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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 them.AIM To investigate the SARS-CoV-2 epidemiology in prisons,this study evaluated the infection incidence rate in prisoners who underwent nasopharyngeal swabs.METHODS This is an observational cohort study.Data collection included information on prisoners who underwent nasopharyngeal swab testing for SARS-CoV-2 and the results.Nasopharyngeal 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 facility.Another section included information on the diagnosis of the disease according to the International Classification of Diseases,Ninth Revision,and Clinical Modification.RESULTS 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 非侵略的方法长期的肝疾病僵硬非侵略的浆液标记

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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 Europe.In 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 infected.Given the high prevalence of infections (such as hepatitis) among inmates,prison is considered a reservoir for facilitating such infections.Based on these premises,this current review examines and discusses emerging trends in the epidemiology of HBV infection,with particular attention to HBV infection in prison.The 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 population.The vaccination was recommended for all inmates,representing an opportunity to prevent HBV infection in a high-risk population.In these subjects,an accelerated hepatitis B immunisation schedule may result in rapid seroconversion for early short-term protection.Therefore,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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Sexual Behavior and Awareness of Sexually Transmitted Diseases Among Street-Based Female Sex Workers in the Florence Area, Central Italy

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International Journal of Dermatology and Venereology 2022年第4期5卷 226-230页

作者： Barbara Giomi Caterina Silvestri Stefano Bravi cristina stasi Lisa Bertini Leslie Mechi Serena Mordini Nicoletta Zocco Fabio Voller Francesco Cipriani Unit for STD and AIDS Department of DermatologyUniversity of FlorenceFlorence 50134Italy Observatory of Epidemiology Regional Health Agency of TuscanyFlorence 50141Italy Interdepartmental Hepatology Center MASVE Department of Experimental and Clinical MedicineUniversity of FlorenceFlorence 50134Italy CAT Social Cooperative Road Unit SATIS Regional Project Florence 50134Italy Department of Prevention Central Tuscany Local UnitFlorence 50135Italy.

Objective:Street-based female sex workers are more likely to practice unprotected sex with multiple partners increases their risk of infection with sexually transmitted diseases.This study was performed to evaluate the understanding of and risk factors for sexually transmitted diseases among street-based female sex workers.Methods:A survey consisted of a sociodemographic section and a health section was conducted from June to August in two consecutive years(2012-2013)using an anonymous questionnaire compiled by street-based female sex workers in the area of Florence(Central Italy).A descriptive analysis of sociodemographic,epidemiological,and anamnestic variables was performed using common methods for proportions;associations between variables were assessed using univariate and bivariate logistic regression.Results:Totally 122 street-based female sex workers(mean age,24.1 years;age range,17-45 years)were enrolled,and were from Europe(63.1%)(mainly from Romania[48.4%]and Albania[13.1%]),Africa(31.2%)(specifically Nigeria),and South America(5.7%).Of the 122 street-based female sex workers,63%were married/engaged and 37%were single.More than half had been living in Italy and Florence for more than 1 year;72.8%stated that they possessed a residence permit and the others were illegal migrants.Eighteen(15%)street-based female sex workers also worked in the industry in neighboring European countries.Their level of education was generally high:58.1%had completed secondary school(lower secondary school and upper secondary school).A total of 81.4%stated that they perceived an actual fear of contracting human immunodeficiency virus;in fact,43.3%had never been tested for any sexually transmitted diseases except for human immunodeficiency virus.Conclusion:Despite the long-time involvement of street-based female sex workers in the commercial sex industry,the large numbers of clients and a strong perception of concerns about sexually transmitted diseases.This study confirms a low rate of condom use and blood screening,and corre

关键词： female sex street workers foreigners sexually transmitted diseases

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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 2015.METHODS 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 Service.RESULTS 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 treatment.CONCLUSION 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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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 study.Data 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 model.Indeed,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 model.Age 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 patients.Higher 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 disturbances.CONCLUSION:The unitary bowel-sleep model based on IRT revealed a strong positive corre

关键词：睡眠质量肠道 Fisher精确检验综合症睡眠障碍严重程度评价项目反应理论

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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 (MD ) 被肌强直的现象和进步肌肉发达的软弱描绘。胃肠道的参与是经常的并且可以发生在任何水平。临床的表明以前被归因于改变的平滑肌损坏，而是 histologic 证据引起的活动性混乱少见、冲突。一个神经因素也被假设了。，在... 详细信息

Myotonic (MD ) 被肌强直的现象和进步肌肉发达的软弱描绘。胃肠道的参与是经常的并且可以发生在任何水平。临床的表明以前被归因于改变的平滑肌损坏，而是 histologic 证据引起的活动性混乱少见、冲突。一个神经因素也被假设了。，在更低的道在上面的消化道，咽下困难，心痛，流回和消化不良是最普通的抱怨，腹的疼痛，膨胀并且在肠习惯的变化经常被报导。消化症状可以是营养不良的疾病的第一症状并且可以先于肌与骨的特征。胃肠的功能的缺陷可能有时是那么渐渐的病人与症状的很少了解适应它。不在内视镜的如此的情况常规和 ultrasonographic 评估是足够、指向的技术(胃电描记法，测压法，肌电描记法，功能的 ultrasonography， scintigraphy，等等) 被需要。而与骨胳的肌肉疾病的持续时间的积极关联被报导了，在胃肠的骚乱的骨胳的肌肉参与和存在和严厉的度之间有低关联。这些药为对待象专业版那样的胃肠的抱怨推荐了运动的、反消化不良的药和 laxatives，主要针对改正活动性混乱。自从许多重要问题仍然是未解决的，在 MD 的胃肠的参与仍然是一个复杂、吸引人的条件。专注于基因方面，早诊断的技术和新治疗学的策略的发展的进一步的研究被需要改进我们 MD 的胃肠的表明的管理。

关键词：肌肉营养不良胃肠疾病强直肌肉临床表现

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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 Th

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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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