A general model of dioxin contamination in breast milk: results from a study on 94 women from the Caserta and Naples areas in Italy.

BackgroundThe Caserta and Naples areas in Campania Region experience heavy environmental contamination due to illegal waste disposal and burns, thus representing a valuable setting to develop a general model of human contamination with dioxins (PCDDs-PCDFs) and dioxin-like-PCBs (dl-PCBs).Methods94 breastfeeding women (aged 19-32 years; mean age 27.9 ± 3.0) were recruited to determine concentrations of PCDDs-PCDFs and dl-PCBs in their milk. Individual milk samples were collected and analyzed according to standard international procedures. A generalized linear model was used to test potential predictors of pollutant concentration in breast milk: age, exposure to waste fires, cigarette smoking, diet, and residence in high/low risk area (defined at high/low environmental pressure by a specific 2007 WHO report). A Structural Equation Model (SEM) analysis was carried out by taking into account PCDDs-PCDFs and dl-PCBs as endogenous variables and age, waste fires, risk area and smoking as exogenous variables.ResultsAll milk samples were contaminated by PCDDs-PCDFs (8.6 pg WHO-TEQ/98g fat ± 2.7; range 3.8-19) and dl-PCBs (8.0 pg WHO-TEQ/98g fat ± 3.7; range 2.5-24), with their concentrations being associated with age and exposure to waste fires (p < 0.01). Exposure to fires resulted in larger increases of dioxins concentrations in people living in low risk areas than those from high risk areas (p < 0.01).ConclusionsA diffuse human exposure to persistent organic pollutants was observed in the Caserta and Naples areas. Dioxins concentration in women living in areas classified at low environmental pressure in 2007 WHO report was significantly influenced by exposure to burns

Melanoma in the Italian population and regional environmental influences: A national retrospective survey on 2001–2008 hospitalization records

Objective: To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives. Methods: We analyzed the Italian national hospitalization records from 2001 to 2008 provided by the Ministry of Health, excluding hospital re-admissions of the same patients, in order to assess the occurrence of Melanoma over a 8-year period. Data were presented by age groups (absolute number of cases from 20 to ≥80 years old) and per Region (rates per 100,000 inhabitants) for each year. Results: The overall number of new hospitalizations due to malignant Melanoma increased by 16.8% from 2001 (n = 4846) to 2008 (n = 5823), with the rate per 100,000 inhabitants passing from 10.5 to almost 12.0 at a national level. The majority of new diagnoses of malignant Melanoma was observed in two age groups: 61–70 years old (from 979 in 2001 up to 2109 in 2008, corresponding to 15.1 and 18.1 new cases per 100,000 inhabitants, respectively) and 71–80 years old (from 954 in 2001 up to 1141 in 2008, corresponding to 19.5 and 21.8 new cases per 100,000 inhabitants, respectively). The number of hospitalizations due to Melanoma increased in all age groups with the only exception of the youngest patients aged 20–30 years old. The highest increases over the 8-year period were observed in people aged ≥81 years old (+34%), 61–70 years old (+20%) and surprisingly in the age group 31–40 years old (+17%). Southern Regions showed lower hospitalization rates compared to Northern Italy and Region Lazio. The highest increases between 2001 and 2008 were observed in Trentino/Alto Adige, Friuli Venezia Giulia, Valla d’Aosta and Veneto Region. Conclusions: Hospitalizations due to malignant Melanoma in Italy seem to be influenced by environmental or population-related factors showing a decreasing incidence rate from the Northern to Southern Regions

Diabetes and obesity as independent risk factors for osteoporosis: Updated results from the ROIS/EMEROS registry in a population of five thousand post-menopausalwomen living in a region characterized by heavy environmental pressure

Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m2. Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (p < 0.001). By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs) of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05-1.83) and 1.46 (CI: 1.20-1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis

Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the EU COHEIRS Project on Environment and Health

The EPIKIT (Epidemiology of Cancer in Italy) Study Group is a result of the COHEIRS project (Civic Observers for Health and Environment: Initiative of Responsibility and Sustainibility), funded by the Europe for Citizens Program 2013–2014 to address the issue of Precautionary Principle applicatio

Exposure to environmental contamination in women living in Naples and Caserta provinces (South Italy): Hair trace metals analysis, first data

The aim of this study was to evaluate the Sn, Cd, Pb, Se, Ba, Cr, Cu, Ni, Be, Al, V, Fe, Mn, Sb concentrations in women's hair childbearing age (20¬ 30 years) along a litoral area, which falls into two provinces of Campania Region: Naples and Caserta. This area is subject to a high human impact. In addition, since the hair allows us to evaluate the different inputs linked both endogenous contaminations (deposition through the blood) and exogenus (deposition of airborne particulate matter and/or cosmetic products used), it was also possible to evaluate them. Preliminary data have shown a not uniform accumulation. An endogenous contamination for Cd, Pb, Ba, Cu, Ni, Be, Al, V, Fe, Mn, Sb; an exogenous for Cr; and a mixed one for Se and Sn were detected. Through Kruskal-Wallis (p) test significance coefficient, the data showed a clear and significant accumulation of Sn, Cd, Se, Ni, Al, V and Sb

Updated incidence and costs of hip fractures in elderly Italian population

Purpose: We aimed at updating our previous researches about the burden of hip fractures in elderly Italian population. Methods: We analyzed national hospitalizations records from 2000 to 2014 to compute age- and sex-specific standardized rates. Results: 1,335,375 hospitalizations were recorded in people ≥ 65 (1,031,816 women: 77.27% and 303,559 men: 22.73%) over 15 years, passing from 73,493 in year 2000 to 94,525 in 2014, with an overall increase of 28.62% over the 15-year period (females: + 25.1%; males: + 41.2%). About 84.9% of total hip fractures were suffered by patients aged ≥ 75 years old. Direct hospitalization costs and rehabilitation costs increased from 343 to 457 million Euros and from 392 to 504 million Euros from year 2000 to 2014, respectively. Overall costs of hip fractures raised from 735 to 961 million Euros (+ 30.74% from 2000 to 2014). Conclusion: The number of hip fractures and related hospitalizations costs in Italian elderly population is still increasing due to the absolute number of fractures occurring in people ≥ 65 years old and particularly over 75 years old

The association between atrial fibrillation and Alzheimer's disease: Fact or fallacy? A systematic review and meta-analysis

BackgroundThe association between atrial fibrillation and dementia has been described. Whether a specific association exists between atrial fibrillation and Alzheimer's disease remains uncertain. This study aims to assess the association between atrial fibrillation and Alzheimer's disease through a systematic review and meta-analysis of the literature.MethodsAn exhaustive search of electronic databases up to October 2018 was conducted. Studies that identified patients with and without atrial fibrillation as well as patients with and without Alzheimer's disease and reported results of at least one relevant outcome, including hazard ratio of the association between atrial fibrillation and Alzheimer's disease were included in this analysis. The hazard ratios and their confidence interval were then pooled using a DerSimonian and Laird random effects model.ResultsSix studies enrolling a total of 56 370 patients were included. At baseline, the mean or median ages ranged from 50 to 78 years with a subsequent follow-up of 3 to 25 years. The random-effect pooled analysis showed a hazard ratio of 1.30 (95% confidence interval 1.01-1.59) and the heterogeneity was not significant, I2 48.1%. All of the included studies were rated as good quality.ConclusionPooled analysis suggest that patients with atrial fibrillation may be exposed to an increased risk of developing new onset of Alzheimer's disease. Given the relevant clinical implications, further studies are required to corroborate these findings

Characteristics and hospital course of patients admitted for acute cardiovascular diseases during the coronavirus disease-19 outbreak

INTRODUCTION: During the coronavirus disease-19 (COVID-19) outbreak in spring 2020, people may have been reluctant to seek medical care fearing infection. We aimed to assess the number, characteristics and in-hospital course of patients admitted for acute cardiovascular diseases during the COVID-19 outbreak.METHODS: We enrolled all consecutive patients admitted urgently for acute myocardial infarction, heart failure or arrhythmias from 1 March to 31 May 2020 (outbreak period) and 2019 (control period). We evaluated the time from symptoms onset to presentation, clinical conditions at admission, length of hospitalization, in-hospital medical procedures and outcome. The combined primary end point included in-hospital death for cardiovascular causes, urgent heart transplant or discharge with a ventricular assist device.RESULTS: A similar number of admissions were observed in 2020 (N\u200a=\u200a210) compared with 2019 (N\u200a=\u200a207). Baseline characteristics of patients were also similar. In 2020, a significantly higher number of patients presented more than 6\u200ah after symptoms onset (57 versus 38%, P\u200a<\u200a0.001) and with signs of heart failure (33 versus 20%, P\u200a=\u200a0.018), required urgent surgery (13 versus 5%, P\u200a=\u200a0.004) and ventilatory support (26 versus 13%, P\u200a<\u200a0.001). Hospitalization duration was longer in 2020 (median 10 versus 8 days, P\u200a=\u200a0.03). The primary end point was met by 19 (9.0%) patients in 2020 versus 10 (4.8%) in 2019 (P\u200a=\u200a0.09).CONCLUSION: Despite the similar number and types of unplanned admissions for acute cardiac conditions during the 2020 COVID-19 outbreak compared with the same period in 2019, we observed a higher number of patients presenting late after symptoms onset as well as longer and more complicated clinical courses