New wine in new bottles: Visualizing the progression over time of the epidemics of tobacco smoking and obesity through the use of modified population pyramids

Tobacco smoking and obesity greatly contribute to premature death and disease in developed countries. In order to measure the extent to which these risk factors affect a population, as well as to describe the progression of these epidemics over time, routine surveillance of the prevalence of obesity and smoking is carried out by international organizations, national departments of health, and statistical offices. To this end, summary measures—like age-standardized rates, and tabular and graphical representations, such as maps—are used. In this study, we argue that population pyramids, a widely used demographic tool, may be easily adapted to provide relevant visual information for public health purposes. By means of two juxtaposed histograms, one for each gender, population pyramids show either the proportion or the actual number of subjects in each age and gender subgroup. We suggest that stratifying each bar of the two histograms according to ordinal categories of the health condition or risk factor examined may provide useful details on the relationship between this condition or factor and key demographic variables like age and gender. In addition, the actual number of exposed subjects can be immediately read from the graph. We therefore built a statistical routine with Stata to create modified population-pyramid plots separately for overweight/obese and current/former smoker. Data were derived from five National Health Interview Surveys carried out in Italy between 1983 and 2005. For each survey, data on age, gender, smoking status, height, and weight were extracted for subjects aged 20–99. Age and gender-specific prevalence rates of overweight/obese, and of current/former/never smoker were computed and applied to population estimates performed by the Italian national statistical institute (ISTAT). The resulting estimated numbers of underweight/normal weight/overweight/obese individuals and of former/current/never smokers were used to create the modified population pyramids. In conclusion, modified population pyramids may contribute to assessing the impact of risk factors on a population in absolute terms, to evaluating how these risk factors are distributed by age and gender, and to assessing how the age and gender distribution of these risk factors changes over time.

A prevalence survey and risk analysis of filariosis in dogs from the Mt. Vesuvius area of southern Italy

A dog microfilariae prevalence and risk factor survey was conducted in 51 contiguous municipalities of the Mt. Vesuvius area (Campania region, southern Italy) in order to add data to the limited epidemiological information available regarding filarial worms in this zone. Between May 1999 and June 2000, blood samples were collected from 351 asymptomatic dogs. Blood samples were examined using a modified Knott's technique and histochemical staining in order to count and identify microfilariae. The results were subjected to statistical analysis and choroplethic municipal maps (MMs) were drawn by a geographical information system (GIS) software. Microfilariae were detected in 63 of the 351 dogs surveyed, constituting a total filarial prevalence of 17.9%. In particular, 56 dogs (15.9%) showed only microfilariae of Dipetalonema reconditum; three dogs (0.8%) only microfilariae of Dirofilaria repens; two dogs (0.6%) microfilariae of both D. reconditum and D. repens and two dogs (0.6%) microfilariae of both Dirofilaria immitis and D. repens. High D. reconditum prevalence was associated with hunting practice, masculine gender and older dogs. There was also a tendency to find high prevalence in dogs sampled in the afternoon. In conclusion, the presence of microfilariae of D. reconditum in 92% of microfilaraemic dogs indicates that this filarial worm was the predominant filarial species in dogs in the Mt. Vesuvius area. In addition, the general trends of the MMs showed that D. immitis and D. repens were present only in a few municipalities, whereas D. reconditum was widely and homogeneously spread throughout the entire study area

The “Ovito” Hydrometrographic station (Carseolani Mounts, Central Apennines). A great adventure born from an innovative idea

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Time evolution of restless legs syndrome in haemodialysis patients

Abstract Background Restless legs syndrome (RLS) is characterized by an urge to move the extremities, accompanied by paraesthesiae, in the evening and at night. Uraemic RLS, a type of secondary RLS, occurs commonly in chronic kidney disease and end-stage renal disease. Progression of uraemic RLS over time is unclear. Therefore we investigated the prevalence, progression over time, risk factors and impact on survival of uraemic RLS in a cohort of dialysis patients. Methods We reviewed at the 7-year follow-up a cohort of haemodialysis (HD) patients we had previously investigated for RLS, through interviews, validated questionnaires and analysis of demographic and clinical data. Results At the 7-year follow-up, RLS was present in 16% of patients, with a persistence rate of 33%. A correlation was obtained between RLS and older age, diabetes, low albumin and low body mass index. RLS was associated with reduced overall survival (median survival of 3.3 versus 3.7 years), particularly with the continuous form of RLS (1.61 years). There was a higher incidence of myocardial infarction and peripheral vascular disease, although not reaching statistical significance. RLS patients had absolute higher scores in all quality of life domains. A large majority of study patients (96%) reported being symptom-free within a few days or weeks following kidney transplantation. Conclusions The development of RLS, especially the continuous form, in patients undergoing HD has important consequences associated with decreased survival. Our results indicated an association between uraemic RLS and ageing, diabetes and malnutrition. Considerable efforts should be focused on the treatment of RLS, since it significantly and persistently impacts the quality of life of HD patients. Kidney transplantation could represent an effective treatment option for that RLS impacts on dialysis patients' quality of life, thus confirming the secondary nature of RLS in most HD patients

Chromosome 3p alterations in pancreatic endocrine neoplasia

Pancreatic endocrine tumors (PET) are rare neoplasms classified as functioning (F-PET) or non-functioning (NF-PET) according to the presence of a clinical syndrome due to hormonal hypersecretion. PETs show variable degrees of clinical aggressiveness and loss of chromosome 3p has been suggested to be associated with an advanced stage of disease. We assessed chromosome 3p copy number in 113 primary PETs and 32 metastases by fluorescence in situ hybridization (FISH) using tissue microarrays. The series included 56 well-differentiated endocrine tumors (WDET), 62 well-differentiated endocrine carcinomas (WDEC), and 6 poorly differentiated endocrine carcinomas (PDEC). Chromosome 3p alterations were found in 23/113 (20%) primary tumors, with losses being predominant over gains (14% vs. 6%). Loss of 3p was found in 5/55 (9%) WDET, 11/52 (21%) WDEC, and never in PDEC. Gains of 3p were detected in 4/55 (7%) WDET, no WDEC, but notably in 3/6 (50%) PDEC (OR 23.6; P = 0.003). Metastases were more frequently monosomic for 3p compared to primary tumors (OR 3.6; P = 0.005). Monosomy was significantly associated with larger tumor size, more advanced tumor stage, and metastasis. No association was found with survival. Chromosome 3p copy number alterations are frequent events in advanced stage PET, with gains prevailing in PDEC while losses are more frequent in WDEC, supporting the view that a specific pattern of alterations are involved in these diverse disease subtypes

The Pathological Point of View

No abstract available.Image: Pancreaticoduodenectomy specimen

Temporal occurrence of Cryptosporidium in the Manila clam Ruditapes philippinarum in northern Adriatic Italian lagoons.

In order to evaluate the temporal occurrence of Cryptosporidium oocysts in Ruditapes philippinarum clams bred along the northeastern Italian Adriatic coast and molecularly characterize the isolates, 2,160 specimens (180 clams per month) were collected from three clam farms from January to December 2004. Two farms (sites A and B) were located in Venice (Chioggia, Veneto region) and one (site C) in the Marano Lagoons (Friuli Venezia Giulia region). Clams from 36 pools (i.e., one pool of 60 clams per month per site) were subjected to a high-sensitivity seminested PCR assay specific for a 360-bp diagnostic region internal to the Cryptosporidium spp. outer wall protein gene. Positive amplicons were sequenced and analyzed. Cryptosporidium DNA was found in clams from seven pools (sites A and B) during 1 month of sampling at site A and 6 months of sampling at site B, with Cryptosporidium hominis and Cryptosporidium parvum being detected. The expected infection rate of the clams was 0.36%. Site B showed a significantly higher expected infection rate (1.15%) than did the other sites (A = 0.14% and C = 0%). Given its high sensitivity and specificity, this seminested PCR assay can be considered a reliable tool for detecting and distinguishing species within the Cryptosporidium genus. The seasonal pattern of contamination and the related public health risks are of particular concern

Assessment of the indoor odour impact in a naturally ventilated room

Indoor air quality influences peopleâ\u80\u99s lives, potentially affecting their health and comfort. Nowadays, ventilation is the only technique commonly used for regulating indoor air quality. CO2 is the reference species considered in order to calculate the air exchange rates of indoor environments. Indeed, regarding air quality, the presence of pleasant or unpleasant odours can strongly influence the environmental comfort. In this paper, a case study of indoor air quality monitoring is reported. The indoor field tests were conducted measuring both CO2 concentration, using a photoacoustic multi-gas analyzer, and odour trends, using an electronic nose, in order to analyze and compare the information acquired. The indoor air monitoring campaign was run for a period of 20 working days into a university room. The work was focused on the determination of both CO2 and odour emission factors (OEF) emitted by the human activity and on the evaluation of the odour impact in a naturally ventilated room. The results highlighted that an air monitoring and recycling system based only on CO2 concentration and temperature measurements might be insufficient to ensure a good indoor air quality, whereas its performances could be improved by integrating the existing systems with an electronic nose for odour detection

[What lies beneath? Brief history of exploration of volcanic lacustrine beds in the metropolitan area of Rome (central Italy)]

[Article in Italian] Cosa c’è sotto? Breve storia dell’esplorazione dei fondali dei laghi vulcanici dell’area metropolitana di Roma Capitale (Italia centrale

Looking at the smoking epidemic through the lens of population pyramids: Sociodemographic patterns of smoking in Italy, 1983 to 2005

Background: Surveillance systems often present data by means of summary measures, like age-standardised rates. In this study, we aimed at comparing information derived from commonly used measures of smoking with that presented in modified population pyramids (PPs), using the example of the diffusion of smoking in Italy over the past two decades.Methods: Data were derived from four National Health Interview Surveys carried out in 1983, 1990 to 1991, 1999 to 2000, and 2004 to 2005. After computing both age-specific and age-standardised rates of current, former, and never smoking, we constructed modified PPs by stratifying the male and female populations according to smoking status and educational level.Results: Modified PPs showed several features of the smoking epidemic in Italy that were not apparent from conventional surveillance techniques. First, they showed that the population of smokers is aging, with most current smokers in 2005 being males aged 25 to 39 and females aged 40 to 49, whereas in 1983 most smokers belonged to the youngest age groups. Second, they showed that in 2005 most smokers were found among subjects with middle and higher education, whereas two decades earlier most smokers were (male) subjects with the lowest education.Conclusions: Modified PPs were able to show how absolute numbers of smokers were distributed by age and sex, how these numbers varied between population subgroups, and how they changed over time. PPs may help provide information on past and future trends in the absolute number of smokers and in their sociodemographic characteristics, which may be missed using only traditional surveillance methods