Foot infections in diabetes (DFIs) in the out-patient setting: an Italian multicentre observational survey.

Aims: To conduct a multicentre observational study to describe management of foot infections in diabetes in the out-patient setting in Italy.

Patients And Methods: Ten centres equally distributed nationwide were asked to collect, by means of a spreadsheet (Access/Excel Microsoft program), data concerning 30 consecutive diabetic patients with foot infections deemed suitable for antibiotic treatment in the out-patient setting. Centres with > or = 5 years' experience of out-patient management were selected.

Viral blips during long-term treatment with standard or double dose lamivudine in HBe antigen negative chronic hepatitis B.

Aim: To evaluate safety and effect on hepatitis B virus (HBV) suppression of a long-term treatment with lamivudine (LAM) at standard (100 mg/d) or double (200 mg/d) dose in chronic hepatitis B.

Methods: This was a case study with matched controls (1:3) in patients with chronic hepatitis B with anti-HBe antibodies.

Results: Twelve patients received LAM 200 mg/d and 35 LAM 100 mg/d, for a median of 28 mo.

Clinical case of seroconversion for syphilis following a needlestick injury: why not take a prophylaxis?

A 47-year-old woman was pricked accidentally with a needle previously used for a neurosyphilitic man. At day 0 she had no positive laboratory results for the infection, while the source, at day 1, had TPHA positive, but no post-exposure prophylaxis (PEP) against syphilis was prescribed. The subject missed the day 30 follow-up, and underwent our visit at day 90, when she showed no clinical signs, but she seroconverted (VDRL = positive 1/2; TPHA = positive 1/320; FTA-Abs IgG and IgM = present).

[Therapeutic options in chronic HBV infection].

A durable suppression of viral replication in chronic HBV infection decreases the risk of liver disease progression. Treatment is recommended for patients in the immune-active phases of chronic HBV infection (HBeAg positive or HBeAg negative patients with serum HBV-DNA and elevated ALT). Licensed HBV therapies include interferon (sIFN, pegylated-IFN alfa-2a) and nucleoside/nucleotide analogues (lamivudine, adefovir, entecavir) allowing for two different treatment strategies: a finite treatment course of IFN that provides sustained off-treatment response in about one third of patients, or an indefinite treatment with nucleoside/nucleotide analogues that provides a therapy maintained response.

[Early and timely therapy: when to interrupt antibiotic therapy in nosocomial acquired pneumonia?].

Nosocomial pneumonia is the second most frequent nosocomial infection and represents the leading cause of death due to hospital acquired infections. In recent years, evidence has accumulated that initial inappropriate antibiotic treatment is an important and independent mortality risk factor for patients with nosocomial pneumonia. On this point, several authors have found that delaying the administration of appropriate antibacterial treatment is associated with an excess in hospital mortality.