Solid urban wastes and toxicity among residents of Ghemme and Cavaglio (Piedmont region, Italy). Results from a historical cohort 1980 to 2013.

BACKGROUND: There is plenty of evidence for a relation between certain environmental pollutants and ecological damage. Landfills, especially if uncontrolled and located near human settlements, may cause an increase in cancer incidence and in various diseases. METHODS: The area of study is represented by the cities of Ghemme (population 6,139) and Cavaglio (population 2,216), in the province of Novara, northern Italy. A solid urban waste landfill is located between these two cities. We analysed mortality data from 1980 to 2013 among subjects residing in the two cities since at least 6 months, according to distance from the landfill. Mortality data was obtained from the National Statistics Institute ( ISTAT). RESULTS: A mortality increase was shown, according to Cox model, in residential areas closer to the landfill. In Cavaglio D'Agogna the total number of cancer deaths occurring in the 0-44 age group and the total death causes were relevant. A significant increase in leukemia cases was detected in Ghemme city. CONCLUSIONS: Our analysis shows an increased risk of diseases (cancer and other diseases), with a possible environmental etiological link.

Mortality in the district of Ghemme and Cavaglio d'Agogna, site of an urban waste landfill.

INTRODUCTION: Aim this study is to assess anomalous mortality rates from 2002 to 2012, in the municipalities of Ghemme and Cavaglio d'Agogna where a landfill has been active. Before the opening of the landfill (1988), studies highlighted the presence of noxious substances, in the ground layers, and not in the groundwater. Goal of our research is to monitor the health levels of the population in an area, with attention to long/midterm effects. MATERIALS AND METHODS: We performed the analysis on data of the National Institute of Statistics death records, and produced indirect standardized rates (SMR) using the rates of Local Healthcare Agencies (ASL) of Novara and Vercelli as reference population. RESULTS: We found various excesses in the population of the two municipalities, in particular for age 0-44 and congenital malformations but also for urogenital and gastrointestinal tumors that have been linked in letterature to housing in dump prossimity. CONCLUSIONS: Further analysis of morbidity and inferential studies will help to define the health status in the area. Such a study will possible help to reduce the greater risks and meet the demands of better public health policy.

The high-dimensional space of human diseases built from diagnosis records and mapped to genetic loci.

Human diseases are traditionally studied as singular, independent entities, limiting researchers' capacity to view human illnesses as dependent states in a complex, homeostatic system. Here, using time-stamped clinical records of over 151 million unique Americans, we construct a disease representation as points in a continuous, high-dimensional space, where diseases with similar etiology and manifestations lie near one another. We use the UK Biobank cohort, with half a million participants, to perform a genome-wide association study of newly defined human quantitative traits reflecting individuals' health states, corresponding to patient positions in our disease space. We discover 116 genetic associations involving 108 genetic loci and then use ten disease constellations resulting from clustering analysis of diseases in the embedding space, as well as 30 common diseases, to demonstrate that these genetic associations can be used to robustly predict various morbidities.

Pediatric encephalic ultrasonography: the essentials.

Nowadays, cranial ultrasonography (US) of the newborn represents the first imaging method in brain damage study and its possible outcomes. This exam is performed using the natural fontanelles, especially the anterior one. It is fast, non-invasive and does not produce any side effect. Ultrasonographic examination is usually performed in cases of prematurity, especially in children with birth weight less than 1500 g, because important informations about the possible presence of pathologies such as cerebral hemorrhage and hypoxic-ischemic encephalopathy are given. This approach can be useful also in the study of pre- and post-natal infections, for example, type II Herpes Simplex virus or Cytomegalovirus infections, or pointing out vascular malformations such as vein of Galen aneurysm. Although less important than methods such as computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of trauma and tumors, ultrasound can provide useful informations or be used in first instance in the suspicion of a brain mass.

Incidence of amyotrophic lateral sclerosis in the province of Novara, Italy, and possible role of environmental pollution.

OBJECTIVE AND METHODS: Based on nationwide death certificates, a cluster of amyotrophic lateral sclerosis (ALS) has been reported in the area of Briga (Novara province, northern Italy), known for its severe environmental contamination. We further investigated this finding, by following up with the collection of recent incidence ALS data in 2002-2012 of Novara province, also to assess the possible long-term effects of environmental pollution in that area. RESULTS: In the whole Novara province we identified 106 ALS cases, of which 35 were from the Briga area. Incidence rates of Novara province were 3.98, 5.14 and 2.97 for the total population, males and females, respectively, compared with the Briga area where they were 4.65, 4.27 and 4.98, respectively. The ratio of observed-to-expected ALS cases in the Briga area, using incidence of the rest of Novara province as a reference, was 1.17 (95% CI 0.81-1.62), with a value of 0.83 (95% CI 0.47-1.37) in males and 1.68 (95% CI 1.03-2.60) in females. CONCLUSIONS: Overall, our study did not confirm previous findings of an excess ALS incidence in an area characterised by severe environmental heavy metal pollution, and it suggests the need to interpret with caution clusters identified through mortality data.

[Family psychoeducational interventions for schizophrenia in routine settings: impact on patients' clinical status and social functioning and on relatives' burden and resources]. / Interventi psicoeducativi familiari per la schizofrenia nella pratica clinica: effetto sullo stato clinico e la disabilità dei pazienti e sul carico e le risorse familiari.

OBJECTIVE: This study explored the effectiveness of a psychoeducational family intervention for schizophrenia on patients' clinical status and disability and relatives' burden and perceived support. METHODS: The study has been carried out in 17 mental health centres. In each of them, 2 professionals were trained in a psychoeducational intervention and applied it for six months with families of users with schizophrenia. At baseline and six months later, patients' clinical status and disability, and relatives' burden, social network and professional support were assessed by validated tools. RESULTS: Of the seventy-one recruited families, 48 (68%) completed the intervention. At six months, a significant improvement was found in patients' clinical status and social functioning, as well as in relatives' burden and social and professional support. In particular, the percentage of patients with poor or very poor global social functioning dropped from 50% to 27% at six months. Forty percent of patients and 45% of relatives reported a significant improvement in their social contacts over the intervention period. CONCLUSIONS: The results of this study confirm the hypothesis that psychoeducational family interventions may have a significant effect on social outcome and family burden in schizophrenia when provided in routine conditions.

[Benefits and difficulties in implementing family psychoeducational interventions for schizophrenia in mental health services: results from a multicentre Italian study]. / Aspetti positivi e difficoltà nella diffusione degli interventi psicoeducativi familiari nella pratica clinica: uno studio multicentrico in 23 CSM italiani.

AIMS: This study aims to explore: a) the feasibility of psycho-educational interventions for families of users with schizophrenia in clinical practice by trained staff; b) the benefits and problems encountered by professionals in the use of these interventions. METHODS: 46 professionals from 23 Italian Mental Health Services (MHS) attended at a three-module training course in psycho-educational interventions and four supervisions in the subsequent year. Following the course, participants provided the intervention to families of users with schizophrenia. The difficulties and benefits encountered by trainees to use the intervention were registered on the Famnily Intervention Schedule. RESULTS: 83% of the participants completed the training course. Following the course, the intervention started in 71 families from 17 MHS. 76% of trainees provided the intervention to 2-5 families, while 13% of them only held informative sessions on schizophrenia. During the supervision period, the organisational difficulties experienced by the professionals were stable, while the benefits increased. Differences in benefits and difficulties were detected in relation to the trainees' experience and professional roles. CONCLUSIONS: It is possible to introduce psycho-educational interventions in MHS after a relatively brief period of training and supervision of the staff. Organisational difficulties need to be addressed to increase the dissemination of these interventions on a large scale.