Eight months of emergency services by ambulance (with doctor on board) of the Emergency Department of Prato, Italy.

BACKGROUND: The aim of the present study was to analyse the types of calls attended by the authors in their ambulance, assigned to one sector of the urban area of Prato. METHODS: We analysed 1060 consecutive calls carried out by our ambulance; 33 calls (3.1%), cancelled for various reasons, were excluded from statistical analysis. The calls regarded 1027 patients, 549 (53.5%) males and 478 (46.5%) females. RESULTS: 46% of calls concerned non trauma cases, 17% trauma cases and 7.2% transfers between hospitals. Calls in the non trauma group were for dyspnea (16.7%), unconsciousness (16.6%), chest pain (11.8%), cerebrovascular pathology (7.7%), mental disorders (7.1%), abdominal pain (5.1%), use of psychotropic substances (4%) and convulsions (3.2%). Support to patients with terminal cancer accounted for 2.3% of cases, metabolic disorders 2.2%, hypertensive events 2.1%, tachycardia 1.9%, vertigo 1.9%, allergies 1%, obstetric pathology 0.5% and cardiorespiratory resuscitation 2,2%. Thirteen point seven percent were miscellaneous, including poisonings, migraines, haemorrhages and flu syndromes. Trauma cases included road accidents (62.6%), falls (27%), aggression (6.9%), work-related accidents (3.5%). The percentage of trauma cases (17%) was similar to that reported for a Swedish urban area (20%). Cases of cardiorespiratory resuscitation were 1.65% of our calls, compared to 1.73% and 1.8% reported in Northeastern Germany and Taiwan. CONCLUSIONS: Although prehospital emergency medical services are organised differently in different countries, our data suggest that emergency medical services in our area have a percentage distribution of case types similar to services in other countries.

Acoustic parameters of voluntary cough in healthy non-smoking subjects.

OBJECTIVE: The aim of this study was to explore cough in healthy subjects. METHODOLOGY: We studied 234 coughs generated by 24 (12 males) healthy non-smokers (forced expiratory volume in 1 s (FEV1) 103+/-8% of predicted), who had no significant differences in FEV1 and age between males and females. For each subject, several bouts of voluntary coughing were recorded using a personal computer with an A/D converter (sampling rate 10 kHz, 8 bit resolution) and the first and second coughs of each bout were analysed using short-time Fast Fourier Transformation. For each cough we studied the three phases that are produced. In particular, we studied the duration of the three parts, loudest frequency in the first part, lowest and highest frequencies, number of continuous frequencies and lowest and highest continuous frequencies in the second part, and the loudest frequency of the third part if present. RESULTS: We found significant differences between males and females in length of the first part (41.4+/-14 vs 44.7+/-10.4 msec, P = 0.04), loudest frequency of the first part (362+/-145 vs 449+/-145 Hz), lowest frequencies (282+/-100 vs 348+/-135 Hz) and highest continuous frequencies (3877+/-571 vs 4147+/-362 Hz; P < 0.001) of the second part. An interesting finding was that healthy males and females had the same number of continuous frequencies. Different frequencies are probably a consequence of anatomical differences in airway geometry involved in the cough. CONCLUSION: In cough frequency spectrum studies the differences between the two sexes should be taken into account to reduce the variability of the results.

Molecular characterization of the P and I variants of alpha 1-antitrypsin.

Two rare alpha 1-antitrypsin variants, Pi I and Plowell, originally defined at the protein level through isoelectric focusing, were characterized at the DNA level by the polymerase chain reaction and direct sequencing. The I variant was confirmed in one individual and three independent families to result from a CGC(Arg) to TGC(Cys) transition at codon 39, within exon II. In our population, the Pi I variant might be more common than expected. The Plowell allele was shown in one M3P heterozygous individual to be due to a GAT(Asp) to GTT(Val) change at codon 256, in agreement with a previous study based on hybridization with allele-specific oligonucleotides.