Valentina Guercio

Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid)

ABSTRACT Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of ≥ 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.

Mediterranean diet and colorectal cancer risk: a pooled analysis of three Italian case–control studies

Background:Adherence to the Mediterranean diet (MD) is associated with a reduced risk of several cancers. However, studies conducted in Mediterranean regions are scanty.Methods:To investigate the relation between MD and colorectal cancer risk in Italy, we pooled data from three case–control studies, including a total of 3745 colorectal cancer cases and 6804 hospital controls. Adherence to the MD was assessed using an a priori Mediterranean Diet Score (MDS), based on nine components.Results:Compared with the lowest adherence to the MD (0–2 MDS), the odds ratio (OR) was 0.52 (95% confidence interval (CI) 0.43–0.62) for the highest adherence (7–9 MDS), with a significant inverse trend in risk (P<0.0001). The OR for a 1-point increment in the MDS was 0.89 (95% CI 0.86–0.91). The inverse association was consistent across studies, cancer anatomical subsites and strata of selected covariates.Conclusions:This Italian study confirms a favourable role of MD on colorectal cancer risk.

Allium vegetables and upper aerodigestive tract cancers: a meta‐analysis of observational studies

SCOPE To provide updated quantitative overall estimations of the relation between total allium, garlic, and onion intake on the risk of cancer of the upper aerodigestive tract (UADT). METHODS AND RESULTS We combined data of published observational studies (21 case-control and four cohort studies), using a meta-analytic approach and random effects models. The overall relative risks (RR) and 95% confidence intervals (CIs) for the squamous cell carcinoma of the UADT were 0.79 (95% CI 0.56-1.11) for total allium, 0.74 (95% CI 0.57-0.95) for garlic, and 0.72 (95% CI 0.57-0.91) for onion for the highest versus the lowest consumption. The inverse relation was apparently stronger in case-control studies (RR 0.56, 95% CI 0.38-0.83 for total allium), in Chinese studies (RR 0.67, 95% CI 0.45-0.98 for garlic intake), and for esophageal than for head and neck cancers. Apparently, there was no relation between allium vegetable intake and adenocarcinoma of the esophagus. CONCLUSION We found a moderate inverse association between allium vegetable intake and the risk of squamous cell carcinoma of the UADT in case-control studies. The relation was unclear in cohort studies and for adenocarcinoma of the esophagus.

Relation of allium vegetables intake with head and neck cancers: Evidence from the INHANCE consortium

SCOPE Only a few studies analyzed the role of allium vegetables with reference to head and neck cancers (HNC), with mixed results. We investigated the potential favorable role of garlic and onion within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. METHODS AND RESULTS We analyzed pooled individual-level data from eight case-control studies, including 4590 cases and 7082 controls. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between garlic and onion intakes and HNC risk. Compared with no or low garlic use, the ORs of HNC were 0.95 (95% CI 0.71-1.27) for intermediate and 0.74 (95% CI 0.55-0.99) for high garlic use (p for trend = 0.02). The ORs of HNC for increasing categories of onion intake were 0.91 (95% CI 0.68-1.21) for >1 to ≤3 portions per week, and 0.83 (95% CI 0.60-1.13) for >3 portions per week (p for trend = 0.02), as compared to <1 portion per week. We found an inverse association between high onion intake and laryngeal cancer risk (OR = 0.69; 95% CI 0.54-0.88), but no significant association for other subsites. CONCLUSION The results of this pooled-analysis support a possible moderate inverse association between garlic and onion intake and HNC risk.

Exposure to PFOA and PFOS and fetal growth: a critical merging of toxicological and epidemiological data

Abstract Toxicological and epidemiological evidence on the association between perfluorooctanoic acid (PFOA) or perfluorooctane sulfonic acid (PFOS) and birth/fetal weight was assessed. An extensive search for toxicological information in rats and mice, and a systematic search for epidemiological evidence were conducted. The linear regression coefficient (LRC) of birth weight (BrthW) on PFOA/PFOS was considered, and separate random effects meta-analyses for untransformed (i.e. not mathematically transformed) and log-transformed values were performed. Toxicological evidence: PFOA: 12 studies (21 datasets) in mice showed statistically significant lower birth/fetal weights from 5 mg/kg body weight per day. PFOS: most of the 13 studies (19 datasets) showed lower birth/fetal weights following in utero exposure. Epidemiological evidence: Sixteen articles were considered. The pooled LRC for a 1 ng/mL increase in untransformed PFOA (12 studies) in maternal plasma/serum was −12.8 g (95% CI −23.2; 2.4), and −27.1 g (95% CI −50.6; −3.6) for an increase of 1 loge ng/mL PFOA (nine studies). The pooled LRC for untransformed PFOS (eight studies) was −0.92 g (95%CI −3.4; 1.6), and for an increase of 1 loge ng/mL was −46.1(95% CI −80.3; −11.9). No consistent pattern emerged for study location or timing of blood sampling. Conclusions: Epidemiological and toxicological evidence suggests that PFOA and PFOS elicit a decrease in BrthW both in humans and rodents. However, the effective animal extrapolated serum concentrations are 102–103 times higher than those in humans. Thus, there is no quantitative toxicological evidence to support the epidemiological association, thus reducing the biological plausibility of a causal relationship.