Annali dell'Istituto Superiore di Sanità
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Illicit drugs consumption evaluation by wastewater-based epidemiology in the urban area of Palermo city (Italy)
Get PDFIntroduction: A Wastewater Based Epidemiology approach was performed to estimate the drug consumption in Palermo city, the fifth largest city of Italy, and to investigate the variability of monthly drug loads in wastewater in different areas of the city, within a seven-months detection campaign 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/1,000 people, corresponding to 1.90 doses/1,000 people and cannabinoids use of 2.85 g/day/1,000 people, corresponding to 35.62 doses/1,000 people. Amphetamines residues in wastewater were always recovered in concentrations lower than the limit of quantification. Conclusion: Prevalence on cocaine and cannabinoids consumption allowed us to compare our data with those of other Italian and European cities and to evaluate how could vary the final estimates in different periods of a year
Trends in adolescent overweight prevalence in Italy according to socioeconomic position
Get PDFBackground: The aim of this research is to update the trend in overweight (including obesity) prevalence among Italian adolescents, evaluating possible differences by age and gender, and analyzing their relationships with socioeconomic status, between 2002 and 2014. Methods: The present study is based on data from the Italian HBSC study at four time points (2002, 2006, 2010 and 2014), which involved 15035 adolescents, aged 11-13-15 (7540 boys and 7495 girls)Results: Gender and age were associated with the occurrence of overweight. In all surveys, boys had a higher prevalence of excess weight compared to girls (p<0.001), but only among girls there was a significant increasing trend (from 11.2% in 2002 to 13.3% in 2014). From 2002 to 2014, the risk of being overweight was inversely associated with the economic level of the family, for both genders and all age groups. Conclusions: Data collected between 2002 and 2014 in Italy showed a low overall increase in prevalence of obesity and overweight and an inverse association between SES and obesity in all age groups and in both genders. These findings suggest that concerted, multi-sectorial, efforts are needed in Italy, in combination with a sound political will, focused on reducing social inequality associate
Drug-resistant tuberculosis in Naples, 2008-2013
Get PDFBackground. Drug-resistant tuberculosis (TB) is an important threat in industrialized countries, but low information is known from Southern Italy. Here, we present the results of a retrospective study on TB cases diagnosed in 2008-2013 in Naples, the biggest city in the South of Italy. Methods. Six hundred ninety Mycobacterium tuberculosis strains were isolated at the Ospedali dei Colli of Naples, and resistance to first-line and second-line drugs was determined. Results. Multidrug-resistant (MDR) TB increased from 2008 to 2013, with most strains being isolated from migrants arriving from 41 countries. Overall MDR-TB rate was 4.5%: Italian-born persons, 2.2%; Romania, 7.5%; Former Soviet Union countries (Ukraine, Russia, Armenia, Georgia), 22.4%; all other foreign countries, 2.0%. Resistance of MDR strains to second-line drugs was high against kanamycin, ofloxacin, capreomycin. Conclusions. MDR-TB increased in 2008-13 and was mostly observed in migrants, indicating the need to intensify diagnosis and treatment of these populations in Naples
The relationship between medical ethics and the legal system in Italy: food for thought
Get PDFRelations between ethics in general – and medical ethics in particular – and legal systems are complex and have been extensively examined in the literature. The topic is important not only for ethicists and jurists, but also for members of the public, who benefit from the services offered by the professions. While the Italian Institute of Health does not claim to propose new avenues for exploration of the relations between ethics and legal systems, it offers some food for thought in the ongoing debate
Agricultural areas in potentially contaminated sites: characterization, risk, management
Get PDFIntroduction. In Italy, the current legislation for contaminants in soils provides two land uses: residential/public or private gardens and commercial/industrial; there are not specific reference values for agricultural soils, even if a special decree has been developed and is currently going through the legislative approval process. The topic of agricultural areas is relevant, also in consideration of their presence near potentially contaminated sites. Aim and results. In this paper, contamination sources and transport modes of contaminants from sources to the target in agricultural areas are examined and a suitable “conceptual model” to define appropriate characterization methods and risk assessment procedures is proposed. These procedures have already been used by the National Institute of Health in various Italian areas characterized by different agricultural settings. Conclusion. Finally, specific remediation techn
Silicosis mortality in Italy: temporal trends 1990-2012 and spatial patterns 2000-2012
Get PDFThe present study investigates the occurrence of silicosis in Italy and its temporal trends and spatial patterns using mortality data. The aim is to give a contribution, albeit with a conservative estimate inferred from mortality data, to epidemiological knowledge of silicosis in Italy. Trends in mortality due to silicosis from 1990 to 2012 were evaluated and a municipal cluster analysis was performed. It shows that mortality due to silicosis is declining but still not eradicated and that one of its main features is regional variability: in this respect, the cluster analysis performed allowed to identify 34 different geographic areas. The results obtained may help display a more detailed picture of silicosis epidemiology and contribute to the fight against exposure to silica, an undisputable public health commitment
Infant immunization coverage in Italy (2000-2016)
Get PDFBackgroundIn Italy, national-level immunization polices are included in the National Immunization Prevention Plan (PNPV), whose latest edition - 2017-2019 PNPV- was approved in February 2017. Immunization coverage is a key measure of immunization system performance; it can inform and support national and regional immunization polices’ implementation monitoring, as well as measure the impact of interventions aimed at increase vaccine uptake. MethodsWe collected, analysed and critically interpreted 2000-2015 Italian national infant immunization coverage trends, by different vaccine, target population, and by Region. Data were provided by the Directorate General for Prevention of the Italian Ministry of Health.ResultsIn 2015, none of mandatory or recommended vaccines reached the 95% national coverage target set in the PNPV. Weighted average national coverage for mandatory vaccines (against polio, tetanus, diphtheria, hepatitis B) and other antigens included in the hexavalent vaccine (pertussis, and Haemophilus influenzae type b) in 2015 was 93.3%; it was lower for measles, mumps and rubella vaccines (85.2%), pneumococcal (88.7%) and meningococcal C conjugate vaccines (76.6%), with a high degree of heterogeneity by Region. Both hexavalent and MMR vaccines coverage rates have been decreasing since 2012, with an annual decrease of, respectively 1% and 1.5%.DiscussionFurther efforts are needed to increase vaccine uptake in Italy, to improve data collection and reporting, as well as to fight the growing phenomenon of the vaccine hesitancy so that PNPV objectives and target can be met in the near future.Ep
Medical tattooing, the new frontiers: a case of nail bed reconstruction.
No full textThe primary objective of medical tattooing is to restore part of a patient’s physical integrity. Moreover, the procedure seeks to assist in psychological recovery from the physical and/or psychological consequences of disease, surgery or trauma. The method described in this brief note marks a step forward in the field of such tattooing. The treatment simulates reconstruction of the nail bed, as the nails of the big toes had previously been removed through a surgical avulsion procedure. This treatment, agreed with the physician and performed by a tattooist with proven experience in medical tattooing, also involved the use of specific colour nuances that resulted in an extremely realistic outcome