Nutritional status of long-term patients in the acute care setting.

The nutritional status of 926 patients (51.4% female) at an acute tertiary private hospital with a length of stay ≥14 days was assessed using Subjective Global Assessment. The prevalence of malnutrition was 42.5% (37.2% length of stay of 14-27 days, 51.6% ≥28 days). From logistic regression analysis, length of stay and age were independent predictors of malnutrition. It is important that the nutritional status of longer stay patients is monitored and appropriate nutrition support is commenced.

[The activity of the Service for Prevention and Safety in Workplaces of the Health Local Agency of Rome C towards the "competent physicians" in the enterprises of the territory]. / L'attività del Servizio Prevenzione e Sicurezza Ambienti di Lavoro della A.S.L Roma C nei confronti dei medici competenti della aziende del territorio.

In the past seven years the Service for Prevention and Safety in Workplaces of the Health Local Agency of Rome C set out some activities towards the occupational physicians (so-called "competent physicians") of three different kinds: control and surveillance, institutional activities on demand and activities for quality improvement. In the first ambit we conducted some investigations on the procedures of the workers' medical surveillance and the role of competent physicians in the risk evaluation inside three different intervention projects (monitoring the enforcement of the D.Lgs. 626/94; intervention on the chemical risk, intervention in the car repair shops). In the second ambit we analysed 92 notifications of occupational diseases and we dealt with 27 appeals against the judgement of the fitness to work. In the third ambit we made 19 meetings on various subjects: correct procedures in medical surveillance, quality in diagnostic examinations, the enforcement of new regulations. We report the results of these interventions which let us identify the most common criticalities in the activity of the competent physicians, but also to face them with a new approach based more on peer review instead of control and surveillance.

Effects of isolated housing and chronic antidepressant treatment on cooperative social behaviour in rats.

Pair-housed, water-deprived rats were trained to run in a two-way shuttle box, using water reinforcement. Animals were tested either singly or in pairs; in the paired condition, the animals were required to shuttle in close physical proximity. Paired performance, but not single performance was severely disrupted by single housing for 3-7 weeks. Performance of singly-housed animals could be restored either by re-housing in pairs (30 days) or by chronic (30 day) treatment with the antidepressants imipramine or fluoxetine. Chronic imipramine was also prophylactically active in preventing the deterioration in performance of singly-housed animals. The superior paired performance of pair-housed animals and of imipramine-treated singly-housed animals, was abolished by the 5-HT antagonist metergoline. Metergoline had relatively little effect on single running: the DA antagonist pimozide disrupted paired and single running equally. The results suggest a role for 5-HT in cooperative performance and in the action of antidepressant drugs in this paradigm.

[Diagnostic value of pan-cavography in obstructed central venous return of intrinsic causes]. / Contributo diagnostico della pan-cavografia nell'ostacolo al ritorno venoso centrale da cause intrinseche.

The authors, after having analyzed the clinical patterns and the causes producing cava syndrome, propose a sequential diagnostic approach to it, whose course makes use of radiological procedures more or less invasive, and of endoscopic and histobioptic techniques. Among radiological investigations pan-cavography has allowed the authors to formulate the diagnosis of limited venous return because of intrinsic causes, conferring so an aetiological connotation and a physiopathological correlation indispensable for a correct and rapid therapy of the uncommon "intrinsic cava syndrome" of two patients, suffering respectively from "idiopathic thrombosis of superior vena cava, concerning also the beginning of inferior vena cava" and from "Fiedler cardiomyopathy".

[A case of leptospirosis in an agrarian community]. / Caso di leptospirosi in comunità agricola.

A mortal case of leptosprosis happened in a little agricultural community situated in a country town in the south Lazio Region, and in consequence of that the Local Health Unit originated a series of epidemiological investigation and preventive treatments. Serological tests were effectuated both on the residents of the interested area and on animals of the farm. These serological tests gave positive results for four inhabitants and eight animals. The agricultural community were subjected to a chemoprophylaxis. No new cases of disease have been found. The drinking water was analyzed because the water supplied came from unprotected wells. The tests gave unfavorable results for the presence of fecal streptococci. It wasn't possible to effect specific tests for the research of leptospira, because it was difficult to find suitably equipped laboratory. As a result of these tests it was decided to apply preventive treatments on a permanent basis on the farm in question. The fact that the serodiagnosis showed the same kind of leptospira in both men and animal, suggested once again the problem of transmission between animals and men and the need for adequate measures of profilaxis. Also the need to cover exposed agricultural work men with an adequate insurance. Great interest was shown in the correct intervention of the operators of Public Hygiene Service and Veterinary Services. It's essential to coordinate the activity of the two services for an effective intervention in these si milar cases, both during the phases of epidemiological research and prevention. Intention of this work is to furnish a possible operative procedure for situations of this kind.