Epidemiologia delle infezioni da HPV e del cervicocarcinoma in Puglia: studi ad hoc e analisi dei dati correnti

HPV infection is common in sexually active women and is an important risk factor for cervical cancer. The aim of this article is to describe the prevalence of HPV infection, the incidence and the mortality rates for cervical cancer and adherence to screening programs in Apulia in the light of recent introduction of anti-HPV vaccines. The prevalence of HPV was evaluated testing biological samples from 1082 women. The 33% resulted positive for HPV (80% for high-risk genotypes and 20% for low-risk genotypes). The 59% of positive samples showed only a single viral type while 37% multiple genotypes. In Apulia, from 1998 to 2005, a total of 1849 women were hospitalized for cervical cancer with a decreasing trend; the 46% had exo cervical cancer; the 22% endocervical cancer, 29% cancer of cervix without specification and 3% infiltrating cervical cancer. The mortality rate was 1,5 x 100.000. Data from PASSI study regarding cervical cancer screening showed that 62% of Apulian women 25-64 years aged had a Pap smear and 54.7% get it every three years. The viral genotypes circulating in Apulia region are present in anti-HPV vaccines; this item could give information on their introduction together with actions to implement the adherence to screening program that results lower than international standard

Cadmium accumulation and antioxidant responses in Sparus aurata exposed to waterborne cadmium.

Cadmium (Cd), a nonessential trace element, is rapidly accumulated by most living organisms and subsequently exerts its toxicity at different molecular levels. This study exposed gilthead sea bream (Sparus aurata) to waterborne 0.1 mg/l Cd for 11 days and investigated the Cd accumulation pattern, lipid oxidation, and response of antioxidant defences. At the end of the experiment, mean Cd concentrations in gills and liver, the organs most prone to metal accumulation, were 209.4 and 371.7 ng/g ww, respectively. Muscle did not show any Cd retention during the 11 days of exposure. In liver, the cytosolic fraction of the metal was chelated into the nontoxic form by metallothionein (MT), a specific Cd-inducible protein. Zn and Cu concentrations were not influenced by Cd exposure. Glutathione (GSH) concentrations and the antioxidant enzyme activities of GSH reductase and GSH peroxidase showed an overall decreasing trend. In addition, lipid and aqueous hydroperoxide levels did not show any significant variation. Oxidative stress indirectly generated by Cd seems to be compensated for by the different biochemical systems tailored to decrease cellular damage. In particular, the negative effects of Cd accumulation in tissues were probably counteracted by the induction of MT

Prophylactic Use of a Probiotic in the Prevention of Colic, Regurgitation, and Functional Constipation. A Randomized Clinical Trial

IMPORTANCE Infantile colic, gastroesophageal reflux, and constipation are the most common functional gastrointestinal disorders that lead to referral to a pediatrician during the first 6 months of life and are often responsible for hospitalization, feeding changes, use of drugs, parental anxiety, and loss of parental working days with relevant social consequences. OBJECTIVE To investigate whether oral supplementation with Lactobacillus reuteri DSM 17938 during the first 3 months of life can reduce the onset of colic, gastroesophageal reflux, and constipation in term newborns and thereby reduce the socioeconomic impact of these conditions. DESIGN A prospective, multicenter, double-masked, placebo-controlled randomized clinical trial was performed on term newborns (age <1 week) born at 9 different neonatal units in Italy between September 1, 2010, and October 30, 2012. SETTING Parents were asked to record in a structured diary the number of episodes of regurgitation, duration of inconsolable crying (minutes per day), number of evacuations per day, number of visits to pediatricians, feeding changes, hospitalizations, visits to a pediatric emergency department for a perceived health emergency, pharmacologic interventions, and loss of parental working days. PARTICIPANTS In total, 589 infants were randomly allocated to receive L reuteri DSM 17938 or placebo daily for 90 days. INTERVENTIONS Prophylactic use of probiotic. MAIN OUTCOMES AND MEASURES Reduction of daily crying time, regurgitation, and constipation during the first 3 months of life. Cost-benefit analysis of the probiotic supplementation. RESULTS At 3 months of age, the mean duration of crying time (38 vs 71 minutes; P < .01), the mean number of regurgitations per day (2.9 vs 4.6; P < .01), and the mean number of evacuations per day (4.2 vs 3.6; P < .01) for the L reuteri DSM 17938 and placebo groups, respectively, were significantly different. The use of L reuteri DSM 17938 resulted in an estimated mean savings per patient of €88 (US $118.71) for the family and an additional €104 (US$140.30) for the community. CONCLUSIONS AND RELEVANCE Prophylactic use of L reuteri DSM 17938 during the first 3 months of life reduced the onset of functional gastrointestinal disorders and reduced private and public costs for the management of this condition

Conoscenze, attitudini e pratiche sulla tubercolosi tra gli studenti italiani: risultati preliminari

Introduzione La tubercolosi (tbc) rappresenta un problema di Sanit\ue0 Pubblica riemergente a livello globale, come indicato dall'Organizzazione Mondiale della Sanit\ue0 (OMS) a partire dal 1993. In Italia, il tasso di notifica di TB negli ultimi anni \ue8 risultato inferiore a 10 casi per 100.000 abitanti, soglia entro la quale un Paese \ue8 definito dall'OMS "a bassa incidenza". Tra i soggetti pi\uf9 a rischio di contrarre l'infezione figurano gli operatori sanitari e gli studenti dei Corsi di Laurea dell'area medica. La corretta conoscenza della malattia rappresenta il presupposto per le attivit\ue0 di prevenzione e controllo. La presente indagine ha lo scopo di valutare le conoscenze sulla tbc degli studenti dei Corsi di Laurea dell'area sanitaria in Italia. Metodi L'indagine \ue8 stata svolta in 14 Universit\ue0 Italiane attraverso un questionario predisposto dal GISIO (Gruppo Italiano Studio Igiene Ospedaliera) e somministrato al termine delle lezioni dei corsi di Igiene e Medicina Preventiva. Il questionario raccoglieva diversi item: corso di laurea, eziologia della tbc, prognosi, trattamento e prevenzione dell'infezione. Risultati Sono stati reclutati 1.855 studenti (66,5% di sesso femminile), di cui 520 iscritti al corso di laurea in Medicina e Chirurgia e 1.335 ai corsi di laurea delle professioni sanitarie. Il 95% degli intervistati conosce l'eziologia della tbc, ed il 77% afferma l'esistenza di potenziali forme di malattia extra-polmonari; il 67% riporta che la tbc non trattata ha una letalit\ue0 superiore al 50%, mentre il 76% evidenzia la necessit\ue0 di una assunzione prolungata di antibiotici, con probabilit\ue0 di sviluppare una farmaco-resistenza (79%). Il 28% sottolinea come la maggior parte delle infezioni decorrono in maniera asintomatica. L'87% degli intervistati conosce l'esistenza di un vaccino anti-tbc, mentre il 69% ritiene che non sia completamente efficace ed il 42% che sia costituito dal bacillo di Calmette-Guerin. L'88% degli studenti identifica la prova tubercolinica quale test di screening dell'infezione latente, il restante 12% la indica come test di laboratorio, vaccino o terapia. Conclusioni Anche se la maggior parte degli studenti conosce la tbc, una parte (rilevante per alcuni quesiti) evidenzia importanti carenze conoscitive, ad esempio quelle concernenti la frequenza di forme latenti o la composizione del vaccino. I dati ottenuti indicano un basso livello di attenzione nei confronti della malattia, probabilmente legato ad una scarsa percezione del rischio. Risulta necessario, pertanto, potenziare le strategie formative nei Corsi di Laurea, con particolare attenzione alla prevenzione del rischio biologico in ambito assistenziale