Hospitalization Rates for Respiratory Diseases After L'Aquila Earthquake.

The study aims to investigate the impact of the earthquake on public health, in terms of hospitalizations for respiratory diseases in the Abruzzo region, focusing on the area damaged by the earthquake "Crater". We collected data of hospitalizations of residents in Abruzzo between 2009 and 2015. Hospital Discharge Records (HDRs) with a primary diagnosis of respiratory disease were included and divided into pneumonia, Chronic Obstructive Pulmonary Disease (COPD), and respiratory insufficiency. Absolute frequencies and standardized hospitalization rates were calculated to perform both a short-term and a medium-long term analysis. A linear regression was performed using standardized hospitalization rates and the time. A total of 108.669 respiratory-related records were collected and the most frequent subgroup was respiratory insufficiency. Standardized Hospitalization Rates (SHRs) for respiratory diseases resulted higher in the non-Crater than Crater area, but the short-term analysis showed a significant increase in hospitalizations for pneumonia and respiratory insufficiency in the Crater area. The medium-long term analysis reported a significant difference on the slope decrease of hospitalizations for acute and chronic respiratory diseases in the Crater versus the non-Crater area. The earthquake may have played a triggering role in the increased detection of respiratory diseases. A temporal relationship between the quake and an increase in admissions was found although it is not yet possible to detect a direct cause-effect relationship.

Autonomic imbalance during apneic episodes in pediatric obstructive sleep apnea.

OBJECTIVES: To investigate the activity of the autonomic nervous system (ANS) during sleep in children with obstructive sleep apnea (OSA), in order to detect a possible cardiac ANS imbalance analyzing heart rate variability (HRV). METHODS: 43 subjects between 4 and 12 years of age (7.26 ± 2.8 years), undergoing a diagnostic assessment for OSA were evaluated. A time domain index (R-apnea index) was developed to evaluate HRV strictly related to obstructive events during sleep. Poincaré plot of RR intervals during the whole night was calculated. RESULTS: R-apnea index was negatively correlated with apnea hypopnea index (AHI) (r=-0.360, p=0.028). AHI and the duration of the disease were the only variables that were significantly correlated with R-apnea index. Three groups were subsequently created according to polysomnographic findings considering AHI. R-apnea index resulted significantly lower in patient with severe OSA compared to primary snoring/mild OSA subjects (p<0.05). Looking at Poincaré plot, SD1 showed a diminishing trend with severity of OSA, however not reaching statistical significance. CONCLUSIONS: Our findings suggest an autonomic impairment in OSA children evidenced by the altered HRV both in the very short term (R-apnea index) and in short term (SD1). SIGNIFICANCE: R-apnea index is an easy and cheap method to undelay early ANS imbalance.