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D Greco

Publications and source records attributed to D Greco.

At least 91 records · Page 5Linked to original sources

The Italian AIDS 'hot-line': providing information to the people.

The Italian AIDS hot-line has recently completed its first two operational years. Established as an emergency service, it was initially overloaded with calls, under the emotional impact of a new disease. As the average number of calls settled to around a hundred per day, a wider approach aimed at the concerns raised by callers has been possible. A particular effort has been made to handle psychological and social aspects of HIV infections. A large proportion of the questions analyzed (62,500) deal with doubts about transmission (30%), reliability of diagnostic tests (15%), and handling individual situations. Some categories of callers, such as drug users, parents or relatives of HIV-infected people, and seropositives often require experienced telephone counselling. HIV-positive callers follow the proportional distribution of AIDS cases in Italy: intravenous drug users forming the majority, followed by homosexuals and finally heterosexual subjects (reaching 10%, a value in accordance with trend projections). The demand for advice has increased over time, together with an evident refinement of question content.

Acquired Immunodeficiency Syndrome↗

The development of infection control in Italy.

A coordinated national program for the control of Hospital Infection (H.I.) was started in 1981 in Italy as a result of growing interest in many fields of public health. The first three years of the program provided greater awareness of the problem on a national scale. The survey showed that out of 38,000 patients, 6.8% developed a hospital acquired infection. Hospitals as well as research institutions responded with studies, periodical surveys and incidence surveys--some of which were on a national scale. One national incidence survey in intensive care units showed a 30% H.I. incidence rate from 6,000 patients. A five year research fund from the National Research Council provided for the study of H.I. by 18 different research groups. There have been several initiatives regarding presentation and control, such as two national guideline regulations made by the Minister of Health for the establishment of H.I. Control Committees in each hospital. Infection Control Nurses have been identified as key persons for the surveillance program. Two hospital schools have started a one-year, 700-hour course for Infection Control Nurses. The first 50 nurses graduated in June 1988. Health officials have agreed that prevention of hospital infection is feasible, and have mandated for a two year experimental prevention project for the Italian region, coordinated by the National Institute of Health. The project is called PRINOS, and the preliminary results are presented.

Cross Infection↗

Acute intestinal infections in Europe. A review of reported cases.

Acute intestinal infections still constitute one of the leading causes of death in the world and a major cause of morbidity in Europe. Unfortunately, most European countries do not have an information system oriented towards acute intestinal infection surveillance. The present work is an analysis of cases of typhoid fever, Salmonellosis, Shigellosis, foodborne infections, and acute gastroenteritis reported from January 1980 to December 1985. Data from 24 of the 33 countries belonging to WHO Regional Office for Europe (EURO-WHO) were considered. Data for 1980 and 1981 were taken from World Health Organization statistics, while data for 1982-85 were taken from bulletins sent to EURO-WHO and WHOCCHDS by individual countries. Data was entered in an IBM 4341 computer system and a data base was organized using a general purpose inquiry language (IBM's APLDI). Rates per 100,000 were calculated using as a denominator 1983 WHO official population figures. The quality of the data is a great problem, as the only available sources of information are official national reports which underestimate the actual incidence of diseases. For typhoid fever, Mediterranean countries show much higher incidences than the rest of Europe, although a decreasing trend can be seen for all European countries. We estimate that the data for typhoid fever, Salmonellosis and Shigellosis are reliable, while reports of foodborne infections and acute gastroenteritis represent only a very small percentage of the actual number of cases.

Acute Disease↗

Chemoprophylaxis in the surgical ward: results of a national survey in Italy.

As part of a national program for the control of hospital acquired infections, a survey on the use of antibiotic chemoprophylaxis was conducted in 1050 public hospitals in Italy (95% of the total number of hospitals in the country). In each hospital, the chief of the general surgery ward was interviewed by means of a standard mail questionnaire. Answers were obtained from 479 surgeons (45.6%) after two mailings. More than 60% of these reported that they used chemoprophylaxis in clean surgery (mastectomy, splenectomy, hernioplasty). More than 80% used antibiotic prophylaxis in surgery in which antimicrobial prophylaxis is facultative (i.e. elective cholecystectomy, gastric resection), and 97.1% used antibiotic prophylaxis in large bowel surgery. The authors recorded starting times and duration of chemoprophylaxis. Cephalosporins were found to be the most commonly used antibiotics followed by penicillin.

Anti-Bacterial Agents↗

A comparison of the effects of preoperative whole-body bathing with detergent alone and with detergent containing chlorhexidine gluconate on the frequency of wound infections after clean surgery. The European Working Party on Control of Hospital Infections.

In a prospective, randomized, double-blind, placebo-controlled study involving 27 surgical units in six European countries, the effect of preoperative whole-body bathing on two occasions with a detergent containing chlorhexidine (CHX+) on the incidence of wound infection in elective, clean surgery was compared with two bathings with a detergent without chlorhexidine (CHX-). In the CHX+ group 2.62% of 1413 patients and in the CHX- group 2.36% of 1400 patients subsequently became infected. The infection rate in the CHX+ group was 1.11 times that in the CHX- group with 95% confidence limits ranging between 0.69 and 1.82. Consequently, bathing patients twice preoperatively with chlorhexidine-detergent did not reduce the incidence of infection of clean wounds.

Adolescent↗

A waterborne tularemia outbreak.

A waterborne tularemia outbreak is described. Forty nine cases were identified in Sansepolcro, a small Medioeval town in the province of Arezzo, Tuscany, Italy. All cases had laterocervical or sub-mandibular adenitis, and occurred within a period of three weeks during March and April 1982. The study showed association between cases and the consumption of water from an unchlorinated water system. Francisella tularensis type 1 was isolated from wild hares captured in the area.

Adolescent↗

Use of ceftazidime in the treatment of otorhinolaryngoiatric bacterial infections.

Within the framework of an investigation into otorhinolaryngoiatric bacterial infections in Italy conducted in 1159 patients (607 with otitis media, 354 with pharyngo-tonsillitis and 198 with sinusitis), 124 ceftazidime-treated subjects (92 with otitis media, 22 with pharyngo-tonsillitis and 10 with sinusitis) were observed. The authors report the examination of a number of microbial isolates obtained in the various forms of otorhinolaryngoiatric bacterial infection. Gram-negative organisms were found as causative agents in such diseases, particularly in otitis media. Bacterial resistance to ceftazidime was assessed in all 1159 cases and proved relatively infrequent (3.6%) and markedly less than the detected resistance to other antibiotics (10.7% resistance to cefotaxime, 35% resistance to ampicillin, 43% resistance to penicillin). Ceftazidime, used mainly in otitis media, showed very substantial clinical efficacy with positive results in as many as 97% of cases treated, which is particularly significant, if one considers that roughly 64% of the infections were caused by "difficult" gram-negative bacteria (49% by Pseudomonas).

Adolescent↗

Immunization coverage in Italy.

In Italy information on immunization coverage against pertussis, measles, and rubella is absent or incomplete. In 1985 the Istituto Superiore di Sanità (ISS) organized a series of immunization coverage surveys for these diseases in several local health units (Unità Sanitaria Locale) (USL). The surveys were conducted simultaneously in 80 USLs in 1985 with modified EPI cluster sampling techniques, using schools attended by children aged 3 to 10 years as the clusters. Information on previously performed immunizations was collected for each child sampled. The total immunization coverage and proportion of immunized children in eight birth cohorts were calculated.Low immunization coverage was reported by the USLs surveyed, and regional differences in the coverage were apparent between the north, centre, and south of Italy. In addition, a steady or decreasing trend in the use of pertussis vaccine was found, while an increasing coverage was observed for measles and rubella immunizations.

Child↗

Surveillance activity in Italy.

Surveillance activities in Italy during the last 5 years can be summarized in three broad categories: collection of data in order to describe the epidemiological pattern of hospital acquired infections, achieved through multicenter studies, involving hospitals or focused on specialized units; organizational efforts for the implementation of Infection Control Committees in Hospitals stimulated by official guidelines (the 1985 Health Ministry Act on this issue); evaluation of preventive strategies in Italy. Results of a one-day prevalence survey conducted in 1983, involving 130 public hospitals, are presented. Out of 34,577 patients surveyed, prevalence of hospital acquired infection was 6.8% and of community-acquired infections 12.5%. Preliminary results of PRINOS (Preventive Study on Hospital Infections) show a 4.6% incidence rate of infections in 16 surgical wards surveilled. Design of the study and target objectives are discussed.

Cross Infection↗

National prevalence survey of hospital-acquired infections in Italy, 1983.

In 1983 a national prevalence survey was conducted in Italy to discover the general distribution of infection among patients in public hospitals. Thirty-four thousand, five hundred and seventy-seven acute patients were surveyed in 130 hospitals spread throughout the country: 6668 patients (19.3%) had an active infection at the time of the survey; the infection was hospital-acquired in 2361 (6.8%) and community-acquired in 4307 (12.5%). The urinary tract was the site most frequently involved in hospital infection (30.2% of patients with hospital-acquired infection). The respiratory tract was the site most often involved in community infections (35.7% for the lower tract and 9.1% for the upper). Hospital-acquired infections were more frequent in intensive care units (12.4%) and in geriatric (11.6%), orthopaedic (8.2%) and surgical wards (7.6%). The prevalence of urinary tract infection was 10.4% among the 9.4% of patients who were catheterized compared with a prevalence of 2.6% in the uncatheterized. Thirty-five point five per cent of patients were receiving an antimicrobial on the day of the survey.

Adolescent↗

A person to person hepatitis A outbreak.

A person to person outbreak of hepatitis A is described: 90 cases of hepatitis A occurred in a small town in Calabria, southern Italy; all cases were under 18 years of age with the highest age-specific incidence rate in the 6-10 year age group. Transmission was identified by tracing close contacts with other incubating or active cases; only eight out of 90 cases were not identified as having a very probable or possible contact with an infecting case. Transmission was high between family members leading to a secondary family attack rate of 51% in children under 16. An enteric disease educational campaign was carried out together with IgG and no cases of hepatitis A were reported in the two years following the investigation.

Adolescent↗