Giuseppe Fatati

Phase II trial with alternating two drug schedules, CAP/MEC', for advanced (stage III Mo/M1) non-small-cell lung cancer.

Sixty-eight evaluable patients with advanced squamous cell carcinoma (48), large cell carcinoma (2) and adenocarcinoma (18) of the lung were treated with a six-drug regimen delivering two monthly alternated combinations. The combinations were cisplatin, adriamycin and cyclophosphamide (CAP) and methotrexate, etoposide and CCNU (MEC). Following a minimum of two courses, the overall response rate was 22 % (confidence limits, 12% to 32%) (15/68, 2 complete responses and 13 partial responses); 47 % (32/68) had stable disease and 31 % (21/68) had progressive disease. The responses lasted a median of 3 months (range, 1-15 months). The actuarial median survival was 11 months in responsive patients, 10 months in stable disease patients, and 5 months in progressive patients. The overall median survival obtained was 9 months (range, 2-28+ months). Toxicity was minimal, and subjective tolerance of the treatment appeared good. However, this alternating program did not improve response rate or survival.

[Sustainable diet: history lessons].

Global dietary patterns changed dramatically in the past 50 years, presenting both a boom and a threat to the health and well-being of populations everywhere. We need sustainable diets, with low-input, local and seasonal agro-ecological food productions as well as short distance production-consumption nets for fair trade. The development of a global food system able to guarantee everyone a balanced food intake requires health professionals an awareness and a commitment to increasingly complex education. Dietary changes such as the adherence of to the Mediterranean Dietary Pattern can reduce the environmental footprint and thus the use of natural resources. Increased focus on improving the utilization of freshwater fishes and the correct use of the waters of rivers and lakes should also be encouraged. Cultural heritage, food quality and culinary skills are other key aspects determining sustainable dietary patterns and food security. The Mediterranean street food (Mediterraneità), for intrinsic characteristics, can represent valid model to address the main issues concerning the sustainable food system. The issues of sustainability offer a great opportunity to nutritional science and scientists to play a more central role in the political analysis of future food systems. We are confident that preserve the past helps us understand the present and build for the future, the Mediterranean lifestyle is much more than the Mediterranean diet and, finally, the rivers and the lakes may be our future.

[Artificial nutrition: technical, scientific and ethical considerations].

Artificial nutrition (AN) is a relatively new medical treatment which started in the 1960 with parenteral nutrition (PN) and over the last 20 years has come to include enteral nutrition (EN) in hospitals and homes. Enormous clinical progress and continual evolution in techniques aimed at rendering organ funtion substitution more complete and efficient have come to the point where AN can only be suitably performed (indications for therapy, treatment regimen and monitoring) in specialized institutions. However, there has been much discussion about whether artificial nutrition should be considered a medical intervention or an essential intervention of care: in 2004 the Terri Schiavo case became worldwide news and the suspension of AN was decided by the law courts. In Italy, on 5 September 2014, the Council of State gave its opinion on case of Eluana Englaro. In 2007 the Italian Association for Dietetics and Clinical Nutrition (ADI) and the Professional Board of Physicians of the Province of Terni, have shared a paper that takes into account the scientific, technical and ethical considerations of AN in the light of the relative codes. The intent of this position paper was to supply a framework of clinical practices, ethical principles, and professional guidelines that will impart information and can assist decision making regarding AN and hydration. The document is still relevant today.

[Diabetes, psychosocial distress and quality of care].

Diabetes is on the rise world wide; according to the latest report from the International Diabetes Federation, the number of people affected by the disease will increase by 55% from 382 in 2013 to almost 600 million in 2033. Individuals living with type 1 or type 2 diabetes are at increased risk for depression and anxiety. Diabetes impacts on physical, emotional, social and financial aspects of life across cultures and countries, yet gaps in care exist around psychosocial and self-management education and support. The DAWN2 study provides a first multinational, multidisciplinary systematic framework for the comparison of unmet needs of people with diabetes and those who care for them in four continents. it is necessary to develop a system of patient-centered care, in which the empowerment of the person is the main instrument, and at the same time target on which to focus. Transforming study results into actions at the national level will represent one of the main activities of the DAWN2 initiative. In Italy, to do so, it is not enough write new documents but new resources are required.

I comportamenti alimentari degli italiani: Osservatorio 2011

Obesity is one of the most serious public health challenges of the 21st century for the European region. The concept of personal responsibility affected social, legal, and political approaches to obesity. It evokes blame and weakness of the individual, and it is a leading basis for inadequate government efforts, given the importance of environmental conditions in explaining high rates of obesity. It is needed not only to gain a correct understanding of the progress of the epidemic but also to evaluate preventive initiatives that are progressively introduced. As part of the social, health and agri-food production in the country, knowledge of dietary habits and lifestyle of the population in real time is a valuable resource. The data from ADI-Nestlé Observatory confirmed that it is unfair to say that poor diet and sedentary behaviour are individually responsible for obesity-related health burden in Italy, but both factors need to be improved and addressed through structural political and social structural measures.: Obesity is one of the most serious public health challenges of the 21st century for the European region. The concept of personal responsibility affected social, legal, and political approaches to obesity. It evokes blame and weakness of the individual, and it is a leading basis for inadequate government efforts, given the importance of environmental conditions in explaining high rates of obesity. It is needed not only to gain a correct understanding of the progress of the epidemic but also to evaluate preventive initiatives that are progressively introduced. As part of the social, health and agri-food production in the country, knowledge of dietary habits and lifestyle of the population in real time is a valuable resource. The data from ADI-Nestle Observatory confirmed that it is unfair to say that poor diet and sedentary behaviour are individually responsible for obesity-related health burden in Italy, but both factors need to be improved and addressed through structural political and social structural measures.