Bowel parasitosis and neuroendocrine tumours of the appendix. A report from the Italian TREP project.

Five children with a neuroendocrine tumour (NET) of the appendix associated with a parasitic bowel infection are described, and the possibility of inflammation-triggered carcinogenesis is discussed. Schistosoma haematobium is linked primarily to bladder cancer but it has been reported in association with several other histotypes, including NETs of the gastrointestinal tract. Conversely, Enterobius vermicularis has not yet been claimed to participate in the onset of pre-cancerous conditions or tumours. The rare occurrence of contemporary appendiceal NETs and parasitic infection, raises the intriguing hypothesis of an inflammation-related carcinogenesis, although a cause-effect relationship cannot be established. Larger international series of childhood appendiceal NETs, which also include countries with higher prevalence of parasitic bowel infections, are needed to further clarify this possible cause-effect relationship.

[Disinfection is prevention]. / Disinfezione è prevenzione.

Prevention of outbreaks is very important in haemodialysis units because of the high risk of infectious complications caused by contaminated water or equipment. Our aim was to evaluate the efficiency of a chloride based disinfectant for haemodialysis machines. Five different machines were tested for infection by culturing water drawn from both inlet (point A) and outlet (point B) of the dialyser and from the waste site (point C). Six series of tests were analysed during a 3-week period. In the first week water was drawn from point A before and after disinfection on two different days; during the second and third weeks the same procedure was performed at points B and C, respectively. Three non-contaminated samples of 2 mL each were sent to the microbiology department for cultures. Samples from point B grew a number of bacteria even after the disinfectant for the water system was changed. We conclude that machine contamination is due to patients and, therefore, a very accurate cleaning and disinfection of system components is essential. This procedure can avoid isolation of infected patients. Prevention of infection is a complex procedure and should engage water systems, machines, as well as environment and nurses.