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BackgroundTattoos were historically associated with deviant behaviours or religious and other social purposes, but in the last decades, they have gained increasing popularity and have become a mainstream. The aim of this systematic review is to assess the literature evidence about decorative tattoos complications, considering both infective and non-infective risks.MethodsThis systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. We searched the following electronic bibliographic databases: PubMed, Scopus and Web of Science (science and social science citation index).ResultsThe literature search resulted in 6473 studies. A total of 207 full articles were considered potentially relevant and were reviewed independently by researchers. After full-text evaluation, 152 of 207 articles were excluded, as they did not meet selection criteria. The remaining 55 studies were included in the systematic review and their quality assessment was performed. Ten studies reported microbiological complications, 37 reported non-microbiological effects and eight reported either microbiological and non-microbiological complications.ConclusionsSeveral well-known and uncommon risks are associated with tattooing and tattoo after-care. Public health authorities could take into account health education programmes for tattooists and customers in order to prevent health complications in people with tattoos.PROSPERO registration numberCRD42020177972.

This Special Issue offers new perspectives on innovation in managing water for recreational uses, in facilities for sport, playtime, rehabilitation, health, and wellness [...]

Tattooing and piercing may lead to health complications. The present multicenter cross-sectional study aimed to assess awareness and knowledge of health risks related to body art and to identify their possible determinants among a large sample of undergraduates in Italy. A web-based questionnaire collecting information on socio-demographic characteristics, awareness, knowledge, and some potential predictors was administered to undergraduates attending twelve Italian universities. The level of knowledge was expressed as the number of correct answers (0–11 for tattooing, 0–14 for piercing). A total of 2985 participants (mean age 23.15 ± 3.99, 73.9% F) participated in the study. Although 95.4% of the respondents were aware of possible health consequences of body art, a low level of specific knowledge was registered for both tattooing (mean number of correct answers 5.38 ± 2.39) and piercing (5.93 ± 3.12) consequences. Lower knowledge was associated with the attendance of non-life science course and with lower duration of academic education for both tattoo and piercing. Lower knowledge of tattooing risks was related with commuter status, while lower knowledge of piercing risks was associated with lower father’s education. These findings highlight the need to enhance information campaigns targeted to youths to increase their awareness of possible health risk of body art.

Next-generation sequencing (NGS) and advances in microbiota knowledge are opening new perspectives for environmental microbiology and public health. Massive parallel sequencing of bacterial DNA is providing new insights to unravel microbial dissemination in different matrices, including air. Here, we have assessed the air biodiversity in several indoor environments by NGS-based metagenomics and compared results with respect to classical approaches. Environmental sampling was achieved in three exemplificative indoor locations: offices, recreational facilities and public restrooms. Sampling was performed by active (surface air system and high-volume aerosol collection system) and passive (index of microbial air contamination and novel tissue-based passive sampling) techniques. Collected samples were tested by traditional microbiology and DNA-based methods. Biodiversity indices were computed using EstimateS software. Statistical analysis by SPSS and R was applied to determine the variability of bacteria groups after comparing sampling and analysis protocols. In each point (n = 6), air was sampled in duplicate by four methods and tested in parallel by culture-based and DNA-based approaches. A total of over 30 ± 10 isolates for each point were identified at species level. A total of 3,207,415 sequence reads were generated by NGS analysis, leading to the identification of over 170 OTUs. NGS analyses of air biodiversity were more informative when using active sampling methods (0.729, p

Background: tattooing and piercing are increasingly common, especially among youths. However, several health complications may be associated with these practices if basic hygiene rules are not respected. This multicenter study was aimed at exploring tattoo and piercing experiences reported by a large sample of Italian undergraduate students through a public health perspective. Methods: tattooed and/or pierced students attending 12 Italian universities were asked to complete a web-based questionnaire regarding their body art experience. Results: out of 1472 respondents, 833 (56.6%) were tattooed and 1009 (68.5%) were pierced. The greatest proportion of tattooed students (93.9%) got her/his first tattoo in a tattoo studio, while most of the pierced were serviced in a jewelry store (48.0%). The pierced ones were less informed on health issues related to the procedure (56.0% versus 77.8% of tattooed p < 0.001), and tattooists were reportedly more attentive to hygiene rules (instrument sterilization 91.5% versus 79.1% of piercers, p < 0.001; use of disposable gloves 98.2% versus 71% of piercers, p < 0.001). Conclusions: educational interventions for both professionals and communities are needed to improve the awareness and the control of health risks related to body art throughout the Italian territory.

SARS-CoV-2 infection shows a wide-ranging clinical severity, requiring prognostic markers. We focused on S100B, a calcium-binding protein present in biological fluids, being a reliable biomarker in disorders having inflammatory processes as common basis and RAGE as main receptor. Since Covid-19 is characterized by a potent inflammatory response also involving RAGE, we tested if S100B serum levels were related to disease severity. Serum samples (n = 74) were collected from hospitalized SARS-CoV-2 positive patients admitted to Covid center. Illness severity was established by admission clinical criteria and Covid risk score. Treatment protocols followed WHO guidelines available at the time. Circulating S100B was determined by ELISA assay. Statistical analysis used Pearson’s χ2 test, t-Test, and ANOVA, ANCOVA, Linear Regression. S100B was detected in serum from Covid-19 patients, significantly correlating with disease severity as shown both by the level of intensity of care (p p

Aim To evaluate the efficacy and feasibility of a physical activity promotion intervention in community-dwelling older adults based on a free program of exercise adapted for older adults aged ≥60 years managed by trainees from the Movement Sciences degree course. Methods A total of 160 adults aged 60–82 years were randomly allocated into the intervention and control group. The exercise program consisted of 1-h sessions carried out twice a week for a year. Control participants received recommendations about an active lifestyle from their physicians. Senior Fitness Tests and the 12-item Short Form Health Survey were used to assess six functional fitness domains of participants and perception of their health status, respectively. Body mass index was also evaluated. Results A total of 62 participants completed the exercise path. At the end of the intervention, they showed a significant body mass index decrease (from 27.9 ± 1.6 to 25.1 ± 1.8 kg/m2, P 0.05). A high acceptance of the intervention was registered among participants (>88.7%); staff competence and gratuitousness were the most appreciated features (>85.5%). Conclusions The structured program represented a useful opportunity to promote physical activity among participants, and it was effective in improving their physical fitness and health status perception. Similar interventions are required to sensitize the whole older population, and experts in Movement Sciences might represent a key figure in this context. Geriatr Gerontol Int 2017; 17: 1421–1428.

Natural swimming ponds (NSPs) are a new type of recreational water facility characterized by the substitution of traditional disinfection with biodepuration. While this feature meets esthetic desires of users, specific concerns on public health issues have been raised by the scientific community and local authorities. The absence of a European directive applicable to these environments leaves each country without specific and harmonized indications. The present work describes the local/national policy situation, describing adopted parameters and monitoring activities. All documents underline the need for appropriate microbiological analysis and correct water management.

Background: Physical activity is associated to an increased risk of sudden cardiac death (SCD). Together with primary prevention, prompt recognition and early management of SCD are crucial in order to improve survival rate. During their duty, sport trainers and teachers can play a key role in secondary prevention of cardiac arrest provided they have received an appropriate training in Cardiopulmonary Resuscitation (CPR) during their curricular study. This is usually achieved through a Basic life Support and Defibrillation (BLS-D) Course which in Italy formally enables to Automated External Defibrillator (AED) use. Objective: To investigate the presence, the type and the diffusion of cardiopulmonary resuscitation training in Sport and Exercise Sciences Universities in Italy. Design: Descriptive survey research design was adopted for the study. Setting: The study sample consisted of 32 Italian Universities with Bachelor and Master-Level Degrees in Sport and Exercise Sciences. Methods: Teaching secretary or directly deans/ course presidents were contacted by email or telephone in order to collect information on the availability of BLS-D courses for Sport and Exercise Sciences students during the academic year 2010-2011. Results: The compliance to the survey has been >93%. Only a reduced number of the contacted Universities offered dedicated courses of Cardiopulmonary Resuscitation with license to Defibrillation according to current local regulation. Conclusion: The described situation shows a limit in the generation of a sport trainers’ category highly specialized in cardiac and respiratory emergencies: only 6 Universities organize BLS-D training with official certification.

Background:Physical education (PE) can be considered an instrument for active lifestyle promotion, and PE teachers can motivate youths to continue their studies in the field of Movement Sciences (MS).Methods:To evaluate the role of PE in higher secondary school in promoting physical activity (PA) and MS careers, previous PE experiences and current PA practice were investigated in a sample of Italian freshmen enrolled in different university degree courses.Results:A total of 7033 questionnaires were completed by students from 14 universities (41.3% males, mean age 20 ± 2.76 years). Recreation seemed to be the principal aim (42.2%) pursued during PE lessons, which are based mainly on practical activities (51.7%). Of all respondents, 67.2% were satisfied with the PE received during higher secondary school, and 51.6% participated in extracurricular PA. Current practice of PA was reported by 58.1% of the sample. Extracurricular activities were associated with choice of MS curricula (odds ratio: 2.15; 95% confidence interval, 1.85–2.50) and with current practice of PA (odds ratio: 1.68, 95% confidence interval, 1.51–1.87). Geographical differences concerning lessons organization and satisfaction were registered (P < .01).Conclusions:To enhance its role in health promotion, PE teaching should be improved by increasing the time allocated to PE and by strengthening the provision of school-based extracurricular PA.

The allergic risk in sport is an emerging issue of relevance for public health. Several natural and synthetic allergens are present in indoor and outdoor sport environments. Epidemiological data show the widespread high incidence of allergies in the population. Elite athletes have been observed to have a high prevalence of allergic reactions and exposure to allergens during training and competitions is a concern for environmental occupational medicine. The connection between exercise-induced bronchoconstriction, genetics and environment is still debated. In recent decades, interest in this field has been growing as shown by the increasing number of ISI/PubMed publications. The main allergens present in the sport and physical activity environments are classified and reported here.

Sexual health education through sport: issues for further perspectives in health promotion - WHO and the EU encourage the development of initiatives to promote teen-age sexual health. In Italy, though, adolescents sexually active age (15-17 years), adequate educational support seems to be lacking. Sexual education programs require a multidisciplinary approach, adequate staff and a conducive and appropriate environment. Sports and Physical Activity may provide additional and complementary support to school-sponsored activities. The sample (57% males and 43% females), stated that they participated in sexual education programs during their school years (58%). The schools do not seem to play an effective role, and friends continue to be the main source of information on sexuality-related issues (70%). Motor activities in schools and sports facilities may provide a useful education and prevention opportunity for youths and the Motor science graduate students may be a possible point of reference in schools or sports centers. They may also play a role in the multidisciplinary teams called to address adolescent issues, by actively participating in sexual education programs promoted by the public health system with other professionals Key words: sexual education, sexual health, physical activity, prevention, sexual behaviour, sport.

New genetic evidence strongly supports a role for the immune system in the pathogenesis of essential hypertension (EH) through chemokines and their receptors (CCR) involvement. The aim of the present study was to evaluate the possible relation between CCR2 and CCR5 alleles and blood pressure (BP) levels in hypertensive subjects. In all, 118 essential hypertensive outpatients (male 90, female 28; stage I and II; age 27-54 years; not previously treated with antihypertensive drugs) were selected for the study. All of the subjects underwent office BP measurement. Subsequently, 24-h ambulatory BP monitoring (ABPM) was performed with a Spacelabs 90207 monitor during a regular working day. CCR264I and CCR5Delta32 polymorphisms were determined by polymerase chain reaction (PCR), following the standard molecular biology protocols. Allelic frequencies were the following: CCR5Delta32= 0.097, CCR264I=0.101. Logistic regression analysis showed an association between the CCR5Delta32 allele and the following: 24-h systolic BP (SBP >140 mmHg; p = 0.027), values over the 50th percentile of 24-h SBP (p = 0.032), and the values over the 50th percentile of nighttime SBP (p = 0.039). Office BP showed an association with the Delta32 allele in a range over the 75th percentile of SBP (p = 0.087) and the 75th percentile of DBP (p = 0.085). No significant association was observed for CCR264I and BP levels or between physiological nocturnal BP decline and genotype. The observed results not only support the role of the immune system in the development and maintenance of hypertension, but they also indicate an influence of CCR5Delta32 polymorphism on the establishment of BP levels.

By using high-density oligonucleotide arrays, we profiled gene expression in reward-related brain regions of rats that developed escalated cocaine intake after extended access to cocaine (6 h per day). Rats allowed restricted daily access to cocaine (only 1 h) that displayed a stable level of cocaine intake and cocaine naive rats were used for controls. Four analysis methods were compared: Affymetrix microarray suite 4 and microarray suite 5 , which use perfect-match-minus-mismatch models, and dchip and rma , which use perfect-match-only models to generate expression values. Results were validated by RT-PCR in individual animals from an independent replication of the experiment. A small number of genes was associated with escalated cocaine intake (ESC genes). Unexpectedly, of the brain regions examined [prefrontal cortex, nucleus accumbens, septum, lateral hypothalamus (LH), amygdala, and ventral tegmental area], the LH was the most transcriptionally responsive in escalation of cocaine intake. Most of the ESC genes identified are also expressed during synaptogenesis and synaptic plasticity and include genes that code for several presynaptic and postsynaptic proteins involved in neurotransmission. These results suggest that LH intrinsic circuitry undergoes a structural reorganization during escalation of cocaine use. This remodeling of LH circuitry could contribute to the chronic deficit in reward function that has been hypothesized to drive the transition to drug addiction. Results also support the value of using multiple analysis strategies to identify the most robust changes in gene expression and to compensate for the biases that affect each strategy.

Over the past 20 years, the interest of the scientific community was increasingly placed in the field of genetic epidemiology and molecular genetics of blood pressure control. This paper explores references related to essential hypertension, gene and genetic epidemiology indexed in the MedLine health science database during the period 1980-2001. A systematic literature search was performed using selected keywords, such as 'genetic', 'genome' or a combination of words. We considered the study heading and evaluated the time profile of published articles. A total number of 3116 publications was collected and analyzed. Allelic distribution for the most studied polymorphisms of the renin-angiotensin system in different world populations was reviewed and reported together with a detection of their frequency in Italy: essential hypertensive patients (n = 90), healthy unrelated subjects (n = 300). Molecular variants at angiotensinogen (M and T), angiotensin II type 1 receptor (A and C) and angiotensin-converting enzyme (D and I) genes were analyzed by amplified fragment length polymorphism. A significant association was detected by chi2 analysis for angiotensinogen and angiotensin II-type I receptor allele distribution in hypertensive patients, in accordance with previous reports. Genetic data and methods are contributing more and more to epidemiological studies of complex diseases, and their application is influenced by information availability and Genome Project results.

Background The purpose of this work was to explore the knowledge and acceptance of Varicella Zoster Virus (VZV)-Herpes Zoster (HZ) vaccination in the general Italian population, where the HZ vaccine has not yet been distributed, using a prevalence study of subjects from two regions in Italy. Methods A group of 3,173 individuals were interviewed using a questionnaire. The youngest age group (≤ 20 year) was composed of students interviewed at university. The middle age group (21-40 years) and the older age group (≥ 41 years) were interviewed by general practitioners in their office. Results In both regions, the majority of subjects had been infected with varicella, and only 165 (5.2%) subjects reported receiving the VZV vaccination. Regarding HZ, 2,749 (86.6%) individuals stated that they knew of the virus and 2,233 (70%) were willing to be vaccinated against HZ. The majority of people willing to be vaccinated were in the middle and older age groups (36.6% and 44.7%, respectively). Conclusion Compliance versus vaccination results were satisfactory and probably, with the upcoming availability of the HZ vaccine in Italy, adults will be favourably disposed towards vaccination.

Background: The aims of the study were to detect nosocomial and community-acquired Legionnaires’ disease among patients with pneumonia recovered in Italian hospitals, to improve knowledge on the disease frequency, and to characterise environmental, personal, genetic and immune risk factors associated with the disease appearance (case-control study). Methods: In six big hospitals, an active surveillance lasting four years was carried out to detect cases among recovered pneumonia. The protocol included the systematic detection of urinary L. pneumophila antigen (EIA), search of the microorganism in respiratory secretions, and seroconversion (IFA) as confirmation test. Cases were included, after obtaining informed consensus, in a case-control study to evaluate environmental, clinical and personal characteristics associated with the disease. As controls, both healthy subjects and patients affected by other pneumonia were recruited. Results: We detected 189 cases on 6,032 examined pneumonia (3.13%), 174 were community and 15 nosocomial-acquired. Prevalence varied between 1.5 and 6.1% according to the surveyed hospital. One hundred and twenty-six patients and 142 controls entered in the case-control design. Pre-existing immune-pathologies were associated with the disease, whereas higher smoking and co-morbidity were risk factors of all pneumonia. A significant decrease in CD16 (natural killer) cell number was found in patients compared with both control groups. Furthermore, significant alterations in iron metabolism and serum trace elements were found. Polymorphisms of the chemokines receptors genes (ccr5 and ccr2) were also evaluated. Conclusions: Our active clinical surveillance scheme was able to identify 189 cases between 2001 and 2004, contributing to increase reports in Italy, where about 600 cases for year are notified. The rate of infection in recovered pneumonia was about 3%, confirming results of other similar surveys. The preliminary results of the case-control study show that cases have peculiar, although not sufficiently studied, alterations in both immune and biochemical parameters, which deserve further investigations.

Objective:To investigate an outbreak ofCandida parapsilosisbloodstream infections (BSIs) involving three patients admitted to a pediatric oncology unit between April and June 2002.Methods:After the third case was documented, cultures were performed of the hands of all medical and paramedical staff members in the pediatric oncology unit and of environmental surfaces in the rooms occupied by the three patients. Electrophoretic karyotyping with pulsed-field gel electrophoresis and arbitrarily primed polymerase chain reaction were used to assess the genetic relatedness amongC. parapsilosisisolates.Results:The three cases ofC. parapsilosisBSI were diagnosed based on blood cultures performed during a 38-day period. Evidence of priorC. parapsilosiscolonization of the gastrointestinal tract was present in only the first case. Each patient had an indwelling central venous catheter (CVC), which was promptly removed, and semiquantitative catheter tip cultures also revealedC. parapsilosis. None of the 30 environmental cultures performed was positive forC. parapsilosis, but the fungus was isolated from the hands of 6 of the 20 nurses tested. Both molecular typing methods revealed identical DNA fingerprinting patterns for all 13 patient isolates (7 from blood, 3 from CVC tips, and 3 from the gastrointestinal tract) and for 5 of the 6 recovered from the nurses' hands.Conclusions:These findings suggest the possibility of cross-infection with a singleC. parapsilosisstrain that was transmitted (probably during CVC dressing changes) by nurses whose hands were colonized with it. The role of previous gastrointestinal colonization in the first case cannot be excluded.

Genetically Modified Organisms (GMOs) are a fact of modern agriculture and a major field of discussion in biotechnology. As science incessantly achieves innovative and unexpected breakthroughs, new medical, political, ethical and religious debates arise over the production and consumption of transgenic organisms. Despite no described medical condition being directly associated with a diet including approved GM crops in large exposed populations such as 300,000,000 Americans and a billion Chinese, public opinion seems to look at this new technology with either growing concern or even disapproval. It is generally recognized that a high level of vigilance is necessary and highly desirable, but it should also be considered that GMOs are a promising new challenge for the III Millennium societies, with remarkable impact on many disciplines and fields related to biotechnology. To acquire a basic knowledge on GMO production, GM-food consumption, GMO interaction with humans and environment is of primary importance for risk assessment. It requires availability of clear data and results from rigorous experiments. This review will focus on public health risks related with a GMO-containing diet. The objective is to summarize state of the art research, provide fundamental technical information, point out problems and perspectives, and make available essential tools for further research. Are GMO based industries and GMO-derived foods safe to human health? Can we consider both social, ethical and public health issues by means of a constant and effective monitoring of the food chain and by a clear, informative labeling of the products? Which are the so far characterized or alleged hazards of GMOs? And, most importantly, are these hazards actual, potential or merely contrived? Several questions remain open; answers and solutions belong to science, to politics and to the personal opinion of each social subject.

The recreational use of waters has increased in recent decades all over the world. Swimming pools and other recreational water facilities offer opportunities for enjoyment and health promotion, but they also may involve health risks, despite the fact that better management and modern technologies for water treatment and quality monitoring (e.g. real-time protocols for detecting bacteria), have made such facilities safer.1,2 Several communicable diseases – cryptosporidiosis, giardiasis, leptospirosis, legionellosis, bacterial and viral gastroenteritis – are commonly associated with bathing in recreational waters.3,4 According to field study surveys in different countries, the rate of diarrhoeal illness among swimmers ranges from 3 to 8%.5,6 Injuries are also common. In the United Kingdom of Great Britain and Northern Ireland alone, more than 13 000 injuries are estimated to occur annually, on average, among bathers.3,4 Preventing injuries, drownings, the toxic effects of chemical contaminants and outbreaks of waterborne diseases in people who swim in recreational waters calls for a sustained, concerted, multisectoral effort involving epidemiologists, physicians, microbiologists, toxicologists, builders, public opinion leaders and public health authorities. Swimming pools and spas are used by millions of people seeking recreation, rehabilitation, wellness and other health benefits. According to 2011 market data issued by the European Union of Swimming Pool and Spa Associations, 5.7 million pools exist in Europe, or about one for every 150 inhabitants.7 A large part of the world’s population is exposed to the health risks posed by swimming pools, which account for much of the world’s water consumption.8 This includes children, the elderly, pregnant women and people with immunodeficiency and disabilities. People in certain occupations, such as swimming coaches, water sport professionals and pool operators, are also exposed to such risks. In the twenty-first century, international safety standards or harmonized national safety laws are essential in light of the booming tourist industry – now the third largest in the world. From a global health perspective, water facilities must be made safe not just for resident populations, but also for travellers. The absence of an international regulatory framework for pool and spa safety and the presence of incomplete national regulations in many countries put local populations and visitors at risk. For example, Europe’s lack of a directive on safety in swimming pools and other recreational water facilities limits standardization and harmonization throughout the continent. Several institutions have recognized the need for international pool and spa safety regulations. This point was discussed in Rome last April, at the Fifth International Conference on Swimming Pool and Spa.9 The Conference focused on the role of aquatic recreational environments in health promotion but also called attention to the need for good surveillance and prevention to reduce safety hazards. Engineers, chemists, biologists, public health experts, architects, sociologists, occupational medicine specialists and ecologists were in attendance. This large and committed panel of experts can update safety guidelines periodically and support their local dissemination through universities and research centres, public health authorities, swimming pool managers and sports clubs and organizations catering to tourists and local residents. Conference attendees also discussed new technologies for monitoring the microbiological and chemical safety of recreational waters. Technological innovations can play a pivotal role in prevention. Rapid techniques for monitoring water quality can allow for quick measures in response to contamination. The new technologies are gradually shifting the focus from mandatory safety requirements towards expectations of good water quality and towards the implementation of collaborative surveillance strategies based on the hazard analysis and critical control point model. Use of the new technologies must, of course, be harmonized and adopted in consultation with public health institutions to avoid any risk to bathers from the application of unvalidated procedures. Appropriate water sanitation and safety measures are not the only priorities, however. Water is a scarce commodity. The conservation of this most precious resource and its rational use in recreation calls for advanced water management in the context of sustainable development. This and other issues will be discussed in Amsterdam in 2015 at the Sixth International Conference on Swimming Pool and Spa,10 which scientists are currently organizing, together with World Water Day (22 March 2014) and other activities promoted by agencies such as UN-Water and the United Nations Educational, Scientific and Cultural Organization.

Left ventricular hypertrophy (LVH) is a major determinant of heart damage. Scientific evidence suggests the influence of genetic factors, but these have yet to be completely clarified. This study investigates a possible relationship between LVH and two chemokine receptor (CCR) gene polymorphisms: CCR5∆32 and CCR264I. Essential hypertensive out-patients (n=118, grade I–II, age 27–54) were recruited from the Catholic University Hypertension Centre. For each subject, clinical data on office blood pressure and M-mode/2D echocardiography were collected. Statistical analysis did not show a significant association between the CCR polymorphisms and LVH in the study population.