Phenotypic and genotypic characterization of clinically relevant bacteria isolated from dental waste and waste workers' hands, mucosas and coats.

Infectious wastes are potential sources of pathogenic micro-organisms, which may represent a risk to the professionals who manage them. In this study, we aimed to characterize the infectious bacteria present in dental waste and waste workers. The dental waste produced over 24 h was collected and waste workers were sampled by swabbing. Isolate resistance profiles were characterized by Vitek® and PCR and biofilm formation by Congo Red agar, string test and microtitre assay. To assess similarity between the waste and the workers' samples, a random amplified polymorphic DNA test was used. Twenty-eight bacteria were identified as clinically relevant. The most frequent gene was blaTEM present in five Gram-negative micro-organisms, and one blaSHV in Klebsiella pneumoniae. All Pseudomonas aeruginosa were positive to extracellular polymeric substances formation, except one isolated from a worker. Klebsiella pneumoniae had negative results for the string test. Pseudomonas aeruginosa showed better adherence at 25°C after 48 h of incubation and K. pneumonia had the best biofilm formation at the same temperature, after 24 h. The similarity between P. aeruginosa recovered from dental waste and from workers was low, however, it is important to note that a pathogen was found on a worker's hands and that improvements in biosafety are required. SIGNIFICANCE AND IMPACT OF THE STUDY: Infectious dental waste can contain clinically relevant bacteria with important resistance and biofilm profiles. These micro-organisms could be transmitted to waste workers, other professionals and patients if the principles of biosafety measures are neglected. To our knowledge, no study has ever evaluated the microbial characterization and the potential contamination risk of dental infectious waste and waste handlers. The presence of clinically relevant bacteria in the hands and nasal mucosa of waste workers highlights the need for studies in this field to clarify the risk of these pathogens in dental healthcare services, and to stress the need for an efficient waste management.

[Ferti-test. A simple method for tubal function diagnosis: feasibility study]. / Ferti-test. Metodologia semplificata per la diagnostica funzionale tubarica. Studio di fattibilità

BACKGROUND: To indicate the simplicity and the feasibility of this new diagnostic technique for infertility investigation. Ferti-test is a technique which combines dye-test and pelvic post coital test, using inexpensive surgical material. Ferti-test allows to perform laparoscopy only in very necessary cases, without loosing diagnostic quality. METHODS: Up to September 2001, 30 patients aged from 24 to 46 years, with infertile problems were enrolled. All the patients, in a preovulatory period, underwent dye-test combined with pPCT. Before the operation, all the patients were investigated for endocrinological assessment; an evaluation of sperm liquid in all the partners and a PCT have been carried out. All these data were organized in a specific diagram, which allowed to recognize the normality or the specific class of pathology of infertile couple. RESULTS: The purpose of this study is to remark the simplicity and the feasibility of this new diagnostic method. In our study, no patients who underwent dye-test and pelvic PCT had any complications. Only 7 patients with negative dye-test and pelvic PCT underwent diagnostic laparoscopy. CONCLUSIONS: The results of this study indicate that Ferti-test is an effective and reliable technique for the first level evaluation in infertile couples. Ferti-test is well tolerated and requires minimal cost. With Ferti-test it is possible to screen the patients who actually need laparoscopy and to reduce risks and costs.

[Water birth. Clinical and practical advice]. / Travaglio e parto in acqua. Raccomandazioni di Pratica Clinica.

Water labor and/or birth are more and more requested and with the increased number of pregnant women choosing water-birth it is necessary to define advice for a safe use of this method of birth-assistance, in order to prevent any possible connected complication. The criteria for admission or exclusion to water labor and/or birth, correlated with maternal-fetal clinical aspects, hygienic aspects, legal-medicine aspects, are indicated. The structural, technical, organizing, specific requirements, in addition those of every delivery room, and considered important for water birth places, are underlined.

Uterine changes during tamoxifen therapy.

Tamoxifen used for adjuvant therapy in breast cancer, has a complex and unclear action on endometrium and myometrium. Many authors demonstrated endometrial proliferous changes in peri and post menopausal women. Our study shows the development of myomas in three patients without uterine pathology before tamoxifen therapy, and the increase of a polip and a myoma after tamoxifen therapy. Moreover, we observed the development of a myoma in a patient after one year tamoxifen in association with LH-RH analogue therapy. It is necessary to continue our study with a larger number of patients to assess the hyperplasic effect of tamoxifen.

[Carcinoma of the vulva: our experience]. / II carcinoma della vulva: nostra esperienza.

The Authors report their experience on the vulvar carcinoma therapy. Patients showed, with high frequency, hypertension and diabetes. The 25.9% of the patients, furthermore, were obese. The surgery was the primary treatment, combined with chemiotherapy and radiotherapy in selected cases. The survival rate was 80% in I stage, while in the III and IV stage was very low, in spite of the use of chemotherapy.