Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy.

INTRODUCTION: In recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC).A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed. MATERIALS AND METHODS: Annex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p < 0.05). The statistical analyses were performed by SPSS and Stata software. RESULTS: A total of 3,454 HCWs participated in the project: 1,236 males and 2,218 females.The sample comprised: physicians (26.9%), trainee physicians (16.1%), nurses (17.2%) and other professional categories (9.8%). Low VC was generally recorded. Higher VC was found with regard to polio, hepatitis B, tetanus and diphtheria, while coverage was very low for measles, mumps, rubella, pertussis, chickenpox and influenza (20-30%). CONCLUSIONS: This study revealed low VC rates among HCWs for all the vaccinations. Measures to increase VC are therefore necessary in order to prevent HCWs from becoming a source of transmission of infections with high morbidity and/or mortality both within hospitals and outside.

Italian position paper on urticaria. Italian Board on Urticaria.

The Italian Board on Urticaria has prepared a document focusing on the definition and classification of urticaria, taking into account the recent progress in identifying the causes, eliciting factors, and pathomechanisms of this disease. As urticaria has a profound impact on the quality of life, effective treatment is important. Therefore, specific treatment options for the management of urticaria are evaluated on the basis of the recent literature. Non-sedating H(1) antihistamines are recommended as the first-line treatment as they have proven effective in several randomized double-blind controlled studies. Dosages higher than those recommended may be necessary in some cases. However, additional or alternative therapies may be required for different urticaria subtypes and in view of individual variations in the course of the disease and response to treatment. Immunosuppressive drugs such as corticosteroids are not recommended for long-term treatment due to unavoidable, severe adverse effects.

[Dermatitis and VDU work]. / Dermatiti e lavoro con VDT/PC.

Skin disorders like rosacea, seborrhoeic dermatitis, non-specific erythema and acne can be VDU work linked. At present, many environmental and individual causes are involved in the development of these disorders, but the former appear to be the issue to investigate more in depth.

Genomic DNA fingerprints and phenotypic characteristics of serotype B Haemophilus influenzae isolates from Italy.

Three different restriction enzymes (PstI, EcoRI, SspI) were used to analyze the total genomic DNA fingerprints of 52 Haemophilus influenzae type b (Hib) isolates collected between 1982 and 1992 from patients and carriers in central-northern Italy. The same isolates were also characterized by biotyping and antimicrobial agent susceptibility typing. In addition, 13 Hib reference strains from Sweden and the Netherlands were subjected to DNA fingerprinting and compared to Italian isolates. Both genotypic and phenotypic analysis revealed low variability among the Italian study isolates. Most were biotype I and all study isolates but one were susceptible to ampicillin, chloramphenicol, rifampin, third-generation cephalosporins and cotrimoxazole. Among the 52 Italian isolates, 3 distinct DNA patterns were identified, and 88.5% of study strains belonged to the same DNA group. There was sharing of the predominant DNA profile among isolates cultured in different years from different geographical areas and different invasive, respiratory and surface infections. However, another DNA pattern was only found in carrier isolates and in one surface infection isolate. Comparison by DNA fingerprinting showed that the majority of Italian isolates were closely related to most of the analyzed Swedish and Dutch reference strains, previously shown by other techniques to be predominant in those areas. This finding provides additional support for the hypothesis that there may be a dominant European Hib clone. The results show that DNA fingerprinting is a reliable method for Hib characterization and may be a useful additional epidemiological tool for this microorganism.

Antitetanus immunity in a sample of adult population from the Siena area (Italy).

1045 subjects (427 males and 618 females) from the Siena area, aged 20-85, were screened for tetanus antitoxin by the means of a passive haemogglutination assay. 32% of subjects was found protected against tetanus (antitoxin titre greater than or equal to 0.1 I.U./ml), 34.7% resulted partially protected (titre greater than or equal to 0.01 - less than 0.1 I.U./ml), and 33.3% was found unprotected (titre less than 0.01 I.U./ml). The protection rate was higher among males (44.9%) than among females (23%) and showed a definite age-related decrease. Within each age group, the protection rate was higher among males. The lowest protection rate (3.2%) was observed among females aged 70 or more. Analysis of the protection rate according to the individuals' occupation showed the highest value (44.9%) among workmen and the lowest (12.1%) among housewives. The anamnestic criterion was found exceedingly unreliable to assess the individual's immune status. Results, which are consistent with present tetanus italian epidemiology, are discussed for their implications relating to a possible improvement of current antitenus immunization policy.

Antitetanus immunity in newborn findings in a sample of population in the Siena area (Italy).

Immunity against tetanus in newborn and in mother-newborn couples was studied in a sample of population from the Siena area, Italy. Mother-newborn antitetanus antibody transfer and the decrease of passively acquired antitoxin, in newborn after birth, were evaluated too. Antitetanus immunity was detected by a passive haemagglutination assay. A high rate of immunologically unprotected newborns was found owing to the low immunisation rate in mothers. The important role played by general prophylactic measures in neonatal tetanus prevention is remarked and a systematic antitetanus immunity screening, during pregnancy, is suggested in order to enhance antitetanus protection in newborns and mothers by immunisation practices.

[Nucleic acids in the liver of rat treated with "E. coli" O 127 lipopolysaccharide (author's transl)]. / Gli acidi nucleici nel fegato di ratto trattato con lipopolisaccaride di "E. coli" O 127.

The Authors have studied the variations of nucleic acids, proteins and histological aspect in the liver of rats, treated with 1 mg of E. coli ) 127 lipopolysaccharide and killed at 24th, 48th, 72th, 96th hour after the inoculation. The endotoxin determines an increase of nucleic acids and a reduction of hepatic proteic contents. The histological observation shows throw-back phenomenons of the hepatocyte with hyperplasy and hypertrophy of Kupffer cells at 24th hour, while at following intervals the phenomenous of hepatic rigeneration emphasize.

[Effect of tetanus toxin on rat liver]. / Azione della tossina tetanica sul fegato di ratto.,

The effects of tetanus toxin on the rat liver, employing as parameters the DNA and protein contents, have been studied. In the animals treated with tetanus toxin the DNA and the total liver proteins appear to be increased in a statistically significant way to comparison with the controls.

[The effects of staphylococcal alpha toxin on regenerating liver (author's transl)]. / Effetti della tossina stafilococcica alfa sulla rigenerazione epatica

The effects of staphylococcal alpha toxin on regenerating liver of partially hepatectomized rats are studied. Sixty six rats are used. They are divided into three groups of twenty two animals each one. The first group included untreated animals, the rats of second and third group are injected with 0,1 UE of staphylococcal alpha toxin, respectively soon after hepatectomy (second group) and after twenty two hours (third group). As parameters we used: mitotic activity, percentage of hepatic regeneration, the contents of liver water and proteins. The results are: a low letality in all the animals, a lower mitotic activity in all treated animals than in the intact ones, the percentage of restoration, the contents of water and proteins are the same in all the animals of the three groups. The AA. conclude that staphylococcal alpha toxin has a little negative mitotic effect on partially hepatectomized rats liver.

[Changes of various lipid fractions in experimental intoxication with diphtheric and tetanic toxins]. / Variazioni di alcune frazioni lipidiche nell'intossicazione sperimentale da tossine difterica e tetanica

In the present study , the Authors have examined the effects of diphtheria and tetanus toxins on the lipid metabolism in the rabbit. Ten animals were treated with diphtheria toxin (five with 1 DL50 and five with 5 DL50 guinea pig). Ten animals were treated with tetanus toxin (five with 1 DL50 and 5 with 5 DL50 guinea pig). Finally, five animals were used as controls. The total lipids, the two cholesterol fractions, the total cholesterol, the triglycerides and the NEFA were measured 4, 24, 48, 72 and 96 hours after the beginning of the experiment. The animals treated with diphtheria toxin all died within 48 hours, and only those given the higher dose of toxin showed an increase in NEFA, found immediately before they died. The animals treated with tetanus toxin all survived and only those injected with the higher dose of toxin showed an increase in the esterificated fraction of cholesterol. The Authors conclude by affirming that the two toxins tested do not have significant influence on the lipid picture in the rabbit.

Serum IgD and IgE in rheumatoid arthritis.

Serum immunoglobulins IgD and IgE have been determined by a single radial immunodiffusion technique and a radioimmunoassay method in serum samples from 95 rheumatoid patients, 5 subjects with Sjögren's syndrome and 50 healthy controls, and compared with levels of IgG, IgM and IgA fractions measured in the same subjects. The IgD and IgE serum content resulted similar in the rheumatoid, Sjögren's and control sera. No correlation of IgD and IgE values with changes of other immunoglobulins or with the activity and the duration of the rheumatoid disease was observed.

[Changes in the blood lipid pattern in experimental poisoning with lipopolysaccharides of E. coli O 127]. / Variazioni del quadro lipidemico nell'intossicazione sperimentale con lipopolisaccaride di "E. coli" O 127

After a short notice on the relations between the endotoxine and lipydic metabolism the AA. refer on the inquiry on 60 animals divided in three groups according to the dosis of the injected endotoxin. The dosis were 0.010-1-5 mg of the lypopolisaccaride from E. coli O-127; seven animals were appointed as controls. In the all animals were examined proofs of blood after 4, 12, 24, 36, 48, 60 and 72 hours from the start of experience. The total lipids, the triglycerides, the phospholypids, the NEFA, the free and esterified cholesterol were doses. The data of lethality and the value of determinations of the single fractions obtained were registered. In the all experienced animals, independently from the injected dosis, an independently from the injected dosis, an increase of the lypidic fractions was remarked: the free fatty acids were the first to rise, suived by triglycerides and phospholypids and denn by the two fractions of cholesterol. The highest dosis of endotoxine have comported a blok in the esterification of cholesterol. This early and persistent hiperlypemie can be caused initially by increased incretion of catecolamine.

[Changes in some blood lipid fractions in experimental poisoning with streptococcal toxin]. / Variazioni di alcune frazioni lipidiche nell'intossicazione sperimentale da tossina streptococcica

After an short bibliographic records in the relation between the endotoxine and lipydic metabolism, the AA. expose an inquiry on the rabbit. Ten rabbits (weight 2500-3000 g) were traited with 10 U.E. (haemolitic units) of streptococcal toxine (1/10 of DL50 for the rabbit). A conspicous increase of all the fractions examined, was remarked in all traited animals. The total lipids and the triglycerides reached the biggest value at 24 hours. Even the two fractions of cholesterol have increased, but the biggest concentration was at 48 hours. An hypotesis of interpretation can be that the streptococcal toxine produce the modification of lipidemic outline with the iperincretion of catecolamine, as in first phase of all toxinfections processes.

[Changes in some blood lipid fractions in experimental poisoning with alpha staphylococcal toxin]. / Variazioni di alcune frazioni lipidiche nell'intossicazione sperimentale da tossina stafilococcica alfa

The AA. have studied the effects provoques by alpha staphylococcal toxin in the lipidemic panel of the rabbit. Of 15 rabbits, five were injected with 0.25 emolitic units (U.E.) five with 1 U.E. and five ad control. The blood from heart was frequently with drawed and examined. In the animals traited with lowest dosis of toxin, the two fractions of cholesterol have increased with the maximum at the last control (96 hours). With a quadruple dosis of toxin increased also the total lipids and triglyceridis with the maximum at 48 hours. Remarked after all the different behaviour of the two fractions of cholesterol at the various dosis. The AA. conclude that the staphylococcal toxin provoque at low dosis only the modification on the cholesterol but at greater dosis also of the triglycerids and phospholipidis.