Indagine statistica su acquisti e vendite dei principali prodotti alimentari locali nei Siti di Interesse Nazionale (SIN)

L’indagine nasce dalla collaborazione tra l’Istituto Zooprofilattico Sperimentale della Sicilia (IZS Sicilia) e l’Istituto per lo Studio degli Impatti Antropici e Sostenibilità in Ambiente Marino del Consiglio Nazionale delle Ricerche (IAS-CNR) nell’ambito del progetto CISAS (Centro Internazionale di Studi Avanzati su Ambiente, Ecosistema e Salute Umana). In CISAS sono state svolte attività indirizzate alla valutazione del rischio sanitario per le popolazioni residenti nelle aree dei Siti di Interesse Nazionale (SIN) di Augusta-Melilli-Priolo (SIN 1), di Milazzo (SIN 2) e di Crotone (SIN 3) caratterizzati da un forte degrado ambientale e da fenomeni di impatto umano di varia origine, sostanzialmente causati dallo sviluppo di importanti attività industriali (Giosuè et al., 2020). In questo scenario, considerati anche i risultati emersi da diversi rapporti sia italiani che Europei (ISMEA, 2019), i quali evidenziano una crescita di vendite dei prodotti di origine locale (certificati con marchi quali ad es. DOP, IGP, ecc..), spesso a km zero, si è ritenuto di fondamentale importanza indagare sul mercato dei prodotti di origine vegetale e animale provenienti dai tre SIN e destinati al mercato locale. Inoltre, tenendo in considerazione che negli ultimi anni la Grande Distribuzione Organizzata (GDO) ha avviato processi di acquisto e vendita di prodotti locali, prevedendo dei disciplinari di produzione, spesso particolarmente rigidi nel garantire la sicurezza alimentare, l’IZS Sicilia ha ritenuto di notevole importanza realizzare un’indagine esplorativa sui flussi di vendita e acquisti di prodotti freschi locali proprio nell’ambito della GDO, al fine di reperire informazioni più puntuali per implementare le valutazioni sul rischio delle popolazioni residenti nel SIN o nelle aree limitrofe. L’indagine è stata condotta attraverso interviste ai responsabili commerciali delle principali insegne della GDO, identificati su base campionaria nei SIN di Augusta Melilli Priolo, di Milazzo e di Crotone

University performance before and during economic crises: an analysis of graduate characteristics

This book briefly analyzes the performance of selected Italian universities during a pre-crisis period and an economic crisis period, on the basis of graduate characteristics and graduate placement statistics. The Electre model is used to produce eighteen university rankings according to three different scenarios (Neutral, University, and Job), three different roles ascribed to the key criteria (overeducation and mismatching), and two years corresponding to two postgraduation placement sampling surveys carried out in a pre-crisis period (2006) and during a crisis period (2011). The eighteen rankings are based on Economics/Statistics and Political & Social Sciences graduates. The rankings vary according to both the scenarios considered and graduate characteristics. Some differences are noted between the two fields of study. The book will be of interest for statisticians interested in evaluation issues, policymakers concerned with university comparisons and rankings, and future students and graduates wishing to make the best choice when selecting their university course. In addition, the new methodology adopted will be relevant for scholars in Statistics and Engineering

Gemcitabine in intravesical treatment of Ta-T1 transitional cell carcinoma of the bladder: Phase I-II study on marker lesions

OBJECTIVES: To study the ablative activity of intravesical gemcitabine against superficial transitional cell carcinoma of the bladder at different doses and concentrations. METHODS: A total of 27 patients were treated with intravesical gemcitabine after transurethral resection during which one to three papillary marker lesions were left unresected. Starting 14 days after transurethral resection, six instillations of gemcitabine were given at weekly intervals. Gemcitabine, diluted in 50 mL of saline solution and maintained for 2 hours, was given at the dose of 500 mg, 1000 mg, and 2000 mg in groups of 9 patients each. A complete response (CR) was defined as negative cytology, cystoscopy, and biopsy findings. Patients achieving a CR received monthly maintenance for up to 1 year and underwent cytology and cystoscopy at 3-month intervals. RESULTS: Of the 27 patients, 1 was lost to follow-up, and of the remaining 26 patients, 6 (23%) achieved a CR. A CR was achieved in 1 patient (12.5%), 2 patients (22.2%), and 3 patients (33.3%) at a dose of 500, 1000, and 2000 mg, respectively. A partial response was obtained in 2 additional patients (22%) at a dose of 500 and 1000 mg. Bladder Tis was diagnosed in 2 patients with a CR at 3 and 8 months after treatment. The remaining 4 patients were disease free at a follow-up of up to 22 months. Systemic and local tolerability was excellent, and no treatment interruption was required. CONCLUSIONS: Our experience has shown the good tolerability and potential efficacy of intravesical gemcitabine against recurrent transitional cell carcinoma of the bladder. Gemcitabine might be proposed, if our results are confirmed by larger studies, as a second-line therapy in patients who cannot tolerate more aggressive intravesical therapy

Multiplicity and history have a detrimental effect on survival in patients with T1G3 bladder tumors selected for conservative treatment.

Purpose: In the absence of Tis tumor we assessed whether history and multiplicity have a detrimental effect on conservative treatment in carefully selected patients with T1G3 bladder carcinoma. Materials and Methods: Between January 1976 and December 1999, 165 select patients with T1G3 bladder tumors were conservatively treated with transurethral resection plus adjuvant intravesical therapy. Patients with concomitant or previous Tis, previous T1G3, tumor size greater than 3 cm and more than 3 lesions were excluded from analysis. Repeat transurethral resection was not routinely performed. However, cytology had to be negative for atypia before the start of adjuvant intravesical therapy. Results: Recurrence-free survival at 1, 3 and 5 years was 71.8%, 55.6% and 45%, respectively. Of the cases 14 (8.4%) progressed with a median progression-free survival of 149 months. A total of 23 patients (14%) died. The 5-year recurrencefree survival rate was 52%, 34% and 15% in cases of single and/or primary, multiple and recurrent tumors, respectively. Median overall survival was 144 months. The 5-year disease-free overall survival rate was 85%, 83%, 79% and 69% in cases of primary, single, multiple and recurrent tumors, respectively. An intact bladder was maintained in 137 patients (83%) with a mean disease-free overall survival of 102.7 months. Patients with recurrent and/or multiple T1G3 tumors showed worse survival (p 0.0021 and 0.0142, respectively). Conclusions: History and multiplicity are relevant predictors of survival even in highly selected patients with TIG3 bladder tumors that are conservatively treated. Key Words: carcinoma, transitional cell; survival; chemotherapy, adjuvant; neoplasms, multiple primary; recurrenc

Re-treatment by intravesical therapy in recurring patients affected by intermediate risk non-muscle invasive bladder cancer (NMIBC)

Introduction & Objectives: Up to 70% of patients affected by intermediate risk NMI-BC recur after intravesical therapy (IT). The majority of them will be retreated by IT. The therapeutic strategy for these patients is not well defined. BCG is advocated when intravesical chemotherapy (ICH) fails. However, some patients are retreated by ICH and some others repeat BCG adopted as the first treatment. Not many studies have been published on second line IT. A retrospective analysis on 179 intermediate-risk patients undergoing re-treatment by IT is presented. Materials & Methods: The clinical files of patients affected by NMI-BC recurring after TUR and IT and retreated by IT were reviewed. The patients not receiving at least 6 instillations of BCG or ICH after the first diagnosis and again after the TUR of the first recurrence were excluded. Only mitomycin c and epirubicin were accepted as chemotherapy. Only intermediate-risk tumours with a recurrencerisk score between 5 and 9 according to the EORTC Risk Tables and in absence of Tis were selected. A multivariate analysis was performed for recurrence-free interval (RFI) and progression considering, first line IT (BCG versus ICH), previous recurrence free interval, tumour’s T-category, G-grade, multiplicity, second line IT (BCG versus ICH) and maintenance regimen. Results: The study included 179 patients. The first line IT was ICH in 131 (73.2%) and BCG in 48 (26.8%) patients. The median RFI was 16 months. At recurrence, BCG in 83 (46.4%) and ICH in 96 (53.6%) patients were administered, with maintenance of at least 12 months in 31% and 38% of patients respectively. Of the 48 patients previously treated by BCG, 40 (83.3%) received BCG again, while of the 131 previously treated by ICH, 88 (67.2%) received ICH again and 43 (32.8%) BCG. Thus, only 8 patients received ICH at recurrence after BCG. At a median follow-up of 29 months, 65 (36.3%) patients recurred with a median RFI of 15 months, 25 (30.1%) and 40 (41.7%) after BCG and ICH respectively. Thirteen patients showed progression at a median interval of 19 months. At multivariate analysis no statistically significant correlation was detected among the considered parameters. Surprisingly, no statistical difference emerged in terms of RFI between first and second line IT (16 versus 15 months), and between patients receiving BCG or ICH as second line therapy at recurrence after ICH (=0.28). Conclusions: No reduction in RFI emerged in patients with intermediate-risk NMIBC recurring after a first cycle of intravesical therapy and retreated by intravesical chemotherapy or BCG. In patients recurring after intravesical chemotherapy, intravesical chemotherapy and BCG, as a second line therapy, resulted equally effective in preventing recurrence

CHOICE OF ADJUVANT INTRAVESICAL THERAPY IN RECURRING INTERMEDIATE-RISK NMI-BC

Objective: The therapeutic strategy for patients affected by intermediate risk non-muscle invasive bladder cancer (NMIBC) recurring after intravesical therapy is not definitively established. Only few studies have been published on secondline intravesical therapy. BCG is advocated when intravesical chemotherapy fails and is often repeated. On the other hand, some patients that suffer recurrence repeat intravesical chemotherapy. A retrospective analysis of 179 intermediaterisk patients submitted to second-line intravesical therapy is reported. Patients and Methods: The clinical files of patients affected by intermediate risk NMI-BC and submitted to second-line adjuvant intravesical therapy were reviewed. Patients not receiving at least six instillations of BCG or intravesical chemotherapy after the first diagnosis and again after the transurethral resection (TUR) of the first recurrence were excluded. Only mitomycin c and epirubicin were accepted as chemotherapy. Only patients with intermediaterisk tumors with a recurrence-risk score between 5 and 9 according to the EORTC risk tables and in absence of Tis were selected. A multivariate analysis was performed for recurrence-free survival (RFS) and progression, considering first line intravesical therapy (BCG versus ICH), previous recurrence-free interval, tumor T category, G grade, multiplicity, second-line intravesical therapy (BCG versus ICH) and maintenance regimen. Results: The study included 179 patients. Chemotherapy was administered as first-line therapy in 131 (73.2%) and BCG in 48 (26.8%) patients. Second-line therapy was represented by BCG in 83 (46.4%) and chemotherapy in 96 (53.6%) patients, with maintenance of at least 12 months in 31% and 38% of patients, respectively. Of the 48 patients previously treated by BCG, 40 (83.3%) received BCG again, while of the 131 previously treated by chemotherapy, 88 (67.2%) repeated it and 43 (32.8%) received BCG. At a median follow-up of 29 months after the second TUR, 65 (36.3%) patients experienced recurrence, 25 (30.1%) and 40 (41.7%) after BCG and chemotherapy, respectively. Thirteen patients showed progression at a median interval of 19 months. At multivariate analysis, no statistically significant correlation was detected. Surprisingly, no statistical difference emerged in terms of recurrence-free interval between first- and second-line therapy and between BCG and chemotherapy as second-line therapy at recurrence after chemotherapy (p=0.28) Conclusion: Almost 65% of patients experiencing recurrence after intravesical chemotherapy received intravesical therapy again. No difference in efficacy was detected between firstand second-line therapies or between BCG and chemotherapy given at recurrence after chemotherapy