Errata corrige: Pneumococcal Vaccination of Adults in Italy: What Strategies?

S. pneumoniae has been classified by the World Health Organization (WHO) as one of the 12 priority pathogens with the greatest global health impact. Although many individuals (approximately 20–30% of adults and nearly 40–50% of children) may carry the bacterium asymptomatically, certain groups are considered at higher risk of disease (non-invasive illnesses and invasive diseases). These include young children, the elderly and individuals who are immunocompromised or affected by pre-existing medical conditions. Italian surveillance data show a significant increase in Invasive Pneumococcal Disease (IPD) incidence in 2023 in comparison with 2021 and 2022, rising from 0.84 cases per 100,000 population in 2021 to 3.02 in 2023. The highest rates were observed in children under 1 year of age [10.41/100,000 (2023)] and in adults aged 65 and over (7.45/100,000 in 2023 compared with 2.11 in 2021 and 4.49 in 2022). Surveillance systems and epidemiological studies on the global distribution of the different pneumococcal serotypes associated with disease continue to be essential to determining which serotypes to include in new vaccines, in order to produce preparations capable of preventing an increasing number of cases, hospitalizations, sequelae and deaths. A milestone in pneumococcal vaccination was the development of conjugate vaccines (PCVs), which started in the 2000s. The first PCV, which covered seven serotypes (PCV7: 4, 6B, 9V, 14, 18C, 19F, and 23F), was introduced in Italy in 2005 for the pediatric population. The introduction of this vaccination strategy leading to a significant reduction in disease among children and an overall decline in the pneumococcal disease burden across all age-groups. However, an increase in disease caused by serotypes not included in PCV7 was observed. This phenomenon, named serotype replacement, led to the development of higher-valency conjugate vaccines. In 2010, the 13-valent pneumococcal vaccine (PCV13) and 10-valent pneumococcal vaccine (PCV10) were approved. However, the phenomenon of serotype replacement continued to be observed, and consequently, the need for broader-spectrum vaccines remained a public health priority. In 2021 and 2022 PCV15 (serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F and 33F) and PCV20 (serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F and 33F) were authorized for immunization in individuals aged ≥18 years, respectively. In March 2025, the use of a new 21-valent pneumococcal vaccine was approved (serotypes: 3, 6A, 7F, 19A, 22F, 33F, 8, 10A, 11A, 12F, 9N, 17F, 20, 15A, 15C, 16F, 23A, 23B, 24F, 31 and 35B) and it included some serotypes particularly aggressive or emerging. Maximizing the effectiveness of a vaccination program in combating diseases related to S. pneumoniae is based on the integration of three key elements: epidemiological need, immunological need and vaccine compliance. From an epidemiological perspective, the 2023 specific data analysis reveals that, out of 1,783 cases, 734 involved individuals over the age of 64 (41.2%). The estimated global coverage with the PCV20 vaccine would be 63.6%, while with the PCV21 vaccine it would be 76.4%. The specific analysis of the most recent available data (1st half of 2024) reveals that a total of 1,152 cases were reported, 58.4% of which occurred in individuals over 64. If only the data referring to subjects over the age of 64 are analyzed, the estimated coverage becomes 72.1% for PCV20 and 79.2% for PCV21. From an immunological standpoint, the vaccine of choice should induce an immune response that is at least non-inferior to the comparator, and ideally, more robust and long-lasting. Regarding compliance, all possible strategies must be activated in order to raise public awareness of the risks of pneumococcal disease and the benefits of vaccination, so as to increase coverage rates. A thorough analysis of epidemiological and clinical data, combined with an assessment of the economic and social impact, is crucial to guiding vaccination policies and supporting efficient decision-making in order to protect the health of the entire population

The Role of SGLT2 Inhibitors in Preventing the Progression of Chronic Kidney Disease in Patients with Type 2 DM: A Systematic Review

Background. Type 2 diabetes mellitus is the most common type of diabetes and is the leading cause of chronic kidney disease globally. Currently, the medications recommended for treatment are not fully effective for treating CKD. Recent findings from the DAPA-CKD and EMPA-KIDNEY clinical trials have revealed that SGLT-2 inhibitors offer significant benefits in improving kidney function and preventing the progression of kidney disease. Objective. This review aims to evaluate the efficacy and safety of SGLT2 inhibitors in delaying CKD progression and reducing dialysis dependency in patients with type 2 diabetes. Methods. This research is a systematic literature study using PRISMA 2020 Protocols. Article searches were carried out in PubMed, Cochrane Library, Sage Journals, and Europe PMC, covering the period from January 2019 to March 2024. The search strategy used the keywords “SGLT2 Inhibitor” AND “Prevention” AND “Chronic Kidney Disease” AND “Type 2 Diabetes”. Articles that met the criteria were assessed for risk of bias using RoB2. Results. From 7 articles with a total of 15,927 participants included in this systematic review, the overall risk of bias was low. Patients with type 2 diabetes and CKD who received SGLT2 inhibitors had a significantly lower risk of renal composite outcomes compared to placebo (e.g. HR 0.70, 95% CI 0.59-0.82). A modest initial decrease in eGFR was observed in the SGLT2i group compared to placebo, followed by stabilization over time. Conclusion. SGLT2 inhibitors can be proposed as an effective treatment option for renal protection in patients with type 2 diabetes mellitus and chronic kidney disease, with moderate certainty of evidence from consistent RCT finding

Cardiovascular risk in seasonal migrant workers in Southern Italy: clinical-epidemiological evaluation

Introduction. As part of the GOV.E.R.NI projects (Effective Government in Reports for New Integrations) and Più Su.Pr.Eme, project that is part of the three-year plan to combat labor exploitation in agriculture and the caporalato approved within the specific Caporalato Table promoted by the Directorate General for Immigration of the Ministry of Labor and Social Security with the aim of combating and overcoming all forms of serious labor exploitation and serious marginality and vulnerability of migrant workers in the territories that present the most critical issues in Southern Italy. The research institute FARBAS has carried out health surveillance activities on migrant workers in Basilicata with the aim of assessing the state of health and conditions that may put the health of workers at risk. Materials and Methods. The epidemiological study concerns the analysis and study of data obtained from a cohort of 135 migrant workers hosting in two reception centers located in the territory of Basilicata (Italy) who have voluntarily joined the health screening activities by means of electrocardiogram examination, spirometry tests, blood pressure measurement and physiological and pathological history. Enlisted come from 12 Central African countries, with a mean age of 37.08 ± 9.8, of male gender. Results. Analysis of clinical and instrumental data shows that 51.1 % of patients have higher than optimal blood pressure values; 42.2 % have higher than normal systolic blood pressure values, 11.1% have above-normal diastolic blood pressure values. From the analysis of the data obtained from the instrumental examinations it is clear that 20% of the subjects present an electrocardiogram indicating a pathological alteration and 14% of the population present an altered spirometry trace attributable to a pathological state. 64% of the population has a normal BMI, the overweight rate is 30.8 % while 1.5% has grade I obesity and the remaining 3.7 % is underweight. Discussion and conclusion. The study shows a significant prevalence of arterial hypertension, cardiovascular disease and pathological changes in the respiratory system. In particular, the presence of risk factors such as high blood pressure associated with work factors such as maintaining difficult postures and working in the presence of heat represent a high risk to the health of seasonal workers working in the field of tomato harvesting in Southern Italy [1]. Future public health and preventive medicine actions should be geared towards precision health surveillance that can control, manage and reduce this risk to the health of workers

Trends in Adolescent Mental Wellbeing in an Italian sample from 2004 to 2022 (HBSC Study): Gender, Age, and Socioeconomic Difference

Introduction. There is an increasing discussion about the decline in adolescent mental well-being over time, but existing literature provides limited data on this trend. The aim of our study is to examine how the mental health of Tuscan adolescents aged 11-13 and 15 years may have changed over the years. Additionally, we seek to investigate the influence of factors such as gender, age, and socioeconomic status on these changes. Method. We analyzed data representative of the Tuscan region, collected from 18,439 adolescents through six rounds of the Health Behaviour in School-aged Children (HBSC) surveys conducted in 2004, 2006, 2010, 2014, 2018, and 2022. Hierarchical regression models were used to assess regional trends in adolescents’ mental well-being, considering life satisfaction, psychological and somatic symptoms, and to evaluate how age, gender, and socioeconomic status might moderate these trends. Results. In all survey years (except 2004), girls consistently reported higher levels of psychological and somatic complaints and lower life satisfaction compared to boys. Trend analysis from 2004 to 2022 showed a steady decline in all measured areas: life satisfaction, psychological complaints, and somatic complaints. Generally, older adolescents reported lower life satisfaction and higher levels of psychological and somatic symptoms. Conclusion. Our findings indicate that the gender gap in mental well-being appears to be widening over time, whereas differences related to age and socioeconomic status have remained relatively stable. It is therefore crucial to pay increased attention, especially considering the potential impacts of the COVID-19 pandemic on adolescent mental healt

Association between blood pressure and waist-to-height ratio in schoolchildren aged 6 to 8 years in the Valparaíso Region, Chile

Background. Hypertension is a serious obesity-related disease that affects the paediatric population. Objective: To examine the positive association between systolic and diastolic blood pressure and waist-to-height ratio in schoolchildren Methods: Cross-sectional study. Convenience sample of 300 schoolchildren aged 6 to 8 years from Valparaíso. Blood pressure, waist circumference and height were evaluated. Data were collected in non-consecutive years (2015, 2018, 2019, 2022) due to logistical constraints. Blood pressure was assessed according to the criteria of the American Academy of Pediatrics (2017). Statistical analysis: Results were expressed as mean, 95% confidence interval (95% CI) for quantitative variables and qualitative variables were expressed in absolute (n) and relative (%) frequencies. Normality was verified with the Shapiro Wilk test (p > 0.05). Associations were made between altered blood pressure and anthropometric variables (BMI, waist circumference, nutritional status) using the Proportion test and Chi Square test. Three different models were developed to determine the association between altered BP with WHR, WC and NS, adjusting for age in all models. Results. A significant positive association was found between systolic blood pressure and waist-to-height ratio (p = 0.0073). Conclusion. Higher WHR is associated with increased blood pressure, highlighting its potential as a screening tool for metabolic ris

The digital tether: a SA-SV based survey on smartphone addiction among young adults in Southern Italy

Introduction. In the post-pandemic era, smartphone usage has surged globally, particularly among young adults. While these devices offer convenience and connectivity, their excessive use has raised concerns about behavioral addiction and psychological well-being. This study investigates the prevalence of problematic smartphone use among young adults in Southern Italy, focusing on usage patterns and socio-demographic correlations. Methods. A cross-sectional survey was conducted between March and June 2025 using an anonymous online questionnaire. The instrument combined ad hoc questions on lifestyle and digital habits with the validated Smartphone Addiction Scale-Short Version (SAS-SV). Participants aged 18-40 were recruited primarily from Sicily and Calabria via university and community networks. Data were analyzed using non-parametric statistical tests and chi-square analysis. Results. The final sample included 451 respondents (average age: 22.42 years), predominantly Italian and non-working students. The SAS-SV identified smartphone addiction in 21.3% of participants, with no significant gender differences. Most users engaged with smartphones for leisure, social media, and entertainment. Significant associations were found between SAS scores and variables such as region, education level, and income. Notably, higher scores correlated with emotional reliance on smartphones and difficulty disengaging from use. Conclusion. Problematic smartphone use affects over one-fifth of young adults in Southern Italy, driven more by app features than screen time alone. These findings underscore the need for targeted public health strategies, including early screening and behavioral interventions, to address digital dependency and promote healthier technology habits in this demographi

Implementing surveillance in territorial healthcare facilities: a proposal from ASST Nord Milano (Italy)

Not applicable (Letter