19.4%). An interesting comparison has been made between clinical data of our Ad with data of elderly patients (E). The role of allergic sensitization is significantly higher in Ad compared to E. Dermatophagoides pteronyssinus is the first sensitizing allergen in Ad and the last in E. Parietaria constitutes the first sensitizing pollen both in Ad and E, the percentage of sensitization is higher in Ad. Another important difference is the higher prevalence of As, as only symptom, in E compared to Ad (19.7% versus 7.6%). In conclusion, our findings confirm the high prevalence and clinical significance of airway allergic sensitization in the adolescents living in Campania region

The role of immune suppression in COVID-19 hospitalization: clinical and epidemiological trends over three years of SARS-CoV-2 epidemic

Specific immune suppression types have been associated with a greater risk of severe COVID-19 disease and death. We analyzed data from patients >17 years that were hospitalized for COVID-19 at the “Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico” in Milan (Lombardy, Northern Italy). The study included 1727 SARS-CoV-2-positive patients (1,131 males, median age of 65 years) hospitalized between February 2020 and November 2022. Of these, 321 (18.6%, CI: 16.8–20.4%) had at least one condition defining immune suppression. Immune suppressed subjects were more likely to have other co-morbidities (80.4% vs. 69.8%, p < 0.001) and be vaccinated (37% vs. 12.7%, p < 0.001). We evaluated the contribution of immune suppression to hospitalization during the various stages of the epidemic and investigated whether immune suppression contributed to severe outcomes and death, also considering the vaccination status of the patients. The proportion of immune suppressed patients among all hospitalizations (initially stable at <20%) started to increase around December 2021, and remained high (30–50%). This change coincided with an increase in the proportions of older patients and patients with co-morbidities and with a decrease in the proportion of patients with severe outcomes. Vaccinated patients showed a lower proportion of severe outcomes; among non-vaccinated patients, severe outcomes were more common in immune suppressed individuals. Immune suppression was a significant predictor of severe outcomes, after adjusting for age, sex, co-morbidities, period of hospitalization, and vaccination status (OR: 1.64; 95% CI: 1.23–2.19), while vaccination was a protective factor (OR: 0.31; 95% IC: 0.20–0.47). However, after November 2021, differences in disease outcomes between vaccinated and non-vaccinated groups (for both immune suppressed and immune competent subjects) disappeared. Since December 2021, the spread of the less virulent Omicron variant and an overall higher level of induced and/or natural immunity likely contributed to the observed shift in hospitalized patient characteristics. Nonetheless, vaccination against SARS-CoV-2, likely in combination with naturally acquired immunity, effectively reduced severe outcomes in both immune competent (73.9% vs. 48.2%, p < 0.001) and immune suppressed (66.4% vs. 35.2%, p < 0.001) patients, confirming previous observations about the value of the vaccine in preventing serious disease

Freezing/storing olives, consequences for extra virgin olive oil quality

The feasibility of producing extra virgin olive oil several months after the harvest season has been investigated. For this purpose, fresh olive drupes have been frozen by three different methods (i.e. blast freezer, cryogenic nitrogen, and conventional static freezer) and processed to olive oil after 6 months of storage at -25\ub0C temperature. The quality of the oils extracted from the frozen olive has been compared to a control olive oil produced from the corresponding fresh olive drupes, without freezing or storing, and according to the oil conventional commercial parameters (free acidity, peroxide value, UV coefficients), biophenolic and volatile profiles. The oils from frozen olive retain the commercial extra virgin grade despite a slight increment in the peroxide values, regardless the initial freezing treatment. A strong reduction of biophenols has been recorded, without significant differences imputable to the initial freezing method. However, the biophenolic profiles were almost unaffected, unlike the volatile profiles which undergo two main variations. First, a shift of the LOX pathway towards more oxidized compounds, such as hexanal and hexan-1-ol. Second, the occurrence of volatiles generally related to olive deterioration as response to microbial activity and/or amino acid conversion, such as butyl acetate, 3-methyl butanol and ethyl propanoate. This effect seems to be more intense when the initial freezing was performed by the conventional static freezer. An olive sanification treatment could be implemented before freezing to face this problem

An artificial neural network model to predict olive mechanical harvesting: A first approach based on metadata

Olive's trees growing, especially intended for olive oil production, is a central agricultural activity in the Mediterranean area and increasing efforts are directed toward reducing its production costs. Under this perspective, mechanical harvesting is a crucial task to improve the profitability of olive groves. In medium and high density, i.e. up to 600 trees per hectare, olive orchards trunk shaking is the most common practice, where harvesting efficiency greatly depends on several parameters, such as tree dimensional traits, cultivar, fruit ripeness indexes. In this contest, the ratio between the fruit removal force and fruit mass has been proposed as a predicting index for the harvesting efficiency, but at the same time has been recognized that such index it's not independent from the other above mentioned crop parameters (e.g. cultivar or canopy volume). So, the harvesting efficiency can be considered the output of a complex system with nonlinear relationships among input data, and where the exact nature of the interactions is unknown. In this situation, artificial neural network (ANN) it is a potentially suitable system to tackle the problem. This approach has been followed in the present work by gathering data from literature about olive mechanical harvesting efficiency and as much as possible of the underlying crop parameters. The latter have been used as input variables of an ANN model built to predict the olive harvest efficiency of trunk shakers. The model (10 input, 1 hidden layer, 2 nodes, learning rate 0.3, momentum 0.4) allows a satisfactory prediction of the harvest efficiency, as stated by a correctness of the internal validation of about 86% (within 5% range of validating internal data set), a determination coefficient of 0.88 between desired and predicted data, and a determination coefficient of 0.93 between actual and predicted data of an external validating data set. The results of this first ANN approach based on metadata indicate that this computing system could be effectively implemented at single orchard level as a tool for olive mechanical harvest optimization

New biliary endoprosthesis less liable to block in biliary infections: Description and in vitro studies

Objective: To test in vitro stents made from a new biomaterial that is less liable to encourage adhesion of bacteria that may lead to blockage of the stent. Design: Laboratory experiment. Setting: University hospital, Italy. Material: 15 polyethylene biliary endoprostheses that had been removed endoscopically a mean of 151 days (range 55–416) after insertion. PUPA, a biomaterial that contains polyamidoamine cross-linked to polyurethane chains. This can bind large quantities of heparin and HyalSx (hyaluronic acid at a different stage of sulphation) in a stable fashion. Main outcome measures: Incidence of blockage and growth of pathogens in the polyethylene biliary prostheses. Adhesion of pathogens to PUPA in vitro on electron microscopy. Results: 12 of 15 polyethylene prostheses were blocked by brown concretions composed of calcium bilirubinate, palmitate, and little cholesterol. All concretions grew more than one pathogen, and the growth always included Escherichia coli. Of the 5 PUPA stents tested, only 1 had bacteria sticking to their surfaces. Conclusion: These results confirm previous studies that showed that HyalSx appreciably inhibited the adhesion of bacteria and is therefore a suitable material for the manufacture of biliary stents

The Real-Life Journey of Elderly Patients in Soft Tissue and Bone Sarcomas: A Retrospective Analysis from a Sarcoma Referral Center

The high complexity of multimodality treatment frequently results in undertreatment of elderly sarcoma patients, and this may be one of the factors that influence their prognosis. We describe the real-life approach to a population of patients aged over 70 with both soft tissue (STS) and bone sarcomas (BS) followed by our Sarcoma Disease Management Team from 2012 to 2017. One-hundred and twenty-three patients with a median age of 77 years (range: 70–92) were identified. STS were the most common histological subtypes (94%) and the grade was high in 79/123 patients (64%). At diagnosis, 88% of patients had localized disease (LD) and 12% were metastatic (MD). Overall, 96% of patients with LD underwent surgery, 46/54 (85%) with high grade STS patients underwent complementary radiotherapy, and 10/54 (19%) received adjuvant treatments. Twelve out of 33 patients who relapsed (36%) underwent local therapies. Seventeen (52%) and eight (24%) patients were treated with first-line and second-line medical treatments, respectively. Tolerability to systemic treatments was fairly good. Overall, 21% of the patients with advanced disease were candidates for best supportive care alone. Our case series of elderly patients with both STS and BS shows that personalized multidisciplinary treatment can nevertheless be offered to this frail population in order to control the evolution of disease