[Which prevention programs effectively reduce the risk of alcohol consumption in young people?]. / Quali programmi di prevenzione possono ridurre efficacemente il rischio di consumo di alcol nei giovani?

Alcohol consumption among young people is a major public health problem and the Italian National Health Institute considers it the leading cause of death for people under 24 years old, mainly due to road accidents. This study summarizes the evidence emerging from three Cochrane Collaboration reviews, aiming to orient the choice of alcohol prevention programs for young people. The first review considered schemes implemented at school to prevent alcohol consumption under 18 years of age; the second concerned studies on programs to reduce alcohol abuse by means of social norms; the third examined 56 trials on schemes for preventing young people from drinking. In the first review, 6 of 11 alcohol prevention schemes showed some signs of efficacy, and 14 of 39 schemes to combat substance abuse generally induced a significantly alcohol use reduction. The second review included three specific programs for alcohol-related problems with a > 17-month follow-up and they were effective. In the third review, 15 of 39 schemes proved effective in the short-term, 9 of 12 with medium follow-up were no longer effective (and alcohol consumption even increased in 2), while 3 long-term trials and 2 of 3 community schemes proved effective. These Cochrane reviews did not assess all strategies for preventing alcohol abuse in the young which have been implemented in different countries, because many interventions has been conducted spontaneously without any evaluation of their efficacy. An international registry on substance abuse prevention measures is warranted, with shared criteria for assessing their effects, to orient public health policies.

Why do patients change their general practitioner? Suggestions on corrective actions.

AIMS: The aim of this study was to determine what made people want to change their choice of general practitioners (GP). Furthermore, the study aimed to correlate the perceived quality of patient-GP communication with the motives inducing individuals to change their doctors. METHODS: All people requesting to change their GPs were asked by the office staff to complete a questionnaire. RESULTS: The study identifies the following main reasons for changing GP: patients perceived the doctor as unwilling to listen to them; patients did not receive the services that they considered useful for their health; and patients perceived the doctor's disorganization as an obstacle to accessibility. CONCLUSIONS: These findings suggest several actions to improve the doctor-patient relationship, including training for physicians to develop their communication skills; involving public health operators in helping to understand the rights and obligations of patients and doctors; and a reorganization of the GP's workload.

Alcohol consumption and metabolic syndrome in the elderly: results from the Italian longitudinal study on aging.

BACKGROUND/OBJECTIVES: Although there is plenty of evidence of the association between metabolic syndrome (MS) and cardiovascular disease, the relationship between alcohol consumption and MS is still questioned. The few publications with respect to the elderly seem to indicate that alcohol consumption is unassociated with MS. The aim of this study was to assess the association between alcohol consumption and the prevalence and incidence of MS, as well as its components in a large sample of Italian elderly people. SUBJECTS/METHODS: This is a multicenter study on a population-based sample of Italian people aged 65-84 years. The Italian Longitudinal Study on Aging (ILSA) included a prevalence phase in 1992 and an incidence phase from 1995 to 1996. The median length of follow-up was 3.5 years. In the present study, the analysis included 1321 men grouped into five alcohol consumption classes: abstainers, and those consuming or=48 g of alcohol in a day. Among the 1122 women considered, the last two of the above five categories were pooled together (>24 g/day). MS was defined according to ATP III criteria. All statistical analyses were stratified by gender. RESULTS: Adjusted odds ratios showed that categorized alcohol consumption was not significantly associated with the prevalence and incidence of MS when compared with abstainers in either gender. For the MS incidence survey, three of five components (systolic pressure, glycemia and waist circumference) proved to be significantly and harmfully affected by alcohol consumption in males, whereas no such significant association emerged in females. CONCLUSIONS: These results suggest that alcohol can modify an individual's metabolic condition and that, even among the elderly, men might be more sensitive to the effects of alcohol than women.

Does yellow fever 17D vaccine protect against melanoma?

BCG vaccine, vaccinia vaccine and certain pathogens that were shown in previous studies to protect against melanoma have antigenic determinants homologous in their amino acids sequence with the melanoma antigen HERV-K-MEL, encoded by a human endogenous retrovirus K (HERV-K), which is expressed in about 95% of malignant melanocytes. Yellow fever vaccine (YFV) likewise contains an antigenic determinant with a close homology to HERV-K-MEL and might therefore also confer protection against melanoma. To investigate this possibility we carried out a cohort study (28,306 subjects) and a nested case-control study (37 melamona cases and 151 tumors not expressing HERV-K-MEL) in Veneto region (North-Eastern Italy). The standardized incidence ratio was 1.33 (95% confidence interval, 0.84-2.11), 1.59 (0.97-2.59) and 0.59 (0.19-1.84), while the age- gender-adjusted odds ratios were 1.00, 0.96 (0.43-2.14) and 0.26 (0.07-0.96), at 0-4, 5-9, and > or =10 years elapsed from YFV administration, respectively. The risk of melanoma may therefore be lowered 10 years after vaccination with yellow fever vaccine.

[The problem of the aged person living alone: a methodological proposal for a pilot project of the aged person's and university student's cohabitation]. / Il problema dell'anziano a casa: proposta metodologica per uno studio pilota di convivenza anziano-studente universitario.

The objective of the present study was to evaluate the outcome of a promotion program for the cohabitation between healthy living-alone-old person and university student. The study aimed to highlight the benefits of both the parts in terms of psyco-physical behaviour of the old subject and of logistic and financial support for the student. The survey was carried out between 1998 and 2000 on voluntary couples of old person-university student living in Padua. The study quantified the level of satisfaction of the material needs of the both parts and it also showed the affective relationship established between the old people and the young subjects.

[Treatment plants: viruses in aerosols]. / Depuratori: virus nell'aerosol.

A survey was carried out on the animal virus occurrence in wastewater and aerosols, in 2 treatment plants. Forty-five samples of sewage (10 litres) and 118 aerosol (2.3 m3) were examined. Forty out of forty-five (88.9%) of sewage and four out of one hundred and eighteen of aerosol (3.4%) samples were positive for viruses. Thirty-three reovirus and nine enterovirus strains were recovered from the sewage, two reovirus and two enterovirus strains from aerosol. Among enterovirus strains 6 resulted coxsackievirus B5, 3 coxsackievirus B4, 1 poliovirus, 1 strains remained unidentified.

Biological monitoring of workers exposed to styrene and acetone.

Twenty-two workers exposed to styrene and acetone in two fiberglass industries were monitored on Monday and Thursday for 8 hours using passive dosimeters. Urine samples were collected at the end of the workshift and before the start of the work on the next morning (Tuesday and Friday). The charcoal disks of the passive dosimeters were analysed by gas-chromatography. Mandelic acid (MA) and phenylglyoxylic acid (PGA) were measured using a HPLC method; values were expressed in mg/g of creatinine. The 8-h TWA exposure values for styrene and acetone ranged respectively from 22 to 522 mg/m3 and 40-1581 mg/m3 on Monday; 25-423 mg/m3 and 55-579 mg/m3 on Thursday. Styrene TWA exposure values significantly correlate with the sum of metabolites at the end of workday (r = 0.70 on Monday and r = 0.95 on Thursday) and also at the next morning (r = 0.86 on Tuesday and r = 0.85 on Friday). A styrene exposure level of 213 mg/m3 (ACGIH-TLV) was associated with an excretion of metabolites (MA+PGA) higher on Thursday (803 mg/g creat) than on Monday (570 mg/g creat). The same result was found on Friday (459 mg/g creat) compared with Tuesday (305 mg/g creat). Moreover our data show that the simultaneous exposure to acetone does not modify the excretion of MA. In conclusion the TLV of styrene is associated with different values of metabolites at the beginning and at the end of the work-week.

[Gram-negative flora of horticultural produce destined for consumption mainly in the raw state]. / La flora gram-negativa di prodotti orticoli destinati al consumo prevalentemente allo stato fresco. Nota I. Enterobacteriaceae.

A survey has been carried out to evaluate the recovery of Enterobacteriaceae in freshly consumed horticultural products. 64 samples of these vegetables random chosen in different stores in the General Vegetable Market of Ferrara have been examined among the families of Compositae (lettuce, prickly lettuce, cabbage lettuce, common chicory, artichoke), Umbrelliferae (curly parsley, carrot, celery, fennel), Cruciferae (garden cabbage, red radish), Liliaceae (onion), and Solanaceae (tomato). 654 bacterial lines were isolated, of which 92.5% were Enterobacteriaceae, found in all kinds of horticultural products, the more contaminated being celery, followed by fennel, onion, common chicory, curley parsley, tomato; less contaminated were the other vegetables. Serratia was found in 29.6% of the samples, Escherichia in 28%, Enterobacter in 21.6%, Hafnia in 8.3%, citrobacter in 4.9%, Klebsiella in 2.3% and Yersinia enterocolitica in 1.5%. The importance of horticultural products as source of contamination and colonization by Enterobacteriaceae, especially in hospital, is emphasized. On the basis of reported data, the Authors suggest an accurate observance on hygienic regulations in order to contain the microbic charge under borderline values, even if it is not demonstrated that environmental Enterobacteriacee have the same pathogenicity than clinical ones.

Family resemblance in blood pressure measurements.

The correlation for diastolic and systolic blood pressure was studied in two samples of quartets each consisting of two pairs. The first sample comprised pairs of sisters and their husbands, and the second sample was comprised of brothers and their wives. All siblings were between 30 and 55 years of age and had been married for at least 5 years. It was found that unrelated men married to sisters had a significant correlation in both diastolic (r = 0.28) and systolic (r = 0.41) pressure. For systolic blood pressure, the correlation between pairs of unrelated men married to sisters was significantly larger than the homologous correlation existing in pairs of brothers married to unrelated women. The correlations of systolic and diastolic pressure in sisters were significantly smaller than the same correlations measured in the wives of brothers. The correlations in height for men, used as an internal control to compare marital and genetic effects, were unaffected by marriage, as expected. The correlations in height for pairs of sisters, however, were no larger than those observed in pairs of unrelated women married to brothers. It was concluded that in adult married men and women of the Ferrara population, aged 30 to 55 years, the influence of genetic factors on blood pressure is less important than the influence of cultural factors.

Mortality for tracheal, bronchial and lung cancer: possibilities and limits in data quality-control.

Linkage of various archives (municipal, hospital, autopsy) has enabled the authors to reconstruct the flow of information regarding death due to tracheal, bronchial or lung cancer (TBL ca) for the population residing within the Municipality of Ferrara during the period 1983-1985. The authors subsequently attempted to verify the cause of death by performing quality controls on clinical charts, radiologic findings, cytohistologic examinations and autopsy findings. Analysis of the data obtained in this manner suggests that municipal records are more "accurate" than are hospital records. The authors likewise indicate the usefulness and importance of the autopsy for a correct diagnosis of cause of death.

[Yersinia enterocolitica: biotypes and serotypes isolated from horticultural products]. / Yersinia enterocolitica: biotipie sierotipi isolati da prodotti orticoli.

A survey has been carried out for the presence of Yersinia enterocolitica (Y.e.) in horticultural products. 100 samples of these vegetables have been examined among the families of Compositae (lettuce, prickly lettuce, cabbage lettuce, common chicory, artichoke), Umbrelliferae (curly parsley, carrot, celery, fennel), Cruciferae (garden cabbage, red radish), Liliaceae (onion), and Solanaceae (tomato). 12 strains have been recorded in carrots (serotype 0:6.30), 1 strain in curly parsley (0:4.32), 3 in celery (0:7.8 and 0:6.30), and 1 in red radish (NAG). 0:6.30--the most commonly serotype found in the horticultural products--can be of special significance in human pathology, since the reference strain (IP 102) has been first isolated from man; besides, 0:6.30 has been recovered from four cases of human infection, and represents the most frequently isolated serotype from humans in Canada, together with 0:3, 0:5.27 and 0:9. According to other Authors, in can be assumed that "environmental" strains of Y.e. may also acquire virulence and cause infection in man. Moreover, a high number of environmental biotypes in foods may mask the presence and recovery of such strains involved in human pathology.