Comparison of Bioactive Substances Content between Commercial and Wild-Type Isolates of Pleurotus eryngii

Mushrooms belonging to Pleurotus genus have been demonstrated to have important nutritional and medicinal value and their regular intake prevent many diseases, reduce the infection probability and increase immunity. In order to investigate the bioactive compounds produced by seven commercial (‘142 F’, ‘142 E’, ‘D+’, ‘V turbo’, ‘V 142’, ‘A 12’, ‘V 160’) and five wild-type (‘Albino 1107’, ‘Altamura 1603’, ‘Muro Lucano 139’, ‘Conversano 1250’, ‘Albino beige chiaro 1094’) P. eryngii isolates, the following qualitative analyses were performed: Total polyphenol content, antioxidant activity (EC50 of ABTS) and antiradical power (ARP) in fresh lyophilized and dry basidioma, and water content, -glucans and phenolic compounds in fresh samples. Standard methods were employed for each of the above mentioned aims. Total polyphenol content was diverse among the P. eryngii isolates. In particular, an elevated polyphenolic content was found in fresh lyophilized P. eryngii samples of the commercial isolates ‘V 142’ followed by ‘A 12’. The highest antiradical activity (ARP) was obtained by ‘Muro Lucano 139’ isolate. Wild P. eryngii isolates were characterized by higher water and -glucans contents compared to the commercial ones, and the highest values were registered for the ‘Albino beige chiaro 1094’ isolate. In conclusion, the present study allowed us to identify the commercial and wild-type P. eryngii isolates from the Basilicata region, with high nutritional and medicinal value based on their bioactive compounds

Bratislava Statement: consensus recommendations for improving pancreatic cancer care

Pancreatic cancer is one of the most lethal tumours, and it is the fourth cause of cancer death in Europe. Despite its important public health impact, no effective treatments exist, nor are there high-visibility research efforts to improve care. This alarming situation is emblematic of a larger group of cancer diseases, known as neglected cancers. To address the impact of these diseases, the European Commission-supported Innovative Partnership for Action Against Cancer launched a multi-stakeholder initiative to determine key steps that healthcare systems can rapidly implement to improve their response. A working group comprising 20 representatives from European medical societies, patient associations, cancer plan organisations and other relevant European healthcare stakeholders was organised. A consensus process based on the results of different studies, discussion of research outcomes, and development and endorsement of draft statements resulted in 22 consensus recommendations (the Bratislava Statement). The statement argues that substantial improvements can be achieved in patient outcomes by centralising pancreatic cancer care around state-of-the-art reference centres, staffed by expert multidisciplinary teams capable of providing high-quality care. This organisational model requires a specific care framework encompassing primary, palliative and survivorship care, and a policy environment prioritising the use of quality criteria and performance assessments as well as research investments dedicated to prevention, risk prediction, early detection and diagnosis. In order to address the challenges posed by neglected cancers in general and pancreatic cancer in particular, a specific control strategy tailored to this reality is required

The role of stakeholder involvement in the evolving EU HTA process:Insights generated through the European Access Academy’s multi-stakeholder pre-convention questionnaire

Involvement of all relevant stakeholders will be of utmost importance for the success of the developing EU HTA harmonization process. A multi-step procedure was applied to develop a survey across stakeholders/collaborators within the EU HTA framework to assess their current level of involvement, determine their suggested future role, identify challenges to contribution, and highlight efficient ways to fulfilling their role. The ‘key’ stakeholder groups identified and covered by this research included: patients‘, clinicians‘, regulatory, and Health Technology Developer representatives. The survey was circulated to a wide expert audience including all relevant stakeholder groups in order to determine self-perception by the ‘key’ stakeholders regarding involvement in the HTA process (self-rating), and in a second, slightly modified version of the questionnaire, to determine the perception of ‘key’ stakeholder involvement by HTA bodies, payers, and policymakers (external rating). Predefined analyses were conducted on the submitted responses. Fifty-four responses were received (patients 9; clinicians: 8; regulators: 4; HTDs 14; HTA bodies: 7; Payers: 5; policymakers 3; others 4). The mean self-perceived involvement score was consistently lower for each of the ‘key’ stakeholder groups than the respective external ratings. Based on the qualitative insights generated in the survey, a RACI Chart (Responsible/Accountable/Consulted/Informed) was developed for each of the stakeholder groups to determine their roles and involvement in the current EU HTA process. Our findings suggest extensive effort and a distinct research agenda are required to ensure adequate involvement of the key stakeholder groups in the evolving EU HTA process.</p

HPV16 E7-Dependent Transformation Activates NHE1 through a PKA-RhoA-Iinduced Inhibition of p38alpha

Background: Neoplastic transformation originates from a large number of different genetic alterations. Despite this genetic variability, a common phenotype to transformed cells is cellular alkalinization. We have previously shown in human keratinocytes and a cell line in which transformation can be turned on and followed by the inducible expression of the E7 oncogene of human papillomavirus type 16 (HPV16), that intracellular alkalinization is an early and essential physiological event driven by the up-regulation of the Na/H-+(+) exchanger isoform 1 (NHE1) and is necessary for the development of other transformed phenotypes and the in vivo tumor formation in nude mice.Methodology: Here, we utilize these model systems to elucidate the dynamic sequence of alterations of the upstream signal transduction systems leading to the transformation-dependent activation of NHE1.Principal Findings: We observe that a down-regulation of p38 MAPK activity is a fundamental step in the ability of the oncogene to transform the cell. Further, using pharmacological agents and transient transfections with dominant interfering, constitutively active, phosphorylation negative mutants and siRNA strategy to modify specific upstream signal transduction components that link HPV16 E7 oncogenic signals to up-regulation of the NHE1, we demonstrate that the stimulation of NHE1 activity is driven by an early rise in cellular cAMP resulting in the down-stream inhibition of p38 MAPK via the PKA-dependent phosphorylation of the small G-protein, RhoA, and its subsequent inhibition.Conclusions: All together these data significantly improve our knowledge concerning the basic cellular alterations involved in oncogene-driven neoplastic transformation

The cancer patient and cardiology

Advances in cancer treatments have improved clinical outcomes, leading to an increasing population of cancer survivors. However, this success is associated with high rates of short- and long-term cardiovascular (CV) toxicities. The number and variety of cancer drugs and CV toxicity types make long-term care a complex undertaking. This requires a multidisciplinary approach that includes expertise in oncology, cardiology and other related specialties, and has led to the development of the cardio-oncology subspecialty. This paper aims to provide an overview of the main adverse events, risk assessment and risk mitigation strategies, early diagnosis, medical and complementary strategies for prevention and management, and long-term follow-up strategies for patients at risk of cancer therapy-related cardiotoxicities. Research to better define strategies for early identification, follow-up and management is highly necessary. Although the academic cardio-oncology community may be the best vehicle to foster awareness and research in this field, additional stakeholders (industry, government agencies and patient organizations) must be involved to facilitate cross-discipline interactions and help in the design and funding of cardio-oncology trials. The overarching goals of cardio-oncology are to assist clinicians in providing optimal care for patients with cancer and cancer survivors, to provide insight into future areas of research and to search for collaborations with industry, funding bodies and patient advocates. However, many unmet needs remain. This document is the product of brainstorming presentations and active discussions held at the Cardiovascular Round Table workshop organized in January 2020 by the European Society of Cardiology.</p

Cetuximab continuation after first progression in metastatic colorectal cancer (CAPRI-GOIM): A randomized phase II trial of FOLFOX plus cetuximab versus FOLFOX

Background: Cetuximab plus chemotherapy is a first-line treatment option in metastatic KRAS and NRAS wild-type colorectal cancer (CRC) patients. No data are currently available on continuing anti-epidermal growth factor receptor (EGFR) therapy beyond progression. Patients and methods: We did this open-label, 1:1 randomized phase II trial at 25 hospitals in Italy to evaluate the efficacy of cetuximab plus 5-fluorouracil, folinic acid and oxaliplatin (FOLFOX) as second-line treatment of KRAS exon 2 wild-type metastatic CRC patients treated in first line with 5-fluorouracil, folinic acid and irinotecan (FOLFIRI) plus cetuximab. Patients received FOLFOX plus cetuximab (arm A) or FOLFOX (arm B). Primary end point was progressionfree survival (PFS). Tumour tissues were assessed by next-generation sequencing (NGS). This report is the final analysis. Results: Between 1 February 2010 and 28 September 2014, 153 patients were randomized (74 in arm A and 79 in arm B). Median PFS was 6.4 [95% confidence interval (CI) 4.7-8.0] versus 4.5 months (95% CI 3.3-5.7); [hazard ratio (HR), 0.81; 95% CI 0.58-1.12; P = 0.19], respectively. NGS was performed in 117/153 (76.5%) cases; 66/117 patients (34 in arm A and 32 in arm B) had KRAS, NRAS, BRAF and PIK3CA wild-type tumours. For these patients, PFS was longer in the FOLFOX plus cetuximab arm [median 6.9 (95% CI 5.5-8.2) versus 5.3 months (95% CI 3.7-6.9); HR, 0.56 (95% CI 0.33-0.94); P = 0.025]. There was a trend in better overall survival: median 23.7 [(95% CI 19.4-28.0) versus 19.8 months (95% CI 14.9-24.7); HR, 0.57 (95% CI 0.32-1.02); P = 0.056]. Conclusions: Continuing cetuximab treatment in combination with chemotherapy is of potential therapeutic efficacy in molecularly selected patients and should be validated in randomized phase III trials

Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART)

Objective: To evaluate effects of remote monitoring of adjuvant chemotherapy related side effects via the Advanced Symptom Management System (ASyMS) on symptom burden, quality of life, supportive care needs, anxiety, self-efficacy, and work limitations. Design: Multicentre, repeated measures, parallel group, evaluator masked, stratified randomised controlled trial. Setting: Twelve cancer centres in Austria, Greece, Norway, Republic of Ireland, and UK. Participants: 829 patients with non-metastatic breast cancer, colorectal cancer, Hodgkin’s disease, or non-Hodgkin’s lymphoma receiving first line adjuvant chemotherapy or chemotherapy for the first time in five years. Intervention: Patients were randomised to ASyMS (intervention; n=415) or standard care (control; n=414) over six cycles of chemotherapy. Main outcome measures: The primary outcome was symptom burden (Memorial Symptom Assessment Scale; MSAS). Secondary outcomes were health related quality of life (Functional Assessment of Cancer Therapy—General; FACT-G), Supportive Care Needs Survey Short-Form (SCNS-SF34), State-Trait Anxiety Inventory—Revised (STAI-R), Communication and Attitudinal Self-Efficacy scale for cancer (CASE-Cancer), and work limitations questionnaire (WLQ). Results: For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards (least squares absolute mean difference −0.15, 95% confidence interval −0.19 to −0.12; P&lt;0.001; Cohen’s D effect size=0.5). Analysis of MSAS sub-domains indicated significant reductions in favour of ASyMS for global distress index (−0.21, −0.27 to −0.16; P&lt;0.001), psychological symptoms (−0.16, −0.23 to −0.10; P&lt;0.001), and physical symptoms (−0.21, −0.26 to −0.17; P&lt;0.001). FACT-G scores were higher in the intervention group across all cycles (mean difference 4.06, 95% confidence interval 2.65 to 5.46; P&lt;0.001), whereas mean scores for STAI-R trait (−1.15, −1.90 to −0.41; P=0.003) and STAI-R state anxiety (−1.13, −2.06 to −0.20; P=0.02) were lower. CASE-Cancer scores were higher in the intervention group (mean difference 0.81, 0.19 to 1.43; P=0.01), and most SCNS-SF34 domains were lower, including sexuality needs (−1.56, −3.11 to −0.01; P&lt;0.05), patient care and support needs (−1.74, −3.31 to −0.16; P=0.03), and physical and daily living needs (−2.8, −5.0 to −0.6; P=0.01). Other SCNS-SF34 domains and WLQ were not significantly different. Safety of ASyMS was satisfactory. Neutropenic events were higher in the intervention group. Conclusions: Significant reduction in symptom burden supports the use of ASyMS for remote symptom monitoring in cancer care. A “medium” Cohen’s effect size of 0.5 showed a sizable, positive clinical effect of ASyMS on patients’ symptom experiences. Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the covid-19 pandemic

Italian Guidelines in diagnosis and treatment of alopecia areata

Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations

Terre e sentieri del Partenio:dalla conoscenza al progetto

La necessità di organizzare, tutelare e valorizzare il territorio diversificato, ha portato alla nascita di questo progetto basato sulla realizzazione di uno strumento di conoscenza e di un programma di supporto alla realizzazione degli obiettivi che l’ente Gal Partenio si è prefissato. Il Gal Partenio (Gruppo di Azione Locale) è soggetto attuatore del Piano di Sviluppo “TERRE E SENTIERI DEL PARTENIO” ai sensi dell’asse quattro del PSR Campania 2007/2013. L’ente ha deciso di dotarsi di un sistema informativo territoriale in continuo aggiornamento che sia di supporto alle attività di programmazione e pianificazione. L’iter progettuale parte quindi dall’acquisizione e successiva elaborazione dei dati forniti in parte dalla Regione Campania e in parte dai vari enti locali, nonché dai continui e ripetuti sopralluoghi sui vari comuni di competenza. L’acquisizione, l’elaborazione dei dati e la successiva rappresentazione di carte tematiche viene sviluppata per sistemi di conoscenza rispetto alle risorse ambientali, storico architettoniche, alla rete delle comunicazioni e dei servizi, il tutto in funzione dello sviluppo dell’intero territorio. Il risultato ottenuto, oltre ad un database in continua evoluzione, che definisce gli orientamenti e delinea le strategie di progetto, è rappresentato dalle carte tematiche che nell’immediato danno forma alle domande poste in fase preliminare per qualsiasi progetto

Implementation of smokefree workplaces: challenges in Latin America Implementación de lugares de trabajo libres de humo de tabaco: desafíos en América Latina

Latin America is at the forefront of global progress in smokefree workplaces. Comprehensive smokefree laws have been implemented in four countries, and in many cities, states and provinces. More than 130 million people in Latin America are now protected from secondhand tobacco smoke. Nevertheless, a survey of tobacco control advocates and governments in Latin America found several challenges to progress in smokefree workplaces: the need for voluntary workplace programs where there is no smokefree legislation; weak legislation or lack of comprehensive national smokefree laws; tobacco industry attempts to undermine progress with smokefree laws or overturn existing laws via litigation; lack of compliance with laws; the need for monitoring and evaluation of smokefree laws; the need to make better use of mass media campaigns; and strengthening civil society. However, much progress has already been achieved to address these challenges, in particular through collaborations and the exchange of experience and expertise across Latin America.América Latina está a la vanguardia del movimiento en favor de lugares de trabajo libres de humo de tabaco. Se han implementado leyes integrales de ambientes libres de humo en cuatro países, y en muchas ciudades, estados y provincias. Gracias a la implementación de estas políticas, más de 130 millones de personas en América Latina están ahora protegidas del humo de tabaco ajeno. Sin embargo, existen varios desafíos para un continuo progreso en la implementación de lugares de trabajo libres de humo de tabaco. A partir de una encuesta realizada con activistas y funcionarios gubernamentales de América Latina, se indentificaron los siguientes desafíos principales: necesidad de adoptar programas voluntarios en los lugares del trabajo cuando no exista legislación; legislación débil o falta de leyes nacionales integrales de ambientes libres de humo de tabaco; intentos de la industria tabacalera por dificultar el progreso de las leyes de ambientes libres de humo o anular leyes existentes a través del litigio; falta de cumplimiento de las leyes; necesidad de monitoreo y evaluación de las leyes de ambientes libres de humo; necesidad de utilizar más eficientemente las campañas de medios masivos de comunicación; y fortalecimiento de la sociedad civil. No obstante, se ha alcanzado ya un gran progreso para enfrentar estos desafíos, particularmente a través de colaboraciones y el intercambio de experiencias entre los países latinoamericanos