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Biomedical subjects

F Palumbo

Publications and source records attributed to F Palumbo.

At least 19 recordsLinked to original sources
PubMed1996

Incidence of non-A, non-B and HCV positive hepatitis in healthcare workers in Italy.

In Italy, using figures from a surveillance system for acute viral hepatitis, the incidence rate of acute non-A, non-B hepatitis (NANBH) and hepatitis C virus (HCV) hepatitis cases was evaluated in healthcare workers (HCWs) and the general population of the same age over the period 1988-1994. The NANBH incidence among the general population declined from 4.7/100,000 in 1988 to 2.1/100,000 in 1994; the corresponding figures among HCWs were 12.3/100,000 (RR 2.62; CI 95% = 1.66-4.15) in 1988 and 4.3/100,000 (RR 2.05; CI 95% = 1.13-3.77) in 1994. Since 1991, NANBH cases have been tested for antibodies to HCV (anti-HCV). During the period 1991-1994 the proportion of NANBH cases tested for anti-HCV was 81% (38/47) in HCWs and 85% (1019/1193) in other NANBH cases. A similar proportion of NANBH cases in each group (74% and 70%) were shown to be due to HCV. The incidence rate of HCV positive cases among the general population was 1.3/100,000 in 1991 and 1.8/100,000 in 1994; the corresponding figures among HCWs were 3.7/100,000 (RR 2.85; CI 95% = 1.42-5.92) in 1991 and 3.1/100,000 (RR 1.72; CI 95% = 0.88-3.59) in 1994. The proportion of cases with jaundice was 56.2% in HCWs and 63.7% in the general population. Needlestick injury without major risk factors such as blood transfusion, intravenous drug use or surgical intervention was reported by 12.0% of HCWs and by 0.1% of the general population. Lack of any risk factor was reported by 40.2% of HCWs. These findings strongly suggest that in Italy healthcare workers are at greater risk than the general population of acquiring NANBH, as well as HCV.

Acute Disease↗
PubMed1996

Risk factors for recent toxoplasma infection in pregnant women in Naples.

Effective primary prevention of congenital toxoplasmosis requires up to date information on locally relevant risk factors for infection in pregnant women. In Naples, risk factors for toxoplasma infection were compared in recently infected women (as assessed by detection of specific IgM in serum) and susceptible, IgG negative women. Recent infection was strongly associated with frequency of consumption of cured pork and raw meat. Eating cured pork or raw meat at least once a month increased the risk of toxoplasma infection threefold. This simple study design for determining locally relevant sources of toxoplasma infection is the first report of cured pork as a risk factor for infection. Further research is required to determine cyst viability in cured pork products. Our findings suggest that in southern Italy, cured pork and raw meat should be avoided by susceptible pregnant women.

Adult↗
PubMed1996

[Heart involvement in Behcet's disease: a personal caseload en review of the literature].

BACKGROUNDS: Various cardiac abnormalities have been described in patients with Behçet's disease. The number of reports remains small, but increasing awareness have widened the spectrum of manifestations. We report our evaluation of cardiac involvement in 15 patients affected by Behçet's disease, diagnosed according to the criteria for the International Study Group for Behçet's Disease. PATIENTS AND METHODS: All the patients have been examined by a clinical, biochemical and instrumental point of view. Six patients resulted to be affected by heart diseases, in particular by mitral valve prolapse; moreover one of them presented an unexpected dilatative cardiomyopathy. CONCLUSIONS: The authors affirm that the pathological heart features are not so uncommon as previously reported in literature, emphasizing the necessity of a constant evaluation for the cardiovascular system also in the asymptomatic patients.

Adult↗
PubMed1996

[The efficacy and safety of glucosamine sulfate in the treatment of gonarthritis].

This study was performed to evaluate the therapeutic efficacy and tolerability of glucosamine sulfate in patients with gonarthritis. During the 12-month study period, the signs and symptoms of the disease were evaluated, as well as the dosage of the urinary pyridinoline. In this trial, we demonstrated that glucosamine sulfate has a chondroprotective activity, which was significant after the first 3 months of therapy. Moreover, this study showed that the side effects due to glucosamine sulfate were mild to moderate and did not require discontinuation of the drug.

Adult↗
PubMed1995

Beauty treatments and risk of parenterally transmitted hepatitis: results from the hepatitis surveillance system in Italy.

The role of ear-piercing, tattooing, attendance at chiropodist or manicurist and barber shop shaving in transmitting hepatitis B and hepatitis non-A, non-B was evaluated. Data reported here were collected from 1985 to 1993 by the National Viral Hepatitis Surveillance System. The association between parenterally transmitted hepatitis and the considered risk factors was estimated, comparing 6,395 hepatitis B and 2,558 hepatitis non-A, non-B cases with 4,789 hepatitis A cases, using the case-control method. Of the non-A, non-B cases tested from 1991 to 1993, 56.6% were anti-HCV positive. The incidence of parenterally transmitted hepatitis cases reporting specific beauty treatments was also evaluated. Tattooing, ear-piercing and barber shop shaving were associated with both parenterally transmitted hepatitides, while attendance at a chiropodist or manicurist was associated only with hepatitis B. During the study period the incidence of acute hepatitis B and non-A, non-B cases reporting beauty treatments declined by 49%. In spite of this decline, considering that a large part of the general population is exposed to the considered risk factors, the role of beauty treatments in transmitting hepatitis B and hepatitis non-A, non-B should not be underestimated.

Adolescent↗
PubMed1995

Case control study of risk factors for hepatitis A: Naples 1990-1991. Hepatitis Collaborating Group.

An increased incidence of hepatitis A was observed in Naples from 1990-1991. A hospital-based case-control study was carried out to evaluate the relative importance of various risk factors. A hundred and ninety-eight cases and 238 hospital controls were recruited during the study period. The strongest association was contact with a jaundiced person among children. A correlation was also shown for children and adults with raw shellfish consumption and pre-school nursery attendance or presence in the household of children attending pre-school nurseries. History of travel and intravenous drug use were risk factors for adult subjects. Considering the relative importance of the specific risk factors we found that 38% of the acute hepatitis A cases were attributable to contact with a jaundiced person, 15% to presence in the household of children attending pre-school nurseries and 28% to raw shellfish consumption.

Acute Disease↗
PubMed1994

Hepatitis B in children in Italy: incidence and risk factors: SEIEVA Collaborating Group. Sistema Epidemiologico Integrato dell'Epatite virale Acuta.

The objectives of the present report were to give a baseline picture of hepatitis B notification incidence rates in children before the campaign of mass vaccination for newborns and adolescents (12-13 years old), and to study the role of different risk factors. Data from a specific national surveillance system of acute viral hepatitis (SEIEVA, Sistema Epidemiologico Integrato dell'Epatite Virale Acuta) were used and acute hepatitis B cases were compared to acute hepatitis A patients with the case-control study method to estimate the associations with the considered risk factors. Since the system began, one hundred and sixty-three local health departments have joined SEIEVA covering 30% of the Italian population. The incidence of acute hepatitis B notifications among 0-14 aged children was 9 per 100,000 in 1985 and 1 per 100,000 in 1990. Such decline in incidence was observed in both the North and the South of Italy. Surgical interventions, dental therapy and household contacts with a HBsAg chronic carrier were found to be associated with acute hepatitis B. The point estimate of the odds ratio was 10 for the latter risk factor. Other preventive measures in addition to vaccination are needed to control the risk of hepatitis B infection and other parenteral diseases due to surgical intervention and dental therapy.

Acute Disease↗
PubMed1994

Hepatitis B in health workers in Italy.

In Italy, a vaccination campaign against hepatitis B was launched in 1985. It was strongly recommended for health care workers. Over the period 1986-91 the incidence rate of acute B hepatitis in the general population declined from 12/100,000 in 1986 to 5/100,000 in 1991. The corresponding figures among hospital workers were 42.5/100,000 (RR 3.5; 95% CI 2.55-4.92) in 1986 and 14.5/100,000 (RR 2.9; 95% CI 2.03-4.14) in 1991, respectively. The proportion of HBV cases with jaundice was about the same in the general population (77.6%) and in the health care staff (74.2%). Nearly 6% of hospital workers cases had completed the schedule of HBV vaccine. Despite the fact that vaccination against HBV has been strongly recommended for hospital workers, the incidence of infection in this job category has continued to be higher than that in the general population, probably as a consequence of poor vaccine coverage. These findings reiterate the need for aggressive vaccination programmes in hospital workers.

Health Personnel↗
PubMed1994

Incidence and risk factors of acute Delta hepatitis in Italy: results from a national surveillance system. SEIEVA Collaborating Group.

The incidence of hepatitis Delta virus in the general Italian population was estimated by a specific surveillance system for acute viral hepatitis over the period 1987-1992. The hepatitis Delta virus incidence rate declined from 3.1/1,000,000 inhabitants in 1987 to 1.2/1,000,000 in 1992. Males predominated (83.8% of cases); the sex ratio was 5.2. Only 2.5% of cases occurred in subjects younger than 15 years. There were 119 (49.4%) coinfections of Delta and B hepatitis and 122 (50.6%) Delta superinfections in chronic HBsAg carriers. Jaundice was present in 83.6% of cases. The hospitalization rate was 97.5%; median stay in hospital was 25 days (range 1-98 days). The results of multivariate analysis showed that a history of intravenous drug abuse (odds ratio 34.9; confidence interval 95% = 16.8-72.5), household contact with an HBsAg+ carrier (odds ratio 10.7; confidence interval 95% = 4.36-23.30) and a history of two or more sexual partners within the previous 6 months (odds ratio 2.44; confidence interval 95% = 1.34-4.43) were independent risk factors associated with Delta hepatitis. No association was found with the other risk factors considered, such as blood transfusion, surgical intervention, hospitalization, other percutaneous exposures, dental therapy, contact with an icteric case, and household contact with an i.v. drug abuser. These findings indicate that, in Italy, Delta hepatitis currently has a minor impact. In addition to intravenous drug abuse and household contact with an HBsAg+ carrier, heterosexual activity appears to be an efficient route of HDV transmission.

Acute Disease↗
PubMed1993

Hepatitis B mass immunization of adolescents: a pilot study in a community.

The National Type Specific Hepatitis Surveillance System (SEIEVA) and seroepidemiological studies have shown that in addition to newborns from mothers who are carriers for hepatitis B surface antigen (HBsAg), adolescents are at high risk of acquiring type B hepatitis virus because of increasing importance of the heterosexual transmission of this virus. In order to evaluate logistic problems and acceptance rate of adolescents to mass vaccination against hepatitis B, a pilot study was carried out among all 7th grade children registered in the 9 schools of an hepatitis B endemic area located in the suburbs of Naples. After meetings held by the local health department with school teachers and parents, 1219 out of 1250 (97.5%) invited children received the first dose of hepatitis B vaccine; 1215 and 1209 received, respectively, the second and third doses. Anti-hepatitis B surface antigen (anti-HBs) values were studied in 406 subjects one month after the third dose, and 21 out of 406 (5.2%) had anti-HBs values less than 10 IU/L. We consider 95% of subjects with anti-HBs values greater than 9 IU/L a good achievement for a field vaccination program. The high acceptance rate of vaccination found in our study outlines the importance of active offer of vaccination combined with school involvement.

Adolescent↗
PubMed1993

[Modification of immunologic parameters in physiologic pregnancy].

Changes in lymphocyte subsets in whole blood of normal pregnant women were examined by flow cytometry. From the first trimester and throughout pregnancy, the count of B cell subset remain unchanged. On the contrary, the percentage of "helper" lymphocytes decreased in the first trimester, increase in the third. These changes of lymphocyte subsets may indicate suppression of immunological activity during pregnancy.

Adult↗
PubMed1992

The control of human brucellosis in the Campania region: an updating of knowledge and results obtained by the third year of the programme activities.

A control programme for brucellosis in Campania was started in 1988, in the province of Caserta, and implied different actions at the regional and provincial levels. The section of the work described here regards the updating of the results obtained during the third year of the project activity. The action performed included experimentation of data sheets in the province of Caserta to gain information on the factors conditioning brucellosis, gathering and analysis of ISTAT data on the size of livestock population as an actual or potential source of infection for man, epidemiological surveillance of human cases, census of dairies, and public health measures taken by the Regional Council. The results show that improvement of human brucellosis surveillance is in progress, whereas the programme implementation has provided a clearer picture of the situation with better understanding of the factors affecting the disease occurrence. Such problems posed by the project management as difficult maintenance of sufficient collaboration between veterinarians and physicians, scarce participation of local and regional administrations, resistance opposed by some categories, and reduced availability of financial resources are also discussed.

Animals↗
PubMed1992

Evaluating drug prescribing in a large, ambulatory population: application of an embedded expert system.

DUR is a process of problem detection and intervention designed to improve the quality and economy of drug prescribing. Retrospective DUR attempts to detect and address patterns of prescribing that might be indicative of inappropriate therapy. When the process is extended to a largely ambulatory population such as Medicaid beneficiaries, a number of complications are introduced due to the large numbers of patients and sparsity of data. In order to examine the impact of implementing a Medicaid DUR program, we developed a system that would apply screening criteria to prescription claims. It has been used to screen prescribing of groups of two antihypertensive drugs in the 1990 Maryland Medicaid population for 177,409 Medicaid eligible individuals. Potentially significant problems were detected with respect to dosing, duplication of therapeutic agents and drug interactions. The system represents, we believe, a significant improvement in the ability to detect and report prescribing decisions by increasing the specificity of the detection system. By the application of this system to a set of real-world data, we have demonstrated that it is feasible to implement such a system and derive results that are potentially useful in reducing the incidence of inappropriate physician decision-making.

Ambulatory Care Information Systems↗
PubMed1991

Travel-associated hepatitis A: effect of place of residence and country visited.

The association between hepatitis A and domestic or international travel from Italy was investigated. Data from a nationwide surveillance system (SEIEVA) for type-specific acute viral hepatitis were used to compare 1102 hepatitis A cases with 3671 hepatitis B cases. An association between hepatitis A and travel was found in northern Italy, where most young and adult people are susceptible. Estimates of odds ratios vary dramatically according to geographical area of travel. Travellers to Mediterranean countries, Eastern Europe, Africa, Asia, and South and Central America had the highest education and age-adjusted odds ratios for hepatitis A, ranging from 6 to 25. Prophylaxis against hepatitis A for such travellers is recommended.

Adolescent↗
PubMed1990

Decline of incidence of A, B and non-A, non-B hepatitis in Italy. Results of four years surveillance (1985-88). SEIEVA collaborating group.

A specific surveillance system for acute viral hepatitis which uses weekly notification of cases and a standard risk factor questionnaire was started in Italy in 1984. From 1985 to 1988 153 Health Departments (27% of Italian population) joined the system. Estimated incidence of reported viral hepatitis was 30 per 100,000 in 1985 and 14 in 1988. The decline was impressive for hepatitis A, particularly in the south. Reduction of incidence was also evident for hepatitis B and Non-A, Non-B hepatitis, particularly in young adults. The decrease of viral hepatitis in Italy is consistent with recent seroepidemiological data. Shellfish consumption was the most frequent risk factor reported for hepatitis A cases at all ages. Hospitalization, surgical intervention, dental therapy and other percutaneous exposures still play a role in the transmission of parenteral hepatitis in Italy. Blood transfusions seem to be important only for Non-A, Non-B. Interventions other than vaccination to prevent B and Non-A, Non-B hepatitis due to hospitalization, surgical intervention, other percutaneous exposures and dental therapy are needed and can further contribute to the decline of hepatitis virus infection rates in Italy.

Acute Disease↗
PubMed1989

[Brucellosis in the Campania region].

The research describes the trend of brucellosis, in the period 1984-86, in the county of the "regione Campania". This trend, in contrast with the national one, is manifested as endemic, with frequent and localised outbreaks of epidemic levels. The research also describes, through the analysis of the illness registration forms of 762 cases of brucellosis in the period 1985-86, the seasonal trend, the ages of major risk of infection and the most frequent modes of infection. The paper concludes with suggestions for the effective prevention of brucellosis.

Brucellosis↗