1,721,058 research outputs found
Herpes zoster: vaccination status and virtuous experiences
No full textHerpes zoster (HZ) infection is widespread in the general population - especially in the elderly - and can be associated with major sequelae such as post-herpetic neuralgia. Live attenuated zoster vaccine was licensed in Europe in May 2006 and in Italy in 2010; since March 2014, it has been commercially available in Italy. In Italy, vaccination against HZV is recommended in all subjects at risk - for example, those with diabetes, cardiovascular disease, chronic obstructive pulmonary disease or patients on immunosuppressive agents - from the age of 50 years onwards and for all persons aged >64 years. This paper summarizes the virtuous experiences on the effectiveness of the HZ vaccine in the elderly, with a focus on the Italian scenario. Considering the current barriers to this immunization registered in some areas (difficulties of vaccine distribution, lack of physician recommendations, costs), proper educational and communication efforts should be pursued to guarantee a good coverage of HZ vaccination
A postmarket safety comparison of 2 vaccination strategies for measles, mumps, rubella and varicella in Italy
Full text linkIt is strategically important to monitor the safety profile of vaccination schedules in order to achieve and maintain high levels of coverage. We analyzed the cohort of individuals actively invited for measles, mumps, rubella and varicella (MMRV) vaccination in the Veneto region (north-east Italy) from 8/1/2013 to 7/31/2014, assessing the onset of adverse events (AE) relating to 2 different vaccination strategies for MMRV (MMR+V vs MMRV). During the vaccination session at 14 months old, parents were given a form for recording local and systemic reactions to vaccinations for 4 weeks afterwards. Overall, 12,288 forms were returned, and 84.6% of them were included in this analysis (5,130 relating to MMR+V and 5,265 to MMRV); 37.3% of the sample reported no AEs, with no difference between the 2 groups. Local reactions were more common in the MMR+V group (9.6% vs 2.9%; RR 3.33; 95% CI 2.79-3.98), while there was no difference in general reactions between the 2 groups (50% MMR+V vs 52% MMRV). The events most often reported were "fever <39.5°C," which was more frequently associated with the MMRV strategy (p<0.001), and "skin blotches and marks," which occurred more often in the MMR+V group (p<0.001). Reports of "fever ≥39.5°C" were equally distributed between the 2 groups. Sixteen cases of febrile seizures were reported (0.14% in the MMR+V group and 0.17% in the MMRV group). Similar safety profiles were identified for the 2 vaccination strategies. Although the method used to record reactions to vaccination demanded considerable resources, it enabled important information to be collected on parents' perception of the AEs occurring in response to their child's vaccination
The new pandemic influenza A/(H1N1)pdm09 virus: is it really "new"?
Full text linkIn June 2009, the World Health Organization (WHO) issued a pandemic alert concerning the spread of an influenza A (H1N1) virus that showed distinctive genetic characteristics vis-à-vis both seasonal influenza strains and vaccine strains. The main mutation occurred in the gene coding for hemagglutinin (HA). Mathematical models were developed to calculate the transmissibility of the virus; the results indicated a significant overlap with the transmissibility of previous pandemic strains and seasonal strains. The remarkable feature of A/(H1N1)pdm09, compared with seasonal strains, is its high fatality rate and its higher incidence among younger people. Data provided by the WHO on the number of deaths caused by A/(H1N1)pdm09 only include laboratory-confirmed cases. Some authors suggest that these data could underestimate the magnitude of the event, as laboratory confirmation is not obtained in all cases. It is important to bear in mind that the A/(H1N1)pdm09 virus is still circulating in the population. It is therefore essential to maintain its epidemiological and virological surveillance
STIMA DELLE OSPEDALIZZAZIONI PER PATOLOGIA PNEUMOCOCCO CORRELATA NELLA REGIONE VENETO NEL PERIODO 2008-2011
No full textLa patologia da Streptococcus pneumoniae rappresenta un importante problema di sanità pubblica. L'eterogeneità della presentazione clinica delle malattie da pneumococco ed una scarsa attitudine da parte dei medici a richiedere una diagnosi eziologica comporta una mancanza della conoscenza reale della loro diffusione nella popolazione generale. L'obiettivo dello studio è descrivere l'impatto delle malattie pneumococciche (polmoniti e malattie invasive) attraverso l'utilizzo delle schede di dimissione ospedaliera (SDO) nella popolazione della Regione Veneto nel periodo dal 2008 al 2011. Sono state estrapolate le SDO riferite alla popolazione residente nella regione Veneto e contenenti i codici ICD 9: 481 (Polmonite pneumococcica), 485 (Broncopolmonite non specificata), 486 (polmonite agente non specificato), 320.1 (Meningite pneumococcica), 322 (Meningite da causa non specificata), 038.9 (Setticemia non specificata) e 038.2 (Setticemia pneumococcica). Alle ospedalizzazioni in cui lo pneumococco è indicato nella diagnosi come microrganismo causale è stato attribuito il 100% di causalità, mentre per le non specificate sono state attribuite allo pneumococco il 58% delle meningiti, il 36% delle polmoniti e broncopolmoniti e il 20% delle setticemie. Le comorbidità sono state analizzate utilizzando il Charlson Co-morbidity index. I costi sono stati calcolati mediante l'utilizzo della tariffa DRG. I casi stimati nell'intero periodo analizzato risultano essere 15.399: nel 93,5% (14.397 casi) il quadro clinico è dato da polmonite, il 4,9% (755 casi) da setticemia e l'1,6% (247 casi) da meningite. Il 53,3% dei dimessi è di sesso maschile, senza differenze nelle tre patologie considerate. La disaggregazione per classe di età evidenzia il maggior numero di ricoveri sopra i 65 anni (70,2%). La degenza media è pari a 11,6±9,8 giorni, con 14,1±13,0, 14,9±17,2 e 11,3±9,2 rispettivamente per setticemie, meningiti e polmoniti. Il Charlson Comorbidity Index risulta superiore a 2 nel 16,6% dei casi con una percentuale maggiore nelle setticemie (29,6%) e minimo nelle meningiti (7,2%). Il 10,7% risulta deceduto durante il ricovero con la letalità maggiore nei soggetti con setticemia (20,8%). Il tasso di ospedalizzazione stimato per le patologie pneumococco correlate è pari a 78,6 per 100.000 abitanti (73.5, 1.3 e 3.9 per 100.000 rispettivamente per polmoniti, meningiti e sepsi). I tassi di ospedalizzazione stimati evidenziano un maggior carico di patologia nel sesso maschile (85,6 per 100.00 rispetto a 71,8 per 100.000 nel sesso femminile ) e nelle classi di età estreme, sotto i 5 anni (140,7 per 100.000) e sopra i 65 anni (275,8 per 100.000). La spesa ospedaliera complessiva per tutte le patologie pneumococco correlate è risultata pari a 13.020.587 €/anno con un costo per ricovero pari a 3.103,04 euro (2.911,43€ per polmonite, 8.306,94€ per meningite e 5.524,8€ per setticemie). Nonostante l'analisi sia stata condotta esclusivamente sulle ospedalizzazioni, la stima del carico della patologia pneumococcica è risultata considerevole, soprattutto nei soggetti con patologie croniche e negli anziani. La vaccinazione dei soggetti a rischio e in particolar modo dei soggetti con età superiore ai 65 anni potrebbe pertanto rappresentare un valido strumento per il contenimento della patologia e dei conseguenti costi da essa derivati
SARS-CoV-2/COVID-19 Vaccines: The Promises and the Challenges Ahead
No full textThe development of a new vaccine usually consists of a linear sequence of several steps and lasts many years [...
Epidemiology of suicide attempts in a psychiatric setting in Northern Italy
Full text linkObjectives
An observational study was carried out to investigate suicide
attempts in the period from January 1, 2006 to December 31,
2010 in the population of legal age from the territory of Rovigo
in Northern Italy.
Methods
All intentional self-poisoning or self-injury events, irrespective of
motivation, that came to the attention of Mental Health Services
was recorded. Personal data (age, sex, marital status, occupation,
educational level and family composition), clinical data
(main diagnostic group, method used in the attempt, previous
contact with the Service, previous suicide attempts, site of first
psychiatric consultation) were recorded for every person encountered
by the psychiatrist involved in the first evaluation. All
the people recruited were also asked to fill in a self-administered
interview composed of three questionnaires: QD - questionnaire
of depression by CBA – cognitive behavioral assessment; BSI –
borderline syndrome index and RFL – reason for living inventory.
Results
Two-hundred and sixty-five suicide attempts with a psychiatric
evaluation were considered in a population of 149,300 people
over a period of 5 years. A higher distribution in females and
younger people was found. There is a high percentage of unemployed
people (23.1%), especially among males (29.3%)
(χ2 test:4.02; p < .05). In the majority of cases the means of
the suicidal attempt is drug poisoning (59%) and violent methods
(hanging, gas poisoning, jumping, fire arms and drowning)
represent the 25.2% of all the sample, with a higher percentage
for male subjects (35.9%; OR: 2.66 [95% CI: 1.34-5.29]).
The great majority of people were assessed in Emergency Rooms
(64.1%) and after the psychiatric evaluation, 69.2% of the people
were hospitalized in psychiatric wards. The main diagnostic
group is personality disorders (33.3%) followed by mood disorders
(24.4%): there is a significant sex difference with more
females with mood disorders (χ2 test: 6.88; p < .01) and more
males with alcohol/substance disorders (χ2 test: 19.4; p <.01).
In 40.6% of cases had at least one contact with Mental Health
Services before while a relevant percentage of people (43.2%)
had a positive history for previous attempts. People with a positive
history of suicidal attempts were at major risk of borderline
personality (OR: 2.01 [95% CI: 1.02-3.95]) while it was less
evident in people with a higher presence of reason for living by
the RFL questionnaire (p < 0.05; adjusted OR: 0.39 [95% CI:
0.16-0.94])
Hospitalization for diseases attributable to human papillomavirus in the Veneto Region (North-East Italy).
Full text linkBackground: Human papillomavirus (HPV) is one of the most common sexually-transmitted pathogens. A number of studies in the literature have estimated the burden of HPV-related diseases by collecting data at primary care level, while a comprehensive assessment of the global burden of HPV-related diseases on hospital resources is still lacking.
Methods: This was a retrospective cohort study based on hospital discharge data collected from 2000 to 2010 in the Veneto Region (north-east Italy). All hospitalizations for diseases potentially associated with HPV were identified by searching the hospital discharge records, then the proportion of these hospitalizations relating to diseases attributable to the HPV infection was calculated.
Results: Overall, the annual hospitalization rate for HPV-related diseases was 21.3 per 100,000 individuals in the general population, 15.8 per 100,000 males, and 27.6 per 100,000 females. Hospitalizations were due mainly to genital warts, and peak among 15-to 44-year-olds in both genders. Taking both sexes together, the hospitalizations attributable to HPV dropped from 24.5/100,000 in 2000 to 17.5/100,000 in 2011, showing a significant decline during this period, with an average annual percent change (AAPC) of -1.9% (CI 95%: -2.8, -0.9;). On the other hand, the hospitalization rate for genital warts tended to increase significantly (AAPC 3.0% [CI 95%: 1.4; 4.7]), whilst there was a significantly declining trend in the hospitalization rate for anal cancer (AAPC -5.0% [CI 95%: -7.7;-2.2]), genital cancer (AAPC -6.2% [CI 95%: -7.8;-4.6]) and oropharyngeal cancer (AAPC -4.3% [CI 95%: -4.8;-3,8]).
Conclusion: Data derived from the hospital records indicate that HPV-related diseases are an important public health issue
Hospitalization for pneumonia in the Veneto Region (North-East Italy), 2004-2012
No full textPneumonia is an important cause of illness and death particularly for elderly adults. The goal of the study was estimate the trend of hospitalization of pneumonia in Veneto Region. A retrospective study, using hospital data was conducted between 2004 and 2012 in all hospitals of region (4.81 millions of inhabitants). The reasons of hospitalization for pneumonia were defined by a first-listed discharge diagnosis of pneumonia or by a first-listed discharge diagnosis of meningitidis, septicemia or empyema associated to a pneumonia diagnosis. Annual total age-specific hospitalization rates and trend were calculated and related with vccines coverage. The total cost was calculated. Overall, 110,927 discharges were selected with an annual pneumonia hospitalization rate of 256.3 per 100,000 inhabitants with peaks in children and the elderly people. The pneumonia hospitalization rate does not increase significantly in study period [AAPC: 1.3% (CI 95%: -0.5; 3.1)], in 0-4 age group the rate significantly dropped to 451.8 per 100,000 in 2012 [AAPC: -2.5% (CI 95%: -4.5; -0.5)]. In adults 80+ the trend increases not significantly [AAPC: 1.2% (CI 95%: -0.9; 3.4)]. The overall pneumonia fatality rate was 10.7%. The estimated cost for hospitalized patient was 3,090.59 Euro.This study shows that hospitalization for pneumonia had a considerable impact on the health services, especially in children and in old groups and the availability of a new generation of conjugate pneumococcal vaccines with an enlarged antigenic spectrum and the extended indication in all ages, open new interesting opportunities to improve the control of pneumococcal disease among the entire population
Vaccinazioni e nanotecnologie
No full textIn ambito preventivo, la vaccinazione rappresenta
uno dei principali strumenti in continua innovazione. Si analizano le varie tipologie di vaccini e la loro costituzione
A population database analysis to estimate the varicella vaccine effectiveness in children < 14 years in a high vaccination coverage area from 2004 to 2022
Full text linkIntroduction: In the Veneto Region of Italy, universal varicella vaccination (VV) started in 2007 with a two-dose schedule at 12-15 months and 5-6 years of age achieving 90 % coverage in 2019. The study aimed at evaluating the vaccine effectiveness (VE) in children using a primary-care database METHODS: This retrospective analysis used Pedianet, a comprehensive database of 73 family paediatricians in the Veneto Region. Incidence rates (IR) of varicella were evaluated in children aged 7 years, irrespective of their vaccination status. Indeed, the IR increased from 5.5 to 19.5 × 1000 person-years and from 1.1 to 5.4 × 1000 person-years in unvaccinated and vaccinated children aged <12 months versus those aged 5-6 years, respectively. Varicella VE was 83.4 % and 94.7 % in those vaccinated with one and two doses. After six years, the cumulative probability of experiencing varicella was 10.7 % for unvaccinated subjects, and 2.5 % and 0.4 % for those vaccinated with one and two-doses (log-rank test, p < 0.001). Conclusions: Two-dose schedule VV is effective in drastically reduce varicella episodes. Breakthrough varicella episodes remain rare events
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