Epidemia durante la Guerra di Gradisca (1615-1617): sulle tracce dei responsabili,

La Guerra di Gradisca, combattuta tra la Repubblica di Venezia e l'impero asburgico, è conosciuta anche come la guerra degli Uscocchi. Nella primavera del 1616 si diffuse un'epidemia che fece molte vittime in entrambi gli eserciti, e tra la popolazione civile. Il contagio cominciò tra i cavalli, affetti da morva, e poi aggredì l'uomo. In base all'analisi dei documenti storici e a alle analisi effettuate sui resti dei morti recuperati archeologicamente, è possibile ipotizzare un'epidemia di salmonella e shigella

Long-Term Evolution and Prognostic Stratification of Biopsy-Proven Active Myocarditis

Background— Active myocarditis is characterized by large heterogeneity of clinical presentation and evolution. This study describes the characteristics and the long-term evolution of a large sample of patients with biopsy-proven active myocarditis, looking for accessible and valid early predictors of long-term prognosis. Methods and Results— From 1981 to 2009, 82 patients with biopsy-proven active myocarditis were consecutively enrolled and followed-up for 147±107 months. All patients underwent clinical and echocardiographic evaluation at baseline and at 6 months. At this time, improvement/normality of left ventricular ejection fraction (LVEF), defined as a LVEF increase > 20 percentage points or presence of LVEF≥50%, was assessed. At baseline, left ventricular dysfunction (LVEF<50%) and left atrium enlargement were independently associated with long-term heart transplantation–free survival, regardless of the clinical pattern of disease onset. At 6 months, improvement/normality of LVEF was observed in 53% of patients. Persistence of New York Heart Association III to IV classes, left atrium enlargement, and improvement/normality of LVEF at 6 months emerged as independent predictors of long-term outcome. Notably, the short-term reevaluation showed a significant incremental prognostic value in comparison with the baseline evaluation (baseline model versus 6 months model: area under the curve 0.79 versus 0.90, P =0.03). Conclusions— Baseline left ventricular function is a marker for prognosis regardless of the clinical pattern of disease onset, and its reassessment at 6 months appears useful for assessing longer-term outcome

Circadian blood pressure pattern in positive drug responsive hypertensives, hypertensives and normotensives, and gender influences.

Circadian rhythm is a characteristic behavior of human physiology and it is known that, in healthy subjects, blood pressure (BP) increases during the day and decreases during the night, as a result of sleep-wake changes. Some studies highlighted that female had lower office BP values than male and this should be considered for define the threshold of hypertension. With the introduction of the Holter Blood Pressure Measurement, it has been possible to record the blood pressure for 24 hours. This innovation allowed to analyze the circadian Blood pressure pattern (CBPP) and some studies identified the differences between normotensives and hypertensives subjects. In this study, we examined the circadian pattern in positive drug responsive hypertensive patients in respect of negative ones and of normotensive subjects and the differences due to gender. The results demonstrated that positive drug responsive hypertensive patients had the same circadian blood pressure pattern as normotensives. Moreover, the difference in circadian blood pressure values between male and female was about 2-4 mmHg

Capitate-trapezoid synostosis: Analysis of an early bronze age case and review of the literature

Carpal synostoses are congenital defects characterized by complete or incomplete coalition of two or more carpal bones. Although most of these defects are discovered only incidentally, sometimes they become clinically manifest. Among the different types of carpal coalition, the synostosis between capitate and trapezoid bones is quite rare, with only sparse data available in the literature. The aim of this report was to describe a case of capitate-trapezoid synostosis observed in an ancient human skeleton, as well as to scrutinize the pertinent literature in order to assess for the characteristics of this type of defect, including its potential relevance to clinical practice

Deleterious impact of mild anemia on survival of young adult patients (age 45 ± 14 years) with idiopathic dilated cardiomyopathy: data from the Trieste Cardiomyopathies Registry.

7OBJECTIVE: The study objective was to evaluate the impact of anemia on a large population of young patients with idiopathic dilated cardiomyopathy (DCM) who were receiving optimal medical treatment. METHODS: The data of 491 patients with DCM who were enlisted in the Trieste Heart Muscle Disease Registry were analyzed. Anemia was defined as hemoglobin less than 13 g/dL for male patients and less than 12 g/dL for female patients. RESULTS: At baseline, 13% of our patients were anemic. During the follow-up of 134 ± 56 months, 144 patients died or underwent heart transplantation: 36.5% anemic patients and 28% non-anemic patients (P = .05). Anemia present at baseline was an independent predictor of outcome (hazard ratio = 1.85, P = .014). Serial hemoglobin determinations during the entire follow-up were available in 122 of 428 patients without anemia at baseline. The impact of new-onset anemia was analyzed in this cohort of patients. Forty-seven patients (39%) developed anemia during follow-up. The new onset of anemia was an independent predictor of poor outcome (hazard ratio = 2.85, P = .02). CONCLUSION: The presence or development of mild anemia in young patients with optimally treated idiopathic DCM is frequent and associated with a worse outcome.The study objective was to evaluate the impact of anemia on a large population of young patients with idiopathic dilated cardiomyopathy (DCM) who were receiving optimal medical treatment.The data of 491 patients with DCM who were enlisted in the Trieste Heart Muscle Disease Registry were analyzed. Anemia was defined as hemoglobin less than 13 g/dL for male patients and less than 12 g/dL for female patients.At baseline, 13\% of our patients were anemic. During the follow-up of 134 ± 56 months, 144 patients died or underwent heart transplantation: 36.5\% anemic patients and 28\% non-anemic patients (P = .05). Anemia present at baseline was an independent predictor of outcome (hazard ratio = 1.85, P = .014). Serial hemoglobin determinations during the entire follow-up were available in 122 of 428 patients without anemia at baseline. The impact of new-onset anemia was analyzed in this cohort of patients. Forty-seven patients (39\%) developed anemia during follow-up. The new onset of anemia was an independent predictor of poor outcome (hazard ratio = 2.85, P = .02).The presence or development of mild anemia in young patients with optimally treated idiopathic DCM is frequent and associated with a worse outcome.nonemixedAleksova A; Barbati G; Merlo M; Stolfo D; Sabbadini G; Di Lenarda A; Sinagra GAleksova, Aneta; Barbati, Giulia; Merlo, M; Stolfo, D; Sabbadini, Gastone; Di Lenarda, A; Sinagra, Gianfranc

Impact of Atrial Fibrillation on Outcome of Patients with Idiopathic Dilated Cardiomyopathy: Data from the Heart Muscle Disease Registry of Trieste

Objective: There is a paucity and inconsistency of data regarding the natural history of patients affected by idiopathic dilated cardiomyopathy (IDCM) and atrial fibrillation (AF). We examined the prognostic implications of AF in a subset of patients with IDCM