A collaborative intervention to improve surgical antibiotic prophylaxis in children: results from a prospective multicenter study.

Purpose: The use of surgical antibiotic prophylaxis (SAP) in children is poorly characterized. Our aim was to evaluate the effectiveness of a quality improvement (QI) intervention targeting SAP in children, by means of a multicenter prospective intervention study, with a before and after design.

Methods: We prospectively investigated elective surgical procedures performed in children <18 years, prior to the QI intervention, after the intervention and at 9-month follow-up.

Recurrence of cardiovascular events in patients with type 2 diabetes: epidemiology and risk factors.

Objective: The purpose of this study was to assess incidence of and risk factors for recurrent cardiovascular disease (CVD) in type 2 diabetes.

Research Design And Methods: We estimated the incidence of recurrent cardiovascular events in type 2 diabetic patients, aged 40-97 years, followed by a network of diabetes clinics. The analysis was conducted separately for 2,788 patients with CVD at enrollment (cohort A) and for 844 patients developing the first episode during the observation period (cohort B).

Incidence and risk factors for stroke in type 2 diabetic patients: the DAI study.

Background And Purpose: Type 2 diabetes mellitus is a strong predictor of cerebrovascular disease, yet few studies have assessed the incidence of stroke and the role of other risk factors in unselected type 2 diabetes mellitus populations.

Methods: We prospectively followed-up 14,432 type 2 diabetes mellitus patients, aged 40 to 97 years, with and without a history of cardiovascular disease at enrollment, and we estimated the incidence of stroke and the hazards ratios with respect to clinical variables.

Results: During a 4-year follow-up, 296 incident stroke events were recorded.

Indexes of abdominal adiposity in patients with type 2 diabetes.

Objective: To assess the relationship of waist circumference and weight/height ratio with height, and their association with components of the metabolic syndrome, in Type 2 diabetic patients.

Design: multicenter cross-sectional survey on a cohort enrolled in a prospective observational study.

Subjects: 13,232 patients (6816 women and 6416 men) with Type 2 diabetes, not currently affected by macrovascular complications.

The geographic relationship between the use of antimicrobial drugs and the pattern of resistance for Streptococcus pneumoniae in Italy.

Objectives: A temporal relationship between the increasing use of antibiotics and the increasing levels of antibiotic resistance has been established for Streptococcus pneumoniae. There are also data that support the presence of a geographic correlation between the level of resistance and the pattern of use among different countries and even within the same country. The aim of this study was to evaluate the potential geographic correlation between the use of beta-lactams and erythromycin in different Italian regions and the resistance of these antibiotics to invasive strains of S.

Secondary prevention of coronary artery disease in high-risk diabetic patients.

Background And Aim: To compare guideline implementation and the actual delivery of secondary prevention for coronary artery disease in the cohort of Italian diabetic patients enrolled in the DAI study.

Methods And Results: The DAI study is a multicentre cohort study of the prevalence and incidence of macroangiopathic events among 19,570 type 2 diabetic patients attending 201 Diabetic Care Units. For this study, we selected 1,475 subjects with a history of myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty at enrollment.

Gastroduodenal toxicity of different nonsteroidal antiinflammatory drugs.

Although the etiologic relation between nonsteroidal antiinflammatory drug (NSAID) use and gastrointestinal lesions is well documented, newly introduced NSAIDs deserve a fresh examination for their risk/benefit ratio. To estimate the association between consumption of ketorolac and the occurrence of gastroduodenal lesions, we conducted a case-control study. The study population comprised 600 outpatients with a confirmed endoscopic diagnosis of ulcer and erosion in 1991 and 1992 and 6,000 community controls matched by age and sex.

Cancer mortality in ethylene oxide workers.

A cohort of 1971 chemical workers licensed to handle ethylene oxide was followed up retrospectively from 1940 to 1984 and the vital status of each subject was ascertained. No quantitative information on exposure was available and therefore cohort members were considered as presumably exposed to ethylene oxide. The cohort comprised 637 subjects allowed to handle only ethylene oxide and 1334 subjects who obtained a licence valid for ethylene oxide as well as other toxic gases.

Epidemiological use of drug prescriptions as markers of disease frequency: an Italian experience.

All Italian citizens are covered by the National Health Service (NHS) and medical records of individual drug prescriptions are routinely collected and processed. A procedure entitled EPIFAR has been developed which, on the basis of a computer routine, makes it possible to trace back the prescription history of each individual included in the NHS. The validity of information gathered through the EPIFAR procedure to provide estimates of tuberculosis (TB) prevalence has been evaluated.