West Nile virus transmission. results from the integrated surveillance system in Italy, 2008 to 2015

IIn Italy a national Plan for the surveillance of imported and autochthonous human vector-borne diseases (chikungunya, dengue, Zika virus disease and West Nile virus (WNV) disease) that integrates human and veterinary (animals and vectors) surveillance, is issued and revised annually according with the observed epidemiological changes. Here we describe results of the WNV integrated veterinary and human surveillance systems in Italy from 2008 to 2015. A real time data exchange protocol is in place between the surveillance systems to rapidly identify occurrence of human and animal cases and to define and update the map of affected areas i.e. provinces during the vector activity period from June to October. WNV continues to cause severe illnesses in Italy during every transmission season, albeit cases are sporadic and the epidemiology varies by virus lineage and geographic area. The integration of surveillance activities and a multidisciplinary approach made it possible and have been fundamental in supporting implementation of and/or strengthening preventive measures aimed at reducing the risk of transmission of WNV trough blood, tissues and organ donation and to implementing further measures for vector control

Representação Social da Síndrome Demencial: o olhar dos cuidadores principais.

Submitted by Nuzia Santos ([email protected]) on 2017-08-24T14:39:15Z No. of bitstreams: 1 Daniela Chiari Rizzo.pdf: 1497859 bytes, checksum: 2aa834d25e5cc4e4f67782bd477c397d (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2017-08-24T14:48:05Z (GMT) No. of bitstreams: 1 Daniela Chiari Rizzo.pdf: 1497859 bytes, checksum: 2aa834d25e5cc4e4f67782bd477c397d (MD5)Made available in DSpace on 2017-08-24T14:48:05Z (GMT). No. of bitstreams: 1 Daniela Chiari Rizzo.pdf: 1497859 bytes, checksum: 2aa834d25e5cc4e4f67782bd477c397d (MD5) Previous issue date: 2007Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.As síndromes depressivas e demenciais são os problemas mentais mais prevalentes na população idosa. A qualidade de vida de pacientes com demência depende, primordialmente, daqueles que são res ponsáveis pelos seus cuidados. Assim, é fundamental a realização de es tudos que possam descrever as percepções, interpretações e reações dos cuidadores frente aos diversos tipos de síndromes demenciais e as estratégias encontradas para enfrentá-las associadas aos diferentes atores e a mobilização de referentes cultu rais em torno da experiência da demência. No presente estudo, com base na teoria das represen tações sociais, foram entrevistados 15 cuidadores, visando compreender como es tes reconhecem e vivenciam a síndrome demencial e quais são as ações realizadas por eles para lidar com a mesma. A análise de conteúdo indicou que o prejuízo nas atividades instrumentai s foram os primeiros sinais que alertaram os cuidadores para o problema de seus familiares. Ao mesmo tempo em que os cuidadores consideram eventos de vida, organicidade e hereditariedade para explicarem o problema do familiar, levantam também outros aspectos que estão intimamente associados ao contexto socioc ultural, influenciando as ações diante das manifestações da síndrome demencial. Es sas são informações essenciais para o planejamento de intervenções e políticas públicas adequadas às características desta população.Depressive symptoms and dementia are mental problems common among the elderly. The quality of life for patients suffering from these disorders depends mostly on their caretakers. Therefore it is of paramount im portance to conduct research which describes perceptions, interpretations and actions of these caretakers in relation to different types of demential disorders, the coping strategies developed associated to the different actors and the mobilization of cultural references connected to the experience with dementia. In the present study, based on the theory of social representations, 15 caretakers were interviewed, focusing on their experiences an d feelings about this disorder and their coping strategies. A content analysis indicated that a decrease in instrumental activities was one of the first signs alerting the caretaker about the problem of the family member. At the same time as caretakers consider life events, organicity and hereditarity in order to explain the problem of the family member , they also raise other aspects, which are intimately associated with the socio-cultur al context, influencing the actions taken regarding the demential syndrome. This is e ssential information to plan interventions, programs and public policies adapted to the characteristics of that populatio

Social representations of main caretakers of patients with dementia

Submitted by Nuzia Santos ([email protected]) on 2013-07-12T18:15:03Z No. of bitstreams: 1 133. RIZZO DC, SCHALL VT.pdf: 1210843 bytes, checksum: be22451abed6302a674b85aa429d926d (MD5)Made available in DSpace on 2013-07-12T18:15:03Z (GMT). No. of bitstreams: 1 133. RIZZO DC, SCHALL VT.pdf: 1210843 bytes, checksum: be22451abed6302a674b85aa429d926d (MD5) Previous issue date: 2008Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brasil /Prefeitura de Belo Horizonte. Belo Horizonte, MG, BrasilFundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Laboratório de Educação em Saúde. Belo Horizonte, MG, BrasilINTRODUÇÃO: As síndromes depressivas e demenciais são os problemas mentais mais prevalentes na população idosa. A qualidade de vida de pacientes com demência depende, primordialmente, daqueles que são responsáveis pelos seus cuidados. Assim, é fundamental a realização de estudos que possam descrever as percepções, interpretações e reações dos cuidadores frente aos diversos tipos de síndromes demenciais, as estratégias encontradas para enfrentá-las associadas aos diferentes atores e a mobilização de referentes culturais em torno da experiência da demência. MÉTODO: No presente estudo, com base na teoria das representações sociais, foram entrevistados 15 cuidadores, visando compreender como estes reconhecem e vivenciam a síndrome demencial e quais são as ações realizadas por eles para lidar com a mesma. RESULTADOS: A análise de conteúdo indicou que o prejuízo nas atividades instrumentais foram os primeiros sinais que alertaram os cuidadores para o problema de seus familiares. Ao mesmo tempo em que os cuidadores consideram eventos de vida, organicidade e hereditariedade para explicar o problema do familiar, levantam também outros aspectos que estão intimamente associados ao contexto sociocultural, influenciando as ações diante das manifestações da síndrome demencial. CONCLUSÃO: Essas são informações essenciais para o planejamento de intervenções e políticas públicas adequadas às características dessa população.Introduction: Depressive symptoms and dementia are the most prevalent mental problems among the elderly. The quality of life of patients suffering from these disorders depends mostly on their caretakers. Therefore, it is of paramount importance to conduct research studies describing the caretaker’s perceptions, interpretations and actions in relation to different types of dementiadisorders, coping strategies developed associated with different actors and mobilization of cultural references connected to the experience of dementia. Method: In the present study, based on the theory of social representations, 15 caretakers were interviewed, focusing on their experiences and feelings about this disorder and their coping strategies. Results: Content analysis indicated that decreased instrumental activities were the first signs alerting caretakers about their relative’s problem. At the same time as caretakers consider life events, organicity and heredity to explain their relative’s problem, they also raise other aspects, which are intimately associated with the sociocultural context, influencing the actions taken regarding the dementia syndrome. Conclusion: This is essential information to plan interventions and public policie adapted to the characteristics of that population

Significance of PD-L1 in Metastatic Urothelial Carcinoma Treated With Immune Checkpoint Inhibitors

Importance Immune checkpoint inhibitors (ICIs) have broadened the metastatic urothelial carcinoma (mUC) therapeutic scenario. The association of programmed death ligand 1 (PD-L1) with response and survival in patients treated with ICIs is still controversial. Objectives To evaluate the association of PD-L1 with response rate and overall survival among patients with mUC treated with ICIs. Data Sources PubMed, Embase, American Society of Clinical Oncology and European Society for Medical Oncology Meeting Libraries, and Web of Science were searched up to December 10, 2023. Study Selection Two authors independently screened the studies. Included studies were randomized and nonrandomized clinical trials enrolling patients with mUC receiving ICIs with available overall survival (OS), progression-free survival (PFS), or overall response rate (ORR) data, separated between patients with PD-L1-positive and -negative tumors. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. Two reviewers independently extracted data. Fixed- or random-effects models were used depending on the heterogeneity among the studies. Main Outcomes and Measures Primary outcomes were odds ratios (ORs) for ORR and hazard ratios (HRs) for OS, comparing patients with PD-L1-positive tumors and patients with PD-L1-negative tumors. Secondary outcomes were the PFS HR between patients with PD-L1-positive and -negative tumors and OS HR between ICI arms and non-ICI arms of only randomized clinical trials. Results A total of 14 studies were selected, comprising 5271 patients treated with ICIs (2625 patients had PD-L1-positive tumors). The ORR was 13.8% to 78.6% in patients with PD-L1-positive tumors and 5.1% to 63.2% in patients with PD-L1-negative tumors, with an association between PD-L1 status and ORR favoring patients with PD-L1-positive tumors (OR, 1.94; 95% CI, 1.47-2.56; P < .001). Median OS ranged from 8.4 to 24.1 months in patients with PD-L1-positive tumors and from 6.0 to 19.1 months in patients with PD-L1-negative tumors. The pooled HR showed a significant reduction for patients with PD-L1-positive tumors compared with those with PD-L1-negative tumors in the risk of death (HR, 0.71; 95% CI, 0.57-0.89; P = .003) and risk of progression (HR, 0.55; 95% CI, 0.44-0.69; P < .001) when ICIs were administered. PD-L1 is not likely to be a predictive biomarker of ICI response. Conclusions and Relevance This systematic review and meta-analysis suggests that PD-L1 expression is associated with improved ORR, OS, and PFS for patients with mUC who receive ICIs, but it is unlikely to be useful as a predictive biomarker. Developing predictive biomarkers is essential to select patients most likely to benefit from ICIs and avoid toxic effects and financial burden with these agents