[Frequency of ischemic cardiopathy in different types of work activities]. / Frequenza della cardiopatia ischemica in differenti tipi di attività lavorativa.

The Authors refer the Health Surveillance outcomes on 3185 workers of Campania region from 1996 to 2001: CHD frequencies and relationship between the individual (age, BMI, smoking, serum cholesterol) and the occupational risks factors (work strain and shift). All risk factors increase the frequencies of CHD, but the work strain and the shift determinate an upper increase of the relative risk. The Authors suggest far reaching programs of Health Surveillance, useful to define and to control the specific work risks and to improve the worksite health promotion.

Efficacy of amphotericin B colloidal dispersion in the treatment of Mediterranean visceral leishmaniasis in immunocompetent adult patients.

Twelve immunocompetent adults with Mediterranean visceral leishmaniasis (VL) were treated with amphotericin B colloidal dispersion (ABCD; 2 mg/kg/d for 7 d). All patients showed rapid clinical response without significant adverse events. Two weeks after therapy they were parasitologically cured and no relapses occurred during 6 months. ABCD is a valid alternative in the management of Mediterranean VL in adult patients.

[Treatment of bronchial asthma in chidren]. / Terapia dell'asma bronchiale in età pediatrica.

Asthma is a condition characterised by airways inflammation and bronchial hyperresponsiveness to specific and aspecific spasmogens associated with reversible airways obstruction. The bronchomotor tone is the result of an interaction between neurotransmitter release and local mediators. The efferent neurohumoral pathways to the muscular, vascular and glandular element include parasympathetic nerves, sympathetic nerves, and non-adrenergic non-cholinergic (NANC) neurotransmission. It is currently recognised that the alteration of these mechanisms can induce bronchial hyperresponsiveness that represents a characteristic feature of asthma. Asthma is common in children and its prevalence in this age group is increasing. The current therapy of asthma involves the use of anti-inflammatory drugs to control the underlying process (causal therapy) and the use of bronchodilators that provide rapid relief of bronchoconstriction (symptomatic therapy). The bronchodilators are represented by beta 2 adrenergic agonists, methylxanthines and anti-cholinergic drugs; the anti-inflammatory drugs are represented by corticosteroids, antileukotrienes and chromones. Other new therapies being studied include anti-immunoglobulin E, anti IL-5 agents, endothelin receptor antagonists, and others.

[Cryptosporidium infection in immunocompetent and immunocompromised host] / L'infezione da criptosporidio nell'ospite immunocompetente e nel paziente immunocompromesso.

Prior to 1980 infections with Cryptosporidium species were considered extremely rare in humans. During the eighties, evidence cumulates that this intracellular protozoan was often responsible of self-limiting diarrheal illness in immunocompetent patients and of a prolonged, life-threatening disease in immunocompromised hosts, especially patients with AIDS. The aim of this paper is to review the present knowledge on Cryptosporidium biology, epidemiology, pathogenesis, diagnosis, therapy and highlight recent studies on the clinical aspects of this infection.

Short-course treatment of visceral leishmaniasis with liposomal amphotericin B (AmBisome).

We evaluated liposomal amphotericin B (AmBisome; Vestar, San Dimas, CA) administered to 88 immunocompetent patients (56 children) with visceral leishmaniasis (VL) caused by Leishmania infantum. Thirteen patients received 4 mg/kg on days 1-5 and 10 (total dose, 24 mg/kg), and all were cured; 42 received 3 mg/kg on days 1-5 and 10 (18 mg/kg), and 41 were cured; 32 received 3 mg/kg on days 1-4 and 10 (15 mg/kg), and 29 were cured (amastigotes were not cleared from 1 child, and 2 relapsed). One adult was cured with a total dose of 12mg/kg. The four children who were not cured received 3 mg/kg for 10 days; none had further relapses. There were no significant adverse events. For VL due to L. infantum, we recommended a total dose of AmBisome of > or = 20 mg/kg, given in > or = 5 doses of 3-4 mg/kg over > or = 10 days.

[Diagnosis of HCV infection by 3rd-generation ELISA in HCV-RNA positive hypertransaminasemic patients with 2nd-generation ELISA negative results]. / Diagnosi di infezione da HCV con ELISA di 3 generazione in pazienti con ipertransaminasemia cronica HCV-RNA positivi ma negativi all'ELISA di 2 generazione.

To evaluate the improved sensitivity of 3rd-generation assays for the detection of ani-HCV antibodies in diagnosing cases of HCV infection, we have re-tested by 3rd-generation ELISA test (ELISA-3) serum samples from immunocompetent patients with chronic hypertransaminasemia who were HCV-RNA positive but tested negative with 2nd-generation ELISA (ELISA-2). Out of 21 HCV-RNA positive/ELISA-2 negative samples, 3 (14.3%) were ELISA-3 positive. Among the ELISA-3 reactive samples, two were indeterminate by RIBA-3 (one was reactive with c1 00 and the other with c22), and one was negative. These results demonstrate that even in the clinical setting ELISA-3 improves the diagnosis of HCV infection. The improvement seems to be related to a better reactivity of HCV peptides rather than to the inclusion of the new determinant NS5. However, the sensitivity of the tests for the detection of anti-HCV antibodies remains to be improved.

Semiquantitative anti-HBc IgM detection in children with chronic hepatitis B: a long-term follow-up study.

Serum anti-HBc IgM titres were monitored monthly by a semiquantitative method in 14 children with HBeAg positive chronic hepatitis B followed up for 18-65 months. All patients, but one, were treated with alfa-interferon (IFN) at different times. On the whole, 12 flare-up episodes were observed and 7 patients cleared HBV-DNA and seroconverted to anti-HBe. Seroconversion occurred only in patients with pretreatment anti-HBc IgM index greater than 0.15 and serum HBV-DNA concentration below 100 pg/ml; the pretreatment alanine aminotransferase (ALT) value was not predictive of response. Combining anti-HBc IgM results and serum HBV-DNA levels observed during the pre-IFN period allowed a precise identification of patients who were likely to respond to IFN therapy. Patients who seroconverted to anti-HBe showed a progressive reduction in serum anti-HBc IgM titres within 6 months. Interestingly, one child, in whom HBV-DNA reappeared and who reconverted to HBeAg 7 months after treatment, showed no anti-HBc IgM decrease after the transient clearance of HBV-DNA and anti-HBe seroconversion. Semiquantitative anti-HBc IgM detection is a useful tool in the decision making process for children with chronic hepatitis B.

Adaptation to group home living for adults with mental retardation as a function of previous residential placement.

Changes in adaptive functioning subsequent to a group home placement was assessed for deinstitutionalized and previously non-institutionalized adults with mental retardation. Results indicated that both groups experienced a significant increase in overall adaptive functioning subsequent to group home placement. The results also indicated that neither group experienced a significantly greater increase in adaptive behaviour compared to the other. Additionally, it was found that the deinstitutionalized group functioned at a higher adaptive level overall than did the previously non-institutionalized group. These results are consistent with previous research regarding the benefits of a group home placement on deinstitutionalized individuals. This research extends previous research by demonstrating that group home placements also have a significant impact on the adaptive behaviour of previously non-institutionalized individuals.

[HCV infection and risk of transfusion in the area of Tivoli and its surroundings]. / Infezione da HCV e rischi trasfusionali nel territorio di Tivoli e dintorni.

The positivity of the anti-HCV antibody has been studied by means of an immuno-enzymatic solid phase method, on 1.605 blood samples. They were drawn from 5 groups of people, during the period from February 1 to October 31, 1992: a) all blood donors who made the donation at the Transfusion Service of Tivoli Hospital during that period; b) all intravenous drug users who came to Tivoli Hospital for control; c) all patients in the Contagious Disease Section with suspected liver disease, always during the same period; d) all patients with suspected liver disease from other Sections of our Hospital; e) all out-patients who came to our Service during the same period to have their hepatitis markers studied. The highest prevalence of HCV Ab positivity was in the drug users, with a prevalence of 80.9%; far from this value, the next two groups were the patients from the Contagious Disease Section (positivity: 23.4%), and from the other hospital Sections (positivity: 20.1%). In the out-patient group only 9.7% were positive and among blood donors only 0.35%. In all 5 groups the HCV-positive subjects were in many cases positive for B hepatitis too; and very often they presented high levels of ALT. These results confirm that in some the percentage of positive-subjects for C hepatitis or for B & hepatitis; very high; therefore the authors underline the great importance to exclude all members of these groups from the donation of blood, its components, and organs too, even if the tests are negative.

[Visceral leishmaniasis in Italy. Its epidemiology, clinical picture and therapy]. / Leishmaniosi viscerale in Italia. Epidemiologia, clinica, terapia.

Visceral leishmaniasis (VL) is a public health problem in most countries bordering the Mediterranean sea. The disease has been found in central and southern Italy, Sicily, Sardinia; some pockets are present in Liguria. Dogs are the reservoirs and the vectors are some species of sandfly (Phlebotomus species). The incubation period is usually between 2 and 8 months; children and adults may become infected; lethality may be high and depends upon a correct diagnosis and treatment. The diagnosis should be suspected on the basis of the epidemiological data and clinical picture and confirmed by the detection of specific antibodies by appropriate techniques. Leishmaniasis can be detected in splenic or bone marrow aspirates. Patients with HIV infection and VL may lack specific antibodies; parasitological diagnosis is mandatory for these patients. Antimonials are the classic therapeutic agents for VL. Recently liposomal amphotericin B (Ambisome) has been successfully used, with negligible toxicity.

Mucocutaneous diseases in drug addicts with or without HIV infection. A case-control study.

A case-control study was performed to evaluate the prevalence of mucocutaneous diseases in 106 male drug addicts (age 21-38 years) with or without HIV infection. A mucocutaneous disease was recorded in ten out of 64 HIV-negative and in 20 of 42 HIV-positive patients (OR = 4.9; p < 0.01). Some mucocutaneous diseases were present in similar proportions in both groups (i.e. fungal skin lesions), while others were typically present only in HIV-positive patients. Stratification for possible confounding factors, such as years of drug addiction and number of sexual partners, confirmed that HIV infection is the main risk factor for mucocutaneous disease. Stratification according to the number of CD4-positive cells showed that the more advanced the HIV disease, the more frequently mucocutaneous disease was present (p = 0.02). The study demonstrates that many, but not all, mucocutaneous diseases are associated with HIV infection.

Mediterranean visceral leishmaniasis in pregnancy.

Visceral leishmaniasis (VL) in pregnancy is rare in Mediterranean countries. We report here 2 cases of VL in pregnant women who acquired the infection in Italy. In the first case, the disease was diagnosed and treated with liposomal amphotericin B during the pregnancy. In the second case, diagnosis was established and treatment with meglumine antimoniate both undertaken shortly after delivery. The 2 infants were followed clinically and serologically for 8-9 months after birth, but no evidence of congenital VL was observed.

Cytometric evidence of cytogenetic and proliferative heterogeneity of human solid tumors.

Flow cytometry is a widely recognized method of rapidly assessing the ploidy and proliferation status of experimental and solid tumors. In the present work, a variety of human cancers from various sites (lung, head and neck, etc.), of traditional interest in our laboratory, have been analyzed. In agreement with a number of recent reports, a general heterogeneity of human solid tumors can be evidenced. In particular: (a) solid tumors are characterized by a variable degree of aneuploidy; (b) the internal structure of solid tumors is highly heterogeneous especially with respect to the fraction of aneuploid malignant cells and their distribution through the cycle phases; and (c) some solid tumors are also characterized by the presence, to a variable extent, in the tumor of mass of multiple cell clones. Static fluorimetry of Feulgen-stained (mitotic) single cells offers a way to confirm this kind of observations.

Flow cytometric analysis of cellular DNA in human acute nonlymphatic leukemias and dysmyelopoietic syndromes.

The proliferation patterns of bone marrow cells from 16 cases of acute nonlymphatic leukemia (ANLL) and 13 of dysmyelopoietic syndromes were analyzed with DNA-flow cytometry. In order to reduce the contamination by nonproliferating peripheral blood cells, all aspirates were submitted to a density centrifugation step. DNA content measurements were performed with a PHYWEICP 22 flow system apparatus. The distribution of cells in te cell cycle phases was calculated by means of an automated fitting procedure. No significant difference between the cell cycle distribution in ANLL and dysmyelopoietic syndromes was detectable. No relationship was observed between the size of the S phase compartment and the percentage of blasts in the original samples. Aspirates from ANLL were also cultured in vitro in liquid phase on dialysis membranes. A clear relationship was observed between the size of the phase compartment and in vitro cell growth since, with the exception of one case, all samples with less than 11% cells in S phase failed to proliferate in vitro. The proliferation profile of ANLL cells after 10 days in culture was similar to that of the original samples.

Maternal locus of control and developmental gain demonstrated by high risk infants: a longitudinal analysis.

The short and long-term effects of a parent-infant training program for biologically handicapped infants was evaluated in terms of maternal locus of control. Twenty-four infants were evaluated on five developmental scales measuring motor, cognitive, and language functioning over a four-year period. Developmental gains on these indices were regressed against maternal locus of control partialing maternal education and socioeconomic status out of the relationship. The results indicated that maternal locus of control accounted for a substantial portion of variance in the developmental gains following the program intervention period. This was especially true for the cognitive and language indices. Locus of control in the mother, however, was not related to the motor indices, nor did it relate to cognitive and language gains achieved during the program intervention period. The results are discussed in terms of the mother's perceived contribution to infant progress in programs designed to produce sustained gains in early infant development.

Expression of tumor-associated antigens and kinetic profile of two in vitro human melanoma cell lines.

The growth characteristics and the antigenic profile of two human melanoma established cell lines in vitro are reported. The growth curves of the two cell lines show some peculiar features which are also detected in their DNA distribution content. In the late stages of growth, in fact, the cell DNA content resumes the initial distribution, suggesting a partial recovery of the cell proliferating potential. When the two cell lines were tested by indirect immunofluorescence with monoclonal antibodies to human melanoma associated antigens, a rather constant expression of these epithopes was observed.

Effects of stimulus probability on encoding by mentally retarded and nonretarded persons.

A choice reaction-time experiment was performed in which probe stimulus probability and probe stimulus quality were orthogonally manipulated. Subjects were retarded and nonretarded junior high school students. The stimuli were random forms presented at four probability levels in order to assess the effect of stimulus probability on the encoding process. The results indicated that the retarded subjects appeared to be less sensitive than did the nonretarded subjects to stimulus-probability information, particularly under degraded stimulus conditions. The results were discussed in terms of the relative sensitivity of retarded and nonretarded persons to stimulus-probability information and the effect of such information on the encoding process.

Comments on the use of the additive factor method with mentally retarded persons: a reply to Silverman.

Maisto and Jerome (1977) reported a choice reaction time (RT) study relating the rate of memory scan to level of intellectual functioning. In this study, slope and intercept values of the RT function were found to be inversely related. Silverman (1978) has raised some concern over the conclusions reached by Maisto and Jerome due to the slope-intercept relationship revealed in their study, which seemingly violates one of the underlying assumptions of the additive factor method. Data were presented from previously reported research that places a number of studies with retarded persons as subjects suspect to this violation. Possible explanations for this finding were also provided.