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Introduction The epidemiology of lung cancer is changing worldwide, with smoking being the key driver of lung cancer incidence and mortality. Our aim is to analyze the incidence, survival and mortality trends in Italy in the framework of the 2017 survey on smoking behavior in Italy.Methods AIRTUM 2017 reports on cancer survival and incidence; 2017 survey on smoking behavior in Italy.Results Men achieved progress in lung cancer control characterized by a decrease in incidence and mortality and an increase in survival. The decreasing use of tobacco in men (from 60% in the 1960s to 24% in 2017) was most likely responsible for the decreasing incidence and mortality. Women showed no progress: although survival improved slightly, the incidence and mortality were both on the rise. This was most likely due to the increasing smoking rates in women in the 1970s and 80s. Of major concern is the accelerated rise in the number of smoking women from 4.6 million in 2016 to 5.7 million in 2017 compared to the decrease observed in men (from 6.9 to 6 million).Conclusions The incidence and mortality trends in males clearly demonstrate that primary prevention is the most effective way to reduce lung cancer mortality. By contrast, a 24% increase in the prevalence of smoking among women in just 1 year is extremely worrying for the future, and calls for immediate action by targeted strategies to reduce tobacco consumption in women and avert the dreadful prospect of a lung cancer epidemic in Italy.

Avec la fréquentation croissante des structures d’urgence, le triage des patients est devenu indispensable, rendant primordial le rôle des infirmiers d’organisation de l’accueil (IOA). Leur fonction est définie par un référentiel édité par la Société française de médecine d’urgence qui préconise l’utilisation d’une classification pour cette pratique. L’objectif était d’étudier la concordance du triage effectué par les IOA avec celui de la Classification Infirmière des Malades aux Urgences (CIMU) qu’ils sont censés réaliser. Nous avons réalisé une étude rétrospective observationnelle sur sept jours intéressant tous les dossiers des patients s’étant présentés aux urgences de l’hôpital universitaire Lariboisière. L’investigateur de l’étude, en se basant sur les informations recueillies dans les dossiers, a réalisé une classification des patients suivant la CIMU. Ce classement a été comparé à celui des IOA avec un test Kappa de Cohen de concordance. La significativité a été définie pour un p<0,05. La comparaison du triage retrouve une concordance dans 1113 cas sur 1463, soit une concordance avec un kappa = 0,639; un IC 95 % (0,6; 0,67). L’erreur principale est une inversion des triages 3 et 4. Le résultat de cette étude correspond à un degré de concordance substantiel. Le triage avec la CIMU apparaît facilement applicable et reproductible par les IOA. With the increasing attendance emergency department, patients’ triage has become essential, making the role of triage nurse (TN) crucial. Their function is defined by a published guideline of the French Society of Emergency Medicine. The aim of our study was to analyze the consistency of triage by TN with the one proposed by the classification (Classification Infirmière des Malades aux Urgences[CIMU]) they are supposed to achieve. We conducted a seven days retrospective observational study. All patient coming to the emergency departments of Lariboisière hospital during this period were included in the study. The study investigator, based on information gathered in the records, performed a triage following exactly the CIMU. This triage was compared to the one by the TN with a Pearson correlation test, a Cohen Kappa concordance test. Comparison of the triage found a match in 1,113 of 1,463 cases; with a kappa concordance of 0.639 and an IC 95% (0.60568; 0.67232; p<0.0001). The result of this study corresponds to a substantial concordance. Sorting with CIMU appears easily applicable and reproducible.

En France, l’arrêt cardiorespiratoire extrahospitalier touche environ 50 000 patients par an. Cet article rappelle les éléments clés pour la réalisation du massage cardiaque externe. Les dernières recommandations sur la prise en charge des AC ont été publiées en 2010 par l’European Resuscitation Council. Les recommandations actuelles préconisent de réaliser entre 100 et 120 compressions thoraciques par minute ; avec les mains au « centre de la poitrine », une profondeur de compressions entre 5 à 6 cm (pour un adulte), une décompression complète du thorax et un rapport compression sur décompression à 1/1. Les interruptions de compressions thoraciques doivent être minimisées. L’utilisation du plan dur est nécessaire lors d’un massage sur une surface molle. Le contrôle de l’efficacité du massage peut être fait à l’aide de l’ETCO2. L’utilisation de dispositif de dispositifs guides et de rétroaction peut être proposée pour améliorer la qualité du massage. Cependant, les limites de tels dispositifs en particulier sur les surfaces molles doivent être connues. La formation au massage cardiaque externe doit être généralisée et proposée au public. Le massage cardiaque externe reste une technique fondamentale pour espérer la survie des patients souffrant d’un arrêt cardiaque. Sa maîtrise est une obligation pour les professionnels de santé en particulier ceux de l’urgence. In France, out of hospital cardiac arrest affects about 50,000 patients a year. This article summarizes the key elements about external chest compressions. The latest recommendations on the management of cardiac arrest were published in 2010 by the European Resuscitation Council. Current guidelines recommend to realize external chest compression between 100 and 120 compressions per minute; with hands placed at the center of the chest, depth should be between 5 to 6 cm (for an adult), a complete decompression of the chest should be realized with compression/ventilation ratio of 1. Interruptions in chest compressions should be minimized. The use of backpack is necessary when external chest compressions are realized on soft surfaces. Elements of physiology and research justifying each of those elements are detailed in the article. Monitoring the effectiveness of chest compression can be done using ETCO2. The feedback devices can be used to improve the quality of the resuscitation. However, the limitations of such devices, in particular on soft surfaces, must be known. External chest compression training should be generalized and proposed to the public. External chest compression remains a fundamental technique for survival of patients with cardiac arrest. Health professionals have to master it, especially emergency doctors.

The mechanisms associated with the onset of luteolysis in the pregnant rat are not well known. The effect of a specific rat LH antiserum (AS-rLH) and of ovine LH (oLH) on luteal steroidogenesis on day 19 of pregnancy was examined. Rat LH antiserum administered intrabursally at 1000–1100 h on day 19 of pregnancy prevented the physiological decrease in 3β-hydroxysteroid dehydrogenase (3β-HSD) activity, the increase in 20α-hydroxysteroid dehydrogenase (20α-HSD) activity and the fall in serum progesterone (P4) level observed at 1800 h on day 21 of pregnancy. To see if oLH has a direct effect on luteal steroidogenesis, the gonadotrophin was injected into the periovarian bursa. The intrabursa treatment with 1 μg oLH on day 19 of pregnancy at 0800–0900 h did not modify corpus luteal function 36 h after treatment, but treatment with 4 μg oLH per ovary induced a significant progressive decrease in luteal 3β-HSD activity starting 12 h after treatment, while a significant increase in 20α-HSD activity, concomitant with a decrease in serum P4 level, occurred 48 h after treatment. Luteal P4content decreased with respect to control groups 36 and 48 h after intrabursal treatment with 4 μg oLH. The intrabursal administration of 8 μg oLH induced an increase in 20α-HSD activity and a decrease in 3β-HSD activity 36 h after treatment. Administration of 4 μg oLH per ovary on day 8 of pregnancy induced a significant increase in serum P4levels without modifying 3β-HSD activity. In rats treated with oLH on day 19 of pregnancy the decrease in 3β-HSD activity occurred 36 h before the significant increase in 20α-HSD activity and serum P4level. In conclusion, the luteal enzymatic activity changes and the significant decrease in the intraluteal P4concentration induced by the intrabursal administration of oLH and the clear effect of AS-rLH preventing the physiological luteal changes preceding parturition provide good evidence of an intraovarian action of LH during the normal progression of luteolysis in late pregnant rats.Journal of Endocrinology(1996) 150,423–429

A cancer registration network based on computerised coded diagnoses has been tested in the Veneto region, north-east Italy, with the goal of estimating cancer incidence during 1987-89. The results of the pilot study based on a population of 1,449,513 (33.1% of the total population of the region) indicate that the computer-assisted system successfully ascertained 61.3% of the cases. The quality indices appear to be close to those from other cancer registries in Europe. The increasing availability of computerised coded information from hospitals, pathology departments and death certificates can provide an important contribution to cancer registration, thus reducing the amount of manual work and consequently allowing cancer registration on larger populations at reduced costs.