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Chiavarini M, Ricciotti GM, Genga A, Faggi MI, Rinaldi A, Toscano OD, D’Errico MM, Barbadoro P. Malnutrition-Related Health Outcomes in Older Adults with Hip Fractures: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:1069. [PMID: 38613102 PMCID: PMC11013126 DOI: 10.3390/nu16071069] [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: 03/01/2024] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Hip fracture is a common condition in older adults, leading to disability and mortality. Several studies have demonstrated the association between nutritional status and the risk of a negative health outcome after fractures. In this systematic review, we evaluated the association between malnutrition and mortality, changes in mobility/living arrangements, and postoperative complications, such as delirium, in older patients with hip fractures. A literature search on the PubMed, Web of Science, and Scopus databases, up to September 2023, was conducted to identify all studies involving older subjects that reported an association between MNA/GNRI/PNI/CONUT and health outcome after hip fracture. Meta-analysis was performed by a random-effects model using risk values (RR, OR, and HR) extracted from the 14 eligible selected studies. Malnutrition significantly increased the risk of any analyzed adverse outcome by 70% at 1 month, and up to 250% at 1 year. Malnutrition significantly increased delirium risk by 275% (OR = 2.75; 95% CI 1.80-4.18; p ≤ 0.05), mortality risk by 342% (OR = 3.42; 95% CI 2.14-5.48; p ≤ 0.05), mortality hazard risk by 351% (HR = 3.51; 95% CI 1.63-7.55; p ≤ 0.05) at 1 month, and transfer-to-more-supported-living-arrangements risk by 218% (OR = 2.18; 95% CI 1.58-3.01; p ≤ 0.05), and declined mobility risk by 41% (OR = 1.41; 95% CI 1.14-1.75; p ≤ 0.05), mortality risk by 368% (OR = 3.68; 95% CI 3.00-4.52; p ≤ 0.05), and mortality hazard risk by 234% (HR = 2.34; 95% CI 1.91-2.87; p ≤ 0.05) at 1 year. Malnutrition of older patients increases the risk of death and worsens mobility and independence after hip fractures. The results of the present study highlight the importance of nutritional status evaluation of older subjects with hip fractures in order to prevent potential adverse outcomes (Registration No: CRD42023468751).
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Affiliation(s)
| | | | - Anita Genga
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60126 Ancona, Italy; (M.C.); (G.M.R.); (M.I.F.); (A.R.); (O.D.T.); (M.M.D.)
| | | | | | | | | | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60126 Ancona, Italy; (M.C.); (G.M.R.); (M.I.F.); (A.R.); (O.D.T.); (M.M.D.)
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Chiavarini M, Ricciotti GM, Genga A, Barbadoro P. Letter to the Editor on "Association between nutritional indices and mortality after hip fracture: a systematic review and meta-analysis". Eur Rev Med Pharmacol Sci 2024; 28:2633-2635. [PMID: 38639500 DOI: 10.26355/eurrev_202404_35889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Affiliation(s)
- M Chiavarini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona (AN), Italy.
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Dolcini J, Chiavarini M, Ponzio E, Firmani G, D’Errico MM, Barbadoro P. Consumption of Tap Water and Sociodemographic-Associated Characteristics: A Nationwide Cross-Sectional Study. Nutrients 2024; 16:944. [PMID: 38612978 PMCID: PMC11013857 DOI: 10.3390/nu16070944] [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: 02/14/2024] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N = 45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water made up 19,674, with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, people concerned about waste production and climate change, and those coming from the north-east regions of Italy. Underweight people showed a higher prevalence of TW consumption as well as those who less than occasionally drank carbonated drinks, drank alcohol, consumed vegetables more than once a day and snacks less than once a week, dairy products more than once a day, sweet less than once a week, cured meat less than once a week, and chicken meat less than once a week, those with no consumption of sheep meat, consumption of beef meat less than once a week and consumption of pork meat less than once a week, and those with a satisfactory level of perceived health status. Regressions showed that all other age classes are less likely to drink tap water than people younger than 20 years old. The category with "inadequate" economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as islands. A concern about waste production and climate change is associated with an increased likelihood of consuming tap water. Tap water consumption was negatively associated with obesity but not with a satisfactory self-perceived health status. Insights from this study can inform public health strategies.
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Affiliation(s)
- Jacopo Dolcini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60131 Ancona, Italy; (M.C.); (E.P.); (G.F.); (M.M.D.)
| | - Manuela Chiavarini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60131 Ancona, Italy; (M.C.); (E.P.); (G.F.); (M.M.D.)
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60131 Ancona, Italy; (M.C.); (E.P.); (G.F.); (M.M.D.)
| | - Giorgio Firmani
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60131 Ancona, Italy; (M.C.); (E.P.); (G.F.); (M.M.D.)
| | - Marcello Mario D’Errico
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60131 Ancona, Italy; (M.C.); (E.P.); (G.F.); (M.M.D.)
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60131 Ancona, Italy; (M.C.); (E.P.); (G.F.); (M.M.D.)
- Centre of Obesity, Marche Polytechnic University, Via Tronto 10a, 60126 Ancona, Italy
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Dolcini J, Ponzio E, D'Errico MM, Barbadoro P. Socioeconomic differences in dietary habits in Italy before and during COVID-19 pandemic: secondary analysis of a nationwide cross-sectional study. BMC Public Health 2024; 24:153. [PMID: 38200456 PMCID: PMC10782767 DOI: 10.1186/s12889-023-17530-6] [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: 04/28/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Several socioeconomic conditions may influence subjects' adherence to healthy eating habits. Food consumption may be influenced by external stress during crisis periods; however, the effects of these events on food habits are difficult to predict. Also, a pandemic crisis like the recent COVID-19 pandemic may have influenced dietary habits and food consumption. The objective of this study was to compare the dietary habits of Italian people before the COVID-19 pandemic with those belonging to the year 2020 in a nationwide population sample. MATERIALS AND METHODS Information on dietary habits has been obtained from the multi-purpose survey on families' "Aspects of daily life", carried out in Italy by the Italian National Statistics Institute (ISTAT). We analyzed data coming from 2016 and 2020 editions of the survey (43,000 subjects each year). We used population attributable fraction (PAF) adjusted for age, defined as the proportional reduction in unhealthy diet that would occur if all participants had had a higher education, assuming higher educated individuals as more socially advantaged. Prevalence association for each dietary exposition has been calculated through logistic regression. RESULTS Looking at aggregated data from 2016 and 2020 both men and women showed a high prevalence of unhealthy dietary habits. Regarding men, excessive consumption of eggs, pork meat, and bovine meat was characterized by a PAF attributable to socioeconomic conditions to an extent greater than 30%. Women showed the same trend. Focusing on different years of investigation, in 2020, during the COVID-19 pandemic, men and women increased their consumption of eggs, cooked fats, snacks, and sweets, and reduced consumption of fruits and vegetables. Additionally, women increased the assumption of dietary products and meat. Both sexes registered an increase in overweight and obese subjects in 2020. CONCLUSIONS To our knowledge, this study was the first in our country to use a yearly, nationwide sample to analyze dietary habits by examining specific types of various foods on a nationwide scale and establishing a correlation between these habits and the COVID-19 pandemic. Our results showed unbalanced dietary habits of the Italian population with an excess of consumption of several foods like eggs, cooked fats snacks, and sweets with low consumption of fruits and vegetables. Socioeconomic differences influence food choices but in a complex way since they seemed to affect some wrong dietary habits but not others, especially regarding fruits and vegetables assumption where differences were less evident among social classes. Outside stressors like a crisis period such as the COVID-19 pandemic seem to have an important role in both men and women regarding the assumption of so-called "junk food".
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Affiliation(s)
- Jacopo Dolcini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy.
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Marcello Mario D'Errico
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
- Centre of Obesity, Marche Polytechnic University, Via Tronto 10a, Ancona, 60126, Italy
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Barbadoro P, Dolcini J, Fortunato C, Mengarelli Detto Rinaldini D, Martini E, Gioia MG, Mengoni D, D'Errico MM. Point prevalence survey of antibiotic use and healthcare-associated infections in acute care hospitals: a comprehensive report from the Marche Region of Italy. J Hosp Infect 2023; 141:80-87. [PMID: 37574019 DOI: 10.1016/j.jhin.2023.07.025] [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: 05/23/2023] [Revised: 07/01/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) are serious health challenges. Point prevalence surveys (PPSs) are valuable tools for monitoring HAIs and AMR. AIM To describe results of the ECDC PPS 2022 dealing with the prevalence of HAIs, antimicrobial consumption, and associated factors, in acute care hospitals. METHODS The survey was performed in November 2022 in 14 hospitals according to the protocol proposed by the European Centre for Disease Prevention and Control. Multilevel logistic regression was performed using geographical area/hospital type as cluster variable to evaluate the factors independently associated with HAIs and antibiotics. FINDINGS The point prevalence of HAIs was 7.43%. Patients hospitalized for longer periods were more likely to have an HAI as well as those aged 15-44 years, with a rapidly fatal disease, intubated, and with one or two devices. Antibiotics prevalence was 47.30%. Males, unknown McCabe scores, minimally invasive/non-National Healthcare Safety Network (NHSN) surgery, patients with HAIs, hospitals with a higher alcohol hand-rub consumption, hospitals with a greater number of IPC personnel, geriatric wards, and hospitals with 300-600 beds were more likely to be under antimicrobial therapy. CONCLUSION This PPS provided valuable information on the prevalence of HAIs and antimicrobial consumption and variables associated. The high prevalence of HAIs highlights the need for improved infection control measures.
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Affiliation(s)
- P Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - J Dolcini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy.
| | - C Fortunato
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - D Mengarelli Detto Rinaldini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - E Martini
- Hospital Hygiene Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - M G Gioia
- Hospital Hygiene Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - D Mengoni
- Hospital Hygiene Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
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Dolcini J, Ponzio E, Campanati A, D'Errico MM, Barbadoro P. Gender, Socioeconomic, and Health Characteristics Associated to Dermatological Visits in Italy: Secondary Analysis of a National Cross-Sectional Survey. Dermatology 2023; 239:1013-1018. [PMID: 37769634 DOI: 10.1159/000534223] [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: 10/17/2022] [Accepted: 09/18/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Very few studies have investigated possible role of sociodemographic factors in terms of differences in access to dermatologic visits, and almost all of them have been conducted in health system realities where insurance companies play an important role in terms of access to healthcare providers. To our knowledge in Italy, there is lack of studies carried out with the aim to investigate possible role of sociodemographic factors regarding differences in outpatient dermatologic use for a variety of dermatologic conditions. Indeed, some investigations have been focused on specific dermatologic conditions without analyzing the big and extremely wide picture of skin diseases. OBJECTIVE The aim of this study was to analyze possible variables associated with tendency to access dermatological visits. METHODS We analyzed data from the multipurpose Italian cross-sectional Health Interview Survey routinely carried out by the Italian National Institute of Statistics (ISTAT). Mixed effect logistic regression models have been built to evaluate factors independently associated with dermatological visit. RESULTS Of the 119,073 subjects, only 2.3% underwent a dermatological visit. People older than 44 years old are less likely of undergoing a dermatological visit as well as people married/cohabiting, separated/divorced, and widowed, with low economic resources and living in southern and islands areas. Upper education levels are associated to increased probability of having a dermatological visit as well as lowering class of self-perceived health status and living in northern and central areas. CONCLUSION This study shows an association between the odds of having dermatological visits and some sociodemographic factors. This could generate possible health disparities in dermatological disease outcomes.
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Affiliation(s)
- Jacopo Dolcini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Anna Campanati
- Department of Clinical and Molecular Sciences, Dermatological Clinic, Polytechnic University of the Marche Region, Ancona, Italy
| | - Marcello Mario D'Errico
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
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Barbadoro P, Brunzini A, Dolcini J, Formenti L, Luciani A, Messi D, Papetti A, Ponzio E, Germani M, Adrario E. Stress responses in high-fidelity simulation and standard simulation training among medical students. BMC Med Educ 2023; 23:116. [PMID: 36797725 PMCID: PMC9936714 DOI: 10.1186/s12909-023-04101-x] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Simulation has been recognized as a shift in healthcare education that can improve skills and patient safety and outcomes. High-fidelity simulation of critical medical situations can be a source of stress among participants that can interfere with students' abilities leading to unexpected emotional responses. The aim of this study is to determine if two simulation methods, high-fidelity (HF) and procedural simulation (PS), may be associated with stress responses at a self-perceived and biological level (salivary cortisol variations), and to compare stress levels of the two different simulation method. We also wanted to find independent variables associated with cortisol total hormonal output. METHODS A quasi-experimental before-after study was used including the administration of questionnaires, and biomarkers evaluation by salivary cortisol samples before and after simulation. A total of 148 students were eligible and agreed to participate in the study. We used paired T-test for mean comparison regarding State-trait anxiety for both HF and PT simulations. For NASA-TLX we performed a T-test mean comparison between groups. We used paired T-test mean comparison for cortisol analysis. Multivariable linear regression has been used to assess variables associated with AUCg values and perceived stress. RESULTS values of STAI-Y scores were relatively higher at the end of the HF and PS sessions. NASA-TLX was significantly higher at baseline for the HF simulations, with respect to the PS simulation. Cortisol fold increase was significantly different in the two groups. Linear regression showed that cortisol AUCg was related to the STAI-Y score in both groups. CONCLUSION Participating students developed a stress response both after in the HF and PS training, testified by psychological and biological outputs. According to our results, stress levels were increased for simply being in a simulation scenario than to the intrinsic complexity of the task required. More studies are needed to confirm this trend and to clarify the role of simulated stress response in a long-term learning scenario.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Agnese Brunzini
- Department of Industrial Engineering and Mathematical Sciences, Polytechnic University of the Marche Region, 60131, Ancona, Italy
| | - Jacopo Dolcini
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy.
| | - Luca Formenti
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Aurora Luciani
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Daniele Messi
- Department of Biomedical Sciences and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Alessandra Papetti
- Department of Industrial Engineering and Mathematical Sciences, Polytechnic University of the Marche Region, 60131, Ancona, Italy
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Michele Germani
- Department of Industrial Engineering and Mathematical Sciences, Polytechnic University of the Marche Region, 60131, Ancona, Italy
| | - Erica Adrario
- Department of Biomedical Sciences and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy
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Barbadoro P, Ponzio E, D'Errico M, Dolcini J, M. D’Errico M. Non-consumption of meat and health status in Italy: 2013-2016 snapshot. CNF 2023. [DOI: 10.2174/1573401319666230210123817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Background
A large number of individuals around the world consider themselves to be vegetarians for many individual reasons, and the vegetarian diet appears very heterogeneous. The prevalence of vegetarianism varies widely around the world.
Objective
This paper examined the variables associated with the non-consumption of meat and valued trends in the plant-based diet among Italian adults in relation to the level of self-perceived health in this category of people in 4 years (2013-2016).
Method
Data were drawn from the survey “Aspects of daily life” conducted by the ISTAT (Istituto Nazionale di Statistica). We considered the data of the 2013-2016 editions to evaluate the trend and attitude of the Italian population towards the non-consumption of meat during 4 years and assessed trends in the plant-based diet among Italian adults in relation to the level of self-perceived health.
Results
The results showed an increasing trend from 2013 to 2016. In statistical analysis, vegetarian status was associated to under the age of 45, having a high level of education, being mainly separated or divorced, being resident in the North-West regions, and with a poor self-perceived state of health. Furthermore, vegetarians had shown healthier lifestyles and lower risk factors for non-communicable diseases than non-vegetarians.
Conclusion
The results suggest that despite perceiving a worse health status, the long-term health of vegetarians is good and may be better than that of comparable non-vegetarians for some conditions and diseases, such as Obesity and IHD. As for all types of diet, well-designed health educational interventions conveying information on correct eating behavior may significantly contribute to increasing the degree of perceived health.
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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
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle 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
| | - 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
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Fortunato C, Radić I, Barbadoro P. HIV/AIDS stigma among University students in Ancona (Italy) and Novi Sad (Serbia). Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sigma associated with HIV/AIDS can be a considerable barrier to HIV prevention. The aim of the study was to assess factors associated with stigmatizing attitudes among university students.
Methods
The study was conducted as a cross-sectional study among 1305 university students in Ancona (Italy) and Novi Sad (Serbia) from October to December 2020 (67.7% females). The mean age of participants was 21.94 ± 2.45. The instrument of the study was an online questionnaire that included socio-demographic data and questions about attitudes toward HIV/AIDS. Stigma was analyzed using five questions and the stigma score was calculated (a lower score indicated a higher stigma attitude).
Results
Among University students 89.7% would share a classroom with a student with HIV/AIDS, 2.5% of students think that students with HIV/AIDS should have separate classes and 5.8% are not sure if they should be in separate classes. Only half of the students (50.1%) said that they would share a bathroom with HIV/AIDS positive students and 80.4% said that they would buy fruits from a HIV/AIDS positive person. Every second student (55.1%) thinks that HIV-positive women should have children. The mean stigma score of the respondents in this study was 3.66 ± 1.26. Stigma score was lowest among youngest participants and among students at lower study year. The stigmatizing attitude was less present among students of medicine (4.09), comparing to other faculties (3.33) (p < 0.001). There were no statistical differences according to gender, data about who they live with, material status of the family and between Universities.
Conclusions
Results of this study showed that there are some negative attitudes toward people living with HIV/AIDS among university students. The stigmatizing attitude was more common among younger students.
Key messages
Stigmatizing attitude toward HIV/AIDS is still present among younger generations. Need for more health promotion activities among students from both countries.
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Affiliation(s)
- C Fortunato
- Facoltà di Medicina e Chirurgia, Università Politecnica delle Marche, Ancona, Italy
| | - I Radić
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - P Barbadoro
- Dipartimento Scienze Biomediche e Sanità Pubblica, Facoltà di Medicina e Chirurgia, Università Politecnica delle Marche, Ancona, Italy
- SOD Igiene Ospedaliera, AOU, Ospedali Riuniti, Ancona, Italy
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Diotallevi F, Campanati A, Radi G, Martina E, Rizzetto G, Barbadoro P, D'Errico MM, Offidani A. Vaccines Against SARS-CoV-2 in Psoriasis Patients on Immunosuppressive Therapy: Implications of Vaccination Nationwide Campaign on Clinical Practice in Italy. Dermatol Ther (Heidelb) 2021; 11:1889-1903. [PMID: 34586598 PMCID: PMC8480269 DOI: 10.1007/s13555-021-00610-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 08/02/2021] [Indexed: 01/08/2023] Open
Abstract
More than 12 months have passed since the World Health Organization (WHO) declared Coronavirus Disease 19 (COVID-19), caused by the SARS-CoV2 virus, to be a pandemic on 11 March 2020. The entire world scientific community agrees that at this time vaccine is the most promising weapon to combat the infection and the severity of the disease. According to the document “Draft landscape of COVID-19 candidate vaccines” by WHO, 272 vaccines against SARS-CoV-2 virus are in development, although only four of these, produced by Pfizer-BioNTech (Pfizer, Inc. and BioNTech), Moderna, AstraZeneca, and Janssen companies, respectively, have been approved by European Medicines Agency and Italian Medicines Agency and subsequently distributed nationwide for use. These vaccines are the result of highly innovative procedures and are quite different from each other in terms of composition. Even clinicians in various medical fields may be unfamiliar with the effects of these vaccines. There is the strong emerging need for dermatologists to understand the crucial role of vaccines, with a focus on the need to vaccinate patients suffering from immune-mediated skin diseases, such as psoriasis, while taking the ongoing treatment into consideration regarding the timing of vaccination. Similarly, psoriasis patients aware of having an immune-mediated and inflammatory disease are increasingly asking the dermatologist information about the efficacy and safety of vaccines against SARS-CoV-2 virus. In this narrative review of the literature and critical analysis of the recommendations of the Italian Ministry of Health, we analyze the implications of the vaccination campaign on dermatological patients with psoriasis undergoing immunosuppressive treatment.
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Affiliation(s)
- Federico Diotallevi
- Department of Clinical and Molecular Sciences, Dermatological Clinic, Polytechnic University of the Marche Region, Via Conca 71, 60020, Ancona, Italy
| | - Anna Campanati
- Department of Clinical and Molecular Sciences, Dermatological Clinic, Polytechnic University of the Marche Region, Via Conca 71, 60020, Ancona, Italy
| | - Giulia Radi
- Department of Clinical and Molecular Sciences, Dermatological Clinic, Polytechnic University of the Marche Region, Via Conca 71, 60020, Ancona, Italy.
| | - Emanuela Martina
- Department of Clinical and Molecular Sciences, Dermatological Clinic, Polytechnic University of the Marche Region, Via Conca 71, 60020, Ancona, Italy
| | - Giulio Rizzetto
- Department of Clinical and Molecular Sciences, Dermatological Clinic, Polytechnic University of the Marche Region, Via Conca 71, 60020, Ancona, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Marcello Mario D'Errico
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - Annamaria Offidani
- Department of Clinical and Molecular Sciences, Dermatological Clinic, Polytechnic University of the Marche Region, Via Conca 71, 60020, Ancona, Italy
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11
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Menditto VG, Maraldo A, Barbadoro P, Maccaroni R, Salvi A, D’Errico MM, Marasca S. Patient-Reported Outcome Measurements (PROMs) After Discharge From the Emergency Department: A Cross-Sectional Study. J Patient Exp 2021; 8:23743735211007356. [PMID: 34179416 PMCID: PMC8205369 DOI: 10.1177/23743735211007356] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The purpose of a patient-reported outcome (PRO) is to elicit the perspectives of patients and translate them into a reliable measurement questionnaire. OBJECTIVES The objective of this cross-sectional study was to detect a set of PROs and PRO measurements (PROMs) about patients with isolated trauma of the limbs receiving emergency department (ED) care. METHODS A survey was performed in the ED using a questionnaire among the enrolled patients to identify which proposed outcomes were perceived as important by the patients according to their expectations. RESULTS Ninety-six consecutive patients were conveniently enrolled. For each item of the questionnaire, the percentage of patients who agreed to perceive it important were calculated. Three items were perceived important by almost 85% of the patients: getting an x-ray (91%; 95% CI: 88%-98%), obtaining a written therapy (94%; 95% CI: 87%-97%), and feeling the physicians' and nurses' empathy (97%; 95% CI: 91%-99%). The ED system was able to satisfy 2 of the 3 agreed PROs in at least 85% of the cases: getting an x-ray (97%; 95% CI: 91%-99%) and obtaining a written therapy (97%; 95% CI: 91%-99%). Moreover, in 30/96 patients (31%; 95% CI: 22%-41%), all the PROs were satisfied, and in 75/96 patients (78%; 95% CI: 69%-85%), all agreed PROs were satisfied. CONCLUSIONS Our study shows an example of core of PROs proposed by the ED physicians and agreed by the patients. Moreover, we presented a set of PROMs which could be used to measure the quality of an ED.
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Affiliation(s)
| | | | - Pamela Barbadoro
- Department of Biomedical Science and Public Health, Universita
Politecnica delle Marche, Ancona, Italy
| | - Roberto Maccaroni
- Department of Emergency Medicine, Ospedali Riuniti di Ancona,
Ancona, Italy
| | - Aldo Salvi
- Department of Emergency Medicine, Ospedali Riuniti di Ancona,
Ancona, Italy
| | - Marcello M D’Errico
- Department of Biomedical Science and Public Health, Universita
Politecnica delle Marche, Ancona, Italy
| | - Stefano Marasca
- Management Department, Università Politecnica delle Marche, Ancona,
Italy
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12
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Diotallevi F, Campanati A, Radi G, Martina E, Rizzetto G, Barbadoro P, D'Errico MM, Offidani A. Vaccination against SARS-CoV-2 and psoriasis: the three things every dermatologist should know. J Eur Acad Dermatol Venereol 2021; 35:e428-e430. [PMID: 33780556 PMCID: PMC8251393 DOI: 10.1111/jdv.17256] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- F Diotallevi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - A Campanati
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - G Radi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - E Martina
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - G Rizzetto
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - P Barbadoro
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | - A Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
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13
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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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14
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Barbadoro P, Bencardino D, Carloni E, Omiccioli E, Ponzio E, Micheletti R, Acquaviva G, Luciani A, Masucci A, Pocognoli A, Orecchioni F, D’Errico MM, Magnani M, Andreoni F. Carriage of Carbapenem-Resistant Enterobacterales in Adult Patients Admitted to a University Hospital in Italy. Antibiotics (Basel) 2021; 10:antibiotics10010061. [PMID: 33435256 PMCID: PMC7827735 DOI: 10.3390/antibiotics10010061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/11/2020] [Revised: 12/23/2020] [Accepted: 01/08/2021] [Indexed: 12/25/2022] Open
Abstract
The emerging spread of carbapenemase-producing Enterobacterales (CPE) strains, in particular, Klebsiella pneumoniae and Escherichia coli, has become a significant threat to hospitalized patients. Carbapenemase genes are frequently located on plasmids than can be exchanged among clonal strains, increasing the antibiotic resistance rate. The aim of this study was to determine the prevalence of CPE in patients upon their admission and to analyze selected associated factors. An investigation of the antibiotic resistance and genetic features of circulating CPE was carried out. Phenotypic tests and molecular typing were performed on 48 carbapenemase-producing strains of K. pneumoniae and E. coli collected from rectal swabs of adult patients. Carbapenem-resistance was confirmed by PCR detection of resistance genes. All strains were analyzed by PCR-based replicon typing (PBRT) and multilocus sequence typing (MLST) was performed on a representative isolate of each PBRT profile. More than 50% of the strains were found to be multidrug-resistant, and the blaKPC gene was detected in all the isolates with the exception of an E. coli strain. A multireplicon status was observed, and the most prevalent profile was FIIK, FIB KQ (33%). MLST analysis revealed the prevalence of sequence type 512 (ST512). This study highlights the importance of screening patients upon their admission to limit the spread of CRE in hospitals.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, 60122 Ancona, Italy; (P.B.); (E.P.); (R.M.); (G.A.); (A.L.); (M.M.D.)
- SOD Igiene Ospedaliera-AOU Ancona Associated Hospitals, 60126 Ancona, Italy
| | - Daniela Bencardino
- Department of Biomolecular Sciences, University of Urbino, 61029 Fano, Italy; (D.B.); (M.M.)
| | - Elisa Carloni
- Diatheva srl, 61030 Cartoceto, Italy; (E.C.); (E.O.)
| | | | - Elisa Ponzio
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, 60122 Ancona, Italy; (P.B.); (E.P.); (R.M.); (G.A.); (A.L.); (M.M.D.)
| | - Rebecca Micheletti
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, 60122 Ancona, Italy; (P.B.); (E.P.); (R.M.); (G.A.); (A.L.); (M.M.D.)
| | - Giorgia Acquaviva
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, 60122 Ancona, Italy; (P.B.); (E.P.); (R.M.); (G.A.); (A.L.); (M.M.D.)
| | - Aurora Luciani
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, 60122 Ancona, Italy; (P.B.); (E.P.); (R.M.); (G.A.); (A.L.); (M.M.D.)
| | - Annamaria Masucci
- SOS Microbiologia Laboratorio Analisi, AOU Ancona Associated Hospitals, 60126 Ancona, Italy; (A.M.); (A.P.); (F.O.)
| | - Antonella Pocognoli
- SOS Microbiologia Laboratorio Analisi, AOU Ancona Associated Hospitals, 60126 Ancona, Italy; (A.M.); (A.P.); (F.O.)
| | - Francesca Orecchioni
- SOS Microbiologia Laboratorio Analisi, AOU Ancona Associated Hospitals, 60126 Ancona, Italy; (A.M.); (A.P.); (F.O.)
| | - Marcello Mario D’Errico
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, 60122 Ancona, Italy; (P.B.); (E.P.); (R.M.); (G.A.); (A.L.); (M.M.D.)
- SOD Igiene Ospedaliera-AOU Ancona Associated Hospitals, 60126 Ancona, Italy
| | - Mauro Magnani
- Department of Biomolecular Sciences, University of Urbino, 61029 Fano, Italy; (D.B.); (M.M.)
| | - Francesca Andreoni
- Department of Biomolecular Sciences, University of Urbino, 61029 Fano, Italy; (D.B.); (M.M.)
- Correspondence: ; Tel.: +39-0722-3049-78
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15
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Barbadoro P, Luciani A, Ciotti M, D’Errico MM. Two-Source Capture-Recapture Method to Estimate the Incidence of Acute Flaccid Paralysis in the Marches Region (Italy). Int J Environ Res Public Health 2020; 17:ijerph17249400. [PMID: 33333947 PMCID: PMC7765411 DOI: 10.3390/ijerph17249400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/28/2020] [Accepted: 11/28/2020] [Indexed: 12/11/2022]
Abstract
A combination of high infant immunization coverage and surveillance of acute flaccid paralysis (AFP) cases, plays a critical role in polio eradication. This study aimed to estimate the incidence of AFP, to evaluate the completeness of AFP ascertainment during the years, age groups and gender, and to define the main associated diagnosis among children aged under 15 in the Marches region of Italy. Analysis was performed on data from the active AFP surveillance system and the hospital discharge records in the 2006-2014 period. The two-source capture-recapture method was applied. After cross-validation, 30 AFP compatible conditions as defined by the WHO were identified, with an incidence estimate of 1.91 cases of AFP per 100,000 children under 15 years (95% CI = 1.4-2.6/100,000). Guillain-Barrè syndrome was the most common diagnosis. A significant difference (p < 0.05) has been registered in the estimated probability of case ascertainment in females. The reasons for the lower reporting of cases in females are unknown. Specific research and the implementation of a more sensitive surveillance system are essential in verifying potential inequalities and to succeed in the polio eradication initiative.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
- Infection Control Unit, AOU Ospedali Riuniti di Ancona, via Conca, 60126 Torrette di Ancona, Italy
- Correspondence: ; Tel.: +39-712-206-200; Fax: +39-71-2206032
| | - Aurora Luciani
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
| | - Matteo Ciotti
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
| | - Marcello Mario D’Errico
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
- Infection Control Unit, AOU Ospedali Riuniti di Ancona, via Conca, 60126 Torrette di Ancona, Italy
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16
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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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17
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Barbadoro P, Brighenti A, Acquaviva G, Catalini A, Diotallevi F, Masiero AL, Montagna V, D’Errico MM. Gender, Socioeconomic, and Health Characteristics Associated with Influenza Vaccination Coverage (VC) among Italian Healthcare Workers: Secondary Analysis of a National Cross-Sectional Survey. Healthcare (Basel) 2020; 8:healthcare8030298. [PMID: 32858784 PMCID: PMC7551854 DOI: 10.3390/healthcare8030298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/08/2020] [Revised: 08/12/2020] [Accepted: 08/18/2020] [Indexed: 11/16/2022] Open
Abstract
Influenza epidemics pose a great overload over health-care facilities with an increase in the burden of disease for patients and healthcare costs. Despite a well-established amount of research in the area, vaccination rates show room for improvement and more research is needed in finding systematic interventions useful in improving healthcare workers (HCWs) vaccination coverage (VC). The purpose of this study was to describe the self-reported frequency of influenza immunization in HCWs and to identify demographic, socioeconomic, lifestyle, and health factors associated with this practice in Italy. Data about 5823 workers participating in the Italian national survey about health and healthcare services utilization are analyzed in the present study. Overall, 18.8% of HCWs reported being vaccinated against seasonal flu. In the multilevel regression, older workers had a higher likelihood of vaccine uptake (OR: 6.07; 95% CI 4.72-7.79), similar to those with chronic conditions or poor self-perceived health status (OR: 2.18 95% CI 1.17-4.09). On the other hand, the results highlighted a lower rate of VC in female HCWs (OR: 0.73 95% CI 0.61-0.86). Data confirm the low compliance towards flu immunization among Italian HCWs and highlight an important gap to be investigated in women.
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18
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Labricciosa FM, Sartelli M, Barbadoro P, Abbo LM, Ansaloni L, Coccolini F, Catena F. Epidemiology and Risk Factors for Superficial Surgical Site Infections after Appendectomy for Acute Appendicitis: A Secondary Data Analysis. Surg Infect (Larchmt) 2020; 22:227-233. [PMID: 33202156 DOI: 10.1089/sur.2020.069] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The identification of risk factors for superficial surgical site infections (SSSIs) associated with appendectomy is paramount in the management of patients with acute appendicitis (AA). Methods: This study was a secondary data analysis from a prospective multi-center observational study. It included all consecutive hospitalized patients with AA who underwent appendectomy and were monitored for complications at 30 days after the intervention. A case-control approach was used to evaluate risk factors associated with the occurrence of SSSI. Results: Among 2,667 patients, 156 (5.8%) developed an SSSI. The series included 1,449 males (54.3%) and 1,218 females with a median age of 29 years (interquartile range [IQR] 20-45 years). Antimicrobial therapy within the previous 30 days was reported by 170 patients (6.4%), and a C-reactive protein concentration (CRP) >50 mg/L was observed in 609 (22.8%). A total of 960 patients (36.0%) underwent open surgery, 1,699 (63.7%) laparoscopic surgery, and 8 (0.3%) another surgical intervention. In 2,575 patients (95.6%), a pathological appendix was detected during the operation. In 776 patients (29.1%), an intra-operative abdominal drain (IAD) was placed; 125 patients (4.7%) were admitted to the intensive care unit. The median hospital length of stay was 3 days (IQR 2-5 days). The overall mortality rate was 0.11%. Multinomial logistic regression analysis of risk factors demonstrated that statistically significant risk factors independently associated with the occurrence of SSSIs were antimicrobial therapy within the previous 30 days, CRP >50 mg/L, open surgical procedures, presence of IAD, and intra-operative findings of complex appendicitis. Conclusions: Knowledge of five easily recognizable variables, assessable at hospital admission or as soon as the surgical intervention is concluded, might identify patients with a greater risk of developing an SSSI.
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Affiliation(s)
| | | | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Lilian M Abbo
- Infectious Disease University, Miami Miller School of Medicine and Jackson Health System, Miami, Florida, USA
| | - Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Fausto Catena
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
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19
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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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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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21
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Labricciosa FM, Sartelli M, Abbo LM, Barbadoro P, Ansaloni L, Coccolini F, Catena F. Epidemiology and Risk Factors for Isolation of Multi-Drug-Resistant Organisms in Patients with Complicated Intra-Abdominal Infections. Surg Infect (Larchmt) 2018; 19:264-272. [PMID: 29298133 DOI: 10.1089/sur.2017.217] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 12/29/2022] Open
Abstract
BACKGROUND Patients with complicated intra-abdominal infections (cIAIs) caused by multi-drug-resistant organisms (MDROs) have been identified as being at increased risk for adverse outcomes. Prompt identification and stratification of these patients is essential in the clinical management, allowing the physician timely optimization of empiric antimicrobial therapy while awaiting results of intra-operative cultures to streamline antibiotic treatment. METHODS The study is a secondary analysis from two prospective multi-center color surveillance studies. It included all consecutively hospitalized adult patients undergoing surgical procedures, interventional drainage, or conservative treatment with cIAIs, with positive cultures performer on intra-operative samples of peritoneal fluid or purulent exudate/discrete abscesses. Patients with pancreatitis and primary peritonitis were excluded. A case-control approach has been used to evaluate the factors associated with the isolation of a MDRO in enrolled patients. RESULTS Among 1986 patients included in the study, a total of 3534 micro-organisms were isolated from intra-peritoneal fluid samples; in 46.5% of cultures, two or more pathogens were identified. The MDROs represented 9.8% of the total of isolated micro-organisms. The overall incidence rate of MDROs was 13.9%. The MDROs were more frequently isolated in patients with health-care-associated cIAIs (25.4%). Multi-nomial logistic regression analysis of risk factors demonstrated that statistically significant risk factors independently associated with the occurrence of MDROs were previous antimicrobial therapy administered within seven days before operation, presence of severe cardiovascular disease, white blood cell count <4000/mL or >12,000/mL, cIAI acquired in a healthcare setting, and inadequate source control. CONCLUSIONS The study showed that knowledge of five easily recognizable variables-assessable on hospital admission or as soon as the surgical intervention is concluded-might guide the surgeon to identify patients with cIAIs caused by MDROs, and therefore to choose the most adequate empiric antimicrobial therapy for them.
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Affiliation(s)
- Francesco M Labricciosa
- 1 Department of Biomedical Science and Public Health, School of Hygiene and Preventive Medicine , Faculty of Medicine and Surgery, Università Politecnica delle Marche, Ancona, Italy
| | | | - Lilian M Abbo
- 3 Infection Prevention & Antimicrobial Stewardship Jackson Health System, University of Miami Miller School of Medicine , Miami, Florida
| | - Pamela Barbadoro
- 1 Department of Biomedical Science and Public Health, School of Hygiene and Preventive Medicine , Faculty of Medicine and Surgery, Università Politecnica delle Marche, Ancona, Italy
| | - Luca Ansaloni
- 4 General Surgery Department, Papa Giovanni XXIII Hospital , Bergamo, Italy
| | - Federico Coccolini
- 4 General Surgery Department, Papa Giovanni XXIII Hospital , Bergamo, Italy
| | - Fausto Catena
- 5 Department of Emergency Surgery, Maggiore Hospital , Parma, Italy
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22
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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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23
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Belvedere C, Ensini A, d'Amato M, Barbadoro P, Leardini A. Three-dimensional patellar tendon fibre kinematics in navigated TKA with and without patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 2017; 25:3834-3843. [PMID: 27738741 DOI: 10.1007/s00167-016-4343-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 09/23/2016] [Indexed: 01/17/2023]
Abstract
PURPOSE Physiological elongation and orientation of patellar tendon fibres are among the scopes of total knee arthroplasty, but little is known in the three dimensions. The study aims to assess in vitro these variations at the intact and replaced knee, with and without patellar resurfacing. It was hypothesised that fibre patterns differ before and after prosthesis implantation, and between specific prosthesis designs. It was also expected that patellar resurfacing would affect relevant results. METHODS Measurements from 16 intact cadaver knees free from anatomical defects are here reported using a surgical navigation system. Data were collected at the intact joint and after implantation with cruciate-retaining or posterior-stabilised prosthesis designs, with and without patellar resurfacing. Relevant anatomical landmarks and patellar tendon attachments were digitised. Anatomical reference frames in the femur, tibia and patella were defined to measure component implantation parameters. Representative tendon fibres were defined as the straight line segments joining the two extremities. Changes in length and orientation of these fibres were calculated and reported versus flexion at the intact knee and after prosthesis implantation, both with and without patellar resurfacing. RESULTS A good intra- and inter-specimen repeatability was found at the intact and replaced knees. In both prosthesis designs, the patterns of fibre lengthening were similar to those in the intact knee, though significant differences were observed before and after patellar resurfacing. Corresponding fibre orientations in the frontal and sagittal planes showed significantly smaller ranges than those in the corresponding intact joints. More natural patterns were observed in the knees implanted with the posterior-stabilised design. Significant correlations were identified between patellar component implantation parameters and both patellar tendon fibre elongation and orientation. CONCLUSIONS Differences, however small, in patellar tendon fibre elongation and orientation were observed after total knee arthroplasty. The posterior-stabilised design provided better results, whereas patellar resurfacing affected significantly normal patellar function. In the clinical practice, the present findings can contribute to the understanding of current prosthesis designs and patellar resurfacing, recommending also enhanced care during this surgery.
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Affiliation(s)
- C Belvedere
- Movement Analysis Laboratory and Functional - Clinical Evaluation of Prostheses, Centro di Ricerca Codivilla-Putti, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy.
| | - A Ensini
- Movement Analysis Laboratory and Functional - Clinical Evaluation of Prostheses, Centro di Ricerca Codivilla-Putti, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy.,2nd Orthopaedic and Traumatologic Clinic, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - M d'Amato
- 2nd Orthopaedic and Traumatologic Clinic, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - P Barbadoro
- 2nd Orthopaedic and Traumatologic Clinic, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Leardini
- Movement Analysis Laboratory and Functional - Clinical Evaluation of Prostheses, Centro di Ricerca Codivilla-Putti, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy
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24
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Ciavattini A, Montik N, Clemente N, Santoni F, Moriconi L, Serri M, Barbadoro P, Sabbatinelli J, Vignini A. Obesity and ultrasound-estimated visceral fat deposits in women undergoing Assisted Reproductive Technology (ART) procedures. Gynecol Endocrinol 2017; 33:972-976. [PMID: 28475432 DOI: 10.1080/09513590.2017.1323858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 01/14/2023] Open
Abstract
The aim of this study was to evaluate the influence of body mass index (BMI) and ultrasound-estimated visceral adipose tissue deposits on oocyte quality and pregnancy rate in women undergoing Assisted Reproductive Technology (ART) procedures. The study included 58 women who underwent ART procedures. According to their BMI, the women were divided into normal weight and overweight/obese; an ultrasound evaluation of preperitoneal fat thickness (PFT) was also performed for each patient. The oocyte quality was then assessed, and samples of follicular fluid were collected from each woman, in order to evaluate the intrafollicular concentration of reactive oxygen species (ROS) as markers of oxidative stress and pro-inflammatory cytokines (IL-1β and IL-6) as markers of chronic inflammation. A negative correlation was found between BMI (as well as PFT) and the number of retrieved oocytes (r = -0.3; p <0.05 and r = -0.5; p < 0.001, respectively), good quality oocytes (r = -0.4; p = <0.05) and obtained embryos (r = -0.3; p < 0.05). In women undergoing ART procedures, BMI and PFT negatively influence the number of oocytes retrieved and their quality. However, on multivariable analysis, only age, PFT and number of retrieved oocytes affect the success rate of ART procedures.
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Affiliation(s)
| | - Nina Montik
- a Woman's Health Sciences Department, Gynecologic Section
| | | | | | | | - Matteo Serri
- a Woman's Health Sciences Department, Gynecologic Section
| | | | - Jacopo Sabbatinelli
- c Department of Clinical Sciences , Section of Biochemistry, Biology and Physics, Polytechnic University of Marche , Ancona , Italy
| | - Arianna Vignini
- c Department of Clinical Sciences , Section of Biochemistry, Biology and Physics, Polytechnic University of Marche , Ancona , Italy
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25
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Sartelli M, Labricciosa FM, Barbadoro P, Pagani L, Ansaloni L, Brink AJ, Carlet J, Khanna A, Chichom-Mefire A, Coccolini F, Di Saverio S, May AK, Viale P, Watkins RR, Scudeller L, Abbo LM, Abu-Zidan FM, Adesunkanmi AK, Al-Dahir S, Al-Hasan MN, Alis H, Alves C, Araujo da Silva AR, Augustin G, Bala M, Barie PS, Beltrán MA, Bhangu A, Bouchra B, Brecher SM, Caínzos MA, Camacho-Ortiz A, Catani M, Chandy SJ, Jusoh AC, Cherry-Bukowiec JR, Chiara O, Colak E, Cornely OA, Cui Y, Demetrashvili Z, De Simone B, De Waele JJ, Dhingra S, Di Marzo F, Dogjani A, Dorj G, Dortet L, Duane TM, Elmangory MM, Enani MA, Ferrada P, Esteban Foianini J, Gachabayov M, Gandhi C, Ghnnam WM, Giamarellou H, Gkiokas G, Gomi H, Goranovic T, Griffiths EA, Guerra Gronerth RI, Haidamus Monteiro JC, Hardcastle TC, Hecker A, Hodonou AM, Ioannidis O, Isik A, Iskandar KA, Kafil HS, Kanj SS, Kaplan LJ, Kapoor G, Karamarkovic AR, Kenig J, Kerschaever I, Khamis F, Khokha V, Kiguba R, Kim HB, Ko WC, Koike K, Kozlovska I, Kumar A, Lagunes L, Latifi R, Lee JG, Lee YR, Leppäniemi A, Li Y, Liang SY, Lowman W, Machain GM, Maegele M, Major P, Malama S, Manzano-Nunez R, Marinis A, Martinez Casas I, Marwah S, Maseda E, McFarlane ME, Memish Z, Mertz D, Mesina C, Mishra SK, Moore EE, Munyika A, Mylonakis E, Napolitano L, Negoi I, Nestorovic MD, Nicolau DP, Omari AH, Ordonez CA, Paiva JA, Pant ND, Parreira JG, Pędziwiatr M, Pereira BM, Ponce-de-Leon A, Poulakou G, Preller J, Pulcini C, Pupelis G, Quiodettis M, Rawson TM, Reis T, Rems M, Rizoli S, Roberts J, Pereira NR, Rodríguez-Baño J, Sakakushev B, Sanders J, Santos N, Sato N, Sawyer RG, Scarpelini S, Scoccia L, Shafiq N, Shelat V, Sifri CD, Siribumrungwong B, Søreide K, Soto R, de Souza HP, Talving P, Trung NT, Tessier JM, Tumbarello M, Ulrych J, Uranues S, Van Goor H, Vereczkei A, Wagenlehner F, Xiao Y, Yuan KC, Wechsler-Fördös A, Zahar JR, Zakrison TL, Zuckerbraun B, Zuidema WP, Catena F. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey. World J Emerg Surg 2017; 12:34. [PMID: 28775763 PMCID: PMC5540347 DOI: 10.1186/s13017-017-0145-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/24/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.
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Affiliation(s)
| | - Francesco M. Labricciosa
- 0000 0001 1017 3210grid.7010.6Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Pamela Barbadoro
- 0000 0001 1017 3210grid.7010.6Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Leonardo Pagani
- Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy
| | - Luca Ansaloni
- 0000 0004 1757 8431grid.460094.fGeneral Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Adrian J. Brink
- 0000 0004 0634 9246grid.415666.6Department of Clinical microbiology, Ampath National Laboratory Services, Milpark Hospital, Johannesburg, South Africa
- 0000 0004 1937 1151grid.7836.aDivision of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape town, South Africa
| | - Jean Carlet
- World Alliance against Antibiotics Resistance, Rome, Italy
| | - Ashish Khanna
- 0000 0001 0675 4725grid.239578.2Center for Critical Care, Anaesthesiology Institute and Department of Outcomes Research, Cleveland Clinic, Cleveland, OH USA
| | - Alain Chichom-Mefire
- Department of Surgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon
| | | | - Salomone Di Saverio
- 0000 0004 1759 7093grid.416290.8Department of Surgery, Maggiore Hospital, Bologna, Italy
| | - Addison K. May
- 0000 0004 1936 9916grid.412807.8Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee USA
| | - Pierluigi Viale
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
| | - Richard R. Watkins
- 0000 0001 0675 4725grid.239578.2Division of Infectious Diseases, Cleveland Clinic Akron General, Akron, OH USA
- 0000 0004 0459 7529grid.261103.7Department of Medicine, Northeast Ohio Medical University, Rootstown, OH USA
| | - Luigia Scudeller
- 0000 0004 1760 3027grid.419425.fClinical Epidemiology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Lilian M. Abbo
- 0000 0004 1936 8606grid.26790.3aDivision of Infectious Diseases, Jackson Health System, University of Miami Miller School of Medicine, Miami, FL USA
| | - Fikri M. Abu-Zidan
- 0000 0001 2193 6666grid.43519.3aDepartment of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Abdulrashid K. Adesunkanmi
- 0000 0001 2183 9444grid.10824.3fDepartment of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Sara Al-Dahir
- 0000 0000 9679 3586grid.268355.fDivision of Clinical and Administrative Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA USA
| | - Majdi N. Al-Hasan
- 0000 0000 9075 106Xgrid.254567.7Department of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia, SC USA
| | - Halil Alis
- 0000 0004 0419 1043grid.414177.0General Surgery Department, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Instanbul, Turkey
| | - Carlos Alves
- 0000 0000 9375 4688grid.414556.7Unit of Prevention and Infection Control, Center of Hospital Epidemiology, São João Hospital Centre, Porto, Portugal
| | | | - Goran Augustin
- 0000 0004 0397 9648grid.412688.1Department of Surgery, University Hospital Center, Zagreb, Croatia
| | - Miklosh Bala
- 0000 0001 2221 2926grid.17788.31Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Philip S. Barie
- 000000041936877Xgrid.5386.8Department of Surgery, Weill Cornell Medicine, New York, NY USA
| | - Marcelo A. Beltrán
- Department of General Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile
| | - Aneel Bhangu
- 0000 0001 2177 007Xgrid.415490.dAcademic Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK
| | - Belefquih Bouchra
- Department of Microbiology National Reference Laboratory Cheikh Khalifa Ibn Zaid Hospital, Mohammed 6th University of Health Sciences, Casablanca, Morocco
| | - Stephen M. Brecher
- 0000 0004 4657 1992grid.410370.1Department of Pathology and Laboratory Medicine, VA Boston HealthCare System, Boston, MA USA
- 0000 0004 0367 5222grid.475010.7Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA USA
| | - Miguel A. Caínzos
- 0000 0000 8816 6945grid.411048.8Department of Surgery, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Adrian Camacho-Ortiz
- 0000 0004 1760 058Xgrid.464574.0Hospital Epidemiology and Infectious Diseases, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Mexico
| | - Marco Catani
- grid.417007.5Department of Emergency, Umberto I Hospital, Rome, Italy
| | - Sujith J. Chandy
- 0000 0004 1781 1790grid.448741.aDepartment of Pharmacology, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala India
| | - Asri Che Jusoh
- Department of General Surgery, Kuala Krai Hospital, Kuala Krai, Kelantan Malaysia
| | - Jill R. Cherry-Bukowiec
- 0000000086837370grid.214458.eDivision of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI USA
| | | | - Elif Colak
- Department of General Surgery, Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey
| | - Oliver A. Cornely
- 0000 0000 8580 3777grid.6190.eDepartment of Internal Medicine and Infectious Diseases, University of Cologne, Cologne, Germany
| | - Yunfeng Cui
- 0000 0000 9792 1228grid.265021.2Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | - Zaza Demetrashvili
- Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Belinda De Simone
- 0000 0004 1795 3510grid.418062.9Department of Digestive Surgery, Cannes Hospital, Cannes, France
| | - Jan J. De Waele
- 0000 0004 0626 3303grid.410566.0Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Sameer Dhingra
- grid.430529.9School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
- Eric Williams Medical Sciences Complex, Uriah Butler Highway, Champ Fleurs, Trinidad and Tobago
| | | | - Agron Dogjani
- Department of Surgery, University Hospital of Trauma, Tirana, Albania
| | - Gereltuya Dorj
- grid.444534.6School of Pharmacy and Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Laurent Dortet
- 0000 0001 2171 2558grid.5842.bDepartment of Microbiology, Bicêtre Hospital, Paris-Sud University, La Kremlin-Bicêtre, France
| | - Therese M. Duane
- Department of Surgery, John Peter Smith Health Network, Fort Worth, Texas USA
| | - Mutasim M. Elmangory
- grid.414827.cSudan National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Mushira A. Enani
- 0000 0004 0593 1832grid.415277.2Department of Medicine, Infectious Disease Division, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Paula Ferrada
- 0000 0004 0458 8737grid.224260.0Department of Surgery, Virginia Commonwealth University, Richmond, VA USA
| | | | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
| | - Chinmay Gandhi
- Department of Surgery, Bharati Vidyapeeth Deemed University Medical College and Hospital, Sangli, Maharashtra India
| | - Wagih Mommtaz Ghnnam
- 0000000103426662grid.10251.37Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Helen Giamarellou
- grid.414012.2Sixth Department of Internal Medicine, Hygeia General Hospital, Athens, Greece
| | - Georgios Gkiokas
- 0000 0001 2155 0800grid.5216.0Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Harumi Gomi
- 0000 0001 2369 4728grid.20515.33Center for Global Health, Mito Kyodo General Hospital, University of Tsukuba, Mito, Ibaraki Japan
| | - Tatjana Goranovic
- University Department for Tumours, Sestre Milosrrdnice UHC, Zagreb, Croatia
| | - Ewen A. Griffiths
- 0000 0001 2177 007Xgrid.415490.dGeneral and Upper GI Surgery, Queen Elizabeth Hospital, Birmingham, UK
| | | | - Julio C. Haidamus Monteiro
- 0000 0001 2198 9354grid.415169.eDepartment of Gastrointestinal Surgery, Santa Casa Hospital, Campo Grande, Brazil
| | - Timothy C. Hardcastle
- 0000 0001 0723 4123grid.16463.36Trauma and Trauma ICU, Inkosi Albert Luthuli Central Hospital and Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - Andreas Hecker
- 0000 0000 8584 9230grid.411067.5Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany
| | - Adrien M. Hodonou
- grid.440525.2Department of Surgery, Faculty of Medicine, University of Parakou, BP 123 Parakou, Benin
| | - Orestis Ioannidis
- 0000000109457005grid.4793.9Fourth Surgical Department, General Hospital G. Papanikolaou, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Arda Isik
- 0000 0001 1498 7262grid.412176.7Department of General Surgery, Erzincan University, Faculty of Medicine, Erzincan, Turkey
| | - Katia A. Iskandar
- Department of Pharmacy, Lebanese, International University, Beirut, Lebanon
| | - Hossein S. Kafil
- 0000 0001 2174 8913grid.412888.fDrug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Souha S. Kanj
- 0000 0004 1936 9801grid.22903.3aDivision of Infectious Diseases, American University of Beirut, Beirut, Lebanon
| | - Lewis J. Kaplan
- 0000 0004 1936 8972grid.25879.31Department of Surgery Philadelphia VA Medical Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Garima Kapoor
- grid.415285.fDepartment of Microbiology, Gandhi Medical College, Bhopal, India
| | - Aleksandar R. Karamarkovic
- 0000 0001 2166 9385grid.7149.bClinic for Emergency Surgery, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Jakub Kenig
- 0000 0001 2162 9631grid.5522.0Third Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Ivan Kerschaever
- Department of Abdominal Surgery, Regional Hospital of Tienen, Tienen, Belgium
| | - Faryal Khamis
- 0000 0004 1772 5665grid.416132.3Department of Internal Medicine, Royal Hospital, Muscat, Oman
| | - Vladimir Khokha
- Department of Emergency Surgery, City Hospital, Mozyr, Belarus
| | - Ronald Kiguba
- 0000 0004 0620 0548grid.11194.3cDepartment of Pharmacology and Therapeutics, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Hong B. Kim
- 0000 0004 0647 3378grid.412480.bDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Wen-Chien Ko
- 0000 0004 0639 0054grid.412040.3Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Kaoru Koike
- 0000 0004 0372 2033grid.258799.8Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Iryna Kozlovska
- Department of Surgery n. 2, Higher educational institutions of Ukraine Bukovina State Medical University, Chernivtci City, Ukraine
| | - Anand Kumar
- 0000 0004 1936 9609grid.21613.37Section of Critical Care Medicine and Section of Infectious Diseases, Department of Medicine, Medical Microbiology and Pharmacology/Therapeutics, University of Manitoba, Winnipeg, MB Canada
| | - Leonel Lagunes
- 0000 0004 0633 6808grid.414410.4Hospital Central Dr Ignacio Morones Prieto, San Luis Potosi, Mexico
| | - Rifat Latifi
- 0000 0001 2168 186Xgrid.134563.6Department of Surgery, Division of Trauma, University of Arizona, Tucson, AZ USA
| | - Jae G. Lee
- 0000 0004 0470 5454grid.15444.30Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Young R. Lee
- grid.449754.fTexas Tech University, Health Sciences Center School of Pharmacy, Abilene, TX USA
| | - Ari Leppäniemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | - Yousheng Li
- 0000 0001 2314 964Xgrid.41156.37Department of Surgery, Inling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Stephen Y. Liang
- 0000 0001 2355 7002grid.4367.6Division of Infectious Diseases, Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO USA
| | - Warren Lowman
- 0000 0004 1937 1135grid.11951.3dClinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gustavo M. Machain
- 0000 0001 2289 5077grid.412213.7Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | - Marc Maegele
- 0000 0000 9024 6397grid.412581.bDepartment for Traumatology and Orthopedic Surgery, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke (UW/H), Cologne, Germany
| | - Piotr Major
- 0000 0001 2162 9631grid.5522.0Second Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Sydney Malama
- 0000 0000 8914 5257grid.12984.36Health Research Program, Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia
| | | | - Athanasios Marinis
- grid.417374.2First Department of Surgery, Tzaneion General Hospital, Piraeus, Greece
| | | | - Sanjay Marwah
- 0000 0004 1771 1642grid.412572.7Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India
| | - Emilio Maseda
- Servicio de Anestesia y Reanimación, Hospital Universitario La Paz Madrid, Madrid, Spain
| | - Michael E. McFarlane
- 0000 0004 0500 5353grid.412963.bDepartment of Surgery, Radiology, University Hospital of the West Indies, Kingston, Jamaica
| | - Ziad Memish
- grid.415696.9Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Dominik Mertz
- 0000 0004 1936 8227grid.25073.33Departments of Medicine, Clinical Epidemiology and Biostatistics, and Pathology and Molecular Medicine, McMaster University, Hamilton, ON Canada
| | - Cristian Mesina
- Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
| | - Shyam K. Mishra
- Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - Ernest E. Moore
- Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO USA
| | - Akutu Munyika
- Department of Surgery, Onandjokwe Hospital, Ondangwa, Namibia
| | - Eleftherios Mylonakis
- 0000 0004 1936 9094grid.40263.33Infectious Diseases Division, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI USA
| | - Lena Napolitano
- 0000000086837370grid.214458.eDepartment of Surgery, University of Michigan, Ann Arbor, MI USA
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Milica D. Nestorovic
- 0000 0004 0517 2741grid.418653.dClinic for General Surgery, Clinical Centre, Nis, Serbia
| | - David P. Nicolau
- Center of Anti-Infective Research and Development, Hartford, CT USA
| | - Abdelkarim H. Omari
- 0000 0004 0411 3985grid.460946.9Department of Surgery, King Abdullah University Hospital, Irbid, Jordan
| | - Carlos A. Ordonez
- 0000 0001 2295 7397grid.8271.cDepartment of Surgery and Critical Care, Universidad del Valle, Fundación Valle del Lili, Cali, Colombia
| | - José-Artur Paiva
- 0000 0001 1503 7226grid.5808.5Intensive Care Medicine Department, Centro Hospitalar São João, University of Porto, Porto, Portugal
| | - Narayan D. Pant
- grid.461024.5Department of Microbiology, Grande International Hospital, Dhapasi, Kathmandu, Nepal
| | - Jose G. Parreira
- 0000 0004 0576 9812grid.419014.9Department of Surgery, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Michal Pędziwiatr
- 0000 0001 1216 0093grid.412700.0Department of General and Emergency Surgery, University Hospital Kraków, Kraków, Poland
| | - Bruno M. Pereira
- 0000 0001 0723 2494grid.411087.bDepartment of Surgery, University of Campinas, Campinas, Brazil
| | - Alfredo Ponce-de-Leon
- 0000 0001 0698 4037grid.416850.eLaboratory of Clinical Microbiology, Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Garyphallia Poulakou
- 0000 0004 0622 4662grid.411449.dFourth Department of Internal Medicine and Infectious Diseases Unit, National and Kapodstrian University-Medical School, Attikon University General Hospital, Athens, Greece
| | - Jacobus Preller
- John Farman Intensive Care Unit, University Hospitals, NHS Foundation Trust, Cambridge, UK
| | - Céline Pulcini
- Infectious and Tropical Diseases Department, University Hospital of Nancy, and EA 4360 APEMAC, Lorraine University, Nancy, France
| | - Guntars Pupelis
- Department of General and Emergency Surgery, Riga East University Hospital ‘Gailezers’, Riga, Latvia
| | - Martha Quiodettis
- 0000 0004 0465 2778grid.461067.2Department of Trauma, Hospital Santo Tomas, Panama, Panama
| | - Timothy M. Rawson
- 0000 0001 2113 8111grid.7445.2National Institute for Health Research, Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, London, UK
| | - Tarcisio Reis
- Emergency Post-operative Department, Otavio de Freitas Hospital and Hosvaldo Cruz Hospital, Recife, Brazil
| | - Miran Rems
- Department of General Surgery, Jesenice General Hospital, Jesenice, Slovenia
| | - Sandro Rizoli
- 0000 0001 2157 2938grid.17063.33Trauma and Acute Care Service, St Michael’s Hospital, University of Toronto, Toronto, Canada
| | - Jason Roberts
- 0000 0000 9320 7537grid.1003.2Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland Australia
| | - Nuno Rocha Pereira
- 0000 0000 9375 4688grid.414556.7Unit of Prevention and Infection Control, Center of Hospital Epidemiology, São João Hospital Centre, Porto, Portugal
| | - Jesús Rodríguez-Baño
- 0000 0001 2168 1229grid.9224.dUnidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío-IBiS and Departamento de Medicina, Universidad de Sevilla, Seville, Spain
| | - Boris Sakakushev
- 0000 0001 0726 0380grid.35371.33General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
| | | | | | - Norio Sato
- 0000 0001 1011 3808grid.255464.4Department of Aeromedical Services for Emergency and Trauma Care, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Robert G. Sawyer
- 0000 0004 1936 9932grid.412587.dDepartment of Surgery, University of Virginia Health System, Charlottesville, VA USA
| | - Sandro Scarpelini
- 0000 0004 1937 0722grid.11899.38Department of Surgery, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Nusrat Shafiq
- 0000 0004 1767 2903grid.415131.3Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishalkumar Shelat
- grid.240988.fDepartment of General Surgery, Tan Tock Seng Hospital, Tan Tock Seng, Singapore
| | - Costi D. Sifri
- 0000 0004 1936 9932grid.412587.dOffice of Hospital Epidemiology/Infection Prevention and Control, University of Virginia Health System, Charlottesville, VA USA
| | - Boonying Siribumrungwong
- 0000 0004 1937 1127grid.412434.4Department of Surgery, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathum Thani, Thailand
| | - Kjetil Søreide
- 0000 0004 0627 2891grid.412835.9Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
- 0000 0004 1936 7443grid.7914.bDepartment of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Rodolfo Soto
- Department of Emergency Surgery and Critical Care, Centro Medico Imbanaco, Cali, Colombia
| | - Hamilton P. de Souza
- 0000 0001 2166 9094grid.412519.aDepartment of Surgery, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Peep Talving
- Department of Surgery, North Estonia Medical Center, Tallinn, Estonia
| | - Ngo Tat Trung
- Department of Molecular Biology, Tran Hung Dao Hospital, No 1, Tran Hung Dao Street, Hai Ba Trung Dist, Hanoi, Vietnam
| | - Jeffrey M. Tessier
- Department of Infectious Diseases, John Peter Smith Health Network, Fort Worth, Texas USA
| | - Mario Tumbarello
- 0000 0001 0941 3192grid.8142.fInstitute of Infectious Diseases, Catholic University, Rome, Italy
| | - Jan Ulrych
- 0000 0000 9100 9940grid.411798.2First Department of Surgery—Department of Abdominal, Thoracic Surgery and Traumatology, General University Hospital, Prague, Czech Republic
| | - Selman Uranues
- 0000 0000 8988 2476grid.11598.34Department of Surgery, Medical University of Graz, Graz, Austria
| | - Harry Van Goor
- 0000 0004 0444 9382grid.10417.33Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Andras Vereczkei
- 0000 0001 0663 9479grid.9679.1Department of Surgery, Medical School University of Pécs, Pécs, Hungary
| | - Florian Wagenlehner
- 0000 0001 2165 8627grid.8664.cDepartment of Urology, Pediatric Urology and Andrology, Medical Faculty of the Justus Liebig University Giessen, Giessen, Germany
| | - Yonghong Xiao
- 0000 0004 1759 700Xgrid.13402.34State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affilliated Hospital, Zhejiang University, Zhejiang, China
| | - Kuo-Ching Yuan
- 0000 0004 1756 1461grid.454210.6Trauma and Emergency Surgery Department, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Agnes Wechsler-Fördös
- 0000 0004 0522 8258grid.413303.6Department of Antibiotics and Infection Control, Rudolfstiftung Hospital, Vienna, Austria
| | - Jean-Ralph Zahar
- Infection Control Unit, Angers University, CHU d’Angers, Angers, France
| | - Tanya L. Zakrison
- 0000 0004 1936 8606grid.26790.3aDivision of Trauma and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami, Miami, FL USA
| | - Brian Zuckerbraun
- 0000 0004 1936 9000grid.21925.3dDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA USA
| | - Wietse P. Zuidema
- 0000 0004 0435 165Xgrid.16872.3aVU University Medical Center, Amsterdam, The Netherlands
| | - Fausto Catena
- Department of General Surgery, Maggiore Hospital, Parma, 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: 32] [Impact Index Per Article: 3.6] [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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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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Barbadoro P, Ensini A, Leardini A, d'Amato M, Feliciangeli A, Timoncini A, Amadei F, Belvedere C, Giannini S. Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty: a radiographic and radiostereometric study. Knee Surg Sports Traumatol Arthrosc 2014; 22:3157-62. [PMID: 24972998 DOI: 10.1007/s00167-014-3147-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [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: 11/11/2013] [Accepted: 06/18/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Unicompartmental knee arthroplasty (UKA) has shown a higher rate of revision compared with total knee arthroplasty. The success of UKA depends on prosthesis component alignment, fixation and soft tissue integrity. The tibial cut is the crucial surgical step. The hypothesis of the present study is that tibial component malalignment is correlated with its risk of loosening in UKA. METHODS This study was performed in twenty-three patients undergoing primary cemented unicompartmental knee arthroplasties. Translations and rotations of the tibial component and the maximum total point motion (MTPM) were measured using radiostereometric analysis at 3, 6, 12 and 24 months. Standard radiological evaluations were also performed immediately before and after surgery. Varus/valgus and posterior slope of the tibial component and tibial-femoral axes were correlated with radiostereometric micro-motion. A survival analysis was also performed at an average of 5.9 years by contacting patients by phone. RESULTS Varus alignment of the tibial component was significantly correlated with MTPM, anterior tibial sinking, varus rotation and anterior and medial translations from radiostereometry. The posterior slope of the tibial component was correlated with external rotation. The survival rate at an average of 5.9 years was 89%. The two patients who underwent revision presented a tibial component varus angle of 10° for both. CONCLUSIONS There is correlation between varus orientation of the tibial component and MTPM from radiostereometry in unicompartmental knee arthroplasties. Particularly, a misalignment in varus larger than 5° could lead to risk of loosening the tibial component. LEVEL OF EVIDENCE Prognostic studies-retrospective study, Level II.
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Affiliation(s)
- P Barbadoro
- 1st Ortopaedic-Traumatologic Clinic, Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli 1, 40136, Bologna, Bo, 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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Belvedere C, Ensini A, Leardini A, Dedda V, Feliciangeli A, Cenni F, Timoncini A, Barbadoro P, Giannini S. Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 2014; 22:1719-27. [PMID: 24408075 DOI: 10.1007/s00167-013-2825-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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] [Received: 06/05/2013] [Accepted: 12/28/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE In total knee arthroplasty, surgical navigation systems provide tibio-femoral joint (TFJ) tracking for relevant bone preparation, disregarding the patello-femoral joint (PFJ). Therefore, the important intra-operative assessment of the effect of component positioning, including the patella, on the kinematics of these two joints is not available. The objective of this study is to explore in vivo whether accurate tracking of the patella can result in a more physiological TFJ and PFJ kinematics during surgery. METHODS Ten patients underwent navigated knee replacement with patellar resurfacing. A secondary system was used to track patellar motion and PFJ kinematics using a special tracker. Patellar resection plane position and orientation were recorded using an instrumented probe. During all surgical steps, PFJ kinematics was measured in addition to TFJ kinematics. RESULTS Abnormal PFJ motion patterns were observed pre-operatively at the impaired knee. Patellar resection plane orientation on sagittal and transverse planes of 3.9° ± 9.0° and 0.4° ± 4.1° was found. A good restoration of both TFJ and PFJ kinematics was observed in all replaced knees after resurfacing, in particular the rotations in the three anatomical planes and medio-lateral patellar translation. CONCLUSIONS Patella tracking results in nearly physiological TFJ and PFJ kinematics in navigated knee arthroplasty with resurfacing. The intra-operative availability also of PFJ kinematics can support the positioning not only of the patellar component in case of resurfacing, but also of femoral and tibial components.
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Affiliation(s)
- C Belvedere
- Movement Analysis Laboratory and Functional - Clinical Evaluation of Prostheses, Centro di Ricerca Codivilla-Putti, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, 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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Politi C, Deales A, Cicchitelli F, Marcobelli A, Barbadoro P, Zorzan R, Di Stanislao F. Analisi dei costi sanitari per lo scompenso cardiaco nella regione Marche. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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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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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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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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