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Giovagnorio F, Geremia N, Scarparo C, Panese S, Bradariolo S, Berti C, Solinas M, Sanguinetti M, Selle V, Cozza A, Parisi SG, Carretta G. Successful control measures to treat the transmission of Candida auris in Northern Italian Hospital. New Microbiol 2024; 46:395-399. [PMID: 38252051] [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] [Received: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 01/23/2024]
Abstract
Candida auris has emerged globally as a multidrug-resistant health care-associated fungal pathogen. In the literature, nosocomial outbreaks are reported worldwide. In addition, C. auris diffusion occurs in high-dependency settings with infections typically affecting critically ill patients, resulting in life-threatening disease. We describe the first documented case of C. auris in northeastern Italy and the measures applied to contain the transmission that led to zero collateral infections.
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Affiliation(s)
| | - Nicholas Geremia
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale "Dell'Angelo", Venice, Italy
- Unit of Infectious Diseases, Department of Clinical Medicine, "SS. Giovanni e Paolo" Civilian Hospital, Venice, Italy
| | - Claudio Scarparo
- Unit of Microbiology and Virology, Department of Medical direction, Ospedale "Dell'Angelo" Hospital, Venice, Italy
| | - Sandro Panese
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale "Dell'Angelo", Venice, Italy
- Unit of Infectious Diseases, Department of Clinical Medicine, "SS. Giovanni e Paolo" Civilian Hospital, Venice, Italy
| | | | - Chiara Berti
- Medical direction, Ospedale "Dell'Angelo", Venice, Italy
| | - Maria Solinas
- Unit of Microbiology and Virology, Department of Medical direction, Ospedale "Dell'Angelo" Hospital, Venice, Italy
| | - Maurizio Sanguinetti
- Institutes of Microbiology and Infectious Diseases and Department of Clinical Anesthesiology and Intensive Care, Catholic University of the Sacred Heart, Gemelli Hospital, Rome, Italy
| | - Vittorio Selle
- Department of Prevention, Ospedale "Dell'Angelo", Venice, Italy
| | - Andrea Cozza
- Department of Cardio-Thorac-Vascular Sciences and Public Health, University of Padua, Italy
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Fonzo M, Pistellato I, Calzavara A, Sorrentino P, Selle V, Sbrogiò LG, Bertoncello C. Spread of SARS-CoV-2 at school through the pandemic waves: a population-based cohort study in Italy. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.281] [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
To limit SARS-CoV-2 transmission, proactive closure of schools is often believed by policy-makers and public an effective strategy. While evidence on the role of students in the spread is ongoing, effects of closure on children's well-being are well known. The number of secondary cases per class has been considered one of main driving criteria to mandate for distance learning. We aimed to calculate the rate of secondary infections per classroom and to identify factors associated with the development of school clusters.
Methods
We conducted a population-based cohort study between October 2020 and November 2021 in the province of Venice, Italy, a catchment area of 600,000 inhabitants. Primary, middle and high-schools were included.
Results
We identified 1,623 primary cases of SARS-CoV-2 infection in students. Of these, 72.5% did not lead to any secondary case in the school setting, 15.6% to 1, and 11.9% to 2+ contagions. The so-called second wave (Oct-Dec 2020) was associated with a lower occurrence of 2+ contagions (AOR=0.37; 95%CI: 0.24-0.56) than the fourth (Sep-Nov 2021). Both primary (AOR=1.74; 95%CI: 1.16-2.63) and middle schools (AOR=1.76 95%CI: 1,14-2,72) showed higher odds than high schools for cluster generation of 2+ cases. The involvement of 2+ secondary cases was lesser associated with the index case being a student rather than school staff (AOR=0.42; 95%CI: 0.29-0.60). The number of 2+ cases clusters per week followed a time trend in line with the general population incidence.
Conclusions
The school environment does not facilitate viral spread, but rather reflects transmission in the community. Appropriate measures (use of airway protection devices, interpersonal distancing, frequent hand and respiratory hygiene) and timely case tracking make school a safe place. Given the documented negative effects of school closures on children's learning and well-being, maintaining school attendance is as essential as it is desirable.
Key messages
• A SARS-CoV-2 positive student at school does not generate secondary infections in 3 out of 4 cases. The risk of cluster generation is lower when the index case is a student rather than school staff.
• The school environment does not facilitate viral spread, but rather reflects transmission in the community. School attendance is essential considering the effects on children’s learning and wellbeing.
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Affiliation(s)
- M Fonzo
- Hygiene and Public Health Unit, DCTVSP, University , Padua, Italy
| | - I Pistellato
- Department of Prevention, Local Health Authority , Venice, Italy
| | - A Calzavara
- Hygiene and Public Health Unit, DCTVSP, University , Padua, Italy
| | - P Sorrentino
- Hygiene and Public Health Unit, DCTVSP, University , Padua, Italy
| | - V Selle
- Department of Prevention, Local Health Authority , Venice, Italy
| | - LG Sbrogiò
- Department of Prevention, Local Health Authority , Venice, Italy
| | - C Bertoncello
- Hygiene and Public Health Unit, DCTVSP, University , Padua, Italy
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3
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Capriotti V, Mattioli F, Guida F, Marcuzzo AV, Lo Manto A, Martone A, Molinari G, Fabbris C, Menegaldo A, Calvanese L, Latini G, Cingolani C, Gradoni P, Boscolo Nata F, De Sisti C, Selle V, Leone G, Indelicato P, Pilolli F, Mevio N, Roncoroni L, Papi S, Meschiari M, Tominz R, D'Ascanio L, Dragonetti A, Torelli L, Trenti L, Spinato G, Boscolo-Rizzo P, Bussi M, Cossarizza A, Presutti L, Tirelli G. COVID-19 in the tonsillectomised population. ACTA ACUST UNITED AC 2021; 41:197-205. [PMID: 33970896 PMCID: PMC8283408 DOI: 10.14639/0392-100x-n1436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/01/2021] [Indexed: 01/11/2023]
Abstract
Objective Interactions between SARS-CoV-2 and pharyngeal associated lymphoid tissue are thought to influence the manifestations of COVID-19. We aimed to determine whether a previous history of tonsillectomy, as a surrogate indicator of a dysfunctional pharyngeal associated lymphoid tissue, could predict the presentation and course of COVID-19. Methods Multicentric cross-sectional observational study involving seven hospitals in Northern and Central Italy. Data on the clinical course and signs and symptoms of the infection were collected from 779 adults who tested positive for SARS-CoV-2, and analysed in relation to previous tonsillectomy, together with demographic and anamnestic data. Results Patients with previous tonsillectomy showed a greater risk of fever, temperature higher than 39°C, chills and malaise. No significant differences in hospital admissions were found. Conclusions A previous history of tonsillectomy, as a surrogate indicator of immunological dysfunction of the pharyngeal associated lymphoid tissue, could predict a more intense systemic manifestation of COVID-19. These results could provide a simple clinical marker to discriminate suspected carriers and to delineate more precise prognostic models.
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Affiliation(s)
- Vincenzo Capriotti
- Otorhinolaryngology-Head and Neck Surgery Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Francesco Mattioli
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - Francesco Guida
- Otorhinolaryngology-Head and Neck Surgery Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Alberto Vito Marcuzzo
- Otorhinolaryngology-Head and Neck Surgery Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Alfredo Lo Manto
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - Andrea Martone
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - Giulia Molinari
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - Cristoforo Fabbris
- ENT Clinic and Regional Center for Head and Neck Cancer, University of Padova Faculty of Medicine and Surgery, Department of Neurosciences, Treviso Regional Hospital, Treviso, Italy
| | - Anna Menegaldo
- ENT Clinic and Regional Center for Head and Neck Cancer, University of Padova Faculty of Medicine and Surgery, Department of Neurosciences, Treviso Regional Hospital, Treviso, Italy
| | - Leonardo Calvanese
- ENT Clinic and Regional Center for Head and Neck Cancer, University of Padova Faculty of Medicine and Surgery, Department of Neurosciences, Treviso Regional Hospital, Treviso, Italy
| | - Gino Latini
- Institute of Otorhinolaryngology, Department of Head and Neck Surgery, Santa Croce Hospital AORMN, Fano (PU), Italy
| | - Cristina Cingolani
- Institute of Otorhinolaryngology, Department of Head and Neck Surgery, Santa Croce Hospital AORMN, Fano (PU), Italy
| | - Paolo Gradoni
- Institute of Otorhinolaryngology, Department of Head and Neck Surgery, Santa Croce Hospital AORMN, Fano (PU), Italy
| | - Francesca Boscolo Nata
- Otorhinolaryngology Unit, Monselice Hospital, Ospedali Riuniti Padova Sud "Madre Teresa di Calcutta", Monselice (PD), Italy
| | - Clelia De Sisti
- Hygiene and Public Health Unit, Department of Prevention, Hospital of Chioggia, AULSS 3 Serenissima, Chioggia (VE), Italy
| | - Vittorio Selle
- Hygiene and Public Health Unit, Department of Prevention, Hospital of Chioggia, AULSS 3 Serenissima, Chioggia (VE), Italy
| | - Giordano Leone
- Department of Otorhinolaryngology, San Raffaele Hospital, Milano, Italy
| | - Pietro Indelicato
- Department of Otorhinolaryngology, San Raffaele Hospital, Milano, Italy
| | - Francesco Pilolli
- Department of Otorhinolaryngology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Niccolò Mevio
- Department of Otorhinolaryngology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Luca Roncoroni
- Department of Otorhinolaryngology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Simona Papi
- Department of Surgery and Clinical Specialties, University of Modena and Reggio Emilia, Modena, Italy
| | - Marianna Meschiari
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, University of Modena and Reggio Emilia Faculty of Medicine and Surgery, Modena, Italy
| | - Riccardo Tominz
- Department of Prevention, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Luca D'Ascanio
- Institute of Otorhinolaryngology, Department of Head and Neck Surgery, Santa Croce Hospital AORMN, Fano (PU), Italy
| | - Alberto Dragonetti
- Department of Otorhinolaryngology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Lucio Torelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - Loris Trenti
- Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, Barcelona, Spain
| | - Giacomo Spinato
- ENT Clinic and Regional Center for Head and Neck Cancer, University of Padova Faculty of Medicine and Surgery, Department of Neurosciences, Treviso Regional Hospital, Treviso, Italy
| | - Paolo Boscolo-Rizzo
- ENT Clinic and Regional Center for Head and Neck Cancer, University of Padova Faculty of Medicine and Surgery, Department of Neurosciences, Treviso Regional Hospital, Treviso, Italy
| | - Mario Bussi
- Hygiene and Public Health Unit, Department of Prevention, Hospital of Chioggia, AULSS 3 Serenissima, Chioggia (VE), Italy
| | - Andrea Cossarizza
- Department of Biomedical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Livio Presutti
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy
| | - Giancarlo Tirelli
- Otorhinolaryngology-Head and Neck Surgery Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
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Del Mistro A, Battagello J, Weis L, Bressan V, Selle V, Ramigni M, Dal Zotto A, Maggiolo A, Gori S, Frayle H, Zappa M, Zorzi M. A Retrospective Cohort Study of Young Women Spontaneously Choosing to Be Vaccinated against HPV: Outcomes from Their First Cervical Cancer Screening Test. Viruses 2021; 13:v13030486. [PMID: 33809436 PMCID: PMC7999740 DOI: 10.3390/v13030486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Efficacy for cervical cancer prevention of opportunistic HPV vaccination in post-pubertal girls is lower than in 11-year-olds. Methods: Women born between 1986 and 1992 vaccinated at 15–25 years of age (at least one dose of 4-valent HPV vaccine) and screened at 24–27 years of age were included. Frequency of opportunistic vaccination, overall and by birth cohort, was calculated; screening outcomes were compared between vaccinated and unvaccinated women. Results: Overall, 4718 (4.9%) HPV-vaccinated, and 91,512 unvaccinated, women were studied. The frequency of vaccination increased by birth cohort, ranging between 1.8% and 9.8%; age at vaccination decreased progressively by birth cohort (p < 0.0001). Participation in screening was 60.8% among vaccinated, and 56.6% among unvaccinated, women (p < 0.0001). Detection rates (DR) for high-grade lesions were lower in vaccinated women (2.11‰ vs. 3.85‰ in unvaccinated, for CIN3+, p = 0.24; 0.0‰ vs. 0.22‰ for cancer). The DR of CIN3+ increased with age at vaccination, scoring respectively 0.0‰, 0.83‰, and 4.68‰ for women vaccinated when they were 15–16, 17–20, and 21–25 years old (p = 0.17). Conclusions: In comparison to unvaccinated women, higher compliance with cervical cancer screening invitation and lower CIN3+ DR among vaccinated women was observed. Age at vaccination was inversely correlated to vaccination efficacy.
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Affiliation(s)
- Annarosa Del Mistro
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
- Correspondence:
| | - Jessica Battagello
- Veneto Tumour Registry, Azienda Zero, 35131 Padua, Italy; (J.B.); (M.Z.)
| | - Luca Weis
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
- Department of Neuroscience (DNS), University of Padua, 35131 Padua, Italy
| | | | | | - Mauro Ramigni
- Local Health Unit Marca Trevigiana, 31100 Treviso, Italy;
| | | | | | - Silvia Gori
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
| | - Helena Frayle
- Immunologia e Diagnostica Molecolare Oncologica, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy; (L.W.); (S.G.); (H.F.)
| | - Marco Zappa
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy;
| | - Manuel Zorzi
- Veneto Tumour Registry, Azienda Zero, 35131 Padua, Italy; (J.B.); (M.Z.)
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Giovanazzi G, Barbara A, Parente P, Restivo V, Selle V, Siddu A, Silenzi A, Trucchi C, Voglino G, gualano MR. Leadership in Public Health: an Italian learning experience. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.679] [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
The “Public Health Leadership” Working Group of Italian Society of Public Health (S.It.I.) organized a two-days Workshop in Verona in January 2020. Leadership is linked to capacity of inspiring people to craft and achieve vision and goals, to provide mentoring, coaching and recognition and to encouragement empowerment, allowing other leaders to emerge and high quality of care. As in others country, in Italy investing in new generations is fundamental and far-sighted to create Leadership culture in tomorrow's professionals.
Objectives
The Workshop aim was to immerse Public Health residents into Health Leadership. Two types of practical/interactive experiences (Design thinking and Barometer strategy) and three speakers' interventions aroused curiosity, suggesting innovative ways to manage emerging local and global healthcare problems. Are residents interested in Leadership? Do they think Leadership could influence, motivate and enable to contribute to organization effectiveness?
Results
100 residents (Male 52, Female 48), from 72% of Public Health Schools (26), attended Workshop: 46 of 1st, 23 of 2nd, 18 of 3rd and 13 of residency program last year. Satisfaction questionnaire was completed by 58 residents (7 points Likert scale from 1 [dissatisfied/not useful] to 7 [satisfied/useful]). 5.91 pts result in interventions satisfaction, increasing from 1st (5.84) to last year (6.00); interventions topics deepening results in 5.38 pts, decreasing from 1st (5.52) to last year (5.00). Overall satisfaction on practical/interactive activities was 5.89 and 5.83 pts results in these methodologies usefulness.
Conclusions
Health Leadership is a hot topic for residents; during residency program Leadership in not a main theme and residents want to improve non-technical skills to realise organization high quality of care. The practical/interactive activities were a winning choice to capture attention and cultivate mutual trust. This experience could be adapted in other countries.
Key messages
Teaching Leadership in Public Health is a main topic that needs to be strengthened in Public Health agenda. Italian Public Health residents are very interested in Health Leadership improvement during their trainings.
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Affiliation(s)
- G Giovanazzi
- School of Specialization in Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - A Barbara
- School of Specialization in Hygiene and Preventive Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - P Parente
- WHO Collaborating Centre for Leadership, Governance and HP, Catholic University of the Sacred Heart, Rome, Italy
| | - V Restivo
- Department of Health Promotion Sciences, University of Palermo, Palermo, Italy
| | - V Selle
- Unit of Hygiene and Public Health, AULSS 3 Serenissima, Venice, Italy
| | - A Siddu
- National Institute of Health, Rome, Italy
| | - A Silenzi
- Centre for Leadership in Medicine Research and Studies, Catholic University of the Sacred Heart, Rome, Italy
- Strategic Directorate, Brescia Agency for Health Protection, Brescia, Italy
| | - C Trucchi
- A.Li.Sa. Liguria Health Authority, Genoa, Italy
| | - G Voglino
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - M R gualano
- Department of Public Health Sciences, University of Turin, Turin, Italy
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6
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Burmaz T, Guicciardi S, Selle V, Lopalco PL, Baldo V, Fantini MP. Management of meningococcal outbreaks: are we using the same language? Comparison of the public health policies between high-income countries with low incidence of meningococcal disease. Expert Rev Vaccines 2019; 18:559-574. [PMID: 30875482 DOI: 10.1080/14760584.2019.1595595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Invasive meningococcal disease (IMD) in high-income countries usually occurs sporadically with low incidence and occasionally as small clusters or outbreaks. The WHO guidelines (GLs) for IMD outbreak applies only to African countries with high endemic incidence. Several high-income countries developed their own GLs on IMD outbreak, and we compare their terminology, classification, definitions, and public health interventions. METHODS National IMD outbreak GLs of the European Union and the Organisation for Economic Co-operation and Development member states were compared. Due to linguistic barriers, 17 out of forty-one countries were selected, and the GLs on the websites of the national health authorities were independently screened by two researchers. RESULTS National GLs on IMD outbreak were available for 12 countries. All GLs classify IMD outbreak into organization and community based using different terminology (cluster, epidemic, etc.). Two GLs introduce also a third condition of hyperendemic. Definitions, thresholds, and countermeasures vary among countries. CONCLUSIONS Different definitions of organization and community-based outbreaks and countermeasures are expected because of uncertainties about their effectiveness, and differences between countries in health-care systems and public health policy approaches. Nevertheless, variations in terminology, definitions and countermeasures are confusing and reflect the need for an international standardization.
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Affiliation(s)
- Tea Burmaz
- a Department of Hygiene and Public Health , Local Health Unit 3 Serenissima , Venice , Italy
| | - Stefano Guicciardi
- b Department of Biomedical and Neuromotor Sciences , University of Bologna , Bologna , Italy
| | - Vittorio Selle
- a Department of Hygiene and Public Health , Local Health Unit 3 Serenissima , Venice , Italy
| | - Pier Luigi Lopalco
- c Department of Transational Research on new technologies in medicine and surgery , University of Pisa , Pisa , Italy
| | - Vincenzo Baldo
- d Hygiene and Public Health Unit, DSCTV , University of Padua , Padua , Italy
| | - Maria Pia Fantini
- e Department of Biomedical and Neuromotor Sciences , University of Bologna , Bologna , Italy
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7
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Burmaz T, Guicciardi S, Selle V, Baldo V, Fantini MP. Meningococcal outbreak, cluster and hyperendemic: are we using the same language? Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Burmaz
- Hygiene and Public Health Sector, Local Health Unit 3 Serenissima, Venice, Italy
| | - S Guicciardi
- Hygiene and Public Health Sector, Local Health Unit 3 Serenissima, Bologna, Italy
| | - V Selle
- Hygiene and Public Health Sector, Local Health Unit 3 Serenissima, Venice, Italy
| | - V Baldo
- Hygiene and Public Health Unit, DSCTV, University of Padua, Padua, Italy
| | - MP Fantini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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8
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Tondo L, Vázquez GH, Baethge C, Baronessa C, Bolzani L, Koukopoulos A, Mazzarini L, Murru A, Pacchiarotti I, Pinna M, Salvatore P, Sani G, Selle V, Spalletta G, Girardi P, Tohen M, Vieta E, Baldessarini RJ. Comparison of psychotic bipolar disorder, schizoaffective disorder, and schizophrenia: an international, multisite study. Acta Psychiatr Scand 2016; 133:34-43. [PMID: 26096273 DOI: 10.1111/acps.12447] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Nosological distinctions among schizoaffective disorder (SA), bipolar I disorder with psychotic features (BDp), and schizophrenia (SZ) remain unresolved. METHOD We compared 2269 subjects with psychotic features in DSM-IV-TR diagnoses (1435 BDp, 463 SZ, 371 SA) from 8 collaborating international sites, by 12 sociodemographic and clinical measures, all between diagnostic pairs. RESULTS In bivariate comparisons, SA was consistently intermediate between BDp and SZ for 11/12 features (except onset stressors), and SZ vs. BDp differed in all 12 factors. SA differed from both BDp and SZ in 9/12 factors: SA and BDp were similar in education and suicidal ideation or acts; SA and SZ were similar in education, onset stressors, and substance abuse. Meta-analytic comparisons of diagnostic pairs for 10 categorical factors indicated similar differences of SA from both SZ and BDp. Multivariate modeling indicated significantly independent differences between BDp and SZ (8 factors), SA vs. SZ (5), and BDp vs. SA (3). Measurement variance was similar for all diagnoses. CONCLUSION SA was consistently intermediate between BDp and SZ. The three diagnostic groups ranked: BDp > SA > SZ related to lesser morbidity or disability. The findings are not consistent with a dyadic Kraepelinian categorization, although the considerable overlap among the three DSM-IV diagnostic groups indicates uncertain boundaries if they represent distinct disorders.
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Affiliation(s)
- L Tondo
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA.,Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - G H Vázquez
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA.,Department of Neuroscience, Palermo University, Buenos Aires, Argentina
| | - C Baethge
- Department of Psychiatry, University of Köln, Köln, Germany
| | - C Baronessa
- Viarnetto Psychiatric Clinic, Lugano, Switzerland
| | - L Bolzani
- Viarnetto Psychiatric Clinic, Lugano, Switzerland
| | - A Koukopoulos
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - L Mazzarini
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy
| | - A Murru
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - I Pacchiarotti
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - M Pinna
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - P Salvatore
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA.,Section of Psychiatry, Department of Neuroscience, University of Parma, Parma, Italy
| | - G Sani
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - V Selle
- Viarnetto Psychiatric Clinic, Lugano, Switzerland
| | - G Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - P Girardi
- NeSMOS Department, Sant'Andrea Medical Center, University of Rome (Sapienza), Rome, Italy.,Lucio Bini Mood Disorder Center, Rome, Italy
| | - M Tohen
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - E Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - R J Baldessarini
- Department of Psychiatry, Harvard Medical School, International Consortium for Bipolar & Psychotic Disorder Research, Boston, MA, USA
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Anello P, Cestari L, Canova C, Vianello L, Pistollato S, Lorenzet K, Sciarrone R, Selle V, Simonato L. [Investigation on the health effects of traffic-related air pollution from Mestre motorway (Veneto Region, Northern Italy)]. Epidemiol Prev 2015; 39:251-260. [PMID: 26499238] [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: 06/05/2023]
Abstract
OBJECTIVES to evaluate whether living near motorway A57 (Mestre motorway, Veneto Region, Northern Italy) might have affected the residents' health status. DESIGN longitudinal cohort study. SETTING AND PARTICIPANTS 148,673 residents on the mainland in the Municipality of Venice (Mestre) who never changed their residence during the follow- up period (2002-2009). MAIN OUTCOMES MEASURES the 2001 Italian census data were linked with the data sources of the epidemiological integrated system which includes: population registry, death certificates, hospital discharges, drug prescriptions, and tax exemption. Mortality and incidence for several subgroups of causes, incidence of acute myocardial infarction and stroke, and prevalence of asthma, chronic obstructive pulmonary disease, ischemic cardiopathy and diabetes were estimated. The ADMS-Urban model was adopted to define three different exposure areas based on PM10 emissions from the motorway: A (highly exposed), B (moderately exposed) used as a comparison for the analysis, C (unexposed). Hazard ratios (HR) for incidence and mortality were estimated from Cox proportional hazard models adjusted for calendar period, age, gender, and instruction level. The relationship between the exposure area and prevalence was investigated by multiple logistic regression analysis adjusted for the same covariates. RESULTS compared with B area (23.25%of the population under study), people living in A area (3.16% of the population under study) had an increased incidence of acute myocardial infarction (HR: 1.43; 95%CI 1.03-1.97) in females, and prevalence of ischemic cardiopathy (odds ratio - OR: 1.12; 95%CI 1.01-1.26) in both genders. Results were borderline for COPD in males (OR: 1.17; 95%CI 0.97-1.41). Positive but nonsignificant associations were found with pneumonia and respiratory recoveries. CONCLUSIONS this study showed that residents who live near Mestre motorway had an increased prevalence of some cardiorespiratory diseases, particularly ischemic cardiopathy.
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Affiliation(s)
- Paola Anello
- Scuola di specializzazione in igiene e medicina preventiva, Università degli Studi di Padova.
| | - Laura Cestari
- Dipartimento di medicina molecolare, Laboratorio sanità pubblica e studi di popolazione, Università degli Studi di Padova
| | - Cristina Canova
- Dipartimento di medicina molecolare, Laboratorio sanità pubblica e studi di popolazione, Università degli Studi di Padova
| | - Luisa Vianello
- Agenzia regionale per la prevenzione e protezione dell'ambiente (ARPA) Veneto, Venezia
| | - Silvia Pistollato
- Agenzia regionale per la prevenzione e protezione dell'ambiente (ARPA) Veneto, Venezia
| | - Ketty Lorenzet
- Agenzia regionale per la prevenzione e protezione dell'ambiente (ARPA) Veneto, Venezia
| | | | | | - Lorenzo Simonato
- Dipartimento di medicina molecolare, Laboratorio sanità pubblica e studi di popolazione, Università degli Studi di Padova
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Selle V, Schalkwijk S, Vázquez G, Baldessarini R. Treatments for Acute Bipolar Depression: Meta-analyses of Placebo-controlled, Monotherapy Trials of Anticonvulsants, Lithium and Antipsychotics. Pharmacopsychiatry 2014; 47:43-52. [DOI: 10.1055/s-0033-1363258] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- V. Selle
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, Massachusetts, USA
| | - S. Schalkwijk
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, Massachusetts, USA
| | - G. Vázquez
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, Massachusetts, USA
| | - R. Baldessarini
- International Consortium for Bipolar Disorder Research, McLean Hospital, Belmont, Massachusetts, USA
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Alessandrini ER, Faustini A, Chiusolo M, Stafoggia M, Gandini M, Demaria M, Antonelli A, Arena P, Biggeri A, Canova C, Casale G, Cernigliaro A, Garrone E, Gherardi B, Gianicolo EAL, Giannini S, Iuzzolino C, Lauriola P, Mariottini M, Pasetto P, Randi G, Ranzi A, Santoro M, Selle V, Serinelli M, Stivanello E, Tominz R, Vigotti MA, Zauli-Sajani S, Forastiere F, Cadum E. [Air pollution and mortality in twenty-five Italian cities: results of the EpiAir2 Project]. Epidemiol Prev 2013; 37:220-229. [PMID: 24293487] [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: 06/02/2023]
Abstract
OBJECTIVES this study aims at presenting the results from the Italian EpiaAir2 Project on the short-term effects of air pollution on adult population (35+ years old) in 25 Italian cities. DESIGN the short-term effects of air pollution on resident people died in their city were analysed adopting the time series approach. The association between increases in 10µg/m(3) in PM10, PM2.5, NO2 and O3 air concentration and natural, cardiac, cerebrovascular and respiratory mortality was studied. City-specific Poisson models were fitted to estimate the association of daily concentrations of pollutants with daily counts of deaths. The analysis took into account temporal and meteorological factors to control for potential confounding effect. Pooled estimates have been derived from random effects meta-analysis, evaluating the presence of heterogeneity in the city specific results. SETTING AND PARTICIPANTS it was analysed 422,723 deaths in the 25 cities of the project among people aged 35 years or more, resident in each city during the period 2006-2010. MAIN OUTCOME MEASURES daily counts of natural, cardiac, cerebrovascular, and respiratory mortality, obtained from the registries of each city. Demographic information were obtained by record linkage procedure with the civil registry of each city. RESULTS mean number of deaths for natural causes ranged from 513 in Rovigo to 20,959 in Rome. About 25% of deaths are due to cardiac diseases, 10% to cerebrovascular diseases, and 7% to respiratory diseases. It was found an immediate effect of PM10 on natural mortality (0.51%; 95%CI 0.16-0.86; lag 0-1). More relevant and prolonged effects (lag 0-5) have been found for PM2.5 (0.78%; 95%CI 0.12-1.46) and NO2 (1.10%; 95%CI 0.63-1.58). Increases in cardiac mortality are associated with PM10 (0.93%; 95%CI 0.16-1.70) and PM2.5 (1.25%; 95%CI 0.17-2.34), while for respiratory mortality exposure to NO2 has an important role (1.67%; 95%CI 0.23-3.13; lag 2-5), as well as PM10 (1.41%; 95%CI - 0.23;+3.08). Results are strongly homogeneous among cities, except for respiratory mortality. No effect has been found for cerebrovascular mortality and weak evidence of association has been observed between ozone and mortality. CONCLUSIONS a clear increase in mortality associated to air pollutants was observed. More important are the effects of NO2 (on natural mortality), mostly associated with traffic emissions, and of PM2.5 (on cardiac and respiratory mortality). Nitrogen dioxide shows an independent effect from the particulate matter, as observed in the bi-pollutant models.
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Affiliation(s)
- Ester Rita Alessandrini
- Dipartimento di epidemiologia del servizio sanitario regionale, Azienda unità sanitaria locale Roma E, Regione Lazio
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Ziprani C, Selle V, Palazzi B, Capretta F, Ghio L, Flora ME, Baldo V. Is Venice an ideal habitat for Legionella pneumophila? J Prev Med Hyg 2012; 53:152-156. [PMID: 23362621] [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 Legionella bacterium manifests itself in Legionnaire's disease and Pontiac fever, it is mainly found and transmitted by aerosol produced in cooling towers, water distribution plants and medical equipment, and it affects mainly elder persons in poor health. METHODS The population of Venice Local Health Unit was divided in two areas of study and the incidence of legionellosis in residents of Venice historical centre (Distretto Sanitario 1) and in residents of the mainland and coastal areas (Distretti Sanitari 2, 3, 4) was calculated. The cases were those notified to the Public Health Unit by law, and the population of residents was that of the eligible for health care in the archives of the Local Health Unit. Only cases of legionellosis in residents who had not travelled in the 10 days previous of the onset of disease, and not related to nosocomial clusters were considered. The standardized incidence ratio was then calculated and confidence interval were defined by Poisson distribution. RESULTS Given the population of the two areas, 59801 in Distretto Sanitario 1 and 237555 in Distretti 2, 3, 4, the raw incidence of disease is respectively 87 per 100000 and 20 per 100000 in time 2002-2010. The standardized incidence ratio for the population of Distretto Sanitario 1 vs the remaining population is 4.3. DISCUSSION The difference in risk of getting the disease in this two residential areas geographically very close, is probably related to the different buildings' characteristics, old and difficult to maintain in Venice historical centre.
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Affiliation(s)
- C Ziprani
- Hygiene and Public Health Service, Department of Prevention, AULSS 12 of Venice
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Mariotto A, Zeni L, Selle V, Favaretti C. Utilization of percutaneous transluminal coronary angioplasty for quality assurance in health care from 1983 to 1996. Int J Technol Assess Health Care 2000; 15:473-9. [PMID: 10874375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVES To examine the distribution of interventional cardiac catheterization laboratories, their case load, the time trends, and the regional variation of percutaneous transluminal cutaneous angioplasty (PTCA) utilization in Italy. METHODS Analysis of data was provided by the annual reports of the Italian Group of Studies and Interventional Cardiology over the period from 1983 to 1996. RESULTS The number of PTCA facilities and their use steadily increased, mainly in the North. In 1996 the utilization rate was 34 per 100,000 population, but only 60% of labs performed 200 or more procedures. CONCLUSIONS Dramatic time trends and regional variations often took place without an epidemiology and technology assessment-based planning process.
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Selle V, Scarpa B. [The quality of hospital discharge data in the Venice general hospital: methods and evaluation in the development of the Diagnosis Related Groups System]. Epidemiol Prev 1995; 19:342-8. [PMID: 8852084] [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: 02/02/2023]
Abstract
In this paper the A.A. illustrate the methodology and development of an evaluation programme of hospital discharge medical records data base quality to implement the DRG system. The work was organized into three phases: the first to analyze the quality base level, the second to sensitize the medical doctors to SDO coding through a Medical Managers Department tutorial action; the third to measure the results of a random sample. The A.A. realized a raise in the compilation level between the two analises, particularly as regards the trascription of surgical procedures and/or diagnostic and therapeutic procedures passed from 39.9% at 64.1%, and a greater correctness in the primary diagnosis coding passed from 69.9% at 83.3% and in the surgical procedures and/or diagnostic and therapeutic procedures (coding) passed from 88.7% at 93.7%.
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Affiliation(s)
- V Selle
- Direzione Sanitaria, Presidio Ospedaliero di Venezia, ULSS 11, Regione Veneto
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Favaretti C, Selle V, Marcolongo A, Orsini A. The appropriateness of human albumin use in the hospital of Padova, Italy. Qual Assur Health Care 1993; 5:49-55. [PMID: 8457688 DOI: 10.1093/intqhc/5.1.49] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The authors present the findings of a study in three stages (1989-1991) on the appropriateness of human albumin use at the hospital of Padova, Italy. In the first stage, guidelines for appropriate use were defined and a monitoring system was set up. In the second stage, compliance of the hospital departments with the new guidelines was assessed in a sample of human albumin prescription charts and related medical records. This revealed a reduction in consumption of 25%. Sixty-eight per cent of all albumin was given for indications that are only occasionally appropriate. The information given in the prescription chart agreed with the diagnosis contained in the medical records in 78% of cases. At the end of this stage new regulating mechanisms were introduced. The third stage consisted of a medium-term assessment and produced basically the same results as the previous stage. Crucial steps in the implementation of effective actions in quality improvement processes have been discussed.
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Affiliation(s)
- C Favaretti
- Medical Directorate, Hospital and University Medical Centre, Padova, Italy
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