Molecular diagnostics of pulmonary metastasis from cervical cancer.

High-risk human papillomaviruses (HPV) are largely implicated in the carcinogenesis of cervical carcinomas. Their role in lung carcinomas, however, is still unclear. We describe the case of 44-year-old female chain-smoker with previous HPV-related cervical cancer and a new distant tumour in the lung after many years. The histologic distinction between metastatic squamous cell carcinoma of the cervix and another primary squamous cell tumour of the lung can be difficult and has important clinical implications. The aim of our study was to investigate whether HPV was present in both the patient's cervical cancer and her subsequent primary lung cancer in order to appropriately plan therapy. We tested both the paraffin-embedded tissue of the cervical cancer and the lung cancer for HPV DNA using the Qiagen HPV Sign Genotyping Test, which detected HPV16-DNA in both tumours. The Qiagen HPV Sign Genotyping Test is a reliable method to detect HPV-DNA in tissue and cytological materials, thus making it possible to distinguish metastatic cervical carcinoma from a new primary tumour in different sites.

[Prioritizing prescriptions in a ambulatory care setting: a tool to achieve appropriateness of care in public health management]. / Il sistema di prioritarizzazione delle prescrizioni nell'ambito della specialistica ambulatoriale: uno strumento operativo nell'ottica dell'appropriatezza assistenziale.

Waiting lists are one of the main Public Health issues within developed countries. To promote appropriateness about General Practitioners' (GPs) prescriptions, during 2009 the project "Priority setting in outpatient prescriptions" in Latium Region has been approved. Regional referees, Latium Public Health Agency managers and advisors, managers and advisors of three Local Public Health Units (LPHUs) within the Latium region and some voluntarily recruited General Practitioners (each one with more than 800 patients enrolled) were included in a team work with the duty to develop the project. During two selected months of 2010, 46 GPs have forwarded overall 2.229 medical prescriptions. The six most numerous prescriptions were picked out and analyzed by the team work. 42% of these prescriptions were identified as belonging to category D of the priority level--"standard", while 42% and 41% of prescriptions bore the expressions of "control" and "diagnostic purpose" respectively. Among these ones, 75% were represented by bilateral mammography, prescribed to women aged between 50 and 69 years: but for those people bilateral mammography is already provided free of charge within the regional program of breast cancer screening, making the routine prescription by their physician a useless duplication, unacceptable in a healthcare system of good quality. Therefore at the conclusion of the project, the team work suggests proper standards be applied by healthcare professionals and GPs to achieve a significant objective: mammography appropriateness prescriptions.

Healthcare students and their knowledge of healthcare-associated infections.

The aim of this study was to assess the knowledge of medical (MS) and nursing (NS) students about prevention of the HCAIs and to detect differences between these two groups. It was the pilot study of a national investigation and was performed administering a questionnaire including 6 multiple choice questions concerning 3 areas: standard precautions (SP), hand hygiene (HH) and nosocomial infections (NI). One hundred and seventeen students, 89 MS and 28 NS, were included in the study. Mean overall score (+/- SD) was 17.63 (+/- 3.8), on an overall perfect score achievable of 25. Mean score obtained by NS (18.5 +/- 3.3) was better than the one achieved by MS (17.4 +/- 3.9), even if the difference wasn't statistically significant. Stratifying the score in the three specific areas, healthcare students obtained weighed scores (+/- SD) of 6.74 (+/- 1.61) for SP, 4.7 (+/- 1.5) for HH and 4.51 (+/- 1.71) for NI. Knowledge level concerning HH area was different between medical students and nursing students (p = 0.013), in favour of the latter. According to correct answers rate, healthcare students properly know how and what kind of personal medical devices are to be used, while they show a lack of knowledge about hand hygiene. This pilot-study underlines the importance of the assessment of teaching effectiveness, and it stresses the need to critically review some specific contents of healthcare university courses.

[Microbiological pollution of operating rooms: critical analysis of two decades of surveillance]. / Inquinamento microbiologico delle sale operatorie: analisi critica di due decenni di sorveglianza.

The objective of this study was to analyze the results of microbiological air sampling of operating rooms (OR) over the last two decades at the Sapienza University Hospital of Rome, in order to describe the time trends of contamination levels and to assess any significant changes. Microbiological air sampling carried out in 14 surgical units between 1992 and 2010 were examined. The sampling results have been aggregated into four time periods (prior to 1996, 1996-2000, 2001-2005, 2006-2010) and the time trend of sampling results was analyzed in comparison with the standard reported by ISPESL for OR at-rest (< or = 35 CFU/mc). The same analysis was repeated after stratification by risk level of the OR (high risk (AR) and low risk (BR)). To verify the significance level of the temporal variations in the distribution of results x2 test for trend was performed. There was a significant downward trend in the number of OR with contamination levels higher of the standard (x2 for trend = 8.94, P < 0.025). This reduction mainly regards AR-OR (x2 for trend = 7.33, P < 0.05). The results suggest that the preventive measures performed in AR-OR have been effective. More attention must be given to BR-OR.