[Changes in tobacco addiction and spirometric variations in workers exposed to chemical risk in biochemical research laboratories of a large Italian University--a retrospective cohort study]. / Cambiamenti nell'abitudine tabagica e variazioni spirometriche nei lavoratori esposti a rischio chimico dei laboratori di ricerca chimica e biologica di una grande realtà universitaria italiana--studio di coorte retrospettivo.

OBJECTIVE: To describe smoking cessation in a group of workers exposed to chemical risk and factors associated; to assess the changes of respiratory function over the years also in relation to risks to which they were exposed. MATERIALS AND METHODS: We studied employees/students occupationally exposed to chemical risk from whom we also had information about smoking status and who had done a spirometry in all periodic visits and who had at least two periodic medical examinations during the follow-up. RESULTS: Variables significantly associated to the smoking cessation are gender and exposure to biological risk. The changes in Forced Vital Capacity between the last and the first visit were associated to a significant negative correlation, from multivariate analysis, to age and to exposure to the display screen equipment. The Tiffeneau index was significantly positively associated with exposure to display screen equipment and to manual handling of loads; the Forced Expiratory Flow 25-75% was significantly associated with physical risk. CONCLUSIONS: A greater awareness on the consequences of smoking is recommended in subjects exposed to chemical risk, especially in women, in addition to a serial monitoring of lung function in order to carry out an early intervention in the first phase of airflow limitation.

High prevalence of hepatitis C virus (HCV) genotype 2 in Italian patients with chronic liver disease.

The prevalence of different genotypes of Hepatitis C virus may vary between geographic areas and it is possible that various genotypes have different pathogenic characteristics. Therefore, 90 consecutive Italian patients anti-Hepatitis C Virus positive with a broad spectrum of chronic liver disease, have been analysed to observe prevalence of various genotypes of Hepatitis C Virus. Genotyping was performed by polymerase chain reaction with a set of nested biotinylated primers, located in 5'UTR region. Genotype 1b and genotype 2a were the most commonly encountered (respectively, 50% and 37%) whereas other genotypes were rare. The unexpected high prevalence of genotype 2a allowed direct comparison of clinical characteristics and response to therapy between patients with genotype 2a and those with 1b. Genotype 1b was more prevalent than 2a in patients over 60 years (29 vs 12) and in those with more severe liver disease (34 vs 16). In a univariate analysis, genotype 2a was associated with less severe liver disease (p = 0.02) and younger age (p = 0.018), in comparison with genotype 1b. Patients with genotype 2a responded to interferon alpha therapy better than those with 1b (p = 0.007). In a multivariate analysis, only younger age was associated with genotype 2a. Genotype 2a (in comparison with 1b) and absence of cirrhosis were independent predictors of response to interferon alpha. In conclusion, genotype 2a is playing an emerging role in younger Italian patients and seems more sensitive than 1b to interferon alpha therapy.

[Anti-GOR antibodies in type II mixed cryoglobulinemia associated with hepatitis C virus infection]. / Anticorpi anti-GOR nella crioglobulinemia mista tipo II associata a infezione da virus dell' epatite C.

The frequent association of chronic hepatitic C virus (HCV) infection and type II mixed cryoglobulinemia is considered to be one of the possible signs of interaction between the virus and the immune system. This could also be the case for the appearance of anti-GOR antibodies in serum, as they react with both viral and host antigens. We studied a group of patients with chronic hepatitis C infection and a group with type II mixed cryoglobulinemia associated with HCV infection to ascertain if anti-GOR or other non-organ specific autoantibodies were present in the serum. We found no significant difference between the two groups in presence, prevalence or titer of anti-GOR or other autoantibodies. Moreover, the expression of anti-GOR does not seem to influence the severity of liver damage. Our data support the hypothesis that anti-GOR antibodies are a simple expression of molecular mimicry between viral and human epitopes.

Reliability of immunoassays for anti-HCV antibodies (ELISA and RIBA II) in patients with essential mixed cryoglobulinemia (EMC).

The recent reports of a very high frequency of signs of hepatitis C virus (HCV) infection among patients with essential mixed cryoglobulins (EMC) suggest new hypotheses for the pathogenesis of this disease. However, most of these studies have been seriously criticized. The serologic test designed for detection of anti-HCV antibodies (ELISA, RIBA I and II) may yield a significant rate of false-positive results when performed on cryoglobulinemic sera, and the detection of the HCV genome by PCR is still heavily conditioned by practical problems. Indirect, but possibly more reliable, evidence of HCV infection in cryoglobulinemic patients might come from the demonstration of anti-HCV antibodies by a conventional technique (ELISA or RIBA) in the purified polyclonal non-rheumatoid immunoglobulinemic fraction excreted in the urine by glomerular filtration. Fifty-two patients whose serum had tested positive for HCV antibodies (by ELISA and RIBA) on multiple occasions were enrolled in this study. They were diagnosed as having either EMC or HCV chronic hepatitis without cryoglobulinemia at least one year ago. The urine samples of these patients were tested for anti-HCV antibodies by ELISA and RIBA. In patients with chronic C hepatitis the antibodies most frequently found in the serum were anti-C33c and anti-C22-3. The results of the RIBA were substantially confirmed by ELISA, with a positive test in the urine of 30 of 32 seropositive patients. Similar results were obtained in patients with EMC II. We conclude that the specificity of the RIBA and ELISA tests for HCV antibodies in patients with EMC appears to be as high as in HCV+ patients without serum cryoglobulins. EMC patients have a high incidence of HCV infection and active chronic liver disease.

[Various biotypes of Escherichia coli: their correlation with antibiotic resistance]. / Biotipi diversi di Escherichia coli: loro correlazione con l'antibiotico resistenza.

The antimicrobial susceptibilities of 572 strains of Escherichia coli were evaluated. The strains were divided according to the biotypes and the differences between the strains towards various antibiotics were examined. We found a correlation between biotype and antibiotype. This correlation lead us to think of a possible existence of more resistant biotypes than others. Now we are doing other studies in order to show if this correlation is constant during time and if similar differences are present for other microorganisms, as well.