"Side" effects of HAART: decreasing and changing occupational exposure to HIV-infected patients.

To investigate percutaneous exposures to HIV in the highly active antiretroviral therapy (HAART) era, we performed an analysis of all percutaneous exposures reported from January 1994 to December 1998 in 18 Italian acute-care hospitals. Frequency and rate per 100 prevalent AIDS cases of HIV exposures decreased by 40% (from 4.3% to 2.6%, and from 1.0% to 0.6%, respectively; p<0.001), which were mainly those related to the insertion/manipulation of peripheral vascular access devices (from 7.2% to 4.8%; p=0.05). We conclude that the benefits of HAART have changed the complexity of care required and therefore, the number and type of procedures performed on HIV patients that place the HCW at risk of injury.

Device-specific risk of needlestick injury in Italian health care workers.

OBJECTIVES: To identify the types of medical devices causing needlestick injuries among Italian health care workers, to document the device-specific injury rates and time trends for different hollow-bore needles, and to compare injury rates from these devices with those reported in the United States. DESIGN: Longitudinal survey. SETTINGS: Twelve Italian acute care public hospitals. METHODS: Data were obtained from a multihospital surveillance database on the number of total injuries reported in each device category. Hospitals provided the corresponding number of devices used annually for each needle type. MAIN OUTCOME MEASURE: Number of needlestick injuries by type of hollow-bore needle per 100,000 devices used per year. RESULTS: A total of 2524 injuries from hollow-bore needles were reported. Disposable syringes/hypodermic needles accounted for 59.3% of injuries, followed by winged steel needles (33.1%), intravenous catheter stylets (5.4%), and vacuum-tube phlebotomy needles (2.2%). Intravenous catheter stylets had the highest needlestick injury rate (15.7/100,000 devices used), and disposable syringes had the lowest needlestick injury rate (3.8/100,000). In contrast to the other devices, the injury rate from winged steel needles increased from 6.2 per 100,000 in 1990 to 13.9 per 100,000 in 1992. CONCLUSIONS: The device-specific needlestick injury rates in Italy are similar to those reported in the United States, suggesting similar exposure experience in two countries. However, in contrast to the United States, needleless intravenous access is standard practice in Italy and thus eliminates one potential risk to Italian health workers. Implementation of safer equipment, such as shielded or retracting needles, and continuing training programs are needed to further reduce the hazards that health care workers face.

[Histologic forms of chronic hepatitis and response to interferon treatment. Clinical effectiveness of interferon alpha and beta treatment compared with chronic active viral hepatitis of various histologic grades]. / Forme istologiche di epatite cronica e risposta al trattamento con interferoni. Efficacia clinica del trattamento con interferoni alfa e beta nei confronti delle epatiti virali croniche attive di vario grado istologico.

The authors evaluated the clinical response to treatment with interferons in relation to chronic virulent hepatitis, different on histological level. All the interferons until now commercially available have been employed following a casual standard of choice. The results underlined a certain therapeutic success in 70% with a clinical answer in course of therapeutic preservation; and a failure rate of 30%.

[Clinical and pharmacokinetic observations on fluconazole in the management of cryptococcal meningitis]. / Osservazioni cliniche e farmacocinetiche sul fluconazolo nel trattamento della meningite da criptococco.

The above study was intended to evaluate certain pharmacokinetic properties as well as the pharmacological activity of fluconazole in patients with cryptococcal meningitis. The results obtained show satisfactory bioavailability of the drug in the cerebrospinal fluid and marked reduction of the number of fungi found in the liquor.

[Treatment of chronic hepatitis with interferon-beta]. / Osservazioni sul trattamento di epatiti croniche con beta interferone.

Thirty-five patients suffering from chronic viral hepatitis were treated with beta-IFN during two periods: 22 during 1991 and 13 in 1992. Patients in the first group were treated with a dose of 3 MUI beta-IFN three times a week for six months with a follow-up of 1 year; those patients treated during 1992 received the same dose but over a period of 12 months. The results confirm a satisfactory response (33%) and a good drug tolerability in patients enrolled in 1991. Those patients tho commenced treatment in 1992 will be the subject of a subsequent analysis.

[Influenza. Sero-epidemiological supervision of the Alitalia airline personnel (1978-1979)]. / Influenza. Sorveglianza sieroepidemiologica presso il personale Alitalia (1978-1979).

From the autumn 1978 to the spring 1979 an epidemiological inquiry was set up concerning samplings of sera of 1648 adult of different ages and of both sexes. It was noticed a contemporaneous presence of A/Texas/1/77(H3N2) and A/USSR/90/77(H1N1) viruses; it was found a larger frequency of the last subtype in the individuals born after 1957. During the winter 1978/1979 it was also noticed an overlap of B influenza virus.