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Ann Ig [journal]
- Immunity status against poliomyelitis in childbearing women in a province of northern Italy -- reply. [Comment, Letter]
- Ann Ig 2014 Jan-Feb; 26(1):120.
- Immunity status against poliomyelitis in childbearing women in a province of northern Italy. [Comment, Letter]
- Ann Ig 2014 Jan-Feb; 26(1):119.
- [Comparison of cultural methods for the recovery of Pseudomonas aeruginosa: the UNI EN ISO 16266 reference method and the alternative method Pseudalert®]. [English Abstract, Journal Article]
- Ann Ig 2014 Jan-Feb; 26(1):110-8.
For the water analysis, for Pseudomonas aeruginosa a presumptive positive result can be achieved in 40- 48 hours using the traditional membrane filtration technique followed by an additional 24-48 hour confirmation stage. Conversely, the Pseudalert Quanti-Tray™ method can give confirmed results after 24-28 hours. In this case, actively growing strains of Pseudomonas aeruginosa show a confirmed positive result when a specific enzyme cleaving the substrate in the reagent produces a blue fluorescence under 365 nm ultraviolet light. A comparison of the performance of the Pseudalert respect to the standard method was conducted using statistical methods.Drinking water was analyzed in parallel with the membrane filtration technique using Pseudomonas CN agar (UNI EN ISO 16266) and the Pseudalert. Confirmation test are requested by the standard method and although Pseudalert Quanti-Tray™ gives confirmed results, all the positive isolates were also confirmed. Data were analyzed by statistical methods.For drinking water, Pseudalert showed a very high sensitivity (98,8%) and a high percentage of specificity (96,8%). From a total of 889 positive isolates, a very high confirmation rates (99,3%) was calculated. Statistical analyses confirmed that the two methods were not statistically different.These results indicate that the Pseudalert produces confirmed results in a shorter time than the standard reference method allowing the detection of Pseudomonas aeruginosa with no further confirmation steps. It could be a valid alternative method for the water analysis.
- H1N1 pandemic influenza: habits and behaviour of the nurses. A public health issue. [Journal Article]
- Ann Ig 2014 Jan-Feb; 26(1):97-109.
One of the main concerns related to pandemic H1N1 influenza 2009 is the overwhelming burden on medical structures. The aim of this work is to study the behaviour and attitudes of Nurses in relation to the spreading pandemic in order to develop public health strategies.During the spread of Pandemic, in winter 2009, an anonymous questionnaire online of thirty-four questions was available for participants. Data obtained were analyzed using descriptive, univariate and multivariate statistics.A total of 2313 nurses were interviewed. In univariate analysis 72.6% of 573 males (versus 63.9% of 1740 females) have been talk to a doctor (p<0.001). The female group appear less likely to get vaccinated (60.3% vs 51.1%, p<0.001). Multivariate analysis revealed that to be worried (OR=2.82 95% CI: 2.31-3.46), female (OR=0.62 95% CI: 0.51-0.77), age group 30-49 (OR=0.72 95% CI: 0.58-0.90) were associated with the willingness of Get vaccinated.Prevention, as washing hands and vaccination, are crucial in pandemics events. Given the low rates of acceptance of pandemic vaccination among nurses, public health bodies should consider campaign education, in order to prevent nosocomial transmission, to protect patients and the continuity of the essential health-care infrastructure.
- Legionella contamination in hospitals of the Campania Region: five years of environmental surveillance results. [Journal Article]
- Ann Ig 2014 Jan-Feb; 26(1):89-96.
The purpose of this study was to assess the presence and the distribution of Legionella serotypes in 50 hospital facilities in the Campania Region (Italy) through the sampling of their waters.From January 2008 to December 2012, in compliance with the Italian Monitoring Guidelines for Legionellosis, 4.842 water samples were collected from the end points of hot water distribution networks, air conditioning systems, boilers and cooling towers.1.426 (29.4%) of the 4.842 samples resulted positive for Legionella spp, with a bacterial average of 3.40 log10 cfu/L. The frequency of Legionella isolation in the specimens progressively decreased during the study (43.8% in 2008 vs 22.9% in 2012). Samples from cooling towers (32.7%), showers and taps (31.9%) revealed a more frequent presence of the microorganism, although considerable bacterial concentration variability was found in all examined points. A bacterial average of 3.33 + 0.88 log10 cfu/L was detected in cooling towers, whereas the lowest values (2.89 + 0.92 cfu/L) were found in ACSs. The most frequently isolated species were L. pneumophila 2-14, detected in 60.6% of positive samples. Within serotypes, types 6 (23.8%), 8 (21.9%) and 3 (21.4%) resulted as being the most representative.A significant contamination was found in examined centers. It is therefore advisable to systematically implement currently available surveillance and monitoring strategies through the scrupulous monitoring of systems as well as through the application of validated and effective procedures.
- Food supplements: survey of the ASL TO3. [Journal Article]
- Ann Ig 2014 Jan-Feb; 26(1):76-88.
In recent years, the increase of the consumption of supplements reveals problems concerning the safety of use. Current legislation states that supplements must be free of any therapeutic purpose and must have quality guarantees for the users' safety. The operators of the of Hygiene, Food and Nutrition Service (SIAN) of ASL TO 3 (province of Turin) conducted a surveillance in order to asses the situation on the territory, to know the use and consumption in local gyms. During the official control at the manufacturers / packers of supplements, located on the territory of the ASL TO 3, labels of supplement produced / packed were acquired, to analyze the components indicated, to carry out a deep evaluation of the individual product .Updating of the register of companies located in the territory of the ASL TO 3 was carried out; and during the period October 2011-March 2013 the labels of the products of these companies have been found and analyzed. The detailed content of the labels (ingredients, dose, method of recruitment, composition, etc. ..) was written in a database. It was also checked how many local gyms marketed supplements, and, in a small sample, a questionnaire was administered to visitors, in order to assess consumption.355 labels were acquired and loaded on the database. 80% of them falls within the category of supplements based on ingredients derived from plants or similar. For these products was evaluated the presence on the label of not allowed plant extracts (according to the Ministerial Decree of 9 July 2012): only 2 products (of the same company) contained an ingredient not allowed. In all the examined labels was evaluated the presence of the substances for which there are specific warnings: 97% of the label is compliant and 3% are not in compliance. In the analyzed products the indications for use mainly found on the labels are related to increased demand and/or reduced intake, followed by antioxidant action. The study also evaluated the sale of supplements at gyms located on the territory of ASLTO3: 59 gyms are available on territory, but only in one of them supplements are sold. Some customers of these gyms have filled a questionnaire concerning the consumption of supplements. The processing of the questionnaires showed that 27% of respondents in the past 2 years used only occasionally food supplements. For 42% of the subjects the use of these products was to achieve weight loss, for 33% for athletes and 17% have used specific products in the case of particular physiological situations such as pregnancy and lactation. The reasons that lead to the use of dietary supplements, in all cases, are attributed to the improvement of health status. In addition, in 50% of cases the pharmacist has led to the use of these products or, alternatively, friends and relatives. The general practitioner is often not informed even in case of disturbances introduced after their use (seen in 8% of our sample). The majority of the sample (58%) said that they had benefited from the use of supplements and they are aware (68%) that there could be contraindications.A greater knowledge of the topic, with attention focused on the entire supply chain of the product, is essential to ensure the safety of consumers in the use of food supplements. For these reasons a more detailed check on the procedure is essential: selection and verification of suppliers (especially for raw materials coming from Eastern countries, because they are not subjected to a thorough inspection); traceability of products marketed; correspondence between manufactured and authorized products. Finally, promote an awareness campaign at all levels is necessary, including general practitioners for a conscious purchase.
- Effectiveness of two interventions in preventing traffic accidents: a systematic review. [Journal Article]
- Ann Ig 2014 Jan-Feb; 26(1):63-75.
The prevention of road traffic accidents should be considered a serious public health concern, since they are the eighth leading cause of death globally and the main cause of death for young people aged 15-29. Evidences from many countries show that successes in preventing road traffic injuries can be achieved through concerted efforts at national level. The aim of our study was to assess the effectiveness of two interventions to prevent road traffic accidents: the introduction of graduated driver licensing (GDL) and the interventions to improve pedestrian and cyclist visibility.Our search started with a scoping review on the interventions to prevent road traffic accidents to allow the development of a logical framework of traffic accidents. Specific and answerable questions formulated according to PICO scheme and combinations of keywords were used to perform a systematic search in the following databases: Pubmed, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Evidence, Transport Research International Documentation (TRID) and Google. References of selected papers were searched. Only systematic reviews and meta-analyses were eligible. No temporal limits or linguistic filters were applied.160 systematic reviews and meta-analyses were found for the question of the introduction of GDL program and 188 on the improvement of visibility in cyclists and pedestrians. After selection, four papers were included in qualitative synthesis for each question. All included studies underwent quality evaluation. GDL programs seem to be effective in reducing crash rates among young drivers, in particular in 16 year-old. Programs with more restrictions seem also to reduce fatal events. To improve visibility of pedestrians and cyclists, street lighting has been suggested as an intervention able to improve driver's visual capabilities and ability to detect roadway hazards and to prevent car crashes. Visibility aids (fluorescent materials, lamps, flashing lights and retroreflective materials) have the potential to increase visibility and enable drivers to detect pedestrians and cyclists earlier.The two interventions seem to be effective, but further examinations are needed to measure long-term effects. It is necessary to provide feasible studies in local context to estimate the impact of introduction of GDL programs or of some of their components and to improve interventions to increase visibility of pedestrians and cyclists.
- [Public health strategies in the prevention of induced abortion. An experience of interprofessional education based strategy]. [English Abstract, Journal Article]
- Ann Ig 2014 Jan-Feb; 26(1):52-62.
In Italy recent statistics show a huge difference between abortion rate among Italian and migrant women: is it an inequity in health? The Italian Ministry of Health / Center for Disease Prevention and Control, which recognized this issue as a specific public health problem, has financed a national Project whose aim was the prevention of abortion among migrant women. The Project was characterized by a multitasking approach: 1) information and health education of migrant women and their communities; 2) education of health and social care professionals; 3) analysis and development of new proposals for the networks of services directed towards the improvement of woman's health. In this article the Authors describe the main characteristics of the realized intervention of inter-professional education. It began with a multidisciplinary process for the identification of educational needs which has allowed the identification of educational goals. A Training of Trainers event was then organized in order to involve and make the ten Italian Regions partners of the Project aware of their responsibilities. A DVD collecting all the material of the course and other useful resources was produced in order to support the educational process. At the moment it is not possible to evaluate the medium- and long-time results of the process (e.g. the efficacy of educational interventions or the health outcomes related to the reduction of abortion among migrant women). Nevertheless all the actors involved have made positive evaluations on the usefulness of the process.
- Quality of life, psychological wellbeing and resilience: a survey on the Italian population living in a new lodging after the earthquake of April 2009. [Journal Article, Research Support, Non-U.S. Gov't]
- Ann Ig 2014 Jan-Feb; 26(1):46-51.
The aim of this study is to estimate the quality of life and the psychological wellbeing as a result of the earthquake which occurred the 6th of April 2009 and that struck the population of the city of L'Aquila.A random sample of 281 subjects, from the population that had the possibility of living in a temporary lodging provided by the State, were interviewed after the earthquake, during the period between July and October 2010. Two self-administered questionnaires were used: the Psychological General Well-Being Index (PGWBI) and the Dispositional Resilience Scale (DRS II).The women's health status is worse than the men's, this is true both on a general level (79,24 vs 70,55), and on different estimated dimensions. Health status is significantly worse in older age groups (F2;245=4,34, p=0,0140): the elderly appear to be more depressed (F2;245=6,52, p=0,0017) and to have less self-control (F2;245=3,06, p=0,0487) than the younger.Generally women tend to experience greater emotional involvement in social and interpersonal relationships. Although many months have passed since the catastrophic event, feelings of disease and a sense of impotence (about life) are still persistent in people, even though they generally are hopeful about the future.
- [Molecular epidemiology of infectious diseases: analytical methods and results interpretation]. [English Abstract, Journal Article]
- Ann Ig 2014 Jan-Feb; 26(1):10-45.
Molecular typing and fingerprinting of microbial pathogens represent an essential tool for the epidemiological surveillance, outbreak detection and control of infectious diseases. Indeed, epidemiological investigation without genotyping data may not provide comprehensive information to allow the most appropriate interventions; despite this consideration, some barriers still hamper the routine application and interpretation of molecular typing data. In this paper, the most important methods currently used for characterization of pathogenic microorganisms for microbial source tracking and for the identification of clonal relationships among different isolates, are described according to their principles, advantages and limitations. Criteria for their evaluation and guidelines for the correct interpretation of results are also proposed. Molecular typing methods can be grouped into four categories based on different methodological principles, which include the characterization of restriction sites in genomic or plasmid DNA; the amplification of specific genetic targets; the restriction enzyme digestion and the subsequent amplification; sequence analysis. Although the development and the extensive use of molecular typing systems have greatly improved the understanding of the infectious diseases epidemiology, the rapid diversification, partial evaluation and lack of comparative data on the methods have raised significant questions about the selection of the most appropriate typing method, as well as difficulties for the lack of consensus about the interpretation of the results and nomenclature used for interpretation. Several criteria should be considered in order to evaluate the intrinsic performance and practical advantages of a typing system. However none of the available genotyping methods fully meets all these requirements. Therefore, the combined use of different approaches may lead to a more precise characterization and discrimination of isolates than a single method, especially if used in a hierarchical manner. The interpretation of the molecular results differs according to the typing system's characteristics: for example in the restriction fragments-based analysis, the divergences or the similarity percentages among the profiles are evaluated, whilst the differences in terms of number and intensity of bands are analyzed in the amplification-based approaches. Moreover, a correct interpretation of molecular results significantly depends by other critical factors, such as the comprehension of the typing system and data quality, the microbial diversity, and the epidemiological context in which the method is used. The analysis of PFGE data, considered as the "gold standard", is based on the differences of the number and position of bands patterns, although recent recommendations are now available from the Centers for Diseases Control and Prevention (CDC) for a more accurate interpretation, which also include the evaluation of the gel quality, the genetic diversity of the microorganism, the time and geographical scale of an epidemic event. Future advances in the molecular typing technologies indeed will provide rapid methodological improvements, such as a greater degree of automation, better resolution, higher throughput, and a greater availability of dedicated bioinformatics tools. These factors will all contribute to an increasing application of genotyping methods to better understand the epidemiology of infectious diseases, and to implement, along with the strengthened international and interdisciplinary partnerships, more effective control and prevention strategies for Public Health improvements.