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Embj (150)

 Frequent antibiotic prescriptions for urinary infections (UI) promote the development and spread of antibiotic resistance. In order to identify effective antibiotics for the first line treatment of UI at the Galaţi Infectious Diseases Hospital, we performed a retrospective study based on disk diffusion antibiotic sensitivity testing on bacterial strains from urine cultures. Urine samples were collected from hospitalized patients admitted with symptomatic UI during 2010. In total, 659 records were found of certified bacteriological UI, of which 82% were caused by Enterobacteriacea. Escherichia coli isolates were the most commonly encountered species of Enterobacteriaceae (83%). The median age of the patients with urinary E. coli was 48 [3; 87], sex ratio M/F= 56/399 and 9.8% of patients were HIV positive. Using the Carmeli scoring system for antibiotic resistance risk, we found that 86% of the E. coli isolates were community acquired infections. High level of resistance was evident for Ampiciline at 85%, Neoxazole at 54,6%, TMP-SMX at 45,6% and AmoxiClavulanate at 40,2%. The best sensitivity was obtained with 3rd generation cephalosporins and carbapenemes. The incidence of ESBL-positive strains was 7.4% (34/421). No ESBLpositive strain was identified in community acquired UI (Carmeli score 1). In conclusion, it is strongly recommended that the first line of antibiotic therapy at the Gala ţi Infectious Diseases Hospital should involve 3rd generation cephalosporins, while carbapenems should be reserved to patients with a Carmeli score of 2 or 3.

A harmful algal bloom (HAB) is defined as a bloom that has deleterious effects on plants, animals or humans. Marine algal toxins are responsible for an array of human illnesses associated with consumption of seafood or exposure to aerosolized toxins. The effects of algal toxins are generally observed as acute intoxications, whereas the environmental health effects of chronic exposure to low levels of algal toxins are, to date, only poorly documented and an emerging issue. Consumption of seafood contaminated with algal toxins can result in five types of seafood poisoning syndromes: paralytic shellfish poison-ing, neurotoxic shellfish poisoning, amnesic shellfish poisoning, diarrhetic shellfish poi-soning and ciguatera fish poisoning. The aim of this paper is to provide an overview on HAB-related issues in the Mediterranean Sea.

 In the contemporary society an International Health Elective (IHE) represents a strategic tool in order to implement future medical doctor’s education. In Italy, in the last decade, an increasing interest of trainees and residents to IHE and opportunities was documented and supported by the reorganization of the Italian residency programs, provided by the Ministry for Education, University and Research (MIUR). Aim of the present study was to collect data on perceived need of medical residents for an IHE.
A structured questionnaire was developed and administered to medical residents of Palermo’s University who underwent their annual visit to the Occupational Health Physician Ambulatory (OHPA) of Palermo’s University Hospital, in the period between March and October 2011.
Medical residents more prone to undergo an IHE were, younger than 29 years old (p <0.01), attending the new educational system (p 0.02) and surgical residents (p= 0.0001). A negative opinion about the formative quality performances of the residency program was significantly associated with surgical residencies (p= 0.002). Future Italian surgeons are more prone to undergo an IHE and this statement is probably related to the not satisfying residency program. Residents attending the old educational system consider the IHE as a way to implement their professional perspectives possibly for their more realistic professional perspective facing an approaching future full of work uncertainties.
Considering the future competition between medical professionals working in different EU contexts, the Italian Government should implement future medical education policy in order to provide for a Healthcare “without Border” in the EU.

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