HACCP (Hazard Analysis and Critical Point system) at a catering service: checklist and microbiological examination

The A.A. carried out a survey on the functioning of a catering service in Rome. The risk analysis assessment was performed by means of a checklist that collected systematically all data about the environment, the operators, the food and the catering process. The results of the microbiological analysis carried out in the CCP's showed that the general conditions of the catering service were not satisfactory, but also indicated the validity of the checklist used. This method showed a high predictive value and can be useful to improve the application of the HACCP system.     

Activities at the Rome Anti-Rabies Center in 2000: analysis and proposals

The Authors analyzed data from the 1,817 patients (mean age 35.3 +/- 20.6, median 32) treated at the Antirabies Centre of Rome in the year 2000; of these 8.9% were immigrants. Dogs (84.1%) and cats (9.8%) were responsible for most bites. Stray animals were 39.9%, with an owner 58.3% and those without data 1.8%. Over 1/3 of patients could not refer the cause of bite. Most patients (93.0%) went first to hospital, where tetanus prophylaxis was administered preferably by immunoglobulins (25.0%) instead of vaccine (6.6%). Antirabies vaccine (HDCV and/or DEV) was prescribed to 777 patients (42.8%) and administered to 642 (35.3%), but only 296 (16.3%) of them received at least 5 doses. Veterinary observation always confirmed the absence of rabies in central Italy. Immunoglobulins were prescribed only to 14 patients. The data shown in this study emphasize the opportunity to differentiate the Italian antirabies protocol according to the geographic area.     

Enterovirus surveillance of Italian healthy children

Surveillance of acute flaccid paralysis (AFP) is the golden strategy recommended by the WHO to verify the condition of polio eradication in a country. Because of the difficulty to detect all of the expected AFP cases and to reach the target incidence of 1/100,000 requested by WHO, the surveillance of enteroviruses in the population has been adopted by several countries as an important additional method to verify the absence of wild-poliovirus circulation. To complete the results of AFP surveillance set up in Italy in 1996, we have conducted a wild poliovirus surveillance by examining stool samples from 1551 healthy children aged less than 5 years, collected during the period January 1997 to January 1998. The children were from three cities (Parma, Rome and Bari) located in northern, central and southern Italy. Thirty-nine polioviruses, 72 non-polio enteroviruses and 50 enteric, non-entero (NE), viruses were isolated from stool specimens. Polioviruses identified were nine type 1, seven type 2 and twenty-three type 3. Characterization of isolates by both antigenic and molecular methods showed that all polioviruses were of vaccine origin. As expected, most polioviruses, especially types 2 and 3, presented retromutations known to be associated with loss of the Sabin attenuated phenotype. The results of this study support the data obtained from the active AFP surveillance conducted in Italy in the same period – on the absence of paralytic disease due to wild poliovirus – and altogether demonstrate the effectiveness of the vaccination program.     

Age- and sodium-sensitive hypertension and sex-dependent renal changes in rats with a reduced nephron number

We have demonstrated that the reduction of angiotensin II effects during the nephrogenic period reduces the nephron number and induces the development of hypertension. The hypotheses examined are that this reduction of angiotensin effects leads to the development of an age-dependent sodium sensitive hypertension and that the hypertension is angiotensin II dependent. Newborn rats were treated with an angiotensin II type 1 receptor antagonist during the first 2 weeks of age. At 3 to 4 and 11 to 12 months of age, changes in systolic blood pressure, proteinuria, and renal function in response to a prolonged high sodium intake were examined. The basal blood pressure response to the administration of the angiotensin II receptor antagonist was also evaluated at both ages. Basal blood pressure was similarly elevated (P<0.05) in male and female treated rats, and the increment was age dependent. High sodium intake only elicited a blood pressure elevation (136+/-1 to 154+/-3 mm Hg; P<0.05) and a decrease in glomerular filtration rate (28%; P<0.05) at 11 to 12 months in treated rats. Blockade of angiotensin II receptors during renal development induced an increase (P<0.05) in proteinuria that was age and sex dependent, but high sodium intake only induced an elevation in proteinuria in the younger rats (50%; P<0.05). Hypertension was maintained by angiotensin II at both ages because blood pressure decreased to normal levels after treatment with an angiotensin II type 1 receptor antagonist. This study shows that the reduction of angiotensin II effects during the nephrogenic period modifies renal function and induces the development of an angiotensin II-dependent hypertension that becomes sodium sensitive during aging.     

Bilateral anterior sacrospinous ligament suspension associated with a paravaginal repair with mesh: short-term clinical results of a pilot study

Introduction and hypothesis  

This study aims to assess anatomical and functional results of bilateral anterior sacrospinous ligament suspension associated with paravaginal repair with mesh.     

Case report: application of peridural stimulation in a case of intractable coccygodynia]

The Authors report a case of coccygodynia following a car accident and describe the therapeutic approach used. In view of the clinical characteristics of pain and the limited quality and duration of benefits, it was proposed to insert an epidural neurostimulation electrode in an attempt to normalise the threshold of neuronal activity at the level of the spine.     

Formulation and Dosage Form Design in Drug-Induced Topical Irritation of the Gastrointestinal Tract

To test drugs for topical effects on gastrointestinal mucosa, a new in situ rabbit colon model was used that permits direct application of drugs in suspensions from gel cups, solutions, or commercially available tablets and capsules onto rabbit colonic mucosa for up to 8 hr. For each agent tested an irritation index was calculated—the product of the area of the mucosa affected by drug exposure and a numerical score for observed effect. Irritation indices ranged from 0 (no effect) to 25.6 (maximal irritation measurable). In general, the immediate release of drug onto tissue elicited the greatest effect, whereas slow or controlled release of drug produced the least response. Topical irritation was found to be a function of (1) the drug, (2) the formulation, (3) the delivery rate, and (4) the concentration. The gastrointestional therapeutic system (GITS) of potassium chloride and of brompheniramine/pseudoephedrine produced far less irritation than current commercial formulations of these drugs. The rabbit colon model is proposed as a useful screening tool during drug development to aid in selecting the formulation of an oral dosage form that will minimize topical irritation.