Human immunodeficiency virus infection among heterosexuals in the northeastern part of Italy

A cross-sectional, seroprevalence study was conducted between1984 and 1991 to investigate prevalence and risk factors forhuman immunodeficiency virus (HIV) infection in heterosexualsin the northeastern part of Italy. Two hundred and eighty-twoheterosexuals self-referring for HIV testing (109 men and 173women), without history of intravenous drug use or of otherrisk factors for HIV infection, constituted the study group.The overall seroprevalence was 17% (95% confidence interval(Cl): 13–22%), similar in men (18%) and in women (17%),and it tended to increase over time. Age was directly associatedwith HIV antibody seropositivity in men, and inversely relatedin women. Fifteen men and 63 women were steady partners of anHIV-positive person. Among them, 33% of men and 27% of womenwere infected with HIV (odds ratio (OR)=2.8, 95% Cl: 0.7–11.4in men; OR=3.5, 95% Cl: 1.4–8.6 in women). Men with promiscuousoccasional partners had a nearly 3-fold higher risk of infection(95% Cl: 0.8–12.7). Among women, a significantly increasedrisk emerged among those who reported intravenous drug usersamong their occasional partners (OR=5.7). Sixty per cent ofmales and 76% of females never used a condom with occasionalpartners and 70% of males and 72% of females never used onewith steady partners.     

Follow-up of Gambian children recruited to a pilot safety and immunogenicity study of the malaria vaccine SPf66

A pilot safety and immunogenicity trial of the malaria vaccine SPf66 was undertaken in The Gambia in 1993. One hundred and fifty infants aged 6–11 months were immunized with either 0.5 mg or 1.0 mg of SPf66 produced either in Colombia or in the USA or with a control vaccine. Children who received SPf66 experienced more clinical attacks of malaria than did children in the control group during the first period of surveillance and the difference in incidence between children who had received high dose Colombian vaccine and the control children was statistically significant at the 5% level. During the 1995 malaria transmission season, 127 children from the original cohort of 150 were observed. During 18 weeks of intensive surveillance, the incidence of clinical malaria was again higher among children who had received SPf66 than among children who had received inactivated polio vaccine (6.23 vs 4.89 clinical attacks per 1000 days at risk), the effect being most marked among children who were in the high dose groups, but differences between groups were now no longer statistically significant .     

A simple new technique to prevent bleeding in transplant nephrectomy

Renal transplantectomy is still a frequent procedure for a transplant surgeon. Nevertheless, it is constantly marred by complications, first of all bleeding. In fact, the local circumstances after the operation and the general health state of the uremic patients lead to a high incidence of this complication. To avoid this, we adopt a particular technique for renal extracapsular transplantectomy, performing three running sutures between the two faces of the renal capsule. This prevents the formation of the hematoma which is the basis of the continuous bleeding and following infection. We collected a series of nine patients who underwent transplantectomy in which we used this technique. No complications were noted.     

A pilot safety and immunogenicity study of the malaria vaccine SPf66 in Gambian infants

A pilot safety and immunogenicity trial of the malaria vaccine SPf66 has been undertaken in 150 Gambian infants. No significant systemic side effects were recorded but modest local reactions were seen after the administration of a third 1.0 mg dose. SPf66 produced in Colombia was more immunogenic than SPf66 produced in the USA and a 1.0 mg dose of each vaccine gave higher antibody levels than a 0.5 mg dose. However, antibody levels fell rapidly after administration of the third dose of vaccine and showed little change over the following malaria transmission season. The incidence of clinical malaria was higher among children who received SPf66 than among children who received inactivated polio vaccine, the effect being most marked among children who received 1.0 mg Colombian SPf66. As the trial was not designed to measure the effect of SPf66 on morbidity from malaria, the significance of this finding is uncertain.     

Psychological and practical difficulties among parents and healthy siblings of children with Duchenne vs. Becker muscular dystrophy: an Italian comparative study

This study explored the burden in parents and healthy siblings of 4-17 year-old patients with Duchenne (DMD) and Becker (BMD) muscular dystrophies, and whether the burden varied according to clinical aspects and social resources.Data on socio-demographic characteristics, patient''s clinical history, parent and healthy children burden, and on parent''s social resources were collected using self-reported questionnaires administered to 336 parents of patients with DMD (246) and BMD (90).Parents of patients with DMD reported higher burden than those of patients with BMD, especially concerning feeling of loss (84.3% DMD vs. 57.4% BMD), stigma (44.2% DMD vs. 5.5% BMD) and neglect of hobbies (69.0% DMD vs. 32.5% BMD). Despite the burden, 66% DMD and 62.4% BMD parents stated the caregiving experience had a positive impact on their lives. A minority of parents believed MD has a negative influence on the psychological well-being (31.0% DMD vs. 12.8% BMD), and social life of unaffected children (25.7% vs. 18.4%).In the DMD group, burden correlated with duration of illness and parent age, and burden was higher among parents with lower social contacts and support in emergencies. In DMD, difficulties among healthy children were reported as higher by parents who were older, had higher burden and lower social contacts. In both groups, burden increased in relation to patient disability.These findings underline that the psychological support to be provided to parents of patients with MD, should take into account clinical features of the disease.Key words: Duchenne muscular dystrophy, Becker muscular dystrophy, parents, healthy siblings, burden, social network