Adherence to Mediterranean diet in a sample of Tuscan adolescents.

OBJECTIVE: The aim of this study was to estimate the level of adherence to the Mediterranean diet in a group of Italian high school students, in relation to their lifestyles and social and family contexts, and to compare the nutrition habits of the sample with other similar groups. METHODS: The KIDMED index and an ad hoc questionnaire were administered to 1127 students (mean age 16.8 ± 1.6 y) in the province of Florence. Any significant associations between the level of adherence to the Mediterranean diet and the aforementioned variables were assessed by the χ(2) test and by logistic regression analysis. RESULTS: The adherence to the Mediterranean diet was good in 16.5%, average in 60.5%, and poor in 23% of the students. The students attending technical high schools, those who played sports less than "almost every day", those who spent >3 h/d in sedentary activities, those who defined their school performance as worse than "more than sufficient," and those who referred to use of a car/moped as the most frequent mode of transportation, had significantly higher odds of poor rather than average or good adherence to Mediterranean diet. Moreover, being normal weight or overweight/obese, and referring to health workers as source of information on diet, seem to be protective factors against poor adherence to Mediterranean diet. CONCLUSIONS: Our sample presents a departure from the Mediterranean dietary pattern. It is certainly necessary to implement public health policies targeting teenagers to promote healthier lifestyle choices; the nutritional patterns of the Mediterranean diet should be among these choices.

[Tuberculosis in Tuscany: epidemiology and drug resistance]. / Tubercolosi in Toscana: epidemiologia e farmacoresistenza.

The aim of this study, conducted in collaboration with the Regional Mycobacteriology Centre at "Careggi" Hospital in Florence, was to describe the epidemiology of tuberculosis (TB) in Tuscany in the years 2007 to 2009. Epidemiological data and mycobacteriology results related to all subjects with confirmed TB in the three years considered were evaluated.Two hundred eighty-five patients were evaluated for the year 2007, 289 for 2008 and 240 for 2009 (data for three provinces are missing for 2009). A large percentage of patients were foreign-born (51.9% in 2007, 56.4% in 2008 and 66.3% in 2009) with the most frequent geographical areas of origin being Africa, Eastern Europe and Asian countries. Overall, the largest number of cases was reported in the cities of Florence and Prato. Among Italian-born patients, the disease was most frequent among patients above 75 years of age while the most frequently affected age group among foreign-born patients was 25-34 years.

Quantification of drugs of abuse and some stimulants in hair samples by liquid chromatography-electrospray ionization ion trap mass spectrometry.

A qualitative and quantitative method for the analysis of drugs of abuse (cocaine and benzoylecgonine, opiates) and some stimulants in human hair was developed and validated. Hair samples were incubated with phosphate buffer (pH 5.0), chosen as the extraction medium, extracted with Bond Elut Certify cartridges and analyzed by LC-MS-MS and LC-MS(3) as confirmation for positive results. The method proved to be specific, accurate and precise across the calibration range (0.1-30 ng/mg) where good linearity was observed. Total extraction recovery, intra-assay accuracy and precision, limits of detection and limits of quantitation were estimated. The method was successfully applied to the analysis of hair samples collected from drug abusers and it was suitable for routine analytical applications in the Antidoping Laboratory of Public Health Laboratory.

Body composition assessment in a sample of eight-year-old children.

OBJECTIVE: We assessed the body composition of 8-y-old children living in Livorno through the integration of bioelectrical and anthropometric evaluations. METHODS: The study, conducted during December 2005, involved 8-y-old third graders of Livorno, Italy. We collected for each subject (449 children, 210 female and 239 male) anthropometric parameters and carried out bioelectrical impedance test with a STA/BIA Soft Tissue Analyzer. Data were processed with SPSS 14.0. RESULTS: According to anthropometric parameters, a statistically significant difference between genders was found only for height. Percentages of overweight and obese children by gender were 13.9 and 2.4 for girls and 21.3 and 2.1 for boys (P<0.05). No significant differences were observed for weight, height, and body mass index percentiles from national reference values, whereras significant differences were found in mid-upper arm circumference between our sample and-lacking national data-the reference (U.S.) population for age and gender. With regard to bioelectrical impedance analysis, a common trend of distribution was observed in both genders toward the left and the area above the spatial ellipses and a statistically significant difference between genders for all parameters with the exception of phase angle. A gradual mean impedance shortening vector was observed with an increase of body mass index or mid-upper arm circumference. The comparison of the two techniques showed a good relation between anthropometric and bioelectrical parameters. CONCLUSION: An integrated interpretation of bioelectrical impedance analysis and anthropometry, demonstrated by the correlation of many parameters between the two techniques, seems to emerge as a good indication of nutritional status for most children of both genders.

The role of environmental factors and distance from Emergency Medical Services on the severity of road accidents.

Aim of this work is to assess the effect of some environmental factors on road accident severity in Tuscany (Italy). ISTAT data on road accidents occurred in Tuscany in 1991-2003 (228,833 accidents) have been analysed, considering the following variables: road type and characteristics, population density in the municipality where the accident occurred, presence of Emergency Medical Services (EMSs) in the municipality, distance between the municipality and the nearest EMS, according to 3 different criteria. The effect of each variable in accident severity (fatal vs not fatal) was assessed through logistic regression analysis. The results confirm the role of structural and environmental factors in influencing accident severity, in particular population density, location on the road and road type, while the effectiveness in preventing serious consequences due to distance from EMS is limited to the municipalities very close to hospitals.

[Assessment of nutritional status in institutionalized elderly individuals through body impedance analysis]. / Stato nutrizionale negli anziani istituzionalizzati:applicazione dell'analisi bioimpedenziometrica.

The aim of this study was to describe changes in body composition and determine the prevalence of malnutrition or of risk of malnutrition in long institutionalized elderly patients. Four hundred five patients aged over 64 years were included in the study. Nutritional status was evaluated by means of questionnaire, height and weight measurements and bioelectrical Impedance Vector Analysis (BIVA). Height, weight and phase angle significantly diminished with increasing age. Significant gender differences were also found, with phase angle being lower in females with respect to males. BIVA confidence analysis showed significant differences in body composition between subjects of different ages and levels of physical self-sufficiency.Overall, a large proportion of subjects in this study had evidence of malnutrition or were shown to be at risk for malnutrition. This indicates the importance of performing nutritional risk screening in all institutionalized subjects upon admission and during their stay in nursing homes.

The prevalence of latent tuberculosis infection in social marginal groups. An experience conducted in Tuscany.

Tuberculosis is encountering a renewal attention due to emergent causes, linked primarily to migration from high-endemic countries of many subjects who present important risk factors as poverty, homelessness, drug abuse, HIV infection. The purpose of the present study is to evaluate the spread of Mycobacterium tuberculosis in social groups traditionally at higher risk of developing the disease and often difficult to detect. Tuberculin screening with Mantoux intradermal reaction has been carried out on 2014 subjects with one or more risk conditions. We have considered the following risk conditions: extra European community (e-EC), immigrants, nomads, drug dependants, immunodeficients, alcohol dependants, prison inmates living in protected community or home, subjects known to have contact with a TB case with also one or more of the above conditions. A logistic-regression model has been applied to evaluate the association between several social and/or pathological risk factors and Mantoux responsiveness. The population groups examined show higher rates than the Italian population. The majority of risk factors have a significant association (positive or negative) with Mantoux positivity. In particular, if we add to the condition of e-EC (coded as reference category) other conditions (community, contact, prison), the probability of positive Mantoux increases. In fact, the OR values are 2.92 (C.I. 95%=2.23-3.82) for "e-EC migrants + protected communities", 2.35 (C.I. 95%=1.62-3.40) for "e-EC migrants + contact" and 2.53 (C.I. 95%=1.24-5.14) for "e-EC migrants + prison". On the other hand the condition of "e-EC migrants + nomad" appears to be significantly "protective" in relation to Mantoux positivity (OR=0.23; C.I. 95%=0.16-0.33), and the same is true for "protected community + contact", "prison", "drug dependence", "drug dependence + immunodeficiency" with respective OR values of 0.37 (C.I. 95%=0.15-0.93), 0.29 (C.I. 95%=0.14-0.58), 0.20 (C.I. 95%=0.14-0.28) and 0.12 (C.I. 95%=0.04-0.41). There is a sharp difference between those socially organized and those without social reference, who seek occasional and temporary hospitality in available structures.

[Injury-related Emergency Department visits in Tuscany (Italy)]. / Accessi ai Pronto Soccorso toscani per cause traumatiche.

The frequency of injuries underscores the need for planning and implementing efficient injury surveillance systems. Emergency Departments represent the preferred source of data on injuries but information regarding emergency department visits is not always available. We examined the feasibility of utilizing emergency department data to monitor the occurrence of injuries in Tuscany. Each of the 52 public hospital emergency departments operating in the 12 local health units of Tuscany were asked to provide yearly data on the numbers and types of injury-related visits since the year 2003. They were also asked whether attendance records were computerised. This data was used to estimate the number of injury-related visits by cause of injury, at the regional level. The results of this study were combined with those of a previous study to estimate the number of hospital admissions for motor vehicle accidents in Tuscany in 2004. The latter was then compared to corresponding data from the hospital discharge abstract database. In 2002, the number of emergency departments with computerised attendance records was only 27 while in 2005 it was 43 and a greater number of emergency departments were able to codify each type of injury-related visit. A slight decrease was observed in the total number of visits for all causes, between 2002 and 2004 (respectively 1.314.874 and 1.256.509). In 2002, motor vehicle accidents were the most frequent cause of injury-related ED visit (8%), followed by home injuries (7.2%) and workplace accidents (6%). In 2004, home injuries were the most frequent type of injury (7.5%) followed by motor vehicle accidents (6.9%) and workplace injuries (5%). We estimated 6836 hospital admissions for the year 2004, while only 4800 admissions were registered in the discharge abstract database in the same year. Computerisation of attendance records and improvement in codification of data are a good starting point in utilizing emergency department data for epidemiological surveillance of injuries.