Annali dell'Istituto Superiore di Sanità
Not a member yet
755 research outputs found
Sort by
First detection of SARS-CoV-2 lineage A.27 in Sardinia, Italy
Get PDFIntroduction. Multiple variants of SARS-CoV-2, since the end of 2020 have emerged in many geographical areas and are currently under surveillance worldwide highlighting the continuing need for genomic monitoring to detect variants previously not yet identified.Methods. In this study, we used whole-genome sequencing (WGS) and phylogenetic analysis to investigate A.27 lineage SARS-CoV-2 from Sardinia, Italy.Results. The Italian A.27 lineage genomes from Sardinia appeared related in a clade with genomes from France. Among the key mutations identified in the spike protein, the N501Y and the L452R deserve attention as considered likely vaccine escape mutations. Additional mutations were also here reported.Conclusion. A combination of features could explain our data such as SARS-CoV-2 genetic variability, viral dynamics, the human genetic diversity of Sardinian populations, the island context probably subjected to different selective pressures. Molecular and genomic investigation is essential to promptly identify variants with specific mutations with potential impact on public health and vaccine formulation
SARS-CoV-2 variants: what have we learnt so far?
Get PDFBesides the timely detection of different SARS-CoV-2 variants through surveillance systems, functional and modelling studies are essential to better inform public health response and preparedness. Here, an overview on the knowledge available so far on SARS-CoV-2 variants are discussed by different expertises
Self-Awareness Multilevel Assessment Scale (SAMAS): psychometric analysis of inter-rater reliability
Get PDFBackground. Severe acquired brain injury (sABI) frequently causes impairment in selfawareness (ISA), leading to reduced patients’ compliance to treatment, worse functional outcome, and high caregiver distress. Self-awareness (SA) is a multilevel and complex function that, as such, requires a specific and effective assessment. To date, many tools are available to evaluate the declarative, but not emergent and anticipatory levels of awareness, therefore the Self-Awareness Multilevel Assessment Scale (SAMAS) was recently proposed. The new tool proved to be useful to assess SA at different levels across all domains of functioning (motor, cognitive, psycho-behavioural, etc.) because it measures not only the declarative SA, but also emergent and anticipatory levels of SA, thus overcoming some important limits of other current assessment methods.Aim. This study evaluated the inter-rater reliability (IRR) of the SAMAS.Methods. Four professionals blind to each other evaluated 12 patients with sABI. Each patient was rated by two professionals.Results. Inter-rater reliability was moderate-to-excellent, adding evidence in support of the use of SAMAS to specifically diagnose ISA after sABI.Conclusions. The SAMAS can help to better address neurorehabilitation, as it allows assessing ISA as early as possible, at all possible levels of awareness and functional domains
Adverse events related to herbal dietary supplements and over-the-counter medications containing laxatives: a 10-year update from the Italian Phytovigilance and Pharmacovigilance systems
Get PDFIntroduction. Products containing anthraquinones (AQ) are associated with an increased risk of serious adverse events (AEs). We performed an update of the available evidence retrieved by the spontaneous reports of AE associated with herbal dietary supplement (DS) and over-the-counter medications (OTC-M) used as laxatives.Methods. Analysis and evaluation of AE reports retrieved from the Italian Phytovigilance and Pharmacovigilance systems was performed from February 2011 to December 2020.Results. Totally 110 AE reports, 24 related to herbal DS and 86 to OTC-M, were analyzed. Most subjects were females. Herbal products analyzed mostly contained AQ derivatives. Most AEs were gastrointestinal (41.6%), central nervous system (18.2%), and dermatological disorders (12.6%).Conclusions. The number of AE reports recorded in the last 10 years is still relatively low. However, given the seriousness of some AEs, that does not represent a guarantee of safety. This study may contribute to enhance public awareness on the risks associated with misuse or abuse of laxatives
The use of concept maps as an assessment tool in students’ risk education about occupational safety and health
Get PDFGiven the relevance of students’ risk education about occupational safety and health (OSH), the need for reliable assessment tools for learning evaluation is widely advocated. However, multiple-choice tests or inventories show several limitations, including the emphasis on basic definitions instead of organized conceptual systems and passive tool to inspect how students actively organize and represent the acquired knowledge in line with the theory of meaningful learning. A concept map specifically developed in the field of risk education and its quantitative scoring protocol are here proposed. Then, a case study with a pre- post-test design is presented, including 611 upper school students who undertook an OSH-related risk educational course. The findings are briefly discussed and help identify the possible information we can get from concept maps in terms of problem-based learning
Neurorehabilitation of severe acquired brain injury in the time of COVID-19: impact of the absence of caregivers
Get PDFIntroduction. During the COVID-19 pandemic, several restrictions were imposed to limit the circulation of the infection within communities. Hospitals denied access to the family and friends of inpatients, and thus to caregivers. This observational study evaluated the impact of the physical absence of caregivers during the lockdown period due to the COVID-19 emergency on the neurorehabilitation of inpatients with severe acquired brain injury (sABI).
Methods. The functional outcome at discharge was measured in 25 inpatients with sABI through the DRS, GOS, and LCF standard scales after neuropsychological rehabilitation in an Adult Inpatient Neurorehabilitation Unit for Post-coma. Fourteen patients were directly assisted by their informal caregivers physically present in the neurorehabilitation ward. Eleven patients were indirectly supported via remote connection because during the lockdown period (from March to July 2020) caregivers could not be admitted to the rehabilitation hospital. The Caregiving Impact on Neuro-Rehabilitation Scale was also used to evaluate both the change since the admission and the impact of the caregiver from the perspective of the cognitive therapist. Demographic characteristics, time since injury, injury severity (duration of impaired consciousness measured by the time to follow commands), level of functioning at the beginning of the neurorehabilitation, and duration of the neurorehabilitation treatment were comparable between the groups.
Results. Both groups improved after the treatment; however, the improvement was consistently greater in the group directly assisted by the caregivers. The results showed that although the caregivers ensured their virtual presence at distance, their physical absence played a role in hindering the functional outcome of the patients.
Conclusions. The role of the caregiver of patients with sABI is underlined in being not only a person handing out generic aid, cares, and affection, but also an integral part of the neurorehabilitation process.
Keywords: Brain injuries, Neurorehabilitation, Informal caregivers, COVID-19 pandemic, SARS-CoV-2, Lockdown
 
A case of medicine in disguise: motion sickness patches sold as medical devices containing active pharmaceutical substances
Get PDFIntroduction. A case study is reported on anti-motion sickness transdermal patches sold in the Internet, claiming to contain only natural ingredients but, actually, containing The visual inspection of the samples evidenced many inconsistencies in secondary and primary packaging, missing of various legal information and a non-compliant “CE” mark.Methods. The qualitative analysis was performed by liquid chromatography - high resolution mass spectrometry and the quantitative by liquid chromatography with diode array detector.Results. The analyses evidenced the presence of the antihistaminic drug Diphenhydramine and of other active substances (Capsaicin, a transdermal absorption enhancer, and Diclofenac in traces, probably a contaminant from other productions of the same plant). Moreover, the presence of several trace elements, including those potentially toxic to humans, was assessed by ICP-MS analysis. Conclusions. The case discussed is a new case of “medicines in disguise” never reportedin literature, and shows the presence of tangible risks for public health