Dinamiche della colonizzazione da pneumococco in Sicilia tra il 2009 ed il 2017: implicazioni nella vaccinazione anti-pneumococcica in soggetti di tutte le età

Introduzione Streptococcus pneumoniae è uno dei maggiori responsabili di meningiti, sepsi e polmoniti a livello globale. La colonizzazione asintomatica da pneumococco (carriage) rappresenta il reservoir di sierotipi batterici ed è considerata un pre-requisito per lo sviluppo della malattia. In questo lavoro viene descritto l’andamento del carriage da pneumococco e la distribuzione dei sierotipi circolanti in Sicilia, una delle regioni italiane a proporre nei nuovi nati, già dal 2004, la vaccinazione universale con il vaccino anti pneumococcico coniugato e dal 2013 anche nei soggetti a rischio di qualsiasi età e negli adulti over-65. Materiali e metodi Soggetti di tutte le età, giunti all’os…

Professional competencies in health promotion and public health: what is common and what is specific? Review of the European debate and perspectives for professional development

According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for pub…

Old and new immunophenotypic markers in multiple myeloma for discrimination of responding and relapsing patients: The importance of "normal" residual plasma cell analysis

Background Multiple myeloma is an incurable disease characterized by proliferation of clonal malignant plasma cells (CPCs), which can be immunophenotypically distinguished from polyclonal plasma cells (PPCs) by multiparameter flow cytometry (MFC). The utility of PPCs analysis in detecting prognostic and predictive information is still a matter of debate. Methods: we tested the ability of 11 MFC markers in detecting differences in the immunophenotype of CPCs and PPCs among patients in various disease stages; we verified if these markers could be associated with disease stage/response to therapy despite the role of clinical parameters. Results: significant changes in the expression of markers…

Pain in paediatric hospital units

Knowledge, attitude, and practice of the use of ready-to-eat vegetables among potential consumers of Palermo (Italy).

The knowledge, attitude, and practice toward the use of ready-to-eat vegetables were evaluated in a sample of 701 (388 women and 313 men) potential consumers in Palermo, by answering to an anonymous questionnaire handed out. Food safety perceptions and behaviors were analysed; in general, interviewed consumers who perceived higher risks exhibited safer food behaviors. There weren't considerable differences in the use of these salads between two sexes; 81.4% of respondents uses these products to save a lot of time, particularly the graduates attach importance to saving in time (p = 0.001), and only 34.4% is worrying about high price. Statistical analysis showed a significant correlation betw…

Mental health of medical students belonging to sexual minorities: A focus on help-seeking behavior in an Italian multicenter survey

The aim was to examine social, university, health-related differences among heterosexual and Sexual Minority Medical students (SM-Meds), and explore predictors of help-seeking behavior (i.e., current psychological support and hypothetical university counseling use). A multicenter cross-sectional study was conducted in Italy (2018). Questionnaires included socio-demographic items and Beck Depression Inventory-II (BDI-II). Chi-squared tests and multivariable regressions adjusted for BDI-II score were performed (sample size = 2513). SM-Meds were 13.9%. SM-Meds with depressive symptoms were 40.5%. Both considering overall and non-depressed students, SM-Meds exercised less and had worst relation…

Epidemiologia della tubercolosi in Sicilia: attività del Laboratorio di Riferimento Regionale per la Sorveglianza e il Controllo della Tubercolosi in Sicilia

Introduzione In Sicilia dal 2014 è stato istituito dall’Assessorato Regionale alla Salute il Laboratorio di Riferimento Regionale per la Sorveglianza ed il Controllo della Tubercolosi (TB), per sviluppare e integrare strumenti epidemiologici tradizionali e molecolari in una regione in cui intensi flussi migratori, insediamenti stabili frutto di pregresse migrazioni ed evoluzione demografica della popolazione autoctona compongono un complesso quadro epidemiologico. Materiali e metodi Sono stati analizzati i flussi dei dati sanitari correnti del periodo 2010- 2017, in particolare le notifiche del Sistema Informativo delle Malattie Infettive e le Schede di Dimissione Ospedaliera. Dal 2014, il …

Is Ranibizumab effective in stopping loss of vision secondary to Choroidal Neovascularization in Pathologic Myopia? A Long Term Follow-up Study.

Purpose: To assess the efficacy and safety of Ranibizumab in the treatment of choroidal neovascularization (CNV) caused by pathologic myopia (PM). Design: Prospective, multicenter, interventional case series. Methods: 40 of 39 consecutive patients with PM and CNV were treated with “on-demand” intravitreal injection of ranibizumab 0.5 mg. Final best-corrected VA (BCVA) and its change from baseline were the main outcome measures. Changes in Optical Coherence Tomography (OCT) central retinal thickness (CRT) were a secondary outcome. Results: Mean age was 53 ± 13 years, mean refractive error -13.5 ± 6.5 diopters. Median follow-up was 13.3 ± 2 months (range 12 – 18). Fifteen eyes (37.5%) had pre…

THE BIAS (BULLYING IN SICILIAN SCHOOL) PILOT STUDY: INVESTIGATING THE PREVALENCE OF BULLYING IN SCHOOL OF PALERMO CITY. A RESEARCH STUDY PROTOCOL

Being a serious threat to physical and emotional health of children and adolescents all over the world, bullying in school represents an important public health issue. Since 2007, in Italy, the Ministry of Education (MIUR) has promoted activities to face and prevent bullying in schools of all levels while at the same time national and local Health Authorities have implemented effective social-health strategies. To date, the lack of consistent data needed to properly describe the concerning increase of this Public Health phenomenon prevents both the ability to systematically survey and measure the effectiveness of the public health strategies against bullying. The Bullying In Sicilian School…

Valutazioni igienico-sanitarie delle acque in tre invasi artificiali della provincia di Palermo destinate al consumo umano

We report the physico-chemical and bacteriological characteristics of three Sicilian reservoirs. The aim of this study was the evaluation of the reservoirs' sanitary conditions, given tha the water is also used for human consumption. 114 samples (4 locations at each lake) were collected in the period from July 1995 to June 1996. We analysed temperature, pH, oxygen saturation, colour and parameters of water mineralization and pollution of natural or human origin.Pathogenic bacteria (Salòmonellae) and opportunistic patjogens such as Pseudomonas aeruginosa and Aeromonas spp. were also investigated. At present, results are not showing particular levels of pollution, and it seems there is no ris…

COVID-19: opinions and behavior of Italian general population during the first epidemic phase

Background and aim: On January 9, 2020, the World Health Organization (WHO) declared that Chinese health authorities had identified a new coronavirus strain never before isolated in humans, the 2019-nCoV later redefined SARS-CoV-2, that still today represent a public health problem. The present survey started on 10 February 2020 with the aim of a) assessing the risk perception in healthcare workers and young students, following the evolution of attitudes, perception and knowledge over time, b) provide useful information to the general population during survey. Results: A study sample consisting of 4116 Italian in-dividuals of both sexes was enrolled. High levels of risk perception, low perc…

NEURODEGENERATION IN MULTIPLE SCLEROSIS: COMPARISON BETWEEN CLINICAL, NEUROPSYCHOLOGICAL, MRI,AND OPTICAL COHERENCE TOMOGRAPHY PARAMETERS

BACKGROUND AND OBJECTIVE Optical Coherence Tomography (OCT) enables rapid, non-invasive in vivo measurement of retinal nerve fiber layer (RNFL) thickness, reflecting axonal density within the optic nerve. There is still lack of concordance about the use of OCT in clinical routine as a surrogate measure of brain atrophy. Objective: To investigate the role of OCT as possible predictor of disability, cognitive impairment and neurodegeneration in Multiple Sclerosis (MS). MATERIAL AND METHODS We recruited patients affected by MS according to validated criteria at the Neurological Department of the University of Palermo. Patients performed Stratus OCT- 3 Zeiss to assess RNFL and GCS measurements.…

Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra®

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Effectiveness of an educational intervention on seasonal influenza vaccination campaign adherence among healthcare workers of the Palermo University Hospital, Italy.

Introduction. Healthcare workers are continuously exposed to the risk of being infected by influenza viruses during their work, thus representing a threat especially for fragile patients. Although the Italian Ministry of Health strongly recommends influenza vaccination for all HCWs, coverage levels in Italy are still far from the expected. Several studies report that one of the preferred strategies to improve vaccination coverage among Healthcare Workers is improving vaccination knowledge through specific multidisciplinary courses. To assess the effectiveness of an educational intervention on influenza vaccination coverage among Healthcare Workers a study was conducted at "Paolo Giaccone" U…

How should vaccination services be planned, organized, and managed? Results from a survey on the Italian vaccination services

Background. Quality improvement is an increasingly recognized approach to maximize service effectiveness and minimize costs in public health. However, the Italian law never provided for the institutional accreditation of vaccination services. Furthermore, a recently approved law added six more compulsory vaccinations to the original four, which has led to a considerable increase in vaccination efforts, without any previous resources evaluation. The aim of the study was to investigate structural, organizational and managerial characteristics of the Italian vaccination services, in order to suggest the adoption of adequate quality standards. Study design. A survey involving the representative…

Autism spectrum disorder in Italy: demand for an integrated epidemiological surveillance system.

Autism spectrum disorder (ASD) is a complex neurodevelopmental syndrome of emerging public health concern, according to a documented significant increase of diagnosed cases of ASD in Europe and USA. In Italy, actually, it is not possible to estimate at national level a reliable ASD occurrence by using existing health and scholastic data flows. The lack of information has implications on social and healthcare services dedicated to subjects affected by ADS. The database of the Italian institute in charge of social and security assistance was accessed at the provincial level to investigate the ASD cases occurred in the Palermo province. The official reports of all subjects visited in 2013 by I…

Impact of the environment on the health: From theory to practice

The Erice 56 Charter titled "Impact of the environment on the health: from theory to practice" was unanimously approved at the end of the 56th course of the "International School of Epidemiology and Preventive Medicine G. D'Alessandro" held from 3th to 7th November 2019 in Erice - Sicily (Italy) and promoted by the Study Group of "Environment and Health" of the Italian Society of Hygiene, Preventive Medicine and Public Health. The course, that included lectures, open discussions and guided working groups, was aimed to provide a general training on epidemiological and toxicological aspects of the environmental health impact, to be used by public health professionals for risk assessment, with…

Stato vaccinale e immunitario contro le malattie prevenibili da vaccino in un campione di operatori sanitari del Policlinico Universitario di Palermo

Introduzione La vaccinazione degli operatori sanitari (OS) riduce il rischio delle infezioni professionali, previene la trasmissione nosocomiale e garantisce la continuità delle cure sanitarie durante le epidemie di malattie vaccinoprevenibili. Nonostante le raccomandazioni del Piano Nazionale della Prevenzione Vaccinale 2017-2019, la copertura vaccinale degli OS in Italia risulta molto bassa. Scopo dello studio è valutare lo stato vaccinale e immunitario degli OS del Policlinico Universitario di Palermo. Materiali e metodi Un questionario anonimo è stato somministrato online tra Settembre e Dicembre 2018 agli OS del Policlinico Universitario di Palermo. Il questionario era suddiviso nelle …

Campagna social #proteggitixproteggermi: andamento delle coperture vaccinali antinfluenzali degli operatori sanitari dell’AOU Policlinico “P. Giaccone” di Palermo in seguito all’implementazione di strategie comunicative ed informative

Introduzione Ogni anno il 20% circa degli operatori sanitari (OS) contrae l’influenza, continuando a lavorare e favorendo la diffusione dei virus influenzali nei reparti. La copertura media della vaccinazione antinfluenzale tra gli OS italiani si attesta attorno al 22%. Alla base del rifiuto vaccinale degli OS vi sono principalmente le scarse conoscenze, attitudini e percezioni in merito all’efficacia e alla sicurezza della vaccinazione antinfluenzale. In questo studio è stato analizzato il trend della copertura vaccinale contro l’influenza durante le ultime 12 stagioni negli OS dell’Azienda Ospedaliera Universitaria Policlinico (AOUP) di Palermo, valutando l’impatto delle strategie comunic…

Improvement in vaccination knowledge among health students following an integrated extra curricular intervention, an explorative study in the University of Palermo

Summary Introduction. Vaccination coverages threaten to decrease because of false beliefs in their unsafety and inefficacy. Therefore formation of future health-care workers on this topic is fundamental to deal with any doubt and to promote active immunization among general population. Methods. In order to assess health-care students' knowledge about vaccination before an integrated seminar on this topic, and to evaluate their improvement after the educational intervention, an integrated educational intervention was held by a multidisciplinary team. Before and after the seminar, 118 students of medicine and biology schools at Palermo University were asked to answer 10 multiple-choice questi…

Antimeningococcal and antipneumococcal vaccination determinants: A European systematic literature review

Background. ESCULAPIO is a multicenter project, funded by the Italian Centre for Disease Prevention and Control, aimed at implementing communication strategies to improve vaccination knowledge and attitudes among different target populations. Objective. The objective of the Sicilian research unit was, in the first phase, to identify, through systematic literature revision, which vaccination determinants play a role in the uptake of recommended vaccines included in the Italian Vaccination Plan. Design. A systematic literature review was carried out on studies describing the determinants underlying pneumococcal and meningococcal vaccination uptake. The analysis was limited to papers published…

Seroepidemiologic research and hygienic-sanitary evaluation about human and animal brucellosis in Palermo province

A randomised controlled study on the use of anti-inflammatory drugs in patients with cancer pain on morphine therapy: effects on dose-escalation and a pharmacoeconomic analysis.

The role of non-steroidal anti-inflammatory drugs (NSAIDs) in cancer pain has been well established in the treatment of mild pain and in association with opioids in the treatment of moderate to severe pain. The aim of this study was to verify the effects of NSAIDs on morphine escalation in advanced cancer patients with pain followed-up at home and to assess the pharmacoeconomic implications. A prospective randomised controlled study was carried out in 156 consecutive advanced cancer patients with pain followed-up at home in the period December 1999-December 2000. In this group of patients, 47 were selected with pain progression after 1 week of opioid stabilisation. Patients were randomly as…