11 research outputs found

    Mild head trauma: Is antiplatelet therapy a risk factor for hemorrhagic complications?

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    Background and objectives: In patients who receive antiplatelet therapy (APT), the bleeding risk profile after mild head trauma (MHT) still needs clarification. Some studies have demonstrated an association with bleeding risk, whereas others have not. We studied the population of our level II emergency department (ED) trauma center to determine the risk of bleeding in patients receiving APT and whether bleeding results not from antiplatelet agents but rather from age. We assessed the bleeding risk, the incidence of intracranial hemorrhage (ICH) that necessitated hospitalization for observation, the need for cranial neurosurgery, the severity of the patient’s condition at discharge, and the frequency of ED revisits for head trauma in patients receiving APT. Materials and Methods: This retrospective single-center study included 483 patients receiving APT who were in the ED for MHT in 2019. The control group consisted of 1443 patients in the ED with MHT over the same period who were not receiving APT or anticoagulant therapy. Our ED diagnostic therapeutic protocol mandates both triage and the medical examination to identify patients with MHT who are taking any anticoagulant or APT. Results: APT was not significantly associated with bleeding risk (p > 0.05); as a risk factor, age was significantly associated with the risk of bleeding, even after adjustment for therapy. Patients receiving APT had a greater need of surgery (1.2% vs. 0.4%; p < 0.0001) and a higher rate of hospitalization (52.9% vs. 37.4%; p < 0.0001), and their clinical condition was more severe (evaluated according to the exit code value on a one-dimensional quantitative five-point numerical scale) at the time of discharge (p = 0.013). The frequency of ED revisits due to head trauma did not differ between the two groups. Conclusions: The risk of bleeding in patients receiving APT who had MHT was no higher than that in the control group. However, the clinical condition of patients receiving APT, including hospital admission for ICH monitoring and cranial neurosurgical interventions, was more severe

    Determination of the Largest Clast Sizes of Tephra Deposits for the Characterization of Explosive Eruptions: A Study of the IAVCEI Commission on Tephra Hazard Modelling

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    The distribution of clasts deposited around a volcano during an explosive eruption typically contoured by isopleth maps provides important insights into the associated plume height, wind speed and eruptive style. Nonetheless, a wide range of strategies exists to determine the largest clasts, which can lead to very different results with obvious implications for the characterization of eruptive behaviour of active volcanoes. The IAVCEI Commission on Tephra Hazard Modelling has carried out a dedicated exercise to assess the influence of various strategies on the determination of the largest clasts. Suggestions on the selection of sampling area, collection strategy, choice of clast typologies and clast characterization (i.e. axis measurement and averaging technique) are given, mostly based on a thorough investigation of two outcrops of a Plinian tephra deposit from Cotopaxi volcano (Ecuador) located at different distances from the vent. These include: (1) sampling on a flat paleotopography far from significant slopes to minimize remobilization effects; (2) sampling on specified-horizontal-area sections (with the statistically representative sampling area depending on the outcrop grain size and lithic content); (3) clast characterization based on the geometric mean of its three orthogonal axes with the approximation of the minimum ellipsoid (lithic fragments are better than pumice clasts when present); and (4) use of the method of the 50th percentile of a sample of 20 clasts as the best way to assess the largest clasts. It is also suggested that all data collected for the construction of isopleth maps be made available to the community through the use of a standardized data collection template, to assess the applicability of the new proposed strategy on a large number of deposits and to build a large dataset for the future development and refinement of dispersal models

    SARS Cov-2 infection in a renal-transplanted patient: A case report

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    The clinical manifestation of COVID-19 can vary from an asymptomatic course to ARDS requiring invasive mechanical ventilation and extracorporeal membrane oxygenation. A kidney transplanted patient infected with SARS CoV-2 infection showed a mild disease despite immune suppression. It is possible that Immunosuppression can \u201cbe protective\u201d as the cytokine storm is an important factor in the disease story. Despite the good outcome reported in the present case report, is remains of vital importance the solid organ transplant patients use precautions in order to avoid the infection

    Rapid response to COVID-19 outbreak in Northern Italy: how to convert a classic infectious disease ward into a COVID-19 response centre

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    none133noopenAsperges E.; Novati S.; Muzzi A.; Biscarini S.; Sciarra M.; Lupi M.; Sambo M.; Gallazzi I.; Peverini M.; Lago P.; Mojoli F.; Perlini S.; Bruno R.; Mondelli M.U.; Brunetti E.; Di Matteo A.; Seminari E.; Maiocchi L.; Zuccaro V.; Pagnucco L.; Mariani B.; Ludovisi S.; Parisi R.L.A.; Sacchi P.; Patruno S.F.A.; Michelone G.; Gulminetti R.; Zanaboni D.; Maserati R.; Orsolini P.; Vecchia M.; Colaneri M.; Di Filippo A.; Roda S.; Pieri T.C.; Sachs M.; Valsecchi P.; Alfano C.; Bonzano M.; Briganti F.; Crescenzi G.; Falchi A.G.; Guarnone R.; Guglielmana B.; Maggi E.; Martino I.; Pettenazza P.; Pioli di Marco S.; Quaglia F.; Sabena A.; Salinaro F.; Speciale F.; Zunino I.; De Lorenzo M.; Secco G.; Dimitry L.; Cappa G.; Maisak I.; Chiodi B.; Sciarrini M.; Barcella B.; Resta F.; Moroni L.; Vezzoni G.; Scattaglia L.; Boscolo E.; Zattera C.; Fidel T.M.; Vincenzo C.; Vignaroli D.; Bazzini M.; Iotti G.; Belliato M.; Perotti L.; Mongodi S.; Tavazzi G.; Marseglia G.; Licari A.; Brambilla I.; Daniela B.; Antonella B.; Patrizia C.; Giulia C.; Giuditta C.; Marta C.; Rossana D.; Milena F.; Bianca M.; Roberta M.; Enza M.; Stefania P.; Maurizio P.; Elena P.; Antonio P.; Francesca R.; Antonella S.; Maurizio Z.; Guy A.; Laura B.; Ermanna C.; Giuliana C.; Luca D.; Gabriella F.; Gabriella G.; Alessia G.; Viviana L.; Claudia L.; Valentina M.; Simona P.; Marta P.; Alice B.; Giacomo C.; Irene C.; Corcione A.; di Martino R.; di Napoli A.; Alessandro F.; Guglielmo F.; Loretta F.; Federica G.; Alessandra M.; Federica N.; Giacomo R.; Beatrice R.; Maria S.I.; Monica T.; Edoardo V.N.; Calvi M.; Tizzoni M.; Nicora C.; Triarico A.; Petronella V.; Marena C.Asperges, E.; Novati, S.; Muzzi, A.; Biscarini, S.; Sciarra, M.; Lupi, M.; Sambo, M.; Gallazzi, I.; Peverini, M.; Lago, P.; Mojoli, F.; Perlini, S.; Bruno, R.; Mondelli, M. U.; Brunetti, E.; Di Matteo, A.; Seminari, E.; Maiocchi, L.; Zuccaro, V.; Pagnucco, L.; Mariani, B.; Ludovisi, S.; Parisi, R. L. A.; Sacchi, P.; Patruno, S. F. A.; Michelone, G.; Gulminetti, R.; Zanaboni, D.; Maserati, R.; Orsolini, P.; Vecchia, M.; Colaneri, M.; Di Filippo, A.; Roda, S.; Pieri, T. C.; Sachs, M.; Valsecchi, P.; Alfano, C.; Bonzano, M.; Briganti, F.; Crescenzi, G.; Falchi, A. G.; Guarnone, R.; Guglielmana, B.; Maggi, E.; Martino, I.; Pettenazza, P.; Pioli di Marco, S.; Quaglia, F.; Sabena, A.; Salinaro, F.; Speciale, F.; Zunino, I.; De Lorenzo, M.; Secco, G.; Dimitry, L.; Cappa, G.; Maisak, I.; Chiodi, B.; Sciarrini, M.; Barcella, B.; Resta, F.; Moroni, L.; Vezzoni, G.; Scattaglia, L.; Boscolo, E.; Zattera, C.; Fidel, T. M.; Vincenzo, C.; Vignaroli, D.; Bazzini, M.; Iotti, G.; Belliato, M.; Perotti, L.; Mongodi, S.; Tavazzi, G.; Marseglia, G.; Licari, A.; Brambilla, I.; Daniela, B.; Antonella, B.; Patrizia, C.; Giulia, C.; Giuditta, C.; Marta, C.; Rossana, D.; Milena, F.; Bianca, M.; Roberta, M.; Enza, M.; Stefania, P.; Maurizio, P.; Elena, P.; Antonio, P.; Francesca, R.; Antonella, S.; Maurizio, Z.; Guy, A.; Laura, B.; Ermanna, C.; Giuliana, C.; Luca, D.; Gabriella, F.; Gabriella, G.; Alessia, G.; Viviana, L.; Claudia, L.; Valentina, M.; Simona, P.; Marta, P.; Alice, B.; Giacomo, C.; Irene, C.; Corcione, A.; di Martino, R.; di Napoli, A.; Alessandro, F.; Guglielmo, F.; Loretta, F.; Federica, G.; Alessandra, M.; Federica, N.; Giacomo, R.; Beatrice, R.; Maria, S. I.; Monica, T.; Edoardo, V. N.; Calvi, M.; Tizzoni, M.; Nicora, C.; Triarico, A.; Petronella, V.; Marena, C

    Detection of the SARS-CoV-2 in different biologic specimens from positive patients with COVID-19, in Northern Italy

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    Coronavirus disease 2019 (COVID-19) diagnosis is based on molecular detection of SARS-CoV-2 in respiratory samples such as nasal swab (NS). However, the evidence that NS in patients with pneumonia was sometimes negative raises the attention to collect other clinical specimens. SARS-CoV-2 was shown in 10.3% rectal swabs (RS), 7.7% plasma, 1% urine, and 0% feces from 143 NS-positive patients. Potential infection by fluids different from respiratory secretion is possible but unlikely
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