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Aims: In hospitals, surfaces are often colonized by potentially pathogenic micro organisms which can remain alive for long periods of time, thus playing a major role in hospitalacquired infections. One way to overcome this drawback could be to use disinfectants with long-term action. Recent studies have shown that not only do disinfectants containing silver present an immediate effect, reducing the surface bacterial load, but that this action also appears persistent in time. This work assesses the bactericidal activity of a long-lasting disinfectant complex composed of silicon oxide, silver ions and a cationic surfactant (BACTERCLINE ENERGY BLAST) applied on the surfaces of two surgery ward rooms and left in place for different amounts of time (15 min and 72 hours). Study Design: An experimental study. Place and Duration of Study: The investigation was carried out in two rooms of a surgical ward at the Villa Erbosa health care facility in Bologna (Italy) over a period of seven weeks. Methodology: The samples were taken using contact plates (diameter: 24 cm2) containing an adequate agar culture medium (Tryptic Soy Agar). After incubation at the temperature of 36±1ºC for 24 and 48h, the number of colonies was counted and the statistical analysis of results was performed. Results: The product was able to achieve a high degree of decontamination (around 90%) immediately after application and that, after 72 hours, decontamination remained at about 55%. The results are statistically significant. Conclusion: It may be concluded that the tested product could be profitably used to decontaminate surfaces in hospital wards.

Objective: The purpose of the present research was to compare the residual microbial load in Solo System microfiber mops with silver and in normal microfiber mops without silver to see whether those with the silver prevent bacterial proliferation and spread more effectively during normal cleaning operations. Methods: Mops with and without silver were experimentally contaminated with suspension of Staphylococcus aureus ATCC 6538. The bioburden was evaluated by a filtering procedure according to UNI EN 1174 after contamination, after washing and after different times of impregnation in an alcohol-base detergent. Results and discussion: The results obtained lead to the conclusion that silver microfiber mop was significantly more effective in reducing bacterial load despite initial high level contamination (106-107 CFU/50 cm2). Indeed, after low temperature washing, the bacterial load was already completely eliminated while the mop without silver still presented relatively high levels of the microorganism (approximately 102 CFU/50 cm2) even after being soaked for 8 hours in a detergent/disinfectant. Keywords: decontamination, surface-active agents, products with antimicrobial action, semi-colon, infection control

Objective: This study analyzed how effectively bacteria penetrate through a new filtering device (Muski™) aimed at providing temporary protection against hazardous air contaminants. Materials and methods: A 1.5–7×108 cfu/ml bacterial or spore suspension was aerosolized. Fragments of the Muski filter, previously sterilized by gamma rays, were placed in a sterile stainless steel Seitz filter holder, plugged into an Erlenmeyer vacuum flask connected to a vacuum pump to force the bacteria aerosol through the Muski filter. As a control the same apparatus was used without the Muski filter. To evaluate the bacteria passing through the apparatus, diluent solution was introduced in the Erlenmeyer flask, which was then subjected to mechanical shaking. Both the contents of Erlenmeyer flask and the diluent solution, used to rinse out the Erlenmeyer flask, were filtered through a membrane filtration apparatus. The filtration membrane was transferred to the surface of a Petri dish containing a suitable culture medium f...

Surgical hand disinfection (with an alcohol-based hand rub) and surgical handwash (with an antiseptic-based liquid soap) are accepted measures to reduce the risk for surgical site infections. The new European Standards allow a comparison of their antimicrobial efficacy. The bactericidal activity of surgical hand rubs [Sterillium and Softaman, (active ingredient=alcohols)] and handwashes [Derman plus (triclosan), Hibiscrub (chlorhexidine) and Betadine (PVP-iodine)] was tested according to the prEN 12054 suspension test using Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus hirae, and to prEN 12791 for the effect on resident skin flora in comparison with 1-propanol, 60% (v/v). All five products achieved a reduction of test bacteria within 3 min of >10(5)-fold so fulfilling prEN 12054. However, only Hibiscrub, Sterillium and Softa Man met the requirements of prEN 12791, giving a mean reduction of resident micro-organisms (immediate and sustained effect) which was not significantly lower than the reference alcohol (P>0.1; Wilcoxon matched-pairs signed-rank test). Sterillium was significantly more effective than the reference alcohol (immediate and sustained affect). Products for surgical hand disinfection may have equal antimicrobial activity in suspension tests but show large differences under practical conditions. Healthcare workers should not rely on results from suspension tests when deciding on a product for surgical hand disinfection.

A protocol for the disinfection of gastroduodenoscopes, retrograde cholangiopancreatography endoscopes and colonoscopes using endoscope washers is described. The process recommends initial manual washing with a disinfectant containing didecyldimethylammonium chloride, surfactants and enzymes, a second washing in the endoscope washer using a detergent associated with a bacteriostatic, fungistatic substance (benzoisothiazolone) and finally the use of a 2% glutaraldehyde product buffered at pH6. After treatment with 2% Steranios added to the washer, less than 1 micro-organism/ml liquid was found in the following units: 83% of the colonoscopes, 83% of the oesophagogastroduodenoscopes, 83% of the main channels of the retrograde cholangiopancreatography endoscopes and 75% of the auxiliary channels of the latter instruments. In 14% of the colonoscopes, 42% of the gastroduodenoscopes, 42% of the main and 50% of auxiliary channels in the retrograde cholangiopancreatography endoscopes there were no signs of microbial growth in the wash liquid. The results obtained indicated that this protocol allowed adequate disinfection of the endoscope channels, structurally the most difficult part of the instrument to disinfect. Emphasis is given to the degree by which instrument contamination can increase during overnight storage, suggesting that endoscopes need to be submitted to further disinfection after overnight storage. Moreover, the water flowing into the washers can also cause instrument recontamination, particularly during the final rinses. Therefore, to better safeguard the health of patients undergoing endoscopy, special care must be taken to maintain the filters and disinfect the washers themselves, no matter how effective the disinfection protocol used may be.

Two methods for cleaning waxed polyvinylchloride and porcelain grès hospital room floors were compared in order to determine their decontamination capacity: dry wiping followed by damp washing, and damp washing followed by dry wiping. Dry wiping followed by damp washing did not produce any significant reduction in the average bacterial load. However, damp washing followed by dry wiping reduced the bacterial load for both types of flooring. The difference was statistically significant.

The plasma GH response to GHRH (100 micrograms i.v.) was evaluated either alone or after pretreatment with pyridostigmine (120 mg orally 1 h prior to GHRH) in 9 younger men (age range: 22-39 years) and in 9 healthy elderly men (age range: 63-77 years). On a different occasion, subjects were tested with pyridostigmine alone. Basal concentrations of glucose, cortisol, androgens, estrogens, thyroid hormones and GH were similar in all subjects, whereas insulin-like growth factor was lower in elderly men. The GH response to GHRH was significantly lower in the older (mean peak was 6 times higher than baseline) than in the younger group (mean peak was 11.3 times higher than baseline). The pretreatment with pyridostigmine induced a striking increase in the GH response to GHRH in the younger subjects (mean peak was 26 times higher than baseline), whereas it produced only a slight increase in the GHRH-induced GH response in elderly men (mean peak was 8.7 times higher than baseline). When pyridostigmine was given alone, plasma GH levels rose significantly in both groups; however, the pyridostigmine-stimulated GH response was significantly higher in younger (mean peak was 6 times higher than baseline) than in older subjects (mean peak was 2.5 times higher than baseline). These data indicate that the cholinergic stimulatory regulation of GH release is reduced in elderly subjects. Since acetylcholine inhibits hypothalamic somatostatin release, the reduced cholinergic tone in elderly subjects may result in an increased somatostatinergic tone.

Decontaminating mats made of several layers of adhesive sheets (water-based acrylic 6 g/m2) supplemented with a bactericidal agent (3-1 benzoisothiazolin) at a concentration of 25% were placed in the passages providing access to the operating rooms of an orthopaedic service. Contact plates containing tryptone soy agar were used to assess bacterial concentration at specific points in front of and beyond the mats. For trolley passageways two areas were defined: central and lateral paths, corresponding to the areas walked upon by the personnel pushing the trolleys and to the paths covered by the trolley wheels, respectively. In order to exclude a simple mechanical effect, a comparison of bacterial loads at defined sites beyond the mats was carried out in the presence and in the absence of decontaminating mats. Bacterial colony counts in the presence of decontaminating mats were substantially and statistically significantly reduced compared with the absence of mats. The lower mean number of colony-forming units detected at points located beyond the mats parallels this finding; this difference is also statistically significant. We thus conclude that decontaminating mats are potentially useful in decreasing micro-organism carry-over due to personnel or the passage of trolleys into areas at high risk of infection such as operating rooms.

The Viterbo Province, located in the Northern area of the Lazio Region is mainly characterised by an exceptional heritage given by centuries of Etruscan culture, well known all over the world. Beside that, many also Roman and Middle Age monuments - like e.g. Via Francigena: a Pilgrimage medieval rout to Rome - distinguish its landscape, which support both quite rich agricultural activities and high level tourism; also antique spas are enjoyed not only by population, owing to their historical and up-to-date reputation. Despite all this singular background, a Provincial landfill has been planned in this area, possibly also used by close Rieti Province. This paper is planning a number of actions to counteract such an ecological and environmental disaster.

In the last years a great number of air quality simulation models have been developed and implemented into widely known computer packages. Presently, the major problem is to select in a rational way the model best suited for a specific situation. Hence, it seems useful to review and organize the knowledge about diffusion models into a computerized system to support the user in the appropriate choice. This means that the system has to provide to the user the expertise on air quality modelling which is necessary for the definition of the functional expression and parameter values corresponding to the characteristics of a specific site (i.e. sources, meteorology, terrain,…).

This paper describes the prototype of a decision support system oriented to air pollution network designers. The purpose is to help the users in the choice of the number and localization of instruments in an assigned area. The criterion employed is to locate instruments so as to evidence concentrations exceeding law standards. AREM runs on IBM PC's or compatibles and provides the following outputs: the number and the localization of the monitoring stations, their efficiency coefficient, the global network efficiency, and finally the station coverages. The user can change the constraints of the problem and examine the resulting different solutions. One example is shown for the town of Piacenza and its sorrounding industrial area, located in Northern Italy.

More than 600,000 cases per year of nosocomial infection in Italy reflect, in part, the scant attention given to the vehicles of infection, conditions which favour cross-contamination and not least to the inappropriate use of antiseptics and disinfectants in our hospitals. Disinfection procedures are intended to remove or neutralise sources of potentially pathogenic organisms or to prevent their transmission by blocking the routes of transmission. Data to support many disinfection policies, particularly those of routine disinfection of inanimate surfaces, i.e. floors and walls, appear unable to show significant benefit to the patient. With the exception of particular areas, a correlation between reduction in counts of airborne bacteria and microbial colonisation or clinical infection has failed to be demonstrated. However, certain antiseptic practices e.g. correct hand washing procedures, surgical skin preparation and instrument sterilisation are of invaluable use in the control of nosocomial infection. It is therefore of critical importance in this period of cost cutting and financial restraint within the hospital services that we adopt those infection control measures which are of greatest cost effectiveness. A recent critical evaluation of the use of antiseptics in several Italian hospitals, illustrates the principal characteristics of antiseptics and their fundamental role in the control of hospital infection. This study also highlights common misuses of antiseptics and their cost/benefit ratio.

Purpose: To compare the efficacy and tolerability of diclofenac and bromfenac ophthalmic solutions as adjunctive therapy after cataract surgery. Materials and Methods: This prospective randomized controlled study included 130 patients who underwent cataract surgery. One hundred patients were randomized to receive postoperatively diclofenac 0.1% (four times daily for 28 days, Group 1) or bromfenac 0.09% (twice daily for 14 days, Group 2) ophthalmic solutions in addition to steroid-antibiotic combination. Thirty patients instilled only steroid-antibiotic combination (Control Group 3). Laser flare-cell photometry and optical coherence tomography scans with central foveal thickness (CFT) measurement were performed before (V0) and 7 (V1), 14 (V2) and 28 days (V3) after surgery. Treatment tolerability was scored using the Ocular Comfort Grading Assessment. Results: Laser flare-cell photometry values were significantly higher at V1, V2 and V3 compared to V0 in all the groups (respectively 13.3 +/- 1.0, 12.7 +/- 0.9 and 9.6 +/- 0.9 vs 8.4 +/- 0.6 ph/ms for Group 1; 13.4 +/- 1.0, 12.7 +/- 0.9 and 12.7 +/- 1.0 vs 8.1 +/- 0.6 for Group 2; 15.9 +/- 0.8, 15.4 +/- 0.7 and 14.5 +/- 0.7 vs 7.5 +/- 0.5 for Group 3) (p < 0.001); flare increase was significantly lower in Group 1 compared to Groups 2 and 3 (p < 0.001). CFT values were higher after surgery in all the three groups; the increase was significantly lower in Group 1 compared to Groups 2 and 3 (p < 0.0002). The percentage of symptoms-free patients after study treatment was significantly higher in Group 2 compared to Group 1 (respectively 74% vs 14% of the total; p < 0.001). Conclusion: The addition of diclofenac or bromfenac ophthalmic solutions contributed to further reduce both inflammation and cystoid macular edema after cataract surgery compared to steroid-antibiotic combination alone. Diclofenac appeared to be more effective in reducing postoperative intraocular inflammation with a more intense and prolonged regimen, while bromfenac more tolerated with lower daily dose and treatment duration.