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Ponzio M, Tacchino A, Amicizia D, Piazza MF, Paganino C, Trucchi C, Astengo M, Simonetti S, Gallo D, Sansone A, Brichetto G, Battaglia MA, Ansaldi F. Prevalence of multiple sclerosis in Liguria region, Italy: an estimate using the capture-recapture method. Neurol Sci 2021; 43:3239-3245. [PMID: 34817728 PMCID: PMC9018629 DOI: 10.1007/s10072-021-05718-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/30/2021] [Indexed: 11/21/2022]
Affiliation(s)
- M Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy.
| | - A Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - D Amicizia
- A.Li.Sa, Liguria Health Authority, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M F Piazza
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | - C Paganino
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | - C Trucchi
- A.Li.Sa, Liguria Health Authority, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Astengo
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | | | - D Gallo
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | - A Sansone
- AISM Rehabilitation Centre Liguria, Italian Multiple Sclerosis Society, Genoa, Italy
| | - G Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy.,AISM Rehabilitation Centre Liguria, Italian Multiple Sclerosis Society, Genoa, Italy
| | - M A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy
| | - F Ansaldi
- A.Li.Sa, Liguria Health Authority, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
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Ponzio M, Amicizia D, Brichetto G, Tacchino A, Piazza MF, Paganino C, Trucchi C, Astengo M, Battaglia MA, Ansaldi F. The Prevalence of Multiple Sclerosis in Liguria region, Italy, using the capture–recapture method. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In recent years, there has been a growing interest in developing methods based on health administrative databases to estimate prevalence of chronic diseases, hoping that this would lead to more precise and reliable estimates. The capture-recapture method can be used to improve the prevalence of a disease reducing the bias of case underestimation.
Objective
To assess the prevalence of multiple sclerosis (MS) in the Liguria region in Italy using routinely collected healthcare data.
Methods
Data from three sources collected in Liguria Health Authority (A.Li.Sa.) databases - hospital discharge records, drug-dispensing records, disease-specific payment exemptions from copayment to health care - and a capture-recapture method with log-linear models were used to estimate the prevalence of MS. The accuracy of the case-finding algorithm was tested using a sample of people residents in Liguria Region with a definite diagnosis of MS extracted from clinical records of Liguria AISM Rehabilitation Service as reference standard.
Results
The case-finding algorithm to capture people with MS from routinely collected healthcare data used in our study found an observed crude prevalence of MS in Liguria region on 31 December 2017, of 202.4 cases per 100,000 inhabitants (95% CI: 195.3-209.5). After linkage to clinical data, the algorithm showed a sensitivity of 82.7%, with 22.1% of MS cases undetected on capture-recapture models. Consequently, the capture-recapture method prevalence estimate of 259.7 per 100,000 inhabitants (95% CI: 251.7-267.8) suggest that this region constitutes a high-risk area for MS.
Conclusions
Our initial study of crude MS prevalence showed an overall regional prevalence of MS of 202.4 cases per 100,000, capture-recapture analysis would add another 20%, to those figures. This method could be considered a good alternative to the population-based study design for estimating the prevalence of MS.
Key messages
Studies based on routinely collected healthcare data could help estimate the prevalence of chronic disease. To reduce the bias of case underestimation, the capture–recapture method can be useful.
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Affiliation(s)
- M Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - D Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - G Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
- AISM Rehabilitation Service, Italian Multiple Sclerosis Society, Genoa, Italy
| | - A Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - MF Piazza
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - C Paganino
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - C Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - M Astengo
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - MA Battaglia
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | - F Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
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Ponzio M, Borreli P, Monti MC, Amicizia D, Perotti P, Silva S, Ansaldi F, Mallucci G, Bergamaschi R, Montomoli C. Prevalence and economic burden of major comorbidities in multiple sclerosis. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.204] [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: 11/13/2022] Open
Abstract
Abstract
Background
Although comorbidity is important in Multiple Sclerosis (MS), few validated methods for its assessment exist. Our aim is to estimate the prevalence and economic burden of major comorbidities in people with MS (pwMS) in two Northern Italy study areas (Pavia, PV and Genoa, GE), using routinely collected healthcare data.
Methods
We estimated prevalence of comorbid conditions in pwMS in the period 2012-2017. Anxiety, depression, cancer, leukemia, lymphoma, hypertension, heart disease, cerebrovascular diseases, vascular diseases, ischemic stroke, hyperlipidaemia, bronchopathy, diabetes, gastropathy, gastric ulcer, autoimmune diseases, chronic renal failure, connective tissue diseases and HIV/AIDS were identified by a specific algorithm currently used for monitoring prevalence of chronic diseases by Italian Local Health Authorities (BDA system). Direct healthcare costs were defined by regional and governmental contracts; the aggregated healthcare expenditure was compared between pwMS with/without comorbidities.
Results
The MS cases identified were 2983, 2035 in GE and 948 in PV. 55.6% of pwMS had at least one comorbidity (50.6% GE and 66.5% PV, p < 0.001). The most prevalent comorbidities were: depression (32.9%), hypertension (18.0%), cancer (10.9%), heart disease (7.8%), cerebrovascular diseases (7.0%) and hyperlipidaemia (6.1%). Comorbidity ranking was similar in the two provinces, although we observed significant differences considering specific prevalence rates. The mean direct healthcare costs of MS were substantially higher for individuals with comorbidity (36,463 €vs 26,284 €, p < 0.001), showing 39% of additive costs.
Conclusions
Our study provides evidence of the burden of comorbidities in MS. Comorbidity is common in MS and produce additive costs.
Key messages
The use of administrative data for tracking the MS comorbidity could help knowledge gaps. When additivity situation is involved, preventive policies could lead to monetary savings.
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Affiliation(s)
- M Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - P Borreli
- Department of Public Health, Experimental and Forensic Medic, University of Pavia, Pavia, Italy
- Department of Medical, Oral and Biotechnological Sciences, L, University, Pescara, Italy
| | - MC Monti
- Department of Public Health, Experimental and Forensic Medic, University of Pavia, Pavia, Italy
| | - D Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - P Perotti
- Pavia Health Protection Agency, Pavia, Italy
| | - S Silva
- Pavia Health Protection Agency, Pavia, Italy
| | - F Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - G Mallucci
- Multiple Sclerosis Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - R Bergamaschi
- Multiple Sclerosis Research Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - C Montomoli
- Department of Public Health, Experimental and Forensic Medic, University of Pavia, Pavia, Italy
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De Donno A, Quattrocchi M, Ansaldi F, Campa A, Rollo MC, Gabutti G. Direct Detection of Bordetella pertussis and Bordetella parapertussis: Comparison of Polymerase Chain Reaction and Culture. J Int Med Res 2016; 34:367-73. [PMID: 16989492 DOI: 10.1177/147323000603400405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We evaluated the diagnostic performance of a genomic DNA amplification method for Bordetella pertussis and Bordetella parapertussis compared with culture isolation. Aliquots from B. pertussis and B. parapertussis cultures were added to sterile physiological saline or sterile distilled water to give bacterial suspensions of 108 cells/ml and serial dilutions were prepared. Suspensions in physiological saline were cultured on charcoal agar medium; bacterial growth was observed up to dilutions of 10−7. Suspensions in distilled water were subjected to DNA extraction and nested polymerase chain reaction (PCR) was performed on the extracts; the PCR was positive up to dilutions of 10−8 for B. pertussis and 10−9 for B. parapertussis. Since the efficacy of culture isolation, regarded as the standard for the detection of B. pertussis and B. parapertussis, declines after the first stage of pertussis or with prior vaccination or antibiotic therapy, PCR, although not yet standardized, may provide an alternative diagnostic tool.
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Affiliation(s)
- A De Donno
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies (DiSTeBA), Faculty of Sciences, University of Lecce, Lecce, Italy.
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Gabutti G, Guido M, Durando P, De Donno A, Quattrocchi M, Bacilieri S, Ansaldi F, Cataldini S, Chiriacò PG, De Simone M, Minniti S, Sticchi L, Gasparini R. Safety and Immunogenicity of Conventional Subunit and MF59-adjuvanted Influenza Vaccines in Human Immunodeficiency Virus-1-seropositive Patients. J Int Med Res 2016; 33:406-16. [PMID: 16104444 DOI: 10.1177/147323000503300406] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 11/15/2022] Open
Abstract
In this study of influenza vaccination, 37 human immunodeficiency virus (HIV)-1-seropositive patients were randomized to receive either a vaccine with a conventional subunit or one adjuvanted with MF59. Blood samples were collected at the time of vaccination, and then 30 and 180 days later, to evaluate immunogenicity, CD4+ T-lymphocyte count and HIV-1 RNA levels. Seroconversion rates against the three viral strains included in the vaccine ranged between 44% and 72% and 53% and 68% for the adjuvanted vaccine and the subunit vaccine, respectively. Other criteria of the European Medicines Evaluation Agency were also met. Vaccination was not associated with serious adverse events. Local and systemic effects were mild and of short duration. CD4+ T-lymphocyte counts and viraemia levels were not negatively affected by vaccination. These results confirmed the safety and immunogenicity of these currently available vaccines in HIV-1-seropositive patients, thus supporting the recommendation for influenza immunization in this high-risk category.
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Affiliation(s)
- G Gabutti
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, Faculty of Sciences, University of Lecce, Lecce, Italy.
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Tisa V, Barberis I, Faccio V, Paganino C, Trucchi C, Martini M, Ansaldi F. Quadrivalent influenza vaccine: a new opportunity to reduce the influenza burden. J Prev Med Hyg 2016; 57:E28-33. [PMID: 27346937 PMCID: PMC4910440] [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] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Influenza illness is caused by influenza A and influenza B strains. Although influenza A viruses are perceived to carry greater risk because they account for the majority of influenza cases in most seasons and have been responsible for influenza pandemics, influenza B viruses also impose a substantial public health burden, particularly among children and at-risk subjects. Furthermore, since the 2001-2002 influenza season, both influenza B lineages, B/Victoria-like viruses and B/Yamagata-like viruses have co-circulated in Europe. The conventional trivalent influenza vaccines have shown a limited ability to induce effective protection when major or minor mismatches between the influenza B vaccine component and circulating strains occur. For this reason, the inclusion of a second B strain in influenza vaccines may help to overcome the well-known difficulties of predicting the circulating B lineage and choosing the influenza B vaccine component. Two quadrivalent influenza vaccines, a live-attenuated quadrivalent influenza vaccine (Q/LAIV) and a split inactivated quadrivalent influenza vaccine (I/QIV), were first licensed in the US in 2012. Since their introduction, models simulating the inclusion of QIV in influenza immunization programs have demonstrated the substantial health benefits, in terms of reducing the number of influenza cases, their complications and mortality. In the near future, evaluations from simulation models should be confirmed by effectiveness studies in the field, and more costeffectiveness analyses should be conducted in order to verify the expected benefits.
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Affiliation(s)
- V. Tisa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - I. Barberis
- Department of Health Sciences, University of Genoa, Genoa, Italy;,Ilaria Barberis, Department of Health Sciences, University of Genoa, via A. Pastore 1, 16132 Genoa, Italy - Tel. +39 010 3538123 - Fax +39 010 505618 E-mail: ilaria.barberis@ fastwebnet.it
| | - V. Faccio
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - C. Paganino
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - C. Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M. Martini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - F. Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy;,IRCCS AOU S. Martino, IST Genoa, Italy
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Orsi A, Alicino C, Faccio V, Zacconi M, Ansaldi F, Durando P, Icardi G. Epidemiology and mortality of Clostridium difficile infection: a 5-year retrospective laboratory-based study in a large teaching hospital in Northern Italy. Antimicrob Resist Infect Control 2015. [PMCID: PMC4474701 DOI: 10.1186/2047-2994-4-s1-p25] [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: 11/10/2022] Open
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8
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Trucchi C, Paganino C, Orsi A, Canepa P, Faccio V, Rappazzo E, Battistini A, Podestà F, Moscatelli P, Morando A, Ansaldi F. Respiratory Syndromes Surveillance System to monitor Emergency Department crowding in Genoa, Italy. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ansaldi F, Orsi A, Durando P, Alicino C, De Florentiis D, Trucchi C, Paganino C, Zacconi M, Albanese E, Barberis I, Turello V, Schiaffino S, Icardi G. First Italian Experience of Elderly Immunization with Pneumococcal Conjugate Vaccine. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Durando P, Alicino C, Orsi A, Barberis I, Paganino C, Mazzarello G, Del Bono V, Viscoli C, Copello F, Sossai D, Orengo G, Sticchi L, Ansaldi F, Icardi G. Latent tuberculosis infection among a large cohort of medical students at a teaching hospital in Italy. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Testino G, Leone S, Ansaldi F, Borro P. Silymarin and S-adenosyl-L-methionine (SAMe): two promising pharmacological agents in case of chronic alcoholic hepathopathy. A review and a point of view. MINERVA GASTROENTERO 2013; 59:341-356. [PMID: 24212353] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The alcoholic liver disease (ALD) is the leading cause of death from liver failure in Italy and worldwide. Ethanol abstention, a healthy diet, and a significant improvement of life-style are the mainstay of treatment for this disease. Currently, we do not have effective therapeutic options are at our disposal to restore and maintain an improved clinical status. Silymarin is a complementary and alternative medicine often prescribed and self-prescribed; it has anti-oxidant, anti-inflammatory, anti-fibrotic, and metabolic properties. It improves the laboratoristic values and the ultrasonographic grading of liver disease in case of steatosis/steatohepatitis. S-adenosyl-L-methionine (SAMe) is the principal biological methyl donor, and it is also a precursor of glutathione (GSH), essential for the anti-oxidant pathways. SAMe is particularly important for opposing the toxicity of free radicals generated by various toxins, including alcohol. An association between Silymarin and SAMe (labelled as a dietary supplement) has been recently brought to market, and seems to be promising. It could be beneficial in such cases of alcoholic hepathopathies. New therapeutic options are needed by hepatologists to successfully overcome a constantly growing disease.
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Affiliation(s)
- G Testino
- Centro Alcologico Regionale - Regione Liguria Unità Operativa di Alcologia e Patologie Correlate, Department of General Internal and Specialistic Medicine Irccs AOU San Martino -National Institute for CancerResearch, Genoa, Italy -
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Gasparini R, Lucioni C, Ansaldi F, Durando P, Sticchi L, Icardi G, Panatto D, Martin M, Chancellor J, Aballéa S. Studio costo-efficacia della vaccinazione influenzale per gli italiani di età compresa tra 50 e 64 anni. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Caffa I, Soncini D, Ansaldi F, Provenzani A, Castiglioni I, Patrone F, Ballestrero A, Nencioni A. 171 Chemical-genetic Screens for Synthetic Lethal Interactions in Pancreatic Ductal Adenocarcinomas. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71969-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ansaldi F, De Florentiis D, Parodi V, Rappazzo E, Coppelli M, Martini M, Alicino C, Durando P, Icardi G. Bacterial carriage and respiratory tract infections in subjects > or = 60 years during an influenza season: implications for the epidemiology of community acquired pneumonia and influenza vaccine effectiveness. J Prev Med Hyg 2012; 53:94-97. [PMID: 23240167] [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
INTRODUCTION During the 2010/11 influenza season an epidemiological prospective cohort active study was organized, to evaluate etiologic role due to the main bacteria and viruses causing Community Acquired Pneumonia (CAP) and Influenza like-illness (ILl) in elderly and to explore the role of the bacterial nose-pharingeal carriage in subjects with respiratory tract infections. METHODS An integrated active surveillance of a cohort of adults aged > or = 60 y based on a double prospective and retrospective mechanisms of capture of ILl and CAP cases was organized. Samples were collected from all ILI and CAP prospectively identified. The samples were be tested by multiplex PCR for detection of the main respiratory bacteria and viruses. RESULTS AND DISCUSSION The study population amounted to 2,551 adults. During the 2010/11 influenza season, the ILl cumulative incidence was 4.2%, that was twice higher than that calculated by regional sentinel-based Influenza surveillance system during the 2010/11 season in the elderly (2.2%). Among 45 patients with ILI of which had been collected the swab, 17 (37.8%) were positive for influenza viruses and 2 (4.4%) for RSV, 6 (13.3%) patients carried Streptococcus pn and 6 (13.3%) Haemophilus in. In the same period, 7 CAP cases were observed; 3 cases were prospectively identified and samples were collected, while 4 cases were retrospectively detected. The CAP cumulative incidence was 0,3%. The influenza vaccine effectiveness in prevention of laboratory-confirmed influenza emerged by our study was 61%, in condition of good antigenic matching between vaccine and circulating strains observed during the 2010/11. These data contribute to better defining the epidemiological picture of upper and lower respiratory tract infections, fundamental information in light of the recent introduction of new vaccines for prevention of pneumonia in the elderly, including 13-valent conjugate pneumococcal vaccine.
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Affiliation(s)
- F Ansaldi
- Department of Health Sciences, University of Genoa, Italy.
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15
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Ansaldi F, Canepa P, Bassetti M, Zancolli M, Molinari M, Talamini A, Ginocchio F, Durando P, Mussap M, Orengo G, Viscoli C, Icardi G. Sequential outbreaks of multidrug-resistant Acinetobacter baumannii in intensive care units of a tertiary referral hospital in Italy: combined molecular approach for epidemiological investigation. J Hosp Infect 2011; 79:134-40. [DOI: 10.1016/j.jhin.2011.05.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 05/14/2011] [Indexed: 10/17/2022]
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16
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De Florentiis D, Parodi V, Orsi A, Rossi A, Altomonte F, Canepa P, Ceravolo A, Valle L, Zancolli M, Piccotti E, Renna S, Macrina G, Martini M, Durando P, Padrone D, Moscatelli P, Orengo G, Icardi G, Ansaldi F. Impact of influenza during the post-pandemic season: epidemiological picture from syndromic and virological surveillance. J Prev Med Hyg 2011; 52:134-136. [PMID: 22010543] [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: 05/31/2023]
Abstract
INTRODUCTION Following the observation that 1 or 2 pandemic peak due to the circulation ofAHINlv had occurred in most countries and in most World Health Organization (WHO) Regions, WHO declared on August 10"h, 2010 that the world was moving into the post-pandemic period, whose surveillance presents considerable interest both from epidemiological and clinical point of view. We described the epidemiological picture emerged from syndromic and virological surveillance during the post-pandemic season in Liguria, Italy. MATERIALS AND METHODS An Emergency Department Syndrome surveillance system, based on data collected at "San Martino" and IRCCS "G. Gaslini" Liguria Regional Reference University Hospitals for adults and children is active since July 2007. Monitored syndromes include "Influenza-Like Illness" (ILl) and "Low Respiratory Tract Infections" (LRTI). The Ligurian Regional Reference laboratory for Influenza virological surveillance and diagnosis offers rapid detection of influenza viruses by real-time and block RT-PCR, viral culture and genetic characterization by entire sequence analysis of haemagglutinin- and neuraminidase-coding regions in accordance with the international standards established by the global laboratory network. RESULTS AND DISCUSSION The integration of syndromic surveillance system and laboratory surveillance for rapid detection and characterization of the disease responsible agent represented a specific and sensitive tool for influenza surveillance. The post-pandemic season was characterized by early onset and by the heaviest impacts for ILI and LRTI among the recent epidemic seasons. In contrast to the picture observed during the pandemic season, the 2010/11 winter was characterized by the intensive circulation of pandemic AH1N1v coupled with sustained activity due to influenza B and Respiratory Syncytial Virus (RSV). Antigenic and molecular characterization of influenza strains confirmed the good matching between circulating and 2010/11 vaccine viruses.
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Affiliation(s)
- D De Florentiis
- CIRI-IV, Department of Health Sciences, University of Genoa, Italy.
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17
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Filia A, Tavilla A, Bella A, Magurano F, Ansaldi F, Chironna M, Nicoletti L, Palù G, Iannazzo S, Declich S, Rota MC. Measles in Italy, July 2009 to September 2010. Euro Surveill 2011. [DOI: 10.2807/ese.16.29.19925-en] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Outbreaks of measles continue to occur in Italy, as in other European countries. We present here details of cases reported through the Italian enhanced measles surveillance system from July 2009 to September 2010. In total, 2,151 cases were reported, 42% (n=895) of which were laboratory confirmed. The median age of cases was 18 years and 1,709 of 1,856 cases (92%) were unvaccinated. Many cases with complications were reported (n=305), including three with encephalitis. A total of 652 of 1,822 cases (36%) were hospitalised. Molecular characterisation revealed circulation of a limited number of measles virus genotypes (D4, D8 and B3), which is consistent with the current epidemiology of the disease in Italy. A national measles elimination plan was approved in 2003 with the aim of interrupting endemic measles transmission by 2007. Since elimination was not achieved, the target date was recently moved to 2015. The emphasis of the new elimination plan, approved in March 2011, is on strengthening surveillance, implementing evidence based-interventions to increase measles-mumps-rubella vaccine uptake in children, adolescents and young adults, and implementing communication activities related to the vaccine. The strategies proposed by the plan should be implemented fully and appropriately by all regions in order to meet the elimination goal by 2015.
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Affiliation(s)
- A Filia
- Infectious Diseases Epidemiology Unit, National Health Institute, Rome, Italy
| | - A Tavilla
- Infectious Diseases Epidemiology Unit, National Health Institute, Rome, Italy
| | - A Bella
- Infectious Diseases Epidemiology Unit, National Health Institute, Rome, Italy
| | - F Magurano
- Viral Diseases and Attenuated Vaccines Unit, National Health Institute, Rome, Italy
| | - F Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Chironna
- Department of Biomedical Sciences and Human Oncology, Hygiene Section, University of Bari, Bari, Italy
| | - L Nicoletti
- Viral Diseases and Attenuated Vaccines Unit, National Health Institute, Rome, Italy
| | - G Palù
- Regional Reference Centre for Infectious Diseases, Microbiology and Virology Unit, Padua University Hospital, Padua, Italy
| | - S Iannazzo
- Infectious Diseases and International Prophylaxis Office, Ministry of Health, Rome, Italy
| | - S Declich
- Infectious Diseases Epidemiology Unit, National Health Institute, Rome, Italy
| | - M C Rota
- Infectious Diseases Epidemiology Unit, National Health Institute, Rome, Italy
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18
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Filia A, Tavilla A, Bella A, Magurano F, Ansaldi F, Chironna M, Nicoletti L, Palù G, Iannazzo S, Declich S, Rota MC. Measles in Italy, July 2009 to September 2010. Euro Surveill 2011; 16:19925. [PMID: 21801692] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Outbreaks of measles continue to occur in Italy, as in other European countries. We present here details of cases reported through the Italian enhanced measles surveillance system from July 2009 to September 2010. In total, 2,151 cases were reported, 42% (n=895) of which were laboratory confirmed. The median age of cases was 18 years and 1,709 of 1,856 cases (92%) were unvaccinated. Many cases with complications were reported (n=305), including three with encephalitis. A total of 652 of 1,822 cases (36%) were hospitalised. Molecular characterisation revealed circulation of a limited number of measles virus genotypes (D4, D8 and B3), which is consistent with the current epidemiology of the disease in Italy. A national measles elimination plan was approved in 2003 with the aim of interrupting endemic measles transmission by 2007. Since elimination was not achieved, the target date was recently moved to 2015. The emphasis of the new elimination plan, approved in March 2011, is on strengthening surveillance, implementing evidence based-interventions to increase measles-mumps-rubella vaccine uptake in children, adolescents and young adults, and implementing communication activities related to the vaccine. The strategies proposed by the plan should be implemented fully and appropriately by all regions in order to meet the elimination goal by 2015.
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Affiliation(s)
- A Filia
- Infectious Diseases Epidemiology Unit, National Health Institute, Rome, Italy.
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19
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Zancolli M, Canepa P, Ceravolo A, Parodi V, Ansaldi F. Determinants of invasiveness and ability to cause invasive pneumococcal disease, pneumonia and acute otitis media of different serotypes of Streptococcus pneumoniae. J Prev Med Hyg 2011; 52:47-54. [PMID: 21842705] [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: 05/31/2023]
Affiliation(s)
- M Zancolli
- Department of Health Sciences, University of Genoa, Italy.
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20
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Tubaro A, Durando P, Del Favero G, Ansaldi F, Icardi G, Deeds JR, Sosa S. Case definitions for human poisonings postulated to palytoxins exposure. Toxicon 2011; 57:478-95. [PMID: 21255599 DOI: 10.1016/j.toxicon.2011.01.005] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 12/31/2010] [Accepted: 01/10/2011] [Indexed: 11/28/2022]
Abstract
A series of case reports and anecdotal references describe the adverse effects on human health ascribed to the marine toxin palytoxin (PLTX) after different exposure routes. They include poisonings after oral intake of contaminated seafood, but also inhalation and cutaneous/systemic exposures after direct contact with aerosolized seawater during Ostreopsis blooms and/or through maintaining aquaria containing cnidarian zoanthids. The symptoms commonly recorded during PLTX intoxication are general malaise and weakness, associated with myalgia, respiratory effects, impairment of the neuromuscular apparatus and abnormalities in cardiac function. Systemic symptoms are often recorded together with local damages whose intensity varies according to the route and length of exposure. Gastrointestinal malaise or respiratory distress is common for oral and inhalational exposure, respectively. In addition, irritant properties of PLTX probably account for the inflammatory reactions typical of cutaneous and inhalational contact. Unfortunately, the toxin identification and/or quantification are often incomplete or missing and cases of poisoning are indirectly ascribed to PLTXs, according only to symptoms, anamnesis and environmental/epidemiological investigations (i.e. zoanthid handling or ingestion of particular seafood). Based on the available literature, we suggest a "case definition of PLTX poisonings" according to the main exposure routes, and, we propose the main symptoms to be checked, as well as, hemato-clinical analysis to be carried out. We also suggest the performance of specific analyses both on biological specimens of patients, as well as, on the contaminated materials responsible for the poisoning. A standardized protocol for data collection could provide a more rapid and reliable diagnosis of palytoxin-poisoning, but also the collection of necessary data for the risk assessment for this family of toxins.
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Affiliation(s)
- A Tubaro
- Department of Materials and Natural Resources, University of Trieste, Via A Valerio 6, 34127 Trieste, Italy.
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21
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Durando P, Bassetti M, Orengo G, Crimi P, Battistini A, Tiberio G, Bellina D, Talamini A, Dodi F, Ansaldi F, Alicino C, Iudici R, Sticchi L, De Florentiis D, Viscoli C, Icardi G. Hospital-acquired infections and leading pathogens detected in a regional university adult acute-care hospital in Genoa, Liguria, Italy: results from a prevalence study. J Prev Med Hyg 2010; 51:80-86. [PMID: 21155410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND A prevalence study aimed to update the epidemiological scenario of Hospital-Acquired Infections (HAI) was performed at the San Martino University Hospital of Genoa, the Regional Reference Adult-care Center in Liguria, Italy, with more than 1300 beds. MATERIALS AND METHODS The investigation was performed in all the wards, except the Psychiatric Units, between 19th March and 6Ih April, 2007, using a one-day monitoring system for each ward. International standardized criteria and definitions for the surveillance of HAI were used for the collection of data, which were recorded in specific software for subsequent consolidation, analysis and quality control. RESULTS The hospital infection control staff actively monitored 912 inpatients: a total of 84 HAI among 72 patients were diagnosed, with an overall prevalence of infections and affected cases of 9.2% (95% CI: 7.3-11.1) and 7.9% (95% CI: 6.1-9.7), respectively. Urinary Tract Infections (UTI) (30.9%), Respiratory Tract Infections (RTI) (28.6%) and Blood Stream Infections (BSI) (21.4%) were found to be the most frequent infections. As expected, both specific prevalence and localization of HAI varied considerably between wards, with the highest values recorded in Intensive Care Units (ICU) and in Functional Rehabilitation wards. RTI (26.3%) and BSI (13.2%) were found primarily represented in ICU, while the highest values of UTI (13.3%) were registered in Functional Rehabilitation Units. Enterococcus spp. (16.8%), Candida spp. (14%), Pseudomonas spp. (12.2), Staphylococcus aureus (10.7%), Escherichia coli (10.3%) and Coagulase-negative staphylococci (CNS) (9.3%) were the most frequent pathogens isolated. The overall rate of administration of antibiotics was 55.3% and penicillin (26.7%), cephalosporins (22.8%) and fluoroquinolones (17.9%) were found to be the leading antibacterial administered. CONCLUSION Results of the present study have been, and are currently, used for orientating surveillance and control hospital policies, planning activities according to a rational and evidence-based approach.
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Affiliation(s)
- P Durando
- Department of Health Sciences, Section of Hygiene and Preventive Medicine, University of Genoa and San Martino University Hospital of Genoa, Italy.
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Bassetti M, Righi E, Ansaldi F, Molinari MP, Rebesco B, McDermott JL, Fasce R, Mussap M, Icardi G, Bobbio Pallavicini F, Viscoli C. Impact of limited cephalosporin use on prevalence of methicillin-resistant Staphylococcus aureus in the intensive care unit. J Chemother 2010; 21:633-8. [PMID: 20071286 DOI: 10.1179/joc.2009.21.6.633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a leading pathogen causing nosocomial infections. Many studies have shown that the restricted use of antibacterials is associated with a decline in resistance. To establish whether an intervention protocol designed to limit the use of cephalosporins can lower mRSA infection rates and impact on Gram-negative bacteria susceptibility in an intensive Care Unit (ICU), we conducted a prospective, non-randomized, before-after intervention study in an 18-bed ICU in Genoa, Italy. The intervention was a hospital antibiotic control policy and the observation was routine monitoring for nosocomial infections and antibiotic use, recording periodically the incidence density and MRSA prevalence. The intervention included a new antibiotic guideline that restricted the use of cephalosporins for all ICU inpatients. The analysis showed that the intervention determined a significant reduction in cephalosporin usage (-70.3%), while fluoroquinolones, mainly ciprofloxacin, increased after introduction of the antibiotic policy (+46.5%). A significant reduction in the percentage of MRSA infections (-30%) and heterogeneous susceptibility patterns in Klebsiella pneumoniae and Pseudomonas aeruginosa were noted.
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Affiliation(s)
- M Bassetti
- Infectious Diseases Division, S. Martino Hospital and University of Genoa School of Medicine, Genoa, Italy.
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23
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Canepa P, Valle L, Cristina E, De Florentiis D, Parodi V, Banfi F, Zancolli M, Durando P, Icardi G, Ansaldi F. Role of congenital rubella reference laboratory: 21-months-surveillance in Liguria, Italy. J Prev Med Hyg 2009; 50:221-226. [PMID: 20812517] [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
INTRODUCTION Rubella is generally a mild rush fever disease when acquired in childhood, but when infection occurs during the first months of pregnancy, high risk of trans-placental transmission to the foetus and of congenital anomalies exists. In November 2003, a National Plan for measles and congenital rubella elimination was approved in Italy. The aim was to reduce and maintain Congenital Rubella Syndrome incidence lower than 1 case per 100,000 live births/year by 2007. Since June 2006, Liguria Administrative Region recognized U.O. Hygiene, "San Martino" University Hospital, Genoa, as regional reference laboratory for diagnosis of rubella infection during pregnancy and post-partum. METHODS Twenty-one-month virological-surveillance results between April 2007 and December 2008 were reported in terms of demographic data, risk factors, access reasons, clinical picture, vaccination, previous rubella disease, laboratory results of pregnant women and newborns. RESULTS AND CONCLUSION Since the beginning of surveillance, 65 pregnant women with suspected virus infection and 18 newborns with suspected congenital rubella were followed up. The results of laboratory surveillance highlighted (i) the importance of an early screening, (ii) the suboptimal specificity of chemiluminescent assays, that often yield false positive IgM results and (iii) the fundamental role of second-level laboratory to confirm the serological diagnosis and to detect the virus by molecular techniques.
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Affiliation(s)
- P Canepa
- Doctoral School in Clinical and Experimental Medicine, University of Genoa, Italy.
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24
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Pessino A, Andretta V, Guglielmi A, Mammoliti S, Caprioni F, Fornarini G, Comandini D, Sciallero S, Ansaldi F, Sobrero A. 6075 A triple combination of Imatinib, Bevacizumab and Cetuximab plus modified FOLFOX-6 in advanced untreated colorectal cancer. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71170-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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25
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Bassetti M, Ansaldi F, Nicolini L, Malfatto E, Molinari MP, Mussap M, Rebesco B, Bobbio Pallavicini F, Icardi G, Viscoli C. Incidence of candidaemia and relationship with fluconazole use in an intensive care unit. J Antimicrob Chemother 2009; 64:625-9. [DOI: 10.1093/jac/dkp251] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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26
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Testino G, Gentile R, Ansaldi F, Borro P, Ravetti G, Icardi G, Sumberaz A. Pegylated interferon alfa-2a and ribavirin treatment for recurrent hepatitis C: role of steatosis and body mass index. Panminerva Med 2009; 51:135-136. [PMID: 19776716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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27
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Sobrero AF, Bennicelli E, Pessino A, Guglielmi A, Mammoliti S, Caprioni F, Fornarini G, Comandini D, Sciallero S, Ansaldi F. Phase II trial of imatinib, bevacizumab and cetuximab plus modified FOLFOX-6 in advanced untreated colorectal cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15030 Background: Imatinib inhibits PDGFR interfering with pericytes, the structural support to newly formed tumor blood vessels. It may thus synergize with bevacizumab. Microenvironment and tumor targeted agents along with chemotherapy could be a promising add-on approach. Methods: cetuximab 500 mg/m2, bevacizumab 5 mg/kg and modified FOLFOX-6 were given i.v. on day 1 and repeated every 2 weeks. Imatinib 400 mg/day per os was given continuously. Due to the cost and potential toxicity of the combination, the endpoint for this phase II study was very ambitious: at least 25% of complete response (medically or surgically achieved), lasting a minimum of 12 months in advanced untreated colorectal cancer patients with clearly unresectable disease. Results: Of 26 patients (16 with 1 site of disease), 17 completed the first 4 months of treatment according to the protocol, while 9 had to discontinue one biologic drug due to side effects (5 cetuximab, 3 imatinib and 1 bevacizumab). Grade 3–4 toxicity: diarrhea 12%, neutropenia 24%, skin rash 24%, hypersensitivity reactions 16%, asthenia 8%, neuro 8%. All patients were evaluable for response. Eleven responses ( 1 CR and 10 PR), 13 SD and 2 PD were observed, corresponding to 42% RR ( 95% CI = 23–61). The minimum follow up is 12 months; median PFS is 10 months. One patient among responders underwent radiofrequency ablation and 17 patients underwent surgery: 8 R-0, 3 R-1, 5 R-2 and one exploratory laparotomy. Major post surgical complications occurred in 5/17 patients. No evidence of macroscopic disease after the entire treatment plan was obtained in 13/26 patients: 12 surgical and 1 medical CR. Seven/13 were disease free at 6 months, but only 3 were still disease free at 12 months. ERCC1, ERCC2/XDP, GSTP1,TS,EGF, COX2, CYCLIN D, FCgR polymorphisms and K-RAS mutations were evaluated on all 26 patients, but no correlations were found with clinical outcome. Conclusions: The triple combination of biologics with modified FOLFOX-6 is feasible and tolerable as initial aggressive treatment. The primary endpoint of the study was not met . In fact the activity, 42% RR, was not outstanding and the high resectability rate, 69%, is misleading in the light of the short duration of the surgically induced CR. [Table: see text]
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Affiliation(s)
- A. F. Sobrero
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - E. Bennicelli
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - A. Pessino
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - A. Guglielmi
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - S. Mammoliti
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - F. Caprioni
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - G. Fornarini
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - D. Comandini
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - S. Sciallero
- Azienda Ospedale Universita, San Martino, Genova, Italy
| | - F. Ansaldi
- Azienda Ospedale Universita, San Martino, Genova, Italy
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28
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Crimi P, Valgiusti M, Macrina G, Grieco A, Massone L, Ciucci A, Ansaldi F, Sticchi L, Sasso L, Del Buono S, Durando P. Evaluation of microbial contamination of air in two haematology departments equipped with ventilation systems with different filtration devices. J Prev Med Hyg 2009; 50:33-36. [PMID: 19771758] [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: 05/28/2023]
Abstract
BACKGROUND Nosocomial infections (NI) are above all due to health-care workers practices, but also the contamination of the environment could lead to their rise in health-care facilities. Introduction. In the last years, the incidence of NI has increased due to a substantial rise in the number of immuno-compromised patients. These patients are often gathered in hospital areas declared at "high risk" of infection such as Hematology and Bone Marrow Transplant ward. In this study, we evaluated microbial contamination of the air in two divisions with high risk patients, focusing on the validity of the air system with correlation to the presence or not of the HEPA absolute filters. METHODS An environmental surveillance study has been carried out in two Divisions of Haematology, in two different Hospitals. Investigations have been performed by sampling air and by analyzing bacterial and fungal growth on microbiology plates after an incubation period. RESULTS Unit A, without HEPA filters in the ventilation systems, showed a gradual increase in the bacterial load 20 and 60 days after cleaning of the ventilation system. Mycetes and Aspergilli were not present in basal conditions, at 20 or 60 days after decontamination. Unit B, equipped with HEPA filters placed at the inlet vents, showed extremely low values of the bacterial load either in basal conditions or upon inspection 60 days after cleaning. No mycetes were present. DISCUSSION From the results obtained, it was evident that following the cleaning operation, the quality of the air is excellent in both types of equipment, since no mycetes were present and the bacterial load was < 20 CFU/mc in all the sites tested. However, although in subsequent controls mycetes were absent in both types of equipment, a great difference in the suspended bacterial load was found: Unit B was close to sterility whereas in Unit A a progressive increase was observed.
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Affiliation(s)
- P Crimi
- Department of Health Sciences, San Martino Hospital, University of Genoa, Italy.
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29
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Boccardo FM, Ansaldi F, Bellini C, Accogli S, Taddei G, Murdaca G, Campisi CC, Villa G, Icardi G, Durando P, Puppo F, Campisi C. Prospective evaluation of a prevention protocol for lymphedema following surgery for breast cancer. Lymphology 2009; 42:1-9. [PMID: 19499762] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Lymphedema is a common complication of axillary dissection and thus emphasis should be placed on prevention. Fifty-five women who had breast-conserving surgery or modified radical mastectomy for breast cancer with axillary dissection were randomly assigned to either the preventive protocol (PG) or control group (CG) and assessments were made preoperatively and at 1, 3, 6, 12 and 24 months postoperatively. Arm volume (VOL) was used as measurement of arm lymphedema. Clinically significant lymphedema was confirmed by an increase of at least 200 ml from the preoperative difference between the two arms. The preventive protocol for the PG women included preoperative upper limb lymphscintigraphy (LS), principles for lymphedema risk minimization, and early management of this condition when it was identified. Assessments at 2 years postoperatively were completed for 89% of the 55 women who were randomly assigned to either PG or CG. Of the 49 women with unilateral breast cancer surgery who were measured at 24 months, 10 (21%) were identified with secondary lymphedema using VOL with an incidence of 8% in PG women and 33% in CG women. These prophylactic strategies appear to reduce the development of secondary lymphedema and alter its progression in comparison to the CG women.
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Affiliation(s)
- F M Boccardo
- Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, S. Martino Hospital, University of Genoa, Italy.
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30
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Ansaldi F, Sticchi L, Durando P, Carloni R, Oreste P, Vercelli M, Crovari P, Icardi G. Decline in pneumonia and acute otitis media after the introduction of childhood pneumococcal vaccination in Liguria, Italy. J Int Med Res 2009; 36:1255-60. [PMID: 19094434 DOI: 10.1177/147323000803600612] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The effect of the pneumococcal conjugate vaccine immunization programme on pneumococcal-associated or potentially pneumococcal-associated hospital admissions in the Italian region of Liguria was assessed. Hospital admission rates were compared in subjects belonging to birth cohorts before and after the introduction of widespread immunization for 0 - 2-year old children with a seven-valent conjugate vaccine (PCV7). Significant reductions in hospitalization rates for all-cause and pneumococcal pneumonia and for acute otitis media were observed in subjects born after widespread uptake of the vaccine. The preventive fraction (a measure of vaccine effectiveness) ranged from 15.2% for all cause pneumonia to 70.5% for pneumococcal pneumonia. This study contributes to the growing body of information that supports the beneficial effect of PCV7 vaccination.
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Affiliation(s)
- F Ansaldi
- Department of Health Sciences, University of Genoa, Italy
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31
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Panatto D, Amicizia D, Ansaldi F, Marocco A, Marchetti F, Bamfi F, Giacchino R, Tacchella A, Del Buono S, Gasparini R. Burden of rotavirus disease and cost-effectiveness of universal vaccination in the Province of Genoa (Northern Italy). Vaccine 2009; 27:3450-3. [PMID: 19200850 DOI: 10.1016/j.vaccine.2009.01.054] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rotavirus is acknowledged to be a major cause of acute gastroenteritis in infants and young children. As gastroenteritis due to rotavirus is a public health problem and two new vaccines are currently available, we investigated the rotavirus burden and developed a cost-effectiveness analysis, using data collected in the Province of Genoa (Italy), to evaluate the benefits of new borns vaccination. The cost-effectiveness of a rotavirus vaccination programme in the Province of Genoa was performed, in comparison with no vaccination, for both the regional healthcare system (RHS) and society (S). In 2006, admissions to the paediatric emergency department for gastroenteritis numbered 2338 (about 11% of total admissions); of these 33% were hospitalised. In 28% of cases, the children tested positive for rotavirus. During epidemics, paediatricians receive from 3 to 5 calls per day for gastroenteritis, carry out 1 or 2 ambulatory examinations and for children with a severe case history, make house visits. A rotavirus immunisation programme would have a great impact on disease burden, in that 90% coverage would reduce the number of severe cases by more than 85%. From the perspective of both the RHS and S, vaccination proved to be highly cost-effective.
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Affiliation(s)
- D Panatto
- Department of Health Science, University of Genoa, Via Pastore 1, 16132 Genoa, Italy.
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32
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Ansaldi F, Orsi A, Altomonte F, Bertone G, Parodi V, Carloni R, Moscatelli P, Pasero E, Oreste P, Icardi G. Emergency department syndromic surveillance system for early detection of 5 syndromes: a pilot project in a reference teaching hospital in Genoa, Italy. J Prev Med Hyg 2008; 49:131-135. [PMID: 19350960] [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: 05/27/2023]
Abstract
Early detection is fundamental for achieving effective control of infectious disease outbreaks. We described the development of a local chief complaint emergency department (ED)-based syndromic surveillance system to improve public health response in Genoa, Italy. The five syndromes under investigation by the syndromic surveillance system were influenza-like illness (ILI), low-respiratory tract illness (LRTI), not-haemorrhagic gastroenteritis, acute hepatitis, fever-with-rash (maculo-papular or vescicular) syndrome. Syndrome coding, data capture, transmission and processing, statistical analysis to assess indicators of disease activity and alert thresholds, and signal response were operatively described. Preliminary results on ILI syndromic surveillance showed that new system allowed the activation of the alert state with a specificity of 90.3% and a sensitivity of 72.9% in predicting epidemiological relevant events, such as > or = 10 accesses to ED for ILI in 3 days. The new syndromic surveillance system allowed to alert the public health institutions 2.5 days before than the local surveillance system based on sentinel physicians and paediatricians, permitting the early activation of the necessary measures for the containment and for burden reduction of the epidemic event. It is noteworthy that the syndromic surveillance epidemic cut-off was overcome once before and 4 times after influenza outbreak detected by sentinel-based surveillance system: all episodes were contemporary with Respiratory Syncytial Virus and Parainfluenza Virus circulation, as detected by regional reference laboratory.
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Affiliation(s)
- F Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy.
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33
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Durando P, Sticchi C, Compagnino F, Ansaldi F, Sticchi L, Gasparini R, Castiglia P, Lugarini J, Alberti M, Icardi G. Heptavalent Pneumococcal Conjugate Vaccine: growing knowledge and its implications for Italy. J Prev Med Hyg 2008; 49:34-46. [PMID: 18792532] [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: 05/26/2023]
Affiliation(s)
- P Durando
- Department of Health Sciences, University of Genoa, Italy.
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34
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Durando P, Fenoglio D, Boschini A, Ansaldi F, Icardi G, Sticchi L, Renzoni A, Fabbri P, Ferrera A, Parodi A, Bruzzone B, Gabutti G, Podda A, Del Giudice G, Fragapane E, Indiveri F, Crovari P, Gasparini R. Safety and immunogenicity of two influenza virus subunit vaccines, with or without MF59 adjuvant, administered to human immunodeficiency virus type 1-seropositive and -seronegative adults. Clin Vaccine Immunol 2008; 15:253-9. [PMID: 18003811 PMCID: PMC2238067 DOI: 10.1128/cvi.00316-07] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 08/31/2007] [Accepted: 11/01/2007] [Indexed: 11/20/2022]
Abstract
The objective of this study was to evaluate and compare both the safety and tolerability and the humoral and cell-mediated immune responses for two influenza virus subunit vaccines, one with MF59 adjuvant (Fluad) and one without an adjuvant (Agrippal), in healthy and in human immunodeficiency virus type 1 (HIV-1)-infected adult individuals. To achieve this aim, an open, randomized, comparative clinical trial was performed during the 2005-2006 season. A total of 256 subjects were enrolled to receive one dose of vaccine intramuscularly. Blood samples were taken at the time of vaccination and at 1 and 3 months postvaccination. A good humoral antibody response was detected for both vaccines, meeting all the criteria of the Committee for Medical Products for Human Use. After Beyer's correction for prevaccination status, Fluad exhibited better immunogenicity than Agrippal, as shown from the analysis of the geometric mean titers, with significant differences for some virus strains; however, no definitive conclusions on the clinical significance of such results can be drawn, because the method used to estimate antibody response is currently nonstandard for influenza virus vaccines. Significant induction of an antigen-specific CD4+ T-lymphocyte proliferative response was detected at all time points after immunization, for both the vaccines, among HIV-1-seronegative subjects. This was different from what was observed for HIV-1-infected individuals. In this group, significance was not reached at 30 days postvaccination (T30) for those immunized with Agrippal. Also when data were compared between treatment groups, a clear difference in the response at T30 was observed in favor of Fluad (P = 0.0002). The safety profiles of both vaccines were excellent. For HIV-1-infected individuals, no significant changes either in viremia or in the CD4+ cell count were observed at any time point. The results showed good safety and immunogenicity for both vaccines under study for both uninfected and HIV-1-infected adults, confirming current recommendations for immunization of this high-risk category.
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Affiliation(s)
- P Durando
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
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Guarino A, Ansaldi F, Ugazio A, Chiamenti G, Bona G, Correra A, Di Pietro P, Mele G, Sapia MG. [Italian Pediatrician's consensus statement on anti-Rotavirus vaccines]. Minerva Pediatr 2008; 60:3-16. [PMID: 18277359] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- A Guarino
- Dipartimento di Pediatria, Università degli Studi di Napoli Federico II, Napoli, Italia.
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Bassetti M, Repetto E, Righi E, Boni S, Diverio M, Molinari MP, Mussap M, Artioli S, Ansaldi F, Durando P, Orengo G, Bobbio Pallavicini F, Viscoli C. Colistin and rifampicin in the treatment of multidrug-resistant Acinetobacter baumannii infections. J Antimicrob Chemother 2007; 61:417-20. [DOI: 10.1093/jac/dkm509] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Sumberaz A, Centenaro M, Ansaldi F, Ancarani AO, Andorno E, Icardi G, Testino G. Relationship between laboratory parameters and intensive care unit stay post-liver transplantation: proposal of a model. Transplant Proc 2007; 39:1868-70. [PMID: 17692636 DOI: 10.1016/j.transproceed.2007.05.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 01/23/2023]
Abstract
UNLABELLED The aim of this study was to create a model that forecasted the stay in the intensive care unit in post-liver transplantation. METHODS Twenty-three consecutive patients who underwent liver transplantation provided samples for serum sodium, serum creatinine, total bilirubin, cholesterol, aspartate and alanine aminotransferase, alkaline phosphatase (ALP), albumin, and platelet count for correlation together with age at transplantation in a Pearson correlation model with intensive care unit stay. Multivariate analysis used a regression model to evaluate the relationship between the dependent variable "intensive care unit stay" and the predictor variables that were correlated by a Pearson correlation test. To test the acceptability and strength of the model, analyses of variance was performed and a multiple correlation coefficient R was calculated for the model. RESULTS Pearson correlation test showed a strong correlation between intensive care unit stay and creatinine (correlation coefficient = 0.34, P = .03), serum sodium (correlation coefficient = -0.42, P < .01), and total bilirubin (correlation coefficient = -0.29, P = .06). Other variables showed no significant correlation, namely correlation coefficients < 0.24 (P > .1). The final model to evaluate the relationship between the dependent variable "intensive care unit stay" and laboratory parameters included ALP, serum creatinine, serum sodium, and total bilirubin as well as a correction for age. CONCLUSIONS The most significant parameters were total bilirubin, serum creatinine, and serum sodium. The proposal model significantly correlated with the variable "intensive care unit stay." Such data are particularly important since increased intensive care unit stay correlates with a significant reduction in 1-year survival rate.
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Affiliation(s)
- A Sumberaz
- Unit of Hepatology and Alcoholic Disease, S Martino Hospital, Genova, Italy.
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38
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Gasparini R, Durando P, Ansaldi F, Sticchi L, Banfi F, Amicizia D, Panatto D, Esposito S, Principi N, Icardi G, Crovari P. Influenza and respiratory syncytial virus in infants and children: relationship with attendance at a paediatric emergency unit and characteristics of the circulating strains. Eur J Clin Microbiol Infect Dis 2007; 26:619-28. [PMID: 17610094 DOI: 10.1007/s10096-007-0351-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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: 10/23/2022]
Abstract
A study was carried out on 2,696 Italian children, aged 0-14 years. The goals were: (1) to define the age-related impact of acute respiratory infections (ARI), measured as the risk of attendance at the Paediatric Emergency Room, (2) to better define the importance and proportion of influenza and respiratory syncytial virus (RSV) infections and (3) to acquire deeper knowledge of the influenza strains circulating in infants and children. A standardised emergency unit attendance risk (EUAR) was calculated, by age group for ARI. Specific EUARs were also calculated for the two pathogens. Pharyngeal swabs were tested by polymerase chain reaction (PCR) for influenza and RSVs. Isolation in Madine-Darby canine kidney cells (MDCK) and Hep cells, haemagglutination inhibition (HI) testing and HA1 gene sequence analysis were performed for influenza viruses. Most of the patients enrolled were aged 0-5 years, 1,139 (84.6%) and 1,061 (78.5%) in the two seasons, respectively. The most represented age class was that of 1 year olds (331 cases in 2001-2002 and 301 in 2002-2003). The highest EUAR for ARI was in patients aged 0-3 years (16.8 and 12.9 during the two seasons). The same was observed on calculating this risk by specific pathogens: 17.4 and 5.5 for influenza and 13.0 and 12.7 for RSV. Virological analysis was performed on 2,696 samples, 595 of which proved positive (22%). The highest number of isolates (326) came from patients aged 1-3 years. RSVs were more often identified than influenza viruses in infants aged up to 1 year (32 vs. 20 isolates). Of 265 strains isolated in 2001-2002, 103 were RSVs (87 type A, 16 B) and 162 were influenza (90 type A, 72 B). HI showed that influenza B viruses were related to two lineages, B/Victoria/2/87 (32%) and B/Yamagata/16/88 (68%). Of 330 strains isolated in 2002-2003, 102 were RSVs (91 type A, 11 B) and 228 were influenza viruses (220 type A, 8 B). A/H3N2 strains belonged to two clusters, A/Panama/2007/99-like and A/Fujian/411/02-like, a new variant. This paper discusses the possible role of the identified flu strains in determining EUARs among the population by age class.
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Affiliation(s)
- R Gasparini
- Interuniversity Centre for Research on Influenza and Viral Infections (CIRI-IV), Department of Health Sciences, University of Genoa, Italy.
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Ansaldi F, Marensi L, Puppo S, Rosselli R, Turello V, Zoppi G, Carloni R, Oreste P, Riente R, Valle L, Orsi A, Sticchi L, Durando P, Icardi G. Molecular epidemiology and case-control approaches for management of an outbreak of hepatitis A in Liguria, Italy. J Prev Med Hyg 2007; 48:103-108. [PMID: 18274347] [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
INTRODUCTION AND METHODS Hepatitis A remains an important public health problem in low endemicity areas, because of the social and economic high burden of cyclical outbreaks. In this study we described an outbreak of HAV infection occurred in the city of Genoa and in its proximity and the viral circulation in the post-epidemic period. In order to identify risk factors associated to the illness and to determine the source of infection and the dynamics of virus evolution, we conducted an epidemiological and molecular investigation by a case-control study and by sequence analysis of high variable regions of the genome. RESULTS From May to October 2005, 58 HAV hepatitis cases were notified. The case-control study showed that beach establishment attending is strongly associated with HAV hepatitis (OR = 24.5, p-value < 0.01), at multivariate analysis. The profile of epidemic curve, the clinical onset of primary cases who occurred in few weeks and the geographic distribution of cases clearly indicated a common exposure to a point source: the outbreak can be probably associated with a contaminated food product dispensed in the affected area. The outbreak has been mainly caused by a single variant, confirming the common exposure to a point source; this variant previously circulated within homosexual man (MSM) network in Northern Europe. During the outbreak and in the following months, different variants originating from Southeast Asia, Southern America and Northern Africa, have co-circulated: all these cases were related to international travel and none of these had determined secondary cases. DISCUSSION The epidemiological picture of hepatitis A in Liguria is characterized by a wide heterogeneity of circulating HAV strains. This pattern could be associated with the increase of imported cases and transmission within network of persons with similar risk factors. Molecular approach coupled to descriptive and analytical epidemiological studies appeared un-replaceable tools for management and control of HAV outbreaks, because of their capacity to recognize infection origin, transmission patterns and dynamics of virus evolution.
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Affiliation(s)
- F Ansaldi
- Department of Health Sciences, University of Genoa, Italy.
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Durando P, Ansaldi F, Oreste P, Moscatelli P, Marensi L, Grillo C, Gasparini R, Icardi G. Ostreopsis ovata and human health: epidemiological and clinical features of respiratory syndrome outbreaks from a two-year syndromic surveillance, 2005-06, in north-west Italy. ACTA ACUST UNITED AC 2007; 12:E070607.1. [PMID: 17868580 DOI: 10.2807/esw.12.23.03212-en] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [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: 11/20/2022]
Abstract
There appears to be a lack of data regarding the effects on human health of Ostreopsis ovata, a marine dinoflagellate species usually living in tropical and subtropical areas but recently found with more and more frequency in the Mediterranean Sea.
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Affiliation(s)
- P Durando
- Department of Health Sciences, Section of Hygiene and Preventive Medicine, San Martino Hospital, University of Genoa, Genoa, Italy.
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Ansaldi F, Bertone A, Carloni R, Gasparini R, Icardi G, Marensi L, Mastroianni F, Oreste P, Riente R, Sasso L, Turello V, Valle L, Zoppi G. Molecular epidemiology of measles in Liguria, Italy: a tool for the elimination of the infection. J Prev Med Hyg 2007; 48:39-42. [PMID: 17713136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Arkema JMS, Meerhoff TJ, Paget WJ, Meijer A, Ansaldi F, Buchholz U, Fleming D, Nicoll A, van der Velden J. Seasonal influenza activity in Europe: declining in most countries in the West but increasing in the North-East. ACTA ACUST UNITED AC 2007; 12:E070308.3. [PMID: 17439783 DOI: 10.2807/esw.12.10.03152-en] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/20/2022]
Abstract
This winter, the consultation rates for influenza like illness (ILI) and/or acute respiratory infection (ARI) started to increase firstly in Scotland, Greece and Spain in December 2006 [1], where they have already returned to levels just above or at the baseline.
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Affiliation(s)
- J M S Arkema
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
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Arkema JMS, Paget WJ, Meijer A, Meerhoff TJ, Ansaldi F, Buchholz U, Fleming D, Nicoll A, van der Velden J. Seasonal influenza beginning in Europe: report from EISS. Euro Surveill 2007; 12:E070125.3. [PMID: 17370943 DOI: 10.2807/esw.12.04.03126-en] [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: 05/14/2023] Open
Abstract
Increased influenza activity was reported in six countries in the second week of 2007: Greece, the Netherlands, United Kingdom (Northern Ireland), Scotland, Spain and Switzerland. Based on trends of previous years, influenza activity is expected to increase in many more European countries in the weeks ahead. The influenza activity reported so far has mainly been associated with influenza A viruses.
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Affiliation(s)
- J M S Arkema
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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Valle L, Amicizia D, Bacilieri S, Banfi F, Riente R, Durando P, Sticchi L, Gasparini R, Esposito C, Icardi G, Ansaldi F. Performance testing of two new one-step real time PCR assays for detection of human influenza and avian influenza viruses isolated in humans and respiratory syncytial virus. J Prev Med Hyg 2006; 47:127-33. [PMID: 17263157] [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: 05/13/2023]
Abstract
INTRODUCTION AND METHODS Two real time one-step RT-PCR assays were developed for simultaneous detection and typing of influenza A and B viruses and detection of Respiratory Syncytial Virus (RSV). As regard influenza, primers were designed to amplify specific sequences of gene M of A/H1N1, A/H3N2, A/H5N1, A/H7N7 and A/H9N2 viruses and of gene NP of type B viruses belonging both Yamagata and Victoria lineage. Specificity, analytical and clinical sensitivity, dynamic range, linearity of the new assays were evaluated. RESULTS Dynamic ranges for Influenza A and B, and RSV were at least five logs and linearity was conserved. In order to evaluate the specificity, 80 nasopharyngeal swabs resulting Influenza and RSV negative by multiplex nested PCR and cell culture, were tested and 79 resulted negative. The detection limits for influenza A and B, calculated by 95% probit, was 0.008 and 0.09 PFU, respectively, resulting more sensible than nested PCR. A total of 75 specimens (10 A/H1N1, 3 A/H1N2, 8 A/H3N2 Johannesburg/94-like, 10 A/H3N2 Panama/2007/99-like, 10 A/H3N2 Fuijian/411/02-like, 2 A/H5N1, 2 A/H7N7 and 2 A/H9N2, 15 B/Yamagata-like and 13 B/Victoria-like) collected between 1994 and 2004 or received by WHO Influenza Centre, London, were chosen as representative of the circulating strains and tested. All samples resulted positive although one B/Victoria sample was not clear typed. Thirty swabs nested RT-PCR positive for RSV collected during the four seasons, were also analysed by realtime PCR, resulting positive. To evaluate the performance of the new assay on fresh material, 250 specimens, collected during the 2004/05 seasons, were tested by nested-PCR, cell culture and real-time PCR. DISCUSSION AND CONCLUSION The new assays provide accurate and sensitive diagnosis of influenza and RSV infection and they represent a sensitive tool for virological surveillance and management of patient with ILI.
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MESH Headings
- Animals
- Antiviral Agents/chemical synthesis
- Antiviral Agents/therapeutic use
- Birds
- Cell Culture Techniques
- Communicable Diseases, Emerging/prevention & control
- Communicable Diseases, Emerging/virology
- Humans
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza A virus/drug effects
- Influenza A virus/genetics
- Influenza A virus/isolation & purification
- Influenza in Birds/epidemiology
- Influenza in Birds/virology
- Influenza, Human/epidemiology
- Influenza, Human/virology
- Phylogeny
- RNA, Viral/analysis
- RNA, Viral/genetics
- Respiratory Syncytial Virus Infections/epidemiology
- Respiratory Syncytial Virus Infections/virology
- Respiratory Syncytial Viruses/drug effects
- Respiratory Syncytial Viruses/genetics
- Respiratory Syncytial Viruses/isolation & purification
- Reverse Transcriptase Polymerase Chain Reaction/methods
- Reverse Transcriptase Polymerase Chain Reaction/standards
- Sensitivity and Specificity
- Sentinel Surveillance
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Affiliation(s)
- L Valle
- CIRI-IV, Department of Health Sciences, University of Genoa, Italy
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45
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Boncompagni G, Incandela L, Bechini A, Giannini D, Cellini C, Trezzi M, Ciofi degli Atti ML, Ansaldi F, Valle L, Bonanni P. Measles outbreak in Grosseto, central Italy, 2006. ACTA ACUST UNITED AC 2006; 11:E060803.4. [PMID: 16966773 DOI: 10.2807/esw.11.31.03015-en] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/20/2022]
Abstract
From 2003 to 2007, Italy is implementing a national plan to eliminate measles and congenital rubella
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Affiliation(s)
- G Boncompagni
- Local Health Agency 9 - Hygiene and Public Health (zone 4) - Grosseto, Italy
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Ansaldi F, Valle L, Amicizia D, Banfi F, Pastorino B, Sticchi L, Icardi G, Gasparini R, Crovari P. Drug resistance among influenza A viruses isolated in Italy from 2000 to 2005: are the emergence of Adamantane-resistant viruses cause of concern? J Prev Med Hyg 2006; 47:1-3. [PMID: 17061402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Ansaldi F, Bruzzone B, Frabetti M, Cardinale F, Calderisi S, Demetri D, Icardi G. O.118 Combination hepatitis C virus antigen and antibody immunoassay as a new tool for early diagnosis of infection. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80113-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ansaldi F, Bruzzone B, Testino G, Bassetti M, Gasparini R, Crovari P, Icardi G. Combination hepatitis C virus antigen and antibody immunoassay as a new tool for early diagnosis of infection. J Viral Hepat 2006; 13:5-10. [PMID: 16364076 DOI: 10.1111/j.1365-2893.2005.00646.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Reduction of the window period of hepatitis C virus (HCV) infection represents an important goal in the transfusional and diagnostic setting. A prototype assay designed to simultaneously detect circulating HCV antigen and anti-HCV, has been developed. Aim of this study was to evaluate the performance of this new assay in terms of specificity and sensitivity and to compare its efficacy with commercial assays. To evaluate the specificity of the assay, 400 samples from the general population and 100 'difficult' sera, negative for anti-HCV, were tested. To assess sensitivity, the new test was used on 76 PCR-positive and anti-HCV negative sera, seven natural or commercial seroconversion panels that included 17 RNA-positive and anti-HCV negative sera and 31 anti-HCV positive sera, 20 weak anti-HCV positive sera, 80 viraemic and anti-HCV-positive sera from patients infected with different subtypes and 10 sera from patients with HBV-HCV or HIV-HCV co-infections. Of 500 anti-HCV negative samples, 499 (99.8%) were negative with a cut-off index <0.5, while one sample was within the grey zone. Of the 93 HCV-RNA positive and anti-HCV negative sera from patients and panels, 85 (91.4%) resulted positive, and one had the cut-off index in the grey zone. The reduction in the diagnostic window period observed with the new test and HCV-RNA assays were equal, on average, to 24 and 34.4 days respectively. All anti-HCV positive sera were positive. The new assay shows high sensitivity and specificity and could be a useful tool not only in the diagnostic setting, where procedures to reduce the window period, such as antigen or HCV-RNA detection, are not currently recommended, but also in the screening of blood donations, when nucleic acid technologies is not feasible because of costs, organization, emergency and/or logistic difficulties.
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Affiliation(s)
- F Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy.
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Ansaldi F, Turello V, Lai P, Bastone G, De Luca S, Rosselli R, Durando P, Sticchi L, Gasparini R, Delfino E, Icardi G. Effectiveness of a 23-valent polysaccharide vaccine in preventing pneumonia and non-invasive pneumococcal infection in elderly people: a large-scale retrospective cohort study. J Int Med Res 2005; 33:490-500. [PMID: 16222881 DOI: 10.1177/147323000503300503] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This retrospective cohort study evaluated the effectiveness of a 23-valent pneumococcal polysaccharide vaccine in reducing hospital admission for pneumonia, otitis media and exacerbation of asthma or other syndromes due to Streptococcus pneumoniae in 9170 high-risk individuals. Cohort members were followed from 1 January 1998 to 31 December 2002. With regard to preventing hospitalization due to pneumonia, we observed a decrease in the incidence of 1/10000 person-months and a reduction in the relative risk of 38% in the vaccinated cohort compared with the non-vaccinated subjects. A decrease in the risk of hospital admission for asthma, acute otitis media, chronic obstructive pulmonary disease and other respiratory infections was also observed in vaccinated compared with non-vaccinated subjects. The specificity of these findings was confirmed by the lack of a protective effect from vaccination for those outcomes, such as hospitalization 'for all causes' and 'other otorhinolaryngological diagnoses', that were not directly related to pneumococcal disease.
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Affiliation(s)
- F Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
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50
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Ansaldi F, D'Agaro P, Burgnich P, de Florentiis D, Favero S, Dal Molin G, Comar M, Coppola N, Campello C. Three-year (1999-2002) of epidemiological and virological surveillance of influenza in north-east Italy. Eur J Epidemiol 2005; 19:885-90. [PMID: 15499899 DOI: 10.1023/b:ejep.0000040529.60673.b7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The results of the epidemiological and virological surveillance of influenza performed during the 1999/2000, 2000/2001 and 2001/2002 seasons in the northeastern Italy were presented and the relationship between age-specific morbidity rates and circulating strains were discussed.The epidemiological findings pointed out a change in age distribution. During the 1999/2000 season, characterized by a circulation of viruses antigenically close to the vaccine strain, a similar incidence rate in the 0-14 and 15-64-year-old groups was observed, while during the 2001/ 2002 winter the virus infected mostly children. During 2001/2002 season, B type viruses predominated with at least three distinguishable molecular variants. In particular, B/Victoria/2/87-like viruses re-emerged after more than a decade, and the antibodies elicited by the vaccine strain and by the strains circulating in previous seasons were poor or not protecting. The accumulation of susceptible subjects in young age group during the 1990s, due to the lack of circulation of B/Victoria/2/87-like viruses, was responsible for the unusual morbidity in the 0-14 year group. No circulation of B/Victoria/2/87-like viruses was observed in > 64-year-old group during 2001/2002 epidemic, probably due to a long-lasting immunity against viruses belonging to this lineage.
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Affiliation(s)
- F Ansaldi
- Department of Public Medicine Sciences, U.C.O. Hygiene and Preventive Medicine, University of Trieste and IRCCS Burlo Garofolo, Trieste, Italy
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