[A study of the nurses quitting Legnano Hospital USSL 70]. / Indagine sull'abbandono dell'Ospedale da parte degli infermieri nell'USSL 70 di Legnano.

Reasons why nurses left a general Hospital were analyzed through a questionnaire sent to all nurses who abandoned their position over the last 5 years (218). 50.6% of these nurses do not live in Lombardy region. 127 (57.7%) answered the questionnaire. 35% of whom answered the questionnaire would get back to work in the hospital. The main reason for hospital leave is related to family reasons (children and parents) for registered nurses and to shift work state enrolled nurses. Low salary is the main problem for 21-30 years old nurses. According to nurses who answered the questionnaire, more efficient recruitment and retention strategies should include higher salaries, riqualification of the profession in general and improvement of working conditions and organization.

[A sampling study in 6 Lombardy hospitals on the knowledge possessed by nurses on the risks associated with accidental exposure to patient blood]. / Indagine campionaria in sei ospedali lombardi sulle conoscenze possedute dagli infermieri sui rischi associati all'esposizione accidentale al sangue dei pazienti.

In six hospitals of the Lombardy Region 3.000 questionnaires have been circulated to evaluate the degree of awareness and information of the personnel with respect to the behavior to be adopted at the occasion of an accidental exposure to the blood of patients. Up to 63% (1896) of the original questionnaires were available for the analysis. The mean of the responses which can be considered correct for the professional level involved, does not seem to be an area-dependent variable. The number of correct answers declines proportionally as the age increases. A drastic difference in the degree of knowledge is documented to exist between general and professional nurses, who however are exposed to the same risk. The ignorance on the role and choice of disinfectants and on the way of disposing of used needles is particularly striking. The results of the questionnaire, mainly when they are referred to each hospital, are easily utilizable to finalize and support information and training programs.

Effects of the allogeneic stimulation on B cell function in thalassaemic polytransfused patients.

The immunological abnormalities of polytransfused patients affected by beta-thalassaemia major have been investigated in relation to B cell function. The spontaneous in vitro production of Ig by patient peripheral mononuclear cells was not modified, while the pokeweed mitogen induced IgM synthesis was significantly reduced. However, by comparing the splenectomized and non-splenectomized patients, this alteration proved to be present only in the splenectomized group. The proliferation of patient peripheral B cells in vitro stimulated with B cell growth factor alone was not significantly enhanced in respect to the controls. These results indicate that in vivo activation state of patient B cells is not different from that of the controls. The stimulation of peripheral B cell with anti-mu or anti-alpha antibodies and anti-mu and anti-alpha antibodies plus B cells growth factor induced a significant increase in proliferative responses of B cells from the splenectomized patients. Taken together, these findings suggest that circulating B cells of thalassaemic polytransfused patients are not hyperactivated. The splenectomy can account for the immunological changes observed in our thalassaemic sample as compared to control group.

Immune profile alterations in thalassaemic patients.

Aspects of the humoral and cellular immune response have been studied in polytransfused patients with beta-thalassaemia major. Serum immunoglobulins (G, A, M) levels were significantly higher than in controls; reduced C4 serum level and high incidence of circulating immune complexes and anti-nuclear autoantibodies were found in the majority of patients. Marked increases were also observed in absolute and relative numbers of lymphocytes and their subpopulations. Such results suggested that the allogenic stimulation, by frequent transfusion, is the mainly responsible of the immunological alterations observed in these patients.