Impact of communicative and informative strategies on influenza vaccination adherence and absenteeism from work of health care professionals working at the university hospital of palermo, Italy: A quasi-experimental field trial on twelve influenza seasons

Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs’ awareness about influenza vaccination. Vaccines administration within hospital units, dedicated web pages on social media and on the UH of Palermo institutional web site, and mandatory compilation of a dissent form for those HCWs who refused vaccination were carried out during the last four influenza seasons. After the introduction of these strategies, influenza vaccination coverage went up from 5.2% (2014/2015 season) to 37.2% (2018/2019 season) (p<0.001), and mean age of vaccinated HCWs significantly decreased from 48.1 years (95% CI: 45.7–50.5) to 35.9 years (95% CI: 35.0–36.8). A reduction of working days lost due to acute sickness among HCWs of the UH of Palermo was observed. Fear of adverse reactions and not considering themselves as a high-risk group for contracting influenza were the main reasons reported by HCWs that refused vaccination. Strategies undertaken at the UH of Palermo allowed a significant increase in vaccination adherence and a significant reduction of absenteeism from work

LIGAND BASED PHARMACOPHORE MODELING, VIRTUAL SCREENING AND MOLECULAR DOCKING STUDIES TO DESIGN NOVEL PANCREATIC LIPASE INHIBITORS

Objective: To understand the essential structural features required for pancreatic lipase (PL) inhibitory activity and to design novel chemical entities, ligand-based pharmacophore modeling, virtual screening and docking studies were carried out.Methods: The pharmacophore model was generated based on 133 compounds with PL inhibitory activity using PHASE. An external test set and decoy dataset methods were applied to validate the hypothesis and to retrieve potential PL inhibitors. The generated hypothesis model was further subjected to virtual screening and molecular docking studies.Results: A five point pharmacophoric hypothesis model which consists of three hydrogen bond acceptor sites and two hydrophobic sites was developed. The generated pharmacophore gave significant 3D QSAR (three-dimensional Quantitative Structural Activity Relationship) model with r2 of 0.9389 and Q2 value of 0.4016. After database screening, five molecules were found to have better glide scores and binding interactions with the active site amino acid residues.Conclusion: As an outcome of this study, five hit molecules were suggested as potent PL inhibitors as they showed good glide scores as well as binding interactions with required active site amino acids. The five molecules obtained from this study may serve as potential leads for the development of promising anti-obesity agents.Â

Meta-analysis: Post-COVID-19 functional dyspepsia and irritable bowel syndrome

Introduction: The burden of post-COVID-19 functional dyspepsia (FD) and irritable bowel syndrome (IBS) remains unclear. The aim of this meta-analysis was to estimate the rate of post-COVID-19 FD and IBS. Methods: MEDLINE, Scopus and Embase were searched through 17 December 2022. Studies reporting the incidence of FD and/or IBS in COVID-19 survivors and controls (without COVID-19), when available, according to the Rome criteria, were included. Estimated incidence with 95% confidence intervals (CI) was pooled. The odds ratio (OR) with 95% confidence intervals (CI) was pooled; heterogeneity was expressed as I2. Results: Ten studies met the inclusion criteria and were included in the analysis. Overall, four studies including 1199 COVID-19 patients were considered for FD. Post-COVID-19 FD was reported by 72 patients (4%, 95% CI: 3%–5% and I2 0%). The pooled OR for FD development (three studies) in post-COVID-19 patients compared to controls was 8.07 (95% CI: 0.84–77.87, p = 0.071 and I2 = 67.9%). Overall, 10 studies including 2763 COVID-19 patients were considered for IBS. Post-COVID-19 IBS was reported by 195 patients (12%, 95% CI: 8%–16%, I2 95.6% and Egger's p = 0.002 test). The pooled OR for IBS development (four studies) in COVID-19 patients compared to controls was 6.27 (95% CI: 0.88–44.76, p = 0.067 and I2 = 81.4%); considering only studies with a prospective COVID-19 cohort (three studies), the pooled OR was 12.92 (95% CI: 3.58–46.60, p < 0.001 and I2 = 0%). Conclusions: COVID-19 survivors were found to be at risk for IBS development compared to controls. No definitive data are available for FD

Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review with Meta-Analysis

The novel coronavirus disease 2019 (COVID-19) has been reported to affect the gastrointestinal system with a variety of symptoms, including bleeding. The prevalence of bleeding in these patients remains unclear. The aim of this meta-Analysis is to estimate the rate of gastrointestinal bleeding in COVID-19 patients and its association with mortality. MEDLINE and Embase were searched through December 20, 2020. Studies reporting COVID-19 patients with and without gastrointestinal bleeding were included. Estimated prevalence with 95% confidence intervals (CI) was pooled; heterogeneity was expressed as I2. Metaregression analysis was performed to assess the impact of confounding covariates. Ten studies met the inclusion criteria and were included in the analysis. A total of 91887 COVID-19 patients were considered, of whom 534 reported gastrointestinal bleeding (0.6%) [409 (76.6%) upper and 121 (22.7%) lower gastrointestinal bleeding (UGIB and LGIB, resp.)]. The overall pooled gastrointestinal bleeding rate was 5% [95% CI 2-8], with high heterogeneity (I2 99.2%); "small study effect"was observed using the Egger test (p=0.049). After removing two outlier studies, the pooled bleeding rate was 2% [95% CI 0-4], with high heterogeneity (I2 99.2%), and no "small study effect"(p=0.257). The pooled UGIB rate was 1% (95% CI 0-3, I2 98.6%, p=0.214), whereas the pooled LGIB rate was 1% (95% CI 0-2, I2 64.7%, p=0.919). Metaregression analysis showed that overall estimates on gastrointestinal bleeding were affected by studies reporting different sources of bleeding. No significant association between gastrointestinal bleeding and mortality was found. In this meta-Analysis of published studies, individuals with COVID-19 were found to be at risk for gastrointestinal bleeding, especially upper gastrointestinal bleeding

The role of basic and applied research activities for the improvement of OS&H conditions and the dissemination of the Culture of Safety

Although the European panorama is experiencing a profound change in advance to the Industry 4.0, revolutionizing the world of work with technical, technological and information innovations, in Italy even today we have to deal with the "old" problem of work related injuries and fatalities. In particular, the accident indices of the last few years do not seem to differ much from those typical of the 1970s. The cultural effort matured with the enforcement of the European Directives, with the consequent passage from a rigid prescriptive approach to a flexible one based on risk analysis, is therefore not sufficient to face without “trauma” such rapid technological development accompanied by legislative, productive changes and increasingly widespread reassignment of tasks within the Companies. In this context, the role of scientific research is essential to contribute to technological transfer and scientific knowledge by reconciling the essential aspects of Occupational Safety and Health, through a rigorous and devoted analysis of working scenarios. Furthermore, the dissemination of a Culture of Safety at all levels (Management and Staff roles) can encourage a bilateral synergy "Industry-University" from an OS&H point of view. The present work discusses in more detail the results of the research carried out by the “young” OS&H researchers of the Polytechnic University of Turin presented on the second day of the Conference Dissemination of The Culture of Safety and Health at Work - “Eras of OS&H Development from early ’50 to industry 4.0”

Imaging appearance of treated hepatocellular carcinoma.

Surgical resection and imaging guided treatments play a crucial role in the management of hepatocellular carcinoma (HCC). Although the primary end point of treatment of HCC is survival, radiological response could be a surrogate end point of survival, and has a key role in HCC decision-making process. However, radiological assessment of HCC treatment efficacy is often controversial. There are few doubts on the evaluation of surgical resection; in fact, all known tumor sites should be removed. However, an unenhancing partial linear peripheral halo, in most cases, surrounding a fluid collection reducing in size during follow-up is demonstrated in successfully resected tumor with bipolar radiofrequency electrosurgical device. Efficacy assessment of locoregional therapies is more controversial and differs between percutaneous ablation (e.g., radiofrequency ablation and percutaneous ethanol injection) and transarterial treatments (e.g., conventional transarterial chemoembolization, transarterial chemoembolization with drug eluting beads and radioembolization). Finally, a different approach should be used for new systemic agent that, though not reducing tumor mass, could have a benefit on survival by delaying tumor progression and death. The purpose of this brief article is to review HCC imaging appearance after treatment

Occurrence and transformation of illicit drugs in wastewater treatment plants.

Illicit drugs (IDs) and their metabolites have been recently recognized as a new group of water emerging contaminants (ECs) with potent psychoactive properties and unknown effects to the aquatic environment (Pal et al., 2013). IDs are excreted via urine and feces and arrive at wastewater treatment plants (WWTPs) where can reach ppb levels (Castiglioni et al., 2006). Over the past few years, it has been demonstrated that conventional biological processes in WWTPs are not or scarcely able to remove IDs. Thus, they are discharged into water bodies through the treated effluent (Postigo et al., 2011). Therefore, monitoring the IDs concentration in WWTPs can have a twofold advantage: i. increase knowledge on the amount of IDs discharged in the environment and estimate their effect; ii. estimating indirectly the community level consumption (Senta et al., 2014). The objective of this paper is to provide a comprehensive analysis of the occurrence and behaviour of illicit drugs and their metabolites in two Sicilian WWTPs. Specifically, two WWTPs (namely, WWTP-1 and WWTP-2) located at the north-western Sicilian coast have been monitored for 5 months (one sampling per week). The two WWTPs have a conventional scheme and mainly differ for their potentiality. Indeed, the average daily flow expressed as m3d-1 for WWTP-1 and WWTP-2 was equal to 153,600 and 19,704, respectively. Samples were analyzed for total suspended solids (TSS), illicit drugs and their metabolites (metham-phetamine; COC = cocaine; MDMA = 3,4-methylenedioxymethamphetamine; METH = methadone; EDDP = 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine; MDA = 3,4-methylenedioxy amphetamine; MDEA = 3,4-methylenedioxy ethylamphetamine; THC-COOH = 11-nor-9-carboxy-\u3949-tetrahydrocannabinol; BEG= Benzoylecgonine). In order to provide a fast and sensitive approach to quantify IDs, an automated online sample preparation method has been developed. The method uses a Thermo Scientific Transcend TLX-1 system powered by TurboFlowTM technology coupled with a TSQ Quantiva Triple Quadrupole Mass Spectrometer. Specifically, THC-COOH has been extracted from 75 \ub5L of pre-filtered water (using 7 and 0.4 \ub5m paper filters) by an online sample extraction method and quantified using an isotopic dilution approach between 30 and 2000 ng L-1

Illicit drugs consumption evaluation by wastewater-based epidemiology in the urban area of Palermo city (Italy)

Introduction. A wastewater-based epidemiology approach was performed to estimate the drug consumption in Palermo city, the fifth largest city of Italy with a population of 671 696 inhabitants, and to investigate the monthly variability of drug loads in wastewater from different areas of the city. A seven-months detection campaign was conducted at the two wastewater treatment plants of the city. Methods. Following a pre-treatment, 32 samples of wastewater were analyzed by liquid chromatography-tandem mass spectrometry. Results. We estimated a mean cocaine use in Palermo of 0.19 g/day/1000 people, corresponding to 1.90 doses/1000 people and cannabinoids use of 2.85 g/day/1000 people, corresponding to 35.62 doses/1000 people. Amphetamines residues in wastewater were always recovered in concentrations lower than the limit of quantification. Conclusion. Our findings showed that drugs consumption in Palermo is in line with those of other Italian cities and that no significant differences on prevalence on cocaine and cannabinoids consumption were recorded in the different months of the survey, except for the summer period in a wastewater treatment plant of the city

Impact of Candida species colonization and azoles resistance in a neonatal intensive care unit

Background: Candida species are among the top 10 most frequently isolated nosocomial bloodstream pathogens in Europe. In particular, in neonatal intensive care units (NICUs) Candida infections are an emerging concern because of the increasing incidence, the related high morbidity and mortality rates reported. Moreover, the epidemiology of Candida infection rapidly changed in these years leading to the selection of less sensitive strains and species. Surveillance studies are mandatory to identify the local distribution of species, their antifungal susceptibility profiles and the emergence of resistance strains. Material/methods: From December 2012 we performed a cohort prospective surveillance study in our NICU, collecting weekly nasal and rectal swabs. Swabs were placed on Sabouraud agar. Candida growth on agar plates was confirmed by microscopic observation. Furthermore, Candida spp. was identified through Candida chromogenic agar (Candida chromogenic agar, Laboratorios Conda) and API\uae 20C AUX (Biom\ue9rieux). The first isolated non-C.albicans Candida (NCAC) species from colonized patients were tested with the main antifungal agents (YeastOne\uae Y010 Thermo Fisher Scientific) and the obtained MIC values were read according to CLSI. Results: From December 2012 to June 2016 we enrolled 874 neonates and analyzed respectively 2014 nasal and rectal swabs. 20/2014 (0,99%) of nasal swabs and 128/2014 (6,35%) of rectal swabs tested positive for Candida spp. The species distribution is showed in the Graph 1. 89/874 (10,18%) neonates tested positive at least in one swab. 59 isolates of NCAC species were tested with the main antifungal agents. All the tested strains were susceptible to echinocandins and amphotericin B. The susceptibility patterns for azoles are shown in the Table 1. Conclusions: Our study confirm the rule of surveillance in the prevention and control of Candida spp. healthcare related infections especially in an high risk ward such as NICU. In particular, in our NICU fluconazole prophylaxis is administered according to standard protocols from 2009.Antifungal susceptibility testes allowed to identify resistant and mutant strains whom acquired resistance so to obtain both clinical and epidemiological data promptly

A study on occupational exposure of Sicilian farmers to Giardia and Cryptosporidium

Introduction. A cross-sectional study was undertaken to deter- mine the prevalence of Giardia and Cryptosporidium in calves of Palermo area (Sicily) and to evaluate the occupational risk associated with occurrence of zoonotic genotypes. Methods. A total of 217 faecal samples, from 149 calves (between 2 and 240 days of age) and 68 farmers, were collected in 19 cattle- farms of Palermo area. A questionnaire regarding demographic characteristics and personal hygienic measures was submitted to all farmers. All faecal samples were analyzed by Immunoflu- orescence assay and Polimerase Chain Reaction (PCR); geno- types were determined by DNA sequencing of Triose Phosphate Isomerase gene for Giardia and Small Subunit Ribosomal RNA gene for Cryptosporidium. Results. None farmer tested was positive for Giardia and Cryptosporidium, whereas these protozoa were respectively detected in 53 (including 5 with zoonotic G. duodenalis geno- type A) and 17 (of which 1 with zoonotic C. ubiquitum) of the examined calves. Discussion. The results indicate that the risk of transmitting both protozoa to farmers in Palermo area is negligible although it can- not be considered null because of identification of human geno- types/species in calves