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Introduction: Despite global immunization efforts, rubella remains a public health concern, particularly in high- and middle-income countries. This study focused on rubella seroprevalence in the province of Florence, Italy, aiming to identify susceptibility clusters, especially among women in their childbearing age., Methods: A cross-sectional study was conducted between April 2018 and December 2019, enrolling 430 adult subjects (age over 18 years). Serum samples were collected, and anti-rubella antibodies were quantified using the ELISA test. Data were analyzed descriptively and compared by sex, nationality, and age groups using statistical tests., Results: The overall rubella seroprevalence was high (92.3%), with no significant differences between genders or nationalities. Among childbearing-age females (18-49 years), the highest seroprevalence was observed in the 30-39 age group (94.1%). However, susceptibility clusters exceeding the 5% threshold set by WHO were identified, especially in females aged 40-49 years (7.0%)., Conclusions: Despite high overall seroprevalence, the study identified pockets of susceptibility, even in childbearing age women. Continuous monitoring, targeted immunization strategies, and public health interventions are recommended to maintain rubella elimination, emphasizing the importance of sustained vaccination efforts to protect vulnerable populations.

Aim: To compare the need for intubation and mechanical ventilation after surfactant delivery between less invasive surfactant administration (LISA)-treated and intubation-surfactant-extubation (IN-SURE)-treated premature infants with respiratory distress syndrome (RDS)., Methods: Retrospective registry-based cohort study enrolled 36 newborns admitted to the Neonatal Intensive Care Unit of the "Santa Maria" Hospital of Terni between 2016 and 2023. As a primary outcome, the need for intubation and mechanical ventilation within 72 hours of life was followed, and major neonatal morbidities and death before discharge as the secondary outcome., Results: The LISA group and the IN-SURE group included 13 and 23 newborns, respectively. Demographic features showed no significant differences between the two groups. The need for mechanical ventilation in the first 72 hours of life was similar in both groups (p>0.99). There were no significant differences in morbidities., Conclusion: LISA and INSURE are equally effective modalities for surfactant administration for the treatment of RDS in preterm infants., (Copyright© by the Medical Association of Zenica-Doboj Canton.)

Background: Respiratory distress syndrome (RDS) is a major cause of morbidity and mortality in preterm infants. Early nasal CPAP and selective administration of surfactant via the endotracheal tube are widely used in the treatment of RDS in preterm infants., Objective: The aim of this study was to compare the need for intubation and mechanical ventilation after surfactant delivery between LISA-treated and INSURE-treated premature infants with respiratory distress syndrome (RDS)., Methods: Retrospective registry-based cohort study enrolled 36 newborns admitted to the neonatal intensive care unit of the "Santa Maria" Hospital of Terni between 2016 and 2023. As a primary outcome, we followed the need for intubation and mechanical ventilation within 72 hours of life, while the secondary outcomes were major neonatal morbidities and death before discharge., Results: The LISA group and the INSURE group included 13 and 23 newborns respectively. Demographic features showed no significant differences between the two groups. The need for mechanical ventilation in the first 72 hours of life was similar in both groups (p >0.99). There were no significant differences in morbidities., Conclusion: LISA and INSURE are equally effective modalities for surfactant administration for the treatment of RDS in preterm infants., Competing Interests: There are no conflicts of interest., (© 2024 Gianluca Dini, Maria Grazia Santini, Federica Celi.)

Introduction: Borrelia recurrentis, transmitted by Pediculus humanus humanus, is the etiological agent of louse-borne relapsing fever (LBRF). Currently the main focus of endemicity of LBRF is localized in East African countries. From July 2015 to October 2015, 36 cases of LBRF have been diagnosed in Europe in immigrants from the Horn of Africa. Here we report a case of LBRF with meningitis diagnosed in Florence, Italy, in an immigrant arrived from Somalia., Case Study: In October 2015, a 19-year-old Somali male presented to the emergency department of the Azienda Ospedaliero Universitaria Careggi, Florence, Italy, with a 3-day history of high fever. The patient had disembarked in Sicily 10 days before admission after a long migration trip from his country of origin. On clinical examination, neck stiffness was found. Main laboratory findings were thrombocytopenia, increased procalcitonin, and increased polymorphonucleates in the cerebrospinal fluid. Suspecting a possible meningitis, the patient was treated with ceftriaxone, pending results of laboratory testing for malaria, and developed severe hypotension that was treated with fluid resuscitation and hydrocortisone. Hemoscopic testing revealed the presence of spirochetes and no malaria parasites. The patient rapidly improved with doxycycline for 7 days and ceftriaxone for 11 days, then was lost to follow-up. Total DNA from blood was extracted, and amplification and sequencing with universal 16S rDNA primers D88 and E94 revealed a 100% identity with B. recurrentis A1., Conclusions: LBRF is a rare but emerging infectious disease among vulnerable displaced immigrants from the Horn of Africa. Since immigrants from endemic areas can carry the vector with them, the infection should be suspected even in subjects with compatible clinical features living in the same place where new arrival immigrants are hosted. Healthcare providers should be aware of this condition to implement adequate diagnostic, therapeutic, and public health measures.

Objective: To estimate the use, during transport by car, of restraint/booster seats by children of 6-12 years old in Florence., Design, Setting and Participants: To examine children's use, knowledge and behaviors regarding safety devices in cars, a questionnaire has been administered to 537 students attending 17 primary schools in Florence, during their visit to an area equipped for street education. Sociodemographic data (nationality, level of education and parents' work) have been collected as well to assess the socioeconomic membership. Collected data have been analyzed using SPSS 17.0. Chi squared test has been used to evaluate differences in the frequency of distribution of the use of safety devices by available variables. Univariate and multivariate logistic regressions have been used to calculate the degree of association among the modes of transport and the available variables., Main Outcome Measures: Prevalence of use of restraint/booster seats, risk of having been incorrectly transported., Results: 39.1% children, during the last travel, has been correctly transported, i.e. on the booster seat with fastened seat belt, 38.0% only with fastened seat belt and 22.9% free.The risky behaviors were not so much related to socioeconomic indices, but rather to some geographical variables and parents' nationality (especially of the mother).Children whose parents were both Italian were more frequently transported correctly compared to foreigners. We also observed peculiar and different modes of transport within specific ethnic minorities., Conclusions: It is necessary to design and implement interventions aimed at promoting interventions for improving safety for the whole population, but with specific safeguarding social and territorial specificities as regards to territory and ethnicity.

Objective: to evaluate the trend over time of the use of seat belts by drivers and passengers of cars and vans and the use of hand held mobile phone while driving in Florence from 2005 to 2009. DESIGN, SETTING AND PARTICIPANTS AND MAIN OUTCOME MEASURES: direct observations (58,773 vehicles) have been conducted to detect the use of seat belts by occupants of cars and vans, and the use of mobile phone while driving. It has been carried out correlation analysis between the use of the seat belt by occupants of vehicles and between the simultaneous use of this device and mobile phone while driving.Moreover, it has been carried out time series analysis (ARIMA Box Jenkins) of in the prevalence of the use of seat belts by occupants of vehicles observed, of mobile phone by drivers and the trend of the risk to drive using the mobile phone with unfastened seat belt rather than to drive using the mobile phone with fastened seat belt., Results: seat belts were used on average by 75.7% of drivers, 75.5% of front passengers and 25.1% of rear passengers. The average mobile phone use while driving was 4.5%. Drivers most frequently fasten seat belt if front passengers use it and while they do not use mobile phone. The use of seat belts by drivers and front passengers has not changed over time, whereas the use of mobile phone while driving has significantly increased. The prevalence of using mobile phone with unfastened seat belt rather than to use it with fastened seat belt while driving has significantly decreased over the years, indicating an increase in the use of mobile phone, especially among those who fasten the seat belt., Conclusions: it is necessary to plan and realize stronger interventions in the whole area.