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2.
Sci Total Environ ; 803: 149972, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34482142

RESUMO

The present study assesses the spatial distribution and temporal trends of the water dissolved phase (WDP), suspended particulate matter (SPM) and sediment partitioning of atrazine (ATR) and its metabolites in the Volturno River estuary. The load contribution of ATR and its metabolites in this river to the Central Mediterranean Sea was estimated. Samples were collected in 10 sampling sites during the four seasons. The total concentrations of ATR and DPs detected ranged from 18.1 to 105.5 ng L-1 in WDP, from 4.5 to 63.2 ng L-1 in SPM, and from 4.6 to 18.6 ng g-1 in sediment samples, indicating high levels of these pollutants. Structural equation model and the ratio study indicated that the relationship between sediment and WDP pollutants occurred through the SPM. The pollutants load at the Volturno River in its mouth was evaluated in about 30.4 kg year-1, showing that this river is an important source of these analytes through discharge into Central Mediterranean Sea. Principal component analysis indicated that ATR and its metabolites pollution moves from Volturno River mouth southward and increased in the rainy season. The desethylatrazine-to-atrazine ratio was higher than 0.5 for all samples analyzed, indicating an historical discharge and a long residence time of ATR in sediment about two decades after its ban, and classifying ATR as a nonpoint source contaminant. This study makes up the first record of ATR and its metabolites in superficial water of Southern Italy and provides helpful data as starting point for future studies.

3.
Artigo em Inglês | MEDLINE | ID: mdl-34574768

RESUMO

Squamous cell carcinoma represents the most common cancer affecting the oral cavity. At the University of Naples "Federico II", two different antibiotic protocols were used in patients undergoing oral mucosa cancer surgery from 2006 to 2018. From 2011, there was a shift; the combination of Cefazolin plus Clindamycin as a postoperative prophylactic protocol was chosen. In this paper, a health technology assessment (HTA) is performed by using the Six Sigma and DMAIC (Define, Measure, Analyse, Improve, Control) cycle in order to compare the performance of the antibiotic protocols according to the length of hospital stay (LOS). The data (13 variables) of two groups were collected and analysed; overall, 136 patients were involved. The American Society of Anaesthesiologist score, use of lymphadenectomy or tracheotomy and the presence of infections influenced LOS significantly (p-value < 0.05) in both groups. Then, the groups were compared: the overall difference between LOS of the groups was not statistically significant, but some insights were provided by comparing the LOS of the groups according to each variable. In conclusion, in light of the insights provided by this study regarding the comparison of two antibiotic protocols, the utilization of DMAIC cycle and Six Sigma tools to perform HTA studies could be considered in future research.

4.
BMJ Open Qual ; 10(3)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34493488

RESUMO

Life expectancy globally increased in the last decades: the number of people aged 65 or older is consequently projected to grow, and healthcare demand will increase as well. In the recent years, the number of patients visiting the hospital emergency departments (EDs) rocked in almost all countries of the world. These departments are crucial in all healthcare systems and play a critical role in providing an efficient assistance to all patients. A systematic literature review covering PubMed, Scopus and the Cochrane Library was performed from 2009 to 2019. Of the 718 references found in the literature research, more than 25 studies were included in the current review. Different predictors were associated with the quality of EDs care, which may help to define and implement preventive strategies in the near future. There is no harmonisation in efficiency measurements reflecting the performance in the ED setting. The identification of consistent measures of efficiency is crucial to build an evidence base for future initiatives. The aim of this study is to review the literature on the problems encountered in the efficiency of EDs around the world in order to identify an organisational model or guidelines that can be implemented in EDs to fill inefficiencies and ensure access optimal treatment both in terms of resources and timing. This review will support policy makers to improve the quality of health facilities, and, consequently of the entire healthcare systems.


Assuntos
Atenção à Saúde , Serviço Hospitalar de Emergência , Humanos , Itália
5.
PLoS One ; 16(9): e0258017, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34587188

RESUMO

BACKGROUND: We aim to overcome limitations of previous clinical and population-based studies by merging a clinical registry to routinely-collected healthcare data, and to specifically describe differences in clinical outcomes, healthcare resource utilization and costs between interferon beta formulations for multiple sclerosis (MS). METHODS: We included 850 patients with MS treated with interferon beta formulations, from 2015 to 2019, seen at the MS Clinical Care and Research Centre (Federico II University of Naples, Italy) and with linkage to routinely-collected healthcare data (prescription data, hospital admissions, outpatient services). We extracted and computed clinical outcomes (relapses, 6-month EDSS progression using a roving EDSS as reference), persistence (time spent on a specific interferon beta formulation), adherence (medication possession ratio (MPR)), healthcare resource utilization and costs (annualized hospitalization rate (AHR), costs for hospital admissions and DMTs). To evaluate differences between interferon beta formulations, we used linear regression (adherence), Poisson regression (AHR), mixed-effect regression (costs), and Cox-regression models (time varying variables); covariates were age, sex, treatment duration, baseline EDSS and adherence. RESULTS: Looking at clinical outcomes, rates of relapses and EDSS progression were lower than studies run on previous cohorts; there was no differences in relapse risk between interferon beta formulations. Risk of discontinuation was higher for Betaferon®/Extavia® (HR = 3.28; 95%CI = 2.11, 5.12; p<0.01). Adherence was lower for Betaferon®/Extavia® (Coeff = -0.05; 95%CI = -0.10, -0.01; p = 0.02), and Avonex® (Coeff = -0.06; 95%CI = -0.11, -0.02; p<0.01), when compared with Rebif® and Plegridy® (Coeff = 0.08; 95%CI = 0.01, 0.16; p = 0.02). AHR and costs for MS hospital admissions were higher for Betaferon®/Extavia® (IRR = 2.38; 95%CI = 1.01, 5.55; p = 0.04; Coeff = 14.95; 95%CI = 1.39, 28.51; p = 0.03). CONCLUSIONS: We have showed the feasibility of merging routinely-collected healthcare data to a clinical registry for future MS research, and have confirmed interferon beta formulations play an important role in the management of MS, with positive clinical outcomes. Differences between interferon beta formulations are mostly driven by adherence and healthcare resource utilization.

6.
Chemosphere ; 282: 131052, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34470149

RESUMO

The "Land of pyres", namely "La Terra dei Fuochi", is an area of Campania region (South-Italy), highly inhabited and comprises between the Provinces of Naples and Caserta, sadly known worldwide for the criminal activities related to the illegal waste disposal and burning. These fires, concomitantly with traffic emissions, might be the source of potential toxic element (PTE) dangerous for the human health and causing pathologies. In the framework of Correlation Health-Environment project, funded by the Campania region, eight municipalities (of area "Land of pyres") and three remote sites have been bio-monitored using the olive (Olea europaea L.) plants as biomonitors. Leaves of olive plants were collected in each assayed municipality and the concentration of 11 metal(loid)s was evaluated by means of ICP-OES. Our findings revealed that the air of these municipalities was limitedly contaminated by PTE; in fact, only Sb, Al and Mn were detected in the olive leaves collected in some of the assayed municipalities and showed a high enrichment factors (EC) manly due, probably, to the vehicular traffic emissions. Furthermore, the concentrations of the other assayed PTEs were lower than those of Sb, Al and Mn. For these reasons we suppose that their emissions in the troposphere have been and are limited, and they mainly have a crustal origin. Even if our data are very comforting for those urban area, regarded by many as one of the most contaminated one in Italy, a great environment care, in any case, is always needed.


Assuntos
Poluição do Ar , Olea , Eliminação de Resíduos , Monitoramento Biológico , Monitoramento Ambiental , Humanos , Emissões de Veículos
7.
J Healthc Eng ; 2021: 8826048, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34457223

RESUMO

Background: The Health Technology Assessment (HTA) is used to evaluate health services, manage healthcare processes more efficiently, and compare medical technologies. The aim of this paper is to carry out an HTA study that compares two pharmacological therapies and provides the clinicians with two models to predict the length of hospital stay (LOS) of patients undergoing oral cavity cancer surgery on the bone tissue. Methods: The six Sigma method was used as a tool of HTA; it is a technique of quality management and process improvement that combines the use of statistics with a five-step procedure: "Define, Measure, Analyze, Improve, Control" referred to in the acronym DMAIC. Subsequently, multiple linear regression has been used to create two models. Two groups of patients were analyzed: 45 were treated with ceftriaxone while 48 were treated with the combination of cefazolin and clindamycin. Results: A reduction of the overall mean LOS of patients undergoing oral cavity cancer surgery on bone was observed of 40.9% in the group treated with ceftriaxone. Its reduction was observed in all the variables of the ceftriaxone group. The best results are obtained in younger patients (-54.1%) and in patients with low oral hygiene (-52.4%) treated. The regression results showed that the best LOS predictors for cefazolin/clindamycin are ASA score and flap while for ceftriaxone, in addition to these two, oral hygiene and lymphadenectomy are the best predictors. In addition, the adjusted R squared showed that the variables considered explain most of the variance of LOS. Conclusion: SS methodology, used as an HTA tool, allowed us to understand the performance of the antibiotics and provided variables that mostly influence postoperative LOS. The obtained models can improve the outcome of patients, reducing the postoperative LOS and the relative costs, consequently increasing patient safety, and improving the quality of care provided.

8.
Risk Manag Healthc Policy ; 14: 2897-2911, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34267567

RESUMO

Purpose: A risk assessment matrix is a widely used tool for analyzing, assessing and setting priorities in risk management in many fields. This paper overviews critical variables, advantages, disadvantages, strengths and weaknesses of this tool, according to the ISO 31000 risk management framework. Results: Risk assessment is one of the key stages in the Risk Management Process and involves specific steps: identifying hazards, analyzing and evaluating all possible risks. Several methods are developed to assess risks in the literature. A risk matrix method, also called "decision matrix risk assessment (DMRA) technique", is a systematic approach used to determine the risk level and to compare different risks and define which threats need to be controlled first. The actors involved in risk assessment are called on to manage different issues related to the choice of the most appropriate methodological approach, the assessment of the adequacy of the existing control measures, the articulation of risk consequence domains, the definition of the impact-consequences, the explanation of risk likelihood scales and the development of a risk matrix. Conclusion: We highlighted a number of recommendations in order to address these issues, especially useful when healthcare organizations provide insufficient guidance on how to use risk matrices as well as what to do in response to the existing criticisms on their use.

9.
J Clin Med ; 10(13)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202910

RESUMO

Cardiovascular disease is one of the most frequent causes of long-term sickness absence from work. The study aims to develop and validate a score to assess the 10-year risk of unsuitability for work accounting for the cardiovascular risk. The score can be considered as a prevention tool that would improve the cardiovascular risk assessment during health surveillance visits under the assumption that a high cardiovascular risk might also translate into high risk of unsuitability for work. A total of 11,079 Italian workers were examined, as part of their scheduled occupational health surveillance. Cox proportional hazards regression models were employed to derive risk equations for assessing the 10-year risk of a diagnosis of unsuitability for work. Two scores were developed: the CROMA score (Cardiovascular Risk in Occupational Medicine) included age, sex, smoking status, blood pressure (systolic and diastolic), body mass index, height, diagnosis of hypertension, diabetes, ischemic heart disease, mental disorders and prescription of antidiabetic and antihypertensive medications. The CROMB score was the same as CROMA score except for the inclusion of only variables statistically significant at the 0.05 level. For both scores, the expected risk of unsuitability for work was higher for workers in the highest risk class, as compared with the lowest. Moreover results showed a positive association between most of cardiovascular risk factors and the risk of unsuitability for work. The CROMA score demonstrated better calibration than the CROMB score (11.624 (p-value: 0.235)). Moreover, the CROMA score, in comparison with existing CVD risk scores, showed the best goodness of fit and discrimination.

10.
Environ Health Prev Med ; 26(1): 67, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34154531

RESUMO

BACKGROUND: Identifying individual and contextual factors that influence adolescent well-being is a research priority. This study aimed to assess the prevalence of symptoms of mental health problems and some related factors in Italian adolescents in 2017-2018. METHODS: The present study was a cross-sectional survey among 3002 students aged 15-16 years who resided in two Italian provinces, in North and South Italy. Symptoms of mental health problems were assessed using the SDQ and CES-DC, and students' risk-taking behaviors and school climate perception were assessed. All information was collected anonymously. Logistic regression models were used to assess the associations of tobacco and alcohol use, screen time, bullying, and school climate with symptoms of mental health problems. RESULTS: One student out of five reported symptoms of mental health problems, with a more than double proportion among girls than boys (28.7% vs 10.4% with depressive symptoms, respectively). Thirty percent and 40% of students smoked tobacco or drank alcoholic beverages at least once in the past month, and more than 40% reported being victims or authors of bullying in the past 6 months. Smoking behavior, alcohol consumption, screen time, bullying, and negative school climate had 1.2- to 3.3-fold increased odds of symptoms of mental health problems without substantial differences between sexes and geographical areas. CONCLUSIONS: Tobacco and alcohol use, screen time, bullying, and school climate were independently associated with symptoms of mental health problems in a large sample of 15-16-year-old Italian adolescents without substantial gender and geographical differences.


Assuntos
Comportamento do Adolescente , Transtornos Mentais/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Bullying/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Escalas de Graduação Psiquiátrica , Fatores de Risco , Instituições Acadêmicas , Estudantes
11.
Artigo em Inglês | MEDLINE | ID: mdl-34070427

RESUMO

In 2013, in a bid to combat Vaccine Hesitancy (VH) and provide information on vaccines by communicating with the general public and the health community (e.g., healthcare workers and public health operators), the Italian Society of Hygiene and Preventive Medicine (S.It.I.) published the national website "VaccinarSì". The project was subsequently extended to ten Italian Regions. This led to the creation of the VaccinarSì Network, whose websites are publicly owned. The aim of this work was to present the framework of the websites of the VaccinarSì Network and to analyse user behaviour in the pre-COVID-19-era (dating from each website's publication until 31 January 2020) and in the COVID-19-era (from 1 February 2020 to 31 January 2021). Some metrics such as the number of visits to the site (sessions, number of users and average session duration), user behaviour (pages viewed, bounce rate and organic search) and the session acquisition path (direct traffic, referrals and social traffic) were searched, extrapolated and processed with Google Analytics. Qualitative and normally distributed quantitative variables were summarised with their absolute (relative) frequencies and means. Statistical differences between the means of the two periods were evaluated through paired t-test. A two-tailed p-value less than 0.05 was considered to be statistically significant. When the total values recorded over the period were compared, an overall increase in metrics was observed-the number of individual users, visits and individual pageviews rose in a statistically significant way. Our study aimed to highlight how combining disciplines such as health education and digital communication via Information and Communication Technologies (ICT) represents the best strategy to support citizens. This approach gives them the tools to become independent and responsible players that are capable of voluntarily and consciously choosing to adhere to vaccination programs. The VaccinarSì Network's goal for the future is to reach an even wider audience. By building each user's critical knowledge, this network enables users to be active components of a wider, more empowered community.


Assuntos
COVID-19 , Comunicação em Saúde , Vacinas , Comunicação , Humanos , Itália , SARS-CoV-2
12.
Front Public Health ; 9: 658959, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34046390

RESUMO

This article describes how innovations are exploited in Campania (Italy) to improve health outcomes, quality of life, and sustainability of social and healthcare services. Campania's strategy for digitalization of health and care and for healthy aging is based on a person-centered, life-course, "One Health" approach, where demographic change is considered capable of stimulating a growth dynamic linked to the opportunities of combining the "Silver Economy" with local assets and the specific health needs of the population. The end-users (citizens, patients, and professionals) contribute to the co-creation of products and services, being involved in the identification of unmet needs and test-bed activity. The Campania Reference Site of the European Innovation Partnership on Active and Healthy Aging is a flexible regional ecosystem to address the challenge of an aging population with a life-course approach. The good practices, developed in the context of research and innovation projects and innovative procurements by local stakeholders and collaborations with international networks, have been allowing the transfer of innovative solutions, knowledge, and skills to the stakeholders of such a multi-sectoral ecosystem for health.


Assuntos
Envelhecimento Saudável , Qualidade de Vida , Idoso , Envelhecimento , Ecossistema , Humanos , Itália
13.
Front Public Health ; 9: 649781, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33996728

RESUMO

The onset of the new SARS-CoV-2 coronavirus encouraged the development of new serologic tests that could be additional and complementary to real-time RT-PCR-based assays. In such a context, the study of performances of available tests is urgently needed, as their use has just been initiated for seroprevalence assessment. The aim of this study was to compare four chemiluminescence immunoassays and one immunochromatography test for SARS-Cov-2 antibodies for the evaluation of the degree of diffusion of SARS-CoV-2 infection in Salerno Province (Campania Region, Italy). A total of 3,185 specimens from citizens were tested for anti-SARS-CoV-2 antibodies as part of a screening program. Four automated immunoassays (Abbott and Liaison SARS-CoV-2 CLIA IgG and Roche and Siemens SARS-CoV-2 CLIA IgM/IgG/IgA assays) and one lateral flow immunoassay (LFIA Technogenetics IgG-IgM COVID-19) were used. Seroprevalence in the entire cohort was 2.41, 2.10, 1.82, and 1.85% according to the Liaison IgG, Abbott IgG, Siemens, and Roche total Ig tests, respectively. When we explored the agreement among the rapid tests and the serologic assays, we reported good agreement for Abbott, Siemens, and Roche (Cohen's Kappa coefficient 0.69, 0.67, and 0.67, respectively), whereas we found moderate agreement for Liaison (Cohen's kappa coefficient 0.58). Our study showed that Abbott and Liaison SARS-CoV-2 CLIA IgG, Roche and Siemens SARS-CoV-2 CLIA IgM/IgG/IgA assays, and LFIA Technogenetics IgG-IgM COVID-19 have good agreement in seroprevalence assessment. In addition, our findings indicate that the prevalence of IgG and total Ig antibodies against SARS-CoV-2 at the time of the study was as low as around 3%, likely explaining the amplitude of the current second wave.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Imunoensaio , Imunoglobulina M , Itália , Luminescência , Sensibilidade e Especificidade , Estudos Soroepidemiológicos
14.
Accid Anal Prev ; 157: 106161, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33971486

RESUMO

The use of mobile phones while driving is one of the main causes of road accidents and it is a phenomenon in continuous growth. The key aim of this study is to analyse simultaneously knowledge, attitudes, and behavior toward the use of mobile phones while driving in one of the largest and populous metropolitan areas of Italy, Naples. The data acquired from 774 questionnaires - administered to subjects evenly divided by gender and with an average age of 39 years - revealed that 69 % have used their mobile phone while driving at least once in their lifetime. Among those who used the phone, 63.6 % use it to make phone calls while 75.2 % only to answer them; 49.1 % read messages and only 33.3 % write them. It is also notable that 34.1 % do not stop to answer a call and only 10 % do not value the use of headsets while driving as fundamental. The results indicate that cell phone usage while driving is common in the study population, despite many having university-level education and satisfactory risks awareness. The multiple linear regression analysis shows how knowledge is not correlated to the behavior held. On the contrary, attitudes are strongly correlated to knowledge and behavior, meaning that good attitudes bring forth positive behavior. According to the collected data and statistical analysis, it is possible to identify factors that can greatly affect the use of mobile phone while driving and establish targeted prevention programs.


Assuntos
Condução de Veículo , Telefone Celular , Acidentes de Trânsito/prevenção & controle , Adulto , Atitude , Humanos , Itália
15.
Surg Innov ; : 15533506211014857, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33961529

RESUMO

Background. The COVID-19 pandemic leads to several debates regarding the possible risk for healthcare professionals during surgery. SAGES and EAES raised the issue of the transmission of infection through the surgical smoke during laparoscopy. They recommended the use of smoke evacuation devices (SEDs) with CO2 filtering systems. The aim of the present study is to compare the efficacy of different SEDs evaluating the CO2 environmental dispersion in the operating theater. Methods. We prospectively evaluated the data of 4 group of patients on which we used different SEDs or standard trocars: AIRSEAL system (S1 group), a homemade device (S2 group), an AIRSEAL system + homemade device (S3 group), and with standard trocars and without SED (S4 group). Quantitative analysis of CO2 environmental dispersion was carried out associated to the following data in order to evaluate the pneumoperitoneum variations: a preset insufflation pressure, real intraoperative pneumoperitoneum pressure, operative time, total volume of insufflated CO2, and flow rate index. Results. 16 patients were prospectively enrolled. The [CO2] mean value was 711 ppm, 641 ppm, 593 ppm, and 761 ppm in S1, S2, S3, and S4 groups, respectively. The comparison between data of all groups showed statistically significant differences in the measured ambient CO2 concentration. Conclusion. All tested SEDs seem to be useful to reduce the CO2 environmental dispersion respect to the use of standard trocars. The association of AIRSEAL system and a homemade device seems to be the best solution combining an adequate smoke evacuation and a stable pneumoperitoneum during laparoscopic surgery.

16.
Artigo em Inglês | MEDLINE | ID: mdl-33799518

RESUMO

Surgical intervention within 48 h of hospital admission is the gold standard procedure for the management of elderly patients with femur fractures, since the increase in preoperative waiting time is correlated with the onset of complications and longer overall length of stay (LOS) in the hospital. However, national evidence demonstrates that there is still the need to provide timely intervention for this type of patient, especially in some regions of central southern Italy. Here we discuss the introduction of a diagnostic-therapeutic assistance pathway (DTAP) to reduce the preoperative LOS for patients undergoing femur fracture surgery in a university hospital. A Lean Six Sigma methodology, based on the DMAIC cycle (Define, Measure, Analyze, Improve, Control), is implemented to evaluate the effectiveness of the DTAP. Data were retrospectively collected and analyzed from two groups of patients before and after the implementation of DTAP over a period of 10 years. The statistics of the process measured before the DTAP showed an average preoperative LOS of 5.6 days (standard deviation of 3.2), thus confirming the need for corrective actions to reduce the LOS in compliance with the national guidelines. The influence of demographic and anamnestic variables on the LOS was evaluated, and the impact of the DTAP was measured and discussed, demonstrating the effectiveness of the improvement actions implemented over the years and leading to a significant reduction in the preoperative LOS, which decreased to an average of 3.5 days (standard deviation of 3.60). The obtained reduction of 39% in the average LOS proved to be in good agreement with previously developed DTAPs for femur fracture available in the literature.


Assuntos
Fêmur , Gestão da Qualidade Total , Idoso , Humanos , Itália , Tempo de Internação , Estudos Retrospectivos
17.
Future Sci OA ; 7(4): FSO673, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33815819

RESUMO

The Italian municipality of Ariano Irpino (Avellino, Campania, Italy) was locked down by the regional authorities from March until April 2020 after several citizens tested positive for SARS coronavirus 2 (SARS-CoV-2). A serological mass screening campaign targeting the Ariano Irpino population using the Roche Cobas Elecsys anti-SARS-CoV-2 assay was organized by the Zoo-Prophylactic Institute of Southern Italy (Portici, Italy) and conducted in cooperation with the Local Health Unit (Azienda Sanitaria Locale - ASL - Avellino, Avellino, Italy), the Department of Public Health of University Federico II (Naples, Italy) and Department of Health Services of Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital (Naples, Italy) in May 2020. A total of 13,218 asymptomatic individuals were reviewed in this analysis. A total of 738 citizens tested positive for anti-SARS-CoV-2 antibodies (398 females, 340 males). The overall prevalence in the sample was 5.6% (95% CI: 5.2-6.0). Among seropositive citizens, 101 cases tested positive on RT-PCR (0.76% of the overall population). Among citizens aged 14-18, 18-65 and >65 years, the seroprevalence was equal to 6.1 (95% CI: 4.1-8.7), 5.6 (95% CI: 5.1-6.1) and 4% (95% CI: 3.3-4.8), respectively. In the pediatric cohort (<14 years old), seroprevalence was 13% (95% CI: 10.2-16.2). A serological-based screening strategy could be a cost-effective public health intervention to tackle the COVID-19 pandemic.

18.
J Clin Pathol ; 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33837109

RESUMO

AIMS: To date, reverse transcriptase PCR (RT-PCR) on nasopharyngeal swabs is the 'gold standard' approach for the diagnosis of COVID-19. The need to develop easy to use, rapid, robust and with minimal hands-on time approaches are warranted. In this setting, the Idylla SARS-CoV-2 Test may be a valuable option. The aim of our study is to evaluate the analytical and clinical performance of this assay on previously tested SARS-CoV-2 people by conventional RT-PCR based approach in different settings, including initial diagnosis and clinical follow-up. METHODS: To evaluate the sensitivity and specificity of the Idylla SARS-CoV-2 Test, we retrieved 55 nasopharyngeal swabs, previously analysed by a fully validated assay, from symptomatic patients or from people who have been in close contact with COVID-19 positive cases. Discordant or high discrepant cases were further analysed by a third technique. In addition, a second subset of 14 nasopharyngeal swab samples with uncertain results (cycle threshold between 37 and 40), by using the fully validated assay, from patients with viral infection beyond day 21, were retrieved. RESULTS: Overall, Idylla showed a sensitivity of 93.9% and a specificity of 100.0%. In addition, in the additional 14 nasopharyngeal swab samples, only five (35.7%) featured a positive result by the Idylla SARS-CoV-2 Test. CONCLUSIONS: We demonstrated that the Idylla SARS-CoV-2 Test may represent a valid, fast, highly sensitive and specific RT-PCR test for the identification of SARS-CoV-2 infection.

19.
Am J Ophthalmol ; 227: 182-190, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33781767

RESUMO

PURPOSE: This study investigated changes in retinal vessel density in macular and papillary regions in post-SARS-CoV-2 pneumonia patients by means of optical coherence tomography angiography (OCTA). DESIGN: Prospective, observational, cohort study. METHODS: Forty eyes of 40 patients (mean age: 49.7 ± 12.6 years old) post-SARS-CoV-2 infection and 40 healthy subjects were enrolled in this study. COVID-19 patients had to be fully recovered from COVID-19 pneumonia and were evaluated 6 months after COVID-19 infection. The primary outcome resulted from OCTA studies of the following vascular structures: vessel density (VD) in the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillaries (RPC) compared to those of controls. Structural spectral domain (SD)-OCT parameters were also evaluated: ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). RESULTS: The patients showed a significant reduction in VD of the SCP in whole images and in the DCP in all sectors compared to those in healthy subjects (P <.05). COVID-19 patients featured a reduced VD of the RPC compared to that in controls (P <.001). No differences were found in the GCC, whereas the RNFL was reduced in the COVID-19 group compared to that in controls (P = .012). Significant correlations were found between the RNFL and VD of the SCP, DCP, RPC, and FAZ area in the COVID-19 group (P <.05). CONCLUSIONS: OCTA showed retinal vascular changes in subjects fully recovered from COVID-19 pneumonia. These findings could be a consequence of a thrombotic microangiopathy that affected retinal structures as well as other systemic organs. OCTA could represent a valid, noninvasive biomarker of early vascular dysfunction after SARS-CoV-2 infection.


Assuntos
COVID-19/epidemiologia , Angiofluoresceinografia/métodos , Macula Lutea/patologia , Doenças Retinianas/diagnóstico , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Capilares/diagnóstico por imagem , Comorbidade , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Doenças Retinianas/epidemiologia , SARS-CoV-2
20.
Artigo em Inglês | MEDLINE | ID: mdl-33546201

RESUMO

This study reports the data on the contamination caused by polycyclic aromatic hydrocarbons (PAHs) drained from the Volturno River. The seasonal and spatial distribution of PAHs in water and sediment samples was assessed. The 16 PAHs were determined in the water dissolved phase (DP), suspended particulate matter (SPM), and sediments. A multidimensional statistical approach was used to identify three pollution composite indicators. Contaminant discharges of PAHs into the sea were calculated in about 3158.2 kg/year. Total concentrations of PAHs varied in ranges 434.8 to 872.1 ng g-1 and 256.7 to 1686.3 ng L-1 in sediment samples and in water (DP + SPM), respectively. The statistical results indicated that the PAHs mainly had a pyrolytic source. Considering the sediment quality guidelines (SQGs), the water environmental quality standards (USEPA EQS), and risk quotient (RQ), the Volturno River would be considered as an area in which the environmental integrity is possibly at risk.


Assuntos
Hidrocarbonetos Policíclicos Aromáticos , Poluentes Químicos da Água , China , Monitoramento Ambiental , Sedimentos Geológicos , Itália , Mar Mediterrâneo , Hidrocarbonetos Policíclicos Aromáticos/análise , Medição de Risco , Rios , Poluentes Químicos da Água/análise
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