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S Spila Alegiani

Publications and source records attributed to S Spila Alegiani.

8 recordsLinked to original sources
PubMed2004

The geographic relationship between the use of antimicrobial drugs and the pattern of resistance for Streptococcus pneumoniae in Italy.

OBJECTIVES: A temporal relationship between the increasing use of antibiotics and the increasing levels of antibiotic resistance has been established for Streptococcus pneumoniae. There are also data that support the presence of a geographic correlation between the level of resistance and the pattern of use among different countries and even within the same country. The aim of this study was to evaluate the potential geographic correlation between the use of beta-lactams and erythromycin in different Italian regions and the resistance of these antibiotics to invasive strains of S. pneumoniae during the period 1999-2000. METHODS: Ecological study. RESULTS: In Italy the mean level of resistance for penicillin and erythromycin was 11.4% and 28.9%, respectively. The highest level of resistance for both antibiotics was observed in central and southern regions (i.e. Campania, Lazio and the combined regions of Calabria, Puglia and Sicilia). These regions were also those with the highest consumption of antibiotics. A strong correlation was found between the prevalence of resistance to erythromycin and the regional use of macrolides (r=0.93, P=0.001) and beta-lactams (r=0.84, P=0.002). With regard to penicillin resistance, the greatest correlation was observed for oral penicillin (r=0.85, P=0.002). CONCLUSION: Our study provides further evidence of the association between regional level of antibiotic use and prevalence of antibiotic resistance.

Anti-Bacterial Agents↗
PubMed2004

Indexes of abdominal adiposity in patients with type 2 diabetes.

OBJECTIVE: To assess the relationship of waist circumference and weight/height ratio with height, and their association with components of the metabolic syndrome, in Type 2 diabetic patients. DESIGN: multicenter cross-sectional survey on a cohort enrolled in a prospective observational study. SUBJECTS: 13,232 patients (6816 women and 6416 men) with Type 2 diabetes, not currently affected by macrovascular complications. MEASUREMENTS: height, weight, waist and hip circumference, waist/hip and waist/height ratios. RESULTS: waist circumference was significantly correlated with height after adjustment for potential confounders (adjusted r=0.19 and 0.23 in women and men, respectively), while waist/height ratio showed an inverse correlation with height (r=-0.14 and -0.15, respectively). Elevated waist/height ratio was more predictive of hypertension and hypertriglyceridemia, than waist circumference or waist/hip ratio. CONCLUSIONS: Waist circumference is correlated with height; thresholds for waist circumference could need adjustment for height. Waist/height ratio, although inversely correlated with height, could be a better predictor of abnormalities associated with abdominal adiposity than waist circumference alone.

Adipose Tissue↗
PubMed2003

Secondary prevention of coronary artery disease in high-risk diabetic patients.

BACKGROUND AND AIM: To compare guideline implementation and the actual delivery of secondary prevention for coronary artery disease in the cohort of Italian diabetic patients enrolled in the DAI study. METHODS AND RESULTS: The DAI study is a multicentre cohort study of the prevalence and incidence of macroangiopathic events among 19,570 type 2 diabetic patients attending 201 Diabetic Care Units. For this study, we selected 1,475 subjects with a history of myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty at enrollment. Only 25% of the coronary patients in secondary prevention were receiving lipid-lowering drugs, and 20% were receiving beta-blockers. None of the patients in 54/185 Diabetic Care Units were on statins, and none in 82/185 Units were on beta-blockers. Multivariate analysis showed a positive correlation between the number of treatments and the taking of statins, and a negative correlation with age. CONCLUSION: Our data highlight a gap between the therapeutic guidelines and actual treatment, with wide variability in the delivery of secondary prevention across Units. The out-of-pocket cost of medication, daily treatment burden and geographic area can be ruled out as possible explanatory factors. Physicians' prescription attitudes may be a possible reason.

Adrenergic beta-Antagonists↗
PubMed1997

[Patterns of use of hormone replacement therapy in 2 Italian populations].

We analysed the pattern of hormone replacement therapy (HRT) use, over the period 1990-92, in a random sample of 76,537 women (45-74 years old) resident in the province of Rome, and in 1994 among all women (45-74 years old) resident in the Umbria region; data were collected through the regional drug prescription monitoring systems. During the three-year period an estimated 3.8% of women were prescribed HRT, among these 42% received estrogen with concomitant progestin therapy. The prevalence of use increased from 1.5% in 1990 to 2.2% in 1992 mainly because of an increased use of skin patches. In the Umbria region, out of the 166,112 women, 2.1% received at least one estrogen prescription. The prevalence of use increased in younger age classes but is almost unchanged over the sixties.

Aged↗
PubMed1993

Antipsychotic drug prescription in general practice in Italy.

Prescribing patterns of neuroleptic drugs in a population of about 3,700,000 inhabitants were analysed using all individual prescriptions delivered by the Italian National Health Service during 4 years (1986-1989). Data contained in a regional prescription database were analysed using an outpatient drug monitoring system (VIDEOFAR). The proportion of subjects receiving neuroleptics was about 1.3% of the entire population. During 1989, 20.2% of 52,716 observed subjects received multiple neuroleptic therapy. Haloperidol, the most frequently prescribed antipsychotic, was dispensed to 21.3% of the individuals as the only neuroleptic treatment. Consumption sharply increased with age and about 60% of patients receiving a prescription were women. Nonetheless, among the heavy users in the younger ages, the male-to-female ratio is significantly greater than one. Although the principal indications for neuroleptics are subacute or chronic clinical conditions, a surprisingly high proportion of subjects (ranging from 48% to 76% depending on the type of neuroleptic) received only one single prescription during 1989.

Age Factors↗
PubMed1991

Drug utilization studies within the VIDEOFAR project.

The epidemiological use of drug prescription data is getting increasing attention in Italy. All Italian citizens are included in the National Health Service (NHS) which reimburses almost every drug prescription. The potential information content of such systems have to be evaluated within a technological context which will allow, for medium term, drug prescription data collection for all of the individuals served by the NHS. The VIDEOFAR project did explore the possible use of drug prescription data for descriptive epidemiological studies, in the evaluation of General Practitioners activity and as a tool for Post-Marketing Drug Surveillance. Some examples are presented in this paper using data derived from Latium Region.

Adverse Drug Reaction Reporting Systems↗
PubMedDate not supplied

Mortality among workers of three thermoelectric power plants in northern Italy: a retrospective cohort study.

During the last ten years, interest has been focussed on occupational exposure in thermoelectric power plants (i.e., coal dust, polycyclic aromatic hydrocarbons, dioxin, dielectric liquids, PCB's, asbestos, etc.), although available evidence on its effects on the health status of the occupational population are far from being definitive. A retrospective cohort study was carried out to investigate the association between exposure to risk factors and mortality for cancer in three thermoelectric power plants located in the north-east of Italy. The three plants studied started with oil and coal but since 1968 they utilized mostly coal as fuel. In spite of the different fuel used at the beginning, the production process has been fairly constant since the main conversion from oil to coal with a substantial increase in power production. A total of 1,772 male workers were included in the total study cohort and followed-up from 1968 to 1987, with a total of 22,090 person-years of exposure. Eighty percent of the cohort began to work in the plant before 30 years of age, and had a mean period of employment of 9.5 years. The cohort was completely traced to the end of the follow-up period by using an original computer system based on personal fiscal codes. Causes of death were ascertained in the municipalities where the deaths occurred and coded according to the International Classification of Disease, IX Revision. During the study period 68 deaths were observed with an SMR for all causes of death equal to 0.79.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗