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Puzelli S, Facchini M, Piacentini S, Di Mario G, Colucci ME, Calzoletti L, Fabiani C, Di Martino A, Veronesi L, Biasucci G, Codeluppi M, Cascio GL, Schiavo R, Rampini A, Affanni P, Palamara AT, Stefanelli P. Characterization of an influenza B virus isolated from a fatal case of myocarditis in a pediatric patient in Italy. J Infect Public Health 2024; 17:417-420. [PMID: 38262078 DOI: 10.1016/j.jiph.2023.12.018] [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: 10/02/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Influenza B is one of the infective agents that can cause rapid and fatal myocarditis in children. Here, we describe a fatal case of myocarditis in a previously healthy child, after infection with an influenza B/Victoria-lineage virus during the 2022-23 epidemic season in Italy. Influenza B virus was isolated also in a second case, a younger family member showing only a mild influenza-like illness. Genotypic and phenotypic analyses have been performed on both virus samples and results showed that HA1 sequences were identical and genetically and antigenically related to other B viruses circulating in 2022-23 season in Italy. However, a D129N substitution was found in the receptor binding domain of the HA of the two viruses, not detected in other circulating viruses in Italy but only in a proportion of those circulating in other European countries. Phenotypic analyses assessed the susceptibility towards either neuraminidase inhibitors and baloxavir. Annual influenza vaccination remains one of the best interventions to prevent complications such as myocarditis, particularly in children.
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Affiliation(s)
- Simona Puzelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy.
| | - Marzia Facchini
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Sara Piacentini
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Giuseppina Di Mario
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | | | - Laura Calzoletti
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Concetta Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Angela Di Martino
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giacomo Biasucci
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Pediatrics & Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Mauro Codeluppi
- Infectious Diseases Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Roberta Schiavo
- Microbiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Anna Teresa Palamara
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
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Albertini R, Colucci ME, Coluccia A, Mohieldin Mahgoub Ibrahim M, Zoni R, Veronesi L, Affanni P, Pasquarella C. An overview on the use of ultraviolet radiation to disinfect air and surfaces. Acta Biomed 2023; 94:e2023165. [PMID: 37695170 DOI: 10.23750/abm.v94is3.14666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 09/12/2023]
Abstract
Background and aim Ultraviolet radiation (UV) is the portion of the electromagnetic spectrum of wavelengths between 200 and 400 nm divided into three bands called UVA, UVB and UVC. Due its well-described antimicrobial activity, UVC can represent a useful tool for disinfect surfaces, water, and air. The aim of this study was to illustrate the studies over time ultraviolet germicidal irradiation (UVGI) to disinfect air and surfaces. Methods Articles on Scopus published until April 14, 2023, were considered. Many issues involving UV were deepened crosschecking with e.g., "air", "surfaces", "disinfection", "bacteria", "fungi", "operating theatres". According to the case, the following variables were considered: years and related number of articles, sources of publications, subject areas, type of document published, type of journal, nationalities of the authors. Results Since 30's, 287 448 articles on UV have been published. Among UVGI, 22 159 articles covered bacteria issue, followed by fungi and viruses with about 12000 both. UVGI was addressed by 1941 and 931 articles for surfaces and air respectively. Of these, 122 were performed in operating theatres. Since 1987 works have been published on spacecraft and since 2000, on the use of UVGI robots for disinfect air and surfaces. Conclusions Our study shows the studies on UVGI and related issues. It also shows most recently perspectives about the applications e.g. during prolonged human-crewed missions on spacecrafts, to inactivate microorganisms in environments where the exchange of air is impossible.
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Affiliation(s)
- Roberto Albertini
- Department of Medicine and Surgery, University of Parma; U.O. Medicina interna di continuità, Azienda Ospedaliero-Universitaria di Parma.
| | | | | | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma.
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma.
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Albertini R, Coluccia A, Colucci ME, Zoni R, Affanni P, Veronesi L, Pasquarella C. An overview of the studies on microbial air contamination in operating theatres and related issues over time: a useful tool for a multidisciplinary approach. Acta Biomed 2023; 94:e2023149. [PMID: 37695181 DOI: 10.23750/abm.v94is3.14507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/12/2023] [Indexed: 09/12/2023]
Abstract
Background and aim Surgical site infection (SSI) is a major complication following surgery associated with increased morbidity and mortality, as well as increased health and not health costs. A variety of factors affect airborne contamination in operating theatres (OT). Following the Medical Research Council study showing a correlation between microbial air contamination and SSI incidence in prosthetic joint surgery ultraclean OTs have been recommended for this type of surgery, while OTs supplied by turbulent airflow plants are recommended for other types of surgery. The aim of this study was to illustrate the studies on this topic. Methods Scopus was considered for articles published until January 2023 on OTs and air contamination in article title or abstract or keywords. Many issues were deepened: "microbial", "bacterial", "fungi", "viruses", "surgical site/wound infection", "monitoring/sampling", "air changes", "behaviour", "door openings", "particles", turbulent flow", "unidirectional flow". Results Total papers published were 907 and 249 papers faced monitoring/sampling. A total of 313 papers investigated airborne bacterial contamination and 63 papers investigated fungal air contamination. There were 218 papers that have evaluated particle contamination in OTs. Many other issues were deepened. Conclusions This study shows a picture of the studies on biological air contamination in OTs and related issues over time. We think that the results of our study will provide a useful tool to increase awareness towards a better sharing of aims, approaches, and results, above all in the interest of the patients, but also of the health services of the different countries. (www.actabiomedica.it).
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Affiliation(s)
- Roberto Albertini
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Unit of Medicina Interna di Continuità, University Hospital of Parma, Italy.
| | - Alessia Coluccia
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
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Pasquarella C, Bizzarro A, Martini R, Martini R, Colucci ME, Rossi D, Faetani L, Ghizzoni D, Seidenari C, Paroni E, Muzzetto P, Romiti D, Ruggeri J, Pasquarella ML, Affanni P, Zoni R, Signorelli C, Gobbi G, Presta V, Costantino C, Veronesi L. Transforming waiting pauses into opportunity for physical activity: the "Activate your Wait" pilot study. Acta Biomed 2022; 93:e2022310. [PMID: 36300217 PMCID: PMC9686157 DOI: 10.23750/abm.v93i5.13550] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIM Physical activity is recognized as a major health determinant. However, the prevalence of inactivity can be as high as 80% in some adult subpopulations. From the urgent need to implement strategies to fight sedentary behaviour, considering that physical activity is defined as any bodily movement produced by skeletal muscles that require energy expenditure, the pilot study "Activate your Wait" was born. The project aim is to transform waiting pauses during everyday life into opportunities to perform simple stretching and active mobilization exercises. METHODS The pilot study was carried out in 2019 at Terme S. Egidio (Italy). It was divided in three phases: in the pre-intervention a questionnaire was used to evaluate the interest in the project (96 responders); during the intervention, examples of simple exercises that people can do by themselves were illustrated and undertaken by about 120 participants; in the post-intervention an evaluation questionnaire was administered (71 responders). RESULTS The intervention aroused enthusiastic participation and high approval and resulted in an increase both in willingness to perform exercises during daily waiting pauses (68% vs 94%) and belief in positive results of physical activity on health (74% vs 96%). CONCLUSIONS In a context where the opportunities for physical activity are decreasing and a sedentary lifestyle has reached a high level, this project represents a contribution to the increase in the awareness of the importance of physical activity and the promotion of the culture of movement in the entire population, with an opportunity of easy accessibility in different contexts of life, at all ages.
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Affiliation(s)
| | | | | | | | | | - Deanna Rossi
- Department of Medicine and Surgery, University of Parma, Italy
| | - Lorenzo Faetani
- Department of Medicine and Surgery, University of Parma, Italy
| | | | | | - Eleonora Paroni
- Department of Medicine and Surgery, University of Parma, Italy
| | | | - Davide Romiti
- Department of Medicine and Surgery, University of Parma, Italy
| | - Janis Ruggeri
- Department of Medicine and Surgery, University of Parma, Italy
| | | | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy
| | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy
| | | | - Giuliana Gobbi
- Department of Medicine and Surgery, University of Parma, Italy
| | | | | | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Italy
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Mohieldin Mahgoub Ibrahim M, Colucci ME, Veronesi L, Viani I, Odone A, Arena MP, Incerti M, Tamburini E, Zoni R, Pasquarella C, Affanni P. Virological surveillance of SARS-CoV-2 in an Italian Northern area: differences in gender, age and Real Time RT PCR cycle threshold (Ct) values in three epidemic periods. Acta Biomed 2021; 92:e2021457. [PMID: 34739457 PMCID: PMC8851017 DOI: 10.23750/abm.v92is6.12268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Coronavirus Disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global public health emergency. The aim of this study was to investigate cases characteristics and Real Time RT PCR cycle threshold (Ct) values distribution of COVID-19 in an Italian Northern area during three periods: first period, February-May 2020; second period, June-August 2020; third period, September 2020-February 2021. METHODS Real Time RT PCR was used to detect SARS-CoV-2 in respiratory samples (oro/nasopharyngeal swabs). RESULTS A total of 254,744 samples were tested during the study period. Out of 20,188 positive samples (7.92%), 10,303 were females (51.04%) and 9,885 were males (48.96%). The percentage of positivity varied during the three different periods: 14.1% in the first period, 1.4% in the second and 9.2% in the third. The lowest Ct values were observed in the first phase of pandemic, with an overall average of 25.64. Overall average of the Ct values was lower in males than in females, 26.29 ± 6.04 and 26.84 ± 5.99 respectively. The oldest patients recorded lower Ct values. CONCLUSIONS The findings of our study represent further evidence in support of the fact that male sex and older age showed lower Ct values, which means higher viral loads and higher infectious potential. These knowledges are useful to better understand the epidemiological aspects of COVID-19 and to perform effective Public Health Policies.
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Affiliation(s)
| | | | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Isabella Viani
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy.
| | | | - Monia Incerti
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Elisa Tamburini
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy.
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Sverzellati N, Ryerson CJ, Milanese G, Renzoni EA, Volpi A, Spagnolo P, Bonella F, Comelli I, Affanni P, Veronesi L, Manna C, Ciuni A, Sartorio C, Tringali G, Silva M, Michieletti E, Colombi D, Wells AU. Chest radiography or computed tomography for COVID-19 pneumonia? Comparative study in a simulated triage setting. Eur Respir J 2021; 58:13993003.04188-2020. [PMID: 33574070 PMCID: PMC7877328 DOI: 10.1183/13993003.04188-2020] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/27/2021] [Indexed: 01/11/2023]
Abstract
Introduction For the management of patients referred to respiratory triage during the early stages of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, either chest radiography or computed tomography (CT) were used as first-line diagnostic tools. The aim of this study was to compare the impact on the triage, diagnosis and prognosis of patients with suspected COVID-19 when clinical decisions are derived from reconstructed chest radiography or from CT. Methods We reconstructed chest radiographs from high-resolution CT (HRCT) scans. Five clinical observers independently reviewed clinical charts of 300 subjects with suspected COVID-19 pneumonia, integrated with either a reconstructed chest radiography or HRCT report in two consecutive blinded and randomised sessions: clinical decisions were recorded for each session. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and prognostic value were compared between reconstructed chest radiography and HRCT. The best radiological integration was also examined to develop an optimised respiratory triage algorithm. Results Interobserver agreement was fair (Kendall's W=0.365, p<0.001) by the reconstructed chest radiography-based protocol and good (Kendall's W=0.654, p<0.001) by the CT-based protocol. NPV assisted by reconstructed chest radiography (31.4%) was lower than that of HRCT (77.9%). In case of indeterminate or typical radiological appearance for COVID-19 pneumonia, extent of disease on reconstructed chest radiography or HRCT were the only two imaging variables that were similarly linked to mortality by adjusted multivariable models Conclusions The present findings suggest that clinical triage is safely assisted by chest radiography. An integrated algorithm using first-line chest radiography and contingent use of HRCT can help optimise management and prognostication of COVID-19. This study does not support the routine use of CT to stage disease extent in COVID-19 pneumonia, despite superior interobserver agreement, as chest radiography extent is an equally powerful prognostic determinanthttps://bit.ly/3rdJuxj
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Affiliation(s)
- Nicola Sverzellati
- Scienze Radiologiche, Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Christopher J Ryerson
- Dept of Medicine, University of British Columbia and Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada
| | - Gianluca Milanese
- Scienze Radiologiche, Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Elisabetta A Renzoni
- Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College London, London, UK
| | - Annalisa Volpi
- 1st Anesthesia and Intensive Care Unit, University Hospital of Parma, Parma, Italy
| | - Paolo Spagnolo
- Respiratory Disease Unit, Dept of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Francesco Bonella
- Center for Interstitial and Rare Lung Diseases, Pneumology Dept, Ruhrandklinik University Hospital, University of Duiburg-Essen, Essen, Germany
| | - Ivan Comelli
- Unità Operativa Pronto Soccorso e Medicina d'Urgenza, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Paola Affanni
- Dept of Medicine and Surgery, University of Parma, Parma, Italy
| | - Licia Veronesi
- Dept of Medicine and Surgery, University of Parma, Parma, Italy
| | - Carmelinda Manna
- Scienze Radiologiche, Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Andrea Ciuni
- Scienze Radiologiche, Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Carlotta Sartorio
- Scienze Radiologiche, Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Giulia Tringali
- Scienze Radiologiche, Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Mario Silva
- Scienze Radiologiche, Dipartimento di Medicina e Chirurgia, University Hospital of Parma, Parma, Italy
| | - Emanuele Michieletti
- Dept of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Davide Colombi
- Dept of Radiological Functions, Radiology Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Athol U Wells
- Interstitial Lung Disease Unit, Royal Brompton Hospital, Imperial College London, London, UK
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Musolino A, Pellegrino B, Isella L, Tommasi C, Pucci F, Leonetti A, Rapacchi E, Leonardi F, Bizzoco S, Affanni P, Veronesi L, Sgargi P, Maglietta G, Michiara M. 1587P SARS-CoV-2 infection risk and COVID-19 prevalence in cancer patients during the first wave of COVID-19 pandemic in a Northern Italy’s virus epicenter area. Ann Oncol 2021. [PMCID: PMC8454340 DOI: 10.1016/j.annonc.2021.08.1580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Esposito S, Neglia C, Affanni P, Colucci ME, Argentiero A, Veronesi L, Messina G, Deolmi M, Principi N. Epidemiology of SARS-CoV-2 Infection Evaluated by Immunochromatographic Rapid Testing for the Determination of IgM and IgG Against SARS-CoV-2 in a Cohort of Mask Wearing Workers in the Metal-Mechanical Sector in an Area With a High Incidence of COVID-19. Front Public Health 2021; 9:628098. [PMID: 34249830 PMCID: PMC8267366 DOI: 10.3389/fpubh.2021.628098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/08/2021] [Accepted: 05/27/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Although the diagnosis of new coronavirus 2019 (COVID-19) is made through the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory secretions by means of molecular methods, a more accurate estimation of SARS-CoV-2 circulation can be obtained by seroprevalence studies. The main aim of this study was to evaluate the true epidemiology of SARS-CoV-2 infection among workers in the metal-mechanical sector who never stopped working during the pandemic period in an area with a high incidence of COVID-19 and to define whether and how they could continue the work without appreciable risks during a second wave. Methods: A total of 815 metal-mechanical workers who had never stopped working even during the pandemic period in three different factories in the Emilia-Romagna Region, Italy, and who had always used face masks during working hours, underwent a capillary blood rapid test for the determination of IgM and IgG against SARS-CoV-2 (COVID-19 IgG/IgM Rapid test, PrimaLab, Modena, Italy). In the event of a positive test, a nasopharyngeal was performed and tested for the presence of SARS-CoV-2. Results: The detection of serum IgG/IgM against SARS-CoV-2 was significantly more common among workers employed in Parma (21/345, 6.1%) than among those employed in Calerno (7/242, 2.9%) or in Spilamberto (3/228, 1.3%) (p <0.001). The analysis of the role of the different variables as predictors of seropositivity for IgG/IgM against SARS-CoV-2 revealed that the presence of specific antibodies was strictly associated with a previous history of COVID-19-like symptoms (odds ratio [OR] 3.95, 95% confidence interval [CI] 1.9–8.2) and household members with COVID-19-like symptoms (OR 2.20, 95% CI 1.04–4.82). Conclusion: This study shows that seropositivity to SARS-CoV-2 is low even among employees who did not interrupt their work during the lockdown phase in a region with a high incidence of COVID-19. The use of face masks appears effective in the avoidance of the transmission of SARS-CoV-2 in factories even in the presence of asymptomatic or mildly symptomatic workers, suggesting that work activities can continue if adequate infection control measures are used during a second wave.
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Silva M, Ledda RE, Schiebler M, Balbi M, Sironi S, Milone F, Affanni P, Milanese G, Sverzellati N. Frequency and characterization of ancillary chest CT findings in COVID-19 pneumonia. Br J Radiol 2021; 94:20200716. [PMID: 33471553 PMCID: PMC7934290 DOI: 10.1259/bjr.20200716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Ground-glass opacity and consolidation are recognized typical features of Coronavirus disease-19 (COVID-19) pneumonia on Chest CT, yet ancillary findings have not been fully described. We aimed to describe ancillary findings of COVID-19 pneumonia on CT, to define their prevalence, and investigate their association with clinical data. METHODS We retrospectively reviewed our CT chest cases with coupled reverse transcriptase polymerase chain reaction (rt-PCR). Patients with negative rt-PCR or without admission chest CT were excluded. Ancillary findings included: vessel enlargement, subpleural curvilinear lines, dependent subpleural atelectasis, centrilobular solid nodules, pleural and/or pericardial effusions, enlarged mediastinal lymph nodes. Continuous data were expressed as median and 95% confidence interval (95% CI) and tested by Mann-Whitney U test. RESULTS Ancillary findings were represented by 106/252 (42.1%, 36.1 to 48.2) vessel enlargement, 50/252 (19.8%, 15.4 to 25.2) subpleural curvilinear lines, 26/252 (10.1%, 7.1 to 14.7) dependent subpleural atelectasis, 15/252 (5.9%, 3.6 to 9.6) pleural effusion, 15/252 (5.9%, 3.6 to 9.6) mediastinal lymph nodes enlargement, 13/252 (5.2%, 3 to 8.6) centrilobular solid nodules, and 6/252 (2.4%, 1.1 to 5.1) pericardial effusion. Air space disease was more extensive in patients with vessel enlargement or centrilobular solid nodules (p < 0.001). Vessel enlargement was associated with longer history of fever (p = 0.035) and lower admission oxygen saturation (p = 0.014); dependent subpleural atelectasis with lower oxygen saturation (p < 0.001) and higher respiratory rate (p < 0.001); mediastinal lymph nodes with shorter history of cough (p = 0.046); centrilobular solid nodules with lower prevalence of cough (p = 0.023), lower oxygen saturation (p < 0.001), and higher respiratory rate (p = 0.032), and pericardial effusion with shorter history of cough (p = 0.015). Ancillary findings associated with longer hospital stay were subpleural curvilinear lines (p = 0.02), whereas centrilobular solid nodules were associated with higher rate of intensive care unit admission (p = 0.01). CONCLUSION Typical high-resolution CT findings of COVID-19 pneumonia are frequently associated with ancillary findings that variably associate with disease extent, clinical parameters, and disease severity. ADVANCES IN KNOWLEDGE Ancillary findings might reflect the broad range of heterogeneous mechanisms in severe acute respiratory syndrome from viral pneumonia, and potentially help disease phenotyping.
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Affiliation(s)
- Mario Silva
- Department of Medicine and Surgery, Unit of "Scienze Radiologiche", University of Parma, Parma, Italy
| | - Roberta Eufrasia Ledda
- Department of Medicine and Surgery, Unit of "Scienze Radiologiche", University of Parma, Parma, Italy
| | - Mark Schiebler
- Department of Radiology, UW-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Maurizio Balbi
- Department of Radiology, ASST Papa Giovanni XXIII, University of Milano-Bicocca, Milan, Italy
| | - Sandro Sironi
- Department of Radiology, ASST Papa Giovanni XXIII, University of Milano-Bicocca, Milan, Italy
| | - Francesca Milone
- Department of Medicine and Surgery, Unit of "Scienze Radiologiche", University of Parma, Parma, Italy
| | - Paola Affanni
- Laboratorio di Igiene e Sanità Pubblica, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Gianluca Milanese
- Department of Medicine and Surgery, Unit of "Scienze Radiologiche", University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery, Unit of "Scienze Radiologiche", University of Parma, Parma, Italy
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10
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Esposito S, Zona S, Vergine G, Fantini M, Marchetti F, Stella M, Valletta E, Biasucci G, Lanari M, Dodi I, Bigi M, Magista AM, Vaienti F, Cella A, Affanni P, Re MC, Sambri V, Principi N. How to manage children if a second wave of COVID-19 occurs. Int J Tuberc Lung Dis 2020; 24:1116-1118. [PMID: 33126950 DOI: 10.5588/ijtld.20.0543] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- S Esposito
- Paediatric Clinic, Pietro Barilla Children´s Hospital, University of Parma, Parma, Italy
| | - S Zona
- Azienda Unità Sanitaria Locale (AUSL) di Modena, Modena, Italy
| | - G Vergine
- Department of Paediatrics, Infermi Hospital Rimini, ASL Romagna, Rimini, Italy
| | - M Fantini
- Unit of Microbiology, Greater Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - F Marchetti
- Department of Paediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - M Stella
- Paediatric Clinic, ASL Romagna, Cesena, Italy
| | - E Valletta
- Department of Paediatrics, AUSL Romagna, Forlì, Italy
| | - G Biasucci
- Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - M Lanari
- Emergency Paediatrics, Policlinico Sant´Orsola, University of Bologna, Bologna, Italy
| | - I Dodi
- General and Emergency Paediatrics, Pietro Barilla Children´s Hospital, Parma, Italy
| | - M Bigi
- Paediatric Community Unit, ASL Romagna, Rimini, Italy
| | - A M Magista
- Paediatric Community Unit, ASL Romagna, Ravenna, Italy
| | - F Vaienti
- Department of Paediatrics, AUSL Romagna, Forlì, Italy
| | - A Cella
- Paediatric Emergency Unit, Guglielmo da Saliceto City Hospital, Piacenza, Italy
| | - P Affanni
- Laboratory of Hygiene and Public Health, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M C Re
- Microbiology Unit, Policlinico Sant´Orsola, University of Bologna, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, Greater Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - N Principi
- Università degli Studi di Milano, Milan, Italy, ,
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11
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Zambrano C, Oliva V, Parenti E, Di Motta T, Di Maria A, Farina MT, Palladini A, Parmigiani A, Affanni P, Colucci ME, Pasquarella CIM, Pioli S, Fiaccadori E. [Reorganization of haemodialysis during COVID-19 emergency: a report from Dialysis Centers of Parma province]. G Ital Nefrol 2020; 37:37-5-2020-4. [PMID: 33026200] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The epidemic wave that hit Italy from February 21st, 2020, when the Italian National Institute of Health confirmed the first case of SARS‑CoV‑2 infection, led to a rapid and efficient reorganization of Dialysis Centers' activities, in order to contain large-scale spread of disease in this clinical setting. We herein report the experience of the Hemodialysis Unit of Parma University Hospital (Azienda Ospedaliero-Universitaria, Parma, Italy) and the Dialysis Centers of Parma territory, in the period from March 1st, 2020 to June 15, 2020. Among patients undergoing chronic haemodialysis, 37/283 (13%) had positive swabs for SARS‑CoV‑2, 9/37 (24%) died because of COVID-19. Twenty-three patients required hospitalization, while the remaining were managed at home. The primary measures applied to contain the infection were: the strengthening of personal protective equipment use by doctors and nurses, early identification of infected subjects by performing oro-pharyngeal swabs in every patient and in the healthcare personnel, the institution of a triage protocol when entering Dialysis Room, and finally the institution of two separate sections, managed by different doctors and dialysis nurses, to physically separate affected from unaffected patients and to manage "grey" patients. Our experience highlights the importance and effectiveness of afore-mentioned measures in order to contain the spread of the virus; moreover, we observed a higher lethality rate of COVID-19 in dialysis patients as compared to the general population.
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Affiliation(s)
- Cristina Zambrano
- UO Nefrologia, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
| | - Vincenzo Oliva
- UO Nefrologia, Azienda Ospedaliera Universitaria di Parma, Parma, Italy
| | | | - Tommaso Di Motta
- UO Nefrologia, Azienda Ospedaliera Universitaria di Parma, Italy
| | - Alessio Di Maria
- UO Nefrologia, Azienda Ospedaliera Universitaria di Parma, Italy
| | | | - Andrea Palladini
- UO Nefrologia, Azienda Ospedaliera Universitaria di Parma, Italy
| | - Alice Parmigiani
- UO Nefrologia, Azienda Ospedaliera Universitaria di Parma, Italy
| | - Paola Affanni
- Laboratorio di Igiene e Sanità Pubblica, Dipartimento Medicina e Chirurgia Università di Parma; Dipartimento di Medicina e Chirurgia, Università di Parma, Italy
| | - Maria Eugenia Colucci
- Laboratorio di Igiene e Sanità Pubblica, Dipartimento Medicina e Chirurgia Università di Parma; Dipartimento di Medicina e Chirurgia, Università di Parma, Italy
| | - Cesira Isabella Maria Pasquarella
- Laboratorio di Igiene e Sanità Pubblica, Dipartimento Medicina e Chirurgia Università di Parma; Dipartimento di Medicina e Chirurgia, Università di Parma, Italy
| | | | - Enrico Fiaccadori
- UO Nefrologia, Azienda Ospedaliera Universitaria di Parma; Dipartimento di Medicina e Chirurgia, Università di Parma, Italy
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12
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Esposito S, Gnocchi M, Gagliardi M, Affanni P, Veronesi L, Colucci ME, Neglia C, Argentiero A, Principi N. Therapeutic strategies against COVID-19. Acta Biomed 2020; 91:e2020038. [PMID: 32921732 PMCID: PMC7716986 DOI: 10.23750/abm.v91i3.10450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that mainly affects the upper and lower respiratory tract and is responsible for extremely different degrees of disease, ranging from flu-like symptoms to atypical pneumonia that may evolve to acute respiratory distress syndrome and, ultimately, death. No specific therapy for SARS-CoV-2 has yet been identified, but since the beginning of the outbreak, several pre-existing therapeutics have been reconsidered for the treatment of infected patients. The aim of this article is to discuss current therapeutics against SARS-CoV-2. A literature review was performed using PubMed, collecting data from English-language articles published until June 20th, 2020. Literature analysis showed that with the acquisition of more in-depth knowledge on the characteristics of SARS-CoV-2 and the pathogenesis of the different clinical manifestations, a more rationale use of available drugs has become possible. However, the road to defining which drugs are effective and which schedules of administration must be used to maximize efficacy and minimize adverse events is still very long. To date, it is only clear that no drug can alone cope with all the problems posed by SARS-CoV-2 infection and effective antivirals and inflammatory drugs must be given together to reduce COVID-19 clinical manifestations. Moreover, choice of therapy must always be tailored on clinical manifestations and, when they occur, drugs able to fight coagulopathy and venous thromboembolism that may contribute to respiratory deterioration must be prescribed.
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Affiliation(s)
| | - Margherita Gnocchi
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Martina Gagliardi
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Cosimo Neglia
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Alberto Argentiero
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy.
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13
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Odone A, Bucci D, Croci R, Riccò M, Affanni P, Signorelli C. Vaccine hesitancy in COVID-19 times. An update from Italy before flu season starts. Acta Biomed 2020; 91:e2020031. [PMID: 32921733 PMCID: PMC7716975 DOI: 10.23750/abm.v91i3.10549] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic and response caused a worrying decline in vaccine uptake around the world. In Italy, the immunization coverage targets set in the 2017-19 National Immunization Prevention Plan (PNPV) have been met only partially. The current public health emergency is likely to have negatively impacted on immunization , with the risk of re-occurrence of Vaccine-Preventable Diseases (VPDs) outbreaks. As flu season approaches, both National Health Institutions and the scientific community in Italy have taken action. Well in advance as compared to previous years, the Ministry of Health released the Circular to launch the 2020-2021 influenza immunization campaign which this year is longer (starting on October 2020) and extends flu vaccine recommendations to more "at risk" subgroups, offered the vaccine free of charge. In addition, some Italian Regions have recently tried to make flu vaccination compulsory for all Healthcare Workers (HCWs). Since 2017, when the law on childhood vaccination in Italy was passed, compulsory vaccination has proved to be a successful strategy towards coverage increase.
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Affiliation(s)
- Anna Odone
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
| | - Daria Bucci
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
| | - Roberto Croci
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
| | | | | | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; University of Parma, Parma, Italy.
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14
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Morgado M, Palandri L, Colucci ME, Affanni P, Zoni R, Pasquarella C, Righi E, Veronesi L. Implementation of Acute Flaccid Paralysis Surveillance in Emilia-Romagna, Italy: 2018-2019 analysis. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1340] [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: 11/14/2022] Open
Abstract
Abstract
Problem
Acute flaccid paralysis (AFP) active surveillance is the gold standard in polio eradication process. Italy was classified in 2017 at intermediate risk of poliovirus reintroduction based on suboptimal poliovirus surveillance. The aim of this study was to restore an adequate level of AFP surveillance in Emilia-Romagna Region.
Description of the Problem
The Emilia-Romagna's Reference Centre for AFP surveillance, in collaboration with the regional Public Health Service identified a collaborative network for AFP Surveillance by analysing the 2015-2017 Hospital Discharge Registers in all region's hospitals. The surveillance protocol was reviewed with the development of a computerized system of Active Surveillance-Zero Reporting sent by e-mail to doctors in the network every 15 days since October 2018. The goal was to restore the AFP notification system to meet WHO requirements sensitivity, completeness of case investigation, completeness of follow-up and to monitor the active surveillance program adherence.
Results
The active surveillance network was composed by 49 doctors from both hospital administrations and clinical wards from 4 University Hospitals and 7 Local Health Authorities throughout the region. By the end of 2019, the mean response to each e-mail was 48.5% (SD 7.5%); 7 AFP cases have been reported; 85.7% received a full clinical and virological investigation and 83.3% completed the 60 day's follow-up. The final diagnosis of the cases was: 3 Guillain-Barre, 1 transient polyneuritis after HAV vaccination, 1 neuromyopathy from chronic disease, 1 acute myelitis in patient with DADA2. In 2 cases the paralysis persisted after 60 days.
Lessons
In 2019, the active surveillance system reached sensitivity, completeness of case investigation and follow-up required. Intervention had no expenses, is easily reproducible, created a direct collaboration between clinical colleagues in the network and the reference center which restored adherence to AFP surveillance.
Key messages
This work proposes how to improve AFP surveillance in a setting with low polio risk perception due to the absence of cases. Additionally, it reinforces the importance of direct collaboration/teamwork between institutions, regional reference centres and clinicians.
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Affiliation(s)
- M Morgado
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Palandri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - M E Colucci
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - P Affanni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - R Zoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - E Righi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - L Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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15
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Pasquarella C, Colucci ME, Bizzarro A, Veronesi L, Affanni P, Meschi T, Brianti E, Vitali P, Albertini R. Detection of SARS-CoV-2 on hospital surfaces. Acta Biomed 2020; 91:76-78. [PMID: 32701919 PMCID: PMC8023093 DOI: 10.23750/abm.v91i9-s.10137] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 01/22/2023]
Abstract
The COVID-19 pandemic, affecting 213 countries, with more than 10 million cases and over 500,000 deaths is still causing serious health, social and economic emergency worldwide. Italian Northern regions are among the most badly affected areas. Surfaces represent matrices to which particular attention should be paid for prevention and control of SARS-CoV-2 transmission. A few studies have highlighted virus presence on surfaces. We report the evidence of its presence on hospital surfaces, in a single room hosting a patient whose nose-pharyngeal swab resulted positive for SARS-CoV-2 RNA at the admission. The surfaces sampling was carried out using pre-wetted swabs followed by extraction and amplification of viral RNA by reverse Real-Time Polymerase Chain Reaction (rRT-PCR). A total of 4/15 (26.66%) surfaces were positive for SARS-CoV-2 RNA: the right bed rail, the call button, the bed trapeze bar, the stethoscope; moreover, the patient's inner surgical mask was positive, showing the emission of the virus from the patient. This study is a further confirmation that the surfaces represent a potential vehicle of transmission. This supports the need for strict adherence to hand and environmental hygiene.
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16
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Veronesi L, Colucci ME, Pasquarella C, Caruso L, Mohieldin Mahgoub Ibrahim M, Zoni R, Pergreffi M, Arcuri C, Seidenari C, Viani I, Capobianco E, Mezzetta S, Affanni P. Virological surveillance of SARS-CoV-2 in an Italian northern area: comparison of Real Time RT PCR cycle threshold (Ct) values in three epidemic periods. Acta Biomed 2020; 91:19-21. [PMID: 32701912 PMCID: PMC8023099 DOI: 10.23750/abm.v91i9-s.10138] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 12/31/2022]
Abstract
Aim of the study was to investigate the differences in Ct values in nasopharingeal swabs collected in three SARS-CoV-2 epidemic periods: first one from February 23 to March 25 (14 days from lockdown started on March 11); the second one from March 26 to May 18 (14 days from the end of strict lockdown on May 4) and the third one from May 19 until June 15. Viral RNA was detected in nasopharyngeal swabs obtained both from inpatients and outpatients. COVID-19 infection was confirmed according to the Ct values for N1 and N2 genes ascertained by Real-Time RT-PCR assay as described by the CDC. We calculated the prevalence of nasopharyngeal swabs tested positive for SARS-CoV-2, the mean and median of the Cts and the percentage of samples equal or below the Ct value of 25 in the 3 periods considered. The average value of Ct increased, going from 24.80 in the first epidemic period to 26.64 in the second period to 28.50 in the third period (p <0.001). The percentage of samples with Ct lower than or equal to 25 also decreased sharply from 54.7% to 20.0%. These findings need to be integrated with epidemiological and clinical data.
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Affiliation(s)
| | | | | | - Luca Caruso
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Carlo Arcuri
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Isabella Viani
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Sandra Mezzetta
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy.
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17
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Rossi GM, Delsante M, Pilato FP, Gnetti L, Gabrielli L, Rossini G, Re MC, Cenacchi G, Affanni P, Colucci ME, Picetti E, Rossi S, Parenti E, Maccari C, Greco P, Di Mario F, Maggiore U, Regolisti G, Fiaccadori E. Kidney Biopsy Findings in a Critically Ill COVID-19 Patient With Dialysis-Dependent Acute Kidney Injury: A Case Against "SARS-CoV-2 Nephropathy". Kidney Int Rep 2020; 5:1100-1105. [PMID: 32426558 PMCID: PMC7230145 DOI: 10.1016/j.ekir.2020.05.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Giovanni Maria Rossi
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Delsante
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Letizia Gnetti
- Pathological Anatomy and Histology, University Hospital of Parma, Parma, Italy
| | - Liliana Gabrielli
- Clinical Microbiology, University Hospital Sant’Orsola of Bologna, Bologna, Italy
| | - Giada Rossini
- Clinical Microbiology, University Hospital Sant’Orsola of Bologna, Bologna, Italy
| | - Maria Carla Re
- Clinical Microbiology, University Hospital Sant’Orsola of Bologna, Bologna, Italy
| | - Giovanna Cenacchi
- Department of Biomedical and Neuromotor Sciences, University “Alma Mater” of Bologna, Bologna, Italy
- Pathological Anatomy, Sector of Diagnostic and Subcellular Pathology, University Hospital Sant’Orsola of Bologna, Bologna, Italy
| | - Paola Affanni
- Hygiene and Public Health Laboratory, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Maria Eugenia Colucci
- Hygiene and Public Health Laboratory, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Edoardo Picetti
- U.O 1st Anesthesia and Resuscitation, University Hospital of Parma, Parma, Italy
| | - Sandra Rossi
- U.O 1st Anesthesia and Resuscitation, University Hospital of Parma, Parma, Italy
| | - Elisabetta Parenti
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Caterina Maccari
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Paolo Greco
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Di Mario
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Umberto Maggiore
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Regolisti
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Enrico Fiaccadori
- Renal Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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18
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Conte C, Sogni F, Affanni P, Veronesi L, Argentiero A, Esposito S. Vaccines against Coronaviruses: The State of the Art. Vaccines (Basel) 2020; 8:E309. [PMID: 32560340 PMCID: PMC7350246 DOI: 10.3390/vaccines8020309] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 05/29/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022] Open
Abstract
The emerging epidemic caused by the new coronavirus SARS-CoV-2 represents the most important socio-health threat of the 21st century. The high contagiousness of the virus, the strong impact on the health system of the various countries and the absence to date of treatments able to improve the prognosis of the disease make the introduction of a vaccine indispensable, even though there are currently no approved human coronavirus vaccines. The aim of the study is to carry out a review of the medical literature concerning vaccine candidates for the main coronaviruses responsible for human epidemics, including recent advances in the development of a vaccine against COVID-19. This extensive review carried out on the vaccine candidates of the main epidemic coronaviruses of the past has shown that the studies in animal models suggest a high efficacy of potential vaccines in providing protection against viral challenges. Similar human studies have not yet been carried out, as the main trials are aimed at assessing mainly vaccine safety and immunogenicity. Whereas the severe acute respiratory syndrome (SARS-CoV) epidemic ended almost two decades ago and the Middle East respiratory syndrome (MERS-CoV) epidemic is now better controlled, as it is less contagious due to the high lethality of the virus, the current SARS-CoV-2 pandemic represents a problem that is certainly more compelling, which pushes us to accelerate the studies not only for the production of vaccines but also for innovative pharmacological treatments. SARS-CoV-2 vaccines might come too late to affect the first wave of this pandemic, but they might be useful if additional subsequent waves occur or in a post-pandemic perspective in which the virus continues to circulate as a seasonal virus.
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Affiliation(s)
- Cristiano Conte
- Pediatric Clinic, Department of Medicine and Surgery, Pietro Barilla Children’s Hospital, University of Parma, 43126 Parma, Italy; (C.C.); (F.S.); (A.A.)
| | - Francesco Sogni
- Pediatric Clinic, Department of Medicine and Surgery, Pietro Barilla Children’s Hospital, University of Parma, 43126 Parma, Italy; (C.C.); (F.S.); (A.A.)
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.A.); (L.V.)
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.A.); (L.V.)
| | - Alberto Argentiero
- Pediatric Clinic, Department of Medicine and Surgery, Pietro Barilla Children’s Hospital, University of Parma, 43126 Parma, Italy; (C.C.); (F.S.); (A.A.)
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, Pietro Barilla Children’s Hospital, University of Parma, 43126 Parma, Italy; (C.C.); (F.S.); (A.A.)
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19
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Pasquarella C, Bizzarro A, Martini R, Ricci B, Martini R, Colucci ME, Rossi D, Faetani L, Ghizzoni D, Tamarri F, Seidenari C, Saccani E, Romiti D, Ruggeri J, Pasquarella ML, Affanni P, Zoni R, Caruso L, Signorelli C, Gobbi G, Costantino C, Veronesi L. ["Activate your Wait" project : pilot study carried out at a thermal centre]. Acta Biomed 2020; 91:146-149. [PMID: 32275280 PMCID: PMC7975901 DOI: 10.23750/abm.v91i3-s.9429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/23/2022]
Abstract
“Activate your wait” project: pilot study carried out at a thermal centre: Physical activity is recognised as a major health determinant, with positive effects on health, environmental sustainability and economy. National surveillance data show that one out of three Italians - adult and elderly alike - declares to be sedentary, with a progressively increasing trend. From the urgent need to implement strategies to promote physical activity the “Activate your Wait” (“Attiva l’Attesa”) project was born, aimed at transforming the waiting pauses during day to day life into opportunities to perform simple stretching and active mobilization exercises. The pilot study was carried out at the Terme S. Egidio, Suio Terme Castelforte (Latina). The results of the questionnaire distributed in the pre-intervention phase, aimed at assessing the users’ interest in the project and physical activity in general, are reported. The questionnaire was administrated in the waiting rooms in September 2018 and September 2019. A total of 129 subjects responded to the questionnaire: 43% declared themselves sedentary, 73% reported willingness to perform simple physical exercises while waiting, and 76% believed that physical activity during waiting moments could have a positive impact on health. The project’s subsequent goal is to identify suitable exercises to be proposed during the intervention period, which can be easily reproduced independently by users in their everyday life.
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Affiliation(s)
| | | | | | | | | | | | - Deanna Rossi
- Department of Medicine and Surgery, University of Parma;.
| | | | | | | | | | - Elisa Saccani
- Department of Medicine and Surgery, University of Parma;.
| | - Davide Romiti
- Department of Medicine and Surgery, University of Parma;.
| | - Janis Ruggeri
- Department of Medicine and Surgery, University of Parma;.
| | | | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma;.
| | - Luca Caruso
- Department of Medicine and Surgery, University of Parma;.
| | | | - Giuliana Gobbi
- Department of Medicine and Surgery, University of Parma;.
| | | | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma;.
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20
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Rossi D, Croci R, Affanni P, Odone A, Signorelli C. [Influenza vaccination coverage in Lombardy Region: a twenty-year trend analysis (1999-2019)]. Acta Biomed 2020; 91:141-145. [PMID: 32275279 PMCID: PMC7975897 DOI: 10.23750/abm.v91i3-s.9455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/19/2022]
Abstract
Influenza vaccination coverage in Lombardy Region: a twenty-year trend analysis (1999-2019). Recent events and phenomena, such as A(H1N1) pandemic in 2009, “Fluad case” (2014-2015) and the spread of vaccine hesitancy, affected influenza vaccination coverage rates in Italy. In this study, the annual coverage rates in Lombardy Region and in Italy (from 1999-2000 season) have been critically described and compared. Regarding both the general population and the elderly over-65s, Lombardy’s coverages always remained consistently below the national average. However, declines and peaks occurred simultaneously. The current slight recovery, both at national and regional level, is not sufficient. Coverages are still widely below the recommended thresholds.
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Affiliation(s)
| | | | | | - Anna Odone
- Università Vita-Salute San Raffaele, Milano.
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21
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Zoni R, Capobianco E, Viani I, Colucci ME, Mezzetta S, Affanni P, Veronesi L, Di Fonzo D, Albertini R, Pasquarella C. [Fungal contamination in a University building]. Acta Biomed 2020; 91:150-153. [PMID: 32275281 PMCID: PMC7975915 DOI: 10.23750/abm.v91i3-s.9426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/24/2020] [Indexed: 12/02/2022]
Abstract
Fungal contamination in a University building.
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22
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Colucci ME, Affanni P, Cantarelli A, Caruso L, Bracchi MT, Capobianco E, Zoni R, Paini G, Odone A, Mohieldin Mahgoub Ibrahim MM, Veronesi L. Influenza vaccine effectiveness in children: a retrospective study on eight post-pandemic seasons with trivalent inactivated vaccine. Acta Biomed 2020; 91:63-70. [PMID: 32275269 PMCID: PMC7975907 DOI: 10.23750/abm.v91i3-s.9424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/24/2020] [Indexed: 01/12/2023]
Abstract
Background and aim of the work: The global burden of disease attributable to seasonal influenza virus in children is difficult to quantify. Children with chronic medical conditions and healthy children may experience severe or fatal complications. Aim of the study was to estimate the influenza vaccine effectiveness (VE) in a cohort of outpatient children. Methods: From 2010 to 2018, a Pediatrician of Parma from the InfluNet network of Emilia-Romagna Region, performed nasal/throat swabs on every child with Influenza-like illness at least 14 days from the vaccination with trivalent vaccine. VE estimates against influenza season, virus type and subtype and age group were evaluated using a test-negative design. Results: 2,480 swabs were performed. The 57.6% of the analyzed swabs were positive for influenza viruses. Type A (57%) and type B viruses (43%) co-circulated. The 37.1% of type A viruses belonged to subtype A(H3N2), 19.4% to subtype A(H1N1)pdm09. The subtype A(H3N2) was prevalent among children up to 23 months (42.4%) while the type B in the 2-4 (40.7%) and 5-16 year old age groups (49.4%). Overall, 19.9% of the children were vaccinated. The highest prevalence of vaccinated subjects was found in children aged 5-16 (30.5%). The VE against subtype A(H1N1)pdm09 was 63% (95%CI 42.6-76.0), against type B 27.5% (95%CI 7.9-42.9) and against subtype A(H3N2) -14.3% (95%CI - 46.0-10.7). Conclusions: Our findings represent a useful contribution to the ongoing debate about the appropriateness of including influenza vaccination for healthy children, 6 months and older, in the updating National Vaccine Prevention Plan (PNPV).
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Affiliation(s)
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma.
| | | | - Luca Caruso
- Department of Medicine and Surgery, University of Parma.
| | | | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma.
| | - Giulia Paini
- Department of Medicine and Surgery, University of Parma.
| | - Anna Odone
- School of Public Health, Faculty of Medicine, University Vita-Salute San Raffaele, Milan.
| | | | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma.
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Affanni P, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Viani I, Caruso L, Carlone L, Arcuri C, Veronesi L. Immunity status against tetanus in young migrants: a seroprevalence study. Acta Biomed 2020; 91:77-84. [PMID: 32275271 PMCID: PMC7975914 DOI: 10.23750/abm.v91i3-s.9438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Thanks to the highly effective vaccine, tetanus became sporadic in high-income countries with well-established primary childhood immunization programs, but it is common in low-income countries. The migrants, leaving countries with poor immunization programs or where vaccinations have been interrupted, may represent a new risk group for tetanus in host countries. A seroprevalence study was conducted to estimate the immunological status against tetanus in young migrants without vaccination documentation. METHODS After a careful assessment by vaccination services of the Local Health Authority, all migrants recently arrived in Italy were included in the serosurvey. Titers of anti-tetanus toxoid were measured using a commercial ELISA kit. Subjects were stratified by age and by WHO region. Antibody titers <0.10 IU/ml were considered to be seronegative, between 0.10 and 1.00 IU/ml as intermediate protection, and >1.00 IU/ml high protection. RESULTS From January 2004 to December 2019, 2,326 blood samples were collected. Mean age was 13.9 years with no differences between WHO regions. The percentage of the subjects without protective antibodies was 22.3%, with an intermediate level was 45.2%, with high titer was 32.5%. Among migrant coming from African and Eastern Mediterranean WHO regions, the highest percentages of seronegative titers and, at the same time, the low percentages of high protective levels were found. Titers decreased with age. CONCLUSIONS The significant proportion of seronegative migrants and the decrease of protective titers increasing age, confirm the importance of the evaluation of the immunological status to employ the appropriate vaccination strategy.
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Affiliation(s)
| | | | | | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Isabella Viani
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Luca Caruso
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Carlo Arcuri
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Italy.
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Signorelli C, Priori M, Odone A, Vezzosi L, Colucci ME, Affanni P, Veronesi L, Maio T. [New challenges in vaccination policies: the role of General Practitioners]. Acta Biomed 2020; 91:135-140. [PMID: 32275278 PMCID: PMC7975910 DOI: 10.23750/abm.v91i3-s.9452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/25/2022]
Abstract
New challenges in vaccination policies: the role of General Practitioners. The phenomenon of “Vaccine Hesintacy” and the consequent decrease in vaccination coverage with the re-ignition of some epidemic outbreaks has led Italian national and regional authorities to set a new vaccination plan (PNPV 2017-19) and even coercive measures such as the the Law n.119/2017. In addition, there have been initiatives by scientific societies also in order to increase involvement of professionals in information and education campaigns. Among the professional figures involved, the general practitioners represents the starting point from which to regain the citizen’s trust. This article assesses their important role in the implementation of vaccination policies in Italy by identifying the essential points of the campaigns carried out on their patients.
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Affiliation(s)
- Carlo Signorelli
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy. Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | | | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy.
| | | | | | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
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25
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Viani I, Colucci ME, Pergreffi M, Rossi D, Veronesi L, Bizzarro A, Capobianco E, Affanni P, Zoni R, Saccani E, Albertini R, Pasquarella C. Passive air sampling: the use of the index of microbial air contamination. Acta Biomed 2020; 91:92-105. [PMID: 32275273 PMCID: PMC7975895 DOI: 10.23750/abm.v91i3-s.9434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/23/2022]
Abstract
Background: Bioaerosol plays an important role in human life with potentially infectious, allergic and toxic effects. Active and passive methods can be used to assess microbial air contamination, but so far there is not a unanimous consensus regarding the indications about methods to be used and how to interpret the results. The passive method has been standardized by the Index of Microbial Air contamination (IMA). Classes of contamination and maximum acceptable levels of IMA have been proposed, related to different infection or contamination risks. The aim of this study was to provide information about the use of the passive sampling method, with reference to the IMA standard. Methods: We searched PubMed and Scopus for articles published until January 2020 reporting the citation of the article by Pasquarella et al. “The index of microbial air contamination. J Hosp Infect 2000”. Only studies in English language where the IMA standard was applied were considered. Studies regarding healthcare settings were excluded. Results: 27 studies were analyzed; 12 were performed in Europe, 8 in Asia, 5 in Africa, 2 in America. Cultural heritage sites, educational buildings and food industries were the most common indoor monitored environments; in 8 studies outdoor air was monitored. Conclusions: This review has provided a picture of the application of standard IMA in different geographic areas and different environments at risk of airborne infection/contamination. The analysis of the results obtained, together with a wider collection of data, will provide a useful contribution towards the definition of reference limits for the various types of environments to implement targeted preventive measures.
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Palandri L, Morgado M, Colucci ME, Affanni P, Zoni R, Mezzetta S, Bizzarro A, Veronesi L. Reorganization of Active Surveillance of Acute Flaccid Paralysis (AFP) in Emilia-Romagna, Italy: a two-step Public Health intervention. Acta Biomed 2020; 91:85-91. [PMID: 32275272 PMCID: PMC7975913 DOI: 10.23750/abm.v91i3-s.9436] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK The International Health Regulations Emergency Committee declared in 2014 that poliovirus circulation is a public health emergency of international concern. In 2017 and 2018 Italy was classified at intermediate risk of poliovirus reintroduction based on suboptimal poliovirus surveillance. Acute flaccid paralysis active surveillance is the gold standard in the polio eradication process. The aims of this study were to investigate the causes of reduced acute flaccid paralysis case reporting in Emilia-Romagna in the last few years (step 1) and to study a public health intervention to restore an adequate level of acute flaccid paralysis surveillance in that region (step 2). METHODS In the first step a context analysis was performed by analysing the 2015-2017 Hospital Discharge Registers in Emilia-Romagna with the ICD-9-CM differential diagnosis codes for acute flaccid paralysis. Data from context analysis was then used to plan a new regional collaborative network of acute flaccid paralysis active surveillance. RESULTS The active surveillance network was, at the end of the study, composed by 49 doctors from both hospital administrations and clinical wards from 4 University Hospitals and 7 Local Health Authorities throughout the Region. In 15 months, 7 acute flaccid paralysis cases have been reported; 85,7% received a full clinical and virological investigation and 83,3% completed the 60 day's follow-up. The mean response to each e-mail was 48,5% (SD 7,5%). CONCLUSIONS In 2019, the Emilia-Romagna's active surveillance system reached the sensitivity, completeness of case investigation and follow-up required to achieve the minimum levels for certification standard surveillance.
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Affiliation(s)
- Lucia Palandri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Mariana Morgado
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Maria Eugenia Colucci
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Sandra Mezzetta
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
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Bersanelli M, Scala S, Affanni P, Veronesi L, Colucci ME, Banna GL, Cortellini A, Liotta F. Immunological insights on influenza infection and vaccination during immune checkpoint blockade in cancer patients. Immunotherapy 2020; 12:105-110. [PMID: 32046555 DOI: 10.2217/imt-2019-0200] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Melissa Bersanelli
- University Hospital of Parma, Medical Oncology Unit, Parma, Italy.,University of Parma, Medicine & Surgery Department, Parma, Italy
| | - Stefania Scala
- Functional Genomics, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Paola Affanni
- University of Parma, Medicine & Surgery Department, Parma, Italy
| | - Licia Veronesi
- University of Parma, Medicine & Surgery Department, Parma, Italy
| | | | | | - Alessio Cortellini
- Medical Oncology Unit, St Salvatore Hospital, Medical Oncology Unit, L'Aquila, Italy.,St. Salvatore Hospital, University of L'Aquila, Department of Biotechnological & Applied Clinical Sciences, L'Aquila, Italy
| | - Francesco Liotta
- Department of Experimental & Clinical Medicine, University of Florence, Florence, Italy
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Vergine G, Fantini M, Marchetti F, Stella M, Valletta E, Biasucci G, Lanari M, Dodi I, Bigi M, Magista AM, Vaienti F, Cella A, Affanni P, Re MC, Sambri V, Esposito S. Home Management of Children With COVID-19 in the Emilia-Romagna Region, Italy. Front Pediatr 2020; 8:575290. [PMID: 33194906 PMCID: PMC7644844 DOI: 10.3389/fped.2020.575290] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/07/2020] [Indexed: 12/24/2022] Open
Abstract
In most children, coronavirus disease 2019 (COVID-19) is a mild or moderate disease. Moreover, in a relevant number of cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains totally asymptomatic. All these findings seem to suggest that otherwise healthy children with suspected COVID-19 might be managed in the community in most cases, thus avoiding hospital admission and closely related medical, social and economic problems, including overwhelming hospitals. Unfortunately, home management of children with suspected COVID-19 rarely occurs, and many children with suspected or laboratory-confirmed SARS-CoV-2 infection are frequently hospitalized irrespective of the severity of disease. To evaluate the role of community health houses (CHHs) in the management of children with COVID-19, 1,009 children with suspected SARS-CoV-2 infection were studied in Emilia-Romagna Region, Italy. Among them, 194 (19.2%) resulted positive for SARS-CoV-2. The majority (583, 58%) were tested at home by CHHs, while 426 (42%) were brought to the hospital for testing. The patients who were managed in the hospital had a significantly lower median age than those who were managed at home (2 vs. 12 years, p < 0.001). Exposure to SARS-CoV-2 cases within the family was significantly more frequent among those who were managed at home (82 vs. 46%, p < 0.05). The clinical findings were similar between the children who were managed at home and those who were managed in the hospital. Only one of the children managed at home (0.7%) required hospitalization; in comparison, 26 (48%) of those whose swab samples were taken at the hospital were hospitalized. Our research shows for the first time the importance of CHHs in the management of COVID-19 in children; because of the high frequency of mild to moderate cases, management by CHHs can reduce the care load in hospitals, providing enormous advantages on the familial, medical, social, and economic levels. These findings could be useful for suggesting a territorial rather than hospital-based strategy in pediatrics in the case of a new wave of the epidemic.
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Affiliation(s)
- Gianluca Vergine
- Department of Pediatrics, Infermi Hospital Rimini, Azienda Sanitaria Locale Romagna, Rimini, Italy
| | - Michela Fantini
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena, Italy
| | - Federico Marchetti
- Department of Pediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Marcello Stella
- Department of Pediatrics, Azienda Sanitaria Locale Romagna, Forlì, Italy
| | - Enrico Valletta
- Pediatric Clinic, Azienda Sanitaria Locale Romagna, Cesena, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marcello Lanari
- General and Emergency Pediatrics, Policlinico Sant'Orsola, University of Bologna, Bologna, Italy
| | - Icilio Dodi
- General and Emergency Pediatrics, Pietro Barilla Children's Hospital, Parma, Italy
| | - Maurizio Bigi
- Pediatric Community Unit, Azienda Sanitaria Locale Romagna, Rimini, Italy
| | - Anna Maria Magista
- Pediatric Community Unit, Azienda Sanitaria Locale Romagna, Ravenna, Italy
| | | | - Andrea Cella
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Paola Affanni
- Laboratory of Hygiene and Public Health, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Maria Carla Re
- Microbiology Unit, Policlinico Sant'Orsola, University of Bologna, Bologna, Italy
| | - Vittorio Sambri
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena, Italy
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
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Puzelli S, Di Martino A, Facchini M, Fabiani C, Calzoletti L, Di Mario G, Palmieri A, Affanni P, Camilloni B, Chironna M, D'Agaro P, Giannecchini S, Pariani E, Serra C, Rizzo C, Bella A, Donatelli I, Castrucci MR. Co-circulation of the two influenza B lineages during 13 consecutive influenza surveillance seasons in Italy, 2004-2017. BMC Infect Dis 2019; 19:990. [PMID: 31752738 PMCID: PMC6873537 DOI: 10.1186/s12879-019-4621-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 06/05/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Since 1985, two antigenically distinct lineages of influenza B viruses (Victoria-like and Yamagata-like) have circulated globally. Trivalent seasonal influenza vaccines contain two circulating influenza A strains but a single B strain and thus provide limited immunity against circulating B strains of the lineage not included in the vaccine. In this study, we describe the characteristics of influenza B viruses that caused respiratory illness in the population in Italy over 13 consecutive seasons of virological surveillance, and the match between the predominant influenza B lineage and the vaccine B lineage, in each season. METHODS From 2004 to 2017, 26,886 laboratory-confirmed influenza cases were registered in Italy, of which 18.7% were type B. Among them, the lineage of 2465 strains (49%) was retrieved or characterized in this study by a real-time RT-PCR assay and/or sequencing of the hemagglutinin (HA) gene. RESULTS Co-circulation of both B lineages was observed each season, although in different proportions every year. Overall, viruses of B/Victoria and B/Yamagata lineages caused 53.3 and 46.7% of influenza B infections, respectively. A higher proportion of infections with both lineages was detected in children, and there was a declining frequency of B/Victoria detections with age. A mismatch between the vaccine and the predominant influenza B lineage occurred in eight out of thirteen influenza seasons under study. Considering the seasons when B accounted for > 20% of all laboratory-confirmed influenza cases, a mismatch was observed in four out of six seasons. Phylogenetic analysis of the HA1 domain confirmed the co-circulation of both lineages and revealed a mixed circulation of distinct evolutionary viral variants, with different levels of match to the vaccine strains. CONCLUSIONS This study contributes to the understanding of the circulation of influenza B viruses in Italy. We found a continuous co-circulation of both B lineages in the period 2004-2017, and determined that children were particularly vulnerable to Victoria-lineage influenza B virus infections. An influenza B lineage mismatch with the trivalent vaccine occurred in about two-thirds of cases.
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Affiliation(s)
- Simona Puzelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy.
| | - Angela Di Martino
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Marzia Facchini
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Concetta Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Laura Calzoletti
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Giuseppina Di Mario
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Annapina Palmieri
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | | | | | - Maria Chironna
- Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | | | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Caterina Rizzo
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Isabella Donatelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
| | - Maria Rita Castrucci
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome, Italy
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Rossi D, Bizzarro A, Affanni P, Pasquarella C, Odone A, Signorelli C. The educational background of the Top Managers of the Italian Health Authorities: results of a study on eight Regions. Acta Biomed 2019; 90:87-91. [PMID: 31517894 PMCID: PMC7233660 DOI: 10.23750/abm.v90i9-s.8731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 07/30/2019] [Indexed: 11/23/2022]
Abstract
A survey to investigate the educational background of the Health Top Managers recently appointed by Italian Regions as CEOs (Chief Executive Officer) of Local Health Authorities (ASL) and General Hospitals was performed in April 2019, approximately one year after the entry into force of the new law for their selection (D.Lgs 171/2016). The study follows a similar one carried out by Bocconi University in 2013 and focuses on 8 Italian Regions (Piedmont, Lombardy, Liguria, Umbria, Lazio, Basilicata, Sicily, Sardinia). The study examined the CVs of the 112 recently appointed CEOs: the average age is 58.7 years, with the proportion of female surprisingly low (16%). About half of them (50.5%) have a Degree in Medicine and Surgery. Among Managers with a non-medical degree (49.5%), Law (21) and Economic sciences (21) are the most common degrees. Among medical doctors, 33 (58.9%) are specialists in Hygiene and Preventive Medicine. Overall, our data are consistent with those recorded in 2013 (except a decrease in medical graduates -18.5%) and confirm the diversified backgrounds of Health Managers. The background in Public Health, acquired from the 35 Schools of Hygiene and Preventive Medicine, remains relevant among Managers of the Italian National Health Service.
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Colucci ME, Veronesi L, Bracchi MT, Zoni R, Caruso L, Capobianco E, Rossi D, Bizzarro A, Cantarelli A, Affanni P. On field vaccine effectiveness in three periods of 2018/2019 influenza season in Emilia-Romagna Region. Acta Biomed 2019; 90:21-27. [PMID: 31517886 PMCID: PMC7233652 DOI: 10.23750/abm.v90i9-s.8699] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 02/08/2023]
Abstract
Background and aim of the work: Epidemic influenza is associated with significant morbidity and mortality, particularly in people at risk. The vaccine reduces complications, hospitalization and mortality excess, as well as health care and social costs. Aim of the study was to estimate the influenza vaccine effectiveness (VE) in Emilia-Romagna Region during the 2018/2019 season. Methods: Within the context of virological surveillance conducted at the Regional Reference Laboratory of Parma, nasal/throat swabs were performed by sentinel practitioners and clinicians, on patients with ILI (Influenza-like illness). VE estimates, overall and against subtype A(H1N1)pdm09 and A(H3N2), were evaluated in three periods of the season, using a test-negative case-control design. Results: From November 2018 to April 2019, 2,230 specimens were analyzed: 1,674 (75.1%) performed by clinicians and 556 (24.9%) by sentinel practitioners of the regional network. The season was characterized by the predominant circulation of influenza type A viruses: 57.4% belonged to subtype A(H3N2), 41.2% to subtype A(H1N1)pdm09. 23.5% of patients was vaccinated against influenza with quadrivalent or adjuvate vaccine. The overall VE was -5% (95% CI -33% - 18%) with a decreasing trend during the season. The overall VE against subtype A(H1N1)pdm09 was 39% (95% CI 11% - 58%) and remained stable during the season. The overall VE against subtype A(H3N2) was -43% (95% CI -89% - -9%), and showed an important decreasing trend. Conclusions: The possibility to make accurate and continuous VE estimates during the season will help to better define the composition of the vaccine for the following season. (www.actabiomedica.it)
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Veronesi L, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Palandri L, Affanni P. Immunity status against poliomyelitis in young migrants: a seroprevalence study. Acta Biomed 2019; 90:28-34. [PMID: 31517887 PMCID: PMC7233651 DOI: 10.23750/abm.v90i9-s.8700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 01/13/2023]
Abstract
Background and aim of the work: Recent seroprevalence studies in different population groups have shown low antibody titers against poliomyelitis, especially in young adults. This, together with the reduction of vaccination rates, could favor the reintroduction of poliovirus in long-time polio-free countries. Within the Surveillance system of acute flaccid paralysis, a prevalence study was conducted to estimate the immunological status associated with poliomyelitis in young migrants. Methods: Local Health Authority collected serum samples in young migrants, without vaccination documentation. Antibodies levels were assessed with a long incubation neutralization assay. Subjects were stratified by age and by WHO region. Seroprotection was defined by a titer equal or above 1:8 and titers > 1:2 were log-transformed and evaluated as geometric mean titers (GMTs). Results: From January 2004 to August 2017, 1138 blood samples were collected. Mean age was 13.3 years with no differences between WHO regions. The percentage of antibody titers below 1:8 was 6.0% versus poliovirus 1 (PV1), 7.7% versus poliovirus 2 (PV2) and 15% versus poliovirus 3 (PV3). The GMTs were 45.5, 29.5 and 20 towards PV1, PV2 and PV3 respectively. In each WHO region, the GMTs towards PV3 were consistently the lowest, and the Europeans showed the lowest GMTs both towards PV2 and PV3 (27.5 and 15.3 respectively). GMTs decreased with age. Conclusion: The low GMTs and the clear tendency to decrease with increasing age of the subjects, especially against to PV1, confirm the framework of attention that polio is receiving at national and international level. (www.actabiomedica.it)
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Bizzarro A, Rossi D, Zoni R, Affanni P, Mazzocchi B, Pasquarella C, Goldoni M, Romanò L, Odone A, Signorelli C. The University Degree in Environment and workplace prevention techniques: a quasi unicum Course in the European panorama for non-medical professionals involved in prevention activities. Acta Biomed 2019; 90:92-94. [PMID: 31517895 PMCID: PMC7233664 DOI: 10.23750/abm.v90i9-s.8725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 11/23/2022]
Abstract
The University Degree programme in Environment and workplace prevention techniques (Tecniche della Prevenzione nell'Ambiente e nei Luoghi di Lavoro) is a 3-year course established in Italy in 2000 by the Ministry of University to train healthcare professionals responsible for prevention activities such as environment and food controls, and workplaces prevention, operating both in the National Health Service and in private settings. Frontal teaching activities and training programmes include a background in bio-medical sciences, epidemiology, public health, social sciences and law, including the inspection and control tasks of health and safety in living and working environment, food hygiene, environmental controls and veterinary public health, which represent the field of specific competences of graduates. Currently, 38 courses have been activated in 30 Italian Universities, but relatively few similar courses are present in Europe (similar programmes were found in France, Spain, UK and Belgium) causing the lack of internalization and student exchange programmes. It is essential to identify similar training tasks in other European countries, in order to enhance cultural exchanges and the development of research activities in these strategic areas.
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Affanni P, Colucci ME, Bracchi MT, Capobianco E, Zoni R, Caruso L, Castrucci MR, Puzelli S, Cantarelli A, Veronesi L. Virological Surveillance of Influenza in the eight epidemic seasons after the 2009 pandemic in Emilia-Romagna (Northern Italy). Acta Biomed 2019; 90:35-44. [PMID: 31517888 PMCID: PMC7233653 DOI: 10.23750/abm.v90i9-s.8722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Influenza virological surveillance is essential for monitoring the evolution of influenza viruses (IVs) as well as for annual updating of the vaccine composition. The aim of this study is to analyse IVs circulation in Emilia-Romagna during the eight epidemic seasons after the 2009 pandemic and to evaluate their match with seasonal vaccine strains. METHODS A total of 7882 respiratory specimens from patients with influenza-like illness (ILI), were collected by regional sentinel practitioners and hospital physicians. Viral investigations were conducted by rRT-PCR assay. Genetic characterization was performed for a spatial-temporal representative number of influenza laboratory-confirmed specimens. RESULTS Influenza-positive samples per season ranged between 28.9% (2013-2014) and 66.8% (2012-2013). Co-circulation of IVs type A and type B was observed in all seasons, although with a different intensity. In all seasons, the highest number of positive samples was recorded in younger patients aged 5-14 years with relative frequencies ranging from 40% in the 2013-2014 season and 78% in the 2012-2013 season. Since the 2009 pandemic, A/H1N1pdm09 IVs circulating were closely related to the vaccine strain A/California/7/2009. Antigenic mismatch between vaccine strain and A/H3N2 IVs was observed in the 2011-2012 and 2014-2015 seasons. During 2015-2016, 2016-2017 and 2017-2018 seasons a complete or nearly complete mismatch between the predominant influenza B lineage of IVs type B circulating and vaccine B lineage occurred. CONCLUSIONS This analysis confirms the importance of the virological surveillance and highlights the need of a continuous monitoring of IVs circulation, to improve the most appropriate vaccination strategies. (www.actabiomedica.it).
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Affiliation(s)
- Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy.
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Zoni R, Mezzetta S, Affanni P, Colucci ME, Fiore S, Fontana S, Bracchi M, Capobianco E, Veronesi L. Poliovirus and non-polio-enterovirus environmental surveillance in Parma within the "Global Polio Eradication Program" (GPEI). Acta Biomed 2019; 90:95-97. [PMID: 31517896 PMCID: PMC7233654 DOI: 10.23750/abm.v90i9-s.8702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/04/2022]
Abstract
Poliovirus and non-polio-enterovirus environmental surveillance in Parma within the “Global Polio Eradication Program” (GPEI) Background: Environmental surveillance of poliovirus plays an essential role in GPEI both for the detection of WTP and VDPV circulation in endemic areas and for monitoring their absence in polio-free countries. Methods: Since 2005 to 2018, in Parma, 642 wastewater samples were collected from the two wastewater treatment plants and analyzed according to the WHO Guidelines. All isolates supposed being poliovirus were sent to ISS reference laboratory for molecular characterization while NPEV only refer to samples up to 2016. Results: Positivity was obtained in 68% of samples without significant difference between the two treatment plants. Six polioviruses (1.4%) were detected, all characterized as Sabin-like: 4 of them (66.7%) were type 3 and 2 (33.3%) type 1. Coxsackieviruses B mainly recurred among NPEV (85%) while residual 15% was Echoviruses. B4 was the most frequent Coxsackie serotype isolated (31%) while, among Echovirus, Echo 7 and Echo 11 prevail (both 23%). Conclusion: As OPV isn’t used in Italy since 2002, recovery of Sabin-like polioviruses indicates the possibility of poliovirus reintroduction, considering also the important exposure to migratory flows. Finally, monitoring the environmental circulation of NPEV, could compensate for the lack of a surveillance system of the infections they cause. (www.actabiomedica.it)
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Affiliation(s)
- Roberta Zoni
- Department of Medicine and Surgery - University of Parma.
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Chiapponi C, Ebranati E, Pariani E, Faccini S, Luppi A, Baioni L, Manfredi R, Carta V, Merenda M, Affanni P, Colucci ME, Veronesi L, Zehender G, Foni E. Genetic analysis of human and swine influenza A viruses isolated in Northern Italy during 2010-2015. Zoonoses Public Health 2017; 65:114-123. [PMID: 28791803 DOI: 10.1111/zph.12378] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 03/10/2017] [Indexed: 11/30/2022]
Abstract
Influenza A virus (IAV) infection in swine plays an important role in the ecology of influenza viruses. The emergence of new IAVs comes through different mechanisms, with the genetic reassortment of genes between influenza viruses, also originating from different species, being common. We performed a genetic analysis on 179 IAV isolates from humans (n. 75) and pigs (n. 104) collected in Northern Italy between 2010 and 2015, to monitor the genetic exchange between human and swine IAVs. No cases of human infection with swine strains were noticed, but direct infections of swine with H1N1pdm09 strains were detected. Moreover, we pointed out a continuous circulation of H1N1pdm09 strains in swine populations evidenced by the introduction of internal genes of this subtype. These events contribute to generating new viral variants-possibly endowed with pandemic potential-and emphasize the importance of continuous surveillance at both animal and human level.
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Affiliation(s)
- C Chiapponi
- OIE Reference Laboratory for Swine Influenza, Parma, Italy.,Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy
| | - E Ebranati
- Dipartimento di Scienze Biomediche e Cliniche "Luigi Sacco", Sezione di Malattie Infettive, Università degli Studi di Milano, Milan, Italy
| | - E Pariani
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - S Faccini
- Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy
| | - A Luppi
- Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy
| | - L Baioni
- OIE Reference Laboratory for Swine Influenza, Parma, Italy.,Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy
| | - R Manfredi
- OIE Reference Laboratory for Swine Influenza, Parma, Italy.,Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy
| | - V Carta
- Dipartimento di Scienze Biomediche e Cliniche "Luigi Sacco", Sezione di Malattie Infettive, Università degli Studi di Milano, Milan, Italy
| | - M Merenda
- OIE Reference Laboratory for Swine Influenza, Parma, Italy.,Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy
| | - P Affanni
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Università degli Studi di Parma, Parma, Italy
| | - M E Colucci
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Università degli Studi di Parma, Parma, Italy
| | - L Veronesi
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, Università degli Studi di Parma, Parma, Italy
| | - G Zehender
- Dipartimento di Scienze Biomediche e Cliniche "Luigi Sacco", Sezione di Malattie Infettive, Università degli Studi di Milano, Milan, Italy
| | - E Foni
- OIE Reference Laboratory for Swine Influenza, Parma, Italy.,Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy
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Veronesi L, Affanni P, Verrotti di Pianella C, Colucci ME, Tanzi ML. Immunity status against poliomyelitis in childbearing women in a province of northern Italy -- reply. Ann Ig 2014; 26:120. [PMID: 24452191 DOI: 10.7416/ai.2014.1965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- L Veronesi
- Unit of Public Health, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T), University of Parma, Italy
| | - P Affanni
- Unit of Public Health, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T), University of Parma, Italy
| | - C Verrotti di Pianella
- Unit of Gynecology and Obstetrics, Department of Surgical Sciences, University of Parma, Italy
| | - M E Colucci
- Unit of Public Health, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T), University of Parma, Italy
| | - M L Tanzi
- Unit of Public Health, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T), University of Parma, Italy
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Veronesi L, Affanni P, Verrotti di Pianella C, Colucci ME, Tanzi ML. Immunity status against poliomyelitis in childbearing women in a province of northern Italy. A cross-sectional analysis. Ann Ig 2013; 25:427-33. [PMID: 24048181 DOI: 10.7416/ai.2013.1944] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This cross-sectional seroprevalence study was carried out in 2007 to estimate the immunological status associated with poliomyelitis among fertile women , according to demographic changes. We consecutively enrolled 493 healthy mothers at the time of delivery in order to assess immunity against poliomyelitis by a neutralisation inhibition test. Despite the lack of seronegative subjects, our investigation showed low GMTs, which confirmed a reduction in the "booster effect". The GMTs against poliovirus 1, poliovirus 2 and poliovirus 3 were 25.20, 14.79 and 8.80, respectively. The data that emerged from our survey showed that GMTs have decreased significantly since 1983 and reached low-to-medium values over the past 25 years. The serum prevalence studies, together with the vaccination coverage estimates, are useful and are strongly recommended in order to highlight and identify the possible scenarios in which susceptible subject groups may be present simultaneously as well the possibility of the reintroduction of wild virus in an area that was previously free of polio.
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Affiliation(s)
- L Veronesi
- Department of Biomedical Biotechnological and Translational Science, Unit of Public Health, University of Parma,Italy
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Rabuffetti M, Farina E, Alberoni M, Pellegatta D, Appollonio I, Affanni P, Forni M, Ferrarin M. Spatio-temporal features of visual exploration in unilaterally brain-damaged subjects with or without neglect: results from a touchscreen test. PLoS One 2012; 7:e31511. [PMID: 22347489 PMCID: PMC3275551 DOI: 10.1371/journal.pone.0031511] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [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: 06/16/2011] [Accepted: 01/10/2012] [Indexed: 11/19/2022] Open
Abstract
Cognitive assessment in a clinical setting is generally made by pencil-and-paper tests, while computer-based tests enable the measurement and the extraction of additional performance indexes. Previous studies have demonstrated that in a research context exploration deficits occur also in patients without evidence of unilateral neglect at pencil-and-paper tests. The objective of this study is to apply a touchscreen-based cancellation test, feasible also in a clinical context, to large groups of control subjects and unilaterally brain-damaged patients, with and without unilateral spatial neglect (USN), in order to assess disturbances of the exploratory skills. A computerized cancellation test on a touchscreen interface was used for assessing the performance of 119 neurologically unimpaired control subjects and 193 patients with unilateral right or left hemispheric brain damage, either with or without USN. A set of performance indexes were defined including Latency, Proximity, Crossings and their spatial lateral gradients, and Preferred Search Direction. Classic outcome scores were computed as well. Results show statistically significant differences among groups (assumed p<0.05). Right-brain-damaged patients with USN were significantly slower (median latency per detected item was 1.18 s) and less efficient (about 13 search-path crossings) in the search than controls (median latency 0.64 s; about 3 crossings). Their preferred search direction (53.6% downward, 36.7% leftward) was different from the one in control patients (88.2% downward, 2.1% leftward). Right-brain-damaged patients without USN showed a significantly abnormal behavior (median latency 0.84 s, about 5 crossings, 83.3% downward and 9.1% leftward direction) situated half way between controls and right-brain-damaged patients with USN. Left-brain-damaged patients without USN were significantly slower and less efficient than controls (latency 1.19 s, about 7 crossings), preserving a normal preferred search direction (93.7% downward). Therefore, the proposed touchscreen-based assessment had evidenced disorders in spatial exploration also in patients without clinically diagnosed USN.
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Affiliation(s)
- Marco Rabuffetti
- Fondazione Don Carlo Gnocchi ONLUS, Falconara Marittima, Ancona, Italy
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40
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Veronesi L, Virdis R, Bizzoco S, Colucci ME, Affanni P, Paganuzzi F, Riccò M, Capobianco E, Tanzi ML. Vaccination status and prevalence of enteric viruses in internationally adopted children. The case of Parma, Italy. Acta Biomed 2011; 82:208-213. [PMID: 22783717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
On age basis, internationally adopted children may have begun or fully completed all required vaccinations, but official documentation from original Countries is frequently insufficient. Aims of this study were to evaluate the seroprotection rate for tuberculosis, hepatitis B, poliomyelitis and tetanus according to immunization cards in 67 children recently adopted and to test the prevalence of enterovirus on faecal specimens. Seroprotection and vaccination status were frequently inconsistent and these results confirm that immunitary surveillance is a cornerstone for the prevention of diseases for which a vaccination is available. (www.actabiomedica.it).
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Affiliation(s)
- Licia Veronesi
- Department of Public Health, Parma Medical School, University of Parma, Italy.
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Cesari C, Colucci ME, Veronesi L, Giordano R, Paganuzzi F, Affanni P, Bracchi MT, Capobianco E, Ferrari G, Tanzi ML. Detection of enteroviruses from urban sewage in Parma. Acta Biomed 2010; 81:40-46. [PMID: 20857852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND AIM OF THE WORK The human enteroviruses (EV) are the most common and widespread human viruses in the world. They have bowel as their natural habitat and they can spread in the environment through the faecal excretion. In the continental climate Regions these viruses may cause epidemic outbreaks in summer and fall, while in the tropical Regions the EV infections present a high incidence during all year. The symptoms can be minor or subclinic, but they can be also associated to rare and serious diseases. The aim of this study was to evaluate the environmental circulation of polioviruses and non-polio enteroviruses (NPEV) using standard methods of urban wastewater surveillance recommended by the WHO. METHODS A total of 188 wastewater samples were collected between February 2005 and December 2008 from two sewage treatment plants in Parma. The sampling was carried out twice a month. Environmental variables were collected for each day of sampling. RESULTS Out of the 188 examined wastewater samples, 78.7% were positive to the enterovirus research. One out of the 148 positive samples was identified as poliovirus Sabin-like type 3. The remaining 147 positive samples were enteroviruses non polio: Coxsakieviruses and Echoviruses. All Coxsakieviruses isolated were of type B. CONCLUSIONS The proposed method has shown high sensibility, also in presence of very low expected prevalence of vaccine poliovirus. It allows to verify the kind and relative frequency of enteric viruses circulating in the country, whose characteristics (virulence and pathogenicity) may vary with reference to a different epidemiologic and demographic structure of the resident population.
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Affiliation(s)
- C Cesari
- Department of Public Health, Unit of Hygiene, Parma Medical School, University of Parma, Parma, Italy
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Veronesi L, Capobianco E, Affanni P, Pizzi S, Vitali P, Tanzi ML. Legionella contamination in the water system of hospital dental settings. Acta Biomed 2007; 78:117-122. [PMID: 17933279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND AND AIM OF THE WORK Among hospital facilities the dental unit is an environment that is at major risk of Legionella due to equipment such as the air/water syringe, the turbine, the micromotor and the scaler which generate potentially harmful aerosols that may to be a source of exposure to Legionella spp. particularly in immunodeficient patients, and those affected by chronic diseases, and also in dental personnel. Therefore, an examination of the extent of Legionella spp. contamination in the dental chairs waterlines and the incoming water supply of some public dental units is the subject of the present study. METHODS From February 2002 to March 2004, a total of 208 water samples were collected: 160 samples from the water supply of 4 dental chair and 48 samples from the cold incoming tap water of 2 units. RESULTS Legionella spp. was detected in 46 samples (22.1% ): 19 of them (41.3% of Legionella spp.; 9.1% of the total) were Legionella pneumophila; Pseudomonas aeruginosa was detected in 86 samples (41.4%) and both microorganisms were detected in 2 samples (0.96%). CONCLUSIONS Our results show a microbiological condition in dental settings, that is not at all satisfactory due to the presence of Legionella in concentrations that are considered to be a health hazard (> or = 10(3)) in certain cases. Given the extent of the health risk in these surroundings, the difficulty in its assessment, and also considering the wide diffusion of general dental care, our investigation has confirmed the need to regularly monitor the microbiological condition of water in dental units.
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Veronesi L, Verrotti Di Pianella C, Benassi L, Benaglia G, Affanni P, Tanzi ML. Mother to child transmission of hepatitis C virus in a province of northern Italy. J Prev Med Hyg 2007; 48:47-9. [PMID: 17713138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Study reports of mother to child transmission of hepatitis C virus (HCV) have shown transmission rates ranging from 3 to 37%, according to maternal viremia and HIV-1 coinfection. The present study evaluated the prevalence of the HCV infection in the general population and the incidence of vertical transmission, from women who delivered in the Obstetric Clinic of the Hospital of Parma from January 1st 1996 to 31st 2001 December. METHODS Mothers and children were tested for the presence of HCV-RNA within one week after delivery. Children were considered to be infected when they were found positive at least twice for viral RNA or antibodies were still detectable at the end of the follow-up period (18 months) in blood. RESULTS Out of 13,025 women, 110 (0.8%) were found positive for anti-HCV antibodies; 72 of them (65.4%) were HCV-RNA positive. All 110 children were positive for anti-HCV antibodies in the first blood sample (time 0); 8 of them were HCV-RNA positive. Three children were still viremic at the end of the follow-up whereas 5 showed a clearance. No significant differences were found between viremic and nonviremic children with respect to gestational week, maternal alanine aminotransferase (ALT) levels and newborns weight at birth. CONCLUSION This investigation shows that vertical transmission may occur in a general obstetric population despite a low prevalence of HCV-positive subjects.
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Affiliation(s)
- L Veronesi
- Department of Public Health, Parma University Medical School, Italy.
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Tanzi ML, Capobianco E, Affanni P, Pizzi S, Vitali P, Veronesi L. Legionella spp. in hospital dental facilities. J Hosp Infect 2006; 63:232-4. [PMID: 16621136 DOI: 10.1016/j.jhin.2006.01.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2005] [Accepted: 01/24/2006] [Indexed: 10/24/2022]
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Affanni P, Veronesi L, Rizziero S, Bizzoco S, Bracchi MT, Tanzi ML. Status of immunity against poliomyelitis: a study among European and extra-European young immigrants living in Parma. Acta Biomed 2005; 76:157-63. [PMID: 16676565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
From January 2001 to December 2003 blood specimens obtained from 323 European and extra-European young immigrants were collected for the determination of anti-polio antibody levels. They were sent to the Section of Hygiene, Department of Public Health, by the Local Health Authorities. A neutralization assay was performed to detect the anti-polio antibodies against serotypes 1, 2 and 3, using rhesus monkey kidney cells. The results showed 98,1% prevalence of anti-polio 1 antibodies (titre > or =1:2), 99,1% of anti-polio 2, and 98,8% prevalence of anti-polio 3 antibodies. The seronegativity against only one or two serotypes (antibody titre <1:2) was found in 9 subjects (2,8%) while no subject was found totally seronegative against all 3 serotypes. According to the total amount of the analyzed samples, the estimated Geometric Mean Titre (GMT) resulted from moderate to low (GMT=29 of serotype 3; GMT=48,4 of serotype 2; GMT=56,5 of serotype 1) and it appeared to be similar to the results obtained in the previous years for all 3 serotypes; the GMT of serotype 3 was still the lowest. No difference was observed in the specimens with respect to the country of origin of the examined subjects and the data collected showed a good level of immunity.
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Affiliation(s)
- Paola Affanni
- Section of Hygiene, Department of Public Health, University of Parma, Parma, Italy
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Tanzi ML, Veronesi L, Affanni P, Piazza N, Bellelli E. [Evaluation of the immune status against poliomyelitis in a group of young immigrants]. Ann Ig 2002; 14:197-204. [PMID: 12162117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The immunity state towards poliomyelitis has been evaluated in 506 young immigrants coming from European and extraeuropean countries without immunization history. Polioviruses 1, 2 and 3 antibodies were detected in 97% of the serum samples. 15 subjects did not have detectable antibodies at 1:2 dilution for one or two polioviruses. Out of these subjects, 6 (coming mostly from East European Region) were negative in the undiluted serum too. On the whole, GMTs for type 1 (43,29) and 2 (41,9) appeared higher than those for type 3 (33,6). Moreover there are differences among the origin countries; in fact, GMTs more elevated for type 1 and 3 (74,6 and 49,6 respectively) have been observed in the subjects coming from the African region, as well in those coming from the American region.
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Affiliation(s)
- M L Tanzi
- Dipartimento di Sanità Pubblica, Università degli Studi di Parma, Via Volturno 39, 43100 Parma.
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Tanzi ML, Veronesi L, Belucchi E, Affanni P, Bellelli E. [Influenza surveillance in a town of northern Italy in 1994-1997]. Ann Ig 2000; 12:7-13. [PMID: 10769478] [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: 02/16/2023]
Affiliation(s)
- M L Tanzi
- 1st. di Igiene, Università degli Studi di Parma
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Patti AM, Santi AL, Bellucci C, Ciapetti C, Fara GM, Germinario C, Calvario A, Lopalco PL, Barbuti S, Tanzi ML, Affanni P, Nieddu A, Bellelli E, Vellucci L, Caraffa De Stefano D. Serological survey on immunity status against polioviruses in Italian young adults and in immigrants. Ann Ig 1999; 11:353-9. [PMID: 10596422] [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: 02/14/2023]
Affiliation(s)
- A M Patti
- Inst. of Hygiene, La Sapienza University, Rome, Italy
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Berti A, Oxbury S, Oxbury J, Affanni P, Umilta C, Orlandi L. Somatosensory extinction for meaningful objects in a patient with right hemispheric stroke. Neuropsychologia 1999; 37:333-43. [PMID: 10199646 DOI: 10.1016/s0028-3932(98)00077-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Implicit, high level processing of extinguished objects has often been described in the visual modality. In the tactile domain, however, research on this topic is meagre and it is still uncertain whether processing of tactually presented stimuli can be affected by the same attentional disorders as visual stimuli. In this paper we describe a patient, ENM, with visual neglect and light touch extinction who, in a naming task of objects presented in the tactile modality, simultaneously to both hands, showed extinction for left hand objects. He was, nevertheless, able to make above chance Same/Different judgements on the two stimuli. We also tested two neurologically intact subjects who performed the test wearing a ski-glove on the left hand to impair the recognition of left hand objects. In these subjects, Same/Different judgements were at chance level when recognition rate was as low as that found in patient ENM. This happened when either the objects, although sharing the same name were different in shape (conditions Same-Different) or when the two objects were different with respect to the category name but were actually physically similar (conditions Different-Similar). However, when the objects were either identical or completely different, i.e., in a condition where judgement could be based simply on the physical analysis of the object shape (condition Same Identical and Different Dissimilar), their Same/Different judgements were above chance, despite the tactual deficit. Our conclusion was that patient ENM showed implicit recognition of left hand objects, at least in the Same Different and in the Different-Similar conditions, whereas, in the same conditions, normal subjects with an artificial sensory impairment did not. Our results also show that Same/Different judgements may be, in some conditions, less demanding than naming tasks, as suggested by Farah et al. Furthermore, patient ENM performed the test both with uncrossed and crossed hands. We found that extinction always affected the hand contralateral to the brain damage, although there was a tendency for a decrement of the ipsilesional hand performance in the crossed condition. We discuss these findings with reference to the most recent theories on the existence of a body centered spatial frame of reference.
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Affiliation(s)
- A Berti
- Dipartimento di Psicologia Generale, Universita' di Padova, Italy.
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Tanzi ML, Colotto P, Vignali M, Affanni P, Bracchi U, Bellelli E. Antipoliomyelitis neutralizing antibodies in maternal and neonatal serum. Eur J Epidemiol 1997; 13:559-65. [PMID: 9258569 DOI: 10.1023/a:1007345930234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
During 1993 blood samples were taken from 1251 women consecutively admitted to the Maternity Ward of the University of Parma. Samples were also taken from all the newborn babies. Absence of antipolio neutralizing antibodies in serum diluted 1/2 was shown in 6 mothers; 4 mothers for polio 1, 1 mother for polio 2 and 1 simultaneously for the poliovirus 1 and 3. If one considers only the cases of absence in undiluted serum, there were 2 negative subjects (0.16%). One of these was for antibodies against polio 1 and the other for antibodies against polio 2. In the cord blood samples the frequency of negative results in serum diluted 1/2 is higher: 42 in all with 13 babies negative for polio 1. 17 babies for polio 2, 8 for polio 3 and 2 babies simultaneously for polio 1 and polio 3. If one considers just the babies without antibodies even in undiluted serum, the fraction of seronegatives is 9 (0.7%) with 1 for polio 1, 6 for polio 2 and 1 for types 1 and 3. The Geometric Mean Titres of the antibodies are significantly higher in mothers born before 1964 (year of introduction of mass vaccination with OPV) compared with those born after that year. Likewise, the same phenomenon was observed in the respective children.
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Affiliation(s)
- M L Tanzi
- Istituto di Igiene, University of Parma, Italy
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