Pancreatic adenocarcinoma (PAC) is a very aggressive cancer with a poor prognosis. To date, the causes and pathogenetic mechanisms involved in the development of this malignancy remain largely unknown. Therefore, additional studies are required to improve our knowledge of the events that occur during the process of pancreatic carcinogenesis. The purpose of this article is to describe the most recent evidence, concerning the possible risk factors and mechanisms that may contribute to determine the development of PAC, as well as models, such as the tensegrity model, that may explain this complex process. Available studies suggest that approximately 15-20% of human malignancies are somehow associated with chronic infection. Some epidemiological research has shown that some infectious agents represent risk factors for PAC. In particular, several reports showed that the infection caused by some micro-organisms, including helicobacter pylori and some bacterial species of oral microbiota, as well as by viral agents, such as human immunodeficiency virus (HIV), and hepatitis B (HBV) and C (HCV) viruses, is associated with an increased probability of developing PAC. For the first time, observational studies and meta-analyses have suggested that HBV and HCV, two hepatotropic viruses with oncogenic properties, may be also risk factors for PAC. However, the small number of available reports, nearly all performed in Asian populations, limits their validity to these ethnic groups. Therefore, additional studies focusing on populations of different geographical areas and enrolling larger series of patients are required to confirm this association. Furthermore, an accurate description and a better understanding of the events and of the pathogenetic mechanisms involved in the process of pancreatic carcinogenesis, as proposed by the tensegrity model, might be a useful approach to effectively deal with this pathology.
Introduction: The study aims to describe the organization of one accredited school of Anesthesia and Intensive Care of University of Modena and Reggio Emilia, Italy. The analysis of the post-graduation period aims to measure the time-to-first job, the perceived challenges, what postgraduate residents choose as first employ, and the overall satisfaction rating of a cohort of residents completing their training until 2017 with the usual and standard training program. Methods: We collected organization and administrative records of the five-year program of the A-IC School of 4 cohorts of residents who joined from 2009 to 2012 and we performed a survey. We also analyzed the differences among school cohorts during the medical training. In the end, it was investigated as a reason to choose hub hospitals or not. Results: The focus of the training activities revolved around the operating room with a mean of 30.41 ± 6.6 (sd), months followed by Intensive care with 17.29 ± 4.49 (sd) months. Although 7.5% of the respondents were not fully satisfied of the school’s program, 89.7% of residents rated their training as adequate. In fact, 97.2% respondents reported they could overcome the professional challenges they faced after graduation. The multiple variables logistic regression showed a correlation among working in hub hospitals and training performed in university hospitals with a p value of 0.015. Conclusion: This paper describes the postgraduation period. This point should be examined as an integral part of the accreditation procedure. Knowing the satisfaction rate, perception autonomy, and which type of hospitals are preferred can measure the education training capacity of a postgraduation school.
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