Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 37
Filtrar
1.
Sci Total Environ ; 659: 973-982, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-31096427

RESUMEN

BACKGROUND: Geothermal power plants for the production of electricity are currently active in Mt. Amiata, Italy. The present study aimed to investigate the association between chronic low-level exposure to H2S and health outcomes, using a residential cohort study design. METHODS: Spatial variability of exposure to chronic levels of H2S was evaluated using dispersion modelling. Cohorts included people residing in six municipalities of the geothermal district from 01/01/1998 to 31/12/2016. Residence addresses were georeferenced and each subject was matched with H2S exposure metrics and socio-economic status available at census tract level. Mortality and hospital discharge data for neoplasms and diseases of the respiratory, central nervous and cardiovascular systems were taken from administrative health databases. Cox proportional hazard models were used to test the association between H2S exposure and outcomes, with age as the temporal axis and adjusting for gender, socio-economic status and calendar period. RESULTS: The residential cohort was composed of 33,804 subjects for a total of 391,002 person-years. Analyses reported risk increases associated with high exposure to H2S for respiratory diseases (HR = 1.12 95%CI: 1.00-1.25 for mortality data; HR = 1.02 95%CI: 0.98-1.06 for morbidity data), COPD and disorders of the peripheral nervous system. Neoplasms were negatively associated with increased H2S exposure. CONCLUSIONS: The most consistent findings were reported for respiratory diseases. Associations with increased H2S exposure were coherent in both mortality and hospitalization analyses, for both genders, with evidence of exposure-related trends. No positive associations were found for cancer or cardiovascular diseases.


Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Exposición a Riesgos Ambientales/análisis , Sulfuro de Hidrógeno/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/mortalidad , Enfermedades del Sistema Nervioso Central/inducido químicamente , Enfermedades del Sistema Nervioso Central/epidemiología , Enfermedades del Sistema Nervioso Central/mortalidad , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Neoplasias/inducido químicamente , Neoplasias/epidemiología , Neoplasias/mortalidad , Centrales Eléctricas , Trastornos Respiratorios/inducido químicamente , Trastornos Respiratorios/epidemiología , Trastornos Respiratorios/mortalidad , Adulto Joven
2.
J Proteomics ; 190: 44-54, 2019 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-29654921

RESUMEN

Fibromyalgia (FM) is a chronic pain disorder characterized by widespread pain and associated with unspecific symptoms. So far, no laboratory tests have been validated. The aim of the present study was to investigate the presence in saliva of potential diagnostic and/or prognostic biomarkers which could be useful for the management of FM patients. Specifically, the salivary profile of FM patients was compared with those of healthy subjects, subjects suffering migraine (model of non-inflammatory chronic pain), and patients affected by rheumatoid arthritis (model of inflammatory chronic pain). For proteomics analysis 2-DE and SELDI-TOF-MS were applied. From 2-DE serotransferrin and alpha-enolase were found differentially expressed in FM. Hence, their expression was validated by ELISA together with phosphoglycerate-mutase-I and transaldolase, which were found in a previous work. Moreover, ROC curve was calculated by comparing FM patients versus control subjects (healthy plus migraine) to investigate the discriminative power of biomarkers. The best performance was obtained by combining alpha-enolase, phosphoglycerate-mutase-I and serotransferrin. On the other hand, none of the candidate proteins showed a statistical correlation with clinical features. Finally, preliminary SELDI analysis highlighted two peaks whose identification need to be validated. Overall, these results could be useful in supporting the clinical diagnosis of FM. SIGNIFICANCE: FM is one of the most common chronic pain condition which is associated with significant disability. The fibromyalgic pain is a peculiar characteristic of this disease and FM patients suffer from reduced quality of life, daily functioning and productivity. Considering the deep complexity of FM, the discovery of more objective markers is crucial for supporting clinical diagnosis. Therefore, the aim of the present study was the selection of biomarkers effectively associated with fibromyalgic pain which will enable clinicians to achieve an unambiguous diagnosis, and to improve approaches to patients' management. We defined a panel of 3 salivary proteins which could be one of the criteria to be taken into account. Consequently, the identification of disease salivary biomarkers could be helpful in detecting FM clusters and targeted treatment. Actually, our future perspective foresees to develop a simple, rapid and not invasive point-of-care testing which will be of use during the diagnostic process. In addition, the present results can offer a clue for shedding light upon the complex entity of such a disease like FM.


Asunto(s)
Fibromialgia/diagnóstico , Proteómica/métodos , Proteínas y Péptidos Salivales/análisis , Adulto , Artritis Reumatoide/diagnóstico , Biomarcadores/análisis , Estudios de Casos y Controles , Dolor Crónico , Diagnóstico Diferencial , Femenino , Fibromialgia/patología , Humanos , Masculino , Persona de Mediana Edad
3.
Neurol Sci ; 38(12): 2183-2187, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29019004

RESUMEN

Tuscany (Central Italy) is a high-risk area for multiple sclerosis (MS) with a prevalence of 188 cases per 100,000 at 2011, and it is characterized by a heterogeneous geographic distribution of this disease. Our objective was to update prevalence at 2013 and to evaluate the presence of spatial clusters in Tuscany. The MS prevalence was evaluated on 31 December 2013 using a validated case-finding algorithm, based on administrative data. To identify spatial clusters, we calculated standardized morbidity ratios (SMRs) for each Tuscan administrative municipality. In addition to the classical approach, we applied the hierarchical Bayesian model to overcome random variability due to the presence of small number of cases per municipality. We identified 7330 MS patients (2251 males and 5079 females) with an overall prevalence of 195.4/100,000. The SMR for each Tuscan municipality ranged from 0 to 271.4, but this approach produced an extremely non-homogeneous map. On the contrary, the Bayesian map was much smoother than the classical one. The posterior probability (PP) map showed prevalence clusters in some areas in the province of Massa-Carrara, Pistoia, and Arezzo, and in the municipalities of Siena, Florence, and Barberino Val d'Elsa. Our prevalence data confirmed that Tuscany is a high-risk area, and we observed an increasing trend during the time. Using the Bayesian method, we estimated area-specific prevalence in each municipality reducing the random variation and the effect of extreme prevalence values in small areas that affected the classical approach.


Asunto(s)
Esclerosis Múltiple/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Teorema de Bayes , Niño , Preescolar , Análisis por Conglomerados , Femenino , Geografía Médica , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
4.
Epidemiol Prev ; 41(1): 29-37, 2017.
Artículo en Italiano | MEDLINE | ID: mdl-28322526

RESUMEN

"OBJECTIVES: to identify the differences among patients of general practictioners (GPs) in both Tuscany Region (Central Italy) and Friuli Venezia Giulia (FVG) Region (Northern Italy), which are different for drinking cultures, as to motivation of consultation, hazardous drinking and alcohol dependence, health problems, and use of health services. DESIGN: cross-sectional study by means of both a medical examination and a subsequent structured interview carried out with a questionnaire. Data were analysed using chi-square test, logistic regression and differences in prevalence. SETTING AND PARTICIPANTS: the study was implemented between July and November 2013 on a sample of 492 patients of 30 GPs in FVG, and 451 patients of 25 GPs in Tuscany. RESULTS: although patients in FVG were less likely to drink alcohol (66.7% vs. 70.9%), consumed lower amounts of alcohol on average per day per drinker (10.9 vs. 14.5 grams of alcohol), and were less likely to be hazardous drinkers (11.2% vs. 13.8%) compared to patients in Tuscany, they had a 3.6 to 4.7 times higher risk of alcohol dependence. In addition, the prevalence of diseases (in particular hepato-gastrointestinal diseases, hypertension, and psychiatric problems), smoking, and obesity/ overweighting was higher among clients of FVG, which exceed the Tuscan patients by 5-12 percentage points. Compared to Tuscany, FVG patients were more hospitalized and required more help to GPs or other people for their drinking problems. CONCLUSIONS: compared to Tuscan patients, GPs' patients in FVG has higher prevalence of alcohol addiction and other diseases, as well as of smoking and overweight/obesity, and higher need for health interventions as to their drinking problems."


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Medicina General/estadística & datos numéricos , Servicios de Salud , Adulto , Alcoholismo/epidemiología , Índice de Masa Corporal , Estudios Transversales , Femenino , Enfermedades Gastrointestinales/epidemiología , Servicios de Salud/estadística & datos numéricos , Humanos , Hipertensión/epidemiología , Italia/epidemiología , Masculino , Trastornos Mentales/epidemiología , Obesidad/epidemiología , Sobrepeso/epidemiología , Prevalencia , Fumar/epidemiología , Encuestas y Cuestionarios
5.
World J Gastroenterol ; 22(44): 9829-9835, 2016 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-27956807

RESUMEN

AIM: To evaluate this prevalence in Tuscan populations that was known and unknown to the Tuscan Regional Health Service in 2015. METHODS: Tuscan Health administrative data were used to evaluate hepatitis C virus (HCV) infected people known to the Regional Health Service. Residents in Tuscany with a HCV exemption code (070.54) were identified. Using the universal code attributed to each resident, these patients were matched with hospital admission codes identified by the International Classification of Diseases, Ninth Revision (ICD-9), Clinical Modification, and with codes for dispensing drugs to patients by local and hospital pharmacies. Individuals were considered only once. Capture-recapture analysis was used to evaluate the HCV-infected population unknown to the Regional Health Service. RESULTS: In total, 14526 individuals were living on 31/12/2015 with an exemption code for HCV. In total, 9524 patients were treated with pegylated interferon + ribavirin and/or direct-acting antiviral drugs during the last 10 years, and 13879 total hospital admissions were noted in the last 15 years. After data linkage, the total number was 25918. After applying the Capture-Recapture analysis, the number of unknown HCV-infected people was 23497. Therefore, the total number of chronic HCV-infected people was 38643, excluding those achieved sustained virological response to previous treatment. CONCLUSION: Our results show a prevalence of HCV infected people of 1%. Tuscan administrative data could be useful for calculating health care costs and health planning in the coming years.


Asunto(s)
Reclamos Administrativos en el Cuidado de la Salud , Hepatitis C Crónica/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Antivirales/uso terapéutico , Biomarcadores/sangre , Niño , Preescolar , Bases de Datos Factuales , Quimioterapia Combinada , Femenino , Genotipo , Hepacivirus/genética , Hepacivirus/inmunología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C Crónica/diagnóstico , Hepatitis C Crónica/tratamiento farmacológico , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Persona de Mediana Edad , Admisión del Paciente , Prevalencia , ARN Viral/sangre , Distribución por Sexo , Factores de Tiempo , Carga Viral , Adulto Joven
6.
Epidemiol Prev ; 40(1): 44-50, 2016.
Artículo en Italiano | MEDLINE | ID: mdl-26951701

RESUMEN

OBJECTIVES: Geographical Information Systems (GIS) are widely used in environmental epidemiology studies to locate study population by geocoding addresses and to evaluate exposures and relationship with health outcomes. Despite this, Italian environmental epidemiologists poorly discuss quality of address geocoding results. DESIGN: two case-studies have been carried out in Tuscany Region (Central Italy): one in the mountain area in the Municipality of Piancastagnaio (Siena Province) and one in the urban area around the airport of Florence. Three geocoding systems have been compared: the geographical database produced by Tuscany Region and two commercial systems (Google and Bing-Microsoft); 1,549 addresses in Piancastagnaio and 2,946 addresses in Florence have been tested. RESULTS: Tuscan geographical database showed better performance than the two commercial systems, with bigger differences in Piancastagnaio. In this area, mean difference between regional system and Google service is more than 300 mt, with peaks of 7-8 km. Bing- Microsoft system does not provide any information on addresses in Piancastagnaio: all input addresses were geocoded in the centroid of the municipality or in the centre of a few principal streets. Lowest differences among the three methods were observed in the urban area of Florence: mean difference between Tuscany and Goggle systems was 150 mt, with less than 2 km peaks; between Tuscany and Bing-Microsoft mean difference was 100 mt with 3 km peaks. In both case-studies, but especially in Piancastagnaio area, these differences gave rise to great misclassification in the evaluation of individual exposure and health outcome. CONCLUSION: the study highlighted the impacts of address geocoding process in exposure assessment in environmental health research and pointed out the need of specifically evaluate the quality of cartographic data.


Asunto(s)
Ciudades , Salud Ambiental/normas , Sistemas de Información Geográfica/normas , Mapeo Geográfico , Bases de Datos Factuales , Humanos , Italia
7.
J Allergy Clin Immunol Pract ; 4(3): 512-9, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26883543

RESUMEN

BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis that occurs in patients with asthma, nasal disease, blood and tissue eosinophilia, and extrapulmonary manifestations. OBJECTIVE: The aim of our study was to assess the clinical, functional, and inflammatory status of upper and lower airways in 37 patients with EGPA, examined 6.4 ± 4.7 years after diagnosis, when they were in partial or complete remission from systemic involvement while on treatment with low-dose oral corticosteroids as maintenance therapy. METHODS: All patients performed spirometry and were assessed for bronchial hyperreactivity, sputum eosinophilia, and fractional exhaled nitric oxide; asthma control was evaluated according to the Global Initiative for Asthma (GINA) guidelines and the Asthma Control Test. Markers of systemic disease were compared with the data available at diagnosis. Nasal involvement was evaluated by using the Sino-Nasal Outcome Test, nasal endoscopy, and nasal cytology. The impact on the quality of life was evaluated by using generic (36-item short form health survey) and organ-specific questionnaires. RESULTS: At the time of the study visit, almost all patients were receiving low-dose oral corticosteroids and immunomodulating drugs, but only 50% were being treated with inhaled corticosteroids. Although low systemic disease activity was documented in the large majority of patients, poorly controlled asthma and rhinosinusitis with eosinophilic airway inflammation were demonstrated in almost all patients. A significant correlation was found between sputum and blood eosinophilia and between fractional exhaled nitric oxide and asthma control. The 36-item short form health survey questionnaire results significantly correlated with the Sino-Nasal Outcome Test but not with the Asthma Control Test. CONCLUSIONS: Systemic treatment controls systemic involvement in EGPA, but not asthma and nasal diseases, which negatively affects patients' quality of life.


Asunto(s)
Asma , Eosinofilia , Granulomatosis con Poliangitis , Rinitis , Corticoesteroides/uso terapéutico , Adulto , Anciano , Asma/tratamiento farmacológico , Asma/inmunología , Asma/metabolismo , Asma/fisiopatología , Citocinas/sangre , Eosinofilia/tratamiento farmacológico , Eosinofilia/inmunología , Eosinofilia/metabolismo , Eosinofilia/fisiopatología , Femenino , Granulomatosis con Poliangitis/tratamiento farmacológico , Granulomatosis con Poliangitis/inmunología , Granulomatosis con Poliangitis/metabolismo , Granulomatosis con Poliangitis/fisiopatología , Humanos , Factores Inmunológicos/uso terapéutico , Masculino , Persona de Mediana Edad , Óxido Nítrico/metabolismo , Calidad de Vida , Rinitis/tratamiento farmacológico , Rinitis/inmunología , Rinitis/metabolismo , Rinitis/fisiopatología , Espirometría , Esputo/citología
8.
BMC Health Serv Res ; 15: 223, 2015 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-26047610

RESUMEN

BACKGROUND: Previous studies have investigated process and structure indicators of nutritional care as well as their use in nursing homes (NHs), but the relative weight of these indicators in predicting the risk of malnutrition remains unclear. Aims of the present study are to describe the quality indicators of nutritional care in older residents in a sample of NHs in Tuscany, Italy, and to evaluate the predictors of protein-energy malnutrition risk. METHODS: A cross-sectional survey was conducted in 67 NHs. Information was collected to evaluate quality indicators of nutritional care and the individual risk factors for malnutrition, which was assessed using the Malnutrition Universal Screening Tool. A multilevel model was used to analyse the association between risk and predictors. RESULTS: Out of 2395 participants, 23.7 % were at high, 11 % at medium, and 65.3 % at low risk for malnutrition. Forty-two percent of the NHs had only a personal scale to weigh residents; 88 % did not routinely use a screening test/tool for malnutrition; 60 % used some standardized approach for weight measurement; 43 % did not assess the severity of dysphagia; 12 % were not staffed with dietitians. Patients living in NHs where a chair or platform scale was available had a significantly lower risk of malnutrition (OR = 0.73; 95 % CI = 0.56-0.94). None of the other structural or process quality indicators showed a statistically significant association with malnutrition risk. CONCLUSIONS: Of all the process and structural indicators considered, only the absence of an adequate scale to weigh residents predicted the risk of malnutrition, after adjusting for case mix. These findings prompt the conduction of further investigations on the effectiveness of structural and process indicators that are used to describe quality of nutritional care in NHs.


Asunto(s)
Casas de Salud/normas , Evaluación Nutricional , Indicadores de Calidad de la Atención de Salud/normas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Italia , Masculino , Evaluación de Procesos y Resultados en Atención de Salud , Medicina Estatal , Encuestas y Cuestionarios
9.
Mod Rheumatol ; 25(4): 585-9, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25496408

RESUMEN

AIMS: (i) To analyze the in vivo corneal structure and sub-basal plexus nerves in patients with primary Sjögren's syndrome (pSS) and no-SS dry eye by confocal scanning laser microscopy (CSLM) and (ii) to correlate CSLM findings with tear function tests and with patients' subjective dryness. METHODS: Seventeen patients with pSS, 16 no-SS dry eye, and 20 healthy volunteers were included. CSLM parameters taken into consideration included: basal epithelial integrity, corneal thickness, epithelial cellular density, keratocyte activation, and sub-basal plexus morphology. Statistical analysis was carried out using SPSS-13 (Chicago IL, USA). RESULTS: CSLM pachymetric data and the superficial epithelium cell density were significantly lower in pSS versus no-SS dry eye (p < 0.0001); keratocyte activation and sub-basal nerve abnormalities were also more frequent in pSS patients (p < 0.0001). CSLM findings well correlated with both the ocular test results and the patients' perception of ocular dryness at the baseline and over the follow-up. CONCLUSION: CSLM might be a useful novel tool in the assessment of the involvement of the lachrymal functional unit in pSS.


Asunto(s)
Córnea/patología , Enfermedades de la Córnea/patología , Síndrome de Sjögren/patología , Recuento de Células , Femenino , Humanos , Masculino , Microscopía Confocal/métodos , Persona de Mediana Edad , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad
10.
Subst Use Misuse ; 49(12): 1646-64, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25122545

RESUMEN

This paper focuses on whether the on-going dramatic decrease in alcohol consumption in Italy, especially of wine, during 1961-2008, was associated with which parallel sociodemographic and economic changes and with alcohol control policies. The study, using both time series (TS) and artificial neural network (ANN)-based analyses documents that its selected sociodemographic and economic factors, and particularly urbanization, had a definite connection with wine consumption decrease, spirits decrease, and the increase in beer consumption over time. On the other hand, control policies showed no effect on the decline in alcohol consumption, since no alcohol control policy existed in Italy between 1960 and 1987. A few policies introduced since 1988 (BAC and sale restrictions during mass events) may have contributed to reducing or to maintaining the on-going reduction. Study limitations are noted and future needed research is suggested.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Cultura , Política de Salud , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/prevención & control , Bebidas Alcohólicas , Cerveza , Conducta Alimentaria , Conductas Relacionadas con la Salud , Humanos , Italia/epidemiología , Evaluación de Programas y Proyectos de Salud , Religión , Factores Socioeconómicos , Vino
11.
Subst Use Misuse ; 49(12): 1515-30, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25099313

RESUMEN

This study confirms that during the decades following WW II there was a tendency towards closure of consumption of alcoholic beverages among the European countries. The Northern countries, which during the 1960s manifested the lowest rates of alcohol consumption, ended up with greater consumption rates than the Southern countries, manifested the opposite trend; greater amounts of consumptions in the 1960s and lower consumptions in the 2000s. During the same some period, social, demographic and economic indicators--urbanization, rate of elderly males, Income, female education, female employment and mother's age at their childbirths, tended to increase, while the alcoholic beverage control policy strategies showed differences according to the country. Liver disease-related mortality, decreased in most countries. Study limitations are noted.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Política de Salud , Adulto , Factores de Edad , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/historia , Consumo de Bebidas Alcohólicas/prevención & control , Bebidas Alcohólicas/economía , Costos y Análisis de Costo , Europa (Continente)/epidemiología , Femenino , Política de Salud/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos
12.
Subst Use Misuse ; 49(12): 1692-715, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25004138

RESUMEN

This AMPHORA study's aim was to investigate selected factors potentially affecting changes in consumption of alcoholic beverages in 12 European countries during the 1960s-2008 (an average increase in beer, decreases in wine and spirits, total alcohol drinking decrease). Both time series and artificial neural networks-based analyses were used. Results indicated that selected socio-demographic and economic factors showed an overall major impact on consumption changes; particularly urbanization, increased income, and older mothers' age at their childbirths were significantly associated with consumption increase or decrease, depending on the country. Alcoholic beverage control policies showed an overall minor impact on consumption changes: among them, permissive availability measures were significantly associated with consumption increases, while drinking and driving limits and availability restrictions were correlated with consumption decreases, and alcohol taxation and prices of the alcoholic beverages were not significantly correlated with consumption. Population ageing, older mother's age at childbirths, increased income and increases in female employment, as well as drink driving limitations were associated with the decrease of transport mortality. Study's limitations are noted.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Política de Salud , Accidentes de Tránsito/mortalidad , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/prevención & control , Bebidas Alcohólicas , Cerveza , Europa (Continente)/epidemiología , Femenino , Humanos , Hepatopatías/mortalidad , Masculino , Evaluación de Programas y Proyectos de Salud , Factores Socioeconómicos , Vino
13.
Nutrition ; 30(10): 1171-6, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24993751

RESUMEN

OBJECTIVE: The aim of this study was to use the Malnutrition Universal Screening Tool (MUST) to assess the applicability of alternative versus direct anthropometric measurements for evaluating the risk for malnutrition in older individuals living in nursing homes (NHs). METHODS: We conducted a cross-sectional survey in 67 NHs in Tuscany, Italy. We measured the weight, standing height (SH), knee height (KH), ulna length (UL), and middle-upper-arm circumference of 641 NH residents. Correlations between the different methods for calculating body mass index (BMI; using direct or alternative measurements) were evaluated by the intraclass correlation coefficient and the Bland-Altman method; agreement in the allocation of participants to the same risk category was assessed by squared weighted kappa statistic and indicators of internal relative validity. RESULTS: The intraclass correlation coefficient for BMI calculated using KH was 0.839 (0.815-0.861), whereas those calculated by UL were 0.890 (0.872-0.905). The limits of agreement were ±6.13 kg/m(2) using KH and ±4.66 kg/m(2) using UL. For BMI calculated using SH, 79.9% of the patients were at low risk, 8.1% at medium risk, and 12.2% at high risk for malnutrition. The agreement between this classification and that obtained using BMI calculated by alternative measurements was "fair-good." CONCLUSION: When it is not possible to determine risk category by using SH, we suggest using the alternative measurements (primarily UL, due to its highest sensitivity) to predict the height and to compare these evaluations with those obtained by using middle-upper-arm-circumference to predict the BMI.


Asunto(s)
Antropometría/métodos , Índice de Masa Corporal , Tamaño Corporal , Evaluación Geriátrica/métodos , Desnutrición/diagnóstico , Evaluación Nutricional , Anciano , Anciano de 80 o más Años , Brazo , Estatura , Estudios Transversales , Femenino , Hogares para Ancianos , Humanos , Italia , Pierna , Masculino , Casas de Salud , Factores de Riesgo , Cúbito
14.
Subst Use Misuse ; 49(12): 1576-88, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24897127

RESUMEN

In the United Kingdom, between 1960 and the 2000s, there were many sociodemographic and economic factors that played a part in the changing picture of alcohol consumption and its related harm. This paper describes some of these variables along with the political measures that were identified as correlated with changes in consumption and harm. The resulting picture is unclear. No consistent pattern was identified among the variables analyzed. Beverage choice changed over time with a reduction in beer consumption and an increase in wines and spirits. Nevertheless, the overall picture showed an increase in total alcohol consumption and resulting harm.


Asunto(s)
Consumo de Bebidas Alcohólicas/prevención & control , Bebidas Alcohólicas/provisión & distribución , Política de Salud , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Cerveza/provisión & distribución , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Factores Socioeconómicos , Reino Unido/epidemiología , Vino/provisión & distribución
16.
Subst Use Misuse ; 49(12): 1531-45, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24915172

RESUMEN

Having qualitatively investigated, both the temporal curves of alcoholic beverage consumption trends and the introduction of preventive alcohol policy measures in six European countries during the 1960s-2000s, drinking control policy measures often appeared to operate as co-factors of change, while during some periods of time they were not even present even if effective consumption changes were occurring. Study limitations are noted.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Política de Salud , Adulto , Consumo de Bebidas Alcohólicas/prevención & control , Europa (Continente)/epidemiología , Finlandia/epidemiología , Humanos , Italia/epidemiología , Noruega/epidemiología , Polonia/epidemiología , Evaluación de Programas y Proyectos de Salud , España/epidemiología , Suiza/epidemiología , Incertidumbre
17.
Subst Use Misuse ; 49(12): 1665-83, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24870987

RESUMEN

Alcohol prevention policies alone neither cause nor explain changes in alcohol consumption, nor in related harm. Alcohol consumption in Spain throughout the period 1962-2008 was analyzed considering selected contextual factors and alcohol policies. Increased urbanization was found to be associated with higher consumption, especially of beer. Restrictive policies regulating purchase age, advertising, and licensing premises to sell alcohol were associated with decreased alcohol consumption, while lower blood alcohol concentration limits were followed by an increase. Study limitations are noted. Changes in the evolution of socioeconomic, sociodemographic, and cultural factors should be carefully analyzed to inform alcohol policy planning and evaluation.


Asunto(s)
Consumo de Bebidas Alcohólicas/prevención & control , Política de Salud , Accidentes de Tránsito/mortalidad , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Bebidas Alcohólicas , Femenino , Humanos , Hepatopatías/mortalidad , Masculino , Evaluación de Programas y Proyectos de Salud , Factores Socioeconómicos , España/epidemiología
18.
Rheumatology (Oxford) ; 53(5): 839-44, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24369420

RESUMEN

OBJECTIVE: The aims of this study were to describe the clinical presentation of primary SS (pSS) in a large cohort of patients by assessing the prevalence of the patient subgroups at high risk for severe extraglandular manifestations and to explore the influence of the patients' serological profile on disease severity and on immunosuppressive drug utilization. METHODS: Cumulative demographic, clinical, serological, histological and therapeutic data of 1115 pSS patients were retrospectively evaluated. Independent serological markers for glandular and extraglandular disease manifestations were identified by logistic regression. RESULTS: The cohort included 1115 (1067 female, 48 male) pSS patients. Severe extraglandular manifestations were detectable in 15% of the patients and were represented by active synovitis (11%), axonal sensory-motor neuropathy (2%), severe leucocytopenia (14%), cutaneous vasculitis (6%) and non-Hodgkin's lymphoma (4.5%). We found that low C3/C4, hypergammaglobulinaemia, RF and cryoglobulinaemia were markers of severity for pSS. According to the number of serological variables, the patients were subdivided into three distinct groups: favourable (no serological markers), intermediate (one serological marker) and poor (two or more serological markers). In comparison with the other two patient groups, pSS patients presenting with two or more adverse determinants had a higher frequency of severe visceral disease complications and required more aggressive therapeutic interventions. CONCLUSION: This study confirmed that the prevalence of the pSS high-risk subset for severe systemic manifestations is ∼15%. Serological markers might help in the early identification of patients who are candidates to receive more aggressive treatments.


Asunto(s)
Leucopenia/epidemiología , Linfoma no Hodgkin/epidemiología , Enfermedades del Sistema Nervioso/epidemiología , Síndrome de Sjögren/epidemiología , Sinovitis/epidemiología , Vasculitis/epidemiología , Adulto , Anciano , Biomarcadores/sangre , Estudios de Cohortes , Comorbilidad , Complemento C3/metabolismo , Complemento C4/metabolismo , Estudios Transversales , Crioglobulinas/metabolismo , Femenino , Humanos , Italia/epidemiología , Leucopenia/sangre , Linfoma no Hodgkin/sangre , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/sangre , Prevalencia , Estudios Retrospectivos , Factor Reumatoide/sangre , Factores de Riesgo , Síndrome de Sjögren/sangre , Sinovitis/sangre , Vasculitis/sangre , gammaglobulinas/metabolismo
19.
Rheumatol Int ; 34(8): 1159-64, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24097207

RESUMEN

Beyond its well-established role in the maintenance of mineral homeostasis, 25-OH-vitamin D deficiency seems to be involved in the development and severity of several autoimmune diseases. To date, contrasting data have been reported regarding the presence of hypovitaminosis D in primary Sjögren's syndrome (pSS). To assess the prevalence of hypovitaminosis D in pSS at an early stage of the disease and to evaluate its impact on pSS clinical manifestations and disease activity, unselected consecutive subjects with recent onset dry mouth and/or dry eyes who underwent a comprehensive diagnostic algorithm for pSS (AECG criteria) were prospectively included in the study. The levels of 25[OH]-D3 were measured by monoclonal antibody immunoradiometric assay. Conditions of 25[OH]-D3 severe deficiency, deficiency, and insufficiency were defined as levels <10, <20, and 20-30 ng/ml, respectively, and their frequencies were investigated in pSS patients and controls. The levels of 25[OH]-D3 were also correlated with patients' demographic, clinical, and serologic features. Seventy-six consecutive females were included: 30/76 patients fulfilled the AECG criteria for pSS. The remaining 46/76 patients represented the control group. No statistical differences were found in the serum levels of 25[OH]-D3 between pSS patients [median levels = 20 ng/ml (IQR 9.3-26)] and controls [median levels = 22.5 ng/ml (IQR 15.6-33)]. In particular, the frequency of 25[OH]-D3 severe deficiency was not significantly different in patients with pSS when compared to controls (23 vs. 17.4 %, p value = 0.24). We found a significant correlation between serum 25[OH]-D3 levels and white blood cells count (r = 0.29, p = 0.01). More specifically, leukocytopenia was significantly associated with 25[OH]-D3 severe deficiency, being documented in 40 % of the subjects with a 25[OH]-D3 severe deficiency and in 11 % of the subjects without a severe vitamin D deficiency (p = 0.02). We did not observe any further association or correlation between hypovitaminosis D and pSS glandular and extra-glandular features. Although the role of hypovitaminosis D in pSS pathogenesis remains controversial, the results of this study encourage the assessment of vitamin D in specific pSS subsets that could mostly benefit from a supplementation.


Asunto(s)
Calcifediol/sangre , Síndrome de Sjögren/sangre , Deficiencia de Vitamina D/sangre , Adulto , Anciano , Biomarcadores/sangre , Femenino , Humanos , Ensayo Inmunorradiométrico , Masculino , Persona de Mediana Edad , Fenotipo , Valor Predictivo de las Pruebas , Prevalencia , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Síndrome de Sjögren/diagnóstico , Síndrome de Sjögren/epidemiología , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/epidemiología
20.
Rheumatol Int ; 34(4): 565-9, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24322453

RESUMEN

This study is aimed at retrospectively studying cancer-associated inflammatory myopathies (CAM) in a cohort of patients with inflammatory myopathies. CAM were diagnosed if the tumor was diagnosed 2 years before or after disease onset. One hundred and sixty-two patients were included, 27 (17 %) had CAM. A significant association was observed between CAM and dermatomyositis (DM), older age and dysphagia at disease onset. CAM have lower creatine kinase (CK) levels at onset and a low prevalence of autoantibodies. In conclusion, the association of male sex, older age, DM, dysphagia at onset, lower CK, and autoantibodies negativity carries a high suspicion of CAM.


Asunto(s)
Miositis/epidemiología , Neoplasias/epidemiología , Factores de Edad , Autoanticuerpos/sangre , Biomarcadores/sangre , Creatina Quinasa/sangre , Trastornos de Deglución/epidemiología , Dermatomiositis/epidemiología , Femenino , Humanos , Italia/epidemiología , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Miositis/sangre , Miositis/diagnóstico , Miositis/mortalidad , Miositis/terapia , Neoplasias/diagnóstico , Neoplasias/mortalidad , Neoplasias/terapia , Valor Predictivo de las Pruebas , Prevalencia , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...