Annali dell'Istituto Superiore di Sanità
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Neurodevelopmental disorders and development of project of life in a lifespan perspective: between habilitation and quality of life
Get PDFAbstractFor some years, the term “project of life” has become widely used in the field of neurodevelopmentaldisorders, and, at the same time, it has begun to make its way in many socialand health planning documents. However, beyond its relatively widespread use, this termdoes not yet possess an adequate and shared frame of the main underlying decision-makingprocesses. In particular, there is a need to identify the crucial questions for orientingthe choice of goals within the adolescent transition, which represents the complex hingebetween childhood and adulthood. Moreover, adulthood, which is often completely devoidof culturally and socially shared references, is still critical precisely because of thelack of future direction prompts usually represented by the stages of development. In thiscase, the themes of quality of life functioning as a guiding compass appear pertinent andmuch more relevant. The present contribution is, therefore, an attempt to present, in aunitary manner, the decision-making processes and questions at the basis of a constructof “project of life” shared within the scientific and associative communities
Bacterial coinfections in COVID-19: an underestimated adversary
Get PDFCurrent literature shows that secondary bacterial infections, although less frequent than in previous influenza pandemics, affect COVID-19 patients. Mycoplasma pneumoniae, Staphylococcus aureus, Legionella pneumophila, Streptococcus pneumoniae, Haemophilus and Klebsiella spp. are the main species isolated. Of note, Mycobacterium tuberculosis-COVID-19 coinfections are also reported. However, bacterial coinfection rates increase in patients admitted in the intensive care units, and those diseases can be due to super-infections by nosocomial antibiotic-resistant bacteria. This highlights the urgency to revise frequent and empiric prescription of broad-spectrum antibiotics in COVID-19 patients, with more attention to evidence-based studies and respect for the antimicrobial stewardship principles
Social cognition deficit and genetic vulnerability to schizophrenia in 22q11 deletion syndrome
Get PDFIntroduction. 22q11.2 microdeletion syndrome (22q11DS) is associated with a 25% risk of psychotic onset.Materials and methods. The sample consist of 120 subjects: 39 schizophrenics (SCZ); 20 siblings of schizophrenic patients (SIB); 34 22q11DS non-psychotic patients (DEL); 17 22q11DS psychotic patients (DEL_scz); 30 control subjects (CS). Social cognition was evaluated with the awareness of social interference test. Intelligence Quotient (IQ) was calculated with Wechsler Adult Intelligence Scale. TASIT (Awareness of Social Inference Test) performance was analyzed via MANOVA, including IQ as covariate.Results. Group and IQ showed significant effect (p < 0.001; p = 0.037). The only TASIT variables where IQ showed no effect were paradoxical sarcasm; sincerity; lie. In sincerity, CS group shows a better performance than both 22q11DS groups (p < 0.05). In paradoxical sarcasm and lie, CS group performed better than each clinical group (p < 0.05).Regarding lie, DEL group was worst also respect to SCZ group (p = 0.029).Conclusions. Our results show a specific social cognition deficit in 22q11DS and schizophrenia
Effectiveness of psycho-educational intervention to promote mental health focused on emotional intelligence in middle-school
Get PDFPurpose. The specific “outcome-oriented” pattern of the emotional intelligence (EI) should be considered of capital importance for teenagers in order to promote mental health. Nevertheless it is rarely evaluated because a specific tool, useful for routinely use, is not available. In this paper the authors describe the effectiveness of a new approach of public health to improve the EI “outcome-oriented”, by a specific index.Design. A comparison of two samples: experimental (i.e. applying the program) vs control group, without randomization.Setting. 12 classes belonging to 3 different schools.Subjects. A sample of 276 students, 146 (53%) belonging to the experimental classes. Intervention. A program of 20 meetings, once a week, based on the handbook Intervento psicoeducativo per la promozione del benessere psicologico e dell’intelligenza emotiva nelle scuole (Psycho-educational intervention for promoting psychological well-being and emotional intelligence at school) in order to stimulate a “peer to peer student approach”.Measures. Index of emotional intelligence (15 items), inventory idea questionnaire (19 items), learning ability questionnaire (6 items).Analysis. Nonparametric tests were used.Results. The authors found significant statistical differences at the conclusion of the study for all considered measures.Conclusion. The results show a remarkable and positive impact of the approach above all on the “outcome-oriented” EI. Significant results were also observed about the indicator concerning irrational beliefs. The same significant results were found about learning abilities (goal definition, problem-solving and communication skills). The main limit is the study design (lack of randomization). Further evaluation is needed
Cancer stem cell targeted therapies
Get PDFIn normal dividing tissues, cell homeostasis is maintained by rare cellular elements, thestem cells, that have the unique property of self-renewal and differentiation to generatea population of functionally mature tissue elements. Recent studies carried out in thelast three decades support the existence of stem cells also in tumors, the so-called cancerstem cells. Cancer stem cells have the property of initiating and maintaining tumorgrowth, are able to self-renew and to differentiate, are the main drivers of intra- andinter-tumoral heterogeneity and the main cellular mediators of drug resistance, leadingto tumor recurrence and metastasis. Cancer stem cells can be identified in many tumorsaccording to specific immunophenotypic features, but cancer stemness cannot be definedas a fixed property, due to cancer plasticity.For these properties, cancer stem cells represent attractive targets for developing newanti-cancer therapies and there is supporting evidence that the combination of conventionalanticancer therapies with drugs targeting cancer stem cells could lead to cancereradication. Ongoing studies in some tumors strongly support the clinical utility of developingefficient strategies of cancer stem cell targeting
Early mortality from malignant mesothelioma in Italy as a proxy of environmental exposure to asbestos in children
Get PDFMalignant mesothelioma (MM) is a rare neoplasm caused by asbestos. Mortality fromMM in ≤50 years old people, considering the long latency, is likely related to asbestosexposure in childhood. Mortality from MM (C45, ICD10 code) is described among ≤50years (ys) old people in Italy, in 2003-2016. National and regional Standardized Rates(SRs) were computed by age-class. The North-South trend of regional SRs, increasing in>50ys age-class, showed a flat cline in ≤50ys old people. Municipal Standardized MortalityRatios (SMRs) were computed, with respect to regional figures, for ≤50 ys oldpopulation. In Italy, 487 people ≤50 ys old died from MM, in 2003-2016 (2.5% of allMM deaths), corresponding to 35/year. The highest SMRs were observed in NorthernRegions, the most industrialized areas. Exceeding SMRs were found in 10 municipalitieswhere former asbestos-cement plants, shipyards, and a quarry contaminated by fluoroedenite fibres were present. Early mortality from MM, proxy of childhood environmental asbestos exposure, deserves particular concern
Gene flow and Bayesian phylogeography of serogroup C meningococci circulating in Italy
Get PDFIntroductionNeisseria meningitidis is a bacterial pathogen that can cause sporadic cases, small outbreaks and large epidemics. Serogroup C and B meningococci are the most common in Italy. In particular, hyperinvasive strains of serogroup C meningococci have caused outbreaks of severe disease in our country. In a previous study we tracked the pattern of dispersal of hyperinvasive strains, focusing the attention on their introduction routes. In the present paper we report the results of the analysis of the migration patterns of C:P1.5-1,10-8:F3-6:ST-11(cc11) meningococcal strains from different Italian regions collected between 2012 and 2017.MethodsN. meningitidis genomes of isolates collected between January 2012 and December 2017 were sequenced using the Illumina MiSeq platform, through the whole genome sequencing (WGS) method and were analyzed using the BIGSdb Genome Comparator tool implemented within the PubMLST website. The phylogeography was performed using the software package BEAST. The gene out/in flows in Italy were tested by a modified version of the Slatkin and Maddison test using MacClade.ResultsThe majority of the Italian C:P1.5-1,10-8:F3-6:ST-11(cc11) strains clustered together and segregated into two main sub-clades. In particular, the hyperinvasive strain, starting from UK reached at first Emilia Romagna region and by 2012 the port of Livorno, causing a small outbreak. Subsequently a wave of migrations involved different Italian regions. The “Tuscany-outbreak strain” was likely introduced in Italy between 2013 and 2014. Most of the observed gene flow events occurred from the Center to Northern part of Italy.DiscussionThe phylogeographic analysis allowed to track the dissemination of this strain belonging to the hypervirulent C:P1.5-1,10-8:F3-6:ST-11(cc11) clone. In particular, Central Italy was identified as a major source of dissemination, with a 54.5% of gene flows to the North and, to a lesser extent, to the South of the country. The information gathered through the application of phylogenetic and evolutionary methods appears consistent with the epidemiological data derived from the national surveillance system.
Epidemiological data and treatment strategies in children with severe haemophilia in Italy
Get PDFObjectives. In a period of important therapeutic changes in the field of haemophiliacare, we provide updated statistics on children with severe haemophilia (0-12 years ofage) in Italy.Methods. Data presented are from the Italian National Registry of Congenital Coagulopathies(NRCC) – survey 2017.Results. Children with severe Haemophilia A (HA) were 242, those with severe haemophiliaB (HB) 48. Prophylaxis was adopted in 92.1% of individuals with severe HA and88.6% with severe HB. Thirty-nine children (14.8%) were on treatment for inhibitors.FVIII prescribed to children with severe HA represented 11.1% of the total consumption,of which 4.6% was extended half-life (EHL). FIX given to children with HB accountedfor 7.2% of the total FIX, of which 19.1% was EHL-FIX.Conclusion. The paediatric population analysed is characterized by a great adherenceto therapy, so this data may constitute a benchmark for use of new, alternative therapiesin the coming years
Stress and wellbeing among professionals working with people with neurodevelopmental disorders. Review and intervention perspectives
Get PDFAbstractSupporting individuals with NDD is extremely demanding, with significant exposure tocritical contexts and events, and painful ongoing experiences. Stress and burnout conditionis a main concern with growing interest in research, despite the lack of consensus ontheoretical explanatory models and modification standards.The paper provides an up-to-date review of risk factors and involved processes, and presentsevidence-based procedures and protocols to implement effective preventive actionsaddressing both organizational and individual factors. The aim is to offer a global understandingof the subject and offer examples of practical plans to increase the impact onthe quality of life of clients and staff members
Turmeric (Curcuma longa L.) food supplements and hepatotoxicity: an integrated evaluation approach
Get PDFIntroduction. Turmeric is the common name for the rhizome of Curcuma longa L. Inthe recent years, food supplements containing turmeric have been marketed and widelyused by an increasing number of consumers. Spontaneous reports of suspected adversereactions to food supplements are collected within the Phytovigilance system.Methods. An ad hoc multidisciplinary group investigated the suspected cases of hepatotoxicity reported to the Italian Phytovigilance system associated with the assumption of turmeric food supplements with the methodology specific to pharmacovigilance as wellas for the evaluation of the quality and safety of food supplements.Results. A cluster of 28 spontaneous reports of acute hepatitis, mostly with cholestasis,associated with turmeric products were sent to the Italian Phytovigilance system in thefirst six months of 2019.In all cases, except one, the causality assessment was at least possible. The suspectedproducts were collected and analysed for the presence of drugs, heavy metals, aflatoxins,pesticides, synthetic dyes and pyrrolizidine alkaloids.Conclusion. On the basis of the results of all the activities performed by multidisciplinarygroup, regulatory intervention was taken. This study highlights the importanceof developing an integrated evaluation approach for the evaluation of the adverse effectsassociated with the use of food supplements