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Balloni A, Tini A, Prospero E, Busardò FP, Huestis MA, Lo Faro AF. Exposure to Synthetic Psychoactive Substances: A Potential Cause for Increased Human Hepatotoxicity Markers. Clin Chem 2024; 70:597-628. [PMID: 38427953 DOI: 10.1093/clinchem/hvad210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/20/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND Approximately 30 million people worldwide consume new psychoactive substances (NPS), creating a serious public health issue due to their toxicity and potency. Drug-induced liver injury is the leading cause of liver disease, responsible for 4% of global deaths each year. CONTENT A systematic literature search revealed 64 case reports, in vitro and in vivo studies on NPS hepatotoxicity. Maximum elevated concentrations of aspartate aminotransferase (136 to 15 632 U/L), alanine transaminase (121.5 to 9162 U/L), total bilirubin (0.7 to 702 mg/dL; 0.04 to 39.03 mmol/L), direct (0.2-15.1 mg/dL; 0.01-0.84 mmol/L) and indirect (5.3 mg/dL; 0.29 mmol/L) bilirubin, alkaline phosphatase (79-260 U/L), and gamma-glutamyltransferase (260 U/L) were observed as biochemical markers of liver damage, with acute and fulminant liver failure the major toxic effects described in the NPS case reports. In vitro laboratory studies and subsequent in vivo NPS exposure studies on rats and mice provide data on potential mechanisms of toxicity. Oxidative stress, plasma membrane stability, and cellular energy changes led to apoptosis and cell death. Experimental studies of human liver microsome incubation with synthetic NPS, with and without specific cytochrome P450 inhibitors, highlighted specific enzyme inhibitions and potential drug-drug interactions leading to hepatotoxicity. SUMMARY Mild to severe hepatotoxic effects following synthetic NPS exposure were described in case reports. In diagnosing the etiology of liver damage, synthetic NPS exposure should be considered as part of the differential diagnosis. Identification of NPS toxicity is important for educating patients on the dangers of NPS consumption and to suggest promising treatments for observed hepatotoxicity.
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Affiliation(s)
- Aurora Balloni
- Department of Excellence-Biomedical Sciences and Public Health, Section of Legal Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Anastasio Tini
- Department of Excellence-Biomedical Sciences and Public Health, Section of Legal Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine, and Public Health, Università Politecnica delle Marche, Ancona, Italy
- School of Nursing Science, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Section of Legal Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Marilyn Ann Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, United States
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Section of Legal Medicine, Università Politecnica delle Marche, Ancona, Italy
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Ponzio E, Di Biagio K, Dolcini J, Sarti D, Pompili M, Fiacchini D, Cerioni C, Ciavattini A, Gasperini B, Prospero E. Epidemiology of listeriosis in a region in central Italy from 2010 to 2019: Estimating the real incidence and space-time analysis for detecting cluster of cases. J Infect Public Health 2023; 16:1904-1910. [PMID: 37866268 DOI: 10.1016/j.jiph.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Contamination and transmission of different Listeria monocytogenes strains along food chain are a serious threat to public health and food safety. Understanding the distribution of diseases in time and space-time is fundamental in the epidemiological study and in preventive medicine programs. The aim of this study is to estimate listeriosis incidence along 10-years period and to perform space-time cluster analysis of listeriosis cases in Marche Region, Italy. METHODS The number of observed listeriosis cases/year was derived from regional data of surveillance of notifiable diseases and hospital discharge form. The capture and recapture method (C-R method) was applied to estimate the real incidence of listeriosis cases in Marche Region and the space-time scan statistics analysis was performed to detect clusters of space-time of listeriosis cases and add precision to the conventional epidemiological analysis. RESULTS The C-R method estimation of listeriosis cases was 119 in the 10- year period (2010-2019), with an average of 31.93 % of unobserved cases (lost cases). The estimated mean annual incidence of listeriosis was 0.77 per 100,000 inhabitants (95 %CI 0.65-0.92), accounting for 6.07 % of additional listeriosis cases per year than observed cases. Using the scan statistic, the two most likely clusters were identified, one of these was statistically significant (p < 0.05). The underdiagnosis and under-reporting in addition to listeriosis incidence variability suggested that the surveillance system of Marche Region should be improved. CONCLUSIONS This study provides evidence of the ability of space-time cluster analysis to complement traditional surveillance of food-borne diseases and to understand the local risk factors by implementing timely targeted interventions.
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Affiliation(s)
- Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene Preventive Medicine, and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Katiuscia Di Biagio
- Environmental Epidemiology Unit - Regional Environmental Protection Agency of Marche, Ancona, Italy
| | - Jacopo Dolcini
- Department of Biomedical Sciences and Public Health, Section of Hygiene Preventive Medicine, and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Donatella Sarti
- Department of Biomedical Sciences and Public Health, Section of Hygiene Preventive Medicine, and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | | | - Daniel Fiacchini
- Public Health Department, Azienda Sanitaria Territoriale Ancona, Ancona, Italy
| | - Chiara Cerioni
- School of Obstetric Sciences, Università Politecnica Delle Marche, Ancona, Italy
| | - Andrea Ciavattini
- Department of Clinical Sciences, Università Politecnica delle Marche, Salesi Hospital, Ancona, Italy
| | - Beatrice Gasperini
- Department of Biomedical Sciences and Public Health, Section of Hygiene Preventive Medicine, and Public Health, Università Politecnica delle Marche, Ancona, Italy; Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy.
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene Preventive Medicine, and Public Health, Università Politecnica delle Marche, Ancona, Italy
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Di Biagio K, Baldini M, Dolcini J, Serafini P, Sarti D, Dorillo I, Ranzi A, Settimo G, Bartolacci S, Simeoni TV, Prospero E. Atmospheric particulate matter effects on SARS-CoV-2 infection and spreading dynamics: A spatio-temporal point process model. Environ Res 2022; 212:113617. [PMID: 35667404 PMCID: PMC9164771 DOI: 10.1016/j.envres.2022.113617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 05/31/2023]
Abstract
Particulate matter (PM) may play a role in differential distribution and transmission rates of SARS-CoV-2. For public health surveillance, identification of factors affecting the transmission dynamics concerning the endemic (persistent sporadic) and epidemic (rapidly clustered) component of infection can help to implement intervention strategies to reduce the disease burden. The aim of this study is to assess the effect of long-term residential exposure to outdoor PM ≤ 10 μm (PM10) concentrations on SARS-CoV-2 incidence and on its spreading dynamics in Marche region (Central Italy) during the first wave of the COVID-19 pandemic (February to May 2020), using the endemic-epidemic spatio-temporal regression model for individual-level data. Environmental and climatic factors were estimated at 10 km2 grid cells. 10-years average exposure to PM10 was associated with an increased risk of new endemic (Rate Ratio for 10 μg/m3 increase 1.14, 95%CI 1.04-1.24) and epidemic (Rate Ratio 1.15, 95%CI 1.08-1.22) infection. Male gender, older age, living in Nursing Homes and Long-Term Care Facilities residence and socio-economic deprivation index increased Rate Ratio (RR) in epidemic component. Lockdown increased the risk of becoming positive to SARS-CoV-2 as concerning endemic component while it reduced virus spreading in epidemic one. Increased temperature was associated with a reduction of endemic and epidemic infection. Results showed an increment of RR for exposure to increased levels of PM10 both in endemic and epidemic components. Targeted interventions are necessary to improve air quality in most polluted areas, where deprived populations are more likely to live, to minimize the burden of endemic and epidemic COVID-19 disease and to reduce unequal distribution of health risk.
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Affiliation(s)
- Katiuscia Di Biagio
- Environmental Epidemiology Unit - Regional Environmental Protection Agency of Marche, Ancona, Italy.
| | - Marco Baldini
- Environmental Epidemiology Unit - Regional Environmental Protection Agency of Marche, Ancona, Italy
| | - Jacopo Dolcini
- Department of Biomedical Sciences and Public Health, Section of Hygiene - Polytechnic University, Ancona, Italy
| | - Pietro Serafini
- Medical Direction Department, Local Health Authority of Marche, Ancona, Italy
| | - Donatella Sarti
- Department of Biomedical Sciences and Public Health, Section of Hygiene - Polytechnic University, Ancona, Italy
| | - Irene Dorillo
- Air Quality Unit, Regional Environmental Protection Agency of Marche, Ancona, Italy
| | - Andrea Ranzi
- Centre for Environmental Health and Prevention, Regional Agency for Prevention, Environment and Energy of Emilia-Romagna, Modena, Italy
| | | | - Silvia Bartolacci
- Environmental Epidemiology Unit - Regional Environmental Protection Agency of Marche, Ancona, Italy
| | - Thomas Valerio Simeoni
- Environmental Epidemiology Unit - Regional Environmental Protection Agency of Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene - Polytechnic University, Ancona, Italy
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Sani T, Morelli I, Sarti D, Tassinari G, Capalbo M, Espinosa E, Gasperini B, Prospero E. Attitudes of Healthcare Workers toward Influenza Vaccination in the COVID-19 Era. Vaccines (Basel) 2022; 10:vaccines10060883. [PMID: 35746492 PMCID: PMC9231023 DOI: 10.3390/vaccines10060883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/21/2022] [Accepted: 05/28/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers (HCWs) are reluctant to participate in the influenza vaccination program, despite their high risk to contract and diffuse influenza due to professional exposure. The onset of the COVID-19 pandemic could raise HCW flu vaccination adherence. The aim of this study was to assess HCW attitudes toward influenza vaccination in the COVID-19 era. A multicenter observational study was carried out in three Italian hospitals (two in Pesaro and one in Fano, Marche region, Italy). Data about HCW influenza vaccination between 2013 and 2021 were extracted from the vaccination registers. An online questionnaire was sent to HCWs from July to October 2020 to assess their opinion about influenza vaccination in terms of knowledge, attitude, and practice during the COVID-19 pandemic. The number of flu-vaccinated HCWs increased from 3.7% in the 2013−2014 flu season to 53.6% in the 2020−2021 flu season (p < 0.001). About 15% (n = 324) of HCWs responded to the online questionnaire, and 30.5% of them declared that they had changed their minds on flu vaccination after the COVID-19 pandemic, deciding to get vaccinated. The COVID-19 pandemic significantly increased HCWs’ attitudes toward flu vaccination. However, flu vaccination adherence remained low and should be improved.
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Affiliation(s)
- Tommaso Sani
- School of Nursing, Università Politecnica delle Marche, Via Lombroso, 61122 Pesaro, Italy; (T.S.); (I.M.)
| | - Ilaria Morelli
- School of Nursing, Università Politecnica delle Marche, Via Lombroso, 61122 Pesaro, Italy; (T.S.); (I.M.)
| | - Donatella Sarti
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (D.S.); (E.P.)
| | - Giovanni Tassinari
- General Direction, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61122 Pesaro, Italy; (G.T.); (M.C.)
| | - Maria Capalbo
- General Direction, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61122 Pesaro, Italy; (G.T.); (M.C.)
| | - Emma Espinosa
- Geriatric Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61032 Fano, Italy;
| | - Beatrice Gasperini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (D.S.); (E.P.)
- Geriatric Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61032 Fano, Italy;
- Correspondence: ; Tel.: +39-0712-206036; Fax: +39-0712-206032
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (D.S.); (E.P.)
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Sisti D, Pazienza V, Piccini F, Citterio B, Baffone W, Donati Zeppa S, Biavasco F, Prospero E, De Luca A, Artico M, Taurone S, Minelli A, Perri F, Binda E, Pracella R, Santolini R, Amatori S, Sestili P, Rocchi MBL, Gobbi P. A proposal for the reference intervals of the Italian microbiota "scaffold" in healthy adults. Sci Rep 2022; 12:3952. [PMID: 35273317 PMCID: PMC8913673 DOI: 10.1038/s41598-022-08000-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/22/2022] [Indexed: 02/06/2023] Open
Abstract
Numerous factors, ranging from genetics, age, lifestyle, and dietary habits to local environments, contribute to the heterogeneity of the microbiota in humans. Understanding the variability of a “healthy microbiota” is a major challenge in scientific research. The gut microbiota profiles of 148 healthy Italian volunteers were examined by 16S rRNA gene sequencing to determine the range and diversity of taxonomic compositions in the gut microbiota of healthy populations. Possible driving factors were evaluated through a detailed anamnestic questionnaire. Microbiota reference intervals were also calculated. A “scaffold” of a healthy Italian gut microbiota composition was identified. Differences in relative quantitative ratios of microbiota composition were detected in two clusters: a bigger cluster (C2), which included 124 subjects, was characterized by more people from the northern Italian regions, who habitually practised more physical activity and with fewer dietary restrictions. Species richness and diversity were significantly higher in this cluster (C2) than in the other one (C1) (C1: 146.67 ± 43.67; C2: 198.17 ± 48.47; F = 23.40; P < 0.001 and C1: 16.88 ± 8.66; C2: 35.01 ± 13.40; F = 40.50; P < 0.001, respectively). The main contribution of the present study was the identification of the existence of a primary healthy microbiological framework that is only marginally affected by variations. Taken together, our data help to contextualize studies on population-specific variations, including marginal aspects, in human microbiota composition. Such variations must be related to the primary framework of a healthy microbiota and providing this perspective could help scientists to better design experimental plans and develop strategies for precision tailored microbiota modulation.
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Affiliation(s)
- Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
| | - Valerio Pazienza
- Division of Gastroenterology, IRCCS "Casa Sollievo della Sofferenza" Hospital, 71013, San Giovanni Rotondo, Italy
| | | | - Barbara Citterio
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
| | - Wally Baffone
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
| | - Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
| | - Francesca Biavasco
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, 60121, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences, Università Politecnica delle Marche, 60121, Ancona, Italy
| | - Antonio De Luca
- Department of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Marco Artico
- Department of Sense Organs, La Sapienza University, 00185, Rome, Italy
| | - Samanta Taurone
- Department of Sense Organs, La Sapienza University, 00185, Rome, Italy
| | - Andrea Minelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
| | - Francesco Perri
- Division of Gastroenterology, IRCCS "Casa Sollievo della Sofferenza" Hospital, 71013, San Giovanni Rotondo, Italy
| | - Elena Binda
- Cancer Stem Cells Unit ISBReMIT, IRCCS "Casa Sollievo della Sofferenza" Hospital, 71013, San Giovanni Rotondo, Italy
| | - Riccardo Pracella
- Cancer Stem Cells Unit ISBReMIT, IRCCS "Casa Sollievo della Sofferenza" Hospital, 71013, San Giovanni Rotondo, Italy
| | - Riccardo Santolini
- Department of Humanities, University of Urbino Carlo Bo, 61029, Urbino, Italy
| | - Stefano Amatori
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy.
| | - Piero Sestili
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
| | - Marco B L Rocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
| | - Pietro Gobbi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Piazza Rinascimento 7, 61029, Urbino, Italy
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Gasperini B, Pelusi G, Frascati A, Sarti D, Dolcini F, Espinosa E, Prospero E. Predictors of adverse outcomes using a multidimensional nursing assessment in an Italian community hospital. PLoS One 2021; 16:e0249630. [PMID: 33857183 PMCID: PMC8049226 DOI: 10.1371/journal.pone.0249630] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 03/22/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is growing evidence about the role of nurses in patient outcomes in several healthcare settings. However, there is still a lack of evidence about the transitional care setting. We aimed to assess the association between patient characteristics identified in a multidimensional nursing assessment and outcomes of mortality and acute hospitalization during community hospital stay. METHODS A retrospective observational study was performed on patients consecutively admitted to a community hospital (CH) in Loreto (Ancona, Italy) between January 1st, 2018 and May 31st, 2019. The nursing assessment included sociodemographic characteristics, functional status, risk of falls (Conley Score) and pressure damage (Norton scale), nursing diagnoses, presence of pressure sores, feeding tubes, urinary catheters or vascular access devices and comorbidities. Two logistic regression models were developed to assess the association between patient characteristics identified in a multidimensional nursing assessment and outcomes of mortality and acute hospitalization during CH stay. RESULTS We analyzed data from 298 patients. The mean age was 83 ± 9.9 years; 60.4% (n = 180) were female. The overall mean length of stay was 42.8 ± 36 days (32 ± 32 days for patients who died and 33.9 ± 35 days for patients who had an acute hospitalization, respectively). An acute hospitalization was reported for 13.4% (n = 40) of patients and 21.8% (n = 65) died. An increased risk of death was related to female sex (OR 2.25, 95% CI 1.10-4.62), higher Conley Score (OR 1.19; 95% CI 1.03-1.37) and having a vascular access device (OR 3.64, 95% CI 1.82-7.27). A higher Norton score was associated with a decreased risk of death (OR 0.71, 95% CI 0.62-0.81). The risk for acute hospitalization was correlated with younger age (OR 0.94, 95% CI 0.91-0.97), having a vascular access device (OR 2.33, 95% CI 1.02-5.36), impaired walking (OR 2.50, 95% CI 1.03-6.06) and it is inversely correlated with a higher Conley score (OR 0.84, 95% CI 0.77-0.98). CONCLUSION Using a multidimensional nursing assessment enables identification of risk of nearness of end of life and acute hospitalization to target care and treatment. The present study adds further knowledge on this topic and confirms the importance of nursing assessment to evaluate the risk of patients' adverse outcome development.
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Affiliation(s)
- Beatrice Gasperini
- Section of Hygiene and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Geriatrics, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Fano (PU), Italy
| | - Gilda Pelusi
- School of Nursing, Università Politecnica delle Marche, Ancona, Italy
| | | | - Donatella Sarti
- Section of Hygiene and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | | | - Emma Espinosa
- Geriatrics, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Fano (PU), Italy
| | - Emilia Prospero
- Section of Hygiene and Public Health, Università Politecnica delle Marche, Ancona, Italy
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Minelli A, Di Palma M, Rocchi MBL, Ponzio E, Barbadoro P, Bracci M, Pelusi G, Prospero E. Cortisol, chronotype, and coping styles as determinants of tolerance of nursing staff to rotating shift work. Chronobiol Int 2021; 38:666-680. [PMID: 33827343 DOI: 10.1080/07420528.2021.1887883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hypothalamo-pituitary-adrenal axis activity and cortisol patterns are likely to play a role in shift work tolerance, i.e., ability to adapt to shift work without suffering stress-related consequences. Yet, the evidence is scanty. Here, salivary cortisol output during night shifts and leisure days was assessed in fast-forward rotating shift work nursing staff (N = 30), and possible links with a series of variables - gender (30% male), age (M = 39.6, SEM = 1.57 y), years of service (M = 12.43, SEM = 1.48 y), BMI (M = 23.29, SEM = 0.66 Kg/m2), self-rated chronotype, sleep quality, and psycho-behavioral factors - were investigated. Main results show that cortisol output during night shifts: i) is larger in morning-oriented chronotypes, thus affected by the circadian misalignment between biological and working rhythms; ii) associates with dysfunctional coping styles at work; iii) positively correlates with diurnal cortisol secretion on leisure days, i.e., individuals with larger cortisol output during shifts display higher cortisol secretion on non-working days. Chronotype and psycho-behavioral factors explain most of the correlational weight linking cortisol output during the night shift and off-days. In conclusion, we confirm salivary cortisol testing as a suitable objective marker of occupational stress and propose it as a valuable index for monitoring shift work tolerance, in combination with chronotype. Moreover, we emphasize the importance of evaluating psycho-behavioral factors in professional settings, because these modifiable variables can be addressed with tailored psychological interventions to ameliorate poor job satisfaction, reduce work-related distress, and avoid chronic cortisol excess experienced by shift workers.
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Affiliation(s)
- Andrea Minelli
- Department of Biomolecular Sciences (DISB), University of Urbino Carlo Bo, Urbino, Italy
| | - Michael Di Palma
- Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, Università Politecnica Delle Marche, Ancona, Italy
| | | | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica Delle Marche, Ancona, Italy
| | - Pamela Barbadoro
- Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, Università Politecnica Delle Marche, Ancona, Italy
| | - Massimo Bracci
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Gilda Pelusi
- School of Nursing Science, Università Politecnica Delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica Delle Marche, Ancona, Italy
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Gasperini B, Cherubini A, Lucarelli M, Espinosa E, Prospero E. Multidrug-Resistant Bacterial Infections in Geriatric Hospitalized Patients before and after the COVID-19 Outbreak: Results from a Retrospective Observational Study in Two Geriatric Wards. Antibiotics (Basel) 2021; 10:antibiotics10010095. [PMID: 33478088 PMCID: PMC7835859 DOI: 10.3390/antibiotics10010095] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 12/23/2022] Open
Abstract
The impact of the COVID-19 pandemic on multidrug-resistant (MDR) bacteria is unknown. The purpose of this study was to assess prevalence, etiology, and association with mortality of MDR bacteria in older adult patients before and after the first peak of the COVID-19 pandemic in Italy. An observational retrospective study was conducted in two geriatric wards of the Azienda Ospedaliera Ospedali Riuniti Marche Nord, Fano, and of the INRCA, IRCCS, Ancona, in the Marche Region, Italy, from December 2019 to February 2020 and from May to July 2020. A total of 73 patients (mean age 87.4 ± 5.9, 27.4% men) and 83 cultures (36 pre-COVID-19 and 47 post-COVID-19) were considered. Overall, 46 cultures (55.4%) reported MDR bacteria (50% in pre- and 59.6% in post-COVID-19 period, p = 0.384). MDR bacteria in bloodstream significantly increased in post-COVID-19 period (68.8% vs. 40.0% p = 0.038) and MDR bacteria in urine did not change (51.6 vs. 54.8%, p = 0.799). Escherichia coli was the main MDR bacterium in pre-COVID-19, p = 0.082 and post-COVID-19, p = 0.026. Among patients with MDR infection, in-hospital mortality was 37.5% and 68.8% in pre- and post-COVID-19, respectively (p = 0.104), and mortality at 30 days was higher in post-COVID-19 period (78.9% vs. 27.3%, p = 0.012). An increased number of MDR bacteria in bloodstream and mortality after MDR infection have been observed in the post-COVID-19 period.
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Affiliation(s)
- Beatrice Gasperini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy;
- Geriatrics, Santa Croce Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61032 Fano, Italy;
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro di Ricerca Per L’invecchiamento, IRCCS INRCA, 60124 Ancona, Italy; (A.C.); (M.L.)
| | - Moira Lucarelli
- Geriatria, Accettazione Geriatrica e Centro di Ricerca Per L’invecchiamento, IRCCS INRCA, 60124 Ancona, Italy; (A.C.); (M.L.)
| | - Emma Espinosa
- Geriatrics, Santa Croce Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61032 Fano, Italy;
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, 60126 Ancona, Italy;
- Correspondence: ; Tel.: +39-071-2206030
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Barbadoro P, Ponzio E, Coccia E, Prospero E, Santarelli A, Rappelli GGL, D'Errico MM. Association between hypertension, oral microbiome and salivary nitric oxide: A case-control study. Nitric Oxide 2020; 106:66-71. [PMID: 33186726 DOI: 10.1016/j.niox.2020.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/04/2020] [Accepted: 11/05/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Nitric oxide (NO) produced in the oral cavity is a powerful resource for the human body, especially when NO-syntethase production is not adequate. The role of oral microbiome in determining blood pressure levels has been linked to the active role of some bacterial species involved in the nitro-reducing process. In the present study we investigated the correlation between selected oral microbiome characteristics, nitric oxide (NO) concentration in saliva and their association with hypertension. METHODS A case-control study including 48 (25 normotensive and 23 hypertensive subjects), subjects between 50 and 70 years old, was carried out at the dental clinic of an Italian teaching hospital. Characteristics of participants have been evaluated by means of a physical examination, and by an assisted interview. A real-time polymerase chain reaction in samples of saliva and plaque was used to detect Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Tannerella forsythia, Porphyromonas gingivalis, Treponema denticola, Streptococcus mutans, Streptococcus sanguinis, Veillonella dispar and Neisseria subflava as well as total bacterial count. Nitric oxide in saliva was evaluated by the ELISA method. RESULTS Normotensive subjects, compared with hypertensive subjects, had significantly higher concentration of NO (165.77 ± 61.7 vs 57.49 ± 19.61 μmol/l; p = 0.023), and higher bacterial concentration of the supragingival plaque (4.73E+07 ± 4.33+07 vs 4.02E+07 ± 4.00+07; p = 0.024). Bacterial species, usually associated to good oral health status, such as Neisseria subflava, were significantly more present in normotensive subjects than in hypertensive ones (9090.88 ± 5481.49 vs 4791.35 ± 4349.37; p < 0.001). considering the concentration of bacteria as a biomarker of the development of hypertension. CONCLUSIONS The results support the association between hypertension, oral microbiome and salivary nitric oxide, in fact do the results allow us to establish any biomarkers (microbial or biochemical, NO) that allow early therapeutic intervention.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy.
| | - Erminia Coccia
- School of Dentistry, Università Politecnica Delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy
| | - Andrea Santarelli
- School of Dentistry, Università Politecnica Delle Marche, Ancona, Italy
| | | | - Marcello M D'Errico
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy
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Bracci R, Gasperini B, Capalbo M, Campanelli T, Caimmi E, Mattioli R, Espinosa E, Prospero E. How to improve the identification of patients with cancer eligible for genetic counselling? Eur J Cancer Care (Engl) 2020; 29:e13276. [DOI: 10.1111/ecc.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 02/09/2020] [Accepted: 04/16/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Raffaella Bracci
- Oncology Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Beatrice Gasperini
- Geriatric Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Maria Capalbo
- Direzione Generale Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Tamara Campanelli
- Oncology Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Eleonora Caimmi
- Section of Hygiene Department of Biomedical Sciences Università Politecnica delle Marche Ancona Italy
| | - Rodolfo Mattioli
- Oncology Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Emma Espinosa
- Geriatric Unit Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro Italy
| | - Emilia Prospero
- Section of Hygiene Department of Biomedical Sciences Università Politecnica delle Marche Ancona Italy
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Prospero E, Galmozzi S, Paris V, Felici G, Barbadoro P, D'Alleva A, Zocco G, Ciavattini A. Factors influencing refusing of flu vaccination among pregnant women in Italy: Healthcare workers' role. Influenza Other Respir Viruses 2019; 13:201-207. [PMID: 30099856 PMCID: PMC6379633 DOI: 10.1111/irv.12600] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/24/2018] [Accepted: 08/07/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pregnant women are at increased risk of influenza complications. Influenza vaccine provides them a substantial protection. OBJECTIVE The aim of this study was to investigate determinants associated with non-adherence to influenza vaccine recommendations in pregnant women in Italy. METHODS A cross-sectional study has been carried out among pregnant women attending their follow-up visit in some mother and child services in a Region of Italy from October 2016 to January 2017. The study protocol was approved by the local research Ethics. A self-administered close-ended questionnaire has been administered to the pregnant women. Differences in background, socio-demographic characteristics, knowledge and attitudes towards flu vaccine were tested in vaccinated and unvaccinated women. Multivariate analysis was performed to control for confounding factors. RESULTS Three hundred and sixty-six women answered the survey (97% response rate) and 96.1% (348) declared of being unvaccinated against influenza during the 2016-2017 influenza season. Frequent reasons for refusing vaccination were drugs objection and concerns about vaccines' effects. According to the refusal attitude, influenza knowledge was low in the group. Moreover, analysis showed that low adherence to vaccination is associated to lacking promotion of vaccination to pregnant women carried out by healthcare workers (P < 0.005). CONCLUSIONS Healthcare workers have a key role in assisting women during the gestational period, so their active involvement in vaccination promotion is essential. It is necessary to improve health care workers' knowledge about vaccine relevance in protecting pregnancy and their communication skills to properly inform pregnant women.
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Affiliation(s)
- Emilia Prospero
- Department of Biomedical Sciences, Section of Hygiene, Università Politecnica delle Marche, Ancona, Italy
| | - Sara Galmozzi
- Department of Biomedical Sciences, Section of Hygiene, Università Politecnica delle Marche, Ancona, Italy
| | - Valentina Paris
- Woman's Health Sciences Department, Gynecologic Section, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Gessica Felici
- Woman's Health Sciences Department, Gynecologic Section, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences, Section of Hygiene, Università Politecnica delle Marche, Ancona, Italy
| | - Antonella D'Alleva
- Department of Biomedical Sciences, Section of Hygiene, Università Politecnica delle Marche, Ancona, Italy
| | - Gemma Zocco
- Department of Biomedical Sciences, Section of Hygiene, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Ciavattini
- Woman's Health Sciences Department, Gynecologic Section, AOU Ospedali Riuniti Ancona, Ancona, Italy
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Bait C, Denti M, Prospero E, Quaglia A, Orgiani A, Volpi P. Posterior cruciate ligament reconstruction with “all-inside” technique: a technical note. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.04.2014.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- C. Bait
- Knee Surgery and Sports Traumatology Unit, Human-itas Research Hospital, Rozzano, Milano, Italy
| | - M. Denti
- Knee Surgery and Sports Traumatology Unit, Human-itas Research Hospital, Rozzano, Milano, Italy
| | - E. Prospero
- Knee Surgery and Sports Traumatology Unit, Human-itas Research Hospital, Rozzano, Milano, Italy
| | - A. Quaglia
- Knee Surgery and Sports Traumatology Unit, Human-itas Research Hospital, Rozzano, Milano, Italy
| | - A. Orgiani
- Knee Surgery and Sports Traumatology Unit, Human-itas Research Hospital, Rozzano, Milano, Italy
| | - P. Volpi
- Knee Surgery and Sports Traumatology Unit, Human-itas Research Hospital, Rozzano, Milano, Italy
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Volpi P, Bait C, Cervellin M, Denti M, Prospero E, Morenghi E, Quaglia A. No difference at two years between all inside transtibial technique and traditional transtibial technique in anterior cruciate ligament reconstruction. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2014.18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- P. Volpi
- Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - C. Bait
- Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - M. Cervellin
- Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - M. Denti
- Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - E. Prospero
- Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - E. Morenghi
- Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
| | - A. Quaglia
- Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, Italy
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Barbadoro P, Ponzio E, Marigliano A, Vincitorio D, Di Tondo E, Scandali VM, Prospero E, Di Stanislao F, D'''''Errico MM. Study of knowledge, attitude, and consumption in Italian students towards the intake of performance-enhancing substances and energy-food supplements. MED SPORT 2018. [DOI: 10.23736/s0025-7826.18.03406-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gasperini B, Cherubini A, Pierri F, Barbadoro P, Fedecostante M, Prospero E. Potentially preventable visits to the emergency department in older adults: Results from a national survey in Italy. PLoS One 2017; 12:e0189925. [PMID: 29267333 PMCID: PMC5739429 DOI: 10.1371/journal.pone.0189925] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 12/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background Despite older adults use emergency department more appropriately than other age groups, there is a significant share of admissions that can be considered potentially preventable. Objective To identify socio-demographic characteristics and health care resources use of older adults admitted to emergency department for a potentially preventable visit. Design Data come from the Multipurpose Survey “Health conditions and use of health services”, edition 2012–2013. A stratified multi-stage probability design was used to select a sample using municipal lists of households. Subject 50474 community dwelling Italians were interviewed. In this analysis, 27003 subjects aged 65 years or older were considered. Methods Potentially preventable visits were defined as an emergency department visit that did not result in inpatient admission. Independent variables were classified based on the socio-behavioral model of Andersen-Newman. Descriptive statistics and a logistic regression model were developed. Results In the twelve months before the interview 3872 subjects (14.3%) had at least one potentially preventable visit. Factors associated with an increased risk of a potentially preventable visit were older age (75–84 years: OR 1.096, CI 1.001–1.199; 85+years: OR 1.022, CI 1.071–1.391), at least one hospital admission (OR 3.869, IC 3.547–4.221), to waive a visit (OR 1.188, CI 1.017–1.389) or an exam (OR 1.300, CI 1.077–1.570). Factors associated with a lower risk were female gender (OR 0.893, CI 0.819–0.975), area of residence (Center: OR 0.850; CI 0.766–0.943; Islands: OR 0.617, CI 0.539–0.706, South: OR 0.560; CI 0.505–0.622), private paid assistance (OR 0.761, CI 0.602–0.962); a better health-related quality of life (PCS score 46–54: OR 0.744, CI 0.659–0.841; PCS score >55: OR 0.746, CI 0.644–0.865). Conclusions Our study identified several characteristics associated with an increased risk of potentially preventable visits to the emergency department. This might allow the development of specific interventions to prevent the access of at risk subjects to the emergency department.
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Affiliation(s)
- Beatrice Gasperini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Department of Geriatrics and Rehabilitation, Santa Croce Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Fano, Italy
- * E-mail:
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l’invecchiamento, IRCCS-INRCA, Ancona, Italy
| | - Francesca Pierri
- Department of Economy, Section of Statistics, University of Perugia, Perugia, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Massimiliano Fedecostante
- Geriatria, Accettazione geriatrica e Centro di ricerca per l’invecchiamento, IRCCS-INRCA, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
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Gasperini B, Cherubini A, Fazi A, Maracchini G, Prospero E. Older adults in Emergency Departments: the challenge of undertriage. Intern Emerg Med 2016; 11:1145-1147. [PMID: 27384767 DOI: 10.1007/s11739-016-1503-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 07/01/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Beatrice Gasperini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
- Department of Geriatrics and Rehabilitation, Santa Croce Hospital, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Viale Vittorio Veneto 2, 61032, Fano, PU, Italy.
| | | | - Andrea Fazi
- Emergency Department Ospedale Principe di Piemonte, Area Vasta 2, via B. Cellini, 1, 60019, Senigallia, AN, Italy
| | - Gianfranco Maracchini
- Emergency Department Ospedale Principe di Piemonte, Area Vasta 2, via B. Cellini, 1, 60019, Senigallia, AN, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
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Barbadoro P, Ponzio E, Chiatti C, Di Stanislao F, D'Errico M, Prospero E. New market labor and obesity:
A nation-wide Italian cross-sectional study. Int J Occup Med Environ Health 2016; 29:903-914. [DOI: 10.13075/ijomeh.1896.00474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Barbadoro P, Bruschi R, Martini E, Savini S, Gioia M, Stoico R, Di Tondo E, D'Errico M, Prospero E. Impact of laminar air flow on operating room contamination, and surgical wound infection rates in clean and contaminated surgery. Eur J Surg Oncol 2016; 42:1756-1758. [DOI: 10.1016/j.ejso.2016.06.409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 06/21/2016] [Indexed: 10/21/2022] Open
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Barbadoro P, Recanatini C, Ponzio E, Illuminati D, D'Errico MM, Prospero E. Barriers to influenza vaccine uptake in obese people in Italy: Changes 2005-2013. Eur J Intern Med 2016; 34:34-38. [PMID: 27139917 DOI: 10.1016/j.ejim.2016.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 04/08/2016] [Accepted: 04/13/2016] [Indexed: 01/25/2023]
Abstract
BACKGROUND Obesity is an independent risk factor for developing flu-related complications. OBJECTIVE The aim of this study was to analyze influenza vaccine uptake (VU) in the Italian obese, before and after the introduction of obesity among the national recommendations, and to evaluate factors associated to VU. METHODS The comparison of two editions of the national survey carried out in 2004-2005, before the inclusion of obese people among the specific high risk categories for flu complications, and in 2013, reaching a sample of 21,857 persons who declared to have a BMI>30. Multilevel logistic regression was used to evaluate potential independent predictors of influenza immunization. RESULTS Influenza vaccination coverage was 27.16% in 2013, versus 31.61% in 2005. A significant reduction of VU was registered after the introduction of obesity among the high risk conditions, for which flu VU was recommended. Regression modeling, both in adults and in older people, confirmed that barriers to VU in 2013 were younger age, medium level of education, absence of chronic disease, smoking habit, and reporting no contacts with GPs during the previous 12months. Among those aged 65 or more, the role of regional policies was associated to VU. CONCLUSIONS Immunization rates among young obese population are low, especially if not affected by comorbidities. Moreover, a reduction was registered in 2013 with respect to 2005. Flu vaccine uptake among the older population seems to be influenced by regional vaccination strategies. The development of novel strategy is warranted, especially among the young adults.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
| | - Claudia Recanatini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Diego Illuminati
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Marcello M D'Errico
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
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Prospero E, Cavicchi A, Bacelli S, Barbadoro P, Tantucci L, D'Errico MM. Surveillance for Surgical Site Infection After Hospital Discharge: A Surgical Procedure–Specific Perspective. Infect Control Hosp Epidemiol 2016; 27:1313-7. [PMID: 17152028 DOI: 10.1086/509838] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Accepted: 05/22/2006] [Indexed: 02/02/2023]
Abstract
Objective.To estimate the rate of surgical site infection (SSI) occurring after hospital discharge, to evaluate whether limiting surveillance to inpatients underestimates the true rate of SSI, and to select surgical procedures that should be included in a postdischarge surveillance program.Design.Prospective surveillance study.Setting.A surgical ward at a university teaching hospital in Italy.Patients.A total of 264 surgical patients were included in the study.Results.The global SSI rate was 10.6% (28 patients); 17 (60.2%) of patients with an SSI developed the infection after hospital discharge. The overall mean length of postoperative stay (±SD) for patients who acquired a postdischarge SSI was 4.9 ± 3.7 days, and SSI was diagnosed a mean duration (±SD) of 11.5 ± 4.5 days after surgery. Among procedures with postdischarge SSIs, those classified by the National Nosocomial Infections Surveillance system (NNIS) as herniorrhaphy, mastectomy, other endocrine system, and other integumentary system were associated with a mean postoperative stay that was less than the mean time between the operation and the onset of SSI. Four (36%) of in-hospital SSIs occurred after procedures with an NNIS risk index of 0, and 7 (64%) occurred after procedures with an NNIS risk index of 1 or higher. Of the 17 SSIs diagnosed after discharge, 14 procedures (82%) had an NNIS risk index of 0, compared with 3 procedures (18%) with an NNIS risk index of 1 or higher.Conclusions.Our results revealed an increased risk of postdischarge SSI after some types of surgical procedures and suggest that there is an important need to change from generalized to NNIS operative category-directed postdischarge surveillance, at least for procedures locally considered to be high-risk.
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Affiliation(s)
- E Prospero
- Department Infectious Disease and Public Health, Universita Politecnica Marche, Ancona, Italy.
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Pierri MD, Crescenzi G, Capestro F, Recanatini C, Manso E, D’errico MM, Prospero E, Barbadoro P, Torracca L. Risk Factors and Impact on Clinical Outcome of Multidrug-Resistant Acinetobacter Baumannii Acquisition in Cardiac Surgery Patients. J Cardiothorac Vasc Anesth 2016; 30:680-6. [DOI: 10.1053/j.jvca.2015.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Indexed: 11/11/2022]
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Barbadoro P, Marmorale C, Recanatini C, Mazzarini G, Pellegrini I, D'Errico MM, Prospero E. May the drain be a way in for microbes in surgical infections? Am J Infect Control 2016; 44:283-8. [PMID: 26717874 DOI: 10.1016/j.ajic.2015.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Surgical site infection (SSI) is among the most frequent hospital-acquired infections occurring in surgical patients and leads to increased morbidity, mortality, and costs. We aimed to identify risk factors for SSI in patients undergoing surgical procedures, with a particular attention to the use of drains. METHODS This study includes all patients undergoing abdominal surgical procedures in 2 surgical wards in a teaching hospital in central Italy. Collected data included patient's demographic and clinical characteristics, procedure characteristics, administration of perioperative antibiotic prophylaxis, and microorganism isolated. The outcome of interest was SSI. FINDINGS A total of 872 abdominal surgery procedures were surveyed during the study period. Drains were placed in 37.0% of cases. SSI rate was 6.4% globally and 13.6% among the patients with drains, versus 2.4% in those without a drain (P < .001). In 72.1% of cases antibiotic prophylaxis was administered. The logistic regression analysis (P < .001) shown insertion of a drain (odds ratio [OR], 5.14; 95% confidence interval [CI], 2.63-10.08), prolonged surgery (OR, 1.98; 95% CI, 1.09-3.59), and American Society of Anesthesiologists score equal to 3 (OR, 6.13; 95% CI, 2.33-16.11) as independent risk factors for SSI, whereas antibiotic prophylaxis was protective (OR, 0.53; 95% CI, 0.29-0.99). CONCLUSION This study revealed surgical drains as a risk factor for SSI, pointing out the need of a clearer understanding of drain role in the dynamics of SSI occurrence, with the purpose of decreasing infection risk through targeted preventive interventions.
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Barbadoro P, Agostini M, D’Errico MM, Di Stanislao F, Filippetti F, Giuliani S, Prospero E. Application of space-time disease clustering by administrative databases in Italy: Adverse Reproductive Outcomes (AROs) and residential exposure. Popul Health Metr 2015; 13:36. [PMID: 26705395 PMCID: PMC4690256 DOI: 10.1186/s12963-015-0070-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/10/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aims of this study were to estimate the existence of clusters of AROs in the municipalities of the Marches Region (Central Italy) after complaints from residents living near an abandoned landfill site. METHODS Cases of AROs (i.e., congenital malformation, chromosomal abnormalities, and low birth weight) were retrieved from hospital discharge data. SaTScan and GeoDa were used to check for the presence of clusters at a regional and a small area level. Moreover, at a small area/neighborhood level, smoothed rates were calculated, and a case-control approach was used to assess the residence in proximity to the abandoned landfill as an independent risk factor for AROs. RESULTS AROs were associated with the price per square meter of the accommodations in the area of residence (OR 2.53, 95 % CI 2.06-3.10). On the other hand, residence within one kilometer of the landfill (OR 0.04, 95 % CI 0.01-0.23) and maternal age greater than 35 years (OR 0.96, 95 % CI 0.92-0.99) were protective. CONCLUSIONS Residency in proximity to the abandoned landfill was not a risk factor for the occurrence of AROs. The results show that basic information, such as the price of accommodations in different neighborhoods, could be of interest in order to target training programs for women living in difficult conditions and highlights the potential role of the building environment in perinatal health. However, we note that aside from the data provided by Geographic Information Systems in public health, collection of the patient's residential address was unreliable for selected conditions. Future efforts should emphasize the patient's residential address as information important for evaluating the health of individuals instead of being merely administrative data.
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Affiliation(s)
- Pamela Barbadoro
- />Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
| | | | - Marcello M. D’Errico
- />Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
| | - Francesco Di Stanislao
- />Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
| | | | - Sara Giuliani
- />School of Hygiene and Preventive Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Emilia Prospero
- />Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
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Lucertini F, Ponzio E, Di Palma M, Galati C, Federici A, Barbadoro P, D’Errico MM, Prospero E, Ambrogini P, Cuppini R, Lattanzi D, Minelli A. High Cardiorespiratory Fitness Is Negatively Associated with Daily Cortisol Output in Healthy Aging Men. PLoS One 2015; 10:e0141970. [PMID: 26529517 PMCID: PMC4631391 DOI: 10.1371/journal.pone.0141970] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 10/15/2015] [Indexed: 12/11/2022] Open
Abstract
Physical fitness has salutary psychological and physical effects in older adults by promoting neuroplasticity and adaptation to stress. In aging, however, the effects of fitness on the hypothalamic-pituitary-adrenal (HPA) axis are mixed. We investigated the association between cardiorespiratory fitness and HPA activity in healthy elderly men (n = 22, mean age 68 y; smokers, obese subjects, those taking drugs or reporting recent stressful events were excluded), by measuring in saliva: i) daily pattern of cortisol secretion (6 samples: 30' post-awakening, and at 12.00, 15.00, 18.00, 21.00, 24.00 h); and ii) the cortisol response to a mental challenge. Cardiorespiratory fitness (VO2max) was estimated using the Rockport Walking Test and the participants were assigned to high-fit (HF, ≥60°, n = 10) and low-fit (LF, ≤35°, n = 12) groups according to age-specific percentiles of VO2max distribution in the general population. At all daytimes, basal cortisol levels were lower in the HF than the LF group, most notably in the evening and midnight samples, with a significant main effect of physical fitness for cortisol levels overall; the area-under-the-curve for total daily cortisol output was significantly smaller in the HF group. Among the subjects who responded to mental stress (baseline-to-peak increment >1.5 nmol/L; n = 13, 5 LF, 8 HF), the amplitude of cortisol response and the steepness of recovery decline displayed an increasing trend in the HF subjects, although between-group differences failed to reach the threshold for significance. In conclusion, cardiorespiratory fitness in healthy aging men is negatively correlated with daily cortisol output and contributes to buffering the HPA dysregulation that occurs with advancing age, thus possibly playing a beneficial role in contrasting age-related cognitive and physical decline.
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Affiliation(s)
- Francesco Lucertini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Michael Di Palma
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Claudia Galati
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Ario Federici
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Marcello M. D’Errico
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Patrizia Ambrogini
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Riccardo Cuppini
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Davide Lattanzi
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Andrea Minelli
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
- * E-mail:
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Recanatini C, Zocco G, Galmozzi S, D'Alleva A, Barbadoro P, Prospero E. Determinants of flu vaccine uptake among the Italian pediatric high risk population in 2012–2013. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barbadoro P, Labricciosa FM, Recanatini C, Gori G, Tirabassi F, Martini E, Gioia MG, D'Errico MM, Prospero E. Catheter-associated urinary tract infection: Role of the setting of catheter insertion. Am J Infect Control 2015; 43:707-10. [PMID: 25840715 DOI: 10.1016/j.ajic.2015.02.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/06/2015] [Accepted: 02/09/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study aimed to describe the epidemiology of catheter-associated urinary tract infections (CAUTIs) in patients admitted to a surgical ward in Central Italy and to analyze the associated risk factors. METHODS An active surveillance program for CAUTI was carried out in patients catheterized for at least 48 hours. Place of catheter insertion (operating room, hospital ward, cystoscopy room, emergency care unit), indication for catheterization and its duration, among other risk factors were monitored until discharge. Antibiotic resistance profiles of isolates were analyzed. RESULTS There were 641 catheterized patients monitored for CAUTI onset. Of these, 40 (6.2%) developed a CAUTI (rates were 15.1/1,000 catheter days, 95% confidence interval [CI], 11.9-22.6; 8.7/1,000 patient days, 95% CI, 6.9-13.1). Patients with CAUTI were older (P < .05) and their durations of hospitalization and catheterization were both longer compared with those who were not affected (P < .05). Catheterization >4 days (odds ratio [OR] = 8.21; 95% CI, 3.79-17.73; P < .05) and place of catheter insertion different from the operating room (OR = 7.9; 95% CI, 2.83-22.08; P < .05, for catheters placed in the ward) were associated with CAUTI. Among the micro-organisms isolated in CAUTIs, the most common were Pseudomonas aeruginosa (41.5%), Klebsiella pneumoniae (19.5%), and Escherichia coli (12.2%); 82.5% of them were resistant to different classes of antibiotics. CONCLUSION These results highlight the role played by the setting of catheter insertion in CAUTIs onset, therefore reflecting the importance of hand hygiene and proper aseptic insertion techniques as crucial determinants in CAUTIs prevention.
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Barbadoro P, Di Tondo E, Menditto VG, Pennacchietti L, Regnicoli F, Di Stanislao F, D’Errico MM, Prospero E. Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy. PLoS One 2015; 10:e0127823. [PMID: 26076346 PMCID: PMC4468197 DOI: 10.1371/journal.pone.0127823] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/19/2015] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED) for non-urgent visits. Methods The study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use. Results Among the 416,698 sampled admissions, 6.39% (95% CI, 6.32–6.47) of re-admissions have been registered; the distribution shows a high frequency of events in the age 65–84 years group, and in the intermediate care hospitals (51.97%; 95%CI 51.37–52.57). The regression model has shown the significant role played by age, type of structure (geriatric acute care), and deprivation index of the area of residence on the readmission, however, after adjusting for the intensity of primary care, the role of deprivation was no more significant. Non-urgent ED visits accounted for the 12.10%, (95%CI 9.38–15.27) of the total number of respondents to the questionnaire (N = 504). The likelihood of performing a non-urgent ED visit was higher among patients aged <65 years (OR 3.2, 95%CI 1.3–7.8 p = 0.008), while it was lower among those perceiving as urgent their health problem (OR 0.50, 95%CI 0.30–0.90). Conclusions In the Italian context repeated readmissions and ED utilization are linked to different trajectories, besides the increasing age and comorbidity of patients are the factors that are related to repeated admissions, the self-perceived trust in diagnostic technologies is an important risk factor in determining ED visits. Better use of public national health care service is mandatory, since its correct utilization is associated to increasing equity and better health care utilization.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Hospital Hygiene Service, AOU Ospedali Riuniti, Ancona, Italy
- * E-mail:
| | - Elena Di Tondo
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | | | - Lucia Pennacchietti
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Februa Regnicoli
- Department of Emergency Care, AOU Ospedali Riuniti, Ancona, Italy
| | - Francesco Di Stanislao
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Marcello Mario D’Errico
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Hospital Hygiene Service, AOU Ospedali Riuniti, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Ancona, Italy
- Hospital Hygiene Service, AOU Ospedali Riuniti, Ancona, Italy
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Ponzio E, Sotte L, D’Errico MM, Berti S, Barbadoro P, Prospero E, Minelli A. Qi-gong training reduces basal and stress-elicited cortisol secretion in healthy older adults. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2015.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Volpi P, Prospero E, Bait C, Cervellin M, Quaglia A, Redaelli A, Denti M. High accuracy in knee alignment and implant placement in unicompartmental medial knee replacement when using patient-specific instrumentation. Knee Surg Sports Traumatol Arthrosc 2015; 23:1292-1298. [PMID: 24306122 DOI: 10.1007/s00167-013-2794-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 11/23/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE The influence of patient-specific instrumentations on the accuracy of unicompartmental medial knee replacement remains unclear. The goal of this study was to examine the ability of patient-specific instrumentation to accurately reproduce postoperatively what the surgeon had planned preoperatively. METHODS Twenty consecutive patients (20 knees) who suffered from isolated unicompartmental medial osteoarthritis of the knee and underwent medial knee replacement using newly introduced magnetic resonance imaging-based patient-specific instrumentation were assessed. This assessment recorded the following parameters: (1) the planned and the postoperative mechanical axis acquired through long-leg AP view radiographies; (2) the planned and the postoperative tibial slope acquired by means of standard AP and lateral view radiographies; and (3) the postoperative fit of the implanted components to the bone in coronal and sagittal planes. The hypothesis of the study was that there was no statistically significant difference between postoperative results and preoperatively planned values. RESULTS The study showed that (1) the difference between the postoperative mechanical axis (mean 1.9° varus ± 1.2° SD) and the planned mechanical axis (mean 1.8° varus ± 1.2° SD) was not statistically significant; (2) the difference between the postoperative tibial slope (mean 5.2° ± 0.6° SD) and the planned tibial slope (mean 5.4° ± 0.6° SD) was statistically significant (p = 0.008); and (3) the postoperative component fit to bone in the coronal and sagittal planes was accurate in all cases; nevertheless, in one knee, all components were implanted one size smaller than preoperatively planned. Moreover, in two additional cases, one size thinner and one size thicker of the polyethylene insert were used. CONCLUSIONS This study suggests that overall patient-specific instrumentation was highly accurate in reproducing postoperatively what the surgeon had planned preoperatively in terms of mechanical axis, tibial slope and component fit to bone. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- P Volpi
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - E Prospero
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - C Bait
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - M Cervellin
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - A Quaglia
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - A Redaelli
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - M Denti
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
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Ciavattini A, Clemente N, Delli Carpini G, Gentili C, Di Giuseppe J, Barbadoro P, Prospero E, Liverani CA. Loop electrosurgical excision procedure and risk of miscarriage. Fertil Steril 2015; 103:1043-8. [PMID: 25624192 DOI: 10.1016/j.fertnstert.2014.12.112] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/14/2014] [Accepted: 12/11/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the risk of miscarriage in the subsequent pregnancy after a loop electrosurgical excision procedure (LEEP), also considering time elapsed from LEEP to pregnancy. DESIGN Multicenter, retrospective cohort study. SETTING Tertiary care university hospitals. PATIENT(S) Women who had undergone LEEP from January 2000 to December 2011. Women with histologic assessment of low-grade cervical dysplasia, not requiring subsequent surgical treatment, constituted the control group. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The first pregnancy after the procedure was evaluated, and only women with singleton spontaneous pregnancies were considered. Women with time intervals of <12 months and women with intervals of ≥12 months or more from LEEP to pregnancy were then compared, to identify adjusted odds ratios for miscarriage. RESULT(S) In women previously treated with LEEP, a total of 116 cases of miscarriage (18.1%) was reported. The mean time interval from LEEP to pregnancy for women with miscarriage compared with women without miscarriage was significantly shorter (25.1 ± 11.7 months vs. 30.1 ± 13.3 months). A higher rate of miscarriage in women with a LEEP-to-pregnancy interval of <12 months compared with controls emerged (28.2% vs. 13.4%; adjusted odds ratio 2.60, 95% confidence interval 1.57-4.3). No significant difference in the rate of miscarriage in women with a LEEP-to-pregnancy interval of ≥12 months compared with controls emerged. CONCLUSION(S) Women with a time interval from LEEP to pregnancy of <12 months are at increased risk for miscarriage.
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Affiliation(s)
- Andrea Ciavattini
- Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy.
| | - Nicolò Clemente
- Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy
| | - Giovanni Delli Carpini
- Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy
| | - Chiara Gentili
- Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy
| | - Jacopo Di Giuseppe
- Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy
| | - Pamela Barbadoro
- Department of Biomedical Science and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Science and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Carlo Antonio Liverani
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Vincitorio D, Barbadoro P, Pennacchietti L, Pellegrini I, David S, Ponzio E, Prospero E. Risk factors for catheter-associated urinary tract infection in Italian elderly. Am J Infect Control 2014; 42:898-901. [PMID: 25087142 DOI: 10.1016/j.ajic.2014.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/08/2014] [Accepted: 05/08/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are the most common cause of hospital-acquired infections, especially in elderly patients. Data on CAUTIs in older persons in acute care settings are lacking, however. This study aimed to describe the epidemiology of CAUTIs and related outcomes (ie, length of stay and mortality), in patients admitted to an acute geriatric care hospital in central Italy. METHODS A CAUTI surveillance program was implemented from October 2011 to April 2012, according to the Centers for Disease Control and Prevention's National Healthcare Safety Network methodology. RESULTS A total of 2773 patients aged ≥65 years were included in the study, and 483 catheterized patients were monitored for the risk of CAUTI. The catheterization rate was 16.7% (95% confidence interval [CI], 15.3%-18.2%), and the overall CAUTI incidence rate was 14.7/1000 device-days (95% CI, 11.7-18.3/1000). Mortality was significantly higher in catheterized patients with a CAUTI compared with noncatheterized patients (19.2% vs 10.5%; P < .05). Female sex (odds ratio [OR], 1.31; 95% CI, 1.06-1.67), increasing age (≥90 years: OR, 2.76; 95% CI, 2.00-3.83), and longer hospital stay before catheter insertion (≥15 days: OR, 2.90; 95% CI, 2.20-3.83) were independent risk factors for catheterization; increasing age (>90 years: OR, 2.75; 95% CI, 1.03-7.35), and duration of hospital stay before catheter insertion (OR, 2.41; 95% CI, 1.12-5.51) were associated with CAUTIs. CONCLUSIONS These results underscore the importance of the proper choice of patients for catheterization, particularly in individuals aged >90 years.
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Affiliation(s)
- Daniela Vincitorio
- Medical Direction Department, National Institute for Health and Science on Ageing, Istituto Nazionale di Ricovero e Cura per Anziani-Istituto di Ricovero e Cura a Carattere Scientifico, Ancona, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
| | - Lucia Pennacchietti
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Ilaria Pellegrini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Serenella David
- Medical Direction Department, National Institute for Health and Science on Ageing, Istituto Nazionale di Ricovero e Cura per Anziani-Istituto di Ricovero e Cura a Carattere Scientifico, Ancona, Italy
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
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Barbadoro P, Marigliano A, Di Tondo E, Chiatti C, Di Stanislao F, D'Errico MM, Prospero E. Determinants of influenza vaccination uptake among Italian healthcare workers. Hum Vaccin Immunother 2014; 9:911-6. [PMID: 24064543 DOI: 10.4161/hv.22997] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We analyzed seasonal influenza vaccination coverage among the Italian healthcare workers (HCW) in order to identify socio-demographic and clinical determinants of vaccination. We used data from the survey "Health and health care use in Italy," which comprised interviews of 5,336 HCWs For each respondent, information on socioeconomic, health conditions, self-perceived health and smoking status were obtained. After bivariate analysis, we used multilevel regression models to assess determinants of immunization. Overall 20.8% of HCWs (95%CI 19.7-21.9) reported being vaccinated against seasonal influenza. After controlling for potential confounders, multilevel regression revealed that older workers have a higher likelihood of vaccine uptake (OR = 6.07; 95% CI 4.72-7.79). Conversely, higher education was associated with lower vaccine uptake (OR = 0.65; 95% IC 0.50-0.83). Those suffering from diabetes (OR = 2.07; 95% CI 1.19-1.69), COPD (OR = 1.95; 95% CI 1.31-2.89) and cardiovascular diseases (OR = 1.48 95% CI 1.11-1.96) were more likely to be vaccinated. Likewise, smokers, or former smokers receive more frequently the vaccination (OR = 1.40; 95% CI 1.15-1.70; OR = 1.54; 95% CI 1.24-1.91, respectively) compared with never-smokers as well as those HCWs reporting fair or poor perceived health status (ORs of 1.68, 95% CI 1.30-2.18). Vaccine coverage among HCWs in Italy remains low, especially among those with no comorbidities and being younger than 44 y old. This behavior not only raises questions regarding healthcare organization, infection control in healthcare settings and clinical costs, but also brings up ethical issues concerning physicians who seem not to be very concerned about the impact of the flu on themselves, as well as on their patients. Influenza vaccination campaigns will only be effective if HCWs understand their role in influenza transmission and prevention, and realize the importance of vaccination as a preventive measure.
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Affiliation(s)
- Pamela Barbadoro
- Section of Hygiene; Department of Biomedical Sciences and Public Health; Università Politecnica delle Marche; Ancona, Italy
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Barbadoro P, Martini E, Savini S, Marigliano A, Ponzio E, Prospero E, D'Errico M. In vivo comparative efficacy of three surgical hand preparation agents in reducing bacterial count. J Hosp Infect 2014; 86:64-7. [DOI: 10.1016/j.jhin.2013.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/23/2013] [Indexed: 10/26/2022]
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Prospero E, Barbadoro P, Marigliano A, D’Errico MM. Health care workers, immunization and safety issues: reflections from Italy. Am J Infect Control 2013; 41:664. [PMID: 23398771 DOI: 10.1016/j.ajic.2012.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 09/04/2012] [Indexed: 10/27/2022]
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Barbadoro P, Santarelli L, Croce N, Bracci M, Vincitorio D, Prospero E, Minelli A. Rotating shift-work as an independent risk factor for overweight Italian workers: a cross-sectional study. PLoS One 2013; 8:e63289. [PMID: 23675472 PMCID: PMC3651162 DOI: 10.1371/journal.pone.0063289] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/02/2013] [Indexed: 11/18/2022] Open
Abstract
Background A job-related factor is attracting a growing interest as a possible determinant of body weight gain in shift-workers. Objective The aim of the study was to reinvestigate the issue of overweight between rotating shift workers and daytime workers, taking into consideration possible confounding covariate factors. Methods This is a cross-sectional study, conducted by reviewing data from subjects participating in an occupational surveillance program in 2008. Participants answered a self-administered questionnaire to retrieve information about socio-demographic factors and working conditions (job schedule type, job-related physical activity, time in job), subjective health status, health care visits during the previous year, and lifestyle factors (dietary habits, leisure time physical activity, alcohol consumption). Participants underwent a medical examination for measurement of BMI, and acquisition of medical history. Results Compared to daytime workers (N = 229), rotating shift workers (N = 110) displayed higher BMI (mean BMI was 27.6±3.9 and 26.7±3.6 for shift workers, and daytime workers, respectively; p<0.05). Logistic regression analysis allowed to highlight the role of rotating shift-work as an independent risk factor for increased body weight (OR 1.93, 95%CI 1.01–3.71), being aged between 35 and 54 years was a major determinant of increased BMI (OR 2.39, 95%CI 1.14–5.00). In addition, family history of obesity was the strongest determinant of overweight/obesity (OR 9.79, 95%CI 1.28–74.74). Interestingly, no significant association was found between overweight and other potentially relevant factors, such as diet quality and food choices, alcohol consumption, levels of occupational and leisure-time physical activity. Conclusions Present findings seem to support the notion that rotating shift work is an independent risk factor for overweight, regardless of workers' dietary habits and physical activity levels.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health, School of Medicine—Università Politecnica delle Marche, Ancona, Italy
| | - Lory Santarelli
- Department of Molecular and Clinical Sciences, School of Medicine—Università Politecnica delle Marche, Ancona, Italy
| | - Nicola Croce
- Department of Molecular and Clinical Sciences, School of Medicine—Università Politecnica delle Marche, Ancona, Italy
| | - Massimo Bracci
- Department of Molecular and Clinical Sciences, School of Medicine—Università Politecnica delle Marche, Ancona, Italy
| | - Daniela Vincitorio
- Department of Biomedical Science and Public Health, School of Medicine—Università Politecnica delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Science and Public Health, School of Medicine—Università Politecnica delle Marche, Ancona, Italy
- * E-mail:
| | - Andrea Minelli
- Department of Earth, Life and Environmental Sciences, University of Urbino Carlo Bo, Urbino, Italy
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Barbadoro P, Annino I, Ponzio E, Romanelli RML, D'Errico MM, Prospero E, Minelli A. Fish oil supplementation reduces cortisol basal levels and perceived stress: A randomized, placebo-controlled trial in abstinent alcoholics. Mol Nutr Food Res 2013; 57:1110-4. [DOI: 10.1002/mnfr.201200676] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 12/03/2012] [Accepted: 12/18/2012] [Indexed: 11/08/2022]
Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health; Università Politecnica delle Marche; Ancona Italy
| | - Isidoro Annino
- Department of Biomedical Science and Public Health; Università Politecnica delle Marche; Ancona Italy
| | - Elisa Ponzio
- Department of Biomedical Science and Public Health; Università Politecnica delle Marche; Ancona Italy
- Department of Agricultural, Food and Environmental Sciences; Università Politecnica delle Marche; Ancona Italy
| | | | - Marcello M. D'Errico
- Department of Biomedical Science and Public Health; Università Politecnica delle Marche; Ancona Italy
| | - Emilia Prospero
- Department of Biomedical Science and Public Health; Università Politecnica delle Marche; Ancona Italy
| | - Andrea Minelli
- Department of Earth, Life and Environmental Sciences (DiSTeVA); Università di Urbino ‘Carlo Bo’; Urbino Italy
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Barbadoro P, Marigliano A, Tondo ED, De Paolis M, Martini E, Prospero E, D’errico MM. Measles among Healthcare Workers in a Teaching Hospital in Central Italy. J Occup Health 2013; 54:336-9. [DOI: 10.1539/joh.12-0016-br] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health, Section of Hygiene, Public Health and Preventive MedicineUniversità Politecnica delle MarcheItaly
- Hospital Hygiene Service, Ospedali RiunitiItaly
| | - Anna Marigliano
- Department of Biomedical Science and Public Health, Section of Hygiene, Public Health and Preventive MedicineUniversità Politecnica delle MarcheItaly
| | - Elena Di Tondo
- Department of Biomedical Science and Public Health, Section of Hygiene, Public Health and Preventive MedicineUniversità Politecnica delle MarcheItaly
| | | | | | - Emilia Prospero
- Department of Biomedical Science and Public Health, Section of Hygiene, Public Health and Preventive MedicineUniversità Politecnica delle MarcheItaly
- Hospital Hygiene Service, Ospedali RiunitiItaly
| | - Marcello Mario D’errico
- Department of Biomedical Science and Public Health, Section of Hygiene, Public Health and Preventive MedicineUniversità Politecnica delle MarcheItaly
- Hospital Hygiene Service, Ospedali RiunitiItaly
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Verdonk R, Volpi P, Verdonk P, Van der Bracht H, Van Laer M, Almqvist KF, Vander Eecken S, Prospero E, Quaglia A. Indications and limits of meniscal allografts. Injury 2013; 44 Suppl 1:S21-7. [PMID: 23351865 DOI: 10.1016/s0020-1383(13)70006-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Meniscal allograft transplantation has emerged as a useful treatment for carefully selected patients. The aim of this review of meniscal allograft transplantation is to put this procedure into a clinical perspective. Since there still is a lack of consensus on how the success of meniscal transplantation should be evaluated it is difficult to compare study outcomes. Nevertheless, almost all studies report an increase in patient satisfaction and improvement in pain and function. Clinical and functional outcome is improved in the majority of patients. Progression of cartilage degeneration according to MRI and radiological criteria was halted in a number of patients, indicating a chondroprotective effect. Joint space narrowing is only significantly progressive at long-term follow-up. On magnetic resonance imaging, shrinkage is seen after some years, but more in lyophilized allografts. Second-look arthroscopy usually shows good healing to the capsule. Overall, the clinical results of this type of surgery are encouraging and long-lasting in a well selected patient population who suffered a total meniscectomy. Meniscal allografting appears to becoming the golden standard therapy for these type of patients.
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Affiliation(s)
- R Verdonk
- Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Gent, Belgium.
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Prospero E, Illuminati D, Marigliano A, Pelaia P, Munch C, Barbadoro P, D’Errico MM. Learning from Galileo: Ventilator-associated Pneumonia Surveillance. Am J Respir Crit Care Med 2012; 186:1308-9. [DOI: 10.1164/ajrccm.186.12.1308] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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de Girolamo L, Quaglia A, Bait C, Cervellin M, Prospero E, Volpi P. Modified autologous matrix-induced chondrogenesis (AMIC) for the treatment of a large osteochondral defect in a varus knee: a case report. Knee Surg Sports Traumatol Arthrosc 2012; 20:2287-90. [PMID: 22842652 DOI: 10.1007/s00167-012-2143-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 07/16/2012] [Indexed: 11/24/2022]
Abstract
This paper presents a case report of a 27-year-old male patient affected by a large osteochondral defect of the medial femoral condyle (6 cm(2)) in a varus knee. He was treated with a combined approach consisting of high tibial osteotomy and autologous matrix-induced chondrogenesis technique enhanced by a bone marrow-enriched bone graft. Twelve months after surgery, the patient reported considerable reduction in pain and significant increase in his quality of life. A hyaline-like cartilage completely covered the defect and was congruent with the surrounding condyle cartilage as revealed by MRI and by a second-look arthroscopy. Level of evidence IV.
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Affiliation(s)
- L de Girolamo
- Orthopaedic Biotechnologies Lab, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
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Barbadoro P, Chiatti C, D’Errico MM, Di Stanislao F, Prospero E. Caesarean delivery in South Italy: women without choice. A cross sectional survey. PLoS One 2012; 7:e43906. [PMID: 23028476 PMCID: PMC3444483 DOI: 10.1371/journal.pone.0043906] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 07/26/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In spite of the World Health Organization's recommendations to maintain caesarean delivery (CD) between 5% and 15% of total births, the rates of CD continue to rise in countries with routine access to medical services. As in Italy CD rate reached 38% in 2008, the highest at EU level, we evaluated socioeconomic and clinical correlates of "elective" and "non programmed" CD in the Country. We performed a stratified analysis in order to verify whether the effect of such correlates differed among women with an "a priori" preference for natural and caesarean delivery respectively. METHODS AND FINDINGS We analyzed cross-sectional data from the Italian National Statistics Institute (ISTAT) survey on health condition. Socio-demographic variables, information on maternal care services use and health conditions during pregnancy, as well as maternal preferences on delivery, were available for a representative sample of 2,474 primiparous women. After an initial bivariate analysis, we used logistic regressions to evaluate factors associated to the study outcomes. Overall CD accounted for 35.5% of the total births in our sample (CI 33.6-37.4%); moreover, 30.7% (CI 28.6-32.6%) of women preferring natural delivery actually delivered with a CD. Elective CD rate is higher among women over 35 years (22.9%, CI 18.8-27.4%), and those living in the South (26.2%, CI 23.0-29.6%). The multivariate analysis showed that, even adjusting for several confounders, women in the South, receiving care in the private sector had higher chances of CD, also in case of preference for natural delivery. CONCLUSION Policy interventions are required to reduce the rate of undesired CD, e.g. increasing women knowledge regarding delivery in order to favour aware choices. An effective strategy to reduce CD rate should address the Southern Regions, as women here appear to have a very limited control over the delivery, in spite of a widespread preference for natural delivery.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Carlos Chiatti
- Department of Biomedical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | | | | | - Emilia Prospero
- Department of Biomedical Sciences, Università Politecnica delle Marche, Ancona, Italy
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Barbadoro P, Cotichelli G, Chiatti C, Simonetti ML, Marigliano A, Di Stanislao F, Prospero E. Socio-economic determinants and self-reported depressive symptoms during postpartum period. Women Health 2012; 52:352-68. [PMID: 22591232 DOI: 10.1080/03630242.2012.674090] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The researchers' aims were to estimate the prevalence of postpartum depressive symptoms in Italy. Cross-sectional data from the survey, "Health and use of health care in Italy" were analyzed. The authors focused on 5,812 women, pregnant some time during five years before the survey. Multiple logistic regression was used to evaluate risk factors independently associated with postpartum depressive symptoms. Evaluation of seasonal trends was also performed.In the total sample, 23.5% (n = 1,365) reported having suffered postpartum depressive symptoms: 20.7% experienced baby blues, and 2.8% postpartum depression. Factors significantly associated with baby blues were, among others, living in northern or central areas (adjusted odds ratio [aOR] 1.88; 95%CI 1.57-2.15 and 1.40; 95%CI 1.20-1.63, respectively), history of depression (aOR 1.34; 95%CI 1.15-1.56), and attendance at antenatal classes (aOR 1.13; 95%CI 1.04-1.22). Factors significantly associated with postpartum depression were: anamnesis of depression (aOR 3.32; 95%CI 2.69-4.09), gaining more than 16 kg of weight during pregnancy (aOR 1.48; 95%CI 1.03-2.12), and undergoing a cesarean section (planned: aOR 1.56; 95%CI 1.05-2.29; unplanned: aOR 1.78; 95%CI 1.16-2.73). Multiparity was a protective factor both for baby blues (aOR 0.80; 95%CI 0.70-0.91), and postpartum depression (aOR 0.71; 95%CI 0.51-0.98). No clear seasonality was observed for postpartum depression, while for baby blues a certain aggregation of events was registered during the central months of the year. The authors' study highlighted variables associated with baby blues and postpartum depression to target screening for women for postpartum depressive symptoms.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science, Polytechnic University of the Marches, Ancona, Italy
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Chiatti C, Barbadoro P, Marigliano A, Ricciardi A, Di Stanislao F, Prospero E. Determinants of influenza vaccination among the adult and older Italian population with chronic obstructive pulmonary disease: a secondary analysis of the multipurpose ISTAT survey on health and health care use. Hum Vaccin 2011; 7:1021-5. [PMID: 21941094 DOI: 10.4161/hv.7.10.16849] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We analyzed seasonal flu vaccination rates among the Italian population suffering from Chronic Obstructive Pulmonary Disease (COPD) in order to identify socio-demographic and clinical determinants for vaccination. We used data from the survey "Health and health care use in Italy", which interviewed 5,935 persons (age 15 - 102 years) suffering from COPD in the period 2004-2005. For each respondent, information on socioeconomic and health conditions, smoking status and patterns of health care utilization were retrieved. After bivariate analysis, we used two multilevel regression models to assess determinants of vaccination among the adult and the older Italian population. Overall 30.5% of adults (N=670) and 74.8% (N=2,796) of older people reported being vaccinated against seasonal flu. After controlling for potential confounders, older age increases the odds of vaccine uptake. Single marital status among the older people, smoking and not having contact with GPs in both age groups, are factors associated with non vaccination. Higher-educated elderly are less likely to be vaccinated, while coverage is higher among the wealthier adults. Vaccine coverage among adults with COPD in Italy remains low, especially among those with no comorbidities, and aged less than 44 years. It is only in older age that vaccination rates increase substantially. We found several risk factors for non vaccination, such as smoking, single marital status, and not having contacts with GPs, which should be considered in developing strategies to increase the coverage of influenza vaccine among people with COPD in Italy.
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Affiliation(s)
- Carlos Chiatti
- Italian National Institute of Health and Science on Aging, Ancona, Italy
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Barbadoro P, Marigliano A, Savini S, D'Errico MM, Prospero E. Group B Streptococcal sepsis: an old or ongoing threat? Am J Infect Control 2011; 39:e45-e48. [PMID: 21704424 DOI: 10.1016/j.ajic.2010.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 12/20/2010] [Accepted: 12/20/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Group B Streptococcus (GBS) is a major cause of severe infections in newborns. Early-onset disease (EOD) occurs within the first week of life, and it is usually vertically transmitted. In late-onset disease (LOD), pathogens may also come from nosocomial sources. We report 3 cases of GBS infection in very low birth weight infants hospitalized by a neonatal intensive care unit (NICU) in Italy. METHODS The cluster was identified thanks to an active surveillance program; an epidemiologic investigation took place. Pulsed-field gel electrophoresis (PFGE) was used to assess the clonal relatedness of strains. An audit to stress the adherence to isolation precautions and hand hygiene was organized. RESULTS During a 16-day period, 2 preterm newborns developed GBS LOD; an earlier case of GBS EOD occurred in a baby hospitalized by the same ward. The 3 GBS strains had the same antibiotic susceptibility pattern. The PFGE profiles of the 2 cases of LOD are indistinguishable from each other and closely related with the case of EOD. Strict infection control measures were adopted. CONCLUSION The implementation of additional infection control measures was able to stop the diffusion of infection; however, clusters like this should remind us the ongoing threat of GBS for the small NICU patients.
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MESH Headings
- Adult
- Age of Onset
- Bacteremia
- Cross Infection/diagnosis
- Cross Infection/epidemiology
- Cross Infection/microbiology
- Cross Infection/transmission
- Electrophoresis, Gel, Pulsed-Field
- Female
- Humans
- Incidence
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/microbiology
- Infant, Very Low Birth Weight
- Infection Control
- Infectious Disease Transmission, Vertical
- Intensive Care Units, Neonatal
- Italy
- Sepsis/diagnosis
- Sepsis/epidemiology
- Sepsis/microbiology
- Sepsis/transmission
- Streptococcal Infections/diagnosis
- Streptococcal Infections/epidemiology
- Streptococcal Infections/microbiology
- Streptococcal Infections/transmission
- Streptococcus agalactiae/classification
- Streptococcus agalactiae/genetics
- Streptococcus agalactiae/isolation & purification
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy; Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy.
| | - Anna Marigliano
- Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy
| | - Sandra Savini
- Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Marcello Mario D'Errico
- Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy; Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy; Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy
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Chiatti C, Barbadoro P, Lamura G, Di Stanislao F, Prospero E. Improving the delivery of flu vaccine for the older people in times of economic recession: what social epidemiology tells us, and what else we need to know. Hum Vaccin 2011; 7:986-8. [PMID: 21860260 DOI: 10.4161/hv.7.9.16693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Carlos Chiatti
- Department of Biomedical Sciences, Section of Hygiene and Public Health, Polytechnic University of the Marche Region, Ancona, Italy.
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Chiatti C, Barbadoro P, Lamura G, Pennacchietti L, Di Stanislao F, D'Errico MM, Prospero E. Influenza vaccine uptake among community-dwelling Italian elderly: results from a large cross-sectional study. BMC Public Health 2011; 11:207. [PMID: 21457562 PMCID: PMC3078885 DOI: 10.1186/1471-2458-11-207] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 04/01/2011] [Indexed: 11/24/2022] Open
Abstract
Background Flu vaccination significantly reduces the risk of serious complications like hospitalization and death among community-dwelling older people, therefore vaccination programmes targeting this population group represent a common policy in developed Countries. Among the determinants of vaccine uptake in older age, a growing literature suggests that social relations can play a major role. Methods Drawing on the socio-behavioral model of Andersen-Newman - which distinguishes predictors of health care use in predisposing characteristics, enabling resources and need factors - we analyzed through multilevel regressions the determinants of influenza immunization in a sample of 25,183 elderly reached by a nationally representative Italian survey. Results Being over 85-year old (OR = 1.99; 95% CI 1.77 - 2.21) and suffering from a severe chronic disease (OR = 2.06; 95% CI 1.90 - 2.24) are the strongest determinants of vaccine uptake. Being unmarried (OR = 0.81; 95% CI 0.74 - 0.87) and living in larger households (OR = 0.83; 95% CI 0.74 - 0.87) are risk factors for lower immunization rates. Conversely, relying on neighbors' support (OR = 1.09; 95% CI 1.02 - 1.16) or on privately paid home help (OR = 1.19; 95% CI 1.08 - 1.30) is associated with a higher likelihood of vaccine uptake. Conclusions Even after adjusting for socio-demographic characteristics and need factors, social support, measured as the availability of assistance from partners, neighbors and home helpers, significantly increases the odds of influenza vaccine use among older Italians.
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Affiliation(s)
- Carlos Chiatti
- Department of Biomedical Sciences, Section of Hygiene and Public Health, Polytechnic University of the Marche Region, via Tronto, 10/a Torrette di Ancona 60020, Italy.
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Barbadoro P, Marigliano A, D'Errico MM, Carnielli V, Prospero E. Gestational age as a single predictor of health care-associated bloodstream infections in neonatal intensive care unit patients. Am J Infect Control 2011; 39:159-62. [PMID: 21050625 DOI: 10.1016/j.ajic.2010.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 03/22/2010] [Accepted: 03/29/2010] [Indexed: 02/05/2023]
Abstract
Neonates rank among those at highest risk for health care-associated bloodstream infections (BSIs), which are linked to high morbidity and mortality rates. The importance of surveillance in preventing BSIs has been reported; however, a comparison of rates between different institution depends on methods used for risk adjustment and on factors identified as associated with infection. The present study aimed to compare the effectiveness of different stratification models in identifying neonates at risk for health care-associated sepsis. An observational prospective study was performed. The effectiveness of risk stratification models was assessed by receiver operating characteristic analysis. Our findings suggest the potential role of gestational age as a simple classification criteria for identifying patients at risk for BSI.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Via Tronto 10/A, Ancona, Italy.
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Betti M, Ambrogini P, Minelli A, Floridi A, Lattanzi D, Ciuffoli S, Bucherelli C, Prospero E, Frontini A, Santarelli L, Baldi E, Benetti F, Galli F, Cuppini R. Maternal dietary loads of α-tocopherol depress protein kinase C signaling and synaptic plasticity in rat postnatal developing hippocampus and promote permanent deficits in adult offspring. J Nutr Biochem 2011; 22:60-70. [DOI: 10.1016/j.jnutbio.2009.11.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Revised: 11/17/2009] [Accepted: 11/30/2009] [Indexed: 01/12/2023]
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Barbadoro P, Ponzio E, Pertosa ME, Aliotta F, D'Errico MM, Prospero E, Minelli A. The effects of educational intervention on nutritional behaviour in alcohol-dependent patients. Alcohol Alcohol 2010; 46:77-9. [PMID: 21097952 DOI: 10.1093/alcalc/agq075] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS To evaluate the nutritional status and the impact of an educational intervention on nutritional behaviour in alcohol-dependent patients. METHODS A pre-and post-intervention questionnaire and a follow-up interview were administered to 58 patients of a residential alcohol treatment service. RESULTS Females were at lower risk of being overweight than males, even after adjusting for amount and preferred type of alcohol beverage. Before intervention, 19% consumed 3 meals/day. Following the educational intervention, 22.2% of participants improved their knowledge. After 6 months, when 45 patients agreed to a telephone interview of whom 80% reported continued abstinence, 70.7% reported eating more than 3 meals/day. CONCLUSIONS Nutritional behaviour of alcohol patients after residential treatments improved during follow-up, and it is possible that an educational intervention to increase knowledge on healthy nutrition style may have contributed.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy.
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Prospero E, Barbadoro P, Esposto E, Manso E, Martini E, Savini S, Scaccia F, Tantucci L, Pelaia P, D'Errico MM. Extended-spectrum beta-lactamases Klebsiella pneumoniae: multimodal infection control program in intensive care units. J Prev Med Hyg 2010; 51:110-115. [PMID: 21361115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The aims of our study were to investigate a nosocomial spread of an extended-spectrum fl-lactamases-Klebsiella pneumoniae cluster at a University teaching hospital in Italy, to describe, and to monitor the implementation of a multimodal infection control program in two mixed ICUs. METHODS During the 1 October 2005-30 September 2006 period, 79 colonized patients have been identified. Isolates were genotyped by pulsed-field gel electrophoresis (PFGE). A mutimodal infection control program with monitoring of alcohol-based hand rub was performed in Intensive Care Units (ICU A and ICU B). RESULTS The epidemiological investigation and PFGE showed a horizontal transmission of the same PFGE genotype, with the isolation of the outbreak strain on the hand of one healthcare operator. Alcohol based hand rub was adopted in ICUA on 18 March 2006, in addition to hand washing with plain or antiseptic soap. ICU B did not change its hand hygiene habits. Following the implementation of the program, the incidence density rate (IDR) in ICU A fell down from 4.50 to 1.68/1000 patient days. DISCUSSION AND CONCLUSIONS Our findings confirm the important role of personnel in cross-transmission. Moreover the inbuilt control group involuntarily offered by the delaying of the intervention in ICU B has given the opportunity to verify the epidemiological association between the actual implementation of infection control practices and the outbreak control.
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Affiliation(s)
- E Prospero
- Institute of Infectious Diseases and Public Health, Università Politecnica delle Marche, Ancona, Italy
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