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Ilaria Casetta

Publications and source records attributed to Ilaria Casetta.

9 recordsLinked to original sources
PubMed2005

Amyotrophic lateral sclerosis, rural environment and agricultural work in the Local Health District of Ferrara, Italy, in the years 1964-1998.

Previous epidemiological surveys, both analytic and descriptive, in the Local Health District (LHD) of Ferrara, northern Italy, have indicated that rural residence and agricultural work might constitute risk factors for Amyotrophic Lateral Sclerosis (ALS). The present investigation is a demographic survey in the LHD of Ferrara in the years 1964-1998 which aimed to verify whether the level of urbanization and agricultural activities might influence the risk of ALS. Based on the data obtained in a recent incidence study in the LHD of Ferrara which reported a mean annual crude incidence rate of ALS in the years 1964-1998 of 1.63 per 100,000 population (95 % CI 1.31-2.00), it was possible to compare the number of observed ALS cases and the number of expected ALS cases according to the level of urbanization and usual occupation on the basis of the residential and occupational pattern identified in the population of the LHD of Ferrara in the study period under the assumption of a homogeneous distribution of ALS. The present survey identified four different levels of urbanization in the LHD of Ferrara in the study period and for none of them was a difference between the number of observed and expected ALS cases found. Also in the most rural of the four identified levels of urbanization (small villages with an average population in the study period lower than 1,000 inhabitants and scattered houses in the countryside) no difference was found between observed and expected number of ALS cases (observed ALS cases 16, 95% Poisson CI 9.1-25.9, expected ALS cases 18.3). Based on the occupational pattern identified in the population of the LHD of Ferrara in the study period the number of incident cases of ALS whose usual occupation was in agricultural work exceeded the expected number (observed ALS cases 22, 95% Poisson CI 13.8-32.3, expected ALS cases 6.0). The present findings indicate that rural residence itself does not influence the risk of ALS while agricultural activities could influence the risk of ALS, with occupational exposure to agricultural chemicals playing a possible role.

Agriculture↗
PubMed2004

Intrathecal production of Chlamydia pneumoniae-specific high-affinity antibodies is significantly associated to a subset of multiple sclerosis patients with progressive forms.

The purpose of this study was to provide further insight into the effective relevance of the association between Chlamydia pneumoniae and MS. We evaluated by ELISA technique cerebrospinal fluid (CSF) and serum levels of anti-C. pneumoniae IgG in 46 relapsing-remitting (RR), 14 secondary progressive (SP) and 11 primary progressive (PP) MS patients grouped according to clinical and Magnetic Resonance Imaging (MRI) evidence of disease activity. Fifty-one patients with other inflammatory neurological disorders (OIND) and 52 with non-inflammatory neurological disorders (NIND) were used as controls. A C. pneumoniae-specific intrathecal IgG synthesis as detected by the relative specific index was present in a small proportion of MS (17%), OIND (22%) and NIND (2%) patients and was significantly more frequent in MS and in OIND than in NIND (p<0.001) and in SP and PP MS than in RR MS patients (p<0.02). Among the patients with C. pneumoniae-specific intratecally produced antibodies, CSF high-affinity anti-C. pneumoniae IgG were found in the majority of SP or PP MS, occasionally in OIND, but not in RR MS and NIND patients. These findings confirm that the presence of a humoral immune response to C. pneumoniae within the central nervous system (CNS) is not selectively restricted to MS, but is shared by several inflammatory neurological conditions. In addition, our results suggest that an intrathecal production of C. pneumoniae-specific high-affinity IgG can occur in a subset of patients with MS progressive forms in which a C. pneumoniae brain chronic persistent infection may play an important pathogenetic role.

Adult↗
PubMed2003

Is there a decrease in Guillain-Barré syndrome incidence after bovine ganglioside withdrawal in Italy? A population-based study in the Local Health District of Ferrara, Italy.

There have been many reports of cases of Guillain-Barré syndrome (GBS) after therapeutic injection of bovine ganglioside preparations with the result that they were withdrawn in Italy in December 1993. As the relationship between bovine gangliosides and GBS has not yet been established, a further epidemiological investigation in the Local Health District (LHD) of Ferrara, Italy, was carried out in the years 1994-2001 to verify whether the incidence of GBS had changed after ganglioside withdrawal. The other aim of this investigation was to update the incidence of GBS in this area since the two previous investigations we carried out showed an increase in incidence from the years 1981-1987 to the years 1988-1993. The cases of GBS were identified prospectively. To guarantee completeness of case ascertainment, an intensive retrospective survey of all possible sources of cases for the entire study period was performed. The mean annual crude incidence rate in the years 1994-2001 (based on 26 new cases) was 1.97 per 100,000 population (95% CI 1.29-2.89), whereas it had been 1.87 per 100,000 population (95% CI 1.35-2.52) in the years 1981-1993 (based on 43 cases) when gangliosides were available. The age-adjusted rates were almost identical (1.66 and 1.65 per 100,000 population, respectively). Although ganglioside administration could have triggered, on the basis of an individual susceptibility, an immunologic reaction which produced GBS, the incidence of GBS in the study area did not change after ganglioside withdrawal. In the whole period 1981-2001, a temporal pattern of incidence was reported with an increase towards a peak in 1990-1992 and a progressive decline thereafter. This temporal pattern did not seem related to ganglioside withdrawal, and no definite explanation for it was found which could imply that the disease incidence is less stable than it was deemed.

Adolescent↗
PubMed2002

Patient demographic and clinical features and circadian variation in onset of ischemic stroke.

BACKGROUND: Studies have reported circadian variation in the onset of ischemic stroke, which may carry important pathophysiological implications. However, there is no detailed information about circadian variations among the subtypes of stroke. OBJECTIVE: To determine whether subgroups of patients with ischemic stroke with specific clinical characteristics would exhibit different circadian patterns, to more systematically examine the role of possible triggering or precipitating factors. DESIGN AND SETTING: Analysis of the effects of demographic, medical, and pathophysiological factors on the circadian pattern of an unselected series of patients with ischemic stroke consecutively admitted to our hospital. RESULTS: The study included 1656 patients. As in other studies, the peak of stroke onset occurred in the morning, with a second peak in the evening. Circadian variation in ischemic stroke onset was shown to be independent of clinical variables considered. CONCLUSIONS: Our study confirms the circadian rhythm of stroke reported in previous studies. There is a chronological pattern of ischemic stroke in the morning, which appears to be independent of the presence of risk factors and of clinical stroke subtypes. The role of circadian variability of blood pressure (present in patients with and without hypertension) and a concurrent morning hypercoagulability are suggested as possible determinants of this pattern. Preventive pharmacological interventions aimed at specifically targeting the morning rise in risk factors could be advantageous in reducing the overall risk of ischemic stroke.

Aged↗
PubMedDate not supplied

Risk factors for cryptogenic and idiopathic partial epilepsy: a community-based case-control study in Copparo, Italy.

OBJECTIVES: The etiology of epilepsy remains unknown in most cases. We sought to investigate the role of some pre-, peri- and postnatal factors in the etiology of idiopathic and cryptogenetic partial epilepsy. METHODS: We carried out a community-based case-control study using the incidence cohort of epileptic patients living in the district of Copparo, in the province of Ferrara, Italy. The study was performed in 55 cases and 165 controls. A standardized questionnaire was used to collect information in face-to-face interviews. RESULTS: Multivariate logistic regression analysis found that a personal history of febrile convulsions [odds ratio (OR) = 4.01, 95% confidence interval (CI) = 1.3-19.1] and a family history of seizures in first-degree relatives (OR = 4.5, 95% CI = 1.8-18.6) were independent risk factors for the condition under study. We failed to demonstrate an association between partial epilepsy and previously suggested perinatal risk factors. CONCLUSION: The findings of this study further support the hypothesis of a genetic propensity for seizures, which may be expressed early by the occurrence of febrile convulsions.

Adolescent↗
PubMedDate not supplied

Incidence of amyotrophic lateral sclerosis in the local health district of Ferrara, Italy, 1964-1998.

One of the epidemiologic characteristics of amyotrophic lateral sclerosis (ALS) still under discussion is whether the incidence of ALS is increasing over time. We performed a new investigation expanding our previous study of ALS in the local health district (LHD) of Ferrara, northern Italy, to determine whether there have been any changes in the incidence of ALS in the years 1964-1998. We used a complete enumeration approach by reviewing all possible sources of case collection available in the study area. We selected all patients with definite and probable ALS according to the World Federation of Neurology criteria. The mean annual crude incidence rate for 1964-1998 was 1.63 per 100,000 population (95% CI 1.31-2.00). An increase in incidence from 1.07 to 2.19 per 100,000 population was observed during the study period. It was greater in women and in individuals of 70 years old and over. Substantial population ageing occurred in the LHD of Ferrara during the study period and it was more prominent in women. This increase in incidence seems to be explained mainly by the ageing of the population. Moreover, greater precision in diagnosis of ALS in elderly women, rather than better case ascertainment of diagnosed patients, may have contributed to the increase. The role of environmental factors cannot be excluded, but based on the present findings, it seems to be of little importance.

Adult↗