Causes of hospitalisation before and after the 2009 L'Aquila earthquake.

On 6 April 2009, an earthquake struck L'Aquila. The San Salvatore Hospital was evacuated, and a field hospital was built. The study aimed to assess the epidemiologic impact of the earthquake through the analysis of patient population admitted to the field hospital during a 2-month period following the disaster. We retrospectively evaluated causes of hospitalisation and demographic data of patients admitted to (i) the Division of Internal Medicine and (ii) the Division of Emergency Medicine of the field hospital from 6 April, 2009 to 29 May, 2009. All data were compared with the admissions made at the same divisions of the San Salvatore Hospital during the same period of previous year. (i) Patient group (n = 102) and comparison group (n = 108). Mean patient age was higher, patients living in L'Aquila were more numerous, while mean length of stay was lower after than before the earthquake. Infectious diseases increased, while 'other' diseases decreased after the disaster both in admission and in discharge diagnoses. Gastroenterological diseases decreased with the earthquake but only in admission diagnoses. (ii) Patient group (n = 5255) and comparison group (n = 6564). Triage codes changed with the earthquake. Cardiovascular, psychiatric, gynaecological, infectious and chronic diseases increased, while pneumologic, gastroenterological, traumatic and 'other' diseases decreased after the quake. The number of hospitalised patients decreased with the tremor, while those discharged transferred to other hospitals and those who rejected hospitalisation increased. A natural disaster completely changes causes of hospitalisation in the Divisions of Internal and Emergency Medicine. These findings can be useful for the design of specific intervention programmes and for softening the detrimental effects of quakes.

Investigating the resonance spectrum of optical frequency combs in fiber-optic cavities.

We report a detailed theoretical and experimental study of fiber-optic cavities under broadband excitation by mode-locked laser combs. We calculate the effects of fiber dispersion on the cavity transmission. For any integer ratio between the comb repetition rate and cavity free spectral range, the theoretical resonant output spectrum exhibits a narrow group of resonant teeth, surrounded by minor, unevenly spaced resonances. Also, the central resonance can be rapidly and precisely tuned over the entire comb span by only acting on its repetition rate. Experimental observations are provided by a single-mode fiber ring and a telecom-wavelength comb laser. The resulting spectral pattern agrees very well with our theoretical prediction, allowing a thorough characterization of the cavity dispersion and opening new perspectives for comb spectroscopy in dielectric resonators.

Platelet activation in patients with the Raynaud phenomenon.

BACKGROUND: The Raynaud phenomenon (RP) is an exaggerated and reversible vasospasm of small arteries triggered by cold or emotional stress. Primary RP (PRP) term is used when the underlying condition is unknown. An altered regulation in vascular tone and/or release of soluble mediators from activated platelets plays a role in PRP through an increased oxidative stress. We assessed platelet activation and oxidative stress in patients with PRP by measuring platelet PAC-1, an index of glycoprotein (Gp) IIb/IIIa receptor activation, thromboxane A(2) (TXA(2)), an index of platelet activation and 8-epi-prostaglandin F(2α) (8-epi-PGF(2α)), a marker of endogenous in vivo peroxidation. METHODS: Eighteen asymptomatic patients with PRP (age 41.37 ± 16.94 years; 17 women, 1 man) and 18 healthy subjects (age of 35.11 ± 13.16 years; 16 women, 2 men) were studied. PAC-1 was analysed by flow cytometry while circulating TXB(2) , a stable metabolite of TXA(2) and 8-epi-PGF(2α) levels were assessed by ELISA kit. RESULTS: Our results show a significant platelet activation in PRP patients as indicated by increased PAC-1 expression (65.29 ± 15.24%; P < 0.001), TXB(2) (1477.83 ± 454.04 pg/mL; P= 0.003) and 8-epi-PGF(2α) circulating levels (42.50 ± 14.14 ng/mL; P < 0.001). An inverse correlation between the degree of PAC-1 expression and TXB(2) levels (r=-0.527; P= 0.02) was also found in PRP patients, suggesting that downregulation of GpIIb/IIIa receptor expression may occur during thrombocytopoiesis, as a consequence of the chronic exposure to increased TXB(2) concentration. CONCLUSIONS: Our study for the first time shows a marked activation of GpIIb/IIIa receptor in asymptomatic patients with PRP and supports antiplatelet therapy in PRP patients.

[Radiological study of the thorax. Evaluation of efficacy-efficiency of a large-field image intensifier in mass screening]. / Studio radiologico del torace. Valutazione dell'efficacia-efficienza dell'intensificatore di brillanza a grande campo nelle indagini di massa.

Chest X-ray is the most frequent examination in radiology and accounts for a considerable portion of total population radiation exposure, mostly in screening programs. The ideal radiographic system is the one providing the best image quality together with the lowest dose to the patient, at a low cost. In this paper the authors analyze the potentials of a new chest X-ray examination unit equipped with a large-screen image intensifier (TS 57-Siemens). Two-thousand subjects were examined with this unit. The technical aspects of everyday practice are analyzed from the radiologist's point of view, together with the dose to the patient, image quality, and costs.

Conservative treatment in the clinical stage T1N0 of breast cancer.

A 18-year experience with 643 cases operated for breast cancer is reported. 161 cases belonged to the clinical stage T1N0: 78 underwent modified radical mastectomy (group 1) and 83 underwent conservative surgery (group 2). Conservative treatment consisted in quadrantectomy and axillary dissection of 1st, 2nd and 3rd level with postoperative radiotherapy (5000 rad). Within the two groups the patient's characteristics were homogeneous with juxtaposable curves of overall and disease-free survival after modified radical mastectomy and after conservative surgery. In 15.38% of cases undergoing modified radical mastectomy and in 13.25% of cases undergoing quadrantectomy, histologic examination showed the presence of lymph node metastases (pT1N1) not identified at the clinical examination. The analysis of results showed that early neoplastic recurrence is almost exclusively limited to cases pN1, but the fall in the survival curve it similar in group 1 as well as in group 2. Therefore it should be understood that the prognostic risk is related to positive lymph nodes and not to the chosen treatment. Postoperative complications, irrelevant in group 1, tend to disappear in group 2. The cosmetic result after conservative surgery was excellent in 37.3%, satisfactory in 54.2% and poor in 8.4% of cases, respectively.