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Another priority for the epidemiological community is to disseminate the already available evidence to the whole staff of the National Health Service.The monograph on immigrants' health recently published by Epidemiologia & Prevenzione provides an updated contribution to this subject by the Italian Network of Longitudinal Metropolitan Studies. This paper suggests methodological and thematic aspects that should be addressed by future studies in order to provide the knowledge relevant to social and health policies networking with researchers and with the subjects dealing in various ways with immigration as well as the preparation of a communication plan aimed at the community and at decision makers are the methodological aspects on which the possibility of studies generating actions depends. Among the objects of investigation the health of the second generations, the study of drug prescriptions and of the access to Emergency Room as well as the evaluation of the interventions implemented by each municipality seem the most relevant. The need of a timely and periodic monitoring of the health outcomes is also underlined and the possibility of a study on the health of migrants during their migrant journey is proposed.In the era of personalised therapies, liquid biopsy is considered an important diagnostic tool in the clinical management of cancer patients. Tissue specimen represents the gold standard for molecular evaluation of specific gene targets alterations that lead cancer patients to benefit of a "tailed therapy" based on molecular features of the tumour. This innovative source of nucleic acids was introduced in clinical setting only for non-small-cell lung cancer (NSCLC) patients to test epidermal grow factor receptor (EGFR) mutations when tissue is not available for a number of reasons (difficult access to the lesion, the presence of other disabling pathologies, especially in elderly patients, rejection by the patient, etcetera) or to monitor acquired resistance mutation after a first line of treatment. The present study aimed at assessing the diagnostic potential of liquid biopsy in balanced tertiary screening modelling. The cases relating to 5 years of activity regarding to molecular diagnostics performed on liq the characteristics of the patients with mutations will drive a further estimate in tertiary prevention screening designs.The SIML Position Paper dedicated to asbestos (PPA) is addressed (mainly) to competent practitioners (CP) for the purposes to provide a guidance about a set of items classified as markedly interesting the actuality of asbestos exposure and the evaluation of the related risk; the diagnosis of the asbestos related diseases; the shape of the risk functions (namely about mesotheliomas); the causal relationship between exposure and disease; the medical surveillance of the workers currently and previously exposed. The scientific literature doesn't acknowledge the idea that nowadays in Italy the frequency of pleural mesotheliomas deriving from environmental asbestos from outdoor sources exposures is really a relevant item. selleck products Inside the SIML PPA the chapter concerning industrial hygiene and environmental monitoring themes shows inaccuracies and deficiencies, so resulting of scarce utility for the CPs that should be called for a more cooperative role in front of the employers. The arguments of the diagnosis of the asbestos related diseases is developed with an undue emphasis upon the differential histological diagnosis of asbestosis and, especially, of pleural mesothelioma nosographic aspects that hardly are posed to the attention of the CP. A similar emphasis is posed towards the shape of the risk function for pleural mesothelioma, a theme absent from the current practice of the CP such as of other occupational practitioners. In conclusion, next to themes of undoubted interest for the PC, the SIML PPA dwells on the scrutiny of some topics representing critical elements of the current contrast between consultants and valuers in the context of criminal prosecutions subjects having forensic relevance but far from the "application actuality" for the CP invoked in the PPA. A greater transparency, last but not least, was to have been posed, inside the SIML PPA, in the disclosure of the conflict of interests (COIs) of some Authors, declaring their consultancy in favour of companies.The rules for distributing public resources for healthcare among Italian Regions are the subject of heated discussions every year among the Regions themselves. The factors of convenience with respect to those of justice very often prevail in the discussion. To think about what the best solution would be, it would be necessary to deepen the theories of justice, from utilitarianism to contractualism, from liberalism to economic egalitarianism. In any case, it would be advisable for the political choice of the allotment criteria to be made "under the veil of ignorance", i.e., independently of pure convenience. The analysis of the current division shows that the factor that practically explains the totality of the differences is the average age of the regional populations, while it does not seem to be associated with both economic and epidemiological indicators.OBJECTIVES to evaluate the implementation of an integrated care model for thyroid disease on thyroid surgery at the University Hospital "Federico II" of Naples (Campania Region, Southern Italy). DESIGN quasi-experimental design employing an interrupted time series analysis. SETTING AND PARTICIPANTS all subjects who were admitted to the University Hospital "Federico II" for thyroid surgery between January 2008 and December 2018. The integrated care model for thyroid disease was implemented starting from January 2016. MAIN OUTCOME MEASURES rate of partial thyroidectomies over all thyroidectomies; rate of diagnosed thyroid cancers over all diagnosed thyroid tumours; length of stay (LOS). Differences pre- and post-interventions were assessed employing Poisson (for count outcomes) and linear (for continuous outcomes) regression models. Models were adjusted for age, gender, tumour diagnosis (none, benign, malignant), Charlson index, and discharge month. RESULTS data on 4,233 thyroidectomies were included. There waser, this intervention had no impact in reducing the rate of total thyroidectomies.OBJECTIVES to describe frequency, characteristics, and consequences of intentional injuries due to interpersonal violence visited at the Emergency Rooms of Udine and Cividale del Friuli (Friuli Venezia Giulia Region, North-Eastern Italy). DESIGN analysis of the administrative database of the Emergency Department. SETTING AND PARTICIPANTS in the two Emergency Departments of Udine and Cividale del Friuli, serving a 250,000-inhabitant area, all the visits due to injuries from interpersonal violence in the years 2015-2017 were analysed. MAIN OUTCOME MEASURES number of visits because of injuries from interpersonal violence, distribution of demographic characteristics of patients, of characteristics of the events (place of occurrence, mechanism, relation with patient's occupation, involvement of persons known to the victims), of consequences (discharge diagnosis, Emergency Department management times). RESULTS in three years, 1,741 visits of violence victims were recorded in the Emergency Department of the Udine area; 8.7% of patients were assigned a triage yellow tag and 1.0% a red tag. Almost one third of victims were non-Italian citizens; 14.2% of events were work-related; more than one third occurred in the home; in one third of cases, the aggressor was known to the victim; 96 people were diagnosed with fractures. The average time from start of medical care and Emergency Room discharge ranged from half an hour among white triage tags to more than three hours among yellow tags. More than 100 people experiences more than one violent episode. CONCLUSIONS this is the first description of frequency, characteristics, and health impact of violence in the area of Udine, providing information useful for a targeted prevention. It also highlights the central role of the Emergency Department not only for the registration of the phenomenon, but also for the management of the acute episodes and for the prevention of recurrent events.OBJECTIVES to assess time trend of lifestyles, cardiovascular risk factors, and prevalence of high-risk conditions in random samples of the general adult population residing in Emilia-Romagna, examined in two cross-sectional surveys conducted within the Epidemiological Cardiovascular Observatory (OEC 1998-2002) and the Epidemiological Cardiovascular Observatory/Health Examination Survey (OEC/HES 2008-2012). DESIGN cross-sectional surveys conducted on random samples of general adult population stratified by gender and age group in some municipalities of Emilia-Romagna. SETTINGS AND PARTICIPANTS in Emilia-Romagna, 341 males and 354 females were examined in 1998-2002 and 307 males and 300 females were examined in 2008-2012. MAIN OUTCOME MEASURES cardiovascular risk factors, high risk conditions, and proportion of population following healthy lifestyles recommendations. RESULTS in the second survey, prevalence of hypercholesterolemia and mean values of total and LDL cholesterol were higher. Less than 30% of the sample consumes adequate quantities of vegetables and fish; cheeses, sausages, and sweets are overconsumed, as a higher cholesterol intake. CONCLUSIONS increased in total and LDL cholesterol are partly due to the reach diet, as suggested by nutrient consumption. Appropriate preventive actions for the improvement of the lifestyles and lipid profile in the general population are recommended.OBJECTIVES to give an overview of the use of safety devices in motorized vehicles in Italy in the years 2015-2017. DESIGN road side observational study. SETTING AND PARTICIPANTS a sample of 232,283 road users in 28 cities across the Italian territory with a resident population of more than 10 million inhabitants (17% of the Italian population) was considered. MAIN OUTCOME MEASURES the use of seat belts (front and rear), child restraints, and motorcycle helmets were monitored. For each city, the survey was carried out in urban, sub-urban, and extra-urban areas. Data were aggregated by three geographic areas North, Centre, and South. Data for front seat belts was also provided for drivers and passengers separately. RESULTS the use of front seat belts shows a dramatic geographical trend ranging from 82.6% (North) to 36.3% (South). Drivers use seat belts more frequently than passengers (63.3% vs 57.4%). The same North-South trend shows the use of rear seat belts (from 19.0% to 3.3%) and child restraints (from 59.9% to 16.6%). Helmet use was high everywhere in Italy (more than 94%). CONCLUSIONS despite the use of safety devices, which has been mandatory for many years, compliance seems to depend on the voluntary behaviour of drivers and passengers influenced by socioeconomical and cultural patterns. The use of rear seat belts and child restraints is still far from an acceptable level, as well as the use of front seat belts in the South and in the Centre. The increased use of safety devices would have significant public health and traffic safety implications, as a potential of 327 deaths/year could be saved.