High seroprevalence of HCV in the Abruzzo Region,Italy: results on a large sample from opt-out pre-surgical screening

Purpose

Available estimates of the prevalence of chronic HCV infection in Italy are quite conflicting, varying from 1.5 to 22.5 %, with an apparent north to south gradient. As Direct Acting Antivirals are expensive, both National and local governmental Agencies are in urgent need of detailed and reliable estimates of HCV patients to be treated, nationwide and in each district. We investigated the prevalence of anti-HCV antibodies in a large unselected sample of surgical patients providing consent to in-hospital opt-out pre-surgical HCV screening, at two hospitals from the Abruzzo Region, Italy.

Methods

Data were retrieved for 55,533 screened patients (4.1 % of the total population in the Abruzzo Region), admitted in the Orthopedic and General Surgery wards of Pescara and Teramo Hospitals from 1999 to 2014.

Results

The prevalence of anti-HCV antibodies was 4.4 % in the total sample. HCV-positive patients had a mean age of 63.8 ± 19.9 years; 49.2 % were males. From 1999 to 2014, the prevalence of HCV antibodies decreased from 5.4 % to 4.1 %; at both sites, however, two age-related-peaks were evidenced, the first among patients aged 30–49 years, the second among those older than 70 years. Statistical analyses confirmed a significant trend to decrease over time and a higher prevalence in Pescara and among males (all p < 0.01).

Conclusions

Data retrieved from opt-out pre-surgical screening programs may allow inexpensive and easy-to-perform estimates of HCV seroprevalence from large samples of unselected patients with a well-defined provenience, which may turn useful for future treatment resource allocation.

     

Mental distress and sexual harassment in Italian university students

Only a few studies have analyzed the association between sexual harassment (SH) and mental health controlling for other types of violence. The aim of this study was to describe SH among male and female university students and analyze the association between harassment and mental distress controlling for sexual violence. An observational survey was conducted at Trieste University (Italy). Students answered an anonymous questionnaire about harassment that included three domains—sexual harassment, gender harassment, cyber harassment—and three psychological health indicators. The global harassment index was computed, with three levels: 0, no harassment; level 1, harassment in at least one of the three domains; and level 2, harassment in two or three domains. The symptoms of mental distress were measured by the 12-item General Health Questionnaire (GHQ) for depressive symptoms; a question about panic symptoms; and a question about general health. The sample included 759 students (412 women; 18 to 29 years old). After adjustment for age, birth country, couple relationship, employment status, mother’s education, and previous sexual violence, the risk of mental distress was increased with harassment exposure. Men were affected in perceived health and depressive symptoms (GHQ score ≥ 6); women were affected in panic symptoms. Harassment has a strong negative impact on the mental health of victims; in some cases, men may be more affected than women. Clinicians should be aware of the negative impact of SH also on men.

     

Clinical Relevance of Acute Pancreatitis in Allogeneic Hemopoietic Stem Cell (Bone Marrow or Peripheral Blood) Transplants

This study investigated the clinical relevanceof acute pancreatitis in allogeneic hemopoietic stemcell (bone marrow or peripheral blood) transplants(BMT). We studied 26 patients undergoing BMT. Thepreparative regimen was busulfan and cyclophosphamide in 17patients and total body irradiation and cyclophosphamidein 9 patients. Graft-versus-host disease (GVHD)prophylaxis consisted of cyclosporin A and short-term methotrexate in all 26 patients. The pancreaswas studied using amylase and lipase serum levels,abdominal contrast-enhanced tomography, and/orultrasound. Clinical and laboratory signs of acutepancreatitis were found in two patients with acutehepatointestinal GVHD, and in one patient with acutehepatic GVHD and cytomegalovirus infection. This patientdied of multiorgan failure, with interstitial acutepancreatitis at autopsy; the other two patients recoveredwith general supportive care and GVHD therapy. Wesuggest that in the patients with complications afterBMT, particularly acute hepatic/hepatointestinal GVHD, and cytomegalovirus infection, the possibilityof acute pancreatitis should be considered.     

Hepatitis C virus infection is associated with a higher incidence of cholestasis of pregnancy

To investigate a possible relationship between hepatitis C virus infection and cholestasis of pregnancy, we identified all cases of cholestasis of pregnancy (145/16,271) and hepatitis C virus infection (63/16,27 1) between January 1992 and December 1997. Serologic screening was performed universally. The rate of cholestasis of pregnancy was greater in women whose hepatitis C virus antibodies were positive rather than negative [15.9% (10/63) vs 0.8% (135/16,208),   P < 0.0011  . Among women with cholestasis of pregnancy, mean (standard deviation) gestational age at onset of symptoms and at delivery was significantly lower among women whose hepatitis C virus antibodies were positive compared with negative women: 28.9 (3.2) vs 34.3 (3–5) weeks,   P < 0.001  and 36–3 (0.9) vs 37.0 (1–6) weeks,   P = 0.03  , respectively. These findings suggest that early Occurrence of cholestasis of pregnancy may be an indication for serologic testing for hepatitis C virus.     

Action-potential-like depolarizations relieve opioid inhibition of N-type Ca2+ channels in NG108–15 cells

 The ability of action-potential-like waveforms (APWs) to attenuate opioid-induced inhibition of N-type Ca²⁺ channels was investigated in the neuroblastoma × glioma cell line NG108–15 using whole-cell voltage clamp methods. In in vitro differentiated NG108–15 cells, the opioid agonist [d-ala²]-methionine-enkephalin (DAME) reversibly decreased ω-conotoxin-GVIA-sensitive Ba²⁺ currents (N-type currents). Agonist-mediated inhibition of N-type currents could be transiently relieved by strong unphysiological depolarizing prepulses to +80 mV (facilitation). Significant facilitation was also achieved by conditioning the cell with a train of 15 APWs, which roughly mimicked physiological action potentials (1- to 6-ms-long depolarizations to +30 mV from a holding potential of –40 mV). The APW-induced facilitation depended on both conditioning pulse frequency and duration. Summation of the disinhibition produced by each APW was possible because reinhibition following repolarization to –40 mV was a much slower process (τ=88 ms) than the onset of facilitation at +80 mV (τ=7 ms). These results provide evidence that N-type Ca²⁺ channel facilitation may be a physiologically relevant process, and suggest that neuronal firing may relieve agonist-induced inhibition of N-type currents to an extent depending on both the shape of action potentials and the frequency of firing. Received: 14 September 1998 / Accepted: 29 September 1998