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Annali Dell'Istituto Superiore di Sanità

Annalisa Del Giudice, Alessandro Mustazzolu, Angelo Iacobino, Rossella Perna, Riccardo Smeraglia, Rachele Marino, Lanfranco Fattorini, Giulia Santoro
BACKGROUND: Drug-resistant tuberculosis (TB) is a serious threat in industrialized countries, but information from Southern Italy is lacking. Here, we present the results of a retrospective study of TB cases diagnosed in 2008-2013 in Naples, the largest city in Southern Italy. METHODS: Six hundred ninety Mycobacterium tuberculosis strains were isolated at the Ospedali dei Colli of Naples, and resistance to first-line and second-line drugs was determined. RESULTS: Multidrug-resistant (MDR) TB increased from 2008 to 2013, with 77...
October 2016: Annali Dell'Istituto Superiore di Sanità
Roberto Perilli, Rosamaria Di Biagio, Renato Seller, Luigi Ruotolo, Carla Granchelli, Valeria Marisi, Stefania Melena, Agostino Consoli
INTRODUCTION: Integrated care, by allowing information exchange among health professionals, improves outcomes and favours a reduction in hospital admission in diabetes. Retinal complications can be sight-threatening, and diabetic patients often miss the suggested yearly clinical examination. METHODS: Teleretinography can be easily performed in patients attending Diabetes Clinics: images are sent to a remote ophthalmologist, grading and instructions are received and forwarded to General Practitioners by a dedicated software...
October 2016: Annali Dell'Istituto Superiore di Sanità
Elizabeta Ristanovic, Ana Gligic, Sonja Atanasievska, Vesna Protic-Djokic, Dragutin Jovanovic, Miodrag Radunovic
Variola (smallpox) virus is classified as class A of potential biological weapons, due to its microbiological, genetic, antigenic and epidemiological characteristics. The potential danger is more real because vaccination against smallpox has stopped since disease eradication in 1979. That is why we want to share our unique, rich experience and acquired knowledge in the fight against this highly contagious and deadly disease during the smallpox outbreak in ex-Yugoslavia in 1972. It was the largest postwar outbreak in Europe when there were officially registered 175 ill patients, 35 of them with lethal outcome...
October 2016: Annali Dell'Istituto Superiore di Sanità
Carlo Petrini, Walter Ricciardi
Relations between ethics in general - and medical ethics in particular - and legal systems are complex and have been extensively examined in the literature. The topic is important not only for ethicists and jurists, but also for members of the public, who benefit from the services offered by the professions. While the Italian Institute of Health does not claim to propose new avenues for exploration of the relations between ethics and legal systems, it offers some food for thought in the ongoing debate.
October 2016: Annali Dell'Istituto Superiore di Sanità
Michele Santoro, Fabrizio Minichilli, Nunzia Linzalone, Alessio Coi, Maria Teresa Maurello, Domenico Sallese, Fabrizio Bianchi
INTRODUCTION: The association between reproductive health outcomes and exposure to municipal solid waste incinerators (MSWIs) is inconclusive. This study investigates the association between exposure to a MSWI and various reproductive outcomes (preterm birth, low birth weight, small for gestational age, and sex ratio), taking into account other sources of pollution (industrial plants, highway, major roads with high traffic flows) and maternal factors, including the socioeconomic status...
October 2016: Annali Dell'Istituto Superiore di Sanità
Claudia Esposito, Laura Pezzulo, Francesco Napolitano, Gabriella Di Giuseppe
INTRODUCTION: The aims of this study were to assess the levels of knowledge, attitudes and behaviors of pediatricians about melanoma and to estimate any variables associated with this outcome of interest. MATERIALS AND METHODS: A cross-sectional survey was conducted on a sample of pediatricians using a questionnaire sent by postal mail. RESULTS: 40.8% and 41.6% of pediatricians respectively stated that they "often" and "always" carried out a full skin examination during routine checkups of children...
October 2016: Annali Dell'Istituto Superiore di Sanità
Rita Maria Ferrelli, Dolores Mattossovich, Mervat El-Seweify, Nabil Dowidar
The Authors present the main activities and results of a Project financed by the Italian-Egyptian Debt Swap Agreement (IEDDS/DS) of the Italian Development Cooperation to repay public debt. The Health Governance Project operated within the Egyptian health reform paradigm and aimed at producing evidence for policy makers to direct and reorient the health sector and service management. It developed along three phases: i) preparatory training of trainers, ii) training in health governance according to modern andragogic methods, such as problem-based learning, iii) following implementation...
October 2016: Annali Dell'Istituto Superiore di Sanità
Franca Benini, Marcello Orzalesi, Anna de Santi, Sabrina Congedi, Pierina Lazzarin, Federico Pellegatta, Lucia De Zen, Marco Spizzichino, Enrico Alleva
INTRODUCTION: In recent years the emergence of new types of patient, clinical situations, technological frontiers and "health" objectives have changed considerably the needs of ill children, this also concerns pediatric palliative care (PPC). In Italy, despite the introduction of legislation (Law 38/2010) stipulating the right of children and families to access appropriate services for pain control and pediatric palliative care, the availability of these services is still limited. AIM: The aim of this study is to highlight, through a review of the existing data and published literature, the critical issues that obstacle the planning and development of PPC services in Italy...
October 2016: Annali Dell'Istituto Superiore di Sanità
Mariacarla Moleti, Giacomo Sturniolo, Francesco Trimarchi, Francesco Vermiglio
Iodine deficiency disorders (IDD) still represent a major public health problem, with almost 30% of the world population being exposed to the consequences of nutritional iodine deficiency (ID). In Italy, despite a sustained policy of iodine prophylaxis, more than 10% of people is still affected with goiter, and a presumably higher rate of subjects may suffer from minor cognitive deficits due to inadequate iodine supply during antenatal life. This review of systematic observational studies carried out over thirty-five years (1980-2015) in a sentinel ID area in North-eastern Sicily highlights the changing phenotypes of IDD in this region...
October 2016: Annali Dell'Istituto Superiore di Sanità
Carlo Corchia, Enrica Lapucci, Francesco Franco, Sara Farchi, Stavros Petrou, Domenico Di Lallo
OBJECTIVE: To investigate differences by gestational age in emergency department visits and re-hospitalizations during the three years following childbirth discharge. METHODS: We performed a historical cohort study in Lazio Region, Italy, for infants born in 2007-2008 to resident mothers. Health administrative data were used. Analysis was performed by multinomial logistic regression. RESULTS: Of 90 545 infants, more than 50% had at least one emergency department visit, and 18...
October 2016: Annali Dell'Istituto Superiore di Sanità
Benedetta Contoli, Patrizia Carrieri, Maria Masocco, Luana Penna, Alberto Perra
BACKGROUND: Italy is particularly concerned by population ageing. The costs for society are substantial. In this context a national, representative surveillance system, Passi D'Argento (PDA), was implemented in 2009 to monitor "active aging" and health status in people aged over 64 and to develop preventive health programs to reduce frailty. METHODS/DESIGN: PDA recruited a representative sample of 24 129 individuals (March 2012-January 2013) aged over 64 who were interviewed by trained staff using a standardized questionnaire...
October 2016: Annali Dell'Istituto Superiore di Sanità
Maria Mazzitelli, Giulio Caridà, Caterina Scigliano, Maria Concetta Vallone, Federico Pirrò, Maria Rita Lombardo, Giovanni Clemente, Federica Bernaudo, Maria Concetta Postorino, Alessio Strazzulla, Rosario Maselli, Carlo Torti
BACKGROUND: Continuous spreading of HIV infection may be due to lack of knowledge, especially among young people. It is important to monitor level of knowledge and risk behaviours especially in young people to set up appropriate preventative and informative campaigns. METHODS: We assessed knowledge of HIV infection and risk factors in a sample of students at the "Magna Graecia" University of Catanzaro, using an anonymous multiple-choice questionnaire. RESULTS: Two-hundred and sixteen medical students attending the first year at "Magna Graecia" University (age: 18-20 years) were prescribed an anonymous multiple-choice questionnaire...
October 2016: Annali Dell'Istituto Superiore di Sanità
Claudia Giacomozzi, Francesco Martelli
INTRODUCTION: The increasing spread of software components in the healthcare context renders explanatory guides relevant and mandatory to interpret laws and standards, and to support safe management of software products in healthcare. METHODOLOGY: In 2012 a working group has been settled for the above purposes at Italian Electrotechnical Committee (CEI), made of experts from Italian National Institute of Health (ISS), representatives of industry, and representatives of the healthcare organizations...
October 2016: Annali Dell'Istituto Superiore di Sanità
Daniela Marsili
Cross-disciplinary approaches to Global Environmental Health are essential to address environmental health threats within and beyond national boundaries, taking into account the links among health, environment and socio-economic development. The aim of this study is to present a cross-disciplinary approach where knowledge and findings from environmental epidemiology and social research are integrated in studying environmental health issues, focusing on environmental health inequities, public and environmental health literacy, and international scientific cooperation...
October 2016: Annali Dell'Istituto Superiore di Sanità
Paola De Castro, Roberto Pasetto, Daniela Marsili, Pietro Comba
The article focuses on the multidisciplinary nature of public health and the need to develop target oriented capacity building and dissemination plans taking into account both scientific evidence and the information needs of the different stakeholders. In particular, issues regarding stakeholders' involvement in epidemiological studies in contaminated sites, considering their different levels of awareness on risk characterization and management, are discussed. In a public health perspective, the main stakeholders in contaminated sites are researchers and public health officers, risk managers and policy makers, population residing in the contaminated areas, environmental associations, patient's organizations...
October 2016: Annali Dell'Istituto Superiore di Sanità
Francesca Romana Mancini, Luca Busani, Sabrina Tait, Cinzia La Rocca
Food may be contaminated with many chemical substances at any level along the production chain. Chemicals that may be found in food items can simultaneously be present in other matrices, as air, water, soil and dust; therefore, human exposure to chemicals via food has to be summed to the exposure through all the other possible routes. The role played by the food production chain with regard to the population exposure to chemicals assumes amplified proportions when considering contaminated sites. Indeed the link between environment and food production is undeniable and consequently, when population chemical exposure is considered, an integrated approach assessing the contribution of the different routes of exposure, including dietary exposure, is needed...
October 2016: Annali Dell'Istituto Superiore di Sanità
Fabiana Vanni, Federica Scaini, Eleonora Beccaloni
INTRODUCTION: In Italy, the current legislation for contaminants in soils provides two land uses: residential/public or private gardens and commercial/industrial; there are not specific reference values for agricultural soils, even if a special decree has been developed and is currently going through the legislative approval process. The topic of agricultural areas is relevant, also in consideration of their presence near potentially contaminated sites. Aim and results. In this paper, contamination sources and transport modes of contaminants from sources to the target in agricultural areas are examined and a suitable "conceptual model" to define appropriate characterization methods and risk assessment procedures is proposed...
October 2016: Annali Dell'Istituto Superiore di Sanità
Raúl Harari, Florencia Harari, Francesco Forastiere
INTRODUCTION: Nickel is a strong skin and respiratory sensitizer and a recognized carcinogen. Oil refineries are important sources of atmospheric emissions of toxic pollutants, including nickel. Populations residing close to oil refineries are at potential risk. The aim of this study was to evaluate the exposure to nickel in a population living close to the largest oil refinery in Ecuador, located in the city of Esmeraldas. METHODOLOGY: We recruited 47 workers from the oil refinery as well as 195 students from 4 different schools close to the plant and 94 students from another school 25 km far from the industry...
October 2016: Annali Dell'Istituto Superiore di Sanità
Carla Ancona, Lisa Bauleo, Giovanni Biscotti, Beatrice Bocca, Stefano Caimi, Fabio Cruciani, Sabrina Di Lorenzo, Morena Petrolati, Anna Pino, Giovanna Piras, Augusto Pizzabiocca, Silvia Rabbiosi, Flavia Ruggieri, Chelo Salatino, Alessandro Alimonti, Francesco Forastiere
BACKGROUND: The assessment of individual exposure to toxicants in industrially contaminated areas is difficult when multiple productions are active close to residential areas. Two thermoelectric power plants and a large harbor have been operating since the '60s in the area of Civitavecchia (North of Rome). METHODS: The ABC (Ambiente e Biomonitoraggio nell'area di Civitavecchia, Environment and Biomonitoring in Civitavecchia) program involved, in the period 2013-2014, residents in Civitavecchia and in the nearby municipalities (Santa Marinella, Allumiere, Tolfa and Tarquinia)...
October 2016: Annali Dell'Istituto Superiore di Sanità
Colin L Soskolne
This paper brings understanding to the ethical dimensions of human health research conducted in the context of contaminated sites. Principle-based ethical analysis, complemented with virtuous traits of character, aid in bringing clarity to recommendations for actions following research. Epidemiology is the discipline for conducting health research not only because of its methodological foundations, but also because of its social justice focus. Because contaminated sites include communities that have been exposed to excessive concentrations of hazardous substances, extra care is needed when using epidemiology...
October 2016: Annali Dell'Istituto Superiore di Sanità
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