The use of complementary and alternative medicine is frequent in patients with pancreatic disorder

BACKGROUND: Herbal remedies and other complementary and alternative medicine (CAM) are used by 30% of the patients with liver and inflammatory bowel diseases. However, there are no data regarding CAM use in patients with pancreatic disorders, including potential pancreatotoxicity. AIM OF THE STUDY: The aim of the study was to assess the prevalence of CAM use in patients with pancreatic disorders and screen for pancreatotoxicity. MATERIALS AND METHODS: This was a cross-sectional survey of consecutive outpatients seen at a Pancreas Center. Data were collected in a specific questionnaire. Descriptive statistics were used to analyze the prevalence and the patterns of CAM use. Characteristics associated with CAM use were analyzed by appropriate statistics. RESULTS: Of 108 patients (52% male; mean age, 65±13 years), 47 (43.5%) used CAM. The use of CAM was more frequent among patients with previous acute pancreatitis (47%). Reported reasons for the use of CAM were to help standard therapies and for an overall better feeling. About 61% of the patients reported advantages with treatment. As compared with nonusers, CAM users were more often female (55% vs. 42%), with a higher school degree (43% vs. 36%), more frequently performing physical activity (51% vs. 41%), and reporting anxiety (45% vs. 31%). However, none of these differences were statistically significant. Three patients with previous acute pancreatitis reported the use of Serenoa repens that is potentially pancreatotoxic. DISCUSSION: The rate of CAM use in patients with pancreatic disorders is similar to those reported for other digestive diseases. CAM use seems to be more frequent in women with a higher education level and a "healthier lifestyle." Patients might not be aware of the potential pancreatotoxicity of CAM, which should be carefully considered by physician

The prevalence of pancreatic cystic lesions in patients with liver cirrhosis is double that in controls

Background and aims: Pancreatic cystic lesions (PCLs) are commonly diagnosed incidentally and are often preneoplastic. Their presence may influence the management of patients with chronic diseases such as liver cirrhosis (LC). This study evaluated the prevalence and nature of PCLs in LC patients. Methods: The images of 192 LC patients and 192 controls who underwent either computed tomography scan or nuclear magnetic resonance were reviewed for the presence and nature of PCLs. The prevalence of PCLs in both groups and differences between LC patients with and without PCLs were analysed. Multiple logistic regression analysis was used to investigate factors associated with PCLs. Results: Thirty-five of 192 LC patients (18%) and 19/192 controls (10%) had PCLs (p =.027). The prevalence of presumptive intraductal pancreatic mucinous neoplasm (IPMN) was double in LC patients compared with controls (14% vs 7%; p =.065). In multivariate analysis, age, LC and having undergone a magnetic resonance cholangiopancreatography were factors associated with PCLs and IPMNs. LC patients with PCLs were older at the time of imaging and had a longer history of liver disease (67 vs. 43 months; p = 0.039) compared with LC patients without PCLs. Conclusions: PCLs are more common in LC patients than in controls, and most are IPMNs. The occurrence of PCLs in LC patients seems to be related to age and disease duration

Past&Present at Tarchna&Tarquinia: a flexible approach to make visible the invisible

This contribution falls within the topic of the “development of guidelines and best practices” and deals with the study case of the ancient Etruscan city of Tarchna (Tarquinia, central Italy). The “Tarquinia Project” started here in 1982 with the investigations carried out by the Università degli Studi di Milano in two sacred areas and along the fortifications. The Project was endowed since its beginnings with the collaboration of several experts in disciplines other than Archaeology which number has increased in the past years. Their aim is to find out as much as possible about the material aspects of Archaeology to decode their relationship with the invisibility of ancient life. This contribution aims at presenting our approach addressed to put scholars in the condition to handle data according to their own procedures, within the same environment, through an ecosystem of benchmarks and references in ways close to the individual practices, supported by ICTs. This is meant to avoid the use of predetermined terminologies and categories, enhancing the proper methods of every single discipline involved in a multidisciplinary environment, beyond the current work of every individual scholar. We propose a radical change of perspective, starting from the collection of raw data in several fields (material aspects of Archaeology, Geoarchaeology, Architecture, Topography) to grasp the underlining model, thanks to the assessment of recurrent associations among different categories of evidence, instead of starting from preconceived theoretic models and using data to confirm them. Distinct small, medium and large scale investigation methods are integrated for the first time to produce a significant interdisciplinary cognitive tool to shift from the materiality of the leftovers of Ancient Past, to its integrity, to what lies behind at a metaphysical level and is, therefore, invisible to us. This is related to the materiality of rituals, based on the recurrence of cultic practices in the above-mentioned sacred areas, whose gestures might also be revealed by sediments and organic remains, in addition to other archaeological and epigraphic issues. Tarquinia strongly challenges researchers to be open to unconventional and unexploited issues due to the complexity of the site. It is the ideal place to create awareness among the general public about the results of Archaeological research and to disseminate and make visible its acquirements, according to the European Charter for Researchers. The support of Environmental Psychologists helps to ensuring outreach entails initiatives directed to the local population, in order to introduce them to an equilibrated connection between their invisible Past and the local present culture. In this framework students from high school are involved in the Archaeological field activities, since 2012. Our best practices are therefore addressed to give back to the ancient Etruscan city its value of prominent cultural and natural landmark in the Past, to make it possible for the modern community to assess it in the same way. According to current theories of “place identity” and "place attachment" the modern community is in the condition to feeling and experiencing the continuity between past, present and future