Catalogue of Communication Tools and Dissemination Guidelines: benchmarking current practice in EU and Member State bodies.

A comprehensive benchmarking exercise on current best practices on communication tools and dissemination processes of EU Member State organisations plus Iceland and Norway, selected ENVI EU agencies (EFSA, EMA, ECHA, ECDC), and EU bodies (DG SANTE, JRC, EU COUN) was carried out via an online survey, remote qualitative interviews, and a desk analysis of documents and web content.These current practices have been compiled into a catalogue of communication tools and a guide to their effective dissemination. Both elements are designed to help inform the EC General Plan for Risk Communication (GPRC)andfacilitate a coordinated communication framework at the EU and national level on matters relating to the food chain. The reportsets out a broad overview of the current tools that are commonly used, their intended communication purposes and target audiences. It also describes dissemination channels andmethods to optimise outreach. This work provides a solid platform for EU and Member State bodies to build on going forward. The report should be viewed as a living document that will evolve to meet fast-changing information needs and the requirements of the future GPRC.The catalogue highlights that multimedia tools show relatively high impact scores and high mention rates by the respondents participating in the online survey. Editorial tools are still very important, especially to reach the media. Both physical meetings and events and educational tools have very high impact scores but limited mention rates. All communication tools can be effective if properly designed (i.e. right content and tone of voice for the intended target audience(s) and disseminated through the right channels). Social media and the website are the most used dissemination channels. The reliance on campaigns is widespread as they help achieve a stronger impact on the target audience. Moreover, communication tools supported by best practices in dissemination perform much better and are used by a wider audience than tools that are merely published on an organisation's website. A systematic phased approach to dissemination (1. planning, 2. preparation, 3. publication and distribution, and 4. post-publication and distribution) is, therefore, crucial for a successful communication strategy. Effective leverage of amplifiers (planned and prepared in the first two phases) substantially increases communication tools' outreach in the publication and distribution phase. The usage of Key Performance Indicators, set during the planning phase, allows an organisation to improve both communication tools and their dissemination strategy. Post-publication and distribution is a strategic phase to learn from the outcomes and fine-tune subsequent communication practices.

Detection of circulating tumor cells in patients with adrenocortical carcinoma: a monocentric preliminary study.

CONTEXT: Adrenocortical carcinoma (ACC) is a rare malignancy, the prognosis of which is mainly dependent on stage at diagnosis. The identification of disease-associated markers for early diagnosis and drug monitoring is mandatory. Circulating tumor cells (CTCs) are released into the bloodstream from primary tumor/metastasis. CTC detection in blood samples may have enormous potential for assisting in the diagnosis of malignancy, estimating prognosis, and monitoring the disease. OBJECTIVE: The aim of the study was to investigate the presence of CTCs in blood samples of patients with ACC or benign adrenocortical adenoma (ACA). SETTING: We conducted the study at a university hospital. INTERVENTION: CTC analysis was performed in blood samples from 14 ACC patients and 10 ACA patients. CTCs were isolated on the basis of cell size by filtration through ScreenCell devices, followed by identification according to validated morphometric criteria and immunocytochemistry. MAIN OUTCOME MEASURE: We measured the difference in CTC detection between ACC and ACA. RESULTS: CTCs were detected in all ACC samples, but not in ACA samples. Immunocytochemistry confirmed the adrenocortical origin. When ACC patients were stratified according to the median value of tumor diameter and metastatic condition, a statistically significant difference was found in the number of CTCs detected after surgery. A significant correlation between the number of CTCs in postsurgical samples and clinical parameters was found for tumor diameter alone. CONCLUSIONS: Our findings provide the first evidence for adrenocortical tumors that CTCs may represent a useful marker to support differential diagnosis between ACC and ACA. The correlation with some clinical parameters suggests a possible relevance of CTC analysis for prognosis and noninvasive monitoring of disease progression and drug response.

[Arterial hypertension and RU-486: a complex case of secondary hypertension]. / Dall'ipertensione alla pillola RU-486: un complesso caso di ipertensione secondaria.

Secondary hypertension accounts for 10-15% of all cases of hypertension, and early diagnosis with identification of its etiology can be challenging. In this scenario, therapeutic management of affected patients may be difficult. Hypercortisolism is one of the possible causes of secondary hypertension, but its low prevalence and atypical clinical symptoms can lead to a delayed diagnosis. The complex clinical presentation and potential complications need a close collaboration among different clinicians in order to plan optimal or new treatment protocols.

Head and neck paragangliomas: genetic spectrum and clinical variability in 79 consecutive patients.

Head and neck paragangliomas (HNPGLs) are neural crest-derived tumors. In comparison with paragangliomas located in the abdomen and the chest, which are generally catecholamine secreting (sPGLs) and sympathetic in origin, HNPGLs are, in fact, parasympathetic in origin and are generally nonsecreting. Overall, 79 consecutive patients with HNPGL were examined for mutations in SDHA, SDHB, SDHC, SDHD, SDHAF2, VHL, MAX, and TMEM127 genes by PCR/sequencing. According to a detailed family history (FH) and clinical, laboratory (including metanephrines), and instrumental examinations, patients were divided into three groups: a) patients with a positive FH for HNPGL (index cases only), b) patients with a negative FH and multiple HNPGLs (synchronous or metachronous) or HNPGL associated with an sPGL, and c) patients with negative FH and single HNPGL. The ten patients in group a) proved to be SDHD mutation carriers. The 16 patients in group b) proved to be SDHD mutation carriers. Among the 53 patients in group c), ten presented with germ-line mutations (three SDHB, three SDHD, two VHL, and two SDHAF2). An sPGL was found at diagnosis or followed up in five patients (6.3%), all were SDHD mutation carriers. No SDHC, SDHA, MAX, and TMEM127 mutations were found. In SDHD mutation carriers, none of the patients affected by HNPGL associated with sPGL presented missense mutations. In conclusion, a positive FH or the presence of multiple HNPGLs is a strong predictor for germ-line mutations, which are also present in 18.8% of patients carefully classified as sporadic. The most frequently mutated gene so far is SDHD but others, including SDHB, SDHAF2, and VHL, may also be affected.