267 Occupation and Multiple Sclerosis: an Italian case-control study

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Prevalence of distressing symptoms in hospitalised patients on medical wards: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Many patients with advanced, serious, non-malignant disease belong to the population generally seen on medical wards. However, little research has been carried out on palliative care needs in this group. The aims of this study were to estimate the prevalence of distressing symptoms in patients hospitalised in a Department of Internal Medicine, estimate how many of these patients might be regarded as palliative, and describe their main symptoms.</p> <p>Methods</p> <p>Cross-sectional (point prevalence) study. All patients hospitalised in the Departments of Internal Medicine, Pulmonary Medicine, and Cardiology were asked to do a symptom assessment by use of the Edmonton Symptom Assessment System (ESAS). Patients were defined as "palliative" if they had an advanced, serious, chronic disease with limited life expectancy and symptom relief as the main goal of treatment.</p> <p>Results</p> <p>222 patients were registered in all. ESAS was completed for 160 patients. 79 (35.6%) were defined as palliative and 43 of them completed ESAS. The patients in the palliative group were older than the rest, and reported more dyspnea (70%) and a greater lack of wellbeing (70%). Other symptoms reported by this group were dry mouth (58%), fatigue (56%), depression (41%), anxiety (37%), pain at rest (30%), and pain on movement (42%).</p> <p>Conclusion</p> <p>More than one third of the patients in a Department of Internal Medicine were defined as palliative, and the majority of the patients in this palliative group reported severe symptoms. There is a need for skills in symptom control on medical wards.</p

Effects of biophysical stimulation in patients undergoing arthroscopic reconstruction of anterior cruciate ligament: prospective, randomized and double blind study

Pre-clinical studies have shown that treatment by pulsed electromagnetic fields (PEMFs) can limit the catabolic effects of pro-inflammatory cytokines on articular cartilage and favour the anabolic activity of the chondrocytes. Anterior cruciate ligament (ACL) reconstruction is usually performed by arthroscopic procedure that, even if minimally invasive, may elicit an inflammatory joint reaction detrimental to articular cartilage. In this study the effect of I-ONE PEMFs treatment in patients undergoing ACL reconstruction was investigated. The study end-points were (1) evaluation of patients’ functional recovery by International Knee Documentation Committee (IKDC) Form; (2) use of non-steroidal anti-inflammatory drugs (NSAIDs), necessary to control joint pain and inflammation. The study design was prospective, randomized and double blind. Sixty-nine patients were included in the study at baseline. Follow-up visits were scheduled at 30, 60 and 180 days, followed by 2-year follow-up interview. Patients were evaluated by IKDC Form and were asked to report on the use of NSAIDs. Patients were randomized to active or placebo treatments; active device generated a magnetic field of 1.5 mT at 75 Hz. Patients were instructed to use the stimulator (I-ONE) for 4 h per day for 60 days. All patients underwent ACL reconstruction with use of quadruple hamstrings semitendinosus and gracilis technique. At baseline there were no differences in the IKDC scores between the two groups. At follow-up visits the SF-36 Health Survey score showed a statistically significant faster recovery in the group of patients treated with I-ONE stimulator (P < 0.05). NSAIDs use was less frequent among active patients than controls (P < 0.05). Joint swelling resolution and return to normal range of motion occurred faster in the active treated group (P < 0.05) too. The 2-year follow-up did not shown statistically significant difference between the two groups. Furthermore for longitudinal analysis the generalized linear mixed effects model was applied to calculate the group × time interaction coefficient; this interaction showed a significant difference (P < 0.0001) between the active and placebo groups for all investigated variables: SF-36 Health Survey, IKDC Subjective Knee Evaluation and VAS. Twenty-nine patients (15 in the active group; 14 in the placebo group) underwent both ACL reconstruction and meniscectomy; when they were analysed separately the differences in SF-36 Health Survey scores between the two groups were larger then what observed in the whole study group (P < 0.05). The results of this study show that patient’s functional recovery occurs earlier in the active group. No side effects were observed and the treatment was well tolerated. The use of I-ONE should always be considered after ACL reconstruction, particularly in professional athletes, to shorten the recovery time, to limit joint inflammatory reaction and its catabolic effects on articular cartilage and ultimately for joint preservation

The Survival of Non-capitalism

This article explores the importance of non-capitalist space within the global political economy. The issue of how to categorise and understand space in so-called peripheral regions such as Latin America has been a contentious one. Whilst many radical analyses have focused on the dynamics of capitalism in relation to the geography of development, explaining how it has been able to survive and grow, this article makes the case for a more multi-linear theoretical framework with which to view the socio-economic landscape. This is inspired not only by the later writings of Marx but also the specific Marxian class analysis of those involved in Rethinking Marxism. Via a focus on Oaxaca in southern Mexico, this article highlights both the survival and the recreation of spaces of non-capitalism, and provides an argument for why we should consider these to be important for transformative action more broadly, whilst also discussing their potential limitations

Cancer as a continuum: a literature review and a biological interpretation

Basic research shows that the genetic control of development cannot fully explain the phenotypic plasticity of humans and other metazoans. This challenges some tenets of the conventional paradigm of life sciences based on DNA, restoring a role of the environment in biological processes like the regulation of development, cell differentiation and disease. The environment — in a broad sense — affects biological phenotypes throughout the entire lifespan and can induce cancer, its progression and recurrence as well as its reversal. This is very important in cancer epidemiology as it implies that environmental exposures can be considered both as risk (or protective) and prognostic factors. This review integrates information from epidemiologic and biological research. We studied the impact of hazardous and protective exposures, lifestyles, and diet on the survival of patients who had been diagnosed with cancer.We selected studies from two digital databases, using a few combinations of key terms, namely overall survival, cancer-specific survival, recurrence and quality of life (QoL). Survival and/or recurrence were expressed as hazard or risk ratios, as second cancer diagnosis and as indicators of QoL such as performance status. We found 53 articles indicating that risk and protective factors can also influence prognosis after cancer diagnosis. Cigarette smoking and, among protective factors, diet and physical activity are the exposures most frequently investigated after a diagnosis of cancer

Occupational exposures and colorectal cancers: A quantitative overview of epidemiological evidence.

A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer. In more recent times, however, a growing evidence has shown that other determinants can be very important in increasing (or reducing) incidence of this malignancy. The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground, and high risks of colorectal cancer have been reported among workers in some industrial branches. The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities, by means of a scientific literature review and meta-analysis. This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds, such as leather (RR = 1.70, 95%CI: 1.24-2.34), basic metals (RR = 1.32, 95%CI: 1.07-1.65), plastic and rubber manufacturing (RR = 1.30, 95%CI: 0.98-1.71 and RR = 1.27, 95%CI: 0.92-1.76, respectively), besides workers in the sector of repair and installation of machinery exposed to asbestos (RR = 1.40, 95%CI: 1.07-1.84). Based on our results, the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%. However, homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review

MaCoSa: un "libro di testo" elettronico?

The educational group MaCoSa (MAtematica per COnoscere e per SApere), which operates at the Department of Mathematics, University of Genoa, prepare material for years on the teaching of mathematics. Today, following the diffusion of new technologies has decided to create a free electronic version of textbooks for secondary school, to meet the needs of new teachers who find it difficult to realize in schools reflections conducted in university courses in mathematics education. With this paper we try to present this initiative, to find forms of cooperation with it, and encourage similar initiatives

[Female breast cancer and occupational sectors : a preliminary study in the provinces of Lombardy, Italy]

BACKGROUND:The role of occupational exposures in breast cancer development is still uncertain. A recent paper showed increased risks in some occupational sectors in Lombardy, Italy. We deepened this analysis at the level of single provinces of the same Italian region. METHODS: Based on administrative data, a case-control study was carried out recruiting all incident cases of female breast cancer in the period 2002-2009, aged between 35 and 69 years, residing in Lombardy, Italy. Controls were randomly sampled from all women residing in Lombardy as of December 31, 2005. Occupational histories, including blue collar status, were available from 1974 through record linkage with a social security pension database, and were obtained for 11188 cases and 25329 controls. Adjusted odds ratios (ORs) and corresponding 90% confidence intervals (CIs) were calculated using multiple unconditional logistic regression models. Analyses were performed also by single provinces of Lombardy, Italy. Multiple comparisons were accounted for according to the Benjamini-Hochberg method. RESULTS: The ORs for female breast cancer were modestly but significantly increased for employment in electrical manufacturing (OR 1.12, 90% CI 1.04-121), textile (OR 1.08, 90% CI 1.02-1.15), paper (OR 1.25, 90% CI 1.06-1.46) and rubber (OR 1.26, 90% CI 1.03-1.54) industries. Analysis by province showed significantly increased ORs for electrical manufacturing in the Milano province. After adjustment for multiple comparisons no estimates remained statistically significant, except OR for electrical manufacturing in the Milano province. CONCLUSIONS: Although with several limitations, our results point to a possible role of exposures in electrical manufacturing, textile, paper and rubber industries in the process leading to breast cancer. An in-dept study for the electrical manufacturing industry has been already planned in Milano province