[Permanent environmental disinfection techniques in hospital settings with infectious risk]. / Tecniche di disinfezione ambientale permanente negli ambienti ospedalieri a rischio infettivo.

While the world's economies avoid the COVID-19 pandemic blockade, there is an urgent need for technologies aimed at reducing the transmission of COVID-19 in confined spaces such as hospital environments. Although the cleaning and disinfection procedures now have rather complex and sophisticated weapons, they do not seem to be sufficient to continuously maintain low levels of environmental microbiological contamination. This result can now be achieved through the cross-use, in space and time, of improved, more efficient and effective technologies. This result can now be achieved through the cross-use, in space and time, of improved technologies. This work highlights the possibility of crossing and cooperation of different disinfection techniques, such as to keep the microbial and viral load low over time.

Effectiveness of ATP bioluminescence to assess hospital cleaning: a review.

INTRODUCTION: Contamination of hospital surfaces plays an important role in the transmission of several healthcare-associated microorganisms, therefore methods for evaluating hospital surfaces' cleaning gain particular importance. Among these, there are visual inspection, quantitative microbiology, fluorescent markers and adenosine triphosphate (ATP) bioluminescence. The latter seems to provide interesting features, detecting the presence of ATP on surface (as Relative Light Units, RLU), a proxy of organic matter and microbial contamination. Several studies have investigated the effectiveness of this technology; with this research, we aim to summarize the most significant results. METHODS: A systematic review was conducted. The keywords (namely, "ATP", "bioluminescence", "hospital" and "surfaces") were searched in PubMed/MEDLINE and Scopus databases, in order to find relevant data, from January 2000 to October 2014. After the selection, we globally considered 27 articles. RESULTS: Most of the studies were conducted in United Kingdom and in USA. Different threshold RLU benchmark values were identified by analyzed studies. Fourteen of these researches compared the ATP bioluminescence with microbiological methods, 11 identified a significant correlation between the two methods, although poor or not complete for 5. DISCUSSION: ATP bioluminescence is not a standardized methodology: each tool has different benchmark values, not always clearly defined. At the moment, we can say that the technique could be used to assess, in real time, hospital surfaces where cleanliness is required, but not sterility.

Dermatological conditions presenting at the Emergency Department in Siena University Hospital from 2006 to 2011.

BACKGROUND: Published studies on emergency dermatology consultations are few because there are few dermatology emergency units in the world. No study has yet described the Italian situation. OBJECTIVES: To quantify and characterize patients evaluated in our dermatology emergency unit from 2006 to 2011. METHODS: We studied personal details, diagnosis, annual trend of cases, emergency level and hospitalization of dermatology cases over the 6-year period. RESULTS: A total of 12,226 patients were evaluated. The most numerous diagnostic group was infections (27.1%), followed by non-specific and descriptive diagnosis (22.5%), skin conditions caused by mechanical or physical agents (13.1%), eczematous diseases (10.5%), insect bites (9.5%) and urticaria/angio-oedema (8.8%). The most common indications for admission to hospital were skin conditions caused by mechanical or physical agents (33.3%), infections (27.5%), drug eruption (15.9%) and autoimmune or inflammatory disorders (7.4%). Emergency dermatology cases followed a variable annual trend, with more consultations in the summer months. CONCLUSION: This is the first long-term retrospective analysis of a large series of dermatology emergency patients. It provides useful quantitative and qualitative information on cases for physicians and the national health system for the purposes of improving patient care and cost-effectiveness.

Degree of antioxidant protection: a parameter to trace the origin and quality of goat's milk and cheese.

Traceability is an essential tool in reassuring consumers and traders that food is as safe, authentic, and of good quality as expected. Today, food traceability procedures often consist of attached documents and declarations, but scientific parameters that could objectively identify a product would be preferable. Scientific efforts in this area are mostly focused on selection and validation of experimental indicators that would be useful for tracing a food product in any step of its commercial life, describing its raw materials, processing procedures, and storage conditions. In this research, milk and cheese samples from zero grazing and grazing goats were studied to identify a tracing parameter correlated to the feeding system. In particular, alpha-tocopherol and cholesterol were analyzed by HPLC on a normal phase column and were combined to calculate the degree of antioxidant protection (DAP). This parameter, expressed as the molar ratio between antioxidant compounds and an oxidation target, is useful for tracing and distinguishing products from grazing and zero-grazing animals. Degree of antioxidant protection values greater than 7.0 x 10(-3) were found in samples from grazing goats and values lower than 7.0 x 10(-3) were found in samples from zero-grazing goats, for both milk and cheese, meaning that cholesterol was highly protected against oxidative reactions when herbage was the only feed or was dominant in the goat diet. The reliability of DAP to measure the antioxidant protection of cholesterol appeared more effective when the feeding system was based on grazing than when cut herbage was utilized indoors by animals. The DAP index was able to distinguish dairy products when the grazed herbage in the goats' diet exceeded 15%.

[Technology assessment and operating procedures for the technological resources in the new Community Health Service]. / Technology assessment e procedure per la gestione del patrimonio tecnologico nella nuova Azienda Sanitaria Locale.

INTRODUCTION: The main purpose of this contribution is to set today's situation of technology assessment and point to some organizing and integrative ways with the evolution concern ASL (Local Health Firm). PATIENTS AND METHODS: We outline main critical processes that fix correct management of technological resource thought data available in national and international literature. We single out more common methods to quantify, evaluate, control and manage biomedical technologies. RESULTS: We expound decisional process that lead Viterbo ASL (Local Health Firm) to a progressive controll of tecnological resource and its management after aggregation of the five USL (Local Health Units) that constituted Viterbo ASL and describe procedures assumed. CONCLUSIONS: We underline the importance of full and complete information in business and decisional process. Inside the complexity of italian view, we outline an organizative solution with a low economic impact and with a high technical content.

Solid-state (13)C CP MAS NMR spectroscopy of mushrooms gives directly the ratio between proteins and polysaccharides.

The solid-state (13)C CP MAS NMR technique has the potential of monitoring the chemical composition in the solid state of an intact food sample. This property has been utilized to study mushrooms of different species (Pleurotus ostreatus, Pleurotus eryngii, Pleurotus pulmunarius, and Lentinula edodes), already characterized by chemical analyses for protein and dietary fiber components. Solid-state (13)C CP MAS NMR spectroscopy reveals a large difference in the ratio between the glucidic and the proteic resonances probably depending on the mushroom species. An accurate inspection by model compounds and suitable mixtures of proteins and saccharides gives a methodology to interpret these experimental data. A good correlation (R(2) = 0.93; R(2) = 0.81) has been obtained by comparing the NMR data with the results of the chemical analyses. The results suggest the possibility to perform a taxonomic study and/or a nutritional study on the basis of the ratio between protein and polysaccharide levels determined by NMR or chemical methodologies.

Rapid assay of choline in foods using microwave hydrolysis and a choline biosensor.

A fast procedure for the determination of choline in food was developed by coupling a microwave hydrolysis procedure with an O(2)/choline oxidase-based electrochemical biosensor. Time and temperature were varied to select the best conditions for the microwave hydrolysis. Results have been compared with those found by the traditional method, constituted by hydrolysis at 70 degrees C followed by enzymatic-colorimetric assay. Data obtained by the biosensor method correlated well with the enzymatic-colorimetric assay (R(2) = 0.998). Microwave versus traditional hydrolysis gave a good correlation both with the colorimetric and with biosensor procedures with a relative error below 6%. The method is sensitive and selective enough to be used for a wide variety of food items reducing remarkably the analysis time.

[The laparoscopic treatment of a rare case of intestinal obstruction due to an ectopic pregnancy]. / Trattamento laparoscopico di un raro caso di occlusione intestinale da gravidanza ectopica.

A rare case of intestinal occlusion due to primary abdominal pregnancy is described. Laparoscopy revealed normal appendix and bowel obstruction by adhesion between the last ileal loop and cecum. The adhesion started from a neoformation (diameter 2 cm) localised on the mesenteric side of the ileum, about 30 cm from the ileocecal valve. A resection of the adhesion and dissection of the neoformation were performed. Laparoscopic procedures lasted 30 minutes. Histologic examination of the specimen revealed to be an ectopic pregnancy. The laparoscopic technique permitted to verify the diagnosis and perform the treatment of the abdominal pregnancy in absolute conditions of safety, maintaining the fertility of the patient (actually she is presenting a regular pregnancy).

Health economics in the Canadian pharmaceutical industry.

OBJECTIVE: To assess the goals, strategic focus, structure, capabilities, activities and effectiveness of health economics (HE) departments in the Canadian pharmaceutical industry, to examine how these have evolved, and the implications of HE in the future of the pharmaceutical industry. DESIGN AND INTERVENTIONS: A mixture of telephone and face-to-face interviews with members of the HE unit (survey 1) and the chief executive officers (CEOs) [survey 2] of the top 21 Canadian pharmaceutical companies was undertaken in 1997. MAIN OUTCOME MEASURES AND RESULTS: 17 out of 21 companies responded to the first survey, and 12 of the 17 CEOs responded to our second survey. The goals of the HE department in most of the pharmaceutical companies have evolved from supporting efforts to gain reimbursement on government drug plans to include pricing, promotion, internal decision-making and other activities. Members of the HE department perceive their work to be valuable to the company. The CEOs felt that the true value of HE data is not adequately understood by formulary reviewers and, therefore, HE data may be an impediment to market access. CONCLUSIONS: The purpose of the HE department is to demonstrate the value of the company's product to provincial government insurers. However, pharmaceutical companies are having difficulty justifying the importance of the HE department because of inconsistencies in the interpretation of economic evaluations by healthcare payers.

Maillard reaction in mild-based foods: nutritional consequences.

Chemical reactions occurring during industrial treatments or storage foods can lead to the formation of epsilon-deoxyketosyl compounds, the Amadori products. Food protein value can be adversely affected by these reactions, and in particular lysine, an essential amino acid having on its side chain a free amino group, can be converted to nonbioavailable N-substituted lysine or blocked lysine. by acid hydrolysis of epsilon-deoxyketosyl compounds, furosine is formed. In this paper furosine prepared from milk-based commercial products has been evaluated by use of a recently developed HPLC method using a microbore column and phosphate buffer as the mobile phase at controlled temperature. Furosine levels have been used, together with protein, total amino acids, and lysine content, as an estimate of protein quality of a few different products such as cooked-cream dessert, yogurt mousse, white chocolate, milk chocolate, milk chocolate with a soft nougat and caramel center, milk chocolate with a whipped white center, chocolate spread, part-skim milk tablets, milk-based dietetic meals, and baby foods. The protein content of the analyzed products ranged from 34.3 gxkg(-1) (milk nougat) to 188.4 g x kg(-1) (milk tablets). The Maillard reaction caused a loss in available lysine that varied from 2.5% (cooked cream) to 36.2% (condensed milk). The contribution to the lysine average daily requirement is heavily affected by this reaction and varied from 13% (milk tablets and soft nougat) to 61% (dietetic meal). Variable results were also obtained for the other essential amino acids.

Influence of thermal and other manufacturing stresses on retinol isomerization in milk and dairy products.

An analytical procedure, based upon HPLC, has been used to determine the degree of isomerization of retinol (vitamin A) in various dairy products. In raw milks, which are not subjected to thermal processing, there was no conversion of the predominant all-trans-isomers to cis-isomers in samples from various species. Pasteurized milks with mild heat treatment (high quality milk) had an average 13-cis: all-trans ratio of 2.6%, while pasteurized milk treated for 15 s at temperatures ranging from 72 to 76 degrees C had an average ratio of 6.4%. Milk subjected to more severe heat treatments had a higher degree of isomerization (UHT milk, 15.7%; sterilized milk, 33.5%), consistent with increased thermal conversion of the retinol isomers. In pasteurized and UHT cream, the increase in 13-cis-isomer was also a consequence of heat treatment (pasteurized cream, 3.0%; UHT cream, 14.4%). The presence of cis isomers in fermented milk suggests that fermentation processes, directly or indirectly, can induce cis-trans isomerization. In the cheeses analysed, the extent of retinol isomerization ranged from 7.6 to 35.0%. Our results confirm the importance of individual isomers in evaluating the vitamin A status of dairy products.

[Current therapeutic methods in primary sclerosing cholangitis]. / Moderni orientamenti di terapia della colangite sclerosante primitiva.

The authors synthesize the main etiopathogenetic, physiopathologic and clinic findings of CSP and describe the pharmacs employed in the treatment of disease: corticosteroids, cyclosporin, penicillamine, colchicine, tacrolimus, metotrexate, hydrophylic bile salts. They outline the poor or none therapeutic activity of the majority of these and stress the improvement of some clinical parameters after prolonged use of hydrophilic bile salts. However none of the used pharmacs can stop the pathologic course of the disease. At the end authors remember the usefulness of liposoluble vitamins to prevent carential syndromes.

[Current aspects of therapy of primary biliary cirrhosis]. / Moderni orientamenti di terapia della cirrosi biliare primitiva.

The authors expose the epidemiological features of PBC and outline the role of the immunologic disorders in the disease's pathogenesis. The main clinic and laboratory features of the PBC, its course and pathology are also synthesized. The authors describe the drugs employed in the therapy of the PBC: cortisone, azathioprine, metotrexate, chlorambucil, colchicine, D-penicillamine and hydrophilic bile salts; the favourable risk-benefice rate of colchicine, azathioprine and hydrophilic bile salts is outlined, even if they are poorly active on the disease's course. The use of lyposoluble vitamins is stressed, to improve malabsorption's syndromes. At the end the role of orthotopic liver transplant is regarded.

[The treatment of chronic viral hepatitis with recombinant alpha-2 interferon: meta analysis and clinical contribution]. / La terapia delle epatiti virali croniche con interferone alpha 2-ricombinante: metanalisi e contributo clinico.

The Authors have developed a work of meta-analysis on the employment of IFN in the virus-correlated chronic hepatitis. They have examined World literature on: virus causing chronic hepatitis, type and duration of the treatment, criteria in the choice of the observed patients, clinical effects, effects on the virus, effects on the isto-pathologic situation. Have been considered the useful actions at the end of the treatment and in the follow-ups, so to evaluate the permanence of favourable effects. Have been also reminded the main collateral effects, even about frequency and intensity, as the various Authors relate. There are quite clear data indicating: efficacy in B-correlated chronic hepatitis greater than in C-correlated ones, greater efficacy in the treatments with Interferon with duration of more then 6 months in chronic hepatitis C. Doses greater than those generally employed appear not to give better results. The Authors moreover show the results of a clinical survey they made on patients with chronic hepatitis HBsAg+/HBeAg+ (treated with IFN-alpha 2r 5 MU t.i.w. for six months) and chronic hepatitis anti-HCV+ (treated with IFN-alpha 2r 3 MU t.i.w. for six months). The results confirm the efficacy of IFN in B-correlated chronic hepatitis (50% of sustained response) and its scarce efficacy in C-correlated chronic hepatitis for treatment shorter than 12 months (9.1% of sustained response).

[Alcoholism and HCV-antibody association. Effects on the course and severity of chronic liver disease]. / Etilismo e HCV-anticorpo positività associati. Effetti sul decorso e la gravità delle epatopatie croniche.

BACKGROUND: The authors evaluated the role of the association alcohol-hepatitis C virus on the course and severity of chronic liver disease; they also regard the researches of many authors on this subject. MATERIALS AND METHODS: 280 consecutive patients, suffering from chronic liver disease and admitted to the Department of Medical Hydrology of Rome University ''La Sapienza'' are studied. Fifty-nine of them were affected by chronic alcoholic liver disease without evidence of hepatitis virus infection (AC-), 58 were alcoholic and positive for HCV antibody (AC+), 163 positive for HCV antibody and non alcoholic (NAC+). They are divided according to the diagnosis into chronic hepatitics, cirrhotics and those affected with hepatocarcinoma; among them 193 patients, age and sex matched, are evaluated as regards the course and severity or the chronic liver disease. RESULTS: In the total of 280 patients the hepatic damage arises significantly faster in the alcoholic and anti-HCV positive than in other patients. In the age and sex matched, in alcoholic and HCV positive patients the hepatocarcinoma significantly prevailed (AC-: 8.2%, NAC+: 9.4%, AC+: 19%; p=0.04). The three groups of cirrhotics did not show a significant difference with respect to the severity of the disease evaluated according to Child-Pugh criteria. CONCLUSIONS: Our research confirms the role of the association of HCV virus infection and alcoholism on the severity and impairment of chronic liver disease.

[The evaluation of in-hospital precoronary times. The experience of a department of emergency medicine]. / Valutazione dei tempi precoronarici intraospedalieri. Esperienza di un dipartimento di medicina d'urgenza.

The above study was aimed at evaluating the "in-hospital precoronary times" of patients with acute myocardial infarction presenting to the Emergency Department of Policlinico Umberto I, Rome. From April to August 1993, 58 cases of acute myocardial infarction were admitted. In six of these, over 24 hrs had elapsed before admission. In 24 of the remaining cases thrombolysis was indicated. Mean time before admission to the coronary unit was 5 hrs for 52 patients. Mean in-hospital delay before starting thrombolysis was 40 +/- 20 minutes; mean delay before admission to the coronary unit was 3 h/45 min. In-hospital time before thrombolysis was one of the lowest in the literature and shows the efficient organization of the department. Delay until transfer to the coronary unit was long and is a sign of the paucity of these specialized beds. Therefore, the possibility to perform thrombolytic therapy immediately in the emergency department becomes even more essential.

High-performance liquid chromatographic method for the simultaneous determination of tocopherols, carotenes, and retinol and its geometric isomers in Italian cheeses.

In the present study we describe a high-performance liquid chromatographic method for the simultaneous determination of alpha-, beta-, gamma- and delta-tocopherol, cis and trans isomers of retinol, and total carotenes in different Italian cheeses. The method involves sample extraction and saponification followed by normal-phase high-performance liquid chromatography (HPLC). Monitoring of the absorbance and fluorescence is achieved using a programmable spectrophotometer and a programmable spectrofluorometer connected in series. The proposed method, which has the advantage of being able to evaluate simultaneously the fat-soluble vitamins considered by us in this work, has been applied to some Italian cheeses (Percorino romano, Taleggio, Provolone, and Caciotta) and milk samples (cows', goats', and sheep milk). The HPLC analytical procedure provides excellent reproducibility of results and is less subject to interferences from the sample matrix than wet chemical techniques. These factors combine to make the simultaneous determination of alpha-, beta-, gamma-, and delta-tocopherol, cis and trans isomers of retinol, and total carotenes by HPLC a practical technique for routine quality control and chemical and nutritional research applications.

Changes in plasma dolichol levels, transport, and hepatic delivery during rat liver regeneration.

During the proliferative process that follows partial hepatectomy in the rat, the dolichol content increases in both plasma and liver. Its transport in the blood by lipoproteins also changes. The difference in the distribution of dolichols of various chain lengths in plasma and in the liver is further enhanced during liver regeneration. The dolichol released by perfused liver shows a homologue distribution more similar to that observable in blood than in the liver, thus confirming the importance of the liver as a regulatory site for the blood dolichol supply.

[The effect of two contraceptive methods (EP vs. IUD) in relation to inflammatory changes and CIN]. / L'influenza di due metodiche contraccettive (EP versus IUD) nei confronti di alterazioni infiammatorie e CIN.

The authors examine Smear Test phlogistic picture repair processes, endometrial cells and preneoplastic lesions in women who used IUD and EP. The research has pointed out that infection due to Actinomyces is only (present) in IUD carriers. CIN affects for 4.2% of IUD carriers.

Seasonal commitment of HMGCoA reductase activity to vitellogenin production.

In female frogs (Rana Esculenta) during gametogenesis the cholesterol synthesized in the liver by 3-hydroxy-3-methylglutaryl coenzyme A reductase is mostly exported into the blood and taken up by the oocytes. In order to understand the fate of the neosynthesized cholesterol, female and male frogs and estrogenized male controls were injected with the labelled precursor 14C mevalonate. In females and in estrogenized controls, mevalonate-derived radioactivity is found in a plasmatic lipoprotein that has been identified as vitellogenin by immunological detection. The increased 3-hydroxy-3-methylglutaryl coenzyme A reductase activity present in females in Fall is likely to be committed to provide cholesterol for the lipidation of this cholesterol-rich protein.