1,721,233 research outputs found
Estimating the Prevalence and Burden of Multiple Sclerosis in China Using the Global Burden of Disease Study: Challenges and Future Directions
No full textCOVID-19 Vaccination Coverage in Italy: How Many Hospitalisations and Related Costs Could Have Been Saved If We Were All Vaccinated?
Full text linkThe first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were reported in December 2019. On March 11, 2020, the WHO declared coronavirus disease 2019 (COVID-19) a pandemic (1). By the end of 2021, COVID-19 has caused 5.4 million deaths worldwide, impacting severely on health systems and triggering a global economic and social crisis.
On November 24, 2021, Europe is once again the epicenter of the COVID-19 pandemic (2), with 75% of fatal cases occurring in people aged 65 years and above, and hospital admission rates more than doubling in 1 week, according to the latest data (2). The reasons behind this increase are mainly insufficient vaccination coverage and relaxation of public health and social measures (2).
Vaccination has been shown to be 70–95% effective against COVID-19 after two doses and against COVID-19-related hospital admissions up to 6 months after being fully vaccinated (3–5) and is considered one of the most cost-effective interventions to preserve healthcare resources and system efficiency (6). Yet, vaccination coverage within Europe is still suboptimal (2).
As of November 24, 2021, Italy has administered 95,571,957 doses of COVID-19 vaccines, with an 84.5% coverage of fully vaccinated population over 12 years old, and 87.3% with at least one dose (7). Four different vaccines (Cominarty, Spikevax, Vaxzevria, and Janssen) have been administered since December 27, 2020. Up until September 26, 2021, 71.2% of administered doses were Cominarty, 14.5% were Vaxzevria, 12.5% were Spikevax, and 1.8% were Janssen (8). Since September 27, 2021, the booster dose, administered right after the date of vaccination only of Cominarty and Spikevax, as well as the second dose of Janssen, was initially indicated only for people aged over 80 years, as well as residents and staff of nursing homes and healthcare facilities. It was subsequently extended to all subjects vaccinated with a single dose of Janssen vaccine from at least 6 months, regardless of age, and has now been extended to the whole over-18 population, provided a minimum of 5 months have passed since the completion of the primary course with two doses (9–11). Despite these efforts and the establishment of a COVID-19 Green Pass, which allows access to public events, transportations, and nursing homes only to vaccinated people or people tested for SARS-CoV-2 (12), trends of hospital admissions due to COVID-19 are rising, particularly among the non-vaccinated who amount to 8 million people. Indeed, as of November 24, 2021, data provided by the Italian National Health Institute (ISS) show an increased risk of hospital admission and death for the non-vaccinated population in all age groups, with new cases primarily caused by the B.1.617.2 (Delta) variant of SARS-CoV-2 (13). In the light of this situation, the Italian Ministry of Health (MoH) instituted a reinforced COVID-19 Green Pass that allowed only people who are fully vaccinated or recovered from COVID-19 to access shows, sporting events, indoor bars and restaurants, parties and discos, public ceremonies for the period December 6, 2021 to January 15, 2022 in the Italian white zones, and from November 29, 2021 to the end of the state of emergency in the yellow and orange zones (14). Moreover, mandatory vaccination has been extended to new categories (e.g., school and police personnel) and the validity of the COVID-19 Green Pass has been reduced from 12 to 9 months (14).
Using the official data from ISS for the period October 24-November 24, 2021, on vaccination status, new positives, hospitalisations in general wards and intensive care units, this brief report aims to: (i) to assess the risks of hospital admission for different age groups ≥12 years of age, and by vaccination status; (ii) to calculate the costs of vaccine refusal during the observation period.
The costs of excess cases due to vaccine refusal were calculated only for hospitalization. Neither the direct and indirect costs of non-hospitalized cases nor the cost of deaths, which however we believe to be significant, were factored into the calculation
Association between up-regulated expression proteins and circulating steroidal hormones in leiomyoma
No full textSeveral studies have shown that both ovarian hormones estrogen and progesterone and various proteins are involved in uterine leiomyoma growth. We hereby describe a study carried out to investigate the possible relation between progesterone, estrone, 17β-estradiol and the seven dysregulated proteins in the leiomyoma. Statistical analyses showed a significant inverse rank correlation between desmin expressed in leiomyoma and progesterone (ρ = −0.9276; p = 0.0077) and between alpha-1-antitrypsin expressed in leiomyoma and 17β-estradiol (ρ = −0.8571; p = 0.0137). Our data suggest that decreased levels of 17-β-estradiol involve an increasing of the inflammation response stimulating alpha-1-antitrypsin expression in leiomyoma and that lower levels of progesterone associated with increasing of desmin expression may be related to increase of inflammation response, and to the role played by desmin in signal transduction inducing leiomyoma growth
Analysis of multimorbidity compression using a latent variable in a mixed mixture model
Full text linkAbstract Background Multimorbidity, i.e., the co-presence of multiple diseases in an individual, is an increasing concern, particularly as the population ages. Addressing it is critical to improving health status and optimizing healthcare resources. Particularly relevant in this scenario is the concept of multimorbidity compression, i.e., the onset of chronic diseases is delayed more rapidly than the increase in life expectancy. According to this theory, the duration individuals spend in poor health should be shortened. Existing studies have started examining multimorbidity trends, yet often overlook the cumulative burden of multiple diseases. Methods We define the multimorbidity concept as a latent variable estimated with the disease burden described by the disability weights from the Global Burden of Diseases (GBD) project. Using a mixed-mixture model, we analyze the nonlinear relationship between multimorbidity and socioeconomic traits, accounting for zero inflation and spatial variability in Italy. We use twelve years of the surveillance system PASSI data to investigate the multimorbidity compression concept. Results Our findings suggest multimorbidity compression is acting in Italy: severe multimorbidities are increasingly concentrated later in life, indicating a positive impact of healthcare improvements on the quality of life. The phenomenon is observed in both socially advantaged and disadvantaged subpopulations
Measures of type 2 diabetes burden in Italy assessed using the AMD dataset over a twelve year span across the Great Recession
No full textAbstract Patients with Type 2 Diabetes Mellitus (T2DM) are rapidly increasing in Italy due to aging, preventable risk factors, and worsening socioeconomic context. T2DM and its sequelae take a heavy toll on healthcare systems and the economy, given costly management, difficulties in coping with everyday life, and decreasing patient/worker productivity. Considering long life expectancy in Italy and a decreasing mortality rate due to T2DM, this study aims to calculate the years lived with disability (YLDs) of T2DM and its sequelae grouped into three categories: Neuropathy, Chronic Kidney Disease and No Complications, taking into consideration sex, year, and geographical location. This is the first attempt to measure YLDs from data that do not rely on self-reported diabetes diagnoses. Data come from the Italian Diabetologists Association dataset, the most comprehensive longitudinal source of national outpatient data. YLDs are obtained by multiplying the number of individuals living with a specific health condition and a disability weight which represents the magnitude of health loss associated with that particular condition. Findings show increasing YLD age-standardized rates for T2DM and its sequelae, especially Neuropathy, with the trend being stronger in the central macro-region and among men, and that 2009 marks a structural change in YLD growth rate. Systematic data collection for measuring the burden of diseases is key, among other things, to policy-making and implementation
A novel definition of comorbidity based on the Global Burden of Diseases project weights
No full textUnderstanding comorbidity characteristics is essential for policymakers and healthcare providers to allocate resources accordingly. However, several definitions of comorbidity can be found in the literature. The main reason for these differences lies in the available information about the analyzed diseases (i.e., the target population analyzed), how to define the burden of diseases, and how to aggregate the occurrence of the detected health conditions. In this manuscript, we focus on the data from the Italian surveillance system PASSI proposing a definition of comorbidity based on the disability weights coming from the
Global Burden of Disease project. Thanks to that, we can explore the level of comorbidity based on the presence of ten different non-communicable diseases across socioeconomic sub-populations in Italy
Microglia activation and interaction with neuronal cells in a biochemical model of mevalonate kinase deficiency
No full textMevalonate kinase deficiency is a rare disease whose worst manifestation, characterised by severe neurologic impairment, is called mevalonic aciduria. The progressive neuronal loss associated to cell death can be studied in vitro with a simplified model based on a biochemical block of the mevalonate pathway and a subsequent inflammatory trigger. The aim of this study was to evaluate the effect of the mevalonate blocking on glial cells (BV-2) and the following effects on neuronal cells (SH-SY5Y) when the two populations were cultured together. To better understand the cross-talk between glial and neuronal cells, as it happens in vivo, BV-2 and SH-SY5Y were co-cultured in different experimental settings (alone, transwell, direct contact); the effect of mevalonate pathway biochemical block by Lovastatin, followed by LPS inflammatory trigger, were evaluated by analysing programmed cell death and mitochondrial membrane potential, cytokines' release and cells' morphology modifications. In this experimental condition, glial cells underwent an evident activation, confirmed by elevated pro-inflammatory cytokines release, typical of these disorders, and a modification in morphology. Moreover, the activation induced an increase in apoptosis. When glial cells were co-cultured with neurons, their activation caused an increase of programmed cell death also in neuronal cells, but only if the two populations were cultured in direct contact. Our findings, being aware of the limitations related to the cell models used, represent a preliminary step towards understanding the pathological and neuroinflammatory mechanisms occurring in mevalonate kinase diseases. Contact co-culture between neuronal and microglial cells seems to be a good model to study mevalonic aciduria in vitro, and to contribute to the identification of potential drugs able to block microglial activation for this orphan disease. In fact, in such a pathological condition, we demonstrated that microglial cells are activated and contribute to neuronal cell death. We can thus hypothesise that the use of microglial activation blockers could prevent this additional neuronal death
Incidence and estimated prevalence of endometriosis and adenomyosis in Northeast Italy: A data linkage study
Full text linkDespite being quite frequent and having serious implications in terms of symptomatology and fertility, data on incidence and prevalence of endometriosis and adenomyosis following gold standard definitions are dramatically lacking. The average time from onset of symptoms to diagnosis in industrialized countries still ranges from five to ten years. Using the regional centralized data linkage system, we calculated incidence and prevalence of endometriosis and adenomyosis in the female population of Friuli Venezia Giulia region, Italy, for the years 2011-2013. Cases were defined as new diagnoses from hospital discharge records, following procedures allowing direct visualization for endometriosis and hysterectomy for adenomyosis, with or without histological confirmation. Diagnoses were considered "new" after verifying women had not been diagnosed in the previous ten years. Incidence of endometriosis and adenomyosis in women aged 15-50 years is 0.14%. Prevalence, estimated from incidence, is 2.00%. Adenomyosis, representing 28% of all diagnoses, becomes increasingly prevalent after the age of 50 years. Our results shows how the study of both endometriosis and adenomyosis should not be limited to women of premenopausal age. Further efforts are needed to sensitize women and health professional, and to find new data linkage possibilities to identify undiagnosed cases
Pancreatic ductal adenocarcinoma can be detected by analysis of volatile organic compounds (VOCs) in alveolar air
Full text linkAbstract Background In the last decade many studies showed that the exhaled breath of subjects suffering from several pathological conditions has a peculiar volatile organic compound (VOC) profile. The objective of the present work was to analyse the VOCs in alveolar air to build a diagnostic tool able to identify the presence of pancreatic ductal adenocarcinoma in patients with histologically confirmed disease. Methods The concentration of 92 compounds was measured in the end-tidal breath of 65 cases and 102 controls. VOCs were measured with an ion-molecule reaction mass spectrometry. To distinguish between subjects with pancreatic adenocarcinomas and controls, an iterated Least Absolute Shrinkage and Selection Operator multivariate Logistic Regression model was elaborated. Results The final predictive model, based on 10 VOCs, significantly and independently associated with the outcome had a sensitivity and specificity of 100 and 84% respectively, and an area under the ROC curve of 0.99. For further validation, the model was run on 50 other subjects: 24 cases and 26 controls; 23 patients with histological diagnosis of pancreatic adenocarcinomas and 25 controls were correctly identified by the model. Conclusions Pancreatic cancer is able to alter the concentration of some molecules in the blood and hence of VOCs in the alveolar air in equilibrium. The detection and statistical rendering of alveolar VOC composition can be useful for the clinical diagnostic approach of pancreatic neoplasms with excellent sensitivity and specificity
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