Prevalence of previously undiagnosed abdominal aortic aneurysms in the area of Como: the ComoCuore "looking for AAA" ultrasonography screening.

The prognosis for abdominal aortic aneurysm (AAA) rupture is poor. Long-term follow-up of population-based randomized trials has demonstrated that ultrasound (US) screening for abdominal aortic aneurysms (AAAs) measuring 3 cm or greater decreases AAA-related mortality rates and is cost-effective. We though to prospectively perform during a 26-month period a limited US examination of the infrarenal aorta in volunteers of both gender aged 60-85 years without history of AAA living in the area of Como, Italy. From September 2010 to November 2013 ComoCuore, a no-profit nongovernmental association, enrolled 1555 people (aged 68.8 ± 6.8 years; 48.6 % males). Clinical data and a US imaging of the aorta were collected for each participant. AAA was found in 22 volunteers (1.4 %) mainly males (2.5 % in males vs. 0.4 % in females p = 0.005). Overall, the prevalence of cardiovascular risk factors was higher in patients with vs. without AAA (mean 2.9 ± 3.0 vs. 1.4 ± 1.0 respectively, p < 0.0001). Independent predictors of AAA on multivariate analysis were age (OR 1.14, 1.06-1.22; p < 0.0001), male gender (OR 8.23, 1.79-37.91; p = 0.007), and both current (OR 4.98, 1.57-15.79; p = 0.007) and previous smoking (OR 2.76, 1.12-8.94; p = 0.03). Our study confirms the feasibility of one time US screening for AAA in a large cohort of asymptomatic people. Independent predictors of AAA were male sex, older age and a history of smoking. Accordingly to recent data the prevalence of AAA seems to be declining, maybe due to a reduction of smoking in Italy.

Cardiopulmonary resuscitation training in high-school adolescents by distributing personal manikins. The Como-Cuore experience in the area of Como, Italy.

BACKGROUND: Most witnessed out-of-hospital cardiac arrests (OHCA) do not receive bystander cardiopulmonary resuscitation (CPR). The incidence of laypersonsO' CPR could be increased by widespread training. We evaluated the effect of distribution of CPR educational material to high-school students in the area of Como, Italy. METHODS AND RESULTS: From January 2008 to October 2009, we distributed 3200 resuscitation manikins to pupils (62% boys, mean age 16.5 ± 0.8 years) at 20 high schools in the area of Como. All students received a kit including a personal manikin and a 27 min educational digital video disc. Furthermore, they received 40 min school training in the fundamental maneuvers of CPR utilizing the manikin. Afterwards, they were encouraged to train friends and relatives at home (second tier), utilizing the kit. Eight months later, a questionnaire was randomly submitted to a sample of 600 students (19% of the distributed manikins). The 600 kits had been used to train 1058 from the second tier (mean, 1.77 persons per pupil; 95% confidence interval 1.62-1.93). Boys had a significantly lower multiplier effect than girls: 1.45 ± 1.01 vs. 2.26 ± 1.89 (P < 0.0001). Ninety-five percent of pupils considered themselves sufficiently trained in CPR and 62.3% declared their availability to effectively practice CPR if necessary. One pupil performed an effective CPR during her mother's OHCA. CONCLUSIONS: CPR training can be disseminated using personal manikins distributed to pupils. Most students declared themselves trained and willing to start bystander CPR if necessary. One successful CPR was effectively performed.