Improvement of knowledge, attitude, and behavior about oral health in a population of alcohol addicted persons.

AIMS: To improve knowledge, attitude, and behavior about oral health and oral cancer prevention in a population of alcohol-addicted persons involved in a residential rehabilitation program in Italy. METHODS: A questionnaire was administered to obtain socioeconomic and oral risk factors data, and a complete dental examination was performed. A lecture on oral health risk factors and healthy behaviors was delivered. A pre-post test questionnaire was used to assess the short-term effectiveness of the intervention. Long-term effectiveness was assessed by a follow-up interview at 1 year from the intervention. The independent effect of several covariates on oral health at baseline and on the outcome of the intervention was evaluated. RESULTS: Seventy-six individuals from the residential alcohol rehabilitation program participated in our study. About half had been addicted to alcohol for more than 10 years; 81.6% smoked at the time of survey; 31.0% declared that they never used toothbrushes or that they brushed less than once/day. We found an improvement of 25.0% in exact answers between the pre-post test questionnaire. At 1 year from the intervention, the 42 participants who reached follow up showed a great improvement in knowledge and attitude towards oral health. In particular, toothbrushing had become a daily routine after every meal for 67.1% of participants. CONCLUSIONS: Education of alcohol-dependent individuals in a rehabilitation setting may contribute to their attention to oral health and willingness to change habits.

Surgical site infections: might a longer locally defined T time affect the benchmarking?

BACKGROUND: A local surgical site infection surveillance system (LS System) was established in 1998 at our teaching hospital. The aims of this article were to compare locally defined cut-points with the NNIS System T times, and to evaluate the effectiveness of different cut-points in identifying procedures at high risk for infection. METHODS: The LS System T times were compared to those reported by the NNIS System. Procedures and surgical site infections (SSIs) were stratified according to two infection risk index (IRI) scores calculated by using the two cut-points. The effectiveness of the two IRI scores in predicting SSIs was assessed by receiver operating characteristic (ROC) analysis. RESULTS: We have found a longer T time in three procedures categories compared to those reported by the NNIS System (GAST, OGIT, and XLAP). The LS System risk index predicted SSIs better than did the NNIS System risk index only in other digestive category, with areas under ROC curve: being, respectively of 71.1% (95% CI, 60.9, 81.3) and 63.1% (95% CI, 54.0, 72.2). CONCLUSIONS: The use of the NNIS System T time is suitable in our local SSI surveillance system because it does not significantly affect the benchmarking.

Cluster of Pseudomonas aeruginosa catheter-related bloodstream infections traced to contaminated multidose heparinized saline solutions in a medical ward.

Intravascular catheters are indispensable in modern medical practice; healthcare institutions purchase millions of them each year. The present study describes an outbreak of Pseudomonas aeruginosa catheter-related bloodstream infection (CRBSI) in a medical ward of the associated hospitals, a teaching hospital with 1005 beds, in Ancona, Italy, with details of the source of infection and the efficacy of the control measures adopted. The environmental strain of P. aeruginosa was isolated from the mixture of heparin and saline solution. Clinical and environmental isolates were identical at PFGE, showing that the outbreak had been caused by a single clone of P. aeruginosa. The frequency of P. aeruginosa bacteraemia depends on the population of patients studied; our patients did not show risk factors that increased their susceptibility to hospital infections. As these pathogens cannot be eradicated from the hospital environment, constant infection control measures are needed in order to prevent nosocomial infections.

Microbial aerosol contamination of dental healthcare workers' faces and other surfaces in dental practice.

The purpose of this study was to focus attention on the need to adopt infection control procedures in dentistry. The quantitative and qualitative bacterial contamination of dental healthcare workers' faces and other surfaces in dental practice was determined. Oral fluids become aerosolized during dentistry and oral microbes have been used as the markers of their spread that may carry blood-borne pathogens.

Fish oil supplementation reduces cortisol basal levels and perceived stress: a randomized, placebo-controlled trial in abstinent alcoholics.

Behavioral distress and dysfunctions of hypothalamic-pituitary-adrenocortical (HPA) axis play a central role in alcohol abuse. Omega-3 fatty acids are proposed as having antistress, regulatory effects on HPA responsiveness, but a possible protective role in ethanol addiction is unexplored.A randomized, doubleblind, placebo-controlled trial was performed in male alcoholics undergoing residential rehabilitation program, to evaluate the effects of 3-week supplementation with fish-oil providing eicosapentaenoic (60 mg/day) and docosahexaenoic acid (252 mg/day) on perceived stress/anxiety and HPA activity, assessed by measuring saliva basal cortisol levels at various daytimes (0730 h, 1130 h, 1600 h, 2000 h, and 2400 h) and the acute cortisol response to Trier Social Stress Test.Results showed that in supplemented subjects, before versus after decrease of stress/anxiety ratings was accompanied by reduction of cortisol basal levels throughout the day; no changes were observed in placebo group. At the end of intervention, amplitude, and duration of stress-evoked cortisol response did not differ between groups; however, the peak of cortisol response was temporally anticipated in supplemented subjects. In conclusion, an elevated omega-3 intake may reduce distress symptoms and basal cortisol secretion in abstinent alcoholics, thus providing a valid subsidiary measure to increase the efficacy of rehabilitation programs in ethanol addicts.