Can a validated website help improve university students' e-health literacy?

Background: The fight against fake news, mainly spread through Internet, is a major public health issue, even among undergraduate students. This study aims to evaluate the effectiveness of a website promoted by the Italian Federation of the Provincial Orders of the Medical Doctors as a first aid communication kit for health topics. Study design: Pre-post study using a web-based survey, conducted in April-May 2019 on Medical students and October-November 2020 on Communication Sciences students at the University of Florence (Italy). Methods. Undergraduate students of both schools were exposed to the use of the "dottoremaeveroche" website. Primary and secondary outcomes measures: the Italian-electronic Health Literacy Scale self-assessment tool was used to examine subjects' electronic Health literacy, and source quality. All responses were rated on a 5-point Likert scale. Changing in perception of abilities were examined using the Wilcoxon test. Results: The 362 participants felt moderately confident in electronic Health Literacy, with an initial Italian-electronic Health Literacy Scale overall mean score of 3.6±0.7 for medical and 3.2±0.8 for communication students. Medical students had a good idea of how to find helpful sources (3.9±0.8) and communication students felt confident in recognizing their quality (3.5±1.0). In contrast, their confidence in using Web information to make health decisions was low (medical: 2.9±1.1; communication: 2.8±1.1). All items improved significantly after "dottoremaeveroche" use (p<.001), with the overall mean score of Italian-electronic Health Literacy Scale increasing to 4.3±0.6 for medical and 4.1±0.8 for communication students. Conclusions: Low electronic health literacy levels can affect public health efforts, as seen during the COVID-19 pandemic. The effectiveness of "dottoremaeveroche" among students showed the usefulness of online educational interventions that, if further implemented, could help combat the spread of infodemic.

Renal osteodystrophy with hyperparathyroidism: the diagnostic value of intact parathormone, alkaline phosphatase, osteocalcin and procollagen.

In 27 patients on periodic haemodialysis, serum levels of alkaline phosphatase (ALP), osteocalcin (BGP), intact parathyroid hormone (PTHi) and its two fragments, terminal COOH (PTH-Cter) and middle molecule (PTH-MM), and procollagen type 1 carboxy-terminal extension peptide (P1CP) were measured. The same patients underwent radiography of the skull and of the hands, ultrasonography of the parathyroids and scintigraphy of the skeleton with 99mTc-MDP. The study was completed by the measurement of aluminium (Al) in the blood and the deferoxamine test (DFO). Two groups of patients emerged, one (group A, n = 14) with PTHi greatly increased (201.07 +/- 109.72 pg/mL) and the other (group B, n = 13) with values within the normal range (32.69 +/- 17.06 pg/mL) (p < 0.001). In group A, ALP, BGP and particularly P1CP were increased with a statistically significant difference compared to group B. Specific radiographic alterations were found in 12 patients of group A; 7 patients also had hypertrophy of the parathyroids. There was no difference in the scintigraphic alterations of the skeleton between the two groups. The authors conclude that it is the association of the high values of PTHi with those of the markers of bone metabolism, the normal level of Al, the negativity of the DFO test and the radiological alterations which together allow the diagnosis of renal osteodystrophy with hyperparathyroidism.

[Determination of bone mineral content and correlations with calciotropic hormones in periodic hemodialysis patients]. / Determinazione del contenuto minerale osseo e correlazioni con gli ormoni calciotropi nei soggetti in emodialisi periodica.

The investigation on several forms of uremic osteodystrophy by means of bone mineral content (BMC) measurement led to contradictory conclusions. BMC in 27 patients on periodical hemodialysis treatment was measured correlating it to the seric levels of Ca, P, Mg, alkaline phosphatase (AP), calcitonin (Ct), osteocalcin (BGP), intact parathormone (PTHi), c-terminal and mean molecule PTH. Patients on dialysis treatment from a long period of time showed high AP and low BMC levels. This correlation proved significant just for the values recorded at a third distal site of radius. Patients with BMC under the normal range showed higher BGP levels and a longer period of dialytic treatment than those presenting normal BMC. The former showed a Ct inverse correlation as to age and mineralization indexes. Higher values of Ct and BMC have been reported in males rather than in females. Hence BMC is not suited to investigate different kinds of uremic osteodystrophy. Seric PTH dosage is certainly best fitted to discriminate patients affected with hyperparathyroidism from those with low turnover osteodystrophy. BMC determination is a valid support to evaluate the bone mineral loss in patients on haemodialysis treatment. It significatively correlates to the duration of the dialytic treatment; it is higher in female than in male population; it mainly affects cortical components rather than trabecular ones and is related to a seric Ct decrease.

[Capillaroscopic studies in connective tissue inflammations]. / Studi capillaroscopici nelle connettiviti.

Capillarioscopy has been unjustifiably neglected in the study of connective tissue diseases, where examination of the microcirculation is clearly important. A study of 80 cases is reported. 12 systemic lupus, 11 progressive systemic sclerosis (PSS), 20 rheumatoid arthritis (including 3 juvenile and 2 Still's disease); 9 Raynaud's disease (of which 3 idiopathic, 4 with rheumatoid arthritis and 2 with UCTD); 1 dermatomyositis; 11 other CTD (2 overlap syndrome--1 lupus + dermatomyositis; 1 lupus + PSS--3 Sjögren syndromes with rheumatoid arthritis, 1 MCTD, 2 primary mixed cryoglobulinaemia, 1 systemic vasculitis, 1 Behçet syndrome, and 1 UCTD); 9 miscellaneous forms (3 psoriatic arthropathy, 1 rheumatic pelvispondylitis, 1 allergic dermatitis, 1 pulmonary TB, 1 ulcerative colitis; 1 scapulohumeral periarthritis, 1 unclassifiable rheumatism; 7 healthy subjects). During capillarioscopy, from one to nine slides were prepared for each subject. These were interpreted separately by three persons who were unaware of the respective diagnosis. Calibre, tortuosity, length and number of capillaries were recorded, plus the visibility of the subpapillar plexus, height and number of the termal, subungual and/or ungual vallum haemorrhage, plugging. It was found that PSS, dermatomyositis, MCTD, and overlap-PSS revealed a very typical common pattern, possibly pathognomonic, namely marked reduction in the number of capillaries + megacapillaries. The other forms presented less evocative diagnostic patterns, though they were fairly indicative in some instances. Clinical correlations of particular significance with respect to prognosis, however, were not observed.