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Objective: Five-year net survival and conditional survival from vulvar squamous cell carcinoma (VSCC) patients in Italy have shown no progress during the past three decades. This study aims to estimate the complete prevalence and multiple indicators of cure., Methods: Observed prevalence was estimated using 31 Italian cancer registries covering 47 % of Italian women. A subset of 22 cancer registries was used to estimate model-based long-term survival and indicators of cure, i.e., complete prevalence, cure fraction (CF), time to cure (TTC), proportion of 'already cured' patients, and cure prevalence., Results: In 2018, VSCC patients alive in Italy (complete prevalence) were 6620 or 22 per 100,000 women. The cure fraction (the proportion of newly diagnosed patients who will not die of VSCC) did not change between 2000 and 2010 both for all patients (32 %) and in each age group. The time to cure (5-year conditional net survival >95 %) was 11 years for patients aged ≥44 years, but excess mortality remained for >15 years in the other age groups. This led to a negligible (5 %) proportion of 'already cured' patients (living longer than time to cure). The proportion of patients alive <2 years (21 %) was the same as that of patients surviving ≥15 years. The cure prevalence (patients who will not die of VSCC) was 64 %. A considerable proportion of patients will not be cured even among those who survived ≥5 years., Conclusion: There is an urgent need to reshape the current vulvar care model in Italy., Competing Interests: Declaration of competing interest Emanuele Crocetti declares an epidemiological advice for Astrazeneca, not related to this study. The author Gemma Gatta is a Guest Editor for the European Journal of Surgical Oncology and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)

Objectives: to identify any differences between Italian and foreign women in the access to prenatal care, including the number and appropriate scheduling of visits, the execution of diagnostic, blood, and microbiological tests and the use of specific healthcare services., Design: retrospective cohort epidemiological study, based on the monitoring of current information flows., Setting and Participants: data extrapolated from the Birth Attendance Certificate information flow of the Autonomous Province of Trento (Northern Italy) between 2012 and 2016. A total of 23,165 women with data regarding citizenship were included in the analysis., Main Outcomes Measures: outcome variables used to assess appropriateness of antenatal care were medically assisted procreation techniques, use of invasive prenatal diagnosis, gestational age at the first appointment, total number of appointments and ultrasounds during pregnancy, blood and microbiological tests taken, and participation in antenatal classes., Results: data indicates a significant difference in the use of chorionic villus sampling, testing for Cytomegalovirus, and vaginal-rectal swab for the detection of group B streptococcus, which are lower in the foreign population. Furthermore, there is a statistically significant difference in the gestational age at which the first appointment is attended, in the total number of visits, and in the number of ultrasounds performed during pregnancy as well as in participation in antenatal classes., Conclusions: this study reveals significant differences in access and use of pregnancy assistance between foreign and Italian women. There are also differences in terms of social determinants of health, with a concentration of unemployment and low education in the foreign population. It is therefore necessary to identify the factors that can potentially create health inequalities, considering the socioeconomic determinants and the specific needs of migrant women.

Background: The number and projections of cancer survivors are necessary to meet the healthcare needs of patients, while data on cure prevalence, that is, the percentage of patients who will not die of cancer by time since diagnosis, are lacking., Materials and Methods: Data from Italian cancer registries (duration of registration ranged from 9 to 40 years, with a median of 22 years) covering 47% of the population were used to calculate the limited-duration prevalence, the complete prevalence in 2018, projections to 2030, and cure prevalence, by cancer type, sex, age, and time since diagnosis., Results: A total of 3 347 809 people were alive in Italy in 2018 after a cancer diagnosis, corresponding to 5.6% of the resident population. They will increase by 1.5% per year to 4 012 376 in 2030, corresponding to 6.9% of the resident population, 7.6% of women and ∼22% after age 75 years. In 2030, more than one-half of all prevalent cases (2 million) will have been diagnosed by ≥10 years. Those with breast (1.05 million), prostate (0.56 million), or colorectal cancers (0.47 million) will be 52% of all prevalent patients. Cure prevalence was 86% for all patients alive in 2018 (87% for patients with breast cancer and 99% for patients with thyroid or testicular cancer), increasing with time since diagnosis to 93% for patients alive after 5 years and 96% after 10 years. Among patients who survived at least 5 years, the excess risk of death (1 - cure prevalence) was <5% for patients with most cancer types except for those with cancers of the breast (8.3%), lung (11.1%), kidney (13.2%), and bladder (15.5%)., Conclusions: Study findings encourage the implementation of evidence-based policies aimed at improving long-term clinical follow-up and rehabilitation of people living after cancer diagnosis throughout the course of the disease. Updated estimates of complete prevalence are important to enhance data-driven cancer control planning., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Objectives: to investigate vaccine uptake among pregnant women during the 2nd and 3rd trimester of pregnancy. To describe the factors influencing vaccine uptake during pregnancy, comparing sociodemographic and clinical characteristics of pregnant women who were vaccinated during the 2nd or 3rd trimester with those who were not vaccinated, despite having the indication for vaccination., Design: observational study with a cross-sectional approach and prevalence estimation in the population of women who gave birth in the study period, through record linkages between the ministry information flow Birth assistance certificate, the Regional vaccination register and the Italian flow for SARS-CoV-2 infections., Setting and Participants: the study included all the 4,772 pregnant women living in Trentino (north-east Italy), who were in the 2nd or 3rd trimester of pregnancy between the 5th May 2021 and the 28th February 2022 and who delivered in Trentino., Main Outcome Measures: vaccine uptake among pregnant women during the 2nd and 3rd trimester of pregnancy. Results: 33.3% of pregnant women got vaccinated with at least one dose of vaccine during the 2nd or 3rd trimester of pregnancy. Independent factors associated with vaccine uptake in the 2nd or 3rd trimester were the mother's citizenship, educational level, occupational status and age., Conclusions: the proportion of women who received at least one dose of COVID-19 vaccine during pregnancy was low. The results are important to start efficient actions to promote vaccination in pregnant women, particularly in the most vulnerable ones (unemployed, foreigners and with a low educational level), who appear to be less vaccinated frequently.

Background: Hepatitis C virus (HCV) infection has a worldwide incidence of 1.1%. In Italy, 60% of people who inject drugs (PWIDs) and are receiving assistance for substance use disorder are infected with HCV. However, this subset of patients has extremely limited access to care due to multiple factors, including alcohol abuse, psychological comorbidities, and homeless status., Aim: To describe the impact of our HCV-dedicated service for substance use disorder (SSUD) service on PWIDs receiving anti-HCV therapy., Methods: A dedicated, multidisciplinary team was set up at the SSUD of Trento in October 2020 to provide antiviral treatment to HCV RiboNucleic Acid-positive patients with an active or previous history of substance abuse. The treatment was followed by a health education program. Patients were treated with Direct-Acting Antivirals (DAAs). Data were retrospectively analyzed to assess the efficacy of our dedicated program in terms of therapy completion, HCV eradication, and compliance (primary endpoint). The rate of HCV reinfection and DAA-related toxicity were also assessed (secondary endpoints)., Results: A total of 40 patients were enrolled in the study: 28 (70.0%) were treated with Sofosbuvir/Velpatasvir, while 12 (30.0%) received Glecaprevir/Pibrentasvir. At the time of inclusion in the study, 36 patients were receiving opioid agonist maintenance therapy, whilst another 4 had just finished the treatment. 37.5% had a history of alcoholism and 42.5% received concomitant psychiatric treatment. All 40 patients (100.0%) completed the therapy cycle and 92.5% of patients adhered to the program. All patients tested negative for viral load at the end of the treatment. There were no significant drug interactions with common psychiatric treatments and no side effects were observed. The sustained virological response was achieved in 92.5% of cases with good tolerability, although two patients discontinued treatment temporarily. After HCV eradication, one patient died from an overdose, another from complications of cirrhosis, and one reinfection occurred., Conclusion: Very high adherence to therapy and good tolerability was observed in our series of HCV patients treated at the SSUD, regardless of the substance abuse condition. Further validation in a larger population is required., Competing Interests: Conflict-of-interest statement: All authors declare that they have no conflict of interest., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: The impact of a faecal immunochemical test-based colorectal cancer (CRC) screening program in terms of patient prognosis could be affected by lead-time bias, which artificially increases the survival of screen-detected patients due to the early diagnosis., Aims: To provide a description of the impact of the CRC screening program in the Trentino Region (Italy), including the Cure Fraction (CF), a prognostic indicator not affected by lead-time bias., Methods: The program started in 2008, inviting the resident population aged 50-69 years. In this retrospective cohort study, 1,697 CRC diagnosed between 2003 and 2014 in patients aged 50-69 years were classified as pre-screening (PS), screen-detected (SD), interval cancers (IC) and not-screen-detected (NSD). We compared groups by stage at diagnosis and CF. Trends in CRC mortality were reported., Results: The proportion of stage I among SD cases was 51%, higher than PS (19%; OR 4.66, 95%CI 3.50-6.20), NSD (20.6%; OR 3.96, 95%CI 2.95-5.32) and IC (33.3%; OR 2.11, 95%CI 1.10-4.04). The CF of PS, NSD and SD cases was respectively 57% (95%CI 54-60%), 60% (95%CI 58-63%) and 93% (95%CI 89-96%). CRC mortality dropped from 40.7 to 25.6\100,000., Conclusion: The program significantly improved the prognosis of patients, decreasing CRC mortality and incidence of advanced CRCs., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Background: To assess the diagnostic accuracy of dual-energy computed tomography (DECT) in diagnosing bone marrow edema (BME) of the knee in traumatic and non-traumatic patients., Methods: This prospective IRB approved study included 33 consecutive patients (20 males, 13 females; mean age of 52.2 years) evaluated with DECT (80 and 150 kV) and MRI within 6 days. Two experienced radiologists qualitatively and quantitatively evaluated DECT images. The accuracy values were calculated by using receiver operator curves (ROC) and area under the curve (AUC), using MRI as the reference standard. Inter-observer and intra-observer agreement were calculated with k-statistics. A p < 0.05 was considered statistically significant., Results: MRI depicted BME in 25/33 patients (75.7%). The sensitivity, specificity, PPV, NPV, and accuracy of per-partition qualitative analysis were 92.9, 92.9, 78.2, 97.9, and 92.9%, for reader 1, and 88.2, 93.9, 79.8, 96.6, and 92.6%, for reader 2, respectively. The inter-observer agreement was substantial (k = 0.793) and the intra-observer agreement was near-perfect (k = 0.844). At the quantitative analysis, a significant difference (p < 0.001) was depicted between the density values of positive (mean 3.6 ± 25.3 HU) and negative cases (mean - 72.2 ± 45.1 HU). By using - 15 HU cutoff to identify BME, sensitivity, specificity, PPV, NPV, and accuracy of DECT were 84.7, 93.6, 78.2, 95.7, and 91.6%, respectively., Conclusion: DECT can accurately identify BME of the knee.

Objectives: to describe the organisation and the role of the Department of Prevention of the Local Health Unit (APSS) of Trento (Trentino-Alto Adige Region, Northern Italy) against the spread of COVID-19 in the population, in the management of possible cases (with only clinical criteria of influenza-like illness, ILI, without diagnostic swab) reported by General practitioners (GPs) and by Family paediatricians (FPs) during the initial phase of the pandemic COVID-19 in Trentino-Alto Adige Region., Design: descriptive study., Setting and Participants: this study analysed the reports of patients with ILI sent to the Healthcare company from 17 March to 17 April 2020 by their GPs or FP and subsequently classified into: redundant reports (people already known to the healthcare company as confirmed or probable case COVID-19); reports inconsistent with ILI criteria (patients not known to APSS as probable/confirmed case; without ILI criteria); appropriate reports (patients not known to APSS as probable/confirmed case; with ILI criteria)., Main Outcome Measures: proportion of GPs and FPs who participated to report system reporting at least one patient, out of the total number of GPs and FPs; frequency of patients reported as ILI; time (in days) to manage reported patients. The cumulative weekly rate of "non-redundant" (not already known to APSS as probable/confirmed case) reports per thousand inhabitants was also calculated., Results: over 80% of GPs and FPs voluntary participated into the reporting system of patients with COVID-19 clinical criteria. Overall, 4,270 patients were reported; of these, 2,865 (67%) were not known to APSS as probable/confirmed case. Response time in days decrease progressively during the period of activity (from a mean of 6 days to 0.4 days during the 12th and 16th week of 2020, respectively). The cumulative weekly rate of client reports which were not already known as probable or confirmed cases (per 1,000 population) ranges from 3.54 to 6.84 cases in the 12th and 16th week, respectively. Among the 4,270 reports, 1,471 patients considered possible COVID-19 cases were identified due to the presence of ILI symptoms, even in the absence of a swab or a positive history for close contact with COVID-19 case. From the epidemiological investigation into the 1,471 possible cases, 2,514 close contacts were identified and quarantined at home. Of the 2,514 close contacts, 127 (5.05%) people developed symptoms during quarantine., Conclusions: the integration among primary care, GPs and FPS, and the Department of Prevention could be an element of success in the management of the COVID-19 emergency and in the return to a normal phase. However, further assessments are required on the effectiveness and impact of the adopted model, especially in relation to the exit from phase 1 and phase 2 of the pandemic emergency.

Objective: To compare the diagnostic accuracy of dual-energy computed tomography arthrography (DE-CTA) and magnetic resonance arthrography (MRA) of the shoulder in depicting glenoid labral tears., Methods: This prospective institutional review board-approved study included 47 consecutive patients (28 males, 19 females; mean age of 34.2 years) studied between January 2017 and October 2018. All patients underwent DE-CTA and MRA the same day. Two radiologists (25 and 11 years of experience, respectively), blinded to clinical data, evaluated the presence labral tears on virtual-blended 120 kV standard CTA and on DE-CTA images. A third radiologist (18 years of experience) evaluated the MRA images. Diagnostic accuracy values were calculated by using surgery as standard of reference. Inter-observer and intra-observer agreements were calculated with k statistics. A value of p < 0.05 was considered statistically significant., Results: Surgery revealed the presence of labral tears in 38/47 patients (80.9%). Sensitivity and specificity values in diagnosing labral tears were 84.2% and 77.8% for MRA (Reader 3), 84.2% and 77.8% for CTA (Reader 1), 84.2% and 88.9% for CTA (Reader 2), 89.5% and 88.9% for DE-CTA (Reader 1), and 92.1% and 88.9% for DE-CTA (Reader 2). A nonsignificant increase in AUC values with respect to MRA was obtained by reading the CTA (p = 0.470) and DE-CTA dataset (p = 0.217), respectively. Inter-observer agreements were near perfect for CTA (k = 0.84) and substantial for DE-CTA reading (k = 0.76). Intra-observer agreements were near perfect both for CTA (k = 0.88) and for DE-CTA reading (k = 0.82)., Conclusion: DE-CTA and MRA were not different in terms of diagnostic performance.

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events., (© 2019 The Authors. Ecology © 2019 The Ecological Society of America.)

Background: To compare the surgical outcomes of radical prostatectomy (RP) performed via 3 different approaches: retropubic (RRP), laparoscopic-assisted (LRP), and robot-assisted (RARP), in a single non-academic regional center by a single surgeon., Materials and Methods: The data of patients undergoing RP from 2005 to 2014 were reviewed. The standard approach changed through the years: RRP (n = 380, years 2005 to 2008), LRP (n = 240, years 2009 to 2011), and RARP (n = 262, years 2012 to 2014). Our analysis included the last consecutive 100 RP for each surgical technique by a single surgeon. A logistic regression model adjusted for pre-and postoperative variables was done to evaluate whether transfusion, conversion, and post-operative complication rates were influenced by the approach., Results: RARP was associated with significantly lower blood loss (400 vs. 600 and 600 ml, respectively), transfusion (6 vs. 21 and 21%, respectively), and shorter hospital stay (6 vs. 7 and 8 days, respectively), compared to LRP and RRP, and a lower conversion rate (1 vs. 12%) compared to LRP. Multivariate analysis adjusted for confounders confirmed that the risk of transfusion and conversion was significantly lower in the RARP group compared to the LRP and RRP groups. The RARP group was also associated with a significantly lower risk of complications compared to the RRP group and with a trend in favor of the RARP group compared to the LRP group. The 1-year continence rate was significantly higher in the RARP group compared to the RRP and LRP groups (80 vs. 72 and 68%, respectively)., Conclusion: The surgical approach affected the operative outcomes in a regional setting. The advantages of RARP over RRP (complications, transfusion, conversion, hospital stay, 1-year continence) were over LRP as well, with the only exception being complications.

The objective of this is to compare the surgical outcomes of partial nephrectomy (PN), performed via three different approaches: robot-assisted (RAPN), laparoscopic (LPN), and open (OPN), in a single non-academic regional center. The data of patients undergoing PN at our Department from 2005 to 2016 were prospectively collected. A logistic regression model adjusted for preoperative variables (age, tumor size, creatinine and hemoglobin, ASA and Padua scores) was performed to evaluate whether transfusion, conversion, and postoperative complication rate were influenced by the surgical approach. Overall 270 patients underwent PN: analysis included 253 cases (RAPN = 110, LPN = 70, OPN = 73). Preoperative variables did not differ significantly among the three groups. Shorter operative (130 vs 180 and 200') and ischaemia (12 vs 23 and 22') times and longer hospital stay (8 vs 7 and 6 days) were found in the OPN group as compared to LPN and RAPN, respectively. The RAPN group included a higher rate of pT1b (31.8 vs 14.2 and 15%) and malignant histotype (90 vs 82.9 and 68.5%) as compared to LPN and OPN, respectively. Clavien Grade III-IV complications were lower in the RAPN (7.2%) as compared to OPN (12.3%) and LPN (17.1%) groups. Multivariate analysis showed a lower risk for conversion, transfusion and overall complications in the RAPN group versus LPN and OPN. The surgical approach affects the perioperative outcomes in a regional setting. The advantages of RAPN over OPN (lower risk of conversion, transfusion, and overall complications) are extended over LPN as well, although OPN offered faster operative and ischemia times at the expense of greater blood loss and hospital stay.

Purpose: To compare the diagnostic accuracy of three-dimensional (3D) fast spin echo (FSE) intermediate-weighed (IW-3D) and 3D hybrid double-echo steady-state T1-weighted sequences (Hy-3D) and two-dimensional (FSE) images (2D) at shoulder MR arthrography (MRA)., Materials and Methods: Institutional review board approval was obtained and informed consent was waived for this retrospective study. From September 2011 to October 2014, 102 patients who had undergone 1.5 Tesla MRA of the shoulder, including conventional 2D-FSE and IW-3D and Hy-3D images were included in our study. The mean interval between MRA and surgery was 21 days (range 2-70 days). MR images were retrospectively and independently reviewed by two experienced radiologists blinded to the clinical and surgical data. Supraspinatus tendon (SST), infraspinatus tendon (IST) and subscapularis tendon (SCT) tears, as well as antero-inferior, superior and posterior labral lesions were assessed, using surgery as the reference standard. Each reader's performance in assessing rotator cuff and labrum abnormalities was evaluated using the area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs). The difference was evaluated using a univariate z test. The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and accuracy (Acc) for all types of rotator cuff tears and labral lesions were calculated. A value of p < 0.05 was considered statistically significant. Inter-observer agreement was calculated using kappa statistics., Results: The difference of diagnostic accuracy achieved was not significant (p > 0.05). In particular, differences in AUC values ranged from 0.002 (p = 0.98) to 0.014 (p = 0.82) as regards the comparison between 2D and IW-3D images, from 0.002 (p = 0.98) to 0.034 (p = 0.08) concerning the comparison between 2D and Hy-3D images and from 0.010 (p = 0.82) to 0.032 (p = 0.09) when comparing Hy-3D to IW-3D images. Accuracy values in evaluating RC lesions and labral lesions were 95.1, 92.1, 91.2, 93.1, 93.1 and 94.1% by reading 2D, Hy-3D and IW-3D images, respectively. The difference of diagnostic accuracy achieved using the datasets analyzed was not significant (p > 0.05). Inter-observer agreement was very good for each of the datasets that were evaluated, with near-perfect agreement for 2D dataset (k = 0.86), Hy-3D (k = 0.81) and IW-3D (k = 0.83)., Conclusions: The accuracy of IW-3D and Hy-3D images was not significantly higher than the 2D sequences in evaluating RC and labral lesions.

Artificial nighttime lighting from streetlights and other sources has a broad range of biological effects. Understanding the spatial and temporal levels and patterns of this lighting is a key step in determining the severity of adverse effects on different ecosystems, vegetation, and habitat types. Few such analyses have been conducted, particularly for regions with high biodiversity, including the tropics. We used an intercalibrated version of the Defense Meteorological Satellite Program's Operational Linescan System (DMSP/OLS) images of stable nighttime lights to determine what proportion of original and current Brazilian vegetation types are experiencing measurable levels of artificial light and how this has changed in recent years. The percentage area affected by both detectable light and increases in brightness ranged between 0 and 35% for native vegetation types, and between 0 and 25% for current vegetation (i.e. including agriculture). The most heavily affected areas encompassed terrestrial coastal vegetation types (restingas and mangroves), Semideciduous Seasonal Forest, and Mixed Ombrophilous Forest. The existing small remnants of Lowland Deciduous and Semideciduous Seasonal Forests and of Campinarana had the lowest exposure levels to artificial light. Light pollution has not often been investigated in developing countries but our data show that it is an environmental concern., Competing Interests: The authors have declared that no competing interests exist.

Background: After implementation of the PREDICA annual chest X-ray (CXR) screening program in smokers in the general practice setting of Varese-Italy a significant reduction in lung cancer-specific mortality (18 %) was observed. The objective of this study covering July 1997 through December 2006 was to estimate the cost-effectiveness of this intervention., Methods: We examined detailed information on lung cancer (LC) cases that occurred among smokers invited to be screened in the PREDICA study (Invitation-to-screening Group, n = 5815 subjects) to estimate costs and quality-adjusted life-years (QALYs) from LC diagnosis until death. The control group consisted of 156 screening-eligible smokers from the same area, uninvited and unscreened, who developed LC and were treated by usual care. We calculated the incremental net monetary benefit (INMB) by comparing LC management in screening participants (n = 1244 subjects) and in the Invitation-to-screening group versus control group., Results: The average number of QALYs since LC diagnosis was 1.7, 1.49 and 1.07, respectively, in screening participants, the invitation-to-screening group, and the control group. The average total cost (screening + management) per LC case was higher in screening participants (€17,516) and the Invitation-to-screening Group (€16,167) than in the control group (€15,503). Assuming a maximum willingness to pay of €30,000/QALY, we found that the intervention was cost-effective with high probability: 79 % for screening participation (screening participants vs. control group) and 95 % for invitation-to-screening (invitation-to-screening group vs. control group)., Conclusions: Based on the PREDICA study, annual CXR screening of high-risk smokers in a general practice setting has high probability of being cost-effective with a maximum willingness to pay of €30,000/QALY.

Purpose: To identify magnetic resonance (MR)/MR cholangiopancreatography (MRCP) imaging signs helpful in the differential diagnosis between serous cystadenomas (SCAs) and mucinous cystic neoplasms (MCNs), arising from the body/tail of the pancreas., Material and Methods: This retrospective study had institutional review board approval and informed consent was waived. Fifty-three patients with non-communicating cystic pancreatic neoplasm of the body/tail, undergoing MR/MRCP, were included. Qualitative image analysis assessed the macroscopic pattern, number of cysts, presence of central scar, contrast enhancement of peripheral wall, and mural nodules. Quantitative analysis assessed the maximum diameter of the neoplasm, thickness of the peripheral wall, and calibre of the upstream main pancreatic duct., Results: Histopathology results revealed that 27/53 (51 %) were SCAs, 26/53 (49 %) were MCNs. Microcystic pattern was observed in 88.2 % of SCAs and 11.8 % of MCNs; macrocystic pattern was observed in 90.5 % of MCNs and 9.5 % of SCAs (p < 0.0001). Central scar was detected in 29.6 % of SCAs and no MCNs (p = 0.003). Contrast enhancement of the peripheral wall was evident in 99.5 % of MCNs and 11.5 % of SCAs (p < 0.0001); mural nodules were depicted in 94.1 % of MCNs and 5.9 % of SCAs (p < 0.0001). Median maximum diameter was 54 mm for MCNs, 32 mm for SCAs (p = 0.001); median wall thickness was 4 mm for MCNs, 2 mm for SCAs (p < 0.0001)., Conclusions: Macrocystic pattern, enhancement of a peripheral wall and mural nodules are suggestive of MCNs; whereas microcystic pattern, lack of peripheral wall and central scar are suggestive of SCAs., Key Points: • MCNs have macrocystic patterns, contrast enhancement of the peripheral wall and mural nodules • Microcystic pattern and central scar are suggestive of SCA • Mural nodules detected in MCNs correlate with epithelial dysplasia • Chronic obstructive pancreatitis is equally depicted in patients with MCNs and SCAs.

Objective: To evaluate, through active call, lifestyles of an asymptomatic population in order to identify hyperglycaemic subjects and/or high-blood pressure sufferers to dispatch to their GP to perform suitable checking, and subjects to invite to a cardiovascular disease prevention programme because of their lifestyles., Setting and Participants: Between April 2011 and March 2013, all healthy residents in 6 Local Health Authorities of Regione Veneto aged 45-59 years were invited to join a cardiovascular disease prevention programme., Design: All participants were evaluated through an administered lifestyle questionnaire. Parameters such as blood pressure (BP), glycemia, waist circumference and body mass index were collected and recorded. Participants also received counseling, informational materials on lifestyle and were invited to individual or group health promotion initiatives in relation to personal risk factors., Results: Among the invited, 60.84%(10,346/17,004) adhered. Subjects without risks factors were 23.95%. Subjects with lifestyle risk factors but normal BP and glycemia were 56.59%, while those with altered values for BP and glycemia were 13.9%. The 5.55% of the respondents was not eligible for the study., Conclusions: The results confirmthat a preventive programme based on the citizens active call by the Department of prevention could be an effective tool to identify asymptomatic individuals with unknown hypertension and/or hyperglycaemia and to offer lifestyle interventions to lower the risk of cardiovascular diseases. Since the results were positive, the the Regional Veneto Centre for Disease Prevention and Control (CCMR - Veneto) presented a similar project to the Ministry of Health, involving 12 Italian Regions.