Efficacy and tolerability of bendamustine, bortezomib and dexamethasone in patients with relapsed-refractory multiple myeloma: a phase II study.

Bendamustine demonstrated synergistic efficacy with bortezomib against multiple myeloma (MM) cells in vitro and seems an effective treatment for relapsed-refractory MM (rrMM). This phase II study evaluated bendamustine plus bortezomib and dexamethasone (BVD) administered over six 28-day cycles and then every 56 days for six further cycles in patients with rrMM treated with 4 prior therapies and not refractory to bortezomib. The primary study end point was the overall response rate after four cycles. In total, 75 patients were enrolled, of median age 68 years. All patients had received targeted agents, 83% had 1-2 prior therapies and 33% were refractory to the last treatment. The response ratepartial response (PR) was 71.5% (16% complete response, 18.5% very good PR, 37% partial remission). At 12 months of follow-up, median time-to-progression (TTP) was 16.5 months and 1-year overall survival was 78%. According to Cox regression analysis, only prior therapy with bortezomib plus lenalidomide significantly reduced TTP (9 vs 17 months; hazard ratio=4.5; P=0.005). The main severe side effects were thrombocytopenia (30.5%), neutropenia (18.5%), infections (12%), neuropathy (8%) and gastrointestinal and cardiovascular events (both 6.5%). The BVD regimen is feasible, effective and well-tolerated in difficult-to-treat patients with rrMM.

[Working overseas and cardiovascular diseases: application of a screening method on Oil&Gas employees]. / Lavoro all'estero e malattie cardiovascolari: applicazione di un protocollo di screening su un gruppo di lavoratori del settore Oil&Gas.

Working overseas is a reality for decades in the Oil&Gas Industry and many noxae impact on the cardiovascular system. In fitness to work evaluation the physician should consider besides the conventional risk factors, the presence of cardiovascular diseases, and prevent their evolution. A cardiovascular screening and follow up after 2 years was carried out on 42 Oil&Gas employees, over 45 of age, during medical fitness to work. The main tests were ECG, exercise tolerance test (ETT) and echocardiocolordoppler, completed with other instrumental tests. Cardiovascular diseases causing unfitness to working overseas occurred in 7%, blood hypertension in 23%. The screening permitted to diagnose and correct acute cardiovascular diseases, that caused unfitness to work, and disease that can get worse related to occupational risk. Moreover it was fundamental for evaluation of fitness and timing of health surveillance.

[Technical survey of safety levels established in building sites in the Pescara area]. / Indagine tecnico conoscitiva sul livello di sicurezza raggiunto nei cantieri edili della provincia di Pescara.

In 2006, in the context of the initiative aimed at "Promotion of safety and health of workers in construction yards", the Operative Unit of Occupational Health, University G. d'Annunzio, in collaboration with the Construction School of the Province of Pescara and INAIL, started a survey of construction yards around Pescara aimed at collecting data regarding respect of the specific law concerning construction yards and the risk perception of workers. The survey of 100 construction yards provided useful information towards a concise picture of safety levels obtained. In addition 300 interviews were carried out with workers to find out about their knowledge of accident prevention, how important they considered the use of personal protection devices, how often they used them, reasons for not using them, the devices most used,....and any injuries that occurred. The studied showed that, although the situation as improved compared to the past, further steps need to be taken.

[Anxiety, job stress and job insecurity among teachers with indefinite or definite time contract]. / Ansia, stress lavorativo e "job insecurity" negli insegnanti a tempo indeterminato e determinato.

Object of this study was the occupational stress of 336 teachers (276 women and 60 men) with stable or temporary employment in schools of Pescara, town of Central Italy. The levels of anxiety were determined by STAI and STAI II, those of job strain", "job insecurity" and social support by the Karasek's questionnaire, and the perception of subjective symptoms by a 12 item test. There were no significant differences depending on the type of school. The women with temporary contract showed higher levels of "job insecurity", while the men with temporary job showed also higher values of STAI I and STAI II. The scores of anxiety of the women were positively correlated with "job strain", "job insecurity" and perception of subjective symptoms and negatively with social support, while the only correlations of STAI I and STAI II of men showing statistical significance of men was that with "job insecurity. Job strain was negatively correlated with the perception of symptoms both in women and men. These results evidence differences in the occupational stress of men and women; in particular, job insecurity may enhance anxiety in men.

[Occupational stress and job insecurity in men working in a university]. / Stress lavorativo e "job insecurity" in uomini che lavorano nell'università.

77 men working in a university were investigated. Trait and state anxiety were determined by STAI I and STAI II; job strain (job demand/decision latitude), social support and job insecurity were analysed by a 46 item Karasek's questionnaire and subjective symptoms by a 12 item test. The employees of a library (mean age 49 years), in contact with students, showed significantly higher values of job strain, STAI I, STAI II and subjective symptoms than a control group of employees with similar age. Young employees and sanitary staff with temporary employment showed higher level of job insecurity than control subjects with stable position. Blood cytotoxic activity (reported in another study) was significantly lower in the old employees with job strain or in the young employees with job insecurity (but not in the sanitary staff) than in the controls; this demonstrates that not only occupational stress but also job insecurity may play an important role in affecting the health status.