[Preliminary experience with O.P.A.T. (Outpatient parenteral antimicrobial-drug therapy) in infective endocarditis]. / Esperienze preliminari di trattamento delle endocarditi infettive in OPAT.

The authors evaluated the efficacy and safety of an OPAT program in a small group of patients affected by infective endocarditis. Three patients were considered eligible for the treatment; i.e. they had a stable hemodynamic balance and no embolic events. Streptococcus spp. grew in blood cultures of two patients, while blood cultures were negative in the third patient. Long-acting antibiotics were used and all patients recovered from the infection without adverse events. The treatment was efficacious and safe. This preliminary experience suggests that OPAT programs can be promoted in infective endocarditis with advantage. Strictness and caution are necessary in screening and monitoring patients.

[Infective endocarditis: a retrospective analysis of inpatient cases]. / Endocardite infettiva: analisi retrospettiva di una casistica ospedaliera.

The authors analysed retrospectively the clinical and laboratory features of patients hospitalised in a unit of infectious diseases in the period from 1996-99. In particular, the etiology, the antimicrobial susceptibility of responsible microorganisms, criteria utilized for diagnosis, antibiotic courses and outcomes were evaluated and discussed. Echocardiography is an essential tool in the diagnosis. Infective endocarditis remains a serious infection and is still associated with high morbidity and mortality rate, despite appropriate treatment. Seriously ill patients may require prompt surgery.

Effect of skim milk supplementation on blood cholesterol concentration, blood pressure, and triglycerides in a free-living human population.

In 82 subjects, aged 21-73, we studied the effect of skim milk supplementation on serum cholesterol concentration, blood pressure, and serum triglyceride level. The study involved a 1-week pretreatment baseline period followed by 8 weeks of milk supplementation. Sixty-four people were designated to a test group and 18 people were placed in a seasonal index group. The study was designed as a free-living trial, i.e., participants were requested to maintain their normal lifestyles, including dietary pattern, except for the supplementation of one quart of 2% solids-not-fat fortified skim milk to the daily diet in the test group. Supplemental milk treatment was associated with a 6.6% reduction (p = 0.0004) of serum cholesterol in the high cholesterol (greater than or equal to 190 mg/dl) test subgroup within the first 4 weeks. No change was noted in serum cholesterol in the low-cholesterol (less than 190 mg/dl) subgroup throughout the study. Body weight and seasonal variation of blood cholesterol did not significantly influence serum cholesterol levels. Reduction (p = 0.0140) in percentage of calories from fat in the high-cholesterol subgroup was not correlated with the decrease in serum cholesterol in this test subgroup. Reductions in systolic and diastolic blood pressure occurred in the test subgroups; the low-cholesterol subgroup had a greater reduction (p = 0.0002) in diastolic blood pressure than the high-cholesterol group (p = 0.0049). Milk supplementation was associated with reduction (p = 0.0370) in serum triglycerides in the high-cholesterol subgroup.

["Pseudomonas aeruginosa" in the hospital of Avellino, and the presence of colonies in the obstetric, pediatric and neonatal wards. A microbiological and epidemiological study (author's transl)]. / Ospitalismo da "Pseudomonas aeruginosa" nell'ospedale di Avellino. Colonizzazione delle divisioni di ostetricia, pediatria e della sezione neonatale. I. Studio microbiologico ed epidemiologico.

Two episodes of unexpected and widely spread colonisation of Pseudomonas aeruginosa in a hospital urged us with a series of measures concerning personnel and environmental hygiene and prophylaxis. We referred on the microbiological researches made on nine stories of the hospital building in which the microorganism settled and the countermeasures were adopted. The isolates proved to have a strong resistance to the various types of disinfectant we used and it was particularly difficult to clean wash-hand-basins and some medical tests. The AA. think that carefully instructing the staff in the hospital on bacterial biology and their channel of diffusion, and on the appropriate measures to avoid and fight them, could give better results compared to those we actually obtain by simply disinfecting the environment.

["Pseudomonas aeruginosa" in the hospital of Avellino, and the presence of colonies in the obstetric, pediatric and neonatal wards. A microbiological study of the environment and of hygienic and prophylactic measures (author's transl)]. / Ospitalismo da "Pseudomonas aeruginosa" nell'ospedale di Avellino. Colonizzazione delle divisioni di ostetricia, pediatria e della sezione neonatale. II. Studio microbiologico ambientale ed interventi di igiene e profilassi.

We observed two episodes of Pseudomonas aeruginosa colonisation taking place in a Hospital. This organism was isolated in a pure culture from the faeces of 41 newborn children, many patients and from a large part on the obstetrics and pediatry division's staff. The AA. investigated the ways of spreading of this germ which caused both in the adults and the babies, no sign of illness. Biotypes one causing the first episode and the other related to the second one were isolated them showed a wide spectrum of resistance to several antibiotics and they of disappeared after accurate measures of hygiene concerning persons and places were adopted.