“Self stabbing sucide”: 116 casi occorsi nella città di Milano dal 1993 al 2016

Introduzione Mentre molti omicidi nel Mondo sono compiuti con armi da taglio, i suicidi realizzati con siffatta modalit\ue0 lesiva sono rari accadimenti, comprovati nello 0,5-0,7% di tutti i casi di autosoppressione; in genere, sui corpi si osserva una sola ferita mortale, per quanto possano esserne eccezionalmente osservate anche molte, che sollevano la necessit\ue0 di stabilire se trattasi di modalit\ue0 realmente suicida piuttosto che omicida. In questi casi, ulteriori informazioni per configurare l\u2019esatta natura dell\u2019accadimento, sono desumibili dall\u2019anamnesi della vittima, dai dati circostanziali e di sopralluogo, nonch\ue9 dalle caratteristiche delle lesioni e dalla loro localizzazione. In questo studio, presentiamo l\u2019analisi dei casi di suicidio con armi da taglio, occorsi a Milano in 24 anni. Materiali e metodi Sono stati analizzati retrospettivamente 23417 verbali di autopsia redatti tra il 1993 e il 2016 presso la Sezione di medicina legale dell\u2019Universit\ue0 degli Studi di Milano estrapolando da 4022 suicidi totali, solo quelli realizzati con armi da taglio. Su questi casi, abbiamo approfondito lo studio delle caratteristiche delle vittime, della distribuzione e del numero delle lesioni autoinferte e delle caratteristiche dell\u2019arma feritrice. Risultati Abbiamo desunto 116 casi di suicidio con armi da taglio di cui: 103 realizzati con modalit\ue0 semplice e 13 con modalit\ue0 complessa, che hanno visto maggiormente coinvolti maschi italiani di et\ue0 compresa tra 41-e 50 anni, affetti da patologie psichiatriche, che si sono uccisi nella propria abitazione utilizzando, prevalentemente, coltelli da cucina. Le lesioni sono risultate monodistrettuali e localizzate agli arti superiori o al torace. In tutti i casi osservati, la morte, per la presenza di lesioni \u201cda assaggio\u201d a profondit\ue0 variabile, mancanza di segni di lotta, sangue limitato all\u2019area circostante il corpo e per la direzionalit\ue0 delle lesioni, da destra a sinistra, con il gomito piegato a 90 gradi verso il corpo, \ue8 stata attribuita, anche nel caso dei suicidi complessi, a shock emorragico da azione suicida. Conclusioni Gli inusuali suicidi compiuti con armi da taglio richiedono un approccio forense completo basato su un approfondito esame della scena del crimine durante il sopralluogo giudiziario, un\u2019accurata raccolta dei dati anamnestico-circostanziali e degli esiti autoptici i quali, unitamente alle indagini tossicologiche, possono rappresentare strumenti fondamentali per esprimersi motivatamente su un giudizio di accadimento omicida piuttosto che suicida

The hidden burden of adult allergic rhinitis : UK healthcare resource utilisation survey

Funding Funding for this survey was provided by Meda Pharma.Peer reviewedPublisher PD

Allergic Rhinitis and its Associated Co-Morbidities at Bugando Medical Centre in Northwestern Tanzania; A Prospective Review of 190 Cases.

Allergic rhinitis is one of the commonest atopic diseases which contribute to significant morbidity world wide while its epidemiology in Tanzania remains sparse. There was paucity of information regarding allergic rhinitis in our setting; therefore it was important to conduct this study to describe our experience on allergic rhinitis, associated co-morbidities and treatment outcome in patients attending Bugando Medical Centre. This was descriptive cross-sectional study involving all patients with a clinical diagnosis of allergic rhinitis at Bugando Medical Centre over a three-month period between June 2011 and August 2011. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 17.0. A total of 190 patients were studied giving the prevalence of allergic rhinitis 14.7%. The median age of the patients was 8.5 years. The male to female ratio was 1:1. Adenoid hypertrophy, tonsillitis, hypertrophy of inferior turbinate, nasal polyps, otitis media and sinusitis were the most common co-morbidities affecting 92.6% of cases and were the major reason for attending hospital services. Sleep disturbance was common in children with adenoids hypertrophy (χ2 = 28.691, P = 0.000). Allergic conjunctivitis was found in 51.9%. The most common identified triggers were dust, strong perfume odors and cold weather (P < 0.05). Strong perfume odors affect female than males (χ2 = 4.583, P = 0.032). In this study family history of allergic rhinitis was not a significant risk factor (P =0.423). The majority of patients (68.8%) were treated surgically for allergic rhinitis co morbidities. Post operative complication and mortality rates were 2.9% and 1.6% respectively. The overall median duration of hospital stay of in-patients was 3 days (2 - 28 days). Most patients (98.4%) had satisfactory results at discharge. The study shows that allergic rhinitis is common in our settings representing 14.7% of all otorhinolaryngology and commonly affecting children and adolescent. Sufferers seek medical services due to co-morbidities of which combination of surgical and medical treatment was needed. High index of suspicions in diagnosing allergic rhinitis and early treatment is recommended

Agreements and controversies of national guidelines for bronchiolitis: Results from an Italian survey

Introduction: Significant variations in the management of bronchiolitis are often recorded, and, in parallel, to recommend a univocal clinical approach is challenging and still questioned. This study is aimed to evaluate the diagnostic and therapeutic management of bronchiolitis in children adopted by Italian pediatricians following the national guidelines. Material and methods: A survey study was designed and carried out by sending an email an open-ended questionnaire developed by an expert panel of the Scientific Board of the Italian Society of Pediatric Allergology and Immunology (SIAIP). Questions were designed according to the national intersociety consensus document on treatment and prevention of bronchiolitis in newborns and infants. Results: Overall, 234 pediatricians were taking part in the study. When diagnosing bronchiolitis, only 44.01% (103/234) of participants correctly followed the national guidelines. All participants (100%) would perform laboratory tests and/or radiological exams. 44.01% administered oxygen (O2 ) when O2 saturation was minor than 92%. About the therapeutic regimen, marked discrepancies between national guidelines and recorded answers were reported. Indications for hospital admission and discharge criteria were in line with the national guidelines. Conclusions: There is a significant practice variation in the management of acute bronchiolitis among Italian physicians. Some wrong attitudes need to be further discouraged, such use of diagnostic procedures and therapeutic approaches. Further research is urgently required to define the best management of patients with bronchiolitis and implement strategies to standardize care and improve the quality of care

Systemic and local eosinophil inflammation during the birch pollen season in allergic patients with predominant rhinitis or asthma

<p>Abstract</p> <p>Background</p> <p>The aim of the study was to investigate inflammation during the birch pollen season in patients with rhinitis or asthma.</p> <p>Methods</p> <p>Subjects with birch pollen asthma (n = 7) or rhinitis (n = 9) and controls (n = 5) were studied before and during pollen seasons. Eosinophils (Eos), eosinophil cationic protein (ECP) and human neutrophil lipocalin were analysed.</p> <p>Results</p> <p>Allergic asthmatics had a larger decline in FEV1 after inhaling hypertonic saline than patients with rhinitis (median) (-7.0 vs.-0.4%, p = 0.02). The asthmatics had a lower sesonal PEFR than the rhinitis group. The seasonal increase in B-Eos was higher among patients with asthma (+0.17 × 109/L) and rhinitis (+0.27 × 109/L) than among controls (+0.01 × 109/L, p = 0.01). Allergic asthmatics and patients with rhinitis had a larger increase in sputum ECP (+2180 and +310 μg/L) than the controls (-146 μg/L, p = 0.02). No significant differences in inflammatory parameters were found between the two groups of allergic patients.</p> <p>Conclusion</p> <p>Patients with allergic asthma and rhinitis have the same degree of eosinophil inflammation. Despite this, only the asthmatic group experienced an impairment in lung function during the pollen season.</p

Treatment trends in allergic rhinitis and asthma: a British ENT survey

<p>Abstract</p> <p>Background</p> <p>Allergic Rhinitis is a common Ear, Nose and Throat disorder. Asthma and Allergic Rhinitis are diseases with similar underlying mechanism and pathogenesis. The aim of this survey was to highlight current treatment trends for Allergic Rhinitis and Asthma.</p> <p>Method</p> <p>A questionnaire was emailed to all registered consultant members of the British Association of Otorhinolaryngologists - Head and Neck Surgeons regarding the management of patients with Allergic Rhinitis and related disorders.</p> <p>Results</p> <p>Survey response rate was 56%. The results indicate a various approach in the investigation and management of Allergic Rhinitis compatible with recommendations from the Allergic Rhinitis and Its Impact on Asthma guidelines in collaboration with the World Health Organisation.</p> <p>Conclusion</p> <p>A combined management approach for patients with Allergic Rhinitis and concomitant Asthma may reduce medical treatment costs for these conditions and improve symptom control and quality of life.</p

Broncalt®, class ii medical device, in patients with chronic relapsed upper airways disease: A survey in clinical practice

Chronic respiratory otorhinolaryngological (ORL) diseases may exacerbate. Broncalt® is a class II Medical Device containing: thermal water (Medesano, PR, Italy), hyaluronic acid, and grapefruit seed extract. It could exert a safe and effective anti-inflammatory, washing, and antimicrobial activity. The current survey, conducted in clinical practice of 84 Italian ORL centers, evaluated its safety and efficacy in the treatment of patients with exacerbated chronic upper airways disease. The 459 (254 males, mean age 44.7 years) patients were evaluated at baseline (T0) and after a 2-week treatment (T1), treated or not-treated with Broncalt®. Signs and symptoms severity were measured by visual analogue scale. Broncalt® significantly, quickly, and safely diminished the clinical features in all sub-groups (p&lt;0.001 for all). In conclusion, Broncalt® is a class II Medical Device able to exert a safe, quick, and effective activity in patients with relapsed chronic ORL disorders. (www.actabiomedica.it)