Long-term follow-up of liver function in Italian haemophilic patients

A 14-year follow-up of 153 haemophilic patients treated with clotted factor concentrates was made to assess liver function. Investigations included measurement of alanine amino transferase (ALT), immunoglobulins, HIV antibody, HBsAg, antibody to HBs and HBc antigens, antibodies to HCV (assayed by ELISA-2 and by RIBA-2) and HCV viraemia assessed by PCR. Assessment of liver function also included liver ultrasound scan and oesophageal X-ray. A positive correlation was found between abnormal liver function and age, HIV infection, HBV infection, HCV infection and hepatomegaly. However, there was no correlation between abnormal liver function and annual clotting factor concentrate use. The increasing incidence of liver insufficiency with increasing age is likely to result in substantial morbidity and mortality amongst haemophilic patients.

Morphological aspects of endothelial cell-monocyte interactions in culture

Monocytes obtained from the blood of healthy volunteers were added to cultures of bovine aortic endothelial cells (BAEC) at increasing time intervals (from 1 h to 24 h). Cultures of BAEC without the added blood elements were used as controls. The ultrastructural features of cellular interactions were studied by transmission electron microscopy. After 4 h, in the co-cultured endothelial cells focal cytoplasmic lesions appeared in the areas where activated monocytes were strictly in contact. Adhering monocytes frequently appeared apoptotic. After 24 h, pseudopod-like cytoplasmic projections originating from the endothelial cells gave rise to areas of close contact between the BAEC and the monocytes. These data reveal until now unknown endothelial cell taxis toward blood cells.

AIDS related information, attitudes and behaviours among Italian male young people

In order to evaluate the AIDS related sources of information, knowledge, attitudes and behaviours among male young people it was filled in a multi-choice anonymous questionnaire by 2018 subjects, called for the first medical examination to Italian Navy and by 1348 recruits. The data from the latter group were used to make comparisons with our previous survey carried out in 1988. The most important sources of information on AIDS were mass media and school, on sexuality friends and family. AIDS awareness was greater among the high educated subjects and positively influenced by mass media and school as sources of information. In agreement with these data, knowledge was better about AIDS than about sexuality. Risk perception was positively influenced by the AIDS-related knowledge for called youth and a greater intolerance towards infected people was observed among the less educated and the less AIDS-aware subjects. On average 46% of the called up young men and 74% of recruits declared to be sexually active: among these, the mean age at the first sexual intercourse was 16, over 60% declared to have had multiple partners, over 30% unknown partners and over 30% didn't use condoms; 20% of called up and 38% of recruits indicated 2 or 3 risk behaviours. Factors determining sex-related risks were different according to the behaviour and the considered group. These results suggest that it is important for young people to be well informed about sex and AIDS before the beginning of sexual activity, if possible during compulsory school.

Three-phase radionuclide bone imaging and magnetic resonance imaging detection of occult knee fractures in athletes

Twelve athletes presenting acute knee injury with normal radiological findings underwent both three-phase radionuclide bone imaging (TPBI) and magnetic resonance imaging (MRI). The association of these highly sensitive diagnostic procedures detected occult fractures in all patients. The areas of signal intensity alterations on MRI corresponded to those of increased radionuclide uptake in blood pool images. However, the same areas seemed to be more extended on delayed TPB images. TPBI yielded early diagnostic information about lesion sites and functional activities, while MRI provided better anatomical definition and specific information about associated soft tissue lesions and served to establish the correct therapeutic approach and follow-up.

HIV serology among Italian male military recruits at entrance and discharge

To evaluate the usefulness of anti-HIV mass screenings, we examined 662 new military recruits and 1353 soldiers being discharged. None of the former and only one of the latter (0.07%) resulted seropositive on repeated ELISA and Western-blot. For comparison we also report the results of routine anti-HIV antibody testing in our diagnostic laboratory: the highest proportion of seropositive subjects was found among symptomatic patients (79%), followed by haemophiliac patients (31%), drug addicts (24%), sexual partners of seropositive subjects (21%), prisoners (5%) and homosexual men (5%). Health care personnel and prison guards were all negative. These data confirm that in Italy HIV infection is still relatively confined to the classic risk groups. While generalized screening during military service seems to be excessive, periodic sample surveys could be very useful to follow the evolution of HIV epidemiology.

Serum antibodies to polioviruses in a Tuscan population, Italy

In order to study the serological status of a population against poliomyelitis, neutralizing antibody for the three types of polioviruses were examined in 742 serum specimens from individuals aged from 1 to 70 years and over were collected during 1985. Sixty-two percent of the sera had antibodies (titre greater than or equal to 1:8) to all three polioviruses, while 5% had no poliovirus antibody at all. However the rates of seropositivity did vary with age: the 10-19 age group had the lowest frequency of antibody (38%) to the three viruses and the difference between the percentage of this group and the previous (1-10 years) and following ones (20-70 years and over) was highly significant. The results of this seroprevalence survey indicate a gap in immunity to poliomyelitis in the population examined.

Cost-benefit analysis of tetanus prophylaxis by a mathematical model

A mathematical model has been developed which allows estimation of the epidemiological and economic effects of different tetanus vaccination strategies. The model was used to simulate the epidemiology of tetanus in Italy from 1955 to 1982, and then applied to a district of Tuscany by utilizing data obtained from a seroepidemiological survey carried out in the same area. For this district we simulated vaccination programmes designed to reach, within 1 or 10 years, coverages of 60 or 90% of the population aged over 10 years who had not been exposed to the neonatal vaccination programme. The most effective strategy, from both the epidemiological and economic point of view, seems to be 90% coverage reached in 1 year's time. Benefits would be increased by improving the reliability of vaccinal anamnesis.

[Urinary infections caused by non-typhoid Salmonella]

Between January 1986 and January 1989, 524 non-typhoid salmonella strains, of which 4 (0.8%) from urine, were isolated at the Microbiology Laboratory of Department of Biomedicine (University of Pisa). These strains were isolated from a man with systematic lupus erythematosus, from two little girls with structural defects of the lower urinary tract, and from a woman with ulcerous colitis. Except the last case, the others were associated with immunological or structural abnormalities that are thought to predispose to salmonella infections.

Experimental model for evaluating the effects of genetic and exogenous factors on transplacental mutagenesis

Cyclophosphamide (CP)-induced micronuclei were evaluated in females of two strains of mice (C57BL and CD1), in F1 hybrid females and in fetuses (day 13 of gestation) obtained from different crosses. F1 adult hybrids from a cross between the strain with a high level of induced micronuclei (C57BL) and the strain with a low response (CD1) exhibited micronuclei values closer to the latter. CD1/CD1 fetuses showed a higher susceptibility than C57BL/C57BL ones. Heterozygous fetuses from reciprocal crosses, whatever the maternal genotype, showed the same sensitivity, which is very close to that of C57BL/C57BL fetuses. Phenobarbital (PB) pre-treatment modified the mutagenic response to CP depending on the genotype of the treated animal. These results demonstrate that the response to a pro-mutagen requiring metabolic activation depends to a large extent on the genetic background of the target animals, and that mother-fetus interactions in transplacental mutagenesis seem to depend more on the fetal than on the maternal genotype.

[Pseudomonas aeruginosa: immunotypes and drug resistance]

Serotyping of Pseudomonas aeruginosa by Fisher's schema has been used to study the prevalence of particular immunotypes among strains of P. aeruginosa obtained from clinical specimens. About 78% of the isolates were serotypable and about 22% were not. Immunotypes 2 and 6 turned out to be the most prevalent, whereas immunotypes 5 and 7 were the least frequent. Immunotypes 2, 5, 6 and 7 did not vary significantly as far as frequency in the various sources is concerned, with the exception of immunotype 2, which was significantly less frequent in isolates from the expectorated sputum. In such isolates immunotype 3 was significantly more frequent than in other sources, whereas immunotype 4 was significantly more frequent in isolates from the feces. It was next investigated whether a correlation exists between antibiotic susceptibility and particular immunotypes. A high percentage of the non-typable strains and of those belonging to immunotypes 2 and 6 proved to be resistant to the antimicrobial agents tested.