Immuno-oncological treatment of Non-Small-Cell Lung Cancer (NSCLC) in advanced stage with Nivolumab

Immuno-oncology marked a therapeutic revolution in the treatment of cancer. Thanks to the new strategy that aims to awaken the immune system to fight cancer cells, there has been a change in the clinical course in the treatment of advanced Non-Small Cell Lung Cancer (NSCLC). Our study aimed to evaluate the therapeutic efficacy of nivolumab monotherapy in the treatment of patients with advanced stage IIIB/IV non-small cell lung cancer beyond the second line. The results showed a progression-free survival of 7.35 months and an improvement in the quality of life of patients compared to other treatments. In addition, no type 3 and type 4 adverse reactions were detected in patients treated with Nivolumab. We hope that these results, already promising, will lead to an increase in overall survival in the future

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

IMMUNO-ONCOLOGICAL TREATMENT OF NON-SMALL-CELL LUNG CANCER IN ADVANCED STAGE WITH NIVOLUMAB

In recent years, significant scientific progress has been made in the therapy of non-small cell lung cancer (NSCLC),which has made possible a better knowledge of this pathology and above all the realization of new personalized therapies. The main therapeutic revolution in advanced NSCLC is immunooncology, a new therapeutic strategy that aims to awaken the immune system to fight cancer cells. Our work helped us evaluate the therapeutic efficacy of monotherapy with Nivolumab in the treatment of patients with advanced stage IIIB/IV non-smallcell lung cancer beyond the second line. We can conclude that in the treatment of non-small-cell lung cancer, the use of Nivolumab improves the prognosis and quality of life of the patients, without causing serious side effects compared to other treatments. We hope that in the future the combination of predictive biomarker research combined with the improvement of Immunoncology protocols will led to ever greater overall survival data

Life cycle assessment of olive oil: A case study in southern Italy

The paper describes the results of a specific LCA based analysis of the production of olive oil in the region of Calabria, in southern Italy. The goal of the study is to assess the energy and environmental impacts of different scenarios involving conventional and organic cultivations, plains and hills cultivations and involving different operating techniques. The study also aims at assessing the share of each life cycle step on the total of energy and environmental impacts. The functional unit chosen for the comparative analysis is a glass bottle of 0.75 L of extra virgin olive oil. A “from cradle to gate” perspective was chosen. The analysis was developed according to the LCA standards of the ISO 14040 series. The analysis is based on a field analysis developed in the last years in the province of Reggio Calabria between more than 50 enterprises and stakeholders of the field, representative of the whole Calabria region and of most southern Italy. The data used for the development of mass and energy balances are related to the years 2013–2015. The results clarify that for all indicators that the first part of the life cycle – from the production, including the growth of the olive plant to the full production stage – is the most relevant, variable between 80.6% share in the case of the particulate matter indicator to the 99.64% in the case of land use (Hill – Biological agriculture scenario). Relevant differences can be also traced for each specific indicator among all scenarios; high impacts are traced for the agricultural stages among all scenarios (70% −90% in all indicators) with high impacts caused by fertilizers. Among the transformation stages the bottle production is one of the most relevant sources of life cycle energy uses and environmental impacts (80–90%)

Statistical survey focused on diffusion and knowledge of energy drinks, conducted in Palermo

In recent years energy drinks consumption has increased, due to their ability to improve physical and cognitive performance. Unfortunately, because of poor or incorrect information, people are not always aware of the harmful consequences of these drinks such as obesity, diabetes, hypertension, tachycardia until death. Therefore, we conducted a statistical survey in the Palermo area, submitting a paper questionnaire to 1003 people. Data analysis shows that only 29% of the audience never consumed energy drinks, while 71% tried them at least once in their life, especially in adolescence; 81% never or rarely drink them, 14% drink them a few times a month, while 5% drink them several times a week. Energy drinks are mostly consumed in disco, sport and study contexts; 93% of respondents are aware of the risks caused by the excessive consumption of them; 91% know that it is not appropriate to associate them with alcohol, but 9% think it is better to mix them; 72% of interviewees know that people should never drink energy drink with alcohol, 13% do it only in the weekend, while 15% think it is appropriate to do whenever they want. In fact, 14% do not believe it is risky to take energy drinks together with alcohol, and 40% do not know whether it is risky or not, while 46% know it can be risky; 45% associate the idea of cigarettes with alcohol and energy drinks. In conclusion, it is appropriate to highlight their risks to prevent some fatal consequences

Encefalopatia neonatale e disfunzione multiorgano, considerazioni eziologiche e correlati clinici. Valutazione di una casistica

encefalopatia neonatale, disfunzione multiorgan

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified