[Retrospective demographic study in a small mountainous region of the province of Rome]. / Studio demografico retrospettivo di un piccolo centro montano della provincia di Roma.

This retrospective study takes into consideration demographic and epidemiological data relative to the population of Arcinazzo Romano, a little village on the mountains situated at 831 m. above sea level in the province of Rome. The socio-economic structure of the village is mainly agropastoral, though, in the last decades, 50% of the ground has been left uncultivated due to emigration and commuting. ISTAT data relative to population censuses of 1951, 1961, 1971 and 1981 have been used to study the population natural movement from 1943 to 1987. The active/passive rate and the population ageing index have also been considered. Whenever possible local population data have been compared with similar data on a provincial, regional and national level. From 1943 (1697 inhabitants according to the archives of the Civil Status Office) the population of Arcinazzo R. has been increasing until 1955 (1903 inhabitants). Afterwards, there has been a slow, but constant, decrement till 1987 (1435 inhabitants). The reason for this is undoubtedly the migration movement (mainly towards Rome) due to the scarcity of job possibilities in the zone. This has resulted in a decrease in both active population and agricultural manpower. From 1943 to 1987 there has been a continuous decrease in birth-rate. Starting from 33.5 in 1943, the lowest value (4.6) is reached in 1981; in the last decade the index has settled on average values (11.22) which are slightly higher than national and regional averages (10.2 and 9.7 respectively). The general death-rate has its highest value in 1944 (19.3) and its lowest value in 1958 (4.8). From this date on, the index settles on an average of 12.0, which is slightly higher than national and regional averages (9.5 and 8.4 respectively). The infant death-rate starts from a value of 228/1000 in 1943 to decrease in following years. Keeping into account that the number of children born each year in Arcinazzo R. is very small, a comparison with national or regional averages is not felt to be appropriate. In fact, local values of this index may casually result very high: for instance, in 1981, the death of two premature twins, on a total of seven children born in the same year, brings the infant death-rate to a value of 285/1000 while in the years 1982-87 the infant death-rate is 0. The population natural growth index is obtained from the difference between general birth- and death-rates.(ABSTRACT TRUNCATED AT 400 WORDS)

[Epidemiologic approaches, in school health education programs with particular attention to dentistry]. / Approccio epidemiologico per interventi di educazione sanitaria nella scuola con particolare attenzione al campo odontoiatrico.

At the request of the Cultural Union of the Upper Aniene Valley, the social-health workers dealing with school medicine of the Teaching District of Affile (Rome) have tried to define the programming lines for a health education intervention in the elementary schools of the district. The basic requisites of the intervention were pinpointed as: effectiveness, in terms of improvement of health conditions; short-term results; cognitive-transformative methodology having a spiral progression (cognitive, decision-making, implementative and of verification). The departure point of the intervention was the cognitive study on the social-health situation of the school population based on an analysis of the individual data contained in the medical files compiled by the school doctor, standardised and filled out with the pupils' social and family data. Out of 257 children, 212 were examined, namely 82.4% of the school population. The first social-anamnestic data on pupils' families was in respect of parents' level of education, giving the following results: 65% with elementary schooling only, 11% semi-illiterate and 10.5% diploma- or degree-holders. In respect of parents' working activities, on the other hand, a clear difference emerged: compared with 50.4% of worker or artisan fathers and about 33.3% engaged in the tertiary sector, almost all the mothers were still home-based (90.9% housewives). Another interesting fact emerged from the cards, namely that only 69% of the boys and girls have undergone the full cycle of antidiphtheria-antitetanus vaccinations, and only 80% of antipolio vaccinations. As regards pupils pathological anamnesis, cases of hospitalisation were for the following causes: 5.7% fractures and/or burns, followed by intestinal infections (4.5%). Whereas, as regards current pathology the high incidence of a cariogenic pathology emerged, with such high values as to indicate, in the field of prevention and health education, oral hygiene as the priority intervention to be undertaken in respect of the pupils included in the teaching district. The stages of the planned intervention were fixed as follows: -campaign to make teachers and families, considered as the primary educators, aware of this health problem; -meetings with pupils for the purpose of informing them in a simple way of the problem of caries and of discussing together behaviours liable to ensure greater dental hygiene; -involvement of the school and local administrative authorities for the implementation of any measures aimed at favouring the improvement of the behavioural and eating habits of the boys and girls (access for all to school canteens, free dental examinations, etc.).(ABSTRACT TRUNCATED AT 400 WORDS)

Ranitidine and somatostatin. Their effects on bleeding from the upper gastrointestinal tract.

In a randomized, double-blind placebo-controlled clinical trial, the effect of ranitidine was compared with the effect of somatostatin in the control of massive gastrointestinal tract bleeding. Ninety-six patients completed the study. Rates of continuing bleeding and death, incidence of surgery, and blood transfusion requirements were not significantly different in the three treatment groups. Eighteen of the 96 patients presented with a visible vessel at endoscopy. In this group the percent of patients with continuing bleeding, mean transfusion requirements, and mortality were significantly higher than in patients without a visible vessel. Seven patients with a visible vessel underwent surgery and six survived; 11 patients underwent conservative measures and eight died. Ranitidine and somatostatin do not seem to alter the clinical course of patients with upper gastrointestinal tract hemorrhage.

Acid and gastrin levels after bombesin and calcium infusion in patients with incomplete antrectomy.

In 17 patients with postoperative recurrent peptic ulcer, incomplete antrectomy (I.A.) was found by endoscopic biopsies in 5. No evidcence of I.A. was found in the remaining 12 patients. Gastric acid output and gastrin levels were measured in basal conditions and following a calcium I.V. infusion (4 mg/kg hr of Ca++ over 4 hr) and a bombesin (BBS) I.V. infusion (15 ng/kg min over 90 min). Basal gastrin levels were significantly differnt in the two groups of patients: BBS infusion augmented significantly serum gastrin levels in all patients with I.S., while BBS infusion had no significant effect on serum gastrin levels in the group of patients without I.A. Acid output following BBS infusion showed a pattern similar to the pattern seen for gastrin. Calcium infusion augmented gastric acid secretion and gastrin levels in the patients with I.A.; however, the response to calcium could not clearly separate in all instances patients with I.A. from patients without I.A. It is concluded that the "BBS infusion test" may be heplful in the diagnosis of I.A. in patients with postoperative peptic ulcer.

External pancreatic secretion after bombesin infusion in man.

The effect of bombesin on external pancreatic secretion was studied in seven healthy volunteers and intwo patients with a two-thirds gastrectomy and a pancreatic fistula. After bombesin infusion (15 ng/kg/min), gastrin levels were significantly raised in all volunteers, but remained at basal levels in the gastrectomized patients. Bombesin was effective in stimulating pancreatic secretion in all patients. The volume of secretion increased tow-fold when compared with basal volume. Amylase and trypsin concentrations and outputs in the duodenal juice were greatly agumented (amylase concentration: basal, 70 dye U/ml; post-bombesin, 620 dye U/ml. Amylase output: basal, 1000 dye U/15 min; post-bombesin, 15,800 dye U/15 min). Secretin, when administered in conjunction with bombesin, partially inhibited its secretory effect. Bicarbonate secretion was slightly stimulated by bombesin, but at a very low level. A similar pattern of results was obtained in the two gastrectomized patients. In man, bombesin exerts an effect on pancreatic secretion that mimics the effect of CCK-PZ, thus confirming the results obtained in the experimental animal. Gastrin does not play a fundamental role in this phenomenon.