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Vincenzo Puro

Publications and source records attributed to Vincenzo Puro.

24 records · Page 2Linked to original sources
PubMed2003

Genotypic resistance tests for the management of postexposure prophylaxis.

Single witness: Given the increased utilization of highly active antiretroviral therapy (HAART) and the growing number of patients harbouring a drug-resistant virus, the potential exists to become infected with drug-resistant HIV. Available data suggest the emergence of drug-resistant HIV among source persons for occupational exposures. Despite this non-negligible rate, none of the health-care workers have become infected with HIV. The prevalence of antiretroviral resistance is high among source patients who reported any use of antiretroviral agents and is rare among those who reported no history of use, and in the majority of cases of failure of postexposure prophylaxis (PEP), the source was reported to have experience of the same agents included in the PEP regimen provided to the exposed individual. There are no data available to demonstrate that resistance testing leads to improvements in PEP outcomes. In fact, testing HIV isolates from a source patient, when available, for antiretroviral resistance would be of no immediate significance, as PEP should be initiated within hours of the exposure. The source patient's treatment history may be helpful in predicting which resistance mutations might be present in the source isolate.

Anti-HIV Agents↗
PubMedDate not supplied

The initial hospital response to an epidemic.

The last decades have been characterized by the appearance of a substantial number of newly recognized or novel infectious agents and by the re-emergence of infectious diseases with a global impact. The objective of this article is to briefly describe the model of hospital response for early diagnosis and prompt management of patients with highly contagious infectious diseases. We reviewed the main components of hospital preparedness in response to clustering of highly contagious diseases. A model for the initial hospital response to an epidemic in our referral Institute is discussed. Prompt recognition and identification is the initial and indispensable step in facing any communicable diseases, regardless of whether it is a prevalent, a newly emerging one or deliberately released. The importance of developing and implementing nontraditional methods of public health surveillance and a system that allows a wide and immediate dissemination of information and exchange of views on risk assessment and risk management are highlighted. Case identification and laboratory capabilities and isolation procedures are the essential components for an initial hospital response. The recent bioterrorist events and the worldwide outbreaks of highly contagious infectious diseases have evidenced the need for institutional preparedness at each hospital and for identification of referral centers for patient isolation and of laboratories with adequate capabilities. Moreover, hospitals should develop a plan for coordinating all hospital components to respond to critical situations deriving from the admission of patients with highly contagious infectious diseases.

Biological Warfare↗
PubMedDate not supplied

[Time trends in infectious disease mortality in Italy: 1969-1999].

OBJECTIVE: To describe the global impact of infectious diseases on mortality in Italy from 1969 to 1999. DESIGN: Statistical analysis of routinely collected mortality data, using a revised definition of infectious causes of death based on target organs. SETTING: The present paper summarizes time trends of infectious disease mortality widely discussed in the Atlas "30 Anni di Malattie Infettive in Italia: Atlante di Mortalità". MAIN OUTCOME MEASURES: Age standardized mortality rates (/100,000); standardized mortality ratios (SMR); percentage of deaths attributable to infectious diseases. RESULTS: Apart from HIV infection and AIDS, infectious diseases were responsible of 1.7% of the overall mortality that occurred in Italy in the study period: 57.5% of such deaths were not included in the ICD8 and ICD9 codes for infectious diseases. The mortality for all infectious diseases showed a very strong downward trend up to 1994, (with a 6-fold decline). Thereafter, a slight increase in deaths for septicaemias, heart infections and hepatitis was recorded. Over time, an increasing proportions of deaths due to infections occurred in the elderly (i. e., > or = 65 years of age), from 48.1% in 1969-1979 to 77.3% in 1990-1999. Mortality rates were consistently higher in men than in women, and showed a substantial geographic heterogeneity. In newborns, from 1969 thru 1999 mortality rates declined 10-fold all over the country, but an inverse north-south geographic gradient persisted during the whole study period. The spread of HIV infection and AIDS epidemic in the first '80s dramatically interrupted the downward trend in infectious disease mortality outlined above. Between 1993 and 1996, HIV/AIDS was the main cause of death among Italian men aged 30 to 39 years. CONCLUSIONS: This statistical analysis allowed to better quantify the impact of infectious diseases on overall mortality in Italy. Observed time trends were in accordance to the picture recorded in other western Countries, whereas the higher newborn mortality in southern Italy reflects the persistence of geographical inequalities in the health care organization.

Adult↗