Annali dell'Istituto superiore di sanita最新文献

Introduction: Sexually transmitted infections (STIs) represent a group of widespread infectious diseases. The objective of this study is to investigate the knowledge on HIV and STIs as well as sexual risk behaviours among blood donors in Italy.

Materials and methods: The study was carried out in 2017 among blood donors who accessed social media of the Italian Association of Blood Donors (Associazione Volontari Italiani del Sangue, AVIS), and answered to a questionnaire posted online.

Results: Participating blood donors were 9,021, median age 36 years (IQR 26-47), 53.9% males, 94.3% heterosexual, and 2.7% reported having a current occasional partner. Unprotected sex in the last 4 months was reported by 54.1% of participants. About half of the participants were not informed of most STIs, 11.0% reported never having searched for information on HIV and STIs, one third considered unlikely acquiring HIV through unprotected sex with a known person, 21.3% would stop having sex with a partner found to be HIV-positive, and 15.8% would be afraid to hug or kiss a person with HIV.

Discussion: Our results show that most blood donors have a stable partner and search actively for information on HIV and STIs. However, there is a proportion of them who engage in high-risk behaviours, have misconceptions on HIV and STIs transmission, reporting a stigmatising attitude towards people with HIV.

Conclusion: A more comprehensive and updated information on various STIs, transmission modes and safe sex should be provided to blood donors, not only to prevent the spread of these infections but also to avoid unjustified discrimination.

Introduction: COVID-19 lockdown in Italy resulted in increased smoking consumption, mainly associated with mental distress. This study aims to update previous findings investigating changes in smoking intensity during the whole COVID-19 pandemic.

Methods: This analysis was carried out within the "LOST IN ITALY" ("LOckdown and lifeSTyle IN ITALY") and "LOST IN TOSCANA" studies on 880 smokers with information collected during main pandemic peaks. Changes in cigarettes/day were investigated in association with survey-periods, socio-demographic and psychological characteristics through a linear mixed-model.

Results: Net of psychological distress and socio-demographic variables, in comparison to pre-pandemic period cigarettes/day increased by 1.16 during lockdown, and remained over half higher subsequently. In the overall period, an increase of >1 cigarette/day was also associated to lower education, older age, male gender and psychotropics drugs use.

Conclusions: After 2 years of pandemic, cigarettes/day have not yet returned to the pre-pandemic levels, mainly due to socio-demographic factors, but also to nicotine addiction, that tends to stabilize consumption.

Introduction: Healthcare-associated infections are often associated with poor hand hygiene (HH) by healthcare workers (HCWs). The objective of this cross-sectional study at the Umberto I teaching hospital in Rome was to quantify compliance with HH by direct observation following a multimodal strategy devised by the World Health Organisation and to map critical areas for improvement.

Methods: Predictors of HH compliance were identified using a multivariable logistic regression model. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.

Results: Eighty-four trained observers from 50 wards collected 4,081 observations showing that overall HH compliance was 71.9%. The multivariable analysis found a positive association with the outcome for midwives compared to physicians (aOR=2.5, 95% CI: 1.5-4.1), and a negative association for healthcare assistants (aOR=0.5, 95% CI: 0.3-0.8). There was greater compliance during public holidays and weekends (aOR=1.5, 95% CI: 1.1-2.1), but compliance was lower for external staff (aOR=0.7, 95% CI: 0.5-0.9). We found a positive association with all HH indications after interaction with a patient or with patient surroundings compared with the indication "before touching a patient" (all p<0.001); the highest association was with the indication "after contact with biological fluids" (aOR=7.7, 95% CI: 4.7-12.5).

Conclusion: Overall, we observed reasonable compliance levels, but it is important to increase adherence to HH practice and monitor any behaviour change.

Introduction: We presented a four-case series of COVID-19 related deaths occurred in patients with Guillain-Barré syndrome (GBS) between February 2020 and January 2022 in Italy.

Methods: They were extracted from 8,436 medical charts of COVID-19 patients dying. All cases, ranged 48-73 years, showed classical GBS clinical onset - limb weakness, sensory deficits, hypoareflexia - and three of them were admitted in intensive care unit (ICU) for ventilator support.

Results: The cerebrospinal fluid showing albumin-cytological dissociation was performed in two cases. Nerve conduction studies supported the diagnosis in all cases. Interstitial pneumonia was documented by chest X-rays or CT scans in all cases: they were treated with intravenous immunoglobulin (IVIg) and the drugs used for COVID-19 infection.

Conclusions: Although the mechanism of GBS onset is still unclear in COVID-19, fatal cases may be more frequent than other virus-related GBS, so that strictly monitoring in high-risk patients could dramatically decrease the mortality of GBS.

Introduction: Sarcopenic obesity and hypertension are a public health problem that is increasing worldwide due to the progressive aging of the population and the increasing prevalence of obesity and physical inactivity. Sarcopenic obesity is characterized by the simultaneous presence of sarcopenia (loss of muscle mass) and adiposity (increase in fat mass). Because symptoms are not specific, sarcopenic obesity remains largely undiagnosed. This review explores the latest research on sarcopenic obesity and its association with hypertension, with a focus on arterial stiffness.

Methods: A comprehensive narrative review was conducted by systematically searching PubMed and Scopus databases for relevant scientific literature.

Results: Sarcopenic obesity and hypertension are closely linked, sharing common factors such as inflammation, insulin resistance, and oxidative stress, with arterial stiffness playing a crucial role.

Discussion: Given the lack of specific symptoms for sarcopenic obesity, early diagnosis and management are crucial. Treatment strategies should prioritize weight loss, adequate protein intake, and regular physical activity. Further investigation is warranted for pharmacological interventions.

Conclusion: Sarcopenic obesity and hypertension present significant challenges to global public health. Addressing arterial stiffness is paramount in managing these conditions effectively. Lifestyle modifications, including weight management and physical activity, remain central to the treatment of sarcopenic obesity, while additional research is needed to explore potential pharmacological options.

Background: The presence in Italy of a significant foreign population (5-6 million including both formally residents and not officially registered ones) introduces significant transformations in the Italian demography with important challenges on ensuring fundamental rights including work, education and above all, health. Access to healthcare. Issues common to the entire migrant population concern the difficulty of accessing the health system of the host country due to the lack of knowledge of its rules and its functioning, the linguistic and cultural barriers and the distrust towards a system that is not recognized as his own, as well as the difficulties and misunderstandings encountered in the relationship with health professionals. Religion, culture and gender may even increase these difficulties. Conlusion and future perspective. Culture and religion should be taken into account when designing and implementing healthcare services and healthcare workers need to be trained in acknowledging these challenges. The National Health Service should become more sensitive to the increasing cultural and religious pluralism of patients starting with investing more in the training of health professionals.

Introduction: After transplantation, engaging in regular physical activity (PA) or sport is recommended for health. Participation to competitive sports is increasingly common among kidney transplant recipients while little is known on how training affects the physical performance in transplanted athletes.

Aim: The purpose of this case study was to assess the effects of a tailored training program on exercise parameters in kidney transplant cyclists (CKTRs) and runners (RKTRs).

Methods: Twelve male transplanted athletes were enrolled. The workload at aerobic and anaerobic thresholds, the submaximal aerobic power (V'O2 stage) and rate of perceived exertion (RPE) during an incremental cycling or running test, and the peak instantaneous force (PIF) during a countermovement jump were assessed at baseline (T0) and after 6 months of tailored training (T6) consisting in strength and aerobic exercises. Exercise adherence, blood lipid profile and renal function were also investigated.

Results: Eight CKTRs and 4 RKTRs completed the 6-month training period, with a significant increase of training volume (minutes/week). The exercise adherence was met by 90% in both groups. At T6, there were significant (p<0.05) improvements of maximum workload attained, the workload corresponding to the aerobic threshold and PIF, while workloads at anaerobic threshold, V'O2 stage and RPE were unchanged. Blood cholesterol significantly decreased (p<0.01), while the other blood parameters were unchanged.

Conclusions: These findings indicate that the combined strength and endurance training is well tolerated and may improve exercise performance in this selected population of KTRs.

Background: A mesothelioma cluster in Biancavilla (Sicily, Italy), drew attention to fluoro-edenite, a fibre classified by International Agency for Research on Cancer as carcinogenic to humans. Significant excesses in mortality and morbidity were observed for respiratory diseases and a significant excess of pneumoconiosis hospitalizations was reported.

Objective: Aim of this study is to assess the characters of the lung damage in Biancavilla residents hospitalized with pneumoconiosis or asbestosis diagnoses.

Methodology: Medical records, available radiographs and computed tomography scans were collected. The obtained imaging was reviewed by a panel of three specialists and focused on pleural and parenchymal abnormalities. Cases with an ILO-BIT or ICOERD score equal or greater than 2 were considered positive for a pneumoconiosis-like damage, cases with a score lower than 2 or insufficient quality of imaging were considered inconclusive. If no pneumoconiotic aspects were present the cases were classified as negative.

Results: Out of 38 cases, diagnostic imaging for 25 cases were found. Ten cases out of 25 showed asbestosis-like features, nine subjects were considered negative. In six patients' results were inconclusive.

Conclusions: Asbestosis-like features were substantiated in Biancavilla residents without known occupational exposure to asbestos. Further studies to estimate population respiratory health are required. Experimental studies on the fibrogenic potential of fluoro-edenite are needed.

Objectives: Vaccination against human papilloma virus (HPV) in adolescents and persons at increased risk of infection and related consequences is an effective strategy to prevent genital cancers. The objective of this study was to assess vaccination activity and coverages in a Northeastern Italian area.

Methods: Anonymous data from various health administrative databases of the Italian 530,000-inhabitant Health Authority "Azienda Sanitaria Universitaria Friuli Centrale" were deterministically linked at the individual level through an anonymous stochastic key. Doses of HPV vaccine administered by year and coverages in different birth cohorts were calculated. Vaccinations of women treated for a CIN2+ lesion were also identified.

Results: The number of doses administered by year followed the evolution of national and regional laws. A steep drop was observed in 2020 and 2021 in both males and females (from 6,907 in 2019 to 5,027 in 2020 in males and from 6,989 in 2019 to 4,348 in 2020 in females). Coverages in adolescents were variable across Vaccination Services located in different sub-areas (complete cycle coverage in the 2008 cohort ranged from <40% in some Districts to >70% in others). Vaccination doses administered in adult women have increased almost steadily since 2018. One third of women treated for a CIN2+ were vaccinated.

Conclusions: In this area, efforts must be done to catch-up with doses missed during the pandemic and to overcome differences among different sub-areas.