Waiting time for outpatient specialist care in Lombardy Region: evaluating accessibility and quality of information on websites of public health agencies and healthcare structures.

BACKGROUND: Waiting time for outpatient specialist care is an ever-present problem for all Countries with a universal healthcare system. In Italy, information about waiting times must be available on all websites belonging to public health agencies and healthcare structures. The aim of the present descriptive study is to evaluate the accessibility and quality of such information on websites of all public health agencies and healthcare structures in Lombardy Region. METHODS: All websites belonging to 8 health agencies (ATS), 27 public hospitals (ASST), 4 research and teaching hospitals (IRCCS) were analyzed using a newly designed 30-item checklist. The items were scored 0/1 and grouped in five categories: Accessibility, Architecture, Content, Interactivity, Utility. RESULTS: In all, 76.3% of websites reported their waiting times directly, but three did not update data at least monthly as required by current legislation. Less than half of websites provided information aimed at raising awareness and tackling no-shows, and only 10.5% explained the role of private practice in public structures when maximum waiting times are exceeded. CONCLUSIONS: The lack of exposition of waiting times on some websites belonging to ATS, ASST and IRCCS appears to be a relevant issue. There is also little empowering information that may help tackle waiting times themselves. These results warrant further efforts to improve accessibility, quality and transparency of information for all citizens.

Antimicrobial resistance in key bloodstream bacterial isolates: electronic surveillance with the Surveillance Network Database--USA.

To assess the prevalence of antimicrobial-resistant pathogens among the most common bloodstream isolates, we examined antimicrobial susceptibility data from The Surveillance Network Database-USA, an electronic surveillance system that collects data from 118 clinical microbiology laboratories across the United States. Between 1995 and 1997, resistance to both vancomycin and ampicillin was much more prevalent among Enterococcus faecium than Enterococcus faecalis, suggesting the need for laboratories to identify to species. When staphylococcal isolates were examined for reduced susceptibility to vancomycin (minimum inhibitory concentration = 4 microg/mL), the frequency was highest in methicillin-resistant coagulase-negative staphylococci. We also learned that nonsusceptibility to ceftazidime in Klebsiella pneumoniae was more prevalent among isolates from blood (12.7%) than among isolates from urine (7.1%) or respiratory sources (9.3%). Although antimicrobial resistance is low overall for isolates of Escherichia coli from blood, the prevalence of cefoxitin resistance among ceftazidime-resistant strains (61.9%) suggests the action of mechanisms other than extended-spectrum beta-lactamase.

[Indoor pollution and biological monitoring of volatile organic compounds (VOC)]. / Indoor pollution e monitoraggio biologico di Composti Organici Volatili (COV).

Indoor air is a complex mixture of chemicals and airborne particles. Volatile Organic Compounds (VOC), a broad class of chemicals including diverse compounds such as Aldehydes, Terpenes, Aromatic and Aliphatic Hydrocarbons and Halogenated Volatile Organics, are an important category of indoor air pollutants. The evaluation of exposure to low doses of Chloroform and Benzene through the measurement of Chloroform and Benzene in urine was performed. Results show that biological monitoring may be helpful in indoor environmental studies in non occupational situations.

In vitro effects of recombinant human granulocyte-macrophage colony-stimulating factor (RhGM-CSF) on polymorphonuclear cell (PMN) and monocyte (MO) functional capacities in ovarian cancer patients versus human volunteers.

Human polymorphonuclear cells (PMN) and monocytes (MO) from four ovarian cancer patients and seventeen normal donors were in vitro pretreated with different concentrations (25, 50 and 100 IU, respectively) of rhGM-CSF. Phagocytosis and killing of PMN and MO as well as PMN polarization were evaluated in cancer patients before treatment (T0) and at the end of each chemotherapeutic cycle (T1, T2, T3 and T4, respectively) in comparison with normal donors. RhGM-CSF did not affect phagocytosis and killing of PMN and MO. On the other hand, this cytokine was per se endowed with the capacity to enhance PMN polarization in both cancer patients (at T2 interval) and normal donors.