PubMed Health⌕ Search

Biomedical subjects

T Stroffolini

Publications and source records attributed to T Stroffolini.

At least 145 records · Page 8Linked to original sources

Trends in meningococcal disease in Italy 1987.

Meningococcal disease in Italy decreased 29% in 1987 from the previous year. The highest number of cases was seen in the 1-4 year-old age group (27%). The frequency in army recruits was 5/100,000, still higher than the 0.57/100,000 in the general population, but less than the 7/100,000 reported in the previous year. Sixty-three percent of the isolates belonged to serogroup C while serogroup B constituted 25%. The proportion of strains resistant to sulphonamides was 52.6%. Six strains were resistant to rifampin and none to minocyclin. No secondary cases occurred. These results are consistent with the trends reported in Italy in 1986. There were two findings of interest in 1987: the absence of secondary cases, attributable to the appropriate administration of chemoprophylaxis; and the decrease in military cases, reflecting the use of bivalent serogroup (A + C) meningococcal polysaccharide vaccine in all new military recruits since January 1987.

Cohort Studies↗

Meningococcal disease in Italy.

In 1985, nationwide surveillance of meningococcal disease aimed at establishing appropriate guidelines for prophylaxis started in Italy. The incidence of disease was 1.1/100,000 in 1985 and 0.6/100,000 in 1987. This decreasing trend was particularly evident among military recruits (from 17.3/100,000 in 1985 to 5/100,000 in 1987), reflecting the use of bivalent serogroup (A + C) meningococcal polysaccharide vaccine in all new recruits since January 1987. The age distribution of cases was statistically different from that observed during the 1970s (P less than 0.001), with a shift towards older age groups. Men have been in the majority (516 vs. 358, P less than 0.0000001). Group C has been the most common serogroup encountered (72.2%), while only 18% of the isolates belonged to serogroup B. Among military recruits, serogroup C accounted for 92% (81/88) of the cases. The proportion of strains resistant to sulphonamides was 67%, while only 3% strains were resistant to rifampicin and to minocycline. Reduced susceptibility to ampicillin and to penicillin was observed in 3 and 4% strains respectively. Nine secondary cases were all due to failure in the administration of chemoprophylaxis (sulphonamide given in seven cases, prophylaxis not attempted in two cases). Immunisation of all new military recruits and effective chemoprophylaxis of close contacts of cases are the major guidelines provided by the National Meningitis Surveillance Programme.

Age Factors↗

Hepatitis A virus infection in children in Sardinia, Italy.

The prevalence of antibody to hepatitis A virus (anti-HAV) in a sample of 1662 Sardinian children aged 3 to 11 years was estimated by ELISA. The overall anti-HAV prevalence was 3.8 per cent; it increased from zero among children of 3 to 7.2 per cent in children of 11 years. A slight male predominance was observed (4 versus 3.6 per cent). Anti-HAV prevalence was inversely related to the number of years of education received by the father and positively related to the number of households in the sample. Children whose fathers had received less than six years of schooling, had a 6.2-fold risk (Cl 95 per cent = 2.6-15.3) and children with five or more households under one roof had a 2.6-fold risk (Cl 95 per cent = 1.4-5.0) of previous exposure to hepatitis A virus (HAV) infection. These findings suggest that exposure of Sardinian children to hepatitis A virus is relatively low, probably because of improvements in socioeconomic conditions in recent years in the island. However, overcrowding and poor education in the father of schooling appear to be important determinants of infection.

Child↗

A one year survey of meningococcal disease in Italy.

For the last ten years, meningococcal disease has been endemic in Italy with an annual average of 900 cases (rate of 1.6/100,000). The age specific attack rate has been highest for children under one year of age, and the majority of cases have been due to serogroup B. During 1985, the epidemiology of meningococcal disease changed substantially: twice as many cases were observed in males as in females. There was a shift toward older age groups, with the highest number of cases occurring in the 15-24 year old age group (25%). The frequency in army recruits was 17.3/100,000, as opposed to 1/100,000 for the general population. Serogroup C caused the majority of cases (75.8% of the isolates). The proportion of strains resistant to sulfonamides was 71.1%, while only one strain was resistant to rifampin and none to minocycline. Seven secondary cases occurred (2%): in five, chemoprophylaxis was inappropriate (sulfonamide), and in two, no drug was given. A single co-primary case was seen. We conclude that in Italy, the use of sulfa drugs as chemoprophylactic agents is not warranted at present, compulsory vaccination of army recruits with bivalent vaccine (A + C) is advisable, and the shift in age distribution of cases and the high predominance of serogroup C increases the need for careful surveys.

Adolescent↗

[Diabetic neuropathies. IV. Autonomous neuropathy. Peripheral sympathetic innervation and the cardiovascular system].

The clinical conditions due to damage to the peripheral sympathetic nervous system during diabetic neuropathy mainly involve alterations to subcutaneous vasomotility , temperature body regulation and exudation, which may take form of hyper or hypoactivity. Gustatory exudation and local anhydrosis are described in detail as well as the connection with aggravating factors like long duration, poor balance and early onset of diabetes mellitus . Change in the relevant cardiovascular reflexes, commonly used in diagnosing diabetic neuropathy, are also analysed with a discussion of their physiopathological background and clinical significance. Finally the painless infarct, sudden death and abnormal response to hypoglycaemia, that are the common features of diabetic neuropathy, are also described.

Body Temperature Regulation↗

[Diabetic neuropathy. III: Autonomic neuropathy. Genito-urinary system].

When considering urogenital complaints occurring during diabetic autonomous neurotherapy , three clinical situations are important due to their frequency and the clinical situation, the considerable effect they have on quality of life. In addition they may also be responsible for severe complications as in the case of diabetic cystopathy . This syndrome is the cause of considerable subjective disturbances even though it may be diagnosed instrumentally in its early, completely asymptomatic stage. The complaint evolves inevitably towards bladder denervation, chronic urinary retention and more or less severe septic complications. Retrograde ejaculation may lead to the loss of procreative ability as in the case of neurogenic impotence in diabetics. These three autonomous neuropathic situations occur quite frequently, especially in older subjects who have suffered from diabetes for more than ten years. Often the three syndromes are interconnected or linked to autonomous or peripheric neuropathic complaints affecting other areas. The few therapeutic measures practised have not proved very conclusive. Only a diligent examination of signs and symptoms with the aim of early diagnosis and the maintenance of good glycometabolic balance are considered to be at all effective as preventive measures.

Adult↗

[Diabetic neuropathy. II. Autonomic neuropathy. The gastrointestinal system].

Autonomic diabetic neuropathy of the alimentary canal takes several basic forms: a) oesophagopathy , b) gastroparesis, c) enteropathy, d) bile duct disorders. In many cases three are no subjective symptoms. In other the onset of the clinical condition may take acute and dangerous forms as in gastropathy. In still other cases e.g. enteropathy, the neuropathy may develop in bizarre and unexpected ways which are highly damaging to the patient's quality of life though in most cases they are not fatal. Bile disorders involving minimal motility after stimulus, as in denervation and reduced sensitivity to pain are particularly significant. Diabetics are more likely to suffer from calculosis (59.6% of cases), with septic complications (20% in diabetics compared to 7.8% in non-diabetics) or cholestasis (20% in diabetics v. 15.8% in non-diabetics). These figures indicate that all diabetics and especially the elderly should be subjected to careful examination to identify any bile disorders.

Cholelithiasis↗

[Diabetic neuropathy. I). Peripheral neuropathy].

This is the first of a series of reports on diabetic neuropathy. Peripheral or somatic diabetic neuropathy is discussed with reference to its major symptoms: central, peripheral and amyotrophic mononeuropathies, symmetrical and asymmetrical polyneuropathies, peripheral arthropathy and finally diabetic cachexia. The various theories on the pathogenesis of peripheral neuropathy are presented. Finally data on 173 type I and II diabetics are presented. These patients, treated in outpatients departments, were paired by sex, weight and age with an equal number of non-diabetic subjects. The results of the survey largely confirm report in the literature. The importance of continuous medical surveillance for the identification and hence prevention of diabetic neuropathy is emphasized. This is particularly necessary since we have still much to learn about the natural history of the disease and for the moment the therapeutic approaches to the various neuropathies concerned are both tentative and symptomatic.

Adult↗