Annali dell'Istituto Superiore di Sanità
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The Italian National Institute of Health helpline to quit tobacco and nicotine dependence: 20 years of activity
Get PDFIntroduction. Tobacco use is one of the world’s leading preventable causes of death and is a major preventable risk factor of non-communicable diseases. Although smokers are aware of the health risks, their attempts to quit often fail, primarily due to the strong nicotine and/or tobacco dependence. Antismoking helplines have become an integral part of tobacco control efforts in many countries. In Italy, the ISS Antismoking Helpine is active since 2000.Material and methods. The professional staff of the ISS Antismoking Helpline have gathered socio-demographic and smoking-related data via an electronic form, related to the received calls. The collected data have been processed in a dedicated database and analyzed to monitor the use and the quality of the service. In this study, a descriptive statistical analysis was conducted to inform about the activity of the helpline over the years.Results. From May 2003 to June 2023 the helpline received 99,423 calls. Most smokers called to receive “support to quit” (82.6%). Counselling was provided in 11.4% of cases,and in the last two years has been strongly increased (40.0% of cases). The percentage of users requesting information on emerging tobacco and nicotine products is 1.2%, even ifin 2023 this percentage has risen significantly (6.0%). Two legislative measures (in 2012 and in 2016) required to add the helpline number to all packets of tobacco cigarettes. Accordingly, the offer of counselling increased from 2.6% to 12.2%.Conclusions. The available resources in tobacco control, including the helpline, are still not sufficient to meet all the users needs. Adequate policies and stable funding to fighttobacco and nicotine dependence need increased commitment from government institutions to ensure equal access to treatments for all Italian citizens
ViolHelp: results of a pilot study to identify potential warning signs and risk factors for self- and heterodirected violence in the calls received by the Helplines of the Italian National Institute of Health
Get PDFBackground. Self- and hetero-directed violence (SHDV) is a serious public health problem and a complex phenomenon, influenced by individual and environmental factors. SHDV may occur particularly in moments of personal, economic and/or social crisis. During the COVID-19 pandemic, the ISS-Helplines operators have perceived an increase in psychological distress and self-isolation among callers. The ViolHelp project aimed at identifying potential warning signs and risk factors of SHDV emerging in the activity of the ISS-Helplines (Istituto Superiore di Sanità, ISS, Italian National Institute of Health).Materials and methods. A dashboard collecting warning signs and risk factors of SHDV was developed to be used during the ISS-Helplines activity.Results. In one year of data collection, 135 calls were compiled. In 106 calls, callers referred experienced violence: 72 self-directed violence (SDV), 20 hetero-directed violence (HDV), 14 both. The most frequent warning signs and risk factors for SDV were desire to die (68.6%), previous suicide attempts (31.4%) and threat of self-harm (25.6%); for HDV were depressed mood (32.4%), diagnosis of pathology and/or psychiatric disorders, desire to die, use of psychotropic drugs, and alcohol abuse (29.4%).Conclusions. The results of this pilot project show the importance of being able to read the warning signs and to create a network that can improve information, prevention and support activities for people at risk of violence and their families
Use of antidepressant and antipsychotic drugs in subjects with hemophilia of the Umbria Region in the period 2011-2022
Get PDFIntroduction. Chronic diseases, such as hemophilia, can evoke psychological sequelae and be associated with a higher risk of mental health disorders. The utilization of antidepressant and antipsychotic drugs in subjects with hemophilia is not completely understood and few data are available.Objectives. The aim of this analysis is to describe use of antidepressant and antipsychotic drugs in subjects with hemophilia of the Umbria Region in the period 2011-2022.Methods. A descriptive, cross-sectional, and retrospective analysis based on data on filled prescriptions for antidepressants and antipsychotics has been carried out. The overall and annual prevalence of drugs use and consumption were calculated based on pharmaceutical prescriptions charged to the National Health Service in subjects with hemophilia and matched controls from general population.Results. In the study period 170 subjects with hemophilia were identified; about 80%were male. About 20% and 8.2% received antidepressants and antipsychotics, respectively.A higher percentage of users and consumption were found in subjects with hemophilia compared to matched controls, although no statistically significant differences were observed.Conclusions. Our analysis suggests that depression and psychosis are important comorbidities in subjects with hemophilia. Further larger studies are needed in order to confirm these data and better define the burden of mental health disorders in subjects with hemophilia
Tobacco, heated tobacco products, e-cigarette, alcohol, cannabis and other psychotropic substances. Polysubstance use during the COVID-19 pandemic in Italy
Get PDFObjective. Psychoactive substance use is largely found to involve multiple substances. In recent years, the COVID-19 pandemic has changed psychoactive substance use patterns. Aim of this study is to investigate profiles of polysubstance and their pattern duringand after the COVID-19 pandemic.Methods. We collected information on alcohol consumption, use of tobacco, cannabis and other psychotropic substances, and nicotine-containing electronic devices (NCEDs; i.e. heated tobacco products and electronic cigarettes) on representative samples of theItalian adult population in five surveys from 2020 to 2023 (3,000≤n≤6,600). We used a Latent Class Analysis model to identify substance use profiles and their associated variables in each time period.Results. We initially identified two profiles, “light users”, characterized by a low use of tobacco and NCEDs (3%-20%) and a 40% at-risk alcohol consumption, and “polysubstance users”, characterized by a large use of all psychoactive substances. After the 2020 COVID-19 lockdown, we also found the “dual users” profile, which show a large use of tobacco (90%) and NCEDs (50%), and also alcohol (50%). Being “dual users” and “polysubstance users” were associated with younger age and high economic status, with strengths of association less pronounced during lockdown but more marked immediately thereafter. Moreover, reporting anxiety or depressive symptoms as well as using psychotropic drugs were strongly associated with both profiles, especially in the last two years.Conclusions. Heterogeneity of polysubstance users and their socio-demographic characteristics need to be considered to design tailored prevention interventions, with special attention to the new “dual users” profile, which confirmed the increasing trend in NCED use
Efficacy of sodium oxybate plus disulfiram for the maintenance of alcohol abstinence in treatment-resistant patients with alcohol use disorder: a multicentre retrospective study
Get PDFIntroduction. Disulfiram (DF), acamprosate, naltrexone, baclofen and sodium oxybate (SO) are currently the medications approved for the treatment of alcohol use disorder (AUD). In this context, combined pharmacological interventions and sex differences arean interesting area in the treatment of non-responder AUD patients.Aim. To evaluate the efficacy of SO in combination with DF in maintaining alcohol abstinence in patients with AUD who failed to achieve abstinence either with SO or DF alone.Methods and results. 126 detoxified AUD patients, previously treated with only SO or DF, were retrospectively enrolled from 2018 to 2022. At the end of treatment, a higher number of females than males (74.1% vs 66.3%: p=0.03) maintained continuous abstinencefrom alcohol, and all the females responded completely or partially to the treatment.Conclusions. This study shows that the combination of SO and DF may be considered a further pharmacological oppo
Publications from International Organizations on Public Health
Get PDFThe Publications from International Organizations on Public Health section includes a wider selection of the most recent publications edited by the main international organizations active in the field of public health, such as: the European Food Safety Authority (EFSA), the Food and Agriculture Organization of the United Nations (FAO), the International Labour Organization (ILO), the Organisation for Economic Co-operation and Development (OECD), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the United Nations Environment Programme (UNEP), the United Nations Programme on HIV/AIDS (UNAIDS), and the World Health Organization (WHO)
Live biotherapeutic products and their regulatory framework in Italy and Europe
Get PDFIn Italy and Europe, live microorganisms-containing products meant to be used by vulnerable or sick people for preventing or curing a disease are defined as live biotherapeutic products and are regulated as biological drugs. As such, they must undergo extensive quality, safety and efficacy testing and evaluation before receiving a marketing authorization. This review describes the regulatory framework of live biotherapeutic products with special focus on the European Pharmacopoeia monograph 3053 that set mandatory requirements for this kind of medicines, including verification of the number of live microorganisms and absence of certain contamination indicator microorganisms. The other product categories that may contain live microorganisms are also described, with brief references to the overlaps possibly occurring between the different categories
Knowledge and behaviours associated with HIV infection and other sexually transmitted infections in blood donors in Italy
Get PDFIntroduction. Sexually transmitted infections (STIs) represent a group of widespread infectious diseases. The objective of this study is to investigate the knowledge on HIV and STIs as well as sexual risk behaviours among blood donors in Italy.Materials and methods. The study was carried out in 2017 among blood donors who accessed social media of the Italian Association of Blood Donors (Associazione Volontari Italiani del Sangue, AVIS), and answered to a questionnaire posted online.Results. Participating blood donors were 9,021, median age 36 years (IQR 26-47), 53.9%males, 94.3% heterosexual, and 2.7% reported having a current occasional partner. Unprotected sex in the last 4 months was reported by 54.1% of participants. About half of the participants were not informed of most STIs, 11.0% reported never having searched for information on HIV and STIs, one third considered unlikely acquiring HIV through unprotected sex with a known person, 21.3% would stop having sex with a partner found to be HIV-positive, and 15.8% would be afraid to hug or kiss a person with HIV.Discussion. Our results show that most blood donors have a stable partner and search actively for information on HIV and STIs. However, there is a proportion of them who engage in high-risk behaviours, have misconceptions on HIV and STIs transmission, reporting a stigmatising attitude towards people with HIV.Conclusion. A more comprehensive and updated information on various STIs, transmissionmodes and safe sex should be provided to blood donors, not only to prevent the spread of these infections but also to avoid unjustified discrimination
Sarcopenic obesity and hypertension in elderly patients: a narrative review of pathophysiology and management strategies
Get PDFIntroduction. Sarcopenic obesity and hypertension are a public health problem that isincreasing worldwide due to the progressive aging of the population and the increasingprevalence of obesity and physical inactivity. Sarcopenic obesity is characterized by thesimultaneous presence of sarcopenia (loss of muscle mass) and adiposity (increase in fatmass). Because symptoms are not specific, sarcopenic obesity remains largely undiagnosed.This review explores the latest research on sarcopenic obesity and its association with hypertension, with a focus on arterial stiffness.Methods. A comprehensive narrative review was conducted by systematically searchingPubMed and Scopus databases for relevant scientific literature.Results. Sarcopenic obesity and hypertension are closely linked, sharing common factorssuch as inflammation, insulin resistance, and oxidative stress, with arterial stiffness playing a crucial role.Discussion. Given the lack of specific symptoms for sarcopenic obesity, early diagnosis and management are crucial. Treatment strategies should prioritize weight loss, adequate protein intake, and regular physical activity. Further investigation is warranted for pharmacological interventions.Conclusion. Sarcopenic obesity and hypertension present significant challenges to globalpublic health. Addressing arterial stiffness is paramount in managing these conditions effectively. Lifestyle modifications, including weight management and physical activity, remain central to the treatment of sarcopenic obesity, while additional research is neededto explore potential pharmacological options