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D Di Lallo

Publications and source records attributed to D Di Lallo.

17 recordsLinked to original sources
PubMed2004

Home breastfeeding support by health professionals: findings of a randomized controlled trial in a population of Italian women.

AIM: We conducted a randomized controlled trial to assess the effectiveness of a support intervention delivered by health professionals to increase the rate and duration of breastfeeding. METHODS: A randomized controlled intervention study was conducted in the period 2000-2001 among 605 mothers who had given birth in a public maternity ward located in the city of Rome, Italy. The intervention consisted of a home visit by a midwife from the maternity ward of the hospital. The outcome of the study was the infant's feeding habits, assessed by a 24-h recall. The effect of the intervention on the duration of breastfeeding was estimated by the Kaplan-Meier method and by the Cox multivariate regression model. RESULTS: According to intention-to-treat analysis, there was no significant difference between the intervention and the control group, after controlling for confounding factors (hazard ratio (HR) 1.04; 95% confidence interval (95% CI): 0.85-1.26). The duration of breastfeeding was shorter (HR 1.61; 95% CI: 1.13-2.31) for women in the intervention group who refused the obstetric visit. CONCLUSION: Our study shows that an early home support programme delivered by health professionals was not effective in increasing breastfeeding initiation and duration.

Adolescent↗
PubMed1999

Determinants of psychiatric inpatient admission to general hospital psychiatric wards: an epidemiological study in a region of central Italy.

OBJECTIVE: To determine which factors contribute to the decision to admit individuals to psychiatric wards in general hospitals. METHOD: Data on 1,379 individuals undergoing psychiatric evaluation in eight emergency rooms in a region of central Italy were collected. A logistic regression analysis was used to evaluate the likelihood of psychiatric admission considering the independent effects of demographic, social, and clinical factors and of the history of psychiatric treatment. RESULTS: The adjusted odds ratio for psychiatric admission significantly increased with the following variables: severity of symptoms; presence of paranoid states and schizophrenic psychoses, affective psychoses and acute psychotic conditions (with neurotic disorders used as reference); a history of outpatient treatment; the presence of a staff member of a community mental health facility upon presentation at the emergency room; and the availability of beds in the psychiatric ward. CONCLUSION: The independent effect played by the presence of a staff member of a community mental health facility is of particular interest, suggesting the existence of a collaborative relationship between inpatient and outpatient services.

Adult↗
PubMed1999

Risk factors of hepatitis C virus infection in patients on hemodialysis: a multivariate analysis based on a dialysis register in Central Italy.

A seroprevalence survey of antibodies to HCV was carried out among 2788 hemodialysis (HD) patients in a region of central Italy. Anti-HCV seroprevalence was 28.6%. A multivariate analysis of risk factors showed a significant association with time on HD, history of blood transfusion and metropolitan area of residence. Our study clearly showed that HCV infection is common among HD patients and is partially associated with preventable factors.

Adolescent↗
PubMed1999

End stage renal disease among ceramic workers exposed to silica.

OBJECTIVES: To evaluate whether ceramic workers exposed to silica experience an excess of end stage renal disease. METHODS: On the basis of a health surveillance programme, a cohort of 2980 male ceramic workers has been enrolled during the period 1974-91 in Civitacastellana, Lazio, Italy. For each worker, employment history, smoking data, and x ray film readings were available. The vital status was ascertained for all cohort members. All 2820 people still alive and resident in the Lazio region as in June 1994 were searched for a match in the regional end stage renal diseases registry, which records (since June, 1994) all patients undergoing dialysis treatment in public and private facilities of the region. Expected numbers of prevalent cases from the cohort were computed by applying the rate of patients on dialysis treatment by the age distribution of the cohort. RESULTS: A total of six cases was detected when 1.87 were expected (observed/expected (O/E) = 3.21; 95% confidence interval (95% CI) 1.17 to 6.98). The excess risk was present among non-smokers (O = 2; O/E = 4.34) and smokers (O = 4; O/E = 2.83), as well as among workers without silicosis (O = 4; O/E = 2.78) and workers with silicosis (O = 2; O/E = 4.54). The risk was higher among subjects with < 20 years since first employment (O = 4; O/E = 4.65) than among those employed > 20 years. CONCLUSION: These results provide further evidence that exposure to silica dust among ceramic workers is associated with nephrotoxic effects.

Adult↗
PubMed1992

[Mortality and care level of very low birth weight newborn infants. A population study].

A population study on 314 very low birth weight infants (VLBW) was carried out in 1987 in the Lazio Region of Italy to investigate the relation between the availability at birth of neonatal intensive care and infant mortality. Fifty-two percent of VLBW infants did not survive the first year of life. The mortality Odds Ratios, adjusted for four potential confounding variables, did not show a beneficial effect of Maternity units with neonatal intensive care (level 3) compared with those with special (level 2) and normal care (level 1). The overall high crude mortality rate together with the homogeneity of odds ratios among the different levels of care suggest that, when a regionalized perinatal care system is missing, as in Lazio region, the availability of neonatal intensive care, per se, does not improve the survival on this group of infants.

Female↗
PubMed1990

Reduction of births in Italy after the Chernobyl accident.

After the Chernobyl accident serious concern spread throughout Italy about the possible effects of the consequent exposure to radioactivity on fetuses. A reduction of births in the first three months of 1987, and particularly in February (7.2% reduction in the birth rate), was observed throughout Italy. In April-June 1987 a 4.8% increase in the number of births was observed. The magnitude of both phenomena varied in different areas of the country. The total number of births in the first six months of 1987 was very similar to the expected (264,241 versus 263,659). Induced abortions increased in Lombardia (northern Italy) in June (+1.6%) and July of 1986 (+3.4%) and in Campania (southern Italy) in June (+12.7%) and August (+4.3%). No increase in legal abortions was detected in Lazio (central Italy). Italian data suggest a voluntary decrease in the number of planned pregnancies and the termination of some of them in the first weeks after the accident as a consequence of postdisaster stress.

Abortion, Induced↗
PubMedDate not supplied

Cesarean section rates by type of maternity unit and level of obstetric care: an area-based study in central Italy.

BACKGROUND: The rate of cesarean section in the Lazio region of Italy is one of the highest in the Western world, 26.5%. In order to evaluate the effects of nonmedical factors on cesarean section, we examined its relationship to the characteristics of maternity units in the region. METHODS: We collected data from the birth certificates of 91,557 infants born to women residing in Lazio in 1988-1989 and classified all maternity units in the region by method of financing (public, semiprivate with arrangements with the national health service, and completely private) and level of obstetric care (unclassified and levels I,II, and III). The rates of cesarean section were examined for primiparous and multiparous women, taking into account birthweight, gestational age, fetal presentation, maternal age, and day of delivery. RESULTS: The adjusted odds ratio for cesarean section (with public units of level I taken as reference) was 1.06 (primiparous) and 1.22 (multiparous) for semiprivate maternity units and 1.59 (primiparous) and 1.52 (multiparous) for private units; it increased to 1.59 (primiparous) and 1.61 (multiparous) for unclassified semiprivate units and to 2.06 (primiparous) and 1.87 (multiparous) for unclassified private units. CONCLUSIONS: The rate of cesarean section was associated in the Lazio region with private payment for hospital care and with inadequate level of obstetric care. The latter factor is of particular concern and should be investigated elsewhere.

Adult↗
PubMedDate not supplied

[Socioeconomic inequalities in health care efficacy. Three examples in Lazio region].

There has been a limited number of studies in Italy investigating the relationship between socioeconomic inequalities and efficacy of treatments. This paper reviews three case studies on the association between socioeconomic status and disease outcome in the Lazio Region, Italy. The studies investigated: a) the probability of renal transplantation among patients with endstage renal disease; b) the survival of AIDS patients before and after the introduction of the new antiretroviral therapies; c) the 30-day mortality of patients who underwent coronary artery bypass graft surgery. The three studies demonstrate the complex relationship between socioeconomic status and both access to, and efficacy of, important health interventions.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Collaborative study on peritoneal dialysis (PD) as first dialysis treatment in an Italian region: 1994-2000].

BACKGROUND: In Lazio, only about 5% of uremic patients are on peritoneal dialysis (PD). The present study focuses on the parameters of PD selection, the treatment schedules, and the clinical outcomes of PD patients in the nine public facilities offering a PD program. A cohort of 249 first-time PD patients, from July 1, 1994 to December 31, 2000, was retrospectively considered. METHODS: For the enrollment of the patients, the Regional Dialysis Registry databank was consulted. On December 31, 2000, a systematic review of patient charts was performed to extract the reasons for the PD choice, details of PD schedule, peritonitis episodes, reasons for drop-out, and patient survival rates. In regard to technique success-defined as the probability of having a patient alive on PD-change of modality and death were considered as final events. In regard to patient survival, only death, even in the first 2 months after a shift to hemodialysis, was considered the end point. RESULT: The main PD selection reasons were patient and/or nephrologist preference in 90% of cases. One-hundred eighty-nine patients (76%) had been started on CAPD. During the follow-up, 38.2% dialysis schedules had been modified at least once. At the end of follow-up, 41.2% patients were on APD. The peritonitis rate was one episode per 30 patient-months (1 per 27 patient-months in CAPD; 1 per 37 patient-months in APD; p = 0.08). The technique success rate was 66.3% after 2 years and 49.8% after 3 years. The patient survival rate was 81.1% after 2 years and 68.7% after 3 years. CONCLUSIONS: Patients chose PD as a first dialysis treatment mainly because of reasons unrelated to their clinical status. The technique's success, patient mortality rates, and the peritonitis rate do not explain the low PD diffusion in the region. The peritonitis rate meets the target criteria for excellence recommended by the Italian Society of Nephrology. The observed outcomes may have been favored by the selection of motivated patients and by the increased use of APD.

Adult↗
PubMedDate not supplied

[Italian Registry of Dialysis and Transplantation: 1996-2001 experience].

The Italian Registry of Dialysis and Transplantation (RIDT) was born in 1996 under the aegis of the Italian Society of Nephrology, and it is organized as a federation of regional registries. This study aimed to completely revise the epidemiological data collected during the first 5 yrs (1996-2001) of RIDT activity to evaluate the trends of the main epidemiological features. During this period, regional registries were not always able to assure complete and exhaustive information according to RIDT requirements, owing to different levels of organization and functioning. To avoid any possible error in data analysis, information inadequately assessed was refused. The incidence of end-stage renal disease (ESRD) patients on renal replacement therapy (RRT) in Italy has increased from 114 pmp in 1996 to 139 pmp in 2001, that means an increase of 3.5%/yr, corresponding to 5718 patients during 1996 and 8000 patients during 2001. Primary renal diseases (according to the EDTA) in incident ESRD patients are vascular and diabetic nephropathy. Main dialysis modality in incident patients was hemodialysis (HD) (85%), while peritoneal dialysis (PD) was only 15%; pre-emptive transplantation was a very unusual modality. The prevalence of ESRD patients at 31 December was 693 pmp in 1996 and 827 pmp in 2001; among dialysis patients, the corresponding rates were 575 pmp and 657 pmp, respectively. Consequently, the number of dialyzed patients increased, respectively, from 28892 to 37919. The prevalent dialysis modality was bicarbonate dialysis in 74% of cases, followed by hemodiafiltration (HDF) in 15%, continuous ambulatory peritoneal dialysis (CAPD) in 7% and APD in 3%. The gross mortality rate in dialyzed patients was stable during this period, at approximately 14%, the main causes of death being cardiovascular diseases and cachexia.

Adolescent↗
PubMedDate not supplied

[The descriptive epidemiology of patients with kidney failure on chronic dialysis treatment. The results of the Lazio Population Registry. The Lazio Dialysis Registry].

The study presents the methodology and selected results of the Lazio Dialysis Registry. The registry, begun in 1994, documents basic demographic data, minimal clinical information and vital status of all end-stage renal disease patients on dialysis treatment in Lazio region. At June 1994 the register included 2834 patients; during the next 12 months, 618 new patients had been notified. In one-year follow-up, among prevalent patients, 308 deaths and 90 renal transplants, and among new patients, 80 deaths and 9 renal transplants were observed. The mean age of the studied population was 59.6 (SD 15.1) for prevalent patients and 61.9 (SD 15.3) for new patients. Among prevalent patients 58.8% were males and 41.2% females, among new patients these figure were 62.1% and 37.9%, respectively. The prevalence rate was 55 per thousand population and the incidence rate was 12.0. The leading cause of renal failure was glomerulonephritis in prevalent patients (27.7%), among new patients the most representative group was nephropathies of unknown origin (27.0%). About 85% were on hemodialysis treatment, and about 4% on peritoneal dialysis. The cumulative survival rates during the one-year follow-up was 81.9%, among patients with age less than 65 years a better survival for males (94.9%) than females (90.1%) was observed. The results of the first year of activity show that a population-based registry of patients on chronic dialysis treatment can be an useful tool for service planning and epidemiological research.

Adolescent↗