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Piscitelli P.,University of Florence | Chitano G.,Euro Mediterranean Scientific Biomedical Institute | Johannson H.,University of Sheffield | Brandi M.L.,University of Florence | And 2 more authors.
Osteoporosis International | Year: 2013

In order to update data underlying the Italian version of FRAX, we computed the national hip fracture incidence in Italy from hospitalization records for the year 2008. Mortality data and 10-year probabilities of major osteoporotic fractures were also updated. This revision will improve FRAX accuracy and reliability. Introduction: The original Italian version of FRAX® was based on five regional estimates of hip fracture risk undertaken up to 20 years previously. Our objective was to update hip fracture rates for the model with more recently derived data from the whole Italian population and more recent data on mortality. Methods: We analyzed the Italian national hospitalization database for the year 2008 in order to compute age- and sex-specific hip fracture incidence rates. Re-hospitalisations of the same patients within 1 year were excluded from the analysis. Hip fracture incidence rates were computed for the age range of 40-100 years, whereas the original FRAX model lacked data on the youngest and oldest age groups. In addition, we used the national mortality data for the same year 2008 to update the model. Ten-year fracture probabilities were re-calculated on the basis of the new fracture incidence rates. Results: The new hip fracture age- and sex-specific incidence rates were close to those used in the original FRAX tool, although some significant differences (not exceeding 25-30 %) were found for men aged 65-75 years and women under 55 years of age. In general, the revision resulted in decreased estimated 10-year probabilities in the younger age groups, whilst those in the older age groups were slightly increased. Conclusions: The Italian version of FRAX has been updated using the new fracture incidence rates. The impact of these revisions on FRAX is likely to increase the accuracy and reliability of FRAX in estimating 10-year fracture probabilities. © 2012 International Osteoporosis Foundation and National Osteoporosis Foundation.

Mazza A.,General Hospital Sarno | Mazza A.,CNR Institute of Neuroscience | Piscitelli P.,Southern Italy Hospital Institute | Piscitelli P.,Coleman LTD | And 3 more authors.
International Journal of Environmental Research and Public Health | Year: 2015

The region of Campania (particularly Naples and Caserta) has experienced an emergency in the waste management cycle during past years. Although the most critical phase has been overcome after the construction of the incineration plant in Acerra (an old-fashioned technology built up over a few months, whose impact on environment and health has not yet been assessed), most of the underlying problems have not been resolved. The illegal burning of wheels, plastics, textiles, and other industrial residuals, along with the detection of two thousand toxic substance dumping sites, still represents major concerns of environmental pollution and population health. This review summarizes the most relevant studies, which analyzed chemical contamination (primarily dioxins and polychlorinated biphenyls (PCBs)) of the air, soil, water, animals, and humans in Campania. In addition, we reviewed information on population health (i.e., mortality data, congenital malformations, and cancer incidence). Moving from a detailed mapping of (mostly illegal) waste dumping sites in Campania, we have focused on recent studies which have found: (a) high concentrations of dioxins (≥5.0 pg TEQ/g fat) in milk samples from sheep, cows, and river buffaloes; (b) remarkable contamination of dioxin and PCBs in human milk samples from those living in the Naples and Caserta areas (PCDDs+PCDFs and dioxin-like-PCBs (dl-PCBs) assessed at 16.6 pg TEQ/g of fat; range: 7.5–43 pg/g of fat); (c) potential age-adjusted standardized mortality rates associated with some specific cancer types; (d) a statistically significant association between exposure to illegal toxic waste dumping sites and cancer mortality, even after adjustment by socio-economic factors and other environmental indicators. © 2015 by the authors; licensee MDPI, Basel, Switzerland.

Piscitelli P.,Coleman LTD | Piscitelli P.,Coleman LTD | Neglia C.,Euro Mediterranean Scientific Biomedical Institute | Vigilanza A.,Euro Mediterranean Scientific Biomedical Institute | Colao A.,University of Naples Federico II
Current Opinion in Endocrinology, Diabetes and Obesity | Year: 2015

Purpose of review: Type 1 and type 2 diabetes mellitus are known to increase fracture risk. It is known that type 1 diabetes mellitus is associated with lower bone mineral density, but for type 2 diabetes mellitus, the real risk of increasing osteoporotic fractures is not explained by bone mineral density, which was found to be normal or paradoxically higher than controls in several studies, thus claiming for further investigations. This review summarizes some of the newest findings about factors that contribute to bone alterations in diabetic patients. Recent findings: Most recent evidences showed that bone of diabetic patients presents a cortical porosity which is not captured by the bidimensional densitometric measurements as performed by dual energy X-ray absorptiometry. Other studies investigated bone matrix searching for molecular mechanisms underlying the reduced bone strength in diabetic patients. The loss of bone biomechanical properties in diabetes has been associated to the glycated collagen matrix induced by hyperglycemia. Other studies analyzed the effect on bone microarchitecture of the most common antidiabetic drugs. Summary: Disease management of fracture risk in diabetic patients needs new methodologies of assessment that also take into account bone quality and evaluation of clinical risk factors, including balance, visual, and neurological impairments. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Piscitelli P.,Euro Mediterranean Scientific Biomedical Institute | Piscitelli P.,University of Salento | Feola M.,University of Rome Tor Vergata | Rao C.,University of Rome Tor Vergata | And 11 more authors.
World Journal of Orthopaedics | Year: 2014

Aim: To evaluate the hospitalization rate of femoral neck fractures in the elderly Italian population over ten years. Methods: We analyzed national hospitalizations records collected at central level by the Ministry of Health from 2000 to 2009. Age- and sex-specific rates of fractures occurred at femoral neck in people ≥ 65 years old. We performed a sub-analysis over a three-year period (2007-2009), presenting data per five-year age groups, in order to evaluate the incidence of the hip fracture in the oldest population. Results: We estimated a total of 839008 hospitalizations due to femoral neck fractures between 2000 and 2009 in people ≥ 65, with an overall increase of 29.8% over 10 years. The incidence per 10000 inhabitants remarkably increased in people ≥ 75, passing from 158.5 to 166.8 (+5.2%) and from 72.6 to 77.5 (+6.8%) over the ten-year period in women and men, respectively. The oldest age group (people > 85 years old) accounted for more than 42% of total hospital admissions in 2009 (n = 39000), despite representing only 2.5% of the Italian population. Particularly, women aged > 85 accounted for 30.8% of total fractures, although they represented just 1.8% of the general population. The results of this analysis indicate that the incidence of hip fractures progressively increased from 2000 to 2009, but a reduction can be observed for the first time in women ≤ 75 (-7.9% between 2004 and 2009). Conclusion: Incidence of hip fractures in Italy are continuously increasing, although women aged 65-74 years old started showing a decreasing trend. © 2014 Baishideng Publishing Group Inc.

Bortone I.,KISS Health Project Knowledge Intensive Social Services for Health | Argentiero A.,KISS Health Project Knowledge Intensive Social Services for Health | Agnello N.,KISS Health Project Knowledge Intensive Social Services for Health | Denetto V.,Euro Mediterranean Scientific Biomedical Institute | And 2 more authors.
Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, LNICST | Year: 2014

Back pain in children and adolescents is quite common, so developing preventive strategies for back pain is highly desirable.This article describes a planned school-based postural education project (PoSE) to promote healthy behaviors among middle school students and their families and to moderate postural diseases. As first step, we evaluated which aspects of postural behaviorswere integrated in children’s lifestyle through a questionnaire. Then, the educational program consisted of interactive lessons on back posture and good principles both in class and at home. The strength of the participatory approach used in this study lies in the contribution to empowerment social change. © Institute for Computer Sciences, Social Informatics and Telecommunications Engineering 2014.

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