RESUMEN
The epidemiology of salmonellosis in Italy has clearly changed over the years. The circulation of human-specific genotypes has diminished while there has been an increase in genotypes of animal origin. In the years 1994-2009, 3727 Salmonella genotypes were isolated and/or genotyped in Sardinia (Italy). The most frequent serotypes were Salmonella Enteritidis (29%) and Salmonella Typhimurium (25,7%). If we consider the years 2000-2009, 6.4% of isolated genotypes were found to be Salmonellae with the serologic profile 4,5,12:i:-, 35.8% of which were multiresistant. Molecular analyses have shown a correlation between Salmonellae 4,5,12:i:- and Salmonellae Typhimurium DT104. Further studies will be conducted to evaluate the link with other Salmonella variants with a similar serologic profile.
Asunto(s)
Infecciones por Salmonella/epidemiología , Salmonella enteritidis/aislamiento & purificación , Salmonella typhimurium/aislamiento & purificación , Análisis por Conglomerados , ADN Bacteriano/análisis , Farmacorresistencia Bacteriana Múltiple , Genotipo , Humanos , Italia/epidemiología , Morbilidad/tendencias , Vigilancia de la Población , Estudios Retrospectivos , Infecciones por Salmonella/microbiología , Salmonella enteritidis/clasificación , Salmonella enteritidis/efectos de los fármacos , Salmonella enteritidis/genética , Salmonella typhimurium/clasificación , Salmonella typhimurium/efectos de los fármacos , Salmonella typhimurium/genética , SerotipificaciónRESUMEN
The presence of disinfection byproducts (DBP) in drinking water raises concerns about the safety of chlorination and is one of the problems inherent the use of surface water as a source of drinking water. In order to reduce the presence of DBP (in particular of chlorites), we evaluated the combined use of chlorine dioxide for primary disinfection and monochloramine for residual disinfection in a water purification plant and distribution system in Sardinia (Italy). The results are very encouraging. Disinfection byproducts were reduced and other parameters were found to be within the recommended standards, indicating further improvements of the purification process.
Asunto(s)
Cloraminas/farmacología , Compuestos de Cloro/farmacología , Desinfectantes , Óxidos/farmacología , Contaminantes Químicos del Agua , Contaminación Química del Agua/prevención & control , Purificación del Agua/métodos , Purificación del Agua/normasRESUMEN
A 13-valent pneumococcal conjugate vaccine (PCV13) has been developed to improve protection against pneumococcal disease beyond that possible with the licensed 7-valent vaccine (PCV7). This study compared the safety and immunogenicity of PCV13 with those of PCV7 when given as part of the pediatric vaccination schedule recommended in Italy. A total of 606 subjects were randomly assigned to receive either PCV13 or PCV7 at 3, 5, and 11 months of age; all subjects concomitantly received diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio-Haemophilus influenzae type B (DTaP-HBV-IPV/Hib) vaccine. Vaccine reactions were monitored. Antibody responses to DTaP-HBV-IPV/Hib antigens, serotype-specific anticapsular polysaccharide IgG responses, and antipneumococcal opsonophagocytic assay (OPA) activity were measured 1 month after the two-dose primary series and 1 month after the toddler dose. Overall, the safety profile of PCV13 was similar to that of PCV7. The response to DTaP-HBV-IPV/Hib antigens was substantially the same with both PCV13 and PCV7. PCV13 elicited antipneumococcal capsular IgG antibodies to all 13 vaccine serotypes, with notable increases in concentrations seen after the toddler dose. Despite a lower immunogenicity for serotypes 6B and 23F after the primary series of PCV13, responses to the seven common serotypes were comparable between the PCV13 and PCV7 groups when measured after the toddler dose. PCV13 also elicited substantial levels of OPA activity against all 13 serotypes following both the infant series and the toddler dose. In conclusion, PCV13 appeared comparable to PCV7 in safety profile and immunogenicity for common serotypes, demonstrated functional OPA responses for all 13 serotypes, and did not interfere with immune responses to concomitantly administered DTaP-HBV-IPV/Hib vaccine.
Asunto(s)
Anticuerpos Antibacterianos/sangre , Infecciones Neumocócicas/inmunología , Vacunas Neumococicas , Vacunas Conjugadas , Anticuerpos Antivirales/sangre , Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Método Doble Ciego , Femenino , Vacunas contra Haemophilus/administración & dosificación , Vacunas contra Hepatitis B/administración & dosificación , Vacuna Neumocócica Conjugada Heptavalente , Humanos , Esquemas de Inmunización , Inmunoglobulina G/sangre , Lactante , Italia , Masculino , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas/administración & dosificación , Vacunas Neumococicas/efectos adversos , Vacunas Neumococicas/inmunología , Vacuna Antipolio de Virus Inactivados/administración & dosificación , Resultado del Tratamiento , Vacunación , Vacunas Combinadas/administración & dosificación , Vacunas Conjugadas/administración & dosificación , Vacunas Conjugadas/efectos adversos , Vacunas Conjugadas/inmunologíaRESUMEN
This study evaluates interregional variability in threshold levels fixed by the various regions, for DRGs at high risk of inappropriateness, and analyses regional and national objectives achieved with respect to the reduction of hospital admissions (years 2001-2004). A reduction of inappropriate admissions has been observed.
Asunto(s)
Grupos Diagnósticos Relacionados , Admisión del Paciente , Hospitalización , Humanos , ItaliaRESUMEN
A cross-sectional study was carried out in a population of North Italy to determine the prevalence of eight oncogenic human papillomavirus (HPV) types most commonly found in cervical carcinoma and to study the relationship between HPV DNA loads and severity of disease. A total of 597 cervical samples obtained from patients with pathological findings (n = 472) and from women with normal cytology (n = 125) were analyzed by means of normalized Real-time PCR assays to quantify HPV-16, -18, -31, -45, and -33 group (including -33, -52, -58, -67); the normalization of oncogenic HPV viral load was carried out by quantitation of a single copy gene. The two most common oncogenic HPV types found were 16 and 31 (24.3% and 22.9% of pathological samples, respectively); multiple infections were demonstrated in 22% of pathological samples. Overall, the HPV total viral load was found to increase with increasing severity of associated lesions, although a stronger association was observed only for HPV-31 and HPV-16 (gamma = 0.49 and 0.41, respectively) as compared to HPV-18 and -33 group (gamma = 0.19 and 0.02, respectively). However, we found that high levels of HPV-31 or 33 group DNA could be prognostic of minor oncogenic risk for high-grade squamous intraepithelial lesions (H-SIL) (age adjusted odds ratio [AORs] = 1.57 and 1.26, respectively) than HPV-16 and HPV-18 (AORs = 30 and 8, respectively). The AORs also increased with HPV total viral load and reached a maximum of AORs = 15.7. Thus, HPV load is a type-dependent risk marker for the development of H-SIL.
Asunto(s)
Papillomaviridae/genética , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Neoplasias del Cuello Uterino/virología , Carga Viral , Adulto , Anciano , Estudios Transversales , ADN Viral/análisis , ADN Viral/genética , Femenino , Humanos , Italia/epidemiología , Persona de Mediana Edad , Papillomaviridae/clasificación , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/genética , Prevalencia , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patología , Adulto JovenRESUMEN
An economic analysis was performed at the University of Sassari (Italy) teaching hospital, to evaluate the economic impact of treating a set percentage of patients, admitted in the years 2002-2004 and assigned to one of the 43 Diagnosis Related Groups considered at "high risk of inappropriateness", as outpatients or day-hospital patients as opposed to treating them as inpatients.The actual economic impact consisted in substantial savings for the paying body but lower returns for the healthcare service delivery facility. The estimated potential impact of utilizing the updated DRG rates for day hospital services (2005 rates), may lead to possible further loss of receipts for the facility.
Asunto(s)
Hospitales Universitarios , Pacientes Internos , Grupos Diagnósticos Relacionados , Humanos , Italia , Pacientes AmbulatoriosRESUMEN
Infection by Helicobacter pylori is the most important risk factor for gastric cancer. However, only a small fraction of colonized individuals, representing at least half of the world's population, develop this malignancy. In order to shed light on host-microbial interactions, gastric mucosa biopsies were collected from 119 patients suffering from dyspeptic symptoms. 8-Hydroxy-2'-deoxyguanosine (8-oxo-dG) levels in the gastric mucosa were increased in carriers of H.pylori, detected either by cultural method or by polymerase chain reaction, and were further increased in subjects infected with strains positive for the cagA gene, encoding the cytotoxin-associated protein, cagA. Oxidative DNA damage was more pronounced in males, in older subjects, and in H.pylori-positive subjects suffering from gastric dysplasia. Moreover, 8-oxo-dG levels were significantly higher in a small subset of subjects having a homozygous variant allele of the 8-oxoguanosine-glycosylase 1 (OGG1) gene, encoding the enzyme removing 8-oxo-dG from DNA. Conversely, they were not significantly elevated in glutathione S-transferase M1 (GSTM1)-null subjects. Thus, both bacterial and host gene polymorphisms affect oxidative stress and DNA damage, which is believed to represent a key mechanism in the pathogenesis of gastric cancer. The interplay between bacterial and host gene polymorphisms may explain why gastric cancer only occurs in a small fraction of H.pylori-infected individuals.
Asunto(s)
Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Daño del ADN , Dispepsia/genética , Mucosa Gástrica/metabolismo , Helicobacter pylori/fisiología , 8-Hidroxi-2'-Desoxicoguanosina , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antígenos Bacterianos/metabolismo , Proteínas Bacterianas/metabolismo , Niño , ADN Glicosilasas/genética , ADN Glicosilasas/metabolismo , ADN Viral/genética , Desoxiguanosina/análogos & derivados , Desoxiguanosina/metabolismo , Dispepsia/metabolismo , Dispepsia/virología , Femenino , Mucosa Gástrica/patología , Mucosa Gástrica/virología , Glutatión Transferasa/genética , Glutatión Transferasa/metabolismo , Infecciones por Helicobacter/genética , Infecciones por Helicobacter/metabolismo , Infecciones por Helicobacter/virología , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Estrés Oxidativo , Especies Reactivas de Oxígeno/metabolismo , Neoplasias Gástricas/virologíaRESUMEN
Travel for business or tourism has become increasingly common in the age we live in. The great volume of national and international traffic and the speed of transportation are inevitably linked to a possible increased risk of acquiring certain illnesses such as Legionellosis, which, in fact, has shown a consistently increased incidence in recent years. In this paper, a brief introduction regarding the etiology and clinical and epidemiological characteristics of the disease, is followed by recent national and international data regarding its diffusion and guidelines for its prevention and control.