scispace - formally typeset
Search or ask a question

Showing papers by "Luca Ronfani published in 2022"


Journal ArticleDOI
Giulio Castelpietra, Ann Kristin Knudsen, Emilie Agardh, Benedetta Armocida, Massimiliano Beghi, Kim Moesgaard Iburg, Giancarlo Logroscino, Rui Ma, F. Starace, Nicholas Steel, Giovanni Addolorato, Catalina Liliana Andrei, Tudorel Andrei, José Luis Ayuso-Mateos, Maciej Banach, Till Bärnighausen, Francesco Barone-Adesi, Akshaya Srikanth Bhagavathula, Félix Carvalho, Márcia Siqueira de Carvalho, Joht Singh Chandan, Vijay Kumar Chattu, Rosa A. S. Couto, Natália Cruz-Martins, Paul I. Dargan, Keshab Deuba, D. D. da Silva, Adeniyi Francis Fagbamigbe, Eduarda Fernandes, Pietro Ferrara, Florian Fischer, Peter Gaal, Alessandro Gialluisi, Juanita A. Haagsma, Josep Maria Haro, M. Tasdik Hasan, Syed Shahzad Hasan, Sorin Hostiuc, Licia Iacoviello, Ivo Iavicoli, Elham Jamshidi, Jost B. Jonas, Tamás Joó, Jacek Jerzy Jozwiak, Srinivasa Vittal Katikireddi, Joonas H. Kauppila, Moien Ab Khan, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Kamrun Nahar Koly, Ai Koyanagi, Manasi Kumar, Tea Lallukka, Berthold Langguth, Caterina Ledda, Paul H. Lee, Ilaria Lega, Christine Linehan, Joana A. Loureiro, Áurea Madureira-Carvalho, Jose Martinez-Raga, Manu Raj Mathur, John J. McGrath, Enkeleint A. Mechili, Alexios-Fotios A. Mentis, Tomislav Mestrovic, Bartosz Miazgowski, Andreea Mirică, Antonio Mirijello, Babak Moazen, Shafiu Mohammed, Gabriele Nagel, Ionut Negoi, Ruxandra Irina Negoi, V. E. Nwatah, Alicia Padron-Monedero, Songhomitra Panda-Jonas, Shahina Pardhan, Maja Pasovic, Jay Patel, Ionela-Roxana Petcu, Marina Pinheiro, Richard Pollok, Maarten J. Postma, David Laith Rawaf, Salman Rawaf, Esperanza Romero-Rodríguez, Luca Ronfani, Dominic Sagoe, Francesco Sanmarchi, Michael Schaub, Nigussie Tadesse Sharew, Rahman Shiri, Farhad Shokraneh, Inga Dora Sigfusdottir, João Pedro Silva, Renata Silva, Bogdan Socea, Miklós Szócska, Rafael Tabarés-Seisdedos, Marco Torrado, Marcos Roberto Tovani-Palone, Tommi Vasankari, Massimiliano Veroux, Russell M Viner, Andrea Werdecker, Andrea Sylvia Winkler, Simon I. Hay, Alize J. Ferrari, Mohsen Naghavi, Peter Allebeck, Lorenzo Monasta 
TL;DR: The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time as mentioned in this paper .
Abstract: Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time.Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated.In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs.Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people.The Bill and Melinda Gates Foundation.

44 citations


Journal ArticleDOI
TL;DR: NCD-related mortality has substantially declined among adolescents in the EU between 1990 and 2019, but the rising trend of YLL attributed to mental disorders and their YLD burden are concerning.

24 citations


Journal ArticleDOI
01 Aug 2022
TL;DR: Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRIs and deaths.

20 citations


Journal ArticleDOI
TL;DR: In this paper , the authors report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades, using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study.
Abstract: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades.Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10-14, 15-19, and 20-24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019.In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10-24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010-19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010-19.As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low-middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury.Bill & Melinda Gates Foundation.

20 citations


Journal ArticleDOI
TL;DR: It is estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution, and air pollution mitigation might have an essential role in reducing the global disease burden resulting from type 1 diabetes.

19 citations


Journal ArticleDOI
TL;DR: In this article , the authors estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.

8 citations


Journal ArticleDOI
TL;DR: It is shown that social isolation measures had an impact on the circulation of RSV and influenza, although children under the age of 2 were most affected by the other respiratory infections, which highlights the need for continuing surveillance for a delayed spread ofRSV and other respiratory pathogens.
Abstract: The social distancing measures adopted during the coronavirus disease 2019 (COVID-19) pandemic led to a profound change in the behavioral habits of the population. This study analyzes the impact of restriction measures on the shaping of the epidemiology of common winter respiratory pathogens in the pediatric population of northeast of Italy. From August 2020 to March 2021, a total of 1,227 nasopharyngeal swabs from symptomatic pediatric patients were tested for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A and B, adenovirus, other coronaviruses, parainfluenza virus 1–4, enterovirus, bocavirus, metapneumovirus, respiratory syncytial virus, rhinovirus, Bordetella pertussis, Bordetella parapertussis, and Mycoplasma pneumoniae. To relate virus positivity with the clinic characteristics of the subjects enrolled, multinomial logistic models were estimated. SARS-CoV-2 was detected in 5.2% of the children; fever resulted as risk factor for infection [relative risk ratio (RRR) = 2.88, p = 0.034]. Rhinovirus was detected in the 40.7% of the subjects, with cough and rhinitis as risk factors (respectively, RRR = 1.79, p = 0.001 and RRR = 1.53, p = 0.018). Other coronaviruses were found in 10.8% of children and were associated to pharyngodynia (RRR = 4.94, p < 0.001). Adenovirus, observed in 11.6% of subjects, showed to have fever as risk factor (RRR = 6.44, p < 0.001). Bocavirus was detected in 3.2% of children. In conclusion, our results showed that social isolation measures had an impact on the circulation of RSV and influenza, although children under the age of 2 were most affected by the other respiratory infections. Therefore, this study highlights the need for continuing surveillance for a delayed spread of RSV and other respiratory pathogens.

7 citations


Journal ArticleDOI
TL;DR: In this paper , the authors compared the effect of intranasal dexmedetomidine and intra-nasal ketamine on the onset of action in younger children compared to intrannasal-ketamine and intranrasal-dexmedetiomidine, and showed a correlation between age and sedation effectiveness.
Abstract: Abstract Background Non-painful diagnostic procedures require an inactive state for a prolonged time, so that sedation is often needed in younger children to perform the procedures. Our standard of care in this setting consists of the association between oral midazolam (0.5 mg/kg) and intranasal dexmedetomidine (4 mcg/kg). One of the limits of this approach is that the onset of action is quite delayed (up to 55 min) and poorly predictable. We chose to compare this association with intranasal-ketamine and intranasal-dexmedetomidine. Methods This is a “pre-post” study. The study population included the first forty children receiving sedation with the “new” combination intranasal ketamine (3 mg/kg) and intranasal dexmedetomidine (4 mcg/kg) compared to a historical cohort including the last forty children receiving sedation with our standard of care combination of intranasal dexmedetomidine (4mcg/kg) and oral midazolam (0,5 mg/kg). Results The association intranasal dexmedetomidine and intranasal ketamine allowed for a significantly shorter sedation induction time than the combination intranasal dexmedetomidine and oral midazolam (13,5 min versus 35 min). Both group’s cumulative data showed a correlation between age and sedation effectiveness, with younger children presenting a higher success rate and shorter induction time (p 0,001). Conclusions: This study suggests that the ketamine and dexmedetomidine intranasal association may have a shorter onset of action when compared to intranasal dexmedetomidine and oral midazolam.

5 citations


Journal ArticleDOI
Periklis Charalampous, Juanita A. Haagsma, Filippo Ariani, Anne Gallay, Kim Moesgaard Iburg, Evangelia Nena, Che Henry Ngwa, Alexander Rommel, Ausra Zelviene, Kedir Hussein Abegaz, Hanadi Al Hamad, Luciana Albano, Catalina Liliana Andrei, Tudorel Andrei, Ippazio Cosimo Antonazzo, Olatunde Aremu, Ashokan Arumugam, Alok Atreya, Avinash Aujayeb, José Luis Ayuso-Mateos, Luchuo Engelbert Bain, Maciej Banach, Till Bärnighausen, Francesco Barone-Adesi, Massimiliano Beghi, Derrick A Bennett, Akshaya Srikanth Bhagavathula, Félix Carvalho, Giulio Castelpietra, Ledda Caterina, Joht Singh Chandan, Rosa A. S. Couto, Natália Cruz-Martins, Giovanni Damiani, Anna Dastiridou, Andreas K. Demetriades, Diana Dias-da-Silva, Adeniyi Francis Fagbamigbe, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Florian Fischer, Urbano Fra-Paleo, Silvia Ghirini, James Glasbey, Ionela-Roxana Glavan, Nelson G.M. Gomes, Michal Grivna, Netanja I. Harlianto, Josep Maria Haro, M. Tasdik Hasan, Sorin Hostiuc, Ivo Iavicoli, Milena Ilic, Irena Ilic, Mihajlo Jakovljevic, Jost B. Jonas, Jacek Jerzy Jozwiak, Mikk Jürisson, Joonas H. Kauppila, Gbenga A. Kayode, Moien Ab Khan, Adnan Kisa, Sezer Kisa, Ai Koyanagi, Manasi Kumar, Om P Kurmi, Carlo La-Vecchia, Demetris Lamnisos, Savita Lasrado, Paolo Lauriola, Shai Linn, Joana A. Loureiro, Raimundas Lunevicius, Áurea Madureira-Carvalho, Enkeleint A. Mechili, Azeem Majeed, Ritesh G. Menezes, Alexios-Fotios A. Mentis, Atte Meretoja, Tomislav Mestrovic, Tomasz Miazgowski, Bartosz Miazgowski, Andreea Mirică, Mariam Molokhia, Shafiu Mohammed, Lorenzo Monasta, Francesk Mulita, Mukhammad David Naimzada, Ionut Negoi, Subas Neupane, Bogdan Oancea, Hans Orru, Adrian Otoiu, Nikita Otstavnov, Stanislav S. Otstavnov, Alicia Padron-Monedero, Songhomitra Panda-Jonas, Shahina Pardhan, Jay Patel, P. Pedersini, Marina Pinheiro, Ivo Rakovac, Chythra R Rao, Salman Rawaf, David Laith Rawaf, Violet Rodrigues, Luca Ronfani, Dominic Sagoe, Francesco Sanmarchi, Milena Santric-Milicevic, Brijesh Sathian, Aziz Sheikh, Rahman Shiri, Siddharudha Shivalli, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Catalin-Gabriel Smarandache, Bogdan Socea, R. A. Sousa, Paschalis Steiropoulos, Rafael Tabarés-Seisdedos, Marcos Roberto Tovani-Palone, Fimka Tozija, Sarah Van de Velde, Tommi Vasankari, Massimiliano Veroux, Francesco Saverio Violante, Vasiliy Victorovich Vlassov, Yanzhong Wang, Ali Yadollahpour, Sanni Yaya, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Suzanne Polinder, Marek Majdan 
TL;DR: In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 1000,000; 95% UI 34 to 42) and three times as high as Western Europe (27 injury death per 1000 deaths per 100 000;95%UI 25 to 28) as discussed by the authors .
Abstract: Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries.We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year.In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019.Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.

5 citations


Journal ArticleDOI
TL;DR: Ozone therapy is a simple and painless approach, which might be useful for controlling caries’ progression in uncooperative children until appropriate cooperation is achieved and quality of life improved.
Abstract: The present study aimed to evaluate the effectiveness of ozone therapy in (1) increasing the compactness of decayed dentin (main aim), (2) reducing dentin hypersensitivity, (3) decreasing the salivary bacterial count, and (4) improving the quality of life in ECC-affected children during a 3-month follow-up. A total of 20 subjects uncooperative with conventional restorative treatment were treated with a 60 s ozone application/week (OzoneDTA®) for 4 weeks. Patients were evaluated at T0 = baseline; T1 = after ozone cycle and T2, T3, T4 = 1, 2, 3-month follow-up, respectively. Dentin compactness was evaluated according to the Affected Dentine Scale (ADS) proposed by the authors; dentin hypersensitivity was recorded with the Wong–Baker Faces Pain Rating Scale (WBFPRS); salivary bacteria were measured with the Saliva Check Mutans Test and quality of life with the Early Childhood Oral Health Impact Scale (ECOHIS). ADS values and salivary bacteria count results were analyzed using non-parametric tests. Statistically significant differences were detected for both parameters between T0 and T1 (p < 0.01). At T1, dentin hypersensitivity was resolved and quality of life improved. Ozone therapy is a simple and painless approach, which might be useful for controlling caries’ progression in uncooperative children until appropriate cooperation is achieved.

5 citations


Journal ArticleDOI
TL;DR: Infectious Diseases Surveillance, Prevention and Treatment as mentioned in this paper Public Health, 03 March 2022Sec. of State, Public Health and Public Health Division, U.S. Department of Health and Human Services
Abstract: OPINION article Front. Public Health, 03 March 2022Sec.Infectious Diseases – Surveillance, Prevention and Treatment https://doi.org/10.3389/fpubh.2022.825416

Journal ArticleDOI
TL;DR: This systematic analysis suggests the heterogeneity in GC levels and causes, paired with a more detailed analysis of local practices, strengths and weaknesses, could be a positive element in a strategy for the reduction of GCs in Italy.
Abstract: Abstract Background The proportion of reported causes of death (CoDs) that are not underlying causes can be relevant even in high-income countries and seriously affect health planning. The Global Burden of Disease (GBD) study identifies these ‘garbage codes’ (GCs) and redistributes them to underlying causes using evidence-based algorithms. Planners relying on vital registration data will find discrepancies with GBD estimates. We analyse these discrepancies, through the analysis of GCs and their redistribution. Methods We explored the case of Italy, at national and regional level, and compared it to nine other Western European countries with similar population sizes. We analysed differences between official data and GBD 2019 estimates, for the period 1990–2017 for which we had vital registration data for most select countries. Results In Italy, in 2017, 33 000 deaths were attributed to unspecified type of stroke and 15 000 to unspecified type of diabetes, these making a fourth of the overall garbage. Significant heterogeneity exists on the overall proportion of GCs, type (unspecified or impossible underlying causes), and size of specific GCs among regions in Italy, and among the select countries. We found no pattern between level of garbage and relevance of specific GCs. Even locations performing below average show interesting lower levels for certain GCs if compared to better performing countries. Conclusions This systematic analysis suggests the heterogeneity in GC levels and causes, paired with a more detailed analysis of local practices, strengths and weaknesses, could be a positive element in a strategy for the reduction of GCs in Italy.

Journal ArticleDOI
25 Jan 2022-PLOS ONE
TL;DR: The timely identification of SARS-CoV2 cases among children is useful to reduce the dissemination of the disease and its related burden and the predictive score may be adopted in a public health perspective to rapidly identify at risk children.
Abstract: Objectives We aimed to identify clinical, anamnestic, and sociodemographic characteristics associated with a positive swab for SARS-CoV2, and to provide a predictive score to identify at risk population in children aged 2–14 years attending school and tested for clinical symptoms of COVID-19. Design Cross sectional study. Setting Outpatient clinic of the IRCCS Burlo Garofolo, a maternal and child health tertiary care hospital and research centre in Italy. Data collection and analysis Data were collected through a predefined form, filled out by parents, and gathered information on sociodemographic characteristics, and specific symptoms, which were analysed to determine their association with a positive SARS-CoV-2 swab. The regression coefficients of the variables included in the multivariate analysis were further used in the calculation of a predictive score of the positive or negative test. Results Between September 20th and December 23rd 2020, from 1484 children included in the study, 127 (8.6%) tested positive. In the multivariate analysis, the variables retained by the model were the presence of contact with a cohabiting, non-cohabiting or unspecified symptomatic case (respectively OR 37.2, 95% CI 20.1–68.7; 5.1, 95% CI 2.7–9.6; 15.6, 95% CI 7.3–33.2); female sex (OR 1.49, 95% CI 1.0–2.3); age (6–10 years old: OR 3.2, 95% CI 1.7–6.1 p<0.001; >10 years old: OR 4.8, 95% CI 2.7–8.8 p<0.001); fever (OR 3.9, 95% CI 2.3–6.4); chills (OR 1.9, 95% CI 1.1–3.3); headache (OR 1.45, 95% CI 0.9–2.4); ageusia (OR 1.3, 95% CI 0.5–4.0); sore throat (OR 0.48, 95% CI 0.3–0.8); earache (OR 0.4, 95% CI 0.1–1.3); rhinorrhoea (OR 0.8, 95% CI 0.5–1.3); and diarrhoea (OR 0.52, 95% CI 0.2–1.1). The predictive score based on these variables generated 93% sensitivity and 99% negative predictive value. Conclusions The timely identification of SARS-CoV2 cases among children is useful to reduce the dissemination of the disease and its related burden. The predictive score may be adopted in a public health perspective to rapidly identify at risk children.

Journal ArticleDOI
TL;DR: In this article , the authors compared ibuprofen and ketorolac for children with acute traumatic musculoskeletal pain in the Paediatric Emergency Department setting.
Abstract: This study is to compare ibuprofen and ketorolac for children with trauma-related acute pain. We conducted a multicentre randomized, double-blind, controlled trial in the Paediatric Emergency Department setting. We enrolled patients aged 8 to 17 who accessed the emergency department for pain related to a limb trauma that occurred in the previous 48 h. At the admission, patients were classified based on numeric rating scale-11 (NRS-11) in moderate (NRS 4–6) and severe (NRS 7–10) pain groups. Each patient was randomized to receive either ibuprofen (10 mg/kg) or ketorolac (0.5 mg/kg) and the placebo of the not given drug in a double dummies design. NRS-11 was asked every 30 min until 2 h after drug and placebo administration. The primary outcome was NRS-11 reduction at 60 min. Among 125 patients with severe pain, NRS-11 reduction after 60 min from drug administration was 2.0 (IQR 1.0–4.0) for ibuprofen and 1.0 (IQR 1.0–3.0) for ketorolac (p = 0.36). Ibuprofen was significantly better, considering secondary outcomes, at 90 min with a lower median of NRS-11 (p 0.008), more patients with NRS-11 less than 4 (p 0.01) and a reduction of pain score of more than 3 NRS-11 points (p 0.01). Among 87 patients with moderate pain, the NRS-11 reduction after 60 min from drug administration was 1.63 (± 1.8) for ibuprofen and 1.8 (± 1.6) for ketorolac, with no statistically significant difference. Conclusions: Oral ibuprofen and ketorolac are similarly effective in children and adolescents with acute traumatic musculoskeletal pain. Trial registration: ClinicalTrial.gov registration number: NCT04133623.

Journal ArticleDOI
TL;DR: In conclusion, the enrolled children showed suboptimal intakes of several macro- and micronutrients, in line with Italian and European studies on primary school children, and public health interventions may be targeted to specific nutrients or subpopulations.
Abstract: Few Italian and European studies have assessed adherence to dietary recommendations in primary school children using dietary records. No Italian studies have provided an index-based nutritional adequacy assessment. We provided a comprehensive overview of dietary intake in 381 7-year-old children from NAC-II cohort study, Friuli Venezia Giulia (Italy). Energy, macro-, and micronutrient intakes were derived from 3-day dietary records. Standard (median and percentage) and index-based (Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR)) approaches were used to evaluate adequacy to Italian dietary reference values at nutrient- and overall-diet-level. Percentage contribution of macronutrients to energy intake (%En) was unbalanced towards total fats and protein. In 25% of children, total fats intake exceeded the reference intake upper limit. In ~63% of children, protein intake was at least doubled in their child-specific population reference intake. Median intakes of sodium (1.7 g/day), saturated fatty acids (12.2 %En), and soluble carbohydrates (19.4 %En) exceeded the suggested dietary target in most (65–84%) children. Inadequacy was also observed for micronutrients, with median NARs ranging from 0.11 (vitamin D) to 0.90 (zinc). The median MAR was 0.75 (0.69–0.79), with 1 indicating optimal overall dietary intake. In conclusion, the enrolled children showed suboptimal intakes of several macro- and micronutrients, in line with Italian and European studies on primary school children. Based on the current findings, public health interventions may be targeted to specific nutrients or subpopulations.

Journal ArticleDOI
TL;DR: To evaluate the relationship between lower respiratory tract infections (LRTI), in the first 2 years of life and lung function at school age in the Piccolipiù birth cohort (Italy), a large number of children were diagnosed with LRTI during the first year of life.
Abstract: To evaluate the relationship between lower respiratory tract infections (LRTI), in the first 2 years of life and lung function at school age in the Piccolipiù birth cohort (Italy).

Journal ArticleDOI
TL;DR: In this paper , the authors investigated the coping strategies of a group of adolescents with somatic symptom disorder compared to non-somatic symptom disorder peers during the COVID-19 related lockdown.
Abstract: To investigate the coping strategies of a group of adolescents with somatic symptom disorder compared to non-somatic symptom disorder peers during the COVID-19 related lockdown.This cross-sectional study is the second part of a previously published study showing an improved trend in depression and anxiety in a group of patients with somatic symptom disorder compared to non-somatic symptom disorder peers. An anonymous semi-structured survey was distributed to two groups of Italian adolescents to measure the impact of quarantine on their daily life and coping strategies.We recruited 115 adolescents, 58 (50.4%) mean age 15.3, with a recent diagnosis of somatic symptom disorder and 57 (49.6%) mean age 15.8, control peers.The aim of this study was to detect differences in coping strategies and relationships with parents and peers, during the lockdown period in a group of adolescents with somatic symptom disorder and low disease burden when compared with a non-somatic symptom disorder group.The relationship with parents significantly worsened in 4 (6.9%) of adolescents with somatic symptom disorder compared to 12 (21.1%) adolescents in the non-somatic symptom disorder group (p = 0.048). The relationship with peers significantly improved in 13 (22.4%) of adolescents with symptom disorder versus 3 (5.3%) of peers of the non- somatic symptom disorder group (p = 0.013).Adolescents with somatic symptom disorder with a low burden of physical symptoms experienced less deterioration in their relationships with parents and peers than the non-somatic symptom disorder group.

Journal ArticleDOI
12 Dec 2022-Trials
TL;DR: In this paper , the authors evaluated the effectiveness of an mHealth app to support women during the first 1000 days (from conception to 24 months of age) and to improve health prevention behaviours such as immunizations during pregnancy, weight gain during pregnancy and abstinence from smoking and alcohol consumption, and adherence to the routine childhood immunization schedule.
Abstract: Abstract Background Recent developments in eHealth and mobile health (mHealth), as well as the introduction of information and communication technology innovations in clinical practice, such as telemedicine, telemonitoring, and remote examinations, are already changing the current scenario and will continue to generate innovations in the coming decades. The widespread use of mobile devices, with an estimated nearly 30 billion devices and more than 325,000 apps worldwide, will provide various opportunities for people to take control of their own health. Already in 2017, most of the apps available were focused on pregnancy support, more than any other medical field. There have been some reported experiences with social media and mHealth that could benefit the promotion of maternal physical and mental health during pregnancy. However, many apps targeting the first 1000 days of a child’s life do not consider the continuity between the prenatal and postnatal periods and their joint impact on maternal and child health. The aim of this study is to evaluate the effectiveness of this mHealth app to support women during the first 1000 days (from conception to 24 months of age) and to improve health prevention behaviours such as immunizations during pregnancy, weight gain during pregnancy, abstinence from smoking and alcohol consumption, and adherence to the routine childhood immunization schedule. In addition, the study aims to understand the level of appreciation of this mHealth app as a tool to overcome information and communication gaps between patients and institutions. Methods Conduction of a randomized controlled trial. Discussion Our results will be relevant for improving this mHealth app to promote health and prevention and to support the first 1000 days of life for both mother and child. Our results will be relevant to the future expansion of such an mHealth app to promote positive health-related outcomes in patients and co-user satisfaction and to support the organization of health services. Trial registration ClinicalTrials.gov NCT05500339.

Journal Article
TL;DR: In this paper , the authors evaluated the effect of Resin infiltration on the in vivo functional treatment of molar hypomineralization (MH)-affected permanent first molars (PFMs).
Abstract: Purpose: The purpose of this study was to evaluate resin infiltration (RI) technique's effects on the in vivo functional treatment of molar hypomineralization (MH)-affected permanent first molars (PFMs). Methods: Fifteen MH-affected PFMs were resin-infiltrated and evaluated for a three-month follow-up (FU). In vivo resin replicas were used for profilometric and scanning electron microscope (SEM) analysis of PFM surfaces; any variation of clinical aspect and dentin hypersensitivity was registered as: T0 equals baseline; T1 equals right after treatment; T2 equals oneweek follow-up; and T3, T4, and T5 equal one-, two-, and three-month FU. Results: At T0, MH-affected surfaces were rougher and more irregular than sound ones; at T1, resin-infiltrated surfaces were smoother while a progressive increase of superficial roughness was observed over time. Hypersensitivity improved at T1 and remained stable over time in severe MH cases. Conclusions: Resin infiltration seems to be a promising treatment, especially in managing severe molar hypomineralization cases for the evaluated follow-up.

Journal ArticleDOI
03 Oct 2022-PLOS ONE
TL;DR: It is suggested that a higher risk of FERF is associated with socio-demographic factors, maternal characteristics and child sleeping behavior that could hinder parent empowerment.
Abstract: Objectives Unintentional injuries such as falls, are particularly frequent in early childhood. To date, epidemiological studies in this field have been carried out using routine data sources or registries and many studies were observational studies with a cross-sectional design. The aims of the study are to describe unintentional injuries in the first two years of life in the Piccolipiù birth cohort, and to investigate the association between mother and children characteristics and the First Event of Raised surface Fall (FERF). Methods This longitudinal observational study included 3038 children from an Italian birth cohort. Data on socio-demographic factors, socio-economic indicators, maternal health and lifestyle characteristics and child’s sleeping behavior, obtained from questionnaires completed at birth, 12 and 24 months of age, were considered in the analyses as potential risk factors of FERF. Time of occurrence of FERF was analyzed using the Kaplan-Meier method. The multivariable analysis for time to event was carried out using a Cox proportional hazards model. Results Falls from raised surfaces are the leading cause of unintentional injuries in the cohort with 610 (21.1%) and 577 (20.0%) cases among children during the first and second year of life, respectively. An increased risk of FERF was associated with several risk factors: maternal psychological distress (HR 1.41, 95%CI 1.10–1.81), maternal alcohol intake (HR 1.26, 95%CI 1.10–1.45), and child’s sleeping problems (HR 1.28, 95%CI 1.09–1.51). Children with older aged mothers (HR 0.98, 95%CI 0.96–0.99) and living in northern Italy (HR 0.64, 95%CI 0.55–0.75) had a lower risk of FERF. Conclusion The results of the study suggest that a higher risk of FERF is associated with socio-demographic factors, maternal characteristics and child sleeping behavior that could hinder parent empowerment.

Journal ArticleDOI
01 Sep 2022-Toxics
TL;DR: The results do not provide evidence of an association between concurrent phthalate/DINCHHEXAMOLLR DINCH exposure and IQ in children.
Abstract: Information about the effects of phthalates and non-phthalate substitute cyclohexane-1,2-dicarboxylic acid diisononyl ester (HEXAMOLL® DINCH) on children’s neurodevelopment is limited. The aim of the present research is to evaluate the association between phthalate/HEXAMOLL® DINCH exposure and child neurodevelopment in three European cohorts involved in HBM4EU Aligned Studies. Participating subjects were school-aged children belonging to the Northern Adriatic cohort II (NAC-II), Italy, Odense Child Cohort (OCC), Denmark, and PCB cohort, Slovakia. In each cohort, children’s neurodevelopment was assessed through the Full-Scale Intelligence Quotient score (FSIQ) of the Wechsler Intelligence Scale of Children test using three different editions. The children’s urine samples, collected for one point in time concurrently with the neurodevelopmental evaluation, were analyzed for several phthalates/HEXAMOLL® DINCH biomarkers. The relation between phthalates/HEXAMOLL® DINCH and FSIQ was explored by applying separate multiple linear regressions in each cohort. The means and standard deviations of FSIQ were 109 ± 11 (NAC-II), 98 ± 12 (OCC), and 81 ± 15 (PCB cohort). In NAC-II, direct associations between FSIQ and DEHP’s biomarkers were found: 5OH-MEHP+5oxo-MEHP (β = 2.56; 95% CI 0.58–4.55; N = 270), 5OH-MEHP+5cx-MEPP (β = 2.48; 95% CI 0.47–4.49; N = 270) and 5OH-MEHP (β = 2.58; 95% CI 0.65–4.51; N = 270). On the contrary, in the OCC the relation between DEHP’s biomarkers and FSIQ tended to be inverse but imprecise (p-value ≥ 0.10). No associations were found in the PCB cohort. FSIQ was not associated with HEXAMOLL® DINCH in any cohort. In conclusion, these results do not provide evidence of an association between concurrent phthalate/DINCHHEXAMOLLR DINCH exposure and IQ in children.