scholarly journals A Survey of Marine Coastal Litters around Zhoushan Island, China and Their Impacts

2021 ◽  
Vol 9 (2) ◽  
pp. 183
Author(s):  
Xuehua Ma ◽  
Yi Zhou ◽  
Luyi Yang ◽  
Jianfeng Tong
Keyword(s):  
Rapid Development ◽  
Univariate Analysis ◽  
Local Environment ◽  
Marine Litter ◽  
Social Ecological ◽  
The Social ◽  
Significant Difference ◽  
Valuable Method ◽  
Beach Litter ◽  
The Impact

Rapid development of the economy increased marine litter around Zhoushan Island. Social-ecological scenario studies can help to develop strategies to adapt to such change. To investigate the present situation of marine litter pollution, a stratified random sampling (StRS) method was applied to survey the distribution of marine coastal litters around Zhoushan Island. A univariate analysis of variance was conducted to access the amount of litter in different landforms that include mudflats, artificial and rocky beaches. In addition, two questionnaires were designed for local fishermen and tourists to provide social scenarios. The results showed that the distribution of litter in different landforms was significantly different, while the distribution of litter in different sampling points had no significant difference. The StRS survey showed to be a valuable method for giving a relative overview of beach litter around Zhoushan Island with less effort in a future survey. The questionnaire feedbacks helped to understand the source of marine litter and showed the impact on the local environment and economy. Based on the social-ecological scenarios, governance recommendations were provided in this paper.

scholarly journals POS1189 THE IMPACT OF TELEMEDICINE AND COVID-19 ON A TERTIARY RHEUMATOLOGY SERVICE: A RETROSPECTIVE AUDIT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 876-877
Author(s):  
W. Zhu ◽  
T. De Silva ◽  
L. Eades ◽  
S. Morton ◽  
S. Ayoub ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Univariate Analysis ◽  
Diagnostic Delay ◽  
Cohort Differences ◽  
Phone Calls ◽  
Retrospective Audit ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Background:Telemedicine was widely utilised to complement face-to-face (F2F) care in 2020 during the COVID-19 pandemic, but the impact of this on patient care is poorly understood.Objectives:To investigate the impact of telemedicine during COVID-19 on outpatient rheumatology services.Methods:We retrospectively audited patient electronic medical records from rheumatology outpatient clinics in an urban tertiary rheumatology centre between April-May 2020 (telemedicine cohort) and April-May 2019 (comparator cohort). Differences in age, sex, primary diagnosis, medications, and proportion of new/review appointments were assessed using Mann-Whitney U and Chi-square tests. Univariate analysis was used to estimate associations between telemedicine usage and the ability to assign a diagnosis in patients without a prior rheumatological diagnosis, the frequency of changes to immunosuppression, subsequent F2F review, planned admissions or procedures, follow-up phone calls, and time to next appointment.Results:3,040 outpatient appointments were audited: 1,443 from 2019 and 1,597 from 2020. There was no statistically significant difference in the age, sex, proportion of new/review appointments, or frequency of immunosuppression use between the cohorts. Inflammatory arthritis (IA) was a more common diagnosis in the 2020 cohort (35.1% vs 31%, p=0.024). 96.7% (n=1,444) of patients seen in the 2020 cohort were reviewed via telemedicine. In patients without an existing rheumatological diagnosis, the odds of making a diagnosis at the appointment were significantly lower in 2020 (28.6% vs 57.4%; OR 0.30 [95% CI 0.16-0.53]; p<0.001). Clinicians were also less likely to change immunosuppressive therapy in 2020 (22.6% vs 27.4%; OR 0.78 [95% CI 0.65-0.92]; p=0.004). This was mostly driven by less de-escalation in therapy (10% vs 12.6%; OR 0.75 [95% CI 0.59-0.95]; p=0.019) as there was no statistically significant difference in the escalation or switching of immunosuppressive therapies. There was no significant difference in frequency of follow-up phone calls, however, patients seen in 2020 required earlier follow-up appointments (p<0.001). There was also no difference in unplanned rheumatological presentations but significantly fewer planned admissions and procedures in 2020 (1% vs 2.6%, p=0.002). Appointment non-attendance reduced in 2020 to 6.5% from 10.9% in 2019 (OR 0.57 [95% CI 0.44-0.74]; p<0.001), however the odds of discharging a patient from care were significantly lower in 2020 (3.9% vs 6%; OR 0.64 [95% CI 0.46-0.89]; p=0.008), although there was no significance when patients who failed to attend were excluded. Amongst patients seen via telemedicine in 2020, a subsequent F2F appointment was required in 9.4%. The predictors of needing a F2F review were being a new patient (OR 6.28 [95% CI 4.10-9.64]; p<0.001), not having a prior rheumatological diagnosis (OR 18.43 [95% CI: 2.35-144.63]; p=0.006), or having a diagnosis of IA (OR 2.85 [95% CI: 1.40-5.80]; p=0.004) or connective tissue disease (OR 3.22 [95% CI: 1.11-9.32]; p=0.031).Conclusion:Most patients in the 2020 cohort were seen via telemedicine. Telemedicine use during the COVID-19 pandemic was associated with reduced clinic non-attendance, but with diagnostic delay, reduced likelihood of changing existing immunosuppressive therapy, earlier requirement for review, and lower likelihood of discharge. While the effects of telemedicine cannot be differentiated from changes in practice related to other aspects of the pandemic, they suggest that telemedicine may have a negative impact on the timeliness of management of rheumatology patients.Disclosure of Interests:None declared.

scholarly journals Conceptualizing the effects of the COVID-19 pandemic on people with opioid use disorder: an application of the social ecological model

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ethan Cowan ◽  
Maria R. Khan ◽  
Siri Shastry ◽  
E. Jennifer Edelman
Keyword(s):  
Structural Changes ◽  
Ecological Model ◽  
Disease Incidence ◽  
Opioid Use Disorder ◽  
Social Ecological Model ◽  
Physical And Mental Health ◽  
Opioid Use ◽  
Social Ecological ◽  
The Social ◽  
The Impact

AbstractThe COVID-19 pandemic has resulted in unparalleled societal disruption with wide ranging effects on individual liberties, the economy, and physical and mental health. While no social strata or population has been spared, the pandemic has posed unique and poorly characterized challenges for individuals with opioid use disorder (OUD). Given the pandemic’s broad effects, it is helpful to organize the risks posed to specific populations using theoretical models. These models can guide scientific inquiry, interventions, and public policy. Models also provide a visual image of the interplay of individual-, network-, community-, structural-, and pandemic-level factors that can lead to increased risks of infection and associated morbidity and mortality for individuals and populations. Such models are not unidirectional, in that actions of individuals, networks, communities and structural changes can also affect overall disease incidence and prevalence. In this commentary, we describe how the social ecological model (SEM) may be applied to describe the theoretical effects of the COVID-19 pandemic on individuals with opioid use disorder (OUD). This model can provide a necessary framework to systematically guide time-sensitive research and implementation of individual-, community-, and policy-level interventions to mitigate the impact of the COVID-19 pandemic on individuals with OUD.

scholarly journals Stigma dan Tingkat Kecemasan Masyarakat pada Covid-19

2021 ◽  
Vol 16 (3) ◽  
pp. 131
Author(s):  
Lilis Banowati ◽  
Cucu Herawati ◽  
Wiwiet Indriyani
Keyword(s):  
Social Impact ◽  
Univariate Analysis ◽  
Sampling Technique ◽  
Positive Thinking ◽  
Frequency Distributions ◽  
Data Presentation ◽  
The Public ◽  
The Social ◽  
Study Population ◽  
The Impact

Background: The increasing number of positive patients with Covid-19, the social impact in the form of stigma from being shunned by neighbors and even families and the impact of mental health, namely causing major psychosocial stresses that can trigger anxiety. Purpose  this study was to determine the stigma and level of public anxiety about Covid- 19. Methods: This type of research is descriptive quantitative, the study population is all people in the UPTD Haurgeulis Puskesmas, Indramayu Regency, as many as 88,468 people. The number of samples was 100 respondents using purposive sampling technique. Data were analyzed statistically using univariate analysis and data presentation in the form of frequency distributions. Results: This study shows that people have a low stigma as much as 1% and those who experience a high stigma are as much as 99%. As well as people who do not experience anxiety as much as 14% and most of them experience mild anxiety as much as 86%. Conclusion: The public should be wiser in sorting out information related to Covid-19 from various sources and can manage anxiety with good self-coping management, for example by relaxation and positive thinking related to Covid-19.

Impact of diabetes on caregiver stress in patients with Alzheimer's disease: data from the ICTUS study

2018 ◽  
Vol 30 (8) ◽  
pp. 1109-1117 ◽  
Author(s):  
Jun Li ◽  
Matteo Cesari ◽  
Natalia Del Campo ◽  
Sandrine Andrieu ◽  
Birong Dong ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Self Report ◽  
Personal Life ◽  
Diabetic Patients ◽  
Psychological Burden ◽  
Factorial Model ◽  
The Social ◽  
Significant Difference ◽  
The Impact

ABSTRACTBackground:To estimate the impact of comorbid diabetes on caregiver stress in Alzheimer's disease (AD) patients from the Impact of Cholinergic Treatment Use (ICTUS) study.Methods:Using the Data from the ICTUS study, diabetes mellitus (DM) was recorded at baseline and caregiver burden was assessed twice per year using the Zarit Burden Interview (ZBI) scale. The three-factorial model of ZBI (the effect on the social and personal life of caregivers, the psychological burden and the feelings of guilt) was adopted. Linear mixed models were used to examine the relation between DM and the scores of ZBI.Results:The present analyses were conducted on 1,264 AD subjects. A total of 156 patients (12.3%) had DM with taking antidiabetic medication and/or self-report of a history. At baseline, the caregivers of patients with or without DM had similar ZBI global scores and similar scores of three different factors of ZBI. Unadjusted and adjusted models both indicated that ZBI global score increased over a 24-month follow-up without significant effect of DM. Similarly, unadjusted model showed that DM was not determining any significant difference in the score of any factor. However, adjusted model indicated that in diabetic patients, the scores of the social and personal life of caregivers and the psychological burden increased more slowly than those in non-diabetic patients (p = 0.04 and 0.01, respectively).Conclusions:DM may affect the caregivers’ daily social and personal life and psychological burden in AD patients. It is necessary for further research.

scholarly journals Social Learning for Facilitating Dialogue and Understanding of the Ecosystem Services Approach: Lessons from a Cross-Border Experience in the Alboran Marine Basin

2019 ◽  
Vol 11 (19) ◽  
pp. 5239 ◽  
Author(s):  
María D. López-Rodríguez ◽  
Javier Cabello ◽  
Hermelindo Castro ◽  
Jaime Rodríguez
Keyword(s):  
Ecosystem Services ◽  
Social Learning ◽  
Social Transformation ◽  
Decision Makers ◽  
Ecological System ◽  
Social Ecological ◽  
The Social ◽  
Governance Practice ◽  
The Impact ◽  
Marine Basin

Social learning (SL) appears to have considerable potential to enhance the impact of the ecosystem services approach (ESA) discourse on policy and society. However, empirical research to better understand the processes that support SL, the effects it generates, and the conditions that enable such learning is limited. This study assesses the ability of SL to enhance dialogue and understanding of the ESA to support transformative social change in governance practice in the Alboran Marine Basin. To do so, we conducted a specifically designed SL process oriented towards the ESA as a governance approach in this marine region. The SL process was developed through three interlinked workshops involving scientists, decision-makers and local users from Spain and Morocco, the two countries that share the governance of this social-ecological system. The results revealed that the SL process progressively facilitated (i) a more inclusive and constructive ecosystem services dialogue, (ii) a better understanding of the social-ecological system in which the actors were embedded, (iii) an enhanced recognition of science-policy-society complementarities to address sustainability issues, and (iv) a gradual social transformation towards more sustainable and equitable governance. Via the SL process, a variety of factors were identified as contributing to the creation of four relevant conditions that facilitated its successful operationalisation. These conditions included (i) the generation of trust and shared understanding, (ii) the facilitation of knowledge exchanges between actor groups across frontiers, (iii) the promotion of more democratic participation, and (iv) the co-production of practical outcomes. These contextual insights provided empirical evidence of the prominent role SL can play to enhance dialogue and understanding of the ESA for supporting its adoption as governance practice. On this basis, it is argued that operationalising SL in those processes focused on making the ESA relevant to policy and society is pivotal to its implementation in governance practice.

Attitudes towards sex with alcoholics

2011 ◽  
Vol 26 (S2) ◽  
pp. 67-67
Author(s):  
Z.M. Krivokapic ◽  
R.V. Sapic
Keyword(s):  
Sexual Experience ◽  
Social Situation ◽  
Control Group ◽  
List Type ◽  
Homosexual Orientation ◽  
The Social ◽  
Significant Difference ◽  
The Difference ◽  
Attitudes Toward Sex ◽  
The Impact

Attitude is defined as acquired disposition, readiness for a certain way of perception, thinking, emotional reacting and behaving. The formation of social attitudes is greatly in influence by a group (alcoholics group). Drinking alcohol also disrupts higher cognitive processes: abstraction, conceptualization, problem solving and influences on different opinions.Our research concerned the impact of chronic alcohol use and membership to alcoholic group as a framework that influences attitudes towards sexuality. 200 persons were sample in this research: 100 alcohol addicts and 100 persons of the control group. The instrument used in this study was-Scale of attitudes toward sex.Statistically significant difference was found in five attitudes:–Differences in two paragraphs point to some homosexual orientation. We can confidently say that this is a “latent homosexuality in an alcoholic”, it is possible that the difference arises because of the presence of homosexuals in the group of alcoholics, although the subjects did not say to have such orientation.–Some conservatism is present in the attitude drinkers to sexuality of the young, they argue that sexual experience can wait until more mature years.–Extramarital relationships are positively evaluated by the control group, while alcoholics show greater disapproval.–Alcoholics have the attitude that sexual arousal does not come with ease, unlike the control group.–They are more liberal about the social situation of people with HIV (a certain degree of identification with an estimated negative social group).Results showed small difference in attitudes between alcoholics and nonalcoholic.

scholarly journals USE OF A WASHER DOES NOT AFFECT THE RATE OF IMPLANT REMOVAL OR ELBOW MOTION AFTER FIXATION OF MEDIAL EPICONDYLE FRACTURES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0018
Author(s):  
Neeraj M. Patel ◽  
Christopher R. Gajewski ◽  
Anthony M. Ascoli ◽  
J. Todd Lawrence
Keyword(s):  
Screw Fixation ◽  
Univariate Analysis ◽  
Medial Epicondyle ◽  
Implant Removal ◽  
Hardware Removal ◽  
Rank Test ◽  
Retrospective Case ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

Background: The use of a washer to supplement screw fixation can prevent fragmentation and penetration during the surgical treatment of medial epicondyle fractures. However, concerns may arise regarding screw prominence and the need for subsequent implant removal. The purpose of this study is to evaluate the impact of washer utilization on the need for hardware removal and elbow range of motion (ROM). Methods: All surgically-treated pediatric medial epicondyle fractures over a 7-year period were queried for this retrospective case-control study. Patients were only included if their fracture was fixed with a single screw with or without a washer. Per institutional protocol, implants were not routinely removed after fracture healing. Hardware removal was performed only if the patient experienced a complication or implant-related symptoms that were refractory to non-operative management. Full ROM was considered flexion beyond 130 degrees and less than a 10-degree loss of extension. Univariate analysis was followed by creation of Kaplan-Meier (one minus survival) curves in order to analyze the time until full ROM was regained after surgery. Curves between patients with and without a washer were compared with a log rank test. Results: Of the 137 patients included in the study, the mean age was 12.2±2.3 years and 85 (62%) were male. A total of 31 (23%) patients ultimately underwent hardware removal. A washer was utilized in 90 (66%) cases overall. There was not an increased need for subsequent implant removal in these patients compared to those that underwent screw fixation alone (p=0.11). The mean BMI of patients that underwent hardware removal (19.1±2.5) was similar to that of children who did not (20.4±3.5, p=0.06). When analyzing a subgroup of 102 athletes only, there was similarly no difference in the rate of implant removal if a washer was used (p=0.64). Overall, 107 (78%) patients regained full ROM at a mean of 13.9±9.7 weeks after surgery (Figure 1). There was no statistically significant difference in the proportions of patients with and without a washer that achieved full ROM (p=0.46). Full ROM was achieved at a mean of 14.1±11.0 weeks in those with a washer compared to 13.6±6.2 weeks in those without one (p=0.21). Conclusions: Use of a washer did not affect the need for subsequent implant removal or elbow ROM after fixation of pediatric medial epicondyle fractures, even in thinner patients or competitive athletes. If there is concern for fracture fragmentation or penetration, a washer can be included without concern that future unplanned surgeries may be required.

A New Cytokine-Based Stratification Is Highly Predictive of Survivals in AML Patients

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 1412-1412
Author(s):  
Pierre Peterlin ◽  
Joelle Gaschet ◽  
Thierry Guillaume ◽  
Alice Garnier ◽  
Marion Eveillard ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Stratification ◽  
Univariate Analysis ◽  
Standard Of Care ◽  
Healthy Controls ◽  
First Line ◽  
Serum Samples ◽  
Gm Csf ◽  
Significant Difference ◽  
The Impact

Introduction: Recently, a significant impact of the kinetics of Fms-like tyrosine kinase 3 ligand concentration (FLc) during induction (day[D]1 to D22) has been reported on survivals in first-line acute myeloid leukemia (AML) patients (pts) (Peterlin et al, 2019). Three different FLc profiles were disclosed i) sustained increase of FLc (FLI group, good-risk), ii) increase from D1 to D15, then decrease at D22 (FLD group, intermediate-risk) and iii) stagnation of low levels (&lt;1000 pg/mL, FLL group, high-risk). An update of this prospective monocentric study (www.ClinicalTrials.gov NCT02693899) is presented here evaluating also retrospectively the impact on outcomes of 6 other cytokine level profiles during induction. Methods: Between 05/2016 and 01/2018, 62 AML pts at diagnosis (median age 59 yo [29-71], &lt;60 yo n=33) eligible for first intensive induction were included and provided informed consent. They received standard of care first-line chemotherapy. Serum samples collected on D1, 8, 15 & 22 of induction were frozen-stored until performing ELISA for FL, TNFa, SCF, IL-1b, IL-6, IL-10, GM-CSF. Normal values were assessed in 5 healthy controls. Pts outcomes considered were relapse/leukemia-free (LFS) and overall (OS) survivals. Results: FLI, FLD and FLL profiles were observed for 26, 22 and 14 pts respectively. A total of 372 samples were assayed for the 6 other cytokines. Median concentrations at D1, D8, D15, D22 for these 6 cytokines were as follows, considering the whole cohort (and healthy donors): TNFa: 0.53, 0, 0, 0 (0); SCF: 5.91, 0, 0, 0 (3); IL-1b : 0, 0, 0, 0 (0); IL-6: 4.85, 16.28, 10.11, 7.1 (0), IL-10: 0, 0, 0, 0 (0) and GM-CSF:1.63, 1.8, 0.67, 1.34 (9.98). Median IL-6 and GM-CSF levels, compared to healthy controls, were respectively higher and lower during induction. No significant difference was observed in terms of median cytokine concentrations at any time when comparing the three FL sub-groups or FLI vs FLD pts. With a median follow-up of 28 months (range: 17-37), FLI and FLD pts show now similar 2-y LFS (62.9% vs 59%, p=0.63) and OS (69.2% vs 63.6%, p=0.70). FLL pts have a significantly higher rate of relapse (85,7% vs FLI 19,2% vs FLD 32%, p=0,0001). Comparing FLL vs FLI+FLD pts disclosed significantly different LFS (7.1% vs 61.1%, p&lt;0.001) but not OS (36.7% vs 66.6%, p=0.11). In univariate analysis, 2y LFS and OS were not affected by the concentration (&lt; or &gt; median) of the 7 cytokines studied except for LFS and GM-CSFc at D8 (p=0,04) and D15 (p=0,08), for LFS and FLc at D1 (p=0.06), D8 (p=0,03), D15 (p=0,04) and D22 (p=0,03) and for OS and GM-CSF at D15 (p=0.08). A significant association between LFS was observed with ELN 2017 risk stratification (2-y LFS: favorable: 68,1% vs intermediate: 48,1% vs unfavorable: 30,7%, p=0.03) but not OS (2 y: 77% vs 55,5% vs 46,1%, p=0.09). Multivariate analysis showed that no factor was independently associated with OS while LFS remained significantly associated with the FLc profile (FLL vs others, HR: 5.79. 95%CI: 2.48-13.53, p&lt;0.0001) and GM-CSF at D15 (HR: 0.45; 95%CI: 0.20-0.98, p=0.04) but not with ELN 2017 risk stratification (p=0.06). Cytokine levels were then assessed to try to better discriminate FLI and FLD pts. A significant higher IL-6 level at D22 was found in relapsed or deceased FLI/FLD pts (median:15,34 vs 5,42 pg/mL, p=0,04). FLI/FLD pts with low IL-6 at D22 (&lt; median, 15.5 pg/mL, n=35 vs n=14 with high level) had significant better 2y LFS and OS (74,2% vs 38,4%, p=0,005 and 77,1% vs 38,4%, p=0,009, respectively). A new prognostic risk-stratification could thus be proposed, i.e. FLI/FLD with IL-6 &lt;15.5 pg/mL (favorable), FLI/FLD with IL-6 &gt;15.5 pg/mL (intermediate) and FLL (unfavorable). This new classification was considered for a second multivariate analysis, showing that it is the strongest factor associated with OS (p=0.006, ELN p=0.03, FL profile p=0.04) and LFS (p&lt;0.0001, ELN p=0.005, GM-CSFc D15 p=0.03) (figure 1). Conclusion: This study confirms stagnation of low FLc during AML induction as a strong poor prognosis factor. Moreover, IL-6 levels at D22 further discriminate FLI/FLD pts. Thus, a new cytokine-based risk-stratification integrating FL kinetics and IL-6 levels during induction may help to better predict outcomes in first-line AML patients. These results need to be validated on a larger cohort of AML patients while anti-IL-6 therapy should be tested in combination with standard 3+7 chemotherapy. Figure 1 Disclosures Peterlin: AbbVie Inc: Consultancy; Jazz Pharma: Consultancy; Daiichi-Sankyo: Consultancy; Astellas: Consultancy. Moreau:Janssen: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; Takeda: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria; Celgene: Consultancy, Honoraria. Chevallier:Jazz Pharmaceuticals: Honoraria; Incyte: Consultancy, Honoraria; Daiichi Sankyo: Honoraria.

Revalidation of the Flipi Score in the Era of Immunotherapy.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4437-4437
Author(s):  
German Stemmelin ◽  
Carlos Doti ◽  
Claudia Shanley ◽  
Jose Ceresetto ◽  
Oscar Rabinovich ◽  
...  
Keyword(s):  
Bone Marrow ◽  
High Risk ◽  
Univariate Analysis ◽  
Risk Groups ◽  
Marrow Transplant ◽  
Intermediate Risk ◽  
Significant Difference ◽  
The Difference ◽  
The One ◽  
The Impact

Abstract The FLIPI prognosis score for follicular lymphoma (FL) was developed based on cases diagnosed between 1985 and 1992, and treated with different schemes that did not include rituximab (R). In the present study, we report the evolution of all FL treated in a single institution through the last decade and analize whether FLIPI mantains its effectiveness to identify different risk groups within patients treated with the new therapeutic alternatives available. Material and Methods: We identified sixty two patients with diagnosis of grade I-II-IIIa FL. Patients characteristics: median age 57.5 yr (r, 30–80); 36 males; 63% stages III–IV, and 37% with bone marrow infiltration at the time of diagnosis. Thirty eight percent had a low risk by FLIPI, 34% had an intermediate risk and 27.4% had a high risk. In 19 pts (30.6%) the initial decision was “watch and wait” but 82% received a form of treatment at some point. R was used in 36 pts (58%) with some of the following regimes: chemotherapy (chemo) + R and/or R as consolidation therapy and/or R as monotherapy and/or R as maintenance therapy. Of all prescribed treatments (excluding R as monotherapy and/or maintenance treatment), 52.8% were chemo alone, 20.2% chemo + R, 21.3% radiotherapy and 5.6% received a bone marrow transplant. Results: we considered the analysis of overall survival (OS) the most appropiate approach, since most treatments were seeking the control of the FL, and not the complete remission or cure. The follow up median time was 53.2 months ± 34.8 1SD. The 5-yr OS for the 62 pts was 81.8% ± 11.3 CI 95%. The 5-yr OS for those with a low, intermediate and high risk FLIPI was 100% −5, 84.2% ± 21 and 52% ±26.2, respectively. The difference in 5-yr OS was statistically significant between low and high risk, intermediate and high risk, but failed to prove a significant difference between low and intermediate risk. Among the different risk factors tested in a univariate analysis only age ≥ < 60 yr old demonstrated a significant difference, 60.7% vs 90%, respectively. Conclusions: The 5-yr OS in our series is higher than the one described in the original FLIPI study (Blood2004; 104:1258–65) which was 81.8% vs 71% for the whole group; 90% vs 78.1% for pts <60 yr old; 60.7% vs 57.7% for ≥ 60 yr old; 100% vs 90.6% for low FLIPI and 84.2% vs 77.6% for intermediate FLIPI. The only group that failed to prove an improvement was the high risk FLIPI with 52% vs 52.5%. The impact of novel therapies was more evident in patients with a low or intermediate FLIPI and was even more evident in patients younger than 60 yr old. According to our results, FLIPI maintains its effectiveness in differentiating two risk groups, i.e., low-intermediate vs high. We believe that the OS curves will probably continue to improve as the treatments that are considered today as the most effective ones, were just included in our series in the last three years.

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