Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Preferences of healthcare professionals regarding hexavalent pediatric vaccines in Italy: a survey of attitudes and expectations: Hexavalent pediatric vaccines in Italy

Introduction. In Italy, three hexavalent pediatric vaccines are available: two are ready-to-use (RTU) as pre-filled syringes, while the third must be reconstituted (need-for-reconstitution [NFR]). The formulation is related to the vaccination timing, safety of preparation and administration, and possible errors in immunization. We surveyed Italian healthcare professionals (HCPs) experienced with RTU and NFR vaccines in order to investigate their opinions on key aspects of the vaccines. Methods. In Q1 2018, a qualitative study, ethnographic observations and in-depth interviews were performed in public vaccination settings of three Italian Regions. Data on how the vaccination process was managed and perceptions about the value of the RTU formulation were collected. In Q2 2018, face-to-face interviews were carried out to explore the attitude and preferences of Italian HCPs from nine Regions, assessing advantages and disadvantages of the two formulations from a quantitative point of view. In Q3–Q4 data analysis was carried out, using both qualitative and quantitative methodologies. Results. The first phase demonstrated the following advantages of the RTU versus the NFR formulation: time-saving, lower probability of needle contamination and needle stick incidents, better handling, simpler procedure, easier disposal of waste. For the survey, 149 HCPs were interviewed; 80% and 40%, respectively, were very satisfied with the RTU and NFR vaccine. Conclusions. Our study demonstrated that HCPs prefer the RTU formulation, as it simplifies vaccinations, reduces preparation time and minimizes the risk of errors. This formulation also saves time that can be spent on more in-depth counseling

Fourteen years’ clinical experience and the first million babies protected with human live-attenuated vaccine against rotavirus disease in Italy

Rotavirus (RV) causes up to half of hospital and community acute gastroenteritis (AGE) cases in young children in Italy. Two RV vaccines, available since 2006, are human RV (HRV) and human bovine RV (HBRV). This report looks back at the implementation of RV vaccination with HRV in Italy, and at HRV current and future perspectives. Initial regional policies led to national implementation by 2018, after scientific societies’ disease awareness efforts. Following vaccination, RV hospitalizations declined significantly, and cost savings were observed. The two-dose HRV vaccine is easily administered during compulsory vaccine visits, helping increase coverage. Intussusception, a serious event in children <1 year, was reported in Italy with a rate of 33–40 per 100,000 infants. RV vaccination presents a low increased risk of intussusception after the first dose, estimated at 0.6 cases per 100,000 doses in Italy in 2019. Parents should be aware of the intussusception risk and symptoms to ensure prompt treatment. It is widely recognized that the vaccination benefits (large numbers of RV hospitalizations prevented) outweigh the risk. HRV introduction in Italy was supported by epidemiologic burden studies, healthcare provider opinions, and congress debates, which significantly contributed to implementation of RV universal routine infant vaccination in Italy

Why, when and for what diseases pregnant and new mothers “should” be vaccinated

Immunological and serological changes that occur during pregnancy can alter the susceptibility of both the mother and the fetus against various infectious diseases. The pregnant woman has an altered immune response and, for some pathologies, is at increased risk of infection and of developing complications and serious outcomes. In addition, maternal infections can result in congenital anomalies, malformations or severe neonatal diseases. Vaccination of pregnant women can therefore have a double goal: to protect the mother from diseases that could have an impact on her health and to avoid infection/disease transmission to the fetus or the newborn. Despite the potential benefits of immunization in pregnant women, it is still evident reluctance and/or refusal of vaccinations by health professionals as well as by pregnant women, who are wary of the real advantages linked to vaccines. For these reasons a group of experts has evaluated the latest scientific evidence reported in the international literature on this relevant topic

[Universal vaccination against varicella in Italy: the same opportunity for all children]

Varicella is an infectious disease still frequent in Italy, where 8 out 20 Regions have adopted universal vaccination programs starting from 2003. Accordingly to National Vaccination Plan, all Regions should introduce universal varicella vaccination in 2015. An independent multidisciplinary group of experts met to discuss some debated questions. The available evidence of varicella vaccine efficacy in the 8 Regions was evaluated and the evidence of safety of monovalent and combined varicella vaccines are presented. The strategy for introducing universal varicella vaccine in the pediatric immunization schedule is discussed. The expert group concludes that available evidence supports the active offer of varicella vaccine in all Italian Regions and that catch up programs for susceptible cohorts should be encouraged

I vaccini e le vaccinazioni

Le quattro Società firmatarie del Calendario per la Vita (SITI, SIP, FIMMG e FIMP) vista la richiesta di attenzione su questo elaborato sul tema dei vaccini, prodotto dalla Società Italiana di Farmacologia (SIF) presieduta dal Prof. Giorgio Cantelli Forti, ne esprimono grande apprezzamento. Gli argomenti trattati sono divenuti particolarmente importanti e attuali con la recente approvazione dei LEA in concomitanza al Piano Nazionale Vaccini 2017 – 2019. Il testo ispirato anche ai contenuti e principi del nostro Calendario per la Vita, arricchisce la cultura vaccinale con la giusta positività che si contrappone alle strumentali campagne denigratorie che periodicamente compaiono sul web creando incertezze e smarrimento a una popolazione che, per merito delle vaccinazioni, si è dimenticata le tragiche conseguenze di molte malattie infettive degli scorsi decenni

I vaccini e le vaccinazioni

Le quattro Società firmatarie del Calendario per la Vita (SITI, SIP, FIMMG e FIMP) vista la richiesta di attenzione su questo elaborato sul tema dei vaccini, prodotto dalla Società Italiana di Farmacologia (SIF) presieduta dal Prof. Giorgio Cantelli Forti, ne esprimono grande apprezzamento. Gli argomenti trattati sono divenuti particolarmente importanti e attuali con la recente approvazione dei LEA in concomitanza al Piano Nazionale Vaccini 2017 – 2019. Il testo ispirato anche ai contenuti e principi del nostro Calendario per la Vita, arricchisce la cultura vaccinale con la giusta positività che si contrappone alle strumentali campagne denigratorie che periodicamente compaiono sul web creando incertezze e smarrimento a una popolazione che, per merito delle vaccinazioni, si è dimenticata le tragiche conseguenze di molte malattie infettive degli scorsi decenni