Lactose intolerance assessed by analysis of genetic polymorphism, breath test and symptoms in patients with inflammatory bowel disease

Many patients with inflammatory bowel disease (IBD) restrict dairy products to control their symptoms. The aim of the study was to investigate the prevalence of lactose intolerance assessed with hydrogen breath test (H-BT) in IBD patients in clinical remission compared to a sex, age and BMI matched control population. We further detected the prevalence of three single nucleotide polymorphisms of the lactase (LCT) gene: the lactase non persistence LCT-13910 CC (wildtype) and the intermediate phenotype LCT-22018 CT and LCT-13910 AG; finally, we assess the correlation between genotype and H-BT. A total of 54 IBD patients and 69 control who underwent clinical evaluation, H-BT and genetic test were enrolled. H-BT was positive in 64.8% IBD patients and 62.3% control (p = 0.3). The wild-type genotype was found in 85.2% IBD patients while CT-22018, AG-13910 and CT-22018/AG-13910 polymorphisms were found in 9.3%, 1.8% and 3.7%. In the control group, the wild-type genotype, CT-22018, AG-13910 and CT-22018/AG-13910 polymorphisms were found in 87%, 5.8%, 5.8% and 1.4% of cases, respectively. Therefore, the wild-type and polymorphisms’ prevalence did not differ between IBD population and control group (85.2% vs. 87%, p = 0.1) (14.8% vs. 13%, p = 0.7). The correlation between positive H-BT and genetic analysis showed that the wild-type genotype was associated with higher rate of lactose intolerance in the total population (OR 5.31, 95%CI 1.73–16.29, p = 0.003) and in the IBD (OR 7.61, 95%CI 1.36–42.7, p = 0.02). The prevalence of lactose intolerance in IBD patients did not differ from that of control. Despite suggestive symptoms, about 1/3 of IBD patients are not lactose intolerant, thus not needing “a priori” elimination diet. This may encourage a rationale and balanced dietary management in IBD

CONSAPEVOLEZZA ED ATTENDIBILITÀ DELLO STATO VACCINALE SELF REPORTED IN UN CAMPIONE DI STUDENTI DELLA SCUOLA MEDIA.

vaccinazioni; studenti; educazione sanitari

Promote immunization among high school students: the school-based project “VacciniAmo le Scuole”

The Italian vaccination calendar recommends some vaccinations to adolescents, which often represent a difficult target for immunization campaigns. Without adequate health education they could remain unaware or be misinformed and miss their opportunity. The “VacciniAmo le Scuole” project (“let's vaccinate the School”) aimed at evaluating and enhancing students’ knowledge and attitudes regarding vaccine-preventable diseases. Students of 4 Italian secondary schools fulfilled a questionnaire before and after they attended a health promotion intervention (“vaccination day”) carried out by public health specialists, coming from both University and Local Health Authorities (LHA). Each class received a 90 minutes intervention that was divided into a first theoretical part and a second one more practical (using role-play). Later, each LHA arranged to receive students in their surgery to carry out recommended vaccinations or give specific information (“Vaccine day”). 22 vaccination days involving 680 pupils were carried out. Students showed a significant mean improvement in their knowledge of vaccinations (mean pre-post difference = 2.9±0.2, p < 0.01) and a small but significant step towards the maximum self-perceived importance of vaccination (mean pre-post difference = 0.4±0.2, p < 0.01). Few students (5%) participated in one of the 13 Vaccine days, but within 6 months since the “vaccination day” 178 of the involved students went to their ASL to get vaccines or information. The study highlights a significant amelioration in students’ knowledge and attitude towards vaccine-preventable diseases. Considering the importance of informing and educating, especially in this field, role-play could represent an excellent and innovative way of imparting the best knowledge available to young students. The responsiveness to the dedicated Vaccine days has been below the expectations. Key messages: Our results suggest that role-play can be a successful teaching method in secondary schools enabling students to practise through simulation what they have learned The vaccine supply out of the school context could have limited the efficacy of the intervention. Better results could be reach offering the vaccination in school facilitie

IL ROLE PLAY AL SERVIZIO DELLA PROMOZIONE DELLA SALUTE TRA GLI STUDENTI DELLE SCUOLE MEDIE: IL PROGETTO PILOTA “VACCINIAMO LE SCUOLE”.

Role play; promozione salute; vaccinazion