Annali dell'Istituto Superiore di Sanità
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Mortality of populations residing in geothermal areas of Tuscany during the period 2003-2012
Get PDFThe limited scientific knowledge on the relationship between exposure and health effects in relation to geothermal activity motivated an epidemiologic investigation of Tuscan geothermal area. This study aims at describing mortality of populations living in Tuscan municipalities in the period 2003-2012. Sixteen municipalities were included in the study area, eight in the Northern and eight in the Southern Area. Mortality data come from the Regional Mortality Registry of Tuscany. Fifty-four causes of death, considered of interest for population health status or consistent with "Project SENTIERI" criteria, are analyzed. Results show a worse mortality profile in the Southern area, especially in males, for whom excesses of all cancers and some causes of cancer emerge, while in the Northern Area an excess of cerebrovascular diseases among females merits attention. Further and more appropriate studies are needed to clarify the etiology of some diseases and to better assess a potential cause-effect relationship
Melanoma prevention in children: knowledge, attitudes and behaviors of pediatricians in Italy
No full textIntroductionThe aims of this study were to assess the level of knowledge, attitudes and behaviors of pediatricians about melanoma and to estimate any variables associated with this outcome of interest. Materials and MethodsA cross-sectional survey was conducted on a sample of pediatricians using a questionnaire sent by postal mail. ResultsThe 40.8% and 41.6% of pediatricians stated that respectively “often” and “always” carried out a full skin examination during routine checkup of children. Only 14.1% and 21.1% informed “always” parents respectively about risk factors for melanoma and about preventive interventions. The results of the multivariate logistic regression analysis have revealed that pediatricians older, those who believed it is very important the role of pediatricians in the prevention of melanoma, those who considered very important that pediatricians perform a skin examination during routine visit, and those who acquired information about melanoma were more likely to perform “always” a full skin examination of children and inform parents about preventive interventions for melanoma. ConclusionsThe findings indicate that the pediatricians need to be more careful regard to malignant melanoma prevention in order to play a crucial role in the educational activities to the parents and dissemination of the most effective interventions screening
Association between serum vitamin D and metabolic syndrome in middle-aged and older adults and role of supplementation therapy with vitamin D
Get PDFObjectives. To evaluate i) the correlation between vitamin D (vit. D) serum concentra-tions and metabolic syndrome (MetS); ii) the efficacy of 6 months supplementation therapy with vit. D. Method. 200 patients were enrolled. Blood analyses and anthropometric measurements were carried out. Patients with hypovitaminosis D received an oral supplement therapy. Results. 81% of the sample shows vit. D levels < 30 ng/mL. Rate of MetS was significant-ly higher in vit. D deficiency group than in vit D insufficiency (p = 0.009) and sufficiency (p = 0.002) groups. Vit. D shows a significant negative correlation with both waist circum-ference (WC) (ρ - 0.202 p = 0.004) and glycaemia values (FBG) (ρ -0.185 p = 0.009). After the supplementation therapy in a group of 60 subjects a significant increase in vit. D levels (p = 0.001) and a significant reduction in WC values (p = 0.001) were observed. Conclusions. MetS, WC and FBG appeared to be associated vit. D status and it is well-known that central obesity, with the inflammatory alterations thereto correlated that determine insulin resistance, can be considered the “primum movens” for the develop-ment of MetS
Smallpox as actual biothreat: lessons learned from its outbreak in ex-Yugoslavia in 1972
No full textBioterrorism today represents a current threat and risk that could have enormous health, environmental, economic, social, political and psychological consequences. Variola (smallpox) virus is classified as class A of potential biological weapons, due to its microbiological, genetic, antigenic and epidemiological characteristics. The potential danger is more real because vaccination against smallpox has stopped since disease eradication in 1979. That is why we want to share our unique, rich experience and acquired knowledge in the fight against this highly contagious and deadly disease during the smallpox outbreak in ex-Yugoslavia in 1972. It was the largest postwar epidemic in Europe during which were officially registered 175 ill patients, 35 of them with lethal outcome. This outbreak was specific by the time of its occurrence, the affected territory, dimensions and some epidemiological characteristics, but also by well-organized, synchronized and efficient reaction of the competent state services in the fight against it
A case of fulminant subacute sclerosing panencephalitis presenting with acute myoclonic-astatic epilepsy
Get PDFThe neurologic sequelae post-measles are less common than other complications measles-related and can lead to severe disability or death: primary measles encephalitis (PME), acute post-infectious measles encephalomyelitis (APME), Measles Inclusion Body Encephalitis (MIBE), and Subacute Sclerosing Panencephalitis (SSPE). SSPE syndrome can affect people years from the acute measles virus infection, as result of the persistence of defective viral particles in brain cells. Clinical onset typically manifests with progressive intellectual deterioration, behavioral changes, and myoclonic jerks. The course of SSPE in the majority of affected children is that of a progressive worsening with fatal outcome within 2 years. This report described an Italian case of fulminant SSPE syndrome that led to death within few months from the initial onset
The emerging role of the human bone marrow as a privileged developmental niche for the transmission stages of the malaria parasite Plasmodium falciparum
Get PDFThe spread of malaria relies on the ability of the Plasmodium parasites to be transmitted from infected individuals to the Anopheles mosquito vectors. Recent work on the most lethal of the malaria parasites, Plasmodium falciparum, identified the infected human bone marrow as a preferential site for the localization and maturation of the parasite transmission stages, the gametocytes. These findings unveil a complex host parasite interplay and an unsuspected role of the bone marrow microenvironment in the successful transmission of the malaria parasite and have major implications in developing and targeting future interventions to block the transmission of P. falciparum
Knowledge and participation. Moving towards scientific citizenship
Get PDFThe current transition to the society of knowledge implies to make modifications in the traditional forms of social, political and economic representation. This modifications must be capable of favoring the interactions between the language of experts and non-experts. In this sense, the "Public engagement with science" represents a new dimension of citizenship rights as it can be considered a useful tool to recognize to citizens a more active role in the co-production and utilization of scientific research results
Long-term services for the care and rehabilitation of people with severe acquired brain injury: a multicentre, cross-sectional study of 536 Italian families.
Get PDFBACKGROUND: people with severe acquired brain injuries (ABIs) require complex, long-term multidisciplinary healthcare and social welfare programmes, and their families experience social and emotional consequences that profoundly condition their quality of life.OBJECTIVE: to investigate whether the possibility of gaining access to local rehabilitation and other services positively influences not only the quality of life of the patients, but also the quality of life of their families.METHODS: the sample consisted of 536 families of patients with severe ABIs. They were administered a specific 50-item questionnaire with a mix of multiple choice answers, dichotomous (yes/no) answers, or answers based on a Likert-type scale.RESULTS: the results suggest that the long-term services provided to patients are substantially, but the data concerning the patients’ social and working reintegration are discomforting. Furthermore, the families experience profound social discomfort related to their economic, emotional and caregiving burden regardless of the number and quality of the rehabilitation services activated, or the amount of welfare support received.CONCLUSIONS: post-severe ABI services provided at local level should include not only long-term rehabilitative and social support for the patients, but also long-term social and psychological support for their families
Ethical aspects of epidemiological research in contaminated sites
Get PDFThis paper brings understanding to the ethical dimensions of human health research conducted in the context of contaminated sites. Principle-based ethical analysis, complemented with virtuous traits of character, aid in bringing clarity to recommendations for actions following research. Epidemiology is the discipline for conducting health research not only because of its methodological foundations, but also because of its social justice focus. Because contaminated sites include communities that have been exposed to excessive concentrations of hazardous substances, extra care is needed when using epidemiology. For instance, vigilance over potential influence and engagement with affected communities are needed. Community engagement not only aids in understanding the contextual framework, but also demonstrates respect for both community and individual autonomy. Ethical analysis makes transparent the rationale for decisions against which researchers can be held accountable and provides a basis for evaluating observed outcomes as a function of the rationale provided for past actions