[Computerized acquisition and elaboration of clinical data in Rheumatology during ten years: state of art and prospectives]

The well known complexity to collect the clinical data of patients and in particular in the area of rheumathology push us to develop a computerized clinical chart in order to facilitate the classification, evaluation and monitoring of these patients. The proposed computerized clinical chart is easy to use but at the same time is a very potent tool that allow the clinicians to organize the classic rheumathological pathologies as well as the more complexes or even rare. The proposed clinical chart is based on a relational database (FileMaker Pro 5.0v1) available for both the actual operative systems implemented on personal computers (Windows and Macintosh); this allow the full compatibility among the two systems, the possibility of exchanging data without any loss of information. The computerized clinical chart is structured on modules for specific pathologies and for homogeneous groups of illnesses. Basically the modules are defined correlated files of data for a specific pathology but that can be used also as a common pool for different pathologies. Our experience, based on ten years of use, indicates in the computerized rheumathological clinical chart an indispensable tool for rheumathologists with a real friendly use

Tectonic stress and renewed uplift at Campi Flegrei caldera, southern Italy: New insights from caldera drilling

Deep drilling is a key tool for the investigation of active volcanoes in the modern Earth Sciences, as this provides the only means to obtain direct information on processes that occur at depth. Data acquired from drilling projects are fundamental to our understanding of volcano dynamics, and for mitigation of the hazards they pose for millions of people who live close to active volcanoes. We present here the first borehole measurement of the stress field in the crust of Campi Flegrei (southern Italy), a large active caldera, and one of the highest risk volcanoes worldwide. Measurements were performed to depths of ∼500 m during a pilot study for the Campi Flegrei Deep Drilling Project. These data indicate an extensional stress field, with a minimum horizontal stress of ca. 75% to 80% of the maximum horizontal stress, which is approximately equal to the vertical stress. The deviation from lithostatic conditions is consistent with a progressive increase in applied horizontal stress during episodes of unrest, since at least 1969. As the stress field is evolving with time, the outcome of renewed unrest cannot be assessed by analogy with previous episodes. Interpretations of future unrest must therefore accommodate the possibility that Campi Flegrei is approaching conditions that are more favourable to a volcanic eruption than has previously been the case. Such long-term accumulation of stress is not expected to be unique to Campi Flegrei, and so might provide a basis for improved forecasts of eruptions at large calderas elsewhere

[Automation and computerization of the articular and Ritchie's indexes calculation].

Compilation and calculation of some articular indexes is time consuming. Therefore the authors present a data base for automatic compilation and calculation of articular and Ritchie's indexes. Moreover the program allows to determine the number of the swollen and painful joints

Volcanic hazard assessment at the Campi Flegrei caldera

Previous and new results from probabilistic approaches based on available volcanological data from real eruptions of Campi Flegrei, are assembled in a comprehensive assessment of volcanic hazards at the Campi Flegrei caldera, in order to compare the volcanic hazards related to the different types of events. Hazard maps based on a very wide set of numerical simulations, produced using field and laboratory data as input parameters relative to the whole range of fallout and pyroclastic-flow events and their relative occurrence, are presented. The results allow us to quantitatively evaluate and compare the hazard related to pyroclastic fallout and density currents (PDCs) in the Campi Flegrei area and its surroundings, including the city of Naples. Due to the dominant wind directions, the hazard from fallout mostly affects the area east of the caldera, and the caldera itself, with the level of probability and expected thickness decreasing with distance from the caldera and outside the eastern sectors. The hazard from PDCs decrease roughly radially with distance from the caldera centre and is strongly controlled by the topographic relief, which produces an effective barrier to propagation of PDCs to the east and northeast, areas which include metropolitan Naples. The main result is that the metropolitan area of Naples would be directly exposed to both fallout and PDCs. Moreover, the level of probability for critical tephra accumulation by fallout is relatively high, even for moderate-scale events, while, due to the presence of topographic barriers, the hazard from PDCs is only moderate and mostly associated with the largest events

A systematic review of the literature on the role of tracheostomy in COVID-19 patients

– The Coronavirus Disease 2019 (COVID-19) is a viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which emerged in East Asia and spread around the world from December 2019. The most severe stage of COVID-19 pathology is characterized by respiratory distress requiring intubation. In specific cases, tracheostomy is indicated to ensure the safety of the procedure. The aim of our study was to analyze the scientific literature identifying the indications for tracheostomy and safety precautions to reduce contamination. We analyzed the literature from February 2003 to April 2020, including papers on pandemics of other coronaviruses, such As Severe Acute Respiratory Syndrome Coronavirus 1 and Middle East Respiratory Syndrome Coronavirus, to obtain a variety of relevant information. We focused on indications for tracheostomy in patients affected by COVID-19 or related viruses and the measures adopted to perform a safe procedure. We included 35 papers, of which 24 (68.57%) discussed guidelines for tracheostomy indications. All 35 studies discussed the procedures for performing tracheostomy safely. Data obtained indicated that the authors generally agreed on safety measures but expressed different opinions about indications. Therefore, we provided guidelines addressing safety recommendations. After the pandemic has been resolved, we plan to conduct an international retrospective study to identify the criteria for tracheostomy indications

Sutureless Valve in Repeated Aortic Valve Replacement: Results from an International Prospective Registry

Objective: To report early and midterm results registry of patients undergoing repeated aortic valve replacement (RAVR) with sutureless prostheses from an international prospective registry (SURE-AVR). Methods: Between March 2011 and June 2019, 69 patients underwent RAVR with self-expandable sutureless aortic bioprostheses at 22 international cardiac centers.Results: Overall mortality was 2.9% with a predicted logistic EuroSCORE 11 of 10.7%. Indications for RAVR were structural valve dysfunction (84.1%) and infective prosthetic endocarditis (15.9%) and were performed in patients with previously implanted bioprostheses (79.7%), mechanical valves (15.9%), and transcatheter valves (4.3%). Minimally invasive approach was performed in 15.9% of patients. Rate of stroke was 1.4% and rate of early valve-related reintervention was 1.4%. Overall survival rate at 1 and 5 years was 97% and 91%, respectively. No major paravalvular leak occurred. Rate of pacemaker implantation was 5.8% and 0.9% per patient-year early and at follow-up, respectively. The mean transvalvular gradient at 1-year and 5-year follow-up was 10.5 mmHg and 11.5 mmHg with a median effective orifice area of 1.8 cm 2 and 1.8 cm 2 , respectively. Conclusions: RAVR with sutureless valves is a safe and effective approach and provides excellent clinical and hemodynamic results up to 5 years