Drinking habits among high school students in Perugia, Italy, in 1981 and 1988: time trends and correlates

The prevalence of alcohol consumption among 9th (14-15 years old) and 13th grade (18-19 years old) high school students in Perugia, Italy, was investigated in 1981 and 1988. Wine was the most popular beverage, although its use declined in the 7-year period. Beer consumption remained stable, but it was at a lower level than wine. Overall, alcohol consumption showed a slight decline among both 9th and 13th graders. However, the proportion of excessive drinkers increased, and a growing phenomenon of drunkenness among students was observed. Alcohol consumption was positively associated with sex and smoking and negatively associated with father's education and knowledge of the health hazards of alcohol abuse by multivariate analysis.

Regional variations in total and nonprotein sulfhydryl compounds in the human gastric mucosa and effects of ethanol

This study evaluated the regional distribution of sulfhydryl compounds in the human gastric mucosa and the effect of ethanol on gastric sulfhydryl tissue levels. Total sulfhydryl, glutathione, and cysteine and their oxidized forms were measured in biopsy specimens taken from the gastric body and antrum of 22 healthy volunteers. Total sulfhydryl and glutathione contents of the body of the stomach were significantly higher than those of the antrum. In contrast, cysteine concentration was higher in the gastric antrum than in the body. No difference was found in the levels of oxidized sulfhydryls between the gastric body and antrum. The effect of acute administration of ethanol on gastric sulfhydryl content was studied in nine subjects. Ethanol caused gross mucosal damage and lowered the concentration of sulfhydryl compounds in both the body and the antrum. In 10 chronic alcoholics total sulfhydryl and glutathione, but not cysteine, were markedly decreased in the gastric body but not in the antrum as compared with nonalcoholic controls. In conclusion, 1) the human gastric body contains significantly higher tissue levels of total sulfhydryls and glutathione and lower concentrations of cysteine than the antrum; 2) ethanol in a damaging concentration significantly decreases gastric tissue levels of sulfhydryl compounds; and 3) chronic ethanol intake lowers total sulfhydryl and glutathione tissue levels in the gastric body.

Factors associated with non-participation of women in a breast cancer screening programme in a town in northern Italy

STUDY OBJECTIVE

The aim was to investigate the reasons for the high percentage of women refusing to attend a breast cancer screening programme in the Health District of Brescia, Italy.

DESIGN

This was a survey of a sample of non-attenders to the programme, who were interviewed using a structured questionnaire.

SETTING

Non-attenders all lived in a central area of the town near the screening centre.

PARTICIPANTS

Of the 612 non-attenders eligible for interview, 183 could not be interviewed: one had died, 86 were away from home at two different visits, 32 were no longer resident at the known address, eight had serious health problems, 17 had undergone mastectomy, and 39 refused the interview. Overall, a total of 429 of the 612 eligible women were interviewed (70.1%).

MEASUREMENTS AND MAIN RESULTS

Attenders and non-attenders were compared with respect to demographic and socioeconomic factors, use of preventive medicine, and prevalence of risk factors for breast cancer. The response was higher among less educated women, married and widowed women, and those born in the province than among more educated, single or divorced, and immigrant women. Most of the women interviewed gave practical reasons for non-participation, but lack of interest/distrust and fear/worry/anxiety also seemed important. The number of non-attenders who had had a Papanicolaou test within the previous three years was three times higher than those who had had mammography, suggesting that non-attenders were more interested in types of preventive medicine other than screening for breast cancer by mammography. Attenders and non-attenders appeared similar as regards distribution of conventional breast cancer risk factors.

CONCLUSIONS

Greater effort in the information campaign might increase the participation rate in screening for breast cancer, although to a lesser extent than expected: if non-attenders potentially recruitable in our screening were added to attenders, overall compliance of the programme was about 75%, lower than that observed in some programmes in northern Europe.

Aneuploidy in pancreatic insulinomas does not predict malignancy

Nuclear deoxyribonucleic acid (DNA) ploidy studies with paraffin embedded archival material from 14 pancreatic insulinomas were performed by flow cytometry. Clinical follow-up (2 to 17 years; mean, 8 years) was obtained for all patients. Half of the tumors had a normal DNA histogram and half exhibited an abnormal DNA profile consistent with DNA aneuploidy. Six of the seven patients with aneuploid tumors are alive and disease free (2 to 5 years postresection), and one is alive with metastatic disease. Of the seven patients with tumors showing normal DNA profiles, five are alive and disease free, one is dead of disease, and one is alive with metastatic disease. These data suggest that DNA ploidy analysis is unlikely to provide useful prognostic information for patients with insulinomas.

[Peridural anesthesia and narcosis with propofol in thoracic surgery]

Twelve patients undergoing elective thoracic surgery because of lung cancer, have been studied. The anesthetic management included: continuous epidural anesthesia with bupivacaine (T6-T7), continuous infusion of propofol and vecuronium, mechanical ventilation with an oxygen/air mixture. We evaluated the perioperative analgesia and the cardiovascular side effects of two groups of patients differing for the position (supine or lateral) selected to administer the local anesthetic. We also analysed the most important characteristics of the recovery from anesthesia (degree of analgesia and consciousness, respiratory function and cooperation with physiotherapeutic manoeuvres). The authors conclude that, although the number of patients studied is limited, there are no significant differences between the two groups for intraoperative analgesia and hemodynamic imbalance; the anesthetic technique employed is a reliable alternative to classic balanced anesthesia, because seems to reply very well to the mayor purposes of thoracic surgery. Moreover it makes the operative room free from pollution caused by volatile anesthetics.

Immunocytochemical staining for human chorionic gonadotropin subunits does not predict malignancy in insulinomas

Insulinomas, the most common pancreatic endocrine tumors, produce a clinical syndrome of hyperinsulinism and hypoglycemia. Although the majority of insulinomas are benign, a significant proportion (4-16%) behave aggressively. Because malignant potential cannot be assessed adequately by histopathologic criteria, reliable serum and immunocytochemical markers for malignancy have been sought. Recent reports suggest that subunits of human chorionic gonadotropin (hCG) are of prognostic value in pancreatic endocrine tumors. Elevated serum levels of either the alpha-subunit or beta-subunit of hCG have been reported to be associated with malignancy in pancreatic endocrine tumors. Both hCG and its alpha-subunit have been demonstrated in malignant pancreatic endocrine tumors by immunohistochemistry. In this study, 17 insulinomas have been analyzed by immunohistochemistry using monospecific antibodies to both the alpha-subunit and beta-subunit of hCG. Clinical follow-up was obtained in all cases, and four of the tumors proved to be malignant. Alpha-subunit immunoreactivity was found in only two tumors, both of which were benign. Immunoreactivity for the beta-subunit was not found in any tumor. The authors' results indicate that for this subset of pancreatic endocrine tumors, staining for hCG subunits is of no value in predicting malignant behavior.

Decrease of total, glutathione and cysteine SH in non-alcoholic cirrhosis

The content of plasma thiols was determined in 42 patients with non-alcoholic cirrhosis. Total thiols were evaluated by Ellman's method, glutathione and cysteine by HPLC in fluorescence. Cirrhotic patients showed a significant decrease in plasma thiol content with respect to a control group of 32 healthy subjects, as total sulphydryls as well as glutathione and cysteine. The thiol decrease does not seem to be related to nutritional status or dietetic factors. Our data indicate that liver cirrhosis, independently from alcohol abuse, produces a decrease in all plasma thiols, probably secondary to a complex alteration of the transsulfuration pathway.

The frog spinal cord: a model to study methanethiol-central nervous system interaction

1. The effects of methanethiol (MT), DL-dithiothreitol (DTT) and N-ethyl-maleimide (NEM) were studied on the electrical activities of the frog cord. 2. Methanethiol depressed spontaneous dorsal and ventral root potentials, whereas no effects were observed on evoked responses. 3. N-ethyl-maleimide, a SH modifying agent, irreversibly depressed electrical cord activities. 4. DL-Dithiothreitol, a SH reducing agent, dramatically increased spontaneous electrical cord pattern. 5. It is suggested that interneuronal membrane sulphydryl groups of dorsal horn cell population are involved in the origin of spontaneous electrical cord activities and that MT interacts with these interneurones, probably oxidizing membrane SH groups.

[Effectiveness of topical selective decontamination, without systemic antibiotic prophylaxis, in prevention of pulmonary infection in intensive care]

Forty-seven patients admitted in our general ICU and treated with Selective Digestive Decontamination (SDD) without any systemic antibiotic prophylaxis, were prospectively studied and compared with an historical group of 50 non treated subjects. The 2 groups were no different as to underlying disease, age, sex and prognostic index (SAPS). In the treated group was recorded an important and statistically significant reduction in the incidence of pneumonia and in the frequency of pulmonary infections caused by enterobacteriaceae and pseudomonceae. Gram-positive identification in tracheal aspirates was not significantly different in the two groups as well as the incidence of "early pneumonia". In the treated group, a sharp decrease of the total amount of fever-days through ICU stay was observed. The antibiotic consumption resulted to be an overall 28.3% lower in the group treated with, SDD with particular regard to broad-spectrum ones.

[Antibioticotherapy based on statistics in intensive therapy]

The authors present the epidemiological data concerning nosocomial infections in their Intensive Care Unit, and discuss an antibiotic strategy statistically oriented by these data. In their experience, treatment based on statistical criteria, brought to a reduction in antibiotic consumption with particular regard to broad-spectrum antibiotics, and to a decrease in individual budget.

[Survey of alcohol and psychoactive drug consumption in a sample of high school students of the 9th and 19th local health units in the Marche Region]

A random sample of high school students of the Health Districts N. 9 and N. 19 of Marche Region, Central Italy, was interviewed about their alcohol and psychoactive medicine consumption. The questionnaire, previously used in other surveys in Italy, was anonymous and collected information on demographic and socio-economic status, smoking and drinking habits, psychoactive medicine consumption attitudes and knowledges on the health hazards of alcohol and psychoactive medicine abuse. A total of 237 males and 352 females in the 9th grade (mean age: 14.7 yrs) and of 131 males and 207 females in the 13th grade (mean age: 18.4 yrs) were enrolled in the survey. We observed higher alcohol consumption in males than in females and in grade-13 than in grade-9 for each beverage. Wine was the most used alcohol beverage: 30.4% of males in grade-9 and 39.7% in grade-13 were used to drink it daily, 13.7% of females in grade-9 and 17.4% in grade-13 were daily drinkers. In the youngest group, 6.8% of males and 0.3% of females drank 4 or more glasses of wine a day, while in grade-13 the percentages of heavy wine drinkers were 7.6% of males and 0.5% of females. On the contrary, beer consumption seemed to be more occasional: 55.7% of males and 33.6% of females in grade-9, and 67.2% of males and 49.4% of males and 36.8% of females in grade-13 were occasionally drinkers. However, the percentages of heavy drinkers of beer were not far from those observed in wine drinkers: 2.9% of males and 0.3% of females in grade-9 and 6.9% of males and 0.5% of females in grade-13 daily drank 4 glasses of beer or more. Spirit consumption reached a particularly high level in grade-13th males. And 22.9% of them were used to have 11 or more drinks per month. Among spirit drinkers, about 35-40% of males drank brandy, whisky, cognac and other strong spirits, while females showed to prefer less alcoholic liquors. According to the amount of pure alcohol consumed, 10.1% of males in grade-9 and 16.9% of males in grade-13 drank 200 or more g/week, while only 1.5% of females admitted such a high consumption. A large part of students in the youngest group drank more than one alcoholic beverage, particularly wine and beer. Among grade-13 students, 47.3% of males and 15.9% of females daily or occasionally drank wine, beer and spirits.(ABSTRACT TRUNCATED AT 400 WORDS)

A study on airborne allergenic pollen content in the atmosphere of Ascoli Piceno

The results of 4 years (1981-1984) of monitoring airborne pollen concentration, using a volumetric trap, in the atmosphere of Ascoli Piceno (central Italy) are reported. Pollen production wasn't constant during the studied years, showing in 1982 and 1984 a very high concentration in comparison to 1981 and 1983. This is due to a dry period from April to June in 1982 and from June to July in 1984. We found that the most important allergenic pollen is Gramineae with a principal period of pollination occurring from April to July. After Gramineae, Parietaria plays an allergenic role frequently in association with the pollen of Olea, which is the most important allergenic pollen of all the trees in this area. From August to October we observed the pollination of mugwort, which was found in small quantities but nevertheless an offender in localized cases of pollinosis in Ascoli Piceno.

Viral antibodies in serum and cryoprecipitate of patients with essential mixed and secondary cryoglobulinemia. Preliminary results

Antibodies to measles virus, CMV, HSV1, HSV2 and EBV have been tested in 9 patients with essential mixed cryoglobulinemia (EMC) and 24 patients with cryoglobulinemia associated with lymphoproliferative, autoimmune or hepatic diseases (secondary cryoglobulinemia, SC). The assays were performed in serum, cryoprecipitate and supernatant by using immunoenzymatic methods. The highest prevalence was observed in the supernatant of both EMC and SC patients. Antibodies to measles virus show a serum/cryoprecipitate ratio higher than that of the other viral agents. Statistically significant differences between EMC and SC patients in the positivity of the various viral antibodies were not shown.

Faecal bacteria of wild ruminants and the alpine marmot

Faecal samples from 60 red deer (Cervus elaphus), 13 roe deer (Capreolus capreolus), 7 chamois (Rupicapra rupicapra), 41 alpine marmot (Marmota marmota) and soils mixed with deer faeces from the Stelvio National Park were examined for Campylobacter sp. and Salmonella sp. with negative results. The same material, especially deer faeces, was a habitat highly suitable for Yersinia sp.: Y. enterocolitica (two biotypes) was isolated twice, Y. kristensenii (two serotypes) was isolated 19 times, Y. frederiksenii and Y. intermedia were isolated once. Antibiotic-resistant Escherichia coli were isolated from 16 specimens from wild ruminants, one from marmot and two from feeding places.

[Neutralizing and inhibiting activity of hemagglutination of serum antibodies after natural infection and after vaccination with influenza virus A/USSR/90/77 (H1N1) strain]

Sera with different content of hemagglutination-inhibiting antibody (h.i.a.) collected from healthy subjects in late summer 1978, from influenza cases which occurred in winters 1977-78 and 1978-79 and from vaccinees in autumn 1978 were checked for neutralizing antibodies (n.a.) to A/USSR/90/77 influenza virus strain. Neutralizing activity (Geometric mean titer of n.a.) of h.i.a. was found dependent chiefly on the previous antigenic experience of the subjects. This because, given the same h.i.a. level, geometric mean titers of n.a. were lower in children and adolescents than in adults more than 24-year-old. For the age of the subjects and for time of collection of sera, the presence of antibodies in the former group is very likely due to the first antigenic stimulus. Moreover among the vaccinated adults the Geometric mean titers of n.a. in sera with the same h.i.a. content were higher in the age group 25-40 years. With any probability this is the cohort with an original antigenic sin due to H1N1 variants. The results have been also discussed in relation to the epidemiological behaviour of H1N1 strains in the first years of the second prevalence era. The above observations suggest caution in adopting the only hemagglutination-inhibition test for evaluating the immune status of populations and the immunizing efficacy of influenza virus vaccines.

Non-enzymic oxidation of cysteinyldopa catalyzed by metallic ions

1. Evidence is presented that under physiological conditions cysteinyldopa behaves similarly to catecholamines, e.g. adrenaline, in forming reversible complexes with various metallic cations. 2. As a rule, these complexes are stable under anaerobic conditions, but readily autoxidize in the presence of O2 to give the 1,4-benzothiazine acid (II) corresponding to one of the postulated intermediates in the biosynthesis of phaeomelanic pigments. 3. Copper catalyzed oxidation of cysteinyldopa proceeds differently to give the red-purple trichochrome F presumably via decarboxylation and oxidative coupling of the same benzothiazine intermediate. 4. The relevance of these in vitro experiments to the metabolism of cysteinyldopa is briefly discussed.

Intraoperative irradiation: a pilot study combining external beam photons with "boost" dose intraoperative electrons

Intraoperative "boost" dose electron beam therapy given in combination with 4500--5000 rad (45--50 Gray) external beam irradiation has been demonstrated as a practical therapeutic modality at the MGH. This procedure has been employed thus far in 58 patients; the results in the initial 36 are analyzed in detail in this paper. Thirty-four of the 36 patients had locally advanced lesions--unresectable, recurrent, or residual disease. Results achieved to date are in full agreement with our expectations: high radiation doses have been delivered to the primary intra-abdominal and pelvic tumors, excluding the sensitive structures from irradiation. This has been accomplished by a truly multidisciplinary effort comprising surgery, anesthesiology, OR nursing, administration, engineers, physicists, therapy technologists, and radiation therapists. Although follow-up is not yet sufficient to judge ultimate efficacy, acute and chronic severe morbidity is low and local control is good. There is justified enthusiasm for continuing the procedure.

[Isolation and serotyping of Streptococcus pneumoniae]

87 strains of Str. pneumoniae were typed by serology and a chemoantibiotic resistance assay was made. Among them, the most frequent serological types are 4, 6, 7, 19, 33. None of these has shown a marked chemoantibiotic resistance and no prevalent resistance has been related to a particular specimen.

Coffee and cancer of the pancreas

We questioned 369 patients with histologically proved cancer of the pancreas and 644 control patients about their use of tobacco, alcohol, tea, and coffee. There was a weak positive association between pancreatic cancer and cigarette smoking, but we found no association with use of cigars, pipe tobacco, alcoholic beverages, or tea. A strong association between coffee consumption and pancreatic cancer was evident in both sexes. The association was not affected by controlling for cigarette use. For the sexes combined, there was a significant dose-response relation (P approximately 0.001); after adjustment for cigarette smoking, the relative risk associated with drinking up to two cups of coffee per day was 1.8 (95% confidence limits, 1.0 to 3.0), and that with three or more cups per day was 2.7 (1.6 to 4.7). This association should be evaluated with other data; if it reflects a causal relation between coffee drinking and pancreatic cancer, coffee use might account for a substantial proportion of the cases of this disease in the United States.

[Virological research in acute respiratory diseases in 1976--1977 (author's transl)]

From October 1976 to June 1977 virological researches have been carried out on 5 subjects with influenza, on 302 children hospitalized in pediatric departments for respiratory illness and 94 children hospitalized in the same departments for other (non respiratory) diseases. The incidence of influenza was moderate and restricted to small epidemic episodes in school and preschool children. The isolated viruses resulted of A type, substantially similar to the prototype strains appeared from 1972 to 1975. Among children hospitalized for respiratory diseases Adenoviruses (6.8%) and, with decreasing frequency, Enteroviruses, paraifluenza viruses and RS have been also isolated. The incidence of isolation of RS virus is significantly related to bronchopneumonia cases in infants under on year of age. The incidence of significant increases of FC antibodies against influenza (A and B) viruses, RS and Myc. pneumoniae in children with bronchitis and broncho-pneumonia is also considerable. The drawing of pharyngeal swabs at different intervals from the entry to the hospital has shown that the shedding of respiratory viruses is generally very short and that hospital cross-infections may occur.

[Detection of Salmonella in surface waters]

After a detailed description of some of the methods used for the research of Salmonella in superficial waters, the AA. examine some problems relative to the collection of the samples and to the culture of these bacteria. Results obtained in the Po river and its affluents are also briefly presented; the high incidence of samples positive for Salmonella is stressed and some aspects of an epidemiological nature are considered.

[Epidemic due to group B Coxsackie viruses in a newborn infants' department (author's transl)]

Virological and clinical researches have been done on hospitalized newborn infants' with various infectious diseases (respiratory infections, aseptic meningitis, serious generalized disease). Initially from some newborn children Coxsackie B5 virus has been isolated and later from other patients Coxsackie B3 virus. The pathological findings, in those newborn who died as a result of serious generalized disease were dominated by hemorragic lesions in different organs.

Carcinoma of the pancreas: review of MGH experience from 1963 to 1973. Analysis of surgical failure and implications for radiation therapy

A retrospective study was done of all patients who were seen for definitive treatment of adenocarcinoma of the pancreas at the Massachusetts General Hospital from 1963 to 1973. There were a total of 145 patients. Thirty-one patients were treated with radical surgery, with a 16% operative mortality, a 5-year crude survival rate of 15%, and a local recurrence rate of 50%. Sixty-two patients were treated with biopsy alone, with no 5-year survivors. In addition, there were 35 patients who did not have a radical surgical procedure performed only because of the extent of the local disease. It is proposed that postoperative irradiation may reduce the incidence of local failure after radical surgery, and that preoperative radiation therapy or radiation therapy alone would be an appropriate treatment of those patients in whom the local extent of disease is initially too far advanced to perform radical surgery.