A Simon's two-stage design trial evaluating the potential role of a kind of honey in preventing chemotherapy-hematopoietic toxicities.

BACKGROUND AND AIM: Hematopoietic toxicities are a serious consequence of myelosuppressive CT that may result in dose reductions, delays or even discontinuation of CT, which, in turn, may compromise patient outcomes. Concerns about tolerability and costs of CSFs are still ongoing, therefore the potential use of supportive therapeutics agents are still of interest. EXPERIMENTAL PROCEDURE: We performed a monocentric, phase II study using Simon's two-stage design. The primary endpoint was the evaluation of the potential clinical benefit of a special kind of honey (Life-Mel Honey) administered prophylactically to reduce the incidence of hematopoietic toxicities following chemotherapy. We have enrolled patients undergoing adjuvant or first-line chemotherapy. RESULTS AND CONCLUSION: From November 2013 to May 2014 (First stage) and from November 2014 to April 2016 (Second stage), 39 patients were enrolled at our Institution. The majority of patients was male (24/39, 61.5%), medium age was 60.4 years (range 34-77 years). The median follow up was 74.5 days (SD +/- 28.5). Overall, the majority of patients could underwent their chemoterapy with a regular schedule (25/39, 64.1%), while 9/39 patients (23.1%) need to delay chemotherapy due to hematological adverse events of various grade. Ten/39 patients (25.6%) had a grade 1 neutrophils count decreased, 56.4% a grade 1 platelets count decrease and 64.1% a grade 1 hemoglobin decrease. Therefore, Life-Mel Honey showed an interesting profile to reduce hematological toxicities. The proportion of responses is sufficiently high to recommend this honey to go to a next step in the clinical trial phase.

Estimation of Occupational Exposure to Asbestos in Italy by the Linkage of Mesothelioma Registry (ReNaM) and National Insurance Archives. Methodology and Results.

The identification and monitoring of occupational cancer is an important aspect of occupational health protection. The Italian law on the protection of workers (D. Leg. 81/2008) includes different cancer monitoring systems for high and low etiologic fraction tumors. Record linkage between cancer registries and administrative data is a convenient procedure for occupational cancer monitoring. We aim to: (i) Create a list of industries with asbestos exposure and (ii) identify cancer cases who worked in these industries. The Italian National Mesothelioma Registry (ReNaM) includes information on occupational asbestos exposure of malignant mesothelioma (MM) cases. We developed using data from seven Italian regions a methodology for listing the industries with potential exposure to asbestos linking ReNaM to Italian National Social Security Institute (INPS) data. The methodology is iterative and adjusts for imprecision and inaccuracy in reporting firm names at interview. The list of asbestos exposing firms was applied to the list of cancer cases (all types associated or possibly associated with asbestos according to International Agency for Research on Cancer (IARC) monograph 100C) in two Italian regions for the indication of possible asbestos exposure. Eighteen percent of the cancer cases showed at least one work period in firms potentially exposing to asbestos, 48% of which in regions different from where the cases lived at diagnosis. The methodology offers support for the preliminary screening of asbestos exposing firms in the occupational history of cancer cases.

Manual para el cuidado de personas con enfermedades crónicas no transmisibles manejo integral en el primer nivel de atención / Procedures for the care of people with chronic noncommunicable diseases integral management in the first level of care

Las enfermedades crónicas no transmisibles (ECNT) son patologías de larga duración cuya evolución es generalmente lenta. Las principales ECNT son las enfermedades vasculares (cardio y cerebrovasculares), la diabetes, el cáncer, las enfermedades respiratorias crónicas y la obesidad. Todas se caracterizan por compartir los mismos factores de riesgo: el tabaquismo, la alimentación inadecuada y la falta de actividad física La Estrategia Nacional de Prevención y Control de las Enfermedades no Transmisibles tiene como objetivo reducir la prevalencia de factores de riesgo y la morbimortalidad por ECNT en la población en general. Las acciones desarrolladas están focalizadas en la promoción de la salud, la reorientación de los servicios de salud y la vigilancia epidemiológica. Este Manual fue desarrollado considerando las guías de práctica clínica (GPC) elaboradas por la Dirección y otras guías y documentos técnicos de otras áreas del Ministerio de Salud de la Nación, fundamentalmente en lo referente a las recomendaciones del control periódico de salud. En aquellos casos en los que no se contaba con una guía de práctica clínica, como es el caso de hipertensión arterial, se realizó una revisión de las recomendaciones actuales, consolidadas en un capítulo y se actualizaron las recomendaciones pertinentes en el resto de los capítulos. El conjunto de recomendaciones que se presentan, no ambiciona establecer normativas sino otorgar una herramienta que favorezca la atención de la población independientemente del profesional que lo asista