Biomedical subjects
Publications and source records attributed to G Guasticchi.
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In the Lazio Region, it has been put into effect a plan of clinical Risk Management for the Breast Cancer Screening Regional Program (BCSP), involving all of the 12 Local Health Units and the Public Health Agency of Lazio (ASP). Being the BCSP a health care service, it consists of a perfect integration of health care structures, professionals and skills working for the citizens. This program originates from an unexpressed health need and leads to a evidence-based health benefit. The BCSP provides free breast screening for 700,000 women aged between 50 and 69 in the Lazio region; the Public Health Agency carries out the clinical governance of the BCSP The prevention of errors and incidents represents a fundamental basis of governance: it is a contribution to the achievement of efficacy in breast cancer screening. The BCSP deals with screening incidents from a systemic point of view and actively involves several Local Health Units staff going through each step of the whole patient's clinical path, from the identification of the target population, to the oncological treatment of positive cases. The programme is an integration of different tools: literature research, process analysis using the HFMEA methodology and reporting system. The results reached so far are the following: the regional severity rating scale, the regional Master-List of possible adverse events, occurrence and detection rating scale.
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As the bacteria found more frequently in hospital infections are the same found in the linen, it is speculated that hospital linens can contribute to the spread of nosocomial patologies. Nevertheless this consideration does not prove that linen constitutes a significant source for transmission of hospital infections, although some studies have strengthened this possibility. The hygienic problems of hospital linens washing have a great importance and in this contest the possibility of contagion throught infected sheets or overalls constitutes only a part of the question. The problem of the spreading of nosocomial infections has to be divided into (1) collection and arlage of the linens; and (2) their disinfection and washing. Collection and carriage need precautions to prevent the hospital staff and the patients from the direct contagion, while during the washing the infected, or potentially infected, linen are to be regarded as a potential risk, which can be avoided through a disinfection before the standard washing cycle. During the washing the processes of cleansing, the dilution and the effect of temperature could be sufficient to obtain the final results. The last consideration is linked to gestational aspects, that's to say the consumptions, the costs, the traditional organizing procedures and the alternative ones, such as the possibility of substituting disposable material to linens or to refer to central laundries placed outside the hospital building and independently operated.
The study aimed at searching whether antibiotic prophylaxis was practised after animal bites, and, in this case, what were the criteria adopted. It was performed by considering 162 outpatients requiring assistance after animal bites at the Antirabies Centre of Rome, Italy. In this circumstances, prevention of bacterial and viral infections is performed by wound detersion, by administering anti-tetanus and anti-rabid prophylaxis where required by italian policy, according to the patient's history. Infectious complications are described in literature as a common consequence of animal bites and include cellulitis, septic arthritis, osteomyelitis and even fatal sepsis. Microorganisms related to these infections are frequently typical of animal oral flora and include aerobic and anaerobic species, such as Pasteurella multocida, DF-2, and Leptospira. It was noted that 58 (35.8%) out of 162 were treated with antibiotic prophylaxis; the most common drug used was amoxicillin, given in 18 cases (31%). The overall results do not show any particular reason for practising or not this prophylaxis. The need of standardising the behaviour of Emergency Services, where a different and unjustified attitude to treat or not patients with antibiotic prophylaxis in order to prevent infectious complications following animal bites was observed, emerges from this study.
This study investigates the role of 46 public Consultori of Rome, as far as the hormonal contraception with "pill', the most common contraceptive method used by roman women, is concerned. With a series of phone calls, a hypothetic potential customer asked for an appointment directly with the gynaecologist for getting adviced to use "pill" for the first time. The results show that, although the wait for the first appointment directly the gynaecologist is not long (11,3 days as an average), it is very difficult to get it and this was possible only in 12 cases out of 46. We have noted that the first appointment for "pill" was offered with no-medical personnel, like social assistants, sanitary assistants or midwives, in most 16 of cases, and that in a significant number of Consultori was not possible to obtain an appointment whatever. In public Consultory of Rome we have found a different attitude in giving appointment to women for contraception with pill, even inside the same USL (Local Sanitary Unit, the basic structure of public health in Italy, in which Consultori have the role of prevention and promotion of maternity and tutelage of infancy). From this study the need emerges of uniformity in the attitude of Consultori staff in managing the customers, in order to avoid that women, finding so many difficulties, give up referring to these public structure for beginning contraception and choose private professionals or decide not to use the "pill".
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