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Corradini R.,Azienda Usl di Modena | Giuliani O.,Instituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST | Falcini F.,Instituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST | Sajani S.Z.,Regional Center for Environment and Health
Journal of Medical Screening | Year: 2016

Objective: To assess the impact of ambient temperature on faecal immunochemical test (FIT) performance in the colorectal cancer screening programme of Emilia-Romagna (Italy). Methods: A population-based retrospective cohort study on data from 2005 to 2011. Positive rate, detection rate, and positive predictive value rate for cancers and adenomas, and incidence rate of interval cancers after negative tests were analysed using Poisson regression models. In addition to ambient temperature, gender, age, screening history, and Local Health Unit were also considered. Results: In 1,521,819 tests analysed, the probability of a positive result decreased linearly with increasing temperature. Point estimates and 95% Confidence Intervals were estimated for six temperature classes (<5, 5 |-10, 10 |-15, 15 |-20, 20|-25 and ≥25°C), and referred to the 5|-10°C class. The positive rate ratio was significantly related to temperature increase: 0.99 (0.97-1.02), 1, 0.98 (0.96-1.00), 0.96 (0.94-0.99), 0.93 (0.91-0.96), 0.92 (0.89-0.95). A linear trend was also evident for advanced adenoma detection rate ratio: 1.00 (0.96-1.04), 1, 0.98 (0.93-1.02), 0.96 (0.92-1.00), 0.92 (0.88-0.96), 0.94 (0.88-1.01). The effect was less linear, but still important, for cancer detection rates: 0.95 (0.85-1.06), 1, 1.00 (0.90-1.10), 0.94 (0.85-1.05), 0.81 (0.72-0.92), 0.93 (0.80-1.09). No association or linear trend was found for positive predictive values or risk of interval cancer, despite an excess of +16% in the highest temperature class for interval cancer. Conclusions: Ambient temperatures can affect screening performance. Continued monitoring is needed to verify the effect of introducing FIT tubes with a new buffer, which should guarantee a higher stability of haemoglobin. © The Author(s) 2016.


Guidi E.,Azienda USL di Modena | Cuoghi G.,Azienda USL di Modena
Industrie Alimentari | Year: 2014

The survival of Listeria monocytogenes in ready-to-eat frozen broth was evaluated utilizing the Microbiological Challenge Test in order to confirm the date of minimum durability of 12 months and demonstrate that the limit 100 cfu/g will not be exceeded during the product shelf-life. The results show that the microorganism is not detected after 24h in samples artificially contaminated with 2 cfu/mL. In addition, its concentration decreases progressively even in food products with a higher level of contamination (102 and 104 cfu/mL) stored at both -18°C and -10°C. Consequently, if the bacterium concentration is ≤100 cfu/mL, this value is not exceeded during and after the date of minimum durability, which is confirmed. Therefore, regarding Listeria monocytogenes, the food safety criterion of 100 cfu/g can be used instead of absence in 25 g, when the product is placed on the market during its shelf-life.


Marinaccio A.,ISPESL Instituto Superiore per la Prevenzione e la Sicurezza del Lavoro | Di Marzio D.,ISPESL Instituto Superiore per la Prevenzione e la Sicurezza del Lavoro | Binazzi A.,ISPESL Instituto Superiore per la Prevenzione e la Sicurezza del Lavoro | Napoli G.,Azienda USL Viterbo | And 14 more authors.
Medicina del Lavoro | Year: 2010

Background: Legislation in Italy concerning health, safety and prevention at the workplace recently established a new data communication standard. Objectives: The findings are reported of a spe-cific survey on 18 Local Health Units (ASL) over the entire Italian territory, aimed at identifying the critical points in data management and analyze the available information. Methods: The occupational health physician for each company must collect and transmit information on the number of workers submitted to health surveillance protocols to the Local Health Unit. Information must be divided by risk factor and gender. Local health Units then transmit the data to the Regions and finally to the Italian National Institute for Occupational Safety and Prevention (ISPESL). Results: A sample of'22.977 companies was studied, providing information on about 410,009 workers undergoing health surveillance protocols. Carrying or moving heavy loads, exposure to noise, VDU and chemical substances were the most frequent risk factors. The difference between genders was significant in risk allocation, with exposures to VDU and biological agents prevalently among females. Conclusions: The information thus collected suffered from a lack of data organization and completeness in the sample under study, but nevertheless provides preliminary evidence of a map of occupational risks on a national basis, confirming the potential for the new law (D.Lgs 81/2008) to investigate health safety and prevention at the workplace.


PubMed | Instituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST and Azienda Usl di Modena
Type: | Journal: European journal of cancer care | Year: 2016

There is a lack of agreement about which routine invitation strategy should be adopted in colorectal cancer screening. We conducted an observational study to assess the impact of three invitation strategies on participation. Invitation records for the years 2005-2009 were evaluated. There were 2,234,276 invitations from 1,230,683 individuals. Among first invitations, participation associated with direct mailing of the faecal occult blood test kits was slightly lower (relative risk, RR 0.985; 95% confidence interval 0.979-0.990) than that of the reference invitation strategy, that is, the distribution of the test kits by pharmacies. In repeated invitations/previous non-responders, the participation associated with the direct mailing of the test kits was even lower (RR 0.914; 95% confidence interval 0.895-0.933) and this was also the case for the distribution of the test kits by primary care centres (RR 0.983; 95% confidence interval 0.971-0.995). In contrast, in repeated invitations/previous responders, the impact of primary care centres and direct mailing of the test kits was greater than the use of pharmacies, showing only modest RRs: 1.021 (95% confidence interval 1.019-1.023) and 1.029 (95% confidence interval 1.025-1.033) respectively. The faecal occult blood test mailing strategy modestly increased participation in previous responders.


PubMed | Regional Center for Environment and Health, Instituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST IRCCS and Azienda Usl di Modena
Type: Journal Article | Journal: Journal of medical screening | Year: 2016

To assess the impact of ambient temperature on faecal immunochemical test (FIT) performance in the colorectal cancer screening programme of Emilia-Romagna (Italy).A population-based retrospective cohort study on data from 2005 to 2011. Positive rate, detection rate, and positive predictive value rate for cancers and adenomas, and incidence rate of interval cancers after negative tests were analysed using Poisson regression models. In addition to ambient temperature, gender, age, screening history, and Local Health Unit were also considered.In 1,521,819 tests analysed, the probability of a positive result decreased linearly with increasing temperature. Point estimates and 95% Confidence Intervals were estimated for six temperature classes (<5, 5 |-10, 10 |-15, 15 |-20, 20|-25 and 25), and referred to the 5|-10 class. The positive rate ratio was significantly related to temperature increase: 0.99 (0.97-1.02), 1, 0.98 (0.96-1.00), 0.96 (0.94-0.99), 0.93 (0.91-0.96), 0.92 (0.89-0.95). A linear trend was also evident for advanced adenoma detection rate ratio: 1.00 (0.96-1.04), 1, 0.98 (0.93-1.02), 0.96 (0.92-1.00), 0.92 (0.88-0.96), 0.94 (0.88-1.01). The effect was less linear, but still important, for cancer detection rates: 0.95 (0.85-1.06), 1, 1.00 (0.90-1.10), 0.94 (0.85-1.05), 0.81 (0.72-0.92), 0.93 (0.80-1.09). No association or linear trend was found for positive predictive values or risk of interval cancer, despite an excess of +16% in the highest temperature class for interval cancer.Ambient temperatures can affect screening performance. Continued monitoring is needed to verify the effect of introducing FIT tubes with a new buffer, which should guarantee a higher stability of haemoglobin.


OBJECTIVE: postpartum depression is one of the most important and common health problems. The aim of this study is to investigate and determine significant risk factors associated with the development of postnatal depressive symptomatology at 6-8 weeks after childbirth in a sample of Italian women.DESIGN: retrospective study on risk factors related to the development of postnatal depressive symptomatology at 6-8 weeks after childbirth.SETTING AND PARTICIPANTS: the study was conducted in the Southern Area of the Local Health Unit of Modena: 300 women who gave birth in Pavullo in the Frignano's Hospital or in Sassuolo's Hospital from 13.12.2009 to 3.2.2010 were considered.METHODS: four weeks after delivery, women had to complete the Postpartum Depression Predictors Inventory-Revised (PDPI-R) to detect the presence of specific risk factors. Then a double-test strategy, including the Edinburgh Postnatal Depression Scale (EPDS) and the General Health Questionnaire 12 items (GHQ12) at 6-8 weeks after childbirth, was used. The women who scored values above the cut-off in both tests have been considered to have high depressive symptomatology.RESULTS: risk factors associated with postnatal depressive symptomatology were: low self-esteem, prenatal anxiety, prior depression, child care stress and baby blues (p <0.01), prenatal depression, lack of social support from partner and difficult infant temperament (p <0.05).CONCLUSION: 14.3% of the women considered showed high depressive symptomatology at 6-8 weeks after delivery (according to the prevalence rates of postpartum depression in Western Countries). Furthermore, the results (risk factors) mainly confirmed the evidence of the international literature.


The principal aim of this article is to consider the different roles and competencies of both clinical pharmacists and POD's (Patients' Own Drugs) Technicians, and to discuss their potential relevance in the ongoing discussion on the pilot experience focused on the development of a clinical pharmacist figure in Italy. Should hospital pharmacists be involved in the clinical management of patients, liaising with medical and nursing staff on the ward? Will professional education be required for different roles in the future? Will it be necessary to develop specialist pharmacists, each with knowledge of a different clinical field (for example neurology, cardiolgy, orthopaedics, nutrition ...)? Is there a real need for the Hospital Pharmacist to develop his role and career towards new objectives?


Rivetti S.,Servizio Fisica Sanitaria | Lanconelli N.,University of Bologna | Bertolini M.,Arcispedale Santa Maria Nuova | Nitrosi A.,Arcispedale Santa Maria Nuova | And 2 more authors.
Medical Physics | Year: 2010

Purpose: In this study, five different units based on three different technologies-traditional computed radiography (CR) units with granular phosphor and single-side reading, granular phosphor and dual-side reading, and columnar phosphor and line-scanning reading-are compared in terms of physical characterization and contrast detail analysis. Methods: The physical characterization of the five systems was obtained with the standard beam condition RQA5. Three of the units have been developed by FUJIFILM (FCR ST-VI, FCR ST-BD, and FCR Velocity U), one by Kodak (Direct View CR 975), and one by Agfa (DX-S). The quantitative comparison is based on the calculation of the modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE). Noise investigation was also achieved by using a relative standard deviation analysis. Psychophysical characterization is assessed by performing a contrast detail analysis with an automatic reading of CDRAD images. Results: The most advanced units based on columnar phosphors provide MTF values in line or better than those from conventional CR systems. The greater thickness of the columnar phosphor improves the efficiency, allowing for enhanced noise properties. In fact, NPS values for standard CR systems are remarkably higher for all the investigated exposures and especially for frequencies up to 3.5 lp/mm. As a consequence, DQE values for the three units based on columnar phosphors and line-scanning reading, or granular phosphor and dual-side reading, are neatly better than those from conventional CR systems. Actually, DQE values of about 40% are easily achievable for all the investigated exposures. Conclusions: This study suggests that systems based on the dual-side reading or line-scanning reading with columnar phosphors provide a remarkable improvement when compared to conventional CR units and yield results in line with those obtained from most digital detectors for radiography. © 2010 American Association of Physicists in Medicine.


Coronary artery disease is the leading cause of morbidity and mortality in patients with type 2 diabetes. Screening for asymptomatic coronary artery disease with treatment by means of revascularization seems to be an appealing option for prevention. The utility of such a strategy has never been challenged in a randomized trial.In the present study a cohort of diabetic patients without any symptoms and without known coronary artery disease will be screened at two diabetes outpatients services. Those with intermediate or high risk (equal or greater than 10% according to the Italian risk chart) will be asked to participate and enrolled. They will be seen and followed in order to provide the best adherence to medical therapy. Half of the patients will be randomized to undergo an exercise tolerance testing while the other group will continue to be regularly seen at diabetes outpatients services. Best medical/behavioral therapy will be offered to both groups. Those patients with a positive exercise tolerance testing will be studied by coronary angiography and treated according to the severity of coronary lesions by percutaneous stenting or surgery.The objective of the study is to evaluate the efficacy of the screening strategy aimed at revascularization. A cost-effectiveness analysis will be performed at the end of the follow up.The study will provide useful information about prevention and treatment of diabetic patients at high risk of coronary events. It will be made clearer if detection of silent coronary artery disease has to be recommended and followed by treatment. Given the simplicity of the study protocol, it will be easily transferable to the real world.(ClinicalTrials.gov): NCT00547872.

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