Surveillance of acute flaccid paralysis in the Marches region (Italy): 1997–2007

BACKGROUND: The last case of poliomyelitis due to transmission of indigenous wild poliovirus occurred in Italy in 1982, however, it is important to guarantee a high quality surveillance as there is a risk of importation of cases from areas where polio is endemic. Stopping poliovirus transmission is pursued through a combination of high infant immunization coverage and surveillance for wild poliovirus through reporting and laboratory testing of all cases of acute flaccid paralysis (AFP) among children under fifteen years of age. The aim of this study was to describe and to evaluate 11 years of active surveillance in the Marches (Italy) in terms of: incidence, aetiology and clinical manifestation of AFP cases. METHODS: The active Acute Flaccid Paralysis surveillance has been carried out in the Marches region since February 1997 by the Chair of Hygiene which established a regional hospital network. Active surveillance involves 15 hospital centres. RESULTS: In the considered period, 0-15 years population varied between 187,051 in 1997 to 201,625 in 2007, so the number of AFP expected cases is 2 per year. From February 1997 to October 2007, 27 cases were found with rates of 1.0/100,000 in 1997; 2.0/100,000 in 1998; 1.0/100,000 in 1999; 0.5/100,000 in 2000; 2.5/100,000 in 2001; 1.0/100,000 in 2002; 0 in 2003; 0.5/100,000 in 2004; 1.5/100,000 in 2005; 2.0/100,000 in 2006; 1.5/100,000 in 2007. In 29.6% of cases two stool samples were collected in 14 days from the symptoms onset. The 60-days follow-up is available for 23 out of 27 cases reported. In 44.5% of cases the definite diagnosis was Guillain Barrè syndrome. CONCLUSION: In general, the surveillance activity is satisfactory even if in presence of some criticalities in biological samples collection. The continuation of surveillance, in addition to the maintenance of current levels of performance, will tend to a further and more detailed sensitization of all workers involved, in order to obtain spontaneous and prompt reporting, and to achieve the optimal standards recommended by the WHO both in the collection of biological samples and the availability of 60 days follow-up, with the goal of eradicating polio from all countries

Brief Training of Psychoneuroendocrinoimmunology-Based Meditation (PNEIMED) Reduces Stress Symptom Ratings and Improves Control on Salivary Cortisol Secretion Under Basal and Stimulated Conditions

n/

Influenza vaccine uptake among community-dwelling Italian elderly: results from a large cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Flu vaccination significantly reduces the risk of serious complications like hospitalization and death among community-dwelling older people, therefore vaccination programmes targeting this population group represent a common policy in developed Countries. Among the determinants of vaccine uptake in older age, a growing literature suggests that social relations can play a major role.</p> <p>Methods</p> <p>Drawing on the socio-behavioral model of Andersen-Newman - which distinguishes predictors of health care use in predisposing characteristics, enabling resources and need factors - we analyzed through multilevel regressions the determinants of influenza immunization in a sample of 25,183 elderly reached by a nationally representative Italian survey.</p> <p>Results</p> <p>Being over 85-year old (OR = 1.99; 95% CI 1.77 - 2.21) and suffering from a severe chronic disease (OR = 2.06; 95% CI 1.90 - 2.24) are the strongest determinants of vaccine uptake. Being unmarried (OR = 0.81; 95% CI 0.74 - 0.87) and living in larger households (OR = 0.83; 95% CI 0.74 - 0.87) are risk factors for lower immunization rates. Conversely, relying on neighbors' support (OR = 1.09; 95% CI 1.02 - 1.16) or on privately paid home help (OR = 1.19; 95% CI 1.08 - 1.30) is associated with a higher likelihood of vaccine uptake.</p> <p>Conclusions</p> <p>Even after adjusting for socio-demographic characteristics and need factors, social support, measured as the availability of assistance from partners, neighbors and home helpers, significantly increases the odds of influenza vaccine use among older Italians.</p

Indagini sulle cultivar di ciliegio dolce (Pr.avium L.) della Campania. I. Suscettibilità allo spacco.

Serie Quart

Diphtheria: Epidemiological update and review of prevention and control strategies

The importance of anti-diphtheria immunity in adults through periodic booster doses of vaccine is now increasing after last years diphtheria outbreaks in Newly Independent States (NIS) and Algeria and a few cases found in Europe and USA. Diphtheria cases notified in Italy between 1991-1994 have been reported. In 1995 WHO outlined the need to review vaccination schedules against diphtheria in all countries where gaps occur in the immunity of adults. The main sero-epidemiological studies performed in adults and vaccination schedules against diphtheria in some industrialized countries have been examined. Actual situation and control strategies adopted by WHO in the NIS and implications for other countries have been briefly presented. Finally, guidelines for management, investigation and control of diphtheria have been reported, including CDCs recommendations

Sorveglianza delle infezioni del sito chirurgico in Italia Interventi ortopedici anno 2011. Interventi non ortopedici anno 2012. Sistema Nazionale di sorveglianza delle Infezioni del sito Chirurgico

Interventi ortopedici anno 2011. Nell’ambito del sistema nazionale di sorveglianza delle infezioni del sito chirurgico (ISC), SNICh, sono stati raccolti, nel periodo gennaio-dicembre 2011, dati su 11.040 interventi relativi a 7 categorie chirurgiche ortopediche in 80 ospedali. Nella popolazione sorvegliata il rischio di infezione è pari a 1,3%.Il 72% delle infezioni viene diagnosticato durante la sorveglianza post-dimissione. Il 34% delle infezioni è di tipo profondo e il 12% coinvolge organi e spazi. Interventi non ortopedici anno 2012 Nell’ambito del sistema nazionale di sorveglianza delle infezioni del sito chirurgico (ISC), SNICh, sono stati raccolti, nel periodo gennaio-dicembre 2012, dati su 50.313 interventi relativi a 34 categorie chirurgiche in 103 ospedali. Nella popolazione sorvegliata il rischio di infezione è pari a 1,7%.Il 46% delle infezioni viene diagnosticato durante la sorveglianza post-dimissione.Il 21% delle infezioni è di tipo profondo ed il 12% coinvolge organi e spazi

Sorveglianza igienico-sanitaria per la prevenzione della contaminazione microbica degli emoderivati: esperienza in una azienda ospedaliera marchigiana (1992-1999).

Blood transfusion is usually a safe and effective procedure. However, bacterial infections transmitted by blood or its products, although rare, remain a serious problem. The authors report an eight year surveillance (1992-1999) on sterility of blood or its products being prepared and distributed by the Blood Transfusion Service of Umberto I in Ancona, Italy. Out of 1084 sample analysed, 14 (1.3%) were contaminated by Propionibacterium acnes, Staphylococcus epidermidis, hominis, Enterococcus faecalis. No sample was positive in the empty bag sterility test. No transfusion reactions have ever arisen following the administration of hemocomponents. The surveillance set up at Umberto I Hospital, during the last eight years demonstrated that high levels of prevention can be guaranteed

Qi-gong training reduces basal and stress-elicited cortisol secretion in healthy older adults

Introduction: Qi-gong, a mind-body practice combining meditation, physical movement and controlled breathing, is reported to improve psychological well-being and physical function in older adults. However, the effects of Qi-gong on hypothalamic-pituitary-adrenal (HPA) axis activity and reactivity to stress in older people are elusive. An uncontrolled, before-and-after study in a group of healthy older adults was conducted to investigate the possible benefits of 12-week Qi-gong training on self-rated distress symptoms and cortisol secretion under basal and stimulated conditions. Methods: Before (T0) and after (Tf) Qi-gong training, participants (n = 28), men and women, mean age 65 years;(smokers, obese subjects, persons with chronic diseases and oral pathologies, and subjects reporting major stressful events in their recent past were excluded) answered the PSS-10 questionnaire. Salivary samples were collected for cortisol detection at various times of the day during a challenging mental task. Results: Qi-gong training reduced basal cortisol output across the day, notably in the morning. In subjects who responded to the stressor at T0 (n = 16, baseline-to-peak increment > 1.5 nmol/l), cortisol response to cognitive challenge was markedly blunted after training, accompanied by a decreasing trend of PSS-10 score. Conclusion: Qi-gong practice in elderly people appears to improve control on HPA axis activity, reducing daytime cortisol levels and attenuating cortisol responses to mental stress. Ameliorating the profile of basal and stimulated HPA activity, may reflect better adaptation to stress, and may favor successful aging and positive health outcomes. Present findings encourage the implementation of programs aimed at further disseminating Qi-gong practice among the older population