A Azara

Università degli Studi di Sassari, Sassari, Sardinia, Italy

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Publications (16)12.32 Total impact

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    ABSTRACT: An economic analysis was performed at the University of Sassari (Italy) teaching hospital, to evaluate the economic impact of treating a set percentage of patients, admitted in the years 2002-2004 and assigned to one of the 43 Diagnosis Related Groups considered at "high risk of inappropriateness", as outpatients or day-hospital patients as opposed to treating them as inpatients.The actual economic impact consisted in substantial savings for the paying body but lower returns for the healthcare service delivery facility. The estimated potential impact of utilizing the updated DRG rates for day hospital services (2005 rates), may lead to possible further loss of receipts for the facility.
    Igiene e sanita pubblica 01/2007; 63(2):151-62.
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    ABSTRACT: The aims of this study are to assess the quality of the coastal waters of central-northern Sardinia through data from a monitoring network and to outline maps and experimental models of environmental risk correlated to the presence of chemical and microbiological contaminants. The area studied is the coast between Capo Falcone and the mouth of the river Coghinas, in the northwestern part of the island. In a first phase, 7 sampling stations of sea water and 1 sampling station of bivalve molluscs (Mytilus galloprovincialis Lam.) were identified. For each transept 3 different collection points at respectively 500, 1000, and 3000 meters from the coast for a total 21 sampling sites were identified. In a second phase, another 7 transepts were identified, 2 of which on the island of Asinara. As regards the microbiological monitoring of the sea water, very low concentrations of Total coliforms, Faecal coliforms and Faecal Streptococci were found and no Salmonella were isolated. Chemical analysis of the waters showed a high constant presence of phenols. In the bivalves we found rather high concentrations of Faecal coliforms without any clear seasonal variation, while no Salmonella was isolated in any of the examined samples. The results show that the considered area is not affected by serious pollution processes, thus allowing to express a completely satisfactory judgement on its state of health. However anthropic pressure in the considered territory is testified by the presence in the water of high concentrations of phenols. The results point out to the necessity of targeted and rational preventive action by means of control and protection measures for environmental ecosytems.
    Journal of preventive medicine and hygiene 07/2006; 47(2):49-55.
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    ABSTRACT: In the last years, international traffic volume has significantly increased, raising the risk for acquisition of infectious diseases. Among travel-associated infections, increased incidence of legionellosis has been reported among travellers. Aim of our study was: to describe the frequency and severity of Legionella spp. contamination in ferries and cruise ships; to compare the levels of contamination with those indicated by the Italian ministerial guidelines for control and prevention of legionellosis, in order to assess health risks and to adopt control measures. A prevalence study was carried out on 9 ships docked at the seaports of northern Sardinia in 2004. Water samples were collected from critical sites: passenger cabins, crew cabins, kitchens, coffee bars, rooms of the central air conditioning system. It was performed a qualitative and quantitative identification of Legionella spp. and a chemical, physical and bacteriological analysis of water samples. Forty-two percent (38/90) water samples were contaminated by Legionella spp.. Positive samples were mainly drawn from showers (24/44), washbasins (10/22). L. pneumophila was isolated in 42/44 samples (95.5%), followed by L. micdadei (4.5%). Strains were identified as L. pneumophila serogroup 6 (45.2%; 19 samples), 2-14 (42.9%), 5 (7.1%) and 3 (4.8%). Legionella spp. load was high; 77.8% of the water samples contained > 10(4) CFU/L. Low residual free chlorine concentration (0-0.2 mg/L) was associated to a contamination of the 50% of the water samples. Legionella is an ubiquitous bacterium that could create problems for public health. We identified Legionella spp. in 6/7 ferries. Microbial load was predominantly high (> 10(4) CFU/L or ranging from 10(3) to 10(4) CFU/L). It is matter of concern when passengers are subjects at risk because of Legionella spp. is an opportunist that can survive in freshwater systems; high bacterial load might be an important variable related to disease's occurrence. High level of contamination required disinfecting measures, but does not lead to a definitive solution to the problem. Therefore, it is important to identify a person responsible for health safety in order to control the risk from exposure and to apply preventive measures, according to European and Italian guidelines.
    BMC Public Health 02/2006; 6:100. · 2.08 Impact Factor
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    ABSTRACT: Isolates of Salmonella enteritidis PT3, a rare phage type, were recovered from patients and strains were isolated from an outbreak of gastroenteritis that occurred during the summer of 1997 in North-East Sardinia, Italy. To investigate possible clonal involvement in the outbreak and to evaluate the capacity to discriminate among S. enteritidis PT3 strains, a number of molecular typing methods including ribotyping with a mixture of PstI and SphI (PS-ribotyping), PFGE with endonuclease XbaI and RAPD typing with four arbitrary primers was used. The typical XbaI endonuclease generated PFGE pattern also explained the prevalence of highly clonal S. enteritidis PT3 strains in the outbreak and adjacent areas. RAPD fingerprinting with primers OPA 4, OPB 15, OPB17 and P1254 exhibited a single but unique RAPD profile among the outbreak strains from various sources that differed significantly from control strains. The results of this study showed that when an appropriately chosen set of primers is employed, RAPD fingerprinting can be used as an alternative, rapid, highly reproducible technique for tracing the clonal relations of S. enteritidis PT3, and can be more discriminatory than PFGE. Furthermore, this study revealed the possibility of PT3 causing outbreak.
    The New Microbiologica: official journal of the Italian Society for Medical Virology (SIVIM) 11/2001; 24(4):371-7. · 1.67 Impact Factor
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    ABSTRACT: A collection of Salmonella enterica serotype Typhimurium human strains isolated in Northern Sardinia (Italy) was examined for the insertion sequence IS200, phage type, antibiotic profile, ribotyping polymorphisms and plasmid profile. All clinical isolates studied contained from 4 to 10 copies of the IS200 element. IS200 permitted to discriminate Typhimurium strains and to identify five IS200 types, some of them circulating in Sardinia at least since 1900. Strains belonging to phage DT104 predominated and correlated with a specific IS200 pattern.
    Epidemiology and Infection 07/1998; 120(3):215-22. · 2.87 Impact Factor
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    ABSTRACT: The seroprevalence of anti-HCV antibody was studied among 2,749 children and teenagers (1,438 males and 1,311 females) living in Italy. Anti-HCV antibody testing was positive by both EIA and RIBA in ten (0.36%) subjects. The positivity rate increased with age, ranging from 0 among children less than 6 years of age to 0.8% among those aged 17–19 years x2 linear regression=0.038). Anti-HCV prevalence ranged from 0.2% in northeastern regions and in Apulia to 0.6% in Sicily and Sardinia (p>0.005), and no difference was seen between males (0.35%, C.I. 95%: 0.04–0.66) and females (0.38%, C.I. 95%:0.04–0.66) (Fisher's exact test=0.565). From these data it appears that in Italy HCV infection is an uncommon event during childhood.Bei 2.749 Kindern und Jugendlichen (1.438 Jungen und 1.311 Mdchen), die in Italien leben, wurde eine Studie zur Seroprvalenz der anti-HCV Antikrper durchgefhrt. Bei zehn der Getesteten (0,36%) fand sich mit EIA und RIBA ein positiver Befund. Die Rate an positiven Fllen nahm mit dem Alter zu von 0 bei Kindern unter 6 Jahren auf 0,8% bei den 17–19jhrigen (Chi2 lineare Regression=0,038). In den nordstlichen Regionen and Apulien lag die anti-HCV Seroprvalenz bei 0,2%, in Sizilien und Sardinien bei 0,6% (p>0,005). Zwischen Mdchen und Jungen fand sich kein Unterschied (0,35%, 95% CI: 0,04–0,66 bei Jungen und 0,38%, 95% CI: 0,04–0,66; Fisher's exakter Test 0,565). Aus diesen Daten lt sich ableiten, da die HCV-Infektion in der Kindheit in Italien ein seltenes Ereignis ist.
    Infection 09/1994; 22(5):350-352. · 2.44 Impact Factor
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    ABSTRACT: Between 1987 and 1989, the prevalence of antibodies to Toxoplasma gondii was determined by ELISA in serum samples from 1,494 apparently healthy subjects, 3-18 years old. Subjects were selected by a systematic cluster sampling from five geographical areas in Italy. The overall prevalence of antibodies was 17.9%, increasing from 4.7% in 4-6 year olds to 28.4% in 17-18 year olds (P less than 0.01). A slight predominance was observed among males (18.2% vs. 17.5% in females), as well as among subjects residing in Southern Italy and the Islands (21.9% vs. 19.2% in subjects residing in the North), but neither difference was statistically significant. Toxoplasma infection was associated with sociodemographic factors. Subjects belonging to a household with six or more persons had a 1.8-fold risk (C.I. 95% = 1.3-2.6) and subjects whose fathers had less than six years of schooling had a 2.7-fold rosk (C.I. 95% = 1.8-3.9) of previous exposure to toxoplasma infection. Considering the large proportion (70%) of young women entering childbearing age without toxoplasma antibodies, it appears that the risk of congenital toxoplasmosis will not be negligible in Italy in forthcoming years.
    Microbiologica 08/1991; 14(3):229-34.
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    ABSTRACT: In 1989, the prevalence of antibodies to hepatitis A virus (anti-HAV) in a sample of 1350 Sardinian teenagers aged 14 to 19 years was estimated by Elisa method. The overall anti-HAV prevalence was 20%; it increased from 12.3% among 14-16 year old subjects to 27.4% in subjects aged 17-19 years (P less than 0.01). A slight female preponderance was observed (22.1% versus 17.9) but no statistically significant difference was attained. Compared with the corresponding figure (71.6% of prevalence rate) observed in North Sardinia in 1980, the results of the present study show a dramatic reduction in anti-HAV prevalence among teenagers. A significant association was found with sociodemographic factors: subjects whose fathers had less than six years of schooling, had a 2.1-fold risk (C.I. 95% = 1.5-3.1) and subjects belonging to a household of 6 or more under one roof had a 1.7-fold risk (C.I. 95% = 1.2-2.3) of previous exposure to hepatitis A virus (HAV) infection. These findings indicate that exposure to HAV in Sardinia is decreasing, probably because of improvements in socio-economic conditions during recent years. However, overcrowding and short paternal education appear to be important determinants of infection.
    Microbiologica 02/1991; 14(1):21-4.
  • G Bo, A Maida, A Azara
    Journal of chemotherapy (Florence, Italy) 08/1989; 1(4 Suppl):938-41. · 0.83 Impact Factor
  • Nuovi annali d'igiene e microbiologia 01/1987; 38(5-6):395-436.
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    ABSTRACT: The seroprevalence of anti-HCV antibody was studied among 2,749 children and teenagers (1,438 males and 1,311 females) living in Italy. Anti-HCV antibody testing was positive by both EIA and RIBA in ten (0.36%) subjects. The positivity rate increased with age, ranging from 0 among children less than 6 years of age to 0.8% among those aged 17-19 years chi 2 linear regression = 0.038). Anti-HCV prevalence ranged from 0.2% in northeastern regions and in Apulia to 0.6% in Sicily and Sardinia (p > 0.005), and no difference was seen between males (0.35%, C.I. 95%: 0.04-0.66) and females (0.38%, C.I. 95%: 0.04-0.66) (Fisher's exact test = 0.565). From these data it appears that in Italy HCV infection is an uncommon event during childhood.
    Infection 22(5):350-2. · 2.44 Impact Factor
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    ABSTRACT: The work is a synthesis of the qualitative monitoring on waters resources (specially surface water), that were potable and distributed as drinkable waters in north Sardinia between 1996-2002. The obtained results point out: for the surface waters, recurrent problems of elevated turbidity, color, oxidability, microbial contamination and eutrofication; for the ground waters, lower levels of pollutants even if an high content of natural elements and substances that, for as of natural origin, could endanger and limit the use as drinkable water (sodium, chlorides, iron, manganese). Drinking water plants have, largely, solved the main causes of ineffectiveness of treatment such as the demolition of the organic load and the formation of trihalomethanes but it as been found an high concentration of chlorites; occasionally, the values of ammonia, aluminum, iron, manganese and, rarely, trihalomethanes are out law in piped.
    Annali di igiene: medicina preventiva e di comunità 16(1-2):255-64.
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    ABSTRACT: The epidemiology of salmonellosis in Italy has clearly changed over the years. The circulation of human-specific genotypes has diminished while there has been an increase in genotypes of animal origin. In the years 1994-2009, 3727 Salmonella genotypes were isolated and/or genotyped in Sardinia (Italy). The most frequent serotypes were Salmonella Enteritidis (29%) and Salmonella Typhimurium (25,7%). If we consider the years 2000-2009, 6.4% of isolated genotypes were found to be Salmonellae with the serologic profile 4,5,12:i:-, 35.8% of which were multiresistant. Molecular analyses have shown a correlation between Salmonellae 4,5,12:i:- and Salmonellae Typhimurium DT104. Further studies will be conducted to evaluate the link with other Salmonella variants with a similar serologic profile.
    Igiene e sanita pubblica 67(1):9-20.
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    ABSTRACT: Travel for business or tourism has become increasingly common in the age we live in. The great volume of national and international traffic and the speed of transportation are inevitably linked to a possible increased risk of acquiring certain illnesses such as Legionellosis, which, in fact, has shown a consistently increased incidence in recent years. In this paper, a brief introduction regarding the etiology and clinical and epidemiological characteristics of the disease, is followed by recent national and international data regarding its diffusion and guidelines for its prevention and control.
    Igiene e sanita pubblica 62(3):305-18.
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    ABSTRACT: This study evaluates interregional variability in threshold levels fixed by the various regions, for DRGs at high risk of inappropriateness, and analyses regional and national objectives achieved with respect to the reduction of hospital admissions (years 2001-2004). A reduction of inappropriate admissions has been observed.
    Igiene e sanita pubblica 65(6):583-98.
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    ABSTRACT: The presence of disinfection byproducts (DBP) in drinking water raises concerns about the safety of chlorination and is one of the problems inherent the use of surface water as a source of drinking water. In order to reduce the presence of DBP (in particular of chlorites), we evaluated the combined use of chlorine dioxide for primary disinfection and monochloramine for residual disinfection in a water purification plant and distribution system in Sardinia (Italy). The results are very encouraging. Disinfection byproducts were reduced and other parameters were found to be within the recommended standards, indicating further improvements of the purification process.
    Igiene e sanita pubblica 66(5):583-600.