Riemergenza del poliovirus ed implicazioni per la vaccinazione anti-poliovirus in Italia

Nel 1988, l\u2019Organizzazione mondiale della Sanit\ue0 (OMS) ha approvato il piano di eradicazione mondiale della poliomielite con l\u2019obiettivo di annullare la circolazione del virus a partire dall\u2019anno 2000. Tale target, per motivi economici, organizzativi, culturali, bellici e financo religiosi, \ue8 stato successivamente spostato in avanti negli anni fino a giungere attualmente al 2015. A seguito di questo impegno, negli anni si \ue8 registrata una riduzione dell\u2019incidenza di poliomielite di oltre il 99%, passando dai 350.000 casi annui di polio paralitica documentati nel 1988 in 125 paesi, alle poche centinaia di casi riscontrati nel 2013 sia negli ultimi 3 paesi endemici (Nigeria, Afghanistan, Pakistan) sia in paesi polio-free spesso confinanti con quelli endemici ed interessati da un corollario di epidemie di dimensioni variabili

Decline in hospitalization rates for herpes zoster in Italy (2003–2018): reduction in the burden of disease or changing of hospitalization criteria?

Background: Herpes Zoster (HZ) is a very demanding disease caused by the reactivation of latent Varicella Zoster Virus. The main aim of this study was to estimate the burden of the HZ hospitalizations in Italy from 2003 to 2018 evaluating temporal trends. Methods: Retrospective population-based study analyzing Hospital Discharge Records. Hospitalization records reporting the ICD-9 CM 053.X code in the principal diagnosis or in any of the five secondary diagnoses were considered as cases. Trends of hospitalization rates have been evaluated by Joinpoint analyses. Results: Overall, 99,036 patients were hospitalized with HZ in the 16-year period of the study, and 83,720 (84.5%) of these patients were over 50 years. Hospitalization rate was 10.4 per 100,000 persons/year with a significant decreasing trend from 13.9 in 2003–2006 to 7.8 in 2015–2018 (p < 0.001). Hospitalization rates showed a 20-fold higher risk among subjects aged over 80 years and 11-fold higher risk among 70–79-year-old subjects with respect to those aged less than 50 years. Over time, a statistically significant increase was observed for the case fatality rate (from 1.2 to 1.7%; p < 0.001) and the median length of stay (from 7 to 8 days; p < 0.001). Conclusions: Zoster is a disease that causes hospitalization as relatively frequent complication and the observed reduced trend over time could be due to a restriction in hospitalization criteria instead of a reduced burden of disease. The decreasing trend should be carefully interpreted, since it could have an impact on promoting herpes zoster vaccination

Children's exposure to Di(2-ethylhexyl)phthalate and dibutylphthalate plasticizers from school meals.

Packed school meals for children 310 years old were studied to evaluate the levels of di(2-ethylhexyl)phthalate (DEHP) and di-n-butylphthalate (DBP) and the influence of the packaging process on meal contamination, and their contribution to daily intake was estimated. The packaging consisted of polyethylene-coated aluminum (PE/Al) dishes thermally welded by a polyethyleneterephthalate-coated aluminum (PET/Al) foil. Foodstuffs before processing were analyzed, too. Total meals before packaging and after packaging were collected. It was found that 92% of foodstuffs employed in meal preparation contained DEHP, and 76% of them DBP, at detectable levels. In cooked foods before packaging the DEHP median concentration levels varied from 111.4 to 154.8 ng/g ww and those of DBP between 32.5 and 59.5 ng/g ww. In packed meals the DEHP median values ranged from 127.0 to 253.3 ng/g ww, and DBP median values varied from 44.1 to 80.5 ng/g ww. The mean increases of median concentrations of DEHP in cooked foods before and after packaging were 113 and 125% for DBP

Evaluation of the burden of HPV-related hospitalizations as a useful tool to increase awareness: 2007–2017 data from the sicilian hospital discharge records

In light of the implementation of human papillomavirus (HPV) prevention strategies, epidemiological studies in different geographical areas are required in order to assess the impact of HPV-related diseases. The purpose of the present study was to describe the burden of HPV-related hospitalizations in Sicily. A retrospective observational study estimated 43,531 hospitalizations attributable to HPV from 2007 to 2017. During the observed period, there was a decrease for all HPV-related conditions with a higher reduction, among neoplasms, for cervical cancer (annual percent change (APC) = −9.9%, p < 0.001). The median age for cervical cancer was 45 years old, with an increasing value from 43 to 47 years (p < 0.001). The age classes with greater decreases in hospital admissions for invasive cancers were women aged 35 years or more (APC range from −5.5 to −9.86) and 25–34 years old (APC = −11.87, p < 0.001) for women with cervical carcinoma in situ. After ten years for vaccine introduction and sixteen years for cervical cancer screening availability, a relatively large decrease in hospital admissions for cervical cancer and other HPV-related diseases in Sicily was observed. Some clinical characteristics of hospitalization, such as increasing age, are suggestive clues for the impact of preventive strategies, but further research is needed to confirm this relationship

PH-Controlled Assembly of DNA Tiles

We demonstrate a strategy to trigger and finely control the assembly of supramolecular DNA nanostructures with pH. Control is achieved via a rationally designed strand displacement circuit that responds to pH and activates a downstream DNA tile self-assembly process. We observe that the DNA structures form under neutral/basic conditions, while the self-assembly process is suppressed under acidic conditions. The strategy presented here demonstrates a modular approach toward building systems capable of processing biochemical inputs and finely controlling the assembly of DNA-based nanostructures under isothermal conditions. In particular, the presented architecture is relevant for the development of complex DNA devices able to sense and respond to molecular markers associated with abnormal metabolism

Screening for Latent Tuberculosis Infection among Students of Healthcare Professions and Postgraduates of the Faculty of Medicine of the University of Palermo

Introduction and objective: Italy is a country with a low incidence of tuberculosis and in the last fifty years the annual number of TB cases decreased from 12,247 to 4,418, showing a reduction of approximately 64% in the number of cases and 71% in incidence. Despite of this encouraging trend, in the last years the epidemiology of tuberculosis changed and today it is a re-emerging infectious. The aim of this study is to measure the prevalence of positivity to tuberculosis infection (latent TB) in students, without any obvious manifestation of disease, attending degree courses of the health care professions and postgraduate medical courses of the School of Medicine of the University of Palermo, Italy. Materials and methods: A cross-sectional observational study in students of nursing, midwifery, dentistry degree courses and in resident physicians of postgraduate medical schools was carried out from January 2012 to July 2016. Mantoux test was performed and all positive cases were tested with Interferon-Gamma Release Assay (IGRA). Results: Of the 1,351 subjects evaluated, 25 (1.8%) resulted positive to Mantoux test; in 17 students (1.2%) the diagnosis was confirmed with IGRA. Positive cases were significantly more frequent among students attending Postgraduated Medical School Courses (p<0.001) and were older than negative cases (p<0.001). Conclusion: This study suggests that in our geographic area, latent TB shows a relatively low prevalence among students of medical schools. Despite of this evidence, and considering that several students have been found to be positive for TB, this infectious disease has to be considered a re-emerging biohazard that requires preventive strategies for the containment of the risk in exposed workers as well as in the general population

Coverage, efficacy or dosing interval: which factor predominantly influences the impact of routine childhood vaccination for the prevention of varicella? A model-based study for Italy

Background: Varicella is a highly infectious disease with a significant public health and economic burden, which can be prevented with childhood routine varicella vaccination. Vaccination strategies differ by country. Some factors are known to play an important role (number of doses, coverage, dosing interval, efficacy and catch-up programmes), however, their relative impact on the reduction of varicella in the population remains unclear. This paper aims to help policy makers prioritise the critical factors to achieve the most successful vaccination programme with the available budget. Methods: Scenarios assessed the impact of different vaccination strategies on reduction of varicella disease in the population. A dynamic transmission model was used and adapted to fit Italian demographics and population mixing patterns. Inputs included coverage, number of doses, dosing intervals, first-dose efficacy and availability of catch-up programmes, based on strategies currently used or likely to be used in different countries. The time horizon was 30 years. Results: Both one- and two-dose routine varicella vaccination strategies prevented a comparable number of varicella cases with complications, but two-doses provided broader protection due to prevention of a higher number of milder varicella cases. A catch-up programme in susceptible adolescents aged 10-14 years old reduced varicella cases by 27-43 % in older children, which are often more severe than in younger children. Coverage, for all strategies, sustained at high levels achieved the largest reduction in varicella. In general, a 20 % increase in coverage resulted in a further 27-31 % reduction in varicella cases. When high coverage is reached, the impact of dosing interval and first-dose vaccine efficacy had a relatively lower impact on disease prevention in the population. Compared to the long (11 years) dosing interval, the short (5 months) and medium (5 years) interval schedules reduced varicella cases by a further 5-13 % and 2-5 %, respectively. Similarly, a 10 % increase in first-dose efficacy (from 65 to 75 % efficacy) prevented 2-5 % more varicella cases, suggesting it is the least influential factor when considering routine varicella vaccination. Conclusions: Vaccination strategies can be implemented differently in each country depending on their needs, infrastructure and healthcare budget. However, ensuring high coverage remains the critical success factor for significant prevention of varicella when introducing varicella vaccination in the national immunisation programme