Few Italian drug users undergo HIV testing.

We estimated the proportion of drug users at treatment centres in Italy who had undergone HIV testing and the correlates of testing. Of the 1,917 drug injectors, 37.4% had been tested in the current year; of the 665 non-injectors, 28% had been tested. Among injectors, testing was associated with: being older than 35, foreign nationality, residing in central Italy, drug use for over 2 years, and having undergone both pharmacological and psychological treatment. Among non-injectors, an association was found for foreign nationality and not having been treated at other facilities. The results stress the need to facilitate access to testing.

[Proportion of drug users in treatment who have never undergone serological testing for HIV, HBV and HCV and correlates of failure to undergo testing: Italy, 2005-2007]. / Proporzione di tossicodipendenti in trattamento che non hanno mai eseguito i test sierologici per HIV, HBV e HCV e fattori correlati alla mancata esecuzione: Italia, 2005-2007.

In Italy, although the most recent guidelines stress the importance of screening for the human immunodeficiency virus (HIV) and the hepatitis B and C viruses (HBV and HCV) those subjects considered to be at high risk (e.g., injecting drug users), not all drug users being treated at public drug dependency centres are regularly tested for these infections. The results of the present study show that 7.2%, 13.0%, and 7.4% of injecting drug users seeking treatment at public drug dependency centres are not tested for, respectively, HIV, HBV and HCV infections and while corresponding figures for drug users who do not inject drugs are 20.3%, 25.1% and 16.2%. The failure to undergo testing among injectors was associated with a shorter history of drug use and with drug centres in central or southern Italy; these associations were also found among non-injectors, with the addition of low level of education. The results stress the importance of facilitating access to testing, of providing the drug dependency centres with the necessary resources for taking blood samples at the centres themselves, of making access to (and performance of) testing uniform throughout the country, and of removing obstacles that can lead to the drug user's refusal to undergo testing.

[The clinical, angiographic and procedural predictors of thrombosis and restenosis in Micro stent II (AVE) coronary stents]. / Predittori clinici, angiografici e procedurali di trombosi e di restenosi in stent coronarici Micro stent II (AVE).

The aim of the study was to assess the incidence and the predictors of thrombosis and restenosis in Micro stent II AVE. In a sample of 197 stents successfully implanted in 181 consecutive patients, the incidence of thrombosis was 4.1%. The multivariate analysis showed the minimum lumen diameter post-stenting to be the only independent predictor of overall thrombosis. In fact, we found that the risk of thrombosis increases as the minimal lumen diameter decreases. Angiographic follow-up was available in 74% of the stents at 6.8 +/- 4.1 months and stent restenosis occurred in 26.2% of cases. Independent predictors of restenosis (multivariate linear discriminant analysis) were: 1) nominal stent diameter (the risk of restenosis decreases as the stent diameter increases); 2) the ratio between the diameter of the balloon carrying the stent measured at the maximum pressure/nominal stent diameter (the risk increases as the ratio decreases); 3) stented vessel (the risk increases in the following order: right coronary < circumflex < left anterior descending); 4) the American Heart Association classification of lesion morphology (the risk increases in the order A < B < C); 5) a lower risk was found in the absence of diabetes mellitus.

Prognostic factors for long-term survival in cirrhotic patients after the first episode of liver decompensation.

BACKGROUND/AIMS: Prognostic studies on cirrhosis are needed, since several attempts to obtain better survival predictors than the empirically derived Child-Pugh's score have failed. METHODS: Four hundred and ninety-four consecutive in-patients with cirrhosis at the first episode of decompensation (ascites, jaundice, encephalopathy) and/or of digestive haemorrhage from ruptured oesophageal varices were followed from admission (1983-1989) to 1993, studying the relationship between 26 prognostic variables and survival. Three prognostic models were constructed using Cox's regression model and the Receiver Operating Characteristic (ROC) analysis was used to compare their predictive ability. RESULTS: During follow-up 351 patients died (median cumulative survival 1.82 years). Child-Pugh's score (explicative variable of the first Cox's model), albumin and encephalopathy among the 5 Child-Pugh variables (second model), and oesophageal varices haemorrhage and 3 biochemical indexes among the 7 significant variables on univariate analysis (third model) correlated with survival. The area under the ROC curve of the first model did not significantly differ from that for the other 2 models. CONCLUSIONS: The Child-Pugh's score is still the best and simplest index for assessing the prognosis of liver cirrhosis.

Spirometric prediction equations for male Italians 7-18 years of age.

The purpose of this study was to develop spirometric predictive equations (SPE) for forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximum midexpiratory flow (MMF25-75) derived from a large sample of healthy italian boys and male adolescents. We used the univariate and multiple linear regression models and considered as independent variables age and the following anthropometric measurements: height, weight, chest circumference. The predictive power of multivariate models was slightly higher than that of the univariate model using height as independent variable for FVC, FEV1 and MMF25-75.

Statistical evaluation of the persistence of acquired hypersensitivity by standardized patch tests.

Numerous studies have focused attention on the influence of various biological and environmental factors on contact hypersensitivity. In order to evaluate the persistence and/or modification of allergic contact sensitivity to a number of common contact sensitizers, the same standardized patch tests were repeated on 174 subjects with contact sensitivity after a time lapse of 5 years (1987-1992). In 18.4% of the cases, 1 or more sensitivities were lost; 28.7% of the patients had a higher number of positive patch tests after 5 years, while the remaining 52.9% of the patients showed no change in the number of positive patch tests. In 88%, the positive allergens were unchanged, whereas in the remaining 12% of the subjects, they showed 1 or more variations. The association between the allergens most often positive was calculated for both the 1st and the 2nd patch test results. Moreover, to evaluate the frequency of an allergen's positivity, we studied the disappearance of old sensitivities and the appearance of new sensitivities by the McNemar test. Cobalt chloride was the only allergen with a significant frequency of new positivities over the period of observation (p < 0.01). Logistic regression analysis was performed to evaluate the possible influence of positive tests to other allergens, and of some clinical findings associated with contact dermatitis, on the sensitivity to cobalt chloride in 1987 and in 1992.