NMS is a rare adverse drug reaction, with a complex pathophysiology and presentation. Timely diagnosis and discontinuation of antipsychotic therapy is the first-line treatment, followed by supportive care and pharmacotherapy. Antipsychotic rechallenge is often required and should be attempted only after a drug-free period and with a different agent, slowly titrated with close monitoring.
Among 5005 Navy recruits aged 18-26 years from all sections of Italy, whose blood was tested in 1981, regional prevalence of serologic markers for hepatitis B was higher in southern Italy and in the Italian islands as compared with northern Italy and central Italy (4.3% vs. 2.3% for hepatitis B surface antigen (HBsAg) and 23.5% vs. 10.5% for any B marker). Social-demographic variables such as region, family size, and education were associated with hepatitis B as were the more traditionally associated variables related to blood or medical care such as history of intravenous injection, history of blood transfusion, or exposure to hospital. Number of siblings was positively related and educational attainment inversely related to prevalence of hepatitis B markers. The prevalence of HBsAg among Italian males aged 18-26 years with residence in southern Italy or in the Italian islands, whose education was limited to lower middle school, and who were from a family of eight siblings or more, is 14.6%. These are among the highest prevalence rates for hepatitis B antigen ever reported for a general population group in Europe. Good correlation exists between incidence of reported cases of hepatitis and prevalence of markers in the different regions of Italy.
Prevalence of hepatitis A antibodies among 5005 naval recruits aged 18-26 from all parts of Italy was almost double in the south and islands (83.3%) as compared to the north and central regions (45.2%). Social-demographic variables such as education and number of siblings are associated with prevalence of anti-HAV. Hepatitis A infection is still an early acquired infection in Italy, particularly in the south where among the 18-26-year-old recruits with education limited to lower middle school or less and eight siblings or more, prevalence of anti-HAV was 95%. Good correlation exists in Italy between prevalence of anti-HAV and incidence of reported cases of hepatitis.
The majority of RPD and resident respondents indicated that residents could be better prepared for the emotional challenges of patient care. The most commonly reported method of training for coping with emotional challenges was a one-on-one discussion between a preceptor and a resident on an as-needed basis.
A random sample of sera from children admitted over a 23-month period to a large paediatric hospital in Rome for diagnoses believed unrelated to viral hepatitis, was tested for HBsAG, anti-HBs, anti-HBc and anti-HAV. No sex or area of residence differences were found. The prevalence for markers of prior hepatitis B infection in children aged 1-12 years was 6.5%, in agreement with other observations in Italy and European countries. Prevalence of anti-HAV among children age 1-12 admitted for diagnoses believed unrelated to viral hepatitis was 10%. Prevalence of hepatitis markers in Roman women of reproductive age is estimated as 23.5 for B and 68.2 for A.
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