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Abstract: Meningococcal disease is particularly severe. The case-fatality rate is 7.78% in Europe and 10–14% in the USA. This paper reports the results of a sero-epidemiological study in Italy on meningitis due to Meningococcus C before the introduction of the monovalent conjugate vaccine. In 2003–2004, a total of 577 sera were collected in 17 of the 20 Italian Regions. Serum Bactericidal Assay (SBA) was performed by using rabbit complement serum according to standardized SBA. The results showed that the percentages of protected subjects decreased from 6 to 12 months of age, increased from 1 to 4 years, decreased again until the age of 8 years and from 13 to 16 years, and were particularly high in 9- and 17-year-old subjects. The geometric mean titre of bactericidal antibodies (SBAbs GMT) was low in subjects under 1 year of age, significantly increased in 1–9-year-old children and decreased in adolescents and young adults. Finally, in each one-year age-group, low levels of antibodies were observed in subjects under 1 year of age, in 10-year-old subjects and in 14–16-year-old adolescents. High titres were observed in 3-, 8-, 9- and 17-year-old subjects. Our results therefore indicate that meningococcus C has the highest probability of spreading among 1–4, 8–10 and 14–17-year-old subjects in Italy. [Copyright &y& Elsevier]

Background: The economic evaluation of any human papillomavirus (HPV) vaccination strategy requires the measurement of clinical benefits (quality-adjusted life-years [QALY]) gained to reflect both the increase in life expectancy and the economic benefits associated with an effective intervention., Objective: The purpose of this pilot study was to investigate the feasibility of a standardized time trade-off (TTO) procedure to quantify utilities loss in health states affected by HPV-induced pathologies in Italy., Methods: This multicenter, retrospective, observational, cross-sectional study was designed to elicit data on utilities in a cohort of women with a histologically confirmed diagnosis of high-grade cervical intraepithelial neoplasias (CIN2-3). An algorithm for the computerized administration of a TTO questionnaire was developed for the standardized elicitation of data on health utilities in CIN2-3, anogenital warts, and invasive cervical cancer. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to assess the respondents' baseline perception of their health conditions. The correlation between utilities and age, time from conization to questionnaire administration, and EQ-5D score, was tested using the Spearman rank correlation coefficient (ρ) as a measure of validity., Results: Of 42 enrolled patients, 36 responded (85.7%) (mean [SD] age, 37.2 [9.0] years). The women's perception of their health state was high (mean [SD] EQ-5D score, 0.93 [0.10]). The mean utility values were 0.73 (0.22), 0.71 (0.35), and 0.02 (0.08) for CIN2-3, anogenital warts, and invasive cervical cancer, respectively. Based on ρ values, none of the 3 HPV-induced pathologies considered was significantly correlated with utility. Nonsignificant variability was found among utilities elicited for anogenital warts (range, 0.54 [0.47] to 0.79 [0.27]); this variability was a limitation of this pilot study and was likely the result of the limited sample size., Conclusions: Based on the findings from this pilot study, a TTO standardized procedure is expected to be feasible and appropriate for assessing utilities in patients affected by HPV-related diseases and for cost-effectiveness analyses of cervical cancer prevention in Italy., (Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.)

Background: Numerous epidemiological studies have shown that air pollution due to both industry and heavy traffic has short- and long-term effects on health. The study was carried out in an industrial area with heavy urban and motorway traffic in the Province of Genoa (Italy)., Methods: The study was carried out from June 2005 to July 2008. An epidemiologic study was conducted by monitoring an elementary/middle school situated in an area of recent industrial development and an elementary/middle school located in an area free from sources of industrial pollution. Furthermore, we conducted an investigation of workers in commercial premises situated in one area of heavy vehicular traffic. In the study areas, environmental monitoring campaigns were carried out in order to determine the association between indoor and outdoor pollution and respiratory disorders., Results and Discussion: The study did not bring to light any specific health problems attributable with certainty to industrial emissions. The impact of pollution caused by motor traffic proved to be greater than that due to industrial emissions. More exhaustive sampling campaigns should be implemented in order to quantify the effects of specific sources of emissions and to correlate these sources with pollutants (industry, urban traffic, motorway traffic).

Human papillomavirus is a common sexually transmitted virus, and persistent infection with high-risk types is the necessary factor for cervical cancer. We investigated sexual behaviour and the age of the first sexual intercourse among young people (14-24 years) in Liguria (Northern Italy) in order to provide information that might orient the country's future vaccination policy. The Italian Authorities offer free vaccination to 12-year-old females, however a better prevention of HPV would to be implemented by introducing the vaccine to new cohorts of females after the first year of the vaccination campaign. Our survey was carried out from 1st May 2006 to 31st December 2007 and involved 3474 volunteers. We administered a written questionnaire to students (14-24 years) and workers (20-24 years). The median age+/-MAD of the sexual debut was 15+/-1 for both females and males in students group and 16+/-1 for both males and females in workers group. This study provides evidence that many Ligurian adolescents have their first sexual experience at a very early age, and often without protection against sexually transmitted diseases. Furthermore, a large percentage of all age-groups are sexually active and have multiple partners. The aim of this study was to identify those cohorts of females to whom vaccination should be offered free of charge. To this end, we calculated the percentage of infections that could be avoided by vaccination in each age-class: the younger the subjects, the higher the number of preventable infections. Our findings suggest that current HPV vaccination should be implemented by introducing new cohorts, especially young girls (14-16 years).

Introduction: Accidents in the home are a major public health issue in most industrialised countries, as they are a frequent cause of injury and death. Moreover, since a considerable portion of such accidents involve elderly people, it is important to assess their social impact in this population. In Italy, the available data indicate that well over 3 million people per year suffer accidents in the home, and that this number is rising. The aim of the present study was to evaluate the number, characteristics and causes of domestic accidents among the elderly., Materials and Methods: The study population was made up of subjects of both sexes aged between 65 and 92 years admitted to first aid units and emergency departments of hospitals in Genoa. The investigation was conducted by means of an ad hoc questionnaire designed to record the circumstances of the accident, the functional capacity of the subject involved, any risky behaviour enacted and the safety profile of the subject's home., Results: The study enrolled 111 voluntary participants: 62 women and 49 men. At the time of the accident, subjects were engaged in the following activities: housework (36.9%) "rest" (14.5%), ablutions (10%), gardening (9%), leisure activities (8.1%), eating and drinking (2.7%). The most common injuries were bruises (39.6%), followed by fractures (23.4%) and cuts (23.4%); the frequency of other, some time more severe injures (burns, poisoning, asphyxia, crush injuries, etc.) was,fortunately, very low. Anyway, taking into account their consequences, their surveillance and prevention is very important. Most subjects were deemed to be in good health and, in 76% of cases, the safety profile of their houses proved to be satisfactory., Discussion and Conclusions: The data collected during this survey are in line with those yielded by national and international studies. They show that the elderly are very vulnerable to domestic accidents and that, even in the event of only slight injury, the management of elderly victims requires a strong organisational commitment on the part of relatives and considerable financial resources for healthcare services. Falling proved to be the main cause of injury. Clearly, efforts to reduce the cost of accidents in the home should aim to implement preventive intervention among elderly people, since the elderly population is destined to grow as a result of increasing life expectancy. In particular, preventive action should focus on reducing the incidence of falls by eliminating risk-related structural features in domestic settings as far as possible and by raising public awareness of the problem through health education campaigns.