1,720,975 research outputs found
L'antibiotico resistenza un problema di sanità pubblica: il caso delle micoplasmosi genitali
No full textGeneral dental practitioners and hearing impairment
No full textObjective: Hearing impairment (HI) remains a problem among dentists Hearing loss at speech frequencies was recently reported among dentists and dental hygienists. This study aimed to investigate prevalence and factors associated with perceived HI among dentists. Methods: In 2009-2010, 100 general dental practitioners (GDPs) and 115 general (medical) practitioners (GPs) (mean ages, 43.7 and 44.4 years) from Rome (Italy), who commenced practice >= 10 years ago, were interviewed on a series of occupation- and recreation-related HI risk factors and on HI-associated symptoms (tinnitus, sensation of fullness, hypoacusis). Prevalence of presumptive HI (>= 1 symptom perceived during workdays and weekends) was assessed and factors associated with presumptive HI were investigated. Results: Prevalence was 30.0% (95% confidence interval, 21.0-39.0%) and 14.8% (95% confidence interval, 8.3-21.3%) among GDPs and GPs, respectively. Occupation (GDP vs. GP), family history of hypoacusis, hypertension, ear diseases and smoking were significantly associated with presumptive HI. Within GDPs alone, significant associations were found for frequent use of ultrasonic scalers, use of dental turbines aged >= 1 year and prosthodontics as prevalent specialty. Conclusions: GDPs experienced HI risk than GPs. Such a risk was not generalized to all dentists, but was specific for those who frequently used noisy equipment (aged turbines, ultrasonic scalers) during their daily practice. Clinical significance: GDPs with 10 or more years of practice who routinely use potentially noisy equipment, could be at risk of HI. In order to prevent such condition, daily maintenance and periodical replacement of dental instruments is recommended. (c) 2012 Elsevier Ltd. All rights reserved
Nano-TiO2-based photocatalytic disinfection of environmental surfaces contaminated by meticillin-resistant Staphylococcus aureus
No full textBackground: Traditional cleaning and disinfection methods are inefficient for complete
decontamination of hospital surfaces from meticillin-resistant Staphylococcus aureus
(MRSA). Additional methods, such as nano-TiO2-based photocatalytic disinfection (PCD),
could be helpful.
Aim: To evaluate anti-MRSA activity of PCD on polyvinyl chloride (PVC) surfaces in naturallike conditions.
Methods: Two identical PVC surfaces were used, and nano-TiO2 was incorporated into one
of them. The surfaces were contaminated with MRSA isolated from hospitalized patients
using a mist sprayer to simulate the mode of environmental contamination caused by a
carrier. MRSA cell density was assessed before contamination until 180 min after
contamination using Rodac plates. The differences between test and control surfaces in
terms of MRSA density and log MRSA density reduction were assessed using parametric and
non-parametric statistical tests. Five strains were tested, and each strain was tested five
times.
Findings: The highest median MRSA densities [46.3 and 43.1 colony-forming units (cfu)/
cm2 for control and test surfaces, respectively] were detected 45 min after contamination.
Median MRSA densities 180 min after contamination were 10.1 and 0.7 cfu/cm2 for control
and test surfaces, respectively (P<0.01). Log MRSA density reduction attributable to PCD
was 1.16 log cfu/cm2
, corresponding to 93% reduction of the baseline MRSA contamination.
Conclusions: The disinfectant activity remained stable throughout the 25 testing occasions, despite between-test cleaning and disinfection. The anti-MRSA activity of PCD was
compatible with the benchmark for surface hygiene in hospitals (<1 cfu/cm2
), but
required 3 h of exposure to photocatalysis. Thus, PCD could be considered for non-clinical
surfaces. However, for clinical surfaces, PCD should be regarded as supplemental to
conventional decontamination procedures, rather than an alternative
Antibody level and immunity against hepatitis b virus infection among general dental practitioners
No full textIntroduction: Immunization against Hepatitis B virus (HBV) is crucial for an effective control in dental healthcare settings. Nevertheless, vaccination rates among general dental practitioners (GDPs) from developed countries range between roughly 50%, as in Italy and Japan, and >90% as in US and UK. Furthermore, vaccination does not necessarily imply immunity, as serum anti-HBs antigen (Ag) level tends to decrease and booster doses are periodically required. Aim: To investigate HBV vaccination and immunity rates among Italian GDPs. Material and methods: 195 GDPs voluntarily participated. They provided information regarding HBV vaccination in the last 10 years and underwent blood samples to detect serum anti-HBs Ag level. Immune subjects were considered subjects with anti-HBs Ag =10 mIU/mL. Vaccination and immunity rates were assessed with 95% confidence intervals (95CIs). Sensitivity (proportion of immune GDPs among vaccinated GDPs), Specificity (proportion non-immune GDPs among non-vaccinated GDPs) also were assessed. Results: 88% GDPs were vaccinated (95CI, 83-92%), but only 83% were immune (95CI, 77-88%). Sensitivity was 95.6%, suggesting that among immune GDPs, 4.4% were not recently vaccinated. Specificity was 50%, suggesting that among nonimmune GDPs, 50% were recently vaccinated. Conclusion: Vaccination rate among Italian GDPs was high. Nevertheless, a fraction of 5% of them was vaccinated but was not immune, thus suggesting that serum antibody level should be periodically checked because susceptible GDPs are at risk for HBV infection. © 2013 Medicinski fakultet Niš
Rapporto tra deficit cognitivo lieve e parodontite. Studio osservazionale in un campione di pazienti geriatrici
No full texta popolazione mondiale sta celermente invecchiando e parallelamente aumenta il numero di persone affette da demenza, le quali mostrano gravi difficoltà intellettive e motorie, con perdita totale o parziale di autosufficienza, che si riflette significativamente su parenti e società. La demenza è un importante problema di salute pubblica, in quanto costituisce la causa principale di incapacità a lungo termine nella terza età. È ormai largamente riconosciuto che la malattia parodontale si possa andare ad associare a numerosissimi disordini sistemici legati alla salute dell’individuo. Più di recente alcuni studi hanno rilevato la correlazione tra l’infezione parodontale legata a diverse specie batteriche del cavo orale e l’eziologia del decadimento cognitivo.
È stato osservato come, generalmente, la diagnosi della parodontite si basa sulla presenza ed entità dell’infiammazione gengivale, spesso misurata come livello di attacco (CAL), profondità di tasca (PD) ed estensione della perdita di osso alveolare, quest’ultima valutata radiograficamente.
Lo stato di Mild Cognitive Impairment (MCI), in italiano compromissione cognitiva lieve, nota anche come disturbo neurocognitivo minore (nel DSM V) è una condizione diagnosticata agli individui che hanno deficit cognitivi che sono maggiori rispetto a quelli che statisticamente si possono aspettare per la loro età e istruzione, ma che non interferiscono significativamente con le loro attività giornaliere.
Partendo dai presupposti che la MCI è spesso considerata come precursore dello stato di demenza, un’eventuale associazione tra quest’ultima e la malattia parodontale, attualmente non verificata da nessuno studio, potrebbe influenzare significativamente gli approcci terapeutici nei confronti di entrambe le patologie. Perciò se da un lato, l’obiettivo della ricerca proposta con tale tesi è quello di verificare una possibile correlazione tra MCI e parodontite, dall’altro lato è essenziale menzionare i già avvenuti studi relativi al deterioramento cognitivo ed altre problematiche dentali.
Un recente meta analisi del 2019 di Nangle MR et Al. ha fornito prove di un'associazione tra apprendimento e memoria, attenzione complessa e funzione esecutiva con la salute orale in età avanzata.
Il nostro studio ha avuto lo scopo principale di valutare se la profondità di tasca (PD) che è considerata indice ideale di malattia parodontale è associata in qualche modo al Mild Cognitive Impairment (MCI).
È stato effettuato uno studio di tipo osservazionale. I pazienti oggetto di studio presentavano caratteristiche peculiari necessarie ed uguali per tutti, dovevano essere affetti da un deficit cognitivo e quindi presentare la diagnosi di MCI ma non di Alzheimer, non dovevano presentare una diagnosi di depressione, non dovevano mostrare edentulia in ultimo non dovevano essere sottoposti a trattamento parodontale. Non essendoci studi scientifici precedenti per calcolare il numero di
pazienti necessario abbiamo deciso di selezione un campione consecutivo di 50 pazienti.
Si è giunti alla conclusione finale che sussiste una correlazione tra la parodontite e il MCI, seppur non molto forte. Detto ciò la malattia parodontale è correlabile ad un deficit cognitivo lieve, spesso condizione antecedente di demenze più gravi. Tale conclusione pone un importante accento sul ruolo che l’odontoiatra o l’igienista dentale rivestono nell’ambito della prevenzione, poiché la dimensione cognitiva che maggiormente diminuisce in relazione alla parodontite è l’attenzione.
Tanto premesso è naturale che l’odontoiatria o l’igienista dentale possano osservare, analizzare e comprendere un deficit dell’attenzione, tramite, ad esempio, semplici domande raccolte durante la compilazione della cartella clinica e durante l’aggiornamento della stessa nelle sedute successive; non solo, anche tramite il feedback relativo all’educazione e istruzione di specifiche manovre di igiene domiciliare, i professionista sanitari possono comprendere se il paziente mostra un deficit di attenzione o memoria.
La possibilità di intercettare precocemente la condizione clinica di MCI permette di indirizzare subito il paziente verso cure e trattamenti specifici al fine di eludere la possibilità di un’evoluzione successiva verso il morbo di Alzheimer.
Quindi data la scarsità di studi relativi ai meccanismi eziopatogenetici tra la parodontite e l’Alzheimer e date la carenze comportamentali dei
pazienti affetti dal morbo, attualmente non è possibile comprende se è la malattia di Alzheimer ad essere responsabile della parodontite o viceversa, ma sicuramente grazie a questo studio osservazionale, sappiamo che il Mild Cognitive Impairment è associato con la malattia parodontale e perciò intercettare tali due condizioni può significare diagnosticare precocemente una condizione patologica come l’Alzheimer, per la quale non esiste ancora un trattamento farmacologico efficace e risolutivo
Predictors of legionella occurrence in dental unit waterlines of a highly colonized dental hospital
No full textIntroduction: Legionella is frequently detected in Dental Unit Waterlines (DUWLs). Although such a high occurrence is not necessarily associated with high risk for Legionnaire's disease among patients and staff, it is prudent to monitor DUWLs for Legionella periodically. Since this procedure is long and expensive, surrogate markers are frequently used. Aim: To investigate whether surrogate markers are predictive of Legionella detection in DUWLs in a highly colonized dental hospital. Material and methods. DUWLs from a dental hospital where legionellae were detected intermittently throughout a period of ten years was considered. The investigated predictors were total viable flora (TVF) at 37°C and at 22°C, Pseudomonas (legionellae competitor) occurrence and season. Multivariate analysis was made and, using the best fitting logistic regression model, the probability to detect legionellae in water from DUWLs was estimated. Results: Legionellae were detected in 52% water samples collected in summertime and never detected in wintertime at levels ranging between 0 and 200 colony forming units(CFU)/L. The odds ratio of legionellae occurrence were 25.0 for Pseudomonas undetected vs. detected, 108.3 for summertime vs. wintertime, 2.2-2.3 for TVF levels at 37°C and 22°C >200 CFU/mL vs. =200 CFU/mL. A 29% probability to detect legionellae from DUWLs, where Pseudomonas was undetected, TVF levels were >200 CFU/mL and in summertime, was estimated. Conclusion: Despite legionellae were ubiquitous in the dental hospital during the study period, in the most favourable conditions for Legionella growth (lack of competitor, high biofilm and hot weather), legionellae were detected in almost one third of DUWLs. © 2013 Medicinski fakultet Niš
Alcohol is not a risk factor for oral cancer in nonsmoking, betel quid non-chewing individuals. A meta-analysis update.
No full textAlcohol drinking is associated with high oral cancer (OC) risk. This association is particularly evident in tobacco smoking/betel quid (BQ) chewing subjects. In a previous stratified meta-analysis (Petti S et al., Cancer Epidemiol 2012) we reported that drinking was inversely associated with OC in non-smoking BQ non-chewing individuals, while this association was reversed in smoking individuals. However, the previous study could be excessively influenced by a large primary study, which yielded more than 50% of the weight of all the primary studies. Therefore, we updated this analysis using only recent studies. Case-control studies published between 2010 and 2012 were searched. In each study, non-smoking/ BQ non-chewing exposed (ever routine drinkers) and unexposed (never drinkers) subjects with (cases)/without (controls) OC were extracted and odds ratio (OR) calculated. Between-study heterogeneity was assessed with Cochran's Q. Publication bias was formally assessed with trim and fill method. Sensitivity analysis to inclusion criteria was made. The pooled OR was assessed with the fixed- and random-effect methods and corrected for publication bias. Seven of these studies met the inclusion criteria: they were not heterogeneous enough. Correction for publication bias was not necessary and provided only one missing study. The OR estimates were 0.70 (95% confidence interval -95CI, 0.51-0.98), 0.70 (95CI, 0.51-0.96), 0.75 (95CI, 0.54-1.03) with the three methods. Sensitivity analysis did not change the OR estimates considerably. This analysis corroborated the results of the previous analysis, confirming that drinking was inversely associated with OC in non-smoking, BQ non-chewing subjects
Ebola virus infection among western healthcare workers unable to recall the transmission route
No full textIntroduction. During the 2014-2016 West-African Ebola virus disease (EVD) outbreak, some HCWs from Western countries became infected despite proper equipment and training on EVD infection prevention and control (IPC) standards. Despite their high awareness toward EVD, some of them could not recall the transmission routes. We explored these incidents by recalling the stories of infected Western HCWs who had no known directly exposures to blood/bodily fluids from EVD patients. Methodology. We carried out conventional and unconventional literature searches through the web using the keyword "Ebola" looking for interviews and reports released by the infected HCWs and/or the healthcare organizations. Results. We identified fourteen HCWs, some infected outside West Africa and some even classified at low EVD risk. None of them recalled accidents, unintentional exposures, or any IPC violation. Infection transmission was thus inexplicable through the acknowledged transmission routes. Conclusions. We formulated two hypotheses: inapparent exposures to blood/bodily fluids or transmission due to asymptomatic/mildly symptomatic carriers. This study is in no way intended to be critical with the healthcare organizations which, thanks to their interventions, put an end to a large EVD outbreak that threatened the regional and world populations
Streptococcus pneumoniae carriage rate in healthy preadolescent dental patients
No full textIntroduction: Streptococcus pneumoniae is the major cause of death for pneumonia in the world, responsible 800,000 deaths annually among children and elderly. Most pneumonia caused by pneumococci are healthcare associated, while the remaining are community acquired. Airborne infections are frequent in dental healthcare settings, but data regarding the risk for pneumococci transmission are lacking. Aim: To estimate S. pneumoniae carriage rate among adolescent dental patients, in order to investigate the risk for pneumococci acquisition and spread in dental healthcare settings. Material and methods: 199 children aged 10-12 years attending the paediatric dentistry section of a dental hospital in Rome underwent oropharyngeal swab samples. Pneumococci were presumptively identified with cultural methods (growth on selective media, alpha haemolysis, bile solubility). Routine exposure to passive smoking, use of antibiotics, recent respiratory tract infections (RTIs) were anamnaestically investigated. Unadjusted and adjusted odds ratios (ORs) and individual probability to carry S. pneumoniae were assessed with logistic regression analysis. Results: Overall S. pneumoniae carriage rate was 11.6% (95% confidence interval, 95CI, 7.2-16.0%). RTIs were significantly associated with carriage (adjusted OR, 3.3; 95CI, 1.3-8.7), exposure to passive smoking (OR, 2.0; 95CI, 0.8-4.9), male gender (OR, 3.2; 95CI, 0.6-17.1) were marginally associated (0.05<p<0.20). According to the regression model, male patients with recent RTI history and routinely exposed to passive smoking yielded 58.2% probability to carry pneumococci. Conclusion: S. pneumoniae carriage rate in healthy preadolescent dental patients was moderately high. Patient's profile could be helpful to identify potential carriers and to adopt transmission-based precautions. © 2013 Medicinski fakultet Niš
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