The purpose of this paper is to report the clinical characteristics and treatment outcome following different therapeutic approaches in a large series of patients with primary low-grade MALT lymphoma of the stomach. A total of ninety-three patients (median age 63 years) were reviewed. The patients were treated by different modalities (local treatment alone, combined treatment, chemotherapy, antibiotics alone); seven patients refused any treatment. The antibiotic-treated group of patients was prospectively followed with regular endoscopic biopsies, and their responses were histologically evaluated. The 5-years projected overall survival is 82% (95% C.I.; 67%-91%) in the series as a whole. Second tumors were observed in 21.5% of the patients in this series (95% CI 14%v to 31%). There was no apparent difference in overall survival and event-free survival between patients who received different treatments. In the antibiotic-treated group histologic regression of MALT lymphoma was documented in 67% of patients (95% CI 51% to 80%). In conclusion the indolent nature of the disease justifies a conservative approach. The use of antibiotics as first-line therapy may avert or at least postpone the indication for surgical resection in the majority of patients.

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A multicenter retrospective study was undertaken in northern Italy to assess clinical characteristics and pattern of care of elderly patients (> 70 years) with lung cancer seen in 1984, at 14 non-surgical institutions. Overall, 1 out of 5 patients with lung cancer was elderly. Eighty-four percent of the 264 elderly patients under study were males, and overall, their median age was 76 years. Squamous cell carcinoma was the most frequent histologic type (53%), and most of the patients (61%), after a rather intensive diagnostic workup, had loco-regional disease. Sixty-three percent of patients underwent radiotherapy, which was mostly classified as palliative. Chemotherapy was given to 13% of patients, mostly with small cell histology. Response to radiotherapy and chemotherapy was observed in about 50% of the patients; however, 3 out of 34 (10%) patients treated with chemotherapy died from toxicity. The median survival time from diagnosis was 9.9 months; survival time was not related, in this population of elderly patients, to age. Throughout the study, the quality of data recording during the patient's illness was often found to be suboptimal. In conclusion, elderly patients with lung cancer appear to be actively staged and treated outside a protocol context in the clinical practice of cooperating nonsugical institutions in northern Italy. This stresses the importance of prospective studies aimed to evaluate the cost/effectiveness of the various procedures used and the impact of treatments used (or even of a policy of no treatment) on the survival and quality of life of these patients.

In the last decades, climate change and the rapid urbanization due to the development of the coastal economy have led to biodiversity loss and the fragmentation of habitat in many coastal zones. The presence of protected areas cannot prevent the progress of land degradation. However, these areas are very important because they provide significant ecosystem services and affect local tourism. With regard to increasing adaptation strategies to human pressures and climate change, the present study proposes a detailed monitoring activity and an ecological restoration plan which could improve the resilience of a protected coastal zone in the Pantano forest of Policoro, located on the Ionian coast (southern Italy). In this area, continuous phenomena of intensive deforestation, hydraulic reclamation actions, and fires have reduced the native species of particular naturalistic value, favouring the advancement of desertification, coastal erosion, and saltwater intrusion. The proposed actions are derived from a preliminary analysis on maps, UAV-images, climate data and from meetings with the local community. The operative process detailed in this article could be applied to other protected areas which are subjected to the same phenomena and problems.

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