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Biomedical subjects

F Carle

Publications and source records attributed to F Carle.

13 recordsLinked to original sources

Interaction between alcohol consumption and positivity for antibodies to hepatitis C virus on the risk of liver cirrhosis: a case-control study. Provincial Group for the Study of Chronic Liver Disease.

To assess the risk of developing liver cirrhosis associated with alcohol consumption, HBV and HCV infection markers, we carried out a case-control study involving 115 patients admitted to the medical departments of the general hospitals in the province of L'Aquila (Abruzzo, Italy) who received for the first time the diagnosis of liver cirrhosis, and 167 controls randomly selected among patients admitted to the same hospitals as the cases. Alcohol intake was measured in all 282 subjects using an already validated standardized questionnaire, and expressed as mean lifetime daily alcohol intake in grams. The mean lifetime daily alcohol intake showed a dose-dependent effect on the risk of cirrhosis: the relative risk significantly rose to 3.8 (95% CI: 2.0-7.3) for a mean daily intake of > or = 101 g alcohol; for HBsAg positivity the relative risk of cirrhosis was 23.0 (95% CI: 4.9-107.8) and for anti-HCV positivity it was 8.7 (95% CI: 4.3-17.6). After applying a multiple logistic regression analysis in a multivariate model including mean lifetime alcohol intake and anti-HCV status, both variables were significantly associated with the risk of cirrhosis (relative risks = 5.3-95% CI: 2.3-12.2 and 9.9-95% CI: 4.4-22.0, respectively). The combination of these two variables was found to fit an additive--but not multiplicative--model relative to the risk of cirrhosis: furthermore, the interaction of the anti-HCV status with the presence or absence of cirrhosis did not result in a significant source of variability for the mean lifetime daily alcohol intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking

[Portacaval anastomosis in patients with liver cirrhosis. Study of prognostic factors of survival by multivariate analysis].

Seventeen preoperative variables were collected in order to assess their prognostic value on survival in 82 cirrhotic patients who underwent a portosystemic shunt for ruptured esophageal varices. Univariate analysis showed that the presence of encephalopathy, bad nutritional status, elevated serum bilirubin, low serum albumin, the presence of ascites and Child-Turcotte's or Child-Pugh's C class were significantly associated with a reduction of long-term survival. Multivariate analysis according to the Cox model showed that only encephalopathy and nutritional status were independently associated with survival. Six survival curves were proposed to estimate the survival probability with these 2 preoperative data; encephalopathy had a predominant effect on survival during the first 5 years after surgery.

Adult

Alcohol consumption and non-cirrhotic chronic hepatitis: a case-control study.

We carried out a hospital-based case-control study to assess the association of both the daily amount and the duration of alcohol intake with the risk of developing non-cirrhotic chronic liver disease (chronic hepatitis) in 121 chronic hepatitis patients diagnosed by laparoscopy and liver biopsy, and in 242 matched 'controls' randomly selected from inpatients of the same hospital. Alcohol intake was quantified in all subjects using a standardized questionnaire administered by two doctors unaware of the aim of the study. The odds ratio (OR) for chronic hepatitis was estimated by conditional logistic regression and increased exponentially from 1.0 for non-drinkers to 11.4 for daily alcohol intake of 325 g or more. Considering duration of alcohol consumption from up to 10 to up to 30 years, the ORs for chronic hepatitis consistently decreased for the daily alcohol intake categories of 25-50 g (from 74.1 to 0.7 respectively), 75-100 g (from 149.7 to 0.7 respectively) and 125 g or more (from 212.0 to 1.8 respectively). Our results suggest the existence of a dose-dependent individual susceptibility to the damaging effect of alcohol on the liver.

Alcohol Drinking

A case-control study on alcohol consumption and the risk of chronic liver disease.

We carried out a hospital based case-control study involving 655 patients with chronic liver disease encompassing chronic hepatitis, asymptomatic liver cirrhosis and symptomatic liver cirrhosis and 655 pair-matched control individuals in order to estimate the dose-response relationship between alcohol consumption and the occurrence of chronic liver disease. Alcohol intake was measured by a questionnaire and expressed as Daily Alcohol Intake (DAI) during the patient life. DAI estimates from patient interviews were in good agreement with those obtained by interviewing a sample of relatives. We found an exponential positive association between DAI and the risk of chronic hepatitis and cirrhosis. However, consuming less than 100g of alcohol every day did not increase the risk of developing chronic liver disease. For asymptomatic cirrhosis the risk was lower than for chronic hepatitis, especially at high DAI, probably because high consumption carried a high probability of liver decompensation. For symptomatic cirrhosis, the risk function showed a similar pattern as for chronic hepatitis. Chronic hepatitis patients were 6-7 years younger than cirrhotics. Our results suggest that the evolution towards cirrhosis once a chronic liver damage has occurred is probably time-dependent, but not or minimally dependent on alcohol intake.

Adult

[Disability, perceived health, and risk of death in a cohort of elderly].

An elderly cohort has been submitted to a five-year mortality follow-up in order to evaluate the relationship between environment, social and health conditions and survival probability. Particular attention has been directed to disability measure proposed by OECD (Organization for Economic Co-operation and Development). An extension of Cox multiple regression model has been used. Results show that the social and living conditions are not associated with survival probability. On the contrary, disability is a strong determinant of mortality risk and subjective health status is a modifier of its effect. Following disability level is an indicator of long-term health status and health services needs.

Aged

Legionella pneumophila in a hospital in Torino, Italy. A retrospective one-year study.

Legionella pneumophila serogroup 1 was isolated from post mortem specimens from 13 out of 58 patients with pneumonia diagnosed at autopsy. The results of a study undertaken in the hospital environment showed that the water plumbing system was colonized with L. pneumophila serogroup 1 which could also be isolated from respiratory devices filled with tap water. Control measures instituted are described.

Aged

Cancer risk in a cohort of licensed pesticide users.

First admissions to the hospital among 25,945 men living in southern Piedmont and holding a license authorizing them to use pesticides were analyzed in a study of the cancer risk related to exposure to pesticides. Standardized incidence ratios significantly higher than one were encountered for malignant skin cancers and lymphomas. The risk of lymphoma was particularly high in predominantly arable areas. The standardized incidence ratios for tumors of the nervous system and hematopoietic tissue showed an interesting age-related pattern and a higher risk in areas primarily devoted to forest tree plantation, but did not reach significance. Certain hypotheses are advanced to explain these findings.

Aged

[A method for evaluating the hepatitis B vaccination program].

Two mathematical models have been created in order to estimate the effectiveness (number and proportion of infections saved) and the cost/effectiveness ratio (cost per infection saved) of a hepatitis B vaccination strategy among hospital personnel. The aim of the models is to analyse the mathematical relationship between the measurement of strategy impact and some variables: theoretical effectiveness of vaccine, proportion of assent to the programme, epidemiological characteristics. Applying models to Piedmont situation it has been possible to identify factors which have negatively influenced the effectiveness and efficiency of strategy.

Cost-Benefit Analysis

Immunoprophylaxis for influenza: comparison of a subunit and a whole virion vaccine.

In order to evaluate and compare immunogenicity, reactogenicity and protection of a subunit vaccine and a whole virus vaccine 102 elderly subjects were vaccined against influenza in November 1986: 53 received the subunit vaccine and 49 were immunized with the whole virus preparation. Local and systemic reactions following immunization, as well as the presence of influenza clinical symptoms were recorded throughout the study period (November 1986 - June 1987). Antibodies against influenza were detected using the Single Radial Haemolysis (S.R.H.) technique on two serum samples obtained from volunteers prior to immunization and 1 month later. The subunit vaccine showed equal immunogenicity, equal protection and lower reactogenicity as compared with the whole virus preparation.

Aged

[Epidemiology of bronchopulmonary hospital infections].

Hospital acquired infections (HAI) represent one of the major problems, due to their elevated frequency and high number of fatal cases, in the control of infectious diseases. With the perspective to evaluate the incidence of bronchopulmonary infections and to determine their role as cause of death of hospitalized patients, as well as to identify the etiology and the associated risk factors, we have studied 105 autopsy cases of patients decreased in hospital. 37 patients had pneumonias, of which 48.6% were of hospital origin. Hospital pneumonia was responsible for death in 12.3% of the cases. The risk factors significantly associated with HAI were recognized to be the following: hospital recovery for a period longer than 10 days, and surgery. Among the etiologic agents isolated in HAI, there was a distinct prevalence in Gram-negative bacteria (55.5% of the samples), such as Pseudomonas aeruginosa, Klebsiella pneumoniae, Legionella pneumophila.

Bacterial Infections

Nosocomial legionellosis associated with use of oxygen bubble humidifiers and underwater chest drains.

In 1 year 12 of 48 patients who developed fatal pneumonia following admission with non-respiratory disorders to the Hospital Molinette, Torino, yielded Legionella pneumophila serogroup 1 from lung at autopsy. Patients were hospitalized on seven different wards for different conditions; only two of the wards had air conditioning but legionellas were not isolated from these. All patients were in poor health or immunocompromised. Some patients had inhaled humidified oxygen from piped supplies and three had undergone surgery. Legionella pneumophila serogroup 1 was detected in the water of oxygen bubble humidifiers and an underwater chest drain. The contaminated devices had been filled with tap or distilled water and the hospital water supply was found to be contaminated with L. pneumophila serogroup 1. Our findings suggest that filling bubble humidifiers or underwater chest drains with tap water is a potential hazard and should be avoided.

Cross Infection