Comparative efficacy and acceptability of pharmacological treatments for insomnia in adults: A systematic review and network meta-analysis

This is the protocol for a review and there is no abstract. The objectives are as follows: 1) To compare individual pharmacological treatments for insomnia in adults in terms of: efficacy, measured as self-rated quality of sleep or satisfaction with sleep; and acceptability of treatment. 2) To generate a clinically-useful hierarchy of available pharmacological treatments for insomnia in adults, according to their efficacy and acceptability

Co-circulation of SARS-CoV-2 Alpha and Gamma variants in Italy, February and March 2021

Background. Several SARS-CoV-2 variants of concern (VOC) have emerged through 2020 and 2021. There is need for tools to estimate the relative transmissibility of emerging variants of SARS-CoV-2 with respect to circulating strains.AimWe aimed to assess the prevalence of co-circulating VOC in Italy and estimate their relative transmissibility.Methods. We conducted two genomic surveillance surveys on 18 February and 18 March 2021 across the whole Italian territory covering 3,243 clinical samples and developed a mathematical model that describes the dynamics of co-circulating strains.Results. The Alpha variant was already dominant on 18 February in a majority of regions/autonomous provinces (national prevalence: 54%) and almost completely replaced historical lineages by 18 March (dominant across Italy, national prevalence: 86%). We found a substantial proportion of the Gamma variant on 18 February, almost exclusively in central Italy (prevalence: 19%), which remained similar on 18 March. Nationally, the mean relative transmissibility of Alpha ranged at 1.55-1.57 times the level of historical lineages (95% CrI: 1.45-1.66). The relative transmissibility of Gamma varied according to the assumed degree of cross-protection from infection with other lineages and ranged from 1.12 (95% CrI: 1.03-1.23) with complete immune evasion to 1.39 (95% CrI: 1.26-1.56) for complete cross-protection.Conclusion. We assessed the relative advantage of competing viral strains, using a mathematical model assuming different degrees of cross-protection. We found substantial co-circulation of Alpha and Gamma in Italy. Gamma was not able to outcompete Alpha, probably because of its lower transmissibility

Emergenza immigrazione. Risultati della sorveglianza sindromica in Italia: maggio 2011 - aprile 2012

Dai primi disordini in Tunisia nel dicembre 2010, nel 2011 e 2012 proteste popolari hanno profondamente cambiato l’assetto di politico di molti paesi del Mediterraneo meridionale e promosso processi di democratizzazione o riforme costituzionali. Una conseguenza dell’instabilità politica e della riduzione dei controlli alle frontiere è stata l’aumento nell’afflusso di migranti verso paesi del sud Europa, particolarmente Italia, Malta e Grecia, e movimenti di popolazione tra Egitto, Tunisia e Libia. Questo rapporto ISTISAN ripercorre l’esperienza italiana nell’utilizzo di un sistema di sorveglianza sindromica volto a fornire allerte precoci su potenziali emergenze di sanità pubblica nei centri di accoglienza degli immigrati giunti in Italia in questa circostanza. Lo scopo di questa pubblicazione è di lasciare una documentazione utile a riattivare eventualmente questa sorveglianza in futuro e/o adattarne la metodologia per future esigenze nazionali o regionali di salute pubblica

Tracking the progressive spread of the SARS-CoV-2 Omicron variant in Italy, December 2021 to January 2022.

BackgroundThe SARS-CoV-2 variant of concern Omicron was first detected in Italy in November 2021.AimTo comprehensively describe Omicron spread in Italy in the 2 subsequent months and its impact on the overall SARS-CoV-2 circulation at population level.MethodsWe analyse data from four genomic surveys conducted across the country between December 2021 and January 2022. Combining genomic sequencing results with epidemiological records collated by the National Integrated Surveillance System, the Omicron reproductive number and exponential growth rate are estimated, as well as SARS-CoV-2 transmissibility.ResultsOmicron became dominant in Italy less than 1 month after its first detection, representing on 3 January 76.9-80.2% of notified SARS-CoV-2 infections, with a doubling time of 2.7-3.3 days. As of 17 January 2022, Delta variant represented < 6% of cases. During the Omicron expansion in December 2021, the estimated mean net reproduction numbers respectively rose from 1.15 to a maximum of 1.83 for symptomatic cases and from 1.14 to 1.36 for hospitalised cases, while remaining relatively stable, between 0.93 and 1.21, for cases needing intensive care. Despite a reduction in relative proportion, Delta infections increased in absolute terms throughout December contributing to an increase in hospitalisations. A significant reproduction numbers' decline was found after mid-January, with average estimates dropping below 1 between 10 and 16 January 2022.ConclusionEstimates suggest a marked growth advantage of Omicron compared with Delta variant, but lower disease severity at population level possibly due to residual immunity against severe outcomes acquired from vaccination and prior infection

Emergenza immigrazione. Risultati della sorveglianza sindromica in Italia: maggio 2011-aprile 2012

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