125 research outputs found
Low back pain and FokI (rs2228570) polymorphism of vitamin D receptor in athletes
No full textBackground: Low back pain (LBP) is common in athletes. LBP can be detrimental to athletic performance and
health. Factors predisposing to LBP in athletes remain elusive and require further studies. We investigated whether
carriage of a specific genotype and/or allele of vitamin D receptor gene (VDR) FokI polymorphism (rs2228570) was
a risk factor for LBP in athletes of different sports disciplines.
Methods: This genotype/phenotype association case-control study included 60 Italian athletes (25 females and
35 males; mean age 33.9 ± 13.3 years; body-mass-index 23.5 ± 3.5 kg/m2) of which 16.7% were swimmers, 11.
7% soccer players, 11.7% volleyball players, 10.0% rugby players and other disciplines. VDR-FokI polymorphism
was measured by PCR-RFLP in 24 athletes with LBP and 36 athletes without LBP episodes. Absence or
presence of the FokI restriction site was denoted “F” and “f”, respectively. Other risk factors were evaluated by
a questionnaire.
Results: The homozygous FF genotype was found in 58.3% (14/24) of athletes with LBP versus 27.8% (10/36)
of athletes without LBP, adjusted OR = 5.78, 95% CI 1.41–23.8, P = 0.015. The F allele was a 2-fold risk factor to develop LBP,
adjusted OR = 2.55, 95% CI 1.02–6.43, P = 0.046, while f allele was protective. Exposure to vehicle vibrations ≥2 h daily, and
family history of lumbar spine pathology were significant risk factors for LBP with OR=3.54, and OR=9.21, respectively.
Conclusions: This is the first study in which an association between VDR-FokI polymorphism and LBP in athletes was
found. Further research is needed to extend our results, and to clarify the biochemical pathways associated with how
vitamin D modulates LBP in athletes. The VDR-FokI polymorphism should be considered when developing genetic
focused studies of precision medicine on health in athletes
Comparative Diagnostic Accuracy of the STANDARD M10 Assay for the Molecular Diagnosis of SARS-CoV-2 in the Point-of-Care and Critical Care Settings
No full textAccurate and rapid molecular diagnosis of COVID-19 is a crucial step to tackle the ongoing pandemic. The primary objective of this study was to estimate the real-world performance of the novel RT-PCR STANDARD M10 SARS-CoV-2 assay in a large number of nasopharyngeal (NP) specimens eluted in universal transport medium. The secondary objective was to evaluate the compatibility of this kit in testing NP samples eluted in an inactivated transport medium (essential for point-of-care testing) and lower respiratory tract (LRT) specimens, which are commonly collected in critical care. A total of 591 samples were analyzed. Compared with the standard extraction-based RT-PCR Allplex 2019-nCoV (time-to-result of 270 min), the sensitivities of the STANDARD M10 were 100% (95% CI: 98.1–100%), 95.5% (95% CI: 91.7–97.6%), and 99.5% (95% CI: 97.2–99.9%) for ≥1 gene, the ORF1ab gene, and the E gene, respectively, while the specificity was 100% (95% CI: 98.7–100%). The diagnostic accuracy was 100% in testing both NP samples eluted in an inactivated transport medium and LRT specimens. STANDARD M10 reliably detects SARS-CoV-2 in 60 min, may be used as a POC tool, and is suitable for testing LRT specimens in the critical care setting
Development of a User-friendly Health Promotion Website to Spread Evidence-based Information in Italy: A new digital platform to enhance health literacy
No full textIntroduction
Appropriate communication models are crucial in order to strengthen preventive and health promotion interventions via digital platforms. Today, 52.23% of the Italian population use the Internet as a source of health-related information. The aim of the “Insegna Salute” project was to create a website that would enable people to satisfy their health needs and increase their awareness in the field of prevention.
Methods
To create the website, a literature search was carried out to obtain an overview of online health communication before, during and after the Covid-19 pandemic.
Results
The investigation resulted in 26 sources regarding health communication, vaccine hesitancy, online health information seeking, visual identity, current digital and social trends and mis/disinformation. Our findings led to the definition of insegnasalute.it according to the one-to-many (screen-to-face) communication model and a user-centred design. The website will be organised in sections dedicated to the University Department\u27s projects and preventive health issues. Tools such as Google Analytics and questionnaires will provide further insights and enable the platform to be updated.
Conclusions
In line with the preventive guidelines issued by the Italian Ministry of Health, new tools, such as “Insegna Salute”, integrate health knowledge with communication strategies. Addressing vaccine hesitancy and health prevention issues necessitates the use of effective strategies that foster trust-based relationships
Characteristics of the First Italian Older Adults Vaccinated with an Adjuvanted Respiratory Syncytial Virus (RSV) Vaccine
No full textBackground and Objectives: Three respiratory syncytial virus (RSV) vaccines have been recently made available for older adults. Understanding the principal characteristics of the first vaccine-takers can pave the way for a successful vaccination campaign. The objective of this study was to explore the sociodemographic and clinical characteristics of the first Italian users of an adjuvanted RSV vaccine and their attitudes towards RSV and vaccination. Materials and Methods: This cross-sectional study was conducted in 2024 in Liguria (Italy). Individuals aged ≥60 years with no contraindications to the adjuvanted vaccine RSVPreF3 OA were eligible. Following vaccination, subjects filled in a questionnaire, which comprised items on sociodemographic and clinical characteristics, attitudes towards RSV and RSV vaccination and a vaccination trust indicator (VTI). Results: A total of 453 vaccinees completed the survey. Their mean age was 74.9 ± 8.0 years, and 50.6% were males. Nine of ten (89.2%) individuals had ≥1 co-morbidity, of which cardiovascular conditions (70.4%), respiratory diseases (27.6%) and diabetes (18.5%) were the most common. Uptake of the routine vaccines was high: 91.2% and 98.7% received the 2023/2024 season influenza and ≥2 COVID-19 vaccines, respectively. The most common reasons for the current RSV vaccination were general practitioner advice (43.9%), followed by the willingness to be protected against (20.8%) and feelings of being at risk (16.6%) of RSV. The average VTI score was 91.5%, suggesting high trust in vaccines. More positive attitudes towards RSV vaccination were observed (p < 0.01) among subjects who received more COVID-19 vaccine doses, whose reasons for the current RSV vaccination were the willingness to be protected or to be in good health and the feeling of being at risk for RSV. Conclusions: The first Italian users of the novel RSVPreF3 OA vaccine were represented by high-risk individuals with a comparatively high prevalence of co-morbidities, high uptake of the seasonal respiratory vaccines and high trust in immunization
Prostatic Artery Embolization in Elderly Comorbid Patients with Benign Prostatic Hyperplasia: Safety, Efficacy, and Predictive Factors of Clinical Failure
No full textBackground: This study aims to evaluate the safety and efficacy of prostatic artery embolization (PAE) in elderly, multimorbid patients with benign prostatic hyperplasia (BPH). Additionally, it seeks to identify technical and clinical factors that predict clinical failure at the mid-term follow-up. Methods: We analyzed the clinical records of 175 consecutive patients who underwent PAE. Technical success was defined as achieving embolization on at least one side. Safety was assessed using the Clavien–Dindo classification. The pre-procedural international prostate symptom score (IPSS), quality of life (QoL) score, prostate volume (PV), prostate-specific antigen (PSA), maximum urinary flow rate (Qmax), and post-void residual urine (PVR) were compared with values assessed at the follow-up evaluation. Clinical failure was defined as no improvement or worsening of lower urinary tract symptoms (LUTS) based on the IPSS at the follow-up evaluation. Univariate and multivariate regression models were applied to identify predictors of clinical failure. Results: 158 patients met the inclusion criteria. The median age was 74 years (68, 79), with a median ASA score of 2 (2, 3) and a Charlson comorbidity index (CCI) of 5 (4, 7). Follow-up assessments were carried out at a median of 12 months (0, 1). IPSS decreased by −5 points (−8, 0), QoL by −1 point (−1, 0), PV by −19 cc (−26, −8), PVR by −45 cc (−25 to −80), and PSA by −1.1 ng/mL (−2.5, −0.2) (p < 0.01); while Qmax improved by 4 mL/s (2, 6) (p < 0.01). A total of 44 patients (30.3%) experienced clinical failure, which was significantly correlated with unilateral embolization (p < 0.01). Multivariate regression analysis indicated that higher CCI, elevated PVR, and the use of larger microspheres were associated with poorer clinical outcomes, with odds ratios of 2.17 (95% CI: 1.4–3.38), 1.02 (95% CI: 1.01–1.03), and 26.83 (95% CI: 4.81–149.8), respectively (p < 0.01). Conclusions: PAE is a safe and effective treatment for elderly multimorbid patients with BPH. Comprehensive pre-procedural clinical assessment, incorporating the CCI and PVR, is essential to optimize treatment outcomes
Exploring missed opportunities for influenza vaccination and influenza vaccine co-administration patterns among Italian older adults: a retrospective cohort study
No full textBackground: Missed opportunities constitute a main driver of suboptimal seasonal influenza vaccination (SIV) coverage in older adults. Vaccine co-administration is a way to reduce these missed opportunities. In this study, we quantified missed opportunities for SIV, identified some of their socio-structural correlates and documented SIV co-administration patterns. Methods: In this registry-based retrospective cohort study, we verified the SIV status of all subjects aged ≥65 years who received at least one dose of coronavirus disease 2019 (COVID-19), pneumococcal or herpes zoster vaccines during the 2022/23 influenza season. The frequency of concomitant same-day administration of SIV with other target vaccines was also assessed. Results: Among 41 112, 5482 and 3432 older adults who received ≥1 dose of COVID-19, pneumococcal and herpes zoster vaccines, missed opportunities for SIV accounted for 23.3%, 5.0% and 13.2%, respectively. Younger, male and foreign-born individuals were generally more prone to missing SIV. The co-administration of SIV with other recommended vaccines was relatively low, being 11.0%, 53.1% and 17.1% in COVID-19, pneumococcal and herpes zoster cohorts, respectively. Conclusions: A sizeable proportion of older adults who received other recommended vaccines during the last influenza season did not receive SIV. This share of missed opportunities, which are subject to some social inequalities, may be addressed by increasing vaccine co-administration rates and implementing tailored health promotion interventions
Exploring case definitions and the natural history of respiratory syncytial virus in adult outpatients: First-season results of the RESPIRA-50 study
No full textBackground: Data on the natural history of the community-acquired RSV in adult outpatients are limited. It is also unclear whether the existing influenza surveillance platforms based on influenza-like illness (ILI) case definitions are efficient for RSV. The two-season RESPIRA-50 study was established in 2023 to identify an optimal RSV case definition and to explore the natural history of RSV. Here, the first-season results are reported. Methods: The study was conducted in Genoa (Italy) during the 2023/2024 RSV season. Twenty-four general practitioners were randomized 1:1 to enroll adults aged ≥ 50 years seeking care for acute respiratory infection (ARI) or ILI, respectively. Both syndromes were defined according to the European criteria. All subjects were tested by real-time polymerase chain reaction (RT-PCR) for RSV and other pathogens. RSV-positive adults were followed for up to 30 days. Results: Of 517 subjects included, 7.0 % [95 % confidence interval (CI): 4.9–9.5 %)] tested positive for RSV. RSV prevalence in the ARI group (8.0 %; 95 % CI: 5.0–12.1 %) was higher than in the ILI group (6.0 %; 95 % CI: 3.5–9.5 %) with an odds ratio of 1.36 (95 % CI: 0.69–2.70). Conversely, positivity for influenza (10.4 % vs 12.4 %) and SARS-CoV-2 (12.4 % vs 16.9 %) were lower in the ARI group and the corresponding ORs were 0.82 (95 % CI: 0.48–1.42) and 0.70 (95 % CI: 0.43–1.15), respectively. The mean duration of an RSV episode was 18.8 ± 8.0 days and two thirds of individuals were prescribed antibiotics. A total of 33.3 % (95 % CI: 18.6–51.0 %) of RSV-positive individuals developed complications, of which bronchitis (13.9 %) and pneumonia (8.3 %) were the most frequent. Conclusions: Compared with ARI, ILI-based surveillance may underestimate the burden of RSV in community-dwelling adults aged ≥ 50 years. A high proportion of RSV-positive adult outpatients develops complications, which lead to substantial resource consumption
Economic and Environmental Effectiveness of a Technology-based Climate Protocol
No full textThe present stalemate in climate negotiations has led policy analysts and economists to explore the possible emergence of alternative climate regimes. This paper explores the idea of replacing international cooperation on greenhouse gas emission control with international cooperation on climate-related technological innovation and diffusion. This idea – recently proposed among others by Barrett (2001) and Benedick (2001) – is based on the insight that incentives to free-ride are much smaller in the case of technological cooperation than in the case of cooperation on emission control. This paper provides a first applied game theory analysis of a technology-based climate protocol by assessing: (i) the self-enforcingness (namely, the absence of incentives to free ride) of the coalition that would form when countries negotiate on climate-related technological cooperation; (ii) the environmental effectiveness of a technology-based climate protocol. The analysis is carried out by using a model in which endogenous and induced technical change are explicitly modelled and in which international technological spillovers are also quantified. The results of our analysis partly support Barrett’s and Benedick’s conjecture. On the one hand, a self-enforcing agreement is more likely to emerge when countries cooperate on environmental technological innovation and diffusion than when they cooperate on emission abatement. However, technological cooperation – without any commitment to emission control – may not lead to a sufficient abatement of greenhouse gas concentrations.Agreements, Climate, Incentives, Technological change, Policy
Dose x Depth Monte Carlo Simulations, comparing the two densities; black squares for 7.4g/cm<sup>3</sup> and red circles for 5.0g/cm<sup>3</sup>.
No full textDose x Depth Monte Carlo Simulations, comparing the two densities; black squares for 7.4g/cm3 and red circles for 5.0g/cm3.</p
OMTFSFI: OPERATED MALE TO FEMALE SEXUAL FUNCTION INDEX. DEVELOPMENT AND VALIDATION OF THE FIRST QUESTIONNAIRE TO ASSESS SEXUAL FUNCTION AFTER MALE TO FEMALE GENDER REASSIGNMENT SURGERY
No full textThe available literature does not provide any questionnaire to evaluate sexual function after male to female (MtF) gender reassignment surgery (GRS). The assessment of sexual function in these patients is routinely performed by using tools designed for biological women, such as Female Sexual Function Index (FSFI). Such a limit leads to a suboptimal evaluation, especially in domains like lubrication and dyspareunia. Moreover, FSFI scores in MtF patients often are similar to those observed in non-transsexual women with sexual dysfunction. We aim at developing validate new questionnaire, the operated Male to Female Sexual Function Index (oMtFSFI) in order to assess sexual function in patients who underwent MtF GRS
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