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Jaramillo L, Camussi E, Dotti M, Ferrante G, Segnan N, Castagno R, Ullrich A, Giordano L. EuroMed Cancer Network contributions to eliminating cervical cancer in low- and middle-income Mediterranean countries. East Mediterr Health J 2023; 26:894-902. [PMID: 38279885 DOI: 10.26719/emhj.23.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 04/26/2023] [Indexed: 01/29/2024]
Abstract
Background Cervical cancer places a significant burden on low- and middle-income countries (LMICs). The EuroMed Cancer Network (EuMedCN) brings together cancer experts and stakeholders from the Mediterranean countries to promote sustainable cancer screening and support implementation of the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. Aim To highlight the constructive role of EuMedCN in mitigating inequalities in access to cervical cancer prevention and screening across the Mediterranean LMICs. Methods Through its workshops and meetings, EuMedCN members discussed new developments in cancer prevention and control, and how best to translate the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem into public health policies in the Mediterranean LMICs. This led to targeted actions in the selected countries. Results Seven priority actions were implemented to improve cervical cancer screening in the Mediterranean LMICs. EuMedCN supported organized screening, new pilot technologies and enhancement of evaluation systems. Integrating cervical cancer screening into other disease programmes and fostering multidisciplinary networks were promoted as key to achieving targets of the WHO global strategy. Conclusion International networks, such as EuMedCN, have the potential to bring together experts and stakeholders to share experiences and catalyse resource mobilization. They can support affordable and synergistic solutions for cervical cancer prevention.
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Affiliation(s)
- Lina Jaramillo
- Epidemiology and Screening Department, CPO, AOU Città della Salute e della Scienza di Torino, Ospedale S. Giovanni Antica Sede, Via Cavour, Turin, Italy
| | - Elisa Camussi
- Epidemiology and Screening Department, CPO, AOU Città della Salute e della Scienza di Torino, Ospedale S. Giovanni Antica Sede, Via Cavour, Turin, Italy
| | - Marta Dotti
- Epidemiology and Screening Department, CPO, AOU Città della Salute e della Scienza di Torino, Ospedale S. Giovanni Antica Sede, Via Cavour, Turin, Italy
| | - Gianluigi Ferrante
- Epidemiology and Screening Department, CPO, AOU Città della Salute e della Scienza di Torino, Ospedale S. Giovanni Antica Sede, Via Cavour, Turin, Italy
| | - Nereo Segnan
- Epidemiology and Screening Department, CPO, AOU Città della Salute e della Scienza di Torino, Ospedale S. Giovanni Antica Sede, Via Cavour, Turin, Italy
| | - Roberta Castagno
- Epidemiology and Screening Department, CPO, AOU Città della Salute e della Scienza di Torino, Ospedale S. Giovanni Antica Sede, Via Cavour, Turin, Italy
| | - Andreas Ullrich
- Department of Gynaecology and Center for Global Health, Charité, Universitätsmedizin, Augustenburgerplatz, Berlin, German
| | - Livia Giordano
- Epidemiology and Screening Department, CPO, AOU Città della Salute e della Scienza di Torino, Ospedale S. Giovanni Antica Sede, Via Cavour, Turin, Italy
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Evangelista A, Camussi E, Corezzi M, Gilardetti M, Fonte G, Scarmozzino A, La Valle G, Angelone L, Olivero E, Ciccone G, Corsi D. Routine vs. On-Demand Discharge Planning Strategy in Intermediate-Risk Patients for Complex Discharge: a Cluster-Randomized, Multiple Crossover Trial. J Gen Intern Med 2023; 38:2749-2754. [PMID: 37170018 PMCID: PMC10506972 DOI: 10.1007/s11606-023-08186-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/22/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Early hospital discharge planning can help to reduce the length of stay and unplanned readmission in high-risk patients. Therefore, it is important to select patients who can benefit from a personalized discharge planning based on validated tools. The modified Blaylock Risk Assessment Screening Score (BRASS) is routinely used in the Molinette Hospital (Turin, Italy) to screen patients at high risk for discharge, but the effectiveness of the discharge planning is uncertain in intermediate-risk patients. OBJECTIVE To evaluate the best strategy for discharge planning by the Continuity of Care Hospital Unit (CCHU) in intermediate-risk patients according to modified BRASS. DESIGN Cluster-randomized, multiple crossover trial. PARTICIPANTS Adult patients admitted in the Medicine and Neurology departments of the Molinette Hospital in Turin, Italy, between June 2018 and May 2019 with a BRASS intermediate risk. INTERVENTIONS A routine discharge planning strategy (RDP, Routine Discharge Plan), which involved the management of all intermediate-risk patients, was compared to an on-demand discharge planning strategy (DDP, on-Demand Discharge Planning), which involved only selected patients referred to the CCHU by ward staff. MAIN MEASURES The primary outcome was the 90-day hospital readmission for any cause (HR90). Secondary outcomes included the prolonged length of stay (pLOS). KEY RESULTS Eight hundred two patients (median age 79 years) were included (414 RDP and 388 DDP). Comparing RDP vs. DDP periods, HR90 was 27.6% and 27.3% (OR 1.01, 90%CI 0.76-1.33, p = 0.485); and pLOS was 47 (11.4%) and 40 (10.3%) (OR 1.24, 95%CI 0.72-2.13, p = 0.447), respectively. CONCLUSIONS This is one of the largest randomized study conducted to compare the effectiveness of two different hospital discharge planning strategies. In patients with intermediate risk of hospital discharge, a RDP offers no advantage over a DDP and results in an unnecessary increase in staff workload. TRIAL REGISTRATION Clinicaltrials.gov: NCT03436940.
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Affiliation(s)
- Andrea Evangelista
- Unit of Clinical Epidemiology, AOU Città Della Salute E Della Scienza Di Torino and CPO Piemonte, Via Santena, 7 10126, Turin, Italy.
| | - Elisa Camussi
- Unit of Screening Epidemiology, AOU Città Della Salute E Della Scienza Di Torino and CPO Piemonte, Turin, Italy
| | - Michele Corezzi
- Quality and Safety of Care Department, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Marco Gilardetti
- Unit of Clinical Epidemiology, AOU Città Della Salute E Della Scienza Di Torino and CPO Piemonte, Via Santena, 7 10126, Turin, Italy
| | - Gianfranco Fonte
- Unit of Screening Epidemiology, AOU Città Della Salute E Della Scienza Di Torino and CPO Piemonte, Turin, Italy
| | - Antonio Scarmozzino
- Hospital Medical Direction, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Giovanni La Valle
- Hospital Medical Direction, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Lorenzo Angelone
- Hospital Medical Direction, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Elena Olivero
- Hospital Medical Direction, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Giovannino Ciccone
- Unit of Clinical Epidemiology, AOU Città Della Salute E Della Scienza Di Torino and CPO Piemonte, Via Santena, 7 10126, Turin, Italy
| | - Daniela Corsi
- Hospital Medical Direction, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
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Visioli CB, Giorgi Rossi P, Armaroli P, Iossa A, Rizzolo R, Bonelli LA, Venturino E, Carozzi FM, Bisanzi S, De Marco L, Giordano L, Camussi E, Del Mistro A, Zappa M. The Consensus Project: Participation in cervical cancer screening by the first cohorts of girls offered HPV vaccination at age 15-16 years in Italy. J Med Screen 2023; 30:142-149. [PMID: 36999190 DOI: 10.1177/09691413231165237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE To evaluate the association between human papillomavirus vaccination status and participation in cervical cancer screening (at age 25) by the first cohorts of girls who were offered vaccination at the age of 15 to 16 years in Italy. METHODS Women born in 1993, 1994 and 1995 were invited to participate in cervical cancer screening between 2018 and 2020. We report participation in screening by vaccination status in three large areas, Florence province, Piedmont region and Savona province, where the Consensus Project was carried out. The relative risk of participation among vaccinated (≥2 doses) and unvaccinated women was estimated. Odds ratios (OR) of participation by vaccination status were estimated by logistic regression, adjusted by birthplace and birth cohort. RESULTS Overall, 34,993 women were invited for screening: 13,006 (37.2%) participated and 10,062 of these agreed to participate in the Consensus intervention study. Among the invited women and screening participants, vaccinated women were 51.0% and 60.6%, respectively. Comparing vaccinated and unvaccinated women, the adjusted OR of screening participation was 1.80 (95% confidence interval (CI): 1.72-1.89), 2.17 (95% CI: 1.94-2.42), 1.59 (95% CI: 1.50-1.68) and 1.15 (95% CI: 0.86-1.54) for overall, Florence, Piedmont and Savona, respectively. About 33% of the invited women were unvaccinated and did not participate in screening: 25.8%, 59.5% and 64.2% of women born in Italy, in high migration pressure countries and in advanced development countries, respectively. CONCLUSIONS Screening participation was higher among vaccinated than unvaccinated women. Active policies are needed to reduce inequalities, targeting the unscreened and unvaccinated population, particularly non-native women, to accelerate cervical cancer elimination in Italy.
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Affiliation(s)
- Carmen B Visioli
- Clinical Epidemiology and Clinical Governance Support Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paola Armaroli
- Cancer Epidemiology Unit and Centre for Cancer Prevention (CPO), City of Health and Science Hospital, Turin, Italy
| | - Anna Iossa
- Screening and Secondary Prevention Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Raffaella Rizzolo
- Cancer Epidemiology Unit and Centre for Cancer Prevention (CPO), City of Health and Science Hospital, Turin, Italy
| | - Luigina A Bonelli
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ezio Venturino
- Pathological Anatomy Unit, ASL2 Liguria, San Paolo Hospital, Savona, Italy
| | - Francesca M Carozzi
- Regional Laboratory for Cancer Prevention, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Simonetta Bisanzi
- Regional Laboratory for Cancer Prevention, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Laura De Marco
- Cancer Epidemiology Unit and Centre for Cancer Prevention (CPO), City of Health and Science Hospital, Turin, Italy
| | - Livia Giordano
- Cancer Epidemiology Unit and Centre for Cancer Prevention (CPO), City of Health and Science Hospital, Turin, Italy
| | - Elisa Camussi
- Cancer Epidemiology Unit and Centre for Cancer Prevention (CPO), City of Health and Science Hospital, Turin, Italy
| | - Annarosa Del Mistro
- Immunology and Molecular Oncology Diagnostics, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Marco Zappa
- Clinical Epidemiology and Clinical Governance Support Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
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Chiorino G, Petracci E, Sehovic E, Gregnanin I, Camussi E, Mello-Grand M, Ostano P, Riggi E, Vergini V, Russo A, Berrino E, Ortale A, Garena F, Venesio T, Gallo F, Favettini E, Frigerio A, Matullo G, Segnan N, Giordano L. Plasma microRNA ratios associated with breast cancer detection in a nested case-control study from a mammography screening cohort. Sci Rep 2023; 13:12040. [PMID: 37491482 PMCID: PMC10368693 DOI: 10.1038/s41598-023-38886-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/17/2023] [Indexed: 07/27/2023] Open
Abstract
Mammographic breast cancer screening is effective in reducing breast cancer mortality. Nevertheless, several limitations are known. Therefore, developing an alternative or complementary non-invasive tool capable of increasing the accuracy of the screening process is highly desirable. The objective of this study was to identify circulating microRNA (miRs) ratios associated with BC in women attending mammography screening. A nested case-control study was conducted within the ANDROMEDA cohort (women of age 46-67 attending BC screening). Pre-diagnostic plasma samples, information on life-styles and common BC risk factors were collected. Small-RNA sequencing was carried out on plasma samples from 65 cases and 66 controls. miR ratios associated with BC were selected by two-sample Wilcoxon test and lasso logistic regression. Subsequent assessment by RT-qPCR of the miRs contained in the selected miR ratios was carried out as a platform validation. To identify the most promising biomarkers, penalised logistic regression was further applied to candidate miR ratios alone, or in combination with non-molecular factors. Small-RNA sequencing yielded 20 candidate miR ratios associated with BC, which were further assessed by RT-qPCR. In the resulting model, penalised logistic regression selected seven miR ratios (miR-199a-3p_let-7a-5p, miR-26b-5p_miR-142-5p, let-7b-5p_miR-19b-3p, miR-101-3p_miR-19b-3p, miR-93-5p_miR-19b-3p, let-7a-5p_miR-22-3p and miR-21-5p_miR-23a-3p), together with body mass index (BMI), menopausal status (MS), the interaction term BMI * MS, life-style score and breast density. The ROC AUC of the model was 0.79 with a sensitivity and specificity of 71.9% and 76.6%, respectively. We identified biomarkers potentially useful for BC screening measured through a widespread and low-cost technique. This is the first study reporting circulating miRs for BC detection in a screening setting. Validation in a wider sample is warranted.Trial registration: The Andromeda prospective cohort study protocol was retrospectively registered on 27-11-2015 (NCT02618538).
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Affiliation(s)
- Giovanna Chiorino
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Elisabetta Petracci
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Emir Sehovic
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy.
- Department of Life Sciences and Systems Biology, University of Turin, Turin, Italy.
| | - Ilaria Gregnanin
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Elisa Camussi
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Maurizia Mello-Grand
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Paola Ostano
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Emilia Riggi
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Viviana Vergini
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Alessia Russo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Enrico Berrino
- Department of Medical Sciences, University of Turin, Turin, Italy
- Pathology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy
| | - Andrea Ortale
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Francesca Garena
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Tiziana Venesio
- Pathology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy
| | - Federica Gallo
- Epidemiology Unit, Staff Health Direction, Local Health Authority 1 of Cuneo, Cuneo, Italy
| | | | - Alfonso Frigerio
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Giuseppe Matullo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Nereo Segnan
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy.
| | - Livia Giordano
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
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Riggi E, Baccini M, Camussi E, Gallo F, Anatrone C, Pezzana A, Senore C, Giordano L, Segnan N. Promoting healthy lifestyle habits among participants in cancer screening programs: Results of the randomized controlled Sti.Vi study. J Public Health Res 2022; 11:22799036221106542. [PMID: 35928498 PMCID: PMC9343860 DOI: 10.1177/22799036221106542] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Unhealthy diets, physical inactivity, alcohol and tobacco consumption are among the leading risk factors for non-communicable diseases. It is estimated that around 40% of cancers could be prevented by adopting healthy lifestyles. Design and methods: The Stili di Vita (Sti.Vi) study was a randomized study for assessing the impact of healthy lifestyle interventions on anthropometric measures, metabolic parameters, and health outcomes among participants of cancer screening programs in Turin (Italy). Eligible women aged 50–54 years, invited to biennial mammography screening, and 58-years-old men and women, invited to a once-only sigmoidoscopy for colorectal cancer (CRC) screening were randomly allocated to Diet group (DG), Physical Activity group (PAG), Physical Activity plus Diet group (PADG), or control group (CG). Physical and eating habits, metabolic and anthropometric measurements, repeatedly collected, were the study outcomes. The active intervention, offered to participants assigned to the DG, PAG, and PADG arms, consisted of a basic module and an advanced module. The effect of the interventions was estimated through logistic regression or a difference in differences approach. A multiple imputation procedure was implemented to deal with missing values and q-values have been calculated in the presence of multiple hypothesis testing. Results: Out of the 8442 screened attendees, 1270 signed informed consent, while 1125 participants accomplished the baseline visit. Participants were equally distributed across the four treatments as following: 273 (24.3%) in DG, 288 (25.6%) in the PAG, 283 (25.1%) in PADG, and 281 (25%) in the CG. Participants assigned to DG or PADG increased their consumption of whole grains (OR = 1.77, 95% CI: 1.20–2.60 and OR = 1.55, 95% CI: 1.06–2.27, respectively) and legumes (OR = 1.77, 95% CI: 1.12–2.79 and OR = 2.24, 95% CI: 1.41–3.57, respectively), with respect to CG. The participants randomized to DG reduced processed meat and increased fruit consumption (OR = 2.57, 95% CI: 1.76–3.76 and OR = 2.38, 95% CI: 1.12–5.06, respectively). The effects were more evident in the CRC screening subgroup. No relevant difference was observed between PAG and CG. No impact was observed on physical activity habits. Conclusions: Our findings suggest that active interventions can increase awareness and induce diet changes. However, participation rate and compliance to the courses was quite low, innovative strategies to enhance participants’ retention are needed, with the ultimate goal of increasing awareness and inducing positive lifestyle changes.
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Affiliation(s)
- Emilia Riggi
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy
| | - Elisa Camussi
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Federica Gallo
- Epidemiology Unit, Staff Health Direction, Local Health Authority 1 of Cuneo, Cuneo, Italy
| | - Caterina Anatrone
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Andrea Pezzana
- Dietetics and Clinical Nutrition Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Carlo Senore
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Livia Giordano
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Nereo Segnan
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
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Giordano L, Camussi E. [Screening and COVID-19: what to do and how make a virtue out of necessity?]. Epidemiol Prev 2022; 46:14-18. [PMID: 35354262 DOI: 10.19191/ep22.1-2.p014.009] [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: 06/14/2023]
Affiliation(s)
- Livia Giordano
- SSD epidemiologia e screening, CPO Piemonte, AOU Città della salute e della scienza, Torino;
| | - Elisa Camussi
- SSD epidemiologia e screening, CPO Piemonte, AOU Città della salute e della scienza, Torino
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Rousset S, Camussi E, Piccinelli C, Senore C, Armaroli P, Giordano L, Ferrante G, Bert F, Siliquini R. Depression and post-traumatic stress disorder symptoms during the COVID-19 pandemic in Italy. Eur J Public Health 2021. [PMCID: PMC8574706 DOI: 10.1093/eurpub/ckab164.013] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Social restrictions imposed by the Italian Government during the COVID-19 emergency might have had a significant impact on mental health. The purpose of this study was to estimate the prevalence of depressive and post-traumatic stress disorder (PTDS) symptoms in a sample of Italian citizens during the first COVID-19 pandemic wave. Materials and methods A cross-sectional survey was carried out between April and June 2020 using a snowball sampling. Depressive symptoms were explored through the Patient Heath Questionnaire-2 (PHQ-2), while the post-traumatic stress disorder (PTDS) was investigated through the SPAN (Startle, Physical arousal, Anger, Numbness) questionnaire. Poisson regression models were used to explore the association between the outcomes under study and sociodemographic/housing characteristics. Results A total of 10.758 interviews were collected and 7.847 (73%), complete for a minimum set of indicators (age, sex, area of residence), were included in the final analysis. The majority of the respondents were females (71%). Sample mean age was 48.6 years. The prevalence of depressive symptoms was 21.2% and that of PTDS was 43.8%. Symptoms of depression and PTDS significantly diminished across age groups, in particular in people over 70 years compared with people aged 14-29 years (PR 0.65, 95% CI 0.49-0.86). A higher prevalence was found in students compared with retired people, both for depressive symptoms (PR 1.49, 95% CI: 1.05-2.10) and PTDS (PR 1.31, 95% CI: 1.02-1.69). Conclusions Prevalence of depressive and PTDS symptoms was high, in particular among younger people and students. That could potentially lead to adverse mental health outcomes in the future, with serious public health consequences. As the pandemic emergency is not solved yet, it is necessary to implement preventive strategies in order to protect the mental well-being of particularly vulnerable subgroups in the population. Key messages The prevalence of psychological symptoms was high in this sample during the first wave of COVID-19 pandemic. The subgroups of the population at higher risk for adverse psychological outcomes were younger people and students.
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Affiliation(s)
- S Rousset
- Dipartimento di Scienze della Sanità Pubbliche e Pediatriche, Università di Torino, Turin, Italy
- Epidemiologia e Screening, CPO, Turin, Italy
| | - E Camussi
- Epidemiologia e Screening, CPO, Turin, Italy
| | | | - C Senore
- Epidemiologia e Screening, CPO, Turin, Italy
| | - P Armaroli
- Epidemiologia e Screening, CPO, Turin, Italy
| | - L Giordano
- Epidemiologia e Screening, CPO, Turin, Italy
| | - G Ferrante
- Epidemiologia e Screening, CPO, Turin, Italy
| | - F Bert
- Dipartimento di Scienze della Sanità Pubbliche e Pediatriche, Università di Torino, Turin, Italy
| | - R Siliquini
- Dipartimento di Scienze della Sanità Pubbliche e Pediatriche, Università di Torino, Turin, Italy
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Lesa L, Brunelli L, Valent F, Aprili I, Cametti E, Ferrari S, Camussi E, Degan S, De Corti D, Bellomo F, Tardivo S, Siliquini R, Brusaferro S. The underestimated burden of aspiration event and pneumonia within hospitals: what happens after dysphagia. Ann Ig 2021; 33:555-563. [PMID: 33565565 DOI: 10.7416/ai.2021.2436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Study design Prospective observational study. Background Despite dysphagia large prevalence and the growing ageing phenomenon occurring in European countries, aspiration events among inpatients are often underestimated, given their frequent spontaneous resolution or silent contribution to aspiration syndromes. Our main objective was to evaluate the incidence of aspiration events among medical inpatients and to identify risk factors influencing the outcome of the event. Methods Data about aspiration events - day, hour, type and outcome of the event occurred - along with underlying patient clinical conditions at the admission were collected. Between May 2015 and September 2016, data about aspiration event occurred among medical inpatients were collected in three large Italian hospitals. Results Patients affected by aspiration events were 135 on 102,619 cumulative days of hospitalization; they were mostly females (53%) with an average age of 82. The total incidence of aspiration events was of 1.4 every 1,000 days of hospitalization (C.I. 95%: 1.2-1.7) and the most frequent manifestation was cough (61.6%). The addition of drugs or an infection diagnosis during the 24 hours preceding the event acted as risk factors for those events that needed additional interventions during the hospitalization (OR 3.1 e OR 1.9 respectively), while the elimination of one or more prescribed drugs seemed to lead to aspiration events without impact on the hospitalization. Conclusions Results showed a large incidence of aspiration events within medical wards, many of them influencing patient outcomes. Healthcare professionals' attention concerning aspiration events should be fostered during the first hours and days of hospitalization.
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Affiliation(s)
- L Lesa
- Department of Medicine, University of Udine, Italy.,Medical Directorate, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine, Italy.,Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - F Valent
- Hygiene and Clinical Epidemiology Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - I Aprili
- Diagnostic and Public Health Department, University of Verona, Italy
| | - E Cametti
- Diagnostic and Public Health Department, University of Verona, Italy
| | - S Ferrari
- Diagnostic and Public Health Department, University of Verona, Italy
| | - E Camussi
- Public Health and Pediatric Science Department, University of Torino, Italy
| | - S Degan
- Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - D De Corti
- Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - F Bellomo
- Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - S Tardivo
- Diagnostic and Public Health Department, University of Verona, Italy
| | - R Siliquini
- Public Health and Pediatric Science Department, University of Torino, Italy
| | - S Brusaferro
- Department of Medicine, University of Udine, Italy
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9
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Ferrante G, Camussi E, Piccinelli C, Senore C, Armaroli P, Ortale A, Garena F, Giordano L. [Did social isolation during the SARS-CoV-2 epidemic have an impact on the lifestyles of citizens?]. Epidemiol Prev 2021; 44:353-362. [PMID: 33412829 DOI: 10.19191/ep20.5-6.s2.137] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES to study the impact of social isolation, related to the SARS-CoV-2 epidemic, on lifestyles in Italy, with particular reference to physical activity, alcohol consumption, smoking, and eating habits. Moreover, to investigate the association between lifestyle changes during the pandemic and sociodemographic characteristics. DESIGN epidemiological investigation based on a cross-sectional study. SETTING AND PARTICIPANTS between April 21st and June 7th 2020, an electronic questionnaire to collect information on physical activity, alcohol consumption, smoking, and eating habits during the period of home containment was made available on the web. Respondents were recruited through non-probabilistic snowball sampling. The link to the electronic questionnaire was disseminated through institutional websites, social networks (Facebook, Twitter), and messaging systems such as WhatsApp, Telegram, and SMS. A total of 10,758 interviews were collected, of which 7,847 (73%) were complete for a minimum set of indicators (age, gender, and area of residence). MAIN OUTCOME MEASURES reduction of physical activity, increase in alcohol consumption, increase in cigarette smoking, increase in consumption of unhealthy foods (processed meat, red meat or desserts) without increasing healthy foods (vegetables, legumes or whole grains) and, vice versa, increase in consumption of healthy foods without increasing unhealthy foods. RESULTS the population under study consists of 7,847 people with a mean age of 48.6 years (standard deviation: 13.9). Most of respondents are women (71.3%), 92.5% have a high school or university degree and 91% live in Northern Italy. During home containment, 56% of interviewees reported they had reduced the time devoted to physical activity. In particular, this happened among older people and those living in large cities. More than 17% of respondents increased their alcohol consumption, especially men, those highly educated and those living in large urban centres. Older age and residence in the Southern Italy represent, instead, protective factors for this outcome. Among smokers, 30% increased cigarette consumption during the period of home containment, on average of 5.6 cigarettes per day. A small proportion of former smokers (0.6%) resumed smoking. With regard to eating habits, 3 out of 10 respondents (29.9%) reported an inappropriate eating behaviour (increasing unhealthy food without increasing healthy ones). This behaviour was less frequent among men (adjusted Prevalence Ratio 0.80, p=0.005). A lower percentage of respondents (24.5%) increased the consumption of healthy foods without increasing the consumption of unhealthy ones. CONCLUSIONS the results of this survey show that social isolation during the SARS-CoV-2 pandemic has had an impact on citizens' behaviours. In particular, it was found a noteworthy increase in sedentariness, alcohol consumption, and tobacco smoking. A meaningful proportion of respondents reported a worsening of eating habits, especially among women. However, for each of the behavioural risk factors investigated, small proportions of respondents with resilient attitudes were also found, namely, capable of taking advantage of social isolation for improving their daily habits. Studying changes in lifestyles during a pandemic, identifying population groups most at risk of adopting unfavourable behaviours, is a useful tool for policy makers to plan targeted and effective public health interventions.
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Affiliation(s)
- Gianluigi Ferrante
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy);
| | - Elisa Camussi
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy)
| | - Cristiano Piccinelli
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy)
| | - Carlo Senore
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy)
| | - Paola Armaroli
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy)
| | - Andrea Ortale
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy)
| | - Francesca Garena
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy)
| | - Livia Giordano
- SSD Epidemiologia screening, CPO-AOU Città della salute e della scienza di Torino (Italy)
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10
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Bert F, Camussi E, Gili R, Corsi D, Rossello P, Scarmozzino A, Siliquini R. Transitional care: A new model of care from young age to adulthood. Health Policy 2020; 124:1121-1128. [DOI: 10.1016/j.healthpol.2020.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 11/26/2022]
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11
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Camussi E, Boccia T, Ciccone G, Coggiola D, Evangelista A, Scarmozzino A, Zarovska A, Siliquini R, Corsi D. [Qualitative experiential analysis of the BRASS scale.]. Recenti Prog Med 2020; 110:275-284. [PMID: 31282483 DOI: 10.1701/3182.31608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Hospital discharge can potentially represent an issue. Therefore, it is important to early identify patients at higher risk. A valid tool in this field is the Blaylock Risk Assessment Screening Score (BRASS). AIMS The study aims to elaborate a simplified score system, throughout the contribution of healthcare professionals considering the single items of the original score. METHODS The study included a qualitative analysis, conducted in order to draft the synthetic tool. Alongside, a statistical analysis was carried out. The findings of these two works were compared and joined in the realization of the proposed evaluation tool. RESULTS The synthetic tool, developed by the working team, is composed by 20 items. The qualitative analysis agrees with the statistical approach. Moreover, the qualitative analysis consented to redefine some items, especially considering social support, and to include some additional information e.g. clinical problems. LIMITATIONS The analysis considered only General Medicine wards, all located in the same Hospital. Therefore, generalisation to other settings or patients should be further tested. CONCLUSIONS The synthetic tool, realized during the study, aims to improve the individuation of at-risk inpatients. The agreement between statistical and qualitative analysis can be considered a point of strength of our work. Our analysis consented to include some new items, improving overall organization. In conclusion, the working group aims to conduct further study in order to individuate the more appropriate cut-off of the new scoring method.
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Affiliation(s)
- Elisa Camussi
- SC Direzione Sanitaria Presidio Molinette, AOU Città della Salute e della Scienza di Torino
| | - Tiziana Boccia
- SC Direzione Sanitaria Presidio Molinette, AOU Città della Salute e della Scienza di Torino
| | - Giovannino Ciccone
- SSD Epidemiologia Clinica e Valutativa CRPT, AOU Città della Salute e della Scienza di Torino
| | - Daniela Coggiola
- SC Direzione Professioni Sanitarie DiPSa, AOU Città della Salute e della Scienda di Torino
| | - Andrea Evangelista
- SSD Epidemiologia Clinica e Valutativa CRPT, AOU Città della Salute e della Scienza di Torino
| | - Antonio Scarmozzino
- SC Direzione Sanitaria Presidio Molinette, AOU Città della Salute e della Scienza di Torino
| | | | - Roberta Siliquini
- Università di Torino, AOU Città della Salute e della Scienza di Torino
| | - Daniela Corsi
- SC Direzione Sanitaria Presidio Molinette, AOU Città della Salute e della Scienza di Torino
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Quattrocolo F, D'Ambrosio A, Blanco V, Voglino G, Clemente S, Camussi E, Martorana M, Zotti CM. Prevalence of healthcare associated infections and antibiotic use in Piedmont’s acute care hospitals. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.551] [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: 11/12/2022] Open
Affiliation(s)
- F Quattrocolo
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - A D'Ambrosio
- Department of Public Health, University of Turin, Turin, Italy
| | - V Blanco
- Department of Public Health, University of Turin, Turin, Italy
| | - G Voglino
- Department of Public Health, University of Turin, Turin, Italy
| | - S Clemente
- Department of Public Health, University of Turin, Turin, Italy
| | - E Camussi
- Department of Public Health, University of Turin, Turin, Italy
| | - M Martorana
- Department of Public Health, University of Turin, Turin, Italy
| | - CM Zotti
- Department of Public Health, University of Turin, Turin, Italy
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13
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Scaioli G, Bert F, Gualano MR, Camussi E, Siliquini R. Inter-hospitals care pathway for Centers of Welcoming and Services for oncologic patients in Italy. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.154] [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)
- G Scaioli
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - F Bert
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - MR Gualano
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - E Camussi
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - R Siliquini
- Department of Public Health Sciences, University of Turin, Turin, Italy
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Voglino G, Gualano MR, Bert F, Camussi E, Thomas R, Siliquini R. The impact of intergenerational programs on children and elder adults. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- G Voglino
- Department of Public Health, University of Torino, Torino, Italy
| | - MR Gualano
- Department of Public Health, University of Torino, Torino, Italy
| | - F Bert
- Department of Public Health, University of Torino, Torino, Italy
| | - E Camussi
- Department of Public Health, University of Torino, Torino, Italy
| | - R Thomas
- Department of Public Health, University of Torino, Torino, Italy
| | - R Siliquini
- Department of Public Health, University of Torino, Torino, Italy
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15
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Bert F, Gualano MR, Biancone P, Brescia V, Camussi E, Martorana M, Thomas R, Secinaro S, Siliquini R. HIV screening in pregnant women: A systematic review of cost-effectiveness studies. Int J Health Plann Manage 2017; 33:31-50. [PMID: 28556453 DOI: 10.1002/hpm.2418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Vertical transmission represents the major route of HIV infection for children. However, the preventive interventions available are extremely effective. This review summarizes evidence regarding the cost-effectiveness of mother-to-child-transmission preventive screenings, to help policy makers in choosing the optimal antenatal screening strategy. METHODS A systematic review following PRISMA guidelines was conducted, using 3 databases: PubMed, Scopus, and Cost-Effectiveness Analysis Registry. All articles regarding HIV screening to avoid vertical transmission were included. RESULTS The review included 21 papers. Seven studies assessed the cost-effectiveness of universal antenatal screening during early gestation. Two papers considered the integration of HIV screening with other medical interventions. Eight works estimated the cost-effectiveness of HIV screening in late pregnancy. Finally, 4 papers considered the combination of multiple strategies. The selected papers focused on both developed and developing countries, with a different HIV prevalence. The characteristics and methodology of the studies were heterogeneous. However, all studies agreed about the main findings, outlining the cost-effectiveness of both universal antenatal screening and HIV rescreening in late pregnancy. Cost-effectiveness improved when HIV burden increased. The major findings were proved to be robust across various scenarios when tested in sensitivity analysis. CONCLUSIONS The review confirmed the cost-effectiveness not only of HIV universal antenatal screening but also of rescreening in late gestation in both developed and developing countries. Universal screening is cost-effective even in case of extremely low HIV prevalence. Therefore, to maximize screening, coverage appears as a worldwide priority. In certain settings, a targeted screening towards high-risk groups could be a valuable option.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | | | - Paolo Biancone
- Department of Management, University of Turin, Turin, Italy
| | | | - Elisa Camussi
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Maria Martorana
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Robin Thomas
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | | | - Roberta Siliquini
- Department of Public Health Sciences, University of Turin, Turin, Italy
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16
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Colombo A, Bert F, Camussi E, Gualano MR, Arensi D, Castaldo D, Siliquini R, Pirola ME. Analysis of users and reasons for use of a physician-on-call service in an Italian local health unit. Fam Pract 2016; 33:684-689. [PMID: 27559002 DOI: 10.1093/fampra/cmw089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In recent years, several countries have proposed changes to primary care organisation. OBJECTIVE Our study investigated the characteristics of 'physician-on-call' usage in a local health unit of Lombardy (ASL MI1). METHODS We analysed the incoming calls to the Operative Medical Central Station and collected the user characteristics, the call reasons and the outcomes from 1 October to 31 December 2012. Then, we randomly extracted 10% of the call sample from this period. We focused on two outputs: telephone advice (TA) and emergency department referral. We fit a logistic regression model to identify potential predictors of these outputs. RESULTS In total, we evaluated 2146 calls. Women made most of the calls. Older age was associated with the referral to emergency care [adjusted odds ratio (aOR) 3.1], while paediatric calls were associated with TA (aOR 1.9). Information requests were related to TA (aOR 2.3), while cardiovascular symptoms (aOR 3.5), pain (aOR 2.6) and traumas (aOR 4.7) were linked to emergency care. CONCLUSIONS Our study outlined the increasing use of TA, particularly for calls regarding paediatric patients. In contrast, calls for elderly patients were more frequently referred to emergency care. These findings led to the implementation of an age-targeted educational programme. Overall, our observations highlighted that women used the physician-on-call service more frequently than men. Furthermore, some reasons for calling were significantly associated with emergency care.
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Affiliation(s)
| | - Fabrizio Bert
- Department of Public Health, University of Torino, Torino, Italy,
| | - Elisa Camussi
- Department of Public Health, University of Torino, Torino, Italy
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17
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Gualano MR, Bert F, Camussi E, Pieve G, Voglino G, Siliquini R. Could Animal Assisted Intervention be implemented in public health programs? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw165.030] [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: 11/13/2022] Open
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18
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Camussi E, Gualano MR, Amprino V, Bert F, Siliquini R. A meta-analysis of Hepatitis B, Hepatitis C and HIV prevalence in prisons of high-income countries. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw166.053] [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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19
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Bert F, Gualano MR, Biancone P, Brescia V, Camussi E, Martorana M, Secinaro S, Siliquini R. HIV-screening in pregnant women: a systematic review of cost-effectiveness studies. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Lasagni A, Giordano P, Lacilla M, Raviolo A, Trento M, Camussi E, Grassi G, Charrier L, Cavallo F, Albera R, Porta M, Zanone MM. Cochlear, auditory brainstem responses in Type 1 diabetes: relationship with metabolic variables and diabetic complications. Diabet Med 2016; 33:1260-7. [PMID: 26605750 DOI: 10.1111/dme.13039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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] [Accepted: 11/18/2015] [Indexed: 01/29/2023]
Abstract
AIMS Few studies have analysed the presence of hearing abnormalities in diabetes. We assessed the presence of subclinical auditory alterations and their possible association with early vascular and neurological dysfunction in young adults with Type 1 diabetes of long duration. METHODS Thirty-one patients with Type 1 diabetes (mean age 33 ± 2.3 years, disease duration 25.7 ± 4.2 years) and 10 healthy controls underwent pure tone audiometry (PTA), distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) analyses. Associations with metabolic variables and chronic complications were explored. RESULTS Compared with healthy controls, patients with diabetes had significantly higher mean hearing thresholds, although still within the normoacusic range. DPOAE intensities at medium frequencies (2.8-4 kHz) were significantly lower in patients with diabetes. In ABR, in addition to waves I, III and V, we observed the appearance of a visible wave IV in patients with diabetes compared with controls (prevalence 61% vs. 10%, P < 0.05), and its appearance was related to a prolonged I-V interval (4.40 ± 0.62 ms vs. 4.19 ± 0.58 ms, P < 0.05). Diastolic blood pressure was higher in people with abnormal DPOAE (P < 0.05), whereas systolic blood pressure correlated with wave V and interpeak I-V interval latencies. A trend towards an association between evidence of wave IV and the presence of somatic neuropathy or abnormal cardiovascular autonomic tests was observed. CONCLUSIONS Young adults with long-term Type 1 diabetes have subclinical abnormalities in qualitative auditory perception, despite normal hearing thresholds, which might reflect neuropathic and/or vascular alterations.
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Affiliation(s)
- A Lasagni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - P Giordano
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - M Lacilla
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - A Raviolo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Trento
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - E Camussi
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - G Grassi
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - L Charrier
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - F Cavallo
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - R Albera
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - M Porta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - M M Zanone
- Department of Medical Sciences, University of Turin, Turin, Italy
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21
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Bert F, Gualano MR, Camussi E, Siliquini R. Risks and Threats of Social Media Websites: Twitter and the Proana Movement. Cyberpsychol Behav Soc Netw 2016; 19:233-8. [PMID: 26991868 DOI: 10.1089/cyber.2015.0553] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In recent years, there was a spread of "proanorexia" Web sites. The aim of our study is to investigate the presence, popularity, and content of the "proana" accounts on Twitter. On January 2015, we used "Twitter Search" to retrieve the "proana" accounts. For each account, we analyzed the number of followers, tweets, and the biographical information of the users. We followed these accounts for 4 weeks, assessing the variations in followers and tweets. We also investigated the most used hashtags and the main contents of these profiles. We retrieved 341 accounts. These accounts were popular (mean followers: 2360.9, range: 5-32,700) and active (mean tweets: 4351.2, range: 5-85,700). The users were mostly girls (97.9 percent), in general teenagers (mean age: 17.9 years, range: 12-28). Only around six percent of the accounts presented a warning text about the dangerous content. Each week, we found a mean increase in both followers and tweets. The five most used hashtags resulted in descending order as follows: "thinspo," "thinspiration," "Thin15," "EDprobs," and "proana." The most commonly used contents were in the following order: autobiographic, "thinspiration" photos (inspirational photos of extremely thin girls), "thinspiration" quotes (motivational mottos), "ana tips" (advices for weight loss), and "fasting competition." We underlined a concerning high number and popularity of Twitter proanorexia groups. These accounts contain dangerous information, especially considering the young age of the users. Given the lack of warnings in almost all the accounts, a first step to control this phenomenon could be the increase of such written alerts.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health Sciences, University of Turin , Turin, Italy
| | | | - Elisa Camussi
- Department of Public Health Sciences, University of Turin , Turin, Italy
| | - Roberta Siliquini
- Department of Public Health Sciences, University of Turin , Turin, Italy
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Camussi E, Bert F, Gualano MR, Siliquini R. Risks and threats of social media websites: Twitter and the pro-Ana movement. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv171.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Zanone MM, Favaro E, Miceli I, Grassi G, Camussi E, Caorsi C, Amoroso A, Giovarelli M, Perin PC, Camussi G. Human mesenchymal stem cells modulate cellular immune response to islet antigen glutamic acid decarboxylase in type 1 diabetes. J Clin Endocrinol Metab 2010; 95:3788-97. [PMID: 20466784 DOI: 10.1210/jc.2009-2350] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [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: 12/18/2022]
Abstract
CONTEXT Mesenchymal stem cells (MSCs) exert an immunosuppressive effect on the immune system. However, studies on the immunomodulatory potential of MSCs in type 1 diabetes are lacking. OBJECTIVE We aimed to evaluate whether human MSCs may inhibit in vitro pancreatic islet antigen-specific T cell activation in type 1 diabetes. DESIGN Human MSCs were isolated and characterized. Peripheral blood mononuclear cells (PBMCs) were obtained from nine type 1 diabetic patients at disease onset and 13 healthy control subjects. IFN-gamma, IL-10, and IL-4 enzyme-linked immunospot responses of lymphocytes incubated with glutamic acid decarboxylase 65 (GAD65) were investigated in PBMC cultures and PBMC/MSC cocultures. Levels of prostaglandin E2 (PGE2), IFN-gamma, IL-4, and IL-10 in supernatants were measured by ELISA. PGE2 inhibition experiments with NS-398 and indomethacin were also performed. RESULTS Five diabetic patients were identified with a positive PBMC IFN-gamma response to GAD65 and negative IL-10 and IL-4 response. PBMC/MSC cocultures resulted in a significant decrease in the number of spots and in detection of IL-4-secreting cells. PGE2 inhibitors abrogated the immune-suppressive effect, indicating an involvement of PGE2 production, and the constitutive production of PGE2 by MSCs was enhanced in PBMC/MSC coculture. Moreover, in GAD-responder patients, GAD-stimulated PBMC/MSC cocultures significantly decreased secretion of IFN-gamma and IL-10 and increased secretion of IL-4. CONCLUSIONS These results provide evidence that human MSCs abrogate in vitro a proinflammatory T helper type 1 response to an islet antigenic stimulus in type 1 diabetes. MSCs induce IL-4-producing cells, suggesting a possible switch to an antiinflammatory T helper type 2 signaling of T cells.
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Affiliation(s)
- Maria M Zanone
- Department of Internal Medicine, University of Turin, Turin, Italy.
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Bazzucchi M, Camussi E, Diani GM, Frattegiani T, Guerra M. [Radiologic and histologic aspects of 100 cases of ameloblastoma of the jaws]. Dent Cadmos 1987; 55:73-80. [PMID: 3477493] [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: 01/06/2023]
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