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Prevalence and features of SARS-CoV-2 infection in prisons in Tuscany

World Journal of Experimental Medicine 2024年第1期14卷 70-77页

作者： cristina stasi Martina Pacifici Caterina Milli Francesco Profili Caterina Silvestri Fabio Voller Epidemiology Unit Regional Health Agency of TuscanyFlorence 50141Italy Department of Medicine Surgery and NeuroscienceUniversity of SienaSiena 53100Italy

BACKGROUND Prisons can be a reservoir for infectious diseases,including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),due to the very intimate nature of the living spaces and the large number of people forced to share *** To investigate the SARS-CoV-2 epidemiology in prisons,this study evaluated the infection incidence rate in prisoners who underwent nasopharyngeal *** This is an observational cohort *** collection included information on prisoners who underwent nasopharyngeal swab testing for SARS-CoV-2 and the *** swab tests for SARS-CoV-2 were performed between 15 February 2021 and 31 May 2021 for prisoners with symptoms and all new arrivals to the *** section included information on the diagnosis of the disease according to the International Classification of Diseases,Ninth Revision,and Clinical *** Up until the 31 May 2021,79.2%of the prisoner cohort(n=1744)agreed to a nasopharyngeal swab test(n=1381).Of these,1288 were negative(93.3%)and 85 were positive(6.2%).A significant association[relative risk(RR)]was found only for the risk of SARS-CoV-2 infection among foreigners compared to Italians[RR=2.4,95%confidence interval(CI):1.2-4.8].A positive association with SARS-CoV-2 infection was also found for inmates with at least one nervous system disorder(RR=4,95%CI:1.8-9.1).The SARS-CoV-2 incidence rate among prisoners is significantly lower than in the general population in Tuscany(standardized incidence ratio 0.7,95%CI:0.6-0.9).CONCLUSION In the prisoner cohort,screening and rapid access to health care for the immigrant population were critical to limiting virus transmission and subsequent morbidity and mortality in this vulnerable population.

关键词： SARS-CoV-2 Epidemiology Prison Prevalence Foreigners Swab tests

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Evolving strategies for liver fibrosis staging: Non-invasive assessment

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World Journal of Gastroenterology 2017年第2期23卷 191-196页

作者： cristina stasi Stefano Milani Department of Experimental and Clinical Medicine University of Florence Department of Biomedical Experimental and Clinical SciencesUniversity of Florence

Transient elastography and the acoustic radiation force impulse techniques may play a pivotal role in the study of liver fibrosis. Some studies have shown that elastography can detect both the progression and regression of fibrosis. Similarly, research results have been analysed and direct and indirect serum markers of hepatic fibrosis have shown high diagnostic accuracy for advanced fibrosis/cirrhosis. The prognosis of different stages of cirrhosis is well established and various staging systems have been proposed, largely based on clinical data. However, it is still unknown if either noninvasive markers of liver fibrosis or elastography may contribute to a more accurate staging of liver cirrhosis, in terms of prognosis and fibrosis regression after effective therapy. In fact, not enough studies have shown both the fibrosis regression in different cirrhosis stages and the point beyond which the prognosis does not change- even in the event of fibrosis regression. Therefore, future studies are needed to validate noninvasive methods in predicting the different phases of liver cirrhosis.

关键词： Elastography Non-invasive methods Chronic liver diseases Stiffness Non-invasive serum markers

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Emerging Trends in Epidemiology of Hepatitis B Virus Infection

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Journal of Clinical and Translational Hepatology 2017年第3期5卷 272-276页

作者： cristina stasi Caterina Silvestri Fabio Voller Observatory of Epidemiology Regional Health Agency of Tuscany Florence Italy Department of Experimental and Clinical Medicine University of Florence Florence Italy Observatory of Epidemiology Regional Health Agency of Tuscany Florence Italy

Although a vaccine against hepatitis B virus (HBV) has been available since 1982,the prevalence of adults with chronic HBV infection in sub-Saharan Africa and East Asia is still estimated at 5-10%.A high rate of chronic infections is also found in the Amazon and the southern parts of eastern and central *** the Middle East and the Indian subcontinent,the prevalence is 2-5%.Less than 1% of the population of Western Europe and North America is chronically *** the high prevalence of infections (such as hepatitis) among inmates,prison is considered a reservoir for facilitating such *** on these premises,this current review examines and discusses emerging trends in the epidemiology of HBV infection,with particular attention to HBV infection in *** hepatitis B surface antigen (HBsAg) prevalence in prisoners in west and central Africa is very high (23.5%).The Centers for Disease Control and Prevention has highlighted the importance of HBV blood screening and subsequent anti-HBV vaccination in the prison *** vaccination was recommended for all inmates,representing an opportunity to prevent HBV infection in a high-risk *** these subjects,an accelerated hepatitis B immunisation schedule may result in rapid seroconversion for early short-term ***,it is necessary to seek collaboration among public health officials,clinicians and correctional authorities to implement a vaccination programme.

关键词： Chronic hepatitis B virus infection Public health Anti-HBV vaccine Epidemiology Prison

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Irritable bowel syndrome: a disease still searching for pathogenesis, diagnosis and therapy

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World Journal of Gastroenterology 2014年第27期20卷 8807-8820页

作者： Massimo Bellini Dario Gambaccini cristina stasi Maria Teresa Urbano Santino Marchi Paolo Usai-Satta Gastrointestinal Unit Department of Gastroenterology University of Pisa 56124 Pisa Italy Department of Experimental and Clinical Medicine University of Florence 50134 Florence Italy Epidemiological Observatory Health Agency of Tuscany 50141 Florence Italy Gastrointestinal Unit P. Brotzu Hospital09124 Cagliari Italy

Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient’s quality of life. The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain (gut-brain axis). The diagnosis of IBS can only be made on the basis of the symptoms of the Rome III criteria. Because the probability of organic disease in patients fulfilling the IBS criteria is very low, a careful medical history is critical and should pay particular attention to the possible comorbidities. Nevertheless, the severity of the patient’s symptoms or concerns sometimes compels the physician to perform useless and/or expensive diagnostic tests, transforming IBS into a diagnosis of exclusion. The presence of alarming symptoms (fever, weight loss, rectal bleeding, significant changes in blood chemistry), the presence of palpable abdominal masses, any recent onset of symptoms in patient aged over 50 years, the presence of symptoms at night, and a familial history of celiac disease, colorectal cancer and/or inflammatory bowel diseases all warrant investigation. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. This review examines and discusses the pathophysiological aspects and the diagnostic and therapeutic approaches available for patients with symptoms possibly related to IBS, pointing out controversial issues and the strengths and weaknesses of the current knowledge.

关键词： Irritable bowel syndrome Pathogenesis Diagnosis Therapy

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Attempt to calculate the prevalence and features of chronic hepatitis C infection in Tuscany using administrative data

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World Journal of Gastroenterology 2016年第44期22卷 9829-9835页

作者： Caterina Silvestri Simone Bartolacci Pasquale Pepe Mirko Monnini Fabio Voller Francesco Cipriani cristina stasi Observatory of Epidemiology Regional Health Agency of Tuscany Department of Experimental and Clinical Medicine University of Florence

AIM To evaluate this prevalence in Tuscan populations that was known and unknown to the Tuscan Regional Health Service in *** Tuscan Health administrative data were used to evaluate hepatitis C virus(HCV) infected people known to the Regional Health Service. Residents in Tuscany with a HCV exemption code(070.54) were identified. Using the universal code attributed to each resident, these patients were matched with hospital admission codes identified by the International Classification of Diseases, Ninth Revision(ICD-9), Clinical Modification, and with codes for dispensing drugs to patients by local and hospital pharmacies. Individuals were considered only once. Capture-recapture analysis was used to evaluate the HCV-infected population unknown to the Regional Health *** In total, 14526 individuals were living on 31/12/2015 with an exemption code for HCV. In total, 9524 patients were treated with pegylated interferon + ribavirin and/or direct-acting antiviral drugs during the last 10 years, and 13879 total hospital admissions were noted in the last 15 years. After data linkage, the total number was 25918. After applying the Capture-Recapture analysis, the number of unknown HCV-infected people was 23497. Therefore, the total number of chronic HCVinfected people was 38643, excluding those achieved sustained virological response to previous *** Our results show a prevalence of HCV infected people of 1%. Tuscan administrative data could be useful for calculating health care costs and health planning in the coming years.

关键词： Hepatitis C Public health Fibrosis Antiviral treatment Epidemiology

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Non-invasive assessment of liver fibrosis:Betweenprediction/prevention of outcomes and cost-effectiveness

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World Journal of Gastroenterology 2016年第4期22卷 1711-1720页

作者： cristina stasi Stefano Milani Department of Experimental and Clinical Medicine University of Florence50134 FlorenceItaly Department of Biomedical Experimental and Clinical SciencesUniversity of Florence50134 FlorenceItaly

The assessment of the fibrotic evolution of chronic hepatitis has always been a challenge for the clinical hepatologist. Over the past decade, various noninvasive methods have been proposed to detect the presence of fibrosis, including the elastometric measure of stiffness, panels of clinical and biochemical parameters, and combinations of both methods. The aim of this review is to analyse the most recent data on non-invasive techniques for the evaluation of hepatic fibrosis with particular attention to costeffectiveness. We searched for relevant studies published in English using the Pub Med database from 2009 to the present. A large number of studies have suggested that elastography and serum markers are useful techniques for diagnosing severe fibrosis and cirrhosis and for excluding significant fibrosis in hepatitis C virus patients. In addition, hepatic stiffness may also help to prognosticate treatment response to antiviral therapy. It has also been shown that magnetic resonance elastography has a high accuracy for staging and differentiating liver fibrosis. Finally, studies have shown that non-invasive methods are becoming increasingly precise in either positively identifying or excluding liver fibrosis, thus reducing the need for liver biopsy. However, both serum markers and transient elastography still have "grey area" values of lower accuracy. In this case, liver biopsy is still required to properly assess liver fibrosis. Recently, the guidelines produced by the World Health Organization have suggested that the AST-to-platelet ratio index or FIB-4 test could be utilised for the evaluation of liver fibrosis rather than other, more expensive non-invasive tests, such as elastography or Fibro Test.

关键词： stiffness serum markers liver fibrosis hepatitis C virus public health

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Gastrointestinal manifestations in myotonic muscular dystrophy

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World Journal of Gastroenterology 2006年第12期12卷 1821-1828页

作者： Massimo Bellini Sonia Biagi cristina stasi Francesco Costa Maria Gloria Mumolo Angelo Ricchiuti Santino Marchi Gastroenterology Unit Department of Internal MedicineUniversity of PisaItaly

Myotonic dystrophy （MD） is characterized by myotonic phenomena and progressive muscular weakness. Involvement of the gastrointestinal tract is frequent and may occur at any level. The clinical manifestations have previously been attributed to motility disorders caused by smooth muscle damage, but histologic evidence of alterations has been scarce and conflicting. A neural factor has also been hypothesized. In the upper digestive tract, dysphagia, heartburn, regurgitation and dyspepsia are the most common complaints, while in the lower tract, abdominal pain, bloating and changes in bowel habits are often reported. Digestive symptoms may be the first sign of dystrophic disease and may precede the rnusculo-skeletal features. The impairment of gastrointestinal function may be sometimes so gradual that the patients adapt to it with little awareness of symptoms. In such cases routine endoscopic and ultrasonographic evaluations are not sufficient and targeted techniques （electrogastrography, manornetry, electromyography, functional ultrasonography, scintigraphy, etc.） are needed. There is a low correlation between the degree of skeletal muscle involvement and the presence and severity of gastrointestinal disturbances whereas a positive correlation with the duration of the skeletal muscle disease has been reported. The drugs recommended for treating the gastrointestinal complaints such as prokinetic, antidyspeptic drugs and laxatives, are mainly aimed at correcting the motility disorders. Gastrointestinal involvement in MD remains a complex and intriguing condition since many important problems are still unsolved. Further studies concentrating on genetic aspects, early diagnostic techniques and the development of new therapeutic strategies are needed to improve our management of the gastrointestinal manifestations of MD.

关键词： Myotonic dystrophy Digestive disorders Gastrointestinal symptoms

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MicroRNAs in inflammatory bowel disease:What do we know and what can we expect?

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World Journal of Gastroenterology 2024年第16期30卷 2184-2190页

作者： Ellen cristina Souza de Oliveira Ana Elisa Valencise Quaglio Thais Gagno Grillo Luiz Claudio Di stasi Ligia Yukie Sassaki Department of Internal Medicine Medical SchoolSão Paulo State University(Unesp)Botucatu 18618-686São PauloBrazil Verum Ingredients Botucatu Technology ParkBotucatu 18605-525São PauloBrazil Department of Biophysics and Pharmacology Institute of BiosciencesSão Paulo State University(Unesp)Botucatu 18618-689São PauloBrazil

MicroRNAs(miRNAs),small non-coding RNAs composed of 18–24 nucleotides,are potent regulators of gene expression,contributing to the regulation of more than 30%of protein-coding *** that miRNAs are regulators of inflammatory pathways and the differentiation of intestinal epithelial cells,there is an interest in exploring their importance in inflammatory bowel disease(IBD).IBD is a chronic and multifactorial disease of the gastrointestinal tract;the main forms are Crohn's disease and ulcerative *** studies have investigated the dysregulated expression of miRNAs in IBD,demonstrating their important roles as regulators and potential biomarkers of this *** editorial presents what is known and what is expected regarding miRNAs in *** the important regulatory roles of miRNAs in IBD are clearly established,biomarkers for IBD that can be applied in clinical practice are lacking,emphasizing the importance of further *** regarding the influence of miRNAs on the inflammatory process and the exploration of their role in gene regulation are expected to provide a basis for the use of miRNAs not only as potent biomarkers in IBD but also as therapeutic targets for the control of inflammatory processes in personalized medicine.

关键词： MicroRNAs Inflammatory bowel disease Crohn’s disease Ulcerative colitis Biomarker Therapy

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Irritable bowel syndrome and chronic constipation: Fact and fiction

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World Journal of Gastroenterology 2015年第40期21卷 11362-11370页

作者： Massimo Bellini Dario Gambaccini Paolo Usai-Satta Nicola De Bortoli Lorenzo Bertani Santino Marchi cristina stasi Gastrointestinal Unit Department of GastroenterologyUniversity of Pisa Gastrointestinal Unit P. Brotzu Hospital Department of Experimental and Clinical Medicine University of Florence Epidemiological Observatory Regional Health Agency of Tuscany

Irritable bowel syndrome(IBS) and functional constipation(FC) are the most common functional gastrointestinal disorders. According to the Rome ⅢCriteria these two disorders should be theoretically separated mainly by the presence of abdominal pain or discomfort relieved by defecation(typical of IBS) and they should be mutually exclusive. However,many gastroenterologists have serious doubts as regards a clear separation. Both IBS-C and FC,often associated with many other functional digestive and non digestive disorders,are responsible for a low quality of life. The impact of the media on patients' perception of these topics is sometimes disruptive,often suggesting a distorted view of pathophysiology,diagnosis and therapy. These messages frequently overlap with previous subjective opinions and are further processed on the basis of the different culture and the previous experience of the constipated patients,often producing odd,useless or even dangerous behaviors. The aim of this review was to analyze the most common patients' beliefs about IBS-C and CC,helping physicians to understand where they should focus their attention when communicating with patients,detecting false opinions and misconceptions and correcting them on the basis of scientific evidence.

关键词： Irritable bowel syndrome Chronic constipation Func

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Evaluation of latent links between irritable bowel syndrome and sleep quality

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World Journal of Gastroenterology 2011年第46期17卷 5089-5096页

作者： Massimo Bellini Angelo Gemignani Dario Gambaccini Simona Toti Danilo Menicucci cristina stasi Francesco Costa Maria Gloria Mumolo Angelo Ricchiuti Remo Bedini Nicola de Bortoli Santino Marchi Gastrointestinal Unit Department of GastroenterologyUniversity of Pisa Institute of Clinical Physiology National Research Council Extreme Centre Scuola Superiore S Anna Department of Physiological Science University of Pisa Italian National Institute of Statistics

AIM:To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bow-el syndrome(IBS).METHODS:One hundred and forty-two outpatients(110female,32 male)who met the Rome Ⅲ criteria for IBS with no psychiatric comorbidity were consecutively en-rolled in this *** on age,body mass index(BMI),and a set of life-habit variables were recorded,and IBS symptoms and sleep quality were evaluated using the questionnaires IBS Symptom Severity Score(IBS-SSS)and Pittsburgh Sleep Quality Index(PSQI).The associa-tion between severity of IBS and sleep disturbances was evaluated by comparing the global IBS-SSS and PSQI score(Pearson's correlation and Fisher's exact test)and then analyzing the individual items of the IBS-SSS and PSQI questionnaires by a unitary bowel-sleep model based on item response theory(IRT).RESULTS:IBS-SSS ranged from mild to severe(120-470).The global PSQI score ranged from 1 to 17(median 5),and 60 patients were found to be poor sleepers(PSQI>5).The correlation between the global IBS-SSS and PSQI score indicated a weak association(r=0.2 and 95% CI:-0.03 to 0.35,P<0.05),which becomes stronger using our unitary ***,the IBS and sleep disturbances severities,estimated as latent variables,resulted significantly high intra-subject cor-relation(posterior mean of r=0.45 and 95% CI:0.17 to 0.70,P<0.05).Moreover,the correlations between patient features(age,sex,BMI,daily coffee and alcohol intake)and IBS and sleep disturbances were also ana-lyzed through our unitary *** was a signif icant regressor,with patients≤50 years old showing more severe bowel disturbances(posterior mean=-0.38,P<0.05)and less severe sleep disturbances(posterior mean=0.49,P<0.05)than older *** daily coffee intake was correlated with a lower sever-ity of bowel disturbances(posterior mean=-0.31,P<0.05).Sex(female)and daily alcohol intake(modest)were correlated with less severe sleep ***:The unitary bowel-sleep mod

关键词： Irritable bowel syndrome Sleep disorders Item response theory model Bayesian model

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