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ABSTRACTObjective:The present study intended to evaluate the impact of a standardized format-called the "Music Givers," based on a single session of music intervention followed by a buffet-on the psychological burden and well-being of hospitalized cancer patients.Method: The Distress Thermometer (DT), the Hospital Anxiety and Depression Scale (HADS), and self-reported visual analogue scales (score range = 1-10) to assess pain, fatigue, and five areas of well-being (i.e., physical, psychological, relational, spiritual, and overall well-being) were administered to 242 cancer patients upon admission to and at discharge from the hospital. Among them, 103 were hospitalized during which time a live concert took place (intervention group), whereas 139 patients were hospitalized when it did not (control group).Results: Compared to the control group, patients in the intervention group demonstrated less distress at discharge according to the DT (adjusted estimate of difference = -0.8, p = 0.001), lower HADS-Anxiety (-1.7, p < 0.001) and HADS-Depression scores (-1.3, p = 0.001), and higher scores on all the well-being scales, with the exception of spiritual well-being. In addition, no between-group differences were found in terms of pain and fatigue scores at discharge.Significance Of Results: The one-session format of the Music Givers intervention is an effective, standardized, easy-to-replicate, and low-cost intervention that reduces psychological burden and improves the well-being of hospitalized cancer patients. Listening to live music and the opportunity to establish better relationships between patients and staff could explain these results. [ABSTRACT FROM AUTHOR]

In Italy a new experience of music medicine called 'The Music Givers' is spreading among Oncology Units; it aims to organise weekly live concerts (length 45-60 min) followed by a buffet. Purpose of the present study is to evaluate the effect of the format of The Music Givers on cancer in-patients' anxiety. State-Trait Anxiety Inventory ( STAI-Y) was administered to 111 in-patients before and after the concerts. After the concerts we observed a 3.87 point decrease in state anxiety ( p < .001) and statistically significant differences in most of the domains assessed by STAI-Y. These results invite a reflection on the importance of offering to inpatients events such as live music concerts, in order to improve their psychological condition during hospitalisation. [ABSTRACT FROM AUTHOR]

Abstract: Context: In Italy, data regarding the use of complementary therapies (CTs) among patients with cancer are sparse and discordant. Objectives: The present study aimed to investigate the demographic and psychological characteristics of Italian cancer patients who use CTs and the perceived benefit of users. Methods: Eight hundred three patients from six Italian oncology departments were interviewed about CT use and completed two questionnaires to explore psychological distress and the resilience trait called sense of coherence (SOC). Patients included in the study had different primary tumor sites and were in different phases of the disease and care process. Results: At the time of measurement, 37.9% of patients were using one or more types of CTs. The most commonly used CTs were diets and dietary supplements (27.5%), herbs (10.8%), homeopathy (6.4%), and mind-body therapies (5.5%). The Italian context is characterized by a high percentage of patients who informed their physicians about CT use (66.3%) and who experienced benefits (89.6%); 75.2% of the patients had used CTs in the past. Multivariate analysis revealed that young, female patients, who previously used complementary and alternative medicine in the past, appear more likely to use at least one type of CT in the present. Predictors of the use of CTs varied according to the type of CT. Among psychological factors, SOC was positively associated with both past and present CT use. Conclusion: Overall prevalence of CTs among Italian cancer patients is high and is in accordance with the European average. In addition to clinical and sociodemographic factors, the resilience trait SOC also was associated with CT use. [Copyright &y& Elsevier]

Background: Since gemcitabine became the standard treatment for metastatic pancreatic adenocarcinoma, combination chemotherapy obtained conflicting impact on survival (OS)., Aims: To evaluate Italian treatment trends in metastatic pancreatic cancer., Methods: Data on treatment outcome of 943 chemo-naive patients with pathological diagnosis of stage IV pancreatic adenocarcinoma treated between 1997 and 2007 in Italian centres were analysed., Results: Four treatment groups could be identified: (1) single agent gemcitabine (N=529); (2) gemcitabine-platinating agent doublets (N=105); (3) gemcitabine-free three-drug intraarterial combination (N=75); (4) four-drug gemcitabine-cisplatin-fluoropyrimidine based combinations (N=170). Median and actuarial 1 y OS of the whole population were 6.2 months and 20%, respectively. Gemcitabine (median OS 5.1 months) appeared significantly inferior to gemcitabine-free triplets (median OS 6.0 months; p=.04), gemcitabine-platinating agent doublets (median OS 7.4 months; p=.00001), or gemcitabine-based four drug combinations (median OS 9.1 months; p<.00001)., Conclusion: These data mirror the Italian clinical practice in the therapeutic management of pancreatic cancer and suggest that four-drug combination chemotherapy may be included amongst the candidate regimens for phase III testing., (Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

A series of 650 patients treated between 1997 and 2007 at 10 Italian centers was analyzed to assess treatment trends and efficacy in stage III pancreatic adenocarcinoma. Data on patient characteristics, treatment and outcomes were collected. The inclusion criteria were pathological diagnosis of stage III pancreatic adenocarcinoma; age more than 18 years, Eastern Cooperative Oncology Group performance status less than 3, and no past therapy. Most patients (95%) received up-front chemotherapy, which mainly consisted of gemcitabine alone (N=323), gemcitabine-based four-drug combinations (N=107), gemcitabine-platinum compound doublets (N=87), or intra-arterial gemcitabine-free triplets (N=57). The use of gemcitabine-platinum compound doublets increased over time (1997-2001: 2%; 2002-2007: 21%) whereas an inverse trend was observed for gemcitabine (71-61%). No overall survival (OS) difference was observed between patients enrolled in clinical trials and those not enrolled. The median and 1-year OS were 9.5 months and 35.5% for patients treated with gemcitabine; 8.9 months and 36.8% for those treated with gemcitabine-free intra-arterial triplets; 13.3 months and 55.8% for those treated with gemcitabine-platinating agent doublets; and 16.2 months and 62.6% for those treated with gemcitabine-based four-drug combinations. Moreover, the median and 1-year OS were 12.7 months and 51.4% in patients who underwent planned consolidation chemoradiation, and 8.4 months and 30.4% in patients who did not. The use of a strategy consisting of a gemcitabine-platinating agent containing chemotherapy followed by consolidation chemoradiation has been increasing over time and may represent a suitable choice in the therapeutic management of stage III pancreatic adenocarcinoma.

In this retrospective non controlled trial we evaluated the incidence of sepsis in cancer patients in two different periods (January-June 2003 versus January-June 2004). The main difference in these two periods was that in our oncology department we changed from systemic chemotherapy to loco-regional chemotherapy using less myelosuppressive drugs and developed the domiciliary assistance. The aim of the study was to assess the incidence of sepsis in order to demonstrate a reduction of the infection related to the change of chemotherapy. In addition, this study may be able to describe the epidemiology of sepsis in cancer patients afferent to our oncology department. The incidence of sepsis was reduced in the second period from 24.3% to 6.2%. The pathogens more frequently isolated in this study were coagulase-negative staphylococci (CNS) followed by Escherichia coli and Staphylococcus aureus. Less invasive therapy may reduce infective complication of chemotherapy. The epidemiology of sepsis may be very helpful to design empiric therapeutic protocol for febrile patients that have received chemotherapy.

Study Design: Cross-sectional., Objectives: To evaluate the assessment of patients with low back pain by general practitioners (GPs) in a non-English-speaking country and to compare their behavior with AHCPR and CSAG clinical guidelines., Summary of Background Data: The diffusion of clinical guidelines (and their everyday application by health care professionals) is a significant problem. Because most guidelines are developed in English, concerns over their diffusion are obviously greater in non-English-speaking countries., Methods: A questionnaire was sent to all the GPs in the province of Mantua, Italy (n = 318). The authors evaluated what examinations are routinely performed and what danger symptoms and signs prompt referral of patients. GPs indicated the frequency of their prescription of radiographs, computed tomography scans, magnetic resonance imaging, laboratory tests, and consultations. The findings were compared with a "gold standard": the AHCPR and CSAG clinical guidelines., Results: The response rate was 68.2%. Only 28.0% of GPs perform all the tests considered important by the clinical guidelines, and 33.0% were aware of all the red flags. Correspondence with the clinical guideline recommendations ranged from 14.6% to 89.4%. There is a clear tendency to overprescribe examinations in acute cases, whereas in chronic cases underprescription is sometimes seen., Conclusions: In a non-English-speaking country the evaluation of low back pain by GPs does not reflect current recommendations, and the situation is seen to be worse than in English-speaking countries. Concerns over the diffusion of guidelines must therefore be considered greater in non-English-speaking countries, where thorough presentation to GPs of the existing "evidence-based" guidelines is to be recommended.