Communication strategy during the A/H1N1v influenza pandemic in Italy

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Vaccinazione anti-Rotavirus: razionale, efficacia, impatto

L\u2019impatto delle gastroenteriti da Rotavirus (GERV) a livello mondiale \ue8 drammatico, determi-nando importanti ricadute di tipo organizzativo ed economico sui sistemi sanitari dei Paesi ad elevato income sia elevati tassi di letalit\ue0 nei Paesi in via di sviluppo. I due vaccini attualmente disponibili sono i preparati monovalente e pentavalente. I dati disponibili in letteratura mostrano ottimi livelli di efficacia e sicurezza per entrambi i vaccini. Tuttavia, alla luce dell\u2019aumentata incidenza di intussuscezione intestinale osservata nella sorveglianza post-marketing dei bambini vaccinati con Rotashield\uae, ritirato dal commercio nel 1999, \ue8 stata posta particolare attenzione a rilevare un eccesso di incidenza di questo evento avverso. Tuttavia, nei Randomized Clinical Trial (RCT) condotti sia per RV1 sia per RV5, la frequenza di invaginazione intestinale \ue8 risultata uguale nei due gruppi di trattamento. La strategia di vaccinazione universale rivolta a tutti i nuovi nati, raccomandata dall\u2019Organizza-zione Mondiale della Sanit\ue0 (OMS) e dalle pi\uf9 autorevoli societ\ue0 scientifiche, rappresenta l\u2019approccio di Sanit\ue0 Pubblica in grado di garantire il contenimento del burden delle GERV, consentendo anche un notevole risparmio di risorse economiche e sociali da parte sia del Sistema Sanitario Nazionale (SSN) che della popolazione general

State of the Art, Unresolved Issues, and Future Research Directions in the Fight against Hepatitis C Virus: Perspectives for Screening, Diagnostics of Resistances, and Immunization

Hepatitis C virus (HCV) still represents a major public health threat, with a dramatic burden from both epidemiological and clinical points of view. New generation of direct-acting antiviral agents (DAAs) has been recently introduced in clinical practice promising to cure HCV and to overcome the issues related to the interferon-based therapies. However, the emergence of drug resistance and the suboptimal activity of DAAs therapies against diverse HCV genotypes have been observed, determining treatment failure and hampering an effective control of HCV spread worldwide. Moreover, these treatments remain poorly accessible, particularly in low-income countries. Finally, effective screening strategy is crucial to early identifying and treating all HCV chronically infected patients. For all these reasons, even though new drugs may contribute to impacting HCV spread worldwide a preventive HCV vaccine remains a cornerstone in the road to significantly reduce the HCV spread globally, with the ultimate goal of its eradication. Advances in molecular vaccinology, together with a strong financial, political, and societal support, will enable reaching this fundamental success in the coming years. In this comprehensive review, the state of the art about these major topics in the fight against HCV and the future of research in these fields are discussed

The impact of 10-valent and 13-valent pneumococcal conjugate vaccines on hospitalization for pneumonia in children: A systematic review and meta-analysis

Abstract Background This systematic review and meta-analysis aimed at summarizing available data on the impact of PCV10 and PCV13 in reducing the incidence of CAP hospitalizations in children aged Methods A systematic search of the literature was conducted. We included time-series analyses and before-after studies, reporting the incidence of hospitalization for pneumonia in the periods before and after the introduction of PCV10 or PCV13 into the immunization program. Pooled estimates of Incidence Rate Ratio (IRR) were calculated by using a random-effects meta-analytic model. Results were stratified according to age-groups ( Results A total of 1533 potentially relevant articles were identified. Of these, 12 articles were included in the analysis. In children aged In children aged 24–59 months, the meta-analysis showed a reduction of 9% (95%CI: 5–14%, p-value High heterogeneity was detected among studies evaluating the hospitalization rate for clinically and radiologically confirmed pneumonia. Conclusions The results of this study revealed a significant impact of PCV10 and PCV13 in reducing the hospitalizations for pneumonia, particularly in children age

Impatto della pertosse nella popolazione e strategie di prevenzione vaccinale

L'impatto epidemiologico della pertosse ha subito variazioni rilevanti soprattutto in et\ue0 pedia-trica, in seguito alla disponibilit\ue0 di vaccini cellulari altamente efficaci e alla successiva dif-fusione di preparati acellulari, caratterizzati da un migliore profilo di tollerabilit\ue0 e formulati in combinazione con altre componenti antigeniche. Cionondimeno, la pertosse rappresenta tutt\u2019oggi un\u2019importante causa di morbosit\ue0 e mortalit\ue0 nei neonati non ancora vaccinati o che non hanno completato il ciclo primario, e che possono essere infettati dai contatti suscettibili. Le coperture vaccinali sub-ottimali, la progressiva riduzione della protezione immunitaria conferita sia dall\u2019infezione naturale sia dalla vaccinazione e la mancata effettuazione dei richiami vaccinali contribuiscono, infatti, a rendere gli adolescenti e gli adulti le fonti princi-pali di trasmissione dell'infezione ai neonati. Strategie di prevenzione integrate e indirizzate a tutti i target coinvolti nella trasmissione dell'infezione (i.e. soggetti in et\ue0 pediatrica, ado-lescente e adulta, le donne in gravidanza, e gli operatori sanitari) rappresentano, pertanto, uno strumento chiave per il controllo della pertosse

Leadership Effectiveness in Healthcare Settings: A Systematic Review and Meta-Analysis of Cross-Sectional and Before-After Studies

To work efficiently in healthcare organizations and optimize resources, team members should agree with their leader's decisions critically. However, nowadays, little evidence is available in the literature. This systematic review and meta-analysis has assessed the effectiveness of leadership interventions in improving healthcare outcomes such as performance and guidelines adherence. Overall, the search strategies retrieved 3,155 records, and 21 of them were included in the meta-analysis. Two databases were used for manuscript research: PubMed and Scopus. On 16th December 2019 the researchers searched for articles published in the English language from 2015 to 2019. Considering the study designs, the pooled leadership effectiveness was 14.0% (95%CI 10.0-18.0%) in before-after studies, whereas the correlation coefficient between leadership interventions and healthcare outcomes was 0.22 (95%CI 0.15-0.28) in the cross-sectional studies. The multi-regression analysis in the cross-sectional studies showed a higher leadership effectiveness in South America (beta = 0.56; 95%CI 0.13, 0.99), in private hospitals (beta = 0.60; 95%CI 0.14, 1.06), and in medical specialty (beta = 0.28; 95%CI 0.02, 0.54). These results encourage the improvement of leadership culture to increase performance and guideline adherence in healthcare settings. To reach this purpose, it would be useful to introduce a leadership curriculum following undergraduate medical courses

Is first-line antimicrobial therapy still adequate to treat MRSA in the ICU? A report from a highly endemic country

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Burden and prevention of HPV. Knowledge, Practices and Attitude Assessment Among Pre-adolescents and their Parents in Italy

Despite infections due to HPV nowadays represent the most common sexually transmitted diseases worldwide with recognized effective and safe preventive strategies, knowledge, attitudes; however, awareness on HPV is considerably low. The present study has two main objectives: 1. To conduct a literature review to analyze the evolution of preventive tools, the complexity of the vaccine choice process, and the challenges posed by HPV vaccine hesitancy and refusal among pre-adolescents and their parents; 2. To assess knowledge, practices and attitudes toward HPV infection and vaccination in a sample of Italian pre-adolescents and their parents. The observational study was carried out through the use of two anonymous and self-administered pre- and post-intervention questionnaires dedicated to the target populations. Between the administrations of the pre- and post-intervention questionnaires, an educational intervention on ITV infection and related diseases, and prevention strategies was conducted. All participants demonstrated suboptimal knowledge and positive attitudes in the pre-intervention questionnaire. Higher levels of knowledge and attitudes were observed among pre-adolescents thatused social networks and had heard of sexually transmitted diseases at home/school/physician and from parents and also who had heard of HPV from General Practitioners, Gynecologists, family members and newspapers. A significant increase in HPV vaccination awareness was observed among pre-adolescents after the educational sessions. Health education programs aimed at increasing knowledge, attitudes and awareness on HPV are needed to implement the outcomes of HPV immunization programs, especially if supported by the physicians involved in counselling and recommendation processes

Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions