Maternal mortality in Italy: a record-linkage study.

OBJECTIVE: To detect maternal deaths, analyse associated causes and compute absolute and specific maternal mortality ratio among five Italian regions in response to a recent ranking of Italy by the Lancet as having the lowest maternal mortality ratio among 181 countries. DESIGN: Record-linkage study. SETTING: Five Italian regions. POPULATION: All women aged 15-49 years resident in the participating regions, with one or more hospitalisations for pregnancy or any pregnancy outcome between 2000 and 2007. METHODS: Maternal deaths have been identified by record linkage between the Death Registry and the Hospital Discharge Database. Different time periods were analysed according to local data availability. Cases have been selected and causes of death have been classified according to the 10th International Classification of Diseases. MAIN OUTCOME MEASURE: Maternal mortality ratio. RESULTS: Underreporting of official figures based on death certification in the participating regions is 63%. A total of 118 maternal deaths have been identified resulting in a maternal mortality ratio of 11.8, compared with the official figure of 4.4, per 100,000 live births. Haemorrhage, thromboembolism, and hypertensive disorders of pregnancy are the leading causes of direct deaths. CONCLUSIONS: This study implies that only 37% of all maternal deaths are included in the official data. Our analysis shows a predominance of direct obstetric deaths, which implies that emphasis is needed on improvements of obstetric care.

Blood parasites, total plasma protein and packed cell volume of small wild mammals trapped in three mountain ranges of the Atlantic Forest in Southeastern Brazil.

A study of blood parasites in small wild non-flying mammals was undertaken in three areas of the Atlantic Forest in Southeastern Brazil: Serra de Itatiaia, RJ, Serra da Bocaina, SP and Serra da Fartura, SP, from June 1999 to May 2001. A total of 450 animals (15 species) were captured in traps and it was observed in 15.5% of the blood smears the presence of Haemobartonella sp. and Babesia sp. in red blood cells. There was no statistically significant difference between parasited and non-parasited specimens regarding total plasma protein, packed cell volume and body weight, which strongly suggests that these specimens might be parasite reservoirs.

Blood parasites, total plasma protein and packed cell volume of small wild mammals trapped in three mountain ranges of the Atlantic Forest in Southeastern Brazil

A study of blood parasites in small wild non-flying mammals was undertaken in three areas of the Atlantic Forest in Southeastern Brazil: Serra de Itatiaia, RJ, Serra da Bocaina, SP and Serra da Fartura, SP, from June 1999 to May 2001. A total of 450 animals (15 species) were captured in traps and it was observed in 15.5 percent of the blood smears the presence of Haemobartonella sp. and Babesia sp. in red blood cells. There was no statistically significant difference between parasited and non-parasited specimens regarding total plasma protein, packed cell volume and body weight, which strongly suggests that these specimens might be parasite reservoirs.

A presença de hemoparasitos em pequenos mamíferos silvestres não voadores foi pesquisada em animais de três áreas serranas do Sudeste brasileiro, pertencentes ao complexo da Serra do Mar e da Serra da Mantiqueira, nos Estados de São Paulo, Rio de Janeiro e Minas Gerais. Foram capturados 420 animais de 15 espécies, durante dois anos, dos quais, 15,5 por cento apresentaram Haemobartonella sp. e Babesia sp., observadas em lâmina de esfregaço sangüíneo no interior de suas hemácias. Os níveis de proteína total plasmática e de volume globular não apresentaram diferença estatisticamente significativa entre os indivíduos parasitados e não parasitados, assim como o peso corporal, o que sugere fortemente que esses animais possam ser reservatórios desses parasitos.

[Gas gangrene. Clinical considerations, prognosis and therapeutic prospects in our experience]. / La gangrène gazeuse. Considérations cliniques, pronostic et perspective thérapeutiques selon notre expérience.

The prognosis of gas gangrene is changing as the means of treatment become more accurate and are implemented earlier. The authors, in their work referring to 10 cases of gas gangrene, point out to the extreme fastness of debridement and immediate exeresis, of wide-spectrum antibiotic protection and of caloric balance, associated to a treatment using trace elements. The importance of hyperbaric oxygen therapy seems to be increasingly proven with time. Lastly, in their general experience of treatment, the authors suggest the use of a specific frequency soft laser therapy, which might speed up the process of tissue repair.