- Research Article
- 10.4415/ann_24_01_03
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Lorenzo Farina
The completion of human DNA sequencing in the early 2000s initially generated widespread excitement and hope that it would revolutionize medicine. Over time, however, it revealed major limitations due to a lack of understanding of the highly complex genotype-phenotype pathway. Precision medicine has emerged as a response to these biotechnological innovations, tailoring treatments based on an array of new molecular and clinical "omics" data. However, the large volume and heterogeneity of data available today requires the use of dedicated and highly efficient computational analyses. Widely used today are artificial intelligence techniques (such as machine learning) based on artificial neural networks, i.e., a mathematical model of how biological neurons work. Here, we show that artificial neural networks have nothing to do with biology, although their popularity is largely due to their alleged ability to simulate the human brain. Furthermore, we argue that the analysis of large molecular datasets cannot be left to the computational side alone, i.e., to be exclusively data-driven, but on the contrary must meet the challenge of integrating data and expertise, of getting clinicians and data analysts to work together to take into account the absolute and ineradicable uniqueness of each patient's characteristics.
- Research Article
- 10.4415/ann_24_02_06
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Amerigo Zona + 5 more
A pooled study on Italian asbestos cement plant cohorts observed mortality risk for asbestos-related diseases. This study analysed the mortality of workers cohort of an asbestos cement plant in Syracuse, Italy. Workers' vital status and causes of death, during 1970-2018, were identified in regional health databases. Standardized mortality ratios (SMRs) by sex and temporal variables were calculated. Of the 900 cohort's subjects (636 men, 259 women, 5 unknown sex), for 867 the vital ascertainment was possible: 505 died during study period. All-cause mortality is similarly to the expected among men and lower among women. Pleural and lung malignant neoplasms (MN) exceeded in men (SMR=27.1, SMR=1.95), retroperitoneal and peritoneal MN in both sexes, no cases of larynx MN were observed. Mortality excess for ovarian MN (SMR=1.5) and asbestosis in both sexes (men: SMR=431.9, women: SMR=116.6) were found. Exceeding mortality from asbestos-related diseases, particularly in men was highlighted.
- Research Article
- 10.4415/ann_24_02_07
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Luisa Mastrobattista + 8 more
Tobacco use is one of the world's leading preventable causes of death and is a major preventable risk factor of non-communicable diseases. Although smokers are aware of the health risks, their attempts to quit often fail, primarily due to the strong nicotine and/or tobacco dependence. Antismoking helplines have become an integral part of tobacco control efforts in many countries. In Italy, the ISS Antismoking Helpine is active since 2000. The professional staff of the ISS Antismoking Helpline have gathered socio-demographic and smoking-related data via an electronic form, related to the received calls. The collected data have been processed in a dedicated database and analyzed to monitor the use and the quality of the service. In this study, a descriptive statistical analysis was conducted to inform about the activity of the helpline over the years. From May 2003 to June 2023 the helpline received 99,423 calls. Most smokers called to receive "support to quit" (82.6%). Counselling was provided in 11.4% of cases, and in the last two years has been strongly increased (40.0% of cases). The percentage of users requesting information on emerging tobacco and nicotine products is 1.2%, even if in 2023 this percentage has risen significantly (6.0%). Two legislative measures (in 2012 and in 2016) required to add the helpline number to all packets of tobacco cigarettes. Accordingly, the offer of counselling increased from 2.6% to 12.2%. The available resources in tobacco control, including the helpline, are still not sufficient to meet all the users needs. Adequate policies and stable funding to fight tobacco and nicotine dependence need increased commitment from government institutions to ensure equal access to treatments for all Italian citizens.
- Research Article
1
- 10.4415/ann_24_03_08
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Ilaria Ippoliti + 4 more
Beehive products are widely used in food supplements; however, their composition variability and allergenic components have raised some concerns. This work aims to provide information about the beehive products safety profile by evaluating the suspected adverse reactions (ARs). The suspected report of ARs collected within the Italian Phytovigilance System (IPS) were evaluated. The clinical and demographic characteristics of the cases were described, and the causality assessment performed. 61 reports were analysed, mainly concerned women. Serious events were reported in 17 forms (28%). The ARs (n=116) referred to respiratory (25.0%), skin (24.1%), and gastrointestinal disorders (21.5%). Label warnings for atopic subjects were present only in 7 food supplements. The causality assessment was mostly probable (54.1%). Present findings outline relevant information about the safety issues of beehive product consumption, especially in atopic or allergic subjects, and strengthen the importance of IPS to point out safety signals.
- Research Article
- 10.4415/ann_24_04_03
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Fabio Caputo + 11 more
Disulfiram (DF), acamprosate, naltrexone, baclofen and sodium oxybate (SO) are currently the medications approved for the treatment of alcohol use disorder (AUD). In this context, combined pharmacological interventions and sex differences are an interesting area in the treatment of non-responder AUD patients. To evaluate the efficacy of SO in combination with DF in maintaining alcohol abstinence in patients with AUD who failed to achieve abstinence either with SO or DF alone. 126 detoxified AUD patients, previously treated with only SO or DF, were retrospectively enrolled from 2018 to 2022. At the end of treatment, a higher number of females than males (74.1% vs 66.3%: p=0.03) maintained continuous abstinence from alcohol, and all the females responded completely or partially to the treatment. This study shows that the combination of SO and DF may be considered a further pharmacological opportunity for AUD patients (particularly in females) who do not respond to mono-therapy.
- Research Article
1
- 10.4415/ann_24_03_09
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Anna Carannante + 3 more
Violence against women (VAW) is a persistent global public health problem that runs across all social classes and ethnicities with a considerable negative influence on women's health and behaviour. Early detection, appropriate interventions and multidisciplinary cooperation are crucial factors in tackling gender violence. This note describes "The Violence against women: long-term health effects for precision prevention" transdisciplinary and multicenter project that aims to implement the National Guidelines with two sets of questions: the European Injury Database (EU-IDB) violence module and the Post-Traumatic Stress Disorder (PTSD) questionnaire for improving innovative approaches to limit the long-term health effect of VAW. Furthermore, the analysis of epigenetic profile in women's DNA may contribute to the knowledge of molecular mechanisms underlying PTSD and other non-communicable diseases. Epigenomic research in parallel with rigourous guidelines and social, educational, clinical and community interventions could accomplish innovative precision prevention protocols. Public health plays essential role in identifying risk factors and strengthening the support for women victims of violence.
- Research Article
2
- 10.4415/ann_24_04_01
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Tiziana Catone + 3 more
The potential impacts of microplastics pollution on the environment and possibly human health have raised concerns in various parts of the world. Once in the environment, microplastics do not biodegrade and cannot be removed. Several Member States have adopted or proposed specific measures. However, a patchwork of national restrictions can hinder the functioning of the internal market and therefore requires harmonization at Union level. The European Commission, on 9 November 2017, requested the European Chemicals Agency to prepare possible proposals for restrictions regarding oxo-plastics and intentionally added microplastic particles. On 25 September 2023, the restriction on microplastics intentionally added was published on the Official Journal of the European Union. By the end of 2024 it is envisaged the publication of a Guidance on the application of the microplastic restriction under Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH).
- Research Article
- 10.4415/ann_24_02_05
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Fabio Caputo + 9 more
Worldwide, almost 1.2 million people drive under the influence of alcohol. However, early identification of alcohol use disorder (AUD) in subjects driving under the influence (DUI) of alcohol is seldom achieved. The aim of our retrospective study is to investigate the presence of AUD in a population of DUI subjects who had their driving license suspended, and if they were following a specific rehabilitation program. 750 subjects were retrospectively enrolled from 2018 to 2021. DSM-V to assess AUD was used. Forty-eight (6.4%) subjects presented a diagnosis of AUD, after one month they showed a statistically significant reduction of carbohydrate-deficient transferrin (CDT) (p<0.0001); however, none were following a program for the treatment of AUD. This outpatient setting may be considered a place of primary and secondary prevention where DUI subjects with a diagnosis of AUD may be entrusted to a Centre in order to follow rehabilitation treatment.
- Research Article
- 10.4415/ann_24_04_08
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Cosimo Campagni + 12 more
Psychoactive substance use is largely found to involve multiple substances. In recent years, the COVID-19 pandemic has changed psychoactive substance use patterns. Aim of this study is to investigate profiles of polysubstance and their pattern during and after the COVID-19 pandemic. We collected information on alcohol consumption, use of tobacco, cannabis and other psychotropic substances, and nicotine-containing electronic devices (NCEDs; i.e., heated tobacco products and electronic cigarettes) on representative samples of the Italian adult population in five surveys from 2020 to 2023 (3,000≤n≤6,600). We used a Latent Class Analysis model to identify substance use profiles and their associated variables in each time period. We initially identified two profiles, "light users", characterized by a low use of tobacco and NCEDs (3%-20%) and a 40% at-risk alcohol consumption, and "polysubstance users", characterized by a large use of all psychoactive substances. After the 2020 COVID-19 lockdown, we also found the "dual users" profile, which show a large use of tobacco (90%) and NCEDs (50%), and also alcohol (50%). Being "dual users" and "polysubstance users" were associated with younger age and high economic status, with strengths of association less pronounced during lockdown but more marked immediately thereafter. Moreover, reporting anxiety or depressive symptoms as well as using psychotropic drugs were strongly associated with both profiles, especially in the last two years. Heterogeneity of polysubstance users and their socio-demographic characteristics need to be considered to design tailored prevention interventions, with special attention to the new "dual users" profile, which confirmed the increasing trend in NCED use.
- Research Article
3
- 10.4415/ann_24_04_02
- Feb 1, 2024
- Annali dell'Istituto superiore di sanita
- Carlo Signorelli + 8 more
Five consecutive national vaccination plans (from 1999 to 2025) were revised, outlining their objectives, challenges, and results. Vaccination coverage for children consistently approached target levels, though regional differences emerged. In contrast, coverage for adolescents, the elderly, and vulnerable groups, consistently fell short of targets. While vaccination policies in Italy over the past 25 years were ambitious and well-planned, success was primarily limited to newborns immunization, thanks to effective organizational activities. Failure to achieve goals for other population groups was partly due to inconsistent implementation of regional vaccination prevention plans.