rome and Cardiovascular-Diseases

Cardiovascular diseases (CVDs) are the most frequent causes of death in the world. Inflammation and oxidative damage contribute significantly to the development of atherosclerosis and CVDs. European Food Safety Authority scientific opinion has acknowledged that hydroxytyrosol (3,4-dihydroxyphenylethanol) and derivatives, contained in extra virgin olive oil (EVOO), typically used in Mediterranean diet may play a crucial role in the reduction of the inflammatory pathway and in the prevention of CVDs. The aim of the study was to determine the effect in healthy volunteers of 25 g of phenols-rich EVOO (p-EVOO).. The clinical study was a randomized, controlled trial to determine the acute effect in the postprandial time of 25 g of p-EVOO. We evaluated nutritional status using anthropometric parameters, body composition, serum metabolites, oxidative stress biomarkers and gene expression of eight genes related to oxidative stress and human inflammasome pathways, lasting 2 h after p-EVOO administration. Twenty-two participants resulted as eligible for the study.. A significant reduction of oxidized LDL, malondialdehyde, triglycerides and visceral adiposity index was highlighted (P < 0.05). Significant upregulation of catalase, superoxide dismutase 1 and upstream transcription factor 1 were observed (P < 0.05).. The current study shows that intake of 25 g of p-EVOO has been able to be modulated, in the postprandial time, the antioxidant profile and the expression of inflammation and oxidative stress-related genes, as superoxide dismutase 1, upstream transcription factor 1 and catalase. We also observed a significant reduction of oxidized LDL, malondialdehyde, triglycerides and visceral adiposity index. We have demonstrated that a daily intake of phenols and antioxidants can reduce the inflammatory pathway and oxidative stress and therefore the risk of atherosclerosis and CVDs. More studies on a larger population are necessary before definitive conclusions can be drawn.Trial registration ClinicalTrials.gov NCT01890070.

Topics: Adolescent; Adult; Aged; Cardiovascular Diseases; Catalase; Diet, Healthy; Diet, Mediterranean; Double-Blind Method; Female; Humans; Inflammation Mediators; Lipoproteins, LDL; Male; Middle Aged; Nutrigenomics; Olive Oil; Oxidative Stress; Phenols; Phenylethyl Alcohol; Postprandial Period; Protective Factors; Risk Factors; Rome; Superoxide Dismutase-1; Upstream Stimulatory Factors; Young Adult

To evaluate the long-term effects of drospirenone (DRSP)/ethinylestradiol (EE) alone, metformin alone, and DRSP/EE-metformin on CD4(+)CD28(null) T lymphocytes frequency, a cardiovascular risk marker, in patients with hyperinsulinemic polycystic ovary syndrome (PCOS).. Randomized clinical trial.. Ninety three patients with hyperinsulinemic PCOS were age matched and body mass index matched and randomized to receive a 6 months daily treatment with DRSP (3 mg)/EE (0.03 mg), or metformin (1500 mg), or DRSP/EE combined with metformin.. CD4(+)CD28(null) T-cell frequencies.. The DRSP/EE and metformin groups did not show any significant change in the CD4(+)CD28(null) frequency compared to the baseline. Interestingly, a statistically significant decrease in CD4(+)CD28(null) frequency occurred after 6 months of DRSP/EE-metformin (median 3-1.5; P < .01). Of note, this statistically significant association was confirmed after adjusting for baseline values in DRSP/EE-metformin group by analysis of covariance (P < .05).. In women with hyperinsulinemic PCOS, combined therapy with DRSP/EE and metformin may reduce cardiovascular risk.

Topics: Adolescent; Adult; Analysis of Variance; Androstenes; Cardiovascular Diseases; CD28 Antigens; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; Chi-Square Distribution; Ethinyl Estradiol; Female; Humans; Hyperinsulinism; Hypoglycemic Agents; Metformin; Polycystic Ovary Syndrome; Reproductive Control Agents; Risk Factors; Rome; Time Factors; Treatment Outcome; Young Adult

Socioeconomic inequalities have a strong impact on population health all over the world. Occupational status is a powerful determinant of health in rich societies. We aimed at investigating the association between occupation and mortality in a large metropolitan study.. Cohort study.. Rome, capital of Italy.. We used the Rome Longitudinal Study, the administrative cohort of residents in Rome at the 2001 general census, followed until 2015. We selected residents aged 15-65 years at baseline. For each subject, we had information on sex, age and occupation (occupational status and type of job) according to the Italian General Census recognition.. We investigated all-cause, cancer, cardiovascular and accidental mortality, major causes of death in the working-age population. We used Cox proportional hazards models to investigate the association between occupation and all-cause and cause-specific mortality in men and women.. We selected 1 466 726 subjects (52.1% women). 42 715 men and 29 915 women died during the follow-up. In men, 47.8% of deaths were due to cancer, 26.7% to cardiovascular causes and 6.4% to accidents, whereas in women 57.8% of deaths were due to cancer, 19.3% to cardiovascular causes and 3.5% to accidents. We found an association between occupational variables and mortality, more evident in men than in women. Compared with employed, unemployed had a higher risk of mortality for all causes with an HR=1.99 (95% CI 1.92 to 2.06) in men and an HR=1.49 (95% CI 1.39 to 1.60) in women. Compared with high-qualified non-manual workers, non-specialised manual workers had a higher mortality risk (HR=1.68, 95% CI 1.59 to 1.77 and HR=1.30, 95% CI 1.20 to 1.40, for men and women, respectively).. This study shows the importance of occupational variables as social health determinants and provides evidence for policy-makers on the necessity of integrated and preventive policies aimed at improving the safety of the living and the working environment.

Topics: Accidents, Occupational; Cardiovascular Diseases; Cause of Death; Cohort Studies; Employment; Female; Humans; Longitudinal Studies; Male; Mortality; Neoplasms; Rome; Social Determinants of Health; Socioeconomic Factors; Urban Population

Living in areas with higher levels of surrounding greenness and access to urban green areas have been associated with beneficial health outcomes. Some studies suggested a beneficial influence on mortality, but the evidence is still controversial.. We used longitudinal data from a large cohort to estimate associations of two measures of residential greenness exposure with cause-specific mortality and stroke incidence.. We studied a population-based cohort of 1,263,721 residents in Rome aged [Formula: see text], followed from 2001 to 2013. As greenness exposure, we utilized the leaf area index (LAI), which expresses the tree canopy as the leaf area per unit ground surface area, and the normalized difference vegetation index (NDVI) within 300- and [Formula: see text] buffers around home addresses. We estimated the association between the two measures of residential greenness and the outcomes using Cox models, after controlling for relevant individual covariates and contextual characteristics, and explored potential mediation by air pollution [fine particulate matter with aerodynamic diameter [Formula: see text] [Formula: see text] and [Formula: see text]] and road traffic noise.. We observed 198,704 deaths from nonaccidental causes, 81,269 from cardiovascular diseases [CVDs; 29,654 from ischemic heart disease (IHD)], 18,090 from cerebrovascular diseases, and 29,033 incident cases of stroke. Residential greenness, expressed as interquartile range (IQR) increase in LAI within [Formula: see text], was inversely associated with stroke incidence {hazard ratio (HR) 0.977 [95% confidence interval (CI): 0.961, 0.994]} and mortality for nonaccidental [HR 0.988 (95% CI: 0.981, 0.994)], cardiovascular [HR 0.984 (95% CI: 0.974, 0.994)] and cerebrovascular diseases [HR 0.964 (95% CI: 0.943, 0.985)]. Similar results were obtained using NDVI with 300- or [Formula: see text] buffers.. Living in greener areas was associated with better health outcomes in our study, which could be partly due to reduced exposure to environmental hazards. Further research is required to understand the underlying mechanisms. https://doi.org/10.1289/EHP2854.

Topics: Adult; Aged; Aged, 80 and over; Air Pollution; Cardiovascular Diseases; Cerebrovascular Disorders; Female; Humans; Incidence; Italy; Longitudinal Studies; Male; Middle Aged; Motor Vehicles; Myocardial Ischemia; Noise; Particulate Matter; Prospective Studies; Rome; Stroke

Chronic kidney disease (CKD) is a condition with high cardiovascular mortality associated with emerging risk factors, including sarcopenia. Several mechanisms can affect muscle mass, such as vitamin D deficiency, low protein intake, physical inactivity, metabolic acidosis, and inflammation leading to a worsening of cardiovascular outcomes and cognitive function. We aimed to evaluate the prevalence of sarcopenia in CKD patients on conservative and replacement therapy and the associations between sarcopenia and markers of atherosclerosis, endothelial dysfunction, psychological and cognitive function.. We enrolled CKD patients (stage 3/5 KDIGO [Kidney Disease: Improving Global Outcomes]) and hemodialysis, peritoneal dialysis, and post-kidney transplant patients. Clinical, laboratory and instrumental assessments, including bioimpedance analysis, hand-grip strength, intima media thickness, flow-mediated dilation, and epicardial adipose tissue, were performed in addition to analysis of psychological and cognitive status by the Montreal Cognitive Assessment, Mini-Mental State Examination, and Geriatric Depression Scale.. A total of 77 patients (43 male) with a mean age of 69.6 ± 9.85 y were studied. According to validated criteria (using bioimpedance analysis and hand-grip strength), the prevalence of sarcopenia was 49.4%. Sarcopenic patients had higher values of intima media thickness (P = 0.032) and epicardial adipose tissue (P = 0.012) and lower flow-mediated dilation (P = 0.002), total cholesterol (P = 0.005), and high-density lipoprotein cholesterol (P = 0.008) with respect to non-sarcopenic patients. We found higher Geriatric Depression Scale scores (P = 0.04) in sarcopenic patients, whereas we did not find differences between the two groups in Mini-Mental State Examination and Montreal Cognitive Assessment score.. Sarcopenia is highly prevalent in CKD/end stage renal disease patients and is associated with changes in early systemic indices of atherosclerosis and endothelial dysfunction, known as markers of worse prognosis.

Topics: Aged; Biomarkers; Cardiovascular Diseases; Carotid Intima-Media Thickness; Comorbidity; Female; Humans; Kidney Transplantation; Male; Prevalence; Prospective Studies; Renal Dialysis; Renal Insufficiency, Chronic; Risk Assessment; Rome; Sarcopenia

Lifestyle habits including indoor and outdoor activities among community school children, adherence to the Mediterranean diet and awareness about total cholesterol blood levels represent determinant factors in cardiovascular disease (CVD) prevention. The aim of this study was to analyze the relationship between adherence to the Mediterranean diet, total cholesterol blood levels, body composition and hours per day spent in in-house or outdoor among 29,159 Italian 6-14 years-old community school children (50% boys). The KidMed questionnaire, modified to handle missing information on olive oil consumption, was used to assess the adherence to the Mediterranean diet among participants.. Associations between variables were tested according to 3 classes of the Mediterranean diet adherence score using analysis of variance. Participants with high adherence to Mediterranean diet were few (1%). Overall awareness of total cholesterol blood levels was low among children (4.5%), slightly higher among parents (26.2 and 24.1% in mothers and fathers, respectively). Among Mediterranean diet adherent children, BMI was significantly (p < 0.001) smaller than among the non-Mediterranean or intermediate adherent children as were the total hours spent per day watching television or playing with videogames (p < 0.001) whereas the hours/day in sport or outdoor activities were more (p < 0.001). These results were confirmed by multiple linear regression with KidMed scored 0 to 8 as dependent variable.. Although awareness of total cholesterol blood levels and adherence to the Mediterranean diet are rare among community school children, only among these a healthier lifestyle was practiced with a tendency to lower CVD risks. These results are important as the first sized experience of this type in Italy.

Topics: Adolescent; Age Factors; Biomarkers; Body Mass Index; Cardiovascular Diseases; Child; Cholesterol; Diet, Healthy; Diet, Mediterranean; Exercise; Female; Humans; Male; Nutritive Value; Retrospective Studies; Risk Factors; Risk Reduction Behavior; Rome; Screen Time; Sedentary Behavior; Television; Time Factors; Video Games

Background Homozygous familial hypercholesterolaemia is a rare life-threatening disease characterized by markedly elevated low-density lipoprotein cholesterol (LDL-C) concentrations and accelerated atherosclerosis. The presence of double gene defects in the LDL-Receptor, either the same defect (homozygous) or two different LDL-raising mutations (compound heterozygotes) or other variants, identify the homozygous phenotype (HopFH). Apheresis is a procedure in which plasma is separated from red blood cells before the physical removal of LDL-C or the LDL-C is directly removed from whole blood. It is currently the treatment of choice for patients with HopFH whose LDL-C levels are not able to be reduced to target levels with conventional lipid-lowering drug therapy. Design The aim of this study is to report a cohort of six paediatric patients and to evaluate the long term efficacy of combined medical therapy and LDL-apheresis on LDL-C reduction. Methods We collected data from six children with confirmed diagnosis of HopFH (two females and four males; age range at diagnosis 3-8 years, mean 6 ± 1 years) from a single clinical hospital in Italy from 2007 to 2017. Results Clinical manifestations and outcomes may greatly vary in children with HopFH. Medical therapy and LDL-apheresis for the severe form should be started promptly in order to prevent cardiovascular disease. Conclusions Lipoprotein apheresis is a very important tool in managing patients with HopFH at high risk of cardiovascular disease. Based on our experience and the literature data, the method is feasible in very young children, efficient regarding biological results and cardiac events, and safe with minor side-effects and technical problems. We advise treating homozygous and compound heterozygous children as soon as possible.

Topics: Age Factors; Anticholesteremic Agents; Biomarkers; Blood Component Removal; Cardiovascular Diseases; Child; Child, Preschool; Cholesterol, LDL; Female; Genetic Predisposition to Disease; Homozygote; Humans; Hyperlipoproteinemia Type II; Male; Phenotype; Retrospective Studies; Risk Factors; Rome; Severity of Illness Index; Time Factors; Treatment Outcome

The aim of the study was to evaluate the health effects associated with the exposure to ground-level of particulate matters with aerodynamic diameter ≤ 2.5 μm (PM

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Cardiovascular Diseases; Child; Child, Preschool; Environmental Exposure; Female; Hospitalization; Humans; Infant; Infant, Newborn; Male; Middle Aged; Morbidity; Particulate Matter; Proportional Hazards Models; Risk Factors; Rome; Time Factors; Young Adult

The effect of long-term exposure to metal components in particulate matter on mortality are still controversial.. To study the association between long-term exposure to PM. All 30+ year olds from the Rome Longitudinal Study were followed for vital status from October 2001 until December 2010. We used land use regression models to estimate annual average concentrations at residences and Cox models to estimate the associations between pollutants and cause-specific mortality, adjusting for individual and contextual characteristics. Hazard ratios (HRs) were expressed per increments equal to the 5. We analyzed 1,249,108 residents and found strong associations between all exposure indicators and mortality. We observed higher mortality risk with increasing exposure to PM. In addition to vehicular exhaust pollutants, PM related to non-tailpipe emissions and mixed oil burning/industry plays an important role in mortality.

Topics: Adult; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Exposure; Female; Humans; Longitudinal Studies; Male; Metals, Heavy; Middle Aged; Mortality; Particulate Matter; Proportional Hazards Models; Risk Factors; Rome; Vehicle Emissions

Topics: Cardiology; Cardiovascular Diseases; Clinical Trials as Topic; Guidelines as Topic; Humans; Rome; Societies, Scientific

Topics: Cardiology; Cardiovascular Diseases; Congresses as Topic; Humans; Rome

The Fourth International Symposium on Thymosins in Health and Disease brought together many of the leading scientists, clinicians and thought-leaders from the United States, Israel, Europe, China and Japan to discuss the latest advances and clinical applications of the thymosins in both basic and clinical areas. The symposium, held in Rome, Italy, on October 23 - 25, 2014, was sponsored by The George Washington University and the University of Rome 'Tor Vergata.'

Topics: Animals; Cardiovascular Diseases; Europe; Health Status; HIV Infections; Humans; Internationality; Rome; Thymosin

We investigated the role of socio-economic status on diabetes prevalence, on mortality and hospitalization in a large population-based cohort enrolled in Rome, Italy.. Diabetic residents aged ≥ 35 years in 2007 were identified using multiple data sources. The effect of the deprivation of the area of residence on diabetes prevalence and on mortality and hospitalization (years 2008-10) was investigated by multilevel regression models, both among diabetic and non-diabetic populations.. Prevalence of diabetes (8.3%) was directly related to the deprivation of the area of residence, especially for women. Diabetes increased the risk of mortality and hospitalization, mainly for cardiovascular complications, compared with non-diabetic subjects, with increasing relative risks in more deprived areas. The social gradients observed among diabetic patients are modest compared with non-diabetic subjects, both for some acute complications (myocardial infarction, stroke) and chronic complications (ischaemic heart disease, nephropathy, retinopathy and amputation).. Prevalence of diabetes is directly related to deprivation, especially for women. Diabetes increases the risk of mortality and hospitalization for cardiovascular complications. However, similar to another study conducted in Northern Italy, we found that social differences in health outcomes do not differ between people with and without diabetes, suggesting that the care for diabetic patients living in Rome is provided without social disparities, and in some cases, it protects against the adverse effects of social inequalities. The Italian care system for diabetes deserves to be further investigated, as it could represent a model for the care of other chronic conditions and for contrasting social inequities in health.

Topics: Adult; Aged; Cardiovascular Diseases; Case-Control Studies; Diabetes Complications; Diabetes Mellitus; Female; Hospitalization; Humans; Male; Middle Aged; Poverty Areas; Prevalence; Risk; Rome; Sex Factors; Socioeconomic Factors

To assess the effects of bariatric surgery (BS) on peripheral endothelial function and on coronary microvascular dilator function.. We studied 50 morbidly obese patients (age 38 ± 9, 13 M) who underwent BS and 20 comparable obese controls (age 41 ± 11, 6 M) without any evidence of cardiovascular disease. Peripheral vascular dilator function was assessed by brachial artery diameter changes in response to post-ischemic forearm hyperaemia (flow-mediated dilation, FMD). Coronary microvascular function was assessed by measuring coronary blood flow (CBF) velocity response to i.v. adenosine and to cold pressor test (CPT) in the left anterior descending coronary artery by transthoracic Doppler echocardiography. The tests were performed at baseline and at 3-month follow-up. At baseline, FMD and CBF response to adenosine and CPT were similar in the 2 groups. Compared to baseline, FMD at follow-up improved significantly in BS patients (5.9 ± 2.7% to 8.8 ± 2.4%, p < 0.01), but not in controls (6.3 ± 3.2% vs. 6.4 ± 3.1%, p = 0.41). Similarly, a significant improvement of CBF response to adenosine (1.63 ± 0.47 to 2.45 ± 0.57, p < 0.01) and to CPT (1.43 ± 0.26 to 2.13 ± 0.55, p < 0.01) was observed in BS patients but not in controls (1.55 ± 0.38 vs. 1.53 ± 0.37, p = 0.85; and 1.37 ± 0.26 vs. 1.34 ± 0.21, p = 0.48, respectively). The favourable vascular effects of BS were similar independently of the presence and changes of other known cardiovascular risk factors and of basal values and changes of serum C-reactive protein levels.. Our data show that, in morbidly obese patients, together with peripheral endothelial function, BS also improves coronary microvascular function. These effects suggest global improvement of vascular function which can contribute significantly to the reduction of cardiovascular risk by BS reported in previous studies.

Topics: Adenosine; Adult; Bariatric Surgery; Biomarkers; Blood Flow Velocity; Brachial Artery; C-Reactive Protein; Cardiovascular Diseases; Case-Control Studies; Coronary Circulation; Echocardiography, Doppler; Endothelium, Vascular; Female; Humans; Hyperemia; Male; Microcirculation; Middle Aged; Multivariate Analysis; Obesity, Morbid; Regional Blood Flow; Risk Assessment; Risk Factors; Rome; Time Factors; Treatment Outcome; Vasodilation; Vasodilator Agents

Topics: Adult; Age Distribution; Aged; Biomarkers; Cardiovascular Diseases; Cholesterol; Cholesterol, HDL; Cohort Studies; Diabetes Complications; Female; Humans; Hypercholesterolemia; Hypertension; Male; Medical Records; Middle Aged; Proportional Hazards Models; Risk Assessment; Risk Factors; Rome; Smoking

Topics: Animals; Cardiomyopathies; Cardiovascular Diseases; Catheter Ablation; Disease Models, Animal; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine; Myocardial Infarction; Myocarditis; Radiography, Interventional; Rome; Societies, Medical

The last few years have seen an increased necessity to assess the cardiovascular risk factors on large samples of the population in Italy. A look at the citizens of a small rural town Brisighella is well known.. Three hundred and five individuals of average age 40.8 years (+/-8.22), recruited between September 1988 and December 1989 (198 men, 107 women) were taken into consideration. Clinical and instrumental investigations were then performed (intern visits with data obtained from primary anthropometric, otorhinolaryngological and ocular variables, heart X-ray, electrocardiogram). The following analyses were also performed: haemochrome, ESR, uricemia, azotemia, glycemia, AST, ALT, bilirubinemia, protein electrophoresis, triglyceridemia, total cholesterol, HDL cholesterol, creatinine level and urine analysis. Women also received PAP-test. Another variable was lifestyle habits which may be considered a risk for cardiovascular disease. Hygienic and diet suggestions were made. After seven years, in 1997, 100 of these individuals (51 men, 49 women - mean age 42.7+/-6.5 years) were chosen at random and administered the same clinical and laboratory examinations as before.. The analysis of the data show average BMI values 24.07+/-2.7 in men and 22.8+/-2.6 in women, inferior to those found in other Italian investigations. We observed an increase of BMI along with age, despite measures of preventive medicine, in married subjects and along with education and occupation level. Mean values of cholesterol level in men increased between the ages 30 and 39 and stabilised after 40 years; in women they increased only after the 5th decade of life.. We observed a direct correlation between the increase of uricemia and triglyceride levels, triglyceride and cholesterol levels, BMI and triglyceride levels conferming the tight bond among these metabolisms and the importance of obesity as a risk factor. Uricemia levels correlate with systolic and diastolic blood pressure.

Topics: Adult; Blood Glucose; Body Mass Index; Body Weight; Cardiovascular Diseases; Cholesterol; Female; Humans; Male; Middle Aged; Prospective Studies; Risk Factors; Rome; Triglycerides; Uric Acid

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

We report our experience in the organization and management of a Cardiac First Aid Unit (CFAU) which was developed according to the guidelines of the National Hospital Cardiologists Association as a part of a General Emergency Department. The CFAU is a 24 hour service directed by a Senior Cardiologist. The medical facilities are two monitored beds for short-term observation (cardio-pulmonary resuscitation instruments, echocardiograph, endoesophageal pacing for overdrive). The main goals of CFAU are the treatment of cardiac emergencies (acute myocardial infarction, pulmonary oedema, threatening arrhythmias, etc.) and the screening of patients presenting with chest pain or symptoms suggesting cardio-vascular involvement. In one year, there were 1700 admissions to the CFAU (3.7% of the total Medical Emergencies). The frequency of hospital admissions was 81% and coronary heart disease accounted for 38.3%. A sample of 100 consecutive patients with acute myocardial infarction admitted in the period October-November 1996 was examined to explore the impact of a CFAU on in-hospital delay in the application of thrombolysis. Thirty-nine patients were treated with thrombolysis, 15 in CFAU and 24 in Coronary Care Unit (CCU). The mean in-hospital delay to thrombolysis was 30 +/- 14 minutes for those treated in CFAU and 55 +/- 12 minutes for those treated in CCU (p < 0.0004). In a second sample of 100 consecutive patients with undetermined chest pain, by means of our protocol of short observation we identified 22 cases of acute myocardial infarction (AMI), 8 cases of angina pectoris, 18 various cardiac causes, 30 non-cardiac causes, 22 absent disease. ECG was obtained in all 100 pts, cardiac enzymes in 74, echocardiogram and chest X-ray in 48, ST monitoring in 26. In no case was diagnosed AMI after discharge. Cardiac First Aid Unit, as designed in our Hospital, suits the needs of a level II Emergency Department. It is a useful tool to shorten in-hospital delay to thrombolysis and to screen chest pain with nearly complete safety.

Topics: Adult; Aged; Cardiovascular Diseases; Coronary Care Units; Emergency Service, Hospital; Female; First Aid; Humans; Male; Middle Aged; Rome

The mortality of a cohort of 2310 male workers who obtained a licence to handle pesticides in the period 1973-1979 in the province of Rome was investigated. The cohort contributed 26,846 person-years of exposure. The vital status of the cohort was determined up to the end of 1988. The causes of death of the 207 who had died were ascertained from death certificates. Standardized mortality ratios (SMR) were computed using both the provincial and the national mortality rates. The two methods yielded very similar results. Using the national rates, the SMR for all causes was 56 (95% confidence interval (CI) : 45.3-59.8), for cardiovascular diseases 47 (95% CI : 37.1-59.1), and for all cancers 72 (95% CI : 57.8-89.3). A statistically significant excess was noted for brain cancer (SMR = 270, 95% CI : 108.6-556.9). In addition, the cohort experienced statistically significant lower lung cancer mortality (SMR = 57, 95% CI : 35.6-80.0).

Topics: Adolescent; Adult; Aged; Agricultural Workers' Diseases; Brain Neoplasms; Cardiovascular Diseases; Cause of Death; Cohort Studies; Confidence Intervals; Death Certificates; Exercise; Healthy Worker Effect; Humans; Licensure; Lung Neoplasms; Male; Middle Aged; Neoplasms; Pesticides; Population Surveillance; Rome; Rural Population; Smoking

Topics: Cardiovascular Diseases; Congresses as Topic; Europe; Female; Humans; Male; Physician-Patient Relations; Psychophysiologic Disorders; Research; Rome