Understanding the dynamics of the HIV epidemic among Italian intravenous drug users: a cross-sectional versus a longitudinal approach.

We studied annual human immunodeficiency virus (HIV) seroprevalence and incidence in a large number of intravenous drug users attending drug treatment centers in three Italian urban areas. We also evaluated risk factors for HIV seropositivity and for HIV seroconversion. The results showed that HIV prevalence and incidence are declining. HIV prevalence declined dramatically in study participants that were < 25 years old. Prevalent HIV cases were associated with older age and longer duration of intravenous drug use; however, short duration of drug use increased the risk of seroconversion. The findings of our study suggest that comparing cross-sectional and longitudinal data contributes to a better understanding of the dynamics of the HIV epidemic among intravenous drug users.

[Attitudes and knowledge towards condom use among adolescents and young adults in Southern Italy]. / Attitudini e conoscenze sull'uso del preservativo in un campione di giovani meridionali nell'epoca dell'AIDS.

A correct and consistent condom use can minimize the risk of acquiring HIV infection through sexual intercourse. The aim of this study has been to assess knowledge and attitudes towards condom use among adolescents and young adults living in southern Italy. 620 randomly selected subjects have been interviewed by means of a 16-item standardized questionnaire: 87.3% consider condom an useful tool in the prevention of sexually transmitted diseases; however, 53.5% think that condom may reduce sexual pleasure and 26.8% state that its cost is too high to allow regular use. These results emphasize the need of carefully planned programs aimed to overcome objective and subjective barriers in the use of condom to prevent HIV infection spreading.

Treatment of a large postsurgical para-anastomotic aortic aneurysm using endovascular stent grafts. A case report with four-year follow-up.

This case report describes the outcome of straight endograft placement for treating a large para-anastomotic aortic aneurysm (PAA). A 43-year-old woman was admitted to the emergency department because of a vast PAA (8.7 cm in maximum transverse diameter). Since 1983, she has undergone multiple vascular operations for arterial occlusive disease. In 1990, an aortobifemoral bypass operation was performed. In this most recent intervention, we implanted three tube Excluder® endografts. The procedure was uneventful. Considering the size of the aneurysm sac, particular attention was paid to possible sequelae during the over 4-year follow-up period. No complications developed and the last computed tomography (CT) scan showed a remarkable decrease of 50 mm in aneurysm size. In conclusion, the use of straight endografts seems to be effective and lasting, even in large para-anastomotic aneurysmatic lesions.

[Hypomagnesemia and hypokalemia as risk factors of arrhythmia in acute phase myocardial infarction]. / Ipomagnesemia e ipokalemia come fattori di rischio aritmogeno nell'infarto del miocardio in fase acuta.

In a uniform group of 30 patients the A. have assessed the incidence of lower serum K+ and Mg++ concentrations on the probability of arrhythmias onset in the acute phase of myocardial infarction. The study shows that lower K+ and Mg++ levels significantly influence only the onset of ventricular tachycardia and monofocal PVC.

The influence of cimetidine and ranitidine on the plasma lipid pattern.

The influence of H2-receptor antagonist drugs on the plasma lipid pattern has been studied prospectively in 51 patients treated with cimetidine (26 patients) or ranitidine (25 patients) for gastroenterological diseases. Total and HDL cholesterol and total triglycerides have been measured. Ranitidine did not influence the investigated parameters, while cimetidine produced a significant increase in the HDL cholesterol serum concentration (P = 0.008).

Incidence rate and risk factors for HCV seroconversion among injecting drug users in an area with low HIV seroprevalence.

We conducted a study on injecting drug users attending one of 3 drug treatment centres in Naples, to estimate HIV and hepatitis C virus (HCV) incidence rates and to identify risk factors for seroconversion. Incidence rates were estimated using as denominator the person-time of follow-up of participants who were negative for both HIV and HCV at enrollment and who were retested within 6-12 months. Information on risk factors was collected using a standardized questionnaire. A nested case-control analysis was performed comparing seroconverters with persistently HCV-negative individuals. None of the initially non-infected participants seroconverted for HIV, while the incidence rate for HCV infection was approximately 29 per 100 person-years. Analysis of risk factors showed that age > 28 years and injecting use of cocaine were associated with HCV seroconversion. The protective role of methadone treatment was also marginally significant. Our findings suggest that HCV infection may represent an important public health problem in areas with low HIV circulation. The identification of specific risk factors for HCV infection is needed to plan effective prevention strategies.

Prophylaxis of thrombo/embolic complications in hip surgery.

The problem of the prophylaxis of post-operative phlebitis and pulmonary embolism, which may sometimes be fatal, has received considerable attention in recent medical literature. The combined experience of the Division of Orthopaedics and Traumatology and the Division of Vascular Surgery of the United Hospitals of Bergamo in the prevention of these complications in surgery of the hip are reported. The efficiency of drugs inhibiting platelet aggregation in patients suffering from vascular disease other than thrombophlebitis has already been reported in a previous study, and is now confirmed in its application to orthopaedic surgery (Losapio G. M., Setti M., et al.).