Psychiatric patients at the emergency department: factors associated with length of stay and likelihood of hospitalization

Emergency department (ED) care for psychiatric patients is currently understudied despite being highly utilized. Therefore, we aimed to analyze psychiatric patients' length of stay (LOS) and LOS-related factors at the ED and to investigate and quantify the likelihood of being hospitalized after an emergency psychiatric evaluation. Charts of 408 individuals who sought help at the ED were retrospectively assessed to identify patients' sociodemographic and clinical data upon ED admission and discharge. All interventions performed at the ED (e.g., medications, hospitalization, clinical advice at discharge) were collected as well. The LOS for psychiatric patients was relatively short (6.5 h), and substance/alcohol intoxication was the main factor impacting LOS. Upon ED arrival, hospitalized patients were mostly men, most often had a yellow/severe triage code, and most often had a positive history of psychiatric illness, psychotic symptoms, euphoric mood, or suicidal ideation. Manic symptoms and suicidal ideation were the conditions most frequently leading to hospitalization. Given the paucity of real-world data on psychiatric patients’ LOS and outcomes in the ED context, our findings show that psychiatric patients are evaluated in a reasonable amount of time. Their hospitalization is mostly influenced by clinical conditions rather than predisposing (e.g., age) or system-related factors (e.g., mode of arrival)

Visits to Sexually Transmitted Infection Clinics in Italy from January 2016 to November 2021: A Multicenter, Retrospective Study

There is no evidence of seasonal variation in visits to clinics dedicated to sexually transmitted infections (STIs) in Italy, nor of changes after the advent of the COVID-19 pandemic. An observational, retrospective, multicentric study was conducted to record and analyze all the visits to the STI clinics of the Dermatology Units of the University Hospitals of Ferrara and Bologna and of the Infectious Disease Unit of Ferrara, Italy, between January 2016 and November 2021. Overall, 11.733 visits were registered over a 70-month study period (63.7% males, mean age 34.5 ± 12.8 yrs). The mean number of monthly visits significantly decreased from the advent of the pandemic (136) compared to before (177). In the pre-pandemic period, visits to STI clinics increased in the autumn/winter months when compared to spring/summer, while the trend was the opposite in the pandemic period. Thus, during the pandemic, both an overall significant reduction in visits to STI clinics and a reversal in their seasonality were observed. These trends affected males and females equally. The marked decrease, mostly found in the pandemic winter months, can be linked to the “lockdown”/self-isolation ordinances and social distancing measures during the colder months, coinciding with the spread of the COVID-19 infection, which limited the opportunities for meeting and socializing

La biopiscina in ambiente mediterraneo: due tecniche costruttive a confronto

The natural pool in the mediterranean environment: a comparison between two projects

Like Two Little Cowboys: Lucky Luke Dermatitis

We present 2 pediatric cases of allergic contact dermatitis due to the diaper; considering both clinical aspects and site involved, we diagnosed Lucky Luke dermatitis

Sentinel lymph node biopsy in breast cancer:a technical and clinical appraisal

Breast cancer is the most common type of cancer diagnosed in women worldwide. Regional lymph node status is one of the strongest predictors of long-term prognosis in primary breast cancer. Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection as the standard surgical procedure for staging clinically tumor-free regional nodes in patients with early-stage breast cancer. SLNB staging considerably reduces surgical morbidity in terms of shoulder dysfunction and lymphedema, without affecting diagnostic accuracy and prognostic information. Clinicians should not recommend axillary lymph node dissection for women with early-stage breast cancer who have tumor-free findings on SLNB because there is no advantage in terms of overall survival and disease-free survival. Starting from the early 1990s, SLNB has increasingly been used in breast cancer management, but its role is still debated under many clinical circumstances. Moreover, there is still a lack of standardization of the basic technical details of the procedure that is likely to be responsible for the variability found in the false-negative rate of the procedure (5.5-16.7%). In this article, we report the aspects of SLNB that are well established, those that are still debated, and the advancements that have taken place over the last 20 years. We have provided an update on the methodology from both a technical and a clinical point of view in the light of the most recent publications

Fast and minimally invasive determination of the unsaturation index of white fat depots by micro-Raman spectroscopy.

In the last 20 years increasing interest has been devoted to the investigation of white adipose tissue (WAT) because hypo- or hyperfunction of WAT is involved in the pathogenesis of obesity and other pathologies. The investigation and discrimination of different characteristics in adipose tissues by means of spectroscopic techniques appears as a topic of current interest, also in view of possible medical-technological applications. The aim of this work was to establish micro-Raman spectroscopy as a tool for the characterization of mammals fat tissue. After preliminary tests aimed at defining a suitable sample preparation protocol, Raman spectra of WAT specimens excised from mice of different ages were recorded in the energy range 750-3,350 cm(-1). Quantitative values of the unsaturation index were obtained through the calibration with HR-NMR spectra of lipid extracts. Raman spectroscopy detected a sharp increase in the unsaturation index between 22 and 30 days of age in close correspondence with the weaning of mice (21 days). The present results show that Raman spectroscopy is an inexpensive, fast and robust technique to analyze the unsaturation index of mammals fat tissues that could be routinely used in bioptic samples

MRI characterization of rat brain aging at structural and functional level: Clues for translational applications

Magnetic resonance imaging (MRI) paradigms, using non-invasive approaches, can provide relevant findings about brain aging. The attention has been primarily focused on neurodegenerative diseases, while little or nothing has been done to differentiate physiology from pathology. The present study aimed to test diffusion tensor imaging (DTI) and functional MRI (fMRI) metrics to analyze physiological age-related changes in rats at myelin structure and activation level; findings were validated by ex vivo histology. The purpose is to find comparable biomarkers in rodents and humans to allow a reliable translation from pre-clinical to clinical settings. Data evidenced: i) a significantly higher cerebrospinal fluid volume in middle-aged and aged vs. young rats; ii) a progressive alteration of white matter; iii) a significant reduction of evoked activity in aged animals. These results partially mirror the age-related changes in humans and may represent a preliminary step to find reliable tools for a lifelong monitoring with a value for the clinical practice (e.g., to provide support to the early diagnosis of dementia in asymptomatic subjects)

Knowledge of dental students of avulsed permanent teeth

A manutenção de um dente permanente avulsionado depende de um manejo e um tratamento adequado pelo cirurgião-dentista. O objetivo deste estudo foi verificar o conhecimento sobre avulsão dentária de alunos do primeiro e do último ano da graduação de uma Faculdade de Odontologia. Aplicou-se um questionário com 10 perguntas de múltipla escolha entre 65 alunos do primeiro ano e 60 alunos do último ano da Faculdade de Odontologia da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brasil, entre 2006 e 2007. As questões estavam graduadas de 0 a 3. Os resultados revelaram um baixo grau de conhecimento sobre avulsão dentária entre os estudantes do primeiro e do último ano. O conhecimento dos alunos do último ano foi considerado abaixo do requerido para futuros cirurgiões-dentistas. Necessita-se de uma maior abordagem sobre o tema avulsão, manejo e tratamento, para que se aumente o grau de conhecimento desses alunos sobre o assunto. Devido ao fato de a avulsão dentária apresentar um prevalência grande entre os traumatismos dentoalveolares, é de suma importância que os cirurgiões-dentistas estejam preparados para tratar desse tipo de lesão, evitando-se danos nas estruturas vizinhas, problemas estéticos, funcionais, psicossociais e implicações terapêuticas ao paciente.The survival of an avulsed permanent tooth depends on the management and the appropriate treatment of the injury by the dental surgeon. The aim of this study was to assess the knowledge of first-year and last-year dental undergraduates on guidelines for management and treatment of tooth avulsion. A 10-item multiple-choice questionnaire was distributed among 65 first-year and 60 last-year dental undergraduates at the School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil, between 2006 and 2007. Answers were graded 0 to 3. The results revealed a low level of knowledge among first-year and last-year students on the management and treatment of permanent avulsed teeth. Knowledge of last-year undergraduates of tooth avulsion was lower than what is required for a future dental surgeon. In conclusion, there is a need to improve the knowledge of dental students in the guidelines for the management of tooth avulsion. Because tooth avulsion is the most prevalent lesion in dentoalveolar traumas, it is of the utmost importance that dental surgeons be prepared to treat it properly, avoiding damage to neighboring teeth and structures, and esthetic, functional, psychosocial and therapeutic implications for the patient