The demographic and clinical characteristics of an Italian population of adult outpatients with chronic cough

Background Chronic cough is a major health problem worldwide and patients are best managed in specialised tertiary centres. Little information is available on the characteristics of chronic cough patients in several European countries, including Italy. Aims We report on the demographic, anthropometric and clinical features of a large Italian population of adult chronic cough outpatients (about 1200), who were referred to a specialised clinic in Florence, Italy, from 2008 to 2018. Methods Demographic, environmental, lifestyle and clinical information was collected at enrolment by means of a custom-designed electronic questionnaire that only allowed for uniform responses. A subjective measure of cough-related discomfort (cough score) was also obtained using a modified Borg Scale. A multivariable logistic regression model was defined to identify the patients' characteristics associated with the cough score. Results The characteristics of the examined population (n = 1204 outpatients) were strikingly similar to those described elsewhere. Female patients outnumbered the males [n = 847 females, (70.0%)]; both females and males displayed the same average cough score. The median age of outpatients was 61 (quartile 1 = 48; quartile 3 = 70) years; age and cough duration were unrelated to the cough score. Nasal obstruction, coughing during consultation, coughing during meals, throat clearing and the presence of respiratory abnormalities were correlated with the degree of discomfort caused by coughing. Discussion The features of chronic cough patients are similar worldwide. The process of cough reflex hypersensitisation may soothe sex-related perceptual differences, leading to similar levels of discomfort. Conclusions There seem to be clinical indicators that help in assessing the level of cough-related discomfort

Geotechnical and hydrological characterization of hillslope deposits for regional landslide prediction modeling

We attempt a characterization of the geotechnical and hydrological properties of hillslope deposits, with the final aim of providing reliable data to distributed catchment-scale numerical models for shallow landslide initiation. The analysis is based on a dataset built up by means of both field tests and laboratory experiments over 100 sites across Tuscany (Italy). The first specific goal is to determine the ranges of variation of the geotechnical and hydrological parameters that control shallow landslide-triggering mechanisms for the main soil classes. The parameters determined in the deposits are: grain size distribution, Atterberg limits, porosity, unit weight, in situ saturated hydraulic conductivity and shear strength parameters. In addition, mineral phases recognition via X-ray powder diffraction has been performed on the different soil types. The deposits mainly consist of well-sorted silty sands with low plastic behavior and extremely variable gravel and clay contents. Statistical analyses carried on these geotechnical and hydrological parameters highlighted that it is not possible to define a typical range of values only with relation to the main mapped lithologies, because soil characteristics are not simply dependent on the bedrock type from which the deposits originated. A second goal is to explore the relationship between soil type (in terms of grain size distribution) and selected morphometric parameters (slope angle, profile curvature, planar curvature and peak distance). The results show that the highest correlation between soil grain size classes and morphometric attributes is with slope curvature, both profile and planar

Diagnosis and treatment of pulmonary embolism: a multidisciplinary approach

The diagnosis of pulmonary embolism (PE) is frequently considered in patients presenting to the emergency department or when hospitalized. Although early treatment is highly effective, PE is underdiagnosed and, therefore, the disease remains a major health problem. Since symptoms and signs are non specific and the consequences of anticoagulant treatment are considerable, objective tests to either establish or refute the diagnosis have become a standard of care. Diagnostic strategy should be based on clinical evaluation of the probability of PE. The accuracy of diagnostic tests for PE are high when the results are concordant with the clinical assessment. Additional testing is necessary when the test results are inconsistent with clinical probability. The present review article represents the consensus-based recommendations of the Interdisciplinary Association for Research in Lung Disease (AIMAR) multidisciplinary Task Force for diagnosis and treatment of PE. The aim of this review is to provide clinicians a practical diagnostic and therapeutic management approach using evidence from the literature. © 2013 Lavorini et al