The Po River Delta epidemiological survey: reference values of total serum IgE levels in a normal population sample of North Italy (8-78 yrs).

The aim of this paper was to define, for the first time in Italy, normal levels of total serum IgE in a general population sample of North Italy. Total serum IgE in 1905 subjects, living in Po Delta area (near Venice), were measured by PRIST method. Normal values were derived from 558 subjects without asthma and/or asthmatic/rhinitic symptoms, noncurrent smokers, skin prick-test negatives ('normals'). Cut-off values to differentiate 'normals' from the remaining part of the sample ('others'), from asthmatic, and from rhinitic subjects, were established with the IgE value midway between the upper limit of the 95% confidence intervals (CI) of the geometric mean for 'normals' and the lower limit for 'others', asthmatics, and rhinitics, respectively. Geometric mean of normal children-adolescents was 45 kU/L (SD: 2.6; 95% CI: 38-63). In normal adults geometric mean was 29 kU/L (SD: 3.3; 95% CI: 25-40) in males and 19 kU/L (SD: 3.8; 95% CI: 16-22) in females. The diagnostic sensitivity of IgE test was low, while the specificity was very high. A good positive predictive value in discriminating 'normals' from 'others' was found, on the contrary, we found a good negative predictive value in discriminating 'normals' from asthmatics or from rhinitics. In conclusion, our results confirm that it is necessary to provide separate total serum IgE reference values for what concerns age in children-adolescents and in adults, and gender, in adults. Low serum IgE are helpful to exclude allergic asthma or rhinitis level of total.

The Po River Delta epidemiological study: use of medicines in a general population sample of north Italy.

Purpose-To provide information on the actual use of medicines in a general population sample.Methods-Information was collected in a general population sample of North Italy (1946 subjects; 938 males, 1008 females) by an interviewer-administered questionnaire.Results-Of the subjects 25.9% took habitually at least one medicine, whereas 11.1% used medicaments only occasionally. The use of medicines was significantly higher in females than in males (p < 0.001), but only in 15-44-year-old females, because of the use of oral contraceptives. The use of medicines increased with ageing (OR=1.80, p < 0.001). The highest use of habitual medicaments was found in subjects of 55+ years of both sexes. In both sexes, the medicines classified in the cardiovascular therapeutic group were the most frequently used. The use of gastrointestinal and cardiovascular medicines was significantly higher in males than in females (p < 0.001). In males, the use of habitual medicines was significantly (p < 0.001) higher in current smokers and ex-smokers than in never smokers. Only 23% of allergic subjects used antiallergic medicines, and only 35% of subjects with respiratory symptoms/diseases used medicines classified into the bronchopulmonary therapeutic group. The percentage of subjects who reported cardiovascular symptoms/diseases and used medicines classified in the cardiovascular therapeutic group was greater (62%).Conclusions-We stress the importance of data collection in general population samples by questionnaires to investigate the actual use of medicines. This may give a more accurate estimate of medicine use than is possible from pharmacy sales or hospital records. Copyright (c) 2000 John Wiley & Sons, Ltd.

The Po River Delta Respiratory Epidemiological Survey: an analysis of factors related to level of total serum IgE.

The purpose of the present study was to analyse whether sex, age, skin test reactivity, cigarette smoking and occupational exposure were related to the total serum immunoglobulin (Ig)E concentrations (kU x L[-1]), in a general population sample. We studied 1,905 subjects (915 males, 990 females) of a general population sample (n=2,841, 8-73 yrs) participating in the second cross-sectional respiratory epidemiological survey in the rural Po Delta area (near Venice, North Italy). Distribution of total serum IgE concentrations was skewed, thus a log-transformation was performed to obtain a Gaussian shape. Significantly higher values of IgE were found in males compared to females. In general, a peak of IgE concentration was found at 8-14 yrs. IgE values tended to be lower in older than younger adults. Significantly higher serum IgE levels were shown in subjects with a positive skin-prick test index (ST+) than in those with a negative skin-prick test index (ST-). There was a significant relationship of total IgE levels with skin reactivity to pollens and house-dust mites. In both sexes higher values of IgE were found in current smokers than in ex-nonsmokers, regardless of skin-test reactivity. There was no significant difference in IgE values between ex- and nonsmokers. Passive smoking and occupational exposure were significantly related to increased IgE values. Our results confirm that in a general population sample immunoglobulin E concentrations are related not only to skin-prick test reactivity to common aeroallergens, but also to other risk factors for chronic obstructive lung diseases, such as sex, active/ passive smoking and occupational exposure.

Skin prick test reactivity to common aeroallergens in relation to total IgE, respiratory symptoms, and smoking in a general population sample of northern Italy.

Skin prick test (SPT) reactivity to common airborne allergens and its relationships to sex, age, smoking habits, and respiratory symptoms/diseases were evaluated in a general population sample (n = 2841, 8-75 years of age) living in the Po delta area (northern Italy). Subjects completed a standardized questionnaire and underwent prick tests (12 local allergens, a negative and a positive control) and determination of total serum IgE. Atopy was evaluated by measuring the maximal diameter for each allergen, after subtracting that of the negative control. Thirty-one percent of subjects showed a positive skin response at a 3-mm threshold. Pollens, Dermatophagoides pteronyssinus, and D. farinae caused the highest frequencies of reactions. Young people and those who had never smoked had higher prevalence rates of SPT reactivity. Asthma, asthma symptoms, and rhinitis were significantly associated with SPT reactivity in both sexes (cough only in females) and with the number of positive reactions. IgE values were also significantly associated with SPT reactivity. In conclusion, our findings indicate that almost one-third of the general population of an Italian rural area is skin test positive, emphasizing the importance of assessing atopy in respiratory epidemiologic surveys.

Effects of home environment on respiratory symptoms and lung function in a general population sample in north Italy.

Effects of indoor pollution exposure were evaluated in a general population sample (n = 3,289) living in the Po River Delta area. Prevalence rates of chronic cough in men and dyspnoea in women were significantly higher in association with the use of bottled gas (propane) for cooking instead of natural gas (methane). Chronic cough and phlegm in men and dyspnoea in women were significantly associated with the use of a stove for heating. When combining type of heating and fuel used, in men a trend toward higher prevalence rates of chronic cough and phlegm was shown in those with stove or fan heating (regardless of the fuel); in women the trend reached statistical significance for dyspnoea. The relationship between stove (regardless of fuel) and decrease in forced expirograms was statistically significant only in women. In multiple logistic models, accounting for independent effects of age, smoking, pack-years, parents' smoking, socio-economic status, body mass index, significantly increased odds ratios were found in males for the associations of: bottled gas for cooking with cough (1.66) and dyspnoea (1.81); stove for heating with cough (1.44) and phlegm (1.39); stove fuelled by natural gas and fan or stove fuelled other than by natural gas with cough (1.54 and 1.66). In females, significantly increased odds ratios were found only for dyspnoea when associated with bottled gas for cooking (1.45), stove for heating (1.46), stove fuelled by natural gas (1.58), stove or fan fuelled other than by natural gas (1.73).(ABSTRACT TRUNCATED AT 250 WORDS)

[Inflammatory process caused by intraperitoneal injection of polyester in the rat: chemotactic activity in lavage fluid from the cavity]. / Processo infiammatorio da inoculo intraperitoneale di poliestere nel ratto: attivita chemiotattica nei liquidi di lavaggio della cavita.

Minced polyester threads introduced into peritoneal cavity of guinea pigs or rats cause a granulomatous inflammation with evidence of macrophage stimulation. Chemotactic agents play an important role in the inflammatory reaction; they may be exogenous and/or endogenous. These are released locally by the cells involved in inflammation. In this paper the chemotactic effects of the peritoneal fluids from rats bearing the polyester inflammatory process, have been studied on PMN cells "in vitro". The peritoneal cavity fluids were obtained by washing the cavity of untreated rats or rats intraperitoneally injected with polyester, 1, 3, 7, 14 days after the intraperitoneal injection. The chemotactic response was assayed by employing modified chemotaxis Boyden chambers (Blind Well Neuro Probe) and polymorphonuclear leukocytes from normal or treated rats. Quantification of the migration was calculated by chemotactic index (A/B) (B = random migration, A = chemotaxis). The results demonstrated that the peritoneal fluids taken 3 and 7 days after the intraperitoneal polyester injection, elicit an evident chemotaxis response greater than that showed by peritoneal fluids from control rats. It is suggested that chemotactic factors can be produced and released by mononuclear cells involved in the inflammatory process.

[Chemotactic activity of the peritoneal lavage fluid of guinea pigs with inflammatory processes caused by the inoculation of various types of suture thread]. / Attività chemiotattica dei liquidi di lavaggio della cavità peritoneale di cavie con processo infiammatorio da inoculo di vari tipi di fili da sutura.

Minced non adsorbable or adsorbable suture threads introduced into peritoneal cavity of guinea pigs elicit at inflammation with mononuclear and giant cells surrounding suture thread fragments. We studied the presence in the peritoneal cavity of chemotactic factors for PMN cells and we compared the results in relation to the different type of the suture threads used (Dexon, Mersilene, Gore-Tex). The peritoneal cavity was washed, the fluids collected and used as chemotactic agents. The chemotactic response was assayed by employing multiwell chemotaxis chambers (Neuro Probe) and PMNs from normal, non-treated guinea pigs. Quantification of the migration was calculate by chemotactic index (A/B) (B = random migration, A = chemotaxis). The results demonstrate that a chemotactic activity is present in peritoneal fluids following the inflammatory process. This activity is evident at 7th day after Dexon and Mersilene inoculation; using PTFE however, it decreases at 14th d, when the inflammatory process is already developing into healing tissue. In conclusion the chronic inflammation determines the appearance of chemotactic factors for PMN cells; it is suggested that reactive, mononuclear cells, involved in the process, could be responsible for their production and release.

Genetic structure of the human population in the Po delta.

The genetic structure of the population of Ferrara Province in the Po delta in Italy was investigated using chi 2 analysis, kinship analysis, analysis of correspondences, and geographical mapping of principal components of gene frequencies. chi 2 Analysis tests for Hardy-Weinberg equilibrium and for heterogeneity of gene and phenotype frequencies; kinship analysis tests for association between indicators of genetic and geographic proximity; analysis of correspondences relates localities and genetic systems in an eigenvectorial space; and geographic mapping displays the principal components of gene frequencies in the real space. In 1,364 adults in 26 residential units, seven presumably neutral isoenzyme systems were typed; ACP1 ESD, GLO I, GPT, PGD, PGM1 and PGP. It was found that average kinship for these neutral systems is correlated with geographic distance in this small area, but not as strongly as kinship for beta-thalassemia. A north-south gradient was observed for ESD. Analysis of correspondences indicated GPT, PGM1, and GLO I as the systems contributing most to differentiation within the province. The maps obtained from principal components of gene frequencies were consistent with the migrational history of the area.

Slight middle slurring in V1-V2 without bundle branch block. An electrocardiographic and follow-up study.

A slight middle slurring in V1 and/or V2 with rS morphology (R less than S) in these leads, without right or left bundle branch block is a nearly ignored electrocardiographic finding. The purpose of this work is to provide a prospective and electrocardiographic analysis of this finding. We followed 200 subjects with middle slurring in V1 and/or V2, in the absence of bundle branch block (study group), (age: 41.5 +/- 19 years, follow-up period: 5.7 +/- 2.5 years) and 200 subjects with rS morphology in V1-V2 without the middle slurring (control group), (age: 39.8 +/- 20 years, follow-up period: 5.2 +/- 2 years). The age, sex, prevalence of organic heart disease, QRS duration and follow-up period did not show significant differences between the two group. In the study group there was a higher prevalence of vertical axis (P less than 0.001), of S1S2S3 morphology (P less than 0.001) and of terminal r wave in a VR (P less than 0.05) compared to control group. During the follow-up period, a right bundle branch block appeared in 19 subjects of study group (incomplete in 15 and complete in 4) and in 2 (complete) of control group (P less than 0.001). A left bundle branch block appeared only in one patient of study group and in one of control group. We conclude that the isolated slight middle slurring in V1-V2 expresses an initial involvement of the right bundle branch system and increases the likelihood of appearance of right bundle branch block.

[Inflammatory reaction to polyester material in the guinea pig. V. Semiautomatic determination of peritoneal cell volume]. / Il processo infiammatorio da materiale poliestere nella cavia. V. Determinazione semiautomatica del volume delle cellule peritoneali.

The volume of the peritoneal cells of guinea pigs treated with injections of 1) minced polyester threads (Mersilene), 2) saline, and of untreated animals, has been determined utilizing a Coulter Counter coupled with a pulse height analyzer. The volumetric test on the whole cell population has emphasized a distinctly bimodal distribution, due to the presence of two cellular types picked out as first peak (P 1 degrees) and second peak (P 2 degrees), while the non-adherent cells (CNA) have shown an unimodal distribution. Statistically significant difference in the mean volumes have been found between the P 1 degrees and P 2 degrees cells and between the CNA and P 1 degrees cells. The percentage of CNA in the whole cell population significantly decreases in "Mersilene"-treated guinea pigs.

[Influence of age on blood glucose levels: percentile reference intervals determined on ambulatory patients]. / Influenza dell'età' sui livelli glicemici: intervalli di riferimento percentili determinati su pazienti ambulatoriali.

Data of routine chemical and hematological laboratory tests regarding outpatients were collected in four different hospitals of the provinces of Ferrara, Rovigo and Bologna. Data of about 1500 subjects per hospital were cumulated without preliminary selection of patients; sex, age and pregnancy status were also recorded. At the end of the collection, the second (and third) record of the same patient was discarded; only those referring to the first examination were retained. In this report we consider only the values of the blood sugar level which were obtained by enzymatic methods. Descriptive statistics and regression analysis were performed utilizing a CDC CYBER 70/76 computer. The means and the variances of the data collected at the four hospital laboratories were very similar (Tab 1). The interlaboratory analysis of variance was poorly significant. All frequency distributions were leptocurtic and skewed to the right (Fig. 1). The blood sugar level tend to increase with age (Tab. 2). This correlation is graphically depicted in a two-dimensional plot (Fig 2) in which the regression line and the 2, 5 and 97,5 percentile levels corrected for age were also reported. We think that this diagram may be more helpful to the clinicians interpreting laboratory results than the usual "normal values".

[Semi-automatic determination of the variations in volume of LS fibroblasts grown in the presence of saccharose]. / Determinazione semi-automatica delle variazioni di volume di fibroblasti LS cresciuti in presenza di saccarosio.

A method is described for determination of the volume of fibroblasts, grown in suspension, in normal medium, in medium supplemented with sucrose (Su) 0,04 and 0.08 M. A 4 days permanence in these last two mediums causes an obvious cytoplasmic vacuolation and an increase in cell volume (Tab.1) that reaches its maximum for cells grown in Su 0.08M (87,2%) increase in comparison with control cells). The cell volume determination was performed utilizing a Coulter ZBI Counter coupled with a P64 pulse height analyzer and X-Y recorder. The volume and number of cells for every counting channel of P64 were manually determined from recorder plot (Fig. 1). These data were then elaborated using a desk computer to obtain the mean cell volume, the coefficients of skewness and kurtosis (algorithm for grouped data).

[Observations on cytolysis by cobra venom. Effect of sucrose loading]. / Osservazioni sulla citolisi da veleno di cobra. Effetto del carico con saccarosio.

LS cells cultivated for 4 days in sucrose-containing medium (Su) are more fragile than cells cultivated in medium devoid of this sugar (TN) when they are incubated with Naja-Naja venom; in fact the 51Cr radioactivity released into the medium by previously labelled cells is increased for the sucrose ones. Phospholipase does not seem to contribute to the lytic activity of the venom, which is dependent on the direct lytic factor: neither varying the temperature of incubation nor adding EDTA to the incubation medium modifies the results. Adding Ca++ decreases the 51Cr radioactivity released particularly by the cells grown in TN, suggesting a stabilizing action of this cation.

[Lowered osmotic resistance of mouse LS fibroblasts grown in the presence of various types of dextran]. / Diminuzione della resistenza osmotica di fibroblasti LS di topo cresciuti in terreno addizionato di vari tipi didestrano.

Mouse fibroblasts grown in the presence of dextrans of various molecular weight at various concentrations, show a small but significant decrease of the osmotic resistance (Tab. 1,2,3; ANOVA: source of variation A and C); this decrease is related to the length of time the cells stay in the dextran containing medium (Tab. 2,3; ANOVA: source of variation B). The presence of dextran in the culture medium has no effect on the cell growth (Tab. 4).

Lowered resistance to lytic agents in sucrose vacuolation.

Vacuolation in fibroblasts cultivated in the presence of sucrose is associated with progressive accumulation of the undigestible sugar. In radioisotope experiments the process lasted several days, and when the cells were subcultured back into a medium devoid of sucrose the label was also lost after several days. This type of vacuolated cells is more fragile when it is challenged with lytic agents. 51Cr-labelled LS fibroblasts released more radioactivity when they had been growing in the presence of sucrose, whether they were suspended in media of decreasing osmolarity, in dilutions of various surfactants, exposed to high temperatures, or subjected to mechanical stress. It is concluded that these cells exhibit a lower resistance when exposed to unfavourable environments, but retain their viability in growth media despite some morphological and biochemical alterations.

[Action of high temperature on the integrity of LS fibroblasts. I. Effect of culture in the presence of sucrose]. / Azione di temperature elevate sulla integrità dei fibroblasti LS. Nota I: Effecto della coltura in presenza di saccarosio.

LS fibroblasts which have accumulated sucrose into cytoplasmic vacuoles during 4 days are more fragile than normal controls when they are exposed to temperatures between 45 degrees C and 60 degrees C. Continuing to cultivate for 6 more days in the presence of sucrose apparently improves the resistance of the vacuolated cultures to the damaging temperatures, possibly because of a selective enhancement of the more resistant cells.

[Action of high temperature on the integrity of LS fibroblasts. II. Effect of duration of presence in a medium containing sucrose]. / Azione di temperature elevate sulla integrità dei fibroblasti LS. Nota II: Effetto della diversa durata di permanenza in terreno contenente saccarosio.

The resistance to high temperatures of LS fibroblasts starts lowering quite rapidly when the cells have been suspended in a culture medium containing sucrose. On the other hand, transferring back to normal medium for increasing times cells cultivated for 4 days in the presence of sucrose seems to gradually improve their resistance.