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Introduction: The first two decades of the third millennium have been characterized by deep economic changes in various countries around the world with an inevitable impact on the job market. The aim of this study is to analyze the data of the last twenty years relating to employment in Italy, compared with European ones, to understand how the 2008 economic crisis affected employment in the following years and how the recent crisis, related to the COVID 19- pandemic emergency, may contribute further. Methods: The study analysed data related to the labor market in Italy and in the European Countries. The 2000-2019 period was analytically evaluated by comparing employment and unemployment rates, and contractual typology. The average annual percent changes (AAPC) of the trends were evaluated from join-point regression analysis. Results and discussion: From 2000 to 2019 the Italian population showed a substantial growth with an increase of +6.03%, almost due to the increase of foreign. The employment rate in Italy (age 15-64) has grown from 55.5% to 59.1% with three different trends: 2000-2007 (AAPC=+0.6%, p

A literature review was performed to highlight which work-related diseases express sex/gender differences in health outcomes and focus the main limits of studies in this field. The research, carried out on PubMed by specific search string, identified 4828 articles (1997-2017period) of which 381 are eligible for review (4-22%, depending on the disease). Among them, 68% reported sexlgender differences in health outcomes, which in most cases appear to be due to different exposure and/or work segregation rather than to biological differences. However, few studies place this assessment among the research goals and results are almost never discussed and hypothesis are seldom formulated about any observed differences. It seems necessary to use research methodologies and study design Thai can detect and explain the described complexity and useful in defining appropriate preventive strategies.

Background: Prevention of venous thromboembolism (VTE) in cancer patients remains controversial in most clinical settings. Purpose: The Italian Society for Haemostasis and Thrombosis (SISET) commissioned a project to develop clinical practice guidelines for the prevention of VTE in patients with malignancy. Methods: Key questions concerning the prevention of VTE in patients with malignancy were formulated by a multidisciplinary working group consisting of experts in clinical medicine and research. After a systematic review and discussion of the literature, recommendations were formulated and graded according to the supporting evidence. For those questions for which the literature search did not find any definitive answers (due to absence of evidence, low quality evidence and/or contradictory evidence), a formal consensus method was used instead to issue clinical recommendations. Results: The search for "VTE prevention" resulted in 1021 citations; 69 articles were selected and 24 were used for drafting clinical recommendations. Four areas were graded A to C: 1) Need of prevention (pharmacological and/or mechanical) in cancer patients undergoing major abdominal or pelvic surgery and in 2) those with an acute medical disease requiring hospitalization and who are bedridden. Avoid prevention in 3) cancer patients with a central venous catheter and 4) those on chemotherapy, radiotherapy or hormonal therapy, except patients with multiple myeloma treated with thalidomide/lenalidomide plus high-dose dexamethasone, and those with gastrointestinal or lung cancer. Six areas were considered to be clinically important, but lacked evidence from the literature and thus required a formal consensus (grade D): 1) need of prevention during chemo-radiotherapy or hormonal therapy in patients with previous VTE; 2) optimal duration of pharmacological prevention in patients who are hospitalized/bedridden for acute medical illness; 3) optimal duration of pharmacological prevention in patients undergoing major surgery other than abdominal and pelvic; 4) optimal duration of pharmacological prevention in myeloma patients receiving thalidomide plus dexamethasone; 5) presence of cerebral metastasis as a contraindication to pharmacological prevention; 6) prevention in cancer patients undergoing surgery by laparoscopic procedures lasting> 30 min. Conclusion: Results of the systematic literature review and an explicit approach to consensus techniques have led to recommendations for the most clinically important issues in the prevention of VTE in cancer patients. (C) 2011 Elsevier Ltd. All rights reserved. Background: Prevention of venous thromboembolism (VTE) in cancer patients remains controversial in most clinical settings. Purpose: The Italian Society for Haemostasis and Thrombosis (SISET) commissioned a project to develop clinical practice guidelines for the prevention of VTE in patients with malignancy. Methods: Key questions concerning the prevention of VTE in patients with malignancy were formulated by a multidisciplinary working group consisting of experts in clinical medicine and research. After a systematic review and discussion of the literature, recommendations were formulated and graded according to the supporting evidence. For those questions for which the literature search did not find any definitive answers (due to absence of evidence, low quality evidence and/or contradictory evidence), a formal consensus method was used instead to issue clinical recommendations. Results: The search for "VTE prevention" resulted in 1021 citations; 69 articles were selected and 24 were used for drafting clinical recommendations. Four areas were graded A to C: 1) Need of prevention (pharmacological and/or mechanical) in cancer patients undergoing major abdominal or pelvic surgery and in 2) those with an acute medical disease requiring hospitalization and who are bedridden. Avoid prevention in 3) cancer patients with a central venous catheter and 4) those on chemotherapy, radiotherapy or hormonal therapy, except patients with multiple myeloma treated with thalidomide/lenalidomide plus high-dose dexamethasone, and those with gastrointestinal or lung cancer. Six areas were considered to be clinically important, but lacked evidence from the literature and thus required a formal consensus (grade D): 1) need of prevention during chemo- radiotherapy or hormonal therapy in patients with previous VTE; 2) optimal duration of pharmacological prevention in patients who are hospitalized/bedridden for acute medical illness; 3) optimal duration of pharmacological prevention in patients undergoing major surgery other than abdominal and pelvic; 4) optimal duration of pharmacological prevention in myeloma patients receiving thalidomide plus dexamethasone; 5) presence of cerebral metastasis as a contraindication to pharmacological prevention; 6) prevention in cancer patients undergoing surgery by laparoscopic procedures lasting > 30 min. Conclusion: Results of the systematic literature review and an explicit approach to consensus techniques have led to recommendations for the most clinically important issues in the prevention of VTE in cancer patients. © 2012 Elsevier Ltd. All rights reserved.

Background Clinical characteristics and management of acute deep vein thrombosis and pulmonary embolism (PE) have been reported to be different in patients with and without cancer. The aim of this paper was to provide information on clinical characteristics and management of acute venous thromboembolism in patients with cancer by means of a large prospective registry. Design and Methods MASTER is a multicenter registry of consecutively recruited patients with symptomatic, objectively confirmed, acute venous thromboembolism. Information about clinical characteristics and management was collected by an electronic data network at the time of the index event. Results A total of 2119 patients were enrolled, of whom 424 (20%) had cancer. The incidence of bilateral lower limb deep vein thrombosis was significantly higher in patients with cancer than in patients without cancer (8.5% versus 4.6%; p

A commentary: To screen for calf DVT or not to screen? The highly variable practice among Italian centers highlights this important and still unresolved clinical option. Results from the Italian MASTER registry

INTRODUCTION: Signs and symptoms of venous thromboembolism (VTE) are non-specific and thus can make diagnosis difficult, even for an experienced clinician. We aimed to evaluate the timing of diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in Italian hospitals and to identify individual and clinical predictors of timely or delayed diagnosis. MATERIAL AND METHODS: MASTER is a multicenter prospective registry of patients with acute DVT and PE. Information on clinical presentation and diagnostic methods, temporary and permanent risk factors, were captured by an electronic data network at the time of the index event. RESULTS: Data on 2047 patients (1024 males), 1505 with DVT and 542 with PE, were analysed. Delayed diagnosis (i.e. more than 10 days from onset of symptoms) was observed in 340 (22.6%) patients with DVT and in 88 (16.2%) with PE, respectively. In DVT patients, factors associated with earlier diagnosis were the presence of multiple signs or symptoms (p=0.014), the presence of pain (p=0.049), and previous venous thrombosis (p=0.016). Neither the presence of other known risk factors nor ongoing prophylaxis influenced the timing of diagnosis. In PE patients, only multiple signs or symptoms at presentation (p=0.014) and the presence of transient risk factors (p=0.001) were significantly associated with earlier diagnosis. CONCLUSIONS: Substantial delays occur when diagnosing both DVT and PE. The severity of presentation, but not patient risk profile are associated with earlier diagnosis, even in patients with signs or symptoms of PE.