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1. Molecular epidemiology of a hepatitis C virus epidemic in a haemodialysis unit: outbreak investigation and infection outcome

Author

Lanini Simone, Abbate Isabella, Puro Vincenzo, Soscia Fabrizio, Albertoni Franceso, Battisti Walter, Ruta Amilacare, Capobianchi Maria R, and Ippolito Giuseppe

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background HCV is a leading cause of liver chronic diseases all over the world. In developed countries the highest prevalence of infection is reported among intravenous drug users and haemodialysis (HD) patients. The present report is to identify the pathway of HCV transmission during an outbreak of HCV infection in a privately run haemodialysis (HD) unit in Italy in 2005. Methods Dynamics of the outbreak and infection clinical outcomes were defined through an ambi-directional cohort study. Molecular epidemiology techniques were used to define the relationships between the viral variants infecting the patients and confirm the outbreak. Risk analysis and auditing procedures were carried out to define the transmission pathway(s). Results Of the 50 patients treated in the HD unit 5 were already anti-HCV positive and 13 became positive during the study period (AR = 28.9%). Phylogenic analysis identified that, all the molecularly characterized incident cases (10 out of 13), were infected with the same viral variant of one of the prevalent cases. The multivariate analysis and the auditing procedure disclosed a single event of multi-dose vials heparin contamination as the cause of transmission of the infection in 11 out of the 13 incident cases; 2 additional incident cases occurred possibly as a result of inappropriate risk management. Discussion More than 30% of all HCV infections in developed countries results from poor application of standard precautions during percutaneous procedures. Comprehensive strategy which included: educational programmes, periodical auditing on standard precaution, use of single-dose vials whenever possible, prospective surveillance for blood-borne infections (including a system of prompt notification) and risk assessment/management dedicated staff are the cornerstone to contain and prevent outbreaks in HD Conclusions The outbreak described should serve as a reminder to HD providers that patients undergoing dialysis are at risk for HCV infection and that HCV may be easily transmitted whenever standard precautions are not strictly applied.

Published
2010
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2. Italian cancer figures, report 2011: Survival of cancer patients in Italy

Author

Airtum, Working Group, Fusco, Mario, Buzzoni, Carlotta, Coviello, Enzo, Rashid, Ivan, Bianconi, Fortunato, Cuccaro, Francesco, Castaing, Marine, Angelis, Roberta, Giacomin, Adriano, Guzzinati, Stefano, Mosso, Maria Luisa, Pisani, Paola, Quaglia, Alberto, Randi, Giorgia, Ramazzotti, Valerio, Russo, Antonio, Senatore, Gennaro, Stracci, Fabrizio, Traina, Adele, Vercelli, Marina, Zarcone, Maurizio, Ferretti, Stefano, Mazzoleni, Guido, Bellu, Francesco, Tschugguel, Birgit, Valiere, Elena, Facchinelli, Gerlinde, Falk, Markus, Dal Cappello, Tomas, Vercellino, Pier Carlo, Andreone, Simona, Busato, Anna, Marzola, Laura, Migliari, Elena, Carletti, Nada, Nenci, Italo, Crocetti, Emanuele, Caldarella, Adele, Corbinelli, Antonella, Giusti, Francesco, Intrieri, Teresa, Manneschi, Gianfranco, Nemcova, Libuse, Romeo, Gianpaolo, Sacchettini, Claudio, Zappa, Marco, Paci, Eugenio, Serraino, Diego, Angelin, Tiziana, Bidoli, Ettore, Dal Maso, Luigino, Dottori, Margherita, Paoli, Angela, Santis, Emilia, Forgiarini, Ornella, Lise, Mauro, Zucchetto, Antonella, Zanier, Loris, Orengo, Maria Antonietta, Casella, Claudia, Marani, Enza, Puppo, Antonella, Celesia, Maria Vittoria, Cogno, Roberta, Manenti, Simone, Garrone, Elsa, Pannozzo, Fabio, Busco, Susanna, Maria Cecilia Cercato, Battisti, Walter, Sperduti, Isabella, Macci, Leonarda, Bugliarello, Ester, Bernazza, Edvige, Tamburo, Lucilla, Rossi, Miriana, Curatella, Simonetta, Francesco, Carla, Tamburrino, Silvana, Bisanti, Luigi, Autelitano, Mariangela, Ghilardi, Simona, Leone, Rosanna, Filipazzi, Luisa, Bonini, Annamaria, Giubelli, Cinzia, Federico, Massimo, Artioli, Maria Elisa, Valla, Katia, Braghiroli, Barbara, Cirilli, Claudia, Luminari, Stefano, Pirani, Monica, Ferrari, Lorenza, Bellatalla, Caterina, Fusco, Maria, Panico, Margherita, Perrotta, Carmela, Vassante, Biagio, Vitale, Maria Francesca, Michiara, Maria, Bozzani, Francesco, Sgargi, Paolo, Tumino, Rosario, La Rosa, Maria Guglielmina, Cascone, Giuseppe, Frasca, Graziella, Giurdanella, Maria Concetta, Martorana, Caterina, Morana, Gabriele, Nicita, Carmela, Rollo, Patrizia Concetta, Ruggeri, Maria Grazia, Sigona, Aurora, Spata, Eugenia, Vacirca, Stefania, Mangone, Lucia, Di Felice, Enza, Pezzarossi, Annamaria, Caroli, Stefania, Pellegri, Carlotta, Vicentini, Massimo, Storchi, Cinzia, Cavuto, Silvio, Costa, Jaqueline, Falcini, Fabio, Colamartini, Americo, Bucchi, Lauro, Balducci, Chiara, Ravegnani, Mila, Vitali, Benedetta, Cordaro, Carlo, Caprara, Licia, Giuliani, Orietta, Giorgetti, Stefania, Salvatore, Silvia, Palumbo, Monica, Vattiato, Rosa, Ravaioli, Alessandra, Foca, Flavia, Rinaldi, Elisa, Mancini, Silvia, Tonelli, Chiara, Amadori, Marinella, Cremone, Luigi, Iannelli, Arturo, Zevola, Arrigo, Budroni, Mario, Cesaraccio, Rosaria, Pirino, Daniela, Carboni, Donatella, Fiori, Giovanna, Soddu, Marcella, Mameli, Gianpaolo, Mura, Francesco, Contrino, Maria Lia, Madeddu, Anselmo, Tisano, Francesco, Sciacca, Salvatore, Muni, Angela, Mizzi, Margherita, Russo, Maria, Sacco, Giorgio, Aletta, Paoletta, Colanino Ziino, Antonio, Tessandori, Roberto, Fanetti, Anna Clara, Maspero, Sergio, Annulli, Monica Lucia, Moroni, Elena, Sanoja Gonzalez, Maria Eugenia, Zanetti, Roberto, Rosso, Stefano, Patriarca, Silvia, Prandi, Rossana, Sobrato, Irene, Gilardi, Franca, Busso, Paola, Piffer, Silvano, Gentilini, Maria A., Battisti, Laura, Rizzello, Roberto, Cappelletti, Maddalena, Moser, Marilena, La Rosa, Francesco, D Alo, Daniela, Scheibel, Massimo, Costarelli, Daniela, Spano, Francesco, Rossini, Stefania, Santucci, Cinzia, Petrinelli, Anna Maria, Solimene, Clotilde, Brunori, Valerio, Crosignani, Paolo, Tagliabue, Giovanna, Contiero, Paolo, Preto, Lucia, Tittarelli, Andrea, Maghini, Anna, Codazzi, Tiziana, Frassoldi, Emanuela, Gada, Daniela, Costa, Enrica, Di Grazia, Laura, Zambon, Paola, Baracco, Maddalena, Bovo, Emanuela, Dal Cin, Antonella, Fiore, Anna Rita, Greco, Alessandra, Monetti, Daniele, Rosano, Alberto, Stocco, Carmen, Tognazzo, Sandro, Donato, Francesco, Limina, Rosa Maria, Adorni, Anna, Andreis, Paolo, Zani, Giuseppe, Piovani, Francesco, Salvi, Ornella, Puleio, Maria, Vitarelli, Susanna, Antonini, Silvia, Candela, Giuseppina, Pappalardo, Giuseppe, Scuderi, Tiziana, Lottero, Barbara, Ribaudo, Michele, Ricci, Paolo, Guarda, Linda, Gatti, Luciana, Bozzeda, Annalaura, Dall Acqua, Maria, Pironi, Vanda, Sutera Sardo, Antonella, Mazzei, Adriana, Sirianni, Nicola, Lavecchia, Anna Maria, Mancuso, Pierina, Usala, Mario, Pala, Filomena, Sini, Giovanna Maria, Pintori, Nicolina, Canu, Luisa, Demurtas, Giuliana, Doa, Nina, Ponz Leon, Maurizio, Domati, Federica, Rossi, Giuseppina, Goldoni, Carlo Alberto, Rossi, Federica, Gaetani, Carmela, Benatti, Piero, Roncucci, Luca, Di Gregorio, Carmela, Pedroni, Monica, Pezzi, Annalisa, Maffei, Stefania, Mariani, Francesco, Borsi, Enrica, Carruba, Giuseppe, Cusimano, Rosanna, Amodio, Rosalba, Dolcemascolo, Cecilia, Staiti, Rosalba, Pastore, Guido, Magnani, Corrado, Terracini, Benedetto, Cena, Tiziana, Alessi, Daniela, Baussano, Iacopo, Merletti, Franco, Maule, Milena, Macerata, Vanda, Cocchioni, Mario, Pascucci, Cristiana, Gennaro, Valerio, Lazzarotto, Anna, Benfatto, Lucia, Mazzucco, Giovanna, Montanaro, Fabio, AIRTUM Working Group: [.., Enrica Borsi, and ]

Subjects
Adult, Aged, 80 and over, Male, Adolescent, Age Factors, Infant, Newborn, Infant, Middle Aged, Survival Analysis, CANCER, Survival Rate, Young Adult, Italy, Organ Specificity, Child, Preschool, Neoplasms, Humans, Female, Registries, Child, Aged
Abstract

INTRODUCTION: population-based survival analyses are fundamental to assess the impact of public health interventions and new therapies in cancer control. This monograph updates previous reports on cancer patient survival in Italy up to the year 2007. MATERIAL AND METHODS: we extracted from the Network of Italian Cancer Registries (AIRTUM) database over 1,490,000 records of tumours diagnosed during 1990-2007 and followed up to the end of 2008, including all multiple tumours. We used the Ederer II method to estimate relative survival (RS) for 29 different types of neoplasm. Five-year relative survival rates were analysed by gender and macroarea. Trends in 5-, 10- and 15-year RS were studied by gender over six 3-year diagnostic periods, from 1990 to 2007. Conditional 5-year RS was also computed by gender and macroarea. Hybrid approaches were applied to exploit the recent survival experiences of cases diagnosed up to 2007. Adjustment for age was performed using EUROCARE weights. Additional sections describe cancer patient survival in childhood and in elderly patients and provide a comparison of cancer patient survival rates in Italy with those of other countries. RESULTS: Standardized 5-year RS for all tumours but skin in 52% for men and 61% for women. Patient survival has improved for almost all types of cancer: from 1990 to 2007 5-year RS has increased by 15% for all cancers but skin; the exceptions are some cancers with poor prognosis, where patient survival has remained basically unchanged. In males, RS was usually lower than in females, but trend analysis shows that the gap is narrowing. We also report persisting lower RS in southern Italy: 5-year RS in the South is usually from 4% to 10% lower than in the North and Centre. CONCLUSION: this study provides valuable information for all stakeholders in cancer control, both in Italy and elsewhere. Increasing survival reflects improvements in various areas of cancer control. On the other hand, delayed diagnosis and suboptimal management are consistent with the reported differences in survival within the country.

Published
2011

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