Dermasilk briefs in vulvar lichen sclerosus: an adjuvant tool.

OBJECTIVE: : The purpose of our study was to evaluate whether briefs made of Dermasilk fabric could be an adjuvant tool in the management of vulvar lichen sclerosus (LS). MATERIALS AND METHODS: : A controlled, randomized, double-blind study versus placebo was conducted, comparing Dermasilk versus standard cotton briefs in patients affected by LS during treatment with clobetasol propionate 0.05% ointment and vitamin E moisturizer. For each patient, an evaluation of objective genital signs and subjective symptoms typical of LS was recorded before the start of treatment, after 1 month, and after 6 months of the study. Statistical analysis was performed with SPSS 17.0 for Windows. RESULTS: : Forty-two women affected by LS were recruited and divided into those wearing Dermasilk or cotton briefs. Patients wearing Dermasilk briefs showed a better improvement in the clinical symptoms of burning sensation, skin irritation, and pain (Fisher test, p < .0001) compared with the cotton placebo group. The improvement in itching was also faster in the Dermasilk group (Fisher exact test, p < .05). Erythema also showed a better improvement in the Dermasilk group (Fisher test, p < 0.05). CONCLUSIONS: : Dermasilk fabric seems to be a useful adjunct to topical treatment in producing a better and more rapid control of symptoms in patients with LS.

Fourteen years of compost application in a commercial nectarine orchard: effect on microelements and potential harmful elements in soil and plants.

The objective of this experiment was to valuate, after 14 years, the impact of annual compost applications on micronutrient and potentially toxic trace elements on nectarine tree uptake and soil fertility. The study was performed in the Po valley, Italy, on the variety Stark RedGold (grafted on GF677). Since orchard planting, the following treatments were applied, in a randomized complete block design, with four replicates: 1. unfertilized control; 2. mineral fertilization (N was supplied as NO3NH4 at 70-130 kg ha-1 year-1); 3. compost at 5 t DW ha-1 year-1; 4. compost at 10 t DW ha-1 year-1. The actual rate of application was 12.5 (LOW) and 25 (HIGH) t ha-1, since compost was concentrated in the tree row. Compost was made from domestic organic wastes mixed with pruning material from urban ornamental trees and garden management and stabilized for 3 months. The supply of compost HIGH induced an enrichment of soil total Cu, Zn and Cd, and a decrease of Fe and Co concentration; with values always below the European threshold limits for heavy metals in the soil. In addition, compost (at both rates) increased availability (DTPA-extractable) of Fe, Mn and Zn, Cd, Ni, and Pb in the top soil (0-0.15 m). Total micronutrient and trace element tree content was not affected by fertilization treatments; however, the recycled fraction returned to the soil at the end of the season through abscised leaves and pruned wood of Cu, Fe, Mn and Zn was increased by mineral fertilization; Fe and Zn also by compost HIGH. Our data show that the introduction of compost at both 12.5 and 25 t ha-1 year-1 in the row did not increase the risk of pollution related to potentially toxic trace elements and at the same time increased the bioavailability of Fe, Mn and Zn.

Use of the Italian version of the Pediatric Asthma Quality of Life Questionnaire in the daily practice: results of a prospective study.

BACKGROUND: Asthma is a serious global health problem and its prevalence is increasing, especially among children. It represents a significant social and economic burden, and it can severely affect the health-related quality of life (HRQL) of patients. Among the numerous questionnaires aiming at evaluating asthma HRQL in children, the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) has proved to have good measurement properties.The present study was aimed at investigating the possible role of the Italian, self-administered version of the PAQLQ in the routine clinical evaluation of children affected by bronchial asthma. METHODS: 52 Italian children and adolescents (40 males and 12 females), aged 6 to 17 years, affected by allergic asthma, were enrolled. Each patient was evaluated twice, and at each visit asthma control and severity were assessed, spirometry was performed and the patients completed the self-administered version of the PAQLQ. RESULTS: The questionnaire was well-accepted and understood by the children. Children showed an overall good quality of life, with mild impairment in the activity and emotional function domains. The PAQLQ showed an overall good correlation with the clinical and functional indexes that are normally evaluated in follow-up visits of asthmatic patients. The PAQLQ appeared to be strongly related to asthma control, both at the first (p < 0.01) and second (p < 0.001) time of the study. The PAQLQ was also seen to decrease with increasing asthma severity. The results suggest a better compliance of the children towards completion of the questionnaire at t1. Finally, the PAQLQ does not appear to discriminate HRQL in patients with good lung function. CONCLUSION: The Italian version of the PAQLQ is a quick-to-administer aid to clinical activity and can add valuable information to symptom reports, objective measurements and clinical assessment of asthma control and severity in daily clinical practice. Re-administration at each follow-up visit allows HRQL to be monitored over time.

Soil-plant nitrogen pools in nectarine orchard in response to long-term compost application.

The search for sustainable source of N, the need of soil organic matter restoration, along with the call for recycling of organic wastes has led to a rise of the use of organic fertilizers. The aim of the present experiment was to evaluate: the effectiveness of compost application as a N fertilizer, the impact on N distribution in soil and plant and on tree performances, in a long-term experiment (14 years). The study was carried out in the Po valley, Italy and, since orchard planting (2001), the following treatments were applied: 1. unfertilized control; 2. mineral fertilization; 3. compost at a rate of 5 t DW ha-1 yr-1; 4. compost at a rate of 10 t DW ha-1 yr-1. Soil total N, potentially mineralizable, microbial and extractable N were higher in compost in comparison to mineral (fertilizer). The effect was found both in the row and in the inter-row and the rise of N fractions was evident in the shallowest soil layer of the row. Soil mineral, potentially mineralizable N was increased by mineral (11.1 mg kg-1) and compost 10 (12.4 mg kg-1) fertilization compared with control (6.7 mg kg-1). Vegetative growth and yield were increased in trees treated with mineral and compost 10; moreover, these plants were able to recycle (66.1 and 70.5 kg ha-1 yr-1, respectively) and remobilize (41.5 and 48.7 kg ha-1 yr-1, respectively) a higher amount of N than those of control and compost 5. In conclusion, organic fertilization strategy promoted the buildup of soil N reserve, meaning a capacity of the ecosystem to sequestrate N. The application of compost 10 showed a similar effect on plant growth and production as mineral fertilization, but introduced the advantage of the use of a cheap, renewable waste material, providing a new insight on N fertilization management.

Delivery systems for agriculture: Fe-EDDHSA/CaCO3 hybrid crystals as adjuvants for prevention of iron chlorosis.

Fe-EDDHSA/CaCO3 hybrid crystals are synthesized and tested in vitro to determine their effect in treating iron chlorosis in kiwifruit plants, used as a proof of concept. Under the alkaline conditions provided by the calcareous substrate, plants release protons that dissolve the hybrids and trigger Fe uptake. These CaCO3 hybrids represent a new system for active molecule delivery in agriculture.

Causes of hospitalization among extra-European Union children in a large hospital of Northern Italy, in a five-year observation period.

The hospitalizations of 1,239 patients aged 14 years or less and immigrated from extra-European Union countries in Italy were assessed in the 6-year period, from 1999 to 2004. The main demographic and clinical features were analyzed according to several variables, also distiguishing patients aged less than one year, from those aged 1-14 years. The introduction of a deed of indemnity law in 2001 profoundly changed the pattern of admissions and health care needs and exploitation during subsequent years, leading to a massive regularization of clandestine immigrants.

Time trends in health care needs of non-EU citizens from developing countries, admitted to a general hospital in northern Italy.

Hospitalizations of foreign patients from developing countries outside the European Union were examined for the period 1999-2004, focusing on infectious diseases and on pregnancy issues. Patients over 14 years old had 6,003 admissions, leading to 7,231 overall diagnoses. During the 6-year study period, female hospitalizations increased steadily, with a peak in 2002 (p .001). This trend was mainly due to the rise in women from Eastern Europe (p .001), which occurs at a younger mean age versus that of males (p .001). Admission of illegal immigrants, performed on an emergency basis, accounted for an average of 9.4%. This phenomenon was very frequent in 1999 (43% of admissions), but dropped sharply after 2002 (p .001), caused by changes in Italian law. The prevalent women diagnoses were ob/gyn ones: voluntary pregnancy interruption, spontaneous abortion or pregnancy complications in 30.6% of cases, and childbirths or controls of pregnancies with a favourable outcome in 18.2% of patients. These diagnoses covered nearly 50% of hospitalizations of migrant women: other admissions were due to organic, dysmetabolic, or functional disorders, while infectious diseases were less frequent (4.6%). Among men, dysmetabolic disorder and organic-degenerative diseases, or functional illnesses (36.2%), were prominent, and significantly more frequent versus women (p .001), as well as post-traumatic diseases (16.5%), and infectious illnesses (12.1%; p .001). Also generic-undefined diagnoses were proportionally numerous (6.6%): cultural-language deficiencies affected the physician-patient relationship. Among infectious diseases, the main causative organisms were Mycobacterium tuberculosis (14.9%), HIV (7.1%), HBV (3.3%), and HCV (2.6%). Upper-lower airways represented the most involved organ system (45% of discharges), followed by the gastroenteric tract (16.4%), and skin-soft tissues (7.4%), while systemic infectious diseases accounted for 14.9% of episodes. Such disorders predominated (up to 90% of cases) among non-regular migrants during 1999-2000, while after 2002 an increase in infectious disorders was observed among patients from Eastern Europe. From a health care-social perspective, although a reduced incidence of infectious diseases did not occur, the possibility of attributing them to individuals of ascertained identity and housing makes it possible to trace index patients, and ultimately strive towards well-planned and effective therapeutic-preventive interventions.

Long-term follow-up of atopic dermatitis: retrospective analysis of related risk factors and association with concomitant allergic diseases.

BACKGROUND: The association of atopic dermatitis (AD) with other allergic diseases has been extensively studied; however, there is a lack of reports focusing on long-term studies of the clinical and allergometric evaluations observed during the course of AD in respect to its evolution and association with allergic responses in affected patients. OBJECTIVE: The aim of this study was to evaluate, with defined criteria of clinical diagnosis, severity assessment, and objective allergometric test at the time of inclusion, the natural course of AD, the factors influencing its healing or persistence, and the appearance of other allergic diseases with particular focus on asthma and the presence of specific immunoglobulin E at first observation. METHODS: This study included only children, aged between 6 and 36 months, whose first clinical examination was made between 1981 and 1989. A total of 252 children satisfied these criteria. A semistructured interview was performed by the physician using a preformed questionnaire, which was completed for 205 children (104 boys and 101 girls). RESULTS: AD had completely disappeared in 124 cases (60.5%). Other allergic manifestations that appeared included asthma in 70 cases (34.1%) and rhinoconjunctivitis (RC) in 118 cases (57.6%). Generally the average age of patients recovering from AD was higher in severe AD (6.0 +/- 3.5 years) than in its moderate or mild forms (5.8 +/- 4.5 and 5.5 +/- 3.9 years, respectively). This phenomenon was particularly evident in children with hen's egg sensitization, who show a longer persistence of the condition (Student t = 2.462 and P < .02). The initial severity score of AD was found to be associated with a high frequency of asthma appearance (Pearson chi2 = 14.225 and P < .001). Hen's egg sensitization was significantly related to the appearance of asthma (Fisher's exact test P < .007) and RC (Fisher's exact test P < .05). A retrospective analysis of related risks factors and their association with concomitant allergic diseases in our case studies shows that the egg sensitization, severity of AD, and onset of RC were positively related to the occurrence of asthma. In addition, our analysis shows that, although the appearance of RC was proportional to the incidence of atopy and asthma, it was inversely related to the persistence of AD (corrected odds ratio confidence intervals <1). LIMITATIONS: The study includes children referred to the hospital. However, it is the practice of local national health pediatricians to send all patients with suspected AD, whatever the severity grade, to hospital specialists to perform allergometric assessment. CONCLUSION: The use of defined criteria of clinical diagnosis for the determination of the condition's severity, along with the performance of objective allergometric tests at the time of inclusion, shows that the course of AD is significantly related to egg sensitivity. In addition, the average healing time is higher in egg-sensitive patients affected by the most severe form of AD than in mild or moderate cases.

Admission of foreign citizens to the general teaching hospital of Bologna, northeastern Italy: an epidemiological and clinical survey.

BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy), all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG) features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%), including 2,542 males (34.8%) and 4,769 females (65.2%). Males had a mean age of 36.8+/-14.7 years, while females were aged 30.8+/-12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively) from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8%) were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%), and pregnancy complications (18.7%), followed by psycho-social disturbances (5.9%), malignancies (5.1%), gastrointestinal diseases (4.7%), and voluntary pregnancy interruption (4.4%). Among men, the most frequent causes of admissions were related to trauma (15.9%), followed by gastroenteric disorders (12%), heart-vascular diseases (8.9%), psycho-social disorders (8.4%), respiratory (7.1%), kidney (6.1%), liver (5.2%), and metabolic (4.9%) diseases, and alcohol or substance abuse (4.2%). Infectious diseases (alone or with concurrent disorders) were reported in 881 discharged individuals, representing 12.1% of the 7,312 DRGs attributed to foreign patients. The comprehensive patient population discharged from our hospital with at least one infectious disease diagnosis had lower rates of respiratory tract infections, followed by chronic viral hepatitis, HIV infection and related diseases, enterocolitis, pulmonary tuberculosis, pyelonephritis, severe skin and soft tissue infection, meningoencephalitis, and malaria, as the most frequently-reported disorders. CONCLUSIONS: Our survey, through a combined analysis of both DRGs and discharge diagnoses, allowed us to conclude that 12.1% of foreign citizens hospitalized at our General teaching Hospital of Bologna (Italy) suffered from at least one infectious disease. Respiratory tract, liver, and gastrointestinal infections, and HIV infection, were found with an appreciable frequency among discharge diagnoses, while the frequency of malaria and meningoencephalitis was lower, compared with other series. Among disorders other than infectious diseases, obstetric-gynecological conditions and post-traumatic episodes (for male patients) were the most frequent causes of hospitalization.

[HIVAb, HCVAb and HBsAg seroprevalence among inmates of the prison of Bologna and the effect of counselling on the compliance of proposed tests]. / Prevalenza per HIV, HBV e HCV nei detenuti del carcere di Bologna ed effetti del counselling sul livello di adesione alla proposta dei test.

OBJECTIVES: The aims of the study were to evaluate the HIVAb, HCVAb and HBsAg seroprevalence among Italian and foreign inmates of the prison of Bologna, to evaluate if the extensive counselling of "new" inmates has significantly enhanced adherence to laboratory tests. DESIGN: The serological status was determined by a blood withdraw following the informed consent. Before asking their consent, patients were informed by cultural mediators who had been instructed about the aims of the study/exam during introductory meetings. The initial step managed by mediators was followed by further individual counselling interventions, carried out by hospital infective disease unit, prison and prison drug abuse service physicians. The laboratory tests were performed in an external structure. SETTING: Prison of Bologna. PARTICIPANTS: The study was conducted on 433 subjects among a whole population of 900 inmates in the local prison: 390 subjects were males (90.1%) and 43 were females (9.9%). The median age of the whole population was 34.86 years (+/- 9.9). The studied population counted 147 (33.9%) intravenous drug users (IDU) and 286 not addicts (66.1%). As regards nationality, 212 subjects were Italian (48.9%) and 221 (51.1%) foreigners. Among the total 433 inmates considered, 78 (18%) were known as previous IDU with conviction history or condemned to long term sentences, while 59 (13.6%) were inmates recently convicted active IDU assisted by the internal drug abusers service. The third group was composed by 296 inmates imprisoned during the summer (103 Italians and 193 foreigners) self declared not IDU. RESULTS: A. 12.5% of inmates were HIV positive, 8.1% HBV positive and 31.1% HCV positive. 25 subjects were found positive both to HIV and HCV; 1 both to HIV and HBV and 5 to HIV, HBV and HCV. HIV positivity is more common among Italian vs. foreigners inmates, among IDU vs. not IDU. HCV positivity is more common among Italian vs. foreigners inmates, and among IDU vs. not IDU. The distribution of HBV seropositivity among the different groups shows no statistically significant differences. All subjects receiving multi-focal counselling reached better compliance levels: 10% vs. 1% for HIV, 16% vs. 1% for HBV and 35% vs. 0.3% for HCV, with statistically significant coefficients of contingency. CONCLUSIONS: In the prison of Bologna drug addiction is prevalent in italian seropositive personers and it is often associated with HIV and HCV positivity. Foreign inmates, mostly in the not-IDU group, show a lower prevalence of these two infections. Multi-focal counselling before test increased significantly the adherence of inmates to the study.

[Infection control in dental health care settings: results of a survey on current disinfection practices]. / La disinfezione in ambiente odontoiatrico: risultati di una indagine sulle procedure adottate.

This study was performed to identify which disinfection procedures are currently used in dental offices and to evaluate staff knowledge regarding infection control. Information was collected by means of a questionnaire to which 226 subjects responded. Glutaraldehyde was found to be the most commonly used disinfectant for surfaces/drill units, handpieces and instruments; however, half of the respondents did not specify which disinfectants they used. Eighty-four percent of the respondents reported contact times, which in some cases were found to be insufficient; 43,4% stated that containers are washed and disinfected each time the disinfectant is replaced; 58.8% reported that dental handpieces and instruments are precleaned prior to sterilization while 73% believe that increased attention during performance of work practices could reduce the risk of infection. These findings suggest that dental health care personnel need to be better sensitized toward infection control measures and should be offered periodical training on the proper implementation of practice guidelines.

Operative treatment of flatfoot with talocalcaneal coalition.

Rigid flatfoot or peroneal spastic flatfoot often is associated with a congenital fibrous, cartilaginous, or osseous union of two tarsal bones or more, potentially causing great difficulties in its treatment. Since 1996, 12 patients (14 feet) with painful flatfoot and restricted motion of the hindfoot attributable to talocalcaneal coalition, were treated by resection of the coalition and subtalar arthroereisis by a bioreabsorbable implant. The results were evaluated by the ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society. These clinical results also were evaluated statistically. Radiographs and computed tomography scans were taken preoperatively and postoperatively. Eight (57.1% of patients) had excellent results, three (21.4% of patients) had good results, and three (21.4% of patients) had fair results. No poor results, or subjective or objective complications were reported. On the basis of these early results, arthroereisis by implanting a bioreabsorbable device after removal of the tarsal coalition, seems to be an effective procedure for the treatment of symptomatic flatfoot associated with talocalcaneal coalitions: correcting the relationship between talus and calcaneus, restoring the alignment of the hindfoot, and reducing pain.

Causes of hospitalization among extra-European Union children in a large hospital of Northern Italy, in a five-year observation period

The hospitalizations of 1,239 patients aged 14 years or less and immigrated from extra-European Union countries in Italy were assessed in the 6-year period, from 1999 to 2004. The main demographic and clinical features were analyzed according to several variables, also distiguishing patients aged less than one year, from those aged 1-14 years. The introduction of a deed of indemnity law in 2001 profoundly changed the pattern of admissions and health care needs and exploitation during subsequent years, leading to a massive regularization of clandestine immigrants.

Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: an epidemiological and clinical survey

BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy), all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG) features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15 percent), including 2,542 males (34.8 percent) and 4,769 females (65.2 percent). Males had a mean age of 36.8±14.7 years, while females were aged 30.8±12.2 years. In the assessment of the areas of origin, 34.6 percent of hospitalizations were attributed to patients coming from Eastern Europe, 15.3 percent from Northern Africa, 7.3 percent (comprehensively) from Western Europe and United States, 6.9 percent from the Indian subcontinent, 5.9 percent from sub-Saharan Africa, 5.7 percent from Latin America, 4.1 percent from China, 2.5 percent from the Philippines, and 1.1 percent from the Middle East. Among women, most hospitalizations (58.8 percent) were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1 percent), and pregnancy complications (18.7 percent), followed by psycho-social disturbances (5.9 percent), malignancies (5.1 percent), gastrointestinal diseases (4.7 percent), and voluntary pregnancy interruption (4.4 percent). Among men, the most frequent causes of admissions were related to trauma (15.9 percent), followed by gastroenteric disorders (12 percent), heart-vascular diseases (8.9 percent), psycho-social disorders (8.4 percent), respiratory (7.1 percent), kidney (6.1 percent), liver (5.2 percent), and metabolic (4.9 percent) diseases, and alcohol or substance abuse (4.2 percent). Infectious diseases (alone or with concurrent disorders) were reported in 881 discharged individuals, representing 12.1 percent of the 7,312 DRGs attributed to foreign patients.