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Medical records are a relevant source for real-world evidence. We introduced patient-reported outcomes (PROs) in clinical practice, demonstrating a significant quality-of-life improvement, compared to usual visit. In this secondary analysis, we describe the agreement between patients' and physicians' reports of 5 symptoms. Our hypothesis was that adoption of PROs questionnaire could significantly improve the agreement.Eligible patients were receiving active anti-cancer treatment. Patients in the control group underwent usual visits (group A), while patients of group B, before each visit, filled a PROs paper questionnaire, to provide information about symptoms and toxicities. No specific instructions were provided to physicians to integrate such information in medical records. Agreement between patient and physician evaluations was assessed by Cohen's κ, calculating under-reporting as proportion of toxicities reported by patients but not recorded by physicians.211 patients (412 visits) have been analyzed. For all symptoms, Cohen's κ was better for group B: emesis (0.25 group A vs. 0.36 group B), diarrhea (0.16 vs. 0.57), constipation (0.07 vs. 0.28), pain (0.22 vs. 0.42), fatigue (0.03 vs. 0.08). For all symptoms, although under-reporting was relevant in both groups, it was lower for group B: emesis (75.49% vs. 60.0%, p=0.031), diarrhea (82.89% vs. 50.0%, p0.001), constipation (92.11% vs. 69.57%, p0.001), pain (59.57% vs. 42.31%, p=0.01), fatigue (82.11% vs. 64.10%, p0.001).Adoption of paper PROs allowed a significant reduction in under-reporting of symptoms, but agreement remained suboptimal. Direct integration of electronic PROs could minimize the issue of under-reporting of medical records, increasing their accuracy.

The effect on potential transepithelial electrics resistance (TEER) and the electronic scansion microscopy analysis (SEM) of CaCo-2 cells line monolayer could be one useful method to study the different antioxidant or pro-oxidant capacity values of different concentrations of the hydrolizated polyphenol extracts of bread made with wheat Sant’Agata cultivar (HBPE).The various concentrations of HBPE have been tested on culture in monolayer CaCo-2 cells seeded on polycarbonate filter, in the cell culture chamber (Ø 6.5 μm; area 0.33cm2; pore Ø 0.4 μm), at a density of 1.5x105 cells per filter and placed in a multiwells Falcon; the filter divided the chamber in apical and basal compartments that represent the lumen and the basal area of the gut tract. With HBPE concentrations of 5,10,25,50,100 μg/ml it was observed that both methods (TEER and SEM analysis) showed an antioxidant activity in the monolayer cells incubated with 5 and 10 μg/ml of HBPE, instead the 25,50,100 μg/ml concentrations of HBPE showed a TEER value decrease. This means an evident change of the permeability owed at cells damage. This is confirmed by SEM analysis, which reported a remarkable cell damages due to pro-oxidant activity of HBPE. Conclusion: from our results it is possible to observe the influence of bread polyphenol extract concentrations. In fact, the low concentrations 5 and 10 μg/ml showed an antioxidant behaviour. Increasing the concentrations 25,50,100 μg/ml the HBPE showed a pro-oxidant behaviour.

Background: The world, and Italy on the front lines, has experienced a major medical emergency due to the novel coronavirus outbreak. Cancer patients are one of the potentially most vulnerable cohorts of people, but data about their management are still few. Patients and Methods: In this monocentric retrospective study we included all SARS-CoV-2 oncological patients accepted, between March 27th and April 19th 2020, at the Onco-COVID Unit at San Luigi Gonzaga Hospital, one of the few Italian oncological-COVID wards. Data were obtained from medical records. Results: Eighteen cancer patients with COVID-19 were included. The mean (±SD) age of patients was 67 ± 14 years, 89% were men. Seven (39%) developed infection in communities and 11 (61%) during hospitalization. Lung cancer was the most frequent type of cancer (10, 56%). Seven patients (39%) were symptomatic for COVID-19 at the time of diagnosis and symptoms began 2 (±2) days before. The most common were shortness of breath and diarrhea. Fever was present in 5 patients (28%). Among the 11 asymptomatic patients, 8 (73%) became symptomatic during the hospitalization (mean time of symptoms onset 4 days ±4). Six patients (33%) were on active anti-tumor treatment: 2 (33%) received anti-tumor therapy within 2 weeks before the infection diagnosis and 2 (33%) continued oncological treatment after SARS-CoV-2 positivity. Eight (44%) patients died within a mean of 12 days (±8) from the infection diagnosis. Conclusions: Our series confirms the high mortality among cancer patients with COVID-19. The presence of asymptomatic cases evidences that typical symptoms and fever are not the only parameters to suspect the infection. The Onco-Covid unit suggests the importance of a tailored and holistic approach, even in this difficult situation.