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Healthcare-associated infections (HAIs) surveillance is an essential part of any infection prevention and control programme. Repeated point prevalence surveys (PPSs) according to European Centre for Disease Prevention and Control (ECDC) protocol have been implemented in all Friuli Venezia Giulia (FVG) region (Italy) acute hospitals to reduce and control HAIs.Using the repeated PPSs within a regional-healthcare system (RHS) to promote and evaluate infection prevention and control (IPC) programmes.The standard versions of the ECDC PPS protocols were used in all four surveys (2011, 2013, 2015, 2017). All RHS public and private accredited hospitals were involved within the 'safe care network' programme.The numbers of surveyed patients in the four PPSs were 3172, 3253, 2969 and 3036, respectively. Prevalence of HAIs and antimicrobial use (AU) decreased significantly from 2011: HAIs (P0.05) 7.1%, 6.3%, 5.5%, 5.8% and AU (P0.01) 40.4%, 39.2%, 36.0%, 37.2%, respectively. The appropriateness of duration of surgical prophylaxis increased significantly (24 h increased through surveys related to one in 2011: odds ratio (OR), 95% confidence interval (CI) 1.29, 0.92-1.81; 1.95, 1.31-2.91; 1.78, 1.20-2.64, respectively). The most frequently detected HAIs were: bloodstream, urinary tract, pneumonia and surgical site (more than the 70% of HAIs in each PPS).The FVG regional approach to HAIs and AU surveillance was able to contribute to reduce prevalence over a 7-year period. Furthermore, it was able to keep hospital attention on HAIs and AU through the years and to guarantee a standardized and comparable evaluation of HAIs and AU burden in all RHS hospitals, as well as impacting on HAIs and AU regional programmes.

Background: Scarce information is available about the variation in the incidence of Type 1 diabetes in the Brazilian population in the last decades. Aim: The objective of this study was to assess the long-term trends (1986–2006) in the incidence of Type 1 diabetes in Bauru, Sao Paulo State, Brazil. Subjects and methods: The annual incidence of Type 1 diabetes (per 100,000 per yr) from 1986 to 2006 was determined in children ≤14 yr of age, using the capture and recapture method. Results: A total of 176 cases were diagnosed in the study population. The overall incidence was 10.4/100,000 with a range of 2.82/100,000 in 1987 to 18.49/100,000 in 2002 representing a 6.56-fold increase within the same population. The estimated incidence, using the capture and recapture method varied from 2.82/100,000 per yr in 1987 to 27.20/100,000 per yr in 2002, representing a 9.6-fold variation. The global pattern of incidence variation was categorized as high (10-19.99/100,000 per yr), and very high (≥20/100,000 per yr) in 71.43% of the study-years. Incidence was slightly higher among females, Caucasians, children in the 5–9 yr of age range and belonging to lower socio-economic classes. Most diagnoses were established during the colder months and/or with higher pluviometric indexes. Conclusions: The incidence of Type 1 diabetes in children is increasing in Bauru, Sao Paulo State, Brazil, and the global pattern of incidence was classified as high or very high, mainly in the last 10 yr. All Brazilian regions should be involved in the study.

All 169 caulkers employed at a ship yard were examined to determine the prevalence of vibration syndrome due to pneumatic portable tools (chipping hammer and grinders). Vibration measurements and medical investigations were performed in the field between September 1977 and July 1978. Vibration spectra recorded on pneumatic tools were compared to ISO Draft Proposal No. 5369. The chipping hammer produced the highest acceleration levels and exceeded the maximum ISO limits even for a short exposure time (30 min per shift). The results of medical investigations pointed out that 78.7% of caulkers experienced paresthesia in their hands, 31.3% Raynaud's phenomenon (or VWF), 20.1% presented with radiological signs of osteoarthritis at wrist and shoulders, 10.0% with olecranon exostoses, and 31.3% with cysts of the carpal bones. To diagnose VWF the skin temperature of the hands were recorded in all 169 caulkers and 60 controls at the shipyard. The basal skin thermometric map (recorded in 16 positions per hand) demonstrated an average difference of 2-2.5 degrees C between the two populations. The thermometric curve, monitored every 3 min for 40 min after a provocative cold-test (immersion of hands and wrists in melting ice for 2 min), well differentiated workers exposed and not exposed to vibrations. The authors emphasize that skin temperature (before and after the cold-test) are suitable for epidemiological purposes to compare the prevalence rates of VWF in control-experimental groups.

Summary The results of a survey performed on shipyard caulkers exposed to hand-arm vibration are reported.Percussive(chipping hammer)and rotatory(grinders)hand held tools have been examined, Frequency spectrum of the chipping hammer shows high acceleration levels which exceed ISO acceptable boundaries for the exposure time of caulkers. Acceleration levels of the grinders, on the contrary, exceed ISO limits only in a few third octave bands. Medical investigations included 169 caulkers and 60 controls. The results of medical examinations demonstrate:1)a high prevalence (78.7%)of neurovascular complaints in the upper limbs of the caulkers; 2)among 169 caulkers, 53 (31.3%)are suffering from vibration white finger, while a prevalence of 6.6% is found in the control group; 3)X-ray of the right upper limbs of the caulkers show a moderate prevalence of typical carpal cysts(31.3%) and olecranon exostoses (10.0%);4)the measurement of basal skin temperature of the hands and the recovery time of basal skin temperature after cold test reveal a statistically significant difference between caulkers and controls. At conclusion, some preventive considerations are reported.