QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study

Background: healthcare workers (HCWs) are at higher risk of being exposed to tuberculosis (TB). The aim of this study was to estimate LTBI prevalence and evaluate associated risk factors among Italian HCWs using a new generation IGRA test, Quantiferon Plus (QTF-Plus), providing also an analytical evaluation of this test. Methods: this cross-sectional study was conducted during the annual health surveillance program performed in 2017, evaluating 1470 HCWs of a teaching hospital in Rome, tested with QTF-Plus. A standardized questionnaire was collected for multivariate risk analysis. The independent variables associated with a higher frequency of LTBI were tested in a multivariate logistic regression model. Results: LTBI was diagnosed in 50 out of 1470 (3.4%) of HCWs. The male gender and age>40 years were significantly associated with the risk of LTBI. The levels of interferon-γ were significantly lower in subjects with a recent conversion than in those with an older positivity. Moreover, interferon-γ values exceeding 8 IU/ml were recorded in 8 out of 35 remote subjects but in no recent subjects. The concordance between TB1 and TB2 results was 88%, while in 6 out of 50 subjects we found a discrepancy. Conclusion: the LTBI condition among Italian HCWs was very low. In subjects with discordant outcomes between TB1 and TB2, especially when the test values are close to the cut-off, is recommended a repetition of the test to confirm its positivity. Key words: tuberculosis, latent tuberculosis infection, interferon-gamma release assay, quantiferon plus, healthcare worker

Relationship between the night shift work and thyroid disorders: A systematic review and meta-analysis

AbstractObjectives. The night shift workers were reported to have health consequences, ranging from mild, as cluster headache, to severe, as heart attacks and hormonal irregularities. This study is aimed to perform a systematic review and meta-analyze of the association between the night shift work and the thyroid disorders.Methods. We comprehensively searched eight databases, including PubMed and Google Scholar for the relevant articles. This systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement.Results. We finally included six papers involving 4074 participants. Four papers were eligible for meta-analysis involving 1864 night shift workers and 2017 day shift workers. We against found that thyroid stimulating hormone (TSH) is significantly higher in the night shift group compared to the day shift group.Conclusions. The higher TSH among the night shift workers is attributed to disruption of the circadian rhythm and sleep/wake cycle, with subsequent eating disorders. We proposed that more attention should be paid to the working pattern and the related health consequences

Risk of latent tuberculosis infection among healthcare workers in Italy: a retrospective study with Quantiferon Test

OBJECTIVE. The latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation by Mycobacterium Tuberculosis antigens without clinical manifestation: the healthcare workers (HCWs) have a higher exposure risk so prevention is an important challenge for occupational medicine. The aim of our study is to evaluate the prevalence of LTBI among HCWs of the Foundation Policlinic “Tor Vergata”. METHODS. This is a retrospective study conducted by analyzing the clinical records of 825 HCWs of the PTV, from January 1st to December 31th 2016. To evaluate the TB infection we used the Quantiferon TB Gold interferon-gamma release assay. RESULTS. Our study underline the low prevalence of LTBI in the Italian healthcare workers. CONCLUSION. Although the LTBI status is not contagious, the diagnosis and the safety strategies require specific clinical and preventive considerations

Chemical, Physical and Biological Approaches to Prevent Ochratoxin Induced Toxicoses in Humans and Animals

Ochratoxins are polyketide derived fungal secondary metabolites with nephrotoxic, immunosuppressive, teratogenic, and carcinogenic properties. Ochratoxin-producing fungi may contaminate agricultural products in the field (preharvest spoilage), during storage (postharvest spoilage), or during processing. Ochratoxin contamination of foods and feeds poses a serious health hazard to animals and humans. Several strategies have been investigated for lowering the ochratoxin content in agricultural products. These strategies can be classified into three main categories: prevention of ochratoxin contamination, decontamination or detoxification of foods contaminated with ochratoxins, and inhibition of the absorption of consumed ochratoxins in the gastrointestinal tract. This paper gives an overview of the strategies that are promising with regard to lowering the ochratoxin burden of animals and humans

Valutazione della funzione sisto-diastolica ventricolare sinistra in soggetti con diabete mellito di tipo II. Studio ecocardiografico mediante 2D Strain.

Indipendentemente dalla gravità della malattia coronarica, i pazienti diabetici hanno un maggior rischio di sviluppare insufficienza cardiaca. Sebbene la cardiopatia ischemica rappresenti una delle principali cause di morbilità e mortalità nei pazienti diabetici, numerosi studi hanno comprovato che nel diabete esiste anche una peculiare disfunzione ventricolare sinistra sistolica e diastolica definita come “cardiomiopatia diabetica”. Questa può essere definita come un’entità caratterizzata dai cambiamenti diabete-associati nella struttura e funzione del miocardio non direttamente attribuibili ad altri fattori confondenti come la malattia coronarica o l’ipertensione. Anche se una serie di metodi di diagnosi può aiutare a caratterizzare le alterazioni della funzione cardiaca in generale, fino ad ora nessuno si è dimostrato specifico per tali alterazioni nel diabete. In questo lavoro, per valutare la funzione globale, complessiva del ventricolo sinistro, sono stati impiegati due indici che valutano la deformazione e la velocità di deformazione miocardica, rispettivamente lo Strain e lo Strain Rate. Scopo di questo studio è stato, pertanto, quello di valutare la presenza di eventuali precoci alterazioni miocardiche funzionali (sisto-diastoliche), mediante l’uso del 2D STRAIN, in pazienti asintomatici con diabete mellito di tipo II in buon controllo metabolico e in assenza di complicanze croniche

Pre-vaccination IgG screening for mumps is the most cost-effectiveness immunization strategy among Health Care Workers

Health Care Workers (HCWs) have an increased risk of contracting contagious disease, including mumps. In January 2017 the Italian National Vaccine Prevention Plan 2017–2019, recommended the administration of a dose of MMR vaccine (Measles-Mumps-Rubella) to the Health Care Workers (HCWs) that, working in a risky environment, did not carry out the complete vaccination cycle of MMR or that are seronegative for at least one of the three vaccine viruses. In October of the same year, the Advisory Committee on Immunization Practices (ACIP) recommended a third dose of a vaccine containing Mumps Virus for people previously vaccinated with 2 doses, belonging to a group or to a population at increased risk of acquire mumps in the event of an epidemic. We analyzed the clinical records and values of mumps-specific IgG antibodies of 3032 HCWs (mean age 32.80 ± 10.75 years), that underwent occupational health surveillance between January 1st 2017 and March 31th 2018. The HCWs were also screened for measles, rubella, mumps using serological methods. 13% (405) was seronegative for mumps, especially among HCWs between 18 and 36 years. We calculated the cost-effectiveness of two-doses and three-doses MMR vaccination. The cost of vaccination without screening was significantly more expensive (cost difference: 99 712 € and 184 996 €) both in case of two-dose and three-dose MMR vaccination respectively. Our study suggests that, in HCWs, the assessment of the mumps antibody titer before vaccination may be a useful complement to vaccination itself, because it is more accurate and cost-effective than direct immunization of unvaccinated subjects

Esposizione occupazionale ad atmosfere iperbariche: aggiornamenti in tema di fisiopatologia

Aggiornamento in termini di fisiopatologia dell'esposizione professionale ad atmosfere iperbariche al fine di definire protocolli di sorveglianza sanitaria mirata

Seroprevalence survey for Varicella among healthcare workers and medical students in Italy

Varicella is a potentially serious infectious disease caused by Varicella-Zoster Virus (VZV). In Italy childhood varicella vaccine have gradually introduced into national immunization program since 2003 and from 2017 a two-doses schedule has been stated nationally for all newborns and has become compulsory for school attendance. VZV exposures among healthcare workers (HCWs) and patients can be really dangerous and expensive. According to Centers of Disease Control and Italian national immunization plan health care, institutions should verify that all HCWs have clear evidence of immunity to VZV and should ensure that susceptible subjects will receive 2 doses of VZV vaccine. Currently, the vaccination of HCWs is not compulsory in Italy and the risk of varicella infection among these subjects is not well known. We evaluated the clinical records of 840 HCWs (256 male and 584 female) who underwent the annual occupational screening, from 1st January to 31st August 2018. HCWs were divided into three subgroups according to their age: 18–30, 31–40, and over 40 years old. We compared the mean values of IgG-specific antibodies between the age group through analysis of variance (ANOVA). A total of 784 (93.33%) HCWs were protected for VZV IgG antibodies level. There wasn’t a significant difference between male and female while was found between age group (P < 0.001). Protection levels for varicella are inadequate among HCWs. Despite the epidemiology of varicella in general population has changed with the implementation of the childhood varicella vaccination program transmission of VZV in hospitals is still a serious problem, so it is necessary to increase prevention activities in these settings, including vaccination

Expression of the retinoblastoma-related gene Rb2/p130 correlates with clinical outcome in endometrial cancer.

Purpose: The retinoblastoma gene is the prototype of tumor-suppressor genes and has been shown to be involved in the pathogenesis and progression of several human malignancies. In this study, we determined the relation between the expression of a newly discovered retinoblastoma-related gene Rb2/p130 and outcome in patients with endometrial carcinoma. Patients and Methods: pRb2/p130 expression was determined immunohistochemically in specimens of endometrial carcinoma (stages I to IV) from 100 patients who underwent surgery as the first treatment. The pRb2/p130 status was analyzed in relation to the length of disease-free survival and disease-specific survival. Results: Decreased levels of pRb2/p130 in endometrial cancer cells was significantly associated with a decreased probability of remaining disease-free after treatment (P = .003) and with decreased probability of survival (P < .0001). In a multivariate analysis, pRb2/p130 status (P = .004), tumor stage (P = .009), and ploidy status (P = .02) were independent predictors of clinical outcome. The risk of dying of disease was increased substantially (risk ratio, 4.91; 95% confidence interval, 1.66 to 14.54) among patients with decreased levels of pRb2/p130 in tumor cells. Conclusion: In patients with endometrial carcinoma who did not receive radiotherapy or chemotherapy before surgery, the presence of decreased levels of pRb2/p130 in tumor cells is associated with a significantly increased risk of recurrence and death of disease, independent of tumor stage and ploidy status