[Antiretroviral therapy in HIV infection. Effects of the introduction of new drugs on health care expenditures, 1994-1999]. / Terapia antiretrovirale nell'infezione da HIV. Effetti indotti dalla introduzione di nuovi farmaci sulla spesa sanitaria 1994-1999.

The administration of antiretroviral compounds to our cohort of HIV-infected patients was assessed since 1994, on the ground of some epidemiological, clinical, and therapeutic variables. During the six-year study period, a significant increase of mean prescription rate of overall anti-HIV agents was observed, with a nearly 10-fold rise of mean prescribed daily doses per 1,000 patients-year. In particular, lamivudine and indinavir represented the most frequently administered drugs, among nucleoside analogues and protease inhibitors, respectively. A significant increase of the percentage of HIV-infected patients undergoing combined antiretroviral therapy (79.3% in 1999), and the mean number of drugs prescribed per patient (3.02 in 1999), was concurrently detected. The progressive changes of antiretroviral therapy guidelines were responsible for a nearly 16-fold increase of expenditures directly related to antiretroviral drug administration in 1999 compared with 1994 (with over 41% of costs related to protease inhibitors). On the other hand, a substantial modification of HIV disease evolution occurred in our patient cohort in terms of absolute morbidity and mortality figures, as expressed by a drop of notified AIDS cases and AIDS-related deaths ranging from 2.5 to 5 times, during the considered period.

[Behavior of disinfectant substances in comparisons of bacterial strains]. / Comportamento di alcune sostanze disinfettanti nei confronti di stipiti batterici.

Following a brief of the main requisites of disinfectants, the solutions tested during research are listed: 1) Ethyl alcohol denatured at 70 degrees C. 2) A hydro-alcoholic solution of 0,20% Benzalkonium chloride (F.U.) in association with 0.15% 1-Benzyl-3 [3-Dimethylammoniopropoxy]-1 H-indazol HCl. 3) An acetonic hydro-alcoholic solution of 0.1% Benzoxonium chloride, a water solution of 1% Polyvinylpyrrolidone-iodine (P.V.P.-I), a water solution of 0.5% Chlorhexidine gluconate, and a hydro-alcoholic solution of 0.17% Benzalkonium chloride. The technique used (modified contact test) is illustrated and the results analysed in detail. The best results absolutely were obtained by applying Ethyl alcohol denatured at 70 degrees C and P.V.P.-I in a water solution at a concentration of 1%. Some problem must, however, be borne in mind when using such substances (first, denaturing of proteins, second, action curtailed by temperature). Best results among the Q.A.C. were obtained with the hydro-alcoholic solution of an association of 0.20% Benzalkonium chloride (F.U.) and 0.15% 1-Benzyl-3 [3-Dimethylammoniopropoxy]-1 H-indazol HCl.

[Antibacterial activity of disinfectant solutions containing quaternary ammonium compounds for the storage of surgical instruments]. / Attività antibatterica di alcune soluzioni disinfettanti contenenti Q.A.C. atti alla conservazione dei ferri chirurgici.

A survey conducted among the health managements and dispensary services of all Italian hospitals showed that disinfectants containing quaternary ammonium salts were most commonly used for the disinfection and storage of surgical instruments (66% of frequencies). It was therefore decided to run in vitro tests on the bactericidal activity of some of the more frequently used substances containing one or more of these salts as their active principle. Five were therefore examined against 8 hospital and 4 lab strains, namely three aqueous solution: 1% benzalkonium chloride plus 1% ethylbenzalkonium chloride; 0.6% alkyldimethylbenzylammonium chloride, plus 0.185% diisobutylphenoxyethoxyethylbenzyl ammonium chloride monohdydrate and 0.133% diisobutylcresoxyethoxydimethylbenzyl ammonium chloride monohydrate; 0.1% dodecylbenzylammonium-N-diethyl alcohol chloride; and two alcoholic solutions: 0.1% alkyldimethylbenzylammonium chloride; 0.25% benzalkonium chloride (F.U.).

[Preliminary results of findings on the use of suture threads in Italian hospitals]. / Risultati preliminari di indagine sull'uso dei fili per sutura negli ospedali italiani.

This report describes the partial results of an investigation into preferences for various types of suture in Italy as a whole and in individual geographical areas, which identifies, where possible, differences in the use of such materials.

[Analysis of the use of disinfectants in Italy particularly in Southern Italy]. / Analisi dell'impiego dei disinfettanti in Italia con particolare riguardo all'area geografica Italia Meridionale.

In an investigation of the use of disinfectants in hospitals, the replies received from 338 institutions were analysed and subsequently compared with those obtained from southern Italy. It was found that benzalkonium chloride was the substance most widely used in Italy for disinfection of the surgical field, wounds, excoriations, sores, the skin prior to injections, surgical instruments, medical apparatus, catheters, thermometers and sanitary appliances, whereas chlorhexidine was preferred for disinfection of the hands, and for ambient surfaces in combination with cetrimide. Formic aldehyde was preferred for ambient surfaces, the air of confined spaces, and, in conjunction with chlorine and its derivatives, for sanitary services and their vessels. Glutaraldehyde was the substance most commonly employed for the disinfection of medical apparatus fitted with optic fibre lenses. In southern Italy, by contrast with the position in Italy as a whole, there was a greater use of chlorine and its derivatives for the disinfection of ambient surfaces, benzalkonium chloride for the disinfection and cleaning of sanitary services, vessels, and equipment with optic fibres, and alcohols for the disinfection of surgical instruments and sanitary appliances.

[The use of disinfectants in Northern Italy with special attention to the Emilia-Romagna region]. / Indagine sull'uso dei disinfettanti nell'Italia Settentrionale con particolare riguardo alla Regione Emilia-Romagna.

As part of an extensive investigation into the use of disinfectants in hospitals, data from 189 hospitals in the north of Italy, including 38 in the Emilia-Romagna region, were examined. Eleven fields of employment were assessed. It was found that benzalkonium chloride was primarily used for disinfection of the operative field, wounds, excoriations, sores, the skin prior to injection, surgical instruments, catheters, thermometers, and utensils. Chlorhexidine was preferred to disinfection of the hands and medical equipment. Formaldehyde was preferred for ambient surfaces, the air of confined spaces, and (in association with chlorine and its derivatives) for sanitary services and vessels. Glutaric aldehyde was preferred for apparatus fitted with lenses or optical fibres. By comparison with other parts of N. Italy. Emilia-Romagna made greater use of hydrogen peroxide for skin lesions, and alcohol for disinfection prior to transcutaneous injections.

[Results of statistical studies on the use of disinfectant substances in Italy. Critical analysis]. / Risultanze di un'indagine statistica sull'impiego delle sostanze disinfettanti in Italia. Analisi critica.

A survey was conducted on the use of various disinfectants in Italy. Subsequently the data provided by the various hospitals appealed to (38.7% of which answered the questionnaire) was analysed. The disinfectants were divided into groups and the percentage used in various fields was calculated. A clear difference was revealed between the use of the various disinfectants in the North, Centre and South of Italy. The percentage of mistaken or improper use of the disinfectants was then calculated. Finally the relative consumption of commercial preparations using the disinfectants, the average cost per bed and the total expenditure on disinfectants in Italy were then calculated.

A preliminary report on the use of transfer factor for treating stage D3 hormone-unresponsive metastatic prostate cancer.

As conventional treatments are unsuccessful, the survival rate of stage D3 prostate cancer patients is poor. Reports have suggested the existence of humoral and cell-mediated immunity (CMI) against prostate cancer tumour-associated antigens (TAA). These observations prompted us to treat stage D3 prostate cancer patients with an in vitro produced transfer factor (TF) able to transfer, in vitro and in vivo, CMI against bladder and prostate TAA. Fifty patients entered this study and received one intramuscular injection of 2-5 units of specific TF monthly. Follow-up, ranging from 1 to 9 years, showed that complete remission was achieved in 2 patients, partial remission in 6, and no progression of metastatic disease in 14. The median survival was 126 weeks, higher than the survival rates reported in the literature for patients of the same stage.

Use of transfer factor for the treatment of recurrent non-bacterial female cystitis (NBRC): a preliminary report.

Results of conventional treatment of female non-bacterial recurrent cystitis (NBRC) are discouraging. Most patients show an unexpected high incidence of vaginal candidiasis, while their cell mediated immunity to Herpes simplex viruses (HSV) and Candida antigens seems impaired, and it is known that the persistence of mucocutaneous chronic candidiasis is mainly due to a selective defect of CMI to Candida antigens. Twenty nine women suffering of NBRC, and in whom previous treatment with antibiotics and non-steroid anti-inflammatory drugs was unsuccessful, underwent oral transfer factor (TF) therapy. TF specific to Candida and/or to HSV was administered bi-weekly for the first 2 weeks, and then once a week for the following 6 months. No side effects were observed during treatment. The total observation period of our cohort was 24379 days with 353 episodes of cystitis recorded and a cumulative relapse index (RI) of 43. The observation period during and after treatment was 13920 days with 108 relapses and a cumulative RI of 23 (P < 0.0001). It, thus, seems that specific TF may be capable of controlling NBRC and alleviate the symptoms.