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Ann Ig [journal]
- Antibiotic Effects on Vaginal Microbiota - "Author Reply: To PMID 24048183". [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):553-5.
- Request for ethics support in healthcare practices. Reasons and characteristics of Ethics Consultation Service users. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):539-52.
Background:Ethical problems in healthcare practices are increasing. Therefore, healthcare professionals encounter difficult ethical problems more frequently in their professional activities. For this reason, in several countries Ethics Consultation Services have been created, and a debate concerning their role and organization model has developed. Despite the great interest of healthcare professionals in ethics support, Ethics Consultation Services are scarcely diffused in Italy.
Methods:A survey was conducted to identify the levels of the nurses' experience and knowledge in the field of ethics and to assess their willingness to use a consultation service to approach ethical issues in healthcare. A questionnaire was administered and completed personally by 374 nurses appropriately instructed beforehand on its use. They were recruited from post-basic training courses at the Faculty of Medicine and Surgery of the University of L'Aquila.
Results:The willingness to recur to an ethical consultation, indicated by 90.3% of respondents, would confirm the hypothesis that the increasing ethical difficulties encountered in healthcare activities determined a greater interest towards this kind of service. The results of the study underline both the need and expectations the nurses have for ethics consultation and support to face ethical difficulties in patient care, and describe the characteristics of potential users.
Conclusion:In our country the delay in approaching such problems is in contrast with the marked interest the healthcare professionals have for a possible request for support to face ethical problems in patient care. The study shows the respondents' high degree of appreciation of the contents of an ethics consultation activity and, consequently, it is desirable that the creation of an Ethics Consultation Service takes into consideration the indications given by the potential users, in addition to the experiences coming from other countries.
- Access to prenatal cytogenetic diagnosis in Catania: a retrospective survey. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):529-37.
Background:To determine the incidence of chromosome abnormalities (CAs) in prenatal cytogenetic diagnosis, to describe and compare indications in Italian and migrant women, and to assess the level of compliance with published national guidelines.
Methods:A retrospective analysis of 7806 amniotic fluid samples (AFS) and 228 chorionic villi samples (CVS) was conducted.
Results:Advanced maternal age was the most common indication. CAs incidence was 3.1 per 100 AFS, and 12.6 per 100 CVS. Only parental chromosome rearrangement and ultrasound abnormalities were significantly associated with CA occurrence (RR= 20.15 95%CI: 11.96-33.96; RR= 4.33; 95%CI: 2.95-6.36, respectively). Both in amniocentesis and in chorionic villi sampling CA incidence was significantly higher when performed according to the national guidelines, than for other reasons. Incidence data for trisomy 21, trisomy 18 and inversions were significantly higher than those reported in a previous Italian report.
Conclusions:Increased maternal age may explain, at least in part, the increase by time of CAs, although an excess was shown in our population independently from it. Our results show that advanced maternal age may not be sufficient as a single criterion for prenatal diagnosis, and suggesting a future revision of national clinical indications is suggested.
- Liver function in workers exposed of the cosmetics industry. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):519-27.
Background:The purpose of this study is to assess whether occupational exposure to substances used in the cosmetic factories may cause effects on the liver and blood counts in exposed workers.
Methods:The study included 48 exposed workers and 86 unexposed controls. All workers included in the study underwent blood count, white blood count, total, direct and indirect bilirubin, transaminases, alkaline phosphatase and cholinesterase. The differences between the means and frequencies were compared using the Student's t-test and chi-square test with Yates correction and were considered significant when the p value was <0.05.
Results:The analysis of the results shows that 35.4% of workers in the cosmetics industry had liver test values above the range. We noted a statistically significant higher prevalence of GPT (p <0.05) and total bilirubin (p <0.05) in the workers of the cosmetics industry compared with the control group.
Conclusions:The results obtained suggest that occupational exposure to low doses of substances used in the cosmetic industry is able to influence some liver parameters in occupationally exposed workers.
- Dynamic blood pressure in workers exposed to urban stressors. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):511-7.
Background:The occupational exposure to urban pollution may induce adverse effects on the cardiovascular system.
Methods:Basal blood pressure, electrocardiogram (ECG) and the dynamic blood pressure monitoring during the work shift of 16 policemen (outdoors workers) and 16 administrative employees (indoor workers) were compared.
Results:The mean value of all the diastolic blood pressure surveys in policemen (84,53 ± 10,78) is significantly higher (p = 0,014) than the mean value of all the diastolic blood pressure surveys in indoor workers (82,74 ± 11.52).
Conclusions:The results of our study suggest that the occupational exposure to urban stressors may induce an increase of the diastolic blood pressure in workers during the working hours.
- Alcohol consumption and awareness of the risks related in alcohol-abuse in high school students: evidence from a Health Education program. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):501-9.
Background:The unceasing and widespread increase of alcohol consumption represents an important problem for the European Union. For this reason, we wanted to investigate the patterns of alcohol consumption among high-school students of Rieti, a city in central Italy, and of surrounding rural areas. Furthermore, the study intends to investigate students' awareness on alcohol-related health risks and on the consequences of driving in a state of intoxication.
Methods:In the investigation 7 schools including senior highschools and technical schools were involved, for a total of 669 students aged between 15 and 19 years. As part of a program of health education, a self-administered anonymous questionnaire was proposed to each student. A descriptive and multivariate analysis was carried out.
Results:The prevalence of usual drinkers was equal to 12.7 per cent. The logistic regression analysis showed a statistically significant association between usual consumption of alcohol and the attendance of Technical Institutes (OR=3.43; 95% IC: 2.07 - 5.69), and the residence in rural areas (OR=2.19; 95% IC: 1.38 - 3.47). The area of residence in the multivariate analysis loses significance. Only 54.6 % of the students answered the questions regarding the state of driving under the effect of alcohol; of these, 11.0 % declared of having driven at least once under the effect of alcohol, whereas 18.0 % declared that they had been passengers of a driver who was drunk. The answer to the question whether the consumption of alcohol is harmful to health was "no" for 15.7 % of usual drinkers against 2.2 % of the non drinkers or occasional (episodic) drinkers.
Conclusions:Our study shows that the drinking habits of high school students of Rieti are worse for those attending technical schools. Usual drinkers show lower consciousness of alcohol-related harm. Our study may provide clues useful for the identification of the target population at high risk for alcohol abuse in order to create targeted prevention programs.
- The tubercular disease in immigrants without documents: new diagnostic settings adopted in Milan, Italy. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):493-500.
The tubercular disease (TB) is "the disease of poverty and people in need", spread in the poorest countries and among the less wealthy people of the western world (immigrants). In Italy the health authority has recently defined precise diagnostic and therapeutic patterns for TB. The social and health Association Naga in Milan with the Regional Reference Centre for TB, designed a screening system. In Naga's surgery all the undocumented immigrants, coming to Italy from countries with high TB incidence (> 100/100000) and high immigration rates, are screened by a questionnaire created by the Swiss Lung League; the suspect cases are sent to a designed centre for a second level of investigation. The use of this form allows to set a first selection based on the patients' anamnestic history, thus avoiding the intradermal reaction that, due to its low selectivity, could cause a 4 times higher crowding of the designed secondary centers.
- Vancomycin resistant enterococci healthcare associated infections. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):485-92.
Background:Vancomycin-resistant enterococci (VRE) are among the most common healthcare associated multidrug-resistant organisms. Purpose of the article was to review recent data regarding the epidemiology, clinical issues and infection control of this organisms.
Methods:A PubMed-MEDLINE search was carried out.
Results:The European Antimicrobial Resistance Surveillance System (EARSS) highlights a large variability between the various european countries, with VRE ranging from <2% (Finland, Holland) to >20% (Ireland, Greece, Portugal). Italy shows a low rate level (4.2%). In USA according to the National Healthcare Safety Network (NHSN) in 2006-2007 overall 33% of enterococci were resistant to vancomycin, whereas in Canada VRE prevalence showed to be much lower <10%. Although with some methodological limits, several studies showed that infections caused by VRE are more serious and associated to a higher mortality rate and economic burden compared to those caused by vancomycin susceptible enterococci (VSE). The average increased associated mortality was over two-fold. Resistance to newer antimicrobial agents as daptomycin and linezolid has been described, complicating treatment options for infections caused by these organisms.
Conclusion:Control measures aimed at reducing the incidence of VRE colonization and infection in healthcare settings should include: hand washing with an antiseptic or a waterless antiseptic agent, routine screening for vancomycin resistance among clinical isolates, rectal surveillance cultures, contact isolation for patients with VRE and antimicrobial stewardship.
- National guidelines for the prevention and clinical management of dental trauma in individuals during their developmental age. [Journal Article]
- Ann Ig 2013 Nov-Dec; 25(6):459-84.
Annali di Igiene are happy to publish - in issue 6, 2013 - the "National Guidelines for the Prevention and Clinical Management of Dental Trauma in Individuals during their Developmental Age", which have been prepared by a multidisciplinary team of experts on behalf of the italian Ministry of Health and revised by the WHO Centre "Epidemiology and Community Dentistry" at the Medical School of the State University of Milan. The need for such Guidelines emerges from the fact that the application of correct procedures after a dental trauma is presently far from being satisfactory, only 4% of the cases being managed correctly according to the literature. Actually, compared to the increasing cases of dental trauma due to the growing dynamism of the daily life, especially for the youngsters, many emergency structures are not ready to gather the full set of experts who only are in the position, working together, to obtain a successful aesthetic and functional recovery of the patient. The Guidelines consider the problem gradually, starting from the necessary psychological approach to the traumatized young patient, continuing with the complex diagnostic procedures and the correct therapeutic interventions, ending with the planning of the necessary follow-up, designed to guarantee a correct evolution of the trauma toward the full recovery.