RESUMO
PURPOSE: Evidence of an increased diagnostic pressure on thyroid has emerged over the past decades. This study aimed to provide estimates of a wide spectrum of surveillance indicators for thyroid dysfunctions and diseases in Italy. METHODS: A population-based study was conducted in North-eastern Italy, including 11.7 million residents (20% of the total Italian population). Prescriptions for TSH testing, neck ultrasound or thyroid fine needle aspiration (FNA), surgical procedures, and drugs for hypo- or hyperthyroidism were extracted from regional health databases. Proportions and rates of selected examinations were calculated from 2010 to 2017, overall and by sex, calendar years, age, and region. RESULTS: Between 2010 and 2017 in North-eastern Italy, 24.5% of women and 9.8% of men received at least one TSH test yearly. In 2017, 7.1% of women and 1.5% of men were prescribed drugs for thyroid dysfunction, 94.6% of whom for hypothyroidism. Neck ultrasound examinations were performed yearly in 6.9% of women and 4.6% of men, with a nearly two-fold variation between areas. Thyroid FNA and thyroidectomies were three-fold more frequent in women (394 and 85 per 100,000) than in men (128 and 29 per 100,000) with a marked variation between areas. Both procedures decreased consistently after 2013. CONCLUSIONS: The results of this population-based study describe recent variations over time and between surrounding areas of indicators of 'diagnostic pressure' on thyroid in North-eastern Italy. These results emphasize the need to harmonize practices and to reduce some procedures (e.g., neck ultrasound and total thyroidectomies) in certain areas.
Assuntos
Biópsia por Agulha Fina , Doenças da Glândula Tireoide , Testes de Função Tireóidea , Glândula Tireoide , Tireoidectomia , Ultrassonografia , Adulto , Idoso , Biópsia por Agulha Fina/métodos , Biópsia por Agulha Fina/tendências , Feminino , Humanos , Itália/epidemiologia , Masculino , Uso Excessivo dos Serviços de Saúde/prevenção & controle , Uso Excessivo dos Serviços de Saúde/tendências , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância da População , Fatores Sexuais , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/cirurgia , Testes de Função Tireóidea/métodos , Testes de Função Tireóidea/tendências , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Tireoidectomia/métodos , Tireoidectomia/tendências , Ultrassonografia/métodos , Ultrassonografia/tendênciasRESUMO
BACKGROUND: Home accidents, or domestic accidents, are accidents that occur inside a home or the adjacent areas (stairways, courtyards, gardens, attics, cellars, garages, etc.). In Italy, they are monitored through a number of surveillance systems including the PASSI system and the ISTAT (Italian Institute of Statistics) Multipurpose Survey on Households. Only the SINIACA system (Italian National Information Service on Domestic Accidents), managed by the Istituto Superiore di Sanità (National Institute for Health), provides health-related information regarding such events and their circumstances and consequences, based primarily on Accident & Emergency Departments' data. STUDY DESIGN: This is an observational study on the domestic accidents trends in the province of Trento, using data on Accident & Emergency Departments admissions, between 2009 and 2018, combined with mortality and hospital discharge data. METHODS: The authors extrapolated records regarding admissions for domestic accidents from the digital annual Accident & Emergency admissions archive. For the 2009-2018 period, they analysed: the trend over time, both overall and classified according to gender and age group; and the inflow rate/10,000 inhabitants, broken down according to gender, nationality (Italians and foreign nationals) and age group. The coverage of the additional SINIACA variables regarding the accident dynamic, contingent activity and place of the accident were also analysed. With regard to the case load for 2018, the authors analysed the site and type of the injuries, the level of severity, outcome and the services provided, comparing the 0-14 years and >65 years age groups. Trend significance was analysed using the Cochran-Armitage test for trend and the significance of the differences between the proportions was analysed using the Chi-squared test. We have also calculated the costs of the services provided, overall and by age group. RESULTS: During the study period, a total of 99,386 A&E admissions for domestic accidents were recorded, with an annual average of 9,938 admissions. Between 2009 and 2018, there was a statistically significant increase of 41%, which was due in part to better event recognition and recording. Females prevail over males, especially over the age of 75 years. Over time there is an increase in cases over the age of 65, due to the progressive ageing of the population. Considering the resident population alone, the A&E inflow rate rises from 147 admissions/10,000 inhabitants in 2009 to 197 admissions/10,000 inhabitants in 2018, with a 39.0% increase. Inflow is greater in the two extreme age groups: in 2018, in the 0-4 years age group, the inflow rate is 319 admissions/10,000 inhabitants and in the over 75 years class it rises to 481 admission/10,000 inhabitants, 1.6 and 2.4 times the mean inflow for home accidents in the province of Trento, respectively. Admissions are less amongst foreign nationals than amongst Italians. Generally speaking, the events were of a mild severity, with white triage codes accounting for 16% of cases and green triage codes for 73%. The degree of severity is higher amongst subjects aged over 65, as well as in women and Italian citizens.The level of recording of SINIACA variables increases over time, to reach 100% coverage in 2018. Falls are the most common dynamic in all age ranges; household chores, activities of daily living and DIY are the three most commonly observed activities. Home accidents most commonly occur in the areas adjacent to the home and the kitchen. In over 2/3 of cases, the injuries sustained were to the limbs and the head/face. Head/face injuries prevail in the youngest age group. Wounds, burns and head injuries are the most common types of injury sustained by children in the 0-14 years age group, whereas fractures and dislocations are typical of the older age groups. Diagnostic and care resource consumption is far higher amongst the elderly, which absorb 61% of the total costs of the cases treated in the year 2018. CONCLUSION: Accident & Emergency facilities provide a privileged observatory for the monitoring of domestic accidents in the population. By comparing our data with the ISTAT data, it can be estimated that 1 in 2 home accidents in the population resulted in an A&E admission. Admissions increase over time, particularly amongst the elderly and they are not higher amongst foreign nationals than amongst Italians. The inflow rate is higher in the extreme age ranges: 0-4 and >75 years; however, there are differences between the two in terms of type of injury, level of severity and outcome. It is essential for A&E admission data to be fully digitalised, and facility and staff sensitisation is also important in order to guarantee the availability of good-quality data. The completeness of A&E data and the possibility of obtaining case stratification based on social and demographic characteristics could make it possible, through a virtuous integration of services, to use these data for the implementation of prevention initiatives. These, if carried out effectively, could also contribute to contain healthcare costs.
Assuntos
Acidentes Domésticos , Ferimentos e Lesões , Atividades Cotidianas , Idoso , Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Primeiros Socorros , Hospitalização , Humanos , Lactente , Recém-Nascido , MasculinoRESUMO
BACKGROUND: The purpose of the study was to analyse the trend for post-abortion check-ups among users requesting the abortion certification from Trento Family Planning Center between 2003 and 2017. STUDY DESIGN: Retrospective case-control study. METHODS: During the study period, the Trento Family Planning Center issued a total of 3,870 abortion certificates (46% regarding foreign nationals). The social and demographic characteristics of those users who attended the post-abortion check-up appointments, and of those who did not, were compared. RESULTS: The proportion of resident users who returned for a post-abortion check-up increases significantly during the study period. The multiple logistic regression analysis model indicates that the factors associated with the likelihood of a return for a post-abortion check-up are: possession of medium to high academic qualifications (> 8 years) versus low qualifications, being a non-EU or Asian citizen, being a minor and being nulliparous or multiparous versus primiparous. CONCLUSIONS: According to Family Planning Centers' philosophy, post-abortion check-ups are a good opportunity for promoting responsible procreation. The strategy for the management of the Trento Family Planning Center's users requesting an abortion led to an increase of the proportion of users who returned for the post-abortion check-up greater than is the case for other territorial Family Planning Centers.
Assuntos
Aborto Induzido , Instituições de Assistência Ambulatorial , Estudos de Casos e Controles , Serviços de Planejamento Familiar , Feminino , Humanos , Gravidez , Estudos RetrospectivosRESUMO
The term myofibrillar myopathies (MFM) refers to uncommon neuromuscular disorders that pathologically are characterized by myofibrillar degeneration and ectopic expression of several proteins. MFM are partly caused by mutations in genes that encode mainly Z-disk-related proteins (desmin, alphaB-crystallin, myotilin, ZASP, filamin C and BAG3). We reviewed clinical, light and electron microscopy, immunohistochemistry, immunoblotting and genetic findings of 21 patients with MFM (15 unrelated patients and three pairs of brothers) investigated at our neuromuscular center. MFM patients begin to show symptoms at any age, from juvenile to late adult life and present a different distribution of muscle weakness. Cardiac involvement and peripheral neuropathy are common. Typical histological features include focal areas with reduction/loss of ATPase and oxidative enzyme activity, and amorphous material (eosinophilic on hematoxylin and eosin and dark blue on Engel-Gomori trichrome) in these abnormal fiber areas. Electron microscopy shows disintegration of myofibrils starting from the Z-disk and accumulation of granular and filamentous material among the myofilaments. Immunohistochemical studies demonstrate focal accumulation of desmin, alphaB-crystallin and myotilin in abnormal muscle fibers while immunoblot analysis does not highlight differences in the expression of these proteins also including ZASP protein. Therefore, unlike immunoblot, immunohistochemistry together with light and electron microscopy is a useful diagnostic tool in MFM. Finally three of our 21 patients have missense mutations in the desmin gene, two brothers carry missense mutations in the gene encoding myotilin, one has a missense mutation in alphaB-crystallin, and none harbour pathogenic variations in the genes encoding ZASP and BAG3.
Assuntos
Proteínas Contráteis/genética , Proteínas do Citoesqueleto/genética , Debilidade Muscular/etiologia , Distrofias Musculares/etiologia , Miofibrilas , Idade de Início , Estudos de Coortes , Proteínas Contráteis/metabolismo , Proteínas do Citoesqueleto/metabolismo , Feminino , Estudo de Associação Genômica Ampla , Cardiopatias/etiologia , Cardiopatias/fisiopatologia , Humanos , Imuno-Histoquímica , Padrões de Herança , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Debilidade Muscular/patologia , Debilidade Muscular/fisiopatologia , Distrofias Musculares/epidemiologia , Distrofias Musculares/genética , Distrofias Musculares/metabolismo , Distrofias Musculares/patologia , Distrofias Musculares/fisiopatologia , Mutação , Miofibrilas/metabolismo , Miofibrilas/patologia , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/fisiopatologiaRESUMO
The aims of this longitudinal study are to investigate general practitioners' opinions and knowledge about colorectal cancer screening in Trentino region, to identify their role and level of participation within the screening program and to find out their formative needs. 174 general practitioners answered the postal self-filled questionnaire: 82% of them asserted their main role in colorectal screening is patient counselling, but many physicians also showed availability to collaborate with the Centre for Health Services of Trento in organizing patients recruitment list and in recovering patients who didn't accept screening invitation. 78% thinks the Health Services of Trento should allocate incentives, especially push money, to promote physicians participation in screening program. Moreover 68% needs a basic formative course about screening programme. Female general practitioners are more prepared to collaborate in organizing patients recruitment list and in handing over the kit for fecal occult blood test than their male colleagues. Instead men prefer to take an active role in counselling and are more interested in economic incentives. The study has found considerable general practitioners support for the introduction of the new screening programme. The info-formative line to improve in Trentino could create a better interface between general practitioners and Centre for Health Services, keeping into account the organizing features of physicians. It seems to be important the definition of shared procedures for the counselling and the requirement of formative courses by general practitioners; the Centre for Health Services of Trento has already undertaken these courses disguised as seminars addressed all health operators.
Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer/estatística & dados numéricos , Clínicos Gerais , Programas de Rastreamento/métodos , Educação de Pacientes como Assunto , Papel do Médico , Adulto , Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Neoplasias Colorretais/epidemiologia , Aconselhamento/estatística & dados numéricos , Feminino , Humanos , Itália/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Sangue Oculto , Prevenção Primária/métodos , Inquéritos e QuestionáriosRESUMO
Radioprotection of the eye lens of medical staff involved in Surgical procedures is a subject of international debates since ICRP recommended, on 2011, a lower equivalent dose limit for the lens of the eye. In this work we address the effectiveness of different models of X-ray protective eyewear by relating actual dosimetry measurements to an ad hoc developed mathematical model, in order to disentangle the contribution of geometrical factors and shield capabilities. Phantom irradiation was carried out in fixed exposure conditions in angiographic room: we found that measured Dose Reduction Factors (DRF) strongly depend on the ergonomics of the investigated eyewear. Actually a very poor DRF was observed in the case of a glass model in spite of its high nominal attenuation, whereas a protective tool with low shielding capabilities such a visor resulted much more effective as a consequence of is shape (i.e. extended geometric protection of the eye lens). Our work highlights the need of the introduction of a specific parameter to quantify the effectiveness of the protection tools and able to predict their DRF by taking into account the geometry of the clinical condition of exposure. Aiming at making steps forward the standardization of the guidelines concerning the features of eye protective tools, we developed a simple mathematical model describing the eye lens irradiation geometry which allows the introduction, for each eyewear, of a comprehensive parameter, the Eye Protection Effectiveness (EPE), that, for any defined clinical irradiation condition and glass shielding capabilities and shape, defines the overall effective X-ray protection of the eyewear.
Assuntos
Traumatismos Oculares/prevenção & controle , Cristalino/efeitos da radiação , Lesões por Radiação/prevenção & controle , Proteção Radiológica/métodos , Radiografia/instrumentação , Dispositivos de Proteção dos Olhos , Hospitais , Humanos , Modelos Teóricos , Imagens de Fantasmas , Doses de Radiação , Exposição à Radiação/prevenção & controle , Espalhamento de Radiação , Raios XRESUMO
A record-linkage study was carried out between the Italian AIDS Registry and 24 Italian cancer registries to compare cancer excess among persons with HIV/AIDS (PWHA) before and after the introduction of highly active antiretroviral therapy (HAART) in 1996. Standardised incidence ratios (SIR) were computed in 21951 AIDS cases aged 16-69 years reported between 1986 and 2005. Of 101 669 person-years available, 45 026 were after 1996. SIR for Kaposi sarcoma (KS) and non-Hodgkin lymphoma greatly decreased in 1997-2004 compared with 1986-1996, but high SIRs for KS persisted in the increasingly large fraction of PWHA who had an interval of <1 year between first HIV-positive test and AIDS diagnosis. A significant excess of liver cancer (SIR=6.4) emerged in 1997-2004, whereas the SIRs for cancer of the cervix (41.5), anus (44.0), lung (4.1), brain (3.2), skin (non-melanoma, 1.8), Hodgkin lymphoma (20.7), myeloma (3.9), and non-AIDS-defining cancers (2.2) were similarly elevated in the two periods. The excess of some potentially preventable cancers in PWHA suggests that HAART use must be accompanied by cancer-prevention strategies, notably antismoking and cervical cancer screening programmes. Improvements in the timely identification of HIV-positive individuals are also a priority in Italy to avoid the adverse consequences of delayed HAART use.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Terapia Antirretroviral de Alta Atividade , Neoplasias/epidemiologia , Neoplasias/etiologia , Síndrome da Imunodeficiência Adquirida/complicações , Adolescente , Adulto , Idoso , Feminino , HIV-1 , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Adulto JovemRESUMO
AIMS: To report on the relation between home mould and/or dampness exposure and respiratory disorders in a large sample of children and adolescents in Italy, accounting for age at time of exposure. METHODS: 20,016 children (mean age 7 years) and 13,266 adolescents (mean age 13 years) completed questionnaires on indoor exposures and respiratory symptoms/diseases. Statistical analyses were adjusted for sex, age, questionnaire's compiler, area of residence, season of interview, parental educational status, family history of asthma, rhinitis, eczema, chronic obstructive pulmonary disease, presence of gas water heaters, passive smoking, pets, and active smoking (only for adolescents). Population attributable risk % (PAR) was also computed. RESULTS: Asthma was more strongly related to only early than to only current exposure, both in children (OR 1.80, 95% CI 1.41 to 2.30) and adolescents (OR 1.89, 95% CI 1.38 to 2.59). The same result was found for rhino-conjunctivitis (OR 1.46, 95% CI 1.17 to 1.82), in children, and for wheeze among adolescents (OR 1.56, 95% CI 1.15 to 2.11). In children, wheeze (OR 1.98, 95% CI 1.47 to 2.66) and eczema (OR 1.44, 95% CI 1.09 to 1.91) were more strongly related to mould/dampness when exposed both early and currently; the same occurred in adolescents for rhino-conjunctivitis (1.78, 95% CI 1.30 to 2.45). Although persistent cough/phlegm was significantly related to mould/dampness exposure in children, regardless of exposure timing, no significant association between mould/dampness exposure and eczema or cough/phlegm was found among adolescents. PAR estimates were higher for only early than only current exposures. Avoiding early only exposure would abate wheeze by 6%, asthma or cough/phlegm by 7%, rhino-conjunctivitis in children by 4%, and in adolescents, asthma by 6%, and wheeze by 4%. CONCLUSIONS: Respiratory disorders such as wheeze and asthma can often be explained by exposure to home mould/dampness, especially early in life. The association seems more evident in children than in adolescents. These findings may suggest the need for environmental prevention strategies.
Assuntos
Exposição Ambiental/efeitos adversos , Fungos , Habitação/normas , Umidade/efeitos adversos , Transtornos Respiratórios/epidemiologia , Adolescente , Idade de Início , Criança , Escolaridade , Feminino , Habitação/estatística & dados numéricos , Humanos , Itália/epidemiologia , Masculino , Prevalência , Análise de Regressão , Transtornos Respiratórios/microbiologia , Fatores de RiscoRESUMO
Present paper reports on the results of a pilot customer satisfaction study carried out on 1.720 consecutive women (18.7 with spontaneous access) attended senology department (Trento and Borgo) in the context of a organized mammography screening programme, started in October 2000. Data were collected by a questionnarie filled by the women after mammography. 4.3% of the invited women reported the receiving the letter late, 0.9% considered it inaccurate, 7.2% had some problems for getting a new date for test, 1.8% of the whole sample reported some problems for external access and 2.2% for internal access to health facilities; 1.9% perceived waiting room as not friendly. The welcoming by the personnel is judged quite well, only 0.6% complained about it. Trento centre, is more efficient than Borgo. In 21.7% of the cases the mammography has been performed within next 30 minutes of the fixed time and in 7.9% besides that. 36.8% of the whole sample perceived mammography as tiresome and 4.1% as painful. The percentage of women reporting mammography disconforting increase, in Trento sample, according the education level as previously reported. The data about perceived quality are satisfactory, on the whole. Anyway it would be opportune to contain the waiting time.
Assuntos
Mamografia , Programas de Rastreamento , Satisfação do Paciente , Fatores Etários , Idoso , Educação , Feminino , Humanos , Itália , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e Questionários , Fatores de TempoRESUMO
Among lifestyle factors, nutrition is one of the most important determinants of health, and represents a pivotal element of cancer risk. Nonetheless, epidemiological evidences of the relationship between several cancers and specific foods and nutrients is still inadequate, and solid conclusions are missing. Indeed, caloric restriction without malnutrition is associated to cancer prevention. Food may be also the primary route of exposure to contaminants such as metals, persistent organic pollutants, and pesticides. Exposuredisease associations and the interplay with genetic susceptibility requires further studies on genetic variation, environment, lifestyle, and chronic disease in order to eliminate and reduce associated health risks, thus contributing to improve health outcomes for the population. A primary nutritional approach for Active and Healthy Ageing (AHA) has been developed by the Nutrition group of the European Innovation Partnership (EIP) on AHA. The working group on lifestyles of the Italian Ministry of Health has developed a comprehensive approach to adequate nutrition using a consensus methodology to collect and integrate the available evidences from the literature and from the Italian experiences at the regional level, to raise the interest of other experts and relevant stakeholders to outline and scale-up joint strategies for a primary nutritional approach to cancer prevention.
RESUMO
From September 1980 to August 1981, 25 patients with advanced head and neck squamous cell carcinoma were treated at the Centro Oncologico, Trento, by a chemo-radiotherapeutic combination. The treatment protocol consisted of 4-6 courses of VBM (vincristine, bleomycin and methotrexate) followed by conventional radiotherapy (65 Gy). Only to VBM responders (15 patients) were administered 10 cycles of vincristine-methotrexate. At the end of induction chemotherapy an overall response of 60% (12% complete, 48% partial) was obtained. At the end of radiotherapy the responses were 52.5% complete and 35.5% partial, for an overall response of 88%. The overall survival at 60 months was 8%. This combined approach, in spite of the satisfactory immediate local response rate, does not offer advantages for survival in comparison to conventional treatment modalities.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Adulto , Idoso , Bleomicina/uso terapêutico , Carcinoma de Células Escamosas/patologia , Radioisótopos de Cobalto/uso terapêutico , Terapia Combinada , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Neoplasias Hipofaríngeas/tratamento farmacológico , Neoplasias Hipofaríngeas/patologia , Neoplasias Hipofaríngeas/radioterapia , Masculino , Metotrexato/administração & dosagem , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Neoplasias Bucais/tratamento farmacológico , Neoplasias Bucais/patologia , Neoplasias Bucais/radioterapia , Neoplasias Orofaríngeas/tratamento farmacológico , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/radioterapia , Estudos Prospectivos , Radioterapia de Alta Energia , Fatores de Tempo , Vincristina/administração & dosagem , Vincristina/uso terapêuticoRESUMO
AIMS AND BACKGROUND: The present report combines descriptive statistics (partly never published) on four neighboring areas of north-eastern (NE) Italy [Friuli-Venezia Giulia (1970-89) and Veneto (1970-87) regions and the provinces of Trento (1970-89) and Bolzano (1971-90)], and all Italy (1970-89). The aim was to highlight potential differences in mortality trends and promote a more systematic sharing of data and methodologies. METHODS: Death certificates stratified by cause, sex, age and residence were obtained from official publications of the Italian Central Institute of Statistics. Absolute numbers of deaths from different causes, age-standardized rates (on the basis of the European standard population) and percentage of change over the examined period for both sexes were computed for each geographic area. RESULTS: Unfavorable trends were seen for neoplasms of the upper aerodigestive tract, lung, breast, colorectum, bladder, kidney and pancreas and cutaneous malignant melanoma. Increases in most of these neoplasms were more marked in the 4 NE areas than in Italy, especially with respect to cancers of the upper aerodigestive tract in both sexes and cancer of the lung and ovary in women. In Bolzano, rates of neoplasms associated with tobacco and alcohol consumption were lower and less steeply increasing than in the other NE areas, most notably Trento, therefore, contributing to produce the lowest overall cancer mortality rates of NE areas. Cancers of the stomach, uterus, and testis and Hodgkin's disease presented consistent downward trends in all examined areas. CONCLUSIONS: The analysis of mortality trends across areas is consistent with elevated and still increasing cancer rates in the 4 NE areas considered, especially for tobacco and alcohol-related neoplasms and skin melanoma. Preventive strategies, based on epidemiologic knowledge, especially against tobacco and heavy alcohol consumption, and intense intermittent sun exposure, seem to be priorities and may benefit from systematic sharing of information, expertise and intervention tools in NE Italy. At least part of the lack of cancer deaths in Bolzano must be attributable to the deaths of Bolzano residents abroad (especially in Austria) and/or to differences in coding practices. This should be elucidated in future studies.
Assuntos
Neoplasias/mortalidade , Distribuição por Idade , Causas de Morte , Feminino , Humanos , Itália/epidemiologia , Masculino , Mortalidade/tendências , Distribuição por SexoRESUMO
A retrospective study of patients at the Trento S. Chiara Hospital in the period 1982-86 showed up 8 cases of malignant mesothelioma (7 pleural and 1 peritoneal). The histology was re-examined for each case and clinical records was also looked at so as to identify onset symptomatology, diagnostic procedures and treatment. A standard questionnaire given to patients or close relations revealed previous exposure to asbestos in 2 of 3 males and in none of the 5 females. There was also a significant delay in formulation of correct diagnosis, attributable on the hand to the nonspecificity of the symptomatology of onset and on the other to the inadequacy of currently available clinical and radiological procedures. Only histology with the aid of immunocytochemical procedures was able to pinpoint correct diagnosis, in life. The ineffectiveness of conventional therapies and the poor overall prognosis for these patients is confirmed.
Assuntos
Mesotelioma/diagnóstico , Neoplasias Peritoneais/diagnóstico , Neoplasias Pleurais/diagnóstico , Adulto , Feminino , Humanos , Imuno-Histoquímica , Itália , Masculino , Mesotelioma/mortalidade , Mesotelioma/patologia , Pessoa de Meia-Idade , Neoplasias Peritoneais/mortalidade , Neoplasias Peritoneais/patologia , Peritônio/patologia , Pleura/patologia , Neoplasias Pleurais/mortalidade , Neoplasias Pleurais/patologia , Prognóstico , Estudos RetrospectivosRESUMO
7-valent conjugate pneumococcal vaccine is effective for preventing invasive pneumococcal diseases in childhood. The present serotype formulation of the conjugate Pneumococcal Vaccine is effective for preventing 75-90% of the invasive pneumococcal disease cases, depending of the vaccine-serotypes distribution in the several countries. Recent studies, carried out in the north-american context, show that mass vaccination campaign by 7-valent conjugate Pneumococcal Vaccine in childhood, reduce, in vaccinated subjects, the nasopharyngeal colonization by vaccine-serotypes, that are much more joined to antibacterial resistance. This implies non only an active and specific protection for vaccinated, but also for family and community contacts, children and adults. This interesting results, need to be confirmed also in european countries, open a new view for a wider pharmacoeconomic evaluation of the 7-valent conjugate Pneumococcal Vaccine in childhood.
Assuntos
Vacinas Meningocócicas/administração & dosagem , Nasofaringe/imunologia , Vacinas Pneumocócicas/administração & dosagem , Infecções Estreptocócicas/prevenção & controle , Criança , Pré-Escolar , Vacina Pneumocócica Conjugada Heptavalente , Humanos , Lactente , Vacinas Meningocócicas/imunologia , Vacinas Pneumocócicas/imunologia , Infecções Estreptocócicas/imunologia , Streptococcus pneumoniae/imunologiaRESUMO
Present paper reports the results of a survey on dietary habits of 1,398 children attending first class of primary school in Trento Province (northern Italy). The following items were investigated: frequency of breakfast and foods intake; frequency of foods at school. The consumption of tracer foods as vegetables, fruit and sweets was also investigated. The results were analyzed according gender, area of residence, teaching method (full time or not) and educational level of parents. The data about nutritional style are satisfactory even if they are strongly associated to education level of parents, above all of the mother. The adequacy of nutritional style is increasing with the increasing of education level. School meal, offering selected foods to all children attending full time teaching section, can re-equilibrate nutritional style, decreasing the differences associated to education level of the parents. Present data can be used for implementing and improving health promotion action on correct dietary habits in childhood, keeping count of the role of education level of the parents.