No abstract

BackgroundBreast, colorectal, ovarian, and endometrial cancers constitute approximately 30% of newly diagnosed cancer cases in Switzerland, affecting more than 12,000 individuals annually. Hundreds of these patients are likely to carry germline pathogenic variants associated with hereditary breast ovarian cancer (HBOC) or Lynch syndrome (LS). Genetic services (counseling and testing) for hereditary susceptibility to cancer can prevent many cancer diagnoses and deaths through early identification and risk management.ObjectiveCascade screening is the systematic identification and testing of relatives of a known mutation carrier. It determines whether asymptomatic relatives also carry the known variant, needing management options to reduce future harmful outcomes. Specific aims of the CASCADE study are to (1) survey index cases with HBOC or LS from clinic-based genetic testing records and determine their current cancer status and surveillance practices, needs for coordination of medical care, psychosocial needs, patient-provider and patient-family communication, quality of life, and willingness to serve as advocates for cancer genetic services to blood relatives, (2) survey first- and second-degree relatives and first-cousins identified from pedigrees or family history records of HBOC and LS index cases and determine their current cancer and mutation status, cancer surveillance practices, needs for coordination of medical care, barriers and facilitators to using cancer genetic services, psychosocial needs, patient-provider and patient-family communication, quality of life, and willingness to participate in a study designed to increase use of cancer genetic services, and (3) explore the influence of patient-provider communication about genetic cancer risk on patient-family communication and the acceptability of a family-based communication, coping, and decision support intervention with focus group(s) of mutation carriers and relatives.MethodsCASCADE is a longitudinal study using surveys (online or paper/pencil) and focus groups, designed to elicit factors that enhance cascade genetic testing for HBOC and LS in Switzerland. Repeated observations are the optimal way for assessing these outcomes. Focus groups will examine barriers in patient-provider and patient-family communication, and the acceptability of a family-based communication, coping, and decision-support intervention. The survey will be developed in English, translated into three languages (German, French, and Italian), and back-translated into English, except for scales with validated versions in these languages.ResultsDescriptive analyses will include calculating means, standard deviations, frequencies, and percentages of variables and participant descriptors. Bivariate analyses (Pearson correlations, chi-square test for differences in proportions, and t test for differences in means) will assess associations between demographics and clinical characteristics. Regression analyses will incorporate generalized estimating equations for pairing index cases wit...

Children’s physical activity (PA) is increasingly restricted by the fast pace of modern life. Schools are the opportune setting in which to increase PA during daily recess. The purpose of this study was to record the degree of PA of 6th grade primary school students during recess and determine whether the playground size and available equipment can influence the degree of students’ PA. The study sample comprised of 625 12-year-old students, 324 (51.8%) boys and 301 (48.2%) girls. The PA during recess was calculated by Metabolic Equivalent Time (MET*min) using a self-reference questionnaire. The impact of schoolyard size and equipment on MET*min was evaluated by Kruskal–Wallis analysis of variance (ANOVA). The students’ PA (MET*min) during recess was higher at schools with a large schoolyard (197.55±133.15 MET*min), compared with medium size (152.65±109.23 MET*min) and small ones (117.69±104.22 MET*min), (χ2=50.629, p<0.001). Moreover, students were more physically active during recess in adequately equipped schools (187.11±124.21 MET*min), compared with partially (158.84±128.61 MET*min) or inadequately equipped ones (114.19±89.13 MET*min). This indicates a strong positive relationship between PA and equipment (χ2=21.277, p<0.001). An encouraging school environment can motivate pre-adolescent children to be more physically active and therefore healthier. These data reveal that spacious schoolyards rich in outdoor facilities can lead to more physically active behaviour among students during recess.

Patients' symptoms scores were found to be significantly correlated to pollen counts. Given data are important for the management of AR patients who live in similar Mediterranean climate conditions.

PCT values in CSF can be very helpful in distinguishing BM from VM and other noninfectious diseases.

It is feasible to recruit diverse families at risk for hereditary cancer from a population-based cancer registry. This recruitment approach can be used as a paradigm for harmonizing processes and increasing internal and external validity of large-scale public health genomic initiatives in the era of precision medicine.

Introduction: Patients with plantar fasciitis usually suffer from reduced mobility due to the pain caused by the movement of the tendons involved. Aim: This study was aimed to compare both shockwave and ultrasound therapies in patients with plantar fasciitis by assessing the pain intensity, and both the functionality of the lower limbs and the quality of life impairments. Methods: Total amount of 88 patients with plantar fasciitis constituted the shockwave group, 56 the ultrasound group and 15 the control group. The self-administered questionnaire “University of Peloponnese Pain, Functionality and Quality of Life Questionnaire” was used. The intensity of pain, functionality impairment and quality of life impairment were evaluated on a five-point Likert scale, before treatment, immediately after and at 4-week follow-up. Results: The pain reduction and the improvement of functionality and quality of life after shockwave treatment and ultrasound treatment significantly increased both post-treatment (p<0,001) and at the 4-week follow-up (p<0,001) compared to post-treatment. However, the improvements in the ultrasound group were not as pronounced as in shockwave group (p<0,001). Conclusions: Although both radial shockwave and ultrasound therapies were found to be effective in patients with plantar fasciitis, the statistical analysis showed that radial shockwave is significantly more effective than ultrasound therapy.

The ''Agios Philippos'' mine in the Kirki region (NE Greece) has been abandoned in 1998 after half a century of ore exploration without a reclamation or remediation plan. This article aims at elucidating the potential environmental risks associated with this site by quantifying pollution in tailing basins, stream waters, stream sediments and agricultural fields. Concentrations of heavy metals in the abandoned mine tailings reached 12,567 mg/kg for Pb, 22,292 mg/kg for Zn, 174 mg/kg for Cd and 241 mg/kg for As. The geoaccumulation index and enrichment factor for these metals were indicative of extremely high contamination (I geo [ 5) and extremely high enrichment (EF [ 40), respectively. Stream waters in the proximity of the mine had an acidic pH equal to 5.96 and a high sulfate content (SO 4 -2 = 545.5 mg/L), whereas concentrations of Mn, Zn and Cd reached 2,399 lg/L, 7,681 lg/L and 11.2 lg/L. High I geo and EF values for Cd, Zn and As in stream sediments indicates that surface water pollution has a historic background, which is typically associated with acid mine drainage. Agricultural fields in the proximity of the mine exhibited high I geo and EF values, which were in decreasing order Cd [ Pb [ Zn [ As. These findings urge for an immediate remediation action of the afflicted area.