• Lessons learnt from a birthday party: a Bacillus cereus outbreak, Bari, Italy, January 2012 Brief Notes

    Martinelli, Domenico; Fortunato, Francesca; Tafuri, Silvio; Cozza, Vanessa; Chironna, Maria; Germinario, Cinzia; Pedalino, Biagio; Prato, Rosa

    Abstract in English:

    INTRODUCTION: Bacillus cereus, a ubiquitous bacterium, can be isolated in various starchy food items, causing both emetic and diarrhoeal disease. The real burden of B. cereus outbreaks is actually poorly known in Italy. We report a B. cereus foodborne outbreak that occurred in a pub in Bari (Italy) on January 22nd 2012 during a birthday party, promptly reported by the pub owner. MATERIALS AND METHODS: Between January 22nd and 24th 2012, we performed a retrospective cohort study among the guests of the party to identify risk factors associated with illness. Leftovers of different meals were available for microbiological analysis. Faecal specimens were collected from cases. RESULTS: A total of 12 cases among the 13 customers (attack rate: 92%) were reported. All cases had consumed basmati rice and sweet and sour vegetables (aetiological fraction: 100%). B. cereus was isolated from both basmati rice served during the party and faecal specimens. DISCUSSION: The close collaboration between the pub owner and the public health officers and the possibility to test food leftovers and stool samples contributed to prevent further cases.
  • Referral patterns in elderly emergency department visits Brief Notes

    Buja, Alessandra; Fusco, Marco; Furlan, Patrizia; Bertoncello, Chiara; Baldovin, Tatjana; Casale, Patrizia; Marcolongo, Adriano; Baldo, Vincenzo

    Abstract in English:

    OBJECTIVE: To assess elderly individuals' demand for emergency department (ED) care, in terms of the characteristics, processes, outcomes, costs by referral pattern. DATA SOURCE: All ED visits involving patients aged 65 and older, extracted from the 2010 dataset of an Local Health Agency, in North-Eastern Italy (no. = 18 648). STUDY DESIGN: Retrospective cohort study. PRINCIPAL FINDINGS: Patients were referred by primary care professionals (PCPs) in 43.1% of cases, 1.4% came from nursing homes (NH), and 55.5% were self-referred (SR). The SR group had a higher adjusted odds ratio (aOR) for non-urgent conditions (1.98 CI 1.85-2.12), but a lower aOR for conditions amenable to ambulatory care (0.53 CI 0.48-0.59), and a lower consumption of resources. The SR group tend to occur more frequently out of hours, and to coincide with a shorter stay at the ED, lower observation unit activation rates, lower hospitalization rates and a lower consumption of services than other two groups. The average costs for all procedures were lower for the SR patients (mean = 106.04 € ± SD 84.90 €) than for those referred by PCPs (mean = 138.14 € ± SD 101.17 €) or NH (mean = 143.48 € ± SD 95.28 €). CONCLUSION: Elderly patients coming in ED have different characteristics, outcomes and recourses consume by referral pattern.
  • Bupropion perceived as a stimulant by two patients with a previous history of cocaine misuse Brief Notes

    Vento, Alessandro E.; Schifano, Fabrizio; Gentili, Federica; Pompei, Francesco; Corkery, John M.; Kotzalidis, Georgios D.; Girardi, Paolo

    Abstract in English:

    BACKGROUND AND OBJECTIVE: Despite animal studies having shown a generalisation of the bupropion cue to cocaine, this drug has been used in cocaine abuse with mixed results. We here aimed at describing two cases which contradict current knowledge. CASE REPORTS: We describe two cases of former cocaine abusers who reported a cocaine-like sensation upon taking bupropion. Bupropion improved patients' depression without any increase in cocaine craving. One of the patients increased without doctor consultation his dose on an as needed basis. CONCLUSIONS: The issue of bupropion cue generalisation to cocaine needs further elucidation. People with past cocaine addiction need to be informed on the potential of bupropion to elicit cocaine-like cues and be invited to adhere to medical prescription, because bupropion has been associated with fatalities in some cases.
  • Promotion of mental health in children of parents with a mental disorder Brief Notes

    Verrocchio, Maria Cristina; Ambrosini, Alessandra; Fulcheri, Mario

    Abstract in English:

    Mental disorders are associated with many difficulties in the activities of daily living, work, relationships and family, and they determine high social and economic costs that represent an important public health problem. The literature has shown that children of parents with mental disorders grow up in environments that are potentially harmful to their mental health and are at risk of neglect and maltreatment. Interventions to prevent mental disorders and psychological symptoms of children of parents with mental disorders are effective but supporting these families is a complex task which requires both cooperation between departments and an interdisciplinary knowledge. A greater knowledge of the responses provided to assist families with dependent children and a mentally ill parent, could stimulate reflections on critical issues and government actions aimed at promoting and protecting the mental health of children.
  • Between altruism and commercialisation: some ethical aspects of blood donation Brief Notes

    Petrini, Carlo

    Abstract in English:

    Numerous documents (declarations, codes, recommendations, guidelines) issued by eminent institutions recommend that the donation of blood should be voluntary and unremunerated. This does not preclude the possibility: 1) that donors receive some form of reimbursement; 2) that subsequent procedures, which inevitably incur costs, may involve considerable financial activity; 3) that legislation in some nations may allow trade in certain types of human biological material; 4) that voluntarily donated human blood be used to derive products that are subsequently marketed. The present article highlights some of the contradictions generated by these considerations and affirms that they do not undermine the primary duty to uphold the voluntary nature of donation.
Istituto Superiore di Sanità Roma - Rome - Italy
E-mail: annali@iss.it