The Impact of Lifestyle Interventions in High-Risk Early Breast Cancer Patients: A Modeling Approach from a Single Institution Experience

none21noA healthy lifestyle plays a strategic role in the prevention of BC. The aim of our prospective study is to evaluate the effects of a lifestyle interventions program based on special exercise and nutrition education on weight, psycho-physical well-being, blood lipid and hormonal profile among BC patients who underwent primary surgery. From January 2014 to March 2017, a multidisciplinary group of oncologists, dieticians, physiatrists and an exercise specialist evaluated 98 adult BC female patients at baseline and at different time points. The patients had at least one of the following risk factors: BMI ≥ 25 Kg/m2, high testosterone levels, high serum insulin levels or diagnosis of MS. Statistically significant differences are shown in terms of BMI variation with the lifestyle interventions program, as well as in waist circumference and blood glucose, insulin and testosterone levels. Moreover, a statistically significant difference was reported in variations of total Hospital Anxiety and Depression Scale (HADS) score, in the anxiety HADS score and improvement in joint pain. Our results suggested that promoting a healthy lifestyle in clinical practice reduces risk factors involved in BC recurrence and ensures psycho-physical well-being.openMirco Pistelli, Valentina Natalucci, Laura Scortichini, Veronica Agostinelli, Edoardo Lenci, Sonia Crocetti, Filippo Merloni, Lucia Bastianelli, Marina Taus, Daniele Fumelli, Gloria Giulietti, Claudia Cola, Marianna Capecci, Roberta Serrani, Maria Gabriella Ceravolo, Maurizio Ricci, Albano Nicolai, Elena Barbieri, Giulia Nicolai, Zelmira Ballatore, Agnese Savini and Rossana BerardiPistelli, Mirco; Natalucci, Valentina; Scortichini, Laura; Agostinelli, Veronica; Lenci, Edoardo; Crocetti, Sonia; Merloni, Filippo; Bastianelli, Lucia; Taus, Marina; Fumelli, Daniele; Giulietti, Gloria; Cola, Claudia; Capecci, Marianna; Serrani, Roberta; Gabriella Ceravolo, Maria; Ricci, Maurizio; Nicolai, Albano; Barbieri, Elena; Nicolai, Giulia; Ballatore, Zelmira; Savini and Rossana Berardi, Agnes

Epidemiology of drug use in Perugia (Italy) through the analysis of the Keratin Matrix

Background Drugs and their metabolites can be incorporated into hair so hair testing has become s an alternative and complementary method to assess the extent of drugs abuse. The aim of our study has been to use hair samples to rebuild the epidemiology of illicit substances use  in Perugia. Methods We conducted a cross-sectional study from May to July 2012 asking hairdressers of Perugia to collect hair samples and to compile a schedule for each one. The samples were analyzed in laboratory: the extraction of basic substances was performed adding methanol; the extraction of acid substances was obtained adding  NAOH.  After derivatization, 1μl of each solution was analyzed through gas chromatography / mass spectrometry The data were  organized in a database and processed using R version 3.2.2. Results We collected 238 samples. The most detected drugs were: THC-TMS identified in 15 samples, MDMA in 9, Beg-TMS in 8. There is a statistically significant difference in drug use between centre (23,36%) and periphery (5,34%). Age and sex have not represented influencing factors. The substance with the highest concentration in the keratin matrix is ketamine (9834,86 ng/100 mg of hair). Conclusions The use of keratin matrix offers high advantages in the toxicological analysis compared to conventional biological matrices and let us analyze the situation in Perugia where the increased market of drugs caused constant rise of drug addiction. However, because of the limits of this method, only the simultaneous use of keratin matrix and other traditional indicators, could furnish more precise information

Drugs and psychoactive substances in the Tiber River

7nononeWastewater analysis is a direct and objective method used to measure human consumption of illicit drugs. In the last few years these have become a new class of environmental contaminants. The aim of our study was the identification of drugs in Tiber River waters. We collected 20 water samples from May to June 2012, at six points of the river: at the source, near Perugia, near Rome and at the mouth. Samples were analysed using gas chromatography with a mass detector. Basic analytes were extracted using the method of Varian Certify. For acidic analytes we proceed to direct extraction using organic solvents. The most detected drug was ecstasy. We also identified traces of methadone, morphine, heroine, methylamphetamine and tetrahydrocannabinol (THC). The highest concentration of cocaine was found near Perugia with a peak in the weekend (4744 ng/ml). Psychoactive substances had constant concentrations in the week. Ecstasy (MDMA) was the most detected drug. The most interesting finding was the increased concentration of cocaine and heroin in waters near Perugia showing the alarming phenomenon of weekend use of these substances. © 2016 Australian Academy of Forensic SciencesnoneMilione, S.; Mercurio, Isabella; Troiano, Gianmarco; Melai, P.; Agostinelli, V.; Nante, Nicola; Bacci, M.Milione, S.; Mercurio, Isabella; Troiano, Gianmarco; Melai, P.; Agostinelli, V.; Nante, Nicola; Bacci, M

The analysis of the keratin matrix as a new tool to evaluate the epidemiology of drug use in Perugia (Italy): a cross sectional study

Background: Drugs and their metabolites can be incorporated into hair, so hair drug testing has become an alternative and complementary method to assess the extent of drug abuse. The aim of our study was to use hair samples to reconstruct the epidemiology of illicit substances used in Perugia. Methods: We conducted a cross-sectional study from May to July 2012 asking hairdressers in Perugia to collect hair samples and to compile a worksheet for each one. The samples were analysed in laboratory: the extraction of basic substances was performed adding methanol; the extraction of acid substances was obtained adding NAOH. After derivatisation, 1μl of each solution was analysed through gas chromatography/mass spectrometry. The data were organised in a database and processed using R version 3.2.2. Results: We collected 238 samples. The most detected drugs were: THC-TMS identified in 15 samples, MDMA in 9, Beg-TMS in 8. There was a statistically significant difference in drug use between the city centre (23,36%) and the suburbs (5,34%). Age and sex did not represent influencing factors. The substance with the highest concentration in the keratin matrix was ketamine (9834,86 ng/100 mg of hair). Conclusion: The use of keratin matrix offered significant advantages in the toxicological analysis compared to conventional biological matrices and permitted us to investigate the situation in Perugia where the increased market for illicit drugs has caused a constant rise in drug addiction. However, because this method presented certain limitations only the simultaneous use of keratin matrix and other traditional indicators, could furnish more precise information

New Insights into Hormonal Therapies in Uterine Sarcomas

Uterine sarcoma (US) is a rare mesenchymal malignant cancer type, accounting for 3–7% of uterine malignancies. US prognosis is still poor due to high local and distant recurrence rates. As for molecular features, US may present variable oestrogen receptor (ER) and progesterone receptor (PR) expressions, mostly depending on histotype and grading. Surgery represents the mainstay of treatment for early-stage disease, while the role of adjuvant chemotherapy or local radiotherapy is still debated and defined on the basis of histotype, tumour grading and stage. In metastatic setting, uterine sarcomas’ treatment includes palliative surgery, a metastases resection, chemotherapy, hormonal therapy and targeted therapy. As for the chemotherapy regimen used, drugs that are considered most effective are doxorubicin (combined with ifosfamide or alone), gemcitabine combined with docetaxel and, more recently, trabectedin or pazopanib. Hormonal therapies, including aromatase inhibitors (AIs), progestins and gonadotropin-releasing hormone analogues (GnRH-a) may also represent an effective option, in particular for low-grade endometrial stromal sarcoma (LGESS), due to their favourable toxicity profile and patients’ compliance, while their role is still under investigation in uterine leiomyosarcoma (uLMS), high-grade endometrial stromal sarcoma (HGESS), undifferentiated uterine sarcoma (USS) and other rarer US. The present review aims to analyse the existing evidence and future perspectives on hormonal therapies in US, in order to clarify their potential role in daily clinical practice

A 10 year post-mortem analysis of keratin matrix in Perugia (Italy): focus on cocaine involvement in several types of death

The use of keratin matrix, in detecting drug consumption, offers compelling advantages compared to other conventional biological matrices used for these types of investigation, and provides important information to surveys which are characterised by a general underestimation, especially in Italy. In our study we collected and analysed 424 hair samples from corpses autopsied in Perugia from January 2001 to December 2011 in order to detect traces of drugs and especially of cocaine, and evaluate their involvement in several types of death. Hair samples were analysed by gas chromatography–mass spectrometry in the Laboratory of Forensic Toxicology of the Department of Legal Medicine of the University of Perugia: 232 samples derived from cases of overdose deaths; 192 were connected to different causes of death. The average concentration of cocaine in the keratin matrix samples was of 3.74 ng/mg in people who died from overdose, 3.09 ng/mg in people who died from other causes. In 232 cases of overdose deaths, 135 were positive for cocaine (accounting for 58.18% of total); in 192 deaths from other causes, 39 were positive for cocaine (accounting for 20.31% of the total). Our study demonstrated the crucial role of cocaine in overdose deaths and in other deaths, as is well known in other research

Management of lung cancer patients during COVID-19 pandemic: dos, don'ts and don't knows

Aim: During the coronavirus disease 2019 (COVID-19) pandemic two needs have overlapped: on one hand continuing to provide the best care for patients with lung cancer and preventing the spread of the virus between patients and healthcare professionals on the other hand. Due to the pandemic's unpredictable duration, physicians had to evaluate the risk/benefit ratio of anti-cancer therapeutic strategy to do the best for their patients and to protect patients themselves, as well as healthcare workers. Methods: Systematic literature research was performed with the aim to assess the available guidelines for the management of lung cancer patients during the COVID-19 pandemic. Thirteen potentially relevant articles were selected and recommendations have been divided into three main categories: dos, don'ts and don't knows. Results: All guidelines and recommendations highlighted the relevance of being able to delay, if possible and based on risk stratification, and curative interventions. The selected recommendations should be considered adaptable and flexible because they might be contextualized on the basis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prevalence and the availability of diagnostic-therapeutic resources. Conclusions: It remains of fundamental importance to discuss each diagnostic and therapeutic decision with the patient taking into account risks and benefits that might vary from case to case