Health status of Afro-Asian refugees in an Italian urban area: a cross-sectional monocentric study.

OBJECTIVES: The recent sociopolitical events in the Mediterranean and Middle Eastern areas have significantly impacted international migration flows. As disease prevalence and type are different among western and Afro-Asian countries, physicians dealing with refugees should be aware of their specific health needs. We aimed at evaluating the health status and disease history of refugees at their arrival in the urban area of L'Aquila (Italy). STUDY DESIGN: This is a monocentric cross-sectional study. METHODS: Refugees hosted at the local reception center in L'Aquila (Italy) between July 2014 and December 2014 were cross-sectionally evaluated for anamnestic, clinical, and laboratory features. A subset of randomly selected participants underwent further assessments (screening for tuberculosis, hepatitis B/C, human immunodeficiency virus, syphilis; ambulatory blood pressure measurement [ABPM]) to better define their health status. RESULTS: Ninety-three adult male refugees (27.34 ± 7.41 years) from Africa (76%) and Asia (24%) were enrolled. Overall, the most prevalent diseases according to the International Statistical Classification of Diseases and Related Health Problems 10th revision affected the digestive tract (15.6%) and musculoskeletal apparatus (14.4%). The analysis by continent of origin did not show significant differences in the distribution of diseases, although a trend toward some differences was observed. African refugees had a significantly greater prevalence of viral hepatitis (hepatitis B virus, P = 0.004; hepatitis C virus, P = 0.007) compared with Asians. Hypertension, as detected by ABPM, was uncommon. No written vaccination history was available. CONCLUSIONS: Health issues of our sample of Afro-Asian refugees span both non-communicable and communicable diseases, requiring attention for the safety of the individual and the community. National health systems should provide adequate information and shared guidelines for health professionals regarding identification and management of refugees' health needs.

Advanced glycation end products: possible link between metabolic syndrome and periodontal diseases.

On a planetary scale, Metabolic Syndrome (MetS)is the third cause of inability after malnutrition and nicotinism, even higher than water shortage and sedentariness. In the USA, the prevalence is estimated at over 25 percent of the population; in Italy, it involves approximately 25 percent of men and even 27 percent of women. These are very high figures, corresponding to approximately 14 million affected individuals. The prevalence is alarming and must not be underestimated, particularly in the dental field, where more than one patient out of four sitting in a dentist chair is affected. The etiology of periodontal disease has not yet been clarified, and recently the idea to consider it as a multifactor pathology has been developed. Cofactors such as the formation of free radicals of oxygen (ROS), oxidative stress, lipid peroxidation, and formation of glycation end-products (AGEs) probably play an important role in the onset of periodontal disease. The AGEs are compounds physiologically produced by the cells. However, they accumulate and cause pro-inflammatory conditions, when the cellular clearance fails, or in hyperglycemic and oxidative states. All these conditions can be clinically summarized as Metabolic Syndrome. The purpose of this literature review is to establish a relationship between two pathologies with very high prevalence: Metabolic Syndrome and Periodontal Disorder. The literature seems to have clarified that MetS involves a pro-oxidation status, which induces AGE formation. AGEs play a very important role in the course and severity of periodontal diseases.