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Biomedical subjects

E Franco

Publications and source records attributed to E Franco.

At least 109 records · Page 6Linked to original sources
PubMed1992

Needlestick injury in hospital personnel: a multicenter survey from central Italy. The Latium Hepatitis B Prevention Group.

OBJECTIVES: To assess the rate of needlestick injury in hospital personnel in an Italian region. To identify risk factors potentially amendable to correction. DESIGN: Hospital workers undergoing hepatitis B prevaccination testing in 1985 through 1986 were interviewed regarding needlestick injury in the previous year, job category, area of work, years of employment, and other pertinent information. SETTING: Of the 98 public hospitals of the Latium region, 68 participated in the survey: 32 of 55 with less than 200 beds, 20 of 25 with 200 to 300 beds, 11 of 13 with 400 to 900 beds, and all of the 5 with more than 1,000 beds. PARTICIPANTS: All healthcare workers providing direct patient care or environmental services as well as student nurses were invited by the hospital directors to undergo hepatitis B prevaccination testing and vaccination, if eligible. RESULTS: Of 30,226 hospital workers of the 68 participating hospitals, 20,055 were interviewed (66.3%): 47.7% of the 7,172 doctors, 71% of the 14,157 nurses, 55.9% of the 2,513 technicians, and 71.9% of the 6,384 ancillary workers. Needlestick injury was recalled by 29.3%; the rates were 54.9%, 35.3%, 33.8%, 26.5%, 18.7%, and 14.7% in surgeons, registered and unskilled nurses, physicians, ancillary workers, and technicians, respectively. The recalled injury rate was 39.7% and 34.0% in surgical and intensive care areas; in infectious diseases, it was 16.7%. Rates were lower in hospitals with 200 to 300 beds (25.6%). The needlestick injury rate declined from 32% in those with less than 5 years of employment to 28% in those with more than 20 years (p less than .01). Prevalence of HBV infection was higher in student nurses and young workers recalling a needlestick exposure (14.3% and 15.8%, respectively), versus 10.1% and 12.8% in those not exposed (p less than .01 and less than .05, respectively). CONCLUSIONS: Parenteral exposure to blood-borne infectious agents is a relevant risk among healthcare workers in our region, particularly in defined job categories and hospital areas (surgeons, nurses, surgical, and intensive care areas). Immunization and educational efforts should be made along with better designs of devices to reduce the risk of infection.

Hepatitis B↗
PubMed1992

Control of hepatitis B virus infection in dialysis units in Latium, Italy.

The prevalence of hepatitis B virus (HBV) markers was assessed in 1,841/2,178 (84.5%) dialysis patients (DP) cared for in 38/47 dialysis units (80.9%) in Latium. Among DP, 205 (11.1%) were HBsAg positive: 13.8% of males and 7.1% of females (p less than 0.001); the prevalence increased with the length of time on dialysis (p for trend less than 0.001). No differences in HBV (HBsAg and/or anti-HBc) distribution were seen related to age and sex. Of 664/1,539 vaccinated DP, 150 (22.6%) were anti-HBc positive and 239 (36.0%) positive for anti-HBs alone. Of 875/1,539 nonvaccinated patients, 146 (16.7%) had no HBV marker. Vaccination against HBV did not influence the diffusion of HBV in our dialysis units and must be coupled with the implementation of long-standing infection control strategies.

Female↗
PubMed1991

Baseline sero-epidemiology of hepatitis B virus infection in children and teenagers in Italy. A survey before mass hepatitis B vaccination.

During the period May 1987 to November 1989, the prevalence of hepatitis B virus (HBV) markers was determined by ELISA in serum samples of 7405 (55% male, 45% female) apparently healthy persons 3-19 years of age in Italy. Earlier studies of adults there had shown an intermediate degree of HBV endemicity (hepatitis B surface antigen carrier rate greater than 2%). Persons were selected by systematic cluster sampling in five different geographical areas of Italy. The overall prevalence of hepatitis B surface antigen (HBsAg) was 0.6%. The overall prevalence of at least one marker of HBV was 2.8%; it increased from 1.7% among children 3-5 years of age to 4.5% in teenagers 17-19 years of age (P less than 0.001). The prevalence of any HBV marker was higher in southern then in northern areas (3.5% vs. 1.8%, P less than 0.001). A significant association was found with sociodemographic features. Persons whose fathers had less than 6 years of schooling had a 2.3-fold risk (C.I. 95% = 1.5-3.4) while those belonging to a household of six or more under one roof had a 1.7-fold risk (C.I. 95% = 1.2-2.4) of previous exposure to HBV infection. These findings indicate that, today in Italy, exposure to HBV infection at a young age is very low and suggest a shift towards a low degree of endemicity following improvements in socio-economic conditions, decreased family size and increasing use of disposable syringes during recent years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Heterosexual and homosexual transmission of hepatitis C virus: relation with hepatitis B virus and human immunodeficiency virus type 1.

A seroprevalence study was carried out on 1757 outpatients consecutively seen in a sexually transmitted disease (STD) clinic in order to evaluate the sexual transmission of hepatitis C virus (HCV). A total of 1442 consenting patients were tested for hepatitis C, hepatitis B and human immunodeficiency virus type 1 (HCV, HBV, HIV-1) antibodies. The relations between anti-HCV, anti-HBc and anti-HIV-1 were studied. Of 73 anti-HCV positive reactions, 45 (61.6%) were confirmed by the recombinant immunoblot assay (RIBA). The proportion of individuals with anti-HCV was higher in outpatients with a history of sexually transmitted disease than without. It was 2.8% in non drug user heterosexuals and 2.9% in non drug user homosexuals. Intravenous drug users (IDU) had higher anti-HCV prevalence when a history of STD was taken into account (42.3% in subjects with STD versus 36.7% in subjects without STD). Among non drug user heterosexuals an association was found between anti-HCV and anti-HBc. These data suggest that sexual transmission of HCV occurs, although it seems to be less efficient than other parenteral modes of transmission. When a more sensitive and specific marker of HCV infection become available, a more accurate estimate of the frequency and efficiency of the sexual transmission will be possible.

Adolescent↗
PubMed1991

Gastrointestinal health effects associated with the consumption of drinking water produced by point-of-use domestic reverse-osmosis filtration units.

During a prospective epidemiological study of gastrointestinal health effects associated with the consumption of drinking water produced by reverse-osmosis domestic units, a correlation was demonstrated between the bacterial counts on R2A medium incubated at 35 degrees C and the reported gastrointestinal symptoms in families who used these units. A univariate correlation was found with bacterial counts on R2A medium at 20 degrees C but was confounded by the bacterial counts at 35 degrees C. Other variables, such as family size and amount of water consumed, were not independently explanatory of the rate of illness. These observations raise concerns for the possibility of increased disease associated with certain point-of-use treatment devices for domestic use when high levels of bacterial growth occur.

Canada↗
PubMed1991

Evaluation of a region-wide hepatitis B vaccination program in dialysis patients: experience in an Italian region. The Latium Hepatitis Prevention Group.

In 1985-1986, 634 adult dialysis patients were tested prior to hepatitis B vaccination, representing 40% of the total patients in Latium, an Italian region. HBsAg and anti-HBs prevalences were 7.1 and 36.0%, respectively. Merck, Sharp & Dohme (MSD) and Pasteur plasma-derived vaccines were randomly allocated to the 44 dialysis units. An anti-HBs response greater than or equal to 10 IU/l was elicited in 58.5% of 236 subjects tested at 6 months, 63.4% MSD and 52.4% Pasteur (p n.s.). The relatively low response to the vaccine in this high-risk group stresses the need to improve the efficacy of the vaccination and to maintain policies of environmental control.

Adult↗
PubMed1991

A randomized trial to evaluate the risk of gastrointestinal disease due to consumption of drinking water meeting current microbiological standards.

BACKGROUND: This project directly and empirically measured the level of gastrointestinal (GI) illness related to the consumption of tapwater prepared from sewage-contaminated surface waters and meeting current water quality criteria. METHODS: A randomized intervention trial was carried out; 299 eligible households were supplied with domestic water filters (reverse-osmosis) that eliminate microbial and chemical contaminants from their water, and 307 households were left with their usual tapwater without a filter. The GI symptomatology was evaluated by means of a family health diary maintained prospectively by all study families over a 15-month period. RESULTS: The estimated annual incidence of GI illness was 0.76 among tapwater drinkers compared with 0.50 among filtered water drinkers (p less than 0.01). These findings were consistently observed in all population subgroups. CONCLUSION: It is estimated that 35% of the reported GI illnesses among the tapwater drinkers were water-related and preventable. Our results raise questions about the adequacy of current standards of drinking water quality to prevent water-borne endemic gastrointestinal illness.

Adolescent↗
PubMed1991

Age-specific prevalence of hepatitis A virus infection among teenagers in Sardinia.

In 1989, the prevalence of antibodies to hepatitis A virus (anti-HAV) in a sample of 1350 Sardinian teenagers aged 14 to 19 years was estimated by Elisa method. The overall anti-HAV prevalence was 20%; it increased from 12.3% among 14-16 year old subjects to 27.4% in subjects aged 17-19 years (P less than 0.01). A slight female preponderance was observed (22.1% versus 17.9) but no statistically significant difference was attained. Compared with the corresponding figure (71.6% of prevalence rate) observed in North Sardinia in 1980, the results of the present study show a dramatic reduction in anti-HAV prevalence among teenagers. A significant association was found with sociodemographic factors: subjects whose fathers had less than six years of schooling, had a 2.1-fold risk (C.I. 95% = 1.5-3.1) and subjects belonging to a household of 6 or more under one roof had a 1.7-fold risk (C.I. 95% = 1.2-2.3) of previous exposure to hepatitis A virus (HAV) infection. These findings indicate that exposure to HAV in Sardinia is decreasing, probably because of improvements in socio-economic conditions during recent years. However, overcrowding and short paternal education appear to be important determinants of infection.

Adolescent↗
PubMed1991

[Analysis of 4 prognostic scoring systems in 197 myelodysplastic syndrome patients].

PURPOSE: To evaluate the prognostic significance of four scoring systems applied with predictive trends to myelodysplastic syndromes (MDS). MATERIAL AND METHODS: This study is comprised of 197 patients with MDS diagnosed in accordance with the FAB criteria and followed-up in our Department between Jan '75 and Dec '89. The following MDS subtypes were found: refractory anaemia (RA), 58 cases; sideroblastic refractory anaemia (SRA), 42 cases; refractory anaemia with excess of blasts (RAEB), 46 cases; RAEB in transformation (RAEB-T), 39 cases; and chronic myelomonocytic leukaemia (CMML), 12 cases. The following scoring systems were applied: Mufti's 1985, Varela's 1985, Sanz's 1989 and our own of 1991. The statistical analysis was performed according to Kaplan-Meier actuarial system and the log-Rank test of actuarial survival. RESULTS: (1) Three groups (A, B and C) can be defined by the Bournemouth system, with median survivals of 57.6, 17 and 7.6 months, respectively. The majority of cases (118) were included in group B. Group A has not reached 25% of actuarial survival probability, whereas groups B and C did at 32 and 10 months, respectively. With regard to the morphologic subtypes, RA and SRA were included in groups A and B, and RAEB, RAEB-T and CMML pertained mostly of group C. Sixty cases (90.9%) evolving into acute leukaemia (AL) corresponded to those last groups. (2) The three groups defined by Varela's system (0-1, 2-5 and 6 or more) have median survival of 85.6, 24 and 14 months, respectively. Like in the former system, group 0-1 has not reached 25% actuarial probability, this appearing at 70 and 20 months, respectively, in groups 2-5 and greater than 6. The distribution of the cytological varieties, RA and SRA amongst the groups is heterogeneous although there are more common within the cases included in groups 0-1. All the cases evolving into AL were included in the groups 2-5 and greater than 6. (3) The 3 groups of the system proposed by Sanz (0-1, 2-3 and 4-5) had median survival of, respectively, 58, 15 and 14 months. Like in the preceding cases, group 0-1 has not reached the 25% actuarial probability, while this figure appears at 28 months for group 2-3 and at 20 months for group 4-5. RA and SRA varieties are included chiefly in group 0-1, while RAEB and RAEB-T appear mostly in groups 2-3 and 4-5. The distribution of the cases and evolving into AL in heterogeneous according to this system, although they predominate in groups 2-3 and 4-5. (4) The prognostic groups are defined by the system proposed by us (namely 0-2, 3-5, 5 greater than or equal to 6) with median survivals of 89.3, 17 and greater than 11 months, respectively. Striking difference was seen when studying the cumulated survivals observed, on each of the three percentages considered, between the groups. The different cytological varieties distributed reasonably with higher incidence of RA and SRA in group I and RAEB, RAEB-T and CMML in group III. This system offers statistical significance when comparing RA with SRA, RAEB with RAEB-T and, obviously. RA+SRA with RAEB+RAEB-T+CMML. The evolution into AL showed also statistical significance with respect to the three groups. CONCLUSIONS: 1. Three prognostic groups regarding the patient's survival could be established in our series with all the scoring systems analyzed, except that of Sanz. 2. Low risk (RA and SRA) and high risk (RAEB, RAEB-T and CMML) cytological varieties can be identified with all the scoring systems; that of Sanz is also capable of discriminating RA from SRA. 3. Some prediction on the possibility of evolution into AL can be attained of with each system. 4. The scoring system proposed by us shows higher discriminating capability on the cytologic varieties as well as higher predictive value on the possibility of evolution into AL. Nevertheless, it must be evaluated in other series in order to reach general acceptance.

Actuarial Analysis↗
PubMed1990

Seroprevalence of anti-Chlamydia trachomatis IgG in outpatients attending a sexually transmitted disease clinic in Italy.

Prevalence of anti-Chlamydia trachomatis specific IgG antibodies was evaluated in a sexually transmitted disease outpatient population composed of 741 heterosexuals, 470 males and 271 females, and of 147 homosexual-bisexual men. The prevalence rates were 60.0% in heterosexual males, 50.6% in females and 73.5% in homosexuals-bisexuals. A positive association between age and antibody prevalence was found in males. Among heterosexuals there is an increasing trend of seropositivity with number of partners during the previous year. A significant association between anti-chlamydial and anti-herpes simplex, type 2, antibodies has been demonstrated.

Adult↗
PubMed1990

Depuration of Mytilus galloprovincialis experimentally contaminated with hepatitis A virus.

Mussels (Mytilus galloprovincialis) were contaminated with known amounts of laboratory strains of hepatitis A virus and Poliovirus 1 and the effectiveness of a self-cleansing mechanism was studied using a pilot depuration system. Both viruses were rapidly bioaccumulated by mussels and the maximal concentration of about 10(4) TCID50/ml was reached within 1.5 hours. Depuration was carried out up to 24 h; infectivity titer decreased to 10(2) TCID50/ml and 10(3.2) TCID50/ml within 6 h in hepatitis A virus and Poliovirus 1 contaminated mussels, respectively, but only a very slight further decrease was obtained after 24 h. E. coli was used as a control; within 24 h the concentration decreased from 40 to 2 bacteria/ml of mussel (MPN). The elimination of bacteria is not a reliable parameter to control the effectiveness of viral depuration.

Animals↗