Capacity assessment for provision of quality sexual reproductive health and HIV-integrated services in Karamoja, Uganda

Introduction: Sexual and reproductive health (SRH) and Human Immunodeficiency Virus (HIV) are crucial global health issues. Uganda continues to sustain a huge burden of HIV and AIDS.
 Methods: A cross-sectional health facility-based assessment was performed in November and December 2016 in Karamoja Region, northern Uganda. All the 126 health facilities (HFs) in Karamoja, including 5 hospitals and 121 Health Centers (HCs), covering 51 sub-counties of the 7 districts were assessed. We assessed the capacity of a) leadership and governance, b) human resource, c) service delivery, d) SRH and HIV service integration and e) users satisfaction and perceptions.
 Results: 64% of the establi…

Cancer registries and data protection in the age of health digital interoperability in Europe: The perspective of the Italian Network of Cancer Registries (AIRTUM).

Population-based cancer registries (PBCRs) are advanced public health systems providing ongoing surveillance through systematic collection, analysis, interpretation, and dissemination of high-quality data on cancer incident cases registered in a defined population residing in a specific geographical area (1, 2). Basically, PBCRs are well equipped for strengthening cancer surveillance, playing a strategic role in making geographic and temporal variation comparisons to highlight cancer epidemics, while assessing the effectiveness of preventive interventions and oncological care (3). Furthermore, many PBCRs provide cancer risk communication to local communities and authorities by using valuabl…

EUROMEDITERRANEAN BIOMEDICAL JOURNAL (EMBJ) TO SUPPORT THE INTERNATIONAL CALL FOR GRANTS FROM THE ITALIAN INSTITUTE OF HEALTH DEDICATED TO YOUNG RESEARCHERS.

EuroMediterranean Biomedical Journal (EMBJ) can be considered both a scientific journal and a learning tool for “researchers-in-training” coming from Euro-Mediterranean Countries and other areas of the globe. We announce the launch of an international call for grants from Istituto Superiore di Sanità (ISS, the Italian National Institute Health), reserved to young Italian and foreign researchers. We strongly encourage the junior researchers that have authored manuscripts published in EMBJ to consider the application to this extraordinary opportunity.

Proprietà dei fotocatalizzatori nanostrutturati a base di TiO2: applicazioni sull’inquinamento di acque reflue

Focused ultrasound to diagnose HIV-associated tuberculosis (FASH) in the extremely resource-limited setting of South Sudan: a cross-sectional study

ObjectiveOur cross-sectional study aimed at evaluating the diagnostic performance of Focused Assessment with Sonography for HIV-associated tuberculosis (FASH) to detect extrapulmonary tuberculosis in extremely resource-limited settings, with visceral leishmaniasis as a differential diagnosis with overlapping sonographic feature.DesignCross-sectional study.SettingVoluntary Counselling and Testing Centre (VCT) of Yirol Hospital, South Sudan.ParticipantsFrom May to November 2017, 252 HIV-positive patients out of 624 newly admitted to VCT Centre were registered for antiretroviral treatment. According to the number of trained doctors available to practise ultrasound (US) scan, a sample of 100 pa…

Sistema Informativo Sanitario (SIS)

La Prevenzione dei rischi nei servizi di pronto soccorso: la gestione dei rifiuti chimici e biologici.

Cost effectiveness of aortic valve therapies: a systematic review of the literature

Background: Systematic review on the cost effectiveness of transcatheter aortic valve implantation (TAVI) to standard aortic valve replacement and medical management in high-risk elderly patients with severe aortic stenosis. Evidenced based systematic reviews are the core methodologies in health economics for evaluating cost effectiveness and medical effectiveness. Clarity and transparency of these reports can help to provide health care interventions accurately and reliably. Methods: In accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses, a systematic review on current literature for cost-effectiveness of TAVI, standard aortic valve replacement, and medical m…

A comprehensive one-year correlation analysis between prevalence and number of sars-cov-2 rna copies detected in wastewater from 8 sicilian cities in italy

Background and objectives: Several authors have reported positive correlations between wastewater SARS-CoV-2 concentrations and the community’s burden of infection, providing information about the disease’s epidemiological trend. This pre-post study evaluated – within a year of active surveillance, from October 1st,2021, to September 30th, 2022 – the relation between daily SARSCoV-2 prevalence and the number of genome copies/L detected in West Sicily wastewater samples. This study is part of a national framework coordinated by Istituto Superiore di Sanità. Methods: Quantitative data from analysing 486 wastewater samples collected from 9 purification plants in 8 Sicilian cities (Agrigento, B…

SARS-COV-2 PANDEMIC IN THE MEDITERRANEAN AREA: EPIDEMIOLOGY AND PERSPECTIVES

In December 2019, a disease caused by a novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified in Wuhan, Hubei Province, China. In March 2020, the World Health Organization declared the pandemic due to SARS-CoV-2. At the end of May 2020, SARS-CoV-2 confirmed cases and deaths due to novel Coronavirus disease (COVID-19) were about 6.5 million and 380,000, worldwide. In this commentary the authors argue on the impact of SARS-CoV-2 pandemic in different epidemiological settings within the Mediterranean area, discussing any possible association with higher or lower virus spread according to climatic factors, pollutants, characteristics of general population, and organi…

La vaccinazione antinfluenzale negli operatori sanitari tra necessità di sanità pubblica e limiti medico-legali

An Outbreak of Hepatitis C Virus Infection Among Transfused Thalassemia Patients: Root Cause Analysis, Phylogenetic Epidemiology and Antiviral Therapy

Background: Occurrence of HCV infection is reduced by effective risk management procedures, but patient-to-patient transmission continues to be reported in healthcare settings. We report an outbreak of 11 patients with HCV acute hepatitis (seven new infections and four re-infections) among 128 thalassemia patients followed at a Hospital in Sicily. Methods All patients with acute hepatitis and known chronic infection were tested for HCV-RNA, HCV genotyping, and NS3, NS5A and NS5B HCV-genomic regions sequencing.  To identify transmission clusters we built phylogenetic trees for each gene employing Bayesian methods.  Findings All patients with acute hepatitis were infected with HCV genotype 1b…

MOTIVATIONAL ASPECTS AND LEVEL OF SATISFACTION OF ITALIAN JUNIOR DOCTORS WITH REGARD TO KNOWLEDGE AND SKILLS ACQUIRED ATTENDING SPECIFIC GENERAL PRACTICE TRAINING COURSES. A NATIONAL WEB SURVEY

The demographic and epidemiological transitions resulted in a pressing need to reformulate the health workforce demand and to revise pre- and post-graduate training to prepare the medical profiles to meet the new health needs focused on chronic diseases. The Italian Junior Doctors Association and the Giotto Movement carried out a web survey to identify the motivational aspects and the level of satisfaction of Italian junior doctors regarding knowledge and skills acquired after attending the General Practitioners’ specific training (GP-ST). Three-hundred-forty-seven General Practitioners (GPs), 302 trainees and 45 newly qualified trainees answered a web questionnaire. Significant differences…

Effectiveness of First-Line Bevacizumab in Metastatic Colorectal Cancer: The Observational Cohort Study GRETA

Background: Scant real-world data exist on the clinical outcomes associated with the use of bevacizumab-containing chemotherapy (B+CT) in patients with metastatic colorectal cancer (mCRC). The primary objective of the GRETA cohort study was to compare the overall survival (OS) of patients with mCRC treated with first-line B+CT versus chemotherapy (CT) alone, in an Italian clinical practice setting. Materials and Methods: Incident patients with mCRC were identified during the period 2010–2012 from five population-based cancer registries in Italy. Cases were linked to regional health care utilization databases to obtain the entire spectrum of health services provided to each patient. Patients…

A retrospective follow up study on maternal age and infant mortality in two Sicilian districts

Abstract Background Infant mortality rate (IMR) is a key public health indicator. Maternal age is a well-known determinant of pregnancy and delivery complications and of infant morbidity and mortality. In Italy the Infant Mortality Rate was 3.7/1000 during 2005, lower than the average IMR for the European Union (4.94/1000). Sicily is the Italian region with the highest IMR, 5/1000, and neonatal mortality rate (NMR), 3.8/1000, with substantial variation among its nine districts. The present study compared a high IMR/NMR district (Messina) with a low IMR/NMR district (Palermo) during the period 2004-2006 to evaluate potential determinants of the IMRs' differences between the two districts and…

Use of Saliva in Alternative to Serum Sampling to Monitor Biomarkers Modifications in Professional Soccer Players

We aimed to investigate the correlation between serum and salivary concentrations of steroid hormones and IgA, and the variation in concentrations of these biomarkers, across a soccer competitive season in a sample of players playing for an Italian major League team. Thirty-five elite male soccer players were recruited and assessed for salivary hormones (cortisol, testosterone, T/C‰ and DHEA-S) and IgA at three different time-points: (t1) after the pre-season period and 16 official matches played; (t2) after a winter break and three official matches played; (t3) 2 days after the final match of the championship and 19 matches played. Players were also tested for blood biomarkers (ser-C, ser-…

SARS-CoV-2 and the Risk Assessment Document in Italian Work: Specific or Generic Risk Even If Aggravated?

In December 2019, several cases of atypical pneumonia were detected in Wuhan city, Hubei province, inland China. The initial outbreak was of considerable size first in China subsequently spread to the rest of the world. Immediately after the epidemic (which according to the World Health Organization had risen to pandemic status), the problem of whether or not to update the occupational risk assessment arose, also considering how the biological risk from SARS CoV-2 should be understood: specific or generic. To this end, we conducted a literature review to identify national health legislation and policies, examining how Italy has addressed the COVID-19 emergency in occupational health plannin…

Excess risk of subsequent malignant neoplasms in adolescent and young adult cancer survivors: Results from the first Italian population-based cohort

Background: Evidence about late effects in adolescent and young adult (AYA) cancer survivors is scarce. This study assessed the risk of subsequent malignant neoplasms (SMNs) to identify the most common SMNs to be considered in follow-up care. Methods: Population-based cancer registries retrospectively identified first primary tumors (between 1976 and 2013) and SMNs in AYAs (15-39 years old at their cancer diagnosis). AYA cancer survivors were those alive at least 5 years after their first cancer diagnosis. The excess risk of SMNs was measured as standardized incidence ratios (SIRs) and absolute excess risk together with the cumulative incidence of SMNs. Results: The cohort included 67,692 A…

IL PORTALE ITALIANO DELLE MALATTIE COMPLESSE: UNO STRUMENTO PER L’EMPOWERMENT DI CITTADINI E LA FORMAZIONE DEI MEDICI.

Consumo di fumo di tabacco e sostanze stupefacenti in un campione di studenti del primo anno della facoltà di Medicina e Chirurgia di Palermo

Educational Interventions on Pregnancy Vaccinations during Childbirth Classes Improves Vaccine Coverages among Pregnant Women in Palermo’s Province

Maternal immunization is considered the best intervention in order to prevent influenza infection of pregnant women and influenza and pertussis infection of newborns. Despite the existing recommendations, vaccination coverage rates in Italy remain very low. Starting from August 2018, maternal immunization against influenza and diphtheria-tetanus-pertussis were strongly recommended by the Italian Ministry of Health. We conducted a cross sectional study to estimate the effectiveness of an educational intervention, conducted during childbirth classes in three general hospitals in the Palermo metropolitan area, Italy, on vaccination adherence during pregnancy. To this end, a questionnaire on kn…

Earlier appearance of the ossification center of the femoral head in breast-fed versus formula-fed infants

Abstract Objective The aim of this study was to evaluate possible differences in the rate of appearance of the femoral head ossification center (FHOC) in infants according to the type of feeding (exclusive breast-feeding, formula, mixed feeding). Methods A retrospective study was conducted in a population of 285 healthy infants who consecutively underwent echographic evaluation of the hip as a screening for hip dysplasia from April 1 through October 31, 2008. For each infant, type of feeding, sex, gestational age, weight at birth, and age at the time of echographic examination were recorded. Data analysis was performed in the entire sample population and in a subpopulation of 143 infants af…

Childhood and Adolescence Cancers in the Palermo Province (Southern Italy): Ten Years (2003-2012) of Epidemiological Surveillance

Italy has one of the highest paediatric cancer incidence rates in Europe. We compared cancer incidence and survival rates in children (0&ndash

Distance learning training in genetics and genomics testing for Italian health professionals: results of a pre and post-test evaluation

BackgroundProgressive advances in technologies for DNA sequencing and decreasing costs are allowing an easier diffusion of genetic and genomic tests. Physicians’ knowledge and confidence on the topic is often low and not suitable for manage this challenge. Tailored educational programs are required to reach a more and more appropriate use of genetic technologies.MethodsA distance learning course has been created by experts from different Italian medical associations with the support of the Italian Ministry of Health. The course was directed to professional figures involved in prescription and interpretation of genetic tests. A pretest-post-test study design was used to assess knowledge impr…

Knowledge, Attitudes, Perceptions and Vaccination Acceptance/Hesitancy among the Community Pharmacists of Palermo’s Province, Italy: From Influenza to COVID-19

In Italy, following the start of the SARS-CoV-2 vaccination campaign, community pharmacies (CPs) were recruited on a voluntary basis in order to administer COVID-19 vaccines as part of their activities. The aim of the present study was to investigate the knowledge, attitudes, and practices regarding SARS-CoV-2 infection prevention, and vaccine acceptance/hesitancy towards COVID-19 and influenza vaccinations among the community pharmacists operating in the Palermo Province. A cross-sectional study was conducted, with two different questionnaires administered before and after the conduction of the vaccination campaign against SARS-CoV-2 at the COVID-19 vaccination center of the Palermo Univer…

Comparison of paediatric cancers outcomes between Palermo Province (Sicily) and Southern Europe

Background: Italy has one of the highest paediatric cancer incidence rate in Europe. We compared cancer incidence and survival in children (0-14 years) and adolescents (15-19 years) resident in Palermo Province with statistics derived from Italian and European surveillance systems. Methods: We included all incident cancer cases, malignant tumours and non-malignant neoplasm of central nervous system (benign and uncertain whether malignant or benign), detected in children and adolescents by the Palermo Province Cancer Registry between 2003 and 2012. A joinpoint regression model was applied. Annual Average Percentage Changes were calculated. The Besag–York–Mollie model was used to detect any c…

Survival trends for primary liver cancer, 1995–2009: analysis of individual data for 578,740 patients from 187 population-based registries in 36 countries (CONCORD-2)

CONCORD Working Group Members: Africa—Algeria: S Bouzbid (Registre du Cancer d’Annaba); M Hamdi-Chérif*, Z Zaidi (Registre du Cancer de Sétif); Gambia: R Swaminathan (National Cancer Registry); Lesotho: SH Nortje (Children’s Haematology Oncology Clinics - Lesotho); Libya: MM El Mistiri (Benghazi Cancer Registry); Mali: S Bayo, B Malle (Kankou Moussa University); Mauritius: SS Manraj, R Sewpaul-Sungkur (Mauritius National Cancer Registry); Nigeria: A Fabowale, OJ Ogunbiyi* (Ibadan Cancer Registry); South Africa: D Bradshaw, NIM Somdyala (Eastern Cape Province Cancer Registry); DC Stefan (Umtata University); Tunisia: L Jaidane, M Mokni (Registre du Cancer du Centre Tunisien).
America (Central…

Observational study on risk factors determining residual dizziness after successful benign paroxysmal positional vertigo treatment: The role of subclinical BPPV

Studio osservazionale sui fattori di rischio che causano residual dizziness dopo il trattamento della vertigine parossistica posizionale benigna: il ruolo della VPPB subclinica.Alcuni pazienti, dopo il trattamento della vertigine parossistica posizionale benigna concluso con successo, possono lamentare un disequilibrio residuo. La possibile spiegazione potrebbe essere: la persistenza di otoliti canalari insufficienti a provocare un nistagmo clinicamente evidente, una disfunzione utriculare, coesistenza di altri disordini del sistema vestibolare. Abbiamo condotto uno studio osservazionale prospettico caso-controllo, focalizzando l’attenzione sul ruolo di fattori di rischio che possono causar…

Genotypic and phenotypic aspects of longevity: results from a Sicilian survey and implication for the prevention and the treatment of age-related diseases

Background:It is well known that long living individuals are a model of successful ageing and that the identification of both genetic variants and environmental factors that predispose to a long and healthy life is of tremendous interest for translational medicine.Methods:We present the preliminary findings obtained from an ongoing study on longevity conducted on a sample of Sicilian long-lived individuals.Results:We review the characteristics of longevity in Sicily, taking into account lifestyle, environment, genetics, hematochemical values, body composition and immunophenotype. In addition, we discuss the possible implications of our data for the prevention and/or treatment of age-related…

Current state of genomic policies in healthcare among EU member states: results of a survey of chief medical officers

Abstract Background A need for a governance of genomics in healthcare among European Union (EU) countries arose during an international meeting of experts on public health genomics (PHG). We have conducted a survey on existing national genomic policies in healthcare among Chief Medical Officers (CMOs) of the 28 EU member states, plus Norway. Methods A questionnaire was sent to CMOs after a meeting on the policy implications of PHG held during the Italian presidency of the Council of EU in 2014. The survey was closed in November 2015. Results CMOs response rate was 65.5% (19/29). Twelve (63.2%) reported that their countries had a policy for genomics in healthcare in place, and 15 (78.9%) rep…

Prevalence of the bullying phenomenon in a schools sample of Palermo, Sicily: a pre-post intervention observational study among teachers

Background and aim of the work: Bullying involves a significant percentage of school-age children. According to the latest available surveillance data, in Sicily, the estimated prevalence among 11-15 years old children is 14%. This study aimed to estimate a prevalence of the bullying phenomenon, observed by teachers, in a sample of secondary schools of Palermo, Sicily. Moreover, after the conduction of preventive interventions among teachers, aimed to evaluate any modification in bullying prevalence. Methods: A cluster sampling selection according to socio-economic level of the school neighborhood was carried out. Two anonymous online questionnaires, pre and post-intervention, were administ…

L’infermiere e la cultura delle sicurezza: conoscenze, attitudini e comportamenti in tema di rischio clinico

Prevalence of Sensitization toAnisakis simplexAmong Professionally Exposed Populations in Sicily

Anisakis simplex (AS) is a cause of allergic sensitization and potential occupational risk is suggested in fishermen and workers assigned to fish processing and sale. A cross-sectional study was conducted in order to assess possible health effects of occupational exposure to AS in workers recruited from western Sicily fisheries sector. Social, demographic, and occupation-related data were collected. Serum total immunoglobulin E (IgE) and specific IgE levels to AS (threshold >0.35 kU/L) were determined by an fluoroimmunoassay technique. Ninety-four subjects with potential occupational exposure (fishmongers, fishermen, fish industry employees) were recruited. Specific AS IgEs were detected in…

Funnel plots and choropleth maps in cancer risk communication: a comparison of tools for disseminating population-based incidence data to stakeholders

Background Population-based cancer registries provide epidemiological cancer information, but the indicators are often too complex to be interpreted by local authorities and communities, due to numeracy and literacy limitations. The aim of this paper is to compare the commonly used visual formats to funnel plots to enable local public health authorities and communities to access valid and understandable cancer incidence data obtained at the municipal level. Methods A funnel plot representation of standardised incidence ratio (SIR) was generated for the 82 municipalities of the Palermo Province with the 2003–2011 data from the Palermo Province Cancer Registry (Sicily, Italy). The properties …

Could university training and a proactive attitude of coworkers be associated with influenza vaccination compliance? A multicentre survey among Italian medical residents

Background Although influenza vaccination has been demonstrated to be safe and effective, vaccination coverage rates among health care workers and among medical residents appear generally low. Several investigations have been performed worldwide to analyze the healthcare workers’ educational deficiencies. This multicentre survey aimed to investigate at a nationwide level training quality and work environment associated with seasonal influenza vaccination uptake among Italian medical residents. Methods A retrospective cohort study was carried out from April 2012 to June 2012 on medical residents regularly attending the post-graduate medical schools of 18 Italian Universities via an anonymous…

Wastewater-based epidemiology for early warning of SARS-COV-2 circulation: A pilot study conducted in Sicily, Italy

There is increasing evidence of the use of wastewater-based epidemiology to integrate conventional monitoring assessing disease symptoms and signs of viruses in a specific territory. We present the results of SARS-CoV-2 environmental surveillance activity in wastewater samples collected between September 2020 and July 2021 in 9 wastewater treatment plants (WTPs) located in central and western Sicily, serving over 570,000 residents. The presence of SARS-CoV-2, determined in 206 wastewater samples using RT-qPCR assays, was correlated with the notified and geo-referenced cases on the areas served by the WTPs in the same study period. Overall, 51% of wastewater samples were positive. Samples we…

Consumo di sostanze alcoliche in un campione di studenti del primo anno della Facoltà di Medicina e Chirurgia di Palermo

Determinants of inappropriate hospitalization in cataract surgery in the south of Italy: a retrospective study

Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants. Methods A nested retrospective case–control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model. Results Forty-five cases (…

Addressing the gap between genetics knowledge and clinical practice: a pilot study to implement genetics education among physicians in Italy

As a result of large investments in basic science, the genomic discoveries have brought outstanding advances in understanding the molecular basis of human health. Hundreds of genes whose variations contribute to human diseases, or patients’ responses to drug treatments or even to vaccination have been discovered, laying the foundation for a paradigm shift in healthcare...

La metodica wastewater based epidemiology come proxy di quantificazione del consumo di sostanze stupefacenti nella popolazione: l’esperienza della città di Palermo.

INTRODUZIONE Le istituzioni europee e la comunità scientifica hanno, recentemente, definito un nuovo modello di sorveglianza attiva della potenziale diffusione delle droghe nella collettività, la Wastewater Based Epidemiology (WBE), attraverso la ricerca analitica delle molecole e dei loro metaboliti nelle acque reflue cittadine. Lo scopo di questo lavoro è stato la valutazione di una preliminare applicazione di METODIca WBE nella città di Palermo, poco studiata in precedenti analisi a livello nazionale e internazionale. METODI Sono stati prelevati 28 campioni (2 litri cad) di refluo medio delle 24 ore in ingresso ai due depuratori di Palermo (WP1=45.000 ab. eq.; WP2=330.000 ab. eq.) in un …

Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: a prospective observational study

ObjectivesTo assess the trends concerning utilisation of maternal and child health (MCH) services before, during and after the Ebola outbreak, quantifying the contribution of a reorganised referral system (RS).DesignA prospective observational study of MCH services.SettingPujehun district in Sierra Leone, 77 community health facilities and 1 hospital from 2012 to 2017.Main outcome measuresMCH utililization was evaluated by assessing: (1) institutional deliveries, Cesarean-sections, paediatric and maternity admissions and deaths, and major direct obstetric complications (MDOCs), at hospital level; (2) antenatal care (ANC) 1 and 4, institutional delivery and family planning, at community leve…

Analisi della scarsa attitudine alla vaccinazione antinfluenzale dei medici italiani del futuro: risultati di uno studio multicentrico condotto in 18 Università Italiane.

Introduzione: Nel corso della stagione influenzale, gli Operatori Sanitari (OS) rappresentano una delle categorie lavorative maggiormente investite dalla responsabilità di limitare la diffusione della patologia influenzale tra i pazienti ospedalizzati e contemporaneamente di proteggere se stessi garantendo la continuità dell'assistenza sanitaria nei periodi di maggiore assenteismo lavorativo e sovraccarico delle attività assistenziali (picco influenzale stagionale). La vaccinazione antinfluenzale, ormai riconosciuta sicura ed efficace, rappresenta ancora oggi una argomento di dibattito tra gli OS, nonostante le raccomandazioni dei Center for Disease Control and Prevention Statunitense ed Eu…

Serological pattern of Hepatitis B, C, and HIV infections among immigrants in Sicily: epidemiological aspects and implication on public health.

The objective of this study was to describe the prevalence of Hepatitis B virus (HBV), Hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections in a cohort of immigrants living in Palermo, Sicily. The study was carried out in the period May 2006-June 2010 and recruited a total of 393 patients (59.8% males-median age of 32.6 years). All patients were tested for serological markers of HBV, HCV, and HIV infection. One-hundred thirty-eight (35.1%) individuals did not show any HBV/HCV/HIV serological marker, while 186 (47.3%) were indicative of past or current HBV infection. A total of 42 (10.7%) subjects were HBsAg positive, 59 (15.0%) showed the serological profile "anti-HBc …

Effectiveness of clinical and instrumental follow-up for cutaneous melanoma

Introduction: Follow-up guidelines for melanoma greatly differ in the methods of screening for recurrence, and timing and duration of the follow up, with many areas of controversy and a lack of general consensus. The aims of this study are to present our protocol and case series for follow up and to summarize and discuss current literature on melanoma follow-up guidelines/recommendations in different countries. Methods: We retrospectively reviewed 539 patients operated for melanoma between 2004 and 2013 at the same Institution. Data on the diagnostic role of the different clinical and instrumental detection methods were adjusted for sex, age at diagnosis, staging and evaluated by Fisher's e…

Evoluzione del concetto di salute e revisione degli indicatori tradizionali: l’esempio del tasso di mortalità infantile.

The Dual/Global Value of SARS-CoV-2 Genome Surveillance on Migrants Arriving to Europe via the Mediterranean Routes.

Despite the pandemic, 34,154 migrants, refugees or asylum-seekers landed in Sicily (Italy) in 2020, representing the main point of entry by sea into Europe. The SARS-CoV-2 surveillance program among migrants arriving to Sicily via the Mediterranean Sea, made by the combination of clinical examination and molecular testing, has been integrated by full-genome sequencing strains using the NGS technology from the last week of February. To date, more than one hundred full-genome strains have been sequenced and 8 different lineages have been identified mostly belonging to the lineages B.1.1.7 and B.1.525. As global access to COVID-19 vaccines should be ensured, the need to provide more detailed i…

UTILIZZO DI FONTI INFORMATIVE MULTIPLE E PUNTI DI CRITICITA’ PER INTERVENTI DI SANITA’ PUBBLICA IN TEMA DI MORTALITA’ INFANTILE. Un’esperienza condotta in SICILIA

An algorithm to improve outcomes of radial forearm flap donor site

Background: Due to the high rate of donor site complications the Radial Forearm Flap (RFF) has lost ground in favor of the Antero-lateral tight flap (ALT) and other flaps. We have designed a reconstruction algorithm for reconstruction of its donor site. The goal of this study was to retrospectively evaluate the impact of this algorithm on RFF donor site compli- cation rates. Methods: The authors analyzed retrospectively 31 patients who underwent free radial fore- arm flap reconstruction between November 2009 and May 2013. Donor site complications were compared with data from patients treated before introdutction of the algorithm. Within the group were compared patients in which the flap was…

Il ruolo delle infezioni da Chlamydia nel determinismo delle malattie cronico-degenerative: una nuova sfida per i sistemi sanitari

Le infezioni da Chlamydia stanno riscuotendo una rinnovata attenzione da quando è stato postulato che proteine rilasciate da questi batteri intracellulari possono generare fenomeni di autoimmunità e l’insorgenza di diverse malattie, come l’Alzheimer, l’aterosclerosi, l’arterite reumatoide, la sclerosi multipla e numerose altre ancora. Questo breve articolo ha lo scopo di stressare il problema che, negli Stati Uniti, rappresenta già una emergenza sanitaria

Genomic Analysis and Lineage Identification of SARS-CoV-2 Strains in Migrants Accessing Europe Through the Libyan Route

Many African countries, representing the origin of the majority of refugees, asylum-seekers, and other migrants, toward regions bordering on the Mediterranean area, are experiencing sustained local transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sicily is one of the main entry gates of migrants crossing into Europe. We conducted a pilot study, based on the full-genome sequencing of SARS-CoV-2 strains isolated from migrants coming to Sicily by crossing the Mediterranean Sea, with the aim to investigate the viral genome polymorphism and to describe their genetic variations and the phylogenetic relationships. On June 21, a nongovernmental organization vessel rescu…

Percezione della necessità di svolgere tirocini formativi in ambito internazionale (International Health Electives) tra i medici in formazione specialistica dell’Università degli Studi di Palermo.

Introduzione Nell’attuale scenario mondiale, ricevere una formazione in salute globale (global health) e poter intraprendere una esperienza formativa in ambito internazionale (International Health Elective, IHE) rappresentano validi strumenti per migliorare il percorso educativo della futura classe medica. Pochi studi hanno valutato l’impatto che una IHE può esercitare nei confronti dei medici in formazione specialistica. Considerato che in Italia è stato riscontrato un interesse crescente nei confronti degli IHE, lo scopo dello studio è stato quello di analizzare i dati relativi alla percezione della necessità di svolgere esperienze formative internazionali in un campione di medici in form…

Current epidemiology of HCV in Sicily: the RESIST-HCV model

Background: Real-world data to guide hepatitis C virus (HCV)- related public health initiatives and linkage to care of patients are lacking in our region. Aims: To describe the epidemiological features of a large cohort of patients with chronic HCV infection from Sicily included in a regional network aimed at DAA treatment (RESIST-HCV). Methods: Demographic and clinical data were recorded on a web-based platform before starting treatment with DAAs. Gender, year of birth, HCV genotype, co-infections, stages of liver disease and co-morbidities were analyzed. Chi-square with Yates correc- tion was appliedto assess the differences between cohorts. Results: Overall, 15,270 patients were register…

A study to evaluate the lifestyle of medical students in Palermo (Italy) [Indagine sugli stili di vita degli studenti della Facoltà di Medicina di Palermo]

Scientific evidence confirms that unhealthy life habits play an important role in the development of many disorders in all age groups. This study evaluated the lifestyles of 445 first-year medical students in Palermo and Caltanissetta (Italy) by using an anonymous self-administered multiple choice questionnaire Approximately 97% of participants believe that a healthy diet is either "very important" or "extremely important" but only 44% follow a healthy diet. Fifty eight percent frequently perform sports/physical activities while eight percent report being sedentary. A peak in alcohol consumption was found to generally occur in one single day of the week. Twelve percent of those interviewed …

Perceived need for an International Elective Experience among Italian Medical Residents.

In the contemporary society an International Health Elective (IHE) represents a strategic tool in order to implement future medical doctor’s education. In Italy, in the last decade, an increasing interest of trainees and residents to IHE and opportunities was documented and supported by the reorganization of the Italian residency programs, provided by the Ministry for Education, University and Research (MIUR). Aim of the present study was to collect data on perceived need of medical residents for an IHE. A structured questionnaire was developed and administered to medical residents of Palermo’s University who underwent their annual visit to the Occupational Health Physician Ambulatory (OHPA…

Can the serological status of anti-HBc alone be considered a sentinel marker for detection of occult HBV infection?

Some individuals have “occult” infection with hepatitis B virus (HBV), defined as presence of HBV genome in the serum or liver tissue without HBV surface antigen (HBsAg) in the serum. The aim of this study was to investigate whether serum antibodies against HBV core antigen in isolation (“anti-HBc alone”) are a useful marker of “occult” HBV in patients with or without hepatitis C virus (HCV) infection. “Anti-HBc alone” was detected in the sera of 119/6,544 (1.8%) asymptomatic outpatients referred to the diagnostic laboratory for routine testing for viral hepatitis, 62/607 (10.2%) drug users, and 42/195 (21.5%) patients with hepatocellular carcinoma. Using three in-house nested-PCR amplifica…

Indicatori di performance per una nuova governance delle Direzioni Sanitarie ed Ospedaliere. Strumenti per nuovi professionisti leader che hanno qualcosa da dire e non solo da ridire.

Indicatori di performance; governance Direzioni Sanitarie ed Ospedaliere; leadership

Motivational aspects and level of satisfaction of Italian junior doctors with regard to knowledge and skills acquired attending specific general practice training courses. A national web survey

The demographic and epidemiological transitions resulted in a pressing need to reformulate the health workforce demand and to revise pre-and post-graduate training to prepare the medical profiles to meet the new health needs focused on chronic diseases. The Italian Junior Doctors Association and the Giotto Movement carried out a web survey to identify the motivational aspects and the level of satisfaction of Italian junior doctors regarding knowledge and skills acquired after attending the General Practitioners’ specific training (GP-ST). Three-hundred-forty-seven General Practitioners (GPs), 302 trainees and 45 newly qualified trainees answered a web questionnaire. Significant differences …

Management of labyrinthine fistula in chronic otitis with cholesteatoma: case series.

Labyrinthine fistula is a complication of ear cholesteatoma that increase the risk of sensorineural hearing loss. The management of the fistula must be done contextually with mastoidectomy by: leaving cholesteatoma matrix over the fistula, or remove the matrix reconstructing the defect. Objective: analysis of the two techniques to treat labyrinthine fistula. Methods: retrospective review with case series analysis. Results: a labyrinthine fistula was present in 14% of cholesteatoma patients; CT scan was pre-dictive in all cases; the hearing preservation was obtained with both techniques; a re-currence was detected only in one case; postoperative nystagmus incidence was higher in those cases …

HIV rapid test in a community setting as a strategy to improve access to HIV testing: data from a multicentre experience in Italy

4,000 new HIV diagnoses and approximately 800 AIDS cases are still reported annually in Italy. Improving public awareness and bringing out HIV-undiagnosed individuals are keystones to progress towards the control of the HIV epidemic. For this purpose, the Open HIV TEST project was organized and delivered by the Italian NGO Anlaids, together with local infectious diseases specialists, in order to provide free access to HIV testing outside the healthcare setting. Between October 2017 and February 2019 six Open HIV TEST initiatives were delivered in six Italian cities (3 northern cities, 1 central and 2 southern cities). In all, 581 people were tested: the overall prevalence of HIV test reacti…

Valutazione dei comportamenti sessuali e delle conoscenze in materia di malattie sessualmente trasmesse (mst) in un campione di studenti del primo anno della Facoltà di Medicina e Chirurgia di Palermo

The Greta Study: Generating Real-World Evidence about Bevacizumab Treatment of Metastatic Colorectal Cancer by Linking Cancer Registries and Healthcare Databases in Italy

OBJECTIVES: Based on the results of randomized clinical trials, bevacizumab plus chemotherapy is currently recommended as first­line treatment for metastatic colorectal cancer (mCRC). However, scant real­world data are available about effectiveness of bevacizumab­containing therapy used in patients with mCRC in Italy. The GRETA observational cohort study was designed for comparing overall survival (OS) of mCRC patients treated with first­line bevacizumab plus chemotherapy (B+CT), as compared to CT alone, in the real­world setting of Italian clinical practice, by linking cancer registries and healthcare utilization (HCU) databases. METHODS: Incident mCRC patients were identified during the p…

Metodologia epidemiologica

Neoadjuvant therapy for breast cancer

Objective: To evaluate the frequency of neoadjuvant therapy (NT) in women with stage I–III breast cancer in Italy and whether it is influenced by biological characteristics, screening history, and geographic area. Methods: Data from the High Resolution Study conducted in 7 Italian cancer registries were used; they are a representative sample of incident cancers in the study period (2009–2013). Included were 3546 women aged <85 years (groups <50, 50–69, 70–64, and 75+) with stage I–III breast cancer at diagnosis who underwent surgery. Women were classified as receiving NT if they received chemotherapy, target therapy, and/or hormone therapy before the first surgical treatment. Logistic…

USE OF FUNNEL PLOTS TO ANALYZE THE STANDARD INCIDENCE RATIOS IN THE PROVINCE OF PALERMO

Adverse Reactions to Anti-SARS-CoV-2 Vaccine: A Prospective Cohort Study Based on an Active Surveillance System

To date, Coronavirus disease (COVID-19) has caused high morbidity and mortality worldwide. To counteract the pandemic scenario, several vaccines against the etiological factor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were developed and tested. At the end of December 2020, BNT162b2 (Comirnaty, Pfizer-BioNTech) was the first and only authorized vaccine in Italy for selected categories, such as healthcare workers, fragile patients and people aged over 80 years old. To master our knowledge about BNT162b2 adverse reactions (ARs), an active surveillance system based on instant messaging was realized for voluntary participants who had been vaccinated at COVID-19 Vaccination …

Anisakis sensitization in different population groups and public health impact. A systematic review

Anisakis simplex spp. sensitization rates have increased worldwide, with a significant impact on health-care systems. To date, no clear-cut diagnostic criteria and laboratory algorithm have been established, so anisakiasis still represents an under-reported health problem whose clinical manifestations, when present, mimic the much more common allergic and digestive disorders. Aim of the study was to systematically review the available literature on the prevalence of sensitization against Anisakis in the general population and in specific population groups, taking into account the impact of the different available diagnostic techniques on the epidemiological data. Following the Preferred Rep…

CONSAPEVOLEZZA ED ATTENDIBILITÀ DELLO STATO VACCINALE SELF REPORTED IN UN CAMPIONE DI STUDENTI DELLA SCUOLA MEDIA.

vaccinazioni; studenti; educazione sanitaria

La sorveglianza nutrizionale: una strategia di prevenzione dell’obesità in età evolutiva

Valutazione delle abitudini alimentari e dell'attività fisica in un campione di studenti del primo anno della facoltà di Medicina e Chirurgia di Palermo

Il servizio di ingegneria clinica (S.I.C.) ed il ruolo dell’ingegnere clinico nelle organizzazioni sanitarie complesse: l’esperienza dell’a.o.u.p. “Paolo Giaccone” - Palermo.

RISK OF HEMOLYMPHOPOIETIC NEOPLASM BEFORE AND AFTER THYROID CANCER. A POPULATION‐BASED STUDY IN ITALY, 1998‐2012

Rilevazione della prevalenza del Bullismo in un campione di scuole di Palermo

Il bullismo è uno dei problemi sociali e sanitari più rilevanti in ambito scolastico per i bambini e gli adolescenti di tutto il mondo. Dal 2007, il Ministero Italiano della Pubblica Istruzione (D.M. n°16 del 5 febbraio 2007) promuove attività per il contrasto e la prevenzione del fenomeno in scuole di ogni ordine e grado, ed allo stesso tempo le aziende sanitarie locali o provinciali dovrebbero farsi carico di una risposta socio-sanitaria efficace al problema. Nella città di Palermo, negli ultimi anni, sia alcune scuole che alcuni distretti sanitari hanno messo in atto attività ed interventi per cercare di contrastare il fenomeno in questione. La mancanza di un dato rilevato in maniera uni…

Direct RNA nanopore sequencing of SARS-CoV-2 extracted from critical material from swabs

ABSTRACTBackgroundIn consideration of the increasing prevalence of COVID-19 cases in several countries and the resulting demand for unbiased sequencing approaches, we performed a direct RNA sequencing experiment using critical oropharyngeal swab samples collected from Italian patients infected with SARS-CoV-2 from the Palermo region in Sicily.MethodsHere, we identified the sequences SARS-CoV-2 directly in RNA extracted from critical samples using the Oxford Nanopore MinION technology without prior cDNA retro-transcription.ResultsUsing an appropriate bioinformatics pipeline, we could identify mutations in the nucleocapisid (N) gene, which have been reported previously in studies conducted in…

The impact of overdiagnosis on thyroid cancer epidemic in Italy,1998-2012

Aims: In Italy, incidence rates of thyroid cancer (TC) are among the highest world- wide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attribut- able to overdiagnosis. Methods: Data on TC cases reported to Italian cancer registries during 1998e2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology. TC overdiagnosis was estimated by sex, period, age, and Italian region. Results: In Italy between 1998e2002 and 2008e2012, TC ASR increased of 74% in women (from 16.2 to 28.2/100,000) and of 90% in men (fro…

First detection of SARS-CoV-2 A.23.1 sub-lineage in migrants arriving to Italy via the Mediterranean Sea and public health implications

Public Health Genomics education in post-graduate schools of hygiene and preventive medicine: a cross-sectional survey.

Background The relevance of Public Health Genomics (PHG) education among public health specialists has been recently acknowledged by the Association of Schools of Public Health in the European Region. The aim of this cross-sectional survey was to assess the prevalence of post-graduate public health schools for medical doctors which offer PHG training in Italy. Methods The directors of the 33 Italian public health schools were interviewed for the presence of a PHG course in place. We stratified by geographical area (North, Centre and South) of the schools. We performed comparisons of categorical data using the chi-squared test. Results The response rate was 73% (24/33 schools). Among respond…

Use of trastuzumab for breast cancer: the impact of age.

Indication for the use of trastuzumab was given in Italy in 2000 for the treatment of HER-2 metastatic breast cancer and in 2006 for early stage breast cancer. Information on trastuzumab use and on its possible variation with age in Italy is however limited. Using health care administrative databases, we evaluated the prevalence of the use of trastuzumab, and the probability for administration since the first hospitalization for breast cancer in various age groups, in two series of Italian women diagnosed with breast cancer in the Lombardy region (2004-2009) and in the Palermo district. The rate between trastuzumb users and patients with a hospitalization for breast cancer increased from 2.…

The At Risk Child Clinic (ARCC): 3 Years of Health Activities in Support of the Most Vulnerable Children in Beira, Mozambique

The concept of “children at risk” changes worldwide according to each specific context. Africa has a large burden of overall risk factors related to childhood health and development, most of which are of an infective or social origin. The aim of this study was to report and analyze the volumes of activities of fifteen At Risk Child Clinics (ARCCs) within the Beira District (Mozambique) over a 3 year-period in order to define the health profile of children accessing such health services. We retrospectively analyzed the data from all of the children accessing one of the 15 Beira ARCCs from January 2015 to December 2017. From this, 17,657 first consultations were registered. The mo…

Effects of an intervention to prevent the bullying in first-grade secondary schools of Palermo, Italy: the BIAS study

Abstract Background Bullying is one of the most common expressions of violence in the peer context during school years. This study investigates the prevalence of bullying and the short-term effects on students’ bullying perceptions of a preventive intervention conducted among teachers of first-grade secondary schools in Palermo, Sicily (Italy). Methods Between the 2017/2018 and 2018/2019 school years, a pre-post intervention study was conducted among nine school institutions, sampled and categorized by neighbourhood socioeconomic index. A questionnaire investigating physical, verbal, and indirect bullying, the role of observers, prosociality, and resiliency in bullying was administered befo…

EUROMEDITERRANEAN BIOMEDICAL JOURNAL: THE RENEWED MANUSCRIPT LAYOUT AND WEB RENDERING FORESHADOW FURTHER JOURNAL IMPROVEMENT

In January 2006, a new journal, Capsula Eburnea, was born into the Italian scientific publishing scene with the initial goal of creating, at the same time, “an open scientific forum and a blog”, based on the premise that “in medicine, nothing should be considered stable, immutable or unsusceptible to critical review at any time, by any scientist”. The Editorial Team progressively sought to improve the quality of the manuscripts published, introducing the requirement for all articles to be written in English, and changed the Journal’s name to EuroMediterranean Biomedical Journal in 2012. Over the last five years, approximately 125 articles by young doctors (including original articles, revie…

Does access to care play a role in liver cancer survival? The ten-year (2006–2015) experience from a population-based cancer registry in Southern Italy

Abstract Background Hepatocellular carcinoma (HCC) is the most frequent primary invasive cancer of the liver. During the last decade, the epidemiology of HCC has been continuously changing in developed countries, due to more effective primary prevention and to successful treatment of virus-related liver diseases. The study aims to examine survival by level of access to care in patients with HCC, for all patients combined and by age. Methods We included 2018 adult patients (15–99 years) diagnosed with a primary liver tumour, registered in the Palermo Province Cancer Registry during 2006–2015, and followed-up to 30 October 2019. We obtained a proxy measure of access to care by linking each re…

Illicit drugs consumption evaluation by wastewater-based epidemiology in the urban area of Palermo city (Italy)

Introduction. A wastewater-based epidemiology approach was performed to estimate the drug consumption in Palermo city, the fifth largest city of Italy with a population of 671 696 inhabitants, and to investigate the monthly variability of drug loads in wastewater from different areas of the city. A seven-months detection campaign was conducted at the two wastewater treatment plants of the city. Methods. Following a pre-treatment, 32 samples of wastewater were analyzed by liquid chromatography-tandem mass spectrometry. Results. We estimated a mean cocaine use in Palermo of 0.19 g/day/1000 people, corresponding to 1.90 doses/1000 people and cannabinoids use of 2.85 g/day/1000 people, correspo…

Influenza vaccination coverage among medical residents: An Italian multicenter survey

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of t…

Parametri demografici di interesse sanitario e indicatori di salute di una popolazione

Use of a comprehensive diagnostic algorithm for Anisakis allergy in a high seroprevalence Mediterranean setting

Summary Background.Diagnosis of anisakis allergy (AA) is based on the skin prick test (SPT) and specific IgE (sIgE) determination. Anyway, false positivity cases are due to cross reactivity with numerous allergens. The aim of the study was to evaluate the reliability of a comprehensive diagnostic algorithm for the AA. Methods.An observational study was conducted on a sample of consecutive subjects accessing the allergology outpatient ambulatories of two hospitals located in Western Sicily. All the recruited outpatients were tested by Skin Prick Test performed using anisakis extracts by ALK-Abello (Madrid, Spain). Specific IgE dosage for anisakis extracts was then performed by using ImmunoCA…

COVID-19 Vaccination in Migrants and Refugees: Lessons Learnt and Good Practices.

The COVID-19 pandemic has exacerbated inequalities between low- and high-income countries. Within the latter, a greater impact is seen in the poorest and most vulnerable people, including refugees, asylum seekers, and migrants. They all may experience poor access to quality healthcare or have suboptimal health-seeking behavior, distrust of governments, or fear of detention and deportation if seeking healthcare. Some refugees and migrants may face multiple barriers to vaccination and access to health systems that are relevant to the administration of COVID-19 vaccines, despite the growing inclusion of these populations in public health policies. Several good practices have emerged to ensure …

Tumori Infantili: i dati del Registro Tumori della Provincia di Palermo 2003-2005

Adolescent and Young Adult Cancer Survivors: Design and Characteristics of the First Nationwide Population-Based Cohort in Italy

Purpose: Adolescent and young adult (AYA, 15-39 years) cancer survivors (alive at least 5 years after cancer diagnosis) are less studied than younger and older cancer survivors and research on their late effects is limited. To facilitate research on long-term outcomes of AYA cancer survivors, we established, in Italy, a population-based AYA cancer survivors' cohort. This article describes the study design and main characteristics of this cohort. Methods: The cohort derives from population-based cancer registries (CRs). Each CR identified AYA cancer patients retrospectively. Treatment for first primary cancer and all health events from diagnosis to death can be traced through linkage with av…

Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)

(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS condi…

MEDICAL WORKFORCE PLANNING IN A CHANGING HEALTH CONTEXT: COMPARISON BETWEEN ITALY AND EUROPE

An increasing need for healthcare workers as been estimated worldwide. To provide a comprehensive framework of the medical workforce in Italy, we investigated the post-lauream medical workforce training supply and demand. Further, a comparison of the medical workforce between Italy and other European Countries with a similar epidemiological and/or demographic context was performed. The distribution of pre- and post-lauream medical educational providers and post-lauream resources in place in Italy was analyzed among Italian macro-areas in the academic years 2015-2016, 2016-2017 and 2017-2018.Italy and the European countries in study were compared in term of post-lauream funding and number of…

Incidence trends of colorectal cancer in the early 2000s in Italy. Figures from the IMPATTO study on colorectal cancer screening

We utilised the IMPATTO study's archives to describe the 2000-2008 colorectal cancer (CRC) incidence rate trends in Italy, once screening programmes based on the faecal immunochemical test were implemented in different areas. Data on CRCs diagnosed in Italy from 2000 to 2008 in subjects aged 40-79 years were collected by 23 cancer registries. Incidence rate trends were evaluated as a whole and by macro-area (North-Centre and South-Islands), presence of a screening programme, sex, ten-year age class, anatomic site, stage at diagnosis, and pattern of diagnosis (screen-detected, non-screen-detected). The annual percent change (APC) of incidence rate trends, with 95% confidence intervals (95%CI…

Respiratory Syncytial Virus: New Challenges for Molecular Epidemiology Surveillance and Vaccination Strategy in Patients with ILI/SARI.

Several respiratory pathogens are responsible for influenza-like illness (ILI) and severe respiratory infections (SARI), among which human respiratory syncytial virus (hRSV) represents one of the most common aetiologies. We analysed the hRSV prevalence among subjects with ILI or SARI during the five influenza seasons before the emergence of SARS-CoV-2 epidemic in Sicily (Italy). Respiratory specimens from ILI outpatients and SARI inpatients were collected in the framework of the Italian Network for the Influenza Surveillance and molecularly tested for hRSV-A and hRSV-B. Overall, 8.1% of patients resulted positive for hRSV. Prevalence peaked in the age-groups &lt

Incidence trends of vulvar squamous cell carcinoma in Italy from 1990 to 2015

The incidence of vulvar squamous cell carcinoma has increased for decades in most Western countries - a trend virtually restricted to women aged50 or 60 years. In southern Europe, conversely, the trends have been insufficiently studied. This article reports a study from Italy.Thirty-eight local cancer registries, currently covering 15,274,070 women, equivalent to 49.2% of the Italian national female population, participated. Invasive cancers registered between 1990 and 2015 with an International Classification of Diseases for Oncology, 3rd revision, topography code C51 and morphology codes compatible with vulvar squamous cell carcinoma (n = 6294) were eligible. Incidence trends were analyse…

Cost effectiveness analysis of childhood obesity primary prevention programmes: a systematic review

Background. Childhood obesity is associated with enormous health consequences and costs to society. This study aims to systematically review the studies on Cost Effectiveness Analysis (CEA) of primary prevention programmes of childhood obesity, discussing the gaps and providing recommendations for future research. Methods. All the studies on the cost effectiveness evaluation of primary prevention of obesity among children were included. Studies were retrieved from MEDLINE and Google Scholar, up to 31st March 2012, with only English language papers being eligible. The quality of the retrieved studies was evaluated by using the Drummond scale. Re…

Patterns of care and cost profiles of women with breast cancer in Italy: EPICOST study based on real world data

Objectives To estimate total direct health care costs associated to diagnosis and treatment of women with breast cancer in Italy, and to investigate their distribution by service type according to the disease pathway and patient characteristics. Methods Data on patients provided by population-based Cancer Registries are linked at individual level with data on health-care services and corresponding claims from administrative databases. A combination of cross-sectional approach and a threephase of care decomposition model with initial, continuing and final phases-of-care defined according to time occurred since diagnosis and disease outcome is adopted. Direct estimation of cancer-related cost…

Use of ICT to support epidemiological surveillance on a community of university students during SARS-CoV-2 phase 3 pandemic

Populations documenting to date low incidence rates of SARS-CoV-2 infection are immunologically susceptible and at high exposure risk of new COVID-19 outbreaks during phase 3 of the pandemic. Following the experience documented by other countries with regard to the use of Information Communication Technology (ICT) to counteract the current pandemic, Italy has implemented a contact tracing system based on a mobile application. In this work, we describe the proposal of a complementary ICT-based prototypal model of COVID-19 prevention and surveillance system, involving the university students as sentinels acting both in the academic community and the general population.

L'INFERMIERE E LA CULTURA DELLA SICUREZZA: CONOSCENZE, ATTITUDINI E COMPORTAMENTI IN TEMA DI RISCHIO CLINICO

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes a…

FOCUS ON: Strumenti e strategie per salvare il SSN. Il valore delle Risorse Umane.

Risk of thyroid as a first or second primary cancer. A population-based study in Italy, 1998–2012

Abstract Background The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC. Methods We analyzed two population‐based cohorts of individuals with TC or other neoplasms diagnosed between 1998 and 2012, in 28 Italian areas covered by population‐based cancer registries. Standardized incidence ratios (SIRs) of SPC were stratified by sex, age, and time since first cancer. Results A total of 38,535 TC patients and 1,329,624 patients with other primary cancers were included. The overall SIR was 1.16 (95% CI: 1.12–1.21) for SPC i…

Prevalenza di sensibilizzazione all’Anisakis Simplex in popolazione professionalmente esposta in Sicilia

SARS-CoV-2 Infection in Healthcare Professionals and General Population During “First Wave” of COVID-19 Pandemic: A Cross-Sectional Study Conducted in Sicily, Italy

On December 31, 2019, an outbreak of lower respiratory infections was documented in Wuhan caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the beginning, SARS-CoV-2 has caused many infections among healthcare workers (HCWs) worldwide. Aims of this study were: a. to compare the distribution among the HCWs and the general population of SARS-CoV-2 infections in Western Sicily and Italy; b. to describe the characteristics of HCWs infected with SARS-CoV-2 in the western Sicilian healthcare context during the first wave of the epidemic diffusion in Italy. Incidence and mean age of HCWs infected with SARS-CoV-2 were comparable in Western Sicily and in the whole Ita…

prestazioni erogate dal laboratorio centralizzati dell'AOUP "Paolo Giaccone" di Palermo

NS5A gene analysis by next generation sequencing in HCV nosocomial transmission clusters of HCV genotype 1b infected patients

Background: The aim of the study was to investigate the intra-host variability through next-generation-sequencing (NGS) of the NS5A-gene in nosocomial transmission-clusters observed in two Italian hospitals among hepatitis C virus (HCV)-genotype-1b infected patients. Methods: HCV-sequencing was performed by Sanger-sequencing (NS3 + NS5A + NS5B) and by NGS (NS5A, MiSeq-Illumina) in 15 HCV-1b infected patients [five acute with onco-hematologic-disease and 10 (4/6 acute/chronic) with &beta

Prevalence of Sensitization to Anisakis simplex Among Professionally Exposed Populations in Sicily

Anisakis simplex (AS) is a cause of allergic sensitization and potential occupational risk is suggested in fishermen and workers assigned to fish processing and sale. A cross-sectional study was conducted in order to assess possible health effects of occupational exposure to AS in workers recruited from western Sicily fisheries sector. Social, demographic, and occupation-related data were collected. Serum total immunoglobulin E (IgE) and specific IgE levels to AS (threshold >0.35 kU/L) were determined by an fluoroimmunoassay technique. Ninety-four subjects with potential occupational exposure (fishmongers, fishermen, fish industry employees) were recruited. Specific AS IgEs were detected in…

Strategie formative sui medici potenziali prescrittori per il corretto uso dei test genomici: l'esperienza italiana

Pressioni del mercato, politiche regolatorie, linee guida cliniche e domanda dei consumatori, sono tutti fattori che influiscono sulla conoscenza degli erogatori dell’assistenza sanitaria e sull'uso dei test genetici venduti e/o pubblicizzati direttamente ai consumatori. Obiettivo è presentare un innovativo programma pilota di istruzione e formazione sul corretto uso dei test genomici, dedicato ai potenziali prescrittori, nell'ambito di un progetto finanziato dal Centro Nazionale per il Controllo delle Malattie del Ministero della Salute. Un gruppo di esperti, rappresentanti delle sei regioni coinvolte nel progetto, ha definito i contenuti di un corso modulare concepito per essere somminist…

Impact of screening programme using the faecal immunochemical test on stage of colorectal cancer: Results from the IMPATTO study

To evaluate the impact of faecal immunochemical test (FIT) screening on stage distribution at diagnosis, and to estimate relative incidence rates by stage in screened at first and subsequent rounds vs. unscreened. We included all incident cases occurring in 2000-2008 in 50- to 71-year-olds residing in areas with an FIT-screening programme. Multinomial logistic models were computed to estimate the relative risk ratio (RRR) of stages I and IV, compared to stage II + III, adjusting for age, sex, geographical area, and incidence year. Proportions were then used to estimate incidence rate ratios (IRR) by stage for screened subjects at the first and at subsequent rounds vs. unscreened subjects, a…

IL ROLE PLAY AL SERVIZIO DELLA PROMOZIONE DELLA SALUTE TRA GLI STUDENTI DELLE SCUOLE MEDIE: IL PROGETTO PILOTA “VACCINIAMO LE SCUOLE”.

Role play; promozione salute; vaccinazioni

Safety of Reconstructive Microsurgery in the Elderly Population: a Multicentric Prospective Study

Background: Safety of reconstructive microsurgery in elderly patients is still a topic of debate, because no conclusive evidence exists that provides indications and risk evaluation in elderly patients. The purpose of this study, which the Italian Society for Plastic, Reconstructive, and Aesthetic Surgery (SICPRE) has promoted, is to evaluate the safety and the complication risk of elective reconstructive microsurgery in elderly patients as well as to identify patient- or procedure-related risk factors. The secondary aim is to evaluate the predictive role for complications of the Geriatric 8 score (G8). Methods: A total of 194 consecutive patients from 18 centers, aged 65 or older, who rece…

Policy di genomica in Sanità Pubblica: risultati di una survey condotta tra i Chief Medical Officers.

Policy; Genomica in Sanità Pubblica; Survey

Wastewater-Based Epidemiology as a Tool to Detect SARS-CoV-2 Circulation at the Community Level: Findings from a One-Year Wastewater Investigation Conducted in Sicily, Italy

Wastewater-based epidemiology is a well-established tool for detecting and monitoring the spread of enteric pathogens and the use of illegal drugs in communities in real time. Since only a few studies in Italy have investigated the correlation between SARS-CoV-2 in wastewater and the prevalence of COVID-19 cases from clinical testing, we conducted a one-year wastewater surveillance study in Sicily to correlate the load of SARS-CoV-2 RNA in wastewater and the reported cumulative prevalence of COVID-19 in 14 cities from October 2021 to September 2022. Furthermore, we investigated the role of SARS-CoV-2 variants and subvariants in the increase in the number of SARS CoV-2 infections. Our findin…

The Management of Health Hazards Related to Municipal Solid Waste on Fire in Europe: An Environmental Justice Issue?

Landfilling should be the last option in an integrated Municipal Solid Waste (MSW) management approach. In the European Union (EU), the policy framework to protect the environment and the public health against the impact of health hazards related to urban solid waste management has been consistently implemented in recent decades. A growing interest in the negative impact of fires in waste landfills on the environment and people’s health was reported in some European countries. In Italy, an increasing occurrence of arsons in MSW and landfills has been reported in recent years. During the summer of 2012, a multi-site arson occurred in the Palermo Municipal solid waste landfill of Bellolampo (…

Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

BACKGROUND: Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. METHODS: Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0-14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for …

Obiettivi strategici della prevenzione: controllo, eliminazione ed eradicazione delle malattie

Consumo di sostanze alcooliche in un campione di studenti del I anno della Facoltà di Medicina e Chirurgia

Country Report Italia 2013. Le sfide decisionali per la salute e l’assistenza sanitaria in Italia.

Wastewater surveillance of SARS-CoV-2 variants in October-November 2022 in Italy: detection of XBB.1, BA.2.75 and rapid spread of the BQ.1 lineage

This study adds insight regarding the occurrence and spread of SARS-CoV-2 Variants of Concern (VOCs) and Var-iants of Interest (VOIs) in Italy in October and November 2022, by testing urban wastewater collected through-out the country. A total of 332 wastewater samples were collected from 20 Italian Regions/Autonomous Provinces (APs) within the framework of national SARS-CoV-2 environmental surveillance. Of these, 164 were collected in the first week of October and 168 in the first week of November. A similar to 1600 bp fragment of the spike protein was sequenced by Sanger (for individual samples) and long-read nanopore sequencing (for pooled Region/AP samples).In October, mutations charact…

RISCHI E VIRTU’ DEL CONSUMO DI PESCE CRUDO

Il consumo di pesce crudo in questo ultimo ventennio è notevolmente aumentato, ciò è dovuto non solo alle benefiche caratteristiche alimentari del pesce ma soprattutto alla moda di cui il consumatore è fortemente influenzato. Il pesce è una preziosa fonte di proteine, minerali e vitamine di alta qualità.

WILLINGNESS TO RECEIVE COVID-l9 VACCINATION IN COSTUMERS ACCESSING COMMUNITY PHARMACIES IN THE PROVINCE OF PALERMO.ITALY.

In Italy, vaccination against COVID-l 9 began on December 27, 2020. To date, 13,7 13,224 people in Italy are fully vaccinated, which accounts îor 25.3 oh of the general population, and 44.804 received at least one vaccination dose. Thc prescnt study aim to investigate willingness to receive COVID-I9 vaccination in costumers accessing a sample of community pharmacies in the Province of Palermo, Italy. A self- administered and anon),rnous questionnaire was carried out among costumers older than 18 ycars old between Dcccmbcr 2020 atrd March 2021. Three hundred and sixty-three subjects were enrolled in the study, 259 (71.3%) expressed their willingness to receive COVID-19 vaccination. The main …

Salvate Eva in Sicilia: indagine conoscitiva 2016 sull’adesione allo screening organizzato del cervicocarcinoma.

In Sicilia, a fronte di un incremento dell’estensione dello screening organizzato del cervicocarcinoma, non corrisponde un aumento dell’adesione. Nei mesi di gennaio-giugno 2016 è stata condotta un’indagine trasversale somministrando un questionario standardizzato a un campione di 365 donne, per descrivere le ragioni del fenomeno e promuovere interventi mirati. Per le variabili di atteggiamento e conoscenza è stato utilizzato l’Health Belief Model, che ha esplorato la percezione della donna della suscettibilità (rischio di sviluppare il cancro), della gravità della patologia e dei benefici derivanti dal pap-test. Dai risultati emerge che il 66,6% delle intervistate ha effettuato un pap- tes…

A systematic review of the literature on the human genetic variations in response to vaccination

BACKGROUND: Vaccinomics is a term that refers to the investigation of heterogeneity of host genetic markers at the individual or population level that may result in variations of humoral, cell-mediated, and/or innate immune responses to vaccines. Studying genetic heterogeneity of human response to vaccines is supposed to both afford a better understanding of the way vaccine works, and help in developing future vaccines that are protective. With this premise in mind, we performed a systematic review of the literature on the studies concerning the association between human genetic variations in response to vaccination. METHODS: A detailed literature search on the case-control and cohort studi…