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Background and aim: An increase of vaccine hesitancy has spread worldwide and lead to reduction in coverage rates. The trivalent Measles-Mumps-Rubella (MMR) vaccine has been one of the most targeted leading due to possible (but never proven) adverse effects. This resulted in an increase of measles cases. The aim of the study is to analyze the 24-months coverage rates for the MMR vaccine in Emilia-Romagna Region (RER) between 2007 and 2018 and to correlate any significant changes to index events. Methods: Official aggregate data on vaccination coverage at 24-month provided by the RER and the Italian Ministry of health were analyzed and discussed. Results: From 2012 to 2015 a significant reduction in vaccination rates has been registered. In the following years an increase was recorded temporarily related to national and regional laws. Conclusion: The mandatory vaccination strategies seem to be in the short period effective in RER to counteract the growing population neegative attitudes towards vaccination and mitigate vaccine hesitancy. (www.actabiomedica.it) Premesse e obiettivi: Un aumento dell’esitazione vaccinale si è diffusa in tutto il mondo e ha portato alla riduzione significativa dei tassi di copertura. Il vaccino trivalente morbillo-parotite-rosolia (MMR) è stato uno dei più interessati a causa di presunti (e mai dimostrati) effetti collaterali e il calo della copertura di questa vaccinazione ha portato ad un aumento dei casi di morbillo. L’obiettivo della ricerca è quello di analizzare i tassi di copertura per il vaccino MMR a 24 mesi di età nella Regione Emilia-Romagna (RER) tra il 2007 e il 2018 e di correlare eventuali cambiamenti significativi ad eventi esterni. Metodi: Sono stati analizzati e discussi i dati aggregati ufficiali sulla copertura vaccinale a 24 mesi forniti dalla Regione e dal Ministero della Salute. Risultati: Dal 2012 al 2015 è stata registrata una riduzione significativa dei tassi di vaccinazione. Negli anni seguenti è stato registrato un aumento temporalmente correlato all’entrata in vigore delle leggi nazionali e regionali. Conclusioni: Le strategie di vaccinazione obbligatorie sembrano essere efficaci nel breve periodo nella RER per contrastare l’atteggiamento della popolazione nei confronti della vaccinazione e mitigare l’esitazione vaccinale.

There is evidence that preterm infants of migrant mothers are at a higher risk of adverse perinatal outcomes than those of native-born mothers, and that human milk feeding is beneficial to infants&rsquo, neurodevelopment. Using the United Nations Human Development Index (HDI) to classify mother&rsquo, s country of origin, we investigated whether type of neonatal feeding (human milk vs. mixed milk vs. exclusive formula milk) affected preterm newborn neurodevelopment varying across different HDI categories (Italian native-born vs. high HDI migrant vs. low HDI migrant) up to 2 years of age. Neurodevelopment of 530 infants born in Italy at &le, 32 weeks of gestational age and/or weighing &lt, 1500 g was measured at 3-, 6-, 9-, 12-, 18-, and 24-months corrected age (CA) using the revised Griffiths Mental Development Scale 0&ndash, 2 years. The trajectories of the general developmental quotient and its five subscales were estimated using mixed models. At 24-months CA only preterm infants of low HDI migrant mothers and fed exclusive formula milk showed moderate neurodevelopment impairment, with lower developmental trajectories of eye-hand coordination, performance, and personal-social abilities. Migrant mothers from low HDI countries and their preterm infants should be targeted by specific programs supporting maternal environment, infant development, and human or mixed milk neonatal feeding. Future research should focus on a deeper understanding of the mechanisms through which type of feeding and mother migrant conditions interact in influencing preterm infants&rsquo, neurodevelopment.

Background: Vaccine hesitancy has increased worldwide, leading to reduction in vaccination coverage rates. In particular, reduction in the coverage for the trivalent Measles-Mumps-Rubella vaccine has led to an increase of measles cases. The aim of this study is to analyze the coverage rates for the MMR vaccine in the Emilia-Romagna Region (RER) and Sicily Region (SR) between 2009 and 2018, and to correlate any significant change to index events which could have modified the trend of vaccination rates. Methods: Official aggregate data on vaccination coverage at 24 months provided by the RER and the SR were analyzed through trend analysis and related to important index events. Results: The two regions showed similar results, both achieved the lowest coverage rates in 2015 and both showed an increase in the rates after the introduction of mandatory vaccinations for access to schools. In 2018, both reached the starting point before the decrease. Conclusion: Our results confirm the effectiveness of legislative coercive measures in favor of vaccination. A potential decrease in the coverage rates may be observed as a result of an attenuation of the positive effects of coercive measures over time. It is thus necessary to combine these measures together with information campaigns and political initiatives at different levels (i.e. national, regional).

Aortic valve atresia is a common feature of hypoplastic left heart syndrome, which consists of various degrees of underdevelopment of the left ventricle aorta complex; nevertheless it can also be associated with a large ventricular septal defect (VSD) and a rather developed left ventricle. Atresia of the aortic valve prevents antegrade blood flow from the left ventricle to the ascending aorta, so perfusion of the coronary arteries, ascending aorta and aortic arch is provided by the ductus arteriosus in a retrograde fashion. Interrupted aortic arch (IAA) is quite often associated with aortic or subaortic stenosis; however, very few cases of IAA have been reported in association with aortic valve atresia. Aortic valve atresia with IAA is an extremely rare association which would be incompatible with life, unless blood flow is provided to the ascending aorta and coronary arteries from (i) the ductus/descending aorta through ‘collaterals’ [1], or (ii) from the pulmonary trunk and pulmonary arteries through an aorto-pulmonary window [2] or bilateral ductus [3]. In the absence of a direct connection, blood flow to the coronary arteries is exclusively provided by the Circle of Willis through both carotid arteries, in a reverse