Sleep quality among Italian university students: the UnSleep multicenter study.

Background: Scientific evidence demonstrates that poor sleep quality can lead to various health problems. This study aimed to investigate sleep patterns among Italian university students and identify several factors that may contribute to its quality. Study design: Cross-sectional study. Methods: An electronic questionnaire regarding sociodemographic characteristics, lifestyle, and sleep-related habits, including the Pittsburgh Sleep Quality Index (PSQI) questionnaire, was distributed between January 2022 and July 2023 among students belonging to 12 universities located in Northern, Central, and Southern Italy. Results: On a total of 1,674 questionnaires collected, the participants (mean age 24.06±4.56 years, 71.3% F) reported an average number of hours of nocturnal sleep equal to 6.89±1.28 hours. A total of 927 (54.6%) of respondents showed a poor sleep quality (PSQI >5). Regression analysis showed that better sleep quality is associated with lower age, attending universities in Northern Italy, less time spent on electronic devices during the day, not being used to study at night and not playing videogames before sleep. Conclusion: From a public health perspective, our findings suggest that public health operators should raise the awareness of young adults about the importance of sleep quality for maintaining good health, as well as the impact that certain behaviors can have on sleep.

Perfluoroalkyl substances: a risk for the aquatifc environment? A 1-year case study in river waters of central Italy.

Perfluoroalkyl substances (PFASs) are a large class of persistent emerging pollutants, ubiquitous in different environmental compartments. In this study, twenty-one PFASs were determined in seventy-eight water samples collected from six different rivers in the Umbria region (central Italy) during a 13-month monitoring campaign. The sum of the twenty-one target analytes (Σ21PFASs) ranged from 2.0 to 68.5 ng L-1, with a mean value of 22.0 ng L-1. The highest concentrations of Σ21PFASs were recorded in the warmest months (from June to September) due to reduced river streamflow caused by low rainfall and high temperatures. PFASs with a number of carbon atoms between four and nine prevail over C10-C18 congeners due to their higher water solubility and to their increased use in industry. PFBA, followed by PFPeA, PFHxA, and PFOA, was the most abundant congeners detected in the analyzed river water samples. Finally, the calculation of risk quotients (∑RQs) has allowed to assess the risk for three aquatic organisms (fish, algae, and daphnid) deriving from the exposure to PFASs. The survey showed that the risk for the three aquatic organisms during the four seasons and throughout the year was always negligible. The only exception was a low risk for fish and daphnid in GEN river considering the annual exposure.

Effects of Environmental Tobacco Smoke on Oxidative Stress in Childhood: A Human Biomonitoring Study.

Household smoking is one of the main sources of environmental tobacco smoke (ETS) exposure for children, a population considered to be at high risk for associated negative health outcomes. Several studies evidenced the occurrence of early effects related to ETS exposure, including the development of the oxidative stress process. The aim of this study was to evaluate the correlation between urinary levels of 8-oxo-7,8-dihydro-2-deoxyguanosine (8oxodGuo), a nucleic acid oxidation biomarker, and socio-demographic features and lifestyle factors in school children (aged 5-11 years). A cross-sectional study was conducted among 154 healthy children, residing in rural zones of central Italy. For each participant, one urine sample was analyzed by the HPLC-MS/MS technique to simultaneously quantify 8oxodGuo and cotinine (a biomarker of ETS exposure), while information on the children was collected using a questionnaire filled out by the parents. Urinary levels of 8oxodGuo was found to be significantly higher in children exposed to ETS compared to those not exposed (5.53 vs. 4.78 µg/L; p = 0.019). This result was confirmed by the significant association observed between urinary levels of cotinine and 8oxodGuo (r = 0.364, p < 0.0001). Additionally, children exposed to ETS with no smoking ban at home showed a further increased difference than those not exposed (6.35 µg/L vs. 4.78 µg/L; p = 0.008). Considering the great number of adverse effects on human health due to exposure to passive smoking, especially if this exposure begins early in life, it is essential to implement health promotion interventions in this area.

Occurrence of pharmaceutical residues in drinking water: a systematic review.

The aim of the present paper was to give a complete picture on the drinking water contamination by pharmaceutical residues all over the world. For this purpose, a systematic review was carried out for identifying all available research reporting original data resulting by sampling campaign and analysis of "real" drinking water samples to detect pharmaceutical residues. The investigated databases were PubMed, Scopus, and Web of Science. A total of 124 studies were included; among these, 33 did not find target analytes (all below the limit of detection), while the remaining 91 studies reported the presence for one or more compounds, in concentrations ranging from a few units to a few tens of nanograms. The majority of the studies were performed in Europe and the most represented categories were nonsteroidal anti-inflammatory drugs and analgesics. The most common analytical approach used is the preparation and analysis of the samples by solid-phase extraction and chromatography coupled to mass spectrometry. The main implications resulting from our review are the need for (a) further studies aimed to allow more accurate environmental, wildlife, and human health risk assessments and (b) developing integrated policies promoting less environmentally persistent drugs, the reduction of pharmaceuticals in livestock breeding, and the update of wastewater and drinking water treatment plants for a better removal of drugs and their metabolites.

Knowledge and self-perceived competence about cardiopulmonary resuscitation among youths: a cross-sectional study in a sample of Italian undergraduates.

Introduction: Cardiopulmonary resuscitation is fundamental to improve the outcomes of a life-threatening event. The correct knowledge of first aid actions to provide may guarantee the victim's survival. This study was aimed at evaluating the competence about cardiopulmonary resuscitation and its predictors in a sample of Italian undergraduate students. Methods: Information on socio-demographic characteristics, first aid training, knowledge of stroke and heart attack symptoms and perceived ability to provide first aid, were collected through a web-based questionnaire. Results: On a total of 744 respondents (mean age 23.9±5.4 years, 62.5% female), 71.4% identified correctly first aid actions, 59.9% and 60.8% showed a good knowledge of stroke and heart attack symptoms, respectively. However, only 39.0% of them declared their ability to intervene in case of emergency. Attending a healthcare degree course and having had first aid training were associated with knowledge of symptoms and perceived ability to provide first aid. Female gender was negatively related with perceived ability to intervene. Conclusions: In spite of the satisfactory level of knowledge, these findings highlight the need to enhance the competence about cardiopulmonary resuscitation in the lay population, especially among females.

Balneotherapy using thermal mineral water baths and dermatological diseases: a systematic review.

Balneotherapy includes practices and methods using medically and legally recognized mineral-medicinal waters, muds and natural gases from natural springs for therapeutic purposes. One of the most widely used method in balneotherapy is bathing with thermal mineral water. In the course of the years, scientific community has produced an increasing number of evidences that this practice is an effective method for treating signs and symptoms of several pathologies such as rheumatic, cardiovascular and dermatological diseases. This systematic review is aimed at evaluating the effect of balneotherapy with thermal water baths as a treatment to manage signs and symptoms of patients affected by all types of dermatological diseases. The systematic review was conducted according to the PRISMA Statement, and its protocol was registered on PROSPERO platform (CRD42022295913). The research was performed on the databases Pubmed, Scopus, Web of Science and Cochrane. We included clinical trials evaluating the effects of balneotherapy using thermal mineral water baths for managing dermatological diseases in humans, published in English and Italian language. Eight studies were included, seven of them enrolled adults affected by psoriasis and one studied atopic dermatitis patients. The common result of all the articles included was a clear improvement of signs and symptoms of psoriasis and eczematous diseases after use of thermal mineral water baths. These effects seem to be strictly related to physical and chemical properties of thermal water used for balneotherapy. However, studies in this field are still limited to support robust evidence of the effectiveness of balneotherapy using thermal mineral water baths and often their quality is low. Thus, new clinical studies need to be carried out, using more correct methods for conducting the studies and for processing statistical data.

Optimization of a fast and sensitive method based on matrix solid-phase dispersion-LC-ms/ms for simultaneous determination of phthalates and bisphenols in mussel samples.

Bisphenols and phthalates are wide classes of endocrine disrupting chemicals (EDCs) extensively used as additives in plastic products. In this study, a fast and reliable analytical method based on matrix solid-phase dispersion (MSPD) coupled with LC-MS/MS was developed and optimized for simultaneous determination of 8 bisphenols and 7 phthalates in raw mussel extract. The LC-MS/MS method was tested for linearity (R2), inter- and intra-day repeatability, limit of detection and quantification, both for matrix-free and matrix-matched solutions. The MSPD method was optimized in terms of ratio between sample and sorbent, and the type and quantity of the eluents in order to maximize the recoveries and to minimize matrix effects. The obtained recoveries (values between 75% and 113%), limits of detection (values between 0.048 and 0.36 µg kg-1), limits of quantification (values between 0.16 and 1.28 µg kg-1), repeatability (RSD% between 1.30% and 8.41%) and linearity (R2 > 0.998) were satisfactory and suitable for the determination of target micropollutants in food samples. In addition, the low solvent consumption and fast execution make this method ideal for routinely determinations of bisphenols and phthalates in mussels.

Can Digital Technologies Be Useful for Weight Loss in Individuals with Overweight or Obesity? A Systematic Review.

Digital technologies have greatly developed and impacted several aspects of life, including health and lifestyle. Activity tracking, mobile applications, and devices may also provide messages and goals to motivate adopting healthy behaviors, namely physical activity and dietary changes. This review aimed to assess the effectiveness of digital resources in supporting behavior changes, and thus influencing weight loss, in people with overweight or obesity. A systematic review was conducted according to the PRISMA guidelines. The protocol was registered in PROSPERO (CRD42023403364). Randomized Controlled Trials published from the database's inception to 8 November 2023 and focused on digital-based technologies aimed at increasing physical activity for the purpose of weight loss, with or without changes in diet, were considered eligible. In total, 1762 studies were retrieved and 31 met the inclusion criteria. Although they differed in the type of technology used and in their design, two-thirds of the studies reported significantly greater weight loss among electronic device users than controls. Many of these studies reported tailored or specialist-guided interventions. The use of digital technologies may be useful to support weight-loss interventions for people with overweight or obesity. Personalized feedback can increase the effectiveness of new technologies in motivating behavior changes.

Balneotherapy for osteoarthritis: a systematic review.

This systematic review is aimed to evaluate the effects of balneotherapy with thermal mineral water for managing the symptoms and signs of osteoarthritis located at any anatomical site. The systematic review was conducted according to the PRISMA Statement. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, DOAJ and PEDro. We included clinical trials evaluating the effects of balneotherapy as a treatment for patients with osteoarthritis, published in English and Italian language, led on human subjects. The protocol was registered in PROSPERO. Overall, 17 studies have been included in the review. All of these studies were performed on adults or elderly patients suffering from osteoarthritis localized to knees, hips, hands or lumbar spine. The treatment assessed was always the balneotherapy with thermal mineral water. The outcomes evaluated were pain, palpation/pressure sensibility, articular tenderness, functional ability, quality of life, mobility, deambulation, ability to climb stairs, medical objective and patients' subjective evaluation, superoxide dismutase enzyme activity, serum levels of interleukin-2 receptors. The results of all the included studies agree and demonstrated an improvement of all the symptoms and signs investigated. In particular, pain and quality of life were the main symptoms evaluated and both improved after the treatment with thermal water in all the studies included in the review. These effects can be attributed to physical and chemical-physical properties of thermal mineral water used. However, the quality of many studies resulted not so high due and, consequently, it is necessary to perform new clinical trial in this field using more correct methods for conducting the study and for processing statistical data.

Natural Mineral Water and Diuresis: A Systematic Review.

The present systematic review is aimed at evaluating the diuretic effects determined according to the natural mineral water consumption on healthy individuals. This systematic review has been performed following the guidelines of the PRISMA (preferred reporting items for systematic reviews and meta-analyses) Statement, investigating PubMed, Scopus, Web of Science and Cochrane Library from inception to November 2022. Studies performed both on animals and on humans were considered. After screening, a total of 12 studies have been identified. Of these, 11 studies were performed in Italy and 1 in Bulgaria. The time range of publication is very wide, ranging from 1962 to 2019 for human studies and from 1967 to 2001 for animal studies. All the included studies found an increase in diuresis determined according to the consumption of natural mineral water, in some cases after just one administration of the tested water. However, the quality of the studies is not so high, especially for the research conducted many years ago. Thus, it would be desirable to carry out new clinical studies using more appropriate methodological approaches and more refined methods of statistical data processing.

Perfluorinated Compounds (PFCs) in River Waters of Central Italy: Monthly Variation and Ecological Risk Assessment (ERA).

Perfluorinated compounds (PFCs) are a wide class of emerging pollutants. In this study, we applied the US EPA method 533 for the determination of 21 PFCs in river water samples. In particular, this method was used to investigate the presence of the target PFCs in six rivers in central Italy during a 4-month-long monitoring campaign. In 73% of the analyzed samples, at least some of the target PFCs were detected at concentrations higher than the limit of detection (LOD). The sum of the 21 target analytes (∑21PFCs) ranged from 4.3 to 68.5 ng L-1, with the highest concentrations measured in the month of June, probably due to a minor river streamflow occurring in the warmer summer months. Considering the individual congeners, PFBA and PFPeA, followed by PFHxA and PFOA, were the predominantly detected compounds. Short- and medium-chain PFCs (C4-C9) prevail over the long-chain PFCs (C10-C18), likely due to the increased industrial use and the higher solubility of short-chain PFCs compared to long-chain PFCs. The ecological risk assessment, conducted by using the risk quotient method, highlighted that the risk for aquatic environments associated with PFBA, PFPeA, PFBS, PFHxA and PFOA was low or negligible. Only for PFOA, there was a medium level of risk in two rivers in the month of June. With regard to PFOS, 54% of the river water samples were classified as "high risk" for the aquatic environment. The remaining 46% of the samples were classified as "medium risk."

Consumption of Energy Drinks among Italian University students: a cross-sectional multicenter study.

PURPOSE: The aim of the study was to evaluate the caffeinated Energy Drinks (EDs) consumption among a large sample of Italian undergraduates and its association with some of the major lifestyle risk factors. METHODS: Students attending twelve public Italian universities were involved between October 2021 and May 2022. Information on socio-demographic characteristics, ED consumption, and on health-related behaviors of participants was collected by the use of a web-based questionnaire. RESULTS: A total of 2165 students participated in the study and 15.2% of them reported having used caffeinated EDs in the last six months, mainly once a month (41.5%). In comparison with non-users, ED users showed a higher proportion of males (p < 0.001) and a higher father's educational level (p = 0.003), came mainly from Northern universities (p = 0.004) and life sciences degree courses (p < 0.001). Besides, ED users reported higher BMI values (p = 0.003), more particular dietary regimens (p < 0.001), higher levels of weekly moderate-vigorous physical activity (p < 0.001) and participation in sports (p < 0.001) and in team sports (p = 0.003), and higher proportion of smokers (p < 0.001) and alcohol drinkers (p = 0.005). ED use was negatively related with female gender (OR 0.546; 95% CI 0.374-0.798), the Mediterranean diet (OR 0.587; 95% CI 0.362-0.951) and coming from the center of Italy (OR 0.500; 95% CI 0.275-0.909) and positively associated with tobacco smoke (OR 1.712; 95% CI 1.176-2.492) and participation in a team sport (OR 1.686; 95% CI 1.051-2.707). CONCLUSION: These findings could encourage figures engaged in education to increase the students' awareness on this issue in order to prevent the excessive use of EDs and associated unhealthy behaviors, especially in the most interested subgroups.

Occurrence and congener profiles of dioxins (PCDDs), furans (PCDFs) and polychlorinated biphenyls (PCBs) in ovine and caprine milk samples collected in a very polluted site in Central Italy.

Concentrations of 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs) and 18 polychlorinated biphenyls (PCBs), including 12 dioxin-like (DL-PCBs) and 6 non-dioxin-like PCBs (NDL-PCBs) were measured in 16 ovine and caprine milk samples collected in the territory of Bussi sul Tirino, central Italy, a Site of National Interest (SNI) due to its high and widespread environmental pollution. All the analyzed samples were compliant with the maximum levels fixed by Commission Regulation (EU) 1259/2011 for the content of PCDD/Fs and the sum of PCDD/Fs and DL-PCBs. In two cases, contamination levels of the sum of PCDD/Fs and DL-PCBs were higher than the action levels fixed by EU Recommendation 663/2014. The statistical analysis, performed by Principal Component Analysis (PCA), revealed that the differences in contamination profiles of the different milk samples were independent of the distance of the farms from the Bussi illegal landfill but likely related to local emission sources influencing the exposure to POPs of studied animals.

Decompressive Craniectomy in Severe Traumatic Brain Injury: The Intensivist's Point of View.

INTRODUCTION: Traumatic brain injury (TBI) represents a severe pathology with important social and economic concerns, decompressive craniectomy (DC) represents a life-saving surgical option to treat elevated intracranial hypertension (ICP). The rationale underlying DC is to remove part of the cranial bones and open the dura mater to create space, avoiding secondary parenchymal damage and brain herniations. The scope of this narrative review is to summarize the most relevant literature and to discuss main issues about indication, timing, surgical procedure, outcome, and complications in adult patients involved in severe traumatic brain injury, underwent to the DC. The literature research is made with Medical Subject Headings (MeSH) terms on PubMed/MEDLINE from 2003 to 2022 and we reviewed the most recent and relevant articles using the following keywords alone or matched with each other: decompressive craniectomy; traumatic brain injury; intracranial hypertension; acute subdural hematoma; cranioplasty; cerebral herniation, neuro-critical care, neuro-anesthesiology. The pathogenesis of TBI involves both primary injuries that correlate directly to the external impact of the brain and skull, and secondary injuries due to molecular, chemical, and inflammatory cascade inducing further cerebral damage. The DC can be classified into primary, defined as bone flap removing without its replacement for the treatment of intracerebral mass, and secondary, which indicates for the treatment of elevated intracranial pressure (ICP), refractory to intensive medical management. Briefly, the increased brain compliance following bone removal reflects on CBF and autoregulation inducing an alteration in CSF dynamics and so, eventual complications. The risk of complications is estimated around 40%. The main cause of mortality in DC patients is due to brain swelling. In traumatic brain injury, primary or secondary decompressive craniectomy is a life-saving surgery, and the right indication should be mandatory in multidisciplinary medical-surgical consultation.

External Ventricular Drainage: A Practical Guide for Neuro-Anesthesiologists.

External ventricular drainage is often considered a life-saving treatment in acute hydrocephalus. Given the large number of discussion points, the ideal management of EVD has not been completely clarified. The objective of this study was to review the most relevant scientific evidence about the management of EVD in its main clinical scenarios. We reviewed the most recent and relevant articles about indications, timing, management, and complications of EVD in neurocritical care, with particular interest in patients with subarachnoid hemorrhage (SAH), severe traumatic brain injury (TBI), and intraventricular hemorrhage (IVH) using the following keywords alone or matching with one another: intracranial pressure, subarachnoid hemorrhage, traumatic brain injury, intraventricular hemorrhage, external ventricular drainage, cerebrospinal shunt, intracranial pressure monitoring, and ventriculoperitoneal shunt. In the management of EVD in SAH, the intermittent drainage strategy is burdened with an elevated risk of complications (e.g., clogged catheter, hemorrhage, and need for replacement). There seems to be more ventriculoperitoneal shunt dependency in rapid weaning approach-managed patients than in those treated with the gradual weaning approach. Although there is no evidence in favor of either strategy, it is conventionally accepted to adopt a continuous drainage approach in TBI patients. Less scientific evidence is available in the literature regarding the management of EVD in patients with severe TBI and intraparenchymal/intraventricular hemorrhage. EVD placement is a necessary treatment in several clinical scenarios. However, further randomized clinical trials are needed to clarify precisely how EVD should be managed in different clinical scenarios.

Hyponatremia Related to Neurocritical Care: Focus on Diagnosis and Therapy: A Systematic Review.

INTRODUCTION: Hyponatremia is the most frequently occurring electrolyte disorder in neurocritical care and traumatic brain injury, aneurysmal subarachnoid hemorrhage (SAH), neurosurgery, and ischemic stroke are the clinical conditions more often associated with this condition. SIADH and CSWS are the main causes of hyponatremia in neurologically ill patients. Since hyponatremia is a negative prognostic factor for neurocritical patients, early diagnosis and consequent targeted therapy are of fundamental importance. The present review was carried out to provide a brief recap on the main causes and management of hyponatremia in the neurocritical patient. METHODS: A methodical search of the medical literature using the online database MEDLINE was carried out and studies comprising case reports, prospective and retrospective observational studies, or randomized controlled clinical trials in which there is a diagnosis of hyponatremia in neurocritical patients were included. RESULTS: 18 articles were analyzed, consisting of 8 case reports, 4 case series, 3 prospective trials, 1 retrospective study, and 1 multicenter trial. A total of 1371 patients from 18 studies were included. Patients' average age was 29.28 ± 20.9, respectively. TBI was the main cause of hyponatremia in the literature reviewed; 12 studies were about the relationship between TBI and hyponatremia, 2 studies about stroke, 2 studies about SAH and 1 about hyponatremia postneurosurgical procedure. DISCUSSION: Hyponatremia is the most common electrolyte disorder in hospitalized patients and the main scenarios of hyponatremic neurocritical patients are subarachnoid hemorrhage, ischemic stroke, traumatic brain injury and iatrogenic hyponatremia due to neurosurgical cases. CONCLUSION: Hyponatremia is a frequent finding in neurocritical care and is also a recognized negative prognostic factor leading to increased mortality and ICU length hospitalization. Its diagnosis and therapy are essential for correct neurocritical management. The most common cause of serum sodium abnormality is SIADH, and an early diagnosis for target treatment is paramount to prevent delayed symptoms and complications.

Assessment of dietary supplement consumption among Italian university students: The multicenter DiSCo study.

OBJECTIVES: The aim of this study was to analyze the consumption of dietary supplements (DSs) and related sociodemographic characteristics or behaviors in Italian undergraduates. METHODS: A questionnaire-based, cross-sectional study was carried out between October 2021 and May 2022 involving undergraduates from 12 public universities. The use of DSs in the previous 6 mo, the aim and reason for use, the purchasing channel, and related adverse effects were explored and compared by sex. A logistic regression was performed to highlight possible associations between sociodemographic, anthropometric, and behavioral characteristics of participants and supplement consumption. RESULTS: The use of DSs was reported by 71.5% of the 2165 respondents. Supplementation was related to sex (odds ratio [OR] 0.690; 95% confidence interval [CI], 0.516-0.924, for men), vegetarian or vegan (OR 4.814; 95% CI, 1.669-13.887) and other particular diet regimens (OR 1.819; 95% CI, 1.282-2.580), sport (OR 1.688; 95% CI, 1.116-2.553), and type of sport (OR 0.629; 95% CI, 0.423-0.936, for team sports). Women were more likely to use DSs following a doctor's prescription and to buy them in a pharmacy (P < 0.001) but reported more adverse effects (P = 0.018) than men. The main aim pursued was general health; proteins, amino acids, and non-caffeinated energy supplements were consumed to improve physical performance and caffeinated energy supplements for mental performance. CONCLUSIONS: Diet supplementation was common in the sample examined, especially in women, and associated with particular dietary regimens and sports, especially individual sports. Female consumers follow specialists' indications more than males. These results highlight the need for educational interventions about diet supplementation for this category of users.

Consumption patterns of energy drinks in university students: A systematic review and meta-analysis.

OBJECTIVES: Energy drink (ED) use is promoted to stimulate mental and/or physical activity, and their popularity has increased over the years, especially among young people. However, the use of EDs is often improper, and can induce adverse effects for human health. The purpose of this systematic review and meta-analysis was to analyze the literature to characterize the prevalence of ED consumption and motivations for use among undergraduate students. Furthermore, adverse effects and health-related behaviors associated with ED consumption were explored. METHODS: This systematic review was carried out according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, and the PubMed, Scopus, and Web of Science databases were used for data research. RESULTS: A total of 71 articles published between 2007 and 2021 met the inclusion criteria and were included in the review. The estimated overall prevalence of ED consumption was 42.9% in undergraduate students (95% confidence interval, 42.5%-43.3%), with significant heterogeneity among studies (Q test: P < 0.001; I2 = 99.4%). The main reasons for use were engagement in study, projects or examinations, stay awake or alert, and physical activity/sport engagement. Sleep disturbance and increased heart rate or blood pressure were the most commonly reported adverse effects. ED consumption was frequently associated with alcohol use and smoking. CONCLUSIONS: These findings suggest that the inappropriate use of EDs and related unhealthy behaviors should be identified early, and addressed through effective educational interventions..

Alcohol Mixed with Energy Drinks (AmED) Use among University Students: A Systematic Review and Meta-Analysis.

In the last decades, there has been a huge increase in the consumption of both Energy Drinks (EDs) and alcohol and, concurrently, these two trends generated the additional practice of mixing ED with alcohol, known as Alcohol mixed with Energy Drink (AmED). One of the most important group of AmED consumers is represented by young. Indeed, the study population of the researches in this field are mainly represented by college students and the results evidence a great range of negative consequences for health. The purpose of the systematic review was to explore the prevalence of AmED consumption among undergraduate students, together with motivations to their use, adverse effects and health-related behaviors associated to AmEDs use. The review was conducted according to the PRISMA Statement and PubMed, Scopus and Web of Science were interrogated. 42 articles, published from 2008 to 2021, were included in the review. An overall prevalence rate of 37% was estimated for AmEDs use in undergraduates, with geographical differences. Although a decrease in consumption was observed throughout the studied period, a continuous monitoring on this phenomenon is needed for identifying those risk groups that could develop risky behaviors related to AmEDs consumption and provide them targeted educational interventions.

Studying Respiratory Symptoms Related to Swimming Pools Attendance in Young Athletes: The SPHeRA Study.

This study investigates the prevalence of respiratory symptoms and the training factors possibly associated with them in a sample of young Italian competitive swimmers. A questionnaire about training information and symptoms was administered to participants during the winter and summer 2021 training seasons. In total, 396 athletes took part in the study. In the winter training subgroup (n = 197), we found significant associations between increasing training hours per session and the presence of nasal congestion/rhinorrhoea (OR = 3.10; p = 0.039) and cough (OR = 3.48; p = 0.015). Total training hours per week were significantly associated with nasal congestion/rhinorrhoea (OR = 1.12; p = 0.010). In the summer group (n = 199), the same factors were not associated with respiratory symptoms. Having an allergy was significantly related to nasal congestion/rhinorrhea in both the logistic models (model 1 OR = 2.69, p = 0.013; model 2 OR = 2.70, p = 0.012), while having asthma significantly increased the risk of coughing (OR = 3.24, p = 0.033). The kind of environment (indoor or outdoor facilities) did not affect the studied symptoms either in summer or winter. Further investigations are needed to better understand the mechanisms involved in the development of respiratory symptoms in swimmers, particularly on how inflammation and remodelling develop and which environmental conditions can favour these processes.