Annali dell'Istituto superiore di sanita最新文献

Background: Monitoring medicine prescriptions in pregnancy is an aspect of extreme interest in term of public health.

Methods: A retrospective prevalence study using administrative healthcare databases was performed in order to evaluate medication prescriptions in Italy. A cohort of 274,938 pregnant women (15-49 years) residing in three Italian regions (Emilia-Romagna, Lazio, Puglia), who delivered in 2014-2017, were enrolled. The prevalence of medication use was estimated as the proportion of pregnant women with any medication prescription in each of the following five trimesters: 1 before pregnancy (pre-T), 3 during pregnancy (1st TP, 2nd TP, 3rd TP) and 1 after pregnancy (post-T).

Results: About 80% of enrolled pregnant women received at least one prescription during pregnancy, 36.5% before pregnancy and 50.7% in the post-partum. The most prescribed medicine was folic acid (42%), mostly used in 1st TP (35%). Progesterone use was concentrated in 1st TP (19%) and increased as the number of previous abortions. Pregnancy use of antidiabetics, antihypertensives, and thyroid preparations were 24.1‰, 21.5‰, 101.8‰, respectively.

Conclusions: At the national level, this study confirmed the prescriptive trend observed in other European studies, but a regional variability for all medication groups was found. Further studies are needed in order to identify determinants of medication prescriptions during pregnancy in Italy.

Introduction and objective: Celiac disease (CD) affects the 1% of the general population worldwide. Because of its clinical variability, roughly the 70% of CD patients are not correctly diagnosed and not adequately treated. Active military personnel represent an interesting cohort for a CD screening. Upon the enrollment in the Armed Forces, a complete health check is carried out to exclude any diseases. Aim of the present work is to assess the CD prevalence among the personnel of Carabinieri Corps, an Italian armed force, through a serological screening.

Results and discussion: Out of 291 militaries (281 M, 10 F age range: 18.2-61.5) enrolled, 2 resulted affected by CD (prevalence: 0.7%); 1 to have high serological anti-TG and EMA level without duodenal mucosal lesions and 1 to have high serological anti-TG, but not EMA.

Conclusion: These results show that the CD prevalence among a cohort of Italian militaries is similar to that of the general population.

At the end of the 90s in Europe, the new psychoactive substances (NPS) phenomenon was limited to a small number of molecules created to mimic the actions and psychoactive effects of licensed medicines and existing drugs that are controlled by the United Nations drug conventions and therefore traded as their "legal" replacements. NPS were mostly circulating in rave parties and electronic music festivals. The globalization, the evolution of e-commerce and the growing popularity of NPS, facilitated the development of a wide illegal market in constant expansion. The dynamic nature of this phenomenon has led to an evolution in the prevention and monitoring of NPS trafficking within the European Union. The European legislative system has been amended with the aim of creating a faster and more effective regulatory system to tackle NPS diffusion and ban their sale and circulation. At the end of 2008, in compliance with the European Council Decision 2005/387/JHA, the Anti-Drug Policies Department of the Presidency of the Council of Ministers activated the National Early Warning System to promote a rapid exchange of information on NPS between Italy and the EU.

Introduction: The Italian contaminated sites of interest for remediation are monitored by SENTIERI, an epidemiological surveillance system describing the health status of populations living nearby these sites. There is an increasing concern on how to assess temporal changes in the health status of these populations.

Methods: A sequence of three statistical techniques was adopted to analyse temporal trends of mortality and hospitalization, by using different indicators and reference populations, in a sample of 36 sites with industrial sources of contamination monitored by SENTIERI.

Results: Positive temporal trends in health risks are detected reflecting mainly long term effects of industrial activities. The adopted methodology identifies multiple factors influencing the temporal patterns: type of health outcomes, type of disease, and its link with gender and type of emission sources.

Conclusions: Reliable methods to assess health profile changes in local populations attributable to contaminations are key elements to measure the impact of remediation activities.

The issue of political, institutional and professional liability in the context of the SARS-COV-2 pandemic is currently widely debated and involves several levels of investigation. One crucial aspect relates to the allocation of life-saving resources in situations where there is an imbalance between need and availability and the associated questions of ethical and legal liability. This work looks at the implications of the criteria applied to rationing under extraordinary conditions and the issue of their legitimacy. Considering the European scenario, we describe the approach taken by Italy in proposing criteria for pandemic triage of intensive treatment and highlight certain problems and critical issues. We emphasise that the decision, based on a comparative assessment, to deny treatment to a patient in critical condition, compromising that patient's right to care, exceeds the scope of decision-making autonomy of the professional concerned and requires a theoretical and procedural definition shared at multiple levels of society.

Introduction: The Istituto Superiore di Sanità (ISS) has been asked for rapid technical and scientific advice to the State and Regions during Sars-CoV-2 pandemic preparedness.

Methods: An ad hoc Working Group on Scientific Literature updates (WG SL) was set up at ISS (March-May 2020) to screen pre-prints and peer reviewed papers from arXiv, medRxiv, bioRxiv, and Pubmed to provide a real time knowledge and empirical evidence addressed to health-workers.

Results: The WG SL screened a total of 4,568 pre-prints and 15,590 peer reviewed papers, delivered as daily summary report of pre-print selection for ISS President activity in the National Scientific Technical Committee framework and a weekly open access publication (COVID Contents) on peer-reviewed papers of interest for health professionals, monitored by a satisfaction questionnaire.

Conclusions: Promoting heath literacy, with a cross-cutting approach is a powerful heritage of Public Health Institutes and a proven effective non pharmacological intervention.

Background: Breastfeeding success is determined by early skin to skin contact, early initiation of breastfeeding, rooming-in, baby-led breastfeeding, creation of a favorable environment, specific training of health professionals, and continuity of care.

Objective: To investigate the women's satisfaction regarding the care and support received in the first days after childbirth.

Material and methods: A questionnaire of 24 items was administered to mothers before discharge, from May to September 2019 at the University Hospital of Modena.

Results: The predictive variables of exclusive breastfeeding were the delivery mode, age at birth and parity. The multivariate analysis showed that a high satisfaction score was associated with vaginal birth (OR=2.63, p=0.005), rooming-in during the hospitalization (OR=8.64, p<0.001), the skin to skin contact (OR=6.61, p=0.001) and the first latch-on within 1 hour after birth (OR=3.00, p=0.02).

Conclusions: Mothers' satisfaction is one of the important factors of positive experience during hospital stay and of better health outcomes.

Medical device registries are major tools for public health, able to provide early warning systems for increasing the patient safety. We are now at the forefront of a final legal and procedural step to design the Regulation of the Italian Implantable Prostheses Registry (RIPI) and to make data collection mandatory. This can ensure prostheses traceability, recall of patients and fuel biomedical and epidemiological research. Data completeness will be greatly improved when the Regulation is issued. At that time, rules for accessing data and subjects/entities allowed to access the Registry will be clearly defined. Therefore, the Regulation content is crucial, with no chance to fail in its design. The thorough expertise gained at the Italian National Institute of Health (Istituto Superiore di Sanità) by the Italian Arthroplasty Registry in terms of scientific, technical and privacy management may represent a prototypical model for other registries. Our aim is to identify a few key issues to shape a far-reaching Regulation that might permit the flexible and dynamic functioning of RIPI providing suggestions for other registries at national and international level.

Background: Research based on biological material with linked health and clinical data may produce new strategies for disease prevention, diagnosis and treatment. A survey was conducted among individuals previously screened for major depressive disorder (MDD) to explore participants' attitude towards research biobanking.

Methods: The survey used self-report questionnaires about donation for research biobanks, self-perceived health and life satisfaction. Means and percentages were compared across groups by using t test, ANOVA and chi-square test.

Results: Of 416 subjects who underwent the MDD screening, 51 (12.2%) responded to the survey, with the majority of them (42) agreeing to the use of their biological samples only in absence of feedbacks about health or diseases. Agreement towards biobanking was not affected by life satisfaction or self-perceived health.

Conclusions: Our findings show a prevailing preference against health results disclosure among MDD-screened subjects, suggesting a role of personal - particularly psychosocial - factors in research biobanking individuals' contribution.

Introduction: Pertussis is a highly contagious respiratory disease and vaccination of pregnant women seems to be the most effective strategy to prevent pertussis in infants. The aim of this study is to assess the acceptance by women of pertussis vaccination during pregnancy based on Health Belief Model (HBM) constructs.

Methods: A multicentre observational study was carried out with a convenience sample of 300 respondents.

Results: Most women were worried to contract or to transmit pertussis during the first months of the infant's life and perceived pertussis contracted in the first months of life as very serious. Parity appears to be a factor predicting this health behaviour, as nulliparous women tend to get more vaccinated or have a higher intention to get vaccinated (ORa 2.8 CI 95% 1.5-5.2 p<0.01).

Discussion and conclusions: HBM is an effective tool for identifying facilitators and barriers to health behaviours. Strategies to promote vaccination during pregnancy are needed, including educational interventions and communication campaigns.