rome and Communicable-Diseases

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

The increasing attention of archaeological and anthropological research towards palaeopathological studies has allowed to focus the examination of many skeletal samples on this aspect and to evaluate the presence of many diseases afflicting ancient populations. This paper describes the most interesting diseases observed in skeletal samples from five necropolises found in urban and suburban areas of Rome during archaeological excavations in the last decades, and dating back to the Imperial Age. The diseases observed were grouped into the following categories: articular diseases, traumas, infections, metabolic or nutritional diseases, congenital diseases and tumors, and some examples are reported for each group. Although extensive epidemiological investigation in ancient skeletal records is impossible, palaeopathology allowed highlighting the spread of numerous illnesses, many of which can be related to the life and health conditions of the Roman population.

Topics: Adolescent; Adult; Child, Preschool; Communicable Diseases; Congenital Abnormalities; Female; History, Ancient; Humans; Joint Diseases; Male; Metabolic Diseases; Middle Aged; Mummies; Paleopathology; Rome; Wounds and Injuries; Young Adult

The existence of infectious diseases specialists in Ancient Rome is unlikely, but there were at least three authors able of keen observations on infectious matters, with enough merit to be considered our predecessors: Varro, Columella and Vitruvius, none of them physicians. Varro, in his first Book on Agriculture recommended, "Build the houses distant from swamps, because certain minute creatures are bred which cannot be followed with the eyes but which float in the air and enter the body through the mouth and nose, giving rise to severe diseases". Also in a text of agriculture and in the same sense, Columella says "that with heat a swamp releases a pestilential vapor and produces a very dense swarm of insects, which come flying over us armed with harmful stings Vitruvius, the great architect was worried about drinkable water: its sources and properties, how to obtain it and the methods for testing its quality. The concern on its distribution and disposal of sewage started on 614 B.C., little after the foundation of Rome, with the building of the first aqueduct, the Aqua Marcia. This aqueduct in Trajan's times (century II A.D.), reached a total of 443 km, with 49,500 meters of arcades, which were up to 32 meters high, plus 2.4 km of an underground net. This system released 947,200 m(3) of water per day, two thirds of which were for public use and one third for private customers.

Topics: Communicable Disease Control; Communicable Diseases; History, Ancient; Humans; Rome; Sanitation

Common variable immunodeficiency (CVID) is a chronic condition characterised by a predominant defect of humoral immunity. In most cases the diagnosis of CVID is made during adulthood; the main clinical features of CVID are chronic and relapsing infections (mainly of respiratory and gastroenteric tracts). CVID patients may also develop neoplastic and autoimmune diseases. In our centre (the Regional Centre for Primary Immunodeficiencies of the Lazio Regional Authority) we administered a 23-item questionnaire to 60 patients with CVID undergoing substitutive therapy with intravenous immunoglobulins (IVIG) about their demographic characteristics, time of clinical onset, time of diagnosis of CVID, clinical features, IVIG doses and administration intervals, and self-assessment of health status. In addition, the clinical history of all patients was reviewed, and the levels of serum IgG, IgA and IgM were evaluated and compared with the pre-therapy serum concentration. Moreover, an analysis of the treatment costs was performed. At onset, 67.2% of patients presented recurrent respiratory infections, and 50% had infections of the lower respiratory tract; 39.6% of the patients had gastroenteric infections. Most patients (57%) had recurrent infections of at least 2 of the respiratory, gastroenteric and/or urogenital tracts. In 37.9% of the group the diagnosis of CVID was made in less than 2 years after the beginning of symptoms, but in many cases (22.4%) the diagnosis took more than 10 years. 93% of patients are treated with a dose of IVIG between 6 and 15 g per administration, with intervals between 2 and 3 weeks. The review of patients'clinical history showed that 43% of patients have had respiratory infections during the follow-up in our Centre, 43% have splenomegaly (3% were also subjected to splenectomy) and 18.3% have autoimmune diseases. The mean concentration of IgG before the beginning of IVIG therapy was 235 mg/dl, while during the follow-up it was 664 mg/dl. Given the long time often required for diagnosis, general physicians and specialists should be better informed in order to make diagnosis swifter. The substitutive therapy with IVIG is effective in preventing recurrent infections and complications. A thorough follow-up is important for diagnosing neoplastic and autoimmune complications; in addition, immunologic analysis of peripheral blood and bone marrow are useful in identifying subgroups of patients with more severe clinical features. Finally, in sele

Topics: Adolescent; Adult; Aged; Autoimmune Diseases; Child; Child, Preschool; Common Variable Immunodeficiency; Communicable Diseases; Diagnosis-Related Groups; Disease Susceptibility; Female; Follow-Up Studies; Health Care Costs; Hospitals, Special; Humans; Immunocompromised Host; Immunoglobulins, Intravenous; Infant; Italy; Male; Middle Aged; Neoplasms; Referral and Consultation; Rome; Surveys and Questionnaires

During 2000, the millennium year, 26 million people visited Rome. An improved surveillance system for infectious diseases, especially for foodborne disease outbreaks (FBDO), meningitis, and legionnaires' disease was introduced in 1997. This rapid alert network links public health services with the principal sources of diagnosis and laboratory based surveillance. For travel related legionnaires' disease, international surveillance was implemented. Specific control measures for FBDOs were adopted. No increase in the overall incidence of these diseases was observed, and no atypical pathogens in FBDOs or meningitis were isolated in 2000 relating to 1998-99. Cases of legionnaires' disease and FBDOs involving foreign tourists increased (10/4 and 7/2 observed/expected respectively). Three out of six FBDOs involving pilgrims occurred in religious guesthouses. While an increase in cases of legionnaires' disease and FBDOs among foreign tourists was observed by the surveillance system, the millennium year did not influence the epidemiology of infectious diseases in the residential population of Lazio.

Topics: Communicable Diseases; Disease Outbreaks; Foodborne Diseases; Humans; Legionnaires' Disease; Meningitis; Population Surveillance; Rome; Travel

This article examines the influence of Lucretius' De rerum natura on the theory of contagious diseases which Girolamo Fracastoro developed during the second decade of the 16th century. It is apparent that the use of the concept of semina morbi was neither an anticipation of modern germ theory, nor a mere adaptation of the terminology of classical atomism. In fact, the combination of the humanist interest in the poem of Lucretius with a renewed attention towards direct observation resulted in the publication in of Fracastoro's De morbo gallico (1530), containing an innovative and effective interpretation of the notion of contagion.

Topics: Communicable Diseases; Europe; History, Ancient; History, Early Modern 1451-1600; Philosophy; Poetry as Topic; Rome; Science

An inscription from the II century BC, dedicated to the Roman god Verminus and considered to be due to the rising threat of human worm infections, is studied from linguistic and historical points of view. Having analyzed the historical sources we have reached the conclusion that the erection of the shrine was not related to the human helminthosis but to the epidemic infectuous disease which affected both animal and humans.

Topics: Animals; Communicable Diseases; Helminthiasis; History, Ancient; Humans; Religion and Medicine; Rome

Topics: Allergy and Immunology; Communicable Diseases; England; France; Germany; Greece; History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, Ancient; History, Medieval; Humans; Immunization; Italy; Netherlands; Rome