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Our study investigated the effects of hypoxia on visuospatial attention processing during preparation for a single/double-choice motor response. ERPs were recorded in two sessions in which participants breathed either ambient-air or oxygen-impoverished air. During each session, participants performed four cue-target attention orienting and/or alerting tasks. Replicating the classic findings of valid visuospatial attentional orienting modulation, ERPs to pre-target cues elicited both an Anterior directing attention negativity (ADAN)/CNV and a posterior Late directing attention positivity (LDAP)/TP, which in ambient air were larger for attention orienting than for alerting. Hypoxia increased the amplitude of both these potentials in the spatial orienting conditions for the upper visual hemifield, while, for the lower hemifield, it increased ADAN/CNV, but decreased LDAP/TP for the same attention conditions. To these ERP changes corresponded compensatory enhanced activation of right anterior cingulate cortex, left superior parietal lobule and frontal gyrus, as well as detrimental effects of hypoxia on behavioral overt performance. Together, these findings reveal for the first time, to our knowledge, that (1) these reversed alterations of the activation patterns during the time between cue and target occur at a larger extent in hypoxia than in air, and (2) acute normobaric hypoxia alters visuospatial attention orienting shifting in space.

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The aim of this study was to measure the proportion and characteristics of complementary therapy (CT) users among female breast cancer patients receiving conventional treatment. 473 women who had received surgical intervention for breast cancer in the year of diagnosis were sent a questionnaire for completion, and 242 responded. CT had been used by 16.5% after cancer diagnosis, only 8.7% before. The most commonly used CTs were homeopathy, manual healing method, herbalism and acupuncture. The main reason for using CTs was physical distress. Only a minority was searching for psychological support. 24 users were satisfied with these treatments, and two-thirds would suggest them. Users were significantly younger, more educated, and previous users of CTs than non-users. Adjusting each variable for the effect of the others, only previous use had an independent effect on increasing the probability of being users after cancer diagnosis.

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In the present issue, the report "L'assistenza sanitaria all'estero-rapporti economici nei confronti dei Paesi CEE" by the Italian Health Ministry has been examined. The frequency and the cost of the health migration among Italy and other countries of the European Community during 1990-1993 has been presented. The migration of foreign patients to Italy was in agreement with tourism. About 35-40% of the Italian patients cured in the European Community were tourists. The others were patients migrated to obtain specialised treatments not available in Italy. The most frequent causes of migration were cancer, emathological diseases and radiotherapy, followed by transplants, neurological, cardiovascular and orthopaedic diseases. France was the most frequent destination. The overall cost of Italian health migration was 229 Pounds miliard in 1990, 300 Pounds miliard in 1991, and 264 and 216 Pounds miliard in 1992-1993. In the period analysed in the ministerial report, migration seemed to reduce. Migration however was still important especially from the South of Italy. The effect of the new regulations on the decreasing trend in migration was analysed.

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AIMS AND BACKGROUND: There is growing interest in medical practices other than conventional medicine (complementary medicine, CM). CM is widely used by cancer patients. The purpose of the present study was to evaluate the knowledge of and the attitude towards CM in a sample of Italian allopathic oncologists. METHODS: Seventy-six oncologists of the Istituto Nazionale per la Ricerca sul Cancro of Genoa, 80 oncologists working at the Istituto Tumori Fondazione Pascale of Naples, and 100 hospital practitioners of the Province of Sondrio were asked to answer a self-administered structured questionnaire on CM. The level of their knowledge on CM, their opinion on CM and on CM therapists, the sources of information, the use of CM for themselves, the practice of CM and the attitude to refer patients to CM were investigated. RESULTS: Replies were received from 190 oncologists. The response rate was significantly lower for the oncologists of Naples. One-fifth of the physicians replied that they had no knowledge of CM. The main sources of information were newspapers and TV. One-fourth of the physicians had personally used CM. About one-fourth of the physicians had practiced a kind of CM. The percentage of oncologists from Genoa who would refer their cancer patients to CM was significantly higher than the others. The physicians thought that about 84% of their patients used CM. The variables considered were tested in a multivariate model. The oncologists from Genoa showed a significantly increased risk of referring their patients to CM. Oncologists who had personally used CM referred patients to CM 3 times more frequently than the others. CONCLUSIONS: A large percentage of cancer patients used CM according to their physicians. The level and the quality of the knowledge of CM of the oncologists interviewed were low. The oncologists could hardly be helpful for their patients in dealing with therapies different from conventional medicine.

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We do not intend to specify definite proposals as regards the scientific responsibility of genetic practice. This field of predicting the development of a pathology in an individual and family history requires reflection on the perception of personal risk, of the importance and reassurance deriving from a personal history, and of the benefits sharing knowledge and care with the clinical and scientific world. We evaluate the possibility to expand a reflection on sign-possibility and sign-expression of disease that could develop a wider comparison with personal freedom when confronted by genetic, philosophical and historical determinations. A parallel and preliminary consideration is made of guidelines for diagnostic and therapeutic behavior.

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Most Italian patients who migrate to foreign countries to receive health care, choose France. The Gustave Roussy Institute (IGR) located in Villejuif, a town in the suburbs of Paris, is one of the most important center for cancer diagnosis and treatment in France. The aim of this issue has been to evaluate the admissions of Italian patients in terms of cause of admission, treatment and area of residence of the patients. We analysed the series of Italian patients admitted to IGR from 1988 to 1991; during that period 8159 Italian patients were hospitalized (2.8% younger than 15 years, 84.3% between 15 and 64 years and 12.9% older than 64 years). Most of those patients were resident in the South of Italy (more than 63%) and in particular they came from the region Sicily (27.4%) and Campania (18.8%). A different pattern seems to distinguish patients coming from the Center and the North of Italy from those from the South. In fact the aim of this migration was, for the former, a consultation on the therapy that they had, in large part, already undergone in Italy while the latter wanted to start their treatment there. The admissions related to the three most frequent cancers (breast, lung, lympho-hemopoietic system) have been analysed. The majority of patients were from the South of Italy. Breast cancer patients have migrated to the IGR looking for a post-surgical treatment while lung patients have been in large part treated for the first time at the IGR.

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An interdisciplinary approach was adopted in a pilot programme research project as the most effective way to obtain concrete results in curing tobacco-addiction. The various stages and effects of the treatment are analysed as a means of identifying the most appropriate techniques. The early results are reported under separate headings according to treatment type (psychological, neurophysiological, dietary, clinical, chemical).

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