1,721,155 research outputs found
Review of the scientific literature on the health of the Roma and Sinti in Italy.
No full textBACKGROUND: Roma and Sinti in Italy are excluded from the rest of society, often live in precarious housing conditions and have poor access to health services. In Italy, the Roma and Sinti minority (.3% of the overall population) is scarcely represented if compared with other European countries.
METHODS: To establish what is known and how Roma and Sinti health is studied in Italy, we conducted a review of the scientific literature, including articles published between 2000 and 2010, found in Medline, Embase and Web of Science.
RESULTS: We analyzed 15 relevant articles out of 32 references. Four papers describe rare autosomal recessive disorders. Four illustrate outbreaks of measles. The remaining papers describe health conditions suffered by this minority. All but two, however, are based on data collected at health services.
CONCLUSIONS: The lack of prevalence data and analysis of determinants is a detriment to the health of the Roma and Sinti populations in Italy. Participatory research and evidence-based interventions are needed to improve health outcomes and living conditions of the Roma and Sinti people
A Resin Infiltration Technique for Molar Hypomineralization Treatment: A Preliminary Study in a Pediatric Population
No full textPurpose: The purpose of this study was to evaluate resin infiltration (RI) technique's effects on the in vivo functional treatment of molar hypomineralization (MH)-affected permanent first molars (PFMs). Methods: Fifteen MH-affected PFMs were resin-infiltrated and evaluated for a three-month follow-up (FU). In vivo resin replicas were used for profilometric and scanning electron microscope (SEM) analysis of PFM surfaces; any variation of clinical aspect and dentin hypersensitivity was registered as: T0 equals baseline; T1 equals right after treatment; T2 equals oneweek follow-up; and T3, T4, and T5 equal one-, two-, and three-month FU. Results: At T0, MH-affected surfaces were rougher and more irregular than sound ones; at T1, resin-infiltrated surfaces were smoother while a progressive increase of superficial roughness was observed over time. Hypersensitivity improved at T1 and remained stable over time in severe MH cases. Conclusions: Resin infiltration seems to be a promising treatment, especially in managing severe molar hypomineralization cases for the evaluated follow-up
COVID-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
Typography and dyslexia: A preliminary study on university students
Full text linkSpecific fonts for people with dyslexia are designed under the assumption that text readability can benefit from decreased letter confusability. We asked university students (18-33 yr), either diagnosed with developmental dyslexia (DD= 8) or normal (N= 31) to perform several tasks on materials printed in 7 different fonts. The subjective ranking of fonts was not a strong predictor of individual performance in objective task
Comparison of three sites to check the pulse and count heart rate in hypotensive infants
No full textBACKGROUND: Current international guidelines state that heart rate counted at the brachial pulse must be absent or <60 b x min(-1) to diagnose cardiac arrest. Some data suggest that this site may not be the best to check cardiac activity. Hypotension is a likely real scenario of the need for chest compressions in infants. We compared the performance of three sites of pulse palpation (brachial, carotid, and femoral) for detecting and counting heartbeat in hypotensive infants. METHODS: In an operating theater of a pediatric teaching hospital in Italy, we studied 40 anesthetized hypotensive infants just prior to surgery, checked by two doctors and two nurses by a cross-sectional, repeated-measures study design. Each examiner, blind to the monitoring data of the patient, was asked to find the infant's arterial pulse within 10 s and count heart rate for 15 s. During each examination, the order of the three sites was randomized. RESULTS: Among successful detections, femoral pulse palpation resulted as the most successful, rapid, and accurate site to detect and count heart rate in hypotensive infants. CONCLUSIONS: Femoral palpation proved to be the best site for detecting heartbeat and counting heart rate in hypotensive infants. These findings challenge the current guidelines. More data are needed, but the current standard of brachial pulse assessment is debatable
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
La gestione del bambino con testicolo ritenuto
No full textBackground: The aims of our study were to describe the current management of cryptorchidism among Italian family paediatricians (FP) and detect any difference from the recently published Nordic Consensus guidelines.
Methods: An online questionnaire was filled in by 140 Italian FP from 18/20 Italian regions. The questionnaire requested information on all children with cryptorchidism born between 1/01/2004 and 1/01/2006, their characteristics and management.
Results: Data on 169 children with undescended testis were obtained. Among those, 24% had at diagnosis a retractile testis, while 76% had a true cryptorchidism. Mean age at diagnosis was 9.6 months (SD 13.2; range 0-52.8). In 16% of cases cryptorchydism resolved spontaneously at a mean age of 25.2 months (SD 12; range 6-46.8). On the overall cases, 99 subjects (59%) underwent orchiopexy at mean age of 22.8 months (SD 10.8; range 1.2-56.4), 13% of which before 1 year of age. The intervention was performed by a paediatric surgeon in 89% of cases, with a success rate of 91%. Orchiopexy was the first line treatment in 82/99 cases (83%), while preceded by hormonal treatment in the other 17 cases. Hormonal treatment was used as first line in 20% of cases with a reported success rate of 25% (n=8/32). Overall, 18 children did not undergo any intervention
(mean age at last follow up 44.4 months; SD 12; range 20.4-62.4).
Conclusions: Our study showed an important delay in orchiopexy. Moreover, a high percentage of children with undescended testis was treated with hormonal therapy, although it is not recommended by the recent guidelines
Delayed Prescription May Reduce the Use of Antibiotics for Acute Otitis Media
No full textObjectives: To evaluate the applicability and the effectiveness of practice guidelines based on a wait-and-see strategy for children with acute otitis media (AOM).Population: Children from 1 to 14 years old having AOM who were referred to primary care pediatric practices.Study Design: Prospective observational study.Main Outcome Measure: Proportion of children having a diagnosis of AOM and eligible for symptomatic treatment who, at 72 hours from enrollment, recovered from their symptoms (fever and earache) without receiving antibiotic treatment.Results: One hundred sixty-nine pediatricians participated in the study and enrolled 1672 children. One thousand two hundred seventy-seven children were included in the analysis. One hundred seventy-eight children received antibiotic treatment at first contact according to the practice guidelines criteria (presence of otorrhea or recurrent AOM). Of the 1099 children who were eligible for symptomatic treatment only, 743 (67.6%) recovered without antibiotic treatment at 3 days and 716 (65.1%) at 30 days. No complications were observed. Coexistence of a high fever (temperature >= 38.4 degrees C) and red and bulging tympanic membrane as well as male sex were significantly associated with antibiotic use.Conclusions: Practice guidelines based on a wait-andsee strategy for children with AOM are applicable and effective in primary care. This strategy was able to avoid the administration of antibiotic treatment in 2 of 3 children
E' utile l'urokinasi intrapleurica nel trattamento dell'empiema? Una risposta da una esperienza concreta
No full textThe use of intrapleural fibrynolisis in the treatment of empyema shortens hospital stay and is recommended by international guidelines in children with a B grade of evidence. Even though only few randomized studies have addressed this issue in limited series of patients with conflicting results. One trial for urokinase showed a positive result while another trial with streptokinase did not show a significant reduction in length of hospital stay. We retrospectively rewied a 30 year experience in a third level university hospital comparing length of treatment in a group of children treated with simple drainage and a group treated with urokinase. Even if such a retrospective analysis is limited by possible biases which are highlighted and discussed a significant reduction in length of hospital stay was found without side effects
Essential Infantile Esotropia: A Course of Treatment From Our Experience
Full text linkBackground: Essential infantile esotropia (EIE) is the most common type of childhood esotropia. Although its classical approach is surgical, less invasive techniques have been proposed as an adjunct or alternative to traditional surgery. Among them, chemodenervation with botulinum toxin (BT) has been investigated, showing variable and sometimes conflicting results.Objectives: To compare the outcomes of bilateral BT injection and traditional surgery in a pediatric population with EIE in order to optimize and standardize the therapeutic approach. Other purposes are to evaluate whether early intervention may prevent the onset of vertical ocular deviation (which is part of the clinical picture of EIE) and/or influence the development of fine stereopsis, and also to assess changes in refractive status over time among the enrolled population.Methods: A retrospective consecutive cohort study was conducted in 86 children aged 0–48 months who underwent correction of EIE. The primary intervention in naïve subjects was either bilateral BT injection (36 subjects, “BT group”) or strabismus surgery (50 subjects, “surgery group”).Results: Overall, BT chemodenervation (one or two injections) was effective in 13 (36.1%) subjects. With regard to residual deviation angle, the outcomes at least 5 years after the last intervention were overlapping in children receiving initial treatment with either injection or surgery; however, the success rate of primary intervention in the surgery group was higher, and the average number of interventions necessary to achieve orthotropia was smaller. Both early treatment with chemodenervation and surgery at a later age were not found to prevent the onset of vertical ocular deviation, whereas, surprisingly, the percentage of subjects developing fine stereopsis was higher in the surgery group. Finally, with regard to the change in refractive status over time, most of the subjects increased their initial hyperopia, whereas 10% became myopic.Conclusions: Our data suggest that a single bilateral BT injection by age 2 years should be considered as the first-line treatment of EIE without vertical component; whereas, traditional surgery should be considered as the first-line treatment for all other cases and in subjects unresponsive to primary single BT injection
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