RESUMEN
BACKGROUND: This study aimed to explore the prevalence of breastfeeding at birth points in Sicily and the relevance of the factors influencing the adoption of exclusive breastfeeding during hospitalization linked to childbirth. METHODS: A survey was conducted to monitor the prevalence of breastfeeding in seven out of nine facilities providing maternity services in the province of Catania (Sicily, Southern Italy) in the years 2016-2018. An online questionnaire was administered using an electronic tablet by the midwife to the mother after discharge. RESULTS: Women who had a higher educational qualification breastfed in a greater proportion (59.6%; odds ratio OR 0.60 for abandoning breastfeeding). Having had a caesarean section moderately impaired breastfeeding uptake, with an almost double chance of declining exclusive breastfeeding (OR = 1.74). Starting breastfeeding within 1 h from delivery showed a significant facilitating effect (OR = 0.58). Rooming-in had a strong facilitating effect on exclusive breastfeeding. A breastfeeding advocacy program was shown to protect from abandoning breastfeeding. CONCLUSIONS: It is important to offer in all hospitals the possibility and support for breastfeeding in the first moments after childbirth to increase the number of those who will then continue with exclusive breastfeeding.
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Lactancia Materna , Maternidades , Cesárea , Femenino , Humanos , Recién Nacido , Madres , Embarazo , SiciliaRESUMEN
Measles is a highly contagious airborne disease. Unvaccinated pregnant women are not only at risk of infection but also at risk of severe pregnancy complications. As measles causes a dysregulation of the entire immune system, we describe immunological variations and how immune response mechanisms can lead to adverse pregnancy outcomes. We evaluated data during the measles outbreak reported in the province of Catania, Italy, from May 2017 to June 2018. We controlled hospital discharge records for patients admitted to hospital obstetric wards searching the measles diagnostic code. We have indicated the case as "confirmed" when the IgM was found to be positive with the ELISA method. We registered 843 cases of measles and 51% were females (430 cases). 24 patients between the ages of 17 and 40 had measles while they were pregnant. Adverse pregnancy outcomes included 2 spontaneous abortions, 1 therapeutic abortion, 1 foetal death, and 6 preterm deliveries. Respiratory complications were more prevalent in pregnant women (21%) than in nonpregnant women with measles (9%). 14 health care workers (1.7%) were infected with measles, and none of these had been previously vaccinated. Immune response mechanisms were associated with adverse pregnancy outcomes in women with measles. To reduce the rate of measles complications, gynaecologists should investigate vaccination history and antibody test results in all women of childbearing age. During a measles outbreak, gynaecologists and midwives should be active proponents of vaccination administration and counteract any vaccine hesitancy not only in patients but also among health care workers.
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Sarampión/epidemiología , Sarampión/prevención & control , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Adolescente , Brotes de Enfermedades , Femenino , Humanos , Italia/epidemiología , Sarampión/inmunología , Vacuna Antisarampión/administración & dosificación , Embarazo , Complicaciones Infecciosas del Embarazo/inmunología , Resultado del Embarazo , Adulto JovenRESUMEN
Monitoring the prevalence of breastfeeding is one of the actions provided for in Italian National Health System. This study aims to observe the prevalence of breastfeeding in a representative set of birthing hospitals in the province of Catania, in Sicily, Italy, to assess the factors influencing women in their decisions to breastfeed during hospitalization after delivery. We conducted an observational study on 3813 questionnaires administered to mothers of newborns during their hospital stay from the years 2016 to 2018 in eight hospitals of various types. The average maternal age was 31.3 years ± 5.8. Sixty-nine percent of women did not attend a prenatal course. From childbirth to discharge, the percentage of women who breastfed was 88%, of whom 45% did exclusive breastfeeding. Only 35% of women who had a caesarean section adopted exclusive breastfeeding. In our experience, rooming-in was not associated with an increase in breastfeeding. We observed that both attendance to prenatal courses and the mother's education level played a minor role in influencing the mother's decision in breastfeeding A fairly high percentage of exclusive breastfeeding, 75%, was attained just in one hospital, where dedicated staff was deployed to encourage breastfeeding. The lowest percentage (12%) of exclusive breastfeeding was observed in a large private accredited health facility. Hospital presence of professionals trained in human lactation is a smart investment for society.
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Lactancia Materna , Cesárea , Madres , Adulto , Toma de Decisiones , Femenino , Hospitales , Humanos , Recién Nacido , Lactancia , Embarazo , SiciliaRESUMEN
The hospital environment has been suggested as having an important role in the transmission of health care-associated infections. The aim of this work is to clarify the possible role of visitors in environmental contamination at our hospital. The microbial load was determined by Rodac plate contact on flat surfaces and by swabs on uneven surfaces. A total of 137 samples were taken from four different areas of the hospital unit. The results were divided into two groups according to the types of subjects that most often frequented those environments. We found that the transmission of health care-associated infections (HAIs) occurs mainly in areas where visitors are not allowed.
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Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Microbiología Ambiental , Visitas a Pacientes/estadística & datos numéricos , Carga Bacteriana/métodos , Transmisión de Enfermedad Infecciosa/prevención & control , Hospitales Universitarios/organización & administración , Hospitales Universitarios/estadística & datos numéricos , Humanos , SiciliaRESUMEN
BACKGROUND: Intussusception represents the most common cause of abdominal emergency among young children but nearly 75% of cases are still considered idiopathic. RESEARCH DESIGN AND METHODS: A case-control study was conducted among Sicilian children aged 0-59 months with a hospital admission for intussusception between 2009 and 2015 to identify factors associated with intussusception onset. RESULTS: Overall, 125 cases and 190 controls were recruited for the study. Birth order (OR 1.49, 95%CI: 1.10, 2.02, P = 0.02) and having had gastroenteritis or having taken antibiotics during the 30 days prior to hospitalization (OR 11.55, 95%CI: 3.23, 41.23, P < 0.001; 3.09, 95%CI: 1.17, 8.12, P = 0.009, respectively) were significantly associated with intussusception. On the other hand, exclusive breastfeeding for at least two months was a protective factor (OR 0.48, 95%CI: 0.23, 0.99, P = 0.009). Anti-rotavirus vaccination did not correlate with risk of intussusception (OR 0.96, 95% CI: 0.41, 2.25, P = 0.92). CONCLUSIONS: These findings increase the awareness of intussusception among clinical and public health service providers to obtain a better susceptibility profile. Moreover, identifying children at higher risk of intussusception could be useful in vaccination counselling to intercept early symptoms and to reduce the number of serious cases.
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Hospitalización/estadística & datos numéricos , Intususcepción/epidemiología , Vacunas contra Rotavirus/administración & dosificación , Antibacterianos/efectos adversos , Orden de Nacimiento , Lactancia Materna/estadística & datos numéricos , Estudios de Casos y Controles , Preescolar , Femenino , Gastroenteritis/complicaciones , Gastroenteritis/epidemiología , Humanos , Lactante , Recién Nacido , Intususcepción/etiología , Masculino , Factores Protectores , Factores de Riesgo , Vacunas contra Rotavirus/efectos adversos , Sicilia/epidemiologíaRESUMEN
PURPOSE: Adolescence overweight and obesity have increased considerably, and the misperception of their weight status could reduce the efficiency of intervention programs. The aim of this study was to evaluate the prevalence rate of misperception and to assess the relationship between weight perception and anthropometric parameters, self-perception, physical activity, and adherence to the Mediterranean diet. METHODS: A total of 1643 young adolescents (11-16 years old) were surveyed in a cross-sectional investigation during two scholastic years (period October-May of 2012-2013 and 2013-2014) in 15 secondary schools of Sicily, southern Italy. Data on demographic information, anthropometric characteristics (bioelectrical impedance), physical activity level, The Children and Youth Physical Self-Perception Profile, weight perception, and dietary habits (KIDMED) were collected. RESULTS: Misperception was found in the 27.6 % of the young adolescents, and boys were more likely to underestimate their weight status, while girls had a high percentage of overestimation. The strong association with weight misperception was with socioeconomic status, waist circumference, physical activities, and physical self-worth. Moreover, a good adherence to the Mediterranean diet was inversely associated with both overestimation and underestimation in both boys and girls. CONCLUSION: These findings highlight that almost one-third of the participants had a weight misperception that was associated with several anthropometric, social, and lifestyle factors. Future intervention to prevent overweight and obesity should consider not only gender-specific differences, but also parental SES, perception, and satisfaction of body weight status.
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Imagen Corporal/psicología , Peso Corporal , Dieta , Autoimagen , Adolescente , Antropometría , Composición Corporal/fisiología , Índice de Masa Corporal , Niño , Estudios Transversales , Femenino , Humanos , Estilo de Vida , Masculino , Factores SocioeconómicosRESUMEN
INTRODUCTION: Cancer survival is related not only to primary malignancy but also to concomitant nonmalignant diseases. The aim of this study was to investigate the prognostic capacity of four comorbidity indices [the Charlson comorbidity index (CCI), the Elixhauser method, the National Institute on Aging (NIA) and National Cancer Institute (NCI) comorbidity index, and the Adult Comorbidity Evaluation-27 (ACE-27)] for both cancer-related and all-cause mortality among colorectal cancer patients. A modified version of the CCI adapted for colorectal cancer patients was also built. METHODS: The study population comprised 468 cases of colorectal cancer diagnosed between 1 January 2000 and 31 December 2010 at a community hospital. Data were prospectively collected and abstracted from patients' clinical records. Kaplan-Meier method and multivariate logistic regression models were performed for survival and risk of death analysis. RESULTS: Only moderate or severe renal disease [hazard ratio (HR) 2.71, 95% confidence interval (CI) 1.11-6.63] and AIDS (HR 3.27, 95% CI 1.23-8.68) were independently associated with cancer-specific mortality, with a population attributable risk of 5.18 and 4.36%, respectively. For each index, the highest comorbidity burden was significantly associated with poorer overall survival (NIA/NCI: HR 2.14, 95% CI 1.14-4.01; Elixhauser: HR 1.98, 95% CI 1.09-1.42; ACE-27: HR 1.78, 95% CI 1.07-1.23; CCI: HR 1.68, 95% CI 1.05-1.42) and cancer-specific survival. The modified version of the CCI resulted in a higher predictive power compared with other indices studied (cancer-specific mortality HR = 2.37, 95% CI 1.37-4.08). CONCLUSIONS: The comorbidity assessment tools provided better prognostic prevision of prospective outcome of colorectal cancer patients than single comorbid conditions.
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Neoplasias Colorrectales/complicaciones , Neoplasias Colorrectales/mortalidad , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Anciano , Enfermedades Cardiovasculares/complicaciones , Comorbilidad , Complicaciones de la Diabetes , Femenino , Humanos , Enfermedades Renales/complicaciones , Masculino , Estudios Prospectivos , Medición de Riesgo/métodosRESUMEN
OBJECTIVE: To assess adherence to the Mediterranean diet and nutrient intakes in a population of Sicily, southern Italy and to evaluate possible determinants, particularly socio-cultural and lifestyle factors. DESIGN: Cross-sectional. SETTING: Urban and rural areas of eastern Sicily. SUBJECTS: Between May 2009 and December 2010, 3090 adults were randomly recruited through the collaboration of fourteen general practitioners. Adherence to the Mediterranean diet was measured by the MedDietScore. Nutrient intakes were assessed through the 24 h recall of the previous day's dietary intake. RESULTS: Rural participants were barely more adherent to the Mediterranean diet than their urban counterparts (mean scores were 27·8 and 27·2, respectively, P = 0·037). The MedDietScore was correlated with intakes of MUFA, fibre and vitamin C, as well as with consumption of non-refined cereals, vegetables, fruit, meat, dairy products, alcohol and nuts. Regression analysis revealed that older and more educated people were more likely to be in the highest tertile of MedDietScore (OR = 1.90; 95 % CI 1·39, 2·59 and OR = 1·29; 95 % CI 1·05, 1·58, respectively). A significant difference in quantity (moderate) and quality (red wine and beer) of alcohol was found according to adherence to the Mediterranean diet. Finally, more active participants were 1·5 times more likely to form part of the high-adherence group. CONCLUSIONS: A slow but concrete moving away from traditional patterns has been observed in younger people and low educated people. Public health interventions should focus on these target populations in order to improve the quality of their diet.
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Dieta Mediterránea , Promoción de la Salud , Estilo de Vida , Cooperación del Paciente , Salud Rural , Salud Urbana , Adulto , Factores de Edad , Anciano , Estudios Transversales , Encuestas sobre Dietas , Dieta Mediterránea/economía , Dieta Mediterránea/etnología , Escolaridad , Medicina General , Promoción de la Salud/economía , Humanos , Estilo de Vida/etnología , Persona de Mediana Edad , Actividad Motora , Cooperación del Paciente/etnología , Salud Rural/economía , Salud Rural/etnología , Sicilia , Factores Socioeconómicos , Salud Urbana/economía , Salud Urbana/etnologíaRESUMEN
The present study aimed to examine the factors associated with increased Mediterranean diet (MD) adherence among a sample of Italian adolescents. A cross-sectional survey was conducted on 1135 students (13-16 years) attending 13 secondary schools of Sicily, southern Italy. Validated instruments were used for dietary assessment and the KIDMED score to assess adolescents' adherence to the MD. A higher adherence to the MD was associated with high socioeconomic status (Odds Ratio [OR] 1.53, 95% Confidence Interval [CI]: 1.03-2.26) and high physical activity (OR 1.19, 95% CI: 1.02-1.70), whereas lower adherence was associated with living in an urban environment (OR 0.65, 95% CI: 0.44-0.97) and being obese (OR 0.59, 95% CI: 0.37-0.94). The adolescents' KIDMED scores were inversely associated with adolescents' intake of sweets, fast foods, fried foods, and sugary drinks, and directly with fruit, vegetables, pasta, fish, and cheese intakes. Urban-living adolescents were less likely to eat fruit and more prone to consume meat, sugary drinks, and fast food than rural-living adolescents. The latter were more likely to eat sweets and snacks. A general poor quality of food consumption in Italian adolescents away from the MD was reported, especially among those living in urban areas.
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Dieta Mediterránea , Conducta Alimentaria , Cooperación del Paciente , Adolescente , Índice de Masa Corporal , Estudios Transversales , Ingestión de Energía , Femenino , Frutas , Humanos , Estilo de Vida , Modelos Logísticos , Masculino , Actividad Motora , Análisis Multivariante , Evaluación Nutricional , Obesidad/metabolismo , Población Rural , Sicilia , Factores Socioeconómicos , Población Urbana , VerdurasRESUMEN
BACKGROUND: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females with a progressive increase in prevalence in industrialized countries. The loss of health due to the cancer and/or the consequence of the treatment may result in psychophysical, functional and social impairment; all of these affect health-related quality of life (QoL). DESCRIPTION: The most frequently CRC-specific QoL questionnaires is the FACT-C. QoL is not only important for the well-being of cancer patient but it also influences survival and response to therapy. Many studies investigated various determinants involved in the assessment of QoL in CRC, suggesting that symptoms, surgical procedures and the number of comorbidity significantly affected QoL. CONCLUSION: Despite that CRC patients have a relatively good QoL compared with the general population, a wide range of intervention could be undertaken to improve their QoL. The finding of this review may be useful for cancer clinicians in taking therapy and surveillance-related decisions. However, future research should be directed to large-scale prospective studies using well validated QoL instruments to facilitate comparison of results.