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1.
Occup Med (Lond) ; 2024 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-39056316

RESUMEN

BACKGROUND: Ethical climate in the workplace has been highlighted to have an important impact on workers' mental health; the evaluation of workplace ethics and its impact on workers' health should be considered an occupational health issue. AIMS: The present study aims to investigate ethical climate as perceived by workers, and its correlation with mental health outcomes, in particular, symptoms of depression, anxiety and stress. METHODS: A cross-sectional study was performed by administering an online survey, investigating socio-demographic variables, workplace ethics (through the Italian short version of the Corporate Ethical Virtues questionnaire) and mental health outcomes (using the short version of the Depression, Anxiety and Stress Scale). Descriptive analyses, analyses of variance and regression models were performed; P-values were considered significant for values ≤0.05. RESULTS: The sample included 176 workers; the mean age of participants was 46.22 years and 44% were males. The most represented job sector was health care (37%), and 42% of participants had college-level education. Ethical climate was significantly correlated with all mental health outcomes investigated in the study: anxiety (P ≤ 0.001), depression (P ≤ 0.05) and stress (P ≤ 0.05). CONCLUSIONS: Results from this study highlighted a significant correlation between workplace ethical climate and depression, anxiety and stress. This study underlines the importance of evaluating and improving ethical climate to prevent the onset of psychological distress in workers. Furthermore, results from this study should be a starting point for future research investigating the role of ethics and mental health in employees' turnover intention and job satisfaction.

2.
Ann Ig ; 36(1): 88-98, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38018762

RESUMEN

Introduction: The COVID-19 pandemic has determined a radical change in workplace dynamics, with a reported increase in voluntary resignation from employment at a global level, especially among the young-est workers. The aim of this study is to investigate the social, demographic, and cultural characteristics of young people aged between 25 and 45 years who voluntarily resigned from their previous jobs during the COVID-19 pandemic. Methods: This is a cross-sectional observational study; an ad hoc questionnaire was designed and admin-istered via an online link. Descriptive analyses were performed to describe the sample, and the Pearson analysis was performed to investigate statistically significant correlations; p values ≤ 0.05 were considered statistically significant. Results: A total of 72 valid responses were gathered. Mean age was 32.6 years; 43.1% participants were males, 54.2% were married, and 80.6% had no children; most participants (68.1%) had a college level education. The most reported cause of job resignation was work dissatisfaction (38.9%), followed by inadequate remuneration (27.8%). The most reported perspective for people who had resigned or were planning on resigning, was a better salary (27.8%), followed by the pursuit of a higher work-life balance (25.0%). The perception that having resigned was the right choice was significantly correlated with the timeframe of resignation (p<0.01), with having suffered from COVID-19 (p<0.05), and with a close relative having suffered from COVID-19 (p<0.01). Conclusion: This study highlighted that voluntarily resigning was significantly correlated to having suffered from COVID-19, or a close relative having suffered from it; 84.9% of participants who had resigned thought that it had been the right choice. The COVID-19 pandemic could have changed workplace perception, making employees feel more at risk; the indirect impact of the pandemic should be further investigated, and prevention strategies should be implemented to ensure the safety and wellbeing of employees.


Asunto(s)
COVID-19 , Masculino , Humanos , Adolescente , Adulto , Persona de Mediana Edad , Femenino , COVID-19/epidemiología , Pandemias , Estudios Transversales , Empleo , Lugar de Trabajo
3.
Public Health ; 221: 50-59, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37406450

RESUMEN

OBJECTIVES: The aim of this umbrella review of systematic reviews and meta-analyses was to address workplace violence (WPV) against healthcare workers (HCWs). Several systematic reviews exist in the literature, but the diversity of settings, population considered, and type of violence investigated make it difficult to gain insight and use the vast amount of available data to implement policies to tackle WPV. With this in mind, we conducted an umbrella review of systematic reviews and meta-analyses on WPV against HCWs to examine the global prevalence of the phenomena and its features. STUDY DESIGN AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and ISI Web of Science were searched for relevant systematic reviews and meta-analyses published in English up to November 2022. Data on authors, year, country, violence type, prevalence (pooled and not), setting, population, and specific considerations were extracted. RESULTS: A total of 32 systematic reviews were included, 19 of which performed a meta-analysis, investigating overall, physical, and non-physical violence. Even considering the variability of the data, the COVID-19 pandemic has exacerbated the scale of the problem. From our review, we found that overall violence prevalence among HCWs was reported to be as high as 78.9%, and nurses working in psychiatric wards were the professionals most impacted. CONCLUSION: In conclusion, this umbrella review revealed a high prevalence of WPV among HCWs, which varies between countries, population subgroups, and detection methods. Strengthening recognition of the problem could lead to appropriate local and international strategies to address it.


Asunto(s)
COVID-19 , Violencia Laboral , Humanos , Personal de Salud , Pandemias , Prevalencia , Lugar de Trabajo , Revisiones Sistemáticas como Asunto , Metaanálisis como Asunto
4.
Ann Ig ; 35(5): 521-533, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37057651

RESUMEN

Introduction: Work-related psychosocial risks have been identified as significant occupational health and safety risks; the occupational physicians must assess and monitor the health status of workers in order to verify that work is not a source of harm to exposed operators. The aim of the study was to investigate the outcomes related to anxiety and depression traits in workers exposed to stress-related work. Methods: A questionnaire was administered to a large population of Italian public administration workers; the Centre for Epidemiologic Studies - Depression Scale questionnaire was used to measure depression, the Self rating Anxiety Scale was used to measure anxiety, the UK Management Standards Indicator tool questionnaire was used to assess work adjustment. A descriptive analysis, a multivariate analysis, as well as logistic regression models were used to assess the health outcomes related to stress. Results: A total of 292 workers participated in the study; 100% of participants had a Centre for Epidemiologic Studies - Depression Scale score over the cut-off; 41.78% had a Self rating Anxiety Scale score over the cut-off; the results support a correlation between the Centre for Epidemiologic Studies - Depression Scale results and the UK Management Standards Indicator tool results; and a correlation between Self-rating Anxiety Scale results and the UK Management Standards Indicator tool results. Conclusions: The Demand, Management, Support and Relationship results were associated with mental health outcomes, and it could be a useful tool in occupational medicine, to identify workers at risk for negative mental health outcomes, becoming an essential tool in workers' health assessment and for prevention of mental health disorders.


Asunto(s)
Trastornos Mentales , Exposición Profesional , Estrés Laboral , Distrés Psicológico , Humanos , Proyectos Piloto , Estrés Laboral/diagnóstico , Estrés Laboral/epidemiología , Ansiedad/diagnóstico , Ansiedad/epidemiología , Ansiedad/etiología , Encuestas y Cuestionarios , Exposición Profesional/efectos adversos , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Depresión/diagnóstico , Depresión/epidemiología , Depresión/etiología
6.
Ann Ig ; 32(5 Supple 1): 66-84, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33146368

RESUMEN

In recent years, the Scientific Community and the Public Health world, in general, have devoted increasing interest to housing conditions, which are considered, to date, one of the main environmental and social determinants of the population's health. In particular, the Scientific Community has identified and studied various indoor well-being factors (e.g. lighting, temperature, ventilation, air quality, etc.). Some of these factors have been regulated by laws and regulations at various levels: the availability of clear and updated health requirements dictated by the regulations is fundamental to effectively protect public health, especially in confined environments. In the present work, we propose a revision of the Italian Ministerial Decree of July 5th, 1975 titled Modificazioni alle istruzioni ministeriali 20 giugno 1896 relativamente all'altezza minima ed ai requisiti igienico sanitari principali dei locali d'abitazione (Modifications to the ministerial instructions of June 20th, 1896 regarding the minimum height and the main hygienic-sanitary requirements of living spaces) in order to update the definition of the essential elements that qualify a space as habitable from the hygienic-sanitary point of view, taking into account the evidence gathered from the technical and scientific literature on the requirements and contents of the Building Codes of the major European countries.


Asunto(s)
Vivienda/legislación & jurisprudencia , Higiene/legislación & jurisprudencia , Salud Pública/legislación & jurisprudencia , Códigos de Edificación/legislación & jurisprudencia , Humanos , Italia , Determinantes Sociales de la Salud/legislación & jurisprudencia
7.
BMC Anesthesiol ; 19(1): 42, 2019 03 27.
Artículo en Inglés | MEDLINE | ID: mdl-30917782

RESUMEN

BACKGROUND: Nitrous oxide has a proven clinical efficacy in conscious sedation. At certain environmental concentrations it may pose a health risk to chronically exposed healthcare workers. The present pilot study aims at evaluating the exposure to nitrous oxide of dental ambulatory personnel of a pediatric hospital. METHODS: A descriptive study design was conducted in two phases: a bibliographic analysis on the environmental safety policies and a gas concentration analysis in the dental ambulatories of a pediatric hospital, detected every 6 months from December 2013 to February 2017 according to law provisions. The surveys were carried out using for gas analysis a photoacoustic spectrometer Innova-B&K "Multi-gas monitor model 1312" and Innova-B&K "Multi-sampler model 1309". The biological analysis and monitoring have been carried out on staff urine. RESULTS: The analyses were performed during 11 dental outpatient sessions on pediatric patients. All the patients were submitted to the same dental procedures, conservative care and dental extractions. The pediatric patients were 47 (23 males, 24 females; age range 3-17 years; mean age 6,63, SD ± 2,69) for a mean of 4,27 (SD ± 1,49) per session., The mean environmental concentration of nitrous oxide during the sessions was 24.7 ppm (SD ±16,16). A correlation was found between urinary nitrous oxide concentration of dentists (Pearson's correlation 0.786; p = 0.007) and dental assistants urines (Pearson's correlation 0.918; p < 0.001) and environmental concentrations of nitrous oxide. Weak negative correlations were found between age and sex of patients and environmental concentrations of nitrous oxide. The mean values of the biological monitoring data referring to all the outpatient sessions are lower than the reference values foreseen in accordance to the regulations in force on nitrous oxide concentration. CONCLUSIONS: The mean environmental concentration values recorded in our study are below the limit of 50 ppm considered as a reference point, a value lower than those reported in other similar surveys. The results of the present study provide a contribution to the need to implement technical standards, criteria and system requirements for the dental ambulatories, to date not yet completely defined, and cannot be assimilated to the ones established for the surgical rooms.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios/normas , Sedación Consciente/normas , Asistentes Dentales/normas , Odontólogos/normas , Hospitales Pediátricos/normas , Óxido Nitroso/orina , Exposición Profesional/análisis , Adolescente , Procedimientos Quirúrgicos Ambulatorios/métodos , Niño , Preescolar , Sedación Consciente/métodos , Monitoreo del Ambiente/métodos , Monitoreo del Ambiente/normas , Femenino , Humanos , Italia/epidemiología , Masculino , Óxido Nitroso/administración & dosificación , Proyectos Piloto , Estudios Retrospectivos
8.
Ann Ig ; 30(5 Supple 2): 7-14, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30374507

RESUMEN

BACKGROUND: In Italy there are no rules concerning the establishment of a hospital hygiene structure in hospitals and other healthcare settings, and the hospital organization plans vary widely. The aim of the survey, carried out by the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive medicine and Public health, was to evaluate the presence in the hospital organization plan of a structure referred to as Hospital hygiene, or including in its denomination the words "hygiene" or "hospital hygiene", the activities carried out, the relation to other areas, like patient safety, the type and quantity of professionals involved, the strengths and the critical aspects. METHODS: A semi-structured questionnaire was administered to Healthcare Trusts representing all Italian Regions through the members of the above Study Group. RESULTS: 35 Trusts, 13 in Northern, 8 in Central, 14 in Southern Italy (including Sicily and Sardinia), completed the questionnaire. In 19 Trusts (54.3%) a structure whose denomination included the words "hospital hygiene" or "hygiene" was present. The activities related to the management of infectious risk were most represented, carried out autonomously or in collaboration, but many other activities were covered. In all hospitals the activities of the Hospital Hygiene Unit inter-linked with those of the clinical risk, with different forms of collaboration. CONCLUSION: This survey, even though on a limited sample, provided a picture of hospital hygiene at a national level, showing a considerable heterogeneity and highlighting critical issues but also strengths. It is essential to share organizational and management models that enhance and promote hospital hygiene, to ensure the appropriateness of healthcare practices offered in a safe and comfortable environment to patients, operators, and visitors.


Asunto(s)
Infección Hospitalaria/prevención & control , Administración Hospitalaria , Higiene , Control de Infecciones/organización & administración , Encuestas y Cuestionarios , Hospitales , Humanos , Italia , Sociedades Médicas , Encuestas y Cuestionarios/estadística & datos numéricos
9.
Ann Ig ; 29(6): 481-493, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29048447

RESUMEN

The Erice 50 Charter titled "Strategies for Diseases Prevention and Health Promotion in Urban Areas" was unanimously approved at the conclusion of the 50th Residential Course "Urban Health. Instruments for promoting health and for assessing hygienic and sanitary conditions in urban areas", held from 29th March to 2nd April 2017 in Erice, at the "Ettore Majorana" Foundation and Centre for Scientific Culture and promoted by the International School of Epidemiology and Preventive Medicine "G. D'Alessandro" and the Study Group "Building Hygiene" of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI). At the conclusion of the intense learning experience during the Course, with more than 20 lectures, workshops and long-lasting discussions between Professors and Students, the participants identified the major points connecting urban features and Public Health, claiming the pivotal role of urban planning strategies for the management of Diseases Prevention and Health Promotion activities. The Erice 50 Charter is configured as a Decalogue for Healthy Cities and as a Think Tank for designing effective strategic actions and best practices to develop urban regeneration interventions and improve the urban quality of contemporary cities. The Decalogue is structured into the following key strategic objectives: 1. Promoting urban planning interventions that address citizens towards healthy behaviours; 2. Improving living conditions in the urban context; 3. Building an accessible and inclusive city, with a special focus on the frail population; 4. Encouraging the foundation of resilient urban areas; 5. Supporting the development of new economies and employment through urban renewal interventions; 6. Tackling social inequalities; 7. Improving stakeholders' awareness of the factors affecting Public Health in the cities; 8. Ensuring a participated urban governance; 9. Introducing qualitative and quantitative performance tools, capable of measuring the city's attitude to promote healthy lifestyles and to monitor the population's health status; 10. Encouraging sharing of knowledge and accessibility to informations. Finally, all the participants underlined that a multidisciplinary team, composed of Physicians specialized in Hygiene, Preventive Medicine, Public Health and Technicians as Architects, Urban planners and Engineers, is needed to deepen the research topic of Urban Health.


Asunto(s)
Promoción de la Salud/métodos , Prevención Primaria/métodos , Salud Urbana , Humanos , Italia
10.
Ann Ig ; 29(2): 92-100, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28244578

RESUMEN

The Study Group on Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health (GISIO-SItI) and the Local Health Authority of Foggia, Apulia, Italy, after the National Convention "Safe water in healthcare facilities" held in Vieste-Pugnochiuso on 27-28 May 2016, present the "Vieste Charter", drawn up in collaboration with experts from the National Institute of Health and the Ministry of Health. This paper considers the risk factors that may affect the water safety in healthcare facilities and reports the current regulatory frameworks governing the management of installations and the quality of the water. The Authors promote a careful analysis of the risks that characterize the health facilities, for the control of which specific actions are recommended in various areas, including water safety plans; approval of treatments; healthcare facilities responsibility, installation and maintenance of facilities; multidisciplinary approach; education and research; regional and national coordination; communication.


Asunto(s)
Instituciones de Salud/normas , Seguridad/normas , Microbiología del Agua/normas , Abastecimiento de Agua/normas , Instituciones de Salud/legislación & jurisprudencia , Promoción de la Salud , Humanos , Italia , Salud Pública/legislación & jurisprudencia , Salud Pública/normas , Factores de Riesgo , Seguridad/legislación & jurisprudencia , Purificación del Agua/legislación & jurisprudencia , Purificación del Agua/normas , Abastecimiento de Agua/legislación & jurisprudencia
12.
Med Lav ; 105 Suppl 1: 3-68, 2014 Nov 13.
Artículo en Italiano | MEDLINE | ID: mdl-25488525

RESUMEN

AIM: Current Italian legislation obliges employers to prevent workers who are occupationally at risk or who perform jobs that may be hazardous for the safety or health of third parties from consuming alcohol. The LaRA Group undertook to assess whether the law fully safeguards the health and safety of both workers and third parties, without impinging upon the civil rights of workers. METHOD: A written document expressing agreement was produced following discussions between doctors, lawyers, bioethicists and social partners. RESULTS: There are gaps and inconsistencies in current laws; the differences in local and regional provisions prevent authorities from applying a single strategy at national level. There should be a change in existing rules under which the employer's obligation to enforce the ban on consumption alcohol in the workplace is enacted solely by the "competent" physician whose institutional role is to safeguard and promote health. Some occupational categories that are subject to a ban on alcohol consumption do not currently under-go health surveillance. For example, if road transport drivers are not exposed to a specific occupational risk foreseen under another law, they can be placed under health surveillance only in those regions where the local laws contemplate this type of control. In other cases, the practice of assessing the risk to third parties and providing for compulsory health surveillance in the Risk Assessment Document, is considered by some jurists to be a "consuetudo praeter legem" and therefore acceptable in a field not yet covered by a specific law, but to be "contra legem" or unlawful by other jurists. Moreover, the competent physician who uses a breathanalyser or tests for alcohol addiction faces an ethical dilemma, since by communicating the results to an employer or authorities responsible for the issuing of licenses, he may be violating his professional oath of secrecy. Furthermore, the emphasis placed on testing has induced companies and inspectors to overlook educational and rehabilitation aspects. It is essential to involve general practitioners, educators and specialist services in addressing the problems of alcohol abuse so as to inform/train, recover and rehabilitate. The few studies available indicate that the rules are poorly enforced and that non-compliance may go unobserved. CONCLUSIONS: The Group urges all employers to assess the risk for third parties caused by alcohol abuse and to devise a policy on alcohol. Controlling alcohol-related risks in the workplace calls for a better definition of the roles of Vigilance Bod-ies and Company Physicians together with a shift from a reactive to a proactive attitude of all the parties involved.


Asunto(s)
Alcoholismo/prevención & control , Salud Laboral , Alcoholismo/diagnóstico , Alcoholismo/epidemiología , Unión Europea , Humanos , Agencias Internacionales , Italia/epidemiología , Salud Laboral/legislación & jurisprudencia , Factores Sociológicos , Encuestas y Cuestionarios
13.
Ann Ig ; 24(2): 113-21, 2012.
Artículo en Italiano | MEDLINE | ID: mdl-22755498

RESUMEN

Adherence to vaccination campaigns can be negatively influenced by Web presence of unreliable information. Aim of study is qualitative and quantitative evaluation of Italian WebPages contents about vaccinations to address prevention strategies in countries that, like Italy, wouldn't like vaccination to be mandatory any longer In August 2011 two researchers conducted a Systematic Review in Italian WebPages about vaccination risks. First 100 results of 9 common search engines have been combined; pro and against pages were compared (CHI2, p <0,05). 144 WebPages were analysed: 67% of them, often on top positions, was against vaccinations and 24% of them was written by Medical Doctors. All institutional pages (12%) were pro vaccinations but they resulted in less important positions. Against WebPages were different from pro ones in terms of use of emotional images, personal negative experiences, advertising purposes (books or alternative medicine products). Main criticism was: inefficacy, low safety profile and stakeholder's interests. This study would like to represent a useful tool for parents and Medical Doctors, especially because many of them are progressively more sceptical about vaccination practises. The great number of anti-vaccination movements on Italian Web should improve public health strategies in terms of "Evidence-Based prevention".


Asunto(s)
Educación en Salud/normas , Difusión de la Información , Internet , Padres/educación , Salud Pública , Vacunas/efectos adversos , Niño , Medicina Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Negativa del Paciente al Tratamiento
14.
G Ital Med Lav Ergon ; 34(3 Suppl): 266-8, 2012.
Artículo en Italiano | MEDLINE | ID: mdl-23405637

RESUMEN

Several studies have shown that occupational exposure to anesthetic gases might be higher during pediatric surgery, probably due to the increased use of inhalational induction techniques. Our study aims to assess the level of exposure to sevoflurane in two rooms of pediatric surgery, using multi-point sampling method for environmental monitoring. The gas concentrations as well as its dispersion were measured in strategic points in the rooms for a total of 44 surgical interventions. Although the average of these concentrations has been rather low (1.32, SD +/- 1:55 ppm), the results obtained have documented a significant distribution kinetics difference inside the rooms as function of multiple factors among which there were the anesthetic technique used and the team involved. Therefore the method described allows to correctly analyze the spread of anesthetic gases and suggests a different risk stratification which may be dependent on the professional work.


Asunto(s)
Contaminantes Ocupacionales del Aire/análisis , Anestésicos por Inhalación/análisis , Monitoreo del Ambiente/métodos , Éteres Metílicos/análisis , Exposición Profesional/análisis , Quirófanos , Humanos , Pediatría , Medición de Riesgo/métodos , Sevoflurano
15.
J Hosp Infect ; 66(4): 313-9, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17669550

RESUMEN

The aim of this study was to evaluate the efficacy of a mobile laminar airflow (LAF) unit in reducing bacterial contamination at the surgical area in an operating theatre supplied with turbulent air ventilation. Bacterial sedimentation was evaluated during 76 clean urological laparotomies; in 34 of these, a mobile LAF unit was added. During each operation, settle plates were placed at four points in the operating theatre (one at the patient area and three at the perimeter), a nitrocellulose membrane was placed on the instrument table and an additional membrane near the wound. During four operations, particle counting was performed to detect particles > or =0.5 microm. Mean bacterial sedimentation on the nitrocellulose membrane on the instrument table was 2730 cfu/m(2)/h under standard ventilation conditions, whereas it decreased significantly to a mean of 305 cfu/m(2)/h when the LAF unit was used, i.e. within the suggested limit for ultraclean operating theatres (P=0.0001). The membrane near the wound showed a bacterial sedimentation of 4031 cfu/m(2)/h without the LAF unit and 1608 cfu/m(2)/h with the unit (P=0.0001). Particle counts also showed a reduction when the LAF unit was used. No significant difference was found at the four points in the operating theatre between samplings performed with, and without, the LAF unit. Use of a mobile LAF unit with turbulent air ventilation can reduce bacterial contamination at the surgical area in high-risk operations (e.g. prosthesis implant).


Asunto(s)
Infección Hospitalaria/prevención & control , Ambiente Controlado , Quirófanos , Infección de la Herida Quirúrgica/prevención & control , Recuento de Colonia Microbiana , Monitoreo del Ambiente/métodos , Humanos , Material Particulado/análisis
16.
Infect Control Hosp Epidemiol ; 27(5): 459-65, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16671026

RESUMEN

OBJECTIVES: To perform a 3-year, prospective surveillance program for legionnaires disease (LD) in a large university hospital in Rome, and to assess the usefulness of the hospital water monitoring program in predicting the risk of nosocomial LD. METHODS: Samples from patients with new cases of nosocomial pneumonia were sent for legionella laboratory investigations. Meanwhile, water samples for bacteriological analysis were collected every 6 months from high- and medium-risk hospital wards (10 in total). Legionella pneumophila isolates collected were serotyped and analyzed by pulsed-field gel electrophoresis. RESULTS: From June 2001 through May 2004, the pneumonia surveillance identified one case of nosocomial LD among 43 cases of nosocomial pneumonia (2.3%). Environmental investigations detected L. pneumophila in 12 (18.7%) of the 64 water samples, of which 50% belonged to serogroup 1. The L. pneumophila count and the percentage of positive locations never exceeded 10(2) colony-forming units/L and 20%, respectively, except when the LD nosocomial case occurred (positive water samples, 40%; L. pneumophila count, <10(2) colony-forming units/L). Genotyping showed 3 prevalent clones of L. pneumophila in the water distribution network, of which one persisted over the 3 years. One clone contained 3 different L. pneumophila serogroups (2, 4, and 6). CONCLUSIONS: The low incidence of nosocomial cases of LD appears to be associated with a low percentage (<20%) of positive water samples per semester and with a low contamination level (<10(2) colony-forming units/L). An infection control system for nosocomial LD should, therefore, be based on both environmental and clinical surveillance, together with the appropriate maintenance of the hospital water distribution system.


Asunto(s)
Infección Hospitalaria/epidemiología , Agua Dulce/microbiología , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/epidemiología , Vigilancia de la Población , Abastecimiento de Agua , Infección Hospitalaria/microbiología , Electroforesis en Gel de Campo Pulsado , Hospitales Universitarios , Humanos , Incidencia , Control de Infecciones/métodos , Legionella pneumophila/clasificación , Legionella pneumophila/genética , Enfermedad de los Legionarios/microbiología , Estudios Prospectivos
18.
Br J Anaesth ; 94(4): 453-8, 2005 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15665071

RESUMEN

BACKGROUND: About 98% of plasma propofol is bound to albumin. We investigated if severe hypoalbuminaemia may affect the accuracy of a target-controlled infusion (TCI) device, the Diprifusor, during sedation in critically ill patients. METHODS: Ten critically ill hypoalbuminaemic patients (<24 g litre(-1)) and 10 critically ill normoalbuminaemic patients (>32 g litre(-1)) were included in this study. They underwent sedation with propofol, aimed at a Ramsey sedation score of 4-5. The Diprifusor was used to achieve target propofol plasma concentrations that ranged between 0.6 and 1.5 mg litre(-1). Propofol concentration was measured by high-performance liquid chromatography 5 min, 15 min, 30 min, 1 h, 2 h, 4 h, 6 h and 8 h after starting TCI. The accuracy of TCI was evaluated by calculating performance errors [PE=100x(measured concentration-predicted concentration)/predicted concentration], absolute and relative individual median performance errors (MDAPE and MDPE) and divergence (the slope of individual regression lines between PEs and time). RESULTS: PEs [median (range)] were -7 (-65, 79) in hypoalbuminaemic patients and -2 (-53, 188) in normoalbuminaemic patients; absolute PEs were 21 (1, 79) and 22 (0, 188). No significant difference was observed between the two groups. MDPE, MDAPE and divergence values were also similar. In most patients the accuracy of TCI increased with time because higher PE values were observed during the first 30 min. CONCLUSIONS: Hypoalbuminaemia does not affect the accuracy of Diprifusor during sedation with propofol in critically ill patients.


Asunto(s)
Sedación Consciente , Hipnóticos y Sedantes/sangre , Hipoalbuminemia/sangre , Bombas de Infusión/normas , Propofol/sangre , Adulto , Anciano , Índice de Masa Corporal , Cromatografía Líquida de Alta Presión , Quimioterapia Asistida por Computador/normas , Femenino , Humanos , Hipnóticos y Sedantes/administración & dosificación , Infusiones Intravenosas , Italia , Masculino , Persona de Mediana Edad , Propofol/administración & dosificación
19.
Ann Ig ; 15(5): 493-503, 2003.
Artículo en Italiano | MEDLINE | ID: mdl-14969302

RESUMEN

A multicentric Italian investigation on legionnaires' disease is in course to clarify host factors as well as pathogen associated characteristics involved in the infection/disease. The main goal of the research plan is to account for some critical aspects concerning identification and prevention of legionellosis. To improve knowledge on factors associated with Legionella spp colonisation in hot waters, to detect cases and to characterize risk factors in subjects which develop pneumonia are specific objectives of the research programme. Preliminary results show that hot waters of houses and hotels are frequently contaminated (22.6% and 54.6%, respectively), mainly by L. pneumophila. Microbial concentrations were low in domestic waters (<1.000 ufc/l), but higher in samples from the hotels (geom. mean 1.85 x 10(3) ufc/l). Warming system, age of the plant, type of building were risk factors significantly associated with Legionella spp positivity. The active surveillance on patients affected by pneumonia with search for Legionella urinary antigen allowed the identification of 34 cases, 3 of which of nosocomial origin, corresponding to 4.2% of the screened pneumonia. After informed consent, 26 subjects were recruited for a case-control-study to clarify risk factors for the disease.


Asunto(s)
Legionella/aislamiento & purificación , Legionelosis/epidemiología , Neumonía Bacteriana/epidemiología , Microbiología del Agua , Humanos , Italia/epidemiología , Neumonía Bacteriana/microbiología
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