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Biomedical subjects

F Palumbo

Publications and source records attributed to F Palumbo.

At least 55 records · Page 3Linked to original sources
PubMed1994

Hepatitis B in children in Italy: incidence and risk factors: SEIEVA Collaborating Group. Sistema Epidemiologico Integrato dell'Epatite virale Acuta.

The objectives of the present report were to give a baseline picture of hepatitis B notification incidence rates in children before the campaign of mass vaccination for newborns and adolescents (12-13 years old), and to study the role of different risk factors. Data from a specific national surveillance system of acute viral hepatitis (SEIEVA, Sistema Epidemiologico Integrato dell'Epatite Virale Acuta) were used and acute hepatitis B cases were compared to acute hepatitis A patients with the case-control study method to estimate the associations with the considered risk factors. Since the system began, one hundred and sixty-three local health departments have joined SEIEVA covering 30% of the Italian population. The incidence of acute hepatitis B notifications among 0-14 aged children was 9 per 100,000 in 1985 and 1 per 100,000 in 1990. Such decline in incidence was observed in both the North and the South of Italy. Surgical interventions, dental therapy and household contacts with a HBsAg chronic carrier were found to be associated with acute hepatitis B. The point estimate of the odds ratio was 10 for the latter risk factor. Other preventive measures in addition to vaccination are needed to control the risk of hepatitis B infection and other parenteral diseases due to surgical intervention and dental therapy.

Acute Disease↗
PubMed1994

Hepatitis B in health workers in Italy.

In Italy, a vaccination campaign against hepatitis B was launched in 1985. It was strongly recommended for health care workers. Over the period 1986-91 the incidence rate of acute B hepatitis in the general population declined from 12/100,000 in 1986 to 5/100,000 in 1991. The corresponding figures among hospital workers were 42.5/100,000 (RR 3.5; 95% CI 2.55-4.92) in 1986 and 14.5/100,000 (RR 2.9; 95% CI 2.03-4.14) in 1991, respectively. The proportion of HBV cases with jaundice was about the same in the general population (77.6%) and in the health care staff (74.2%). Nearly 6% of hospital workers cases had completed the schedule of HBV vaccine. Despite the fact that vaccination against HBV has been strongly recommended for hospital workers, the incidence of infection in this job category has continued to be higher than that in the general population, probably as a consequence of poor vaccine coverage. These findings reiterate the need for aggressive vaccination programmes in hospital workers.

Health Personnel↗
PubMed1994

Incidence and risk factors of acute Delta hepatitis in Italy: results from a national surveillance system. SEIEVA Collaborating Group.

The incidence of hepatitis Delta virus in the general Italian population was estimated by a specific surveillance system for acute viral hepatitis over the period 1987-1992. The hepatitis Delta virus incidence rate declined from 3.1/1,000,000 inhabitants in 1987 to 1.2/1,000,000 in 1992. Males predominated (83.8% of cases); the sex ratio was 5.2. Only 2.5% of cases occurred in subjects younger than 15 years. There were 119 (49.4%) coinfections of Delta and B hepatitis and 122 (50.6%) Delta superinfections in chronic HBsAg carriers. Jaundice was present in 83.6% of cases. The hospitalization rate was 97.5%; median stay in hospital was 25 days (range 1-98 days). The results of multivariate analysis showed that a history of intravenous drug abuse (odds ratio 34.9; confidence interval 95% = 16.8-72.5), household contact with an HBsAg+ carrier (odds ratio 10.7; confidence interval 95% = 4.36-23.30) and a history of two or more sexual partners within the previous 6 months (odds ratio 2.44; confidence interval 95% = 1.34-4.43) were independent risk factors associated with Delta hepatitis. No association was found with the other risk factors considered, such as blood transfusion, surgical intervention, hospitalization, other percutaneous exposures, dental therapy, contact with an icteric case, and household contact with an i.v. drug abuser. These findings indicate that, in Italy, Delta hepatitis currently has a minor impact. In addition to intravenous drug abuse and household contact with an HBsAg+ carrier, heterosexual activity appears to be an efficient route of HDV transmission.

Acute Disease↗
PubMed1993

Hepatitis B mass immunization of adolescents: a pilot study in a community.

The National Type Specific Hepatitis Surveillance System (SEIEVA) and seroepidemiological studies have shown that in addition to newborns from mothers who are carriers for hepatitis B surface antigen (HBsAg), adolescents are at high risk of acquiring type B hepatitis virus because of increasing importance of the heterosexual transmission of this virus. In order to evaluate logistic problems and acceptance rate of adolescents to mass vaccination against hepatitis B, a pilot study was carried out among all 7th grade children registered in the 9 schools of an hepatitis B endemic area located in the suburbs of Naples. After meetings held by the local health department with school teachers and parents, 1219 out of 1250 (97.5%) invited children received the first dose of hepatitis B vaccine; 1215 and 1209 received, respectively, the second and third doses. Anti-hepatitis B surface antigen (anti-HBs) values were studied in 406 subjects one month after the third dose, and 21 out of 406 (5.2%) had anti-HBs values less than 10 IU/L. We consider 95% of subjects with anti-HBs values greater than 9 IU/L a good achievement for a field vaccination program. The high acceptance rate of vaccination found in our study outlines the importance of active offer of vaccination combined with school involvement.

Adolescent↗
PubMed1993

[Modification of immunologic parameters in physiologic pregnancy].

Changes in lymphocyte subsets in whole blood of normal pregnant women were examined by flow cytometry. From the first trimester and throughout pregnancy, the count of B cell subset remain unchanged. On the contrary, the percentage of "helper" lymphocytes decreased in the first trimester, increase in the third. These changes of lymphocyte subsets may indicate suppression of immunological activity during pregnancy.

Adult↗
PubMed1992

The control of human brucellosis in the Campania region: an updating of knowledge and results obtained by the third year of the programme activities.

A control programme for brucellosis in Campania was started in 1988, in the province of Caserta, and implied different actions at the regional and provincial levels. The section of the work described here regards the updating of the results obtained during the third year of the project activity. The action performed included experimentation of data sheets in the province of Caserta to gain information on the factors conditioning brucellosis, gathering and analysis of ISTAT data on the size of livestock population as an actual or potential source of infection for man, epidemiological surveillance of human cases, census of dairies, and public health measures taken by the Regional Council. The results show that improvement of human brucellosis surveillance is in progress, whereas the programme implementation has provided a clearer picture of the situation with better understanding of the factors affecting the disease occurrence. Such problems posed by the project management as difficult maintenance of sufficient collaboration between veterinarians and physicians, scarce participation of local and regional administrations, resistance opposed by some categories, and reduced availability of financial resources are also discussed.

Animals↗
PubMed1992

Evaluating drug prescribing in a large, ambulatory population: application of an embedded expert system.

DUR is a process of problem detection and intervention designed to improve the quality and economy of drug prescribing. Retrospective DUR attempts to detect and address patterns of prescribing that might be indicative of inappropriate therapy. When the process is extended to a largely ambulatory population such as Medicaid beneficiaries, a number of complications are introduced due to the large numbers of patients and sparsity of data. In order to examine the impact of implementing a Medicaid DUR program, we developed a system that would apply screening criteria to prescription claims. It has been used to screen prescribing of groups of two antihypertensive drugs in the 1990 Maryland Medicaid population for 177,409 Medicaid eligible individuals. Potentially significant problems were detected with respect to dosing, duplication of therapeutic agents and drug interactions. The system represents, we believe, a significant improvement in the ability to detect and report prescribing decisions by increasing the specificity of the detection system. By the application of this system to a set of real-world data, we have demonstrated that it is feasible to implement such a system and derive results that are potentially useful in reducing the incidence of inappropriate physician decision-making.

Ambulatory Care Information Systems↗
PubMed1991

Travel-associated hepatitis A: effect of place of residence and country visited.

The association between hepatitis A and domestic or international travel from Italy was investigated. Data from a nationwide surveillance system (SEIEVA) for type-specific acute viral hepatitis were used to compare 1102 hepatitis A cases with 3671 hepatitis B cases. An association between hepatitis A and travel was found in northern Italy, where most young and adult people are susceptible. Estimates of odds ratios vary dramatically according to geographical area of travel. Travellers to Mediterranean countries, Eastern Europe, Africa, Asia, and South and Central America had the highest education and age-adjusted odds ratios for hepatitis A, ranging from 6 to 25. Prophylaxis against hepatitis A for such travellers is recommended.

Adolescent↗
PubMed1990

Decline of incidence of A, B and non-A, non-B hepatitis in Italy. Results of four years surveillance (1985-88). SEIEVA collaborating group.

A specific surveillance system for acute viral hepatitis which uses weekly notification of cases and a standard risk factor questionnaire was started in Italy in 1984. From 1985 to 1988 153 Health Departments (27% of Italian population) joined the system. Estimated incidence of reported viral hepatitis was 30 per 100,000 in 1985 and 14 in 1988. The decline was impressive for hepatitis A, particularly in the south. Reduction of incidence was also evident for hepatitis B and Non-A, Non-B hepatitis, particularly in young adults. The decrease of viral hepatitis in Italy is consistent with recent seroepidemiological data. Shellfish consumption was the most frequent risk factor reported for hepatitis A cases at all ages. Hospitalization, surgical intervention, dental therapy and other percutaneous exposures still play a role in the transmission of parenteral hepatitis in Italy. Blood transfusions seem to be important only for Non-A, Non-B. Interventions other than vaccination to prevent B and Non-A, Non-B hepatitis due to hospitalization, surgical intervention, other percutaneous exposures and dental therapy are needed and can further contribute to the decline of hepatitis virus infection rates in Italy.

Acute Disease↗
PubMed1989

[Brucellosis in the Campania region].

The research describes the trend of brucellosis, in the period 1984-86, in the county of the "regione Campania". This trend, in contrast with the national one, is manifested as endemic, with frequent and localised outbreaks of epidemic levels. The research also describes, through the analysis of the illness registration forms of 762 cases of brucellosis in the period 1985-86, the seasonal trend, the ages of major risk of infection and the most frequent modes of infection. The paper concludes with suggestions for the effective prevention of brucellosis.

Brucellosis↗
PubMed1985

Mortality from cancer of the stomach, colon and rectum in the city of Naples and the provinces of Campania.

Utilizing data on deaths from 1951 to 1981, this study attempts to verify a time trend for stomach, colon and rectum cancer in the city of Naples. Time trend analysis and cohort analysis have shown an increase of colon rectum cancer mortality affecting cohorts born after 1871 and a decrease of stomach cancer mortality for those born after 1886. A comparison of mortality rates in three geographical areas shows that, while there is not any difference for stomach cancer, the mortality curves relating to cancer of the colon and rectum are higher in the city of Naples than in the province of Naples and the other provinces of Campania.

Colonic Neoplasms↗