Invasive pneumococcal infections in infants up to three years of age: results of a longitudinal surveillance in North-East Italy.

Pneumococcus is considered one of the main causes of the infections acquired in the community setting and also seems to be the most frequent cause of community-acquired pneumonia in children under 5 years of age. To establish suitable preventive measures as vaccination policy, it would be important to document the incidence of IPD. The main feature of this study was that it demanded a cooperative effort between family pediatricians and those working in the hospitals to estimate the real burden of IPD in children aged 0-36. From 1 January 2003 to 31 December 2003, a prospective active surveillance of clinical cases due to S. pneumoniae was conducted by 87 specifically-trained sentinel pediatricians [all family pediatricians] randomly selected from among those working in North-East Italy. Suspected pneumococcal infections were confirmed by blood cultures at the laboratories of the hospitals involved in the study. 32 cases were suspected, 12 of those proved positive on blood culture and 6 of these 12 confirmed cases were hospitalized. 2 were cases of meningitis, 1 of pneumonia and 9 of bacteremia. The cumulative annual incidence was 58.9 cases/100,000 infants aged 0-36 months (95% CI 30.38-102.71), meaning that North-East Italy can be classified as a mesoendemic area. This study demonstrated that the incidence of IPD in infants aged (0-36 months) is often under-estimated, documenting the importance of prospective active surveillance for assisting rational choices for public health issues.

Influence of different soluble dietary fibers on the bioaccessibility of the minor Fusarium mycotoxin beauvericin.

Beauvericin (BEA) is a bioactive compound produced by the secondary metabolism of several Fusarium strains and is known to have various biological activities. This study investigated the bioaccessibility of the BEA tested in concentrations of 5 and 25mg/L, in a model solution and in wheat crispy breads elaborated with different natural binding compounds as the soluble alimentary dietary fibers ß-1,3 glucan, chitosan low molecular weight (L.M.W.), chitosan medium molecular weight (M.M.W.), fructooligosaccharides (FOS), galattomannan, inulin and pectin, added at concentrations of 1% and 5%. The bioaccessibility was determinated by employing a simulated gastrointestinal digestion that simulates the physiologic conditions of the digestive tract until the colonic compartment. The determination of BEA in the intestinal fluids was carried out by liquid chromatography-mass spectrometry detection (LC-MS). The mean BEA bioaccessibility data in the model solutions ranged from 31.8% of the samples treated with only the duodenal digestion until 54.0% of the samples processed including the colonic fermentation, whereas in the alimentary system composed by the wheat crispy breads produced with different fiber concentration the duodenal and the duodenal+colonic BEA bioaccessibility resulted in 1.9% and 27.0% respectively.

An analysis of the factors influencing the paediatrician-parents relationship: the importance of the socio-demographic characteristics of the mothers.

BACKGROUND: The paediatrician-parents meeting is not always characterized by mutual understanding and final satisfaction. Anxiety and preconceptions of the parents and clinicians may have consequences for the formulation of the diagnosis, for the pharmacological prescription, for the therapeutic alliance. METHODS: We performed a survey in collaboration with a representative sample of Italian paediatricians and mothers in the Veneto region to investigate the influence of paediatricians' and families' socio-demographic characteristics on some clinical aspects of the visit and on their relationship. The survey consisted of a first 7-item anonymous questionnaire addressed to paediatricians and to mothers. An univariate analysis (Pearson chi(2)-test) was applied. RESULTS: A total of 276/527 family paediatricians and 2567/5270 mothers completed the questionnaire. The 69.7% of responding paediatricians reported that mothers are very anxious during the visit and require a therapy (especially antibiotics). However, only 9.74% of mothers said they required a therapy, mainly the younger mothers with a lower level of education. The mothers reported that they were satisfied with the time devoted and the explanations given by paediatrician. The main information sources for mothers are personal experience or health care providers' advice, with a marginal role for mass-media, mentioned especially by the younger, with a lower level of education and less experienced mothers. CONCLUSIONS: Our experience suggests that maternal anxiety and physicians' interpretation of parental expectations are important factors to take into account during the visit. The paediatricians are not always good predictors of parental expectations. Younger mothers, with a lower level of education and with less experience need more time, more information and support by paediatricians. They are more likely to request therapy, are less satisfied, more easily influenced and likely to follow mass-media advice, rather than a reliable source of information.