The Authors evaluate the role of dextromethorphan as heroin adulterant. From De-cember 2010 through April 2013, in our Laboratory of Forensic Toxicology of Universi-ty of Catania, eight fatal overdose of heroin cut with dextromethorphan were ob-served. Our first case (December 2010) was the earliest report in Italy. For these rea-sons we focused our interest on this cutting substance, studying its pharmacological interaction with the depressive morphine action on central nervous system.
Anthracycline is often used for treatment of hematologic malignancies and solid tu-mors, and the damage it causes to the heart muscle has long been known; therefore, the cardiac toxicity, one of the treatment-related co-morbidities, has become an issue for cancer survivors. Cardiotoxicity has been defined using various classifications. In this paper we report the case of a man affected by follicular non-Hodgkin’s lymphoma, which was first diagnosed in 2006 and had a second recurrence in 2012 with a medi-astinal mass: the patient was subjected to a new cycle of chemotherapy with anthra-cycline, the follow-up exam showed a significant reduction of the mass, but the clinical condition worsened and the ejection fraction of the left ventricle had a progressive re-duction, as seen in the cardiac-MRI test. Then, it was decided to discontinue therapy with anthracycline, resulting in a clear recovery of systolic function of the left ventri-cle, as seen in the following echocardiogram.
Material and Methods: Prospective study of consecutive patients undergoing fat plug myringoplasty under local anesthesia. Minimum follow-up considered was 6 months, which included several microscopic examinations. All data were recorded and analyzed statistically.
Results: 33 patients matched the inclusion criteria; the mean perforation size was 2.8 mm. No change in PTA was noted after surgery in the whole series. Recurrence of per-foration was detected in 7 cases (21%), which was statistically related with the cause of perforation rather than location or size (p-value <0.01).
Conclusions: Fat plug myringoplasty is a safe procedure with very low rate of compli-cations, and it is an office-based procedure well tolerate by all patients. Results in case of primary surgery are excellent, with a high success rate (90%). In case of recurrent perforation after traditional surgery, success rate get decreased.
The Italian National Conference of Italian Public Health Medical Residents reachs its 3th edition by renewing its format and getting bigger!
For the first time, the conference is not exclusively open to Medical Residents in Hygiene and Preventive Medicine, but also to Community Medicine and Health Statistics and Biometric Medical Resi-dents, as well as to all members of the European Network of Medical Residents in Public Health (EuroNet MRPH).
This Abstract Book collects all the contri-butions of the Oral Sessions.
These are the TOPICS:
MANAGEMENT AND QUALITY OF HEALTH SER-VICES
PRIMARY HEALTH CARE AND NON COMMUNICA-BLE DISEASES
LIFESTYLE, FOOD AND NUTRITION
GLOBAL HEALTH AND HEALTH INEQUALITY
ENVIRONMENTAL AND OCCUPATIONAL HEALTH
The contributions were collected and arranged by Francesco Soncini, Francesca Campanella, Rocco Guerra and the members of the Scientific Commettee Benedetto Arru, Michela Capelli, Elvira D’Andrea, Francesco Soncini
The “Consulta dei Medici in Formazione Specialistica SItI” (commonly “Consulta”) is part of the Italian Society of Hygiene, Preventive Medicine and Public Health (S.It.I.)
Consulta promotes and to stimulates professional, cultural and personal devel-opment of the Italian Medical Residents in Public Health, to endorse cooperation between the Italian Public Health Schools and to inspire discussions about issues related to Public Health.
Consulta is composed of two delegates for each of the 32 Italian Public Health Schools, accounting for more than 750 residents across Italy, and it’s fully aware of the importance of having tight rela-tions and productive forms of cooperation between Public Health Residents across Europe (Consulta is proud founder of
EuroNet MRPH, the Network of Medical Residents in Public Health:
Moreover, Consulta shares with its European counterparts the need for a better integration of Public Health expertises in Europe (It’s also a support-er of EUPHAnxt Project: eupha.org).
For more information and to view all the documents edited by Consulta, please check the website: www.societaitalianaigiene.org
ASBESTOS-RELATED DISEASES: PENAL, CIVIL AND NATIONAL HEALTH INSURANCE RESPONSIBILITY ACCORDING TO ITALIAN LAWWritten by Tommaso Savì et al.
In this paper, we discuss our experience and a review of the literature on the use of the free Vastus lateralis flap in the head and neck region, analyzing its indications, advan-tages and limitations. We also provide technical tips to minimize donor site morbidity.
Material and Methods: 830 patients requiring central vein catheterization (CVC) were in-cluded in the analysis. The position of the IJV in relation to the other structures of the neck was demonstrated by portable ultrasonography.
Results: The mean diameter of IJV was 10.3 mm in right and 10.5 mm in left side of neck, in male (p > 0.05) and 9.1 mm in right and 10.5 mm in left side of neck, in female (p > 0.05). The mean distance between IJV and CCA was 1.9 mm in right and 1.7 mm in left side of neck in male, and 2.0 mm in right and 2.2 mm in left side of neck in female. The mean distance of IJV from the skin surface was 9.8 mm in right and 10.0 mm in left side of neck in male, and 12.1 mm in right and 12.5 mm in left side of neck in female. On 25.54 % we observed variations of internal jugular vein site. On 3.97 % we observed a small caliber of internal jugular vein that could complicate the catheterization of the vein. On 1.8 % was diagnosed a thrombus of internal jugular vein, that is considered as an ab-solute contraindication for a CVC.
Conclusion: Different patients had anatomical variations that are important and should be knowed, in order to reduce the possibility of severe complications.
PROFILE OF INTRANASAL CORTICOSTEROIDS IN ITALY: SAFETY, COST/EFFECTIVENESS, LOCAL AND SYSTEMIC ADVERSE EFFECTSWritten by Donatella Marchese et al.
Objective: The aim of this review is to inquire intranasal corticosteroids.
Results: We have obtained several randomized, double-blind, placebo-controlled clinical trials, by a MEDLINE search. We analyzed the safety profile, the adverse effects described by the authors, the relation between cost/effectiveness. We have made a search for trade profile, dosage and chemical characteristics by on-line handbook.
Discussion: Several studies demonstrate that intranasal corticosteroids are more effective-ness in nasal symptoms control than other medications for Allergic Rhinitis. Intranasal corticosteroids are relatively safe, only few studies demonstrated systemic adverse ef-fects. In conclusion, newest corticosteroids (Fluticasone Propionate, Mometasone Furoate, Fluticasone Furoate, Ciclesonide aqueous) are safer than older, probably because of their less bioavailability.
Metal-on-metal coupling in total hip replacements has traditionally been a valid alterna-tive to other total hip bearings for young adults and very active elderly patients. Unfortu-nately, clinical experience has revealed that the difference in strength between the tita-nium alloy stem and the cobalt alloy-bearing surface leads to a conflict between the acetabular component and the head, which inturn leads to abnormal wear and osteolysis. The major problems are osteolysis, metal ion intoxication, potential genome toxicity, neoplasms, allergies and implant failure. The authors present an incidental finding of a pseudotumour of the external rotators of the hip in a total hip replacement (THR) revision in a 68 year old female patient.