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Italian consumers changed their food habits in the last period; the increase of raw milk consuming is also related to the high number of self service vending machines that have been authorized, particularly in Northern Italy. According to national rules on raw milk hygienic conditions, the most important bacteria are checked by Veterinary Services; the aim of this study was to investigate some emerging or re-emerging hazards in raw milk at vending machines. For this reason 100 raw milk samples were collected and analyzed in order to detect E. sakazakii, Coxiella burnetii and M. avium subsp paratuberculosis. One milk sample resulted to be positive with PCR method for E. sakazakii (no cultural confirmation was possible); 49% of samples resulted posivite for the presence of Coxiella burnetii specific DNA, and 5% of milk samples came out positive to the presence of M. paratuberuclosis antibodies with ELISA methods.

The European Regulation (EC) n° 2073/2005 on microbiological criteria for foodstuffs enforces operators to carry out microbiological analyses on their products. Following the same criteria the Authority of Piedmont Region decided to adopt the Regulation to carry out the official control on food. During year 2007, 1063 food samples has been analysed by Food Control Laboratory of IZS Piemonte, Liguria e Valle d’Aosta; the aim of this work is to analyse the results obtained.

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Introduction: Undernutrition and growth retardation are often observed in children with severe neurological disabilities. Our experience of feeding gastrostomy in children and adolescents with central nervous system (CNS) disease and dysphagia is reported., Patients and Methods: A gastrostomy feeding tube was placed in 11 children who had severe impairment of swallowing and clinically evident food aspiration. Percutaneous endoscopic technique was preferred, unless operative placement was suggested by unfavourable anatomical conditions or concomitant abdominal surgery. Commercial formulas or natural food were used at home and the children were regularly followed-up at the outpatient clinic., Results: Median age at the gastrostomy placement and median follow-up lenght were 5.9 years (range 1.8-16.7 years) and 15 months (3-66 months) respectively. Four of 11 patients had moderate (weight/height (W/H) ratio = 80%) and 3 severe (W/H ratio < 70%) malnutrition. Ten of 11 subject were exclusively gastrostomy fed. After 3 months of enteral nutrition a weight gain was observed in all patients as well as a significant increase of mean W/H ratio (81.2% vs. 87.2%, p = .002). Nutritional improvement was confirmed at follow-up, despite caloric intakes lower (< 50%) than recommended for age and weight. Micronutrients and vitamins were supplemented on the basis of calculated intakes., Conclusions: In children with severe CNS disease and dysphagia, long-term gastrostomy feeding is a safe and useful method that allows adequate nutritional and micronutrient intakes and prevents the risk of dystrophy.

The complications of percutaneous endoscopic gastrostomy (PEG) placement or replacement or of home management of gastrostomy, must be taken in account in patients with hydrocephalus and ventriculoperitoneal shunt. In this report we describe four children with spastic quadriplegia and ventriculoperitoneal shunt who had a median follow-up of 15 months (range 4-32 months) after PEG placement. Intravenous antibiotic prophylaxis was always used during routine procedures and no shunt infection was observed. In a patient, during accidental PEG dislodgement, peritoneal infection developed that required temporary diversion of the catheter. A second dislodgement, in the same individual, determined a large amount of serous peritoneal fluid that needed to be evacuated but no shunt infection or malfunction. In nobody of our patients, the shunt, located in the upper left abdomen, interfered with gastrostomy placement. Our experience confirms that PEG is not contraindicated in patients with ventriculoperitoneal shunt, provided that the risks of catheter infection are known and prevented.