1,721,210 research outputs found
Epidemiological Surveillance for Italian Childhood Gastroenteritis and Intussusceptions
Full text linkIn 2009 the World Health Organization recommended rotavirus vaccination for all children, and the promotion of vaccination should occur in parallel with a postmarketing surveillance strategy. We review the epidemiological data on pediatric hospitalizations for gastroenteritis and intussusceptions, a rare adverse reaction to rotavirus vaccine, in Italian children aged <6 years. The analysis highlighted that rotavirus gastroenteritis hospitalizations in Italy are still relevant and generate significant costs to the National Health care System, the evidence of natural changes in incidence of intussusceptions that underline the importance of increasing the knowledge of the natural history of this condition, the independence of the intussusceptions with respect to rotavirus gastroenteritis. Continuous monitoring of rotavirus gastroenteritis and intussusceptions hospital discharge database may contribute to a good management of the pediatric extensive rotavirus vaccination, once in place
Tassi e costi delle ospedalizzazioni infantili per GARV in Italia (anni 2005-2012). Rates and costs of RVGE hospitalizations in Italy (2005-2012 years)
No full textEsercizio fisico e prevenzione della cardiopatia coronarica: La difficile ricerca di una relazione casuale
No full textIMPACT OF VARICELLA VACCINATION IN CHILDREN UNDER 1 YEAR OF AGE IN ITALY (2006-2011)
Full text linkINTRODUCTION
Varicella represents the most widespread vaccine
preventable childhood infectious disease in Italy.
In children under 1 year of age, it tends to be
more severe with a higher rate of complications
like pneumonia, hepatitis and encephalitis, and is
associated with higher mortality. In Italy, between
2003 and 2010, 8/21 Regions have progressively
introduced Universal Varicella Vaccination (UVV)
in their immunization programs, with different
schedules in children aged 13-15 months and
5-6 years. Objective of this study was to analyze
hospitalization rates (HR) in children under 1 year
of age, by the different vaccination policies in Italy
in 2006-2011.
PATIENTS AND METHODS
We performed a retrospective review of
hospitalization data from Italian hospital discharge
forms, provided by the Ministry of Health. We
considered the codes 052.0-052.9 by ICD9-
CM system (primary or secondary diagnosis).
HR of varicella in children under 1 year of age
were calculated by different vaccination policies
(referring to the year 2008) in 3 different areas:
area 1, with a UVV policy (Veneto, Sicilia, Puglia,
Toscana), area 2, with policy of vaccinating
susceptible adolescents and at-risk population
(Piedmont, Friuli Venetia Giulia, Liguria, Lazio,
Campania, Basilicata, Calabria, Sardinia) and area
3 with vaccination of only at-risk population (the
remaining regions). The denominator for HR was
calculated using resident population aged less than
1 year numbers according to ISTAT.
RESULTS
10,483 hospitalizations for varicella were
identified in patients of any age. The peak in
varicella hospitalizations was observed in the
first year of life. In this age group varicella was
responsible of 13.7% of hospitalizations. 71.5%
of cases in primary diagnosis (PD) were varicella
without mention of complications, followed by the
varicella with other specified complication (9.6%).
32 diagnosis reported post-varicella encephalitis
and 15 hemorrhagic pneumonia. When varicella
diagnosis was reported as secondary (SD), the
most frequent PD were pneumonia or respiratory
failure (25.7%). Annual HR globally declined in
this age group from 56.4 to 34.2/100,000 children.
The greatest HR were in area 3 and they declined
from 63.9 to 44/100,000. In area 2 HR declined
from 55.6 to 43.1/100,000, and in area 1 HR
significantly decreased from 49.3 to 11.5/100,000
(test for trend, p < 0.001) (Fig. 1).
CONCLUSIONS
This study demonstrated that varicella continues
to represent a relevant health problem in Italy,
especially in the pediatric age. Data obtained by
the Italian Regions that first introduced universal
vaccination demonstrated that it allows to reduce
the incidence of varicella and hospitalization rates
Risk factors for intussusception in childhood gastroenteritis: a nationwide cross-sectional study in Italy
Full text linkBackground. The aetiology of intussusception is unknown for most of the cases studied, although some associated conditions have been identified. We aimed to clarify the role played by enteric pathogens as potential risk factors for intussusception.
Methods. A retrospective review of the records relating to hospitalizations for gastroenteritis with or without concurrent intussusception in Italian children was conducted among children aged <6 years old during the period 2005-2012. Through a multivariate logistic regression model, the associations, expressed as odds ratios with 95% confidence intervals, were estimated between the presence of gastroenteritis with intussusception and the explanatory variables, such as sex, age, the aetiology of gastroenteritis and whether the subjects lived in the North, South and Islands or Centre Italy.
Results. A total of 174 records related to admissions due to the concomitant manifestation of gastroenteritis and intussusception were extracted and analyzed. The estimate of the adjusted odds ratio confirmed the significant contribution that sex and geographical location made to hospitalizations both for gastroenteritis with concurrent intussusception, and in the associated secondary diagnosis of gastroenteritis, with the exception of the rotavirus, where a different seasonality and a bucking trend were observed. The probability of intussusception became statistically significant lower from 12 months of age to ≤23 months and for age 48-59 months, respect to the first year of life.
Conclusions. Our observational study highlighted males, affected by enteric infections, other than rotavirus and parasitic, living in North and Centre of Italy have an increased risk of developing intussusceptions. In the second and fifth year of life the probability of intussusceptions becomes lower than in the first year. Additional research is needed to confirm these findings and evaluate the pathogenesis which may link such infections with intussusception
Intussuscezione e gastroenterite da rotavirus: evidenze di una mancata associazione
No full textIntroduzione
L’interesse della comunità scientifica per l’intussuscezione (IS) è nata in seguito all’aumento dei tassi di IS associati al primo vaccino anti-RV commercializzato, il Rotashield (1).
Riguardo, invece, ai due vaccini anti-RV oggi disponibili, nonostante sia noto un lieve aumento dei casi di IS, tanto che tale rischio è stato introdotto nelle schede tecniche dei due vaccini, l’immunizzazione anti-RV resta ampiamente raccomandata, dato l’ampio burden delle ospedalizzazioni per gastoenterite da rotavirus (GERV) (2).
Obiettivi
Poiché in Italia non sono disponibili studi su scala nazionale sui tassi di ospedalizzazione per IS, né su una possibile associazione tra IS e GERV, è stata condotta un’indagine volta a confrontare il trend temporale dei tassi di ospedalizzazione per IS e per GERV e a valutare i fattori associati allo sviluppo di IS in presenza di gastroenterite (GE).
Metodi
Studio osservazionale retrospettivo delle ospedalizzazione per IS nel periodo 2005-2014 in Italia nei bambini di età <6 anni, utilizzando le SDO, fornite dal Ministero della Salute, come flusso informativo. Sono state estratte ed analizzate tutte le SDO recanti in diagnosi principale o secondaria il codice ICD9-CM 560.0 (intussuscezione del colon o dell’intestino) e, a fini comparativi, anche le schede relative ai ricoveri per GERV (codice 008.61 in qualsiasi diagnosi) per le medesime fasce d’età. Nelle analisi di incidenza delle ospedalizzazioni sono stati esclusi i casi ripetuti di ricovero attraverso un codice anonimo di identificazione.
Per il calcolo dei tassi di ospedalizzazione (TO) è stata considerata la popolazione residente di età <6 anni, al 1° gennaio degli anni oggetto di studio, estratta dalla banca dati demografica dell'Istituto Nazionale di Statistica (3).
Al fine di valutare specificamente i fattori associati all’IS in presenza di GE, sono state estratte tutte le SDO recanti in diagnosi principale il codice 560.0 e, contemporaneamente, in diagnosi secondaria, almeno uno dei codici ICD9-CM di GE (di origine non specificata infettiva 009-009.3 e non infettiva 558.9; di origine specificata virale 008.61-008.69, 008.8, dove il codice 008.61 indica GE da RV, batterica 001-005, 008-008.5 e parassitaria 006-007). I dati sono stati analizzati mediante un modello di regressione logistica univariato, nel quale ogni variabile indipendente è stata inserita separatamente. In presenza di una significatività statistica <0,05 le variabili sono state introdotte in un modello di regressione logistica multivariato, al fine di valutare l’effetto di ciascuna variabile esplicativa, aggiustato per gli effetti delle altre variabili indipendenti. I dati sono stati elaborati usando il package statistico STATA/IC12.0.
Risultati
Nella decade 2005-2014 si sono registrati in Italia un totale di 5.252 ospedalizzazioni per IS, escludendo i ricoveri ripetuti. L’analisi della distribuzione per mese dei TO per IS ha dimostrato l’assenza di stagionalità, al contrario di quanto registrato per i TO per GERV, per i quali è emersa una tipica stagionalità, con un picco nel mese di marzo (tasso medio di ospedalizzazione pari a 49 x 100.000 bambini). Limitando l’analisi ai casi di IS in presenza di GE (GEIS), è emerso che nel periodo oggetto di studio sono state effettuate 174 ospedalizzazioni per GEIS nei bambini di età <6 anni. Dalla regressione logistica univariata è emerso che il sesso maschile (OR 1,43, IC 95% 1,05-1,94; p=0,024), le GE di presunta origine infettiva (OR 2,14, IC 95% 1,23-3,73; p=0,007), virali (OR 3,86, IC 95% 2,14-6,96; p<0,001) e batteriche (OR 7,67; IC 95% 3,44-17,09; p=0,001) e la localizzazione nelle aree centrali (OR 2,62, IC 95% 1,71-4,02; p=0,001) e settentrionali (OR 2,48, IC 95% 1,74-3,53; p=0,001) del Paese, si associano ad una maggiore probabilità di ospedalizzazione per GEIS. Non è emersa, invece, nessuna relazione statisticamente significativa con l’età e le GERV. Tali risultati vengono confermati dalla regressione logistica multivariata.
Conclusioni
Dalle analisi da noi condotte non è emersa alcuna concordanza per i tassi di ospedalizzazione per IS e GERV e il modello logistico ha confermato la mancata associazione tra i due fenomeni. Dato che la valutazione del rischio di IS rappresenta un punto chiave per l’adozione dell’immunizzazione anti-RV nei programmi nazionali di vaccinazione, sarà importante continuare a monitorare il trend delle ospedalizzazioni per IS e GERV, così come raccomandato dall’OMS (4).
Bibliografia
1. Bines JE, Patel M, Parashar U. Assessment of postlicensure safety of Rotavirus vaccines, with emphasis on intussusception. J Infect Dis 2009; 200: S282-90.
2.Mattei A, Sbarbati M, Fiasca F, Angelone AM, Mazzei M, di Orio F. Temporal trends in hospitalization for rotavirus gastroenteritis: A nationwide study in Italy, 2005–2012. Hum Vaccin Immunother 2016; 12(2): 534-9.
3. Istituto Italiano di Statistica (ISTAT). http://www.demo.istat.it.
4.Bines J, Bentsi-Enchill A, Steele D. Vaccines and biologicals. Document WHO/IVB/09.01. Geneva: World Health Organization; 2008. Post-marketing surveillance of rotavirus vaccine safety
Prevalence and correlates for self-reported sleep problems among nursing students
No full text"Introdution. University students report significantly worse sleep. quality than the general population. Sleep problems are related to. increased health concerns, irritability, depression, fatigue, attention. and concentration difficulties, along with poor academic performance.. The aim of this paper is to conduct a survey based on. a questionnaire that would characterize night time and daytime. habits in nursing students to estimate the prevalence of chronic. insomnia, sleep disturbance and their correlates.. Methods. We conducted a cross-sectional survey among 364. nursing students of the University of L’Aquila, in Italy. Self-reported. sleep data were derived from Sleep and Daytime Habits. Questionnaire” (S&DHQ) that covered sleep and daytime habits. and academic progress. Anxiety and depression symptoms were. assessed by the Mental Health Invenctory-5 (MHI-5) questionnaire.. A supplement includes information about lifestyle, health. status and physical activity.. Results. The overall prevalence of insomnia was 26,7%. It. increased significantly from 10,3% for students aged 40 years. The prevalence of sleep problems. were 9,4% for disorders of initiating sleep, 8,3% for disrupted. sleep, 7,7% for early morning awakening and subjectively. poor quality of sleep 22,3%. Multiple logistic regression analysis. showed that greater age was significantly associated with an. increased risk of insomnia. Other risk predictors of insomnia were. headache, severe depression and self perception of poor quality. of life. Daytime sleepiness and morning tiredness were significantly. associated with current smoking habit and painful physical. condition. The risk of unsatisfactory academic progress increased. significantly in students reported poor sleep quality.. Discussion. Our study demonstrates that sleep problems are very. common among students, and supports the need to assess sleep problems. and identify students at risk regarding school achievement.
Programmazione di un servizio di prevenzione delle malattie odontostomatologiche, prevalenza di carie e malocclusione nei bambini Aquilani
No full textMeasles-Related Hospitalizations in Italy, 2004-2016: The Importance of High Vaccination Coverage
Full text linkMeasles is a highly contagious human infectious disease. It can lead to serious complications and often requires hospitalization. In Italy, as in other European countries, the goal of measles elimination in 2015 failed. To reach this target, identifying susceptible individuals, closing any immunity gaps and reaching adequate vaccination coverage is necessary
- …
