[Economic class syndrome: epidemiological features and preventive measures]. / La sindrome da classe economica: aspetti epidemiologici e misure di prevenzione.

The term "economic class syndrome" is generally used to describe the occurrence of venous thromboembolism (VTE) in travelers after long-distance airline travel in economic class. However, cases of VTE have also been reported in business class travelers and in subjects exposed to prolonged periods of immobilization while using other forms of transportation such as automobile, train, and bus. VTE manifests with deep vein thrombosis and pulmonary embolism but may also present with less severe, reversible manifestations such as headache, vertigo, and respiratory symptoms. Epidemiological studies have shown that the risk of VTE doubles following airline travel lasting longer than four hours. The risk of VTE increases with increased duration of air travel even in the presence of multiple stop-overs. In subjects with known risk factors, incidence of VTE depends on the degree of risk (low, medium, high) and on the duration of the flight. The main factor leading to VTE is prolonged immobilization and the pathogenesis is based on Virchow's triad: venous stasis, vessel wall injury, and hypercoagulability of blood. Specific characteristics of airline travel such as jet lag, low air quality and dehydration may increase the risk of VTE with respect to other forms of travel. This article discusses epidemiological aspects and pathogenesis of travel-related VTE and prophylactic measures that should be undertaken.

[Multiple chemical sensitivity: a study in a young adult population in Italy]. / Sindrome da sensibilità chimica multipla: studio di una popolazione di giovani adulti.

Multiple chemical sensitivity (MCS) is a chronic recurrent condition characterized by reduced tolerance to various environmental agents or to a class of chemical substances. An evidence-based diagnostic panel is not available nor is there a universally accepted definition of the syndrome. This study retrospectively evaluated the prevalence of MCS symptoms and associated risk factors in a sample of 660 young adults, by means of a structured questionnaire. Symptoms of MCS were found to be widely distributed in the sample population and several of the main risk factors suspected to be associated with MCS were not consistently associated with these symptoms in the sample. On the other hand a significant correlation (p<0.05) was found between atopy and symptoms. Further studies are therefore needed to evaluate this association and reach a unifying definition of the syndrome.

Immunization practices in athletes.

INTRODUCTION: Immunization practices of athletes is a topic of growing interest in preventive medicine. Several reasons contribute to support such statement including: the demonstrated decrease of the immune response of athletes, the recent increase in vaccine-preventable diseases, the increasing mobility of professional athletes and coaches and sports doctors' frequent lack of awareness of on the issue of athletes' immune prophylaxis. RESULTS: This review offers a concise and schematic framework to the immunization practices in athletes, based on the most recent scientific evidences and the vaccine schedules proposed by international organizations and scientific societies including the recent "Life Vaccination Schedule" proposed by four Italian Scientific Societies and Professional Associations. CONCLUSION: vaccination in athletes, if correctly managed, represents a powerful, costly and long lasting tool for athletes sport teams.

Influenza vaccination coverage among medical residents: an Italian multicenter survey.

Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P<0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P<0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future.