ABSTRACT
In a clinical and epidemiological study used Fine's Pneumonia Severity Index to determine the appropriateness of the hospitalisation of patients with community acquired pneumonia in the Internal Medicine Department of a hospital in Northern Italy. Risk factors and antibiotic treatment were checked against recent international guidelines. The study shows that 20% of the admissions were to be not appropriate. The principal risk factors were old age and such the co-morbidities heart failure, chronic cerebral diseases and COPD. In the home setting macrolides are less used than the new fluoroquinolones respirators. In the hospitals arrangements, b-lactams are still highly used, perhaps because of the high percentage of elderly patients. The data currently available suggest that some new fluoroquinolones such as levofloxacin are quite effective, presenting a broad spectrum of action, high bioavailability and good tolerability. Sequential therapy with this antibiotic leads to shorter hospitalisation times.
Subject(s)
Community-Acquired Infections/epidemiology , Pneumonia/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Algorithms , Anti-Bacterial Agents/therapeutic use , Community-Acquired Infections/diagnosis , Community-Acquired Infections/drug therapy , Comorbidity , Drug Therapy, Combination , Female , Health Services Misuse/statistics & numerical data , Home Nursing/statistics & numerical data , Hospitalization/statistics & numerical data , Humans , Italy/epidemiology , Male , Middle Aged , Patient Admission/statistics & numerical data , Pneumonia/diagnosis , Pneumonia/drug therapy , Risk FactorsABSTRACT
Patients referred to the consultation-liaison psychiatry department of the University of Ferrara over a 12 month period were studied. About 13% of referrals concerned HIV patients. Comparison of HIV infected with non-HIV infected referrals revealed differences in the reasons for psychiatric consultation and the diagnosis made after assessment, as well as in the number of follow-up consultations. The implications of the findings are discussed.
Subject(s)
HIV Infections/psychology , Mental Disorders/complications , Adult , Female , Humans , Italy , Male , Middle AgedSubject(s)
AIDS-Related Opportunistic Infections/diagnosis , Bronchial Diseases/diagnosis , Mycobacterium avium-intracellulare Infection/diagnosis , Tuberculosis, Pulmonary/diagnosis , AIDS-Related Opportunistic Infections/complications , AIDS-Related Opportunistic Infections/microbiology , Adult , Bronchial Diseases/complications , Bronchial Diseases/microbiology , Humans , Male , Mycobacterium avium-intracellulare Infection/complications , Mycobacterium avium-intracellulare Infection/microbiology , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/microbiologyABSTRACT
The Authors report the findings of a perspective study carried out in 214 cases of acute diarrhoea to estimate the presence of giardia intestinalis infections. The incidence of 3.2% has been discussed on the bases of recent epidemiological advances.
Subject(s)
Giardiasis/epidemiology , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Cohort Studies , Diarrhea/etiology , Enteritis/etiology , Female , Giardiasis/diagnosis , Giardiasis/drug therapy , Humans , Italy/epidemiology , Male , Metronidazole/therapeutic use , Middle Aged , Prospective StudiesSubject(s)
Gram-Positive Bacterial Infections/drug therapy , Immunocompromised Host , Teicoplanin/therapeutic use , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedSubject(s)
Bacterial Infections/drug therapy , Drug Therapy, Combination/administration & dosage , Adolescent , Adult , Aged , Aged, 80 and over , Cilastatin/administration & dosage , Cilastatin/therapeutic use , Drug Therapy, Combination/therapeutic use , Female , Humans , Imipenem/administration & dosage , Imipenem/therapeutic use , Injections, Intramuscular , Male , Middle Aged , Severity of Illness IndexABSTRACT
A 33-years-old male presented with a severe malaria, caused by a chloroquine resistant strain of Plasmodium falciparum. The number of parasitized erythrocytes reached 20% and the patient had cerebral complication. During the second hospital day, an erythrocyte exchange was performed as an in addition to chemotherapy. The patient's clinical condition improved and the parasitemia disappeared. The erythrocyte exchange is recommended in severe malaria, when parasitemia greater than 10%, with or without cerebral, renal or blood coagulation complications.
Subject(s)
Blood Transfusion , Brain Diseases/therapy , Erythrocyte Transfusion , Malaria/therapy , Plasmodium falciparum , Acute Disease , Adult , Animals , Brain Diseases/etiology , Combined Modality Therapy , Humans , Malaria/complications , MaleABSTRACT
The protozoon Blastocystis hominis may cause episodes of diarrhoea with abdominal pain, tenesmus, fever and eosinophilia. We have observed 5 cases of blastocystosis in male subjects with symptomatic HIV infection. All patients had a complete response to metronidazole. This report confirms that Blastocystis hominis may be responsible for HIV-related diarrhoea.
Subject(s)
AIDS-Related Complex/complications , Acquired Immunodeficiency Syndrome/complications , Diarrhea/complications , Opportunistic Infections/complications , Protozoan Infections/complications , Humans , MaleABSTRACT
The Authors report a rare case of Legionnaires' disease imported from Spain in a patient with beta-thalassaemia minor. This condition as predisposing factor for Legionella pneumophila infection is discussed, with particular emphasis on the therapeutic implications.
Subject(s)
Legionnaires' Disease/complications , Thalassemia/complications , Humans , Italy , Legionnaires' Disease/drug therapy , Legionnaires' Disease/epidemiology , Male , Middle Aged , Spain/epidemiology , TravelABSTRACT
The Authors report the results of a study performed on 113 samples of raw meat of 6 different animal species in order to evaluate the extent of contamination by some organisms responsible for food-borne infections. A total of 2 strains of Salmonella (1.7%), 36 of Yersinia (31.8%), 35 of Campylobacter (30.9%) and 13 of Listeria (11.5%) were isolated. The possible role of contaminated meat in cases of human listeriosis is pointed out.
Subject(s)
Food Contamination , Food Microbiology , Listeria/isolation & purification , Meat , Animals , Campylobacter/isolation & purification , Cattle/microbiology , Horses/microbiology , Humans , Italy , Listeriosis/transmission , Poultry/microbiology , Salmonella/isolation & purification , Sheep/microbiology , Swine/microbiology , Yersinia/isolation & purificationSubject(s)
Protozoan Infections/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Italy , Male , Middle AgedABSTRACT
On the basis of personal experience, the microbiological, epidemiological, clinical and therapeutic features of Pneumocystis carinii pneumonia are analysed.