[Digitization and Virtual Healthcare in a teaching hospital (Pisa, Italy) during COVID-19 emergency]. / Digitalizzazione e Virtual Healthcare nell'Azienda Ospedaliero Universitaria Pisana (AOUP) ai tempi dell'emergenza COVID-19.

The initial phases of COVID-19 emergency in Italy highlighted the technical delay that the national health system has accumulated in health services digitalization. Italian hospitals rapidly applied a demand systems for virtual health services based on tele-triage, tele-consultation and tele-visits procedures. This led, in the following months, the integration of virtual healthcare services applicable to the Azienda Ospedaliero Universitaria Pisa (AOUP). In particular, BCure system represents an important technological investment for the remote management of care protocols and the analysis of the complete use of health services. This is a unique system for sharing information between specialists, general practitioners and patients.

[Health-care workers vaccination coverage: such a long way to run]. / Copertura vaccinale del personale ospedaliero: ancora molta strada da percorrere.

The poor vaccination coverage among health-care workers in a hospital, resulted from a self-administered questionnaire, showed the necessity to improve educational efforts and to promote vaccination campaign.

Reliability of cerebral radioisotopic angiography and of directional Doppler C.W. in the diagnosis of cerebrovascular insufficiency.

The diagnostic value of radioisotopic cerebral angioscintigraphy (R.A.) and of Doppler CW (D.C.W.) techniques to identify stenosis of the internal carotid artery in its extracranial course was studied in 97 patients with ischaemic lesions (50 T.I.A. and 47 Complete Stroke). The results of R.A. and D.C.W. were compared with those of contrast carotid-angiography (C.A.). C.A. revealed stenosis above 50% or complete occlusion in 22% of cases, whereas D.C.W. and R.A. showed flow reduction in 27% and 48% of the cases respectively. In T.I.A., C.A. positivity went down to 8%; D.C.W. to 16%; and R.A. to 34%. In "Complete Stroke" positivity was 36% for C.A.; 41% for D.C.W.; and 62% for R.A. There was a high number of false positive findings with D.C.W. (8) but even more with R.A. (27). False negative findings occurred only in two cases with R.A. These data confirm the diagnostic value of these two noninvasive techniques to identify haemodynamically carotid stenosis. The use of both methods can reduce error due to false negativity. The rather marked frequency of false positivity, particularly with reference to R.A. doesn't affect the diagnostic value of the two methods.

Neurosurgical indications during pregnancy.

The Authors take into consideration some important forms of vascular and tumoral pathology of neurosurgical interest which can affect pregnant women. Some criteria of urgency or delay of the surgical treatment are proposed in the attempt of saving the mother's and the foetus' life.

Post-traumatic middle cerebral artery thrombosis.

Post-traumatic thrombosis of the middle cerebral artery (MCA) is uncommon: only 39 cases were found in the literature. In the present report, eight cases of post-traumatic MCA thrombosis are analyzed and compared with other reported cases. The symptoms can be easily confused with those of expanding intracranial hematoma. Although ancillary noninvasive diagnostic methods are helpful, cerebral angiography confirms the diagnosis. The morbidity and mortality rates are high, and treatment has been mainly supportive. The low mortality in the present study may be related to the absence of severe head or other trauma. Possible cerebral revascularization procedures are also discussed.

Problems of reconstruction in neurosurgical patients. (The use of boiled bone in cranioplasty).

The authors report their experience in six cases of head surgery for the simultaneous reconstruction of skin, bone and dura mater. They recommend the use of teflon as a dural substitute and the autogenous bone opercolum, boiled to have it free from cancer cells or infection.

The Doppler ophthalmic test: report of a study on its value in diagnosis of internal carotid artery insufficiency.

The Authors have investigated the significance and the limits of the directional Doppler method in a group of subjects affected by internal carotid obstruction in various sites and degree. On the basis of the obtained results the Authors point out how this method represents a concrete progress in the field of non invasive diagnosis of the insufficiency of this artery.