Factors influencing hospital infection control policies in Italian hospitals.

A study was undertaken to determine the resources available in Italian hospitals for the control of nosocomial infections and the factors favouring a successful approach. During January-May 2000 a questionnaire about infection control was sent to the hospital health director of all Italian National Health System hospitals treating acute patients and with more than 3500 admissions in 1999. An active programme was defined as a hospital infection control committee (HICC) meeting at least four times in 1999, the presence of a doctor with infection control responsibilities, a nurse employed in infection control and at least one surveillance activity and one infection control guideline issued or updated in the past two years. There was a response rate of 87.5% (463/529). Almost fifteen percent (69/463) of hospitals had an active programme for Infection Control and 76.2% (353/463) had a HICC. Seventy-one percent (330/463) of the hospitals had a hospital infection control physician and 53% (250/463) had infection control nurses. Fifty-two percent (242/463) reported at least one surveillance activity and 70.8% (328/463) had issued or updated at least one guidance document in the last two years. The presence of regional policies [odds ratio (OR) 8.7], operative groups (OR 4.2), at least one full-time nurse (OR 4.6) and a hospital annual plan which specified infection control (OR 2.1) were statistically associated with an active programme in the multivariate analysis.

[The heterozygote beta-thalassemic patient with regard to radiological hazards]. / Il beta-talassemico eterozigote di fronte al rischio radiologico.

Since anaemia of varying degree is a quite common finding in heterozygous beta-thalassaemia, a research was done to see if beta-thalassaemia heterozygotes occupationally exposed to long-term continuous external radiation should be more susceptible to haematopoietic damage than non thalassaemic subjects. We examined peripheral haematological findings of 20 beta-thalassaemia heterozygotes previously exposed to a mean of 10.7 mSv, compared with 22 non thalassaemic subjects exposed to 6 mSv, and with 50 not exposed beta-thalassaemia heterozygotes. The obtained results suggest that whole-body external irradiation--with the mean doses reported--does not cause noteworthy changes in beta-thalassaemia heterozygotes.

Possible indication of breast cancer risk through discriminant functions.

In the Ferrara province of Italy, a screening programme for the detection of breast cancer was initiated in 1965; by 1976, 21,120 women had been examined. The biologic history of the women participating in the program is routinely collected at registration. Several biological variables can be extracted from the history. We used 15 biologic variables in order to construct discriminant functions between women affected by breast cancer and a group of control women. It was found that four variables suffice to separate the group of the women with breast cancer from the control group, although with some degree of uncertainty. The theory was advanced that the individual values of a discriminant function may be associated with the risk of healthy women for developing breast cancer. Data collected after the construction of the discriminant function hint at such an association. We have attempted to calculate a discriminant value for healthy women participating in screening programs, so that those having a discriminant value below a given threshold may be considered at higher risk than those above the threshold. The women in the high-risk group may then be submitted to an appropriate examination schedule.

Malaria in Maremma, Italy.

BACKGROUND: In August, 1997, a woman with no history of travel to malarious regions developed Plasmodium vivax malaria. She lived in a rural area of Italy where indigenous Anophyles labranchiae mosquitoes were present. METHODS AND FINDINGS: An environmental investigation was done within a 3 km radius of the patient's house. Adult mosquitoes and larvae were collected and examined by PCR with the gene for plasmodium circumsporozoite protein as target. About 200 people living in the area were interviewed to detect possible carriers of P. vivax. FINDINGS: None of the mosquitoes captured were carrying any malarial organisms. The house-to-house investigation identified a 7-year-old girl who had had a feverish illness a few days after her arrival in Italy from India, and who, 3 months later, still had P. vivax in her blood; she and her mother had antimalarial antibodies. INTERPRETATION: These investigations suggest that the index case of malaria was caused by local anopheline mosquitoes infected with exogenous P. vivax.