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Comment on "Vaccination hesitancy: agreement between WHO and ChatGPT- 4.0 or Gemini Advanced". 就 "疫苗接种犹豫不决:世界卫生组织与 ChatGPT- 4.0 或双子座高级版之间的协议 "发表评论。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-16 DOI: 10.7416/ai.2024.2660
Hinpetch Daungsupawong, Viroj Wiwanitkit
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引用次数: 0
Telemedicine for Outpatients: A Case Study of the First Experience with Diabetic Patients in the Local Health Authority of Modena. 门诊病人远程医疗:摩德纳地方卫生局糖尿病患者首次体验案例研究》。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-15 DOI: 10.7416/ai.2024.2658
Francesca Annamaria Perrone, Lucia Pederzini, Federica Casoni, Paola Artoni, Fausta Guidetti, Cristina Vescovini, Valentina Semeraro, Emilia Gaetti, Marco Vinceti, Lucia Palandri, Elena Righi
<p><strong>Background: </strong>During the COVID-19 pandemic, telemedicine had the opportunity to demonstrate its potential. In Italy, after an initial period of mistrust, it became clear that remote medicine can provide significant benefits for both healthcare professionals and patients. In the Local Health Unit of Modena (Emilia Romagna region, Northern Italy), great importance was placed on developing, promoting, and managing all telemedicine activities. In particular, it was decided to prioritize the activation of tele-visit services in accordance with the guidelines of the Emilia-Romagna region.</p><p><strong>Study design: </strong>This case study aims to illustrate the activities planned and developed at the Local Health Authority of Modena for the implementation of the first service of this kind, the tele-visit service for outpatients suffering from type 1 diabetes mellitus, and to analyze data from the first 12 months of activity (from May 2023 to April 2024) to share reflections on the strengths and critical points encountered.</p><p><strong>Method: </strong>For the activation of tele-visits at the Local Health Authority of Modena, a dedicated working group was established with the mandate to manage all clinical, organizational, and IT aspects. Before starting the service, various preliminary activities were carried out, including selecting the clinical specialty to be activated, defining patient inclusion criteria, implementing IT systems, assessing clinical risks, preparing and distributing information materials, training healthcare personnel, and planning outpatient activities.</p><p><strong>Results: </strong>During the first year of experimental activation of the service (May 2023-April 2024), a total of 72 patients were enrolled in the project, with 103 tele-visits provided. The patients were predominantly women (67%), and the most represented age groups were 30-39 (26%) and 40-49 (21%). Half of the specialists in the Diabetology Service (9/19) participated in the initiative by providing tele-visits, most of whom were young and all of whom were women. The main issues identified through regularly scheduled meetings with professionals, to which the working group is seeking the most appropriate solutions, include poor adherence by many patients who still have doubts about this modality, the habit of many patients rescheduling appointments multiple times, a habit not diminished by this visit method, the non-uniform adherence of professionals, and uneven territorial diffusion of the service. Lastly, professionals reported various IT difficulties. Although the number of tele-visits was not high, the initiative has sparked the interest of several specialists, some of whom have already proposed activating other telemedicine services, with some even suggesting innovative new projects. The next steps will involve extending diabetes monitoring to pregnant women with gestational diabetes and developing tele-visit services for endocrinology, neu
背景:在 COVID-19 大流行期间,远程医疗有机会展示其潜力。在意大利,经过最初的不信任期之后,人们逐渐认识到远程医疗可以为医疗专业人员和患者带来巨大的好处。在摩德纳地方卫生单位(意大利北部艾米利亚-罗马涅大区),开发、推广和管理所有远程医疗活动受到高度重视。研究设计:本案例研究旨在说明摩德纳地方卫生局为实施首项此类服务(针对 1 型糖尿病门诊患者的远程会诊服务)而计划和开展的活动,并分析前 12 个月活动(从 2023 年 5 月至 2024 年 4 月)的数据,以分享对遇到的优势和关键点的反思:为了在摩德纳地方卫生局启动远程会诊,成立了一个专门的工作组,负责管理所有临床、组织和信息技术方面的工作。在启动服务之前,开展了各种前期活动,包括选择要启动的临床专科、确定病人纳入标准、实施信息技术系统、评估临床风险、准备和分发信息资料、培训医护人员以及规划门诊活动:在该服务试运行的第一年(2023 年 5 月至 2024 年 4 月),共有 72 名患者加入该项目,提供了 103 次远程会诊。患者以女性为主(67%),年龄段以 30-39 岁(26%)和 40-49 岁(21%)居多。糖尿病科一半的专家(9/19)参与了该项目,提供了远程会诊服务,其中大部分是年轻人,全部为女性。通过与专业人员定期举行会议,工作组发现了一些主要问题,并正在寻求最合适的解决 办法,其中包括:许多患者对这一方式仍心存疑虑,不能很好地坚持;许多患者习惯于多次 重新安排预约时间,而这一习惯并没有因为这种就诊方式而减少;专业人员的坚持程度不一; 以及服务的地区推广不平衡。最后,专业人员报告了信息技术方面的各种困难。虽然远程就诊的人数不多,但这一举措引起了一些专家的兴趣,他们中的一些人已经提议启动其他远程医疗服务,有些人甚至提出了创新的新项目。下一步将把糖尿病监测范围扩大到妊娠糖尿病孕妇,并为内分泌科、神经内科、血液科和消化内科开发远程会诊服务:在地方医疗单位实施远程会诊服务是一个复杂的过程。对开发阶段和交付初期出现的问题进行全面评估,有助于我们采取积极行动,防止未来项目的失败。我们的评估表明,有必要在两个方面采取行动:一方面,我们必须组织进一步的活动,向患者和医疗服务提供者推广远程医疗,另一方面,我们必须努力解决信息技术问题。
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引用次数: 0
Vaccination hesitancy: agreement between WHO and ChatGPT-4.0 or Gemini Advanced. 疫苗接种犹豫不决:世界卫生组织与 ChatGPT-4.0 或 Gemini Advanced 之间的协议。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-07 DOI: 10.7416/ai.2024.2657
Matteo Fiore, Alessandro Bianconi, Cecilia Acuti Martellucci, Annalisa Rosso, Enrico Zauli, Maria Elena Flacco, Lamberto Manzoli

Background: An increasing number of individuals use online Artificial Intelligence (AI) - based chatbots to retrieve information on health-related topics. This study aims to evaluate the accuracy in answering vaccine-related answers of the currently most commonly used, advanced chatbots - ChatGPT-4.0 and Google Gemini Advanced.

Methods: We compared the answers provided by the World Health Organization (WHO) to 38 open questions on vaccination myths and misconception, with the answers created by ChatGPT-4.0 and Gemini Advanced. Responses were considered as "appropriate", if the information provided was coherent and not in contrast to current WHO recommendations or to drug regulatory indications.

Results and conclusions: The rate of agreement between WHO answers and Chat-GPT-4.0 or Gemini Advanced was very high, as both provided 36 (94.7%) appropriate responses. The few discrepancies between WHO and AI-chatbots answers could not be considered "harmful", and both chatbots often invited the user to check reliable sources, such as CDC or the WHO websites, or to contact a local healthcare professional. In their current versions, both AI-chatbots may already be powerful instrument to support the traditional communication tools in primary prevention, with the potential to improve health literacy, medication adherence, and vaccine hesitancy and concerns. Given the rapid evolution of AI-based systems, further studies are strongly needed to monitor their accuracy and reliability over time.

背景:越来越多的人使用基于人工智能(AI)的在线聊天机器人来检索健康相关主题的信息。本研究旨在评估目前最常用的高级聊天机器人--ChatGPT-4.0 和谷歌双子座高级版--在回答疫苗相关问题时的准确性:我们将世界卫生组织(WHO)对 38 个有关疫苗接种神话和误解的开放式问题提供的答案与 ChatGPT-4.0 和 Gemini Advanced 创建的答案进行了比较。如果所提供的信息连贯一致,且与世卫组织当前的建议或药品监管适应症不存在冲突,则被视为 "适当 "的答案:世界卫生组织的回答与 Chat-GPT-4.0 或 Gemini Advanced 的一致率非常高,两者都提供了 36 个(94.7%)适当的回答。世界卫生组织和人工智能聊天机器人答案之间的少数差异不能被视为 "有害",而且两个聊天机器人都经常请用户查看可靠来源,如疾病预防控制中心或世界卫生组织网站,或联系当地医疗保健专业人员。在目前的版本中,这两个人工智能聊天机器人可能已经成为支持初级预防中传统交流工具的有力工具,具有提高健康素养、坚持用药以及疫苗犹豫和担忧的潜力。鉴于基于人工智能的系统发展迅速,我们亟需开展进一步的研究,以长期监测其准确性和可靠性。
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引用次数: 0
Exploring the gap between notified and diagnosed cases of Food-borne Diseases: evidence from a time-trend analysis in Italy. 探索食源性疾病通报病例与确诊病例之间的差距:来自意大利时间趋势分析的证据。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-05 DOI: 10.7416/ai.2024.2656
Angelo Capodici, Jacopo Lenzi, Sara Cavagnis, Matteo Ricci, Francesco De Dominicis, Simone Ambretti, Liliana Gabrielli, Silvia Galli, Tiziana Lazzarotto, Davide Resi

Background: Foodborne diseases are a major global public health concern, causing significant morbidity and mortality worldwide. The COVID-19 pandemic has had widespread effects on various aspects of life, including the food supply chain, potentially impacting the incidence of foodborne diseases. This study aims to analyze the differences between notified and diagnosed cases and investigate the potential impact of the COVID-19 pandemic on foodborne diseases in the metropolitan area of Bologna, Italy.

Study design: A retrospective time trend analysis from two databases was conducted.

Methods: The Local Health Authority of Bologna collected data re/Emilia-Romagna Region on the infectious disease reporting system over a six-year period (2017-2022), which included three years of the COVID-19 pandemic. This data was compared with information collected during the same period at the microbiology laboratory serving the entire metropolitan area of Bologna. Statistical methods included percent change calculations, binomial tests, annual averages, gender and age stratification, and trend analysis with regression.

Results: An increase (+34.4%, P-value ≤ 0.01) in notified cases during the pandemic - compared to the pre-pandemic period - was found. However, no differences were observed in diagnosed cases when comparing the two periods. The year 2021 saw a significant increase in reported cases of foodborne diseases among schoolers (+300.0%) and workers (+133.3%) compared to 2020. On the other hand, diagnosed cases decreased significantly in 2020 (-19.1%, P<0.01) and increased in 2021 (+21.9%, P<0.01). In absolute terms, a stark difference was observed between notified and diagnosed cases across all the study years (2017-2022).

Conclusions: This study highlights the discrepancy between notified and diagnosed cases of foodborne diseases and how the COVID-19 pandemic has increased reporting without affecting transmission. These findings contribute to the ongoing discussion on improving foodborne disease reporting systems.

背景:食源性疾病是一个重大的全球公共卫生问题,在全球范围内造成严重的发病率和死亡率。COVID-19 大流行对生活的各个方面产生了广泛影响,包括食品供应链,从而可能影响食源性疾病的发病率。本研究旨在分析通报病例与确诊病例之间的差异,并调查 COVID-19 大流行对意大利博洛尼亚市区食源性疾病的潜在影响:研究设计:对两个数据库进行回顾性时间趋势分析:博洛尼亚地方卫生局收集了埃米利亚-罗马涅大区传染病报告系统在六年期间(2017-2022 年)的数据,其中包括 COVID-19 大流行的三年。该数据与服务于整个博洛尼亚大都会区的微生物实验室同期收集的信息进行了比较。统计方法包括百分比变化计算、二项式检验、年平均数、性别和年龄分层以及回归趋势分析:结果:与大流行前相比,大流行期间通报的病例增加了(+34.4%,P 值≤ 0.01)。然而,两个时期的确诊病例没有差异。与 2020 年相比,2021 年在校学生(+300.0%)和工人(+133.3%)中报告的食源性疾病病例显著增加。另一方面,确诊病例在 2020 年大幅减少(-19.1%,PConclusions.Pdf):本研究强调了食源性疾病通报病例与确诊病例之间的差异,以及 COVID-19 大流行如何在不影响传播的情况下增加了通报病例。这些发现有助于当前关于改进食源性疾病报告系统的讨论。
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引用次数: 0
How outdoor and indoor green spaces affect human health: a literature review. 室外和室内绿地如何影响人类健康:文献综述。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-03 DOI: 10.7416/ai.2024.2654
Marco Paniccià, Mattia Acito, Iolanda Grappasonni

Background: The analysis of the complex interactions between outdoor or indoor greenness and the health of individuals and ecosystems is a topic of current and growing interest.

Study design: This review aims to examine and summarise the results of studies conducted to evaluate the effects of exposure to greenness on various aspects of human health and the natural environment.

Methods: For this purpose, in April 2024 we searched PubMed, Web of Science, and Scopus databases, Google Scholar and specialised books.

Results: Evidence gathered demonstrates a remarkable correlation between exposure to outdoor and indoor greenness and the improvement of mental health, including the reduction of stress, anxiety, and depression. Contact with greenness is also associated with improvements in physical health, such as reductions in blood pressure, heart rate, and inflammation, as well as in cognitive abilities, concentration, and overall recovery. These benefits are recognisable both in outdoor spaces, such as urban parks, oases, and public gardens, and in indoor spaces, through the introduction of plants and nature-evoking elements in living and working environments. The presence of vegetation in indoor environments, such as offices, schools, healthcare facilities, prisons, and others, can contribute to improving the quality of social spaces, fostering communication, and collaboration, and attenuating aggressiveness and inequalities, thereby increasing employee satisfaction and work efficiency. The combination of outdoor/indoor green spaces and the well-being of the living environment includes exposure to greater biodiversity, mitigation of extreme weather events, absorption of atmospheric pollutants, attenuation of urban background noise, and increased privacy. The presence of vegetation in urban areas has a positive impact on social cohesion, promoting interpersonal interaction and facilitating the development of more cohesive and inclusive communities, thus supporting a sense of belonging and collective identity.

Conclusions: In conclusion, these results underline the importance of considering contact with greenness as a fundamental element in promoting the psychophysical health and well-being of individuals and ecosystems, suggesting the adoption of nature-based therapies and interventions in public health policies and urban planning practices.

研究背景研究设计:研究设计:本综述旨在研究和总结为评估暴露于绿色环境对人类健康和自然环境各个方面的影响而开展的研究的结果:为此,我们在 2024 年 4 月搜索了 PubMed、Web of Science 和 Scopus 数据库、谷歌学术和专业书籍:结果:收集到的证据表明,接触室外和室内绿化与改善心理健康(包括减少压力、焦虑和抑郁)之间存在明显的相关性。与绿色接触还能改善身体健康,如降低血压、心率和炎症,以及提高认知能力、集中力和整体恢复能力。无论是在室外空间,如城市公园、绿洲和公共花园,还是在室内空间,通过在生活和工作环境中引入植物和自然元素,这些好处都是显而易见的。在办公室、学校、医疗机构、监狱等室内环境中种植植物,有助于提高社交空间的质量,促进沟通和协作,减少攻击性和不平等,从而提高员工的满意度和工作效率。室外/室内绿地与生活环境的福祉相结合,包括接触到更多的生物多样性、缓解极端天气事件、吸收大气污染物、减弱城市背景噪声以及增加私密性。城市地区植被的存在对社会凝聚力有积极影响,可促进人际交往,推动更具凝聚力和包容性社区的发展,从而增强归属感和集体认同感:总之,这些结果强调了将与绿色接触视为促进个人和生态系统心理生理健康和福祉的基本要素的重要性,建议在公共卫生政策和城市规划实践中采用基于自然的疗法和干预措施。
{"title":"How outdoor and indoor green spaces affect human health: a literature review.","authors":"Marco Paniccià, Mattia Acito, Iolanda Grappasonni","doi":"10.7416/ai.2024.2654","DOIUrl":"https://doi.org/10.7416/ai.2024.2654","url":null,"abstract":"<p><strong>Background: </strong>The analysis of the complex interactions between outdoor or indoor greenness and the health of individuals and ecosystems is a topic of current and growing interest.</p><p><strong>Study design: </strong>This review aims to examine and summarise the results of studies conducted to evaluate the effects of exposure to greenness on various aspects of human health and the natural environment.</p><p><strong>Methods: </strong>For this purpose, in April 2024 we searched PubMed, Web of Science, and Scopus databases, Google Scholar and specialised books.</p><p><strong>Results: </strong>Evidence gathered demonstrates a remarkable correlation between exposure to outdoor and indoor greenness and the improvement of mental health, including the reduction of stress, anxiety, and depression. Contact with greenness is also associated with improvements in physical health, such as reductions in blood pressure, heart rate, and inflammation, as well as in cognitive abilities, concentration, and overall recovery. These benefits are recognisable both in outdoor spaces, such as urban parks, oases, and public gardens, and in indoor spaces, through the introduction of plants and nature-evoking elements in living and working environments. The presence of vegetation in indoor environments, such as offices, schools, healthcare facilities, prisons, and others, can contribute to improving the quality of social spaces, fostering communication, and collaboration, and attenuating aggressiveness and inequalities, thereby increasing employee satisfaction and work efficiency. The combination of outdoor/indoor green spaces and the well-being of the living environment includes exposure to greater biodiversity, mitigation of extreme weather events, absorption of atmospheric pollutants, attenuation of urban background noise, and increased privacy. The presence of vegetation in urban areas has a positive impact on social cohesion, promoting interpersonal interaction and facilitating the development of more cohesive and inclusive communities, thus supporting a sense of belonging and collective identity.</p><p><strong>Conclusions: </strong>In conclusion, these results underline the importance of considering contact with greenness as a fundamental element in promoting the psychophysical health and well-being of individuals and ecosystems, suggesting the adoption of nature-based therapies and interventions in public health policies and urban planning practices.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The origins of the modern hygiene in Bari: In memory of Enea Grosso. 巴里现代卫生学的起源:纪念埃内阿-格罗索(Enea Grosso)。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-24 DOI: 10.7416/ai.2024.2653
Giacomo Riformato, Chiara Noviello, Eustachio Cuscianna, Giovanna Barbuti, Silvio Tafuri

Abstract: Professor Enea Grosso, a distinguished Italian scholar in Public Health, made significant contributions during his tenure at the University of Milan, Camerino and in particular Bari, expanding the discipline's research horizons. Born in Milan in 1922, Grosso's career included collaborations with renowned scientists like Albert Sabin. Notable achievements include his innovative response to the 1973 cholera epidemic in Apulia and his promotion of mathematical models in epidemiology. Grosso passed away unexpectedly in 1984, leaving a lasting impact on the scientific community.

摘要:埃内亚-格罗索(Enea Grosso)教授是意大利杰出的公共卫生学者,他在米兰大学、卡梅里诺大学,特别是巴里大学任职期间做出了重大贡献,拓展了该学科的研究视野。格罗索 1922 年出生于米兰,他的职业生涯包括与阿尔伯特-萨宾等著名科学家的合作。他的著名成就包括对 1973 年阿普利亚霍乱疫情的创新性应对措施,以及在流行病学中推广数学模型。格罗索于 1984 年意外去世,给科学界留下了持久的影响。
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引用次数: 0
Vaccinations at home: a new strategy to contain vaccine hesitancy? The experience of ASL Napoli 1 Centro, Italy. 在家接种疫苗:遏制疫苗犹豫的新策略?意大利那不勒斯第一中心 ASL 的经验。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-12 DOI: 10.7416/ai.2024.2651
Marina Tesorone, Carla Ungaro, Luisa Graziano, Anna Vitagliano, Ida Luminoso, Maria Corvino, Marco Papa, Ciro Verdoliva

Abstract: Vaccination coverage are generally geographically variable, even within large cities; furthermore, across target population are embedded difficult-to-reach clusters. To address this issue and improve coverage of mandatory vaccinations, a study group explored bringing vaccination at home as an interventional strategy. In a pilot experience, parents of unvaccinated and under vaccinated children of the 2020 birth cohort living in Naples, Italy were contacted by telephone to offer home administration of vaccinations. A specifically trained team arranged vaccinations visits at home. Coverage rates were evaluated at baseline and one month after the intervention strategy. A significant positive increase in hexavalent vaccine (+1.43%) and measles-mumps-rubella (+1.85%) coverage was registered despite the short duration of the pilot program. Home vaccination turned out to be a medical resource consuming but feasible and successful strategy to increase mandatory vaccinations coverage among the most difficult-to-reach and fragile segments of the pediatric population.

摘要:即使在大城市中,疫苗接种覆盖率也普遍存在地域差异;此外,在目标人群中还存在难以到达的集群。为了解决这一问题并提高强制疫苗接种的覆盖率,一个研究小组探索了将疫苗接种带入家庭的干预策略。在一项试点经验中,研究人员通过电话联系了居住在意大利那不勒斯的 2020 年出生组群中未接种疫苗和接种疫苗不足儿童的家长,让他们在家接种疫苗。一个经过专门培训的团队安排了上门接种。对基线和干预策略实施一个月后的覆盖率进行了评估。尽管试点计划持续时间不长,但六价疫苗(+1.43%)和麻疹-腮腺炎-风疹疫苗(+1.85%)的接种率都有了明显的正增长。事实证明,家庭疫苗接种是一项耗费医疗资源但可行且成功的策略,可提高最难接触到的脆弱儿童群体的强制疫苗接种覆盖率。
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引用次数: 0
Screening for colorectal cancer by full colonoscopy in first-degree relatives of colorectal cancer patients: a multicentric study by the Italian League for the Fight against Cancer. 通过对大肠癌患者一级亲属进行全结肠镜检查筛查大肠癌:意大利抗癌联盟的一项多中心研究。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-03-07 DOI: 10.7416/ai.2024.2618
Giacomo Diedenhofen, Augusto Morgia, Nicola Sinnona, Alberto Pacchiarotti, Anna Fiaschetti, Vito Forte, Mauro Tosoni, Fabrizio Liberati, Sandro Boschetto, Enrico Zepponi, Pietro Marogna, Alessandra Manca, Marco Bisail, Annarita Vestri, Alessandro Rossi
<p><strong>Background: </strong>Colorectal cancer currently presents the third-highest incidence of cancers worldwide, making secondary prevention through screening programs for colorectal cancer, usually by Fecal Occult Blood Testing, an essential preventive medicine intervention. First-degree relatives of colorectal cancer patients are a particularly at-risk group, with indications to consider direct screening by full colonoscopy. Colonoscopy is considered the gold standard for diagnosing colorectal cancer, as it has high sensitivity and specificity, and is both a diagnostic and therapeutic tool. However, it requires significant organizational and financial resources, and has a small but relatively higher risk of complications as opposed to fecal occult blood testing. The present study aimed to assess the appropriateness of a screening program without age restrictions of CRC by full colonoscopy in asymptomatic, first-degree adult relatives of patients with colorectal cancer, aiming both to actively increase screening coverage and to determine the detection rate of precancerous lesions and colorectal cancer in this population.</p><p><strong>Study design: </strong>Uncontrolled interventional study - colorectal cancer screening by full colonoscopy for at-risk population.</p><p><strong>Methods: </strong>The Italian League for the Fight against Cancer started a colorectal cancer screening program by full colonoscopy for first-degree relatives of colorectal cancer patients in 1998 in the province of Latina, Lazio Region, Italy. The program was expanded to the provinces of Rieti, Lazio Region, and Sassari, Sardinia Region, in 2014 and 2016 respectively, and was concluded in 2018. Subjects were actively and voluntarily recruited by the study's working group. Subjects that had already been subjected to a full colonoscopy in the preceding 5 years were excluded from this study. Identified neoplastic lesions were treated either directly or referred to the Day Hospital setting, and histologically diagnosed following World Health Organization guidelines.</p><p><strong>Results: </strong>In total, 2,288 subjects (age range 15-88, mean 52.3 yrs, M/F = 946/1,204) were screened by colonoscopy, of which 103 (4.5%) were incomplete and 2,173 (95.0%) complete, with data on colonoscopy performance missing for 12 participants. Out of 468 positive outcomes on colonoscopy, diagnosis for 422 (204M/173F), 19.4% of total subjects, was adenomatous polyps and 46 (20M/20F), 2.1% of total subjects, was colorectal cancer. Female sex was a protective factor against a positive test outcome, with a 35% reduction compared to male sex, with OR=0.64 95%CI (0.52-0.80). On the other hand, being over 50 years of age was found to be a risk factor, making a positive outcome more than twice as likely, with OR=2.3 95%CI (1.8-2.9). Subjects over 50 also had significantly more instances of multiple adenomas being found, however the size distribution of found adenomas was not significantly diff
背景:大肠癌目前在全球癌症发病率中排名第三,因此,通过大肠癌筛查计划(通常是通过粪便隐血试验)进行二级预防是一项重要的预防医学干预措施。结直肠癌患者的一级亲属是一个特别高危的群体,有迹象表明应考虑通过全结肠镜检查进行直接筛查。结肠镜检查被认为是诊断结肠直肠癌的黄金标准,因为它具有很高的灵敏度和特异性,既是诊断工具,也是治疗工具。然而,结肠镜检查需要大量的组织和财政资源,与粪便潜血检测相比,其并发症风险较小,但相对较高。本研究旨在评估在无症状的结直肠癌患者一级成年亲属中开展无年龄限制的全结肠镜检查计划是否合适,目的是积极提高筛查覆盖率,并确定该人群中癌前病变和结直肠癌的检出率:研究设计:非对照干预研究--通过全结肠镜检查为高危人群进行结直肠癌筛查:意大利抗癌联盟于1998年在意大利拉齐奥大区的拉蒂纳省启动了一项大肠癌筛查计划,对大肠癌患者的一级亲属进行全结肠镜检查。该计划分别于 2014 年和 2016 年扩展到拉齐奥大区的里耶蒂省和撒丁岛大区的萨萨里省,并于 2018 年结束。受试者由研究工作组积极自愿招募。本研究不包括在过去 5 年中接受过全面结肠镜检查的受试者。发现的肿瘤病变直接接受治疗或转诊至日间医院,并根据世界卫生组织的指南进行组织学诊断:共有 2,288 名受试者(年龄在 15-88 岁之间,平均 52.3 岁,男女比例 = 946/1,204)接受了结肠镜筛查,其中 103 人(4.5%)未完成筛查,2,173 人(95.0%)完成了筛查,12 人的结肠镜检查结果数据缺失。在 468 例结肠镜检查阳性结果中,422 例(204 名男性/173 名女性)(占总人数的 19.4%)诊断为腺瘤性息肉,46 例(20 名男性/20 名女性)(占总人数的 2.1%)诊断为结直肠癌。女性性别是检测结果呈阳性的一个保护因素,与男性性别相比减少了 35%,OR=0.64 95%CI(0.52-0.80)。另一方面,50 岁以上是一个风险因素,使检测结果呈阳性的可能性增加了一倍多,OR=2.3 95%CI (1.8-2.9)。50岁以上的受试者发现多发性腺瘤的情况也明显增多,但发现的腺瘤的大小分布在50岁以下和50岁以上的受试者之间没有明显差异,尽管大小是预测肿瘤进展风险的一个因素:鉴于研究人群中癌前病变和结直肠癌的检出率较高,我们认为,指南应继续建议对结直肠癌患者的一级亲属进行更早、更频繁的筛查,并且,如果没有更具成本效益和/或风险更低且疗效相似的检查方法,应继续将结肠镜检查作为主要的筛查方法。
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引用次数: 0
Low-intensity rehabilitation in persistent post COVID-19 dyspnoea: the value of Spa health resort as appropriate setting. COVID-19 后持续性呼吸困难的低强度康复治疗:温泉疗养胜地作为适当场所的价值。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-03-01 DOI: 10.7416/ai.2024.2617
Emanuela Resta, Carla Maria Irene Quarato, Giulia Scioscia, Eustachio Cuscianna, Pasquale Tondo, Giuseppe Mansueto, Ernesto Lulaj, Simone Sorangelo, Onofrio Resta, Maria Pia Foschino Barbaro, Silvio Tafuri, Donato Lacedonia
<p><strong>Background: </strong>Post COVID-19 syndrome is a frequent disabling outcome, leading to a delay in social reintegration and return to working life.</p><p><strong>Study design: </strong>This was a prospective observational cohort study. The main objective was to explore the effectiveness of a Spa rehabilitation treatment on the improvement of post COVID-19 dyspnoea and fatigue, also analyzing the relationship between such symptoms. Additionally, it was assessed if different clinical characteristics could predispose patients in experiencing post COVID-19 symptoms or could influence the effectiveness of a Spa intervention.</p><p><strong>Methods: </strong>From July to November 2021, 187 post COVID-19 patients were enrolled in the study. All the patients complained persi-sting dyspnoea, whose impact on daily activities was assessed using the modified Medical Research Council dyspnoea scale. 144 patients (77.0%) reported also fatigue. The Spa treatment was started at least 3 months after COVID-19 acute phase. At the end of the treatment, patients were asked to rate the improvement in the dyspnoea and fatigue sensation. 118 patients also underwent the modified Borg Dyspnoea Scale for severity estimation of Exertion Dyspnoea and the Barthel index for severity estimation of Physical Limitation.</p><p><strong>Results: </strong>165 out of 187 patients (88.2%) reported an improvement in dyspnoea, while 116 out 144 patients (80.6%) reported an improvement in both dyspnoea and fatigue. On a total of 118 subjects, a clinically significant improvement in the modified Borg Dyspnoea Scale (i.e. Delta Borg equal or more than -2.0 points) was reached by the 50.8% of patients, while a clinically significant improvement in the Barthel index (i.e. Delta Barthel equal or more than +10.0 points) was reached by the 51.7% of them. The 31.4% of patients reached a minimal clinically important improvement in both the modified Borg Dyspnoea Scale and the Barthel index. No risk factors were associated to a clinically impacting dyspnoea at entry, while a BMI>30 Kg/m2 was the main risk factor for chronic fatigue. Presence of respiratory comorbidities, obesity and severe acute COVID-19 (phenotype 4) configured risk factors for the lack of improvement of dyspnoea after the treatment, while no risk factors were associated to a lack of improvement for fatigue. Older age, obesity and comorbidities seemed to make more difficult to reach a clinically meaningful improvement in the modified Borg Dyspnoea Scale and the Barthel index after treatment. Female gender may imply more physical limitation at entry, while male patients seem to show less improvement in the Barthel index after treatment.</p><p><strong>Conclusions: </strong>Dyspnoea and fatigue were confirmed to be important post COVID-19 symptoms even in younger subjects of wor-king age and subjects with absent or modest pulmonary alterations at distance from acute COVID-19. A Spa health resort seems to be an effective "lo
研究背景研究设计:研究设计:这是一项前瞻性观察队列研究。研究设计:这是一项前瞻性观察性队列研究,主要目的是探讨 Spa 康复治疗对改善 COVID-19 后呼吸困难和疲劳的效果,并分析这些症状之间的关系。此外,还评估了不同的临床特征是否会导致患者出现 COVID-19 后症状,或是否会影响水疗干预的效果:方法:2021 年 7 月至 11 月,187 名 COVID-19 后患者参与了研究。所有患者均主诉有持续性呼吸困难,其对日常活动的影响通过改良的医学研究委员会呼吸困难量表进行评估。144名患者(77.0%)还报告了疲劳症状。Spa 治疗在 COVID-19 急性期后至少 3 个月开始。治疗结束时,患者被要求对呼吸困难和疲劳感的改善情况进行评分。118 名患者还接受了改良博格呼吸困难量表(用于评估用力呼吸困难的严重程度)和巴特尔指数(用于评估身体受限的严重程度)的评估:187 名患者中有 165 人(88.2%)表示呼吸困难有所改善,144 名患者中有 116 人(80.6%)表示呼吸困难和疲劳均有改善。在总共 118 名受试者中,50.8% 的患者在改良博格呼吸困难量表(即 Delta Borg 等于或大于-2.0 分)方面取得了显著的临床改善,而 51.7% 的患者在巴特尔指数(即 Delta Barthel 等于或大于+10.0 分)方面取得了显著的临床改善。31.4%的患者在改良博格呼吸困难量表和巴特尔指数方面都达到了最小临床意义改善。入院时,没有任何风险因素与影响临床的呼吸困难有关,而体重指数大于 30 Kg/m2 是导致慢性疲劳的主要风险因素。存在呼吸系统合并症、肥胖和严重急性 COVID-19(表型 4)是治疗后呼吸困难得不到改善的风险因素,而疲劳得不到改善则与任何风险因素无关。高龄、肥胖和合并症似乎使治疗后改良博格呼吸困难量表和巴特尔指数更难获得有临床意义的改善。女性患者在入院时可能会受到更多的身体限制,而男性患者在治疗后的巴特尔指数改善程度似乎较低:呼吸困难和疲劳被证实是 COVID-19 后的重要症状,即使是在工作年龄较小的受试者中,以及在急性 COVID-19 后没有或仅有轻微肺部改变的受试者中也是如此。对于此类患者的康复计划而言,温泉疗养地似乎是一个有效的 "低强度 "环境。呼吸困难和疲劳之间的改善关系密切,即使两者发生的风险因素似乎不同。劳累性呼吸困难和身体受限的改善似乎相互关联较小,这可能是由于评估问卷较为复杂。一些风险因素可能预示着治疗后症状没有改善。
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引用次数: 0
Decade-long insights: tracking asbestos-related health impacts among formerly exposed workers in Palermo, Italy. 长达十年的洞察力:追踪意大利巴勒莫曾接触石棉的工人中与石棉相关的健康影响。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-03-07 DOI: 10.7416/ai.2024.2619
Claudio Costantino, Caterina Ledda, Matteo Riccò, Eduardo Costagliola, Francesco Balsamo, Miriam Belluzzo, Nicole Bonaccorso, Alessandro Carubia, Luciano D'Azzo, Martina Sciortino, Tania Vitello, Luigi Zagra, Santo Fruscione, Sara Ilardo, Elisa Trapani, Giuseppe Calamusa, Venerando Rapisarda, Walter Mazzucco

Background: Asbestos is a foremost occupational carcinogen globally. Despite the prohibition under Law 257/1992, Italy persists as one of the European nations most burdened by asbestos-related diseases (ARDs). This research assessed ARD cases in asbestos-exposed workers from the Province of Palermo, Italy, spanning 2010-2021.

Methods: Data acquisition utilized the epidemiological dataset from the 'Service of Prevention and Safety on Work Environment' under the Prevention Department of Palermo's Local Health Authority (LHA).

Results: Between 2010 and 2021, we identified 245 ARD instances, comprising 163 Asbestosis/Pleural plaques, 41 Lung Cancers, 38 Mesotheliomas, and 3 unspecified cases. Multivariate analysis indicated a notable decline in temporal exposure for mesothelioma (HR=0.933; 95% CI=0.902-0.965) and lung cancer (HR=0.93; 95% CI=0.90-0.978) relative to pleural plaques/asbestosis. Tobacco use displayed a pronounced correlation with lung cancer (smoker HR=64.520 95% CI=13,075-318.390; former smoker HR=20.917 95% CI=4,913-89.048). A significant link was observed between mesothelioma and pleural plaques/asbestosis in those employed in shipbuilding and repair (HR=0.371 95% CI=0.155-0.892).

Conclusions: ARDs persist in clinical observations, even following the 1992 cessation of asbestos-related activities, emphasizing an enduring public health challenge. Enhancing prevention strategies is paramount, focusing on amplifying anamnestic and occupational data collection, thereby facilitating superior early diagnosis strategies for these maladies in the occupationally exposed cohort.

背景:石棉是全球最主要的职业致癌物。尽管第 257/1992 号法律禁止使用石棉,但意大利仍然是欧洲国家中患石棉相关疾病(ARDs)最多的国家之一。这项研究评估了 2010-2021 年期间意大利巴勒莫省接触石棉工人的 ARD 病例:数据采集利用了巴勒莫地方卫生局(LHA)预防部下属的 "工作环境预防和安全服务 "的流行病学数据集:结果:2010 年至 2021 年间,我们共发现了 245 例急性放射损伤病例,其中包括 163 例石棉沉滞症/胸膜斑、41 例肺癌、38 例间皮瘤和 3 例不明病例。多变量分析表明,相对于胸膜斑块/石棉沉着病,间皮瘤(HR=0.933;95% CI=0.902-0.965)和肺癌(HR=0.93;95% CI=0.90-0.978)的时间暴露显著下降。吸烟与肺癌有明显的相关性(吸烟者 HR=64.520 95% CI=13,075-318.390;曾经吸烟者 HR=20.917 95% CI=4,913-89.048)。在受雇于造船和修船业的人群中,间皮瘤与胸膜斑块/石棉沉着病之间存在明显联系(HR=0.371 95% CI=0.155-0.892):结论:即使在 1992 年停止与石棉有关的活动之后,ARD 在临床观察中依然存在,这凸显了公共卫生面临的持久挑战。加强预防策略至关重要,重点是扩大异常和职业数据的收集,从而促进对职业暴露人群中这些疾病的早期诊断策略。
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引用次数: 0
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Annali di igiene : medicina preventiva e di comunita
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