Correlation between physical activity and sedentary behavior with healthy and unhealthy behaviors in Italy and Tuscan region: a cross sectional study.

INTRODUCTION: Regular physical activity (PA) has associated with various positive health aspects such as a decreased risk of chronic or generic illnesses, furthermore, a sedentary lifestyle has been associated with health problems such as obesity. To examine the relationship between patterns of PA, screen-based media use (SBM) and social health indicators within a specific demographic group and highlight the regional vs. national differences in these relationships. METHODS: The data is drawn from the Health Behaviour in School-Aged Children (HBSC) database, a national cross-sectional survey in a representative sample (N = 3920) of students aged 11-13-15 years and compared to those of the Tuscan region (N = 3381). Variables considered other than PA and SBM use includes positive health indicators such as physical health status, quality of family and peer relationships, fruit consumption, breakfast consumption as well as negative health indicators, such as health complaints, smoking and alcohol use. RESULTS: Some positive health indicators showed a positive correlation with PA. Students adopting healthy behaviours often met the Physical Activity Guide Line (PAGL). On the contrary, negative health indicators were associated with PAGL in a negative way. In general SBM was positively related to several of the negative health indicators and vice versa. SBM was related in a positive fashion to tobacco use that represents a protective factor. DISCUSSION: The results show that met PAGL is associated with positive health indicators and that high levels of SBM use is associated with negative health indicators. The study also emphasizes the relationship between PA, SBM use and socialfactors. Increasing PA and decreasing SBM use should be an aim in general health behaviour promotion.

BMI from nutritional surveillance of 8-9 years old children in Tuscany (Italy).

INTRODUCTION: The latest increase in childhood obesity focused attention on the important consequences that this phenomenon may have on public health in relationship to the increasing risk that an obese child may become an obese adult. To deal with this problem, there is necessary to assess systematically the distribution of childhood nutritional status at different levels: international, regional and local. In this paper are presented data on underweight, overweight and obesity prevalence in third grade primary school children, aged 8/9 years in Tuscany (2008) and its distribution in relationship to the demographic breadth of their place of residence. METHODS: Data from statistic sample of 2109 (1.091 males, 1.018 females), 8/9 years school-children were collected; weight and height were measured using standardised personnel and instruments. Exact month age was calculated between the data of measurement and that of birth. Body Mass Index (BMI) classes were calculated using Cole et al.'s epidemiologic cut-off for children and adolescents. Residence areas were divided into four classes based on the number of inhabitants (< 10.000; 10.000-50.000; > 50.000; > 50.000 metropolitan). RESULTS: The prevalence of underweight was 0.88% (0.76% in males and 1.01% in females), the prevalence of overweight was 23.43% (22.33% in males and 24.65% in females), the prevalence of obese was 7.95% (9.08% in males, 6.70% in females). The lowest prevalence of obese (6.46%) was found in towns with over 50.000 residents (metropolitan). CONCLUSION: The obesity prevalence in Tuscany children is still lower than that of the Italian National Survey, while the overweight prevalence it's the same. Obesity prevalence (10.71%) is higher in municipalities with low residents number (< 10.000).

A regular or an intermittent treatment for asthma: the long-term effect.

OBJECTIVES: Many asthmatics take therapy intermittently because of their scarce compliance. It is not known if this is effective in controlling and slowing down the lung function decline in asthma. Our aim was to compare the effect of a regular treatment and an intermittent one on some clinical aspects and on the forced expiratory volume 1 (FEV1) decline in 165 persistent asthmatics with FEV1 > 70% (60 men; age 40.87 +/- 14.05; FEV1 95.03 +/- 13.1%), in a retrospective way over 4 years. PATIENTS AND METHODS: Eighty-four patients took inhaled corticosteroids (ICSs) plus long-acting bronchodilator agents (LABAs) regularly (regular) and 81 patients took ICSs plus LABAs intermittently for short periods when symptoms appeared (intermittent). RESULTS: Less patients (p < 0.05) took oral corticosteroids, short-acting bronchodilators as needed in regular compared to intermittent. More patients increased the therapy (step-up) in intermittent (p < 0.01) More patients reported a subjective improvement while fewer reported a worsening in regular (p < 0.05). After 4 years, the variation in maximal mid expiratory flow (FEF25-75) was lower in regular (-159.40 +/- 472.79 ml/sec; CI 95% -261.99, 56.82) than in intermittent (-324.44 +/- 569.97 ml/sec; CI 95% -450.48, -198.41); whereas the FEV1 decline was similar between regular (-276.97 +/- 199.37 ml; CI 95% -316.24, -229.71) and Intermittent (-317.65 +/- 194.05 ml; CI 95% -360.56, -274.74). In males and females, in smokers and non-smokers no differences were found in the FEV1 decline. CONCLUSIONS: In conclusion, the regular use of ICSs plus LABAs is better than the irregular use of them in controlling asthma over a long period of time. Whereas, after 4 years the regular treatment may not decrease the FEV1 decline more effectively than the intermittent therapy.

Self-reported recurrent pain and medicine use among 15-year-olds: results from the HBSC Italian study.

BACKGROUND: The prevalence of adolescent pain varies considerably across epidemiological studies, and little information is available on pain-related behaviours among adolescents, including medicine use. The aims of this study were: [1] to examine the prevalence of recurrent pain among 15-year-old adolescents in Italy; [2] to investigate the association between recurrent pain and medicine use among boys and girls; and [3] to evaluate the consistency of these associations across Regions. METHODS: The World Health Organization (WHO) collaborative International Health Behaviour in School-aged Children 2013/2014 study collected self-reported data on pain and medicine use from 13611 15-year-old adolescents in 21 Italian Regions. We used multi-level multivariate logistic regression, stratified by gender, to analyse the association between recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep. RESULTS: On average, across all Regions, almost 45% of adolescents reported recurrent headache, more than 30% reported recurrent backache and approximately 30% reported recurrent stomachache. Although the prevalence of both pain and medicine use was much higher among girls, the association between pain and medicine use was similarly strong in adolescents of both genders. Adolescents with recurrent pain proved more likely to use medicines also for non-corresponding pain, nervousness and difficulties in getting to sleep. The association between recurrent pain and medicine use was consistent across Regions despite large inter-regional differences in the prevalence of both phenomena. CONCLUSIONS: Recurrent pain in adolescence is common nationwide. Adolescents with recurrent pain are more likely to use medicines in general. Recurrent pain and medicine use should be addressed by adolescent health policies.

Familial non-medullary thyroid carcinoma displays the features of clinical anticipation suggestive of a distinct biological entity.

Non-medullary thyroid carcinoma (NMTC) is mostly sporadic, but familial clustering is described. We aimed to compare the features of patients with sporadic and familial NMTC (FNMTC) patients and to assess whether FNMTC patients with parent-child relationship exhibit the 'anticipation' phenomenon (earlier age at disease onset and increased severity in successive generations). Among 300 NMTCs followed in the Section of Endocrinology (University of Siena, Italy), 34 (11.3%) patients, all with the papillary histotype, (16 kindred), met the criteria of FNMTC. Twenty-seven of them (79.4%) exhibited a parent-child relationship and seven (20.6%) a sibling relationship. These patients were compared with 235 patients with sporadic papillary thyroid cancer (PTCs). To analyze the features of FNMTC of the first and second generations, we cumulated the series of Siena with 32 additional FNMTC patients (15 kindred) from the Department of Endocrinology-Endocrine Oncology, Thessaloniki, Greece. Significant difference between sporadic PTC and FNMTC patients included more frequent tumor multifocality (P=0.001) and worse final outcome in FNMTC patients (P=0.001). Among 47 FNMTC with parent-child relationship, we found an earlier age at disease presentation (P<0.0001), diagnosis (P<0.0001), and disease onset (P=0.04) in the second generation when compared with the first generation. Patients in the second generation were more frequently males (P=0.02); their tumors were more frequently multifocal (P=0.003) and bilateral (P=0.01), had higher rate of lymph node metastases at surgery (P=0.02) and worse outcome (P=0.04) when compared with the first generation. In conclusion, FNMTC displays the features of clinical 'anticipation' with the second generation acquiring the disease at an earlier age and having more advanced disease at presentation.

Underweight and overweight among children and adolescents in Tuscany (Italy). Prevalence and short-term trends.

INTRODUCTION: The recent increase in both childhood obesity and adolescent anorexia nervosa in developed countries has underlined the important consequences that these trends may have on public health, as there is an increased risk that these conditions may become chronic diseases in adulthood. Therefore, it is necessary to monitor prevalence rates and trends in thinness and overweight (including obesity) among children and adolescents at different levels: international, national and sub-national. Since 2001/2002, a nutritional surveillance system has been implemented in the Tuscany Region to estimate the nutritional status and lifestyles of children and adolescents. The main objectives were to assess the prevalence of thinness, overweight and obesity among Tuscan children and adolescents and to provide baseline information on the prevalence of thinness, for the first time calculated according to the new international definitions, for geographical comparisons and descriptions of time trends. METHODS: Independent cross-sectional sample surveys were conducted in 2002, 2004 and 2006 in Tuscany, North-Central Italy. Data were collected from stratified two-stage cluster samples of children aged 9 years (n = 3,048 in 2002 and n = 1,430 in 2006) and of adolescents aged 11-13-15 years (n = 1,066, n = 1185 and n = 1,160 in 2004 and n = 1,189, n = 1,211 and n = 1,178 in 2006, respectively). Weights and heights of primary school children were measured by means of standardized methods, while those of adolescents were self-reported. Decimal age was calculated from the date of birth to the date of measurement. Body Mass Index classes were calculated according to the International Obesity Task Force standards. Instead of the term underweight in children, we used the term thinness, which the World Health Organization uses to mean low Body Mass Index for age in adults and adolescents. According to Cole's recently published cut-offs for thinness, we divided our Body Mass Index values below 18.5 into three grades. RESULTS: This study presents data on the prevalence of different grades of nutritional status (thinness, normal weight, overweight and obesity) among Tuscan school-aged children from primary to high school (9-11-13-15-y-old), assessed by means of Body Mass Index, according to international definitions. From 2002 to 2006 the prevalence of thinness among children aged 9 years decreased from 4.6% to 4.2%, and the prevalence of normal weight from 63.7% to 62.4%; the prevalence of overweight (including obesity) rose from 31.7% to 33.4%. From 2004 to 2006, among pre-adolescents aged 11 years, the prevalence of thinness declined from 11.0% to 10.1%; the prevalence of normal weight rose from 68.4% to 70.2%, and the prevalence of overweight declined from 20.7% to 19.6%. Among adolescents aged 13 years, the prevalence of thinness declined from 9.8% to 8.0%; the prevalence of normal weight rose from 73.5% to 74.0%, and the prevalence of overweight from 16.8% to 17.9%. Among adolescents aged 15 years, the prevalence of thinness declined from 9.8% to 8.7%, and the prevalence of normal weight from 77.0% to 71.6%, while the prevalence of overweight rose from 13.3% to 19.7%. The 2006 data showed that the trend in the prevalence of overweight (including obesity) tended to decrease with age for both sexes, though more markedly in girls (from 34.0% at 9-y of age to 12.2% at 15-y of age) than in boys (from 32.8% at 9-y of age to 22.8% at 13-y of age to 27.5% at 15-y of age). By contrast, the prevalence of thinness increased with age in girls (from 4.9% at 9-y of age to 14,1% at 15-y of age), while boys presented a similar low prevalence at 9 and 15-y of age (3.3% and 3.1%), doubling the values at 11 and 13-y of age (7.5% and 6.5%). The trend in the prevalence of normal weight increased with age from 62.4% at 9-y of age to 74.0% at 13-y of age and to 71.6% at 15-y of age. Boys displayed a higher prevalence than girls only at 9-y of age (63.9% vs. 61.0%). DISCUSSION: The results of this study allow us to analyze data from the nutritional surveillance system in Tuscany using recent definitions of Body Mass Index cut-off points among children, pre-adolescents and adolescents. As a rule, the trend in the prevalence of overweight (including obesity) among girls from 9-y to 15-y-old strongly decreased, while the prevalence of thinness increased. In boys, this decrease was less marked and the prevalence of thinness displayed an irregular trend, with an increment from 9-y to 11-y-old and a decrease from 13-y to 15-y old. The trend in the prevalence of normal weight increased with age, with a higher prevalence among boys than girls.

Semen quality of male idiopathic infertile smokers and nonsmokers: an ultrastructural study.

This retrospective study was aimed at evaluating the effects of cigarette consumption on semen parameters in a group of men with idiopathic infertility. The semen quality of 2 groups of men with idiopathic infertility, smokers (n = 118) and nonsmokers (n = 153), were compared. Conventional semen analysis was performed and sperm morphology was assessed by transmission electron microscopy (TEM). TEM data were elaborated by means of a mathematical formula based on a Bayesian technique able to furnish a fertility index (FI), and the percentages of sperm apoptosis, necrosis, and immaturity. Values of normality recommended by World Health Organization guidelines were used as a control for conventional semen analysis, and values from sperm of 25 men of proven fertility were used for TEM indices. Infertile smoker and nonsmoker patients showed similar sperm parameters, although sperm motility and TEM analysis values in both groups were significantly impaired compared with controls. Smoker patients were then classified as mild (>or=1 and 10 and <20 cigarettes/day), or heavy smokers (>or=20 cigarettes/d). Sperm concentration and FI were significantly (P < .05) different among the 3 considered smoker classes. Comparing the pairs of smoker classes, sperm concentration and FI in heavy smokers were significantly lower (P < .05) than that observed in mild smoker and nonsmoker groups. Although semen quality in males with idiopathic infertility seems not to be dramatically affected by cigarette consumption, heavy smokers show significantly lower sperm concentration and FI: another strong reason to stop smoking.

Sperm aneuploidies and low progressive motility.

BACKGROUND: Patients with poor semen quality show increased sperm disomy and diploidy rates. Oligozoospermia and teratozoospermia are known to influence sperm aneuploidy, but there is still a debate about whether aneuploidies are associated with reduced motility. METHODS: Ejaculates from a large group of patients were examined by light microscopy to evaluate sperm concentration, motility and morphology, and by fluorescence in-situ hybridization (FISH) to analyse the presence of aneuploidies. Statistical analysis was performed to compare differences and to evaluate the relationship between sperm aneuploidy rate and semen quality. RESULTS: Five groups were established following the motility parameter, and total aneuploidy rates were statistically significantly higher in the groups where motility was <30% compared to the controls. A homogeneous group of men with asthenozoospermia showed higher FISH values compared to control data, although the difference was not statistically significant. Motility and sperm morphology were each found to be statistically related to aneuploidy using a multiple linear regression analysis, whereas sperm concentration was only related to aneuploidy by the equation of a hyperbolic curve. CONCLUSIONS: In conclusion, biological and statistical data from the present research support the idea that the presence of aneuploidies could also be associated with reduced sperm motility.