Tuberculosis burden in immigrants and natives, adults and children, in Tuscany between 2000-2018.

BACKGROUND: Updated data on epidemiology of tuberculosis are needed in Italy. The aim of this study is to evaluate trends in incidence and associated lethality of tuberculosis in immigrants compared with Italians. METHODS: All tuberculosis cases diagnosed from 2000 to 2018 in 31 Tuscan hospitals were retrospectively identified. RESULTS: In 10,827 tuberculosis cases 6715 were males (62%), 4312 (60%) were Italian-born. Hospitalization rate was 15.37/100,000 population/year. The most common comorbidity were liver disease (832/10,827; 7.7%), COPD (675/10,827; 6.2%), cancer (614/10,827; 5.7%). HIV was more frequent in the immigrants (p < 0.001). Extra-pulmonary tuberculosis cases (EPTB) were mainly localized in pleura (740/3,894, 19%) and lymph nodes (449/3,894, 11,5%). HIV was associated with an increased risk of EPTB (OR 3.51 95% CI 2.92-4.23, p < 0.0001). EPTB risk was increased in South Asian-born patients (OR 1.77, 95% CI 1.46-2.15, p < 0.0001) as well in African-born patients (OR 1.13, 95% CI 1.03-1.24, p = 0.0091), who were at risk for gastroenteric tuberculosis (OR 3.74, 95% CI 2.69-5.22, p < 0.0001). Overall mortality rate was 0.006 per 1000. Most of death cases (89%) were Italians (p < 0.02) and mainly affected by pulmonary tuberculosis (PTB). CONCLUSIONS: In Tuscany, tuberculosis is still a health concern in terms of both morbidity and mortality.

Incidence and risk factors of retinopathy of prematurity in an Italian cohort of preterm infants.

OBJECTIVE: Non-negligible differences in retinopathy of prematurity (ROP) and its risk factors between different neonatal intensive care units (NICUs) are reported. Our aim was to assess the incidence and risk factors for ROP development in a large cohort of very preterm infants who were assisted in two Italian NICUs. METHODS: Preterm infants with gestational age between 23+ 0 and 29+ 6 weeks were stratified into subgroups of infants who developed ROP and those who did not; their clinical characteristics were compared with univariate and multivariable logistic regression analyses. RESULTS: We studied a total of 178 infants of whom 67 (38%) developed ROP (stage 1: n = 12; stage 2: n = 41; stage 3: n = 14). Regression analysis demonstrated that maternal milk (OR 0.979, 95% Cl 0.961-0.998) decreased the risk of developing ROP, while intraventricular hemorrhage (IVH) (OR 2.055, 95% Cl 1.120-3.772) increased it. Moreover, maternal milk was found to decrease (OR 0.981, 95% Cl 0.964-0.997) the risk of ROP at discharge, while RBC transfusion increased it (OR 1.522, 95% Cl 1.208-1.916). CONCLUSIONS: In our cohort the occurrence of ROP was similar to that previously reported. Strategies for promoting the use of mother's own milk, preventing IVH, and standardizing the approach to RBC transfusions could contribute to decreasing the risk of ROP in very preterm infants.

Two-day-old newborns learn to discriminate accelerated-decelerated biological kinematics from constant velocity motion.

Already in uterus the hand moves with the typical accelerated-decelerated kinematics of goal-directed actions and, from the twenty-second week of pregnancy, the unborn shows the ability to modulate the velocity of the movement depending on the nature of the target. According to the direct matching hypothesis, this motor knowledge may be sufficient to attune neonates' motion perception-like adults'-to biological kinematics. Using dots configuration motions which varied with respect to the kinematics of goal-directed actions, we observed that two-day-old human newborns did not show any spontaneous preference for either biological accelerated-decelerated motion or non-biological constant velocity motion when these were simultaneously presented in a standard preferential looking paradigm. In contrast, newborns preferred the biological kinematics after the repeated visual presentation of the different motions in a standard infant-control visual habituation paradigm. We propose that present results indicate that the relationship between perception and action does not require only action development but also the accumulation of sufficient perceptual experience. They also suggest a fast plasticity of the sensorimotor system in linking an already acquired motor knowledge with a newly experienced congruent visual stimulation.

Increasing imported malaria in children and adults in Tuscany, Italy, (2000 to 2017): A retrospective analysis.

BACKGROUND: Updated data regarding the epidemiology of imported malaria in Italy are needed. The aim of this study is to evaluate trends in incidence and associated lethality of malaria episodes and to consider if there has been an increase in paediatric cases in the region of Tuscany. METHODS: All malaria cases diagnosed from 2000 to 2017 in 31 Tuscan hospitals were retrospectively identified. Epidemiological data regarding hospitalization rates and lethality for malaria in paediatric and adult population were described. RESULTS: Among the 1102 retrieved cases of malaria (134 children and 968 adults). Plasmodium falciparum was the most commonly reported species (67%). The overall hospitalization rate was of 1.69 cases per 100,000 population/year. Hospitalization rate in the total population decreased from 2000 to 2009 (p < 0.01) and increased from 2009 to 2017 (p < 0.01), similar trends were observed in adults and children. However, in 2010-2017, the cumulative child group incidence of 1.78 per 100,000 surpassed that of the adult group of 1.53 per 100,000 (p < 0.01). Fifteen deaths occurred, all of them in adults, giving a crude lethality rate of 1.36%. CONCLUSIONS: In Tuscany, malaria is still a health concern in terms of both morbidity and mortality. Educational actions and pre-travel advice must be promoted.