The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey.

Summary: Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.

The Clean Care Contest: promoting hand hygiene among healthcare and medical students.

INTRODUCTION: Despite continuing efforts, compliance rates and knowledge of best practices in hand hygiene remain disappointing. Recognizing that conventional educational tools seem out of touch with young people and that the med and messages contents need refreshing, the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health devised a novel approach to promote the creation of innovative educational tools for improving knowledge of, and compliance with, hand hygiene rules among healthcare and medical students. METHODS: A contest in creating educational material on hand hygiene practices involved university students of nursing and medicine, and of other healthcare degrees. Students from the universities of the GISIO network were invited to create educational material (e.g., videos, posters, presentations, leaflets, and screensavers) to be presented by May 5th 2019 during the World Hand Hygiene Day / Save Lives: Clean Your Hands Global Annual Initiative of the World Health Organization). A local and a national winners were awarded. RESULTS: Three different local and national contests were performed during 2016, 2017 and 2018. During the three-year period, more than 270 educational tools have been developed: 130 (48%) were judged useful for hand hygiene promotion campaigns. The most frequent projects participating in the contests were videos (39%), posters (29%), leaflets (14%), and others (18%) submitted by more than 1,500 students of nursing (40%), medicine (31%), dentistry (7%), and of other healthcare courses in 14 universities. Products were evaluated by a local committee and, subsequently, local winners represented their University in a national contest. CONCLUSIONS: The contest provided a framework for the creation of innovative and potentially effective educational tools via an engaging approach that leveraged student creativity. Given the need to improve compliance rates, this study suggests that new ways can be advantageously explored to teach hand hygiene procedures and increase awareness of the importance of their consistent use among healthcare and medical students.

Reverse shoulder arthroplasty using a "L" shaped allograft for glenoid reconstruction in a patient with massive glenoid bone loss: case report.

Primary reverse total shoulder arthroplasty (RSA) has demonstrated to relieve pain, restore function and active elevation in patients with Cuff Tear Arthropathy. This condition of muscular imbalance could lead, in the long-term, to morphologic changes of the glenoid's anatomy. Insufficient bone stock of glenoid is a major challenge and without reconstruction, may be inadequate to support a glenoid component. Many authors have proposed the use of a bone graft in these cases and different techniques have been described to reconstruct severe bone loss of the glenoid but no ideal approach has currently been identified. We report the use of a "L" shaped frozen allograft for glenoid reconstruction in a patient with massive, uncontained glenoid bone loss, undergoing a reverse shoulder arthroplasty in a "one step" procedure. At 1-year follow-up both x-rays and CT showed graft incorporation with no resorption of bone and the patient reported continued stability of the shoulder and a high-level of satisfaction in terms of pain and function.

Surveillance of nosocomial infections: a preliminary study on yeast carriage on hands of healthcare workers.

Hospital-acquired fungal infection is increasing. The aim of this preliminary study was to evaluate the frequency and distribution of yeast carriage on the hands of healthcare workers (HCW) from different departments. The study was conducted in three departments (Surgery, Intensive Care Unit, Obstetrics and Gynaecology) of a hospital in Campania, southern Italy. Over a six-month period, 50 healthcare workers were randomly tested. Imprints of palms and fingertips were taken monthly during the morning shift. The plate with yeast was counted and Candida species were identified. Risk factors for hand contamination were determined. Hand carriage of yeast and Candida species in the three departments were found in the following percentages: Surgery (50% and 49%); Intensive Care Unit (61% and 57%); Obstetrics and Gynaecology (65% and 59%). No significant difference in the frequency or distribution of yeast and Candida sp. recovered in the three departments was ascertained by comparing every two months' data, the hand carriage of yeast and Candida species found in the three departments; this varied - min to max - according to the following percentages: Surgery [(45%-54%) and (42%-58%)]; Intensive Care Unit [(53%-66%) and (56%-59%)]; Obstetrics and Gynaecology [(62%-69%) and (57%-63%)]. The only factor associated with yeast carriage on the hands of healthcare workers was the absence of gloving during healthcare procedure (p = 0.0192). We conclude that in our study yeast carriage on the HCWs' hands is common in the three departments investigated, but its causes are unclear. Careful use of gloving may reduce pathogenic yeast on hands.

New approach for evaluating the public health risk of living near a polluted river.

Chemical, physical and microbial analyses were conducted in the Sarno River basin to obtain a comprehensive description of the overall quality of the water bodies. The collection period lasted 12 months, between 2005 and 2006, with high frequency of sampling and analysis. More than 6,000 analytical determinations were performed on samples collected at six sampling points along the Sarno River and two points each on tributaries Solofrana and Cavaiola. The results indicated the presence of inorganic contaminants, which, in most cases, were below the Italian State water quality thresholds. The organic contamination showed an increasing trend, with respect to previous determinations, thus demonstrating the major contribution of untreated urban wastewater to the overall pollution of the river. Moreover, this study was designed to explore the correlation between the presence of microbial indicators of fecal contamination in Sarno River and their presumable presence in the aerosol surrounding the river, thus pointing to the possible environmental hazard associated with the presence of pathogens in the air.

Surveillance of nosocomial infections: a preliminary study on hand hygiene compliance of healthcare workers.

The observance of hand hygiene compliance is important to reduce cross-infection by micro-organisms. The aim of this preliminary study was to evaluate the level of hand hygiene in healthcare workers from different departments, with particular emphasis on transient flora. The study was conducted in three departments (Surgery, Intensive Care Unit, Obstetrics and Gynecology) of a hospital in Campania, southern Italy. Over a six-month period, 50 healthcare workers were randomly tested. Imprints of palms and fingertips were taken monthly during the morning shift. The number of colonies per plate was counted and transient pathogens were identified. Risk factors for hand contamination were determined. Total flora was found in the following CFU means per palm and per five fingertips (95% CI): Obstetrics and Gynecology [palms 130 CFUs (95% CI 85-180); fingertips 125 CFUs (95% CI 92-160)]; ICU [palms 80 CFUs (95% CI 58-99); fingertips 62 CFUs (95% CI 45-82)]; Surgery [palms 75 CFUs (95% CI 41-120); fingertips 70 CFUs (95% CI 52-90)] Transient flora was found on 39% of healthcare workers' hands. The only factor associated with hand contamination by transient flora was the absence of gloving during healthcare procedure (P = 0.02).

Assignment of the TCRA/TCRD locus to sheep chromosome bands 7q1.4-->q2.2 by fluorescence in situ hybridization.

Two genomic clones for the TCRA/TCRD locus have been isolated and characterized in sheep. The first clone corresponds to a new sheep Valpha element, the other to the entire Cdelta gene. Chromosomal mapping by fluorescence in situ hybridization (FISH) of Valpha and Cdelta clones localized the TCRA/TCRD locus on sheep chromosome region 7q14-->q22. This is the first physical assignment for genomic clones on sheep chromosome 7 by FISH. Moreover, the present data put the ovine 7q14-->q22 and the human 14q11.2 regions in the same syntenic group.

Tuberous sclerosis.

Tuberous sclerosis (epiloia, Bourneville-Pringle syndrome) is an inherited disease with an autosomal pattern. Both sexes are affected equally with varied expression in successive generations. Two cases of this unusual disorder in siblings are reported. They illustrate heredofamilial nature, dissimilar expression, mutations, and oral manifestations.