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G Capalbo

Publications and source records attributed to G Capalbo.

8 recordsLinked to original sources
PubMed2006

Prospective 3-year surveillance for nosocomial and environmental Legionella pneumophila: implications for infection control.

OBJECTIVES: To perform a 3-year, prospective surveillance program for legionnaires disease (LD) in a large university hospital in Rome, and to assess the usefulness of the hospital water monitoring program in predicting the risk of nosocomial LD. METHODS: Samples from patients with new cases of nosocomial pneumonia were sent for legionella laboratory investigations. Meanwhile, water samples for bacteriological analysis were collected every 6 months from high- and medium-risk hospital wards (10 in total). Legionella pneumophila isolates collected were serotyped and analyzed by pulsed-field gel electrophoresis. RESULTS: From June 2001 through May 2004, the pneumonia surveillance identified one case of nosocomial LD among 43 cases of nosocomial pneumonia (2.3%). Environmental investigations detected L. pneumophila in 12 (18.7%) of the 64 water samples, of which 50% belonged to serogroup 1. The L. pneumophila count and the percentage of positive locations never exceeded 10(2) colony-forming units/L and 20%, respectively, except when the LD nosocomial case occurred (positive water samples, 40%; L. pneumophila count, <10(2) colony-forming units/L). Genotyping showed 3 prevalent clones of L. pneumophila in the water distribution network, of which one persisted over the 3 years. One clone contained 3 different L. pneumophila serogroups (2, 4, and 6). CONCLUSIONS: The low incidence of nosocomial cases of LD appears to be associated with a low percentage (<20%) of positive water samples per semester and with a low contamination level (<10(2) colony-forming units/L). An infection control system for nosocomial LD should, therefore, be based on both environmental and clinical surveillance, together with the appropriate maintenance of the hospital water distribution system.

Cross Infection↗
PubMed1995

Endoscopic treatment of sessile rectal adenomas: comparison of Nd:YAG laser therapy and injection-assisted piecemeal polypectomy.

This prospective study was carried out in order to compare endoscopic laser therapy with injection-assisted piecemeal polypectomy for treatment of sessile rectal adenomas. We randomized 94 patients with rectal sessile adenomas to either of the two treatments. The adenomas were classified according to size as extensive or intermediate. Of the patients with extensive adenomas, a complete ablation was achieved in 63.6% with laser versus 33.3% with piecemeal snaring (p < .01). For the intermediate adenomas, the rates of permanent ablation were 81.2% with laser versus 86.6% with piecemeal snaring polypectomy (difference not statistically significant). The complication rates were acceptable in both the laser and piecemeal snaring groups. (One case of perforation and one case of stenosis were observed in the laser group, both probably related to prior electroresection.) Our study suggests that the specific indication for laser therapy should be extensive lesions; with intermediate adenomas, laser therapy and injection-assisted piecemeal polypectomy are equally efficacious for achieving complete ablation. However, the duration of initial treatment differs: 6.3 weeks for laser therapy versus 2.4 weeks for piecemeal polypectomy; moreover, about 70% of the intermediate adenomas were eradicated with a single session of piecemeal polypectomy.

Adenomatous Polyps↗
PubMed1989

[Endoscopic endoprosthesis in the palliative treatment of carcinoma of the pancreas].

Perendoscopic treatment of cancer of the pancreas may be carried out through bilionasal drainage or bilioduodenal drainage. These techniques are indicated for preventing choledochic stenosis due to cancer of the head of the pancreas and should be considered as palliative techniques in inoperable patients. The present paper particularly examines the role of biliary endoprosthesis, with special attention to the results obtainable in terms of improvement to the quality of life in patients with inoperable gallbladder-obstructing cancers.

Aged↗
PubMed1980

Peritoneoscopy in chronic hepatitis. A retrospective evaluation of its role in the management of the asymptomatic patient.

The course of chronic hepatitis was retrospectively evaluated in 26 patients in whom both peritoneoscopy and liver biopsy were initially performed. At entry all patients were clinically asymptomatic and showed mild or moderate histological and chemical abnormalities, so that none of them needed steroid treatment. The duration of the follow-up ranged from 24-82 months. At the end of follow-up liver biopsy was obtained in all patients. In a few patients peritoneoscopy was also ultimately performed. In six patients in whom initially chronic persistent hepatitis (CPH) was diagnosed both by peritoneoscopy and liver biopsy, the subsequent course of the disease was benign. In all the nine patients in whom initially peritoneoscopy suggested CPH, in contrast to the histological diagnosis of chronic aggressive hepatitis (CAH), chemical and morphological parameters of liver disease activity did not worsen to require steroid treatment. In five of six patients in whom both liver biopsy and peritoneoscopy initially showed CAH, chemical and morphological abnormalities progressed so that steroids had to be initiated. Finally in four of five patients in whom initially peritoneoscopy showed CAH and liver biopsy CPH, steroid treatment was ultimately required because of chemical and morphological worsening. In conclusion peritoneoscopy may be a useful aid in the management of the asymptomatic patient with moderate chemical and histological features of chronic liver disease.

Adolescent↗
PubMedDate not supplied

[Assessment of the adequacy of health services in day hospital care: experience of an endocrine surgery day care unit at a university polyclinic].

The aim of the study was to assess the appropriateness of the provision of surgical treatment in the day hospital setting and at the same time to evaluate the efficacy of the service provided. The study was conducted on admissions to a day care unit operating in conjunction with the surgery division of a university hospital. The evaluation of appropriateness was carried out using explicit criteria, based on regional regulations and on guidelines drawn up by the Agency for Regional Health Services. The criteria related to the hospital bed equivalent Rotation Index and to the types of DRGs treated and services provided. Efficacy was assessed using the following para-meters: number of US-guided fine needle aspiration biopsies; techniques used; age, sex and nodule size; patient distribution by results of diagnostic examination; cytological classification; percentage of patients with complications. We also evaluated the possibility of transferring short-term (2-3 days) surgical admissions from ordinary regimens to the day care setting. The results of this study yield useful synthetic indicators for assessing the appropriateness both of the day care function as a whole and of individual operating units, providing both administrative and medical staff with a useful frame of reference for the planning of health-care management.

Adult↗
PubMedDate not supplied

[Appropriateness evaluation of short hospital admissions using Appropriateness Evaluation Protocol (Italian version): experience of a teaching hospital].

Italian version of Appropriateness Evaluation Protocol (AEP) is a tool for evaluating the appropriateness of hospitalization for acute patients. In particular, it aims to verify and quantify the reasons of appropriateness associated to the day of admission and the single days of hospital stay. The aim of the present paper is to evaluate the appropriateness of ordinary, 2-3 days lasting, hospital admissions within an university hospital. We examined a sample of 518 hospital admissions: 370 admissions (71%) lasting 2 days, and 148 admissions (29%) lasting 3 days. Results analysis showed different levels of appropriateness between the 2-days and the 3-days admissions: the appropriate admissions were 18% in the sample of the 2-days admissions and 38% in the sample of 3-days admissions. Most inappropriate days of admission and stay in hospital are due to attended or to the execution of diagnostic procedures. In order to evaluate accuracy by means of AEP methodology, it is necessary to improve the quality of medical documentation using standardized medical records. AEP, in the framework of the continuous quality improvement, is a valid tool to reorganise health care processes.

Diagnosis-Related Groups↗
PubMedDate not supplied

[Evaluation of the appropriateness of hospital admissions using the iso-gravity classification systems APR-DRG and Disease Staging and the Italian version of Appropriateness Evaluation Protocol (AEP)].

Our main purpose was to evaluate the organizational appropriateness of admissions made in a university hospital, by comparing two iso-gravity classification systems, APR-DRG and Disease Staging, with the Italian version of AEP (PRUO). Our analysis focused on admissions made in 2001, related to specific Diagnosis Related Groups (DRGs), which, according an Italian Law, would be considered at high risk of inappropriateness, if treated as ordinary admissions. The results obtained by using the 2 classification systems did not show statistically significant differences with respect to the total number of admissions. On the other hand, some DRGs showed statistically significant differences due to different algorithms of attribution of the severity levels used by the two systems. For almost all of the DRGs studied, the AEP-based analysis of a sample of medical records showed an higher number of inappropriate admissions in comparison with the number expected by iso-gravity classification methods. The difference is possibly due to the percentage limits of tolerability fixed by the Law for each DRG. Therefore, the authors suggest an integrated use of the two methods to evaluate organizational appropriateness of hospital admissions.

Diagnosis-Related Groups↗