HPV vaccine and autoimmune diseases: systematic review and meta-analysis of the literature

Background: Human papillomavirus is one of the commonest sexually transmitted viruses worldwide. Though an effective vaccine is available in 65 countries, the worldwide vaccine coverage remains low. One of the reasons of this is the onset of adverse events as autoimmune disease.Methods: We carried out a systematic review to identify all scientific publications dealing with the correlation between vaccine anti-papillomavirus and new onset of autoimmune diseases. To evaluate the safety of HPV vaccines, the dichotomous data on the number of subjects experiencing an autoimmune disorder in the study vaccine group and the placebo group were extracted from each study with subsequent determination of the risk ratios and their 95% confidence intervals. We combined data statistically using a random effects model. Results: We identified 3 studies reporting on bivalent HPV vaccines and 3 studies on quadrivalent vaccines. The total number of subjects included in the meta-analysis comprised 243,289 in the vaccine group and 248,820 in control groups. Four of the six trials had a Jadad score of 3 or 4 indicating an adequate trial quality. The most frequent autoimmune disease observed across the six studies were musculoskeletal,CNS conditions and endocrinological conditions . The results of the meta-analysis demonstrated no correlation between autoimmune disorders and HPV vaccines (pooled OR 1.038, 95% CI 0.689–1.562).Conclusions: No correlation was identified for bivalent and quadrivalent HPV vaccines. It’s therefore essential to correctly inform the general population in order to try to increase both Italian and international vaccination coverage.

Quality and management care improvement of patients with chronic kidney disease: from data analysis to the definition of a targeted clinical pathway in an Italian Region

Background: Clinical Diagnostic Care Pathways(CDCP) are widespread throughout the world and they could  improve the quality of patient care through a well-organized care continuum  and could enhance the patient's "risk-adjusted" outcomes; indeed they could optimize the management of resources. They are important especially for the management of chronic degenerative diseases such as chronic kidney disease; for this disease incidence and prevalence is increasing worldwide, with an estimated 11-13% of the population being affected. So the application of a CDCP is much important for its management.Methods: the aim of this study is the creation of a CDCP for patients in Lazio with stage 5 CKD that allows proper patient management with a reduction in the possible complications and patient migration to facilities outside the region. The study was conducted in collaboration between the National Institute of Health, the University of Messina and the S. Giovanni Addolorata Hospital.Results: We analyzed the data for the KCD in Roma and in the San Giovanni Addolarata Hospital and we found a drop out of the patient, probably to other region or however other hospital. So we make a CDCP that has been adopted as a model in the San Giovanni Addolorata hospital and the reduction of outpatient migration and emergency hospital access are currently being monitored.Conclusions: the optimization of patient management and the organization of adequate health care is therefore essential to ensure the sustainability of the Italian NHS, which today is comparable to a "ship that is heading towards a perfect storm"

Surveillance and evidence of contamination in hospital environment from meticillin and vancomycin-resistant microbial agents

Introduction. Direct contact is undoubtedly the main means of transmission of hospital infections. An investigative study was therefore conducted to assess workplace surfaces at risk from microbial contamination. Methods. The study was conducted using swabs and contact slides placed on the palms of healthcare workers during their routine patient care and on workplace surfaces (e.g. telephones, computers, medication trolleys, taps) in treatment rooms, oper- ating theatres and wards. Disposable swabs were used for rapid screening and read with a bioluminometer. At the same time, a sample was taken from those testing positive using a contact slide. The samples testing positive for Staphylococci underwent identification to assess resistance to meticillin-resistant Sta- phylococcus aureus (MRS/MRSA) and to vancomycin (VISA/ VRSA) Results. Meticillin-resistant Staphylococcus strains were found on 14.7% (20/136) of samples taken from the hands of workers and 35.7% (15/42) of those from hospital surfaces. An even higher resistance to meticillin and/or vancomycin than that found for S. aureus was identified in nosocomial strains of coagulase negative staphylococci, including S. epidermidis and S. haemolyticus. Conclusion. The study concludes that there is thus a need for greater care in complying with procedures designed and support for surveillance to reduce the risk of infection

Study on hepatitis B and C serologic status among municipal solid waste workers in Messina (Italy)

A study on hepatitis B and C virus seroprevalence was carried out on blood samples from 327 municipal solid waste workers in Messina (Italy) to verify the hypothesis that this category of workers is at high risk for such diseases. The fact that 32.41% of all the subjects showed previous exposure to hepatitis B virus (HBV) substantiates the need to proceed with compulsory HBV vaccine prophylaxis in this category of workers, also in anticipation of possible medical legal litigations

Identification of the microorganisms responsible for periodontopathy by Multiplex RT-PCR

The aim of our research was to identify by bacterial genomicDNA analysis the prevalence of five different species of periodontopathogenic bacteria present in the subgingival biofilm,specifically: Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Bacterioides forsytus (Bf), Treponema denticola (Td).For the analysis we used the systematic Multiplex-PCR-microdentkit with species-specific primers. We studied a group of 48 subjects, 18 males and 30 females, from 18 to 78 years of age. Theinitial clinical screening enabled us to select, among the groupanalysed, 24 subjects with signs of active periodontopathy (GroupA) and 24 patients without identifiable clinical evidence of the disease used as the control group (Group B). Within the two experimental groups (A and B), the test was found to be positive in 75%of subjects from group A, whereas the test was found to be negative in all the subjects from group B. Our research shows thatthe Multiplex-PCR system is reliable. Furthermore, the sensitivity and simplicity of this technique, as well as the decrease inworking times and the possibility of identifying non-culturablebacteria, since the presence of viable organisms is not essential,make this technique indicated for the simultaneous identificationof periodontopathogenic bacteria and might, in perspective, pro-vide a more effective clinical alternative to the techniques of bacterial typing of the subgingival plaque

Young people, young adults and Binge Drinking

Introduction and Purpose The consumption of alcohol among young people and young adults has undergone, in recent decades, a sharp upsurge with the increasingly frequent intake of large quantities of alcohol. The aim of our study was to investigate socio-demographic, economic and behavioural factors that have a major impact on the voluntary alcohol habit in young people. Methods The survey was conducted via administration of an anonymous questionnaire based on “the WHO Alcohol Use Disorders Identification Test”, disseminated on-line , to young people and young adults (aged 18 to 35) Results We examined a sample of 365 subjects. Consumption of wine and beer were predominant  followed by super-alcohol mixes. We found correlations between alcohol use and the following variables: marital status (p<0.001), parental education(mother p<0.05; father p<0.001), income level(p<0.05), physical activity (p<0.05) and voluptuous habits(smoke and coffee: p<0.001.The  5% of men and 1% of women had car accidents during the previous year due to alcohol use and 15% said they did not remember what happened in an alcoholic evening once or twice a month. Conclusions The phenomenon of alcohol consummation is deeply ingrained in our reality, with dangerous episodes of binge drinking in young adults with a higher prevalence  in the female sex

Hepatitis E virus (HEV) in sewage from treatment plants of Messina University Hospital and of Messina city council

Samples of sewage from treatment plants at the ?G. Martino? University Hospital of Messina (AOU) and that of Messina City Council were analysed to detect the hepatits E virus. Samples were taken on sewage entering and exiting the treat- ment plants on a monthly basis over a one-year period from both the hospital plant (24 samples) and the municipal plant (22 samples). All sewage samples were pretreated by ultrafiltraton and concen- tration and finally processed by the PCR method to amplify gene material. A total of three samples tested positive: two (8.33%) entering the AOU treatment plant and one (4.5%) entering the municipal plant while no cases of HEV were detected in samples of treated sewage. These findings confirm the presence of the virus in the city of Messina and showed that the two treatment plants to be working efficiently when tested

Comparison between a conventional subunit vaccine and the MF59-adjuvanted subunit influenza vaccine in the elderly: an evaluation of the safety, tolerability and immunogenicity

The objective of this study was to evaluate and compare the safety, tolerability and immunogenicity for two seasonal influ- enza subunit vaccines, one with MF59 adjuvant (Fluad?) and one without an adjuvant (Agrippal?). A total of 195 subjects aged ? 65 years were enrolled to receive one dose of vaccine intramuscularly, 96 were vaccinated with Fluad?, 99 received Agrippal?. Blood samples were taken from all subjects in order to assess their antibody titre by the haemagglutination inhibition assay (HI), before (Time 0) and after (Time 1: 28 ± 7 days) vaccination, against the A/H3N2 (A/Moscow/10/99), A/H1N1 (A/New Caledonia/20/99) and B/Shandong/7/97 antigens contained in the influenza vaccine in the 2002/2003 influenza season for the northern emisphere. A good humoral antibody response was detected for both vac- cines, meeting all the criteria of EMEA. The number of subjects in whom a ? 4-fold increase in antibody titre was recorded, in comparison with the pre-vaccination value, proved to be lower in the group vaccinated with Agrippal? than in those vaccinated with the adjuvated preparation. Fluad? exhibited better immu- nogenicity than Agrippal?. This difference was probably linked to the potentiated immune stimulation exerted by the adjuvant molecules. These results take on a particular importance if we consider that the immune system is weaker in the elderly; the admin- istration of an adjuvated vaccine in such subjects is clearly preferable in that it provides greater and more prolonged protection. Both vaccines were generally well tolerated; no severe adverse events occurred in any of the subjects vaccinated, confirming the excellent safety profile of Fluad? and Agrippa

Trend of MDR-microorganisms isolated from the biological samples of patients with HAI and from the surfaces around that patient

Healthcare-associated infections (HAI) continue to be a major public health concern. A number of epidemiologically relevant HAI microorganisms are multidrug-resistant (MDR) germs that can spread rapidly and/or carry multiple resistance to antibiotics. They are the cause of high mortality and possible nosocomial epidemics. For this reason, we implemented microbiological surveillance acquiring samples from patients with HAI and environmental samples from the surfaces surrounding those patients. A retrospective study was carried out from January 2014 to December 2016 in two departments of the University Hospital in Messina, Italy: the Microbiology and the Hygiene Laboratories. A comparison was made between the microbiological isolates found on the patients and the microorganisms typed further to environmental sampling on the surfaces adjacent to the patient with HAI. There was a 24% match in 2014, 22% in 2015 and 20% in 2016 on total isolates. The most common isolates belonged to the Enterobacteriacae family: in particular, an ever-increasing trend has been registered for Klebsiella spp; Acinetobacter baumannii and multiresistant Pseudomonas aeruginosa have seen a growing trend for both patient and environmental samples. During the three years, the highest infection prevalence rate was found in Anaesthesia and Resuscitation, followed by Thoracic and Vascular Surgery

Humidifiers for oxygen therapy: what risk for reusable and disposable devices?

INTRODUCTION. Nosocomial pneumonia accounts for the vast majority of hospital-acquired infections. Although numerous medical devices have been discussed to be potential vehicles of microorganisms, very little is known about the role played by oxygen humidifiers as potential sources of nosocomial pathogens. The purpose of this research was to analyze the rate of microbial contamination of reusable and disposable oxygen humidifiers used during therapy, and, thus, to speculate their potential role in the transmission of respiratory pathogens.METHODS. Water samples from reusable and disposable oxygen humidifiers were gathered from different wards where nosocomial pneumonia has a higher incidence rate due to “critical” clinical conditions of inpatients. The samples were collected always after a period of 5 days from initial use for both the types of humidifiers. Samples were processed using standard bacteriological techniques and microbial colonies were identified using manual and automated methods.RESULTS. High rates of microbial contamination were observed in samples from reusable oxygen humidifier employed in medical (83%), surgical (77%) and emergency (50%) areas. The most relevant pathogens were Pseudomonas aeruginosa, amongst Gram-negative bacteria, and Staphylococcus aureus, amongst Gram-positive bacteria. Other pathogens were detected in lower percentage. Disposable oxygen humidifier samples showed no contamination.CONCLUSIONS. This research presents evidence of the high rate and type of microbial contamination of reusable humidifiers employed for oxygen therapy. These devices might thus be involved in the transmission of potential pathogens. For the purpose of preventing nosocomial pneumonia, it is advisable to substitute reusable oxygen humidifiers with safer disposable ones