[Skills tracing and activation of multi-professional teams in response to COVID-19 pandemic]. / Mappatura delle competenze ed attivazione di equipe multi professionali in risposta ad emergenza pandemica COVID-19.

The rapid spread of Covid-19 epidemic led to a change in the organizational strategies of all Italian healthcare facilities. From January 31, 2020 (starting date of the state of national health emergency) Asst Valle Olona has prepared a reorganization of the supply units passing from a traditional division system to a structure that foresees the presence of traditional wards and a set of areas dedicated exclusively to the of Covid 19 treatments.The study aims to represent the method used for the redistribution of human capital in the new areas for identified, mapped, evaluated and reordered skills. The method may guarantee assistance to Covid-19 patients with the greatest number of human resources available and adequately trained.

Impact of routine infant and adolescent hepatitis B vaccination in Tuscany, Central Italy.

BACKGROUND: In Italy routine infant and adolescent immunization against hepatitis B was introduced in 1991. OBJECTIVE: Evaluation of (1) coverage with three doses of hepatitis B vaccine in infants and adolescents; (2) seroconversion to anti-hepatitis B surface antigen antibody (anti-HBs) in adolescents receiving three doses of vaccine; (3) concordance of coverage rates in infants with prevalence of neutralizing antibodies in sera from anonymous children; (4) trend of notified cases of acute hepatitis B. METHODS: A sample of infants and adolescents living in Tuscany was studied during 6 years (1992 through 1997) by matching birth records and immunization certificates. Sera from 139 adolescents who completed the vaccination course and from 159 anonymous children belonging to immunized cohorts (1 to 5 years) were tested with a quantitative anti-HBs assay. Incidence of acute hepatitis B by age was calculated from regional statistics on notified infectious diseases between 1992 and 1996. RESULTS: Overall 10,606/11,164 (95%) infants and 10,599/11,100 (95%) adolescents received 3 doses of vaccine. Seroconversion to anti-HBs was detected in 98% of adolescent vaccinees. Anti-HBs titers > or =10 IU/l were detected in 87% of children. A 49% decline of acute hepatitis B cases was registered between 1992 and 1996 in 15- to 24-year-olds living in Tuscany. No case occurred in vaccinated adolescents. CONCLUSIONS: Coverage against hepatitis B is excellent in cohorts subject to mandatory immunization. If efforts to vaccinate are maintained at these levels, elimination of hepatitis B virus transmission could occur within few decades in Italy.

Experience of hepatitis A vaccination during an outbreak in a nursery school of Tuscany, Italy.

An outbreak of hepatitis A started in late October 1996 in a nursery school in Tuscany, Italy. A programme of hepatitis A vaccination without the use of immunoglobulin started at the beginning of December 1996 and included 33 children, 21 household contacts and 6 adults working in the school. Overall, 11 cases occurred in children attending the school (attack rate 27%) and 10 among their household contacts (attack rate 9 %). The latter also included parents, and, in two cases, grandmothers. The data indicate that susceptibility to HAV has increased over recent decades in central Italy. Past and recent experience shows that the usual duration of hepatitis A epidemics in the absence of immune prophylaxis is longer than that described here. The use of hepatitis A vaccine probably contributed to the early extinction of the outbreak, because no further cases were notified in the area after 7 February 1997.

[Nutrition errors in children]. / Errori alimentari nel bambino.

Errors in the childhood feeding administration are commonly met, particularly during the first and second year of life, according to the poor or vague knowledge among paediatricians. A first proof of this assumption is given when, as a consequence of digestive disturbance, caused by a wrong nourishment, the paediatrician suggests remedies that, substantially, make the same primitive mistakes. A second proof is given when a particular diet, due to the presence of intestinal disturbance and already seen to be inefficacious, is reproposed, even more than once, with industrial aliments which differ from the ones used in the name and the brand but not in the composition. Finally, another proof is given when in the exclusion therapy due to an intolerance towards gluten, towards cow's milk, towards disaccharides, the paediatrician inserts, in the diet, products containing, respectively, the above mentioned components. These and other mistakes are reported in the present casuistry (121 cases), the majority of which (75 cases) is accompanied by specific examples. Between the cases that mostly stand out we find the so called "precocious weaning" as cause of digestive disturbance and, frequently, as initial moment of a chain of errors responsible, in their turn for the protraction and the chronicization of the aforementioned intestinal pathology.

[Ankylosing spondylitis with childhood onset. Description of a clinical case]. / Spondilite anchilosante ad esordio giovanile. Descrizione di un caso clinico.

The terms "spondyloarthropathy" and "spondyloarthritis" have been recently introduced to indicate a group of syndromes associated in clinical and genetical peculiarities. The "ankylosing spondylitis with childhood onset", that is usually considered very rare, is, as a matter of fact, a disease difficult to diagnose because of the partial overlap with the "pauciarticular juvenile rheumatoid arthritis type II" for clinical and laboratory data. The Authors, after a recapitulation of the "pauciarticular juvenile rheumatoid arthritis type II" and of the "ankylosing spondylitis with childhood onset" diagnosis definition elements, propose a description of a clinical case that came to their observation. The clinical picture described, even though it presented some clinical peculiarities (particularly a primitive affection of the lumbosacral spine), some radiographic peculiarities (the precocious demineralization of the affected segments) and laboratory characteristics (positive F.A.N. to diffuse pattern) seemed a form of "ankylosing spondylitis with childhood onset", apparently primitive.