[Perceived quality of integrated home care in two health districts of L'Aquila]. / Qualità percepita dell'assistenza domiciliare integrata in due distretti sanitari di base dell'ASL 04 di L'Aquila.

The present research, as far as its planning and realization is concerned, aims at exploring how ADI (Integrated Home Care) offers its services in two districts of Local Health Unit 04 in L'Aquila; a service that assumes a special relevance in the frame of interventions in favour of the individuals, since it is a valid alternative to hospitalization for disabled citizens or old people having special pathologies. The information collected gives a general outline of the competences involved within ADI, and also of the significance of the results that have been reached out in terms of quality of the assistance, since a subjective measurement, based on indexes of satisfaction, has been used.

L-arginine infusion decreases plasma total homocysteine concentrations through increased nitric oxide production and decreased oxidative status in Type II diabetic patients.

AIMS/HYPOTHESIS: Hyperhomocysteinaemia increases cardiovascular risk in Type II (non-insulin-dependent) diabetes mellitus by augmenting oxidative stress and reducing nitric oxide availability. In vitro, nitric oxide decreases homocysteine by its conversion to the vasodilative and antioxidant compound S-nitrosohomocysteine. We investigated whether or not changes in nitric oxide availability decrease homocysteine concentrations in vivo. METHODS: The study group consisted of 20 normotensive, normolipidaemic, non-atherosclerotic Type II diabetic patients in good metabolic control (16 men, 51.2+/-1.4 years) and 15 healthy subjects (12 men, 48.1+/-1.5 years). Circulating concentrations of homocysteine, nitrite+nitrate and sulphydryl groups, a marker of oxidative stress, were assessed at baseline and then 5', 10', 30' and 60' after the intravenous infusion of either L-arginine (3 g in 10 ml saline), the nitric oxide precursor, or vehicle according to a double-blind cross-over randomized protocol. RESULTS: At baseline diabetic patients showed lower plasma sulphydryl group concentrations (491.8+/-16.9 vs 551.3+/-21.0 micro mol/l, p<0.04) and nitrite+nitrate (21.4+/-0.8 vs 29.5+/-0.9 micro mol/l, p<0.0001) and higher total homocysteine concentrations (11.1+/-0.5 vs 8.3+/-0.6 micro mol/l, p<0.002) than the control subjects. After L-arginine infusion, blood pressure levels and total homocysteine concentrations ( p< or =0.05) decreased (peak at 5' and 30', respectively) whereas nitric oxide and sulphydryl group concentrations ( p< or =0.003) increased (peak at 10' and 30', respectively) in the patients and control subjects. CONCLUSION/INTERPRETATION: Acute L-arginine infusion in both Type II diabetic patients and healthy subjects decreases plasma total homocysteine concentrations, counteract oxidative stress and increases the availability of nitric oxide.

[Epidemiological monitoring of psychological, neurological and sensory handicaps in the 0-24-year-old Abruzzo population (Italy). Preliminary results]. / Osservazione epidemiologica degli handicap psiconeurosensoriali nella popolazione abruzzese (0-24 anni). Primi risultati.

OBJECTIVE: To describe the setting up of the Abruzzo Region (Italy) Service for Prevention and Epidemiological Register of Handicaps, to show prevalence data of occurring diseases and fit regression models aimed at explicating disease occurrence in terms of risk factors; to discuss services access data in terms of their efficacy in fitting social and health needs. SETTING AND DESIGN: We managed data obtained from a regional information system, based upon primary information sources operating in the Local Health Agencies (i.e. school medicine services, general practitioners, paediatricians, familiar counseling services, rehabilitation centers) and specialistic structures for diagnostic detection (multidisciplinary school équipes, hospital division of infant neuropsychiatry, outpatient infant neuropsychiatry services). The data managing model is a population-based epidemiological register. The target population is the 0-24 years population of the Abruzzo Region. MAIN OUTCOME MEASURES: Occurrence data are expressed as prevalence rates, using standardisation according to the global population of the area of interest. Diagnoses have been defined according to the standard ICD-9 and ICD-10 criteria; definition of handicaps has been made according to the WHO classification (1981). Association between indicator (socio-demographic and anamnestic) variables and occurrence of disease has been fitted by logistic regression models. RESULTS: Prevalence estimates obtained for the main infant neuropsychiatric diseases, as well as for the main handicap-determining genetic and/or congenital diseases, are consistent with the findings of literature in similar settings. An exception is the high occurrence of hyperkinetic disorders in both sexes. Rehabilitation is the main health need for all diagnostic axes. With respect to social needs, school and home personal care seem to be scarcely relevant if related to disease prevalence. Logistic regression analysis indicates socio-economic status and presence of handicapped relatives in the family as factors associated with the occurrence of disease. Respectively, the two factors are negatively associated with the occurrence of hyperkinetic disorders and positively associated with occurrence of mental retardation. Moreover, living in a natural family is negatively associated with evolutive disorders. CONCLUSIONS: This is a report about the preliminary results obtained by a specialised register for infant psychological and neurological handicaps. The findings suggest, as operating indications, the standardisation of diagnostic procedures and the definition of common managing guidelines in different areas. Anyhow, the findings of this report highlight the importance of an epidemiological knowledge of handicap in order to design correct prevention strategies and health services planning.

[Epidemiology of impotence. A review of methodological problems in the prevalence and risk estimation]. / Epidemiologia dell'impotenza. Una review dei problemi metodologici nella stima della prevalenza e del rischio.

The aim of this paper is to analyze important methodological questions in estimates of the prevalence and risk factors in erection disorders. Sampling problems, lack of standardization in epidemiological and clinical data recording, nosographic uncertainties, explain the wide variability of prevalence estimates (2-10%). Lack of standard epidemiological methods produces differences in risk estimates of reviewed factors.

Citrobacter diversus ULA27 produces two forms of a chromosomal beta-lactamase.

A multi-resistant clinical isolate of Citrobacter diversus, particularly resistant to penicillins and cephalosporins, has been studied. The strain produced constitutively high levels of beta-lactamase which efficiently hydrolysed cephaloridine but not ampicillin. The apparent Km value for cephaloridine (125 +/- 25 microM) was within the range usually observed for beta-lactamases in similar bacteria. The strain possessed two forms of the enzyme as indicated by isoelectric focusing patterns, HPLC analysis and two pH optima. SDS-PAGE analysis indicated a single protein responsible for both forms. The strain possessed a single plasmid, as revealed by agarose gel electrophoresis, but beta-lactamase production was not plasmid encoded. The available data indicate the beta-lactamase(s) of C. diversus ULA27 to be chromosomally encoded.

On the formation of a dicloxacillin-p-hydroxymercuribenzoate suicide complex mediated by beta-lactamase I from Bacillus cereus.

p-Hydroxymercuribenzoate is a non-competitive inhibitor of beta-lactamase I from Bacillus cereus and also, after preliminary preincubation, an inactivator of the enzyme. Submitted to the simultaneous action of PCMB plus dicloxacillin, the enzyme completely loses its activity. Extensive dialysis can restore the enzymatic activity only if preincubation had been carried out with either PCMB or dicloxacillin but not if both inhibitors had been simultaneously present. Mercaptoethanol protects the enzyme from the action of PCMB, but not from the severe inactivation caused by dicloxacillin-PCMB mixtures. All these data suggest the formation of a complex between PCMB and the acyl-enzyme intermediate generated upon hydrolysis of the beta-lactam bond of dicloxacillin.

[Serological typing of Salmonella in the Aquilano area]. / Tipizzazione sierologica di Salmonellae nel territorio Aquilano.

During the years '80 and '81 16 stocks of Salmonellae are been isolated from 1200 coprocoltures coming from no hospital subjects in the Sanitary and Prophylaxis Laboratory. The percentage of positivity(1, 33%) is par from the last research carried out in 1977 and it is par from other researches in other countries. We confirm that women, more than men, are bearer(1, 65% against 1, 10%) the isolated species are 7, with a slight prevalence of the Salmonella anatum.

[Comparison of different methods for the identification of groups of streptococci]. / Confronto di più metodi per l'identificazione di gruppo degli streptococchi.

The Streptococci, isolated from 500 mucus-pharyngeal tampons, have been tested, for a group identification, by means of four different techniques in order to value the specificity and reliability in comparison with more traditional and, sometimes, more complex tests; such as Maxted and Lancefield. The most suitable method for routine researchers of microbiology laboratories is the one based on the extraction, by means of enzyme obtained from Streptomyces Griseus, of streptococci antigens before starting their serum identification, possible for A-B-C-D-F-G groups (Streptex). On the contrary, the method based on the links of group-specific antibodies with the A protein of the surface of Staphylococci Cowan I, has resulted more defective because Streptococci D and F cannot be grouped, and less specific because of frequent co-agglutinations.

[Anti-tetanus immunity in Aquila residents]. / Studio dell'immunità antitetanica nella popolazione Aquilana.

The AA have studied immunologic conditions against tetanus in the people of L'Aquila, through the dosage of the antibodies against the tetanic toxin. Some aged classes are resulted to be less protected, specially grown-up people, because they aren't vaccinated. The female grown-up people and the old women are less protected than the male people.

[Identification by phage, biochemistry and serology of Salmonellae isolated in the province of Aquila and their resistance to antibiotics]. / Identificazione fagica, biochimica e sierologica di ceppi di Salmonellae isolate nella Provincia de L'Aquila e loro resistenza agli antibiotici.

From 1036 coprocolture, coming from hospital subjects and non hospital subjects in the municipality of L'Aquila, are been isolated 18 stocks of Salmonellae through research with phage 0-1, biochemist and serologique. The phage 0-1, confirming the present data in literature, hasn't shown activity towards 2 stocks. The active antibiotics, according to Kirby-Bauer, have resulted to be the Cloramfenicola and the Gentamicina; the Tetracicline haven't resulted active.

[Antitoxic antibodies and antitetanus protection in the Aquila area]. / Anticorpi antitossici e protezione antitetanica nel territorio Aquilano.

A serological survey was carried out on the population in the l'Aquila district to assess the protection level against tetanus. The antitosin titre was evaluated by indirect haemagglutination in 534 sera from healthy subjects of both sexes and all age-groups. The protection level against tetanus was found usually good for subjects till age fifteen, partial and insufficient for older subjects, women especially.

[Meningococcus carriers in the population of L'Aquila: distribution according to blood group, drug resistance and prophylaxis]. / Portatori di meningococco nella popolazione Aquilana:distribuzione in sierogruppi, chemio-resistenza, profilassi.

During 1979 21 stocks of N.meningitidis were isolated from 1024 subjects living in the district of L'Aquila. These 21 stocks belong to the following groups of sera: 13 stocks belong to group B,6 to group Y and 2 to group Z. 85,71% of the stocks showed resistance to Sulfodiazine, 80,95% to Rifampicine, 9,52% to Tetracycline and to Minocycline.

[In vitro antimicrobial activity of pipemidic acid on strains isolated from urine cultures of hospitalized and nonhospitalized subjects]. / Attivita' antimicrobica in vitro dell'acido pipemidico su ceppi isolati da urinocolture di soggetti ospedalizzati e non ospedalizzati.

It has been determined the in vitro antibacterial activity of pipemidic acid on 328 bacterial stocks isolated from urine cultures and composed by E.coli, Proteus, Pseudomonas, Citrobacter, Staphylococcus aureus. The pipemidic acid has shown to have activity against the stocks of B.coli and Proteus.

[A new ICSB classification of staphylococci stocks previously classified according to Bergey's Manual of Determinative Bacteriology]. / Nuova classificazione secondo ICSB di stafilococchi di collezione gia'classificati secondo il Bergey's Manual of Determinative Bacteriology.

A collection of 215 Staphylococci, already classified according to Bergey's Manual of Determinative Bacteriology, has been newly classified by these authors in view of the I C S B classification from 1976. Various stocks coned not be included in this classification. The collection between laboratory tests and patogenic effects of Staphylococci has been considered by the authors.

[Frequency and antibiotic resistance of bacteria isolated from urine cultures]. / Frequenza e resistenza agli antibiotici di batteri isolati da urinocolture.

The AA report the data pertinent to the urine culture performed during a year in the Sanitary and Prophylactic Laboratory of the district of L'Aquila. In urine samples with number of bacteria > 10(5)/ml have been found E. coli (49%), Proteus mirabilis (32%), Pseudomonas aeruginosa (12%), Staphylococcus aureus (5%), Proteus rettgeri (1%), Enterococco (1%). The data are also reported concerning germ resistance to several antibiotics.

[In-vitro antibiotic resistance of hospital and non-hospital strains of Pseudomonas aeruginosa]. / Resistenza in vitro agli antibiotici di stipiti di "Pseudomonas aeruginosa" ospedalieri e non ospedalieri.

The AA report about the resistence towards antibiotics of 42 stocks of Pseudomonas aeruginosa isolated from hospitalized patients and of 18 stocks isolated from non hospitalized patients. The most active antibiotics are Gentamicine, Neomicine and Streptomicine. Interestingly towards Tobramicine no resistence has been detected. The stocks isolated from hospitalized patients have generally shown a higher resistence.

[In-vitro antimicrobial activity of 2 aminoglycoside antibiotics: tobramycin and gentamycin]. / Attivita'antimicrobica in vitro di due antibiotici aminoglucosidici:la tobramicina e la gentamicina.

It has been determined the in vitro antibacterial activity of two antibiotics on 409 bacterial stocks isolated from several pathologic materials and composed by E.coli,Propeus,Salmonellae,Pseudomonas,Staphylococcus aureus. The Tobramicin has shown to have activity against all stocks of E.coli(82),Pseudomonas aeruginosa (62) and Salmonellae (21) and to have a better activity in comparison with Gentamicin also against Proteus and Staphylococcus aureus.