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Biomedical subjects

G M Fara

Publications and source records attributed to G M Fara.

At least 37 records · Page 2Linked to original sources
PubMed1985

Problems in the assessment of human exposure to tetrachlorodibenzodioxin (TCDD): the marker chloracne.

An epidemiological study, aiming to assess the extent of the exposure to tetrachlorodibenzodioxin (TCDD) of the population involved in the Seveso accident, needs an effective information system, able to answer the questions usually asked--such as: why? what? who? where? when? how long?--and therefore concerning the wide range of the expected events, from the early cases till the ones expected in the long term. The paper is concerned with evaluation of possible use of chloracne as indicator of human exposure to TCDD, taking into account from one hand chloracne itself (i.e. its latency period, sensitivity, specificity, predictive value of diagnosis, etc) and, from the other, the development of the observational process. Moreover, the paper points out the role of the dermatological findings as representative--more than and before the other clinical findings--of the exposure conditions in the polluted area. The group of subjects classified as "chloracne" by the end of the second screening (May, 1977) included 187 cases, 164 of which were children 0-14 yrs old by the 10th of July 1976; 34 out of 164 were diagnosed in September-December 1976, the other 130 were diagnosed within the screening program. The results of a survey concerning their exposure data, clinical and laboratory findings are detailed. Finally, some remarks are made related to the quality of data. The authors emphasize that the reliability of assessment of health status of the exposed population depends not only upon a comprehensive a posteriori analysis of the different sets of clinical findings, but also upon the degree of integration of the professional staffs involved at operational levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Acne Vulgaris↗
PubMed1985

Ongoing tetanus prophylaxis of injured patients in five hospital emergency rooms.

The adequacy of antitetanus prophylaxis given in five hospital emergency rooms to 729 individuals up to 15 years, suffering from different types of injuries, was evaluated retrospectively using vaccinal data retrieved from a terminal of the computerized files of the City of Milan Health Authority operated in our Department. Comparing the recommended treatment (according to the guidelines issued by the Italian Ministry of Health, 1982) with that actually obtained, we have classified the subjects into three ("correctly treated", "undertreated" and "overtreated") groups. Correct treatment ranged from 70 to 90 percent, undertreatment from 4 to 6 percent, and overtreatment from 8 to 26 percent at the different hospitals. Undertreatment was most likely in incompletely immunized patients (having previously received one or two doses of tetanus toxoid), while overtreatment was much more common in patients fully immunized. By comparison, 545 patients sixteen and older, whose immunization history was unknown, were evaluated to obtain information about the behaviour adopted by the physicians in the same circumstances. Grouping the subjects by age we found that in two hospitals the highest proportion of untreated (18 and 25 percent) belonged to the group of individuals more prone to the disease (over 60 years of age). Compliance with the Ministerial Instructions would have led to an increase in the use of tetanus toxoid and to a decrease in the use of human immunoglobulin, improving the quality of prevention without adding to its cost.

Adolescent↗
PubMed1983

[Epidemiology of tetanus].

The vaccinal preventive measures which were made compulsory since 1963 for the new working levies of some professional high risk categories, and since 1968 for the newborns, contributed to a large extent to the tetanus control in our country. In the last twenty years a progressive drop in the notified tetanus cases was observed. The epidemiology of this disease is conditioned, on the one hand by the correct application of the legal directions in force; on the other hand, by the level of health education, acquired by those who have not yet been involved, so far, by the compulsory antitetanus vaccination.

Adolescent↗
PubMed1981

Chloracne following environmental contamination by TCDD in Seveso, Italy.

Data are presented on the occurrence of chloracne, clinical symptoms and biochemical changes in 164 children following environmental contamination by TCDD from an industrial accident in Seveso, Italy. An overall positive association was found between the territorial distribution of chloracne cases and the different levels of soil contamination in the affected area. Individual risk factors such as condition and length of exposure, intake via contaminated foods, etc. were evaluated; no single factor appeared to be associated with chloracne. Disturbances of the gastrointestinal tract were more frequently observed in children affected with chloracne in those from the same areas having no skin lesions. However, no clinically definable systemic disease has been diagnosed.

Accidents, Occupational↗
PubMed1981

[Multicenter study on the distribution of Streptococcus pneumoniae strains in Italy].

Pneumococcal serotyping by quellung reaction has been performed in five Italian areas on 267 strains, isolated from throat swab, sputum, blood, liquor, etc. 37 serotypes have been identified. The most frequent types resulted 19, 6, 3, 20, 9, 4 (in 50% of total samples), with no difference from those detected in other European countries. The proportion of type 19 was the highest among all age group, in four out of five different areas and in bacteremic pneumonia and meningitis. 36 strains were isolated from infection sites among which type 19 resulted more frequent than in isolates from throat swab and sputum (27.7% versus 16.1%). Pneumococcal serotyping should be routinely done in the light of forthcoming use of polysaccharide vaccine.

Adult↗
PubMed1980

[Prevalence of tetanus immunity in metal mechanical workers].

The results of a seroepidemiological prevalence survey on the immune status against tetanus of steelmill workers (who, limited to the new work call ups, had to be vaccinated since 1968) are reported. We did not observe remarkable differences in protection against tetanus among those who had begun work before 1968 (46.4% protected) and after 1968 (53.5% protected). In both cases, the protective values were the result of immunization procedures that were performed exclusively in consequence of the military service and/or on the occasion of industrial accident and/or road accident or of accidents of other kinds. It appears, moreover, that the protection of workers against this disease is, nowadays, too often relying on serum prophylaxis, which was the only preventive measure adopted for over half of the workers. In the light of the reported data we need to enforce the existing legislative measures.

Adult↗
PubMed1980

[Duration of tetanus immunity in relation to the number of doses of vaccine].

A study of the duration of the immunity to tetanus, by means of the passive haemagglutination test, was undertaken in three groups of subjects immunized with two (primary immunization), three (basic immunization) and four (basic immunization with booster) does of DT. All the subjects of the first group, who had gone 9 months since their last dose, possessed antitoxin titers greater than or equal to 0.01 I.U./ml. Among the subjects of the second group within 12 months of the basic immunization course none had less than 0.01 I.U./ml, within 13-48 months 3% had less than 0.01 I.U./ml, within 49-72 months 9.7% had less than 0.01 I.U./ml and after 73 months 26.5% had less than 0.01 I.U./ml. No dependence on age at time of vaccination could be demonstrated. In the third group of subjects within 48 months of the immunization course with four doses none had less than 0.01 I.U./ml, after 48 months 11.1% had less than 0.01 I.U./ml. Interpolation of the data with the use of linear regression (y = a + bx), which better-fits in comparison with polynomial model (y = a + b1x + b2x2...+ bnxn) until the quartic term, pointed out the possibility that titer falls below the "alert level" (0.1 I.U./ml) and the protective threshold (0.01 I.U./ml): after 22 and 34 months for subjects of the first group; after 110 and 180 months for subjects of the second group and after 164 and 269 months for subjects of the third group. However, the presence of "poor" or "not responders" in the second group is not negligible and justifies the necessity that the first booster dose be given at five-year intervals.

Adolescent↗
PubMed1980

Experiences from the accident of Seveso.

Provisional data on selected sanitary events which took place at Seveso after July 10 1976 are reported. 187 cases of chloracne, mostly in children, were detected, 50 just after the accident, the others within a year. Most polluted area (zone A) provided almost all "early" and most severe cases, but the territorial distribution of chloracne prevalence rates showed some inconsistencies with the soil TCDD pollution map; interpretations for such findings are discussed. Thirty-eight birth defects were detected in 1977 (none in zones A and B), more than in previous years, but still less than expected in a well controlled "normal" population: no clustering around a given type was observed. Spontaneous abortions, evaluated both as abortion rates and as pregnancy loss rates, showed scattered and statistically non-significant variations, inconsistent with the pollution map. No differences in birth and death rates compared to surrounding areas were observed. Data on ad hoc cytogenetic, neurological and immunological surveys are commented. Limitations of the presently available data are discussed and further research lines are anticipated.

Abnormalities, Drug-Induced↗
PubMed1979

Epidemic of breast enlargement in an Italian school.

An outbreak of breast enlargement in girls and boys attending a school in Milan, first noted in November, 1977, was followed up until the end of 1978. 213 boys aged 3-14 years and 110 girls aged 3-7 years were studied; control children attending five other schools were also examined. In total 1647 boys and 476 girls were examined. Breast enlargement was significantly more common in boys (29.0%) and girls (21.6%) aged 3-5 years, boys (58.0%) aged 6-10, and girls (67.1%) aged 6-7 from the school in Milan, than in age and sex matched children at control schools. Breast enlargement was not pronounced and disappeared within 8 months. Hormonal determinations were within normal limits except for 17 beta-oestradiol which was slightly raised. Although oestrogen contamination was not detected when samples of school meals were tested, an uncontrolled supply of poultry and beef was suspected as being the cause of this outbreak.

Adolescent↗
PubMed1979

[Epidemiology of measles (author's transl)].

A detailed analysis of epidemiology of measles in pre-vaccinal era is reported for both isolated, underdeveloped and developed populations, together with the most recent knowledge on epidemiological changes tooking place in those countries which introduced large-scale vaccination with live, further attenuated measles vaccines: reduction of morbidity mortality and complication rates, morbidity age shift, etc. Results obtained in U.S.A., where vaccination was introduced in 1963, are analyzed also considering that it never spanned above 66% of children 1-4 year. Suggestions derive after the american experience for a correct strategy of the incoming vaccination in this Country.

Adolescent↗
PubMed1975

[Epidemiological findings in the study of congenital malformations].

Experience with thalidomide and German measles contracted during pregnancy has focused attention on the question of birth defects. It is suggested that good reasons exist for the carrying out epidemiological investigations to establish the true incidence and geographical and social distribution of such deformities, and hence their possibly "environmental" origin at least in some instances. Such investigations would supplement research into experimental teratology. The advantages, disadvantages and limitations of retrospective and prospective investigations are discussed. A detailed account is given of a prospective survey in progress in Israel. Reference is also made to a similar survey being launched in some Italian cities with the aid of the CNR.

Abnormalities, Drug-Induced↗