Official controls regarding artisanal ice cream shops: public health policies and consumer protection in the Italian and European legislative frameworks.

Ice cream is a widely enjoyed food that is especially popular during summer. To ensure it is safe and ready-to-eat for consumers, legislation imposes a series of obligations for food business operators, and for competent authorities that have to carry out official controls, including official sampling. This article reviews the general and specific requirements applicable to the premises where ice cream is produced, concerning aspects related to health notification obligations and to implementing and maintaining procedures based on the principles of the Hazard Analysis and Critical Control Point system. The review extends to results stemming from the most recent official control activities conducted in Italy, and to future perspectives on control methods that will have to be compliant with the provisions of the new EU Regulation 625/2017 applicable from 2019.

Healthcare Associated Infections: educational intervention by "Adult Learning" in an Italian teaching hospital.

BACKGROUND: An educational intervention for HAI prevention based on a combination of training, motivation and subsequent application in the current clinical practice in an Italian teaching hospital. METHODS: In 2015-2016 a pilot mandatory training on HAI targeted to HCWs was organized in the 450 bed teaching hospital Sant'Andrea in Rome. By adopting the "Impact/control matrix" prioritization tool, the relative level of impact (risk in causing or favoring HAI) and control (possibility for HCWs to prevent HAI) attributed by the participants to the issues associated to HAI during their working groups was evaluated. RESULTS: Overall, 34 physicians, 43 nurses and 15 non clinical professionals participated actively in seven courses, identifying 58 different issues related to HAI, which were reported 128 times. Results showed frequently that, within the same type of issue, HCW referred various levels of impact (risk in causing or favoring HAI) and personal control (possibility for HCW to prevent HAI). Overall staff shortage was the most reported problem by HCW in our hospital. Also hand washing was regarded as a main problem, but HCW expressed the feeling that individuals could act more successfully on this issue (high or medium control). Results showed that staff frequently did not know how to handle correctly visitors, similarly many colleagues expressed some difficulty in communicating information to patients and relatives on HAI. Surprisingly, "antimicrobial therapy" and "excessive invasive procedures" were not particularly highlighted by the personnel. HCW expressed satisfaction for the course approac. CONCLUSIONS: The study showed an overall good level of knowledge regarding the importance and principles of infection control in our teaching hospital HCW. However personnel perceived a variability in the impact of many issues on HAI and even more on the personal possibility to control their effect. In order to improve HCW compliance with HAI prevention programs, the "Adult Learning" model seems to be very useful.

Point prevalence surveys on healthcare acquired infections in medical and surgical wards of a teaching hospital in Rome.

BACKGROUND: Healthcare acquired infections (HAI) are an important cause of morbidity and mortality in hospitals worldwide. Aim of the study was to analyze nine years surveillance activity, carried out by point prevalence surveys from 2007 to 2015, in a 450-bed teaching hospital in Rome. METHODS: Point prevalence surveys were carried out every year in the medical and surgical wards following the same methodology. In accordance with definitions used by the Centers for Disease Control, all infections occurred more than 48 hours after hospital admission were considered HAI, and included in the study. Baseline characteristics, clinical features, isolated pathogens (only for the period 2011-2015) and antimicrobial resistance were recorded. RESULTS: During the nine years point prevalence surveys a total 2,840 patients were enrolled. Overall 136 (4.79%) patients developed 180 (6.34%) HAI. The most frequent HAI were respiratory tract infections (RTI), which accounted for 35.0% of all HAI, followed by surgical site infections (SSI) 22.2%, urinary tract infections (UTI) 19.4%, bloodstream infections (BSI) 17.2%, and others 6.1%. HAI related to major invasive risk procedures were also evaluated. SSI/patients undergoing surgery 3.99%, UTI/ patients with urinary catheter 4.17% and BSI/patients with CVC 9.42%. Over one-half of all patients surveyed (1,532, 53.9%) were receiving antibiotics at the time of our study. Among them 892 (58.2%) for treatment, 641 (41.8%) for prophylaxis. In the latter group, 109 (17.0%) underwent extra-short term, 89 (13.9%) short term and 443 (69.1%) a long term prophylaxis. During the period 2011-2015 out of 110 HAI episodes 71 (64.5%) were confirmed microbiologically. In total 106 pathogens were isolates, Gram-negative bacteria (63.2%) were isolated more frequently than Gram-positive bacteria (28.3%). CONCLUSIONS: The overall HAI prevalence in our hospital was consistent with those reported in other studies in Italy. The study underlined the role of Gram-negative bacteria in HAI and the need for antimicrobial stewardship. It also provided useful baseline data for rational priorities in allocation of resources, for further infection control activities.

Effect of low-dose oral and intravenous dexamethasone administration on growth hormone secretion in children.

Acute dexamethasone administration (2 mg/m2 i.v. and 4 mg orally) increases growth hormone (GH) release in children. We evaluated the effect of a low intravenous dose (1 mg/m2) of dexamethasone on GH secretion in 8 short normal children and in 6 GH-deficient children. There was a significant GH increase at 120, 150 and 180 min in short normal children (maximal value: 18.9 +/- 2.1 micrograms/l; mean +/- EP), compared to placebo administration. In contrast, no significant GH elevation was seen in GH-deficient children (1.3 +/- 0.4 micrograms/l). There was no difference in the GH response after intravenous dexamethasone and oral clonidine in these same 8 short normal children and 6 GH-deficient children. Although no significant GH release was observed after dexamethasone or clonidine in GH deficiency, an increase in GH after GH-releasing hormone was seen (6.1 +/- 1.9 micrograms/l). There was a significant GH increase (18.5 +/- 3.3 micrograms/l) after low-dose (2-mg) oral dexamethasone administration in another 8 short normal children, which was similar to values after intravenous injection. No side effects were noted after intravenous or oral dexamethasone. In conclusion, low-dose intravenous or oral dexamethasone administration causes a marked GH release in short normal children, probably mediated by hypothalamic structures.