Lower limb lymphedema and NC are more frequent than expected. They are related to the radicality of lymphadenectomy and adjuvant radiotherapy. They affect the quality of life of the patients treated for gynecological cancer and their perceptions of healing. Minor complications are commonly persistent and need a prompt diagnosis and a specialized management to improve their prognosis.

ObjectiveNeedlestick and sharps injuries (NSIs) involving healthcare workers (HCWs) are worldwide under surveillance since long time; the implementation of the European Directive 32/2010 regarding the mandatory use of safety-engineered devices (SEDs) seems to have reduced the number of these accidents. Our surveillance investigated the frequency and the modality of SED-related NSIs in the Piedmont region to verify changes in the epidemiology of these events.MethodsWe analysed the exposure records of NSIs, device usage data and structural data of 42 acute care hospitals and compared conventional and safety devices. We calculated the accident rates per 100 000 needles and, as a measure of SED efficacy, the relative risk between the use of safety and non-safety devices with a 95% CI. We also described the dynamics of the NSIs and the most involved professional groups of HCWs, procedures and devices.ResultsTotal and specific device accident rates for 100 000 needles were lower with the use of SEDs. In 2015–2016, there were 1640 NSIs, with a decreasing absolute number during the observation period; 18% were SEDs related. Half of the total accidents with SEDs occurred in the patient’s room, and nurses were involved in 78% of the cases. The most involved devices were the butterfly needles and peripheral venous catheters, and the most involved procedures were venous sampling (40%) and phlebotherapy (16%). The exposures occurred mostly during the procedure, and 45% of the SED-related injuries occurred during the disposal of the device; 92% of the SEDs involved had a manual activation mechanism.ConclusionIn agreement with the results of other European studies, our results show that SEDs reduce the risk of percutaneous exposure of HCWs, but in introducing SEDs, we must select those with a higher level of safety (with a passive activation mechanism) and improve the healthcare staff training programmes.

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Aim To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design Instrument development and cross‐sectional study for psychometric testing. Methods A self‐administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results Evidence of content validity was found (S‐CVI 0.75; I‐CVI 0.50–1.00). A three‐factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third‐year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second‐year students.

Nella nostra sede è stato istituito un ambulatorio di terapia iniettiva in cui afferiscono i pazienti che per criteri di eleggibilità sono passati a terapia long-acting (LA) con Cabotegravir e Rilpivirina. <br />Descriviamo la nostra esperienza real-life ed i primi dati di efficacia e tollerabilità rispetto agli eventi avversi (EA) registrati.<br />Attualmente sono in LA 82 pazienti di cui 71 hanno effettuato almeno 2 dosi e 30 hanno effettuato la terza somministrazione. Il 98% ha effettuato switch diretto a somministrazione iniettiva; l’aderenza è stata del 100%. <br />Al basale, il 45% dei pazienti ha riportato EA, di questi il 90% erano reazioni a sito di inoculo (ISR), in particolare dolore di grado lieve, con un 20% di dolore moderato-intenso e un 8% di granulomi. Il 7% ha avuto EA non-ISR. <br />A 4 settimane, su 71 pazienti sono stati registrati 18 EA, solo 1 di grado moderato. Dei 30 pazienti il cui follow-up supera la terza somministrazione, attualmente solo 6 hanno riferito la persistenza di EA lievi. Ad una prima analisi tale trend sembra in discesa. <br />1 paziente è tornato alla terapia precedente per rialzo viremico e conferma al genotipo di mutazioni di resistenza agli INSTI, tutti gli altri sono attualmente virosoppressi.<br />La terapia LA nella nostra esperienza presenta un tasso importante di EA alla prima somministrazione di cui la maggior parte di grado lieve-moderato con riduzione nelle somministrazioni successive, in linea con quanto registrato in letteratura. <br />Per il successo della terapia la selezione del paziente e l’organizzazione del servizio costituiscono elemento fondamentale.