1,720,997 research outputs found
Trends in Hospital Admissions for Pertussis Infection: A Nationwide Retrospective Observational Study in Italy, 2002-2016
No full textBackground: Pertussis is a highly contagious infectious disease which continues to be an important public-health issue despite the high immunization coverage rates achieved. However, evidence of increased circulation of pertussis among adolescents and adults due to waning immunity and atypical clinical manifestations seem to be the main reasons for its resurgence. The aim of this study was the analysis of the epidemiological trend for pertussis-related hospitalizations in Italy, in relation with vaccination coverage and information from laboratory confirmed cases of pertussis.Methods: A retrospective observational study investigating hospitalizations for pertussis from 2002 to 2016 in Italy was conducted. Frequencies and rates of hospitalization were analyzed and hospitalization data were compared with a series of already published laboratory confirmed data. Results: This study highlighted a rising trend for pertussis hospitalizations in Italy since 2008. Infants aged <1 year showed the highest frequencies (63.39%) and average rates (74.60 × 100000 infants) of hospitalization despite an extremely high vaccination coverage (95.89%). An increasing trend of hospitalization frequency emerged for the age group with levels of IgG antibodies to pertussis toxin compatible with pertussis infection within the last year (20-29 years old age group). Conclusions: The rising trend for pertussis hospitalizations and the greater involvement of infants aged <1 year require an integrated approach, including the implementation of booster doses administration in adolescence and adulthood, the vaccination of pregnant women and the cocoon strategy
Pertussis in Italy: maternal immunization to protect infants
No full textBackground
Despite effective pertussis vaccines and high rates of pediatric vaccination in Italy, the number of reported pertussis cases has steadily increased. To minimize severe illness and deaths, particularly in infants, in addition to active immunization, maternal vaccination has been nationally recommended. To support this prevention measure, this study sought to gain more insight into the current pertussis burden among hospitalized infants.
Methods
A retrospective observational study investigating infant hospitalizations for pertussis within the first year of life from 2007 to 2018 in Italy was carried out using the Hospital Discharge Database as informational flow. Four age groups were analyzed (<3, 3-4, 5-10, and 11-12 months), according to the expected age for the dose administration of the primary course of pertussis vaccination. The temporal trend of hospitalization rates was analyzed by the slope of the regression line. p < 0.05 was the criterion for statistical significance.
Results
There were 4262 pertussis-related admissions among infants less than 12 months of age. Overall, 61.10% were infants aged <3 months. The overall hospitalization rate was 69 x 100000 infants. When stratified by age, infants <3 months old had the highest hospitalization rate at 169 x 100000 infants, with an increasing trend (β = 9.12, p = 0.002); for the other age groups, the trend increased less strongly or was substantially stable.
Conclusions
This nationwide study highlighted that most of the pertussis admissions in Italy occurred in the first few months of life, before infants had started the primary vaccination course. This result indicates that more needs to be done to protect young infants (<3 months) who are the most vulnerable to severe disease. The implementation of maternal immunization programs could offer the hope of much better pertussis control in infants too young to be vaccinated.
Key messages
Infants aged <3 months showed the highest rates of hospitalization for pertussis, with an increasing trend.
The implementation of maternal immunization programs could protect these high-risk infants
Policy of vaccination of "fragile children": Results of a survey of 14 Italian children's hospitals
Full text linkChildren with chronic disease are at higher risk of invasive infectious disease, including several vaccine-preventable infections. The Italian Association of Pediatric Hospitals (AOPI) carried out a survey of immunization practices: 14/16 AOPI hospitals completed the survey; 50% of them include 100-199 beds, while 21% have <100 beds. In 12/14 hospitals (86%) all vaccinations included in the National Immunization Plan (plus influenza e COVID-19 vaccines) are available for inpatients, in selected wards (n = 4), on single pediatrician initiative (n = 3), by a centralized in-hospital immunization service (n = 2), and the remaining 3 in a "protected vaccination area" or in a COVID-19 pathway. The wards in which vaccination is more frequently offered to in-patients are: General Pediatrics, Neonatology, Pediatric Hematology & Oncology, Pediatric Diabetology, Pediatric Cardiology, and Pediatric Infectious Diseases (range, 58% to 83%). In 58% of vaccinating hospitals, <500 vaccinations/year are reported, while in 17% this number is >2,000/year. A COVID-19 vaccination team is in place for any inpatient child older than 12 years in 42% of hospitals, in 42% only for "fragile" children. A centralized in-hospital immunization service is an emerging model that may contribute to increase compliance to vaccination of fragile patients and to fight against vaccination hesitancy
ANALISI EPIDEMIOLOGICA DELLE OSPEDALIZZAZIONI PER MENINGITE BATTERICA IN ITALIA (ANNI 2006-2015)
No full textINTRODUZIONE:
Le meningiti batteriche continuano ad essere una notevole causa di morbilità neurologica e mortalità in tutto il mondo.
Allo scopo di valutare l’incidenza delle ospedalizzazioni e dei decessi per meningite batterica in Italia, è stato condotto
uno studio osservazionale retrospettivo, con particolare attenzione ai casi di meningite prevenibili da vaccinazione, quali
quelli da Neisseria meningitidis (meningococco), Streptococcus pneumoniae (pneumococco) e Haemophilus influenzae
(HI).
MATERIALI E METODI:
Nell’analisi sono state considerate tutte le schede di dimissione ospedaliera dal 2006 al 2015, recanti i codici ICD9CM
relativi a meningite batterica in diagnosi principale o secondaria. I tassi di ospedalizzazione/di mortalità sono stati
calcolati dividendo il numero di ospedalizzazioni/di decessi per la popolazione residente (dati ISTAT); il trend temporale
di tali tassi è stato analizzato attraverso lo slope (β) della retta di regressione. Nell’analisi si è assunto un livello di
significatività del 5%.
RISULTATI:
Lo pneumococco è risultato essere responsabile del 26,20% (4862/18556) delle ospedalizzazioni per meningite batterica
avvenute nella decade oggetto di studio, con un tasso medio di ospedalizzazione pari a 0,81 per 100.0000 persone. Il
trend temporale dei tassi di ospedalizzazione è risultato essere in diminuzione per pneumococco (β= -0,0007), HI (β=
-0,0013) e meningococco, che ha presentato il decremento più marcato (β= -0,0064), sebbene tali trend non siano
risultati statisticamente significativi. Dal 2006 al 2015 sono inoltre state registrate 2132 morti intraospedaliere per
meningite batterica, con lo pneumococco responsabile del 28,47% (607/2132) di tali decessi. Il trend temporale dei
tassi di mortalità è risultato in lievissimo calo per le forme di meningiti prevenibili con la vaccinazione (HI: β= -0,0001;
p= 0,811; meningococco: β= -0,0006; p= 0,464; pneumococco: β= -0,0025; p= 0,209) rispetto a quello registrato per le
altre forme di meningiti batterica (β= 0,0009; p= 0,519).
CONCLUSIONI:
L’analisi da noi condotta ha evidenziato che i trend temporali dei tassi di ospedalizzazione e di mortalità per le forme di
meningite batterica prevenibili da vaccinazione sono in continua diminuzione nel nostro Paese
TREND TEMPORALE DELLE MENINGITI BATTERICHE IN ITALIA: STUDIO OSSERVAZIONALE RETROSPETTIVO.
No full textINTRODUZIONE:
I bambini nel primo anno di vita e gli anziani rappresentano le fasce d’età maggiormente soggette a contrarre meningite
batterica. Allo scopo di verificare quale fosse la distribuzione per fasce d’età delle ospedalizzazioni per questa causa
in Italia nella decade 2006-2015, è stato condotto uno studio osservazionale retrospettivo utilizzando le schede di
dimissione ospedaliera come flusso informativo.
MATERIALI E METODI:
I tassi di ospedalizzazione per meningite batterica, espressi per 100.000 residenti (dati ISTAT), sono stati calcolati
per le fasce d’età 85 anni. Il trend temporale dei tassi di
ospedalizzazione è stato analizzato attraverso lo slope (coefficiente β) della retta di regressione. La significatività
statistica è stata fissata a p<0,05.
RISULTATI:
La più alta incidenza di ospedalizzazione per meningite batterica è stata registrata nei bambini di età <1 anno. Il trend per
tale fascia di età è però risultato essere significativamente in diminuzione (coefficiente β=-2,06; p=0,007), così come per
la classe 18-44 anni (coefficiente β=-0,16; p=0,003). Al contrario, è emerso un trend in aumento per i soggetti più anziani
(65-85 anni: coefficiente β=0,08; >85 anni: coefficiente β=0,05), sebbene non in modo statisticamente significativo.
Focalizzando l’attenzione sulle forme di meningite prevenibili da vaccinazione, dal 2006 al 2015 nei bambini di età <1
anno si è assistito ad una diminuzione dell’incidenza delle ospedalizzazioni per meningiti da Haemophilus Influenzae e
pneumococco (del 5,41% e 19,37%, rispettivamente), mentre nella fascia 65-85 anni l’incidenza di quest’ultima forma
di meningite è aumentata (del 5,42%), così come quella da Neisseria Meningitidis (7,43%).
CONCLUSIONI:
I dati emersi dal nostro studio confermano la necessità di attuare una strategia vaccinale per la prevenzione delle
meningiti batteriche rivolta non solo ai bambini nel primo anno di vita, ma anche agli anziani di età ≥65 anni, come già
previsto per la vaccinazione anti-pneumococcica
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Association between Anatomical Variations and maxillary canine impaction: A retrospective study in orthodontics
Full text linkThis study aims to evaluate whether or not there is a higher prevalence of skeletal abnormalities in subjects with maxillary canine impaction (MCI). This retrospective study was performed on 67 subjects with maxillary canine impaction (test group) and on 67 patients without dental displacement (control group). Sella turcica bridging (SB), ponticulus posticus (PP), atlas posterior arch deficiency (APAD) and the morphology of sella turcica and pterygopalatine fissure were evaluated on lateral cephalometric radiographs. Statistical analysis was performed using chi-square, Mann-Whitney test and multivariate logistic models; the level of significance was p < 0.05. Results showed that in the test and control groups 87% and 62.7% of patients had SB, respectively. PP was observed in 60% of patients in the test group and in 16.4% of patients in the control group. APAD was observed in 9% of test group and in 4.5% of the control group. Skeletal anomalies were significantly increased (p < 0.05) in subjects with MCI. A significant difference between the groups was observed in regards to the shape of the pterygopalatine fissure, found to be less wide and longer in the test group. SB, PP and APAD were higher in subjects with MCI; furthermore, an elongated pterygopalatine fissure was significantly associated with MCI
Knowledge of, and attitudes towards, adult vaccination among General Practitioners in Piedmont, Italy: results from a cross-sectional study
No full textBackground. “Life-course immunization” is increasingly recognized as important. In Italy, adults are recommended to receive influenza; pneumococcal; tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap); and herpes zoster (HZ) vaccines at various ages. Study design. Cross-sectional study. Methods. To study the knowledge and attitudes of Italian general practitioners (GPs) towards adult vaccination, we surveyed 335 GPs in Piedmont from December 2019 through March 2020; and compared the results by GPs’ age (≤50 vs >50 years). Results. The most common vaccination information source was the regional/local educational courses (72.8%), with older vs younger GPs more likely to attend (79.4% vs 64.4%; p=0.002). Approximately half felt that they needed further information on vaccine co-administration (55.5%), duration of protection (49.6%), and safety/tolerability (48.7%), with older vs younger GPs being more interested in safety/tolerability. Overall, most respondents (86.0%) felt that information for the patient would most engage them, and 68.1% planned to co-administer vaccines. Respondents felt most comfortable proposing influenza, but were also comfortable about pneumococcal/Tdap/HZ vaccination. However, younger vs older GPs were more comfortable about proposing Tdap and HZ. The most common ways to inform patients about influenza or pneumococcal/Tdap/HZ vaccination eligibility were personally during a visit (42.7% or 54.3%, respectively) or via an information poster (30.7% or 17.9%). Conclusions. The surveyed GPs had favorable attitudes towards adult vaccination and were interested in ongoing education
Efficacy and Tolerability of a New Formulation in Rectal Ointment Based on Zn-L-Carnosine (Proctilor®) in the Treatment of Haemorrhoidal Disease
Full text linkHaemorrhoidal disease (HD) shows high prevalence in western countries, reaching 4.4% per year in the US. Topical preparations are the first-line treatments, which are readily available as “over-the-counter” (OTC) products, often containing a nonstandardised mixture of “natural” remedies, or anaesthetics or cortisol;those latter are not free from undesirable effects. The Zinc-L-Carnosine is a cytoprotective compound, promoting mucosal repair in the gastrointestinal tract and also in mucosal repair, following radiation injuries to the rectum as well as in ulcerative colitis. Our aim was to study the efficacy of Zinc-L-Carnosine in relieving acute symptoms of HD, testing a preparation in the rectal ointment, Proctilor®, in patients complaining of bleeding or thrombosed piles. In a multicentre open trial, 21 patients older than 18 years of age were enrolled. The symptoms of HD were graded according to the Haemorrhoidal Disease Symptoms Score (HDSS) in association with the Short Health Scale (SHS) to assess the influence of HD on quality of life. The pain was assessed with the VAS score, bowel habit by means of the Bristol scale. The patients were evaluated at enrolment (T0) and 2 (T1) and 4 (T2) weeks of treatment with Proctilor® rectal ointment. There were 10 men and 11 women; mean age, 49 years. Pain, bleeding, and thrombosis were all significantly reduced after treatment; the mean VAS score decreased from 4.71 ± 3.05 at T0 to.52 ± 0.87 and.05 ± 0.22 at T1 and T2, respectively; (mean ± SD; p < 0.001 in both cases). Similarly, the HDSS score showed to be significantly reduced between T0, T1 (8.05 ± 4.55 vs. 1.14 ± 1.01), and T2 (8.05 ± 4.55 vs. 24 ± 0.44) (mean ± SD; p < 0.001 in both cases). Quality of life showed to be improved as the SHS score decreased significantly with treatment (7.90 ± 4.17 at T0 vs. 4.24 ± 0.44 at T1 vs. 4.05 ± 0.22 at T2; mean ± SD; p < 0.001 in both cases). The Bristol score of defecation remained substantially unchanged. No side effects or discontinuation of treatment were reported. Results of our investigation suggest a role of Proctilor® rectal ointment in treating symptomatic HD with good results and an excellent safety profile. However, our preliminary results encourage further studies on a larger number of patients to confirm the role of Zinc-L-Carnosine in the rectal ointment for the topical treatment of HD
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