Respiratory syncytial virus (RSV) bronchiolitis remains a significant global health burden, particularly in newborns and infants during their first year of life. The quest for an effective preventive ...strategy against RSV has long been sought, and recent developments have shown promise in the form of nirsevimab, a monoclonal antibody specifically designed for RSV prophylaxis. Valle d'Aosta was the first Italian region to propose universal prophylaxis with nirsevimab for newborns and infants in their first epidemic season as early as 2023-2024. This study describes the effectiveness and safety of the universal prevention program of RSV bronchiolitis using the monoclonal antibody nirsevimab in children resident in Valle d'Aosta born during the 2023-2024 epidemic season. There were 556 neonates born from 1 May 2023 to 15 February 2024. The risk of hospitalization for RSV bronchiolitis in 2023-2024 was 3.2%, compared to 7% in the 2022-2023 epidemic season (
< 0.001). After the start of the prophylaxis campaign with nirsevimab, the risk of hospitalization was 8.3% in the sample of infants who did not adhere to the prophylaxis, while no child in the sample of those treated (
< 0.001) was hospitalized for bronchiolitis. Few mild transient side effects were reported. This study shows the efficacy and safety of universal prophylaxis with nirsevimab in neonates, making Valle d'Aosta the first Italian region to offer universal prophylaxis to newborns without risk factors for RSV complications. Future research could further explore its long-term impact and cost-effectiveness.
Introduction
The increasing survival of patients with breast cancer has prompted the assessment of mortality due to all causes of death in these patients. We estimated the absolute risks of death ...from different causes, useful for health-care planning and clinical prediction, as well as cause-specific hazards, useful for hypothesis generation on etiology and risk factors.
Materials and methods
Using data from population-based cancer registries we performed a retrospective study on a cohort of women diagnosed with primary breast cancer. We carried out a competing-cause analysis computing cumulative incidence functions (CIFs) and cause-specific hazards (CSHs) in the whole cohort, separately by age, stage and registry area.
Results
The study cohort comprised 12,742 women followed up for six years. Breast cancer showed the highest CIF, 13.71%, and cardiovascular disease was the second leading cause of death with a CIF of 3.60%. The contribution of breast cancer deaths to the CIF for all causes varied widely by age class: 89.25% in women diagnosed at age <50 years, 72.94% in women diagnosed at age 50–69 and 48.25% in women diagnosed at age ≥70. Greater CIF variations were observed according to stage: the contribution of causes other than breast cancer to CIF for all causes was 73.4% in women with stage I disease, 42.9% in stage II–III and only 13.2% in stage IV. CSH computation revealed temporal variations: in women diagnosed at age ≥70 the CSH for breast cancer was equaled by that for cardiovascular disease and “other diseases” in the sixth year following diagnosis, and an early peak for breast cancer was identified in the first year following diagnosis. Among women aged 50–69 we identified an early peak for breast cancer followed by a further peak near the second year of follow-up. Comparison by geographic area highlighted conspicuous variations: the highest CIF for cardiovascular disease was more than 70% higher than the lowest, while for breast cancer the highest CIF doubled the lowest.
Conclusion
The integrated interpretation of absolute risks and hazards suggests the need for multidisciplinary surveillance and prevention using community-based, holistic and well-coordinated survivorship care models.
Streptococcus pneumoniae is the main cause of community-acquired pneumonia worldwide; pneumonia occurs sporadically in most cases, but rare outbreaks have been reported. We describe an outbreak ...occurred in a 21-guests nursing home for elders in Aosta (Italy); outbreak occurred in april 2014 over a 2 weeks period, resulting in 12 out 20 guests affected (all with high fever and respiratory symptoms), two deaths (at home), nine patients referred to Hospital Emergency Room, and eight admissions. Urinary streptococcus antigen was positive in seven out of eight patient tested. None of the nursing home guests were vaccinated against Streptococcus pneumoniae The Hospital Medical Direction and Public Health Service gave support and adopted strategies to contain the outbreak spread. We underline the need for pneumococcal vaccination in nursing homes/ Long-term care facilities; accurate check of hygiene behaviours in those setting is also mandatory.
Sarcomas are a heterogeneous group of rare cancers of mesenchymal origin. In this study, we provide updated, world age-standardised incidence rate (ASR) and European age-standardised incidence rate ...for malignant soft tissue sarcoma (ICD-O-3 topographic code C47–C49) and bone sarcoma (C40, C41) in Italy, by area (north, centre, and south) and by cancer registry. We also assess morphology in relation to site and area and assess metastases at diagnosis. We analysed 1,112 cases, with incidence 2009–2012, provided by 15 cancer registries (CRs) affiliated to the Association of Italian Cancer Registries (AIRTUM). Overall, ASR was 1.7/100,000/year for soft tissue sarcoma and 0.7 for bone sarcoma. Central Italy had the highest (2.4) ASR and south Italy had the lowest (1.6) ASR for soft tissue sarcoma. Central Italy had the highest (1.1) ASR and north Italy had the lowest (0.7) ASR for bone sarcoma. By CR, ASRs ranged from 1.1 to 2.6 for soft tissue sarcoma and from 0 to 1.4 for bone sarcoma. The most frequent soft tissue sarcomas were sarcoma not otherwise specified (NOS) (29.4%) and liposarcoma (22.2%); the most common bone sarcoma was chondrosarcoma (37.6%). Soft tissue sarcomas occurred most frequently (35.6%) in lower limb connective tissue; bone sarcomas arose mainly (68.8%) in long bones. The frequencies of morphologies arising at different sites varied considerably by Italian area; for example, 20% of hemangiosarcomas occurred in the head and neck in south Italy with 17% at this site in the centre and 6% in the north. For soft tissue sarcoma, the highest ASRs of 2.6 and 2.4 contrast with the lowest ASRs 1.1 and 1.3, suggesting high-risk hot spots that deserve further investigation. The marked variations in morphology distribution with site and geography suggest geographic variation in risk factors that may also repay further investigation particularly since sarcoma etiology is poorly understood.
Summary
Summer bird populations were studied in ten sites: two heathlands, two maritime pine Pinus pinaster plantations, one, four, seven and 13‐year‐old eucalypt Eucalyptus globulus plantations, one ...climax oak Quercus robur woodland, and a farmland area in northwestern Galicia, Spain. The farmland and oak wood contained the greatest number of species (24 and 17 respectively) while the one and four‐year‐old eucalypt stands contained the fewest species (four and six respectively). Avian density was highest in the oak wood (93 birds/ 10 ha) and lowest in a heathland site, the four and one‐year‐old eucalypt stands (26,13, and seven bird/10 ha respectively). The wren was the most widespread and dominant species occurring in all study areas except the one‐year‐old eucalypt stand. Mean bird species diversity for the four eucalypt stands was significantly lower than mean bird species diversity for the other wooded habitats. The avian communities of the heathlands, maritime pine and eucalypt plantations, in contrast to the oak wood and farmland, show an excessively high dominance of one species. Using avian dominance as a biological index of habitat perturbation suggests that over half the landscape (4000 km2) in northwestern Galicia is suffering from chronic stress. The newest stress to the avifauna in a long history of land exploitation by man is the importation and cultivation on grand scale of eucalypts. Balancing this tendency, traditional, small‐scale farming on the mountainous terrain leads to the development of many tiny parcels whose average size is 0.28 ha; this in turn creates much ‘edge’ in hedgerow which serves to maintain a relatively rich avian species diversity in farmland.
Small mammals, particularly the white-footed mouse, Peromyscus leucopus, were live-trapped, marked and released in a radiated, natural oak-pine community at Brookhaven National Laboratory. Studies ...during the summer of 1961 evaluated the population prior to the start of daily radiation in November, 1961. The population was then studied in the summer of 1962 during radiation. No detectable effects of radiation were observed in the population. Lack of detectable effects of radiation may be attributed to: (1) a low population density and too few animals with which to work, and (2) a local nonrandom orientation of this species to certain parts of the radiated forest which resulted in its being found in areas away from the source; that is, they were found where levels of radiation were mostly below 3 r/day. Habitat orientation in Peromyscus leucopus was found to be strongly associated with the 0.0-0.3 m shrub layer which consisted largely of Vaccinium angustifolium. Wherever cover of this shrub layer was thick, captures of the white-footed mouse were at a minimum. Higher capture success was recorded in areas where this shrub layer was not as abundant.
An attempt was made to study the variations of an ecological parameter, water depth, and the effects of these variations on the foraging behaviour of waterfowl. 2 interconnecting freshwater ponds ...were chosen and marked into quadrants by corner stakes. Observing 3 quadrats from one pond and one from the second, the number of foraging dives per minute and the dive and pause times were recorded. Subsequent measurement of depth showed pond I 25-45 cm, pond II 52-74 cm. A significant difference in diving times was found (1.3 plus or minus 0.2 to 1.5 plus or minus 0.2 sec in pond I; 2.5 plus or minus 0.2 to 3.5 plus or minus 0.4 sec in pond II). Dives and pauses were longer and frequency of diving lower in deep water. While water, depth affected both dive time and pause time, the dive: pause ratio (a measure of efficiency) was similar for both ponds. It is pointed out, however, that the efficiency in terms of energy derived from food in relation to work put in to obtain may be affected in dives into deeper water.
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