[Prevalence of monoclonal gammopathies: an experience in Western Sicily]. / Prevalenza delle gammopatie monoclonali: un'esperienza nella Sicilia Occidentale.

Monoclonal gammopathies (GM) are divided into clinically manifest and asymptomatic syndromes. In the last 20 years, the prevalence of GM in industrialized Countries is more than doubled. In order to verify the prevalence of these forms in Western Sicily, at University General Hospital of Palermo an epidemiologic inquiry was made to check the presence of GM as fortuitous event during routine analyses; from March 2000 to March 2001 it was found a prevalence of 0.89% (196 cases on 22100 analysed). Average age was 67.5, with 58.2% men and 41.8% women from different Departments of University General Hospital. The finding of a monoclonal component must be considered an important laboratory datum to observe with time by not invasive laboratory examinations (high-resolution serum-protein electrophoresis and immunofixation).

The changing pattern of human immunodeficiency virus type 1 infection in intravenous drug users. Results of a six-year seroprevalence study in Palermo, Italy.

A cross-sectional seroepidemiologic study was carried out between 1985 and 1990 in 1,567 heterosexual intravenous drug users who had been seen at the AIDS Regional Reference Center in Palermo, Italy, to evaluate the rate of human immunodeficiency virus type 1 (HIV-1) seroprevalence in this group and its long-term trend. Sixty serum samples collected from drug users in 1980 and 1983, before the founding of the Center (1985), were tested as well. Some demographic and behavioral risk factors were studied in a subgroup of intravenous drug users enrolled in 1985, 1987, and 1990 for their possible association with HIV-1. These factors were also studied in relation to hepatitis B virus infection, since both viruses share the same modes of spread. These drug users had a higher prevalence of markers for hepatitis B virus than of HIV-1 antibodies, and the prevalence rates in sera collected declined over time for both infections. The presence of both antibodies to HIV-1 and markers for hepatitis B virus was independently associated with the age of the drug user, the duration of drug use, and the year of serum collection. Antibodies to HIV-1 were observed more frequently in females than in males. No relation was found between education or employment status and the presence of HIV-1 antibodies or hepatitis B virus markers. Although new HIV-1 infections still occur, the decline in seroprevalence observed at the end of the 1980s might be related to modifications in social behavior among newer drug users, partial exhaustion of the susceptible population, and increasing risk awareness in more experienced users.

Epidemiological aspects of hepatitis B in Palermo: changes in HBV spread.

Prevalence of HBV infection in Palermo was investigated in 1989, in comparison with similar data observed in 1982. Between September 1988 and April 1989, 1001 serum samples taken from healthy individuals or from patients with pathology unrelated to liver diseases, in the age groups 0 to 59 years, were collected. Prevalence of HBsAg and anti-HBc was, respectively, 2.7% and 24.3% in males, 2.3% and 19% in females. Prevalence was inversely related to socioeconomic level as defined by occupation, educational level and area of residence. Prevalence of HBV markers in 1989 was compared with that of a sample of sera taken in 1982 and stored at -20 degrees C. Prevalence was lower in 1989 for age groups under 20, while no difference was seen in older age groups.

Epidemiology of boutonneuse fever in western Sicily: accidental laboratory infection with a rickettsial agent isolated from a tick.

A case is reported of an accidental laboratory infection with a strain of Spotted Fever-Group Rickettsiae freshly isolated from a tick collected in Western Sicily. Inoculation into the left thumb of cell-cultured organisms (10(5)/ml) gave rise to clinical signs and symptoms of Boutonneuse Fever after six days, i.e., a lesion at the point of inoculation, fever, headache, conjunctivitis and myalgias. Rickettsiae were isolated from acute-phase blood samples collected from the infected individual and IgM and IgG response was detected in the patient's serum by indirect immunofluorescence. Complete recovery was obtained after antibiotic treatment. Serologic analysis of the strain, together with analyses of the proteins of the isolate, documented that the isolate was Rickettsia conorii and was identical to prototype strain. The relationship of this infection to ongoing studies on the epidemiology of Boutonneuse Fever in Western Sicily is discussed.

Changing patterns of hepatitis A virus infection in children in Palermo, Italy.

In 1988 in Palermo, Italy, the prevalence of antibodies to hepatitis A virus (anti-HAV) in a sample of 490 children 6-13 years old was 10.6%; it increased from 6.3% among children 6-10 years old to 14.7% in children 11-13 years old (P less than 0.01). Compared with findings from a survey conducted in 1978 in the same area, the results of the present study show a significant (P less than 0.01) reduction in the anti-HAV prevalence in both age groups. Anti-HAV prevalence was inversely related to the father's years of education and positively related to the family size. Children of fathers with less than 6 years of schooling had a 3.2-fold risk (C.I. 95% = 1.3-8.1), and children with five or more members in their households had a 2.7-fold risk (C.I. 95% = 1.1-6.4) of previous exposure to hepatitis A virus (HAV) infection. Our findings indicate that exposure of children in Palermo to HAV is decreasing significantly, probably because of improvements in socio-economic conditions during recent years; however socio-demographic factors appear to be important determinants of infection.

Epidemiology of boutonneuse fever in western Sicily: demonstration of multiple spotted fever group-Rickettsiae subtypes.

Electrophoretic analysis of the proteins and genomic DNA of spotted fever-group Rickettsiae isolated from ticks and a human in Western Sicily show that at least two distinct subtypes other than R. conorii are present in this region. All of the spotted fever-group isolates share common features with other, well-defined spotted fever-group rickettsial species, e.g. R. sibirica, Thai Tick Typhus, and R. rickettsii. Based on these data, caution is recommended when identifying species by the more traditional and less specific tests. Studies of the ecology and epidemiology of spotted fever-group Rickettsiae in regions where R. conorii infections occur would benefit and be challenged by intensive antigenic analyses of the proteins and genomic DNA of the various strains of the spotted fever-group Rickettsiae present in those areas.

Excess deaths related to hot weather in Palermo.

A study of monthly mortality in Palermo by the Serfling's method showed a peak of excess deaths in winter 80-81 and two unexpected peaks in June-July 82 and July 83. Extramortality in the summer period could be attributed to hot weather, since in the two periods several consecutive days of high (greater than = 37 degrees C) maximum temperature were recorded. The possibility of summer temperatures monitoring for a public health action is discussed.

Isolation on "VERO" cells of a spotted fever group rickettsia "Mortilli strain" from Rhipicephalus sanguineus.

The isolation of a Spotted Fever Group (SFG) Rickettsia "Mortilli strain" from brown dog ticks Rhipicephalus sanguineus removed from dogs associated with a confirmed case of Boutonneuse Fever (BF) in a site of a Western Sicily is reported. The need is stressed for isolation and adaption on cell cultures of SFG rickettsial strains for analysis of antigenic structure employing modern methodology.

Epidemiology of boutonneuse fever in western Sicily. Distribution and prevalence of spotted fever group rickettsial infection in dog ticks (Rhipicephalus sanguineus).

The distribution and prevalence of spotted fever group rickettsial infection in the ixodid dog tick Rhipicephalus sanguineus were found to occur at a rate of 19.7% with variation related to geographic and sociooccupational factors. A higher rate of infection was demonstrated in ticks removed from dogs associated with documented cases of boutonneuse fever. The results fit into available clinical and seroepidemiologic data on Rickettsia conorii infection in western Sicily.

Epidemiology of boutonneuse fever in western Sicily: isolation of spotted fever group Rickettsiae from Rhipicephalus sanguineus (fam. Ixodidae).

Spotted fever group Rickettsiae were isolated from dog ticks (R. sanguineus) removed from dogs in different areas of western Sicily.

[Separation and purification of Treponema pallidum by density gradient. Technical note]. / Separazione e purificazione di Treponema pallidum mediante gradiente di densità. Nota tecnica.

The reported possibility of obtaining purified suspension of Treponema pallidum through a Percoll density gradient is evaluated. The maintenance of motility and antigenicity of the purified T. pallidum allows further studies on antigenic structure of treponemes.

[Immunoenzyme reactions, immunofluorescence and complement fixation: evaluation in the study of anti-cytomegalovirus antibodies. Technical note]. / Reazione immunoenzimatica, immunofluorescenza e fissazione del complemento: valutazione nella ricerca di anticorpi anti-cytomegalovirus. Nota tecnica.

A comparative study of CF, IF and ELISA was carried out in order to comparatively evaluate the characteristics of sensitivity and specificity of the tests. The results seem to confirm the validity of both IF and ELISA in the laboratory diagnosis of CMV infections.

Non-A, non-B hepatitis in Palermo, western Sicily.

Aetiological studies were carried out on 407 cases of acute viral hepatitis during two consecutive years in two general hospitals in Palermo, Sicily. Two hundred ninety-seven showed serological evidence of hepatitis A virus (HAV) infection and 73 of hepatitis B virus (HBV) infection. Of the remaining 37, two had a serologically diagnosed cytomegalovirus hepatitis, while 35 were classified as non-A, non-B (NANB) hepatitis. The frequency of the different major agents of acute viral hepatitis was notably influenced by the age of the patients, HAV being prevalent in children and HBV and NANB in adults. About one-fourth of the adult cases of sporadic, acute viral hepatitis were attributed to NANB virus(es). The acute disease appeared less severe than B hepatitis, as indicated by the duration of jaundice, peak serum bilirubin, and aminotransferase levels. No history of drug addiction or of parenteral exposure to blood or blood products was obtained from the presumed NANB hepatitis patients.

[Epidemic of viral hepatitis in a mountain community of western Sicily]. / Epidemia di epatite virale in un comune montano della Sicilia occidentale.

Epidemiological investigations were carried out during and after a viral hepatitis A outbreak in a mountain town, Geraci Siculo, in western Sicily. Blood samples were obtained through finger prick or by venipuncture from patients, their family contacts and from healthy school children of different age groups (3 to 15 year old). Serum markers for hepatitis A (anti HAV and IgM anti HAV) and hepatitis B (HBsAg and anti HBs) were tested. All but two of 36 cases, which occurred from August through March with a peak in November and December were under 15; 33 of them, in which laboratory data were available, were due to HAV. Seroepidemiological investigations, performed in December 1979 and in May 1980, have shown a low prevalence of anti HAV antibodies: 11.5% only of the children tested were positive in the first sampling and 22% in the second one. Also prevalence of HBV markers was low, as compared with similar observations carried out previously in other different area of Western Sicily.

[Electroimmunodiffusion reaction in the diagnosis of syphilis (author's transl)]. / La reazione di elettroimmunodiffusione nella diagnostica della lue.

A group of 800 human sera, obtained from syphilitic and nonsyphilitic individuals were tested in the counterimmunoelectrophoresis (CIE) technique with Reiter protein antigen. The sera were assayed for comparison in the following treponemal and nontreponemal tests: standard serologic tests for syphilis with cardiolipin; complement fixation (Kolmer 1/5 vol) with Reiter protein antigen (RPCF); T. pallidium immobilization (TPI) test; haemoagglutination test for T. pallidum antibodies (TPHA). The sensitivity and specificity of CIE test, its simplicity, the low cost, the possibility of practical application as a routine test for syphilis serology were discussed.