[Environmental quality of the operating theatres in Campania: long lasting monitoring results]. / La qualità ambientale di sale operatorie nella regione Campania: i risultati di un monitoraggio pluriennale.

In this study the microbiological, physical and chemical results of an investigation concerning the environmental conditions of operating theatres in 38 public hospitals of the Campania Government are presented. The analysis of the results has been made by considering specific standards suggested by national and international regulations. The results showed that 84% of the operating theatres presented normal microbiological values, in relation to the total bacterial load, while 16% did not. By considering the microclimatic monitoring 55% of the operating theatres showed normal values while 45% at least a microclimatic index did not. In relation to the concentrations of anaesthetics gases the survey pointed out that the nitrous oxides was within non prescribed environmental limits (50 ppm for N2O); while 15% of the halogenated was not in normal values.

Molecular epidemiology of Staphylococcus epidermidis in a neonatal intensive care unit over a three-year period.

Coagulase-negative staphylococci, especially Staphylococcus epidermidis, are increasingly important nosocomial pathogens, particularly in critically ill neonates. A 3-year prospective surveillance of nosocomial infections in a neonatal intensive care unit (NICU) was performed by traditional epidemiologic methods as well as molecular typing of microorganisms. The aims of the study were (i) to quantify the impact of S. epidermidis on NICU-acquired infections, (ii) to establish if these infections are caused by endemic clones or by incidentally occurring bacterial strains of this ubiquitous species, (iii) to evaluate the use of different methods for the epidemiologic typing of the isolates, and (iv) to characterize the occurrence and the spread of staphylococci with decreased glycopeptide susceptibility. Results confirmed that S. epidermidis is one of the leading causes of NICU-acquired infections and that the reduced glycopeptide susceptibility, if investigated by appropriate detection methods such as population analysis, is more common than is currently realized. Typing of isolates, which can be performed effectively through molecular techniques such as pulsed-field gel electrophoresis but not through antibiograms, showed that many of these infections are due to clonal dissemination and, thus, are potentially preventable by strict adherence to recommended infection control practices and the implementation of programs aimed toward the reduction of the unnecessary use of antibiotics. These strategies are also likely to have a significant impact on the frequency of the reduced susceptibility of staphylococci to glycopeptides, since this phenomenon appears to be determined either by more resistant clones transmitted from patient to patient or, to a lesser extent, by strains that become more resistant as a result of antibiotic pressure.

[The role of transvaginal ultrasonography in the screening of ovarian tumors]. / Ruolo dell'ecografia transvaginale nello screening delle tumefazioni ovariche.

BACKGROUND: From January 1992 to March 1996, 1987 women underwent vaginal sonography screening, at the Department of Obstetrics and Gynaecology of the II Faculty of Medicine and Surgery "Federico II" in Naples. This mass screening aimed at early diagnosis of ovarian cancer. METHODS: Patients included in this investigations were all asymptomatic and had no pelvic abnormalities. Each ovary was measured in three planes and ovarian volume was calculated using the prolate ellipsoid formula. In premenopausal women, ovaries were normal if their volume was of > or = 18 cm3 and if they were hypoechogenic or anechogenic. In postmenopausal women a normal ovary was defined as having a volume of > or = 8 cm3 and a uniformly hypogenic internal structure. RESULTS AND CONCLUSIONS: In thirty-five premenopausal women was detected an abnormal volume of the ovaries. Forty-six postmenopausal women had abnormal vaginal sonograms. In this investigations vaginal sonography has permitted the detection of about 4.88% ovarian tumors in asymptomatic women, so that, it can be considered a more accurate and direment screening method for ovarian cancer than abdominal sonography.