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Biomedical subjects

I Casetta

Publications and source records attributed to I Casetta.

At least 37 records · Page 2Linked to original sources

Incidence of transient global amnesia in the Belluno province, Italy: 1985 through 1995. Results of a community-based study.

INTRODUCTION: We sought to determine the incidence rate of all the new cases of first-ever-in-a-lifetime transient global amnesia in the Belluno province, Italy. Only two prospective epidemiological studies on TGA incidence have been performed to date, non in Italy. Our study aimed to provide reliable and comparable information on TGA incidence. MATERIAL AND METHODS: We undertook a prospective population-based study in the territory of the province of Bulluno, Italy, between June 1, 1992 and December 31, 1995. We also retrospectively reviewed the clinical records of all the patients with a diagnosis of amnesia seen in the hospitals of the study area from January 1, 1985 through May 31, 1992. RESULTS: During the prospective study period we identified 77 patients who experienced a first-ever TGA. The crude annual incidence rate was 10.4/100,000 (9.35/100,000 for men and 11.37/100,000 for women). After adjustment to the European population, the incidence rate decreased to 8.60/100,000 per year. The crude annual incidence rate during the retrospective study period was 5.81/100,000. The demographic and clinical features of the two groups did not differ one to the other. CONCLUSIONS: The incidence rate of first-ever TGA registered in the province of Belluno, Italy, was closely similar to that reported in Turku, Finland and confirms that TGA is more common than has been usually proposed. We emphasize the usefulness of prospective, rather than retrospective, epidemiological studies for research on TGA.

Adult↗

Prognosis of childhood epilepsy: a community-based study in Copparo, Italy.

We performed a community-based study among children and adolescents with idiopathic and cryptogenic epilepsy and onset of the seizures between 0 and 19 years of age on the prognosis of being seizure-free. The study population was recruited during a descriptive investigation in the Local Health Service of Copparo (USL 34), Ferrara, Northern Italy. We included 111 patients (61 males and 50 females). The average length of follow-up was 18.8 years (ranging from 7 to 24 years). The cumulative probability of being in remission was 81.2% at 15 years after onset and the estimated percentage of patients in remission without therapy was 56% for the same time period. At 15 years after the onset of epilepsy, approximately 20% of patients continued to have seizures; nearly 25% continued to take antiepileptic drugs but had been free of seizures for at least 5 years; nearly 56% had been without seizures and free of medication for at least 5 years. Seizure type, gender, age at onset of the illness, epileptic abnormalities on EEG, family history of convulsive disorders, number and frequency of seizures prior to the start of treatment were found not to be helpful as prognostic factors. This community study, carried out on patients without the well known factors that adversely affect prognosis, confirms that the prospect of seizure control and for withdrawal of therapy is (generally) good.

Adolescent↗

Phenytoin-induced gingival overgrowth: a community-based cross-sectional study in Ferrara, Italy.

A community-based cross-sectional study was carried out in Ferrara, Northern Italy, to verify the frequency of gingival overgrowth in chronic phenytoin (PHT) users and the risk factors associated with its development. All subjects taking phenytoin were identified using the computerized list of drug prescriptions available in the study area. Most of the subjects were interviewed and underwent an oral examination to evaluate their periodontal condition. The prevalence of gingival enlargement in chronic PHT users was about 40%. In our study, sex, age age at onset of therapy, treatment duration, and oral hygiene were not significantly associated with the risk of developing gingival overgrowth. A direct relationship with daily dose was found to be an independent risk factor. Younger age and poorer oral hygiene seemed to predispose to the severest level of gingival involvement. These results support data from experimental studies by suggesting that drug-induced gingival overgrowth is a dose-dependent side effect whose severity could be affected by local factors.

Adolescent↗

Multiple sclerosis in Italy. A reappraisal of incidence and prevalence in Ferrara.

BACKGROUND: Previous descriptive surveys on multiple sclerosis (MS) in the province of Ferrara, northern Italy, carried out by our own epidemiological research group, pointed out that this area was not at low-medium risk for MS. OBJECTIVE: To verify the morbidity estimates and update the temporal trend of MS. DESIGN AND METHODS: We used a complete enumeration approach by reviewing all the possible sources of case collection available in Ferrara for 1965 through 1993. We included all patients with definite and probable MS according to the criteria of Poser et al. RESULTS: The mean annual incidence rate was 2.3 per 100,000 population (95% confidence interval, 2.0-2.6 per 100,000), 3.0 per 100,000 for women and 1.5 per 100,000 for men. On December 31, 1993, 249 patients (170 women and 79 men) suffering from definite or probable MS were living in the province of Ferrara, giving a crude prevalence rate per 100,000 population of 69.4 (95% confidence interval, 61.2-78.7), 90.8 for women and 46.0 for men. CONCLUSION: The data confirm that in Ferrara, MS occurs more frequently than previously suggested by the latitude-related epidemiological model, supporting the view that northern Italy is a high-risk area for the disease. While the prevalence rate is much higher than in our previous studies, probably owing to the increasing survival of the patients because of improving supportive care, the incidence rates, similar in magnitude to those observed in high-risk areas of northern and central Europe, have remained relatively stable over time.

Adolescent↗

The incidence of Guillain-Barre syndrome in Ferrara, Italy: is the disease really increasing?

The Guillain-Barre syndrome (GBS) incidence has been updated in the area of the Local Health District of Ferrara, Unita Sanitaria Locale n. 31 (USL 31), Northern Italy, (where a previous survey found an average annual incidence of 1.26/10000 population) in order to verify a supposed increase in GBS occurrence. The updated mean annual incidence over the years from 1981 to 1993 (average resident population: 177235 inhabitants) was 1.87/100000 population (1.66/100000 when age-adjusted). The rate increased progressively in the four subsequent time intervals into which the study period was subdivided (from 1.09/100000 in the years 1981-1984 to 2.73/100000 in the years 1991-1993) with a significant temporal variation (0.025 <p <0.05). The incidence was higher in the urban centres than in the rural zone of USL 31 (2.22/100000 and 1.10/100000; 0.025 <p <0.05) and an increase of GBS risk in the urban area was found. The incidence showed an increase in the oldest age groups of the study population. These findings seem to confirm a slight increase of GBS risk in the area of Ferrara with particular reference to urban centres and elderly people.

Adolescent↗

Incidence of transient ischemic attacks in the Belluno Province, Italy. First-year results of a community-based study.

OBJECTIVES: This study formed part of a larger prospective population-based survey on cerebrovascular diseases and aimed to provide reliable and comparable results on TIA incidence and on related risk factors, which could supply investigation objectives and support information for primary and secondary prevention. MATERIAL AND METHODS: We undertook a prospective population-based study in the province of Belluno, an area located in the North-East of Italy where 211,389 people live, utilizing all the possible case-collection sources available in the territory. RESULTS: In the first year of the study (June 1, 1992 to May 31, 1993) 271 patients with a diagnosis of transient ischemic attack were recruited. Among these, we recorded 171 cases of new TIAs. The crude annual incidence rate for new TIAs was 0.80 per 1000, 0.73 per 1000 for men and 0.87 per 1000 for women. After adjustment to the European population, the overall incidence rate decreased to 0.58 per 1000 inhabitants per year. The mean age of new TIA patients was 73.91 years and females were significantly older than males (p < 0.001). A CT scan disclosed an infarct in 21 new TIA patients. CONCLUSION: Our first-year results on new TIAs incidence did not differ from the findings reported in previous population-based studies performed throughout the world and support data as to risk factors for TIA.

Adult↗

A prospective study on the predictive value of CSF oligoclonal bands and MRI in acute isolated neurological syndromes for subsequent progression to multiple sclerosis.

A prospective study in patients with a clinical acute isolated brainstem or spinal cord disorder was undertaken. The aim was to evaluate the predictive value of IgG intrathecal synthesis (through the detection of oligoclonal bands in CSF) and MRI lesions at presentation, for the subsequent progression to multiple sclerosis. Forty four patients took part in this study: 22 had a brainstem disorder and 22 a spinal cord disorder. After a mean period of 26 (SD 22) months, 30 patients (68.2%) developed clinically definite multiple sclerosis. The remaining 14 patients were followed up for more than seven years. Twenty six (59.1%) patients had oligoclonal bands in CSF, with a sensitivity of 80.0%, specificity of 85.7%, and a predictive value of 92.2%. Magnetic resonance imaging showed disseminated white matter lesions in 22 patients (50.0%), with a sensitivity of 60.0%, a specificity of 71.4%, and a predictive value of 81.7%. The difference between patients with multiple sclerosis and patients without the disease was statistically significant for the findings of an IgG intrathecal synthesis (P < 0.001). It was only borderline for the MRI findings (P = 0.052). Thus the detection of an intrathecal synthesis at presentation seemed to be a better prognostic indicator of the progression to multiple sclerosis in patients affected by acute isolated brainstem or spinal cord syndromes.

Adult↗

Risk factors for idiopathic generalized seizures: a population-based case control study in Copparo, Italy.

We examined the etiopathogenetic role of preperinatal risk factors in the history of epileptic patients, identified in a previous descriptive study performed in Copparo, Italy. A community-based case control study of a group of epileptic patients with idiopathic generalized seizures was performed. The population consisted of 55 patients aged < 35 years as of December 31, 1988, residing in Copparo. Symptomatic patients were not included in the present study. The control sample consisted of 165 randomly selected healthy individuals, matched with patients for sex, age, and residence in the study area. The interview for detection of history of presumed risk factors was based on the Protocol of the Italian League Against Epilepsy. Obstetric, neurologic, and neonatal hospital charts were also reviewed. A family history of epilepsy, febrile seizures, and other perinatal factors (such as continual physical stress during pregnancy, maternal age > 35 years, and birth order > 3) were significantly more common in patients as compared with controls. Our data support the hypothesis of genetic propensity for generalized and febrile seizures, which may represent early expression of a low seizure threshold that subsequently develops into epilepsy.

Adolescent↗

Incidence and prognosis of stroke in the Belluno province, Italy. First-year results of a community-based study.

BACKGROUND AND PURPOSE: We sought to register the incidence rate, risk factors, and case-fatality rate of all the new cases of first-ever-in-a-lifetime stroke in the province of Beluno, Italy. This study aimed to provide an epidemiological survey of cerebrovascular disease that could supply investigative objectives and support information for regional healthcare facilities planning. METHODS: We undertook a prospective population-based study in the territory of the 1st, 2nd, 3rd, and 4th local health units in the province of Belluno, an area located in northeast Italy (population, 211 389). RESULTS: In the first year of the study (June 1, 1992, to May 31, 1993), 474 cases of first-ever stroke were registered. The crude annual incidence rate was 2.24/1000 (2.01/1000 for men and 2.45/1000 for women). After adjustment to the European population, the incidence rate for first stroke was 1.70/1000 per year. The pathological diagnosis was confirmed by a CT scan in 89.5% of cases. Cerebral infarction accounted for 319 cases, while 93 patients suffered a primary intracerebral hemorrhage, 12 patients a subarachnoid hemorrhage, and 50 patients a stroke of unknown origin. The overall 30-day case-fatality rate was 33%, and the mortality within the first week from stroke onset was 23%. The recurrence rate after 1 month was 1.9%. After 1 month, 46% of our patients were functionally independent in activities of daily living. CONCLUSIONS: Our first-year results confirm the fairly high risk for stroke in central and northern Italy and support European findings regarding risk factors for stroke.

Activities of Daily Living↗

Prevalence of anti-parkinson drugs' use in Ferrara, northern Italy, 1988.

INTRODUCTION: The period prevalence rate for anti-parkinson drugs (APD) use was reported in the Local Health Service of Ferrara (USL 31), Northern Italy, in 1988 (resident population: 177,000 inhabitants). MATERIAL AND METHODS: The study was performed through the analysis of the complete list of APD prescriptions in the USL 31 area provided by the computerized archives of USL 31 and the identification code of the patients which is unique for each resident of USL 31. The patients treated with neuroleptics known to be potential parkinsonism-inducing drugs were excluded. RESULTS: The period prevalence rate for APD users was 456.9 per 100,000 population. The prevalence rate for dopa derivatives users was 391.3 per 100,000. The prevalence did not varied between rural and urban zones of USL 31 both for APD and dopa derivatives users. A higher prevalence was obtained in a small rural commune of USL 31 both for APD users (758.5 per 100,000) and dopa derivatives users (718.6 per 100,000) than in the other 4 communes in which the study area is subdivided. CONCLUSION: The reported prevalence could provide information on the occurrence of most parkinsonisms in the study area and some suggestion on the role of possible environmental factors.

Adult↗

Intracranial gliomas in Ferrara, Italy, 1976 to 1991.

INTRODUCTION: We planned a descriptive study on the incidence of intracranial gliomas spanning a 16-year period (1976-1991) in the Local Health Service 31 of Ferrara, Northern Italy. MATERIAL AND METHODS: We used a complete enumeration approach by reviewing all the possible sources of case collection available in the study area. RESULTS: The mean annual incidence rate was 5.8 new cases per 100,000 population (6.96 for men and 4.78 for women; p < 0.05), resulting in 4.7 per 100,000 when directly adjusted to the Italian population. The age-specific incidences showed a small peak in childhood, an increase with age, reaching a maximum in the age group 60 to 64 and then a decline in the elderly. This pattern is similar for both sexes. The adjusted rates increased from 3.94 per 100,000 population in the first five-year period to 5.6 per 100,000 in the third (a nonsignificant difference). The distribution of cases within the study area was substantially uniform. CONCLUSION: The incidence rates of Ferrara fell into the middle-high values so far reported and confirmed the male preponderance found in previous studies. The age-related pattern is similar to that observed, with few exceptions, in other surveys. Like other authors we did not find a significant temporal trend, although the incidence rates tended to increase with time. The data encourage further, wider epidemiological studies of a prospective nature.

Adolescent↗

Immunogenetic heterogeneity and associated autoimmune disorders in myasthenia gravis: a population-based survey in the province of Ferrara, northern Italy.

INTRODUCTION: The well-established relationship between myasthenia gravis (MG) and HLA antigens varies among different ethnic groups. In Caucasians B8 and/or DR3 alleles have been found associated with young MG women without thymoma and with high titres of acetylcholine-receptor antibody (AChR Ab). An increased frequency of haplotype HLA-A3, B7 and/or DR2 has been observed in older MG patients with low AChR Ab levels. So far, there is no convincing evidence for an association between a specific haplotype HLA and ocular MG or MG with thymoma. MG subjects often show other concurrent autoimmune disorders suggesting a more general inherited predisposition to autoimmunity. We performed a community-based study to verify the HLA-A, B, C, DR and DQ profile on ethnically homogeneous MG patients and with the aim to estimate the frequency of concurrent autoimmune diseases and to compare HLA phenotypes to autoimmune status in different MG patients groups. METHODS: Forty-seven patients, living in the province of Ferrara, were followed-up in our neurologic department and typed for HLA Antigens. In addition a set of immunological laboratory tests was performed. RESULTS: We found a trend towards an increased B8 and DR3 frequencies in total affected population; an association between B8 allele and early onset of generalized MG sustained by thymic hyperplasia. The DR3 allele is statistically associated with the presence of additional autoimmune disorders. CONCLUSIONS: Our data support the hypothesis of a genetically-based heterogeneity of the disease and show an increased prevalence of associate autoimmune conditions in MG patients.

Adult↗

Environmental risk factors and multiple sclerosis: a community-based, case-control study in the province of Ferrara, Italy.

The frequency of multiple sclerosis (MS) in Italy and in other areas of the world seems to have increased over time, suggesting that some environmental factors operate in its etiology. We performed a retrospective, community-based case-control study on MS in order to verify the etiologic role of selected environmental factors. We found an association between MS and higher educational level, employment in public administration, past history of allergies, and infection at an early age with measles, rubella and whooping cough. Our data seem to confirm that exogenous factors play a role in the etiology of MS although some confounding variables could have accounted for the associations.

Adult↗