rome and Acute-Disease

The role of human bocavirus (HBoV) as a respiratory pathogen has not been fulfilled yet. We aimed to describe clinical and serological characteristics of children with HBoV hospitalized for acute respiratory tract infection and to evaluate whether differences occur between HBoV alone and in co-infection.. We retrospectively reviewed data from 60 children (median age of 6.2 months, range 0.6-70.9) hospitalized for acute respiratory symptoms, with HBoV detected from a respiratory sample, using a reverse transcriptase-PCR for 14 respiratory viruses (including respiratory syncytial virus (RSV), influenza virus A and B, human coronavirus OC43, 229E, NL-63 and HUK1, adenovirus, rhinovirus, parainfluenza virus1-3, and human metapneumovirus).. HBoV was detected alone in 29 (48.3%) patients, while in co-infection with other viruses in 31 patients (51.7%), with a peak between December and January. Among the 60 patients, 34 were bronchiolitis, 19 wheezing, 3 pneumonia, 2 upper respiratory tract infection, and 2 whooping cough. Seven children (11.6%) required admission to the paediatric intensive care unit (PICU) for respiratory failure. No differences was observed in age, family history for atopy and/or asthma, clinical presentations, chest X-ray, or laboratory findings in children with HBoV alone vs. multiple viral detection. RSV was the most frequently co-detected virus (61.3%). When compared with HBoV detection alone, the co-detection of RSV and HBoV was associated with male sex (P = 0.013), younger age (P = 0.01), and lower blood neutrophil count (P = 0.032).. HBoV can be detected alone and in co-infection respiratory samples of children with an acute respiratory tract infection. A cause-effect relationship between HBoV and respiratory infection is not clear, so further studies are needed to clarify this point.

Topics: Acute Disease; Age Distribution; Child; Child, Preschool; Coinfection; Databases, Factual; Emergency Service, Hospital; Female; Hospitalization; Hospitals, University; Human bocavirus; Humans; Incidence; Infant; Intensive Care Units, Pediatric; Italy; Male; Parvoviridae Infections; Prognosis; Respiratory Tract Infections; Retrospective Studies; Rome; Severity of Illness Index; Sex Distribution

To evaluate the diagnostic and prognostic usefulness of procalcitonin (PCT) in patients admitted to the Emergency Department (ED) with signs of infections and to assess the prognostic value of repeated measurements in predicting hospital mortality.. A prospective, observational study was conducted in our 400-bed General Teaching Hospital. 261 patients arriving in ED with signs/symptoms of infection were enrolled. PCT was performed upon arrival in the ED (T0), and 5 days after antibiotic therapy (T5). Blood cultures were performed in all patients upon arrival in the ED.. Mean T0 PCT value was 7.1±17.9 ng/ml, and at T5 3±9.1 ng/ml (p < 0.0001). Mean PCT in septic non-survivors was increased at T5 compared to T0 but not significantly. The PCT increase at T5 was an independent factor of mortality (OR = 1.29, p < 0.02) in septic patients. Compared to baseline mean delta % PCT decrease at T5 was 28%. Patients with a decrease delta % PCT > 28% showed a lower number of deaths, with a statistical significant difference if compared to those patients with a < 28% decrease (p < 0.004). ROC curve of delta % PCT for prediction of death has an AUC = 0.82 (p < 0.03).. PCT is a useful marker for diagnosis of systemic and local infections, and for prognostic stratification in patients with acute infectious diseases at their arrival in ED. PCT variations after antibiotic therapy are highly predictive for in-hospital mortality. PCT normalization during antibiotic therapy suggests a good response to infection possibly leading to less infection-related deaths.

Topics: Acute Disease; Aged; Aged, 80 and over; Anti-Bacterial Agents; Biomarkers; Calcitonin; Calcitonin Gene-Related Peptide; Communicable Diseases; Emergency Service, Hospital; Female; Hospital Mortality; Hospitals, General; Hospitals, Teaching; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Patient Admission; Predictive Value of Tests; Prospective Studies; Protein Precursors; Risk Factors; ROC Curve; Rome; Sepsis; Time Factors; Treatment Outcome

Socioeconomic status could affect the demand for hospital care. The aim of the present study was to assess the role of age, socioeconomic status and comorbidity on acute hospital admissions among elderly.. We retrospectively examined the discharge abstracts data of acute care hospital admissions of residents in Rome aged 75 or more years in the period 1997-2000. We used the Hospital Information System of Rome, the Tax Register, and the Population Register of Rome for socio-economic data. The rate of hospitalization, modified Charlson's index of comorbidity, and level of income in the census tract of residence were obtained. Rate ratios and 95% confidence limits were computed to assess the relationship between income deciles and rate of hospitalization. Cross-tabulation was used to explore the distribution of the index of comorbidity by deciles of income. Analyses were repeated for patients grouped according to selected diseases.. Age was associated with a marginal increase in the rate of hospitalization. However, the hospitalization rate was inversely related to income in both sexes. Higher income was associated with lower comorbidity. The same associations were observed in patients admitted with a principal diagnosis of chronic condition (diabetes mellitus, heart failure, chronic obstructive pulmonary disease) or stroke, but not hip fracture.. Lower social status and associated comorbidity, more than age per se, are associated with a higher rate of hospitalization in very old patients.

Topics: Acute Disease; Age Distribution; Aged; Aged, 80 and over; Chronic Disease; Comorbidity; Confidence Intervals; Female; Hospitalization; Humans; Income; Male; Patient Admission; Registries; Retrospective Studies; Rome; Social Class

Non-invasive positive pressure support ventilation (NIPSV).. In patients with acute hypoxaemic (PaO2/FiO2 &Mac178;100) non hypercapnic respiratory failure (ARF) admitted to a Respiratory Inter-mediate Intensive Care Unit of a general Hospital, between January 1993 and December 1997.. In 21 selected patients (PaO2/ FiO2T0=82+/-9) NIPSV improved PaO2 in 13/21 patients (Group A) and did not improve in 8/21 patients (Group B) (PaO2/FiO2T1=154+/-25 in Group A vs PaO2/FiO2T1=106+/-7.5 in Group B, p=0.00001). Upon admission the two groups did neither significantly differ for blood gas values (PaO2/FiO2T0=84+/-9.6 in Group A vs 79.8+/-8.7 in Group B), nor for clinical status (APACHE II=19.8+/-5 in Group A vs 24.6+/-7 in Group B). Shorter duration of NIPSV in Group B patients (11.2+/-19.7 hrs vs 35.3+/-32.3 hrs in Group A, p=0.047), in spite of a rise in PEEP (9.3+/-2.3 in Group B vs 5.5+/-2.4 in Group A, p=0.003) and Pressure Support (18.7+/-1.8 in Group B vs 15+/-3.2 in Group A, p=0.004) was due to onset of conditions which required shifting from NIPSV to endotracheal intubation (ETI).. 8/21 patients were successfully treated by only NIPSV. 8/21 patients were intubated. 5/21 patients dead in RIICU; 1 month survival: 9/21 patients. Side effects: mask intolerance (3/21); skin necrosis (1/21); pneumothorax (1/21).. NIPSV may be tried in ARF patients to improve PaO2 and avoid ETI.

Topics: Acute Disease; Adult; AIDS-Related Opportunistic Infections; Carbon Dioxide; Critical Care; Hospitals, General; Humans; Hypoxia; Intensive Care Units; Masks; Middle Aged; Oxygen; Pneumonia, Pneumocystis; Positive-Pressure Respiration; Postoperative Complications; Pulmonary Edema; Respiratory Distress Syndrome; Respiratory Insufficiency; Retrospective Studies; Rome; Sepsis; Shock, Cardiogenic; Survival Analysis; Treatment Outcome

Two time-series studies, aimed at evaluating the acute health effect of air pollution among Rome inhabitants, were carried out. In the first study the correlation between daily mortality (1992 to 1995) and daily concentrations of five air pollutants (particles, SO2, NO2, CO, O3) was analyzed. In the second study the association between daily levels of the same pollutants and hospital admissions for respiratory and cardiovascular disease (1995-97) was evaluated. Poisson regression models were used to estimate the association between pollutant levels and health effect variables; the models included smooth functions of day of study, mean temperature, mean humidity and indicator variables for day of the week and holidays. Daily total mortality was associated with particle average concentration on that day and with NO2 levels of one or two days before. Hospital admissions for cardiovascular disease were positively correlated to particles, SO2, NO2, e CO. Hospital admissions for respiratory disease were associated with NO2 and CO levels of the same day and of two days before among children (0-14 years) and among adults (15-64 years). Increments of ozone were associated with increments of total respiratory and of acute respiratory diseases in children (0-14 years).

Topics: Acute Disease; Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Child; Child, Preschool; Hospitalization; Humans; Infant, Newborn; Meteorological Concepts; Middle Aged; Mortality; Nitrogen Dioxide; Ozone; Regression Analysis; Respiration Disorders; Rome; Sulfur Dioxide

Rotavirus infections were detected in 210 of 675 children with acute diarrhea admitted to a major pediatric hospital in Rome from January 1982 through December 1985. Most of the patients with rotavirus infections were admitted during the winter season in both 1982 and 1985, whereas during the two intermediate years, cases occurred in all months. Among 84 rotavirus samples examined, 14 different electropherotypes were recognized, 2 of which largely predominated over the others. The two electropherotypes were particularly frequent in the 2 epidemic years, altogether accounting for 70.2% of the samples typed, and circulated in distinct periods. None of the viruses showed a short pattern of electrophoretic migration of the genome, indicating a minor involvement of subgroup I rotaviruses in hospitalization-requiring diarrheas occurring in the area surveyed.

Topics: Acute Disease; Child, Preschool; Diarrhea, Infantile; Electrophoresis, Polyacrylamide Gel; Feces; Humans; Infant; Infant, Newborn; RNA, Double-Stranded; RNA, Viral; Rome; Rotavirus; Rotavirus Infections; Seasons

Topics: Acute Disease; Aged; Brain Ischemia; Female; Humans; Iodobenzenes; Male; Middle Aged; Organometallic Compounds; Organotechnetium Compounds; Oximes; Rome; Tomography, Emission-Computed

Chromosome banding pattern of bone marrow cells, cell morphology according to the FAB classification, and clinical finding were compared in two groups of adult patients with acute nonlymphocytic leukemia (ANLL): 52 patients occupationally exposed to chemical solvents, insecticides, or petrol products, and 110 patients with no history of occupational exposure to potential mutagenic/carcinogenic agents. Striking differences were found between the two groups: (1) Clonal chromosomal aberrations were present in 75% of exposed patients compared with only 32% in the nonexposed group. (2) Of the patients exposed to solvents and insecticides 92% had abnormal chromosomes, whereas only 29% of patients exposed to petrol products showed abnormalities; in the total material 10/13 exposed patients with normal chromosomes were exposed to petrol products. (3) The relationship between chromosomal abnormality and exposure was evident in both females and males. However, only 29% of women with an abnormal karyotype were exposed, whereas 70% of males with an abnormal karyotype were exposed. (4) The incidence of certain characteristic karyotypic abnormalities, i.e., -5/5q-, 7/7q-, +8, +21, t(8;21), and t(9;22), were decidedly more common in exposed than in nonexposed patients. At least one of these changes were present in 92% of exposed patients with aberrations, whereas in the nonexposed group the incidence was only 60%. (5) The monocytic varieties of ANLL (M4 + M5) were more common in the nonexposed patients, whereas erythroleukemia (M6) was more common in the exposed group. The predominance of abnormal karyotypes in the exposed compared to the nonexposed patients was similar in leukemia types M1 + M2 and in M4 + M5. (6) There was no difference in survival time between the two groups and the same correlation was obvious in both exposed and nonexposed patients: patients who had only abnormal metaphases had poorer prognosis than those with normal bone marrow metaphases only (6 vs 1.5 months). This correlation was obvious in patients classified as acute myeloid leukemia (AML) as well as in the monocytic varieties of ANLL.

Topics: Acute Disease; Adolescent; Adult; Aged; Chromosome Aberrations; Female; Humans; Insecticides; Leukemia; Leukocytes; Male; Middle Aged; Occupational Diseases; Petroleum; Prognosis; Rome; Solvents; Sweden

Topics: Acute Disease; Appendicitis; Egypt; England; Germany; Greece; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Internal Medicine; Rome; Switzerland; United States

Topics: Acute Disease; Adenoviridae Infections; Adenovirus Infections, Human; Adult; Conjunctivitis; Disease Outbreaks; Hemorrhage; Humans; Middle Aged; Rome

Topics: Acute Disease; Adolescent; Adult; Aged; Humans; Male; Middle Aged; Q Fever; Respiratory Tract Infections; Rome; Serologic Tests