Fabio Petrelli

Tobacco, alcohol and illegal substances: experiences and attitudes among Italian university students

OBJECTIVE The purpose of this research was to assess the prevalence of addictive drug use among students of University of Camerino (Italy) and to verify aspects related to substance use in this population. METHODS The survey was carried out in the form of anonymous questionnaires completed by 345 participants. Chi-square test was used for statistic evaluation. RESULTS Most students have experienced legal addictive substances: 28.0 % of participants smoke cigarettes regularly and 23.2 % of respondents have admitted regular alcohol consumption. In addition, 50.4 % of subjects have already tried an illegal drug; the most used substance was cannabis (46.7 %), followed by cocaine (13.3 %). CONCLUSION Our results confirmed the increased experimental use of cannabis among young people in Europe and showed a long-term use of drugs, particularly cocaine, among university students.

Gemcitabine-induced posterior reversible encephalopathy syndrome: A case report

Gemcitabine is a commonly used chemotherapeutic agent for a variety of tumors. Although this nucleoside analog antineoplastic agent is similar in structure to cytarabine, central nervous system toxicities have rarely been attributed to gemcitabine. The posterior reversible encephalopathy syndrome (PRES) is a condition characterized by reversible neurological and radiological findings that has been associated with use of chemotherapeutic and more recently novel targeted therapies. We describe one case of a 41-year-old woman with PRES under treatment for leiomyosarcoma because of the probable association with gemcitabine. Our case, to our knowledge, represents the seventh published report of this particular toxicity. Naranjo algorithm, efficacious method for assessing the causality of adverse drug reactions (ADRs) from a case report, suggests a direct casual relationship. PRES is probably a rare complication of gemcitabine, but the oncologist should take it into careful consideration, because PRES is reversible with treatment of current hypertension or removal of the causative agent. However, failure to quickly recognize the syndrome and discontinue the offending agent may result in profound and permanent central nervous system dysfunction or death.

Deaths on board ships assisted by the Centro Internazionale Radio Medico in the last 25 years

Data on occupational diseases of seafarers and of causes of death during their career are sparse. The causes of deaths on board ships assisted by Centro Internazionale Radio Medico (CIRM), the Italian Telemedical Maritime Assistance Service (TMAS) were reviewed by examining 29,146 files of patients treated from 1986 to 2010. In the 25 years, 383 deaths occurred (1.31%). Diseases of the circulation were the most frequent, followed by external causes such as accidents and violence, infectious and parasitic diseases, alcohol and drug addiction, respiratory system diseases. Cardiovascular and external causes were the principal causes of deaths among seafarers. This investigation is the first study on the causes of death on board ships obtained from data of a maritime telemedical centre, that has assisted seafarers when they were alive or immediately after their death. The fact that diseases of the circulatory system are the first cause of death of sailing seafarers deserves specific initiatives. They should include campaigns for adequate lifestyles and the availability on ships of medical devices useful for diagnostic purposes, resuscitation as well as for verification of death.

The impact of a pharmacist as a member of healthcare team on facilitating evidenced-based prescribing of innovative drugs in an Italian oncology department

Aims and background: At the Oncology Department of the Chieti and Ortona Hospitals, the pharmacist designated by the Abruzzo Region to oversee the obligatory monitoring of innovative oncological drugs listed in the database of the Italian Medicines Agency (AIFA) collaborates with oncologists to educate them about evidenced-based prescribing for off-label uses of drugs and to optimize the efficiency of spontaneous reporting of adverse drug reaction (ADR) local system. Methods: The contribution of the pharmacist as a member of the healthcare team was evaluated using the following indices: the percentage of off-label prescriptions of the innovative drugs monitored, the number of reported ADRs, and the percentage of pharmacist suggestions actually implemented by physicians. Results: In the course of 3 years (2008–2010), the pharmacist monitored a total of 843 patients treated with 716 appropriate uses and 127 off-label uses of drugs, oversaw a reduction in the latter from 28.3% in 2008 to 9.6% in 2010, and contributed to almost tripling the number of reported ADRs, from 10 in 2008 to 27 in 2010. In 2010, the pharmacist identified 60 potentially inappropriate prescribing cases, and proposed more appropriate prescriptions for each case: 68.3% (41) of the suggestions were implemented by the physicians and only 31.7% (19) were not. According to answers to a questionnaire administered at the end of the 2010 to evaluate the usefulness of this particular collaboration, physicians are interested in continuous and extensive collaboration. Conclusions: This article demonstrates that a pharmacist, active in the department as part of the heath-care team, can facilitate evidenced-based prescribing for off-label uses of drugs and improve spontaneous reporting of ADRs.

Effectiveness and response predictive factors of erlotinib in a non-small cell lung cancer unselected European population previously treated: A retrospective, observational, multicentric study

Aims and background: Erlotinib approval was supported by the positive results of a large multicentric phase III trial (BR.21 study) that included 10% Asiatic patients and the remaining were North-American Caucasian. It is well-known that the efficacy of tyrosine kinase inhibitors is strongly influenced by ethnicity and other genetic factors. It is, therefore, relevant to establish whether the same profile of efficacy is seen in an unselected population and whether the results of BR.21 can be generalized to other patient populations, such as that described here. Methods: In this retrospective, observational, multicentric study, we assessed effectiveness and potentially response predictive factors in 222 unselected Italian patients, with stage IIIB/IV non-small-cell lung cancer, with performance status from 0 to 3, who had received at least one line of chemotherapy, treated with the standard dose of erlotinib (150 mg once daily) until disease progression or unacceptable toxicity. Results: The disease control rate was 60.9% (135 patients). Median progression-free survival and overall survival times were 3.1 months and 7.97 months, respectively. The characteristics of non-smoker, female gender, performance status 0 or 1 were associated with a significantly better prognosis in terms of disease control rate and were also predictive of longer overall survival and progression-free survival. The 1-year survival rate was 38.79%. Even though Italian patients baseline characteristics were strongly different to those reported in pivotal BR.21 trial in terms of age, performance status, line treatment and ethnic group, our study confirms the favorable effectiveness profile in real clinical practice of erlotinib according to results from the pivotal study BR.21. Conclusions: Today, we know that epidermal growth factor receptor (EGFR) status assessment is mandatory before starting first-line therapy and that the presence of only certain clinical characteristics initially associated with sensitivity to EGFR-tyrosine kinase inhibitors, as reported in this study, is not sufficient in selecting patients candidates to such treatments.

A New Creative Paradigm: Chaos and Freedom

“In earlier times there was only one field of scholarship and this was philosophy. Nowadays, we are often told — mainly by practitioners of the humanities — that only in recent time has there been a split, a schism in scholarship between natural science and the humanities. This is however a fallacy stemming from a basic misunderstanding of the essence of natural science” (Lorenz Konrad, 1993).

Energy drink consumption: a survey in high school students and associated psychological effects

Introduction Energy drinks represent an emerging health problem among young people. Energy drinks generally refer to a class of beverages containing sugars and various combinations of bioactive ingredients such as caffeine, taurine etc. Also the mix of energy drinks with alcohol is fairly frequent among young people and could be associated with dangerous effects. Methods In 2016-2017, a cross-sectional study was conducted in 1581 students attending eight high school in the Marche Region. Data were collected via an anonymous self-administered questionnaire. Results The 27.7% of students use energy drinks and the majority, corresponding with the 93.0%, are aware of the main ingredients contained in energy drinks. The main activities for which young people use these drinks are: sport, leisure, pleasure, study. Young people who admit to using alcohol mixed with energy drinks more than 4 times a month are an alarming fact. Conclusions This research confirms that energy drinks are used more by young males and especially by those who practice sports. Furthermore, the use these beverages to increase the concentration in the study and to be more brilliant in free time, is confirmed.

Implications of modified food choices and food-related lifestyles following the economic crisis in the Marche Region of Italy

BACKGROUND The economic crisis in Italy has led to profound changes in resource management not only at the macro level but also for individual families, causing substantial changes in different habits of Italians. STUDY DESIGN The purpose of this research was to conduct a study on changes in family eating habits potentially triggered by the economic crisis was conducted in an area of the Marche Region in central Italy. METHODS The research was conducted in the period 2016 - 2017 by administering a specific and anonymous questionnaire. RESULTS The interviewed people has reduced its food consumption. In particular, analyzing the results for the animal protein food group, there has been a reduction in purchase of beef, and an increase in that of pork. Overall fish consumption has decreased by 44%, with a decrease in the purchase of fresh fish, and an increase in that of canned fish products. Finally, consumers have reduced their purchases of fresh and canned legumes, fresh vegetables, and fresh fruit. CONCLUSION The economic crisis seems to have changed the eating habits and food-related lifestyle choices of the subjects studied, especially in the urban area affected by the deeper economic depression. These changes are likely to have permanent social consequences, and deserve to be analyzed also in smaller territories in order to better understand the dynamics of individual choices and the social framework.

Knowledge and Attitudes on Food Hygiene among Food Services Staff on Board Ships

BACKGROUND Ships have long been sites for outbreaks of infectious diseases, particularly gastrointestinal diseases. The ship environment has the potential to facilitate the spread of such diseases, infecting susceptible cohorts of embarked passengers and crew. Gastrointestinal disorders among seafarers are fairly common and usually represent the first or second cause of requests for medical assistance aboard ships in international waters. STUDY DESIGN The purpose of this study was to evaluate food safety and the level of knowledge among food service personnel on board merchant ships, where food handlers could be a cause of health problems for all crew members. METHODS An anonymous self-administered questionnaire containing specific questions about food hygiene and safety knowledge was administered. RESULTS The overall score of correct answers for the food safety aspects tested was 51.77 (SD 3.87) out of 76 points, corresponding to 68.12% of questions answered correctly. Food workers who followed a training course showed higher mean knowledge score (p < 0.05) compared to not-trained workers. The most relevant significant differences (p < 0.05) were noticeable in the personal hygiene, cross-contamination, safe storage, and knowledge of foodborne pathogens sections. CONCLUSION Food services staff on board cargo ships should be adequately trained and should understand basic and fundamental aspects of food hygiene, related pathologies and sanitation, as they are responsible for the health and wellbeing of many seafarers.

The economic crisis and lifestyle changes: a survey on frequency of use of medications and of preventive and specialistic medical care, in the Marche Region (Italy)

Background and aim: In the words of one observer, one of the many effects of the economic downturn has been a “health system shock” marked by reductions in the availability of healthcare resources and increases in the demand for health services. The financial situation influences negatively the low-income family groups, particularly those who normally use the government provided primary prevention services. The goal of this study was to assess the impact of the global recession on the use of medicines and medical investigation recession in different areas of the Marche Region. Methods: An anonymous questionnaire prepared by the National Institute of Statistics, modified and validated by the University of Camerino, has been distributed to junior highschool students of Central Italy to provide a statistically representative sample of families. The questionnaire has been administered in 2016-2017. Results: This article examines the results about healthcare habits, specifically, regarding medicines and medical examinations. Data obtained emphasize a reduction in the use of nonsteroidal anti-inflammatory drugs (NSAIDs). The parents category showed the higher change in medicines use (72.9%). Comparing the data of the Fabriano area with that of the Civitanova Marche area, Fabriano reported a greater reduction in the frequency of taking medicine. Concerning the medical examinations, half of the respondents (62.5%), indicated that they and their family members have regular medical check-up. Conclusions: Respondents who admitted that the economic crisis had reduced their quality of life indicated that the parents were the ones who had experienced the greatest change. This is confirmed by the information on the reduced frequency of medicine use, which affected the parents more than the children, whom they sought to protect and safeguard the most. This reduction was most marked in the Fabriano area. In contrast, in the Civitanova Marche area, with different socioeconomic characteristics, an increase in the use of all the categories of medicines was reported. Concerning visits the situation in the Marche Region appears encouraging. (www.actabiomedica.it)