congenital rubella still a public health problem in italy analysis of national surveillance data from 2005 to 2013

In accordance with the goal of the World Health Organization Regional Office for Europe, the Italian national measles and rubella elimination plan aims to reduce the incidence of congenital rubella cases to?less than?one case per 100,000 live births by the end of 2015. We report national surveillance data for congenital rubella and rubella in pregnancy from 2005 to 2013. A total of 75 congenital rubella infections were reported; the national annual mean incidence was 1.5/100,000 live births, including probable and confirmed cases according to European Union case definition. Two peaks occurred in 2008 and 2012 (5.0 and 3.6/100,000 respectively). Overall, 160 rubella infections in pregnancy were reported; 69/148 women were multiparous and 38/126 had had a rubella antibody test before pregnancy. Among reported cases, there were 62 infected newborns, 31 voluntary abortions, one stillbirth and one spontaneous abortion. A total of 24 newborns were unclassified and 14 women were lost to follow-up, so underestimation is likely. To improve follow-up of cases, systematic procedures for monitoring infected mothers and children were introduced in 2013. To prevent congenital rubella, antibody screening before pregnancy and vaccination of susceptible women, including post-partum and post-abortum vaccination, should be promoted. Population coverage?of two doses of measles-mumps-rubella vaccination of ≥?95% should be maintained and knowledge of health professionals improved

Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation: a role for organ damage markers

BACKGROUND: Cardiovascular risk assessment in the clinical practice is mostly based on risk charts, such as Framingham risk score and Systemic Coronary Risk Estimation (SCORE). These enable clinicians to estimate the impact of cardiovascular risk factors and assess individual cardiovascular risk profile. Risk charts, however, do not take into account subclinical organ damage, which exerts independent influence on risk and may amplify the estimated risk profile. Inclusion of organ damage markers in the assessment may thus contribute to improve this process. OBJECTIVE: Our aim was to evaluate the influence of implementation of SCORE charts with widely available indexes of organ damage, with the purpose to ameliorate individual risk assessment. METHODOLOGY: We searched www.Pubmed.gov for evidence about the predictive value of left ventricular hypertrophy (LVH), estimated glomerular filtration rate (eGFR), microalbuminuria (MAU) and metabolic syndrome on different risk profiles estimated by SCORE. Interventional and observational trials including at least 200 patients and published after 2000 were selected. RESULTS: The presence of organ damage as well as the number of abnormal parameters indicating organ damage is associated with increased cardiovascular risk, independently of SCORE. In the area of high risk, the impact of different markers of organ damage is heterogeneous. Combined risk models of SCORE and subclinical organ damage have major impact on risk stratification and may impact on recommendation in primary prevention in all SCORE categories. CONCLUSION: Available evidence suggests a tangible clinical advantage of adding the evaluation of simple organ damage markers to risk charts in cardiovascular risk prediction

Serum Concentrations of Organochlorine Pesticides and Growth among Russian Boys

Background: Limited human data suggest an association of organochlorine pesticides (OCPs) with adverse effects on children’s growth

Kadun eri ratkaisujen vaikutukset ylläpitokustannuksiin

Tässä opinnäytetyössä tarkastellaan katujen ylläpitokustannuksia Helsingin kaupungissa. Työn toimeksiantajana on Helsingin kaupunki. Ohjaajina toimivat Helsingin kaupungin ylläpitoinsinööri Tuomas Lautaniemi ja Hämeen ammattikorkeakoulun liikennealan lehtori Rami Tervo. Työn tavoitteena oli kehittää Helsingin kaupungille apuväline ylläpitokustannusten arviointiin katusuunnittelun yhteydessä. Apuvälineeksi on toteutettu Excel-taulukko, joka laskee kadun eri ratkaisujen ja ominaisuuksien perusteella arvion vuosittaisista ylläpitokustannuksista. Tämän taulukon on tarkoitus antaa tarkempaa arviota katusuunnitelman yhteydessä ilmoitettaviin ylläpitokustannuksiin kuin ennen. Suurimmat katujen ylläpitoa hankaloittavat ratkaisut ovat kadunvarsipysäköinti, kolmitasoratkaisut (jalankulun, pyöräilyn ja ajoradan erottaminen eri tasoihin) ja ahtaat katutilat. Kadun ylläpitokustannuksiin vaikuttavat myös monet sellaiset asiat, joihin ei suunnittelulla voida vaikuttaa. Kadun eri rakenteellisten ominaisuuksien vaikutuksetkin ovat hyvin moninaisia ja usein vaikutukset vaihtelevat kohteittain. Näiden takia taulukon antama ylläpitokustannusarvio on vain karkea arvio kadun vuosittaisista ylläpitokustannuksista.In this thesis project maintenance costs of streets were examined by the perspective of the city of Helsinki. The commissioner of this thesis was the city of Helsinki. The supervisors included maintenance engineer Tuomas Lautaniemi from the city of Helsinki and traffic and transport management lecturer Rami Tervo from Häme University of Applied Sciences. The goal of this project was to develop an assistive device to the city of Helsinki which would help estimate the maintenance costs of streets. The assistive device was implemented using an Excel-table which calculates estimated annual maintenance costs for a specific street based on solutions and features of the street. The function of this Excel-table is to provide more exact maintenance costs shown in the street plan than before. The biggest challenges in the maintenance of streets are street parking, three-level solutions (walking, cycling and roadway are separated into different levels) and the narrow street space. The maintenance costs of streets are influenced by many factors which cannot be affected by planning. The effects of structural solutions on streets are multifold and often they change by location. This is why the estimated annual maintenance costs of a street are only a very rough estimates

Prevalence of Hepatitis B, C, HIV and syphilis markers among refugees in Bari, Italy

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to assess the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) serological markers and the prevalence of VDRL positive subjects in a population of refugees of various nationalities, living in the Asylum Seeker Centre in Bari Palese, Southern Italy.</p> <p>Methods</p> <p>The study was carried out in the period May-July 2008 and recruited only voluntarily enrolled healthy refugees. HBsAg, anti-HBc, anti-HCV and anti-HIV virus antibodies were detected. VDRL syphilis screening was also carried out on the serum samples.</p> <p>Results</p> <p>A total of 529 refugees, 442 males and 87 females, aged between 7 and 52 years, were studied. Of these, 510 were from Africa and 19 from Asia.</p> <p>Forty-four individuals (8.3%) were HBsAg positive and 241 (45.6%) were anti-HBc positive. A total of 24 (4.5%) individuals were anti-HCV positive. Eight asylum seekers (1.5%) were HIV positive. VDRL tests were performed on 269 subjects and 4 (1.5%) were positive. 12.3% of the study population had serological markers of chronic and transmissible infections with potential blood-borne or sexual transmission.</p> <p>Conclusions</p> <p>In Italy, a suitable protocol is necessary for the early diagnosis of infectious diseases on entering Asylum Centres, so allowing the adoption of prevention measures to safeguard the health of the individuals, the residents and workers in the Centres and the general population.</p

Effect of albiglutide on cardiovascular outcomes in older adults: a post hoc analysis of a randomized controlled trial

Aim: To analyse the effects of albiglutide, a glucagon‐like peptide 1 receptor agonist, on cardiovascular outcomes in older adults aged ≥65 years with type 2 diabetes and cardiovascular disease who participated in the Harmony Outcomes trial (NCT02465515). Materials and methods: We conducted a post hoc analysis of the primary endpoint of the Harmony Outcomes trial—time to first occurrence of a major adverse cardiovascular event—in subgroups of participants aged &lt;65 and ≥65 years and &lt;75 and ≥75 years at baseline. Hazard ratios and 95% confidence intervals (CIs) were generated using Cox proportional hazards regression. Results: The analysis population included 9462 Harmony Outcomes participants, including 4748 patients ≥65 and 1140 patients ≥75 years at baseline. Hazard ratios for the prevention of major adverse cardiovascular events were 0.66 (95% CI, 0.53‐0.82) in persons &lt;65 and 0.86 (95% CI, 0.71‐1.04) in those ≥65 years (age interaction p = .07), and 0.78 (95% CI, 0.67‐0.91) in &lt;75 and 0.70 (95% CI, 0.48‐1.01) in ≥75 year age groups (interaction p = .6). When analysed as a continuous variable, age did not modify the effect of albiglutide on the primary endpoint. Conclusions: This post hoc analysis adds to the body of literature showing that glucagon‐like peptide 1 receptor agonists added to standard type 2 diabetes therapy safely reduce the incidence of cardiovascular events in older adults with established cardiovascular disease. In this analysis, the risk‐benefit profile was similar between younger and older age groups treated with albiglutide

Virgo calibration and reconstruction of the gravitational wave strain during VSR1

Virgo is a kilometer-length interferometer for gravitational waves detection located near Pisa. Its first science run, VSR1, occured from May to October 2007. The aims of the calibration are to measure the detector sensitivity and to reconstruct the time series of the gravitational wave strain h(t). The absolute length calibration is based on an original non-linear reconstruction of the differential arm length variations in free swinging Michelson configurations. It uses the laser wavelength as length standard. This method is used to calibrate the frequency dependent response of the Virgo mirror actuators and derive the detector in-loop response and sensitivity within ~5%. The principle of the strain reconstruction is highlighted and the h(t) systematic errors are estimated. A photon calibrator is used to check the sign of h(t). The reconstructed h(t) during VSR1 is valid from 10 Hz up to 10 kHz with systematic errors estimated to 6% in amplitude. The phase error is estimated to be 70 mrad below 1.9 kHz and 6 micro-seconds above.Comment: 8 pages, 8 figures, proceedings of Amaldi 8 conference, to be published in Journal of Physics Conference Series (JPCS). Second release: correct typo