Search

to compare the cohort and case-control approaches to evaluate the health effects of an incinerator.dispersion maps have been used to identify subjects exposed to the pollutants from the considered incinerator. Both cohort and case-control approaches have been applied to the study population to evaluate the following outcome: hospitalization for cardiovascular and respiratory causes between 2012 and 2014. The same two approaches have been applied to simulated populations, to which the risk and the base prevalence of the outcome have been varied.a total of 218,445 subjects living in 7 municipalities impacted from the fallout of the incinerator of Busto Arsizio (Lombardy Region, Northern Italy) have been included in this study. For the simulated analysis the samples of 100,000 subjects have been used, with age and sex standardization on Italian population of year 2000.the cohort approach estimated the risk ratio to have been hospitalized for the subjects exposed to the pollutants compared to the non-exposed subjects, while the case-control approach estimated the odds ratio for the cases to be exposed compared to controls.both the cohort and the case-control approaches show an excess in risk of being hospitalized for cardiovascular causes, for subjects exposed to the emissions of SO2 and NOx. The results of the simulations show how much the odds ratio overestimates the risk ratio, increasing risk and prevalence.the cohort and case-control approaches are comparable in the real proposed example. Considering that necessary resources for a case-control approach are lower than the ones in a cohort approach, and under the limits of applicability to prevent an excessive overestimation of risk, the case-control approach is considered to be taken into account to evaluate health impact of environmental exposures, as from incinerators.

Rilpivirine (RPV) is a novel NNRTI with a mutational pattern different from first-generation drugs of the same class: 16 resistance-associated mutations (RAM) are listed, but the combination E138K + M184I seems to be the most important. Aims of the present study were to evaluate the prevalence of these RAMs in Italian HIV-1 infected patients and to assess if previous drug history could represent a risk to develop RPV-related RAMs. The analysis was performed using the ARCA database, which contains data on resistance and therapy from subjects throughout Italy. Prevalence of RPV-associated and first-generation NNRTI-associated RAMs was evaluated. Linear regression model, odds ratio and 95% Confidence Interval were used to assess factors associated with the development of RPV RAMs, substitutions at position 184 and their combinations. A total of 8,067 tests were selected within the database. In Italian HIV-positive HAART-naive patients, prevalence of the main RAMs for RPV is low except for E138A (present in 5.1% of subjects). The combination E138K + M184I is absent in both naive and experienced subjects. A previous exposure to NVP might increase the risk to develop RPV-associated RAMs. TDF, EFV, and possibly FTC may predispose to the selection for M184I. Among Italian patients the susceptibility to RPV is widespread since some severe substitutions (e.g., E138K are rare), whereas issues exist for others (i.e., E138A, Y181C) which are more frequent. Appropriate use of RPV within a therapeutic sequencing might be controversial. J. Med. Virol. 86:1459–1466, 2014. © 2014 Wiley Periodicals, Inc.

to figure out if there are differences in access to psychiatric services between Italian and immigrant paediatric populations.we analysed the data of the year 2012 from the Banca dati del disagio psichico, a database on psychological distress created by the Epidemiological Unit of the Local Health Unit Milan 1 (Lombardy, Northern Italy). The database is based on a data warehouse system that integrates health and social data, and gives the opportunity to calculate the prevalence rates of the main clusters of psychiatric diseases according to ICD-10 categories.the sample includes 162,197 residents younger than 18 years (minors), divided into 4 subgroups depending on the place of birth (Italy or abroad) and citizenship (Italian or foreign).we calculated the standardised treated prevalence of the 11 clusters of mental diseases in the 4 subgroups and evaluated the Standardised Prevalence Ratio (SPR) and their confidence intervals using as reference the Italian paediatric population with Italian citizenship.in 2012, 7.2%minors were diagnosed a mental illness or accessed mental health services or were prescribed psychotropic medicines. We found the lowest SPRs of psychiatric illnesses in immigrants (0.91 born in Italy; 0.74 born abroad) and the higher in Italians born in foreign Countries (1.34). In particular, migrant minors born in Italy have lower SPR of developmental disorders (0.84) and behaviour and emotional disorders (0.68), but higher SPR of mental retardation (1.52) and anxiety disorders (1.36). Migrant minors born abroad have lower SPR of developmental disorders (0.52), but higher rates of mental retardation (1.30). Italians born in foreign Countries show a SPR for personality disorders and mental retardation of 4.86 and 2.02, respectively.immigrant minors have a lower prevalence of psychiatric diseases than Italian minors; however, Italians born in foreign Countries show a higher prevalence of psychiatric disorders.

Rilpivirine (RPV) is a novel NNRTI with a mutational pattern different from first-generation drugs of the same class: 16 resistance-associated mutations (RAM) are listed, but the combination E138K + M184I seems to be the most important. Aims of the present study were to evaluate the prevalence of these RAMs in Italian HIV-1 infected patients and to assess if previous drug history could represent a risk to develop RPV-related RAMs. The analysis was performed using the ARCA database, which contains data on resistance and therapy from subjects throughout Italy. Prevalence of RPV-associated and first-generation NNRTI-associated RAMs was evaluated. Linear regression model, odds ratio and 95% Confidence Interval were used to assess factors associated with the development of RPV RAMs, substitutions at position 184 and their combinations. A total of 8,067 tests were selected within the database. In Italian HIV-positive HAART-naïve patients, prevalence of the main RAMs for RPV is low except for E138A (present in 5.1% of subjects). The combination E138K + M184I is absent in both naïve and experienced subjects. A previous exposure to NVP might increase the risk to develop RPV-associated RAMs. TDF, EFV, and possibly FTC may predispose to the selection for M184I. Among Italian patients the susceptibility to RPV is widespread since some severe substitutions (e.g., E138K are rare), whereas issues exist for others (i.e., E138A, Y181C) which are more frequent. Appropriate use of RPV within a therapeutic sequencing might be controversial.

Limited data exist about cancer prognosis and the development of second cancers in renal transplant recipients. In a retrospective cohort study on 3537 patients incidence rates of the first and, if any, of a second cancer, and standardized incidence ratios [SIR (95% CI)] were computed. Two hundred and sixty-three (7.5%) patients developed a NMSC, and 253 (7.2%) another type of cancer after a median follow-up of 6.5 and 9.0 years, respectively. A statistically significant excess risk, if compared to an age- and sex-matched reference general population, was observed for Kaposi sarcoma and NMSC, followed by non-Hodgkin lymphoma and carcinoma of cervix uteri; a small number of unusual cancers such as tumors of the salivary glands, small intestine and thyroid also were detected at a level worthy of additional scrutiny. Ten-year survival rate of all noncutaneous cancers was 71.3%, with lower rates for lung carcinoma and non-Hodgkin lymphoma (0% and 41.7%, respectively). Patients with NMSC had an increased risk of developing a second NMSC [SIR 8.3 (7.0–10.0)], and patients with a primary noncutaneous cancer had increased risk of developing a second noncutaneous cancer [SIR 1.8 (1.2–2.8)], if compared to the whole cohort. Our study underscore that the high risk of primary and second cancer in renal transplant recipients, including unusual cancers.

The efficacy of probiotics is currently well documented with regard to the improvement of gastrointestinal functions, whereas their potential role in the prevention of infectious respiratory diseases has not been sufficiently analyzed. PURPOSE OF THE STUDY AND METHODS: A 3-stage prospective, randomized, double blind, placebo-controlled study was carried out with several synbiotic preparations containing 3 to 5 strains of Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium lactis, lactoferrin and prebiotics such as either FOS (short-chain fructooligosaccharides) or GOS (galactooligosaccharides). The study was performed over 3 different winter seasons between 2003 and 2007, and was aimed at assessing the ability of the different preparations to improve intestinal functions and to increase the body's defences against respiratory infections. In 2003/04 (stage 1; 237 healthy volunteers) an active formulation (A) containing 3 probiotic strains and FOS was used versus placebo; in 2005/06 (stage 2; 234 healthy volunteers) the same formulation versus a similar preparation enriched with lactoferrin (B), and versus placebo; in 2006/07 (stage 3; 250 healthy volunteers), 2 new synbiotic formulations each containing 5 probiotics and FOS (C) or GOS (D), respectively, versus placebo.In stage 1, bowel functions improved (P=0.004) in terms of reduced bloating and more regular intestinal motility. The length of acute respiratory infection episodes considered as a whole (-0.97 d; P=0.007) and upper respiratory tract infections (URTIs, -1.96 d; P=0.044) were significantly decreased in the synbiotic group. The severity of episodes recorded a statistically significant drop in both episodes considered as a whole (3.21 average score vs. 3.98 in the placebo group, P0.001) and in URTI (2.56 vs. 3.82; P=0.004) and flu classes (3.80 vs. 4.67, P=0.001). In stage 2, improvement of bowel functions was statistically significant (P=0.005) in synbiotic preparation A. A statistically significant reduction in the number of respiratory tract infections episodes was noted with both the two active formulations (P=0.002 in group A and P=0.003 in group B). The duration of episodes considered as a whole (-1.12 d in one of the 2 active formulation groups; P=0.005), URTIs (-2.08 d in group A; P=0.036) and influenza-like illness episodes (-1.40 d in group A; P=0.049) was significantly decreased in the synbiotic group. A reduction trend in cold episodes was also recorded. The severity of episodes recorded a statistically significant drop in episodes considered as a whole (-0.73 in group A, P=0.003; -0.65 in group B, P=0.004) and in the case of flu (-1.25 in group A, P0.001; -1.18 in group B, P0.001). In stage 3, the improvement of bowel functions was confirmed for both active formulations (P0.001). A significant decrease in the total length of respiratory episodes (-1.51 d; P0.001 in the group C and -1.39 d; P0.001 in the group D) and in the length of cough (-3.08 d; P0.001 in group C; -2.83 d; P0.001 in group D), cold (-1.02 d; P=0.019 in group C; -1.32 d; P=0.001 in group D) and flu episodes was reported. The severity of episodes recorded a statistically significant drop in regard to episodes considered as a whole, the cold and flu classes in both groups and for cough too in group C. The number of episodes also dropped considerably in terms of overall episodes, cold (group C) and flu.These results demonstrate that a regular, long-term intake of various synbiotics may improve health by reducing the incidence and severity of respiratory diseases during the cold season.