Immunisation registers in Italy: a patchwork of computerisation

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Early Warning Systems for Emerging Profiles of Antimicrobial Resistance in Italy: A National Survey

Antimicrobial resistance (AMR) national surveillance systems in Italy lack alert systems for timely detection of emerging profiles of AMR with potential relevance to public health. Furthermore, the existence of early warning systems (EWS) at subnational level is unclear. This study aims at mapping and characterizing EWS for microbiological threats available at regional level in Italy, focusing on emerging AMR, and at outlining potential barriers and facilitators to their development/implementation. To this end, a three-section, web-based survey was developed and administered to all Italian regional AMR representatives from June to August 2022. Twenty out of twenty-one regions and autonomous provinces (95.2%) responded to the survey. Among these, nine (45%) reported the implementation of EWS for microbiological threats at regional level, three (15%) reported that EWS are in the process of being developed, and eight (40%) reported that EWS are not currently available. EWS characteristics varied widely among the identified systems concerning both AMR profiles reported and data flow: the microorganisms most frequently included were extensively drug-resistant (XDR) Enterobacterales, with the lack of a dedicated regional IT platform reported in most cases. The results of this study depict a highly heterogeneous scenario and suggest that more efforts aimed at strengthening national AMR surveillance systems are needed

Burden of acute otitis media in primary care pediatrics in Italy: A secondary data analysis from the Pedianet database

Background: The incidence of acute otitis media (AOM) vary from country to country. Geographical variations together with differences in study designs, reporting and settings play a role. We assessed the incidence of AOM in Italian children seen by primary care paediatricians (PCPs), and described the methods used to diagnose the disease.Methods: This secondary data analysis from the Pedianet database considered children aged 0 - 6 years between 01/2003 and 12/2007. The AOM episodes were identified and validated by means of patient diaries. Incidence rates/100 person-years (PY) were calculated for total AOM and for single or recurrent AOM.Results: The 92,373 children (52.1% males) were followed up for a total of 227,361 PY: 23,039 (24.9%) presented 38,241 episodes of AOM (94.6% single episodes and 5.4% recurrent episodes). The total incidence rate of AOM in the 5-year period was 16.8 episodes per 100 PY (95% CI: 16.7-16.9), including single AOM (15.9 episodes per 100 PY; 95% CI: 15.7-16.1) and recurrent AOM (0.9 episodes per 100 PY; 95% CI: 0.9-0.9). There was a slight and continuously negative trend decrease over time (annual percent change -4.6%; 95%CI: -5.3, -3.9%). The AOM incidence rate varied with age, peaking in children aged 3 to 4 years (22.2 episodes per 100 PY; 95% CI 21.8-22.7). The vast majority of the AOM episodes (36,842/38,241, 96.3%) were diagnosed using a static otoscope; a pneumatic otoscope was used in only 3.7%.Conclusions: Our data fill a gap in our knowledge of the incidence of AOM in Italy, and indicate that AOM represents a considerable burden for the Italian PCP system. Educational programmes concerning the diagnosis of AOM are needed, as are further studies to monitor the incidence in relation to the introduction of wider pneumococcal conjugate vaccines

Association of Variants at UMOD with Chronic Kidney Disease and Kidney Stones—Role of Age and Comorbid Diseases

Chronic kidney disease (CKD) is a worldwide public health problem that is associated with substantial morbidity and mortality. To search for sequence variants that associate with CKD, we conducted a genome-wide association study (GWAS) that included a total of 3,203 Icelandic cases and 38,782 controls. We observed an association between CKD and a variant with 80% population frequency, rs4293393-T, positioned next to the UMOD gene (GeneID: 7369) on chromosome 16p12 (OR = 1.25, P = 4.1×10−10). This gene encodes uromodulin (Tamm-Horsfall protein), the most abundant protein in mammalian urine. The variant also associates significantly with serum creatinine concentration (SCr) in Icelandic subjects (N = 24,635, P = 1.3×10−23) but not in a smaller set of healthy Dutch controls (N = 1,819, P = 0.39). Our findings validate the association between the UMOD variant and both CKD and SCr recently discovered in a large GWAS. In the Icelandic dataset, we demonstrate that the effect on SCr increases substantially with both age (P = 3.0×10−17) and number of comorbid diseases (P = 0.008). The association with CKD is also stronger in the older age groups. These results suggest that the UMOD variant may influence the adaptation of the kidney to age-related risk factors of kidney disease such as hypertension and diabetes. The variant also associates with serum urea (P = 1.0×10−6), uric acid (P = 0.0064), and suggestively with gout. In contrast to CKD, the UMOD variant confers protection against kidney stones when studied in 3,617 Icelandic and Dutch kidney stone cases and 43,201 controls (OR = 0.88, P = 5.7×10−5)

Uso del láser en urgencias por periodontitis apical post tratamiento endodóntico

Introduction: Laser therapy and stimulation of the acupuncture points are anti-inflammatory and analgesic alternative treatments in dentistry.Objective: to describe the use of low power laser therapy in the emergency treatment of apical periodontitis after endodontic treatment during 2018.Methods: observational, descriptive, longitudinal, and prospective study of patients who attended emergency department at Guama Dentistry Clinic during 2018, Pinar del Río, presenting apical periodontitis after endodontic treatment; 86 patients participated in the study. Descriptive statistics was applied, respecting the bioethical principles.Results: female gender predominated (53,49 %), apical periodontitis after endodontic treatment was more prevalent in the age group 20-24 (30,23 %); 65,5 % of the patients presented remission and relief after the third treatment session. Only 2,33 % needed more than six treatment sessions.Conclusions: apical periodontitis after endodontic treatment is more common in women during the first half of the second decade of life. The treatment showed effectiveness from the first treatment sessions.Introducción: la terapia y estimulación con láser en puntos acupunturales constituyen alternativas de tratamiento antiinflamatorio y analgésico en estomatología.Objetivo: describir el uso de la terapia láser de baja potencia en el tratamiento de urgencias por periodontitis apical post tratamiento endodóntico durante el 2018.Método: estudio observacional, descriptivo, longitudinal y prospectivo en pacientes que acudieron a la consulta de urgencias de la Clínica Estomatológica “Guamá’’, municipio Pinar del Río, en el período durante el año 2018, por presentar periodontitis apical post tratamiento endodóntico. El universo estuvo constituido por 86 pacientes trabajándose con la totalidad. Se empleó estadística descriptiva y se siguieron los principios bioéticos.Resultados: predominó el sexo femenino (53,49 %), donde la periodontitis apical post tratamiento endodóntico se presentó en mayor cuantía en el grupo etario de 20 a 24 años de edad (30,23 %). El 65,5 % de los pacientes presentaron remisión y alivio tras la tercera sesión de tratamiento. Solo el 2,33 % necesitó más de seis sesiones de tratamiento.Conclusiones: la periodontitis apical post tratamiento endodóntico se presentan en mayor cuantía en las féminas, durante la primera mitad de la segunda década de vida. El tratamiento con terapia laser de baja frecuencia mostró efectividad desde las primeras sesiones de tratamiento