• Virtual reality environments for healthcare professional education Letter

    Saxena, Nakul
  • The “Code of Ethics of the Italian National Institute of Health” Editorial

    Petrini, Carlo; Ricciardi, Gualtiero
  • NGF and therapeutic prospective: what have we learned from the NGF transgenic models? Original Articles and Reviews

    Aloe, Luigi; Rocco, Maria Luisa

    Abstract in English:

    It has been shown that topical nerve growth factor (NGF) administration induces healing action on human cutaneous, corneal and pressure ulcers, glaucoma, maculopathy and retinitis pigmentosa suggesting a therapeutic potential of NGF in human ophthalmology and cutaneous ulcers. A similar therapeutic suggestion has emerged for the NGF gene therapy of Alzheimer's disease and ischemic heart injury. Moreover, over the last few years, the role and biological properties of NGF have also been investigated with transgenic mice over-expressing and down-expressing NGF. However, the results obtained with these transgenic mice seem suitable to confirm and/or support the evidence obtained with exogenous administration of NGF regarding the suggested clinical potentiality of NGF. The aim of the present brief review is to report and comment on these two different findings of NGF's healing properties.
  • A quality assessment of systematic reviews on telerehabilitation: what does the evidence tell us? Original Articles and Reviews

    Rogante, Marco; Kairy, Dahlia; Giacomozzi, Claudia; Grigioni, Mauro

    Abstract in English:

    Aims. To evaluate the quality of systematic reviews on telerehabilitation. Methods. The AMSTAR - Assessment of Multiple Systematic Reviews - checklist was used to appraise the evidence related to the systematic reviews. Results. Among the 477 records initially identified, 10 systematic reviews matched the inclusion criteria. Fifty percent were of high quality; anyway the majority of them did not report the following aspects: i) analysis of the grey literature; ii) a list of the excluded studies and their characteristics; iii) the identification of possible source of bias and the assessment of its likehood; iv) an appropriate method to combine the findings of the included studies addressing the heterogeneity as well. From the main findings of the high-scored systematic reviews telerehabilitation resulted at least as effective as usual care: 1) in the short term treatment of mental health related to people affected by spinal cord injury; 2) in rural communities for treating patients affected by chronic conditions; 3) in treating common pathologies (mainly asthma) affecting children and adolescents. As for stroke, evidence is currently insufficient to reach conclusions about its effectiveness. As for costs, there is insufficient evidence to confirm that telerehabilitation is a cost-saving or cost-effective solution. Conclusions. In the authors' knowledge this is the first attempt to evaluate the quality of systematic reviews on telerehabilitation. This work also identified the main findings related to the high-scored systematic reviews; the analysis confirms that there is a mounting evidence concerning the effectiveness of telerehabilitation, at least for some pathologies.
  • Ethyl glucuronide in vitreous humor and blood postmortem specimens: analysis by liquid chromatography-electrospray tandem mass spectrometry and interpreting results of neo-formation of ethanol Original Articles and Reviews

    Vezzoli, Sara; Bernini, Marzia; De Ferrari, Francesco

    Abstract in English:

    Introduction. The determination of ethyl glucuronide (EtG), a stable and sensitive marker that is specific to alcohol intake, finds many applications both in the forensic toxicology and clinical fields. Aim. The aim of the study is to examine the possibility of using a cadaveric biological matrix, vitreous humor (VH), to determine EtG as a marker of recent ethanol use. Methods. The blood, taken from the femoral vein, and the VH were obtained from 63 autopsy cases. Analysis of the EtG was performed using an LC/MS/MS system. Analyses of the ethanol and putrefaction biomarkers, such as acetaldehyde and n-propanol, were performed using the HS-GC/FID technique in both the matrices. Results. In 17 cases, both ethanol and EtG were absent in both matrices.Nineteen cases presented ethanol in blood from 0.05 to 0.30 g/L, EtG-Blood concentration from 0.02 to 3.27 mg/L, and EtG-VH concentration from 0.01 mg/L to 2.88 mg/L. Thirteen cases presented ethanol in blood > 0.05 g/L but EtG concentration in blood and VH lower than 0.01 mg/L, are part of these 8 samples presented acetic aldehyde and n- propanol in blood or VH, means identification of putrefaction indicators. Fourteen cases presented ethanol in blood > 0.46 and EtG concentration in blood and VH higher than 0.01 mg/L. Conclusions. The determination of EtG in biological material is important in those cases where the intake of ethanol appears doubtful, as it allows us to exclude the possibility of any post-mortem formation of ethanol.
  • Incense, sparklers and cigarettes are significant contributors to indoor benzene and particle levels Original Articles and Reviews

    Tirler, Werner; Settimo, Gaetano

    Abstract in English:

    Introduction. The increased use of incense, magic candles and other flameless products often produces indoor pollutants that may represent a health risk for humans. Today, in fact, incense and air fresheners are used inside homes as well as in public places including stores, shopping malls and places of worship. As a source of indoor contamination, the impact of smoke, incense and sparklers on human health cannot be ignored. Aim. In the present work, we report the results of an emission study regarding particles (PM10 and particle number concentration, PNC) and benzene, produced by various incense sticks and sparklers. Results and discussion.The results obtained for benzene, PM10 and PNC, showed a strong negative influence on air quality when these products were used indoors. Various incense sticks gave completely different benzene results: from a small increase of the benzene concentration in the air, just slightly above the background levels of ambient air, to very high concentrations, of more than 200 µg/m³ of benzene in the test room after the incense sticks had been tested.
  • Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery Original Articles and Reviews

    Cognetti, Gaetana; Grossi, Laura; Lucon, Antonio; Solimini, Renata

    Abstract in English:

    Introduction. Systematic reviews are fundamental sources of knowledge on the state-of-the-art interventions for various clinical problems. One of the essential components in carrying out a systematic review is that of developing a comprehensive literature search. Materials and methods. Three Cochrane systematic reviews published in 2012 were retrieved using the MeSH descriptor breast neoplasms/surgery, and analyzed with respect to the information sources used and the search strategies adopted. In March 2014, an update of one of the reviews retrieved was also considered in the study. Results. The number of databases queried for each review ranged between three and seven. All the reviews reported the search strategies adopted, however some only partially. All the reviews explicitly claimed that the searches applied no language restriction although sources such as the free database Lilacs (in Spanish and Portuguese) was not consulted. Conclusion. To improve the quality it is necessary to apply standards in carrying out systematic reviews (as laid down in the MECIR project). To meet these standards concerning literature searching, professional information retrieval specialist staff should be involved. The peer review committee in charge of evaluating the publication of a systematic review should also include specialists in information retrieval for assessing the quality of the literature search.
  • The role of associative and non-associative learning in the training of horses and implications for the welfare (a review) Original Articles and Reviews

    Baragli, Paolo; Padalino, Barbara; Telatin, Angelo

    Abstract in English:

    Horses were domesticated 6000 years ago and since then different types of approaches have been developed to enhance the horse's wellbeing and the human-horse relationship. Even though horse training is an increasingly important research area and many articles have been published on the subject, equitation is still the sport with the highest rate of human injuries, and a significant percentage of horses are sold or slaughtered due to behavioral problems. One explanation for this data is that the human-horse relationship is complex and the communication between humans and horses has not yet been accurately developed. Thus, this review addresses correct horse training based on scientific knowledge in animal learning and psychology. Specifically, it starts from the basic communication between humans and horses and then focuses on associative and non-associative learning, with many practical outcomes in horse management from the ground and under saddle. Finally, it highlights the common mistakes in the use of negative reinforcement, as well as all the implications that improper training could have on horse welfare. Increased levels of competence in horse training could be useful for equine technicians, owners, breeders, veterinarians, and scientists, in order to safeguard horse welfare, and also to reduce the number of human injuries and economic loss for civil society and the public health system.
  • Pathologic diagnosis of malignant mesothelioma: chronological prospect and advent of recommendations and guidelines Original Articles and Reviews

    Ascoli, Valeria

    Abstract in English:

    Malignant mesothelioma (MM) is rare and difficult to diagnose. Its identification depends upon pathological investigation (cyto-histological assessment and immunohistochemistry) supported by clinical and radiological evidence. In the last decade, the standardization of diagnostic methods has become a major focus of debate among pathologists and clinicians. This has led to the writing of guidelines and recommendation for the diagnosis to achieve the goal of a standard diagnosis. In this article, a chronological view relating to the pathological diagnosis of MM is presented together with a review of guidelines and recommendations.
  • Foodborne botulism associated with home-preserved turnip tops in Italy Brief Notes

    Anniballi, Fabrizio; Chironna, Elisa; Astegiano, Sara; Fiore, Alfonsina; Auricchio, Bruna; Buonincontro, Giuseppina; Corvonato, Maria; Segala, Vincenzo; Mandarino, Giuseppina; De Medici, Dario; Decastelli, Lucia

    Abstract in English:

    In Italy, foodborne botulism is a rare disease mainly due to home-preserved food. In the case reported here, clinical diagnosis was performed on the basis of clinical signs and referred consumption of home-preserved turnip tops in oil. Definitive diagnosis was performed by detection of botulinum toxin in sera and neuro-toxigenic organisms in stools and leftover food. This case report highlights the need of a high medical awareness, prompt clinical diagnosis, and synergic collaboration among the health authorities for a correct management of botulism as well as disease containment.
  • A study on prophagic and chromosomal sodC genes involvement in Escherichia coli O157:H7 biofilm formation and biofilm resistance to H2O2 Brief Notes

    Scotti, Raffaella; Nicolini, Laura; Stringaro, Annarita; Gabbianelli, Roberta

    Abstract in English:

    Introduction. Escherichia coli O157:H7 possesses one chromosomal and two prophagic sodC genes encoding for Cu,Zn superoxide dismutases. We evaluated the contribution of sodC genes in biofilm formation and its resistance to hydrogen peroxide. Methods. The biofilm of sodC deletion mutants has been studied, in presence or absence of hydrogen peroxide, by crystal violet in 96-well plates and Scanning Electron Microscopy on glass coverslips. Results. Deletion of prophagic sodC genes had no effect on biofilm construction, in contrast to the chromosomal gene deletion. Hydrogen peroxide treatment showed higher cell mortality and morphological alterations in sodC deletion mutants respect to wild type. These effects were related to the biofilm development stage. Conclusion. The role of the three SodCs is not redundant in biofilm formation and the resistance to oxidative damage. The stage of biofilm development is a crucial factor for an effective sanitization.
  • Preliminary investigation on tick fauna in the neighborhood of Tarquinia, Lazio, Italy Brief Notes

    Toma, Luciano; Khoury, Cristina; Bianchi, Riccardo; Severini, Francesco; Mancini, Fabiola; Ciervo, Alessandra; Ricci, Daniele; Fausto, Anna Maria; Quarchioni, Elisa; Di Luca, Marco

    Abstract in English:

    Introduction. This study represents a preliminary inquiry on tick fauna composition carried out in Maremma, Central Italy, where very few data are available. Materials and methods. The study area was selected in the limestone hills surrounding Tarquinia town, on the base of suitable elements directly affecting the tick occurrence and the possible circulation of tick-borne pathogens, such as wild cattle rearing, kind of vegetation and human activities. Since a proper understanding of tick ecology is critical in predicting the risk of tick-borne pathogen transmission in a given area, a series of surveys was planned in such area in 2011. Results. One hundred fifty-four ticks belonging to 4 genera and 6 species, namely Ixodes ricinus (n. = 109; 70%), Rhipicephalus bursa (n. = 18; 12%), Rhipicephalus turanicus (n. = 14; 9%), Rhipicephalus sanguineus (n. = 6; 4%), Hyalomma marginatum (n. = 4; 3%) and Dermacentor marginatus (n. = 3; 2%) were identified and reported for the area. Discussion. The results of this acarological research represent a significant contribution to the knowledge of the tick fauna of rural areas in Northern Lazio Region, as first step toward a future molecular investigation on pathogen circulation.
  • Barriers in the management of cancer-related pain and strategies to overcome them: findings of a qualitative research involving physicians and nurses in Italy Brief Notes

    Prandi, Cesarina; Garrino, Lorenza; Mastromarino, Paola; Torino, Francesco; Vellone, Ercole; Peruselli, Carlo; Alvaro, Rosaria

    Abstract in English:

    Introduction and aims. There are many barriers and obstacles that even today lead to an inadequate treatment of cancer-related pain. The aim is to describe the experiences of a group of Italian physicians and nurses as far as the nature of these barriers is concerned and the possible tools to be used to overcome them. Material and method. We run 5 focus groups with 42 healthcare professionals (11 physicians, 31 nurses) working in 5 hospitals in Italy. The findings of the focus groups were analysed according to the “Content Analysis” method. Results. Five main items emerged: the importance of communication, the need for education regarding pain therapy, the ethnic/cultural/religious differences, the mutual trust and support within the working group, the daily challenges. Conclusion. In harmony with the most recent literature, physicians and nurses voice above all their need for an education more directly aimed at overcoming the prevailing barriers rooted in ignorance, prejudice and fears.
  • The perception of the fetus in mothers with liver transplantation. Brief communication Brief Notes

    Ambrosini, Alessandra; Paddeu, Erica Maria; Donzelli, Gianpaolo; Stanghellini, Giovanni

    Abstract in English:

    Background. In this brief note we present the preliminary findings of a study of 16 women who underwent liver transplants before becoming pregnant and giving birth. The aim of the study was to show the similarities and differences between ways women experience the transplanted organ (liver) and the fetus. Methods. To explore bodily experiences, a semi-structured ad hoc interview was done on a sample of 16 transplanted women who had completed a pregnancy. The interview was designed to explore the possible similarities between their perception of the transplanted organ (liver) and of the fetus. Results. The main findings that emerge from our study are the following: a) in the post-transplant, pre-pregnancy phase, these women develop a polarized attention on the transplanted organ; b) during pregnancy this attention shifts towards the fetus; c) after childbirth the hyper-attention on the transplanted organ disappears and the subject resumes a normal relationship with her body. Conclusions. Therefore, pregnancy and childbirth are experiences that can normalize relations between a person who has undergone a transplant and their transplanted organ.
  • Books reviews, notes and comments Book Reviews, Notes and Comments

    Cheyne, Federica Napolitani
  • Publications from International Organizations on public health

    Rossi, Anna Maria
Istituto Superiore di Sanità Roma - Rome - Italy
E-mail: annali@iss.it