Case of tracheal rupture after endotracheal intubation: clinical risk management and medico-legal considerations.

Background: Tracheal injury may be a rare complication of the endotracheal intubation procedure. Incidence and determinant factors are not well known, nevertheless a greater incidence have been recognized with a difficult maneuver or the use of nitrogen peroxide. The therapeutic approach can be conservative or surgical, depending on the characteristics of the lesion and of the patient and therefore the outcomes of medico-legal interest can be different. Case description: It is a case of alleged medical liability regarding a 70-year-old woman, that during the intubation procedure was pouncing on the right. Furthermore, nitrous oxide was used as an anaesthetic. A few hours after the operation the patient showed swelling on the right half of the face and on the right lateral region of the neck. The emergency chest CT scan highlighted subcutaneous emphysema and pneumomediastinum. In the operating room, fibrobronchoscopy was performed with a double-lumen bronchial tube which confirmed the hypotheses lesion; then, right posterolateral thoracotomy was perfor-med followed by suturing of the tracheal lesion. Subsequently, the patient was discharged in good clinical conditions but with a scar in the region of the right hemithorax. Conclusions: Iatrogenic tracheal injury is a rare and fearful complication of the orotracheal intubation procedure. Although risk factors that increase the probability of its onset have been recognized, in most cases it is not possible to identify the cause. From a medico-legal point of view, tracheal injury after intubation is unpredictable and inevitable, so in the case reported it was decided to proceed with a conciliatory solution.

Proposal of model for personalized early adapted cancer screening in people living with HIV: experience of "Gaetano Martino" Hospital University of Messina.

Human immunodeficiency virus (HIV) infection has historically been related to the development of specific cancers, some of which are so closely linked to the infection, such as Kaposi's Sarcoma (KS), that they have earned the name Acquired Immuno-Deficiency Syndrome (AIDS)-defining cancers (ADCs). While the development of antiretroviral therapy (ART) has decreased the incidence of AIDS-defining cancers, the resulting aging of people living with HIV (PLWH) highlighted an increased occurrence of other forms of cancer. At the "Gaetano Martino" hospital in Messina, we developed a multidisciplinary approach by creating a bridge between the Oncology Unit and the Infectious Diseases Unit to carry out screening and a more rapid diagnostic and therapeutic journey for cancers in PLWH. The goal is to improve the diagnosis of various types of cancer by involving other professionals, such as gastroenterologists and gynecologists, to ensure faster access to treatment and, therefore, a greater chance of survival. In addition, our multidisciplinary approach has also included vaccine screening, offered by the "Gaetano Martino" hospital and useful for preventing the development of specific forms of cancer in the entire population and particularly in PLWH.

A Southern addiction evaluation project: investigating the impact of addiction through a survey HBSC based.

Background: Adolescence is a critical phase of development characterized by numerous physical, psychological and social changes. During this stage, individuals may engage in experimentation and risky behavior, leading to increased vulnerability to addiction. This article aims to present the results of a survey based on the HBSC (Health Behavior in School-aged Children) surveillance model in a province of Southern Italy for primary and secondary school students. Methods: We conducted a prospective study from March 2020 to April 2023 through the administration of a questionnaire to students of the healthcare faculties of the University of Messina and primary and secondary school students, composed of 19 items and based on HBSC surveillance. Results: We collected a total of 664 questionnaires. We found that smoking habits increase with age: approximately 31% of secondary school students declare they are real smokers compared to 40% of HCP students. At least once, in the three study groups, students experienced alcohol consumption at different rates, with younger students having a greater propensity to drink than older students. Fortunately, in our sample, no middle school students had tried cannabis. At the same time there is a surprising decrease in gambling in all categories compared to national data. Conclusions: The presence of addictive behaviors in our sample was found to be widespread despite being in line with the national trend. Furthermore, we have observed a reduction in recent years which needs to be investigated to assess the reasons. Primary prevention is probably the main weapon in the hands of politicians and must be applied early in school and community settings to reduce prevalence.

Study-related stress, perceived stress and quality of life among healthcare university students.

Background: Many studies have shown that the stress level among healthcare university students is often as high as in workers who experience burnout. Our study investigated if it is possible to observe the burnout syndrome in these kind of students, able to significantly alter the quality of life, their approach to daily activities and relationship life. Methods: The study was conducted through the administration of an anonymous questionnaire, distributed online through messaging apps, during the breaks between lessons. It was formulated using the perceived stress scale (PSS) in its short formula in order to evaluate feelings and thoughts and the WHOQOL-AGE, in order to evaluate the quality of life. Results: The sample consisted of 292 university students aged between 18 and 49, with an average age of 22,42 ± 4,65. 16.4% does not often feel able to control the important things in life, 42.8% is often unable to manage personal problems. The PSS score of all our university students showed a high stress level in 6.2%, an average stress level in 57.2% and low stress level in 36.6%. The WHOQOL score shows that 42% had a high quality of life and only 4% had a poor quality of life, 54% had an intermediate quality of life and half of the sample was unsatisfied with the way he felt every day. Conclusions: Many students (63.4%) are subjected to stress study-related, even if does not affect their quality of live, therefore not perceiving it as negative. There is a gender difference: females have a higher level of stress than men. Two thirds of the sample has an average or high stress level; only a third has a low grade. Stress prevention in young university students must begin through a new way of teaching, even if a certain amount of stress study-related is stimulant.

Impact of the COVID-19 pandemic on HPV vaccination coverage in the general population and in PLWHs.

OBJECTIVE: On March 11, 2020, the World Health Organization (WHO) has declared the novel coronavirus (COVID-19) outbreak as a global pandemic. COVID-19 pandemic has impacted health services, including immunization programs, with a consequent reduction in vaccination coverage in those categories for which the prevention of vaccine-preventable diseases is strongly recommended. SUBJECTS AND METHODS: We conducted a retrospective cross-sectional study on the general population and on PLWHs, comparing anti-human papillomavirus (HPV) vaccination coverage data in 2019, before COVID-19 pandemic, and the 2020 data, after the announcement of the pandemic state and the lockdown and the implementation of restrictive measures to contain the contagion. RESULTS: Compared to 2019, 2020 data show a 42% reduction in HPV vaccine coverage in the general population and 36% in PLWHs. The greatest reduction in anti-HPV vaccination coverage occurred during periods of greatest restriction and mainly concerned the general population. CONCLUSIONS: The prevention of vaccine-preventable diseases remains essential. Above all, it is essential to increase and recover the anti-HPV vaccine coverage, in consideration of the data that show its preventive oncological efficacy.

Family, lifestyles and new and old type of smoking in young adults: insights from an italian multiple-center study.

BACKGROUND: Tobacco smoke is the epidemic of modern times due to its tremendous burden of diseases and deaths, greater than that produced by alcohol, AIDS, drugs, road accidents, murders and suicides combined. In Italy, 26% of the population smokes and the high prevalence of smoking even among young people is crucial for the Tobacco Industry, because young people are the reservoir which replaces smokers who quit or die. The aim of this study is to investigate smoking habits and determinants of smoking among young adults. METHODS: This cross-sectional study enrolled young people from three Italian regions: Latium (central Italy) Calabria (southern Italy) and Sicily (the largest Italian island). An anonymous, multiple-choice online questionnaire was distributed through social networks. Questions investigated individual habits and lifestyles (smoking, alcohol and coffee consumption, physical activity), the presence of smokers in the family and the use of electronic cigarettes. Descriptive and multivariate analyses were used to describe the characteristics of the sample and to evaluate factors associated with smoking status. All statistical analyses were conducted in SAS software version 9.4 (SAS Institute Inc., Cary, NC, USA). All hypothesis tests were 2-tailed and p values <0.05 were considered statistically significant. RESULTS: In a sample of 382 subjects between 18 and 34 years, the prevalence of smoking was 25%. A statistically significant higher percentage of smokers is observed among those who drink coffee and those who drink alcohol. Only 48% of smokers usually smoke classic cigarettes, while 45% roll their own cigarettes and 7% use electronic cigarettes. More than half of the smokers, smoke 1 to 5 cigarettes a day, while 17% smoke over 10 cigarettes a day. In families where there was at least 1 smoker, the percentage of smokers was 34% versus only 15% in families where nobody else smokes. The presence of at least 1 smoker in the family was strongly associated with young adults' smoking behavior: subjects with family members who smoke were more than three times as likely to be current smokers, compared to those with no family smokers (Odds Ratio [OR] = 3.14, 95% confidence interval [CI] 1.8-5.5, p=0.0001). Alcohol, coffee consumption, unemployment and being a student were also found to be independently and significantly associated with smoking of young adults (alcohol OR=2.96, 95%CI 1.64-5.34; coffee OR= 4.33, 95%CI 1.81-10.39; unemployment OR = 4.76, 95%CI 1.26-17.96; being a student OR = 3.21, 95%CI 1.25-8.27). CONCLUSION: Preventing young people from smoking is crucial in order to stop the Tobacco Epidemic. The Tobacco Industry is selling new products and is using new marketing tactics (i.e. the "influencers" in social media) which are hooking young people to addictive products and behaviors, thus threatening to wipe out decades of progress in curbing tobacco use. Effective action to drastically reduce new and old types of smoking or to pursue the "Tobacco Endgame" requires an increasing commitment not only towards young people, but also towards families, that play an important role in influencing young people.

Adherence to the three Italian screening in a sample of women (and men) in the Southern Italy.

INTRODUCTION: Although scientific evidence shows the numerous benefits of screening programs, in Italy. There is a great disparity between the regional coverage of the North and South despite the screening programs have been activated for several years in all regions even with territorial differences. OBJECTIVE: The aim of our study was to evaluate the knowledge and adherence to different screenings in the population, the influence exercised by the local health authority the role of the general practitioner in advising and referring patients to screening tests and the main causes of refuse. MATERIAL AND METHODS: The study was carried out, from December 2019 to May 2020, through the administration of anonymous self-filled "ad hoc" questionnaires to women and men over 26 years old. RESULTS: in our sample 36% have never performed a breast check and 39% of the interviewees never had a mammogram; for cervical cancer 25% did not ever perform screening and 65% did not have an indication by GP. The worst result was found for colorectal cancer (only 27% of the sample performed the screening). The role of GP was fundamental for and similar to other studies, was fundamental in fact,similar to other studies the most frequent reported reasons for the non-execution of screening were the lack of physicians' advice, follwed by lack of time, the most frequent reported reasons for the non-execution of screening were the lack of physicians' advice, a lack of time, fear of cancer and embarrassment at visiting a gynaecologist. DISCUSSION AND CONCLUSIONS: the study carried out found that despite the knowledge of the oncological disease and the possibilities of prevention is fairly rooted in the population, adherence to the screening is quite inadequate, especially as regards colorectal cancer.

Susceptibility to measles among health workers in a university hospital in southern Italy.

OBJECTIVES: Measles still has a high impact on the health of the population in Italy and therefore requires a strong commitment to prevention at national level. In addition to Italy, measles outbreaks have also been reported in other EU countries, with a high number of cases and a rapid spread of the disease even in the nosocomial context between patients and health personnel. The aim of this study is to evaluate the prevalence of measles in a group of health workers working at a university hospital in southern Italy. MATERIALS AND METHODS: A seroepidemiological study was conducted on 458 health workers. Measles antibody IgG and IgM levels were evaluated by immunoenzymatic testing. RESULTS: The highest percentage of susceptible subjects was ≤30 years old, with a statistically significant difference compared to the age group ≥51 years. With regard to gender, susceptibility to measles in males was significantly higher than in females (p<0.05). Additional statistically significant differences were found in the different age groups in both genders. CONCLUSIONS: Although the results show that most health workers are immune to measles, a 20% susceptibility certainly represents a risk for the spread of the disease among operators and patients. Vaccination and control of suspected cases, especially in community settings such as the hospital environment, are the main measures to prevent the transmission and spread of the disease.

Mediterranean diet: knowledge and adherence in Italian young people.

INTRODUCTION: In November 2010 the Mediterranean Diet was recognized by the UNESCO as Intangible Cultural Heritage of Humanity. It is an heritage that brings together the dietary habits of the peoples of the Mediterranean countries, consolidated over the centuries remained almost unchanged until the 1950s. Numerous scientific studies have also shown that the Mediterranean Diet is an healthy diet that helps to prevent the main chronic diseases such as cardiovascular diseases, diabetes, bulimia and obesity and thanks to the antioxidant power of olive oil combined with vegetables consumption, an important means of cancer prevention. The aim of our study was to investigate the knowledge and the adherence to the Mediterranean diet of young people living in the Mediterranean area. MATERIALS AND METHODS: The survey was carried out by administering a web-based anonymous questionnaire from March to May 2019 to Italian young people. In this survey we asked for socio-economic conditions, knowledge, awareness and adherence to the Mediterranean diet (through the KIDMED test) both in childhood and at present time. Parental educational status and family income were used as indicators of socio-economic status (SES). RESULT: The sample was made up by 507 Italian young people between the ages of 17 and 35 (123 males and 384 females), with an average age of 22.88 years (DS 7.02). Only 11.4% knew the Mediterranean diet. During childhood 70.8% of respondents had breakfast and 58% ate fruit and vegetables daily. Today they have maintained the correct eating habits, in fact, 71.2% had breakfast, 60.2% ate fruit and 64.7% ate vegetables. In addition, only 48.3% eat fish and the majority of respondents consume carbohydrates (76.9%). To a lesser extent they consume junk foods like candy and various snacks (18.1%) or fast food meals (9.1%). Moreover, we asked for physical activity and we found that 48.9% did it. We found age, exercise and sex high significant variables (p<0.01). Higher adherence to MD was found in older interviewees. CONCLUSION: Our study we found high knowledge to a Mediterranean diet into 90.5% of the sample and poor adherence into 23.5% of them, medium into 53.4% while higher only in 23.1% of the interviewees. Lower adherence was found among those who do not engage in physical activity and the two regressor with higher weight on the adherence to MD were "eat at home "and "eat fruit and vegetables". Furthermore, in our sample more increased the age more increased adherence to traditional diet models.

The Clean Care Contest: promoting hand hygiene among healthcare and medical students.

INTRODUCTION: Despite continuing efforts, compliance rates and knowledge of best practices in hand hygiene remain disappointing. Recognizing that conventional educational tools seem out of touch with young people and that the med and messages contents need refreshing, the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health devised a novel approach to promote the creation of innovative educational tools for improving knowledge of, and compliance with, hand hygiene rules among healthcare and medical students. METHODS: A contest in creating educational material on hand hygiene practices involved university students of nursing and medicine, and of other healthcare degrees. Students from the universities of the GISIO network were invited to create educational material (e.g., videos, posters, presentations, leaflets, and screensavers) to be presented by May 5th 2019 during the World Hand Hygiene Day / Save Lives: Clean Your Hands Global Annual Initiative of the World Health Organization). A local and a national winners were awarded. RESULTS: Three different local and national contests were performed during 2016, 2017 and 2018. During the three-year period, more than 270 educational tools have been developed: 130 (48%) were judged useful for hand hygiene promotion campaigns. The most frequent projects participating in the contests were videos (39%), posters (29%), leaflets (14%), and others (18%) submitted by more than 1,500 students of nursing (40%), medicine (31%), dentistry (7%), and of other healthcare courses in 14 universities. Products were evaluated by a local committee and, subsequently, local winners represented their University in a national contest. CONCLUSIONS: The contest provided a framework for the creation of innovative and potentially effective educational tools via an engaging approach that leveraged student creativity. Given the need to improve compliance rates, this study suggests that new ways can be advantageously explored to teach hand hygiene procedures and increase awareness of the importance of their consistent use among healthcare and medical students.

"Vaccinate your child for best protection": attitude towards vaccination in a group of pregnant women.

BACKGROUND: Although the benefits and importance of vaccination before and right after pregnancy, are well known, vaccination coverage among pregnant women remains very low. The aim of our study was to evaluate pregnant women's knowledge and attitude towards vaccination. STUDY DESIGN: A cross sectional study was performed from October 2018 to June 2019 at the University of Messina. METHODS: We gave pregnant women >18 years old a non-self-compiling paper questionnaire. We stratified the sample according to age (<30 and >30 years old), marital status (single/divorced, in a relationship and married) and level of education (<8 and >8 years of school attendance). All possible correlations between collected data were analysed using software R. RESULTS: The sample included 156 women (mean age 32±0.49 years old). Only 1.4% of the subjects were aware of all the vaccines indicated for children. Luckily, 86.7% of the sample had a positive attitude, believing in the effectiveness and safety of immunization, despite a limited lack of confidence and a belief in false myths was expressed by some of the subjects. Interestingly, results showed that information about vaccination were more frequently obtained from family/friends (52.6%), mass media (49.1%), blogs/forums (19.3%), rather than from medical institutions (only 17.5%) or the family physician (only 35.0%), reflecting the quality of the information obtained. CONCLUSIONS: Our results proved that a general positive attitude emerged among our sample towards vaccination, however, correct information was not always provided to women, making it a crucial issue for public health in the future.

An observational study of university students of healthcare area: knowledge, attitudes and behaviour towards vaccinations.

INTRODUCTION: Despite vaccines are the most successful public health interventions for prevention of infectious diseases "vaccine hesitancy" spreads today across the world. Despite attitudes of future generations of HCWs is fundamental, these aren't much analysed in the literature. The aim of our research was a) to evaluate attitudes and behaviours reported towards vaccinations among a sample of university students in the health area, b) to know their vaccination status and intention to get vaccines and c) investigate their propensity to vaccinate (who and with which vaccines). MATERIALS AND METHODS: We evaluated a sample of university students of the health area of University of Messina through an anonymous face to face questionnaires based on HProimmune survey appropriately modified, analysing presence of statistical difference between gender. All analyses were carried out using EPI INFO software. RESULTS: Our study showed a general lack of confidence and insecurity towards vaccination by future HCWs and absent perception of the risk of acquire a vaccine preventable disease as they also demonstrate low vaccination coverage in our sample. Their opinion about awareness of recommended vaccines for HCWs also was low, however, they thought that vaccinations should be a prerequisite for healthcare professionals to work in healthcare area. Also, we observed that 96% of respondents would recommend vaccinations to their patients, with a greater propensity of women. CONCLUSIONS: The motivations of vaccine hesitancy are many and maybe other studies would help policymakers and stake-holders to shape programs to improve vaccination coverage among students and HCWs.

The new era of vaccines: the "nanovaccinology".

Vaccinations are the most effective preventive methods against infectious diseases and represent one of the most relevant successes of medicine. Vaccine development is constantly evolving; therefore, the number of vaccine candidates is progressively increasing. However, most of new potential vaccines are characterized by a lower immunogenicity, with the inability to stimulate powerful and long-lasting immune responses. Hence, to get modern and effective vaccines, we need adjuvants and innovative delivery systems that increase their immunogenicity. The use of nanotechnology in vaccinology is providing the opportunity to contrast these difficulties and develop effective vaccines. Particularly, nanoparticles used as vehicles of vaccine components, are able to increase the host's immune responses and, due to their size, to reach specific cellular districts. To date, a certain number of nanovaccines has been approved for human health and many are studied in clinical or pre-clinical trials. There are several types of nanoparticles considered as possible delivers of vaccine antigens. These nanoparticles-based synthetic delivery systems, in the size range of 20-200 nm, protect antigen from degradation, enhance its presentation and facilitate its uptake by professional antigen-presenting cells. Virus-like particles, self-assembled proteins, micelles, liposomes, inorganic nanoparticles, and polymers are the most studied of these systems. In this review, we provide a general overview of different types, methods of synthesis, characterizations, properties and applications of nanoparticles in vaccine production.

Effects of aerators, filters and chlorination on contamination of water samples: a nine years study in a Southern University Hospital.

OBJECTIVES: The aim of our study was to evaluate the microbiological contamination by Pseudomonas aeruginosa in the water system of the University Hospital "G. Martino" in Messina over a period of nine years, in order to a) clarify possible relationship between the presence of aerators and contamination, b) to highlight the presence of a yearly variation and c) to verify the statistical difference between microbiological contamination of taps with and without filters. MATERIAL AND METHODS: We carried out our study between January 2010 and December 2018 through the collection of water samples that were analysed for total bacteria count and Pseudomonas aeruginosa. The differences between the results recorded over the nine-year study period were evaluated using variance analysis. P values of <0.05 were considered statistically significant. Software R was used for statistical assessment. RESULTS: We analysed a total of 6168 samples with a positive rate of 9.31% and a decreasing trend over the years to a value of 2.44% (p<0.001), due to the elimination of the aerators of taps without filters and also to the introduction of filters in taps of high-risk wards and surgical rooms. We found statistical difference between taps with or without filter (p<0.001) and a higher positive rate during the summer season compared to the other months. CONCLUSIONS: These results reveal a high level of contamination of taps by opportunistic bacteria with severe implications especially for high-risk settings and therefore, the need to improve the management of these devices.

Drug-resistant bacteria on hands of healthcare workers and in the patient area: an environmental survey in Southern Italy's hospital.

OBJECTIVE: Drug-resistant bacteria on hands of healthcare workers and in the patient area: an environmental survey in Southern Italy's hospital. METHODS: The study was conducted from June 2017 to May 2018 using contact slides for surfaces and active sampling for air. We used automated biochemical methods to identify microorganisms; antibiograms were performed in compliance with the EUCAST expert rules. RESULTS: We analyzed 3,760 samples, 16.17% were found positive and 34 % of these were antimicrobial-resistant. On analyzing the isolated Staphylococci, 39% were multidrug-resistant and 5% extensively drug-resistant. A 30% of the Enterococcus faecalis isolates were resistant to gentamycin and vancomycin. We found Klebsiella pneumoniae isolates resistant to ceftriaxone, cefoxitin, mecillinam and imipenem. A 7% and 8% of the Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively, were resistant to gentamicin, imipenem, and ceftazidime. CONCLUSIONS: These findings are in line with the international literature, confirming that antimicrobial resistance is also steadily growing in Italy with rates varied for the different pathogens.

Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy.

INTRODUCTION: In recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC).A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed. MATERIALS AND METHODS: Annex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p < 0.05). The statistical analyses were performed by SPSS and Stata software. RESULTS: A total of 3,454 HCWs participated in the project: 1,236 males and 2,218 females.The sample comprised: physicians (26.9%), trainee physicians (16.1%), nurses (17.2%) and other professional categories (9.8%). Low VC was generally recorded. Higher VC was found with regard to polio, hepatitis B, tetanus and diphtheria, while coverage was very low for measles, mumps, rubella, pertussis, chickenpox and influenza (20-30%). CONCLUSIONS: This study revealed low VC rates among HCWs for all the vaccinations. Measures to increase VC are therefore necessary in order to prevent HCWs from becoming a source of transmission of infections with high morbidity and/or mortality both within hospitals and outside.

Nine years of microbiological air monitoring in the operating theatres of a university hospital in Southern Italy.

INTRODUCTION: Surgical site infections are among the most frequent Health Care Associated Infections with severe impact on mortality and high economic costs; the role of air microbiological contamination in surgical site infections was amply discussed in the scientific literature, highlighting differences in air contamination rates between different ventilation systems, number of people present and door opening rates. MATERIAL AND METHODS: The aim of our study was to monitor the presence of bacterial air contamination in operating theaters and its relationship with number of people and type of airflow over a period of nine years (January 2010-November 2018) at Messina's University Hospital. The Rho of Spearman test was used to evaluate differences in microbial contamination between empty and working theaters. The impact of the number of people on colony-forming unit values was assessed by performing a stepwise multiple regression analysis. The differences between the results recorded over the nine-year study period were evaluated using the variance analysis. Software R was used for the statistical assessment. RESULTS: Air samples were taken in each operating theater over nine years. A total of 1,425 samples were collected with a positivity rate of 37.3%. The median bacterial contamination rate was 30 cfu/m3 in empty theaters, while this rate was significantly higher (P < 0.001) in working theaters, where it reached 85 cfu/m3. A statistically significant difference was identified between laminar and turbulent airflow systems, with higher bacterial contamination rates with the latter (p<0.001); in these cases, the value of bacterial contamination (microbial count) was higher in the presence of a higher number of individuals in the operating theater (p<0.001). CONCLUSION: Our study demonstrates the complexity of the Operating Theatres environment, in which a good ventilation system is, indeed, only one prerequisite for clean air, but other factors, such as the behavior of healthcare professionals and environmental conditions, can influenced the bacterial count.

Evaluation of Vaccination Coverages in the Health Care Workers of a University Hospital in Southern Italy.

INTRODUCTION: An adequate immunization of the health care workers is essential for infection prevention and control, to avoid consequences not only for them, but for all patients that the health care workers could infect causing serious damage and / or death. Unfortunately, to date, despite the presence of international and national guidelines (Law Decree 119/2017), the vaccination coverage was low, also because of the "vaccine hesitancy" spread among the same health care workers. In light of the above, the aim of our study was to investigate the vaccination coverage of healthcare workers of all the operational units present in our hospital and to evaluate differences between sex, age, professional profile and area of work. MATERIALS AND METHODS: A study was conducted from March to June 2018 to investigate the vaccination coverage of healthcare workers at the University hospital "G. Martino" of Messina; data were collected using a self-completion questionnaire based on Attachment 3 of Ministerial Circular 25233 of 18 August 2017. We verified any possible association between physicians and pediatricians and between age classes by the chi square method. Also, a logistic regression was used for each vaccination, considering the vaccination as the variable and the following covariates: type of operative unit, sex, age and area) in order to predict the probability of vaccination. RESULTS: We analyzed a sample of 822 health care workers (324 males and 498 females with an age of 49.5 ± 10.5 SD). The sample was made up of physicians (36%), nurses (21%) and other professional categories (43%). Analyzing the data we obtained vaccination coverages lower than the target required to guarantee "herd immunity"; higher vaccination coverages were found for females, physicians and the clinical area and - for influenza vaccination - in the older age groups and - for all the other vaccinations - in the younger groups. CONCLUSION: Data analysis revealed a lax attitude towards vaccinations by health care workers and the need for measures aimed at increasing vaccination their coverage to prevent them from becoming a source of dangerous outbreaks.

Perception of rubella risk in pregnancy: an epidemiological survey on a sample of pregnant women.

BACKGROUND: Rubella is a common exanthematous viral disease all over the world. The disease can be prevented by administering a safe and effective vaccine, and in Italy it is subject to reporting obligations. A national plan for the elimination of measles and congenital rubella (in Italian "PNEMoRC") was approved in 2003 and updated in 2010. This plan originally aimed at reducing the susceptible target population (women in fertile age, 15-49 years old) to below 5% and at eliminating the congenital form of rubella by 2015, a goal which has not been achieved yet. STUDY DESIGN: Our research work was focused on a convenience sample of pregnant women attending the antenatal classes at the two main hospitals in Messina, Sicily (Italy). METHODS: After we obtained an informed consent, we administered to 200 Italian and foreign pregnant women an anonymous questionnaire reporting socio-demographic characteristics, type of gynaecological assistance and information received about Rubella serological statu. RESULTS: The mean age was 30.6 years ± 5.45. The majority of these women were married, at work and with a high educational level. Most of them (75.3%) reported to be assisted by a private gynaecologist, while only 24.7% used a public facility. A remarkable percentage (62.8%) of these women reported to be serologically negative at the anti-rubella antibodies test, but, only 7.5% of them reported to have passed the anti-rubella antibody test before the conception. CONCLUSION: Our results clearly show that we are still far from achieving the elimination of rubella risk in pregnancy. We are facing a cultural gap perhaps also due to a generalized loss of "historical memory" about the impact that infectious diseases have had in the past in terms of mortality and morbidity. In fact, alongside the considerable drop in vaccination coverage in the recent years, our research also reveals a reduced focus on pre-conceptional testing and limited awareness of associated risks. Furthermore, we correlated the serological status with the sociodemographic characteristics of these women and found a statistically significant correlation with their age and their educational level (P<0.05). A lot still needs to be done to improve the situation; in particular, better education at various levels could considerably increase the awareness among women about this relevant public health issue.