TB and HIV in healthcare settings.
Explore the source record for details and available documents.
HIV Infections↗
Biomedical subjects
R Micciolo
Publications and source records attributed to R Micciolo.
Alcohol consumption, smoking habits and body fat distribution in Italian men and women aged 20-60 years.
The study was performed on 601 patients (294 males and 307 females) of a general practitioner. Alcohol intake and smoking habits were compared with other anthropometric measurements including waist-to-hip girth ratio. Patients were divided into non-smokers and smokers (subdivided into three groups according to the number of cigarettes smoked per day) and into non-drinkers and drinkers (subdivided into three groups with different alcohol intakes). Ex-smokers were excluded from the study. Analysis of covariance using age, body mass index, physical activity and menopausal status as covariates, showed that: (1) cigarette smoking is not accompanied by a specific pattern for body fat distribution; (2) waist-to-hip ratio was significantly different for the four classes of alcohol intake for women (non-drinkers: 0.809, < 11 g: 0.805, 11-20 g: 0.809, > 20 g: 0.826; F = 2.8, P < 0.05) but not for men (non-drinkers: 0.944, < 20 g: 0.934, 21-40 g: 0.940, > 40 g: 0.943; F = 0.9); (3) increased alcohol intake corresponds to an increased lipid and energy supply.
Adipose Tissue↗
Transmission of HIV-associated tuberculosis to healthcare workers.
OBJECTIVE: A retrospective investigation was made to compare the occupational risk of tuberculosis in personnel assisting human immunodeficiency virus (HIV)-infected and uninfected subjects with active tuberculosis. DESIGN: We retrospectively reviewed 6 years of hospital activity in 3 units where HIV-infected patients with tuberculosis are hospitalized and in 2 units where non-HIV-infected tuberculosis patients are hospitalized. The risk of occupational tuberculosis in healthcare workers who assisted HIV-infected and non-HIV-infected patients with tuberculosis was investigated. PARTICIPANTS: The risk of occupational tuberculosis in healthcare workers was studied by considering the numbers of potential source cases (hospitalized patients with tuberculosis) in the two conditions investigated (HIV-positive and HIV-negative). Both potential source cases and cases of tuberculosis in healthcare workers had to be microbiologically proven in order to be considered. RESULTS: Seven cases of tuberculosis occurred in persons who cared for 85 HIV-infected subjects with tuberculosis, while only 2 cases occurred in staff members who took care of 1,079 HIV-negative tuberculosis patients over the same period (relative risk = 44.4; 95% confidence interval = 8.5-438). CONCLUSIONS: Tuberculosis seems no longer to be a neglectable risk in healthcare workers assisting patients with HIV infection. Further study is urgently needed to see whether such unexpectedly high dissemination of tuberculosis also is demonstrable in the community.
HIV Infections↗
Transmission of HIV-associated tuberculosis to health-care workers.
Explore the source record for details and available documents.
HIV Seropositivity↗
Is hypertension a confounding factor in the assessment of blood lead reference values?
In order to evaluate whether hypertension can be considered as a confounding factor in the setting up of reference values for blood lead, we examined the results of a cross sectional study which evaluated the relationship between lead in blood and hypertension in a sample of 254 males and 271 females of a general population not occupationally exposed to lead. The statistical analysis and in particular the multiple logistic regression showed that, even if some well-known confounding factors such as age, sex, overweight, smoking and alcohol are taken into account, blood lead levels are well correlated with hypertension. The results suggest that even modest lead absorption is able to influence the probability of being hypertensive. The relationship between blood lead and hypertension and their relationship with the main confounding factors involved in the determination of reference values of metals in blood are discussed.
Adult↗
Trends in the prescription of antidepressants in urban and rural general practices.
Antidepressant drug (AD) prescriptions written in the period 1983-1988 by all GPs working in Verona, Italy were analyzed. The data were provided by a local drug information system and calculated as Defined Daily Dose (DDD). The area was divided in 25 districts, classified on the urban-rural continuum according to population density. Two indices of service provision and two demographic measures were also used in the analysis. An increase in the levels of prescription of AD was observed over the 6 years. No correlation was found between DDD/1000 inhabitants/day rate and population density. This was confirmed using multiple regression analysis, which showed that only the proportion of females in the population was significantly associated with AD prescription. Harmonic analysis of the seasonal variation in prescription showed a moderate degree of seasonality in all districts. When using multiple correlation analysis the seasonality was correlated only with the number of pharmacies available in each district.
Age Factors↗
Suicide and unemployment in Italy: description, analysis and interpretation of recent trends.
This paper assesses the relationship between suicide and unemployment in Italy during the period 1977-1987, taking into account variations by gender and region. The first objective of the study is to provide descriptive longitudinal and cross-sectional aggregate-level analyses and also trends in individual-level and population risks for suicide in relation to unemployment. Our second objective is to use the Italian data to help discriminate between rival interpretations of the unemployment-suicide link, i.e. the operation of health selection or causal (susceptibility) mechanisms. Evidence for an association between suicide and unemployment among women was not convincing. The annual rate of female unemployment was negatively correlated with the female suicide rate and unrelated to the suicide rate among the unemployed, the relative risk or population attributable risk. Individual-level analyses for each year confirmed that unemployed women were more likely to commit suicide than their employed counterparts, although the overall relative risk was low (1.5) and conference intervals for six of the eleven annual risk ratios included unity (1). Among men, the unemployment rate was positively correlated over time with the suicide rate. However, change in the suicide rate across 18 geographic regions of Italy was unrelated to change in the unemployment rate, a finding which did not appear to be invalidated by a regression to the mean effect. Unemployment was also positively related to the suicide rate among the employed and population attributable risk, but unrelated to the rate among the unemployed or the relative risk. Comparison of suicide rates among the employed and unemployed revealed an excess of suicide among the latter in each year, with an overall relative risk of 3.4. On the basis of this contradictory and inconsistent evidence, we are cautious about offering definitive interpretations concerning the nature of the unemployment-suicide link among men. We conclude by suggesting the need for further individual-level studies using retrospective case-control methods.
Adult↗
Factors affecting nitrogen balance in hemodialysis patients.
Explore the source record for details and available documents.
Adult↗
Clustering of hemodynamic and metabolic abnormalities and of anthropometric characteristics in men and women, aged 21-60 years.
The associations between fat pattern and metabolic profile were evaluated, using cluster analysis, in 214 males and 244 females (aged 21-60 years). The subjects were randomly selected from the patients of one general practice in Castel D'Azzano (Italy). The metabolic status was indexed by blood pressure, blood glucose, uric acid, serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (both total and percentage). Fat pattern was evaluated using six skinfolds and three circumferences. The analyses were performed separately on anthropometric and metabolic variables for each sex. The analyses were repeated five times to evaluate the stability of the cluster solution. Anthropometric rather than metabolic variables provided a more stable solution for cluster analysis. Anthropometric clusters showed significantly different metabolic patterns. Most of the differences disappeared when a body mass index (BMI) effect was taken into account but not when an adjustment for waist to hip ratio (WHR) was made. On the other hand, neither BMI nor WHR was able to fully account for the differences in metabolic profiles of metabolic clusters. Cross-classification results of anthropometric and metabolic cluster membership showed a significant, although moderate, degree of association between the two classification sets. These results indicate that in both sexes anthropometric characteristics contribute to a limited degree to the metabolic profile and that the associations probably reflect a complex mechanism.
Adipose Tissue↗
Variations in time of serum pancreatic enzyme levels in chronic pancreatitis and clinical course of the disease.
Thirty-four patients with chronic calcified pancreatitis were evaluated clinically and biochemically (at a time when painful relapses were not present) every 9 mo for 3 yr; 25 of them were also studied at 4 and 9 yr. Serum elastase-1, trypsin, lipase, and amylase in the same sera were measured at each visit; levels on entry and variations during the study were compared with the clinical and functional data of the patients. On entry, low levels of elastase-1 were found in 11.7% of the patients, high levels in 41.1%; in contrast, high levels of trypsin and lipase were found in only a small number of patients (5.8 and 11.7%, respectively), whereas low levels were present in a substantial number (47.8 and 32.3% for trypsin and lipase, respectively). Over time, we found a significant (p = 0.000002) reduction in elastase-1 levels. Such reduction was not found for trypsin, lipase, or amylase. The reduction of serum elastase-1 was significantly (p less than 0.003) more frequent in patients presenting a reduction in painful relapses than in patients with a stable or increased attach rate; this association was weaker (p less than 0.05) for lipase and trypsin, and absent for amylase. No correlation was found between circulating enzymes and either alcohol consumption or age of patients. In patients with severe exocrine impairment, low levels of elastase were found in only 20% of the cases, whereas trypsin and lipase were reduced in 73.3 and 53.3% of the cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Alcohol Drinking↗
Geographical and urban-rural variation in the seasonality of suicide: some further evidence.
The seasonal variation of the suicides (n = 57,007) that occurred in Italy during the years 1969-1984 was evaluated using harmonic analysis, according to the method described by Pocock (1974). Monthly data were analyzed, separately for males and females, taking into account the setting (urban or rural) and the geographical location (Northern, Central or Southern regions). As compared with a previous study by our research group, a more precise (less aggregated) index of the urban-rural continuum was used. Rates for males were greater than those for females; urban were higher than rural rates; the seasonality was greater in the rural than in the urban settings and generally greater in males than in females in the Southern as well as in the Northern regions.
Cross-Sectional Studies↗
The association of body fat location with haemodynamic and metabolic status in men and women aged 21-60 years.
The importance of body fat location as a predictor of metabolic aberrations was evaluated in 214 males and 244 females [aged 21-60] randomly selected from the patients of one general practice of Castel D'Azzano (Italy). The metabolic pattern, indexed by blood pressure, blood glucose, uric acid, serum triglycerides, HDL- and LDL-cholesterol was summarized in a haemodynamic-metabolic score (HMS). Association of HMS with age, anthropometric variables (skinfold thicknesses, girth lengths) and degree of overweight (body mass index, BMI) was evaluated in males and females using multiple regression analysis. Body fat location was associated with metabolic status independent of age in both sexes. This association was also independent of the degree of overweight. BMI, in general, was associated with HMS to a greater extent than anthropometric variables, except for waist girth; when its effect was taken into account BMI did not significantly improve the prediction power of HMS values in males. Among skinfolds, epimesogastric showed in both sexes the highest association with HMS. These results support the abdominal adiposity hypothesis and suggest that waist circumference could be a good index for assessing metabolic status. The abdominal location of adipose tissue, more than just the degree of overweight, could play a role in obesity related disorders.
Adipose Tissue↗
Basal energy expenditure in obese and normal weight schoolchildren.
The present study was performed using indirect calorimetry to test the hypothesis of a reduction of the basal energy expenditure in obese prepubertal children. The obese and control children studied were comparable regarding age, height and fat-free mass (FFM). Total weight and body fat percentage were significantly greater in the obese children. Plasma insulin and glucagon concentrations were significantly higher in obese than in control children. In the two groups of children the basal metabolic rates (BMRs) were comparable in both absolute values and values adjusted for FFM, age and gender utilizing the multiple regression analysis. The most important variable to predict BMR was FFM, followed by age. BMR was significantly correlated with FFM, both for obese and control children, and also when the two groups were combined. In conclusion, our data do not support the idea that a child's obesity is maintained by increased metabolic efficiency at least in basal conditions.
Age Factors↗
A simple test for predisposition to LDL oxidation based on the fluorescence development during copper-catalyzed oxidative modification.
When human low density lipoprotein (LDL) obtained from 10 volunteers was incubated in air at 37 degrees C in the presence of various concentrations of copper, an increase in fluorescence was observed with emission maximum at 430 nm when excitation was performed at 360 nm. The fluorescence increase was inhibited by ethylenediamine tetraacetic acid and by 4-methyl-2,6-di-tert-butylphenol. The fluorescence was found to be tightly bound to the protein moiety. Furthermore, Cu2+ modification of LDL was associated with a decrease in the reactive amino groups of apolipoprotein B and in the uptake of the lipoprotein by rabbit fibroblasts. Under our conditions, the fluorescence increase showed two consecutive periods; an inhibition period during which the fluorescence increased only weakly, and a propagation period with a rapid increase in fluorescence that was linear for at least 5 h. Both periods were influenced by copper concentration. The study also shows that the extent of fluorescence generated upon LDL oxidation varied greatly in the volunteers. Thus, while the results demonstrate that the fluorescence increase may likely monitor the extent of the apoB derivatization, the calculation of the fluorescence development rate of the propagation period together with the duration of the inhibition period may constitute a quantitative measurement of the susceptibility of apoB to be derivatized.
Analysis of Variance↗
The perception of life events in two different cultural settings.
The perceived stressfulness of 63 life events was compared in a North Italian and a South Italian sample, using a 0-20 equal-interval scale. Each sample comprised 48 psychiatric patients and 34 relatives. Three-way analyses of variance for each event showed that South Italians consistently rated events as more upsetting, while patient or relative status and item order of the life event list did not affect the ratings. Multiple regression analysis showed that sociodemographic variables were not related to overall mean scaling scores with the exception of marital status which revealed a significant interaction with the city of residence. Southern Italians scaled recent events as more upsetting than events which had not occurred. This was not the case for the North Italian sample.
Adaptation, Psychological↗
Patterns of care for chronic patients after the Italian psychiatric reform. A longitudinal case register study.
A comprehensive and well-integrated community-based system of psychiatric services has been developed in South-Verona since the Italian psychiatric reform. Using the South-Verona Psychiatric Case Register, we identified chronic psychiatric patients in the community over a 6-year period after the reform. Six first-contact sociodemographic variables (sex, age, marital status, living situation, education, occupational status) and two clinical variables (ICD-9 diagnosis and past history of state psychiatric hospital admission) were studied for these patients. Four full cohort-years of post-reform chronic patients were followed for a 2-year period to determine their subsequent patterns of care. Logistic analysis was used to examine the interaction of cohort-year with outcome and the above sociodemographic and clinical variables studied individually and in combination. We found that 36.4% of post-reform chronic patients in the community remained in long-term contact with psychiatric services for 2 years after they were first identified. Logistic analysis revealed that none of the sociodemographic and clinical variables studied individually or in combination were predictive of the probability of remaining in long-term contact with community psychiatric services.
Aged↗
Blood pressure, metabolic variables and adipose tissue distribution in pre- and post-menopausal women.
The study was performed on 289 female patients (aged 20-60) of a family doctor in Castel D'Azzano, a small town near Verona. The following variables were considered: body mass index (BMI), tricepital, subscapular, hypomesogastric, epimesogastric, supra-iliacal and epitrochanteric skinfolds, waist, umbilical and bitrochanteric circumferences, cholesterol, triglycerides, HDL-cholesterol, glycemia, uricemia and blood pressure. A significant worsening with age was observed in the mean values of the variables. This worsening was particularly evident in women over 50. The population was subdivided according to presence or absence of menopause; the two groups were then matched for age. None of the variables showed significant differences. Our results did not confirm any of the many effects that menopause is supposed to have regarding metabolic and blood pressure alterations.
Adipose Tissue↗
Blood lead and blood pressure: a cross sectional study in a general population group.
In a sample of general population not occupationally exposed to lead (254 males and 271 females), a cross sectional study has been carried out to evaluate the relationship between lead in blood (PbB), blood pressure and hypertension. The data were analyzed by the common statistical significance tests (Student t test, variance analysis) and by logistic regression and showed that, even taking into account the well-known confounding factors (such as age, overweight, heredity, smoking, alcohol) PbB and blood pressure are significantly correlated. In light of these results and according to the more recent literature, it is proposed to consider PbB as a synthetical indicator of major cardiovascular risk rather than a single risk factor.
Adult↗