[Incidence of bacteremia and thrombophlebitis in 4 Italian hospitals and their association with the use of intravenous sets].
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Biomedical subjects
Publications and source records attributed to D Greco.
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A descriptive epidemiological study on the present prevalence of leprosy in Italy is presented. Cases are identified as notified to the Special Leprosy Section at the Italian Ministry of Health. Clinical cases are defined. In addition, sex and professional breakdowns are provided. Cases of the disease are identified as either imported or indigenous. Geographical distribution, according to importation status, is offered: no Italian region is free from leprosy. Incidence curves from 1920 are given, showing the continuous decline in the incidence of the disease. Possible applications of effective eradication programs are discussed.
The susceptibility to antimicrobial agents of 569 salmonella isolated collected in 1977-8 from patients in hospitals in Rome was tested. Fifty-nine per cent of all isolates were resistant to one or more antimicrobials. Resistance was most common to sulphathiazole, tetracycline, streptomycin, whereas colistin, gentamicin, tobramycin, trimethoprim-sulphamethoxazole and nalidixic acid were the most active in vitro. Multiple resistance was most frequently found in strains of Salmonella wien and S. typhimurium (94% and 38% respectively). A significant change in the resistance pattern of S. wien was observed between 1977 and 1978, with a significant increase of susceptibility to some antimicrobials in 1978. Twenty-one R-plasmids transmissible to E. coli K12 were derived from 46 resistant strains of S. typhimurum.
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From Oct. 30 to Nov. 7, 1979, 10 people in the Sardinian province of Cagliari had onset of bacteriologically confirmed cholera. Two symptom-free excretors of Vibrio cholerae O:1 were detected in household contacts of the patients. There were no deaths. All but 1 of the 12 people with V. cholerae O:1 infection gave a history of recent consumption of marine bivalves known locally as arselle (pelecypods). Triplicate matched neighbourhood controls for each of the first 7 cases identified were also interviewed; none had recently eaten arselle. V. cholerae O:1 was also recovered from samples of water and bivalves obtained from a lagoon on the outskirts of the city of Cagliari. Arselle had also been implicated as the vehicle of transmission in 1973 in the last outbreak of cholera in Sardinia. It seems unlikely that cholera transmission had persisted locally in the interim.
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After commeting on the importance of acute postoperative pancreatiti (APP) as a complication of surgery involving the main biliary passages, the authors give a detailed account of the 5 cases of this complication seen in their own clinical material over the last 5 years. In their summation, they identify the presence of pathological conditions of the papilla and the manipulation of the terminal segment of the choledochus as factors conducive to APP in the short-term postoperative period. In their discussion of therapeutic guidelines in the event of APP they call attention to the need for a careful assessment of pancreatic function before surgery.
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A very rare case of carcinoid of the testicle combined with teratoma is illustrated. In fact the literature of the last twenty years reports only eleven cases of carcinoid of the testicle, of which only four combined with teratoma. It is stressed that it is possible that these neoplasias arise on already existing teratomas which may be very small and hence not always evidenced.
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The detection of travel-associated legionellosis can be extremely difficult; hence, an extensive case investigation is recommended in pneumonia-striken travellers and tourists, who are particularly at risk of acquiring the disease. On the Island of Ischia (Isola d'Ischia, Naples, Italy) a total of six cases of Legionnaires' disease occurred from 1986 to 1990. All patients (one man and two women from Germany, one Austrian woman, one Swiss man, and one Italian woman) had taken thermal baths and stayed in local hotels; they all experienced severe pneumonia, and three of them died. These cases were associated with hotels, and the hot-water supply was presumed to have transmitted the infection. Remedial procedures were applied to the hot-water plumbing of the hotels according to the WHO recommendations and were proved to be effective. The occurrences described in this paper stress the importance of rapid and accurate reporting of diagnosed cases to the country where the infection was probably acquired, in order to ensure early detection of endemic foci and emerging clusters of legionellosis.
Epilepsia partialis continua (EPC) has previously been reported in only two patients with Leigh syndrome (LS). We report here a subject in whom LS and partial deficit of cytochrome c oxidase (COX) were associated with EPC. Epilepsy in this subject appeared when neurologic impairment was clearly evident and MRI showed cortical lesions typically associated with congenital lactic acidosis.