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1.
Minerva Anestesiol ; 87(2): 144-146, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-1089296
4.
J Cardiovasc Med (Hagerstown) ; 22(1): 9-13, 2021 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1081605

RESUMEN

: The worldwide response to the current COVID-19 pandemic has been focused on how to prevent the disease and to protect the high-risk patient from a potentially lethal infection. Several consensus and guidelines articles have been published dealing with the cardiac patient with systemic hypertension, heart transplant or heart failure. Very little is known about the patients, both in the pediatric as well as in the adult age, with congenital heart disease. The peculiar physiology of the heart with a native, repaired or palliated congenital heart defect deserves a specialized care. Hereby we describe the early recommendations issued by the Italian Society of Pediatric Cardiology and Congenital Heart Disease and how the network of the congenital cardiac institutions in Italy reacted to the threat of potential wide spread of the infection among this fragile kind of patient.


Asunto(s)
/prevención & control , Cardiología/organización & administración , Cardiopatías Congénitas/terapia , Adulto , Niño , Trasplante de Corazón , Humanos , Italia , Guías de Práctica Clínica como Asunto , Sociedades Médicas
6.
Front Immunol ; 11: 609198, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1080669

RESUMEN

During COVID-19 pandemic the care of onco-hematologic and autoimmune patients has raised the question whether they are at higher risk of infection and/or worse outcome. Here, we describe the clinical course of COVID-19 pneumonia in patients with autoimmune cytopenias (AIC) regularly followed at a reference center in Northern Italy. The study period started from COVID-19 outbreak (February 22, 2020) until the time of writing. Moreover, we provide a review of the literature, showing that most cases reported so far are AIC developed during or secondary to COVID-19 infection. At variance, data about AIC pre-existing to COVID infection are scanty. The 4 patients here described (2 autoimmune hemolytic anemias, AIHA, 1 Evans syndrome, and 1 immune thrombocytopenia) with COVID-19 pneumonia belong to a large cohort of 500 AIC patients, making this study nearly population-based. The observed frequency (4/501; 0.7%) is only slightly superior to that of the general population admitted to hospital/intensive care unit (0.28/0.03%, respectively) in Lombardy in the same period of observation. All cases occurred between March 21 and 25, whilst no more AIC were recorded later on. Although different in intensity of care needed, all patients recovered from COVID-19 pneumonia, with apparently no detrimental effect of previous/current immunomodulatory treatments. AIHA relapse occurred in two patients, but promptly responded to therapy. With limitations due to sample size, these results suggest a favorable outcome and a lower-than-expected incidence of COVID-19 pneumonia in patients with previously diagnosed AIC, and allow speculating that immunomodulatory drugs used for AIC may play a beneficial rather than a harmful effect on COVID-19 infection.


Asunto(s)
Anemia Hemolítica Autoinmune/complicaciones , Neumonía Viral/epidemiología , Púrpura Trombocitopénica Idiopática/complicaciones , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Italia/epidemiología , Masculino , Persona de Mediana Edad , Neumonía Viral/virología , Adulto Joven
7.
J Sports Med Phys Fitness ; 61(2): 294-300, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: covidwho-1079891

RESUMEN

BACKGROUND: During the COVID-19 pandemic, the Italian government took security measures to try to limit infections. Restrictive measures included social distancing, home confinement and the closure of all public structures like gyms and swimming pools. The impact of these limitations on health and lifestyle was inevitably negative. The purpose of this study was to establish the level of physical activity (PA), expressed as energy expenditure (MET-minute/week) in a Southern Italian population before and during the COVID-19 lockdown. METHODS: An adapted version of the International Physical Activity Questionnaire-short form (IPAQ-SF) was published on the official website of the National Institute of Gastroenterology IRCCS S. de Bellis, Castellana Grotte, Bari, Italy and on several social media in May 2020. RESULTS: Three hundred ten replies (72% women) from Apulia (60%), Calabria (28%), Campania (11%) and Sicily (1%) were included in the study. The COVID-19 lockdown had a negative effect on the vigorous PA intensity level and on walking, but not on the moderate PA intensity level. Additionally, daily time spent sitting down increased by more than 12% during the COVID-19 lockdown. CONCLUSIONS: Isolation changed PA behaviors. The decreased energy expenditure (MET-minute/week) during the lockdown had a negative impact in both genders, especially on the young adults and adults' groups.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles , Ejercicio Físico , Adulto , Anciano , Estudios Transversales , Metabolismo Energético , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Sedestación , Encuestas y Cuestionarios , Caminata
8.
Ann Ig ; 33(2): 201-202, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1079810

RESUMEN

the SARS-CoV-2 pandemic started in December 2019 and still remains a major global health issue. Every country in the world has adopted drastic measures to contain the virus, although their stringency varies among countries, ranging from increased surveillance and focused interventions to strict lockdown (1). Italy was the second country where the disease had a major impact early in the pandemic, such that a strict nationwide lockdown was declared from March 9 to May 3, 2020. Nonetheless, between January and May 2020, there were 210,000 COVID-19 cases in Italy and 29,000 deaths were recorded (2). Due to the lockdown, universities (and in general all educational services) shifted to online classes, with students attending lessons and taking their exams from home. On-site activities were reduced to those considered indispensable. Research activities also had to be modified, such as by the adoption of a smart-working model (3). Between May and August 2020, the number of SARS-CoV-2 infections in Italy decreased. In response, the lockdown was loosened and some activities were restarted, albeit with specific safety protocols (social distancing, use of masks, temperature checks at the workplace entry, environmental disinfection, mixed models of smart and in-office work). These actions were accompanied by periodic serological and PCR screening tests (4).


Asunto(s)
/prevención & control , Pandemias , Universidades , /epidemiología , Control de Enfermedades Transmisibles/métodos , Humanos , Italia/epidemiología , Máscaras , Vacunación
9.
J Med Internet Res ; 23(2): e23467, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: covidwho-1073218

RESUMEN

BACKGROUND: Many countries across the globe have released their own COVID-19 contact tracing apps. This has resulted in the proliferation of several apps that used a variety of technologies. With the absence of a standardized approach used by the authorities, policy makers, and developers, many of these apps were unique. Therefore, they varied by function and the underlying technology used for contact tracing and infection reporting. OBJECTIVE: The goal of this study was to analyze most of the COVID-19 contact tracing apps in use today. Beyond investigating the privacy features, design, and implications of these apps, this research examined the underlying technologies used in contact tracing apps. It also attempted to provide some insights into their level of penetration and to gauge their public reception. This research also investigated the data collection, reporting, retention, and destruction procedures used by each of the apps under review. METHODS: This research study evaluated 13 apps corresponding to 10 countries based on the underlying technology used. The inclusion criteria ensured that most COVID-19-declared epicenters (ie, countries) were included in the sample, such as Italy. The evaluated apps also included countries that did relatively well in controlling the outbreak of COVID-19, such as Singapore. Informational and unofficial contact tracing apps were excluded from this study. A total of 30,000 reviews corresponding to the 13 apps were scraped from app store webpages and analyzed. RESULTS: This study identified seven distinct technologies used by COVID-19 tracing apps and 13 distinct apps. The United States was reported to have released the most contact tracing apps, followed by Italy. Bluetooth was the most frequently used underlying technology, employed by seven apps, whereas three apps used GPS. The Norwegian, Singaporean, Georgian, and New Zealand apps were among those that collected the most personal information from users, whereas some apps, such as the Swiss app and the Italian (Immuni) app, did not collect any user information. The observed minimum amount of time implemented for most of the apps with regard to data destruction was 14 days, while the Georgian app retained records for 3 years. No significant battery drainage issue was reported for most of the apps. Interestingly, only about 2% of the reviewers expressed concerns about their privacy across all apps. The number and frequency of technical issues reported on the Apple App Store were significantly more than those reported on Google Play; the highest was with the New Zealand app, with 27% of the reviewers reporting technical difficulties (ie, 10% out of 27% scraped reviews reported that the app did not work). The Norwegian, Swiss, and US (PathCheck) apps had the least reported technical issues, sitting at just below 10%. In terms of usability, many apps, such as those from Singapore, Australia, and Switzerland, did not provide the users with an option to sign out from their apps. CONCLUSIONS: This article highlighted the fact that COVID-19 contact tracing apps are still facing many obstacles toward their widespread and public acceptance. The main challenges are related to the technical, usability, and privacy issues or to the requirements reported by some users.


Asunto(s)
Actitud , Trazado de Contacto/métodos , Aplicaciones Móviles , Privacidad , Australia , Recolección de Datos , Brotes de Enfermedades , Sistemas de Información Geográfica , Georgia (República) , Humanos , Italia , Nueva Zelanda , Noruega , Singapur , Suiza , Tecnología , Estados Unidos , Tecnología Inalámbrica
10.
Acta Biomed ; 91(14-S): e2020028, 2020 12 30.
Artículo en Inglés | MEDLINE | ID: covidwho-1070033

RESUMEN

INTRODUCTION AND AIM: The Coronavirus pandemic represents one of the most massive health emergencies in the last century. Aim of the study is to evaluate the trend of E.R. accesses and orthopaedic events during the pandemic of Covid-19. MATERIALS AND METHODS: we retrospectively analysed all data related to patients admitted to the E.R. Department of the Hospital of Piacenza from August 26th 2019 to August 23rd 2020, splitting this period on February 23rd 2020. RESULTS: Our analysis shows a reduction of -18.0% in E.R. accesses. We calculated a growth of deaths in the E.R. equal to +220%. Our orthopaedic pathway recorded a drop of -26.8%. Traumas occurred at home increased (+19.1%). We note an actual drop only on proximal femur fractures (weighted average of -17.7%), while all the others underwent an increase. DISCUSSION: The amount of E.R. accesses registered a drop -18.0%, while the pathway dedicated to emergency cases underwent an increase. The major complexity of clinical conditions influenced the number of hospitalizations and the fear of the infection increased hospitalization refusals. There has been a zeroing of school traumas, a reduction in sport, transfer home-work/work-home, work, roadside, injuries. Total amount of fractures strongly increase after the end of the lockdown. CONCLUSION: our data confirmed the decrease of retirement houses, sports, works and roadsides traumas and a zeroing of schools ones, while those occurred inside domestic environment underwent a consistent raise. We noticed a reduction in femur fractures and significant spread of all fractures after the end of the lockdown.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Ortopedia/estadística & datos numéricos , Fémur/lesiones , Fracturas Óseas/epidemiología , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hospitalización , Humanos , Italia , Pandemias , Estudios Retrospectivos , Heridas y Traumatismos/epidemiología
11.
Int J Environ Res Public Health ; 18(4)2021 02 05.
Artículo en Inglés | MEDLINE | ID: covidwho-1069810

RESUMEN

Coronaviruses (CoVs) are a large family of respiratory viruses that can cause mild to moderate illness. The new variant COVID-19 has started to spread rapidly since December 2019, posing a new threat to global health. To counter the spread of the virus, the Italian government forced the population to close all activities starting from 9 March 2020 to 4 May 2020. In this scenario, we conducted a cross-sectional study on a heterogeneous sample (average age of 28 ± 12 years, 62.6% females) of the University of Naples Federico II (Italy). The aim of the study was to describe the lifestyle change in the university population during quarantine for the COVID 19 pandemic. Participants compiled an online survey consisting of 3 sections: socio-demographic data, dietary behaviours, physical activity habits and psychological aspects. The different results by gender are: 90.8% of females continued to work from home (81.9% were students); 34.8% increased their physical activity; and, only 0.8% prefer ready meals. Whereas, the same percentage of men continued to work from home (90%), but only 72.1% were students (p < 0.001 vs. females), only 23.9% increased physical activity (p < 0.001) and 1.7% favous ready meals. Our data shows that the male population was more affected by isolation and quarantine reporting more unfavourable behavioural changes.


Asunto(s)
Dieta , Ejercicio Físico , Docentes , Pandemias , Estudiantes , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Estilo de Vida , Masculino , Cuarentena , Encuestas y Cuestionarios , Universidades , Trabajo , Adulto Joven
12.
Front Public Health ; 8: 591900, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1069767

RESUMEN

On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic. Simultaneously, in Italy, in which the first case had occurred on February 18, the rigid phase of the lockdown began. The country has attracted worldwide attention, becoming at the same time a field of study both concerning the spread of the pandemic and advanced assessments of the effectiveness of political, public health, and therapeutic measures. The protagonists of the Italian crisis were the healthcare workers (HCWs) who were exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without having any perception of what they were facing, courageously contributing to the containment of the epidemic to be defined by the media as "heroes." However, in the first phase of the pandemic (March-May 2020), the price that the Italian Public Health System had to pay both in terms of the number of positive virus cases and deaths among the HCWs was beyond and represented a peculiarity compared to what happened in other countries. In the current study, after a summary of the evolution of the pandemic in Italy, we offer an analysis of the statistical data concerning contagions and deaths among healthcare workers (physicians in particular). In conclusion, we describe the critical issues that still need to be resolved and the future challenges facing healthcare workers and the general population.


Asunto(s)
Control de Enfermedades Transmisibles , Personal de Salud/estadística & datos numéricos , ARN Mensajero , /epidemiología , Personal de Salud/ética , Humanos , Italia/epidemiología , Persona de Mediana Edad , Equipo de Protección Personal , Salud Pública , Encuestas y Cuestionarios
13.
Ital J Pediatr ; 47(1): 24, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: covidwho-1069577

RESUMEN

BACKGROUND: Italy was the first Western country to be hit by the SARS-CoV-2 epidemic. There is now mounting evidence that a minority of children infected with SARS-CoV2 may experience a severe multisystem inflammatory syndrome, called Multisystem inflammatory Syndrome associated with Coronavirus Disease 2019 (MIS-C). To date no universally agreed approach is available for this disease. MAIN BODY: as Italy is now facing a second hity of COVID-19 cases, we fear a recrudescence of MIS-C cases. We have, therefore, decided to prepare a report that will help clinicians to face this novel and challenging disease. We propose a diagnostic algorithm, to help case definition and guide work-up, and a therapeutic approach. MIS-C should be promptly recognized, based on the presence of systemic inflammation and specific organ involvement. Early treatment is crucial, and it will be based on the combined use of corticosteroids, high-dose immunoglobulins and anti-cytokine treatments, depending on the severity of the disease. Ancillary treatments (such as. aspirin and thrombo-profilaxis) will be also discussed. CONCLUSIONS: we propose a document that will help physicians to diagnose and treat MIS-C patients. Given the level of evidence available and the methodology used, this document should not be interpreted as a guideline; the final decision about the optimal management should still be taken by the caring physician, on an individual basis.


Asunto(s)
/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Niño , Femenino , Humanos , Italia , Masculino
14.
BMC Infect Dis ; 21(1): 157, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: covidwho-1069549

RESUMEN

BACKGROUND: Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients. METHODS: This was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2. RESULTS: Included were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation. CONCLUSIONS: Pulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.


Asunto(s)
/diagnóstico , Pulmón/diagnóstico por imagen , Adulto , Proteína C-Reactiva/metabolismo , Estudios Transversales , Femenino , Humanos , Italia , Pulmón/patología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Polipéptido alfa Relacionado con Calcitonina/sangre , Pronóstico , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
15.
Acta Biomed ; 91(14-S): e2020001, 2020 12 30.
Artículo en Inglés | MEDLINE | ID: covidwho-1068226

RESUMEN

Limiting people's movement is one of the main preventive measures deployed for the control of coronavirus 2019­nCoV pandemic. This study aims to assess the impact of COVID-19 lockdown on the incidence of the most common skeletal injuries and to provide a management algorithm specific for hospitalized fractured patients.We comparatively analysed the Emergency Department (ED) admissions between March 9th and May 4th 2020 with the same period in 2019. The frequency of the most common skeletal injuries has been derived. Data from the pre-hospitalization phase to discharge of all patients were considered. The impact on clinical orthopaedic consulting has been evaluated. All patients requiring orthopaedic care followed different pathways of hospitalization based on COVID positivity. Data of surgical activity has been analysed.During the 9 weeks of lockdown the access of patients to ED drastically decreased: 11726 accesses compared to 21501 in the same period of 2019. This trend was followed by the most common skeletal injuries but not by proximal femur fracture (PFF) that showed the same absolute numbers compare to the previous years (64 vs 63). If analysed in relation to the total ED access, PFF showed a relatively increase in their frequency.The data from this experience suggest that healthcare providers should strategically allocate resources for management and treatment of PFF during the COVID-19 pandemic. With the begin of the reopening phase, a "rebound effect" for orthopaedic care was observed leading to delayed treatments with a potential overall increased morbidity.


Asunto(s)
Fémur/lesiones , Fracturas Óseas/epidemiología , Anciano , Anciano de 80 o más Años , Servicio de Urgencia en Hospital , Femenino , Fracturas Óseas/cirugía , Hospitalización , Hospitales Universitarios , Humanos , Italia , Masculino , Pandemias , Estudios Retrospectivos
16.
Epidemiol Prev ; 44(5-6 Suppl 2): 400-406, 2020.
Artículo en Italiano | MEDLINE | ID: covidwho-1068164

RESUMEN

BACKGROUND: scientific literature indicates that there are sex, and gender differences in the development, symptomatology and evolution of different diseases, in the response to drugs and in the therapeutic pathways. Even in the COVID-19 epidemic some sex/gender differences emerged. OBJECTIVES: to analyze COVID-19 epidemic data by gender and age in Italy, Germany, Spain, and Sweden, characterized by having implemented different pandemic containment policies, with the aim of observing any characteristics that can be interpreted with the lens of sex/gender differences. MATERIALS AND METHODS: we used confirmed cases and deaths associated with COVID-19 for Italy, Spain, Germany, and Sweden from respective national surveillance databases. Mortality data for Italy were also analysed. The period of investigation was March-May 2020. As indicators, we used the case fatality ratio adjusted for time delay and SMR for mortality. RESULTS: women are more vulnerable to COVID- 19 infection in the 30-60-year age group. Case fatality ratio is higher in men than women, with a ratio men/women equal to 1.7 in Italy, Spain, and Sweden and 1,4 in Germany. The ratio increases in the lower age groups. The analysis of the mortality data observed/expected in Italy in the same period with respect to 2015-2019 shows a comparable excess with SMR equal to 132 for men and 127 for women. CONCLUSIONS: COVID-19 affects both genders with some differences in the incidence, higher in women, and lethality, higher in men. These differences highlight the need to better understand the sex/gender and age interaction both for epidemiological surveillance and for a better gender-appropriateness of the ongoing prophylactic and therapeutic treatments. This would be possible if all health indicators (symptoms, past illnesses, primary and hospital-level health care, hospitalization, etc.) were provided by age and gender. Analysis of the causes of death could help to better understand the increase in mortality for both genders, in particular for women, for whom a lower lethality for COVID-19 appears from data.


Asunto(s)
/mortalidad , Pandemias , Distribución por Sexo , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Causas de Muerte , Niño , Preescolar , Bases de Datos Factuales , Femenino , Alemania/epidemiología , Humanos , Incidencia , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Cuarentena , España/epidemiología , Suecia/epidemiología , Factores de Tiempo , Adulto Joven
17.
Epidemiol Prev ; 44(5-6 Suppl 2): 398-399, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1068163

RESUMEN

In the first stages of the pandemic, the adverse outcomes of COVID-19 were significantly higher in men than in women most likely as the effect of biological, hormonal, metabolic differences between the two sexes. However, gender-related differences in lifestyles and social roles can also greatly influence the course of disease. To fully understand the influence of gender in the COVID-19 outbreak, the collection and dissemination of disaggregated data must be enhanced to allow a better knowledge of the effects of SARS-CoV-2 infection in men and women, not only from a biomedical point of view, but also considering the risk factors associated with the different roles that they play in the society.


Asunto(s)
/epidemiología , Pandemias , Factores Sexuales , Consumo de Bebidas Alcohólicas/epidemiología , Niño , Cuidado del Niño , Violencia Doméstica , Conducta Alimentaria , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Italia/epidemiología , Estilo de Vida , Masculino , Obesidad/epidemiología , Ocupaciones , Embarazo , Cuarentena , Factores de Riesgo , Conducta Sedentaria , Caracteres Sexuales , Fumar/epidemiología
18.
Epidemiol Prev ; 44(5-6 Suppl 2): 369-373, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1068159

RESUMEN

During a pandemic, pregnancy and the postnatal period are complicated by multiple factors. On the one hand, worries about one's own health and the health of loved ones, in particular of the newborn child, can increase the risk of some mental disorders, such as depression and anxiety in the pregnant woman. On the other hand, as happened for the COVID-19 epidemic in Italy, given the need for physical distancing, the maintenance of the social and family network, so important for new parents in the perinatal period, is lacking. In addition, health services are forced to reorganize their offerings to ensure maximum safety for their operators and patients. This work proposes a model of screening and treatment aimed at identifying women at risk and providing them with effective and safe treatment.


Asunto(s)
Ansiedad/diagnóstico , Depresión/diagnóstico , Tamizaje Masivo/organización & administración , Pandemias , Atención Perinatal/organización & administración , Complicaciones del Embarazo/diagnóstico , Mujeres Embarazadas/psicología , Trastornos Puerperales/diagnóstico , Adulto , Ansiedad/epidemiología , Depresión/etiología , Depresión/terapia , Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Depresión Posparto/terapia , Autoevaluación Diagnóstica , Empoderamiento , Medicina Basada en la Evidencia , Femenino , Estudios de Seguimiento , Humanos , Italia/epidemiología , Atención Perinatal/métodos , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/psicología , Complicaciones del Embarazo/terapia , Evaluación de Programas y Proyectos de Salud , Trastornos Puerperales/epidemiología , Trastornos Puerperales/psicología , Trastornos Puerperales/terapia , Factores de Riesgo , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Estrés Psicológico/psicología , Telemedicina
19.
Epidemiol Prev ; 44(5-6 Suppl 2): 353-362, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1068158

RESUMEN

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.


Asunto(s)
/prevención & control , Estilo de Vida , Pandemias , Cuarentena , Aislamiento Social , Adolescente , Adulto , Anciano , Consumo de Bebidas Alcohólicas/epidemiología , Estudios Transversales , Dieta Saludable , Ingestión de Energía , Ejercicio Físico , Conducta Alimentaria , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Conducta Sedentaria , Fumar/epidemiología , Factores Socioeconómicos , Encuestas y Cuestionarios , Poblaciones Vulnerables , Adulto Joven
20.
Epidemiol Prev ; 44(5-6 Suppl 2): 344-352, 2020.
Artículo en Italiano | MEDLINE | ID: covidwho-1068157

RESUMEN

OBJECTIVES: to describe the course of Italian organized cancer screening programmes during the COVID-19 emergency; to provide estimates of the diagnosis of malignant or pre-malignant lesions that will face a diagnostic delay due to the slowing down of screening activities. DESIGN: quantitative survey of aggregated data for each Region and overall for Italy relating to screening tests carried out in the period January-May 2020 compared to those of the same period of 2019; estimate of diagnostic delays starting from the calculation of the average detection rate of the last 3 years available (specific by Region). SETTING AND PARTICIPANTS: Italian mass screening programmes. Data on the tests carried out in the target population of the breast (women 50-69 years old), cervix (women 25-64 years old), and colorectal (women and men 50-69 years old) cancer screening. MAIN OUTCOME MEASURES: the cumulative delay (in absolute numbers and as a percentage) in the period January-May 2020 compared to the same period of 2019, by Region; the difference of screening tests (in absolute number and in percentage) performed in May 2020 compared to May 2019; the estimate of the fewer lesions diagnosed in 2020 compared with 2019 with relative 95% confidence intervals (95%CI); the 'standard months' of delay (proportion of fewer tests carried out from January to May 2020 for the corresponding number of months). RESULTS: 20 Regions out of 21 participated. In the period January-May 2020, the fewer screening tests performed in comparison with the same period of 2019 were: 472,389 (equal to 53.8%) with an average delay of standard months of 2.7 for mammography screening; 585,287 (equal to 54.9%) with an average delay of standard months of 2.7 for colorectal screening; 371,273 (equal to 55.3%) with an average delay of 2.8 standard months for cervical screening. The estimated number of undiagnosed lesions is 2,201 (95%CI 2,173-2,220) breast cancers; 645 (95%CI 632-661) colorectal carcinomas; 3,890 (95%CI 3,855-3,924) advanced colorectal adenomas and 1,497 (95%CI 1,413-1,586) CIN2 or more serious lesions. CONCLUSIONS: mass screenings need to be restarted as quickly as possible. In order to make up for the delay that is accumulating, it is necessary to provide for wider delivery times, greater resources, and new organizational approaches. It will also be essential to develop communication strategies suitable for promoting participation during this emergency.


Asunto(s)
Citas y Horarios , Neoplasias de la Mama/diagnóstico , Neoplasias Colorrectales/diagnóstico , Diagnóstico Tardío , Detección Precoz del Cáncer , Pandemias , Cuarentena , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Anciano , Neoplasias de la Mama/epidemiología , Neoplasias Colorrectales/epidemiología , Diagnóstico Tardío/estadística & datos numéricos , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Italia/epidemiología , Mamografía/estadística & datos numéricos , Persona de Mediana Edad , Utilización de Procedimientos y Técnicas/estadística & datos numéricos , Neoplasias del Cuello Uterino/epidemiología
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