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2 TABLE Raw incidence rates (IR) of type 1 diabetes in Piedmont (Italy) by 100 000 residents and rate ratios (RR), comparison between before and during the COVID pandemic years. Nevertheless, over the 3 years of the COVID-19 pandemic, the overall incidence of DM1 has remained ~17% higher than before the pandemic, suggesting further work to understand the link between coronaviruses and diabetes is a priority. Keywords: database research; observational; population study; study; type 1 diabetes EN database research observational population study study type 1 diabetes 3068 3070 3 09/06/23 20231001 NES 231001 BACKGROUND There have now been several reports that the incidence of type 1 diabetes (DM1) increased during the COVID-19 pandemic, particularly in young children,[[1], [3]] although some data are conflicting.[4] Overall, however, there is emerging evidence from diabetes registries that this observed increase is real. [Extracted from the article]

Earlier in 2020, seven Italian regions, which cover 62% of the Italian population, set up the Mimico-19 network to monitor the side effects of the restrictive measures against Covid-19 on volumes and quality of care. To this aim, we retrospectively analysed hospital discharges data, computing twelve indicators of volume and performance in three clinical areas: cardiology, oncology, and orthopaedics. Weekly indicators for the period January–July 2020 were compared with the corresponding average for 2018–2019; comparisons were performed within 3 sub-periods: pre-lockdown, lockdown, and post-lockdown. The weekly trend of hospitalisations for ST-segment elevation myocardial infarction (STEMI) showed a 40% reduction, but the proportion of STEMI patients with a primary PTCA did not significantly change from previous years. Malignant neoplasms surgery volumes differed substantially by site, with a limited reduction for lung cancer (< 20%) and greater declines (30–40%) for breast and prostate cancers. The percentage of timely surgery for femoral neck in the elderly remained constantly higher than the previous 2 years whereas hip and knee replacements fell dramatically. Hospitalisations have generally decreased, but the capacity of a timely and effective response in time-dependent pathways of care was not jeopardized throughout the period. General trends did not show important differences across regions, regardless of the different burden of Covid-19. Preventive and primary care services should adopt a pro-active approach, moving towards the identification of at-risk conditions that were neglected during the pandemic and timely addressing patients to the secondary care system. [ABSTRACT FROM AUTHOR]

Background: Over the past 50 years there was a substantial decrease in the prevalence of smoking in Italy. The objective of this work is to describe attempts to quit and cessation success in Italian smokers. Methods: A surveillance on health-related behaviors (PASSI) was conducted in 2007-13 on a sample of 203 610 Italian adults 25-64 years of age. An analysis of smokers' characteristics and behaviors was performed, focusing on attempts to quit and quit success. Data from national surveys (ISTAT) from 1983 to 2013 (Italian adults, 25-64 years of age, 1983: 46 634; 1987: 40 915; 1990: 36 622; 2000: 77 531; 2005: 71 032; 2013: 64 205) were used to explore if a cessation trend in Italy exists. Results: Smokers who quit in the previous year and were still abstinent when interviewed increased from 1990 to 2013. In the years 2011-13, 38% of people who had smoked in the last 12 months reported at least a quit attempt during the same period and 7% were still abstinent when interviewed. An association of successful recent quit attempts with higher educational level, absence of economic difficulties and younger age was found. In the years 2007-13, the great majority tried to stop unaided. Having received assistance from a cessation program did not increase the probability of enduring abstinence. Conclusions: In Italy interventions to drive more smokers to quit should be focused in particular on disadvantaged groups. Initiatives have to be studied not only to incentive more smokers to try to quit, but also to maintain abstinence over time. [ABSTRACT FROM AUTHOR]

Background: Thromboembolic vein disease (TVD) comprises of deep vein thrombosis (DVT) and pulmonary embolism (PE). Standard therapy consists of the administration of low molecular weight heparin (LMWH) imbricated with antivitamin K agonists (AVK). Recently a new series of oral anticoagulants known as the direct oral anticoagulants (DOACs) has been introduced. CHEST 2016 guidelines recommend the use of DOACs rather then AVKs for the treatment of TVD., Aim: The aim of this study was to analise the choice of antithrombotic treatment and to see if CHEST 2016 guidelines were used in the ASL TO3 district for TVD therapy., Methods: Data obtained from the SISR archives was used to perform a cohort retrospective study. Patients who had been recovered for TEVD were selected 6 months after dismissal. Based on Chest guidelines, the period that ranged from 01/01/2014 to 30/06/2017 was divided into two parts. The cohort was classified according to antithrombotic therapy administered to these patients., Results: 475 patients that had been dismissed after recovery for TVD were identified and enrolled into this study. 1st period: from 275 patients, 247 had a prescription: 132 TAO, 73 DOACs, 42 eparine, 0 ASA. 2nd period: from 200 patients, 185 had a prescription: 55 TAO, 95 DOACs, 34 eparine, 1 ASA., Discussion and Conclusions: Our analysis shows a significant difference between the choice of antithrombotic therapy during both periods, this difference is greater among males. We can conclude that antithrombotic prescriptions carried out in the ASL TO3 area have been adherent to Chest guidelines.

Objectives: to describe systematically unhealthy patterns in nutrition behaviours, with a special focus on the impact of social, gender, geographical, and age inequalities on diet; to evaluate the potential impact of economic crisis on healthy nutrition choices and on health inequalities., Design: cross sectional study within national surveys., Setting and Participants: population ≥20 years, from representative samples of the Italian population in official national multipurpose surveys, in the periods 2005-2007 and 2009-2012., Main Outcome Measures: prevalence, population attributable fraction (PAF), and relative time variation between periods., Results: wide differences on the prevalence of nutrition healthy behaviour have been found according to social position (low educated have higher consumption of meat, carbohydrates, salty food, higher breakfast skipping rates as well as lower consumption of fish), geographical area (Northern regions have higher consumption of meat, carbohydrates and fats, whereas Southern ones have lower consumption of fruit and vegetables, higher obesity, and overweight rates). Economic crises seems to have had an impact on nutrition (reduction of meat, fruit and vegetable consumption, increase on snack and legumes frequencies, less fish, and meat presence on diet), but lower than expected. Besides, if long period trends seem to increase health inequalities on nutrition, crisis seems to have had an opposite effect., Conclusion: unhealthy patterns seem to be present in Italian food behaviour and long time trends appear to increase them, as illustrated by the spread of obesity and overweight. Nevertheless, Mediterranean diet does not seem to be too much at risk. Economic crisis has been frequently recognized as a determinant of nutrition patterns worsening, but it has had different impacts. Furthermore, health inequalities could be decreased in crisis times.

Methods for accessing information have evolved making thus possible the planning of a new generation of web applications. In the Piemonte region, tools for accessing demographic data and main health and epidemiologic indicators are available since several years. A new application named MADEsmart (from the Italian for "Engine for demographic and epidemiological analysis") provides various functions that allow the user to obtain information useful for creating health reports and health profiles at the subregional level.

The aim of the present study is to assess the quality of the variables "name" and "surname" recorded in the mortality records that the Italian Institute of Statistics (ISTAT) releases to its regional offices since 1999. These records could both constitute a regional mortality database in those regions that do not have one, and be a useful tool for ascertainment of vital status in follow-up studies. The study was conducted in Turin, North West Italy, through record linkage between ISTAT database and the local population register that records all deaths occurred among residents. This was considered as the gold standard. Firstly the concordance of name and surname was studied; this was 92% if the full length of name and surname was used raising to 97% using substrings of the two information. Secondly the cohort of 1999-2001 residents in Turin was linked to the ISTAT database using a four step record linkage with four different keys. 94,3% of subjects were correctly found. Within those not linked there was a higher proportion of subjects born abroad, women, young and unmarried. We conclude that the quality of ISTAT database should be further improved before implementing its use for follow-up studies.

Background: The clinical and epidemiological profiles of infective endocarditis (IE) are continuously evolving. We report the results of a 2-year multicenter prospective survey that investigated new trends in the epidemiology, microbiological and clinical features and the prognosis of IE., Methods: From January 2000 through December 2001, a prospective multicenter survey on IE was conducted in the region of Piedmont, Italy (4.2 million inhabitants)., Results: A total of 267 patients with suspected IE were enrolled, of whom 147 received a definite diagnosis of IE, as confirmed by pathology or follow-up data. The annual estimated incidence of IE was 36 cases per 1 million inhabitants in urban Turin and 30 cases per 1 million inhabitants in the province of Turin. A predisposing heart disease was detected in 70.8% of cases, with prosthetic valve involvement in 27 (18%). The incidence of injection drug use was 10%. Twenty-two cases (15%) were related to invasive procedures. Causative microorganisms included: streptococci 37.4% (oral streptococci 17.7%, group D streptococci 9.5%, pyogenic streptococci 3.4%, enterococci 6.8%), staphylococci 34%, other pathogens 28.5%. Blood cultures were negative in 25% of cases. The mean time between symptom onset and hospital admission was 39.7 days; this interval was shorter and associated with a poorer prognosis in cases of IE due to Staphylococcus aureus infection (p < 0.001). The delay in carrying out echocardiographic and blood culture evaluation often led to a late diagnosis as defined by the Duke criteria (8.2 +/- 7.4 days after admission). Valve surgery was performed in 31% of patients. The in-hospital mortality was 14% and that at 3 months 18%., Conclusions: In Piedmont, the incidence of IE is similar to the rates reported in other recent series. Still, the diagnosis and management of IE remain a challenge. The variegated clinical manifestations of IE and its changing epidemiology require constant surveillance.

Objective: To analyse data from existing sources to assess the distribution over space and time of home accidents in Piedmont., Design: Analysis of distribution of causes of hospitalisation and deaths following a home accident., Setting: For non-fatal accidents, we reviewed the database of hospital discharge records (HDR), which includes data from all hospitals in the region. For fatal accidents, we reviewed the data on deaths provided by the Italian National Institute of Statistics (ISTAT)., Participants: All patients hospitalised for "home accidents" for the period 1999-2001 and deaths due to "external causes of injury and poisoning" and from these excluded transport accidents, homicides, and suicides for the period 1982-1999., Results: The most commonly reported reasons for hospitalisation following a home accident were: fracture for 15-64 year-old age-group and for persons aged 65 years or more (60.7% and 86% respectively) and intracranial transmatism for 0-14 year-old age group (33%). Regarding fatal accidents, the mortality rate per 100,000 was 3.6 among 0-14 year-olds, and 145.1 among the persons aged 65 years or more. The most common cause of death was chocking for 0-14 year-old age-group and falls for the person aged 65 years or more (32.2% and 86.3% respectively). There is an excess of mortality in the geographical areas of Western Alps of Piemonte., Conclusion: In Piedmont, existing sources can be used to estimate the distribution of the most serious home accidents i.e., those resulting in hospitalisation or death. The sources we reviewed in this study are, at the moment, the only ones available to quantify and describe the phenomenon over space and time.