During pregnancy and in the post-partum period, several diseases may arise or become exacerbated. Acute pancreatitis is an inflammatory disease with an increasing incidence in Western countries. The ...incidence of acute pancreatitis during pregnancy is not different with respect to the general population, but this incidence increases in the first 2 years after delivery. Biliary sludge and stones are the most frequent aetiologies, followed by hypertriglyceridemia. Taking care of the mother and foetus through a potentially severe disease requires a team consisting of an obstetrician, a gastroenterologist, an anaesthesiologist, and a surgeon. It is necessary to monitor the health of the foetus/child and the mother during pregnancy, childbirth, and puerperium. The management of this care depends on the systemic and local complications, the severity of the acute pancreatitis, and the trimester of pregnancy. Some diagnostic tools and many drugs are not safe for foetuses, while interventional endoscopy and surgery have limitations and can only be used after an accurate evaluation of benefit/risk ratios. Despite these limitations, maternal mortality due to acute pancreatitis is low during pregnancy, mainly thanks to multidisciplinary approaches for these patients. A careful diet to prevent obesity, alcohol abstinence, routine serum triglyceride control, and breastfeeding for at least three months may prevent acute pancreatitis during and after pregnancy.
Background
Acute pancreatitis (AP) caused by gallstones has an increased rate of incidence in young women in the 2 years postpartum. Middle-aged women with longer periods of breastfeeding have less ...hospitalization for gallbladder disease.
Aim
To investigate whether breastfeeding or other variables may be associated with AP.
Methods
We conducted a population-based case–control study among all Sicilian women of childbearing age, and we identified all women who delivered (2013–2016) and had AP within 2 years postpartum. We reviewed their medical records, and for each case we matched four women of the same age (± 5 years), without AP. Univariate and multivariate logistic regression was used to estimate the odds ratios (OR) with their confidence intervals (CI) to assess associations between AP and clinical determinants.
Results
In the 74 women with AP and 298 controls at univariate analysis, > 6 months oral contraception history (
p
< 0.01; OR 3.30; 95% CI 1.33–8.16), previous biliary disease (
p
< 0.001; OR 5.90; 95% CI 1.98–17.57) and smoking (
p
= 0.035; OR 2.04; 95% CI 1.04–4.0) were predictors of AP; amenorrhea ≥ 3 months (
p
< 0.001; OR 0.34; 95% CI 0.19–0.59) and breastfeeding ≥ 3 months (
p
< 0.001; OR 0.07; 95% CI 0.03–0.14) were protective. At multivariate analysis, previous biliary disease (
p
= 0.011; OR 5.49; 95% CI 1.48–20.38) and breastfeeding ≥ 3 months (
p
< 0.001; OR 0.06; CI 95% 0.03–0.14) were associated with AP.
Conclusions
Women who breastfeed for at least 3 months and do not have a history of biliary disorders have reduced risk of developing AP in the 2 years after delivery.
Background and aimsThe Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and ...European Economic Area (EEA).
DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessment of data availability and quality, and a correction was applied for under-estimation. Calculation of DALYs was performed with the BCoDE software toolkit without applying time discounting and age-weighting.
We estimated that one in 14 inhabitants experienced an infectious disease episode for a total burden of 1.38 million DALYs (95% uncertainty interval (UI): 1.25-1.5) between 2009 and 2013; 76% of which was related to the acute phase of the infection and its short-term complications. Influenza had the highest burden (30% of the total burden), followed by tuberculosis, human immunodeficiency virus (HIV) infection/AIDS and invasive pneumococcal disease (IPD). Men had the highest burden measured in DALYs (60% of the total), adults 65 years of age and over had 24% and children less than 5 years of age had 11%. Age group-specific burden showed that infants (less than 1 year of age) and elderly people (80 years of age and over) experienced the highest burden.
These results provide baseline estimates for evaluating infectious disease prevention and control strategies. The study promotes an evidence-based approach to describing population health and assessing surveillance data availability and quality, and provides information for the planning and prioritisation of limited resources in infectious disease prevention and control.
Abstract Introduction In the last decades, the World Health Organization (WHO) recognized the importance of risk communication as a key factor to achieve general compliance and improve community ...engagement to preparedness and response measures during public health emergencies. The COVID-19 pandemic revealed the weaknesses of risk communication in a context characterized by uncertainty and insufficient medical and scientific knowledge about SARS-CoV-2, which induced confusion in the public and represented a challenge for evidence-based decision making. Additionally, the context of communication was marked by easy access to an unprecedented number of sources of information, not always understandable and manageable by the public (infodemic). Methods In order to contribute to the identification of practical recommendations for the improvement of current risk communication strategies during health emergencies, we propose a model with an integrated approach, which considers interconnections at institutional, scientific and mass communication level. Results We identified a series of guiding principles, including the need for a more inclusive risk communication, which would consider all the actors involved, as well as the adaptation of communication strategies to different scenarios and epidemiological contexts. Discussion Communication should follow pre-established steps (preparation, monitoring, intervention, and reinforcement) to support people, especially during health emergencies. In this sense, institutional communication plays a key role, and the exponential growth of government’s social media accounts during the recent pandemic further highlights it. Conclusion Communication should be embedded in any pandemic plan, therefore the Italian Ministry of Health has established a permanent team to coordinate the aspects of risk communication for the present national pandemic plan.
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