Time trend of Legionella colonization in the waterline of a hospital of Rome, Italy

Background: In many hospital’s Legionella outbreaks, hot water systems are the most frequent source of infection. Objectives: Considering the old age of the hospital waterline, an investigation on Legionella spp. water colonization was performed to evaluate the system weakness and to implement environmental preventive measures. Methods: From 2004 to 2010, a total of 5 sampling campaigns were performed, collecting 99 water samples from 13 wards and 3 other points of the water line (boilers, point of connection with public water line, hospital waterworks). The samples were analyzed, following national Legionella spp. standard methods. Results: A total of 28 samples (28.3%) were positive for Legionella spp. There has been an increasing time trend until 2008, from 4.5% to 75% in 2008; in the first month of 2010 only 26.3% of the samples were positive. The boiler was positive in 45.5% of samples collected since 2006. In total, surgeries were positive in 38% of cases (8/21): 100% of positive samples in 2006 and 2008, reduced at 50% in the first month of 2010. Only in these wards Legionella spp. were found four times to be >10,000 cfu/L. Among other wards, emergency medicine and oncology are the most contaminated (31% of positive samples). The worst year was 2008 with 75% of positive samples. Conclusion: Hospital water system seems to be affected by Legionella spp. colonization most frequently from 2006 to 2010. The high percentage of positivity in 2008 was related to the presence of a building yard in the hospital. In 2010 there was an improvement, although boilers, surgery, medicine and oncology are still contaminated. It is necessary now to investigate the temperature level mantained in hot-water system and also to observe if the structural characteristics of water ducts could have influenced the colonization observed

AIM (Artery in microgravity): Design and development of an ice cubes mission

The Artery In Microgravity (AIM) project is the first experiment to be selected for the “Orbit Your Thesis!” programme of ESA Academy. It is a 2U experiment cube designed for the ICE Cubes facility on board of the International Space Station. The experiment is expected to be launched on SpaceX-20 in early 2020. The project is being developed by an international group of students from ISAE-SUPAERO and Politecnico di Torino, under the supervision of the ISAE-SUPAERO and Politecnico di Torino staff. The experiment is a test-bench for investigating haemodynamics in microgravity focusing on coronary heart disease, the most common form of cardiovascular disease and the cause of approximately 9 million deaths every year. Coronary heart disease is caused by stenosis of the coronary artery due to the build-up of plaque. While the development of atherosclerosis is not fully understood, the primary event seems to be subtle and repeated injury to the artery walls through various mechanisms including physical stresses from flow disturbances as well as from systemic and biological risk factors. In the presence of severe stenosis, patients are treated with the implantation of one or more coronary stents, which are tubular scaffolds devoted to restore and maintain myocardial perfusion. The coronary stenting procedure is largely applied (e.g., 1.8 million stents per year implanted in USA) In view of the impact that coronary artery disease has on humans, as well as of the increasing number of people that will be involved in space flights in the future, the way astronauts in space coronary hemodynamics is affected by the absence of gravity in the presence of stenosis or of stenting needs to be investigated in depth. In addition, as most stents are metallic objects, the radiation exposure in space might interact with their surface, altering blood flow, inducing particles release and ultimately leading to stent failure. Therefore, the aim of AIM is to start studying the vascular haemodynamics in a stented and a stenosed coronary artery on Earth and in microgravity and the stent-radiation coupling. This will allow to learn about the effect gravity plays on coronary artery haemodynamics, the effects of microgravity and radiation on the performance of implantable devices and ultimately the risks of myocardial infarction to astronauts on long-distance spaceflight. The experimental setup consists of a closed hydraulic loop containing two models of a coronary artery in series. An electric pump and reservoir will control the flow of a blood-mimicking fluid through the system. One model of the coronary artery will contain a coronary stent. The pressure of the fluid will be studied along its path using a series of pressure sensors and a camera will visualise the flow. The same experiments will be repeated on the ground with the same conditions as the in-flight model for comparison. The paper will outline in detail the design and development of the AIM experiment cube and the results of testing. The full data and results will be available after the completion of the mission which is expected to be between March and June 2020

Relationship between B-type natriuretic peptide levels and echocardiographic indices of left ventricular filling pressures in post-cardiac surgery patients

<p>Abstract</p> <p>Background</p> <p>B-type natriuretic peptide (BNP) is increased in post-cardiac surgery patients, however the mechanisms underlying BNP release are still unclear. In the current study, we aimed to assess the relationship between postoperative BNP levels and left ventricular filling pressures in post-cardiac surgery patients.</p> <p>Methods</p> <p>We prospectively enrolled 134 consecutive patients referred to our Center 8 ± 5 days after cardiac surgery. BNP was sampled at hospital admission and related to the following echocardiographic parameters: left ventricular (LV) diastolic volume (DV), LV systolic volume (SV), LV ejection fraction (EF), LV mass, relative wall thickness (RWT), indexed left atrial volume (_iLAV), mitral inflow E/A ratio, mitral E wave deceleration time (DT), ratio of the transmitral E wave to the Doppler tissue early mitral annulus velocity (E/E').</p> <p>Results</p> <p>A total of 124 patients had both BNP and echocardiographic data. The BNP values were significantly elevated (mean 353 ± 356 pg/ml), with normal value in only 17 patients (13.7%). Mean LVEF was 59 ± 10% (LVEF ≥50% in 108 pts). There was no relationship between BNP and LVEF (p = 0.11), LVDV (p = 0.88), LVSV (p = 0.50), E/A (p = 0.77), DT (p = 0.33) or RWT (p = 0.50). In contrast, BNP was directly related to E/E' (p < 0.001), LV mass (p = 0.006) and _iLAV (p = 0.026). At multivariable regression analysis, age and E/E' were the only independent predictors of BNP levels.</p> <p>Conclusion</p> <p>In post-cardiac surgery patients with overall preserved LV systolic function, the significant increase in BNP levels is related to E/E', an echocardiographic parameter of elevated LV filling pressures which indicates left atrial pressure as a major determinant in BNP release in this clinical setting.</p

The pneumonitis mortality trend in Italy in the 1975-94 period // Andamento della mortalità per polmoniti in Italia nel periodo 1975-94

Gli autori analizzano l'andamento della mortalità per polmoniti in Italia nel ventennio 1975-1994

Surveillance of Legionella Waterline Colonization in a Hospital of Rome, Italy

BACKGROUND: In many hospital’s legionella outbreaks, hot water systems are the most frequent source of infection. OBJECTIVES: Considering the old age of the hospital waterline, an investigation on legionella water colonization was performed to evaluate the system weakness and to implement environmental preventive measures. METHODS: Three repeated campaigns of water sampling were performed in different seasons from February 2004 to June 2006. Overall, 66 water samples were collected: 52 in wards with at-risk patients from 3 buildings (two old (A-B) and one new (C)); other 14 samples from boilers. The samples were analysed, following national legionella standard methods; water temperature, pH and residual free chlorine were determined at the time of collection. RESULTS: A total of 8 samples (12.1%) resulted positive for Legionella spp. In hospital wards 6 (11.5%) samples were positive and the isolates were L. gormanii (1) and L. pneumophila (5). The highest colonization rate was observed in building C (26.7%), vs 5.5% in B and 5.3% in A. 14.3% samples from boilers were also colonized by L. pneumophila. The percentage of positive samples was: 6.7% in autumn-winter and 23.8% in spring-summar campaigns. The average temperature was lower in colonized samples (39.1° vs 46.5°). In 71.4% of samples the level of L. pneumophila contamination was beween 103 and 104 CFU/L. CONCLUSION: Hospital water system seams to be affected by Legionella colonization most frequently in spring-summar and in the new buildings (C). It is necessary now to investigate on the temperature level mantained in hot-water system and also to observe if the structural characteristics of water ducts of C-building can influence the colonization observed

Physicians and vaccination against influenza: the experience of a Roman hospital

Gli autori riportano i risultati di uno studio effettuato sul personale ospedaliero al fine di valutare le loro opinioni ed atteggiamenti nei riguardi della vaccinazione antinfluenzale del personale sanitario. Lo studio evidenzia che persistono numerose perplessità e lacune formative da parte del personale