Seasonal variation of platelets in a cohort of Italian blood donors: a preliminary report

Massimo Gallerani1*, Roberto Reverberi2, Raffaella Salmi1, Michael H Smolensky3 and Roberto Manfredini4 Author Affiliations 1 Internal Medicine, Azienda Ospedaliera-Universitaria, Ferrara, Italy 2 Immunohematological and Transfusional Service, Azienda Ospedaliera-Universitaria, Ferrara, Italy 3 Department of Biomedical Engineering, The University of Texas at Austin, Austin, USA 4 Clinica Medica, Azienda Ospedaliera-Universitaria, Ferrara, ItalyBackground: Since available data are not univocal, the aim of this study was to explore the existence of a seasonal variation in platelet count. Methods: The study was based on the database of the Italian Association of Blood Volunteers (AVIS), section of Ferrara, Italy, 2001–2010. Hematological data (170,238 exams referring to 16,422 donors) were categorized into seasonal and monthly intervals, and conventional and chronobiological analyses were applied. Results: Platelets and plateletcrit were significantly higher in winter-autumn, with a main peak in December-February (average +3.4% and +4.6%, respectively, P <0.001 for both). Conclusions: Although seasonal variations have been reported for several acute cardiovascular diseases, it is extremely unlikely that such a slight increase in platelet count in winter alone may be considered as a risk factor.Biomedical [email protected]

Seasonal variations in the incidence of cranial nerve paralysis.

The aim of the study was to verify whether there is a seasonal pattern in the occurrence of cranial nerve paralysis. All patients admitted to the Emergency Department of St Anna Hospital, Ferrara, Italy, from 1 January 1991 to 31 December 1997, were reviewed. Cranial nerve paralysis was diagnosed in 126 cases: the oculomotor nerve accounted for 46 cases, the trochlear nerve for 14, and the abducens nerve for 66. The frequencies of cases involving the oculomotor nerve and of all cases were significantly higher in winter than in the other seasons. Compared with other 2-month periods, the highest number of total cases occurred in November to December. Chronobiological analysis of the data for individual months showed a rhythmic 12-month pattern for the total population, with a weakly significant peak in January

Acute Kidney Injury and In-Hospital Mortality. A Retrospective Analysis of a Nationwide Administrative Database of Elderly Subjects in Italy

Background: The aim of this study was to investigate the association between acute kidney injury (AKI) and in-hospital mortality (IHM) in a large nationwide cohort of elderly subjects in Italy. Methods: We analyzed the hospitalization data of all patients aged &gt;= 65 years, who were discharged with a diagnosis of AKI, which was identified by the presence of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and extracted from the Italian Health Ministry database (January 2000 to December 2015). Data regarding age, gender, dialysis treatment, and comorbidity, including the development of sepsis, were also collected. Results: We evaluated 760,664 hospitalizations, the mean age was 80.5 +/- 7.8 years, males represented 52.2% of the population, and 9% underwent dialysis treatment. IHM was 27.7% (210,661 admissions): Deceased patients were more likely to be older, undergoing dialysis treatment, and to be sicker than the survivors. The population was classified on the basis of tertiles of comorbidity score (the first group 7.48 +/- 1.99, the second 13.67 +/- 2,04, and third 22.12 +/- 4.13). IHM was higher in the third tertile, whilst dialysis-dependent AKI was highest in the first. Dialysis-dependent AKI was associated with an odds ratios (OR) of 2.721; 95% confidence interval (CI) 2.676-2.766; p &lt; 0.001, development of sepsis was associated with an OR of 1.990; 95% CI 1.948-2.033; p &lt; 0.001, the second tertile of comorbidity was associated with an OR of 1.750; 95% CI 1.726-1.774; p &lt; 0.001, and the third tertile of comorbidity was associated with an OR of 2.522; 95% CI 2.486-2.559; p &lt; 0.001. Conclusions: In elderly subjects with AKI discharge codes, IHM is a frequent complication affecting more than a quarter of the investigated population. The increasing burden of comorbidity, dialysis-dependent AKI, and sepsis are the major risk factors

Seasonal pattern of peptic ulcer hospitalizations: analysis of the hospital discharge data of the Emilia-Romagna region of Italy

BACKGROUND: Previous studies have reported seasonal variation in peptic ulcer disease (PUD), but few large-scale, population-based studies have been conducted. METHODS: To verify whether a seasonal variation in cases of PUD (either complicated or not complicated) requiring acute hospitalization exists, we assessed the database of hospital admissions of the region Emilia Romagna (RER), Italy, obtained from the Center for Health Statistics, between January 1998 and December 2005. Admissions were categorized by sex, age ( or = 75 yrs), site of PUD lesion (stomach or duodenum), main complication (hemorrhage or perforation), and final outcome (intended as fatal outcome: in-hospital death; nonfatal outcome: patient discharged alive). Temporal patterns in PUD admissions were assessed in two ways, considering a) total counts per single month and season, and b) prevalence proportion, such as the monthly prevalence of PUD admissions divided by the monthly prevalence of total hospital admissions, to assess if the temporal patterns in the raw data might be the consequence of seasonal and annual variations in hospital admissions per se in the region. For statistical analysis, the chi2 test for goodness of fit and inferential chronobiologic method (Cosinor and partial Fourier series) were used. RESULTS: Of the total sample of PUD patients (26,848 [16,795 males, age 65 +/- 16 yrs; 10,053 females, age 72 +/- 15 yrs, p or = 75 yrs of age. There were more cases of duodenal (DU). (89.8%) than gastric ulcer (GU) (3.6%), and there were 1,290 (4.8%) fatal events. Data by season showed a statistically difference with the lowest proportion of PUD hospital admissions in summer (23.3%) (p < 0.001), for total cases and rather all subgroups. Chronobiological analysis identified three major peaks of PUD hospitalizations (September-October, January-February, and April-May) for the whole sample (p = 0.035), and several subgroups, with nadir in July. Finally, analysis of the monthly prevalence proportions yielded a significant (p = 0.025) biphasic pattern with a main peak in August-September-October, and a secondary one in January-February. CONCLUSIONS: A seasonal variation in PUD hospitalization, characterized by three peaks of higher incidence (Autumn, Winter, and Spring) is observed. When data corrected by monthly admission proportions are analyzed, late summer-autumn and winter are confirmed as higher risk periods. The underlying pathophysiologic mechanisms are unknown, and need further studies. In subjects at higher risk, certain periods of the year could deserve an appropriate pharmacological protection to reduce the risk of PUD hospitalization

Agranulocytosis: an adverse effect of allopurinol treatment

Introduction: Allopurinol is a xanthine oxidase inhibitor that is primarily used to treat hyperuricemia and its complications. The drug is rarely associated with adverse effects, but those that occur can be significant. Hematologic side effects, including bone marrow suppression, severe anemia, thrombocytopenia, and leukopenia, have been reported in 0.2-0.6% of treated patients. Materials and methods: We report a case of agranulocytosis associated with allopurinol therapy in a patient admitted for fever

Agranulocytosis: an adverse effect of allopurinol treatment

Introduction: Allopurinol is a xanthine oxidase inhibitor that is primarily used to treat hyperuricemia and its complications. The drug is rarely associated with adverse effects, but those that occur can be significant. Hematologic side effects, including bone marrow suppression, severe anemia, thrombocytopenia, and leukopenia, have been reported in 0.2-0.6% of treated patients. Materials and methods: We report a case of agranulocytosis associated with allopurinol therapy in a patient admitted for fever