Use of the ONCO-TreC electronic diary compared with a standard paper diary to improve adherence to oral cancer therapy in patients with solid and haematological tumours: protocol for a randomised controlled trial.

INTRODUCTION: ONCO-TreC platform consists of a mobile application delivered to patients as electronic diary and a web-based dashboard managed by healthcare professionals. We aim to compare the effectiveness of ONCO-TreC electronic diary with a standard paper diary, in improving adherence to oral cancer therapy in patients with solid and haematological tumours. METHODS AND ANALYSIS: This is an open label, superiority, randomised controlled trial conducted in two Italian oncology units. Patients will be randomised with a 1:1 ratio to electronic or paper diary. For both groups a counsellor will be responsible for drug and diary delivery. The evaluation period will end after six cycles of therapy. The primary aim is to compare the proportion of non-adherent patients in the two arms. Adherence will be measured through pill count; anyone who takes less than 90% of the total prescribed drug dose will be considered non-adherent. Assuming a percentage of non-adherent patients to oral therapy of 40% in arm B, and a 60% reduction in this percentage in arm A, a sample of 124 patients will provide 80% power to identify an absolute difference greater than 24 percentage points using a bilateral Fisher's exact test with a significance level of 0.05. Considering a dropout rate of 10%, approximately 136 patients will have to be enrolled. The primary analysis will be performed on the intention-to-treat population. Secondary aims are to describe the reasons for non-adherence, the level of satisfaction of patients and healthcare professionals with the paper and electronic diary, and the impact of non-adherence in terms of healthcare costs. ETHICS AND DISSEMINATION: Ethical approval was obtained from Romagna Ethics Committee (CEROM), study ID 2108, prot. n. IRST 100.28 of 10/04/2020. Informed consent will be obtained from all study participants. Findings will be disseminated through peer-reviewed journals, conferences and event presentations. PROTOCOL VERSION: Version 2, 6 April 2021. TRIAL REGISTRATION NUMBER: NCT04826458.

Tools for Thought: The Case of Mathematics.

The objective of this article is to take into account the functioning of representational cognitive tools, and in particular of notations and visualizations in mathematics. In order to explain their functioning, formulas in algebra and logic and diagrams in topology will be presented as case studies and the notion of manipulative imagination as proposed in previous work will be discussed. To better characterize the analysis, the notions of material anchor and representational affordance will be introduced.

Ginecomastia (Estudio retrospectivo sobre 54 casos operados) / Gynecomastia: retrospective study of 54 cases surgically treated

Se realiza un estudio retrospectivo de 54 casos operados en el Hospital de Endocrinología y Metabolismo Dr. Arturo Oñativia de Salta. Entre los años 1987 y 2001 fueron intervenidas 63 ginecomastias que representan el 5,58 por ciento de los diagnósticos anátomo-patológicos y el 7,18 por ciento de los informes benignos. Sobre 54 pacientes con historias clínicas presentes se detallan aspectos epidemiológicos, formas de presentación, estudios practicados, diagnóstico causal, características anátomo-patológicas y se intenta cursar una guía para el estudio de la ginecomastia como así también para el tratamiento médico y quirúrgico. Por último se realiza determinación de receptores hormonales por inmunomarcación en 19 casos observando pisitividad nuclear epitelial para estrógenos en el 68,42 por ciento y de progesterona en el 47,36 por ciento.