[Legionella contamination in the hospital environment: monitoring of the hot water distribution systems of three hospitals in Catania (Italy)]. / La contaminazione da legionelle in ambiente ospedaliero. Risultati del monitoraggio delle reti di distribuzione dell'acqua calda in una Azienda ospedaliera.

This study evaluated the presence and extent of contamination with Legionella spp. in the hot water distribution systems of three hospitals in Catania (Italy). In total, 291 hot water samples were collected between September 2002 and August 2005 and these were examined in order to monitor the hospital distribution systems and evaluate the efficacy of decontamination measures. L. pneumophila was detected at variable concentrations up to over 10000 UFC/L at several collection sites in some hospital buildings and branches of the water distribution system while other buildings/branches were found to be free of contamination. The most frequently isolated serogroup was L. pneumophila serogroup 3, occasionally associated with serogroups 4, 5 and 6. Molecular typing of Legionella strains by pulsed-field gel electrophoresis of genomic DNA restriction fragments identified four different genotypes, each recovered from a different branch of the distribution system. Decontamination procedures, including shock hyperchloration and two different thermal shock methods, performed between October 2003 and August 2005, led to only temporary reductions in contamination. In fact, previous concentrations of the same L. pneumophila serogroup were found within 3 to 8 months of decontamination. In order to prevent and monitor Legionella infections, sterilizing filters were installed in water taps of all wards with high-risk patients and urinary antigen testing was performed on all patients diagnosed with nosocomial pneumonia. No cases of Legionella pneumonia were identified in 2005.

Anterointernal approach to the lumbar spine: technical note.

Lumbar surgery is currently benefiting from the development of anterior approaches to the spine and the possibilities of anterior arthrodesis. The transperitoneal approach is being replaced more often by an extraperitoneal approach that enables anterior access to the spine. The authors report an anterointernal approach to the lumbar spine.

Use of Harrington rods with segmental wiring for spinal pathology. Technical note.

The Authors report their experience using Harrington rods with segmental wiring for spinal pathology. They describe the advantages of this technical point in neoplastic and traumatological dorsal compression.

Acrylic reconstruction of an arthritic cervical spine using the transcervical-transclival approach.

We describe the use of a transcervical-transclival approach in the treatment of an ascending luxation of the odontoid by rheumatoid arthritis. We favor this approach and use of methylmethacrylate in this rare condition. Other applications of this route which gives access to the craniocervical junction are discussed.

Bilateral posterolateral approach to the thoracolumbar spine through transversoarthropediculectomy with corporectomy.

Surgery of the dorsolumbar spine is currently benefiting from diverse approaches and the advent of computed tomography. This report describes a bilateral posterolateral approach with transversoarthropediculectomy and corporectomy. The advantages and disadvantages of this approach and its indications are discussed.

[Approach to lesions of the clivus and upper cervical spine by the retropharyngeal intermaxillo-hyoid route]. / Abord des lésions du clivus et du rachis cervical supérieur par voie intermaxillo-hyoïdienne rétro-pharyngée.

The authors report the intermaxillo-hyoido-retropharyngeal approach for cranio-cervical junction's pathology. They underline its advantages. It's indications are discussed by six personal cases.

[Value of approach to the thoracolumbar spine by bilateral transverse arthro-pediculectomy with corporectomy]. / Intérêt de l'abord du rachis dorso-lombaire par transverso-arthro-pédiculectomie bilatérale avec corporectomie.

The authors report the use of bilateral posterolateral approach by transversoarthropediculectomy with corporectomy in dorso lumbar rachidian pathology. They discuss the advantages and inconvenience of this approach before propose its indications.

[Meningoencephalitis in children and computerized axial tomography. Clinico-prognostic evaluation]. / Meningoencefaliti in età pediatrica e T.A.C. Valutazioni clinico-prognostiche.

A large casistic of severe CNS infectious diseases in pediatric age was reviewed to underline mean clinic, EEG features and correlated them with CT images. We conclude that CT scanning is useful in CNS infectious diseases, above all in the first life years, because it can provide diagnostic and prognostic information and sometimes therapeutic indication.

A new model for non-invasive, reproducible fixation of a stereotaxic frame using an orthodontic resin plate. Technical note.

The authors describe a new method for reproducible, non-invasive fixation of a stereotaxic localizing frame. A localizing system similar to that of Brown-Roberts-Wells for MR can be fixed at the base of the facial skeleton to the upper dental arch by an orthodontic resin plate. Results of trials with CT scan, advantages and disadvantages are discussed. The new fixture could be employed in open surgery and in fractionated radiotherapy.

Halo ring supporting the Brown-Roberts-Wells stereotactic frame for fractionated radiotherapy.

The authors describe a new instrumentation for repositioning of the Brown-Roberts-Wells (BRW) stereotaxic system, useful for precise fractionated radiotherapy. A lucite ring is fixed to the patient's skull with four screws. Another ring, partially open, is then firmly connected co-axially to the lower part of the first one with four spacer-bars. The fixture permits an exact repositioning of the B.R.W. stereotaxic system, placing the target point in the linear accelerator isocenter. The preliminary technical results obtained in five children are reported and the fixture performance, advantages, and perspectives are discussed.

Polyorchidism and seminoma in a child.

A case is reported of a neoplasm involving a supernumerary testicle in a 9-year-old boy. The histologic diagnosis was anaplastic seminoma. We have not been able to find a similar case in the literature.

Cystic malformations of the posterior cranial fossa originating from a defect of the posterior membranous area. Mega cisterna magna and persisting Blake's pouch: two separate entities.

Cystic malformations of the posterior cranial fossa are all but arachnoid cysts contained within the general context of the Dandy-Walker complex and may be further classified in two groups on the basis of their embryological origin: anomalies of the anterior membranous area (AMA) and anomalies of the posterior membranous area (PMA). Whether the latter group of malformations can be regarded as separate entities is still quite controversial. The present authors give a detailed account of the various embryological stages in the formation of the posterior cranial fossa and its contents and propose the identification of two anomalies derived from a defect of the PMA: the mega cisterna magna (MCM) and the persisting Blake's pouch, a new entity with different MRI features from MCM. Criteria for their recognition are discussed, stressing the capital importance of a differential diagnosis in view of the radically different therapeutic approach.