Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: practice and outcome analysis in a series of 2237 patients from 11 institutions

OBJECTIVE: Low-dose-rate brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure. METHODS: Between May 1998 and December 2011, 2237 patients with early-stage prostate cancer from 11 Italian community and academic hospitals were treated with iodine-125 ((125)I) or palladium-103 LDR-BT as monotherapy and followed up for at least 2 years. (125)I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume was 145 Gy; the mean target volume receiving 100% of prescribed dose (V100) was 91.1%. Biochemical failure-free survival (BFFS), disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meier method. Log-rank test and multivariable Cox regression were used to evaluate the relationship of covariates with outcomes. RESULTS: Median follow-up time was 65 months. 5- and 7-year DSS, OS and BFFS were 99 and 98%, 94 and 89%, and 92 and 88%, respectively. At multivariate analysis, the National Comprehensive Cancer Network score (p < 0.0001) and V100 (p = 0.09) were correlated with BFFS, with V100 effect significantly different between patients at low risk and those at intermediate/high risk (p = 0.04). Short follow-up and lack of toxicity data represent the main limitations for a global evaluation of LDR-BT. CONCLUSION: This first multicentre Italian report confirms LDR-BT as an excellent curative modality for low-/intermediate-risk prostate cancer. ADVANCES IN KNOWLEDGE: Multidisciplinary teams may help to select adequately patients to be treated with brachytherapy, with a direct impact on the implant quality and, possibly, on outcome

Influenza vaccination coverage among medical residents: An Italian multicenter survey

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P < 0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P < 0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future. © 2014 Landes Bioscience

Nuovi dati da vecchi scavi: censimento, catalogazione e analisi delle monete provenienti da campagne archeologiche della prima metà del Novecento, in particolare dirette da Giovanni Brusin

Da anni è in corso un progetto di riordino e catalogazione del vasto patrimonio numismatico del Museo Archeologico Nazionale di Aquileia. Una delle ultime fasi della ricerca si è concentrata sulle monete riferibili al periodo in cui Giovanni Battista Brusin fu Direttore del Museo, permettendo l’identificazione e la schedatura di diversi gruppi principali di materiali, alcuni dei quali inediti. Un primo gruppo consiste in 1360 monete provenienti dal territorio aquileiese e direttamente acquistate da Brusin per il medagliere del Museo, a cui vanno aggiunti i 560 esemplari del cosiddetto ripostiglio delle Marignane; un secondo nucleo comprende 710 monete rinvenute da Brusin nel corso dei suoi scavi nel territorio della città antica, finora mai studiate, che vanno ad arricchire i dati disponibili sulle sue attività precedenti al 1940. Infine, 828 monete riferibili a due probabili ripostigli, finora mai pubblicati, forniscono ulteriori informazioni sulla provenienza del circolante e sul ruolo principale svolto dalla zecca di Aquileia nella seconda metà del IV secolo

Localizzazione di cose e persone nell’ospedale di Rovereto

La localizzazione è il processo di determinazione della posizione di un oggetto nello spazio, le cui informazioni vengono rese disponibili nell’ambito delle reti di comunicazione mobili grazie ai cosiddetti Location Based Service (LBS). Gli LBS sono applicazioni software (SW) che utilizzano dati di localizzazione per controllare determinate funzioni (ad esempio ricerca di oggetti e indirizzi, social network). Inizialmente essi sono stati indirizzati alla localizzazione outdoor e basati su tecnologie satellitari, come l’ormai a tutti noto GPS (Global Positioning System) di proprietà degli Stati Uniti in servizio per usi civili dal 1994. La diffusione di soluzioni tecnologiche come WiFi, RFID, Bluetooth e Ultra-Wideband stanno ultimamente ampliando il campo di applicazione degli LBS dall’outdoor all’indoor

Diagnosi precoce del cancro polmonare in una popolazione ad alto rischio a Verona

Il tumore del polmone rappresenta la principale causa di morte per cancro in Italia e nel mondo. Attualmente le possibilità terapeutiche, dopo diagnosi sintomatica, sono limitate dall’avanzato stadio di neoplasia.Il progetto S.T.O.P. (Studio Tumori Operabili Polmonari), del quale vengono presentati i primi risultati, si pone l’obiettivo di realizzare un programma di diagnosi precoce dei tumori polmonari centrali e periferici in soggetti volon-tari ad alto rischio, arruolati nella Provincia di Veron

ATP Measurement in the Last Rinse Water of Automated Washer- Disinfectors: The Added Value of Every Load Monitoring

Objective: To assess whether monitoring every loads of automated washer-disinfectors (AWDs) by testing the last rinse water with Adenosine Triphosphate (ATP) would have an added value to document effective and reproducible AWD processes.Methods: Every load monitoring (ELM) of the last rinse water with ATP was performed on three AWDs at the sterilization department of a 329 acute-bed hospital in Italy. No change were made in the routine procedures, except the last rinse water of a process was collected with a water sampler and tested on ATP. Data from negative controls and empty cycles were also obtained for comparison. ATP values were analysed according to AWD, load, and process characteristics.Results: A total of 435 ATP tests were performed, including 74 negative, 74 empty runs and 287 regular load tests. ATP values from regular loads ranged between 2 and 452 RLUs and 1.3%, 0.7%, 0.3% out of the 287 measurements was above 200, 300, and 400 RLUs, respectively. ATP values from negative tests and empty runs differed significantly (p&lt;0.001) from the regular loads with a median value [I quartile; III quartile] of 4[2;5], 5[3;7], and 12[7;22] RLU, respectively. Analysis of ATP values from regular loads grouped by load pre-treatment, AWD washing program, load material or load amount showed significant differences between groups. No significant differences in ATP data were found among AWDs.Conclusion: The measurement of ATP in the last rinse water of AWDs showed that characteristics and quantities of the load relate to the ATP readings. The test is advised as an informative additional test to visual inspection for monitoring every load of an AWD

ATP Measurement in the Last Rinse Water of Automated Washer-Disinfectors: The Added Value of Every Load Monitoring

Objective: To assess whether monitoring every loads of automated washer-disinfectors (AWDs) by testing the last rinse water with Adenosine Triphosphate (ATP) would have an added value to document effective and reproducible AWD processes. Methods: Every load monitoring (ELM) of the last rinse water with ATP was performed on three AWDs at the sterilization department of a 329 acute-bed hospital in Italy. No change were made in the routine procedures, except the last rinse water of a process was collected with a water sampler and tested on ATP. Data from negative controls and empty cycles were also obtained for comparison. ATP values were analysed according to AWD, load, and process characteristics. Results: A total of 435 ATP tests were performed, including 74 negative, 74 empty runs and 287 regular load tests. ATP values from regular loads ranged between 2 and 452 RLUs and 1.3%, 0.7%, 0.3% out of the 287 measurements was above 200, 300, and 400 RLUs, respectively. ATP values from negative tests and empty runs differed significantly (p<0.001) from the regular loads with a median value [I quartile; III quartile] of 4[2;5], 5[3;7], and 12[7;22] RLU, respectively. Analysis of ATP values from regular loads grouped by load pre-treatment, AWD washing program, load material or load amount showed significant differences between groups. No significant differences in ATP data were found among AWDs. Conclusion: The measurement of ATP in the last rinse water of AWDs showed that characteristics and quantities of the load relate to the ATP readings. The test is advised as an informative additional test to visual inspection for monitoring every load of an AWD

Physical activity and exercise priorities in community dwelling people with multiple sclerosis: A delphi study

Exercise and physical activity have been found to be beneficial in managing disabilities caused by multiple sclerosis (MS). Despite the known benefits, many people with MS (pwMS) are inactive. This study aimed to identify the prioritised exercise and physical activity practices of pwMS living the community and the reasons they engaged in these activities. Methods: A four Round Delphi questionnaire scoped and determined consensus of priorities for the top 10 exercise and physical activities and the reasons why pwMS (n=101) engaged in these activities. Data were analysed using content analysis, descriptive statistics and non-parametric tests. Results: The top 10 exercise and physical activity practices and the top 10 reasons why pwMS (n=70) engaged in these activities were identified and prioritised. Consensus was achieved for the exercise and physical activities (W=0.744, p<0.0001) and for the reasons they engaged in exercise and physical activity (W=0.723,p<0.0001). Conclusion: The exercise and physical activity practices and the reasons pwMS engaged in exercise and physical activity were diverse. These self-selected activities and reasons highlighted that pwMS might conceptualise exercise and physical activity in ways that may not be fully appreciated or understood by health professionals. Considerations of the views of pwMS may be essential if the goal of increasing physical activity in this population is to be achieved