[Best practice in risk management of Neisseria meningitidis bacterial meningitis at nurseries]. / Best practice nel risk management della meningite batterica da Neisseria meningitidis negli asili.

In many contexts is often underestimated the biological risk and schools can be an example. Proof of this is the exclusion of work in the school from the example of the work activities of biohazard included in Annex XLIV of Legislative Decree 81/08. Our work proposes a protocol for risk management meningitis contagious in the specific environment of the nursery taking a cue from the specific experience gained by the Service of Prevention and Protection Bambino Gesù Children's Hospital following the course accreditation Joint Commision. This is primary prevention measures (training and information) and secondary (vaccination, reporting of suspected cases, chemoprophylaxis of contacts, contact tracing, counseling) to be applied consistently even and especially in the absence of sick people, at which time the shares are aimed exclusively to control its spread to be taken and monitored, with the cooperation of all subject involved in various capacities in the protection of the health of workers, within these specific working environments.

Familial recurrence of nonsyndromic interrupted aortic arch and truncus arteriosus with atrioventricular canal.

BACKGROUND: Multifactorial inheritance is probably involved in most cases of nonsyndromic conotruncal heart defects (CHDs), but Mendelian transmission is often suspected. RESULTS: We report on a family with recurrence of nonsyndromic CTHD in two double first cousins; i.e., two brothers married two sisters. One of the cousins (case 1) had interrupted aortic arch (IAA) type B, while the other one (case 2) had truncus arteriosus (TA) with atrioventricular canal defect (AVCD). CONCLUSIONS: Our family further supports monogenic inheritance of CTHDs. In addition, the presence of TA associated with AVCD in one of the patients confirms the higher occurrence of CTHD in families with complex TA. The absence of 22q11 microdeletion (del22q11) in our patients, as in several literature reports of familial CTHDs, supports the existence of genes different to those located on chromosome 22q11 which could be implicated in the pathogenesis of CTHDs.

Echocardiographic diagnosis of totally anomalous pulmonary venous connection to the azygos vein.

Totally anomalous pulmonary venous connection to the azygos vein is a rare congenital heart malformation in which all the pulmonary venous blood returns anomalously to the azygos vein. Among 111 consecutive patients with totally anomalous pulmonary venous connection undergoing surgical correction at our institution between June 1982 and September 1997, this malformation was present in seven cases. By echocardiography, using a subxyphoid short-axis view at the atrial level and a modified suprasternal sagittal view, the malformation was diagnosed when the pulmonary venous confluence was traced posteriorly and superiorly relative to the right pulmonary artery and right bronchus, finally reaching reach the superior caval vein. Totally anomalous pulmonary venous connection to the azygos vein was misdiagnosed in the first two patients, both by echocardiography and angiocardiography. In the subsequent five patients, a precise diagnosis was obtained by echocardiography. Echocardiography, therefore, can be considered an accurate diagnostic tool permitting recognition of totally anomalous pulmonary venous connection to the azygos vein, and permitting corrective surgery without recourse to catheterization and angiography.