The report written by the World Health Organization (WHO) in 2016 presents an extensive assessment to show how the improvement of the environment can promote health and well-being. The awareness of how many diseases could be avoided by focusing on environmental risk factors would give a boost to global efforts to promote preventive health. The results obtained by the quantitative analysis on the burden of diseases attributable to the environment, confirm that 24% of global deaths and 26% of deaths among children under 5 years are caused by modifiable environmental risk factors. For this reason, this report strongly supports the idea that the environment is a solid platform for good public, community and individual health. Furthermore, in 2021, WHO with the United Nations developed a Compendium, which provides strategies and key guidance for acting on environmental conditions as a key contributor to reducing many communicable and Non-Communicable Diseases (NCDs). In the following article we examined the environment-related diseases according to WHO paperwork.

Given the critical role of general practitioners (GPs) in the early diagnosis and management of asbestos-related diseases (ARDs), and the significant history of asbestos fibres pollution in Alessandria Local Health Authority (ASL AL), this project aimed to assess the knowledge and awareness of asbestos risks, as well as the experience in diagnosing ARDs among GPs working in Alessandria province, Northern Italy. A questionnaire was administered to 216 GPs from all ASL AL territorial districts during 26 Territorial Assistance Equipes (EATs) meetings, held from September 2022 to January 2023. It contained 29 questions covering three main areas: ‘knowledge and awareness’, ‘competence and experience’, ‘sociodemographic characteristics and workload’. Although GPs were aware of the health hazards of asbestos (94 %) and the increased risk of mesothelioma from asbestos exposure (92.6 %), significant disparities and heterogeneity of knowledge were observed among territorial districts and by comparing Casale Monferrato district with all the others, particularly regarding asbestos exposure routes, reporting of occupational diseases, and mesothelioma latency. This project provides a comprehensive overview of GPs' knowledge, awareness and experience in managing ARDs, providing indications of customised training requirements. This evaluation could be extended to all areas with a history of previous asbestos exposure and provide a useful tool for policy makers to define and plan strategic actions on asbestos. This work could also be adapted to different realities with a history of environmental pollutant exposure other than asbestos, which pose a risk for the development of several diseases.

Asthma is one of the most common chronic diseases in childhood, and the gut microbiota is increasingly recognized as a key player in its pathogenesis through the gut–lung axis. This pilot, cross-sectional study analyzed the intestinal microbiota of 20 children (6–9 years) with intermittent or mild persistent asthma, in the absence of a healthy control group. Stool samples were processed with 16S rRNA sequencing (Illumina iSeq100, V3–V6 regions) and analyzed with MicrobAT-SmartSeq software. Contrary to most literature, no enrichment of Proteobacteria was detected, and Faecalibacterium was not reduced but emerged as the most abundant genus. Higher adherence to the Mediterranean diet correlated with greater microbial richness, while asthma phenotypes showed no major taxonomic differences. Pharmacological treatments modulated microbial profiles: leukotriene antagonists correlated with protective taxa, whereas inhaled corticosteroids and bronchodilators were linked to reduced beneficial functions. These findings highlight an overall eubiotic microbiota in asthmatic schoolchildren and call for larger, controlled studies to confirm these novel observations.

The prevalence of malnutrition in patients is very high in Europe (>70%). An Italian FADOI-SINPE survey revealed that malnutrition is an underestimated problem by internists. The AMIDO study examines malnutrition in Acqui Terme Hospital (Alessandria, Italy) Internal Medicine Department patients. Patients were screened for malnutrition using the Malnutrition Universal Screening Tool (MUST) upon admission. 268 patients (49.63% male) were enrolled, with a median age of 83 years. At admission, the prevalence of malnutrition risk was 48.88%. The proportion of patients who came from home resulted to have a slight decreasing trend among the three subgroups according to MUST (84.67%, 82.76%, and 73.53% in increasing order of MUST score respectively), but was not statistically significant (P=0.10). Dementia [odds ratio (OR): 6.36; 95% confidence interval (CI): 2.52-18.63], heart failure (OR: 2.45; 95% CI: 1.33-4.57), neoplasm (OR: 2.24; 95% CI: 1.08-4.77) and infectious diseases (OR: 2.27; 95% CI: 1.226-4.274) increase malnutrition odds. Increasing attention to malnutrition risk is crucial for patients with dementia, neoplasm, heart failure, and infectious diseases, which raise malnutrition risk probability.

Background: because of the impact of gastritis on patients' quality of life and the importance of accurate diagnosis to identify potential precancerous lesions related to them, we evaluated the determinants that could most influence the risk of gastritis development and gastric mucosa alterations. Materials and Methods: gastric biopsies performed from September to November 2023 were collected. Univariate and multivariate logistic regression models were used to identify determinants of gastritis, gastric mucosa alterations and gastrectomy (sleeve). Results of logistic model were presented as Odds Ratio (OR) with a 95% Confidence Interval (CI) and corresponding p-value. Results: univariate and multivariate logistic analysis showed an increase in odds of gastritis development related to age, while the increase in odds of gastric alterations was also related to gender. Male gender and age ≥65 decreased the odds of receiving a gastric resection (sleeve). Conclusions: recognizing determinants having a greater impact on gastritis and gastric alterations development is imperative, to identify people who are most at risk, so that preventive population interventions can be evaluated.

Aims: prognostic impact of mutations in BRAF and KRAS genes in patients with colorectal cancer was evaluated to detect variations in survival among patients with these mutations, in relation to different morphologic features identified at diagnosis and the expression of mismatch repair proteins. The final purpose of the project will be to establish models to predict variations in survival in different subsets of patients with colorectal cancer. Materials and Methods: partial survival analyses were conducted on 32 subjects in relation to three different variables: mutation in BRAF or KRAS genes, expression of mismatch repair system and morphological features of the tumor. Results: preliminary results of this study provide evidence that survival in different subsets of patients with colorectal cancer can be influenced by several factors, which include, in addition to immunohistochemical and molecular investigations, the assessment of different morphological features. Conclusions: Integrating different characteristics may reveal which factors have a more significant impact on survival in these subgroups. More patients will be needed to design different survival models and to check these preliminary results more effectively. Obiettivi: l’impatto prognostico delle mutazioni nei geni BRAF e KRAS nei pazienti con tumore del colon-retto è stato valutato per individuare le variazioni di sopravvivenza tra i pazienti con queste mutazioni, in relazione alle diverse caratteristiche morfologiche identificate alla diagnosi ed all’espressione delle proteine di Mismatch Repair. Lo scopo finale del progetto sarà quello di stabilire modelli per prevedere le variazioni di sopravvivenza in diversi sottoinsiemi di pazienti con tumore del colon-retto. Materiali e Metodi: sono state condotte analisi di sopravvivenza parziale su 32 soggetti in relazione a tre diverse variabili: mutazione nei geni BRAF o KRAS, espressione delle proteine dei Mismatch Repair e caratteristiche morfologiche del tumore. Risultati: i risultati preliminari di questo studio dimostrano che la sopravvivenza in diverse sottopopolazioni di pazienti con tumore del colon-retto può essere influenzata da diversi fattori, che includono, oltre alle indagini immunoistochimiche e molecolari, la valutazione di diverse caratteristiche morfologiche. Conclusioni: l’integrazione di diverse caratteristiche può rivelare quali fattori abbiano un impatto più significativo sulla sopravvivenza in questi sottogruppi. Sarà necessario un numero maggiore di pazienti per progettare diversi modelli di sopravvivenza e verificare in maniera più efficace questi risultati preliminari.