Knowledge, Attitudes, and Practices on Energy Drink Consumption and Side Effects in a Cohort of Medical Students.

The purpose of this study was to evaluate knowledge, attitudes, and practices concerning energy drink consumption and the prevalence of side effects among medical students. Twenty-two percent of respondents were regular users, particularly men (p < .0005). Users were younger (p = .027) and drank alcohol more frequently (p = .008) than "non-users." Forty-nine percent consumed alcohol associated with energy drinks. Forty-five percent of medical students declared side effects after energy drink consumption, such as palpitations (35%), insomnia (21%), and irritability (20%). The study confirms a large use of energy drinks among students and the occurrence of side effects. The use of energy drinks may influence the ingestion of large amounts of alcohol.

[Impact of the abolition of food handler certification on notification rates of foodborne diseases in Italy]. / Impatto dell'abolizione del libretto di idoneità sanitaria per alimentaristi sui tassi di notifica delle malattie a trasmissione alimentare in Italia.

OBJECTIVES: to assess the trends of foodborne diseases in respect of the abolition of food handler certification by Italian Regions. DESIGN: rates of foodborne diseases recorded before and after the abolition of food handler certification were compared. SETTING AND PARTICIPANTS: the study included notifications collected in Italy through the national infectious disease surveillance system between 1996 and 2009. MAIN OUTCOME MEASURES: annual rates of seven main foodborne diseases. RESULTS: a significant reduction in notifications of foodborne diseases occurred in most Italian Regions in the years after the abolition of the food handler certification. CONCLUSIONS: the abolition of food handler certification coincided with no increase in the overall estimated incidence of foodborne diseases in the Italian population. Furthermore, the temporal and spatial patterns of notification rates suggest the possibility that other key factors have contributed to this result, including the heterogeneity of the surveillance system performance.

Hospitalisation of children aged 0-59 months with rotavirus gastro-enteritis before the introduction of routine vaccination (Sicily 2003-2012).

BACKGROUND: Recent evidence demonstrates that rotavirus vaccination is the best strategy for reducing rotavirus gastro-enteritis (RVGE) in young children. AIMS: This study describes the epidemiology of RVGE hospitalisation of Sicilian children before universal rotavirus vaccination was introduced into the regional immunisation programme in January 2013. METHODS: An observational study was undertaken by analyzing data obtained from the Regional Hospital Discharge database, including hospitalisation from 2003 to 2012 of subjects aged 0-59 months who lived in Sicily. Children discharged with the rotavirus-specific ICD-9-CM code of 008·61 on first or any diagnosis stage were considered to be RVGE cases. RESULTS: From 2003 to 2012, 9317 children (median age 19 months, M/F ratio 1·19) were hospitalised with a diagnosis of RVGE. During the study period, annual rates of hospitalisation were between 2·64 and 4·68 cases/1000 children (mean 3·74 cases). Incidence rates were higher in children aged 6-11 months (8·85/1,000 children/year), decreasing significantly with age (P<0·001). RVGE hospitalisation peaked during winter and spring with a statistically significant downward trend throughout summer and autumn. CONCLUSION: During the study period, the cumulative risk of hospitalisation with RVGE was determined to be about one in 54 Sicilian children in the 1st 5 years of life. Although the present study cannot be considered a proper pharmaco-economic evaluation, the findings suggest that in Sicily the health and economic burden of RVGE hospitalisation strongly supports the introduction of rotavirus vaccination into the regional immunisation programme as a probably cost-saving intervention.

Factors associated with poor adherence to MMR vaccination in parents who follow vaccination schedule.

Due to median vaccination coverage far from elimination level, Italy is still an European country with high number of measles cases per million of people. In this study we explored potential socioeconomic, medical and demographic factors which could influence the propensity of family members for measles vaccination schedule. A cross-sectional study was performed through a questionnaire administered to the parents of children who received the first dose of MMR vaccine in two different vaccination centers in the Palermo area from November 2012 to May 2013. Overall, the role played by internet (OR 19.8 P = 0.001) and the large number of children in a family (OR 7.3 P ≤ 0.001) were the factors more associated to be unvaccinated, whereas the birth order of the child (OR 0.3 P = < 0.05 for the oldest children vs. the closer young one) and reporting a lack of MMR vaccination as a "personal decision" (OR 0.19 P ≤ 0.01) inversely correlated with the risk of quitting vaccination. These findings can be useful for a better knowledge of disaffection to vaccination practice in local settings and could contribute to improve and maintain timely uptake, suggesting approaches to optimize the uptake of MMR tailored to the needs of local populations.

The impact of ten years of infant universal Varicella vaccination in Sicily, Italy (2003-2012).

INTRODUCTION: Universal varicella vaccination in Sicily was introduced in infant population since 2003, with a rapidly increasing coverage. Aim of the present study was to analyze changes in the epidemiology of varicella since the introduction of universal vaccination. METHODS: The study was performed by analyzing Sicilian administrative/clinical data on varicella case notifications and hospitalizations from 2003 to 2012 (ICD-9-CM discharge diagnosis codes 052 and 052.×). MMR+V and V coverage were also calculated for each birth cohort. Moreover, blood samples drawn in 2013/2014 from general population stratified by age were tested for varicella antibodies. RESULTS: From 2003 to 2012, 15 433 varicella cases were notified with a decreasing temporal trend (1.1/1000 population in 2003 to 0.1/1000 in 2012) (P < 0.001). In the same period, a total of 1145 patients were hospitalized with a diagnosis of varicella, with a 6-fold reduced risk of hospitalization over time (from 4.8 to 0.8/100 000 population per year; P < 0.001). Varicella vaccination coverage rates increased from 40% (2001 birth cohort) to 85% (2010 birth cohort), and inversely correlated with both notification and hospitalization rates (P < 0.001). Finally, 80.0% of subjects enrolled in the seroepidemiological survey were positive for varicella and seroprevalence increased significantly with age in both sexes (P < 0.001). DISCUSSION: The results show the impact of infant universal varicella vaccination in Sicily. Noteworthy, notifications and hospitalizations for varicella have significantly decreased after the introduction of universal vaccination, confirming the effectiveness of the adopted strategy.

Hospitalisation of children aged 0-59 months with rotavirus gastro-enteritis before the introduction of routine vaccination (Sicily 2003-2012).

Background: Recent evidence demonstrates that rotavirus vaccination is the best strategy for reducing rotavirus gastro-enteritis (RVGE) in young children. Aims: This study describes the epidemiology of RVGE hospitalisation of Sicilian children before universal rotavirus vaccination was introduced into the regional immunisation programme in January 2013. Methods: An observational study was undertaken by analyzing data obtained from the Regional Hospital Discharge database, including hospitalisation from 2003 to 2012 of subjects aged 0-59 months who lived in Sicily. Children discharged with the rotavirus-specific ICD-9-CM code of 008·61 on first or any diagnosis stage were considered to be RVGE cases. Results: From 2003 to 2012, 9317 children (median age 19 months, M/F ratio 1·19) were hospitalised with a diagnosis of RVGE. During the study period, annual rates of hospitalisation were between 2·64 and 4·68 cases/1000 children (mean 3·74 cases). Incidence rates were higher in children aged 6-11 months (8·85/1,000 children/year), decreasing significantly with age (P<0·001). RVGE hospitalisation peaked during winter and spring with a statistically significant downward trend throughout summer and autumn. Conclusion: During the study period, the cumulative risk of hospitalisation with RVGE was determined to be about one in 54 Sicilian children in the 1st 5 years of life. Although the present study cannot be considered a proper pharmaco-economic evaluation, the findings suggest that in Sicily the health and economic burden of RVGE hospitalisation strongly supports the introduction of rotavirus vaccination into the regional immunisation programme as a probably cost-saving intervention.