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Between August 1985 and June 1987, 809 subjects at risk for AIDS have been studied. 231 (28.5%) were seropositive for human immunodeficiency virus (HIV) antibodies. The seropositivity rate was 41% among drug addicts, 20.5% among homosexual/bisexual males, 19.7% among sexual partners of seropositive individuals. None of 62 subjects belonging to the health care personnel who interacted with seropositive patients and none of the 26 relatives of HIV-infected subject, have been found to be seropositive. Moreover the HIV seropositivity in the population of Parma was only 0.01%. Among the seropositive subjects, 155 (67.1%) were asymptomatic; 2 (0.8%) showed acute infection (a mononucleosis-like syndrome in both, associated with aseptic meningitis in one); 57 (24.6%) had PLG, 7 (3.4%) ARC, 9 (3.8%) full-blown AIDS (8 of these latter are dead).

In January 1984 a hepatitis B vaccination campaign was started in health care workers of Hospital of Parma. Within 3 years, of the 953 subjects submitted to serologic screening, 446 were eligible and 409, serum negative for HBV, completed the vaccination. 202 received HB-VAX vaccine (M.S.D.) intramusculary into the buttock at 0.1 and 6 months, and 208 received HEVAC-B vaccine (Pasteur) into deltoid region at 0, 1, 2 and 12 months. After the booster injection, percent of seroconversion (anti-HBs greater than 10 UI/l) and anti-HBs antibody titres were significantly (p less than 0.01) higher in HEVAC-B recipients (95.6%, mean anti-HBs titres = 6400 UI/l), than in the subjects vaccined with HB-VAX (77.1%, mean anti-HBs titres = 2703 UI/l). There was no significative difference in immune response in both groups with respect to age, sex or occupational category. Three hepatitis B infections were identified in HB-VAX recipients, but no one in individuals vaccined with HEVAC-B. No participants had serious adverse effects, minor side effects occurred with equal frequency in both groups. In general, both plasma-derived vaccines have proved to be highly immunogenic, safe and well tolerated in health care workers, however HEVAC-B vaccine, since contains S and pre-S ag, has shown a more satisfactory immunogenic effect.

The most recent data concerning the characteristics of hepatitis A virus, as well as epidemiology and prophylaxis of type A hepatitis are described. An epidemic of hepatitis A which occurred in a village near Parma is analysed. The diagnosis was based on the detection, by radioimmunoassay, of specific antibody to hepatitis A antigen (anti-HAV) at the beginning of the infection and during the convalescence. In addition the occurrence of high levels of specific immunoglobulins type M anti HAV, during the acute phase, was a further evidence of the diagnosis. The presence of other agents responsible for acute hepatitis, such as Cytomegalovirus and Epstein-Barr virus, has been excluded by laboratory examination.

The different alternative for an ECG's computer interpretative service are described and analyzed. The important factors which can be used as measures of effectiveness for each alternative are identified as: 1) waiting time before sending ECG; 2) waiting time before receiving the report; 3) capability of satisfying emergency calls; 4) cost per ECG. Three major alternatives are compared on the basis of these measures of effectiveness. The utility of a computer center serving more hospitals is evaluated against the utility of having an in-house computer in the hospital, on the basis of cost and convenience of service considerations.

SYNOPSIS An epidemiological study of headache has been carried-out in a hospital staff with the purpose: (a) to check out the prevalence of headache (migraine and muscle-contraction headache in particular) in an occupational group representative of the working population at large; (b) to verify the existence of clinical aspects generally held peculiar to migraine in different types of headache; (c) to evaluate comparatively the reliability of self-administered questionnaire and direct clinical interview in order to quantify epidemiologically the various headaches sub-types. Initially a simple questionnaire was administered to 1331 employees of Parma Regional Hospital; subsequently sufferers from headache were individually submitted to a complete clinical and laboratory examination. On the basis of the questionnaire, 361 subjects (27.12%) resulted to suffer frequently from headache attacks. The subsequent individual examination indicated that 37.1% suffered from common migraine, 27.3% from muscle tension headache, 7.6% from mixed headache, 3.8% from classic migraine, 3% from post-traumatic headache. The findings which were obtained by self-administered questionnaire and by individual direct examination are comparatively discussed.

Thirty members of the staff and fifty-one patients of Parma hemodialysis unit, serum negative for HBV markers, having completed the vaccination (HB-vax vaccine) against hepatitis B, were followed for two years after booster dose. After the third injection, the response to HB vaccine was significantly higher (p less than .0005) in staff members, than in patients. In the staff group, 83.3% were responders at mean titers of anti-HBs of 2703 mUI/ml; only 51% of patients developed anti-HBs at mean titres of 287 mUI/ml. As to either sex or age, no significant differences were observed in the two groups. Among hemodialysis patients the higher response (71.4%) was noted in the less than 40 aged individuals in comparison with those 40-60 (56.9%) or greater than 60 aged (38%). The persistence of the immunisation in both groups appeared to be statistically correlated to the anti-HBs titres after booster injection. At the end of the follow-up, 63.3% of the staff vaccinated members, but only 15.6% of the patients still had protective titre. No ill-effects induced by vaccine developed. Hepatitis B infection was only observed in one non responder member of the staff. The study demonstrates a low response to HB-vaccine and a rapid decrease of anti-HBs titre in the hemodialysis patients, thus leading to the need of frequent revaccination.

An epidemiological survey of hepatitis B virus infection has been carried out in medical and paramedical employees of the Hospital of Parma, in order to identify high-risk groups and to estimate how many of subjects might be immunized with newly available but expansive vaccine. Radioimmunoassay procedures were used to detect the hepatitis B surface antigen (HBsAg) and the corresponding antibody (anti-HBs) in serum samples from 1682 hospital workers. Among these person tested, HBsAg was present in 57 (3.4%) and anti-HBs in 438 (26.3%); at least one of the two markers was found in 495 (29.4%). The prevalence of HBsAg and anti-HBs was related more closely to age, years and kind of occupation, than to clinical service (i.e. renal dialysis or medical services) and title (physician, nurse, laboratory technician, support staff.