The Severe Heart Failure Questionnaire: Italian translation and linguistic validation

Introduction. The quality of life (QoL) is an important outcome indicator for heart failure management. As the use of a validate questionnaire in a different cultural context can affect data interpretation our main objective is the Italian translation and linguistic validation of the Severe Heart Failure Questionnaire (SHF) and its comparison with the MLHF (Minnesota Living with Heart Failure) Questionnaire. Methods. The SHF and ?The Minnesota Living with Heart Failure Questionnaire? were translated. A consensus involving parallel back-translations was established among a group of cardiologists, psychologists and biostatisticians. SHF and MLHF were both administrated to a sample of 50 patients Results. The patients? median age was 63 years. Ace inhibitors therapy was administered in 88% of cases and betablockers in 56% of cases. Finally the Italian version of SHF correlates well with MLHF for all domains, except life satisfaction SHF domain. Discussion: The Italian version of the SHF correlates well with MLHF for almost all domains and it represents a valid alterna- tive for quality of life assessment in heart failure patients

Opportunistic screening for type 2 diabetes in community pharmacies. Results from a region-wide experience in Italy

BACKGROUND AND AIMS:Given the paucity of symptoms in the early stages of type 2 diabetes, its diagnosis is often made when complications have already arisen. Although systematic population-based screening is not recommended, there is room to experience new strategies for improving early diagnosis of the disease in high risk subjects. We report the results of an opportunistic screening for diabetes, implemented in the setting of community pharmacies. METHODS AND RESULTS:To identify people at high risk to develop diabetes, pharmacists were trained to administer FINDRISC questionnaire to overweight, diabetes-free customers aged 45 or more. Each interviewee was followed for 365 days, searching in the administrative database whether he/she had a glycaemic or HbA1c test, or a diabetologists consultation, and to detect any new diagnosis of diabetes defined by either a prescription of any anti-hyperglycaemic drug, or the enrolment in the register of patients, or a hospital discharge with a diagnosis of diabetes. Out of 5977 interviewees, 53% were at risk of developing diabetes. An elevated FINDRISC score was associated with higher age, lower education, and living alone. Excluding the number of cases expected, based on the incidence rate of diabetes in the population, 51 new cases were identified, one every 117 interviews. FINDRISC score, being a male and living alone were significantly associated with the diagnosis. CONCLUSIONS:The implementation of a community pharmacy-based screening programme can contribute to reduce the burden of the disease, particularly focusing on people at higher risk, such as the elderly and the socially vulnerable

Long term effect of air pollution on incident hospital admissions: Results from the Italian Longitudinal Study within LIFE MED HISS project

Background: The LIFE MED HISS project aims at setting up a surveillance system on the long term effects of air pollution on health, using data from National Health Interview Surveys and other currently available sources of information in most European countries. Few studies assessed the long term effect of air pollution on hospital admissions in European cohorts. Objective: The objective of this paper is to estimate the long term effect of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) on first-ever (incident) cause-specific hospitalizations in Italy. Methods: We used data from the Italian Longitudinal Study (ILS), a cohort study based on the 1999–2000 National Health Interview Survey (NHIS), followed up for hospitalization (2001–2008) at individual level. The survey contains information on crucial potential confounders: occupational/educational/marital status, body mass index (BMI), smoking habit and physical activity. Annual mean exposure to PM2.5 and NO2 was assigned starting from simulated gridded data at spatial resolution of 4 × 4 km2 firstly integrated with data from monitoring stations and then up-scaled at municipality level. Statistical analyses were conducted using Cox proportional hazard models with robust variance estimator. Results: For each cause of hospitalization we estimated the hazard ratios (HRs) adjusted for confounders with 95% Confidence Interval (CI) related to a 10 μg/m3 increase in pollutants. For PM2.5 and NO2, respectively, we found positive associations for circulatory system diseases [1.05(1.03–1.06); 1.05(1.03–1.07)], myocardial infarction [1.15(1.12–1.18); 1.15(1.12–1.18)], lung cancer [1.18(1.10–1.26); 1.20(1.12–1.28)], kidney cancer [1.24(1.11–1.29); 1.20(1.07–1.33)], all cancers (but lung) [1.06(1.04–1.08); 1.06(1.04–1.08)] and Low Respiratory Tract Infections (LRTI) [1.07 (1.04–1.11); 1.05 (1.02–1.08)]. Discussion: Our results add new evidence on the effects of air pollution on first-ever (incident) hospitalizations, both in urban and rural areas. We demonstrated the feasibility of a low-cost monitoring system based on available data

Lignosulfonates as fire retardants in wood flour-based particleboards

Wood flour particleboards (WFP), like other wood-based items, require the addition of fire retardants (FRs) to reduce their high flammability. In this work, a waste lignosulfonate (CaLS) from paper mill is used as a low-cost FR to reduce WFP flammability. CaLS is purified by dialysis and the dialysed lignosulfonate (LD) is used, alone or combined with ammonium polyphosphate (APP), as a FR additive in the preparation of urea-formaldehyde WFP. The fire behaviour of the modified WFPs is studied by cone calorimetry. The use of 15 wt.% LD reduces the peak of heat release rate (HRR) and total smoke production by 25%, also increasing char formation. HRR peak is further reduced up to 40%, if APP is introduced in the formulation. This work discloses a viable and cost-effective strategy for improving the fire retardancy performance of WFP by partial replacement of a commercial FR with a fully renewable additive, isolated through a green and cost-effective process. Copyright © 2019 Stefania Angelini et al

Self-medication for migraine: a Nationwide cross-sectional study in Italy

Headache disorders are considered the second leading cause of years lived with disability worldwide, and 90% of people have a headache episode at least once a year, thus representing a relevant public health priority. As the pharmacist is often the first and only point of reference for people complaining of headache, we carried out a survey in a nationwide sample of Italian pharmacies, in order to describe the distribution of migraine or non-migraine type headaches and medicines overuse among people entering pharmacies seeking for self-medication; and to evaluate the association, in particular of migraine, with socio-demographic and clinical characteristics, and with the pathway of care followed by the patients. A 14-item questionnaire, including socio-demographic and clinical factors, was administered by trained pharmacists to subjects who entered a pharmacy requesting self-medication for a headache attack. The ID Migraine™ Screener was used to classify headache sufferers in four classes. From June 2016 to January 2017, 4424 people have been interviewed. The prevalence of definite migraines was 40%, significantly higher among women and less educated people. About half of all headache sufferers and a third of migraineurs do not consider their condition as a disease and are not cared by any doctor. Among people seeking self-medication in pharmacies for acute headache attacks, the rate of definite or probable migraine is high, and a large percentage of them is not correctly diagnosed and treated. The pharmacy can be a valuable observatory for the study of headaches, and the first important step to improve the quality of care delivered to these patients

Foreign bodies in the ears causing complications and requiring hospitalization in children 0-14 age: results from the ESFBI study

The occurrence of foreign bodies (FBs) in otorhinolaryngological practice is a common and serious problem among patients in paediatric age. The aim of this work is to characterize the risk of complications and prolonged hospitalization due to foreign bodies in ears in terms of the characteristics of the injured patients (age, gender), typology and features of the foreign bodies, the circumstances of the accident and the hospitalization's details

Sex-Differences in the Pattern of Comorbidities, Functional Independence, and Mortality in Elderly Inpatients: Evidence from the RePoSI Register

Background: The RePoSi study has provided data on comorbidities, polypharmacy, and sex dimorphism in hospitalised elderly patients. Methods: We retrospectively analysed data collected from the 2010, 2012, 2014, and 2016 data sets of the RePoSi register. The aim of this study was to explore the sex-differences and to validate the multivariate model in the entire dataset with an expanded follow-up at 1 year. Results: Among 4714 patients, 51% were women and 49% were men. The disease distribution showed that diabetes, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, and malignancy were more frequent in men but that hypertension, anaemia, osteoarthritis, depression, and diverticulitis disease were more common in women. Severity and comorbidity indexes according to the Cumulative Illness Rating Scale (CIRS-s and CIRS-c) were higher in men, while cognitive impairment, mood disorders, and disability in daily life measured by the Barthel Index (BI) were worse in women. In the multivariate analysis, BI, CIRS, and malignancy significantly increased the risk of death in men at the 1-year follow-up, while age was independently associated with mortality in women. Conclusions: Our study highlighted the relevance and the validity of our previous predictive model in the identification of sex dimorphism in hospitalised elderly patients underscoring the need of sex-personalised health-care

The risks of acute exposure to black carbon in Southern Europe: Results from the med-particles project

Objectives: While several studies have reported associations of daily exposures to PM2.5 (particles less than 2.5 μm) with mortality, few studies have examined the impact of its constituents such as black carbon (BC), which is also a significant contributor to global climate change. Methods: We assessed the association between daily concentrations of BC and total, cardiovascular and respiratory mortality in two southern Mediterranean cities. Daily averages of BC were collected for 2 years in Barcelona, Spain and Athens, Greece. We used case-crossover analysis and examined single and cumulative lags up to 3 days. Results: We observed associations between BC and all mortality measures. For a 3-day moving average, cardiovascular mortality increased by 4.5% (95% CI 0.7 to 8.5) and 2.0% (95% CI 0 to 4.0) for an interquartile change in BC in Athens and Barcelona, respectively. Considerably higher effects for respiratory mortality and for those above age 65 were observed. In addition, BC exhibited much greater toxicity per microgram than generic PM2.5. Conclusions: Our findings suggest that BC, derived in western industrialised nations primarily from diesel engines and biomass burning, poses a significant burden to public health, particularly in European cities with high-traffic density.Peer reviewe