11 research outputs found
Jaw osteonecrosis associated with intravenous bisphosphonate: is incidence reduced after adoption of dental preventive measures?
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Delineation of the larynx as organ at risk in radiotherapy: a contouring course within âRete Oncologica Piemonte-Valle dâAostaâ network to reduce inter- and intraobserver variability
Aims: To evaluate the usefulness of a contouring course in reducing inter- and intraobserver variability in the definition of the larynx as organ at risk (OAR). Methods: Within the âRete Oncologica Piemonte-Valle dâAostaâ network, a contouring course focusing on larynx delineation was proposed. Twenty-six radiotherapist technicians (RTTs) experienced in delineating OARs were asked to contour larynx before and after the training. An expert radiation oncologist defined the reference volume for educational purpose. The contoured volumes obtained before and after the course were compared using descriptive statistics (mean value, standard deviationâSD, and coefficient of variationâCOV) of volumes and maximum diameters. Conformity index (CI), dice coefficient (DC), and percentage of overlap were used to evaluate the spatial accuracy of the different volumes compared to the reference. Further analysis regarding the variation in the centre of mass (COM) displacement was performed. Results: The mean volume was 40.4Â cm3 before and 65.9Â cm3 after the course, approaching the reference value. Mean anteroposterior, laterolateral, and craniocaudal diameters improved, getting each closer to the reference. Moreover, the COM moved approaching reference coordinates. Mean percentage of intersection and DC strongly increased after the course, rising from 57.76 to 93.83Â % and from 0.68 to 0.89, respectively. CI enhanced from 0.06 to 0.31. Conclusions: This study shows an improvement in larynx definition after the contouring course with lower interobserver variability and major consistency compared to the reference volume. Other specific educational activities may further increase the quality of radiation therapy contouring in this setting
Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study
OBJECTIVE:
To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause.
SUBJECTS:
Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms.
METHODS:
Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year.
RESULTS:
Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73).
CONCLUSIONS:
This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy
Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy
Objective: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy. Methods: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper. Results: The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms. Conclusions: This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms
LâattivitĂ dei Centri Antifumo italiani tra problematiche e aree da potenziare: i risultati di unâindagine svolta attraverso un questionario on-line
Introduzione. In Italia sono 295 i Servizi per la cessazione dal
fumo di tabacco (Centri Antifumo - CA) afferenti al Servizio Sanitario
Nazionale (SSN) censiti nel 2011 dallâOsservatorio Fumo,
Alcol e Droga (OssFAD) dellâIstituto Superiore di SanitĂ . La presente
indagine, condotta dallâOssFAD in collaborazione con i CA,
è stata volta a rilevare alcune delle problematiche con le quali il
personale dei CA si confronta per portare avanti la propria attivitĂ
e le iniziative ritenute utili per migliorarla.
Materiali e metodi. Lâindagine è stata condotta dal 7 al 21
maggio 2012, mediante un questionario compilabile on-line
composto da 5 brevi sezioni di domande con un totale di 38
items da completare. Il link al questionario on-line è stato inviato
per e-mail a 322 indirizzi dei CA censiti nel 2011 dallâOssFAD. I
dati raccolti sono stati elaborati statisticamente con il programma
SPSS 20.
Risultati. Allâindagine hanno risposto 146 operatori dei CA
(45,3%). Sebbene ci siano aspetti ormai consolidati dellâattivitĂ
dei CA, sono ancora molte le criticitĂ che gli operatori riscontrano
nella loro attivitĂ . Le principali problematiche che influiscono
in modo fondamentale/rilevante per la buona attivitĂ
del centro sono le âScarse o nulle risorse economicheâ per il
60,7% del personale, âla mancanza di personale dedicatoâ per
il 52,4% del personale; il âriconoscimento/mandato istituzionale
del CAâ per il 40,9% del personale. Tra le azioni ritenute
piĂš efficaci per facilitare lâaccesso ai CA sono risultate la sensibilizzazione
del personale sanitario (91%), in particolare dei medici
di famiglia e lâinserimento delle prestazioni antitabagiche
nei LEA (76,8%).
Conclusioni. Ă auspicabile che lâattivitĂ dei CA riceva una maggiore
attenzione, attraverso la dotazione di strutture, personale
e finanziamenti adeguati a svolgere un importante ruolo nella
tutela e promozione della salute