A study on the sexual and contraception behaviours of the pre-university students in Puglia (South-Italy)

Introduction. The aim of the present study is to determine attitude and associated factors towards the use of methods of protection/contraception. Methods. In August 2008, a study was carried out using a self-administered standardised anonymous questionnaire. It was administered to school-leavers who were attending a study course at Bari University. Results. The total number of questionnaires returned was 1091, the average age of the interviewed subjects was 19.6. Those declaring to have had sexual intercourse at least once was 88%. Of those sexually active, the average age at first intercourse was 16.8, and 75.2% stated that they had used some form of contraception on this occasion. The condom was the most popular method employed, followed by withdrawal and by contraceptive pills. Around 20% of the interviewees indicated that they used emergency post-coital contraception. Discussion. The study results emphasise the importance of an effective teaching of the aspects of sex and relationship education before puberty

An audit of TB prevention on Italian health care workers

Tuberculosis (TB) is considered an occupational disease in health care workers. The aim of this study is to asses the state of tuberculosis prevention among the personnel of the Vaccina- tion Services of the Puglia Region (Italy), who were given an interview-based standardised questionnaire. Of the 302 replies, TB screening had been undergone by 80.5%, whom 78.6% took advice by the occupational health physician. Of those who were negative to the PPD skin test, 60.6% had received BCG, whom 78% took vaccination advice by the occupational health physi- cian. In Italy, the procedures for the monitoring and prevention of tuberculosis are a consolidated practice for occupational health physicians

Post-marketing surveillance study of the DTaP2-IPV-HB-Hib (Hexyon) vaccine administered in preterm infants in the Apulia region, Italy, in 2017.

Recommendations in many countries state that preterm infants (PTIs) should receive the same routine immunization schedule and timing as for full-term births, according to their chronological age. Data regarding hexavalent vaccine safety in PTIs are still limited. We conducted a post-marketing surveillance study of the DTaP2-IPV-HB-Hib vaccine administered to PTIs in Apulia region, Italy. We identified PTIs by selecting the hospital discharge records of infants born between January and June 2017 using the DRG and ICD-9-CM codes for preterm birth, and we matched these data with records included in the regional immunization registry. We analyzed coverage and timeliness of vaccination. To investigate adverse events (AEs) after the first dose, we interviewed via phone the parents of PTIs vaccinated with at least one dose of the DTaP2-IPV-HB-Hib vaccine. At the time of our analysis (31.12.2017), 866/936 (92.5%) PTIs received the first dose of hexavalent vaccine and 539/936 (57.6%) were vaccinated by the third month of age, as recommended; 700/866 (80.8%) received the DTaP2-IPV-HB-Hib vaccine. The parents of 339 PTIs vaccinated with the DTaP2-IPV-HB-Hib vaccine reported local pain as the most common reaction (35.7% of the children). Erythema, swelling, induration and nodule were also reported in about 25% of the children. Systemic adverse events were generally rarer than local reactions. No serious AEs were reported. Our findings showed that more than 40% of PTIs received delayed hexavalent vaccination. This study showed a reassuring safety profile of the vaccine in the preterm population and may be considered as a pilot for further real-world studies

CeO2 Nanoparticles-Loaded pH-Responsive Microparticles with Antitumoral Properties as Therapeutic Modulators for Osteosarcoma

Osteosarcoma is an aggressive form of bone cancer mostly affecting young people. To date, the most effective strategy for the treatment of osteosarcoma is the surgical removal of the tumor with or without combinational chemotherapy. In this study, we present the development of a pH-sensitive drug-delivery system in the form of microparticles, with increased chemotherapeutic action against the osteosarcoma cell line SAOS-2, and with reduced toxicity against the heart myoblastic cell line H9C2. The delivery system is composed of calcium carbonate and collagen type I, and is loaded with cerium dioxide (CeO2) nanoparticles (<25 nm) and the anticancer drug doxorubicin. The fabricated microparticles were fully characterized morphologically and physicochemically, and their ability to induce or inhibit apoptosis/necrosis was assessed using in vitro functional assays and flow cytometry. The results presented in this study show that the highest concentration (250 μg/mL) of the therapeutic microparticles (CaCO3-based therapeutic modulators (C-TherMods)), which corresponds to 6.4 μg/mL of encapsulated doxorubicin, can protect the H9C2 cells even after 120 h, since the percentage of viable cells at this time point is 65%. On the contrary, when H9C2 cells are treated with 0.5 μg/mL of free doxorubicin, 75% of the cells are dead only after 24 h. When SAOS-2 cells are treated with the same concentration of C-TherMods (250 μg/mL), the viability of SAOS-2 cells is 80% after 24 h, while it reduces to 50% after 120 h. At pH 6.0, the synergic effect of the pro-oxidant CeO2nanoparticles and of the encapsulated doxorubicin leads to almost 100% of cell death, even at the lowest concentration of C-TherMods (50 μg/mL)

La certificación del Parque Nacional del Circeo (Italia central) : evaluación de la calidad de las aguas superficiales

Se ha evaluado la calidad biológica de las aguas corrientes del Parque Nacional del Circeo (Italia Central) en el ámbito de un proyecto de Certificación de esta Área Protegida según la Norma Internacional UNI EN ISO 14001. La calidad ambiental ha sido analizada en 25 estaciones de 13 cursos de agua (Fosso Bagnara, Fosso Fontana delle Rose, Fosso Arciglioni, Fosso Capogrosso, Rio Nocchia, Canale Cicerchia, Diversivo Nocchia, Canale Caterattino, Fiume Ninfa, Collettore Acque Medie, Rio Martino, Canale Papale, Rio Torto) a través de métodos de monitoreo biológico (tests toxicológicos del sedimento e índices biológicos) en el período comprendido entre el invierno del 2000 y la primavera del 2001. Los tests toxicológicos han comprendido el test de inhibición de la bioluminiscencia de la bacteria Vibrio fischeri y el test de germinación de semillas de 3 especies vegetales. Han sido calculados los índices bióticos I.B.E y B.M.W.P.', basados en las comunidades de macroinvertebrados bentónicos (muestreadas con red de mano), y los índices G.I.S., basados sobre las comunidades de macrófitos acuáticos. Ha sido también calculado el índice de funcionalidad fluvial (I.F.F.) en base a las características bióticas y abióticas del sistema acuático y del sistema terrestre asociado. En general la baja calidad de las aguas corrientes examinadas puede relacionarse con las modificaciones artificiales del álveo y a la contaminación química de origen urbana, agrícola e industrial. Estos factores antrópicos han causado la simplificación de las estructuras de las comunidades bentónicas (dominadas por pocas especies resistentes) y la alteración de la funcionalidad de los cursos de agua.An evaluation of the biological quality of running waters of the Circeo National Park (Central Italy) was performed according to the Certification Project of this Protected Area considering the International Standard UNI EN ISO 14001. The environmental quality was analysed in 25 sampling sites of 13 watercourses (Fosso Bagnara, Fosso Fontana delle Rose, Fosso Arciglioni, Fosso Capogrosso, Rio Nocchia, Canale Cicerchia, Diversivo Nocchia, Canale Caterattino, Fiume Ninfa, Collettore Acque Medie, Rio Martino, Canale Papale, Rio Torto) utilizing methods of biological monitoring (sediment toxicity tests and biological indexes) between winter 2000 and spring 2001. Toxicity tests included bio-luminescence inhibition of the bacterium Vibrio fischeri, and seed germination of 3 plant species. Biotic indexes (I.B.E and B.M.W.P') were calculated in relation to the macroinvertebrate communities (sampled with handheld net) and G.I.S. indexes were calculated in relation to aquatic macrophyte communities. The Fluvial Functionality Index was also calculated, taking into account the biotic and abiotic features of the aquatic system and its associated terrestrial system. Generally, the low quality of the studied watercourses can be related to artificial changes and chemical pollution coming from urban, agricultural and industrial areas. These anthropogenic factors have led to simplified benthic communities (dominated by a low number of tolerant species) and have altered the functionality of the watercourses

REDUCTION OF INVASIVE DISEASE IN CHILDREN TWO DECADES AFTER THE INTRODUCTION OF HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINATION IN APULIA REGION, ITALY

Background Haemophilus influenzae type b conjugate (Hib) monovalent vaccination, consisting of 2p+1 doses at 3, 5, and 11 months of age, was introduced in the Italy’s infant immunization schedule in 1999 and included in the DTaP-HBV-IPV/Hib hexavalent vaccine since 2001. The estimated vaccination coverage was 83.4% in 2002, >90% by 2005, and >95% by 2011 [1-4]. In the Apulia region of Italy (about 4,000,000 inhabitants), vaccination coverage for 3 doses reached 75% in 2001, >90% by 2002, and >95% by 2007 (Graph. 1).Methods We considered annual age-specific hospitalization rates in infants <1 year and children 1-4 years as a proxy for incidence in the period 1996-2014. The attributable benefit was calculated as the reduction in incidence of Haemophilus influenzae invasive disease among vaccinated children attributable to the routine use of Hib monovalent vaccine during 1999-2000 (“Hib-monovalent period”) and of the hexavalent DTPa-HBV-IPV/Hib vaccine in the period 2001-2014 (“DTPa-HBV-IPV/Hib period”). The prevented fraction was calculated as the proportion of hypothetical total cases that were prevented by the use of monovalent and hexavalent vaccine, respectively (Panel A) [5]Results The hospitalization rate for Haemophilus influenzae invasive disease among infants decreased from 11.5 (95% CI= 1.4-21.6) per 100,000 in the 1996-1998 pre-vaccination period to 6 (95% CI= -1.4-13.3) per 100,000 in the “Hib-monovalent period”, with an estimated AleB of -5.5 per 100,000 and a PedF of 48.2%. It declined further to 1 (95% CI= -2.2-4.1) per 100,000 in the “DTaP-HBV-IPV/Hib period”, with an AleB of -10.5 per 100,000 and a PedF of 91.6% (Graph. 2). The rate of hospitalization among children aged 1-4 year remained stable at 2.4 per 100.000 from the pre- vaccination period through “Hib-monovalent period” (AleB=0; PedF=2%) and declined to 0.1 (95% CI= - 0.4-0.7) per 100,000 in the “DTaP-HBV-IPV/Hib period”, with an AleB of -2.3 per 100,000 and a PedF of 94.3% (Graph. 3)Conclusions * Hib-monovalent period - ** DTPa-HBV-IPV/Hib period In the Apulia region of Italy, the proportion of Haemophilus influenzae invasive disease requiring hospitalization in children aged <5 years presumably prevented by the introduction of Hib universal vaccination amounted to more than nine in ten cases. These findings are consistent with increased vaccine coverage rates as a result of the wide use of the hexavalent combination vaccines

Genetic characterization of measles virus strains isolated during an epidemic cluster in Puglia, Italy 2006–2007

The genetic characterization of wild-type measles strains isolated during an epidemic cluster of measles occurred in Puglia (South Italy), between November 2006 and January 2007, was performed. Measles virus (MV) detection was carried out by a nested RT-PCR on 8 of 18 total cases. The viruses were analyzed using the standard genotyping protocols. The N gene sequences of the strains from outbreak were identical to each other, and sequence analysis revealed that the viruses belonged to genotype B3, subgroup B3.1, never identified before in Italy. An importation of measles B3.1 strains from Africa was hypothesized. Molecular surveillance will help to monitor the progress in measles elimination

Systematic causality assessment of adverse events following HPV vaccines: Analysis of current data from Apulia region (Italy)

Since 2013, World Health Organization (WHO) recommended that adverse events following immuniza- tion (AEFIs) should be evaluated by a standardized algorithm for causality assessment, however the use of WHO procedure is rarely adopted. In Italy, AEFIs (classified only by temporal criteria) are registered in the National Drug Authority (AIFA) database, but causality assessment is not mandatory. Every year AIFA publishes the AEFIs report, that doesn’t contain information about causal correlation between events and vaccines. From AIFA database, we selected AEFIs following human papillomavirus vaccination (HPV) reported in Apulia (about 4,000,000 inhabitants) during 2008–2016. For serious AEFIs, we applied WHO causality assessment criteria; for cases hospitalized, we repeated the assessment getting additional information from health documentation. In 2008–2016, 100 HPV AEFIs (reporting rate: 17.8 per 100,000 doses) were registered of which 19 were serious (rate: 3.4 per 100,000 doses) and 12 led to hospitaliza- tion. After causality assessment, for 9 AEFIs the classification was ‘‘consistent causal association to immunization”, for 3 indeterminate, for 5 ‘‘inconsistent causal association to immunization” and for 2 not-classifiable. Among hospitalized patients, 5 AEFIs were consistent, 5 inconsistent, 1 not-classifiable and 1 indeterminate; adding information from health documentation, the results were similar except for indeterminate and not classifiable AEFIs that turned into ‘‘not consistent”. Only half of severe AEFIs could be associated with vaccination and this suggests that AIFA report provides a incomplete picture of HPV vaccine safety, with a risk for readers to confound ‘‘post hoc” and ‘‘propter hoc” approach without considering the causality assessment results. In the view of the systematic use of WHO causality assess- ment algorithm in the AEFI surveillance, the efforts of Public Health must be focused on the improvement of the quality of the information provided to reduce conclusions inter-observer variability; the routine follow-up of reports, also to collect additional information, must be guaranteed

Role of the National Immunisation Technical Advisory Groups in 13 European countries in the decision-making process on vaccine recommendations

: In Europe, National Immunisation Technical Advisory Groups (NITAGs) were established in most countries to promote evidence-informed decision-making in introducing new or improved vaccines or changing recommendations for existing ones. Still, the role, activities and outcomes of NITAGs have not been optimally implemented across Europe. Within the European Joint Action on Vaccination (EU-JAV), we conducted a survey to collect information on decision-making process including the main criteria for the introduction of new vaccines or changes to recommendations on their use. Between December 2021 and January 2022, 13 of the 28 European countries invited participated in an online survey. The criteria ranked as most relevant were disease burden and availability of financial resources. Only one country specified that the NITAG recommendations were binding for the government or the health authority. Vaccinations more often reported for introduction or recommendation changes were those against herpes zoster, influenza, human papillomavirus infection, pneumococcal and meningococcal disease. The planned changes will mainly address children and adolescents (2-18 years) and adults (≥ 45-65 years). Our findings show potential overlaps in the activities of NITAGs between countries; and therefore, collaboration between NITAGs may lead to optimisation of the workload and better use of resources